The Sweet Surrender, LLC

02/26/2026

When uterine atony develops, the uterus feels soft, enlarged, and boggy rather than firm. Blood loss may exceed 500 mL after a vaginal birth or 1000 mL after a cesarean birth. As bleeding continues, the patient may develop tachycardia, hypotension, dizziness, pallor, and altered mental status. If not treated promptly, ongoing blood loss can progress to hypovolemic shock, organ failure, and death. Postpartum hemorrhage remains one of the leading causes of maternal mortality worldwide.

These medications are referred to as uterotonics and are used to prevent or treat postpartum hemorrhage by stimulating uterine contraction.

1. Oxytocin (Pitocin)
Oxytocin is the first-line medication for prevention and treatment of uterine atony. It stimulates uterine smooth muscle contraction and is typically administered intravenously or intramuscularly.

2. Methylergonovine (Methergine)
Methylergonovine produces strong, sustained uterine contractions. It is administered intramuscularly.

3. Carboprost (Hemabate)
Carboprost is a prostaglandin F2a analogue that induces powerful uterine contractions. It is given intramuscularly and is highly effective. It is contraindicated in patients with asthma because it can cause bronchospasm.

4. Misoprostol
Misoprostol is a prostaglandin E1 analogue. It may be administered orally, sublingually, or rectally. It is particularly useful in low-resource settings due to its stability and ease of administration. Common side effects include shivering and fever.

5. Tranexamic Acid (TXA)
Tranexamic acid is not a uterotonic. It works by inhibiting fibrinolysis and stabilizing blood clots. When administered within three hours of hemorrhage onset, it has been shown to reduce mortality associated with postpartum hemorrhage.

02/26/2026

Unlike your bicep, where muscle fibers run largely in parallel lines, the middle layer of the uterus called the , is arranged completely differently. Its smooth muscle fibers are woven together in an intricate, interlacing, figure-eight and spiral pattern.

Because of this design, the uterus doesn’t contract in a single direction during labor. It contracts in coordinated, multidirectional waves, effectively wringing itself out. This generates powerful and evenly distributed pressure from multiple angles, helping guide the baby downward while protecting the uterine structure itself.

It is a “biomechanical masterpiece” and something extraordinary happens after birth. When the placenta detaches, it leaves behind large, open blood vessels at the placental site. Immediately, those same crisscrossing muscle fibers contract down around the vessels in a process known as “living ligatures.” The uterus essentially acts as its own internal tourniquet. Through sheer contractile strength, it compresses the blood vessels shut, dramatically reducing the risk of hemorrhage.

The design of the myometrium allows it to both birth our baby and then protect us from catastrophic blood loss, using the same woven architecture for two entirely different but equally critical functions. Human anatomy is layered engineering: intelligent, adaptive, and powerful beyond what we usually see.

If the uterus does not contract effectively after birth, the condition is called uterine atony. It is the most common cause of postpartum hemorrhage (PPH).

When the placenta detaches, large maternal blood vessels remain exposed at the placental implantation site. Under normal circumstances, the interlacing muscle fibers of the myometrium constrict firmly around these vessels (living ligatures) to compress them closed. If this contraction fails, the vessels remain open and significant bleeding can occur rapidly (see my post about uterine atony).

02/19/2026

When our blood pressure rises just from being in a medical setting, that’s our body responding to stress. In many ways, a clinic BP reading becomes a mini stress test. If our blood pressure spikes under that stress, it may be signaling underlying cardiovascular vulnerability, something that can show up later in pregnancy or later in life, says current research.

A 2020 literature review pooling data from 12 studies defined white coat hypertension as:
* Clinic BP ≥ 140/90
* Normal BP at home or work

This affects about 25% of the general population, or roughly 1 in 4 people.
In pregnancy, rates are similar: up to 30%.

What the research found in pregnancy is that compared to those with normal clinic blood pressures, people with white coat hypertension had:
• >2× risk of preeclampsia
• >2× risk of a small-for-gestational-age baby
• 3× risk of preterm birth

When white coat hypertension was identified before 20 weeks, the risk of preeclampsia later in pregnancy was more than 5× higher.

Interestingly, when white coat hypertension appeared after 20 weeks, it was not associated with an increased risk of preeclampsia, suggesting **early pregnancy blood pressure patterns matter most.

While white coat hypertension carries increased risk compared to normal BP, it still has **lower risk than:
• Chronic hypertension
• Gestational hypertension

Global hypertension guidelines (including in pregnancy) advise:
* Regular home blood pressure monitoring
* Averaging readings over several days (not reacting to a single number)
* Avoiding intervention unless severe hypertension is present

Experts also emphasize:
• Always take two readings, at least 1 minute apart
• Keep a BP diary, including wake/sleep times
• Educate on preeclampsia warning signs:
— Persistent headache
— Sudden swelling of face or hands
— Visual changes
— Upper abdominal pain

White coat hypertension is not something your provider may simply dismiss, as it is information. And when identified early in pregnancy, it deserves careful monitoring and respectful communication (ahem, providers).

02/19/2026

Is it true hypertension… or just a bad blood pressure reading?

Many of us have had our blood pressure taken incorrectly, and those small mistakes can seriously inflate the numbers.

Here’s what can falsely raise a BP reading:
• Talking during the reading: +20 points
• Full bladder: +33 points
• Arm hanging with no support: +22 points
• Legs dangling or crossed
• No back support
• Incorrect cuff size
• Cuff over clothing

How to get an accurate blood pressure reading:
• No caffeine, alcohol, ni****ne, or exercise beforehand
• Empty your bladder first
• Sit quietly (no talking)
• Sit upright with your back supported
• Feet flat on the floor, legs uncrossed
• Arm supported at heart level
• Correct cuff size, placed on bare skin
• Take two readings, one minute apart

* Check my next post about white coat syndrome and why some say it matters.

01/31/2026

Thiamine (vitamin B1) is an essential, water-soluble vitamin involved in energy metabolism, nervous system function, and cardiovascular health. Pregnancy increases metabolic demand, which also increases the body’s requirement for thiamine. Historically, thiamine deficiency has been linked to serious conditions such as cardiac dysfunction, neurologic symptoms, and fluid imbalance. In pregnancy, inadequate thiamine status has been associated with hyperemesis, fatigue, cardiac strain, and adverse maternal outcomes.

In the mid-20th century, physician John Irwin proposed that subclinical thiamine deficiency played a role in pregnancy toxemia (now called preeclampsia). In his clinical observations, he reported improved pregnancy outcomes when higher-dose thiamine supplementation was used in the third trimester. Using a daily dose of approximately 100 mg, he documented an absence of conditions such as preeclampsia (then referred to as toxemia), hypertension, hemorrhage, prematurity, and fetal loss within his clinical population. He described these pregnancies as largely trouble-free and noted that the infants appeared particularly robust and healthy, reporting no observed adverse reactions to the supplementation. His observations and clinical rationale were later outlined in his book, The Natural Way to a Trouble-Free Pregnancy. While these observations were not conducted as modern randomized controlled trials, they raised important questions that remain relevant today, particularly given that:
•Thiamine requirements increase during pregnancy
•Thiamine deficiency can exist even with adequate calorie intake
•Thiamine is easily depleted by refined carbohydrates, stress, illness, and certain medications
•Thiamine is water-soluble and has a strong safety profile

01/12/2026

250 DIY Natural Remedies 🪴

12/21/2025

12/19/2025

Between a positive test and the first OB appointment, a woman is often making irreversible developmental decisions (nutrition choices, medication use, toxin exposure); managing symptoms (fatigue, nausea, anxiety, bleeding) without labs; and carrying unknown risks.

Function Health–style panels can surface issues early, so the first OB visit is informed instead of reactive. Reactive care responds to problems after symptoms appear. Informed care identifies and supports risks before they escalate.

Function Health offers 160+ lab tests & their results, detecting 1000+ conditions, for $365 flat. No insurance needed. For more info visit functionhealth.com

12/17/2025

Co-regulation refers to the way one regulated nervous system can support another during moments of uncertainty or stress. During labor and the postpartum period, heightened stimulation, pain, fatigue, and unfamiliar environments can activate the body’s fight-or-flight response, disrupting hormonal flow, communication, and physical progress.

A calm, attuned support person helps buffer this stress by providing steady presence, responsive touch, and emotional regulation. This supports parasympathetic activation, more efficient labor patterns, improved coping, and smoother postpartum adjustment. Co-regulation is not about directing the experience, but about creating physiological safety so the body can function as designed. This is a core component of effective, evidence-informed doula care.

11/23/2025

🧬 Phosphatidylcholine & Pregnancy

Phosphatidylcholine (PC) is a critical nutrient during pregnancy, playing key roles in fetal brain development, methylation, and liver health. It’s a major component of cell membranes and a primary source of choline, which supports memory formation, neural development, and long-term cellular function.

Research shows that adequate choline intake during pregnancy:

🧬 Supports fetal brain and hippocampus development
🧬 Enhances DNA methylation patterns, critical for long-term health
🧬 Promotes maternal liver function, reducing fatty liver risk

11/23/2025

Herbal Blend for Weeks 36+ of Pregnancy

This tea blend was developed specifically for pregnant women who are at least 36 weeks pregnant. Rich in calcium and magnesium, Labor Ease (formerly Eager Mama) helps to strengthen the uterus while also nourishing mama so that she is strong and ready when it’s time to bring baby into the world.

This blend also helps to clear heat and remove stagnation that might otherwise delay onset of labor, and gently encourages contraction of the uterus.

Drink 2-6 cups daily, and throughout labor.

11/20/2025