Thursday, September 22, 2011

Why the things I hate make me love my husband more

We all have them. Things we have to do--that we hate. But, lucky me, my husband takes on many of my least favorite things, most of the time without me having to beg.

Things like:

Making returns. I really hate making returns. Like, I generally won't buy something unless I'm 100% positive that I won't need to return it. Nonetheless, the occasional item makes it way into my house that needs to be returned, and when that happens, my wonderful husband does it for me.

Calling people on the phone. I don't like to talk on the phone. I always feel like I'm coming across weird. I get really awkward with people I know, and I get really stressed out with people I don't know. Also one of my least favorite things: those voice recognition systems where you have to say your name, your SSN, your address, your phone number, and a hundred other things. It never understands what I'm saying. I just want to talk to a person! Now obviously, I still have to make some phone calls, but I usually get to pass on the really annoying phone calls (like cable service calls). That's when I really feel loved.

Cleaning up really awful garage messes. Like when the trash sat in a pile too long and maggots are crawling around. Yuck. Double Yuck. I'm really, really thankful for my husband who drags out the hose to wash it all away.

Filing taxes. Need I say more?

Figure out anything computer glitch related. I can usually get along pretty well if my machine behaves, but if anything goes wrong, I am totally and permanently thrown off. That's when I call my in-house techie.

Thanks, love! You make my days so much better.

Monday, September 12, 2011

Yes, I know...

I have become "that person." You know, the one who starts a blog, posts somewhat regularly for a while, then abandons the blog to pursue other lovers. Sorry folks. That is, if ANY of you are still waiting for me to write something new. Forgive me. I've just been loving on my husband, raising a couple of boys, trying to institute something like daily Bible time, cooking delicious, allergen-free meals (or raiding the refrigerator for allergen-free leftovers), exercising, eating enough to offset the calories I burned exercising (Yes, I'm trying to lose the last five pounds, just like everyone else), very occasionally cleaning something, working on teaching Nathan his letters and sounds, starting my doula business, helping some mamas birth their babies, creating my doula website, stalking other people's blogs, preparing for a wedding (not mine), buying seven eye shadows and eight lipsticks for aforementioned wedding, watching Wipeout with my kids, watching my kids create their own version of Wipeout in our living room, preparing two hundred items for a children's consignment sale, sleeping (did you catch that--SLEEPING!!!!), ordering vitamins, and lotion, and shampoo online, because I like natural products and I really dig online shopping, being my son's allergist, dermatologist, and pediatrician (seriously, I feel like I should have a degree or something!), reading library books, reading books I borrowed from my mom, reading books from my bookshelf to decide whether I would ever want to read them again, reading books to my little boys, reading magazines, trying (futilely) to organize our junk room, ahem, yard sale staging area, loading the dishwasher, unloading the dishwasher, handwashing the knives (how do twelve knives get dirty so fast?), trying to dissuade Nathan from tearing hunks of cheese off and eating them while I'm asleep, learning the names of more Braves players than I ever wanted to know (why do they have games every day?), having meltdowns every three days or so when my husband turns on the baseball game again (three for three should not mean we watch three games in three days!), checking out the latest thing Kate's wearing (if you don't know who I'm talking about, you won't be able to relate), deciding she's too tall and too thin to be a good source for fashion ideas for someone who is 5 ft. 3, weighing myself and agonizing that the number hasn't gone down, weighing Daniel and agonizing that the number hasn't gone up, weighing Nathan, and trying to convince him he hasn't "lost 2 pounds" (this happened after we watched the Firm Express informercial, fighting the battle of the toy monster that seeks to engulf our home in chaos, giving up on the battle of the toy monster because clearly he's already won, deciding to fight the battle again after tripping over no less than seven toys while going from the bedroom to the kitchen in the dark, watching the same Veggie Tales movie every day for a month, and a few other things for the past five months or so. Somehow the blog has been at the very bottom of the priority list. But, today, for one brief, shining moment, the blog made it to the top. Perhaps it shall happen again sooner than five months from now. One can hope.

Saturday, March 26, 2011

How my Children have made me a cynic and an optimist

First of all, I love my children. So much. I would never give them away. Take a two week vacation, maybe. Put them up for adoption? Never. Never, never, never. So please don't interpret anything I say here as a sudden failure of parental affection. However, being the caretaker and responsible party for two little people has taught me a lot about human nature--about the innate evil of man, about the great patience and mercy of God in dealing with us.

Here's the truth I have learned from my own (and other people's) children: Children are naturally uncivilized little brutes. You might be tempted to think I'm just having a bad day--I'm not. (If you have your own kids, you might be nodding in agreement.) The truth is that everything good, and civilized, and obedient, and respectful a child does is the direct result of someone's effort and training on their behalf. They were not born as well-behaved, kind, gentle children. Children left to their own devices will whine, hit other people, destroy property, and generally please themselves and make themselves unpleasant to others.

Yet in God's great economy, where nothing is wasted, he gave parents to shape children, and children to shape parents. Children need the firm discipline tempered by unconditional love that only a parent can give. Discipline without love is abuse. Love without discipline is folly. Only a parent operating in the grace of God can have the patience, perseverance, strength, wisdom, and love needed to raise a child. I know from personal experience that God uses my children to reveal areas in my own heart where I am lacking. He has also used the insights of parenting to give me great hope, because, after all, He is my Father. So, while I am a little bit patient with my children because of my love for them, he is infinitely patient with me because of his unending love. When I get weary of the endless process of training, I think about the way He teaches me the same lessons over and over until I have learned them.

So I am optimistic that, just as my children respond to my love and consistency with better behavior, I will respond to the patient work of God in my life by slow, painful, worthwhile change for the better.

"being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus." Philippians 1:6

Friday, February 25, 2011

A Dozen Days of Doula Scoop: Day 12

Yes, I know a dozen is twelve, and I am finally working on my final blog in this series...

Birth doesn't end with the baby coming out.

Sometimes, birth doesn't unfold the way we expect. I would venture to say that our births often deviate from what we planned and/or wanted. I didn't plan to deliver Nathan via c-section. I didn't expect Daniel to need suctioning for half an hour. However, as every mama knows, getting the baby here safely is the number one priority, and doing that often requires adjustments in the plans. When your birth doesn't meet your expectations, you will probably find you need some time to process everything that happened. You may find you need to relive, blow by blow, every detail of the birth, from the first contraction to the moment you are holding your baby in your arms. You may find yourself wondering whether you might have had a different birth experience if you had made different choices. You may find yourself feeling rather blue, or even full-on depressed, even though the beautiful new baby you waited so anxiously for is finally here.

It's so easy to assume that birth ends the minute the baby leaves your body, but the truth is, the emotional aspect of birth can affect you for years. For most women, birth is more than a mere utilitarian means of obtaining a baby. It is a time of transition, the last step you take from being a woman to being a mother. Birth is also an opportunity for the full expression of your femininity. Because birth is such a unique and special time in a woman's life, a birth experience that is less than what you wanted can leave you reeling emotionally. A doula can be invaluable at this point. Since your doula has been with you through the birth process, she can help fill in the details that you can't remember (and there will be details you can't remember). Maybe you need her to remind you that you had long, painful contractions two minutes apart for six hours before you called for the epidural. Maybe you didn't know that the episiotomy was done because the baby's heart rate plummeted suddenly and they had to get the baby out. Because your doula was continuously present, knows about birth, and was not in labor land at the time, she is the perfect person to help you reconstruct the details of what happened. You can talk to your doula about your birth, because she gets it.

Coming to a place of peace about the way you birthed your baby is critical for your emotional well-being. If you are constantly plagued by feelings of inadequacy because you couldn't birth without medication, or you had a c-section rather than a vaginal delivery, you may struggle to adjust to the physical and emotional demands of mothering. The way you deliver your baby does not determine what kind of mother you will be. In fact, the experience of breastfeeding and nurturing your newborn baby can be an exceedingly healing time for a mother who feels like she missed out on having the perfect birth. The way birth happens is, without doubt, important, but it is more important by far that you love on your baby, day after day. Birth is one day; mothering is the rest of your life.

Tuesday, February 15, 2011

Reframing

Tired of:
Having a messy house.

Thankful for:
Having a house.

Tired of:
My body's limitations.

Thankful for:
My body's capabilities.

Tired of:
Never getting everything done.

Thankful for:
A life so full, I never run out of things to do.

Tired of:
Grimy little hands that dirty up my shirt.

Thankful for:
Grimy little hands that wrap around my neck.

Tired of:
Laundry.

Thankful for:
Clothes.

Tired of:
A husband making one more demand on my time.

Thankful for:
A husband who loves me so much that he wants to spend time with me.

Tired of:
Eating the same old, non-allergenic foods. (Potatoes, anyone?)

Thankful for:
Losing weight while not being hungry.

Tired of:
Managing a tight budget.

Thankful for:
Having a tight budget to manage.

Tired of:
Watching my child suffer.

Thankful for:
God's promise that one day, ALL suffering shall cease.

Tired of:
Messes.

Thankful for:
Mess makers.

Tired of:
Doing so many things wrong.

Thankful for:
Doing a few things right.

Tired of:
Insomnia.

Thankful for:
A little personal time to think through my problems.

Do you need to do some reframing today?

Wednesday, February 9, 2011

A Dozen Days of Doula Scoop: Day 11

Birth Healing, Birth Processing:

Sometimes we moms can get so focused on getting the baby out that we forget to get ready for what comes afterward. The same moms who tell you every detail of their birth experience often neglect to mention anything about the aftermath of birth. After the baby is born, your body needs time to heal and your emotions will probably fluctuate a lot. These emotional fluctuations are both a result of hormonal changes in your body and a natural response to the upheaval in your life (in the form of a very precious, very needy little newborn). Depending on how difficult your labor was and whether you had an instrumental (forceps or vacuum) or surgical (cesarean) birth, you will experience anything from mild soreness to unmanageable pain following the birth.

What you might expect after the baby arrives:
  • You can expect an immense sensation of spaciousness and relief. After all, seven or eight pounds of baby just left your overcrowded abdomen! The first time you stand up, you may feel your organs sliding down into the now roomy pelvic cavity.
  • If you have birthed vaginally, you still have to push the placenta out. Don't be scared. Unlike your baby, a placenta has no bones and slides out quite easily with one or two pushes.
  • Your care provider will check your perineum (your pelvic floor muscle that stretches towards your bottom to make way for the baby) for any tearing. If you have torn, local anesthetic will be used while you are stitched up (unless you already have an epidural in place. Many moms are so distracted (in a good way) by their new baby that they hardly notice this.
  • If you have had a cesarean section, expect to be closely monitored for an hour or two until the initial effects of the surgery (and medications) have worn off. In many hospitals, your baby can be in the recovery room with you if you and the baby are both healthy.
  • Expect soreness and/or pain. After a vaginal birth, you may find your entire pelvic floor is sore from stretching as you pushed the baby out. You will probably have localized pain and tenderness if you had significant tearing or an episiotomy. Most women also have hemorrhoids that will gradually shrink over the next few weeks. If you had an epidural, your back may be sore where the epidural needle was placed. After a cesarean birth, you will be sore on your lower abdomen where the incision was made. Sitting, standing, coughing and laughing will probably be extremely painful until your abdominal muscles recover from the trauma of being separated during the surgery. It's okay to take pain medication for all these achy parts. Your doctor, midwife, or nurse can tell you which pain medications are safe to take while breastfeeding.
  • If you had a completely unmedicated birth (no narcotics, epidural, or Pitocin), you will probably have an incredible birth high. This high is your reward for getting through every bit of your labor without calling for meds. Despite any residual soreness, you may decide you have never felt better and nothing can possibly bother you. Try not to make important decisions until this high wears off. You may agree to something you don't actually want to do because you just feel so incredibly good.
  • Be prepared to sweat and pee--a lot. The body has a lot of extra fluids to get rid of, so expect frequent bathroom breaks for the first couple of days. You may want to lay a towel under your head so you don't drench your pillow with sweat.
  • Starting breastfeeding may be really difficult, but it may also be really easy. If you're having a hard time getting started, call on your nurse, lactation consultant or fellow nursing mom for help, but make sure you take some time to try to nurse when it's just you and the baby. Sometimes what you really need is a little quiet, private time free from the pressure of other eyes to relax and let it happen.
  • Your emotions may be all over the place. You are filled with love for your baby, happiness that you are finally holding her, disappointment if the birth didn't happen the way you wanted, sadness that your life will never be the same, happiness that your life will be changed forever.
Next Post: More on the emotions of birth and beyond

Friday, February 4, 2011

A Dozen Days of Doula Scoop: Day 10

Breastfeeding: Just do it.

After wading the murky pond of labor options and the risks and benefits of various interventions during delivery, its refreshing to enter the crystal clear water of some definitive scientific evidence. Not to give away the punchline, but the verdict is in, and breastfeeding is better for babies. Period. Except in a few rare situations where the mother is HIV positive or has another body-fluid born virus, mothers who breastfeed their babies are conferring a hosts of benefits on their babies with none of the risks inherent in formula feeding and should absolutely breastfeed if they possibly can. A strong statement? Yes. However, scientific evaluation of breast milk versus formula has shown that breastmilk is a superior food for an infant which means, by default, that formula is an inferior food. Breastmilk is tailored to the specific needs of babies at every stage of development, from the colostrum babies get in the first couple of days of life (high in concentrated nutrients but easy to digest), to the milk produced for a breastfeeding toddler that has increased fat and energy contents and continues to deliver protective antibodies (read: less sickness). Formula delivers the same limited nutrients to babies at every stage of development. Breastmilk is chock full of dozens of kinds of beneficial bacteria that subsequently populate the baby's intestines, providing a barrier against infectious agents and potential allergens. Some formulas have one strain of beneficial bacteria that may or may not be viable by the time the baby ingests it. Breastmilk protects against allergies, formula often triggers them (trust me, you do not want this to happen!). Breastmilk is good, good, good stuff!

So why don't more American moms breastfeed their babies? I believe there are two primary problems: cultural stigma and lack of support. Add to that the way that formula is vigorously marketed while breastfeeding makes no one any money, and you have a recipe for babies not getting the perfect food. Somehow moms have gotten the message that breastfeeding is inconvenient, immodest and painful, and while it can be any of these three things, it doesn't have to be. Breastfeeding is, in my opinion, more convenient than bottle feeding. You don't have to worry about sterilizing twenty pieces of equipment (unless you're pumping, which does add a challenge, though not an insurmountable one), you don't have to test the temperature of the milk to make sure it doesn't burn your baby, and you don't have to pay for it (who doesn't love free stuff?). You don't have to stumble around in the middle of the night trying to find a clean bottle and fill it with formula when you can hardly get your eyes open. You just pick up your baby, uncover your breast, and doze while the baby nurses. You can sit in a glider with your feet propped up, recline on your bed, or lie on your side without worrying about a bottle not being held at the proper angle. And many breastfed babies don't even need to be burped since they don't swallow a lot of air while nursing. As for breastfeeding modestly, it is very possible. In most places, you can find a private corner where you can feed your baby without fear of exposure, but even if you have to nurse in the crowded waiting room of your pediatrician's office, you can throw a blanket over your shoulder and feed your baby while staying covered yourself. (My babies never did tolerate the blanket over the head, so I usually retreated to the car if I couldn't find another relatively private location.) Especially once your baby is older, their heads will cover the exposed part of your breast and you can tuck your shirt low enough to cover everything else. Finally, is nursing painful? For some women, it is, and continues to be painful. In most cases, the pain has a cause, i.e. the baby is latching poorly, or mom has a fungal infection of the nipple. For the first few days, breastfeeding is often uncomfortable as baby figures out how latch properly and the nipples adjust to vigorous sucking. This is a time when support from a lactation consultant or another woman who has breastfed a baby is critical. Without help and encouragement, many moms give up before breastfeeding gets easier, because they think it will be that hard the entire time they're breastfeeding. Some mom/baby pairs figure out the nursing dance pretty quickly, while others need a few weeks before it feels natural.

There are a few things you can do to facilitate an easy start to breastfeeding:
  • Give birth without pain medications if possible. These tend to make babies lethargic for a few days which makes it hard to get them interested in breastfeeding.
  • Forego IV fluids, as they can cause tissue swelling in the breast which makes it more difficult for little newborn mouths to latch on.
  • Get the baby skin to skin with mama as soon as she emerges. You may have to fight hospital policy to get your way on this one (they want to wash, weigh and measure, and do the newborn examination right away; if baby is breathing and healthy, these things can wait), but it's worth it because babies who spend the first hour or two of their life skin to skin with mama actually have the ability to find the nipple and latch themselves on without help. It doesn't get any easier than that!
  • Room in (keep your baby with you) instead of sending your baby to the nursery. This is not a guilt trip on you if you send your baby to the nursery while you nap for an hour or two! However, moms are able to be in tune with their babies' hunger cues (opening their mouth wide, sucking on fist, rooting around) when they are close. A busy nurse may not notice a baby's hunger cues until he's crying. This is a late sign of hunger for a newborn, and most babies need to be calmed before their mom can even try to feed them if they have been crying.
  • Take advantage of the lactation specialist before you leave the hospital. Especially if you're having breastfeeding difficulties, a lactation specialist has a wealth of information about getting babies latched on, pumping, and more. Seek help early if you feel things are not going well. Babies arrive with an energy reserve that allows them a few days to figure out this thing called eating, but it's important to get things moving before this energy reserve runs out.
  • Talk to other breastfeeding moms or your doula for encouragement. We all need to know other people have been there and made it through, especially when it comes to this demanding thing called parenting.
I know this entire post has been extremely pro-breastfeeding, and I wish every mom could breastfeed their baby, but I know that, in many cases, the desire to breastfeed is there, but for whatever reason, breastfeeding is not possible. Maybe because the mom has to go back to work and doesn't have much success with pumping or because she has breast infection after breast infection. Not being able to breastfeed when you really wanted to is a loss that you may need to grieve a little bit. That's okay. It's also okay to give yourself a free pass on the guilt. We all want to do more for our children than we ever possibly could. Despite the fact that most parents don't get around to half the things they want to do for their children, most of us turn out okay. Your children will too. If you love them and do your best as their parent, that is the most important thing. But if you can breastfeed your baby, persevere! The benefits are proven, and there is a sweet emotional bonding that takes place when you snuggle your baby to your breast.

Thursday, February 3, 2011

A Dozen Days of Doula Scoop: Day 9

C-sections: Having a good birth when a cesarean is necessary

Cesarean sections save lives. This fact is incontrovertible. Unfortunately, currently about a third of pregnant women in the United States will wind up delivering their baby by cesarean section. This number is far higher than the 10 to 15 percent of moms recommended as the target goal by the World Health Organization. The discrepancy between the target percentage and the actual percentage means that some women are having unnecessary c-sections. The problem is that during labor, no one wants to take chances with the life or health of mother or baby, so if there is any reason to believe a c-section may be a safer means of delivery, it will probably be done. Also, doctors often take every action possible to protect themselves from liability so that if something were to happen to mom or baby during a birth, they could say, "Well, I did everything I could." What this means for you as a mom is that (a) you may want to take measures to protect yourself from an unnecessary cesarean and (b) you need to prepare for a cesarean birth even if you are planning a natural childbirth because you end up needing one during labor. Here is an excellent page that covers ways to avoid an unnecessary c-section. I highly recommend you check it out so you can arm yourself with information.

When a c-section is truly necessary, there is no agonized weighing of risks and benefits. There are a few situations where there is no question of whether a c-section should be done:
  • Cord prolapse, placental abruption, catastrophic uterine rupture: These are all true obstetrical emergencies that require immediate action to save the baby and sometimes the mother as well.
  • Placenta previa: This is the term used when the placenta embeds itself over the mouth of the uterus where the baby would usually emerge during birth. Because the placenta is the baby's oxygen lifeline, he could not be born vaginally because the process of the cervix dilating almost always causes the placenta to begin detaching from the blood supply.
  • Baby is in a transverse position and refuses to move: Transverse means the baby is lying sideways in the uterus in much the same position that moms cradle their babies after they have been born. Babies in a transverse position cannot be delivered vaginally. The good news is that about 90 percent of transverse babies can be turned using a procedure called the external cephalic version.
The link above covers most of the situations where it may be possible to avoid a c-section: breech baby, long labor (slow progress), previous c-section, questionable fetal heart rate readings, and multiple births. If you find yourself in one of these categories before labor begins, research! Read The Thinking Woman's Guide to a Better Birth. Ask your doula for other resources. Ask your care provider how he or she usually handles your situation. If you are not happy with the answer, negotiate a better plan. If you find your doctor is inflexible, consider changing to a care provider who is more in line with what you want, even in the last weeks of your pregnancy. If you face one of these problems during labor, use the four questions I discussed in yesterday's post. Ask your doula for information. Talk through the situation with your husband. If you feel like the c-section is needed, give your consent and know that you are doing the right thing for your baby.

If you choose to have a doula at your birth, ask your doctor before labor starts if they allow both dad and doula into the operating room during a c-section. The official hospital policy usually allows one additional person (either dad, doula, or another labor support person), but doctors often have the final say on whether your doula will be allowed in the O.R. along with dad. It's worth making the effort to have your doula with you during the surgery because it is often a tense and emotional time when a calming influence is greatly needed. Also, babies are often taken to the nursery after the mom gets a quick look at them so the nurses can evaluate and monitor their condition. If baby goes to the nursery, it's best for dad to go with her since as her legal guardian, he is the person with the power to make decisions related to the baby's care. However, if he was the only support person with mom in the O.R, she is then left alone during the lengthy surgical repair. When dad and doula are allowed in the O.R, it allows for the most complete level of emotional support for mother and father throughout the process of the cesarean birth. If this is not possible for some reason, your doula will wait for you to return to your room for some recovery time after the surgery, and help you hold and feed your baby if you are both up to it.

Having a c-section is not a failure of the mom to give birth. After all, you grew and carried that baby for nine months, and your baby entered the world from your body, albeit in a departure from the normal pattern of birth. Stuff happens. Life happens. Cesarean birth often requires a lot of emotional processing. You may need to spend some time grieving for the birth you lost. That's okay. But at the end of the day, you need to know that you allowed your baby to be born in the way that he needed, and that is what a good mommy does.

Wednesday, February 2, 2011

A Dozen Days of Doula Scoop: Day 8

When the birth plan falls apart...

Ask four questions:
  • Am I okay? Is the baby okay?
  • What happens if we do the intervention?
  • What happens if we don't do the intervention?
  • Can we have a couple of minutes to talk about it?
I'm a big fan of birth plans. I think it gives you an opportunity to think through the kind of birth you want, lets dad and doula know what your wishes are, and gives you a list of things to discuss with your doctor before the birth. But births don't always follow the birth plan, and sometimes you have to adapt.

The informational support of a doula is invaluable when problems arise during labor and birth. In the throes of labor, no one has the time or energy to research the pros and cons of various birth interventions. Doctors don't always take the time to discuss the risks and benefits before expecting a decision from parents. Sometimes, with the right information, you feel empowered to choose to do nothing for a little while longer, and sometimes, problems will resolve themselves.

There are times when intervention is necessary and unavoidable. During these times, a doula can help you enjoy the experience of birthing your child, even if it isn't happening the way you wanted. An unwanted but necessary induction can still be a good birth. An unwanted but necessary c-section can still be a good birth. Even when your plan falls apart, it can still be a joyous, special, memorable time as you welcome your new baby into the world.

Monday, January 31, 2011

A Dozen Days of Doula Scoop: Day 7

Doing it naturally: Making it happen

While birth is unpredictable, there are a few things you can do to increase your odds of having an unmedicated labor.

  • Have a doula! You know this one by now...
  • Choose your care provider carefully. Most obstetricians and some midwives tend to use interventions that make labor more difficult to cope with. The best care provider for an unmedicated labor is usually one who uses medical intervention judiciously--only when the situation merits it, not across the board.
  • Do what you can to prepare your body during pregnancy. Exercise. Almost every pregnant woman can walk and stretch, and depending on your prior fitness level, you may be able to do more. If you have been active in pregnancy, your body will be more ready for the physical work of labor.
  • Eat well! Babies need lots of protein to grow. Calcium is important. If you don't like fish, you may want to consider a supplement containing EPA and DHA (Fish oil is one of the best ones.) These nutrients promote brain development. Eat as many fruits and veggies as you can squeeze into your diet. A well-nourished baby is more likely to tolerate the stresses of labor than a baby who is malnourished. A well-nourished mother is also better able to handle the stresses of labor and heals faster after the birth. Think of fast food and desserts as treats, not as foods that nourish mother or baby!
  • Before labor starts, spend a little time thinking about how you already cope with pain. Do you like to lay down in a dark room? Do you like to stretch or massage your sore muscles? You might want to do something similar during labor.
  • Don't go to the hospital too early. Spending early labor and some of active labor at home means your coping options are less limited. You can get in the shower, you can soak in a bathtub (if your water hasn't broken), you can kneel with your arms on the couch (and not be worried about being on a nasty hospital floor), you can eat and drink, you can walk. Once you arrive at the hospital, you will need to spend some time being monitored, have vaginal exams, and your nurse will probably try to start an IV. It's not impossible to cope under these conditions, but it does take away some of your flexibility.
  • When you check in at the hospital, ask for a nurse who likes to work with patients who are laboring without pain medicine. Some nurses do, some don't. You're more likely to get a compatible nurse if you ask.
  • Try the coping techniques discussed in the previous post or the ones suggested by your doula. If one isn't working, it's time to try something different.
  • Make up your mind that you can do it, and you are going to do it. A little mental determination goes a long way.
Tomorrow: What happens when the plan falls apart?

Saturday, January 29, 2011

A Dozen Days of Doula Scoop: Day 6

I've ditched the drugs. Now what?

Getting through natural childbirth is tough. (If it was easy, everyone would do it.) Having continuous support from a doula can make the difference between strong, hard, painful contractions and absolutely unbearable contractions. Some dads, particularly ones who have worked hard to prepare through good childbirth classes, extensive reading, and practice, really excel at the nitty gritty of navigating mom through each contraction. Some don't. Hands-on labor support is not something that comes naturally to everyone. However, if dad is the only other person laboring with the mom, he will be the one she turns to for help. If he is not prepared to give her the kind of help she needs, she will often end up turning to the epidural because she wasn't able to cope under those particular circumstances. She may have been able to do it with more support. She may not have. Yet the research is clear. Having continuous labor support from a doula always increases your odds of having an unmedicated labor and birth. Is it a guarantee? No. No one can give guarantees in the birth process, because birth is unpredictable. But doula support may be what it takes to help you have the birth you want, and if it doesn't, you know that you gave yourself every opportunity to birth naturally, and for whatever reason, it wasn't in the cards for you this time. (Maybe next time!)

Because a doula is not (1) laboring herself or (2) emotionally invested in the process as the parents are, she is able to keep her focus on what can be done to facilitate a more manageable labor for mom.

Some of the coping techniques a doula may suggest:

  • Counterpressure--The doula or dad places their hands on the joint where the lower end of the spine meets the pelvic bones (exact location depends on where it feels good to mom) and presses. Often mom wants lots of pressure. This helps relieve back pain and pelvic pain and offers some distraction from the massive pressure in the contracting uterus. Because most moms need heavy pressure to experience relief from counterpressure, this is a great time to have doula and dad switch out periodically to give their arms a rest.
  • Double Hip Squeeze--Hands are placed on the upper outside portion of both hip bones, and pressure is exerted to squeeze them towards one another. This is easier for two people to do, with one person on one side of the mom and one on the other, pressing in towards each other.
  • Head Pressure--One hand rest on mom's forehead, while the other is placed either on the back of the head or where the spine meets the head. Hands press in towards one another. This one is relaxing for mom and gives her a place to focus other than her abdomen.
  • Relaxation, Rhythm, Ritual--Penny Simkin coined this term; she is my hero for starting the doula movement and coming up with so many wonderful ways to cope with labor. Penny says that as long as a mom has rhythm in what she is doing, she is coping. It could be a rhythmic pounding of her hand, swaying, vocalizing in a rhythmic pattern, rocking--as long as she has a rhythmic ritual, she is coping. If she loses her rhythm, she may need someone to help her find a new pattern.
  • Movement and Position Changes--There are many positions that are helpful during the different stages of labor. Staying upright as much as possible (standing, sitting on a birth ball, leaning over the bed) takes advantage of gravity to get the baby's head pressing on the cervix. This usually makes contractions both more productive and less painful. It can be difficult to get into these positions on your own later in labor or if you are tethered to an IV or external fetal monitoring, so having someone there to help you is extremely helpful.
  • Heat and Cold--Warm compresses, hot showers, ice packs, and cold washcloths can all be used to help manage pain.
  • Breathing, Hydrotherapy, Acupressure, Dimming the Lights, and more!
None of these techniques takes away the pain, but they can often make it possible for moms to manage the pain. Your body was made to give birth! Despite the messages our culture would send us, we are capable of having our babies naturally. Don't think that just because you pop a Tylenol every time you have a headache, you can't handle unmedicated childbirth. The pain of childbirth is a totally different pain. It is a productive pain. Unlike a broken bone or a kidney stone, the pain of birth isn't a sign that something is wrong with your body. It means your body is working, really hard, and at the end, you get a baby for your pains! It is also a pain that comes and goes. Once a contraction is over, the pain is completely gone until the next contraction begins. That means you get a break--time to breathe, rest, and prepare for the next one. Birth pain is pain with a distinct ending. The minute your baby leaves your body, the pain is over. Just like that. While there is usually residual soreness from pushing out seven or eight pounds of baby, the pain is gone!

Next post, you guessed it, more on natural childbirth! I promise I'm going to cover some other stuff too...

Friday, January 28, 2011

A Dozen Days of Doula Scoop: Day 5

I'm planning an unmedicated birth. How can a doula help me?

First of all, good for you! Giving birth without drugs is the only way to ensure with 100% certainty that your baby will arrive unaffected by any drugs that have crossed the placenta. It is also the only way you can completely avoid the potential risks of pain medications to yourself. Going through the birth process without drugs allows you to feel every bit of the power of your own body as it opens, stretches and pushes a baby out. And yes, it does hurt! In the interest of full disclosure, I am a BIG fan of natural childbirth. Not having the natural childbirth I wanted with Nathan only made me more determined to do it the next time around. And I did. And it was everything I wanted it to be. It took me beyond what I thought I could bear, but I found I could bear it, and I did as labor went on. There is no life experience I know of that makes you feel more powerful than birthing your baby all by yourself! But most women need excellent support systems around them to pull it off, especially with nurses popping their heads in the door to offer the epidural if it sounds like they're in pain.

Advantages of doing it natural:
  • Avoids all the potential nasty side effects of drugs, including slowing of labor, malposition of baby, and fetal distress.
  • Allows labor to progress in a more physiological manner as you are able to sway, change positions, get upright, and move, move, move!
  • Gives you an incredible sense of accomplishment (Having a baby at all gives one this feeling, but doing it naturally amplifies it).
  • Increases your odds of all your pain ending as soon as labor ends. One of the unfortunate things about epidurals is that a good epidural will block all your pain during labor, but once it wears off, you are REALLY sore: sore back, sore butt, sore stomach. If you have gone to the peak of labor pain, your body has produced massive amounts of endorphins (natural painkillers) that stay in the body for a while after the baby is born. This means that a lot of stuff that would usually hurt doesn't, and if it does, it doesn't bother you as much.
  • Really increases your odds of having an easy start to breastfeeding. Undrugged babies, left to their own devices, will pedal their little legs until they crawl up to their mother's breast, and then attach themselves unassisted by anyone. Most mothers don't want to wait this long (the process can take around 45 minutes), but baby's alert state makes it much easier to get him or her interested and latched on properly at any point in the first hour or two.
See part 2 of natural birth tomorrow!

I sure am having fun writing about all this birthy stuff; I hope you're having fun reading it!

Thursday, January 27, 2011

A Dozen Days of Doula Scoop: Day 4

I think I want an epidural. Do I still need a doula?

Before we delve into the specifics of doulas at epidural births, I have to spend a little time talking about epidurals. I had an unplanned epidural with my first birth (meaning I wanted to do it without medication, but called for the drugs after the pain escalated and I was completely demoralized by my lack of progress, see this post), and I had my second baby without any pain relief (not even a Tylenol!), so I have personally experienced the gamut of pain relief options. I certainly do not condemn any mom who chooses the drugs; after all, the process of childbirth is for many people the peak pain level they will experience in their life. However, I think we are often woefully uninformed about the potential drawbacks and side effects of epidurals.

Did you know? (Statistics taken from Hey! Who's Having this Baby Anyway?)
  • Epidurals cause a drop in blood pressure in 30 to 35 percent of moms. Drops in blood pressure can lead to a fetal distress as the mom's blood doesn't pump vigorously enough to oxygenate the baby's blood. This can directly lead to the mom having a cesarean birth if her blood pressure cannot be stabilized by the use of additional medications.
  • Epidurals cause fever in the mom in about 15 percent of moms when the epidural is in place more than 4 hours. Why is this a problem? Doctors and nurses have no way of knowing which fevers are caused by the epidural, and which may be the result of infection. Therefore, moms are often separated from their babies as their babies are checked for infection. Some babies may even have to have a spinal tap or be treated with antibiotics in the hospital for several days.
  • 10 percent of the time, epidurals offer only partial or nonexistent pain relief. If this occurs, the epidural may have to be reinserted for better placement to provide more complete pain relief.
  • Spinal headache occurs in 1 to 10 percent of epidural moms. I've had one of these. They are NOT FUN! The only way to keep the headache from pounding out of control is to lay flat on your back. Not what you want to be doing with a newborn to care for. These headaches can last a few days or even a few weeks.
  • Several other side effects occur often with epidurals: postpartum bladder dysfunction, uncontrollable shivering, itching of the face, neck, and throat, nausea and vomiting, postpartum backache, and inability to move about freely on your own (in 100% of epidural moms).
  • Some rare, but very serious, risks of epidurals also exist: convulsions, respiratory paralysis, cardiac arrest, allergic shock, nerve injury and maternal death.
It's enough to make you consider a natural birth, isn't it? However, if you decide that there is no way you can live through the birth process without pain relief, there are some ways to minimize the risks of the most common epidural problems. The number one way to minimize your risk is to have the epidural placed as late in labor as possible (No, not when you're pushing the baby out...). Postponing the epidural means you can keep moving longer, keep cool longer (no epidural-related fevers), and maybe just summit that labor pain mountain and push your baby out sans any medicine at all. It does mean that you have to cope with labor pain longer! That's where your doula can keep you going. When you don't think you can do it, she's there to say, "Let's just do this next contraction." Should you decide you need the epidural, the doula is there to provide emotional support. After all, even though you may not be feeling the pain, you are still birthing your baby! Doulas also make sure you keep moving. Even if you are completely numb, you can still roll from side to side (with help). This is often enough to keep the baby from getting stuck in a bad position. Your doula can also remind you to request some time to labor down once you are fully dilated. Because epidural moms have loss of sensation, it's often very difficult for them to push their babies out. It's harder to focus your pushing efforts when you can't feel what you're pushing (I marvel that epidural moms can push at all!). Often, doctors end up pulling babies out with vacuum extractors because moms can't get their babies out. The best way to prevent some of these problems is to wait! Once you are fully dilated, laboring down means doing nothing for a while, either until you feel pressure, or until the baby's head is visible. Unfortunately, in most hospitals, the minute you're fully dilated, everyone is yelling at you to push and counting to ten. You almost always have to ask for some time to labor down.

So, while it may be easier to get through an epidural birth without a doula than an unmedicated birth, an epidural is not a replacement for a doula! Will an epidural be sensitive to your emotional needs in labor? I don't think so! Do you need PIES during an epidural birth? Yes!

Wednesday, January 26, 2011

A Dozen Days of Doula Scoop: Day 3

Doulas bake pies. (What doulas do, what doulas don't do.)

Since doulas are relatively new on the birth scene (at least named as such, women helping women give birth is as old as time), many people don't know what doulas do at a birth and what is outside their scope. I've come up with a simple acronym to describe what doulas do. (I only arranged the letters, all the terms have originated from other people.)

Physical
Informational &
Emotional
Support

What does this mean in practical terms? Physical support might involve counterpressure or massage, assistance with positioning, cold or heat therapy, reminders to take bathroom breaks, or offering something to drink. It does not include anything that would be considered clinical care such as vaginal exams, fetal heart rate monitoring, blood pressure monitoring, or anything else described as monitoring. Informational support includes offering a thorough review of the pros and cons of obstetrical procedures when needed. Additionally, most doulas spend time before the birth helping their clients prepare a plan to give themselves the best odds of having a safe, and satisfying, birth. Doulas never make decisions for their clients. Although we all come to the table with personal opinions, as doulas, we set that aside because our primary role is helping moms and dads have their birth the way they want it. Finally, emotional support is so important during birth. Moms going through the experience of birth find themselves very vulnerable. They need someone to tell them that they're okay, and that they can do it. Dads are often too overwhelmed themselves to offer the confident reassurance that moms need. This is where doulas often step in, bringing a calming presence to the often chaotic labor room.

Something many people wonder is whether a doula will stand up for them, and make sure their wishes for the birth are carried out. While some doulas do this for their clients, most doulas don't usually step into this role. Instead, we empower moms and dads to speak up themselves, perhaps reminding them that they always have the option of both informed consent and refusal. In today's birthing world, so often the power is taken away from parents; we want to see it returned where it belongs--not to doulas, but to the two individuals who will always have the baby's best interest at heart, that baby's own mommy and daddy.

Tuesday, January 25, 2011

A Dozen Days of Doula Scoop: Day 2

Does a doula replace dad in the delivery room?

Many expectant parents are rightly concerned that a doula might take dad's place at the birth of their baby. After all, this is a special day for dad as much as it is for mom, for although mom will be the one pushing the baby into the world, dad is welcoming his child as well. Parents worry that a doula will swoop in, taking over all the comfort measures, and slowly but surely elbowing dad aside. In reality, the presence of a doula almost always enhances dad's role at the birth. She gives dad gentle instructions when he isn't sure what to try. She offers him information when the burden of decision making falls on him. She makes it possible for dad to take a guilt-free bathroom or snack break, knowing he is not leaving mom to labor alone. And yes, when labor gets dicey and dad find himself overwhelmed by the intensity of the moment, the doula is there to step in and help them both get through the moment. The way my trainer described it is that a doula fills in the gaps. We never interrupt what dad and mom are doing as long as it is working. We carefully observe the dynamics of the relationship and then fill in the gaps as needed.

What a doula does at a birth is also greatly impacted by dad's birth personality. Some dads really want to be involved in the process. They want to be the one wiping mom's forehead with a cool washcloth, applying counterpressure, and giving foot massages. Doulas are there to hand these dads the washcloths or lotion, or spell them when their arms are about to give out. Other dads just want to be there. What these dads really want is the freedom to be present for the birth of their baby without the pressure of being mom's sole support. For these dads, a doula can remove a lot of stress, allowing them to actively participate as much, or as little, as they feel comfortable doing.

I think the emotions dads experience at birth are an often neglected aspect of the process. Somehow everyone gets so focused on mom (as I told my husband while pregnant with Daniel, "I'm the one having the baby here!") that it's easy to forget that a father is born every time a child comes into this world. As a doula, I want to make sure my moms and dads can look back on their babies' birth with joy.

Doulas are pro-dad, just as we are pro-mom and pro-baby!

Monday, January 24, 2011

You complete me...

I think one of the reasons God gives us spouses is to compensate for gaping holes in our personal abilities. In our five and a half years of marriage, I've seen a few of the ways God has made Stephen able to do things I can't, and me to do things he can't. Here's a few examples:

1. Stephen rips things, I mend them.
I don't know why, but I just don't rip my clothes. I can't remember the last item of clothes I ripped. However, Stephen periodically rips his clothes, sometimes in very odd ways, like the day he managed to rip the middle of the back of his shirt. I then use my sewing skills to make the most unobtrusive repair possible so he can keep wearing it.

2. I have tech-no-clue, Stephen is a tech guru.
I am literally like an old person when it comes to anything computer, touch screen, iPhone, etc. (This blog is the most progressive thing I do, and these days, blogs are the new email.) Any given day you may find me saying something along the lines of "What's with these newfangled contraptions?" or "I don't see anything wrong with version 7.2. Why do we need version 7.3?" I can no longer operate Stephen's phone because it's a touchscreen that I don't even know how to turn on. Anytime I have to call someone on Stephen's phone, he has to dial for me and hand it to me ringing. Stephen, on the other hand, enjoys new technologies, and if he doesn't know what to do with a new one, he soon figures it out. He has an iTouch and a Kindle and would have other techie stuff if we could afford it.

3. Stephen loses things; I find them.
Sometimes he also can't find things he didn't lose. He says it's because he's tall, but I don't understand why he can't see the cheese on the top shelf of the refrigerator. All you have to do is bend over, right? Although maybe I have rubbed off on him a little, because he isn't losing things as much these days. What a relief.

4. I stare at things that are broken; Stephen fixes them.
Like the cabinet door that was hanging by one screw. I'm intimidated by power tools. I like having a man around the house who handles man stuff. What a luxury!

I'm so thankful God made us to complete each other.

A Dozen Days of Doula Scoop: Day 1

I just spent two days, sunrise to sunset (and after), fully immersed in the world of birth, and the down and dirty details of being a doula. Of course, being me, I loved it all. Also being me, I want to share! So, rather than one obscenely long post in which I attempt to cover everything I learned, I thought I'd do twelve posts covering some of the different topics we talked about over the weekend.

Why have a doula at your birth, anyway?

You have already chosen a doctor or midwife, you know you will have a labor and delivery nurse at the hospital, you will have your husband and maybe your mom with you at your birth. Why in the world would you want to have a doula at this very intimate life event? Well, would you like to avoid a cesarean? One study showed simply having a doula at her birth reduced a mother's odds of cesarean by 45 percent. Are you trying to have a natural birth? Doulas reduced moms' usage of all pain medications by 31 percent, even women who were not planning an unmedicated birth. Having a doula there reduced their pain perception so much that they simply didn't need it. To put it simply, having a doula is a risk-free way to reduce labor interventions and the risks inherent in those interventions. One of the reasons a doula can provide such outstanding reductions in labor interventions is her continuous support of the mom. No other care provider in our current birth world is able to be with the mom continuously. Doctors tend to pop in only for vaginal exams and to catch the baby. Nurses are often overstretched, having to monitor two or more moms in labor in addition to managing the hospital paperwork. Even Certified Nurse Midwives, who often long to provide a higher standard of care, usually can't stay with mom for the entire duration of her labor. Doulas can. Doulas are not focused on performing any of the clinical tasks that need to be done to insure a safe birth. We are there to make sure mom has a satisfying birth. (I can say that, because I'm a doula now! Yay!) The continuous support of a doula has also been shown to shorten labor. Do you want a shorter labor? Yeah, me too. Worth the trade-off of sharing this most precious life event with yet another person? I think so. Do you?

Tuesday, January 18, 2011

Do you love the same things I do?

A perfectly ripe peach
The kind that drips down your chin, your neck, and down the collar of your shirt.

Harry Potter series
They were gripping, suspenseful, vivid, and thrilling. I'm afraid the movies were not of the same caliber.

Cooking
There's something to thrilling about taking many unrelated ingredients and creating a delicious dish from them.

Bacon
It's crispy, it's salty. What's not to love? I'm a little bit of a bacon snob though, because I only buy the nitrate free version, and I never, never purchase turkey bacon (too soggy).

Fall
Not too hot, not too cold. Like Goldilocks, I want my weather to be just right. I also love those brilliant salmon colored maple leaves.

Birth
It's sweaty, it's bloody, sometimes there's throw-up. Mom gives it all she has to get what she wants most. There's nothing like that moment where suddenly there's another person in the room.

Home
Staying there. Returning from being away. Being snowed in.

Sleeping
Once I became a parent, I discovered sleep is perhaps the greatest luxury item. (Honey, forget the diamonds. All I really want is for you to keep the kids so I can get a few extra hours in my bed.)

Boys
I have three, all sweet.

Jesus
It was the best of times, it was the worst of times, but He has always been there, and He always will be.

Yucky Words

I'm a word person. I like to read them; I like to write them. But I don't like all words. Some words just sound yucky. I don't like to say them.

Here are a few words I think should be removed from the English language.

Moist
Just try saying it out loud. Sounds yucky doesn't it?

Preggers/Preggo
You may be a redneck if...these are the words you choose to tell people you're pregnant! In a stunning but not totally unexpected contradiction, the word "preggie" doesn't bother me at all. I actually find it a little bit cute.

Buttocks
Especially when used to refer to people. What are we, livestock?

Eczema
I have a particular aversion to this word for other reasons, but it's also just not a pretty word.

Acne
Do we have to make people with this condition feel even worse by using such an ugly word to describe it?

Tits
Rhymes with zits. 'Nuff said.

There's also a few words I like to say, but don't have occasion to use much in real life.
Goodly
Vanquished
Aura
Gorgeous
Epic
Abhor
Wrought (Did you know that "wrought" is past tense of work? I didn't, at least until I looked it up in an online dictionary.)
Persay

I'm seeing a trend here. Can anyone say, in the days of King Arthur?

Friday, January 14, 2011

Hidden benefits

Holidays are all about food, aren't they? At least, that's what my family thinks. We like to celebrate with meals. Thanksgiving means a groaning table that could probably feed a hungry family for a couple of weeks. Seriously. My grandmother, two aunts, mother, and now me, all think as we're cooking our respective dishes that there just might not be enough. It's not one pan of dressing, it's two. We have three or four big bowls of different salads. Of course a giant turkey, plus a ham. And then there are sides, usually six or seven of those. And I would never, never forget the dessert. How could I, when it is a spread to dazzle the eye? A couple of cakes, three or four pies, maybe a cheesecake, and other stuff. Needless to say, we usually just lie around and groan for a couple of hours afterward.

We like food at other holidays too. Christmas means baking, Valentine's equals chocolate, Easter calls for a big family dinner with such dishes as macaroni and cheese (something with cheese, definitely), July 4th, we have to grill out, and birthdays mean birthday cake! I have definitely had my share of tight pants following the holidays. However, this year has been an anomaly in my life. Following the allergen free diet (for Daniel's sake) pretty much eliminated all fattening foods from the menu. Thanksgiving dinner was meat, potatoes, and veggies, just as most of are meals are these days. Christmas Eve dinner was (you guessed it), meat, potatoes, and veggies. As for dessert, I didn't have anything. Not even the delicious cherry sorbet that is one of the few desserts containing no allergens. I decided since I was already having a rather austere holiday spread, I would give up all sugar, which is something I'm always trying to do. I have a terrible sweet tooth, but eating sugar makes me feel terrible. I felt like my body needed a break from refined sugar. Apart from the actually week of Christmas, when some maple sugar and cherry sorbet did enter my mouth, I have not eaten sugar since before Thanksgiving.

So knowing that I was not indulging myself, although I certainly didn't count calories or limit food consumption of acceptable foods (for allergy purposes), maybe you won't hate me when I say that I was maybe the only person who lost weight (six pounds to be exact) over the holidays. I didn't work at it, I didn't agonize, I just did what I needed to do for my little Daniel, with the happy side effect of surpassing my post-Nathan weight loss. I'm only about two pounds heavier than I was on my wedding day (the thinnest I have ever been, mainly due to the stress of trying to graduate and plan a wedding three weeks after graduation day), although I still can't fit into some of my snuggest pants. Pregnancy just made me mushier, especially those three inches right below my belly button. But other than the post-preggy mush, I'm fitter than ever. It's been three months since we cut out all the allergy-provoking foods, and the diet, while difficult, has not been without benefits. So thank you allergy diet for making me thin again!

Tuesday, January 11, 2011

Photo Shoots


Every Christmas since Nathan was born, I have taken a nice picture for the grandparents as their Christmas present. The first year (just Nathan, who was not yet walking) was not all that difficult. I nestled him in an obliging tree trunk and simply tried to capture every adorable expression. The second year I found myself a bit more challenged with a child capable of walking and running, but at least with one, I could simply follow him around and snap photos every time he looked in my direction. Last year, Nathan was old enough to follow directions (sometimes), and Daniel was not yet mobile, so the main problem was trying to get them smiling at the same time (or at least not crying). Nonetheless, every year I have been able to come up with a cute picture worthy of framing.

This year, photographing my children reached an entirely new level of difficulty. Nathan was mostly very obliging, but Daniel was cranky and wherever I put him, he would immediately get up and walk straight towards me. You photographers out there know that the one place it is impossible to photograph someone (short of an expensive specialized lens) is six inches from your face. That's pretty much the only place Daniel wanted to be and the only place he wasn't crying. I had them dressed in their matching shirts, and really wanted to get a picture before the shirts got dirty. I knew I only had about a thirty minute window (or less). Since Daniel wouldn't sit in the chair I had set up for them, I got a little desperate and as Daniel was running around, started telling Nathan, "Put your head next to Daniel's, now over there, okay, put it next to Daniel's head." Needless to say, there was a lot of crazy running around for several minutes. Finally, Nathan lunged over Daniel and I snapped the picture at just the right moment before Nathan fell over on top of Daniel. Crying ensued. I rushed to the computer to see if I had anything--anything at all! As luck would have it (or perhaps a miracle of God for a poor tired mom), I got this picture.