Tuesday, July 15, 2014

Norah's First Two Days

Life as a family of five is so wonderful.  But let me back up and share the first couple of days of Norah's life in our world.

I expected her to arrive before her due date.  So by the time her due date came, I had already spent two weeks thinking "maybe today is the day!"  The mental and emotional game is tiring.  I'd been having prodromal labor (or "false" labor, as some people call it), and of course every time the contractions would get regular, I would hope that they would kick into active labor.  This happened off and on for over a week.  So on Thursday, July 3, after a night of waking up many times due to somewhat painful contractions, I was frustrated that they had petered off.  Again.  I went to lunch in the park with a group of friends, and tried to be cheerful.  I just. wanted. to hold. my baby.

I started having some "cramping" at around 4pm. I'd just gotten back from the doctor's office, where the on-call doctor had performed a simple procedure that sometimes nudges women into labor. "I don't know why you're not in labor," he said. "I bet you'll have this baby before the weekend."  Of course being an entire two days past my due date, I was sure that the baby was just going to wait two more weeks to give me a lesson in patience.  So when the "cramps" started coming in "waves," I couldn't shake the mindset that they were just going to taper off.  Again.  I'm glad math is straightforward, because when I timed my cramps, it finally occurred to me that they looked an awful lot like contractions.  Then I realized I was breathing funny and couldn't talk.  It finally sunk in that I might actually be in labor.  My biggest decision was whether or not to summon my sister.  It's a 2 1/2 hour drive, and I didn't want her to make the drive just to have my contractions disappear.  But I texted her.  "I'm going to feel horrible if nothing happens."  I was still in denial.  But somehow I had the sense to call my mom, who was in town.  And I texted Bryan.  "I think I might be in labor.  But I don't know."  He was home within 10 minutes, and rushed around checking things off my list of things I wanted to bring to the hospital.  My camera.  The gift basket for the nurses.  My phone charger cord.  He called the Family Birth Center to let them know we were on our way.  "She's going to want an epidural," he said.

We pulled up to the hospital at about 5:30 pm, and everything was so surreal.  I'd been imaging this moment for so long.  We walked in, and I smiled and gave hugs to the nurses I'd gone to school with.  They got me to my room, and were surprised how much labor had progressed.  "Wow, you don't look like you should be this close to delivery," Jen said. They started scrambling to get everything in order.  The baby could come pretty fast, and if I wanted an epidural, they had to hurry.  Yes yes, I did want the epidural.  While the IV fluids poured into my circulatory system, Betsy showed up with her camera and one-week-old baby Daniel in tow. 

The IV fluids did their thing, and Deb, the anesthetist, did her thing.  I was surprised how little the epidural hurt.  I think the other pain surging through my body might have had something to do with that.  The nurses were changing shift, and Marilyn asked, "did you feel that contraction?"  I had done my Labor and Delivery preceptorship with her eight years ago.  She was just as wonderful now as she was then. "What contraction?" I asked, as a smile spread across my face.

I laid back in bed and relaxed.  I had no pain.  None.  Zero.  They say an epidural usually provides about 70%  pain coverage, but I got all 100%.  It was wonderful.  It was amazing.  I couldn't quite believe that I was still in labor, but the monitor showed nice, regular contractions.

My body slowed things down a little, which was great, because my sister got stopped at a crash for a while.  When she finally showed up, it felt like a party or something.  My friend from church, Melissa, stayed long after her shift was over to be there with me.  ("I told you you you were going to have this baby on Thursday!" she insisted.)  I was laughing and joking with everyone.  Dr. Minudri, true to his word, had come to check on me.  I was so excited that he was there, that I knew and loved the nurses and CNA taking care of me, that Betsy and Katie had made it, that I wasn't in horrible pain, that my mom was home with my other girls, that Bryan was there to hold my hand, and most of all, that I was going to get to meet my baby soon!

It was a completely different experience than the wonderful births I'd had at home.  I loved my home births, but in these moments, I felt like a million bucks.  "So, uh, if we have more kids, we're doing an epidural again, right?" Bryan asked.  It was a completely new experience for him as well.  With my first labor, he spent the final eight hours pushing on my back with all his might.  His arms didn't really work the next day.  "I think probably so," I said, laughing.  Laughing!  When labor was nearing the end!  It was pretty great.

And then it was time to push.  She had been in optimal anterior position for the prior eight weeks, but Baby decided to flip posterior sometime while I was in labor.  Despite that, I only had to push for a half hour.  But her forehead and face were a little smushed when she came out sunny-side up, at 10:38 pm.

But she was here.  She came.  Norah.  She was perfect.

I started crying.  Flooded with so many emotions, the tears just rolled down my cheeks. 

She looked like a beautiful little gnome-frog-lion cub baby.  Her forehead and face were pretty squished, but she was our perfect baby girl.

Bryan couldn't stop smiling, either.

After a good long while of snuggling my baby, they measured and weighed her.  7 pounds, 12.7 ounces.  We rounded up to 13.  And 21 1/8 inches long.  We rounded down to 21.

We eventually made our way into our post-partum room.  Bryan settled down in the fold out loveseat-to-bed.  It was actually my first experience being the patient.  I had a wrist band on, and I was the one in the hospital bed.  But it wasn't the mediocre mattress that kept me awake all night.  It was the joy.  I was just too excited to sleep.  I held my baby close to my heart, and stroked her soft skin and smelled her sweet smell.  I dozed off from about 3:30 to 4:30, but then the sun started rising.

I had my iPhone close, and I needed to tell the world that she was here.  So I took a few pictures of her first glimpses of daylight, and let the world know that she had arrived.

Holding her, waiting for family to arrive to meet her.  I was so excited to introduce her to her sisters.

About 12 hours old, Norah meets Chloë and Elaina for the first time.

Thanks Jessie, for getting a little footage of this special introduction.

Bryan's parents holding their fourth grandbaby.  I'm just sorry we didn't get pictures of everyone holding her. 

After everyone went home, we rested some more.  I even took a little nap while Bryan snuggled Norah. 

The nurses and staff were wonderful.  I was afraid that I might find a hospital setting annoying after the comfort of my own home, but I didn't.  We had room service and ordered whatever we wanted off the menu, the nurses only came in to to check on us a couple of times, and we had a nice little "candlelight" dinner before we went home.

As wonderful as the hospital was, I was glad to be home.  Home... with all three of my girls and my wonderful husband.  God is good.

Photos compliments of Betsy Becker, Katie Botkin, and my and Bryan's iPhones.

Monday, July 7, 2014

Norah Katherine Blakey

Norah Katherine Blakey was born on Thursday, July 3, at 10:38 pm.  She weighed 7 pounds, 13 ounces, and was 21 inches long. 
10 hours old. 

Crinkly skin still adjusting to our world.

We were surprised by how blond she is.  Her eyelashes are platinum, along with the downy lanugo that covers her ears, back, and chubby shoulders.  Her hair is sandy blond, and I'm curious to see how much it will change.

She was born two days after her due date, and I was having a difficult time remaining patient.  My body launched into labor on Thursday afternoon, we hurried to the hospital, and after seven hours (and a glorious planned epidural), she was in our arms.  Everything went wonderfully, and of course we absolutely love her.  More details and pictures coming soon!

Thursday, June 26, 2014

Friends Pregnant

I've been meaning to touch on this subject since that wonderful day way back in October.  We had just found out that we were pregnant, and it was bittersweet telling some of our best friends, since we knew they wanted more kids, too.

Well wouldn't you know it, God had a beautiful plan for this story, too.  Three days later, Betsy got a positive pregnancy test, too.  We were both overflowing with joy, in case you can't tell.

It's been such a crazy, fun, blessed experience being pregnant together.  Encouraging each other through the morning sickness, praying for each other in moments of uncertainty, celebrating clothes that no longer fit, sharing pregnancy cravings, knitting and crocheting baby blankets together, guessing which one of us will get to hold our babies first, and rejoicing together in every good appointment and ultrasound. 

A few months ago, I texted Betsy and mentioned that I was craving the Lettuce Wraps from one of our favorite restaurants in Pullman.  Just the mention triggered the same craving for her, and she ending up driving the half hour round trip to get a double order, and brought it to my house where we indulged our cravings together.  True friendship right there.  We shared a lot of similar cravings, as well as lack of desire to be in our kitchens at times. 

This last Saturday, our husbands spent the day with the kids, and Betsy and I took ourselves out for a day of pampering. We got coffee at Bucer's, and then got pedicures, which was actually a first for me.  Then we went out to lunch at Bloom, and hit the mall to get smoothies and shop for post-partum clothes.

Later, after a picnic dinner from the Co-op, I realized we needed a few pictures together.  I drug Betsy over to a brick wall, and handed Bryan my iPhone.  I was pleased with the results from our impromptu 60 second photo shoot.

I'm really excited about today.  Because Betsy is in labor.  I guess she beat me to it.  But that's okay, because I'm so excited that I get to hold her baby in a little while.  God has been so kind to us, and today is a day of great rejoicing.

Tuesday, June 24, 2014

39 Weeks

Now that this pregnancy is almost over, let me fill you in on how things have been going for the last four months.  What a roller coaster pregnancy can be.  The morning sickness was rough at first; I lost weight, and looked old and tired.  I was surprised how much the malnutrition and dehydration showed up on my face.  Then weeks 15 through 32 were pretty good, considering.  I actually had an appetite, gained weight, slept decently, and kept up with life. 

14 1/2 Weeks
19 Weeks

With each of my pregnancies, my babies have seemed more active.  Maybe because things are more elastic, and baby has more room to squirm around.  And with this pregnancy, my placenta is posterior, which means there isn't that extra cushioning against my belly that I had with the other girls.  Whatever the reasons, I've never seen this much movement so early in pregnancy.  This was a day before 22 weeks, and she weighed about a pound.

I've been fighting the migraines, despite my best efforts to follow my own advice. When I was safely into the third trimester, I agreed to try codeine. The first time I took it was good. It made me feel a little groggy, but drastically decreased the pain in my head. Then the second time I took it, my body decided it didn't like it. I started throwing up. I had started the day with coffee and cereal (and just happened to weigh myself, since I try to do that occasionally when I'm pregnant), and then promptly kept nothing down for the entire day. By 9 pm, I realized my body must be severely dehydrated, and told Bryan that we needed to do something. So for the first time in my life, I had IV fluids. As the beautiful saline dripped into my veins, I became less thirsty. It was glorious. I threw up a few more times, but was able to get some sleep that night. The next day around noon, it occurred to me to see what my weight was. I was seven pounds lighter than I'd been about 30 hours prior. And I'd been keeping things down for a while. That was a rough run.  I haven't touched codeine since, and even told my doctor to list it as an "allergy."  So I have good ol' hydrocodone that I've taken a couple of times now for migraines.  What a blessing to experience some relief after months of toughing out the pain.
Me: 19 weeks, 5 days.  Jessie: 39 weeks, 6 days.
27 Weeks
My other girls never really hurt me like this girl has in utero.  I have been surprised that her kicks and jabs have actually caused me to double over in pain.  She did something at about 32 weeks that made me gasp for breath and stop in my tracks and lean on whatever was available.  And then I was actually sore in that spot for a couple of days.  Crazy kiddo.  More recently, she just tries to stretch out, and actually makes my ribs sore!  I'd heard of such things happening, and now I can empathize.  

This was at 30 weeks.  It seems like a long video, but she did this for about an hour that night. 

34 Weeks.  Enjoying a "hot" day in May.

As the baby (and my belly) got bigger, I started developing some pretty decent pelvic and hip pain. Bones shifting and muscles pinching nerves and all that good stuff. I found myself mostly confined to bed or the couch, and increasingly frustrated with my limitations. I even swallowed my pride and rode one of those little electric carts around Walmart. One particularly rough day at about 33 weeks, I decided to see what insurance would cover for a chiropractor. I saw Dr. McKenzie, and was so impressed with his holistic approach and the moderate pain relief I experienced. I always feel selfish spending money just to relieve pain, but ohmygoodness, three chiropractor appointments and a deep tissue massage made me feel like a new woman. I went from basically being crippled to being able to complete basic household chores with no pain! This last week has been so wonderful compared to the previous month. I've actually been able to do normal "nesting" things, like painting a dresser for the baby, organizing my pantry, and doing some deep cleaning.

34 1/2 Weeks
37 1/2 Weeks

I posted the most recent photos a few days ago.

Besides the pain, occasional headache, not-so-great sleep, occasional nausea and random throwing up, and heartburn, this pregnancy is really going pretty well.  (I'm currently using nine pillows at night to create the perfect little nest of pseudo-comfort.)  Baby has been head down for weeks, and usually anterior (with her back against my belly), which is where we want her to be. My weight, fundal height, blood pressure, lab results, and baby's heart rate have all been great.  I think it's funny that my weight has been exactly the same at the beginning and end of all three pregnancies, despite all of the variations in detail.  Last week Dr. Minudri said he would be happy to deliver, even if he's not on call. The other doctors in his practice are great, but I've been particularly impressed with everything I've seen and heard about him specifically, and am really relieved to know he's willing to be there.  Even though I've done with whole labor and delivery thing twice already, mentally preparing to go to a hospital feels like totally new territory.

The cute little newborn clothes are washed and waiting. I've been having some nice little Braxton-Hicks contractions, and my body is showing little hints of preparing to have this baby.  So now we wait.  We're all ready.  Any day, Baby Girl.  We can't wait to meet you.

Monday, June 23, 2014

I can't wait to wrap her up in this, Chapter 3

I finished crocheting Baby's blanket yesterday.  Now we really are ready for her arrival.

And now I've made each of my daughters a baby blanket.  It's not fancy yarn, but I'm glad to have a little tradition that I can keep up with as I have less free time with each child.
Chloë's, Elaina's, and Baby Sister's.  I ran out of the lavender yarn about 15 stiches short of finishing the last row, so I just pulled it out.  So it's not perfectly symmetrical, which of course bugs those pesky OCD tendencies.  Oh well.  I don't think Baby Sister is going to care. 

Saturday, June 21, 2014

38 Weeks

Mama, age 30, and 38 1/2 weeks pregnant.  Chloë, age 4, and Elaina, age 2.  Bryan took a few quick pictures yesterday, so now the full term baby bump has been documented.
It's fun looking at similar photos from almost 2 1/2 years ago.

Wednesday, June 4, 2014

Fish Tacos

For Chelsea.  Because no one better understands a pregnancy craving than a pregnant lady.

I love fish tacos.  Easy, healthy, inexpensive, and delicious, these are a huge hit in my kitchen.  This seems to feed 4 adults, so adjust as necessary.

You'll need:
1 lb fish.  I use thawed formerly frozen tilapia, but any fish will work.
2-3 cups of finely shredded cabbage
Diced tomatoes
Corn tortillas

For the sauce:
1 cup plain yogurt
1/3 cup mayo
1 tsp lime juice
1/2 tsp cumin
1/2 tsp chili powder
1/2 tsp dried dill
1/2 tsp oregano
1 tsp minced capers

Lay fish fillets on a cookie sheet, sprinkle both sides with a few drop of lime juice, and a little cumin, chili powder, and salt.  Bake at 375 until done.  Tilapia only takes 12-15 minutes.  You can find recipes to batter and fry your fish, but I'm just as happy with the easy baked version, so that's what I do.  While the fish is baking, mix up the sauce and make the slaw.

To make the sauce, mix together sauce ingredients.  You can use more or less yogurt or mayo, and can always substitute sour cream if needed.  The capers aren't essential, but add a nice little undertone.  You can also add garlic, cayenne, or salt, depending on your preferences.

To make the slaw, mix about a third of the sauce with the shredded cabbage.  Add a few extra drops of lime juice, and a sprinkle of salt.

After the fish is done baking, use the warm oven to liven up the corn tortillas.  Grab as many as you think will be consumed (10 or so, maybe), and get them thoroughly wet.  Shake off excess water, and pop them in the oven (straight on the rack) for about 60 seconds.

Serve immediately.  I break up chunks of fish onto my tortillas, and then top with a hefty dollop of sauce, then the slaw, tomatoes, salsa and cilantro.  Pairs well with a Corona or margarita.  Enjoy!

Tuesday, April 29, 2014

Pregnancy and Migraines

Every couple of months, someone asks me for my advice on what I do for migraines during pregnancy.  I finally decided to put everything in one place; hopefully nice and neat and not too long, boring, or confusing.  So here goes.

I've suffered from migraine headaches for as long as I can remember. When I was in my early teens, they became a regular and frequent part of my life.  I remember lying in bed all day in my dark bedroom, trying not to cry, because the stuffiness from crying just made the pain worse.  Some of my grandparents, both of my parents, and all four of my siblings get migraines too.  When a medication called Imitrex was invented, all of our lives experienced drastic relief from the plague of migraines.

Then I grew up, became a nurse, and got married.  When my husband and I decided to start a family,  I knew that Imitrex wasn't safe to take while pregnant, so I wasn't sure what I was going to do. 

Understanding what a migraine actually is is helpful in understanding our treatment options.  A migraine is defined as "a severe recurring headache, usually affecting only one side of the head, that is characterized by sharp, throbbing pain and is often accompanied by nausea, vomiting, sensitivity to light, and visual disturbances."  The physiology of a migraine is complicated, but we know that it involves the blood vessels and nerves threaded through the brain. Blood vessels and nerves usually run right next to each other, and during a migraine, the blood vessels are dilated (expanded), and so they push on the nerves that they're next to.  And nerves just don't like to be messed with, so they get all inflamed and cause a fuss.  Meaning a horrible migraine.  Understanding this concept is really helpful when trying to figure out what to do to make a migraine go away.  Some medications, like Imitrex, can actually stop what's causing the migraine.  It's complicated, but essentially, the medication helps to constrict (or narrow) the blood vessels in the brain, which means they stop pressing on the nerves they're next to.  Basic "pain meds" just help block (or at least dull or turn down) the signal of pain, which is nice, but doesn't really fix the problem.  Drugs like Tylenol and Advil don't help much (although NSAIDs like Advil usually help a little more than Tylenol because they have an anti-inflammatory component, which can help relieve some of the pain-causing pressure on the nerves).  Stronger opioid prescription pain meds like Codeine or Hydrocodone (also referred to as narcotics) do a better job at blocking that pain signal.  They basically numb or dull the sensation of pain.  Which can be nice, but they don't actually solve the problem that is the migraine.

Unfortunately, we don't know much about how Imitrex (and other sumatriptans) affect a growing baby during pregnancy.  It is classified as Pregnancy Category C (look at this if you aren't familiar with Pregnancy Categories), and research shows "in developmental toxicity studies in rats and rabbits, oral administration of sumatriptan to pregnant animals was associated with embryolethality, fetal abnormalities, and pup mortality," especially during the first half of pregnancy. That's enough information for me to steer clear of the stuff, especially during the first and second trimesters.

Now that I'm 3/4 of the way through my third pregnancy, I have experienced a lot of migraines during pregnancy.  I've longed to take one of those little magic Imitrex pills, but in my opinion the risk just doesn't outweigh the benefit, even when the migraines are so bad that I'm awake all night throwing up.

Ways to Treat the Migraine
I usually find the best relief when I combine most of these tactics.  When I feel a migraine coming on, I usually ask my husband to rub my neck, take Tylenol, drink coffee, sip Powerade, take a hot and cold shower, and rest.  I usually get at least some relief, and sometimes I can actually get a migraine to go away.

Tylenol and Caffeine
Although Tylenol (Acetaminophen, also abbreviated APAP) is one of the few drugs considered safe to take during pregnancy (Pregnancy Category A), it should still be taken with caution.  Taking more than four doses of extra strength Tylenol in 24 hours can cause liver damage.  And if something is damaging your liver, it's probably not good for a developing baby.  Caffeine has not been formally assigned a pregnancy category by the FDA, but there are warnings about using it during pregnancy, especially during the first trimester.  Those warnings are usually about how caffeine is a vasoconstrictor, which means not as much blood is going through your blood vessels to your placenta, which means the baby is getting less of what he or she needs from you.  But the vasoconstriction is exactly why caffeine can help migraines.  It causes vasoconstriction (making the blood vessels in your brain shrink down), which relieves that horrible pressure on the nerves causing all the trouble.  In fact, Excedrin Migraine is a medication that has Tylenol, caffeine, and Aspirin.  I would just be tempted to pop a couple of Excedrins, but Aspirin is Pregnancy Category C, which I don't want to take. 

So I take two Extra Strength generic Tylenol (1000mg total of Acetaminophen), and make a double or triple shot of espresso.  Or sometimes I nudge my sweet husband in the middle of the night, and he lovingly gets out of bed to make me coffee: a triple shot espresso, with just a little sugar and cream to cool it down and make it palatable.  If I'm nauseated from the migraine, it's really hard to actually drink (or smell) coffee, but room-temperature espresso is easier to stomach than hot.  Since Tylenol by itself doesn't really help with migraine pain, you may wonder why I bother.  Because caffeine is a stimulant, it can boost the effectiveness of pain killers by 40%.  Which isn't magical, but every little bit helps.

The flip side of this fix is that caffeine actually makes migraines worse for the occasional person or particular headache.  Especially if you're already dehydrated.  Since caffeine is a diuretic, it can make you more dehydrated than you already are, which can make your migraine worse.  Not good.  Also, coffee contains small amounts of tannins, which is a compound that has been known to cause migraines.  This is what I call a bummer.  Or a catch-22.

Hot and Cold Shower
I've been using this treatment for years (even when I'm not pregnant), and it can really help.  When I have a migraine, I have to drag myself to the shower.  Then I get the water nice and hot, and let it blast the back of my head, neck, and shoulders for a couple of minutes.  Then I turn it to cold.  Not all the way, because I can't stand it, but almost.  Then I let the cold water blast the back of my head, neck, and shoulders for about 30 seconds.  Then I go back to the hot water for 30 seconds.  Then back to the cold for 30 seconds.  Back and forth for about five minutes: five hot cycles, and five cold cycles.  A little longer, if I can stand it.
Basically, I'm messing with my blood vessels, trying to shock them into some state of normalcy.  Now this sounds strange, but that's the best hypothesis I've got.  Cold constricts blood vessels, and heat dilates them.  For some reason this back and forth can help a migraine to go away.  Not completely the second I step out of the shower, but I usually experience a good amount of relief, and sometimes within a half hour or so, my migraine is greatly improved. 

Some research has shown that having low magnesium levels may be related to the occurrence of migraines.  One small study showed that people who started taking 600 mg of magnesium a day reduced the frequency of their migraines by 41%.
Some data suggests that magnesium is difficult to absorb when your body is already raging with pregnancy hormones.  (Vitamin D, Vitamin B6, Vitamin B12, and a little calcium are essential for magnesium absorption, so it's good to make sure you're getting those, too.)  Even so, I'm not suggesting you start popping magnesium like candy.  It can cause diarrhea.  Lovely.  And other problems.  However, I did some research and decided to try topical absorption.  Meaning, you put the stuff on your skin, and it absorbs into your bloodstream and goes where it needs to go, without upsetting the gastrointestinal tract.  Some people use magnesium oil.  However, it isn't actually oil at all; just water highly saturated with magnesium chloride salt.  And it's pretty expensive.  A friend said it's easy (and a lot cheaper) to make your own, so I bought a spray bottle and some magnesium bath flakes (which is magnesium choride salt!), and did just that. 
I started using a little every day in the first trimester of this pregnancy, and had a drastic decrease in the number (and longevity) of my migraines. I'm a believer.

Also.  Epsom salt actually has a lot of magnesium in it.  So when I get a migraine, sometimes I pour about a cup of cheap Epsom salt into a bath, and soak for a good long while to let some of the magnesium absorb into my body.  And of course relaxing the muscles in the neck and upper shoulders are good for relieving some of the pain.

I discovered that Powerade has magnesium, but Gatorade doesn't.  From the labels I've read, most Powerades also have Brominated Vegetable Oil, sometimes called BVO, which is used as a flame retardant, and something I try to avoid putting in my body while pregnant.  But, the "white cherry" flavor of Powerade doesn't have BVO.  So I keep a few bottles of that in my pantry, and open one when I feel a migraine coming on.  Maybe there's a larger electrolyte imbalance going on in my body, but sipping a Powerade has actually eased a few of my migraines.  And even if it doesn't actively help, I figure hey, the extra electrolytes will be great if the migraines gets to point where I start throwing up.

Bonuses of taking magnesium: it can help with morning sickness, as well as restless leg syndrome.  That's three times for the win!

Vitamin B2, also called Riboflavin
I need to add this supplement back into my life.  I tried taking B2 regularly in high school, but didn't notice an improvement in my migraines, so I stopped.  That was half my lifetime ago, and I'm sure my body and brain have changed a little since then.  Another small study showed a 50% improvement in migraine occurrence when 400 mg of B2 was taken regularly.  So it certainly might be worth trying.  

Chiropractic Care
I haven't actually tried this, but I have a couple of friends that will testify that regular neck adjustments almost cured them of their migraines.  Part of the reason I haven't tried this option is simply financial.  Our insurance won't help pay for such things, and seeing a chiropractor once or twice a week would get really expensive really fast.

A good massage to the neck and shoulders feels so good when I have a migraine.  Again, visiting a masseuse isn't cheap.  But my husband has been practicing on my neck and shoulders for eight years now, and even a ten minute massage can help.  It doesn't exactly cure a migraine, but it does give me some pain relief.  And if I can have him rub my neck and shoulders when I feel a migraine coming on, I think it has actually helped make it go away.

Perscription Pain Meds
This is where we really get into controversial territory, since narcotics are considered Pregnancy Category C.  If used regularly, they jump over in the D category.  Some medications are considered a little bit safer in the third trimester; once the baby is past the super development stages.  Resorting to narcotics is something I did not do during my first two pregnancies.  But at my appointment with my doctor two weeks ago, I was curious what she had to say about Imitrex and the third trimester.  I wasn't surprised that she said she wasn't comfortable with it, but then we discussed how Codeine or Hydrocodone would probably be a better option-if used very occasionally.  I thought about it, and decided I would be okay with that.  I filled my prescription, and within the week, woke up throwing up with a dreaded migraine.  Two days shy of 30 weeks gestation, I hesitantly took a codeine and a triple shot espresso.  I was so happy when I could feel it numbing my pain, and I went from bedridden to functional (but still with some pain, and a little groggy).  I understand that some people are not comfortable with this option, even in the third trimester, but you should do your own research and talk to your doctor about this one.

Triggers to Avoid
During my second pregnancy, I started figuring things out, and realized that there were some very specific things that triggered migraines during the hyperhormonal state of pregnancy. When I'm not pregnant, I can usually get away with small portions of these things.  But when I'm pregnant, my brain is just more sensitive to these things, and I do my best to avoid them.
There are many other substances and circumstances that may contribute to migraines (extreme changes in temperature, bright or flickering lights, strong smells, etc.), but these are the biggest triggers for me. 

The biggest trigger for me is monosodium glutamate. And not just MSG, but all of it's "cousins."  I found a really helpful list that shows what other ingredients technically aren't MSG, but are similar enough that they act like it: they make food extra savory, and they give me migraines.  Just because a package boasts "No MSG!" doesn't mean it doesn't have one of those other sneaky chemicals in it.  After much experimenting, I've discovered that anything in the first column of that list will straight up give me a migraine when I'm pregnant.  Which means that I read everything with a label.  Sweet stuff is usually safe, since all of those chemicals are responsible for a savory food experience.  So everything from chips and crackers to pre-prepared meats, sauces, and dips are possible migraine triggers.  I realized so much of what I was eating had those horrible chemicals in them.  Sausage, Papa Murphy's pizza, curly fries, cheese crackers, soup broth... the list of foods I don't eat right now is pretty long.  But totally worth avoiding.  It's a small blessing that there are still savory pre-packaged foods that I can eat.  Plain potato chips or plain crackers are great.  I can actually still eat a Papa Murphy's pizza, as long as it has the marinara sauce (and not the garlic alfredo sauce), and none of the meats.  After I adjusted my food intake during my second pregnancy, I went from having migraines constantly to almost never.  It was amazing. 

Wine.  Meaning sulfites, tannins, and tyramines.
Our church serves real wine every Sunday for communion.  And while I have nothing against the occasional sip of wine during pregnancy, I avoid the stuff like it's toxic.  Just that one sip of wine is enough to give me a migraine.  This is a good article that explains what is really going on with wine and migraines.  For me, I think it's the combination of the chemical makeup of the wine.  Because lots of other foods contain sulfites, tannins, and tyramines, and they usually aren't a problem.  But all together in wine?  Nope.  I have noticed the occasional migraine from over-indulging in dark chocolate (which has tannins), so I'm careful about not eating too much at once.

Being pregnant, avoiding fatigue is easier said than done.  Especially in that first trimester.  But when I try to do too much, and skimp on sleep, I almost always get a migraine.  Especially if I do too much and skimp on sleep for two or three days in a row.  No good.  Even now that I have two kids, I prioritize rest and sleep.  I don't stay up late getting projects done or watching TV.  I sleep.  A rested mommy is usually a migraine-free mommy.

I think this goes without saying, but stay hydrated.  If you're doing a lot of sweating (or throwing up, or anything else that uses up electrolytes), make sure you're replenishing those too.  You can actually swing the other direction and have enough water but not enough sodium, potassium, calcium and magnesium, and put your body in a state similar to overhydration (also called water intoxication).  Coconut water is a great natural source of electrolytes.  White cherry Powerade also gets my vote.  I've also been known to drink pickle juice (which has tons of sodium) after a day in the sun. 

As a nurse and life-long migraine sufferer at the end of my third pregnancy, these are my experiences.  I'm sure there are some conflicting testimonies out there, but if you have any tips to add (or corrections on facts), feel free to leave a comment!  And as always, talk to your health care provider about this stuff.