Healthy Options for Pregnancy & Prenatal Care

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Pregnancy and Prenatal Care Options - What I chose
Wellness Mama » Blog » Motherhood » Healthy Options for Pregnancy & Prenatal Care

I’ve gotten several questions lately about the various tests and procedures that come with pregnancy and birth and what I choose. These are topics that I researched extensively when I was expecting my first and have continued to research throughout my pregnancies, so I have shared my opinions and research below. I’ve also written in depth about my own pregnancy and birth experiences and how I’ve come to my opinions. I am not a doctor or midwife and you should always consult with yours before making any decisions during pregnancy.

Personally, while I often feel that some tests and procedures are not needed, I still consent to some of them to make my doctor/midwife more comfortable and more willing to agree to my non-intervention approach to birth and after care. I think that each option should be carefully researched and weighed by an individual couple after taking in to account their specific circumstances.

Prenatal Vitamins Or Not?

Typically, prenatal vitamins are recommended during pregnancy. While these are certainly beneficial for many people, especially those who aren’t getting adequate nutrition from diet, but I don’t usually take them for several reasons:

  • Most contain synthetic forms of Vitamin A and other vitamins that are not only not beneficial during pregnancy but can also be harmful
  • As I’ve mentioned before, you can’t out supplement a bad diet, and while some high quality vitamins can fill in the gaps from a poor diet, they won’t take the place of it and can give a false sense of health
  • I personally notice that I feel better when I take certain isolated nutrients instead and concentrate on an extremely nutrient rich diet

As I said, this is something that is very individualized, but during pregnancy, I take:

  • Consistant daily magnesium intake before and during pregnancy (this post explains what I used) This is also supposed to help with labor- I’ll let you know!
  • Daily bone broth for the minerals and gelatin
  • 800 micrograms of folate (not folic acid!!! it is synthetic) daily before and during the first trimester (this is the one I take)
  • Lots of probiotics, fermented food, and fermented drinks daily since baby inherits my gut bacteria. This is vital!
  • A very high nutrient diet that I consider non-optional. I mostly follow the Weston A. Price pregnancy diet except that I eat sweet potatoes and squash in place of sprouted grains.

First Visit Blood Tests/ Pap Smear

Though I don’t find much of a need for these personally, I agree to them anyway. I monitor my blood levels and check my Vitamin D levels regularly, so I already know that I am not anemic and after four pregnancies with the same person (my husband), I am also relatively confident that I do not have an STD.

The reason I consent is because I refuse some of the routine after-birth options like antibiotic eye drops and then have proof that I don’t have an STD that could be passed on to baby. (more on that later)

These tests are often unnecessary, but can also reveal important information (like rH problems) and have no downside so I don’t mind them.

Ultrasounds/Dopplers for Heartbeat

There is some controversy about the safety and necessity of ultrasounds and regular checks for baby’s heartbeat with a doppler. This article outlines some of the potential dangers in ultrasounds especially multiple or unnecessary ones. While I opt out of routine ultrasounds or those to check the size of the baby (which are not accurate anyway), I do consent to one 20-week ultrasound in my specific case.

My reason for agreeing is that I had placenta previa with my third that was not caught, despite an ultrasound and I hemorrhaged and could have died at 35 weeks gestation (we are both fine now). Since the risk of placenta previa is slightly higher if you’ve already had it, the risks of one ultrasound are less to me than another potential undiagnosed placenta previa. I would not consent to other ultrasounds to diagnose size, gender, etc.

In non-high risk cases, no ultrasounds may be needed and a mother should carefully research and weigh the options for her pregnancy. Most experienced midwives and doctors are able to feel size, position and movement of the baby without the need for ultrasounds unless there is a specific risk.

Dopplers (the instrument used to hear the baby’s heartbeat) come with their own set of concerns and some doctors prefer not to use them because they do pass on some radiation. As this article explains:

“According to the U.S. Food and Drug Administration, fetal Dopplers are not intended for over-the-counter use. The radiation used during a Doppler session has the potential to cause harm to the baby. You should only use a Doppler in your doctor’s office or under your doctor’s supervision. If you chose to use one at home, get a prescription from your doctor first. A Doppler should not be used when the number or lengths of sessions are not specified and should only be used when it is medically useful.”

I’ve had midwives with differing opinions on this and I prefer to avoid dopplers for the most part. I will sometimes consent to one very quick check for a heartbeat to satisfy the midwives at a first appointment, but then once it is possible (3rd-4th appointment usually) I ask them to use a fetoscope instead. Most doctors and midwives have a fetoscope and are able to do this if asked.

In labor, I will consent to doppler checks to monitor baby occasionally if it removes the need for constant monitoring and being tethered to my bed (oh the joys of v-bacs!)

Urine Tests

I consent to urine tests when indicated my my midwife/doc because they are non-invasive and test for sugars or ketones in the urine which can both be signs of problems, especially when paired with other symptoms like blood pressure changes, rapid weight gain, headache, etc.

If a urine test revealed a problem, I would seek additional testing (blood or otherwise) to confirm before consenting to any treatment.

Blood Pressure Checks

Another non-invasive test that I agree to as high blood pressure in pregnancy can be very dangerous and it would be better to find an elevated blood pressure as soon as possible and attempt to treat naturally if possible, or to get medical treatment to avoid a pre-term delivery if needed. High blood pressure, especially paired with other symptoms, can signal preeclamsia, a very dangerous condition.

Internal Exams

I completely refuse internal exams (cervix checks) and only consent during labor when I feel the urge to push (mainly to pacify the midwife, not for me). There is really no information that an internal exam can reveal that is useful or relevant in prenatal care before labor. It is a chance for external bacteria to enter the vaginal area and baby’s size, position, etc. can be determined with an external exam.

Many women like to know how far dilated they are at the end of pregnancy in hopes of knowing when they will go in to labor. Unfortunately, this is a notoriously inaccurate test for when labor will begin. I personally know women who were not dilated and effaced at all and delivered less than 24 hours later, as well as women who walked around at 3-4 cm for weeks.

Without a specific need, I always refuse internal exams… plus, it makes prenatal appointments easier and faster to not have to disrobe at every appointment.

Glucose Test

I do not consent to the normal glucose screening test that involves drinking 50 grams of a glucose solution for several reasons. First, there is no situation during pregnancy in which I would ever consume that much sugar/carbohydrates in one sitting, so the test is not accurate for me. There is a risk of false positive, which leads to another, longer test.

That being said, I do think it is important to make sure I don’t have blood sugar issues or gestational diabetes, as they can both cause complications. Instead, I monitor my blood sugar over a period of a week at two separate times during pregnancy and record it for my doc/midwife to check. I take my blood glucose levels four times a day and record. This article explains more on what the normal levels should be, but basically:

  • Fasting blood glucose (first thing in the morning) of 86 or lower
  • 1 hour after eating= 140 or lower
  • 2 hours after eating= 120 or lower
  • 3 hours after eating= back to fasting level

There can be some variation in this, but the majority of my readings should be in these ranges. I do this at 28 weeks and 33 weeks (my preference) to make sure my levels are good. Another reason I prefer this is that it is a more comprehensive view of glucose tolerance and I even get to see what foods cause higher spikes for me personally and which don’t affect it as much at all. I’ve also found through this testing that adding 1 tablespoon of coconut oil before each meal helps my glucose reactions improve and get back to baseline more quickly, so I would use this if I ever needed to control my levels.

Many doctors may not be familiar with this and I have had to suggest it to a doctor before and let him research it before he agreed to it. With anything I do that goes against the norm, I make sure to present it in a friendly and firm way and show that I’ve done my research and explain why I feel it is a better option. This is one thing I’d encourage you to research for yourself if you consider it, and talk to your doc/midwife about the best option for you.

Personally, I use this monitor and these strips because they are inexpensive and readily available, but any reliable monitor would work.

Optional Screening During Pregnancy

There are various optional screenings that can be done during pregnancy. This article explains the usual ones:

  • “Chorionic villus sampling (CVS). Tests the tissue around the baby to see if he has a genetic condition, like Down syndrome. The test usually is done between 10 and 12 weeks of pregnancy. Your provider may want you to have CVS if you’re older than 35, if genetic problems run in your family, or if your first-trimester screening shows that your baby is at increased risk for birth defects.
  • Cystic fibrosis (CF) carrier screening. Tests to see if you have the gene that causes CF. CF is a disease that affects breathing and digestion. If you and your partner have the gene, you can pass CF to your baby. You and your partner can have this test any time during pregnancy.
  • First-trimester screening. Tests your blood to see if your baby is at risk for some birth defects, like Down syndrome and heart defects. You get an ultrasound as part of this test. The test usually is done at 11 to 13 weeks of pregnancy.
  • Maternal blood screening. Tests your blood to see if your baby is at risk for some birth defects, like Down syndrome and heart defects. The test is done at 15 to 20 weeks of pregnancy.
  • Amniocentesis. Also called amnio. Tests the amniotic fluid from around your baby to see if he has a genetic condition, like Down syndrome. The test usually is done at 15 to20 weeks of pregnancy. Your provider may want you to have an amnio for the same reasons as for CVS.”

I refuse all of these tests. They all have some risk of a false positive, which can cause needless worry for the parents and they provide information which is really irrelevant to me. As one reader put it, one must consider “what you would do with the information.”

Finding out that my baby had any of these problems would not affect my decisions about my pregnancy and I would certainly never consider not continuing the pregnancy, so this is simply not information I need to know and since it could cause needless worry… I skip it.

Group B Strep

Pregnant women are generally screened for Group B Strep or GBS at 25-37 weeks gestation. It can be a life threatening infection if a baby contracts it from a mother during birth, so it is certainly best to avoid GBS, and the usual method is a GBS test and antibiotics during labor if necessary. There is some controversy over if GBS testing actually improves outcomes in GBS cases, and even more controversy over if routine use of antibiotics for all those with GBS is necessary.

The bacteria is naturally present in some women and it can come and go in the gut/vaginal bacteria. In my opinion, the best bet is to optimize good bacteria and work to avoid GBS and a positive GBS test as this makes labor much easier (IV antibiotics = stuck in bed on an IV). I highly encourage all women to do research on this topic before the appointment that tests for GBS.

If you do test positive for GBS, I highly encourage researching the options in depth. Antibiotics are the usual treatment, but as more information emerges on the importance of gut bacteria and how baby inherits it from mom, antibiotics can have a much longer impact than just during the birth and days after. There is even information linking antibiotic use in labor and in baby’s early days to higher rates of allergies and asthma, which makes sense under the gut bacteria theory.

This article explains ways to avoid GBS and treat it naturally should this be an issue. I proactively consume a lot of probiotics and use them vaginally during pregnancy to optimize my gut bacteria that I am passing on, even if GBS is not a concern.

Kick Counts

Many thanks to a brave reader for stressing the importance of checking kick counts, especially if baby is moving less or if there is concern! Especially in the third trimester of pregnancy,  this is an easy and non-invasive way to double check the baby is doing well.

Basically, you just want to ensure that you feel some type of fetal movement within a 2-hour stretch. This doesn’t mean that you have to be constantly kicking, but just that at some point during the day you check to make sure you are feeling movement. A decline in fetal movement can indicate fetal distress or a cord wrapped around the neck and this information can be life saving for baby if found early enough.

This article explains how to do kick counts.

The bottom line…

Whatever a couple decided on pregnancy and prenatal care options, I think it is very important to research individually and not agree to or refuse any test without researching both sides first. While it can be hard to go against the norm, especially under pressure from a doctor, we (as mothers) must remember that ultimately we have the responsibility for our pregnancies, our health and our babies. We have the right to refuse or consent to any procedures and we certainly have the right to make an informed decision! In future posts I’ll be covering specific conditions of pregnancy and my preference on birth options/interventions.

Interested in a more natural pregnancy?

Sign up for the world’s first pregnancy week-to-week series from a *natural* perspective! Created by my friend Genevieve from Mama Natural, the series shows you what’s up with baby, mama, and more each week. You’ll discover natural remedies for various pregnancy symptoms and prepare for your best and most natural birth!
Click the image below to get access now!

weekly pregnancy updates from a natural perspective - purple

I’d love for you to weigh in! What other pregnancy testing is there? What do you refuse or consent to and why? Share below!

Katie Wells Avatar

About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.

Comments

189 responses to “Healthy Options for Pregnancy & Prenatal Care”

  1. Gina Avatar

    Hi Katie!
    You mentioned using probiotics vaginally. How do you do this, please?:)

  2. Dija Avatar

    I am confused, please clarify – Ritual prenatal vitamins are promoted during the podcasts yet in this article Katie says she doesn’t recommend prenatal vitamins?? Which is it??

  3. Leslie Avatar

    Hello Katie,

    So I recently went off of the pill because I was inspired by one of your podcast. However, on the podcast the doctor recommends taking a prenatal vitamin to help with the transition. But, now I’m a bit confused based on your prenatal vitamin opinion.

    I’ve only recently started trying to detox my home and myself of toxic products. So when shopping for prenatal vitamins I am now confused.

    Can you please provide some guidance?

  4. Stephanie Avatar
    Stephanie

    Hi Katie 🙂 Hoping you can find the time to answer me as I know you are extremely busy! Just wondering how many mg of Omega 3’s you aim to take in a day whilst nursing? Thank you so much in advance 🙂 xx

  5. Anna Avatar

    Hi, I recently got your email about Ritual prenatal vitamins. I just ordered some and plan to try to get pregnant soon! Do you recommend still taking other vitamins especially fermented cod liver oil as well as the Ritual prenatal?
    Thanks

  6. Jodi Avatar

    Hello! I am trying to find the folate that you recommended, but the link on Amazon is no longer good. Do you have an alternate folate that you recommend now??
    Thanks!
    Jodi

  7. Yohaira Avatar

    Hi! Thank you so much for this information! A bit overwhelmed, just found out I’m pregnant with #3! and need vitamins asap!
    So if I take fermented cod liver oil that should do it for DHA correct?
    Going to order the Folate you recommended, fermented cod liver oil , and megafood baby and me.
    Would love to hear form you!

  8. Brittany Avatar
    Brittany

    Do you consume kombucha while pregnant if you have been consuming daily prior to pregnancy? There seems to be mixed data. Thanks!

    1. Wellness Mama Avatar

      Always check with your provider first, but yes, I consume a small glass each day while pregnant since my body is already used to it.

  9. Serenity Avatar

    Hey ladies,
    It would be nice if anyone who already had their baby could chime in as to how everything worked out w/respect to diet and supplements.
    I have a question for anyone:
    If I plan on conceiving in about 6 months, should I take the above mentioned folate from now? Or should I take it one month prior to trying to conceive?
    Thanks in advance!

  10. Gina Avatar

    Hi, Kate! I’m 34 years old and 8 weeks into my first (unplanned) pregnancy. I am very holistic and my boyfriend and I are pretty much 100% organic and definitely chemical/medication free. I always thought i’d be 100% holistic when i’d get pregnant, and now i’m so overwhelmed! I obviously don’t want to deprive my baby of nutrients.

    My main concern here is: i decided not to use pre-natal for the reasons you also mentioned, but i’m currently suffering from the super nauseas stage where i can barely eat anything. I’m taking cod liver oil and citrus fruit and probiotics, some days i can stomach drinking my green powder to get the greens in. The first few weeks i was on point with nutrition and very close to weston price diet.. but i can’t stomach anything anymore.

    Any suggestions or advice? My first midwife appt is in 2 days, too.
    My mom had 5 girls too.. NO nausea lol.
    Thank you so much! We love your blog.

  11. Kristen Avatar

    Hello. It seems the last time I read this post you recommended Seeking Health prenatal. I just bought a new bottle. Do you not recommend this line anymore?! Thanks for any suggestions.

  12. Jincy Avatar

    Hi Katie,
    What is the role of DHA? I asked my OBGYN about the prenatal vitamin you shared in the other post about pregnancy supplements. My doc recommends taking one with DHA. I am currently consuming Fermented cod liver oil + Butter oil blend. Considering this, will I still need to take a prenatal with DHA? Do you have any recommendations? I am in 1st trimester – week 6 of pregnancy.

  13. Carrie Avatar

    Which blood sugar monitor do you use? Both links go to the strips. Fingers crossed my midwife will accept this method!

  14. Jenna Avatar

    Hi Katie thank you for all the info. You mention some forms of vitamin A can be toxic – which forms should I steer clear of in a pre-natal? Also so you recommend a dha supplement to take with the prenatal you link to?

  15. Jenee Avatar

    Is there any reason you are now recommending just plain fermented cod liver oil and not the butter blend? I know there was back and forth about Green Pastures but I took the blend my last pregnancy and even my dentist remarked at how great my teeth looked during pregnancy! So I’m planning to take it again unless there is a reason not to.

  16. Deborah Avatar

    You dont know what you are talking about. My babies needed regular growth scans because they were small and the scans were accurate. With my 4th, bless her poor little soul i felt there was something wrong and it was discovered at the 20 week scan that there was, she died inside me at the 6th month mark. That was years ago and things didnt work out with their father. Im pregnant now with my fantastic partner and they are recomending scans because of my previous babies sizes and you bet im doing it.

    1. Meagan Avatar

      How did the scans help? I’m honestly curious, not trying to say they weren’t valuable.

  17. Cynthia Avatar
    Cynthia

    You have written down that you take 1 to 2 teaspoons of cod liver oil daily but your recommendations is the capsules. Do you just take 2 capsules then daily? The price diet says to take 20,000 IU daily which is in two teaspoons but I can’t find on the green pasture blue ice cod liver oil how much is in one capsule. Do you have any advice for how many capsules to take daily?

    1. Lyndsay Avatar

      According to the greenpasture website there is 500mg of DHA per tsp of their liquid and 2 capsules are equivelant to 1 tsp

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