NORTHWEST

NATURAL
CHILDBIRTH
A Workbook to Accompany the 9 Week Class Series
By Betsy Hoffmeister, MPA, IBCLC
Illustrated by Adam Crockett

Your Body, Your Baby, Your Birth

Copyright 2010. All rights reserved.
This workbook is a work in progress undergoing revision. Your feedback, comments, criticism and praise
are greatly appreciated. I have worked hard to cite my sources. The text contains adult language and
references to genitalia, human sexuality, and excretory processes and is thus not for the squeamish or faint
of heart.

Many thanks to Adam Crockett, for the design of my logo and all the fabulous illustrations, all of the
families who relied on me as a birth educator, doula, and La Leche League Leader, and whose stories
I share, and my Facebook pals for providing me with instant quotable quotes. Thank you Lisa Farino,
Kristie Walker and Elizabeth Fletcher for editorial feedback. David James did the copyediting, for which I
am eternally grateful.

Dedicated to my own birth partner, Jerry, my two children, Isaac and Rebecca, for gifting me with the joy
of birthing them, and to all the babies I have helped journey in this world, one way or another.

Betsy Hoffmeister, IBCLC

betsy@betsysbabyservices.com
www.betsysbabyservices.com
206 353 9334
Introduction to Northwest Natural Childbirth 9
Background 9
Northwest Natural Childbirth Class Goals 10
Class structure and format 10
Class fundamentals 11
Class 1: Basics – natural childbirth, exercise and nutrition 12
Class Goals 12
What is “Natural Childbirth” 12
Let’s talk about pain for a minute. 13
Powerful parents for a powerful birth: exercise for a healthy pregnancy 14
Foundation of a Healthy Pregnancy: Nutrition 18
Watch what you eat! 22
Homework Class 1 24
Class 2: Gestating, choosing a health care provider, breathing, communicating & sex 25
Class goals 25
Gestation 25
Breathing – you’ve had a lot of practice 25
Choosing Your Health Care Provider 26
Date night exercise 28
Pregnancy sex: Sex is natural, sex is good, not everybody does it, but everybody should 29
Homework Class 2 31
Class 3: First stage labor 32
Class Goals 32
Pre-labor 32
Labor, the real deal 34
Homework Class 3 45
Class 4: Second and third stages of labor, pushing out the baby and placenta 46
What is happening in second stage labor? 46
The “urge to push” 47
Support for the pushing phase 48
It’s a BABY! 53
Placenta birth 54
Homework Class 4 56
Class 5: The Birth Un-Plan, and What To Do When Things Get Interesting 58
Class goals 58
The Birth Plan 58
When Labor Gets Interesting 61
Making Informed Choices 64
Sample Birth Plan 1 66
Sample Birth Plan 2 67
Sample Birth Plan 3 70
Homework Class 5 74
Class 6: Burning questions, and, an overview of emergency childbirth 75
Class goals 75
Partner’s burning questions 75
Unplanned, unattended birth: what to do 82
Homework Class 6 86
Class 7: Review and rehearsal 88
Class goals 88
Test your knowledge! 88
Labor rehearsal—class activity 92
Homework Class 7 95
Class 8: No one gave us the parenting manual: the chapter about poop. 96
Class goals 96
The immediate postpartum period 96
The first few days at home 102
And what about mom? 106
Postpartum for the birth partner 117
Maintaining connection with your partner 120
Homework Class 8 122
Class 9: Breastfeeding: insert part A into part B, repeat 123
Class goals 123
A little background on breastfeeding 123
Breastfeeding basics 123
The all important “ latch” 131
Eating & the “let down” reflex 131
Nursing bras, clothes, and pads 132
Breastfeeding advice 133
Nursing in Public 134
Troubleshooting 134
Engorgement 138
Plugged ducts 139
Mantitis 140
 Sore, Cracked, Bleeding, miserable nipples 141
Too much milk 146
Not Enough milk 147
Pumped milk smells funny 148
Homework Class 9 149
Appendix 1: Reverse Pressure Softening and Manual Expression 150
Engorged nipples – Reverse Pressure Softening 150
Appendix 2: Postpartum intimacy 152
A word to the partner 152
It’s not about the sex. 154
Perineal trauma and recovery 158
Appendix 3: Safe sleep sharing 160
Advantages to sharing a sleep space 160
Safe sleep arrangements 161
24-hour Keeping track of stuff chart 163
Reminder list for moms 164
Reminder list for partners 165
Introduction to Northwest Natural Childbirth

Background
Birth is only one part of your parenting journey, but it is the most mysterious part. Pregnancy can also
take you by surprise, what with the invisibly growing small human, breasts that are newly the size of
grapefruits, areolas the size of pancakes, weird stripes running up your belly, and spontaneous mood
swings. But pregnant women are everywhere and are eager to talk to you about the minutiae of their
hemorrhoids, support hose, and the quest for the perfect car seat. It’s easy to share the experience.

Parenting also seems really obvious. We were all parented, some of us better than others. Children are
everywhere, screaming, eating gross stuff off the floor, smiling, and dribbling. Parenting support groups
abound. It’s easy to observe parenting and easy to think to yourself “I am never going to do that to my
kid!”

But birth, birth is another story. Some women will tell you way too much about their birth. Others will
look a little spacey and say “I don’t really remember. It hurt a lot.” There are nasty movies and TLC shows
of women who didn’t know they were pregnant, fourteen year olds who are pregnant, women pregnant
with quintuplets, women who have babies with massive defects. But where are the shows, the discussions,
the frank and open conversations about normal, basic, straightforward, simple birth? Birth is really hard to
envision. You’ve never done it before. And no one will tell you the straight scoop.

Birth is messy. Birth is loud, earthy, smelly, hard, sweaty, sexy, profound, powerful, terrifying, exalting,
and transformative. Birth often hurts. Birth can be ecstatic. It is always exhausting. But above all, birth is
normal.

Thank you for choosing Northwest Natural Childbirth as your gateway to birth and parenting. You had a
lot of fantastic options to choose from, and you made a leap of faith. I appreciate it. I hope that this class
is going to lift the veil of mystery and show you birth in all its messy glory.

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Northwest Natural Childbirth Class Goals
1. Empowered, powerful parents starting their journey together as a team.

2. A healthy mother and a healthy baby are always the goals of any birth.

3. Informed decision making by the mother and her partner.

4. Active involvement by mom’s partner as early in pregnancy as possible.

5. Normalizing birth to maximize the likelihood of an unmedicated, vaginal birth.

6. Mother and her partner feel they have made positive birth choices. It may not have been their first
choice, if mom opted for anesthesia or a cesarean birth, but the team made the decisions together.
Epidural and cesarean are valid, important choices. I want you to feel confident in making those
decisions.

7. Healthy, open communication between the mother, her partner, and the birth team.

8. As a team, you will be prepared to give birth with a midwife, a family practice doctor, or an OB/Gyn,
at home, at a birth center, in a hospital, or just the two of you in a Denny’s parking lot.

9. Successful initiation of breastfeeding.

10. A strong bond between mother, baby, and partner.

Class structure and format

Each week, we will review the fundamentals of a healthy pregnancy and birth. There will be plenty of
reading, in books and online, frequent written and oral assignments, physical exercises to do, relaxation to
practice, food to eat, sex to initiate (if appropriate), and some downright squirmy conversations to engage
in. This is not a sit-down, shut-up, listen and leave class. You will be called on to cook, dance, vocalize,
argue, sway, and grunt. I know you are all busy professionals. But this is the only time you are going to be
pregnant with this specific child. You deserve time out of your day to take it seriously and pay attention to
this pregnancy and this baby. It will be worth it!

Class fundamentals
1. Mental, physical, and emotional relaxation.

2. Excellent nutrition.

3. Full information allowing for informed consent.

4. An involved birth partner.

5. A powerful body -- for both partners.

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A note about terminology: in this class, birth is always referred to as birth, not “delivery.” The UPS truck delivers
packages. Doctors and midwives attend or assist. Mothers give birth. Just this change of terminology shifts the
balance of power back to where it belongs. In this text, the growing fetus will always be referred to as “Baby” or “the
baby,” and occasionally as “him.” At least in my class the laboring partner is always female, so the “he” distinguishes
the baby from the mother. The mother is referred to as mom, mother, laboring woman, she, or her… and the birth
partner is referred to as the partner. While many of my couples are married and the majority of partners are male,
many are not. I’ve taught birth partners who were the pregnant woman’s startled roommate, or her mother or sister,
and even the lesbian parents of the pregnant woman’s absent boyfriend. If you feel all husbandly and coach-ish, feel
free to use those terms yourself. It’s all good.

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 Class 1
Basics – natural childbirth, exercise and
nutrition
Class Goals
• Meet your classmates and teacher.

• Explore the concepts of “natural childbirth” and “pain in birth.”

• Demonstrate and practice basic pregnancy exercises.

• Overview of pregnancy nutrition.

What is “Natural Childbirth”

What is natural childbirth? Doesn’t it hurt too much to do it that way? What are the basic things we should
be doing now to prepare for a healthy pregnancy and birth?

Natural birth refers to the idea that women are powerfully capable of safely birthing their babies without
interference. Some OBs use the terms natural childbirth and vaginal birth interchangeably. In this class,
natural birth means a vaginal birth without anesthesia. Why, when safe drugs are so readily available,
would anyone voluntarily undergo the strain, discomfort, and pain of birth? Some major reasons why
we try to reserve the use of epidural for moms who are truly suffering in labor, rather than to use them
universally with every laboring woman:

• Birth is incredibly powerful. Moms who birth without drugs can feel like rock stars. It’s an enormous
hormonal rush. The work itself sucks, but getting it done feels so, so good. For moms who have a hard
time trusting their bodies, an unmedicated vaginal birth may be tremendously healing.

• Birth can bring couples together. During a medicated labor, everyone’s sort of sitting around waiting
for the machines to tell you when to do the next thing. During an unmedicated birth, Mom relies
heavily on her partner for support. The partner often feels deeply, intimately connected with both
mother and baby after being so involved in labor and birth.

• Unmedicated birth is good for the baby. Baby is squeezed, stretched, bathed in hormones, introduced
to good bacteria, and given the room and support to proceed at its own pace. By the time the baby is
born, it is usually prepared to breathe and eat. Baby is more ready to bond with its parents when it is
born clear-eyed and clear-headed.

• Epidural anesthesia may impact babies. A good anesthesiologist will confess to this. Others will lie
to your face and tell you that the anesthetic does not affect the baby. Postpartum nurses, lactation
consultants, and mothers will tell you that prolonged use of epidural anesthesia may cause Baby to be
groggy, have a hard time coordinating his sucking and swallowing, and be difficult to wake up to feed.

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 Epidural anesthesia can increase the risk of jaundice. Baby’s system is not equipped to metabolize
narcotics.

• Epidural anesthesia affects moms. While most moms are going to be totally fine with an epidural, a
certain percentage will experience a long lasting headache or back-ache. Some will have even more
unpleasant and dangerous side effects (more on that later).

• Epidural anesthesia sometimes interferes with the natural progress of labor. It lowers mom’s blood
pressure (but when her blood pressure goes down, she’s given IV fluids, which dilute the hormones in
her blood, making her contractions less effective – oh no! we need Pitocin®!), increases her temperature
(does she have a fever? Tests! Medicine!), restricts her to one position in the bed (no gravity—baby’s
not moving!), sometimes slows the labor (Oh no! slow labor! Give her Pitocin®! Oh no! the baby’s
heart rate got all wacky! Up the dose of anesthesia! Oh no! the labor slowed down! More Pitocin®! Oh
no! bad heart tones!! GET THE BABY OUT!!!). It’s a vicious cycle which is all too common and has
increased the cesarean rate in the U.S.

Epidural anesthesia is mostly safe and can be an extremely useful drug. By the time we are done with
class, you will know when it is the right time to choose anesthesia, and you should not feel guilty or
doubtful about doing so.

Let’s talk about pain for a minute.

Imagine you are in pain. You did thirty pushups two days ago. You have a
throbbing headache. You sprained your finger. You have menstrual cramps. What
are some things you do to cope with pain? Make a list of things you do. On this
list are things moms and dads in my classes say they do to cope with pain. Add
your own.

Advil®, Tylenol®, Motrin®, Aleve®, glass of wine…

Yell at someone, bitch, complain, whine, moan and groan. Curl up in a ball and cry.

Don’t tell anyone, suffer in silence. Acupuncture, massage, craniosacral therapy, yoga.

Deep breathing. Take the hottest possible shower or bath.

Rely on my loved one. Meditate or visualize a happy place.

Eat something really delicious to distract myself. Drink tea.

Go for a walk. Get a huge hug.

Snuggle with my pets. Pray, give it up to a higher power.

Eat chocolate. Listen to music.

Stare at a focal point. Pound on something.

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When labor hurts, it hurts for a reason. Your body wants you to change something to help the baby move
down. Pain in labor is rarely a sign of something going wrong. It usually is a sign of something – the baby
– going in the right direction.

Powerful parents for a powerful birth: exercise for a healthy

pregnancy
Giving birth is a hugely athletic event. Some people compare it to running a marathon or climbing a
mountain. But running and climbing are entirely voluntary. Giving birth is not a choice, the baby has to
come out somehow. For this to work out properly, we need:
• Mom and partner to be in reasonable physical shape.

• Baby to be lined up properly.

Certain basic exercises will help you get these stars in alignment. Both of you, try to include 30 minutes
of active cardiovascular exercise each day (what I like to call “light cardio.”) Swimming feels fabulous.
You may feel like a hippo doing ballet out of water, but underwater you may feel like a streamlined, agile
and sexy dolphin. Well maybe not sexy, but maternity bathing suits have come a long way since I first
got pregnant! Walking is also good basic form of exercise and something you can do together as a team.
Pregnancy yoga, belly dance, and step aerobics are also available.

During the labor, partners can expect to: be awake way longer than
you are used to, walk for hours, hike up and down stairs, assist her in Partner: you need to be
doing lunges, dance with her, hold her upright while she leans on you, healthy and fit along with the
have her sitting on your lap, and have her squeeze your hands, arms, pregnant mom. Yes, she has
to do all the laboring and
or neck. What might you need to do to prepare for this? Increase your pushing, but you have to do
stamina, for one thing! If you don’t currently exercise, start. Try to the walking, squatting, lean-
work your way up to 30 minutes of light cardio 4 days per week. By ing, massaging, stroking, and
the end of the pregnancy, you should also be doing 2 sets of pushups, staying awake along with her.
What are you doing to get
working out, or exercising with kettle balls at least four times per
ready? Make a list here of the
week. Anything you can do to strengthen your arms and back will physical activity you do over
help you out. the course of a week.

Write down a goal of where

you’d like to see yourself in
terms of physical fitness by
the time the baby is due.
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________

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Pregnancy exercises: At the end of each chapter, I will indicate how many of each
exercise you should be doing daily.
1. Kegel: The Kegel, or pubococcygeus muscle, is a hammock of muscles connecting the pubic bone to
the coccyx. Also known as your pelvic floor, it holds up all of your internal organs, especially your
uterus. The vagina, urethra, and rectum pass through the pelvic floor. The baby needs to glide through
this muscle group as it descends. A well toned muscle also promotes good sex and urinary and fecal
continence (not wetting or pooping your pants). The Kegel muscle helps the baby’s head get into the
proper position for birth. We’ll be doing a lot of these.

If you’ve never done one before, drink a very large beverage and wait a while. Then, sit on the toilet if
you’re a woman or stand in the yard if you’re a guy. Start peeing. Stop mid stream. If you’re a guy, try
writing the word P-E-E in capital letters. Every time you stop the flow of urine, you are tightening your
pelvic floor muscles. Don’t do that regularly, because at least in theory, stopping the flow of pee in mid
stream could cause urine to back up the urethra with infection as a consequence. Now that you have
isolated that muscle, you can play around with different ways of tightening it.

Partners: do these along with her. If you are her lover, you can help her with her Kegel exercises by
helping her test her internal muscle tone. Keep it fun, please. Guys, remember you also have a
Kegel muscle. Old men are also prone to incontinence. Some men swear that doing Kegel exercises
really improves their sex lives. You should do your Kegels too.

Repetitions: We will be doing a lot of these! Work them into your daily routine.

2. Pelvic rocking: This simple and useful

exercise can help with lots of pregnancy related
problems. It can help move the heaviest part of
the baby – its head and back – towards your
front, so that baby is facing your butt. This is
ideal. It also helps stretch your lower back, can
help relieve pressure on your intestines to aid
your digestion, and lifts the baby off your
bladder and urethra. It is similar to the “cat-
cow” yoga stretch, but without the cat part.

Rest on your hands and knees and flatten your

back. Let your head be in a neutral position. Do
not look up or forward. Slowly drop your belly
towards the floor and slowly return to a flat position. Repeat.

Partners: get down next to her and do this along side of her. If she’s having trouble, put your hand
lightly on the small of her back to show her the area she’s supposed to be working. Remind her to
do this first thing in the morning and last thing before bed, and during the day as well.

Repetitions: Start with 15 twice a day, plus a few throughout the day especially if you have indigestion
or stiffness.

15
 Tailor sitting: In the old days, tailors sat on a bench cross legged to do their work. Tailor sitting
encourages the uterus to move forward. It may help increase
circulation and should help stretch your thighs.

Sit cross legged on the floor, and lean forwards or backwards.

Switch it up, stretching your legs regularly. If you can’t
comfortably sit cross legged, at least have your knees bent and the
soles of your feet touching.

Partners: You can help her by joining her on the floor. Have a
picnic dinner, watch a movie, play Scrabble on the floor.

Repetitions: Do this exercise throughout the day whenever it’s

appropriate for you to be sitting.

3. Butterfly or legs-apart exercise: During labor, you will be

using leg muscles you are not accustomed to working on a regular basis. The Butterfly exercise helps
strengthen both your inner and outer thighs. It will help you during the first stage of labor, when many
moms experience sore, achy thighs, and right after birth, when many moms have very shaky legs.

Sit face to face. Mom might need to lean

against something sturdy. Lean back with your
knees up and the soles of your feet together.
Partner, face her. Place your palms on the
outsides of her knees. Mom, press his hands
towards the floor. Partner, just resist.

Partners: You have to be present and awake

for this one. Just apply resistance, it’s not a
contest, don’t try to win. She should be
engaging her thigh muscles without using her
abdominal muscles if at all possible.

Repetitions: Start with three per day, work your way up to ten or fifteen.

4. Squatting: Some form of squatting is the most powerful position for the second stage of labor, the
pushing stage. Your unmedicated body will naturally prompt you to get into a modified squatting
position. Squatting helps you bring the full pressure of your upper body, lungs and diaphragm down on
your uterus, opens the outlet of the pelvis by up to 30%1,and shortens the vagina. (Temporarily.) This
exercise will give you thighs of steel for the pushing phase. Most moms don’t birth in a full squat, with

1 Different resources cite different increases in opening, but, the consensus is, squatting opens the outlet of the pelvis by 1-2 cm.
The paper “The effect of maternal posture on pelvic outlet MR measurements” by Sven Claude Andre Michel et al, Depart-
ment of Radiology, University Hospital, Switzerland, 2001, shows significant difference in pelvic outlet diameter between non-
pregnant women lying down or in a full squat. They conclude “Our results show that a difference in maternal posture can result
in a significant increase of pelvic distances and thus give scientific evidence that changing position during labor can facilitate
delivery.” For a more instinctive look at this, the movie “Orgasmic Birth” shows a wide range of women in undisturbed birth all
choosing upright squatting or semi-squatting positions for birth. http://cds.ismrm.org/ismrm-2001/PDF7/2080.pdf
16
 butt down by her heels, but will modify the squat on hands and
knees, lying on her side, sitting on a birth stool, or leaning over
her partner.

From a standing position, slowly squat down until your thighs are
parallel to the floor. Slowly stand up. Over the course of the next
weeks, you will gradually work your way up to holding a squat for
several seconds. If you need support, please have your partner
face you. You will both be more stable standing on a carpeted
surface (if you’re on a slippery floor, please take your socks off
first.) If this hurts, modify the squat until it is comfortable.

Partners: If she’s going to pick something up off the floor, remind her to squat. Don’t drop stuff on
purpose or she will have an excuse to pick it up and throw it at your head.

Repetitions: include throughout your day, plus one set of squats daily as well. (Remember, you’ll get
an assignment in your homework every week).

5. Relaxation: Although relaxation is not technically an exercise, it is something all of us need to

practice. I want you to find a position that allows you to relax all of your muscles at the same time.
During labor, your goal is to be able to relax your entire body in response to your partner’s voice and
touch, giving your uterus the freedom to do its job of contracting without the rest of your muscles
fighting it. We will demonstrate one comfortable position today, but, you should experiment at home
to find the position that is most comfortable for you.

This side lying position has the advantage of

supporting all of the muscles in your body and
your uterus, too, without any work on your part. In
this position, you put very little weight on your
uterus, because you are supported with pillows.
Your partner has full access to massage everything
and monitor your relaxation. It helps with the
baby’s rotation. And, it may make contractions
more effective – translate, more intense.

Partner: help her get into this position for

relaxation practice, and if she needs your help
adjusting pillows before she goes to sleep, try not to resent the fact that there is no longer room in
the bed for you.

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Foundation of a Healthy Pregnancy: Nutrition
“Don’t eat that – you’re pregnant!” Quick, name three things you’re not allowed to eat that you really miss.
The list grows ever longer. When I was pregnant with my first child in 2000, I wasn’t supposed to smoke,
drink alcohol, or eat too much tuna. By the time my second one came along, I wasn’t supposed to eat tuna
more than what, once a month? No sushi, ditto lunchmeat, unpasteurized cheese, lox, pate, unwashed
vegetables … it felt like every meal was a minefield. Then I started reading about whole foods diets and
colorful eating and suddenly it all made sense. I’m giving you a fantastic article by Cynthia Lair, our own
Bastyr University and PCC food guru. Her words are so comforting and sensible and non-restrictive. If
you have a minute of down time and need some great menu ideas, visit her hilarious website, www.
cookusinteruptus.com for tips on whole foods eating.

Yes -- you are growing a new person, and that new person deserves a healthy diet. But, the baby will
grow no matter what you eat. You can grow a healthy baby on a diet of Froot Loops™ and Twix™, but
would really want to? Your diet impacts not only fetal development, but also the growth of your placenta,
blood, and amniotic sacs. The average pregnancy weight gain is
between 25 and 35 pounds. For most of us, that’s going to be no
problem whatsoever. If you are significantly overweight, it’s probably
Quick quiz: How many extra a good idea to moderate what you eat to gain less than 25. If you’re
calories does a woman
significantly underweight, you may need to gain considerably more.
expend during a day of
breastfeeding? That’s why it’s an average. Talk to your health care provider about
__________________________ what she feels is a safe weight gain for you if you are under- or over-
Extra bonus points: Name an weight.
exercise that would burn an
equivalent amount of calories.
__________________________
Eating Healthfully in Pregnancy
__________________________ If you follow a few simple rules, you can eat beautifully, deliciously,
__________________________ and healthfully, which will naturally lead to healthy fetal
__________________________ development, strong placenta and amniotic sacs, and normal weight
__________________________ gain. If you wish, you can follow a regimented pregnancy diet. I can
provide you with a worksheet on that. However, I prefer to trust that
you are grownups, you’ve been eating for a long time, and with a
few tweaks, you can probably be eating better during this pregnancy
than you ever have in your life. It’s a nice time to adjust your partner’s diet too. Many male partners gain
up to 15 pounds of sympathy weight during pregnancy. Immediately after birth, mom will lose a ton of
weight just from birthing the baby, then losing the placenta, extra blood, extra fluids, and amniotic fluid.
Afterwards, mom is expending enormous calories on a daily basis simply lactating. However, if you, birth
partner, are eating like a pregnant person, please don’t. Instead, eat healthfully. Remember, you need to
run that marathon right along next to her. (And the more you weigh, the harder it is to do pushups).2

2 Some moms are so queasy in their pregnancies that the term “morning sickness” seems like a cruel joke. The term “hyper-
emesis” refers to the condition of “constant puking.” Moms experiencing constant nausea will need to work closely with their
health care provider to make sure that they have adequate nutrition. Counter-intuitively, keeping your stomach full most of the
time, eating small protein-rich snacks all day long, may actually help reduce the nausea. If this is you – I’m so sorry. There are
medications available for nausea and hyperemesis. They may even help.
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Eat real food.
I have a few simple rules for eating during pregnancy. Eat more protein, eat colorfully, eat intuitively, and
eat real, whole food.

Why more protein?

Protein is the basic building block of your placenta, amniotic membranes, and extra blood, not to mention
of every cell of the baby’s body. The U.S. Centers for Disease Control simply recommend 3-4 servings
daily of protein-rich foods for the pregnant woman. Ask your care provider what they recommend for
protein intake. Animal sources of protein high in iron will help reduce your risk of anemia.

What is eating colorfully?

This is a great way to teach nutrition to children – eat a rainbow of food every day. The cheerful kid’s band
“Swingset Mamas” even has a song called “Colors of the Rainbow.”

Picking red strawberries from a field,

I eat a yellow banana with every meal
Oranges full of vitamin C,
Keeps a runny nose far away from me.

Pass the green peas if you please,

And make a mushy avocado into guacamole.
I like blueberry pancakes at breakfast time,
And sucking purple plums in the hot sunshine.3

The more intensely colored a food is, the more dense it is in minerals, vitamins, and other nutrients. Deep
colors usually indicate that a food is rich in antioxidants which may help protect your body against disease.
Richly colored foods tend to be more flavorful as well. Research shows that organically-grown foods are
more nutritious and higher in antioxidants than conventionally grown foods.4 Wild Alaska salmon and
grass-fed meats5 have more long-chain fatty acids, the kinds of fats that are good for your brain. Try to eat
a variety of colors every day. Instead of thinking, “did I eat my three servings of fiber a day,” think, “Did I
eat something green, red, blue, orange, or yellow today?” And no, Skittles® don’t count.

3 © 2006, Swingset Mamas.

4 “New Evidence Confirms the Nutritional Superiority of Plant-Based Organic Foods,” State of Science Review, March 2008,
Charles Benbrook, Xin Zhao, Jaime Yanez, Neal Davies, Preston Andrews. The Organic Center. http://www.organic-center.
org/science.nutri.php?action=view&report_id=126 While this study is published by The Organic Center and thus bias is sus-
pect, it is a meta-analysis of nearly 100 studies which should make it reliable. Alternate reports funded by conventional agricul-
ture research institutes are also available.
5 http://news.ucanr.org/newsstorymain.cfm?story=531 “Grass-fed beef has more beta-carotene, vitamin E and omega-3 fatty
acids than beef produced using conventional cattle-feeding strategies, according to a research review conducted by University of
California Cooperative Extension and California State University, Chico.”
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Eating intuitively
Part of my goal for you is to help you tune in to your body, listen to yourself and your baby, and trust
yourself that you are smart and know what you need. But, societal messages tend to override what our
body tells us. Is your body craving Skittles™? Try freeze dried berries. Desperate for Doritos™? Substitute
jicama with chili salt, or popcorn with Brewer’s yeast and sea salt. Are you yearning for a Big Mac™?
Try a serving of steak – with quinoa on the side. Subvert those urges for food with a trademark next to its
name. Convert those ideas in your head to their healthful, natural alternatives. Unfortunately, the natural
alternatives usually take a little more work to prepare. If you must have fast-moving foods, try a pho
restaurant or a mom-and-pop burrito shop instead of a fast food chain; pick up snacks at Whole Foods or
PCC instead of 7-11. Don’t be nutty and deprive yourself all the time. If you need a treat, try the darkest
possible chocolate, preferably one full of dried fruit. Dark chocolate is rich in antioxidants.

When is food not food?

Follow Michael Pollan’s advice and stay out of the center aisles of the grocery store. That’s where the
processed crap is. Try to avoid foods with unpronounceable ingredients. If your great-grandmother
wouldn’t recognize it as food, it’s probably not food.6

What are whole foods?

A “whole food” is a food in as close to its natural state as possible. Most of the food sold in the U.S. is
processed and no longer recognizable as food. That’s because there is a lot of money to be made turning
raw ingredients – soy, corn, dairy, wheat – into complex processed foods. Interestingly, these are some of
the foods most likely to cause allergies and inflammatory reactions in people, particularly in infants. (The
first ingredient in most infant formulas is soy or milk. The second ingredient is often corn syrup.)

For example, corn is food. Summer in Maryland meant putting water on to boil, running out to the
garden, picking corn, shucking it on the way back to the kitchen, boiling it, and eating it as soon as it
cooled down enough not to scorch your tongue. Most of the people indigenous to this continent depended
on corn as a staple food until Europeans came along and introduced wheat and soy. But, corn is incredibly
versatile and easy to turn into not-food.

6 http://www.michaelpollan.com/indefense.php
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 What is it?
Food? Snack Food? Not Food?

Nutrition Facts
Service Size 1 cup 164g (164 g)
Nutrition Facts
Service Size 1 tortilla 24g (24 g)
Amount per Serving Amount per Serving
Calories 177 Calories From Fat 18 Calories 52 Calories From Fat 6
% Daily Value* % Daily Value*
Total Fat 2g 3% Total Fat 1g 1%
Saturated Fat 0g 2% Saturated Fat 0g 1%
Trans Fat Trans Fat
Guess what these “foods” are. Cholesterol 0mg 0% Cholesterol 0mg 0%
Sodium 0mg 0% Sodium 11mg 0%
Which are most nutritious? Total Carbohydrate 41g 14% Total Carbohydrate 11g 4%
Dietary Fiber 5g 18% Dietary Fiber 2g 6%
Which would make a good Sugars 5g Sugars 0g
Protein 5g Protein 1g
snack? Which should you Vitamin A 9% • Vitamin C 17% Vitamin A 0% • Vitamin C 0%
avoid? Calcium 0% • Iron 4%
*Percentage Daily Values are based on a 2,000 calorie diet.
Calcium 2% • Iron 2%
*Percentage Daily Values are based on a 2,000 calorie diet.
Your daily values may be higher or lower depending on Your daily values may be higher or lower depending on
your calorie needs. your calorie needs.

© www.NutritionData.com © www.NutritionData.com

Ingredients: Ground corn treated

with lime, water, cellulose gum,
propionic acid (to preserve
freshness), benzoic acid (to
preserve freshness), phosphoric
acid (preservative), dextrose, guar
gum, amylase.

Nutrition Facts
Service Size 1 kides order 282g (282 g)
Nutrition Facts
Service Size 1 tbsp 19g (19 g)
Nutrition Facts
Service Size 1 ounce 28g (1 ounce (28g))
Amount per Serving Amount per Serving Amount per Serving
Calories 123 Calories From Fat 0 Calories 53 Calories From Fat 0 Calories 145 Calories From Fat 70
% Daily Value* % Daily Value* % Daily Value*
Total Fat 0g 0% Total Fat 2g 0% Total Fat 8g 12%
Saturated Fat 0g 0% Saturated Fat 0g 0% Saturated Fat 1g 5%
Trans Fat 0g Trans Fat 0g Trans Fat 0g
Cholesterol 0mg 0% Cholesterol 0mg 0% Cholesterol 0mg 0%
Sodium 0mg 0% Sodium 0mg 0% Sodium 172mg 7%
Total Carbohydrate 31g 10% Total Carbohydrate 14g 5% Total Carbohydrate 18g 6%
Dietary Fiber 0g 0% Dietary Fiber 0g 0% Dietary Fiber 1g 6%
Sugars 31g Sugars 5g Sugars 0g
Protein 0g Protein 0g Protein 2g
Vitamin A 0% • Vitamin C 0% Vitamin A 0% • Vitamin C 0% Vitamin A 0% • Vitamin C 0%
Calcium 0% • Iron 0% Calcium 0% • Iron 0% Calcium 5% • Iron 2%
*Percentage Daily Values are based on a 2,000 calorie diet. *Percentage Daily Values are based on a 2,000 calorie diet. *Percentage Daily Values are based on a 2,000 calorie diet.
Your daily values may be higher or lower depending on Your daily values may be higher or lower depending on Your daily values may be higher or lower depending on
your calorie needs. your calorie needs. your calorie needs.

© www.NutritionData.com © www.NutritionData.com © www.NutritionData.com

Ingredients: Carbonated Water, Ingredients: Light corn syrup, high Ingredients: Whole White Corn,
high fructose corn syrup, caramel fructose corn syrup, vanilla. Vegetable oil, and Salt.
color, phosphoric acid, natural
flavors, caffeine.

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Watch what you eat!
If you eat a superb diet, good for you. Skip this next section. However, if you have questions about your
diet, observe your food intake for four days. It doesn’t have to be four days in a row, just four sample days
out of the next week. Both partners can try it. Feel free to use the excel spreadsheet I slaved over, or write
it on the back of receipts or put it in your iPhone. I don’t care, because the interesting part comes at the
end.

Evaluate yourself. Here’s how you score. Use the Department of Health and Human Services/National
Institutes of Health “serving size chart.” Every time you eat a serving of the following types of foods,
give yourself points. Foods may count multiple times.7 In addition to these basic foods, cook with healthy
fats and oils. Cynthia Lair prefers butter, ghee, unrefined coconut oil, cold-pressed extra virgin olive oil,
unrefined sesame oil, and for high heat cooking, expeller pressed grapeseed, safflower, sunflower, or
peanut oil. (Note to self: stop buying canola oil). Good fats aid in growing stretchy skin and enable the
absorption of fat-soluble vitamins A, D, E and K.8

Food Type Number of Points To Award

Yourself
Green, red, orange, yellow, or purple foods 10

Whole grains: Popcorn, quinoa, whole wheat or corn tortillas, whole grain bread, 5
whole grain cereal. Read those labels, though. I am looking for foods that are high in
fiber and NOT full of added chemical-derived vitamins! Oatmeal, not whole grain
Froot Loops®!
Beans, tofu, nuts, eggs beef, chicken, fish, turkey, cheese, yogurt, cottage cheese, or 10
another type of protein
Calcium foods: almonds, milk, cheese, yogurt, broccoli, bok choy, etc. 4 (yes, you get to count these foods
twice)
Water: for each glass of water or cup of non-caffeinated tea you drink per day (be 3
careful with juices, which convert to sugar very rapidly)
Dark chocolate 1
Snack foods: fried, fatty, or sugary non-food Minus 5
Soda: for each soda, sports drink, or sugary drink Minus 10
White rice, white bread, white pasta Minus 3
 

7 If you are having trouble with nausea or vomiting, consult your health care provider and disregard this exercise.
8 Go to www.cookusinterruptus.com and search for cookus cupboard, fats, oils & vinegars for a funny video and overview.
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Before getting out of bed
Cheese stick 10 protein+4calcium=14
Breakfast
Corn tortilla, eggs, salsa 5 whole grain+10 eggs+10 red
vegetable=25
Tea 3 liquid
Snack
Handful of almonds & raisins 10 nuts+10 fruits=20
Water 3 liquid
Lunch
Grilled cheese on whole wheat bread 4 calcium+10 protein+5 whole
with tomato slices grain+10 red vegetable=29
Apple 10 fruit (red/green/white, does that
count triple?
Satsuma 10 orange fruit
Baked sweet potato 10 orange vegetable. Surely worth extra.
Two pieces leftover fudge (small pieces) -5 whoops, but so yummy
Water 3 liquid
Snack
Apple with almond butter 10 fruit+10 nuts=20
Bowl of corn tortilla chips -5 snacks, needed something crunchy…
Ten dried apricots 10 orange fruit
Water 3 liquid
Dinner
Grilled Salmon 10 awesome protein
Sauteed kale 10 awesome green vegetable
Salad 10 green veg again! I rock!
Quinoa 10 awesome non-animal protein!
Lemonade -10 It was really good.
Fruit salad (contained blueberries!) 10 fruit
Dark Chocolate covered pomegranate – 1 dark chocolate+1 fruit. Sort of.=2
c’mon, it’s practically health food!
Snack
Popcorn (air popped, with olive oil & sea 5 whole grain
salt)
Water 3 liquid
Total 200 (Yay, I rock).

Comments: rocked the orange fruits and veggies today. Decent whole grains.
Coulda done better with the green foods. Salad for lunch tomorrow? Send fudge to
work with Jerry, concentrate on chocolate covered pomegranate. It’s GOOD FOR ME!
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Homework Class 1
Get a copy of Ina May’s Guide to Childbirth by Ina May Gaskin, The Birth Partner by Penny Simpkin9 and
The Womanly Art of Breastfeeding, 8th Revised Edition. If you are not confident in your choice of health
care provider, pretty please borrow and read Your Best Birth by Ricki Lake. The Baby Book by Dr. Sears is
bar-none the best infant-to-two baby care book on the market. All of these are available at the library and
used. Please watch Ricki Lake’s The Business of Being Born. It is a great background to our class.

Reading: In Ina May’s Guide to Childbirth, read as you wish from Part I. In Part II, read the Introduction,
and Chapters 1, 2, and 3 and p. 187-190. In The Birth Partner, read Part I.

Workbook: Review workbook class 1, fill in blanks. Review workbook class 2. Go on a date together
and do the “Date Night Exercise” on p. 28. This is meant to be thought provoking for you both!

Food: Bring a vegetarian food to share that contains eggs. Please don’t all bring hard boiled eggs. Rather,
eggs can be in muffin batter, egg fried rice, salads, etc. Email the rest of the group to coordinate so there’s
minimal duplication. Keep track of your intake for four days this week (days need not be consecutive).

Relaxation: Spend ten minutes per day in relaxation together.

Physical exercise:
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
20 Minutes Cardio
2 Sets 20 pelvice tilts
3 butterflies
5 Squates
5 sets 10 kegels
Relax together 10
minutes/day
Partner: pushups. Set
your baseline!
Monitor Diet

9 Notes on the books: Ina May’s Guide to Childbirth is written by the preeminent midwife of our time, Ina May Gaskin. Ina May
is absolutely a hippy. Do NOT let this turn you off if you are not a hippy. Her birth statistics are better than any other health
care provider in the entire country! I insist on this book because it normalizes birth and because her discussion of how the body
works in pregnancy and labor is the best I have ever read. Recognize that she works in Tennessee, where the medical establish-
ment is not birth friendly. We are operating in a much friendlier hospital environment, in general. Most of the book will make
you feel happy about birth. Used copies are available for about $10. I don’t know why, maybe it’s because people love it and
don’t want to pass it on.
The Birth Partner is comprehensive and factual (some find it dry). Penny Simpkin is our local birth guru, doula, and educator.
It’s an excellent guide for how labor works, but more importantly, what the partner should be doing throughout pregnancy and
labor. The book does emphasize what a doula can do for you. If you are not interested in hiring a doula, ignore those bits. Doz-
ens of copies are available used through amazon.com for as little as a penny per copy with $4.00 shipping.

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