Category: Practical Planning

What you need to hear about a healthy pelvic floor for pregnancy and beyond

9/28/2016

Pregnancy is a state that puts new strains and pressures on every part of our body, including our pelvic floor. For most women, the pelvic floor is a part of our body we don't think about until it stops working or until we have to push a human through it. I highly recommend you take some time to listen to this fantastic podcast discussing how we can all support healthy function of our pelvic floor through pregnancy and postpartum recovery. Some of the topics covered are Kegels or no Kegels, squatting and how to do it right, and the reason you should stop wearing all shoes with heels.

Tell me more about the pelvic floor!

1 Comment

Atlanta Birth Center is open!

7/1/2016

1 Comment

One of the birth suites at Atlanta Birth Center

Expectant moms in Atlanta finally have the option of choosing to give birth in an independent, free-standing birth center. The midwives of Atlanta Birth Center will be delivering babies in the center beginning this month. With close proximity to area hospitals, the birth center is a great place for moms who want the high touch care of home birth in a setting that allows for rapid transfer in case of emergency.

The birth center is currently staffed by three full-time midwives, who will receive additional assistance at births from several area nurses and midwives. Every birth center birth will have at least two medically trained care providers present to handle whatever needs might arise for mother and baby.

Birth center care is geared toward mothers who want high levels of support, and low levels of intervention. The midwives are prepared with medical equipment to support unexpected emergencies (such as postpartum hemorrhage), however, should a mother require pain medication, including epidural, higher levels of medically managed care, or cesarean delivery, a transfer to the hospital would be done.

Transfers will go to Atlanta Medical Center (a 5 minute drive, 10 in traffic), and urgent transfers to Emory University Hospital Midtown, which is directly across the street from the birth center.

Most low risk mothers will be able to use the birth center, however, there are a few conditions that cannot be handled at the birth center, including pre-existing or ongoing hypertension, pre-existing diabetes, and twins. There may be other high risk complications that are not appropriate for birth center delivery. At this time, the birth center is not an options for mothers seeking a VBAC (vaginal birth after cesarean).

Atlanta Birth Center is located in the heart of downtown Atlanta at 1 Baltimore Place, Atlanta GA.

Take the photo tour of Atlanta Birth Center here.

To find out more, visit their site: Atlanta Birth Center.

1 Comment

Breastfeeding Stations: Why you need one, and how to get it set up

5/19/2016

0 Comments

Something about expecting a baby makes us mamas want to nest. Maybe getting our home turf prepared makes us feel like we’ll be prepared for what’s coming. And while decorating the nursery is fun and regarded by many as a rite of passage, freshening the paint and choosing a crib set won’t truly help you get ready for what lies ahead.

There’s some other practical things you can do with that pregnancy energy that can make your babymoon easier. One of those things is getting a nursing station (or two or three) set up and stocked before your baby arrives.

If you are planning to breastfeed, good for you! You are giving your baby the best nutritional start possible. For you first time moms out there, I’m going to let you in on something. For the first four to six weeks of your baby’s life you will probably feel like you spend all your time feeding your baby. Having a comfortable breastfeeding station can be a lifesaver.

You should create at least two nursing stations, one for sleeping, and one for daytime feedings. If you have a large house, you may want multiple daytime nursing stations.

Three things to know about nursing:

You’ll be trapped.
You’ll be thirsty and hungry.
You’ll be bored.

The goal of your nursing station is to take care of your needs as you take care of your baby’s needs.

Make your nursing station:

Choose a spot that is comfortable, where you will have built in arm support or be able to tuck in pillows easily. You may want to choose a location where you can see the TV or access the internet through your phone, tablet, or laptop. Be aware that this spot will probably end up stained with milk, spit-up, poop or some combination of these. An old blanket will protect your furniture and can be popped in the wash for easy cleaning.
Stash your spot with these items:
1. Breastfeeding pillow. These are great for nursing a tiny baby especially. You may not need one when your baby gets older.
2. Other pillows. You may need extra pillows for your back or under your arms. Having a regular pillow and a couple of throw pillows will give you options until you figure out what works perfectly for you.
3. Burp cloths. Lots of them. These are useful when your baby spits up, but also to tuck into your nursing bra to sop up the milk that drips out of your baby’s mouth and out of the other breast. You may also want to keep some extra breast pads near by.
4. If you also want to be able to change your baby’s diaper at your nursing station, include diapers, wipes, and a surface to lay your baby on, like a foldable changing pad or towel.
5. A case of water bottles. Breastfeeding makes you thirsty, and you will find you don’t realize you’re thirsty until your baby is latched on and you’re stuck. Even if you don’t like room temperature water, have an emergency supply.
6. Non-perishable, healthy snacks. Packs of nuts, trail mix, crackers, or granola bars are good choices. There will be times that if you don’t eat something while nursing, you won’t be able to eat at all, and remember, you’re still eating for two!
7. Entertainment. Reading material, television remote, iphone. Just make it something you can do one-handed.

Make your night time station:
A night time breastfeeding station should have all the same items as a daytime station, but be designed for maximum rest. It is optimally a place you can either lay down to nurse (propped up on your side with pillows behind your back) or recline with pillows under both arms so you can doze while your baby is feeding. Make sure your baby has a place to sleep close by, either in the bed with you or something right next to the bed. Then add these night time necessities:

A lamp with a red bulb. For the first few weeks at least, you’ll probably need to see what you’re doing during feedings. Red light is less jarring in the middle of the night, and won’t disrupt melatonin production for you or your baby.
Pillows--even more of them! For your back, under your arms, behind your head, tucked under your knees. You want your body and your baby fully supported so that you can fall asleep without worrying about your baby falling out of your arms.
Diapers, wipes, extra baby blankets, clean outfits. You don’t want to be wandering the house looking for these items in the middle of the night if your baby spits up or has a leaky diaper.

Happy nesting and nursing!

0 Comments

The "No Warm Body" Rule

8/18/2015

0 Comments

So much of the birth process is not hard and fast rules. There are many elements of labor and birth that are out of your control. This can be a hugely difficult realization for those of us who are control freaks (guilty). The good news for all of you who HATE the thought of giving up control is that there are things about your birth that you should exert control over. While this may be unwelcome news for you free spirits out there, bear with me--putting in some forethought may very well free you up to go with the flow even more during your labor.

Here’s a very important rule: No warm bodies.

In a nutshell:
When choosing companions for your labor and birth, don’t invite anyone who will contribute only a warm body to the experience.

That means anyone who has tried to invite themselves to your birth.

That means your single friends who think your labor might be a great time to get together and socialize.

That means nursing students in a teaching hospital who are there for observation.

That means your best friend who’s “never seen a baby born.”

That also means your baby sister who’s never been pregnant, and who you plan to show how it’s done.

That means your older children.

That may mean your mom.

Anyone who would be present at your birth only as a spectator is likely to be a hindrance to the natural process of labor. The truth is that when you are giving birth, you will need support. You are not putting on a show, you are having a baby. It’s really hard work. You will sweat, and you will only appreciate those people who will wipe the sweat off. You will probably say you can’t do it. You will need the people who will look you in the face and say with conviction “Yes, you can.” You will be in pain. You may throw up. Don’t invite anyone if you aren’t okay with them seeing you at your worst.

When I was pregnant with my second child and planning for a much desired VBAC, I made my choice of labor companions based on who would be useful to me. I wanted people who could support me through the process, but I didn’t want anyone coming who didn’t have a role to play. I chose carefully and selectively, and I didn’t regret those decisions.

One of the biggest problems I’ve seen with birth “observers” is that their presence can slow labor down (not what you want). You know that phrase “a watched pot never boils”? Yep, applies to labor too. Ideally, your birth companions are working almost as hard as you are to keep you going.

Caveat: (There’s always a caveat for rules, isn’t there? Especially in birth…) A few women out there are social birthers, who appreciate being surrounded by a gaggle of women while birthing. However, even if you are one of these women, it is critical to carefully evaluate who will be helpful to you and who may potentially disrupt your labor rhythm before giving out invitations. It's okay to have many people at your birth if that's what you need. If they're coming for any other reason, you may want to reconsider.

By the way, the no warm bodies rule applies after the baby is born also. Especially for the first two to four weeks, you will be sore, milky, elated, cranky, sleepy, and confused. You need people who can bring dinners, fold laundry and entertain older children. Put off anyone who you feel like you need to straighten up the house for. People love newborn babies so much (who wouldn’t?) that they often forget what that sweet baby’s parents are going through.

0 Comments

3 Excellent Reasons to Hire a Doula

7/7/2015

0 Comments

These days, many pregnant women have at least heard of doulas, perhaps because a friend used one or because they have read about doulas on the internet or in a book. More people now understand what a doula does (provide physical, emotional and informational support during pregnancy, labor and birth), although my husband’s grandma still thinks I deliver babies. (The discussion usually goes like this: “Grandma, I don’t deliver babies, I provide support to the mama as she is delivering her baby.”)

Unfortunately, it is still very difficult to be reimbursed by your health insurance company for doula care, although some people have been able to negotiate with their insurance to cover at least some of the cost. This leaves most expecting parents paying for their doula out of their own pocket, at a time when there are many other extra expenses, both for medical care and baby gear. It’s easy to decide that doula care would be nice, but it’s simply a luxury you can’t afford.

Even if your budget is tight, there are some really excellent reasons to consider prioritizing hiring a doula, including the three listed here.

1) You will remember your birth forever.
For most women, the birth of their children will be the single most remembered event of their entire life. They will spend more time telling their birth story than any other story from their past. My mother and grandmother still recount details surrounding the birth of their children. Because of the long-lasting impact of these memories, it’s worth investing in creating a good memory before and during your birth. Women who use doulas tend to have more positive memories of their birth, even if they faced unexpected challenges, both because of the emotional support doulas provide, as well as the opportunity to know their options and fully participate in decision making.

2) Doulas reduce your chances of having medical interventions during your birth, including surgery.
Several studies have been done showing that doulas reduce the usage of all kinds of medical intervention during birth, including epidural use, pitocin use and cesarean surgery. Avoiding these interventions when possible reduces both potential health complications for mother and baby and health care expenses. As labor is happening, a doula can help you ask your care provider questions to identify necessary--and unnecessary--interventions. She also helps you do things including movement and position changes that facilitate labor progress, reducing your chances of “failure to progress,” which can lead to many interventions. Emotional support from a doula often reduces stress levels which, when high, can inhibit your body from effectively laboring.

3) A doula is typically the only person who can offer both continuous support during labor and knowledge of birth.
Your care providers are trained in medical care of birthing women, but will not be present to provide continuous labor support. Your partner is probably going to be with you throughout labor providing support, but likely does not know the ins and outs of birth. However, a doula has extensive knowledge of the birth process and is present continuously throughout labor and birth providing you and your partner with support. This matters because there are many moments in labor when expecting parents need reassurance that everything’s normal or ideas for how to cope with the challenges of labor. If you have a doula, she will already be there every time those moments happen.

0 Comments

Labor Bag Must Have: Pillow

6/10/2015

1 Comment

Hospital pillows are pretty horrible. They are usually flat, and they are covered in an impermeable plastic that does not breathe at all. When you’re giving birth, they’re pretty great to stuff between your legs, but one way to make your hospital birth feel a little more homey is to bring a pillow from home. It doesn’t have to be your favorite, but pick one that feels comfortable tucked behind your head. Labor’s rough enough without feeling like you’re laying your head on a slightly stuffed garbage bag. Put at least two pillowcases on it, preferably colored ones so you can easily tell your pillow from the hospital supply. Then after your baby’s born, you can take the top pillowcase off (it will almost certainly be sweaty) and have a fresh pillow ready for your postpartum stay. Ahhhh...good night!

1 Comment

Giving Birth again after a Disappointing Birth Experience

4/10/2015

0 Comments

My first birth wasn’t at all what I wanted. Everything I had carefully planned went completely out the window. My baby and I were healthy, but I felt disappointed that my birth was so different from what I envisioned. Is there any chance that my second birth can be different?

Yes, absolutely! There is a lot you can do to give yourself the opportunity to have your ideal birth this time around. Of course, like everything in birth, no one can guarantee that you will have a specific birth experience. The process of birth is too unpredictable for that. However, there are several steps you can take to stack the deck in your favor.

Choose your care provider with extreme care. The way your provider practices will have a direct impact on every element of your birth. If ninety percent of your doctor’s patients have an epidural, chances are higher that you will also, even if you didn’t intend to have one. If you discover that your doctor has a 40% cesarean rate, understand that you have a 40% chance of having a cesarean under that doctor’s care. See this article for an in-depth look at how to choose the right care provider for your situation. http://www.wellroundedmama.blogspot.com/2010/09/nice-is-not-enough-questions-for.html
Evaluate your previous delivery, and do your own research. What happened that you were unhappy about? If the same situation happened again this time, what other options are there? What would you rather do?
Ask your care provider questions throughout your entire pregnancy and delivery. Most obstetric appointments are relatively short. If you save all your birth questions for the couple of visits before delivery, you probably won’t have time to fully cover your concerns. Do yourself and your care provider a favor. Start planning early, and ask a couple of questions each visit instead of a lot of questions at the last minute.
Take a really good childbirth class (not the one the hospital offers) or at least do a lot of reading. Two of my favorites are The Birth Book by Erica Lyon and Creating your Birth Plan by Marsden Wagner. The more you can learn about birth before the process starts, the better equipped you will be to handle the twists and turns of labor.
Hire a doula. Mothers who have a doula at their birth report higher levels of satisfaction with their birth. They also experience fewer interventions of all kinds, including epidurals and c-sections. While preparing yourself is key, having a birth professional with you during your entire labor takes the pressure off to remember information and figure out what to do while going through the hard work of labor. A good doula will help you stick to your birth plan when possible, as well as evaluate when you need to deviate from it.
Do whatever you can to stay healthy throughout your pregnancy. Eat well, move, get lots of sleep, find ways to manage anxiety and stress. A healthy mother and baby have more reserves for the stresses of labor, meaning fewer interventions for a baby in distress or a mother who’s run out of energy.
Cultivate a flexible attitude. The more rigid your goals are, the less likely that you will achieve all of them. Leave room for the fluid nature of birth. Understand that you can do everything right, and still have a birth that doesn’t meet your expectations. Realize that if you have followed the above steps and still don’t have the birth you want, perhaps it wasn’t meant to be. Much as we would all like to think that birth is under our control, it is an untamed, elemental process. Especially if you have worked hard to have a certain kind of birth, you don’t have to have any regrets that you could have done something differently if it doesn't turn out the way you planned. You did your best for your baby, and that is what matters most.

0 Comments

The Quick and Dirty Guide to Having a Great Birth: What you really need to do during pregnancy

3/29/2015

0 Comments

The story of modern life is that everyone's busy, and when you’re expecting a baby, you’re often both too busy and too tired to do everything. Yet the things you do to prepare during your pregnancy make a tremendous difference when the big birth day finally arrives. So here’s my cut-to-the-chase guide to the top five steps to take during pregnancy to improve your birth experience.

Choose a care provider who is a good match for the way you want to birth. Doctors and midwives revert to their habitual behaviors just like the rest of us. If they are used to scheduling inductions for most of their patients or encouraging epidural use, they will probably do the same thing with you. Finding someone whose practice style closely matches your wishes is a fantastic way of instantly creating more harmony in decision making which can help you have a more peaceful birth.
Hire a doula. Doulas are birth experts. Having a doula present at your birth means you don’t have to try to learn everything there is to know about having a baby before your baby is born. She can also save you time by pointing you to resources for any specific concerns you have during your pregnancy.
Take a childbirth class. Yes, I just said you don’t have to know everything about having a baby, but it does help to know something! A good childbirth class helps you know what to expect during labor so that when the time comes, you’re (slightly) more ready for what’s ahead.
Nourish yourself and your baby. Eat the stuff you know is good and skip the stuff you know is trash. Easy rule of thumb: whole foods--good; processed foods--bad. A well-nourished mother and baby are physically more capable of handling the stresses of labor.
Walk every day, or as close to every day as you can manage. Walking is one of the best exercises for pregnant women. It’s gentle, builds endurance, and helps baby settle into an optimal position for labor. If you’re pressed for time, try taking five to ten minute mini-walks throughout the day instead of one long walk.

If you can do these five steps during your pregnancy, you will have greatly improved your chances of having a low stress, fantastic birth!

0 Comments

What to wear during labor

3/21/2015

0 Comments

If you’re giving birth in a hospital, you wear a hospital gown, right? I mean, don’t you have to? Actually, no!

There’s nothing wrong with opting for the standard hospital gown if that’s what you want to do, but the fact of the matter is, you can wear whatever you want. Nurses in a hospital have a routine they are accustomed to, and part of that is instructing you to gown up. However, you always have the right to speak up and express your preference for wearing your own garments from home. Most nurses in most cases will not have a problem with this, and you can simply change into (or keep wearing) your choice of clothing.

Check out this link for more about why you may want to consider wearing your own clothes.
http://www.foxnews.com/health/2014/09/23/keep-your-pants-and-your-dignity-at-hospital/

What are some things to consider when choosing your laboring outfit?

These clothes will almost certainly end up with blood, amniotic fluid, perspiration, and other bodily secretions on them. If you want to bring something from home, you may want to bring old clothes you can trash afterwards or at least something that can take heavy duty laundering. Same applies to clothing you wear postpartum; you’ll be leaking lots of wet stuff for a while.
For the actual birth (pushing the baby out) care providers will need access. So while it’s totally okay to wear shorts or underwear while laboring, you will have to ditch these before pushing or anytime your care provider performs a vaginal exam. A birth skirt may be a good option if you want bottoms you won’t have to slip off.
Wearing something a little snug around your belly (a comfy t-shirt or some shorts) can help keep monitor bands from shifting around so much. This can help you move more freely without your labor nurse having to constantly pop in to adjust the straps. Don’t make it too snug though, as most women find added pressure on the abdomen in labor to be uncomfortable.
If you’re bringing clothes from home, remember that you may need a change of clothes during labor. If your water breaks with a huge gush, you will not want to keep wearing wet clothes. If you are absolutely opposed to a hospital gown, bring back up garments.
Bring clothes that you can get on and off easily. During labor you will be making lots of bathroom trips, you may be hopping in and out of the shower, you will likely be having a few vaginal exams, and you will probably at least have some kind of heplock in your arm (an IV port that is not currently connected to an IV bag or pole). You won’t want the added annoyance of clothing you can’t get on and off your pregnant body.
If you have the option to labor or birth in water, you may want to bring either a sports bra or bikini top. No one will blink an eye if you hop in the water wearing nothing at all, but you may feel more comfortable with a little coverage.
Don’t forget socks or flip-flops, especially if you’re squeamish about walking barefoot on the hospital floor.
If you opt for the hospital gown, you can wear it any way you like. You can keep your bra on underneath if you need that extra support. Many women like to wear two hospital gowns, one opening in the back, and another layered on opening in the front to keep your butt from hanging out. This is especially great if you’d like to walk the halls or have labor companions in the room at certain points who you don’t want seeing all your business. Or you can wear a hospital gown with shorts underneath.
If you need a cesarean during labor, you will need to wear what the nurses provide. Period. They need to create a sterile field for the surgery, and they are the experts in how to do this. This is a time when it is best to let them carry out their job in exactly the manner they have been trained. You can ask your nurse after the surgery when it’s appropriate to opt for your own clothing.
You may end up wearing nothing at all during certain parts of your birth. If you are feeling exposed, ask for something to cover up. If you don’t care, that’s also fine. Birthing mothers can’t always be bothered with clothing. That being said, it’s probably wise not to invite anyone to your birth that you wouldn’t want to see you naked. As for your care provider, nurses and doula, they’ve seen it all before, it’s part of the job, and they are way more concerned with your comfort, well-being, and getting your baby born safely than whether you’re wearing any clothes.
Immediately after your baby is born, you probably want to spend some time skin to skin with your fresh little newborn snuggled directly on your breasts. You may want to remove whatever you were laboring in if it doesn’t have a front opening. If you’re feeling cold or exposed, your nurse or doula will be happy to cover you and your newborn with some blankets.
If modesty is a concern for you, let your birth team know. Tell your doula during prenatal visits, and let your nurse know when you arrive at the hospital. They will be happy to take extra precautions to make sure your privacy is protected as much as possible.

0 Comments

What you need to hear about a healthy pelvic floor for pregnancy and beyond

Atlanta Birth Center is open!

Breastfeeding Stations: Why you need one, and how to get it set up

The "No Warm Body" Rule

Recommended Reading: Breastfeeding Made Simple

3 Excellent Reasons to Hire a Doula

Labor Bag Must Have: Pillow

Giving Birth again after a Disappointing Birth Experience

The Quick and Dirty Guide to Having a Great Birth: What you really need to do during pregnancy

What to wear during labor

Author

Archives

Categories