Tuesday, January 20, 2015

What Do You Call It When...?

Or: 8 Pregnancy/Birth Things You've Heard About But Don't Know the Name For

The birth world definitely has its own lexicon. Some words you may have heard before you got pregnant: placenta, trimester, contraction. Some words have been given new or expanded meanings: presentation, heartburn, induction. Other words may have become familiar friends as you worked your way through books or your childbirth class: doula, perineum, fundus.

And then there are those words you can't quite remember, or maybe you never really knew in the first place. Words for things that came up during your pregnancy or a friend's, things you've read about, things that you know about from somewhere but that you just don't know what they're called. Want to expand your vocabulary a bit? Read on for a few of those words.

1.  Amniotomy.  This is an easy one. An amniotomy is the technical term for artificial rupture of membranes, otherwise known as when your caregiver breaks your bag of waters for you (as opposed to letting it break on its own).

2.  Chloasma.  Some women develop darkened patches of skin on their face while they are pregnant, a result of the extra hormones circulating in their body. This is generally known as the "mask of pregnancy," and is a common enough occurence to merit a mention in most pregnancy books, although I do not know many women who have ever experienced it. The technical term for this is chloasma, or sometimes melasma. And thankfully, it almost always disappears once baby has been born.

3.  Supine Hypotension.  You know how your caregivers tell you not to lie on your back starting at some point around the end of your second trimester? That's because the weight of your growing uterus will put pressure on your inferior vena cava, the vein that carries blood from your legs to your heart. This could cause a drop in blood pressure, reduce the blood flow to your placenta, and ultimately restrict oxygen to your baby. This blood pressure drop is known as supine hypotension. It *could.* But you don't need to worry if you flip onto your back while sleeping; chances are good that you won't actually harm your baby.

4.  Nil Per Os.  Most hospitals in the US have a policy of not allowing women in labor to eat or drink. This dates back to the 1940s, when it was discovered that aspirating food particles while under general anesthesia was a very real risk, and when general anesthesia was more common during labor for various reasons. It was believed that by withholding food and liquids, a woman who unexpectedly had to go under was at less risk. Nowadays, general anesthesia is much less common, and most anesthesiologists are much more skilled and use better techniques that minimize that risk. In recent years, there has been much research done that proves that NPO, which stands for nil per os (which is Latin for "nothing by mouth"), is no longer an evidence-based practice. Regardless, it is still standard of care in most hospitals.

5.  Valsalva Maneuver.  When you see people giving birth on television or in the movies, the pushing stage usually involves the woman being told to hold her breath and push as hard as she can for as long as possible. Right? There are various terms for this, such as "directed pushing" or "purple pushing," but this is technically known as the Valsalva Maneuver or Valsalva pushing. Well, if you really want to get technical, the Valsalva Maneuver is actually attempting to exhale against a closed airway and it has a few medical applications, not to mention being useful for "clearing" one's ears. But in the birth field, this style of pushing, which usually inadvertently produces the Valsalva Maneuver, is described using the same name.

6.  Nuchal Cord.  This is another straight-forward one. A baby born with a nuchal cord simply means that the umbilical cord was wrapped one or more times around baby's neck at birth. About a third of all babies are born with a nuchal cord. Contrary to popular belief, however, nuchal cords generally do not cause problems.

7.  Placentophagy.  During one of the childbirth classes I took when I was pregnant, I remember one of the other mamas blurting out something about crazy women who eat their placentas. My husband quickly grabbed my hand and squeezed it tightly, silently warning me to keep my mouth shut. (There were a lot of instances in that class where I kept my mouth shut. That was definitely not the right class for me. But I digress.) Placentophagy is simply the act of consuming one's placenta after birth. The most common form in our society is encapsulation, where the placenta is dehydrated and turned into pills. (That's what I did. Yes, in case you were wondering, I totally ate my placenta.) Some people eat it raw, or cook it in some way. I'm not going to get too deeply into the why here, since there are plenty of perfectly good articles out there explaining it. (Try this one at Placenta Benefits.)  Nor am I going to go into whether or not it's effective. I just wanted to make sure you knew the practice has a name.

8.  Vascular Underfill.  One of the classic symptoms of early pregnancy is fatigue. Newly pregnant women want to sleep. All. The. Time. It makes sense though. You're growing a person, right? That's got to be taxing to the body! There's a little more to it than that, though. While a lot of things undoubtedly contribute to this tiredness, here's one cause that you have likely never thought of, or even heard of: vascular underfill. The gist of it is this: the hormone human chorionic gonadotropin (hCG; it's what a basic pregnancy test detects in your urine) causes your round muscles, including your blood vessels, to relax and dilate. Your blood vessels are actually bigger, but your body hasn't made the extra blood to fill them up all the way yet. Because your circulatory system is suddenly less efficient due to an underfill of blood, it has to work harder to get oxygen to different parts of your body. This results in you being more tired, feeling weaker, getting dizzy on occasion. This issue will resolve itself, sometime near the end of your first trimester or during the second, and then you'll feel much better. But isn't it nice to better understand part of the reason why you feel so fatigued all the time?


  1. This is a great article. I chuckled while reading #7!!

    It's funny how we tend to think of hospital birth as being the more scientific route, while natural or home birth is perceived as more "old-fashioned" and less "science-based", when really so many things that happen routinely in a hospital are by-products of another era, and home birth practices are based on real-life studies and observations of the woman at hand. In hospital, routine use of forceps appears to be fading in most areas, but how many decades did that take? Episiotomy is still standard almost everywhere, among my personal circle of friends nobody who had a hospital birth escaped uncut. NPO, lying on the back, stirrups, and other archaic practices are still completely accepted by people in regions all around the US.

    I have noticed a lot of hospitals are beginning to change their routine practices, albeit slowly. It helps that women are getting more information, more quickly (thanks, Facebook!), and being more confident and vocal about their right to choose.

    In the 70s, there were hardly any books on birth, and now the library is stuffed with everything from Ina May to What to Expect! And blogs like yours, which raise interesting topics and introduce fun words like fundus and perineum Long live the perineum!

    1. I remember you saying once that you had kept the bottle from your placenta pills, because it was a fun way to freak people out. ;) You have no idea how much I wish I had kept the bottle from mine!

      You are absolutely right! I know that episiotomy rates vary wildly from hospital to hospital and doctor to doctor; there are some doctors who genuinely only cut when they feel it's necessary, and there are others who always feel that an episiotomy will help, or who prescribe to the (false) idea that a cut will heal better than a tear. And forceps! I know my mama had a forceps delivery with her first baby (my brother), but she wonders now if simply changing position (i.e. SQUATTING) would have made forceps unnecessary. You don't hear about forceps as often these days, although I think a lot of doctors just use the vacuum extractors instead.

      Some of those other things you mentioned though are the reason why I originally started thinking about an out-of-hospital birth. I did not want to give birth on my back (unless that's what genuinely felt best), I wanted to be able to eat/drink, I did not want an IV, I did not want continuous electronic monitoring... so many things that are still standard in hospitals, even with all of the knowledge we have today, are really not evidence-based! It really is strange that birth centers and home birth midwives sometimes/often practice more based on science than hospitals do.

  2. I love this. I'm a birth junkie, but I don't think I new the name of a single one of these though I did know about all of them. :-) I'm enlightened!

  3. This was a goo post for me to refresh as an old nurse! Thanks :)
    Holly, thanks for stopping by! The Purification EO blend is a solid recipe, and we use it A LOT! It will help bring down the spread of germs in a family if used regularly in bathroom and kitchen. I'm glad you are learning about EOs. Keep up the good work!