A Self-Guided Pregnancy Syllabus - Part Two
How to bear those last few weeks when you really can't stand another day of fucking pregnancy but the thought of being responsible for a newborn is terrifying
There seem to be a lot of new subscribers here, so I want to offer a quick welcome and thank you. I’m thrilled you’re here and that there is such an appetite for pregnancy real-talk. I write about motherhood and culture. If you always have a book in your bag and like talking about family policy and reality dating shows in equal measure, I think we are going to be friends.
ICYMI, I had a piece1 published in Slate last week on pumping and the “simultaneous double shift” new mothers are expected to perform when they return to work with a breast pump—and why we in the U.S. shouldn’t have to trust our employers to be the stewards of our transition to parenthood.
Finally, you can find the first part of this self-guided pregnancy syllabus, on the first and second trimesters, here.
Soooo there’s going to be a baby here soon? (The third trimester)
Take a childbirth class. If you are anything like me, I couldn’t really grasp the reality that it would be my job to push the baby, which was rapidly approaching the size of a watermelon, out of my body, until the third trimester. Taking a childbirth class, as well as becoming increasingly desperate to no longer be pregnant, forced me to think about how I might want to do that.
There are different kinds of childbirth classes. I took one offered at my midwife’s clinic, so it definitely had a point of view. Our instructor casually assumed that participants would be trying to minimize interventions, including epidurals—so it definitely wouldn’t have been the best fit class for everyone. But as a result, a significant portion of the class was dedicated to discussing how we might weather the sensations of labor and teaching partners hands-on comfort measures. (There wasn’t any discussion of Lamaze-style breathing techniques, which was what I envisioned being taught in a childbirth class.) I can’t speak to how a childbirth class in a hospital setting might be different, but I also don’t know a lot of other husbands who learned how to do hip squeezes. If you’re interested in an evidence-based natural birth experience, check out The Bradley Method. Hypnobirthing sounded very intriguing to me, but I felt like I needed more than guided meditations to prepare.
We ended up taking a “weekend intensive” in person - two long six hour sessions over the course of a weekend. It was a lot of information all at once. In retrospect I wish we had found a class that was offered over several weeks. But the upside is that we bonded with the three other couples in the class, who were all expecting babies around the same time as us. This was our first little cohort of new parents.
A good childbirth class is just as important, if not more important, for the birthing person’s partner. Even before I took this class, I knew a fair amount about birth—I had been interested in the subject for years, had heard my friends’ birth stories, I already knew how I wanted things to go, etc. etc. But because we don’t expect men to know things about women’s bodies (not his fault), my husband was encountering a lot of this material for the first time. I realized that it was just as crucial that he understand how labor progresses and be able to understand where we were in the process—and that he know how to support me, especially once I transformed into a bellowing animal. My husband is amazing and I had no doubt that he would be a supportive partner in labor, but I think attending an in-person class together (that involved a lot of hands-on practice) made him realize how integral he would be to our labor and delivery, and that he couldn’t just zone out as he may have in an online class.
“Optimize fetal positioning.” Try to get baby head down and facing down (occiput anterior or “OA”) for an easier vaginal delivery! A big part of third trimester midwifery care, in comparison to obstetric care (as I understand it), is trying to optimize fetal positioning. My midwife and doula suggested I practice the Spinning Babies’ “Three Balances” techniques to get my daughter head down as we approached the final weeks of my pregnancy. I found the positions felt pretty yummy in my body during a time when I felt generally awful.
(But if your baby doesn’t want to be head down, IT IS NOT YOUR FAULT. Fetus is gonna do what fetus is gonna do.)
Invest in comfortable slip-on walking shoes. You probably already know this, but you can’t tie your shoes anymore.
When you realize you are never going to be one of those chic pregnant women Tums are useless. I had horrible heartburn and acid reflux for the second half of my pregnancy. It felt like my digestion had slowed down to the pace of cars merging on the helix outside the Lincoln Tunnel at rush hour. Anything I ate after 1 pm sat in my throat for the next 14 hours. I remember mentioning this to my therapist (also pregnant), who told me that Tums were no better than Skittles. She gently advised me to ask my midwife about taking something stronger. Prilosec helped a little bit, but finally, my midwives let me take Omeprazole. This is one of those drugs for which there isn’t a lot of data on its safety during pregnancy, so it’s something you’ll want to discuss with your provider, but Omeprazole changed my life by allowing me to eat during my last two months of pregnancy.
Listen to The Birth Hour podcast. I had trouble reading anything about childbirth that was intended to be instructional. I just glazed over. I didn’t want facts. I wanted to know how birth felt. And, thanks to this podcast recommendation from a woman in my childbirth class, I realized that listening to birth stores made me feel much less terrified. All of these women had lived to tell the tale! Some births were straightforward. Others were very much not. But all were unpredictable, in one way or another. By listening to three to four episodes of The Birth Hour podcast in my final weeks of pregnancy, my fear transformed into curiosity—what kind of birth would I have? When—and how—would she arrive? I learned sooo much, and because I learned it via story, I remembered it. Episodes are very clearly labeled so you can tell whether you are likely to find them scary, e.g. “Preeclampsia, Prodromal Labor, and Spinal Headache from Epidural” or not, e.g., “Overcoming Medical Anxieties for an Unmedicated Hospital Birth with Doula + Breastfeeding Challenges.” I started out listening to straightforward unmedicated hospital birth stories and worked my way up to emergency c-sections, preeclampsia, and inductions. It was because of The Birth Hour that I knew how preeclampsia is treated during labor and what to expect from the magnesium.
Listen to the Evidence-Based Birth podcast. This is another great podcast that offers evidence-based answers to all of your questions—from the “Pros and Cons of the Foley and Dilapan-S® for Cervical Ripening During an Induction” to “The Evidence on Prenatal Perineal Massage for Preventing Tears in Childbirth with Dr. Rebecca Dekker.”
Identify your birth preferences. After you’ve taken a childbirth class and done some research, you’ve probably started to have a sense of what kind of birth you want. Write out your birth preferences! Your hospital might have a particular form they want you to use. But don’t feel like you have to use it. You can write a one page letter. But make it short, assertive, and snappy. Use bullet points. I’m happy to share mine with anyone who wants to see an example.
Set up a meal train. Or ask someone to set up a meal train for you. Do not decline the offer of a meal train! No one is going to give you a medal if you feed yourself without help while you are still bleeding into your padsicle. You might not ever be able to unsubscribe from their emails, but MealTrain.com will allow your community to show up for you by bringing you soup and a crusty baguette or by giving you Doordash gift certificates. I promise there is nothing better in those early weeks than knowing that food is on the way and you don’t have to cook it. But—and this is important—establish clear drop-off protocol with your village ahead of time. Dropping off dinner should not mean staying for dinner or meeting the baby—unless you want to, of course! This is a realm of the fourth trimester in which dads/non-birthing parents can serve and dominate. Protect the solitude and sanity of your birthing queen! Her nipples are probably bleeding. See also below note on BOUNDARIES.
Pack your hospital bag. Perhaps also nag your partner, whose sense of urgency is much less dire, to pack a hospital bag. Plan to bring your own pillows. You don’t need to bring anything for the baby other than an outfit to go home in.
I overpacked Buy a giant yoga ball. Not only is it helpful in labor, but it might be more comfortable than a desk chair in the third trimester, and nothing soothes a baby better than being bounced on a yoga ball.
Go on leave before your due date. If this is at all a possibility, give yourself some time before your due date. You will be so fucking pregnant. Go to the movies in the middle of the day (it’s possible you will not go to the movies again for years), fold tiny pajamas, batch cook food for the freezer, and tend your nest. Evolutionarily, our bodies need safety and solitude to go into labor. Anecdotally, my midwives said they saw the babies of first-time moms who worked until their due date coming late because they hadn’t gone and crawled off into the metaphorical childbirth cave.
Make a dinner reservation for your due date. If this is your first baby, it’s probably going to be late. Try to plan to do something special with your partner on your due date, because you will likely be disappointed (if not pissed) to still be pregnant.
Do the Miles Circuit. Once you’re 39 weeks and ready to get this fucking baby out of you, it’s time to do everything you can to get your body ready. I will never know if the Miles Circuit worked since I ended up being induced on my due date (after I presented with preeclampsia at my 40-week check-up), but it definitely made me feel like I was doing something in those final weeks of desperation.
Consider a pre-delivery lactation support session. It’s kind of impossible to imagine what, exactly, is hard about breastfeeding until you meet your baby and are actually doing it. (“How hard can it be?” I always sort of thought, until my friends started having babies and I watched them struggle.) I wouldn’t have considered a pre-delivery lactation support session if my doula hadn’t recommended it, and if it hadn’t been fully covered by my insurance. I went on leave at 37 weeks so I had the time to meet with a lactation consultant for an hour. She told me that I would be able to breastfeed if I wanted to (this proved to be true for me, but I remain skeptical that this is true for all mother-child dyads, and think that this kind of messaging can be really shaming and harmful for moms). I also remember holding a doll in various feeding positions. I don’t remember much else. I don’t know if I would actively seek out one of these sessions, but if you have the time and one is available, it can’t hurt. The most important thing about lactation consultants, in my experience, is finding one whom you actually like and who you vibe with. Having someone stuff your boob into your baby’s mouth while you cry is among life’s most intimate experiences, and it’s really important to feel safe and not shamed by that person.
Make your partner practice driving to the hospital and figure out what the parking situation is, in advance. We lived 7-15 minutes away from the hospital where I was going to give birth, so we thought we knew how to get there. But when we practiced, we realized if you missed a one-way turn into the entrance, you were screwed and had to do the equivalent of what seemed liked another entire loop of LAX. Figure out where you can be dropped off and whether your partner can abandon the car. At our hospital, there was an area close to the entrance where you could leave the car for thirty minutes before having to park it in the garage.
Channel your frustration into the fact that the baby isn’t here yet by learning how to tie a baby wrap. This will require several YouTube tutorials and is easier when you are not being triggered by a screaming newborn.
Set boundaries. Okay, this is the most important thing on this whole list. You and your partner need to sit down and decide how big your nest is going to be in your first few days/weeks/months as a family of three. Where and when will the grandparents meet the baby? How about your siblings? How long will visits with friends be? What is your masking/illness protocol? How can you communicate those boundaries to your family? Our midwives recommended that we write a letter to our families and friends, setting expectations and telling them what we would need from them in the early days—that we may ask them to fold laundry rather than hold the baby, that visits at our house would be no longer than three hours at a time, to help themselves to beverages but please put their glasses in the dishwasher, etc. I think our parents probably thought this was a bit extreme, but it worked for us.
Install the car seat. Okay, well maybe this is the most important thing on this whole list. Install the car seat a few weeks in advance. Do the wiggle test. Be sure you know how to safely buckle a newborn into a carseat before you are leaving the hospital and are parked in the ER drop-off lane with the hazards on.
A little more reading.
Enjoy the freedom of these final weeks, to the extent that you can. Follow your bliss. Don’t feel pressure to do all of the homework. Go to the movies and read novels. Rot in bed on your phone. In the words of Mary Oliver, You only have to let the soft animal of your body love what it loves, and you will never be more of a soft animal than you are in the third and fourth trimester. But if you can’t stop reading about motherhood and feel like you need to prepare, here are some third trimester-suitable reads.
Ordinary Insanity: Fear and the Silent Crisis of Motherhood in America by
. A history and cultural exploration of postpartum anxiety (long overshadowed by its sister, postpartum depression) that is ultimately, a history and cultural exploration of childbirth and motherhood.Linea Nigra: An Essay on Pregnancy and Earthquakes by Jazmina Barrera. One of my favorite motherhood reads of all time, this is a short and beautiful meditation on pregnancy, new motherhood, and the body.
For partners, Perry Simkin’s The Birth Partner: A Complete Guide to Childbirth for Dads, Partners, Doulas, and Other Labor Companions. It’s pretty technical, but if you want to have your partner read something, I would recommend this, and also Matrescence (recommended last week).
Coming next—childbirth & the fourth trimester!
If you hit a paywall, Slate is currently offering a deal on Slate Plus Membership - $5 for three months.
Thanks so much for the shoutout!