Is Painless Childbirth Possible?

I think it was Dr. Bradley who stated that pain is not a necessary part of childbirth – and claimed that stating that pain *is* necessary to childbirth is a misapplication of Genesis 3.

But I don’t think a plain reading of Scripture supports that view:

“I will surely multiply your pain in childbearing;
in pain you shall bring forth children.”
~Genesis 3:16 (ESV)

In fact, I think a plain reading suggests that pain was likely a part of childbearing even prior to the fall – since this verse refers to multiplication (which implies something pre-existing to multiply – multiplying by 0 doesn’t make anything). And certainly, it clearly states that woman will bring forth children in pain.

Furthermore, plenty of other Scriptures indicate that pain is a normative experience during childbirth. A frequent simile used by the prophets is “pain like a woman in labor” (Psalm 48:6; Isaiah 13:8, 21:3, 42:14; Jeremiah 6:24, 22:23, 49:24, 50:43; Micah 4:9). Jesus spoke of “birth pains” (Matthew 24:8, Mark 13:8) and of the “sorrow” and “anguish” of a woman in labor (John 16:21). The apostle Paul likened his painful toils for the church to the anguish of a woman in labor (Galatians 4:19). Other references that suggest that pain in childbirth is normative include I Samuel 4:19 (her “pains came upon her”), Isaiah 26:17 (“writhes and cries out in her pangs”), Jeremiah 4:31 (“cries” and “anguish” as of a woman in labor), Jeremiah 48:41 and 49:22 (“birth pains”), Jeremiah 13:21 and Hosea 13:13 (the “pangs” of childbirth), Micah 4:10 (“writhe and groan like a woman in labor”), Romans 8:22 (pains of childbirth), and I Thessalonians 5:3 (“labor pains”).

Other Scriptures imply that childbirth is something that requires great strength. The midwives who cared for the Hebrew women in Egypt stated that they weren’t killing the baby boys they were delivering “because the Hebrew women are not like the Egyptian women, for they are vigorous and give birth before the midwife comes to them.” (Exodus 1:19 ESV) The Hebrew women’s vigor meant that their labors were fast enough (apparently) that the midwife didn’t get there in time to assist. Hezekiah spoke (in 2 Kings 19:3 and Isaiah 37:3) of children coming to the point of birth but mothers not having the strength to deliver them.

From my reading of Scripture, it seems plain that childbirth is indeed labor (work) and that it is generally painful labor.

Yet I am not afraid of childbirth, nor do I wish to blunt the pain of childbirth with drugs. Why is this?

Am I playing martyr, arguing against the umbrella that could guard me from this consequence of the fall?

No. I’m not. I expect pain in childbirth, but I’m not going to shy away from it because I believe two things: I believe that pain in childbirth is purposeful and I believe that it has payoff.

While some pain has no apparent purpose (for instance, in fibromyalgia), most pain does have a purpose. The pain of touching a too-hot stove tells us to withdraw our hand before damage is done. The pain of backache or a strained muscle often tells us to change our posture or our activity patterns. Other times pain simply tells us that our body is working. We feel the “burn” when we’re exercising vigorously. And, when having a baby, we feel pain that lets us know that our uterus is contracting to push baby out. If we know what to look for, pain also tells us when we should be actively working with our bodies’ involuntary impulses to push baby out.

And finally, I believe that the pain of labor has payoff.

“When a woman is giving birth, she has sorrow because her hour has come, but when she has delivered the baby, she no longer remembers the anguish, for joy that a human being has been born into the world.”
~John 16:21 (ESV)

Following the pain of childbirth comes great joy – joy in a new human being. Inasmuch as it depends on me, I want to be fully there and fully aware to experience that joy – even if it means I have to endure additional pain leading up to it.


Everybody do the doula with me…

When I learned at age fourteen that homebirths were officially illegal in Nebraska (or, at least, that it was illegal for midwives to attend homebirths), I struck midwife from my list of potential careers. I started almost immediately to look for alternatives and was delighted at seventeen to learn of this thing called a doula – a woman who helps women during labor. I looked up all the requirements for being certified with DONA (the doulas of North America) and contemplated becoming a doula many a time.

But when I got pregnant, hiring a doula was the last thing on my mind – it didn’t even cross my mind.

When our midwife and her student midwife mentioned the value of doula care at our meet and greet, I blew it off and wouldn’t have thought about it again except that my husband asked me later if we shouldn’t include doula fees in our pregnancy budget.

I don’t think I need one of those, I told him. Diedre and Cynthia will be there and you’ll be there.

But Diedre sounded like she really encourages women to have doulas, he replied. I promised him I’d think about it. I checked The Doula Advantage by Rachel Gurevich out of the library to help me think through doula care.

What I read did little to convince me. It seemed to me like the biggest advantage of doula care is having someone in between you and the medical staff, someone who can help you ask questions and make informed decisions, someone who is going to know your hopes for the birth and help you have the birth experience you want. That’s all great and I think it’s probably vital if you’re giving birth in a hospital (where protocols are king and the chances that your caregivers know your wishes are slim) – but I’m going to be giving birth at home, with a midwife I’ve been visiting with for my entire pregnancy. I don’t need someone else there.

Then, I started reading birth stories and my sensitive first-trimester belly churned. It wasn’t the birth stories themselves that made me sick to my stomach – few can match my excitement over dilation and amniotic fluid and crowning and women who press through back labor. I love me some birth stories – and have since I discovered my parents’ copy of Special Delivery (a 1970s homebirth manual complete with the birth story and photos of the author’s daughter Mariposa) some fifteen (or more) years ago. No, what was making me sick to my stomach was all the people in these stories. There were doctors and nurses and husbands and doulas and best friends and children, oh my! All I could think was “make all these people leave!”

Diedre asked me at our meet and greet if I’d consider an unassisted homebirth – and I told her no without reservation. (EDIT: On rereading, I realize this requires clarification. My midwife was NOT suggesting that I have an unassisted homebirth; instead, she was trying to clarify what I meant when I spoke of my philosophy that childbirth is a natural process and that intervention is usually unnecessary.) I want to have someone present at my delivery who has experience with birthing women and who can share the wisdom of birthing with me. I want someone there who knows what constitutes an emergency and what to do in an emergency. I want a midwife there.

But that’s not to say that I really even want the midwife intruding much. Really, I just want to give birth on my own terms. I want as much privacy as possible to labor my way – and to cling to my husband as we labor our way. I don’t want an audience. (I may not be the most private person, but I am a very independent one – and having a whole lot of people around during delivery is not my idea of fun.)

Having read The Doula Advantage, I was pretty sure I don’t want a doula. That said, I promised Daniel that I’d discuss it in greater depth with Diedre and Cynthia.

I did and was greatly relieved when Diedre informed me that, while a doula is generally beneficial for most women, I should go with my gut here. (She did, of course, clarify that she and Cynthia may NOT be able to provide doula-like coaching care for the entirety of my delivery – because they need to focus on providing midwife care. And that’s just fine with me!)

Did you have a doula when you delivered? Did you prefer to labor in private or did you want lots of people around? Wanna share your birth story? I’d love to hear it (and I promise I’m getting that gag reflex under control.)


Bumps and Books

My siblings have been bugging me for baby bump photos – and, while I’ve been taking them for a while now, I hadn’t yet gone through them and prepared them for posting.

But when Carrie announced her 8th Blogiversary and invited readers to link up with a picture of them with their favorite book (thereby entering them in a drawing for a $50 Amazon gift card), I knew that I had to get busy. Obviously, this would be a perfect opportunity to please my siblings – and let me participate in Carrie’s fun giveaway (which would be a fun meme even if there weren’t a giveaway attached.)

Week 19’s picture would have to feature both my bump and my favorite book. But first, you’ll have to scroll through the prior weeks. Sorry ’bout that. Gotta please the sibs first, you know :-)

Week 12: In which I don’t look pregnant

Week 12

Which was just fine with me since we weren’t planning on telling the general public for another two weeks.

Week 13: In which I have awful posture

Week 12

Apparently, I need to have my glasses on in order to know how to stand up straight. Who knew?

Week 14: In which the front of my shirt hangs higher than the back
Week 14

Oh wait. That’s the way it has hung since I was twelve.

Week 15: In which I think “Why didn’t her mother tell her to tuck in that pooch?”

Week 15

How often have I complained about how girls these days haven’t learned to tuck their tummies in and their tushes under? Guilty as charged.

Week 16: In which I might just really be pregnant

Week 16

After looking through all these photos today and trying desperately NOT to arch my back for my Week 19 photo, I have decided that this must be my new pregnancy posture. So I can’t tell if this is really a belly or if it’s just the result of this new (and completely weird to me) posture.

Week 17: In which an honest picture (where I’m not arching my back?) shows no bump?

Week 17

How pregnant I look varies widely based on my clothing. If I’m wearing a tightly fitting shirt, you can see the rise of a belly under my chest – if it’s a looser one like this, you can’t see anything.

Week 18: In which I lift my shirt to see if I actually look pregnant or if it’s the billowy shirt

Week 18

I think it’s mostly just the billowy shirt. But my midwife says my uterus is just the right size – and I’ve actually gained a little over the recommended amount at this point (just all on my chest and thighs rather than my belly).

Week 19: In which I show off my favorite book.

Week 19

I know, that’s more than a favorite book. But really, how does one decide?

My favorites include the Bible, The Mysterious Benedict Society, Little Town on the Prairie, The Lord of the Rings Trilogy, The Lion, the Witch, and the Wardrobe, and Pride and Prejudice.

Daniel insisted that I also take some photos without the books for continuity’s sake – but I actually think the books do a better job of showing exactly what is bump and what is not (since my dress doesn’t exactly fit my form)!


Having a Healthy Pregnancy (Part 1.0)

Having made my way through the first trimester, I have officially decided that the key to having a healthy first trimester is surviving.

If you’d been establishing some healthy habits in preparation for pregnancy, you’re well set up for this first trimester. You don’t need to really focus on adding anything – just on managing symptoms.

The most common first trimester complaints (in my experience as a WIC dietitian) are nausea and vomiting, fatigue, constipation, heartburn, and frequent urination.

I experienced all but heartburn (and help women with all five on a regular basis), so I do have a few tips for you.

Surviving Nausea and Vomiting

One of the most important things you can do to manage nausea is eat. Oftentimes, nausea is worse when blood sugars drop too low (baby is pulling a steady stream of glucose from your blood) – so small frequent snacks that keep your blood sugars up (but not too high) are useful. Try to include as many food groups as you can in these snacks throughout the day, and add a protein food (peanut butter, yogurt, cheese, eggs, nuts, seeds, etc.) if you can stomach it to help modulate your blood sugar response (protein helps your blood sugar rise slowly and not dip low after the rise.) If you generally have nausea first thing in the morning, keeping some crackers or dried fruit beside the bed to eat before you get out of bed might be helpful. If you’re throwing up just about anything, don’t worry too much about the variety, just eat anything you can hold down.

Some women experience nausea and vomiting when taking their prenatal vitamin. If this is you, taking the prenatal with food or at night may help.

Other women find that odors give them problems. Some techniques for managing odors include trying cold foods instead of hot (the odor isn’t as intense that way), opening a window or turning on a fan to get air moving, taking a walk somewhere away from the odors, and having a “masking odor.” Occasionally get a whiff of BO while you’re shopping that sends you running for the bathroom? Carry a handkerchief with a non-nausea-inducing odor (essential oils or even cooking extracts – some women find lemon, vanilla, or mint to be soothing) on it and delicately dab your nose as you walk past.

Surviving Fatigue

Lower your standards. You’re working hard growing a baby – some things are going to slide. Enlist help with dishes, groceries, whatever. Don’t start ambitious projects. Work to establish good sleep habits. Fatigue most likely won’t last through the entirety of pregnancy – although most women do experience it during the first trimester (and many during the last as well.)

Surviving Constipation

Before I got pregnant, I didn’t spend much time discussing this with my clients. They’d check on their diet questionnaires that they were experiencing constipation but I didn’t bring it up in conversation – and neither did they. Now that I’ve experienced constipation during pregnancy (even if only for two weeks), I bring it up if it shows up on their questionnaire. It’s TERRIBLE.

If you’re constipated, your number one priority is getting unstuck. While you might be tempted to spend a lot of time straining on the toilet, this can lead to unexpected and undesirable consequences (like hemorrhoids). For now, go to the bathroom when you feel like you have to but don’t sit there if there’s no urge. When you do get that urge, squatting on the toilet seat is actually a better approach for getting hard stool out (as opposed to sitting on the seat with your feet on the floor.) In between the urges to go, eat fruits and vegetables and whole grains, drink lots of water, and get moving around. Physical activity (taking a walk or dancing a while) can get your bowels moving. Sitting in a squatting position with your feet flat on the ground and your butt hanging near the floor behind you lets gravity help things out. Fiber and water bulk up and soften your stool. If you’ve already been doing these things and they’re not helping, adding in some apple or prune juice or prunes and raisins can serve as natural stool softeners. Other women find that a little coffee works well as a bowel stimulant (keep it at about 1 cup a day – moderation is important here.) If you’ve been taking an iron supplement or a prenatal with iron, talk to your doctor about switching to an iron free prenatal or taking a single iron supplement just a couple times a week instead of iron with your prenatal daily. If none of the above are helping, talk to your doctor about an appropriate over-the-counter stool softener or laxative. Remember, you only want to use medication as a last defense to get you moving – and then you want to rely on diet and activity to keep things moving from there.

Surviving Heartburn

This is the one I haven’t dealt with much, for which I consider myself fortunate.

For those that are struggling with heartburn, it’s valuable to eat small amounts frequently (rather than large meals only occasionally). Find your trigger foods and avoid them. Many women find that spicy or greasy foods trigger heartburn. Avoid caffeine and mint, both of which relax the sphincter (closure) between the stomach and the esophagus. Drink a little milk with your meals to help neutralize the stomach acid. And avoid lying down within a half hour to hour after eating.

Surviving Frequent Urination

Drink lots of water. Does that sound counterintuitive? It is – and it probably won’t really make you go to the bathroom any less. But it’ll help ensure that you don’t end up with something worse: dehydration or a urinary tract infection. Go ahead and go when you have the urge – and contact your doctor if you have burning with urination. Frequent urination is a bother, but it’s not actually a bad thing – just go with the flow on this one.

Does anyone else have any great tips for handling these first trimester woes? I’m always eager for more suggestions to share with my clients!


In which I am thankful for my sister-in-law

Those who know me know that I’m a touch opinionated opinionated to the point of being obnoxious.

I am generally willing to share many of my opinions here at bekahcubed, since readership is voluntary – but I try to be more circumspect about sharing my opinions in more personal (and therefore inescapable) communication.

I especially try to keep my mouth shut when it comes to how my siblings are raising their families. It’s not my business to inject my opinions into their families. It’s my business to love them and support them in any way I can.

Which is why I consider myself so incredibly blessed to have a sister-in-law who invites my opinions – and even tells me she likes that I have an opinion (and some reasoning behind it) on every conceivable issue.

After I started posting my thoughts on Frank Furedi’s Paranoid Parenting, Debbie sent me a message to let me know that she’d been enjoying my comments – and to ask me if I’d be interested in reading and discussing some parenting books together. We’ve been having a great time reading and discussing Grace-Based Parenting – but Debbie hasn’t limited her invitations of input to that book.

She asked me to read Addie Zierman’s When We Were on Fire because she wanted to hear my thoughts on that (and our shared youth group experiences). She asks me for my thoughts on vaccination schedules. And, yes, she tells me that she likes soliciting my opinion on things because she knows I always have an opinion – and some sort of rationale for why I hold the opinion I do.

As someone who frequently feels like she has to be biting her tongue to keep from being annoying, I can tell you that my sister-in-law has blessed me greatly by inviting me to give my opinions.

I try to bless her in response by giving my opinions in a fair and reasonable way – and by respecting when her opinions and mine differ (because they certainly do in some areas – we are very different people and will undoubtedly raise our children in very different ways.)

But mostly, I am thankful for my sister-in-law – and for her willingness to invite me to share my thoughts and opinions with her. It does this opinionated girl’s heart good to have someone who cares who asks.


So much for the grand plan

I shop a lot of used stores and most trips are not particularly memorable. I go in, I browse the racks, I try on dozens of articles of clothing and purchase less than 10% of what I try on (yes, I calculated that once – I think I purchased 9 of 140 or so items tried on.)

But this trip was memorable because I found this gorgeous shirt.

It was a lovely teal satin button down shirt. The moment I put it on, I felt like a queen.

It. fit. my bust. When I spread my arms wide, the buttons in front didn’t gape. I was sold. It was sold to me.

I got it home and put it on and discovered what I hadn’t noticed in my wonder in the dressing room.

The front was at least ten inches longer than the back.

Yep, I’d just bought a maternity blouse.

I wore it anyway, long tailed bodice tucked into a skirt or slacks. I couldn’t pass up something that fit my bust so beautifully.

But alas, somewhere along the line, I lost contact with that lovely shirt – either I gave it away or… I don’t know what happened to it.


While we were in the pregnancy planning stage, I took a look at my wardrobe and decided that we didn’t need to budget too much for maternity clothing. I wear mostly dresses and skirts with knit shirts – and most of my dresses have extra give around the waist.

I figured I could wear pretty much everything I already own for the first trimester, gradually decreasing my options down to the jersey knit dresses by the second trimester. Then I can make myself a belly band and buy some bigger t-shirts to go with my elastic waist skirts for the third trimester.

What I didn’t count on was the non-belly changes.


I’d been holding off buying bras, expecting that my breasts would be changing as the end of pregnancy drew near. It didn’t seem appropriate to buy new bras if I knew I was going to have to buy still more in different sizes within a few months. So I was making do with majorly stretched out brassieres.

Then I got pregnant. Within a week of finding out, my breasts were so tender I knew I couldn’t hold out any longer. I needed better support.

I went to get fitted and walked out stunned. Two cup sizes in the first month of pregnancy. What on earth! I wasn’t expecting that until the third trimester when my body’d be ramping up for breastfeeding.

My grand plan for not purchasing maternity clothes started to fade as I tried on one dress after another before finally finding one that didn’t squish my breasts into a giant sausage extending from shoulder to navel.

My new plan is to make myself a knit maxi dress that I’ll just wear every single day for the rest of pregnancy.


Did you have any surprising body changes during pregnancy? What did you do wardrobe-wise while you were pregnant?


I’m a desert dweller (almost)

Have you ever heard of a food desert?

The term refers to areas where access to fresh food is scarce.

I learned about food deserts in school and acknowledged that such places theoretically exist, where people (especially those without access to reliable transportation) have a hard time purchasing fresh foods – especially fresh fruits and vegetables.

I thought of Lincoln’s downtown, where there are few grocery stores and where many of the residents (okay, my context is almost entirely based on being a student and employee at the University of Nebraska – Lincoln) don’t have cars.

Surprisingly, when I looked at the USDAs data (check out your location here), I discover that Lincoln’s downtown is NOT a food dessert, but where I grew up IS.

This despite the fact that I spent my childhood and certainly my teenage years walking or riding my bicycle to the Walmart Supercenter or Super Saver (the most amazing grocery store EVER) that were less than 2 miles away. Huh.

Then again, the criterion for limited access in urban areas is that a large (>33%) proportion of the population is not within 1 mile of a grocery store. So I qualified. I hoofed it 1.5 and 1.8 miles respectively to Walmart or SuperSaver.

Oh, and I just forgot, there were a couple of HyVees too. One at 1.4 miles and one at 1.6 miles or so. Yep, I guess I was in a food desert. Strangely enough, I felt like I had the best access to food I’ve ever experienced in my life. Imagine that.

Wichita Food Deserts
I live and work towards the center of this map, right next to or on the green “food deserts”. The red squares are the supermarket complexes nearby.

Now that I’m in Wichita, I’m one street away from a food dessert.

I have one grocery store complex (Walmart Neighborhood Marketplace and Dillons) at 2 miles (an easy enough biking distance); another complex (Walmart Neighborhood Marketplace, Dillons, and ALDI) at 3.2 miles (for me, still a decent biking distance); and a third with all three stores at 3.9 miles. I struggle to come up with the store that’s within 1 mile of the majority of my census tract – but we’re still definitely not deprived.

So, I’m almost a desert dweller, officially. In reality, I’m not so sure.


Where’s baby’s bottle?

I keep a doll in my office to demonstrate breastfeeding. I keep it behind my desk because it’s really there for demo, not for children to play with. But that doesn’t stop children from wanting to play with it.

Generally, I let the children play.

One child, however, had a serious question: “Where’s this baby’s bottle?”

My breastfed baby doll

I told her that this baby didn’t have a bottle, that this baby was breastfed.

At first, mom tried to find something else in my office to take the place of a bottle. Could her daughter use the banana from the puzzle as the baby’s bottle?

She tried, but the banana just didn’t quite work.

Mommy realized that she’d just about missed a teachable moment.

“That baby doesn’t use a bottle. She gets milk from her mommy.”

Child’s eyes got wide – her mind was blown.

Milk from mommy? What a novel thought.

Small steps towards normalizing normal.


How to take “as needed” painkillers

Typically, when you get a bottle of painkillers after some sort of operation, the instructions will read something like “Take 1 to 2 every 4 to 6 hours as needed for pain.”

If you’re anything like me, you don’t like to take more meds than necessary, especially not painkillers – so you struggle with figuring out how exactly to take “as needed” meds.

Your temptation may be to go as long as absolutely possible between taking meds – resulting in excrutiating, hard to control pain. I’ve been there and done that. It’s not good – and it actually doesn’t help you take less, because you have to take more at that point to control the now-out-of-control pain.

I’ve had a couple of surgeries – a septoplasty and a wisdom tooth extraction – where I tried holding out longer than I should have and ended up with more pain than I should have. My sister, the Physician Assistant, told me to NOT wait until the pain was bad to take my painkillers. “That’s less effective,” she told me, “You need to keep your blood levels of the painkiller high enough to control the pain.” Foolishly, I didn’t listen.

After my second wisdom tooth extraction a couple months ago (they’re all out now!), I finally figured out how to take those “as needed” painkillers.

The instructions on my pill bottle were to take one or two every 4-6 hours as needed for pain.

I took one pill as soon as I got home from the oral surgeon’s office, and jotted down the time and the number of pills I took. As soon as I felt pain returning (4 hours later), I took another and jotted it down. 4 hours later, I felt the pain returning, so I took another and jotted down the time. So far, I was taking one every 4 hours.

But my situation changed overnight and it took 6 hours to start feeling more pain. I took one pill and jotted down the time. It was another 6 hours before I needed more. Then ten hours. Then 13 hours. Then 4. Then 6. And so on and so forth.

I took 13 pain pills in a total of 112 hours. That’s one every 8.5 hours on average. I never experienced any side effects of the painkillers, I never felt excrutiating pain, and I had no problem at all not taking them once my pain was gone.

Success.

Moral of the story: Take your painkillers when you have pain. Write down the time you take them and the amount you take so that you don’t exceed the maximum dose (in my case, 2 every 4 hours-which I didn’t even get close to reaching, much less exceeding.)

There you go.