Our Mindful Life

Our Mindful Life: March 2013

Our Mindful Life

Our Mindful Life is about paying attention to what it is that we do on a day to day basis and how we impact each other and the planet. We will talk about all of the things that we do here at home to make ourselves and the world a better place.

Wednesday, March 27, 2013

Mindful Pregnancy Checklist

I was recently sent an email from a big name pregnancy and baby website, directing me to their pregnancy checklist.  I was surprised that while it included things like, "Make a Baby Budget", "Have Sex", and "Find a Prenatal Exercise Class" it left off many things that I consider to be highly important, such as, "Make sure that you and your care provider are compatible", or "Decide where you would like to give birth."  So, I decided that I'd make my own mindful pregnancy checklist.

*****I have worked on this for hours, and there is a lot of information and links here.  Because of this, I made a printable checklist that is only one page, as well.  For the printable checklist, which is quite a bit shorter than the one below, click here.***

Mindful Pregnancy Checklist

* Figure out your "Due Time".  Your due date is an estimation of when you will deliver.  It is smack dab in the middle of a four week window during which the majority of women will give birth, with most of these women giving birth AFTER 40 weeks gestation [12].  Some women refer to this time as their due month.

* Check out your vitamin and make sure that you are getting what you need.  If you weren't already taking vitamins before conception, it is a really good idea to go ahead and start now.  You can often get a prescription from your doctor which insurance will cover, but there are many prenatal options available.  I have a hard time swallowing pills - especially in the first trimester - so chewables work best for me.  Also, vitamins with iron often cause nausea, so opting for one without, if you aren't anemic, can be a good option as well.  Just remember, there are many options and it is better to explore than miss most doses because your current vitamin isn't working for you.

* Think about where you would like to give birth, and research your options.  Many people assume that a woman will simply give birth at the hospital closest to her home, and that is the only option.  However, there are actually several options, and several reasons why a woman would birth somewhere else.  Some hospitals don't have maternity wings, so you may need to go further away to birth than expected.  Many hospitals have policies that may not work for your desired birth, such as policies on VBACs, doulas, or birth plans.  Free standing birthing centers with midwives or home birth are also good options for many low risk women.

* Choose your doctor or midwife.  Sometimes knowing where you want to give birth first is helpful in narrowing down providers, but sometimes you will know you want a certain provider and will go to where he or she practices instead.  For example, if you know you want a homebirth, you will be looking for a midwife instead of an obstetrician.  If you know a certain OB who your friends have used and liked, then you may chose to go to a hospital farther from home in order to use him or her.  The care provider's philosophies on prenatal care, C-section rate, birthing rules, and personality should all be factors in your choice of provider.

* Make sure that any medications you take are safe during pregnancy.  Long term medications may need to be switched or adjusted.  Over the counter medications can also be unsafe during pregnancy, so be certain that whatever you are taking won't hurt your baby.

* Eat well.  Bulk up on your fruits and veggies.  Get lots of good protein.  Aim for 80 - 100 grams per day.

* Learn about the different tests that will be offered (or demanded) during your pregnancy.  This is a decent list of screenings and tests that your provider may want to perform.  Remember that all of these tests are optional, to some degree.  Some may benefit you while others may not.  Learn about each test, the benefits and risks, and decide which ones you are comfortable with pursuing.

* Consider the impact of your pregnancy for others and announce it.  There are people that you will call (or text, ahem) as soon as the second line appears on that stick.  But there are others who you will handle differently.  Employers, for one, will need to be notified in a more professional manner.  Typically, one tells employers when the pregnancy begins to affect work OR after the first trimester - whichever comes first.  Your employer will need time to plan for your maternity leave if you are returning to work, or for your replacement if you are not planning on returning.  Giving them ample time for this is a courtesy.  Also, consider those who may take the news hard, and break it to them gently, while giving them room to process.  With fertility problems at a high in our society right now, we all know someone who has struggled to conceive.  Even if that person is happy for you, they may be sad for themselves at the same time.  Blind siding them with a cheery announcement over Christmas dinner with the family may not be the most kind thing you have ever done.  Consider dropping an email to let them know ahead of time, so that they can process the news alone and be prepared when you spring the news on everyone else.

* Think about the items you will want and need for the new baby.  Register, ask friends to make things, make things yourself, and begin to buy things.  Every family's needs are different.  Some families will want the complete matching nursery, high chair, baby swing, travel system, and wardrobe, while others will want little more than a wrap, a week's worth of gender neutral baby clothes, and some cloth diapers.  Figure out what you really want and need for your baby and start having the fun of picking out those tiny little things!

* Think about the expenses that will occur after the baby arrives.  How will your birth be paid for?  Even if you have health insurance, there may be a deductible to be met.  If you are paying for a home birth, it may be out of pocket (although this may cost less than what your share of a hospital birth might cost).  Then, there will be feeding costs, clothing, diapering, toys and accessories.  How much money will you have to allocate to these things and how will you choose to spend it?

* Determine your support system.  Who is your usual support?  If this is your first baby, do you know other parents who you admire?  How supportive are your parents?  How supportive are your grandparents?  How open to new ideas are they?  Do you have friends with babies?  Do they parent the way you will want to?  If so, you are golden.  You know who you can call with any crazy baby questions that arise (and trust me - there will be crazy baby questions!).  If you don't, start looking around for others who can support you in the areas you may feel lacking.  For example, if you know you want to breastfeed, but all the moms you know formula fed, pregnancy is the time to start searching out breastfeeding support.  Looking for information about La Leche League while holding a screaming week old baby who just isn't latching well is SO much more stressful than attending a couple meetings during your third trimester.  And getting to know some leaders and moms you'd be comfortable calling if problems arise can really be priceless.  Also, if there is a mom in your life whose parenting you would like to emulate, let her know ahead of time!  She may be more comfortable offering advice if she knows you would like to know what she is thinking.

* Stay active during pregnancy.  The first trimester can make this one really tough, what with the exhaustion and all.  But that typically starts to lift as the second trimester approaches.  At this point, try to maintain activity!  The more active you are now, the easier the third trimester and labor will be later.  Your body is going to do some hard work carrying that extra weight around and birthing your baby.  Keeping your muscles toned will help it to do both of these things.

* Consider who you would like at your birth, including a doula.  A hired labor partner can be a great asset.  Many women have the expectation and dream that their husband will be the perfect labor coach, guiding you through every contraction and difficult decision.  But that is a LOT of pressure for someone who can really only sympathize remotely, and may be feeling very overwhelmed himself!  A doula is an experienced labor coach who knows all about how the body works, has studied pain management techniques, knows what to expect from the stages of labor, knows what interventions a doctor may want to perform - and understands the risks and benefits of these interventions - all of which helps you to determine what to do under pressure.  Consider hiring someone if you feel at all uncertain about labor and birth.

Beyond a doula, who else do you want - or not want - at your birth?  Some women really do not want anyone at all extra to be nearby when they give birth.  Some women relish the support and love of an intimate group of friends.  Who you want to be with you is a PERSONAL decision, and should not be dictated by anyone else's standards.  If you love someone who will be nervous the entire time, it may be stressful to have that person in the room with you.  If someone has a tendency to be bossy, it may be too stressful to have that person in the room with you.  If there is someone you know who just KNOWS how to say things in a way that make sense to you, and that pulls you back from the brink of hysterics with just the right words every time, perhaps that person would be a great addition to your labor team - even if it is someone unexpected.  Do you want your children there?  If so, who do you want to be there to take care of your children's needs while you are laboring?  These are all things to consider long and hard before deciding and asking.

* Make a list of baby names.  This can be a really tough decision.  Perhaps there is some tradition that your family has, or one you would like to start, in regard to naming babies.  For example, each of our children have familial names with one name being from each side of the family; first name from one side, middle name from the other.  And don't assume that just because you love a name, your partner will too.  My dh cannot be sold on Beatrice, even though I love it!  Also, no matter what name you pick, some people will hate it.  What matters is whether or not YOU love it.  If you know that someone will hate your choice, you may choose not to share your options until they are on a birth certificate.

* Think about childbirth classes or techniques.  There are so many options for childbirth classes, and not every one is going to be right for every person.  Take the time to learn about what is available and what feels like it would be best for YOU.  Lamaze and Bradley are two well known techniques.  Hypnobabies is my preferred method (great not only for birth but also for pregnancy insomnia and birth fear!).  Birthworks is another natural childbirth technique.  Several stores, birth centers, hospitals and doctors' offices also host birth classes.  One thing to be aware of is that some birth centers, hospitals and doctors' office classes will center around what their policies are, as opposed to helping you learn to manage and not fear labor.  Especially if you are on a limited budget, spending your dollars elsewhere may be a good idea.  Be willing to take a leap on some of these, too.  When I first heard of Hypnobabies, I laughed!  No way I thought it would work.  Turns out, I have used it for 2 amazing births and use the "Relax Me" track to help me sleep even when I am not pregnant!

* Decide what birth culture you are going to surround yourself with.  If you've never thought about "birth culture" before, this is a good time to do so!  If you spend hours every day watching traumatic (dramatic) births on A Baby Story, or some other television program, you may want to consider how you are programming yourself to think of how birth looks.  And once that belly starts to bump, people start feeling the need to tell you their terrible birth stories.  The gorier they are, the more they feel the need to share.  One thing to remember, though, is that MOST of the scary, terrible birth stories out there happened because of lack of preparation, bad positioning, hospital policy, or interventions.  Pitocin, for example, is standard operating procedure in most hospital births these days, though it is almost always unnecessary.  It causes horribly painful contractions that are difficult for both mother and baby to tolerate.  Mother almost always ends up with an epidural to numb the pain of the Pitocin, and then labor and pushing don't proceed well because of the epidural or baby is distressed from the intense contractions and a c-section is performed.  So when Debbie down the street gets to the part of her birth story where they put her on Pitocin because she wasn't progressing fast enough (for the doctor), you can pretty much guarantee that the birth went down hill from there.  It wasn't because BIRTH was scary.  It was because PITOCIN is scary.

Knowing this can help you to decide what images of birth you are willing to allow yourself to receive.  Birth can be one of a couple things.  It can be a beautiful, empowering experience that brings you into a new understanding of your body.  It can be the equivalent of pushing your body to run a marathon.  Or it can be a scary, dreaded time of pain and agony.  How can it be so different for different births?  Fear.  In American culture, birth is portrayed as an illness at best, or a narrow walk with death at worst.  But in reality, birth is simply a natural process that takes place within the human body.  Most issues that would arise during a birth are rare, and modern medicine takes care of most of them.  So, the fear of complications is really something that mothers need to try to put aside.  The reality of the matter is that you are far more likely to have a healthy pregnancy, birth and baby than not.

The fear of pain is the other great worry with child birth.  The thing about fear is that it causes your muscles to tighten for fight or flight. Tight muscles during labor and birth are NOT your friend.  Think of it like this.  If you get a Charlie horse in your leg, clenching your muscle in reaction is PAINFUL!  It doesn't help the Charlie horse to go away.  It actually prolongs the cramp and makes it worse.  But relaxing, stretching, taking a deep breath, drinking some water and breathing makes the cramp go away much more quickly, and leaves less pain behind afterwards.  Now, a Charlie horse is a CONTRACTION of the muscle in your leg.  So when your uterus has the same type of contraction, the same techniques will cause the pain to be less, as well as shorter duration.  And, allowing your body to do its work and get through the contractions instead of fighting them allows your birth to progress more quickly and smoothly, with less intervention.

So, since fear is not your friend during pregnancy and birth, how do you stay away from it?  Not allowing people to tell you their nightmarish birth stories is a good start.  Simply smile and say, "I'm sorry, I'm just not listening to scary birth stories until after the baby is born." And then introduce a new topic of conversation.  People are uncomfortable changing the subject and will usually not even go back to question your statement if you introduce a new topic right away.  Another way to stay away from fear is to surround yourself with positive birthing stories.  You can watch videos of positive births on You Tube.  You can read positive birth stories from me or other people.  You can pick up a copy of pretty much any book by Ina May Gaskin, and get a plethora of positive birth stories.  I would start with Spiritual Midwifery, personally.  Visualize the birth you DO want, instead of worrying about the birth you don't want.  If your birth could be perfect for you, what would it look like?

* Start talking about the baby with your older children.  We give the baby a nickname until we find out the gender, then we give the baby a permanent name when we are ready.  This has helped our children to have a connection with the baby before birth.  We have followed along with Your Pregnancy Week by Week, for some pregnancies, or used websites or phone apps that send a weekly note discussing the development of the baby every week.  Again, you may find that some websites or books send more doom and gloom than baby development and you may choose not to utilize those sites or books.  We used the midwifery guide at the end of Spiritual Midwifery with Elliott's pregnancy when Sofi was old enough to want to see pictures of the organs, the baby, and the birth.  She still has her copy, full of Post-it Note flags.  There are many library books about bringing in a new baby to the home, as well as coloring books.  Getting out baby things and discussing what the baby will be like and what everyone will do with the baby, and how the baby is an asset to the family is a great way to involve siblings.

* Start researching feeding your baby.  The choice between breast and bottle feeding is not something to be taken lightly, nor decided at the last minute.  There is extensive research that supports breastfeeding exclusively for the first six months of a child's life (1, 2, 3, 4, 5).  However, breastfeeding isn't something that just happens without preparation and support.  Also, if you are planning to return to work, you will need to arrange a pump and time to use it, as well as a place to store milk at work and at home.  If you are planning to formula feed, there are considerations to be made there as well.  What type of bottles and formula will you use?  How much will this cost you?  Will you need to rearrange your budget to be able to formula feed?

* Start considering diapering.  Really, you should be considering cloth diapering.  If you are having children to leave this world to, you should really start considering what type of world you are leaving them, and disposable diapers are the third largest contributor to landfills!  I'm not going to go into all of the benefits of cloth diapering here, but this article is probably the best I've ever read about the dangers of disposables.  And cloth diapering isn't what it used to be, with the origami, the pins and the rubber pants.  These days you can buy cloth diapers that are just like changing a disposable, only when the diaper pail is full, you toss it in the washer instead of the trash can.  Or, you can buy very basic prefold diapers with a Snappi and a cute cover, which is more similar to the old concept and probably the most economical if you are buying.  Or, if you are handy with a sewing machine, you can make your own diapers as personalized as you like!  Check out this post to get an idea of the styles that are available now.

However, I know that not everyone - heck, not even MOST people - will cloth diaper.  If that is the case, you will want to start thinking about what diapering options you will use.  Many babies have issues with different types of diapers, so don't assume that you will be able to use the store brand that is the cheapest.  Think about what qualities are most important to you in a diaper, and what brands/types cater to those qualities.

Either way, you need to think about how to pay for the diapers you will be using, and what you can afford to spend.  Cloth diapers are a higher expense up front, but much lower in the long term.  Disposables can be bought in lower quantity as needed and the cost is more spread out over time.  Whichever you choose, starting to buy now means that you will have less expense in this arena after baby arrives, and you will also be prepared should baby arrive a bit before expected.

* Will you be vaccinating?  This is such a personal decision, but it is one that you need to make for yourself as a parent.  Many people assume from the get go that they will (or will not) be vaccinating, based on what the culture around them does.  Many religious faiths do not vaccinate.  Many people simply assume that a child has to have vaccines or they won't be allowed to participate in everyday things, like school or sports.  However, most states have vaccine exemptions that allow children to participate in these things.  The exemptions are based on medical issues (like allergies or adverse reactions to vaccinations), religion, or philisophical views.

So, why would some people opt out of vaccines?  For starters, not everyone believes that the ingredients in vaccines are safe.  For another, many are concerned about the growing number of vaccines given to children and the possibility for side effects or adverse effects.  Also, many people simply are not convinced that vaccines have cured the diseases that they claim to, as there is much evidence that better hygiene and sanitation, along with better nutrition, have actually been responsible for lowering incidence of these diseases.  This is a really great article about that, if you are interested in reading more.

However, as I said, this is an important topic to research and make a decision for yourself.  The overwhelming choice in the United States is to vaccinate, but this is something that every parent should read up on and KNOW that they are making the best decision for their child.

* If you are having a son, will you circumcise?  This is another decision that needs to be researched and made, not just assumed.  Many parents assume that pretty much all boys are circumcised, and so theirs will be too.  However, only in the US are baby boys routinely circumcised, and the number of baby boys being circumcised here is declining.  The latest numbers available have circumcision rates at about 33% of baby boys in the US, meaning that there is a good chance that child's friends will be not be circumcised.  There are many reasons that people regularly give for circumcising - cleanliness, health, cosmetic reasons - but studies now show that most of these are not valid.  Also important to know:

117 baby boys die annually in the United States as a result of circumcision.

As with everything else, the decision is one that only the parents can make for their sons.  But, again, it is something that should be thought about, researched and decided.  Here are some articles to get you started!  (1, 2, 3)  *As a side note, these articles are all opposed to circumcision, however, they all offer links to outside research meant to help parents make the decision for themselves.  If you plan to circumcise your son, please take the time to read these articles and the research involved before making a permanent decision.

* Start thinking about childcare.  Will you or your husband be staying home after the baby is born?  If not, who will care for your baby when you return to work?  Are you more comfortable with a family member?  Friend?  In home day care?  Day care center?  How will your feeding, diapering, vaccination, and parenting choices affect this decision?  What if there are special circumstances for your baby (like a health issue, allergies, etc)?  Start planning this ahead of time so that you are sure you are comfortable with your decision.

* Consider your maternity leave, if you are employed.  How long will you want to take off work?  Can you combine vacation time with your maternity leave to get more time off?  Can you afford to take extra unpaid time off?  Would you prefer to use your leave for the end of your pregnancy as well as after your birth, or are you saving it all until after baby comes?  Plan and talk to the proper people at work to get this lined up.

* Check out parenting classes and support in your area.  If you've got lots of experience with babies and children, you may know exactly what you are doing.  If you or your partner has never changed a diaper before in your life, a class, or at least a crash course with a friend, may be just what you need to help you feel confident.  If you plan to breastfeed, a class or some support group meetings before baby arrives can be invaluable.  La Leche League and your local WIC office (whether you will be participating in the WIC program or not) are two great places to start looking for support groups.  Also, many hospitals with maternity wards offer classes or support groups for breastfeeding moms.

* Think about pediatric care for your baby.  This is a tricky subject. Most doctor's offices will have a schedule for well baby visits.  They will want to check out your baby every few weeks in the beginning and then every few months as they get older.  At these visits, your baby will be physically looked over, measured, weighed, and charted to compare him/her to other babies the same age.  The doctor will go over milestones to be certain that baby is developing at a rate consistent with his/her peers.  And vaccines will be administered if you are vaccinating.

If you are vaccinating, it is important that you have a consistent doctor who can keep track of what vaccines your child has received and when he or she received them.  You will want to stay on schedule so that baby doesn't get behind and have to have extra doses together to "catch up".  Also, it can be nice to have someone else checking over your baby and reassuring you that everything is fine.

On the other hand, if you are old hat at parenting, or aren't vaccinating, and you feel confident that your baby is developing appropriately, many parents choose to skip these well visits, and mainly take the baby in for sick care.  Personally, I take a middle ground.  I like to have a steady caregiver who knows my children well, so that when my child is sick, the caregiver knows me and my children well enough to treat them in a way congruent with our choices.  However, I do not like to haul my children in to doctors any more than needed, so I usually choose a family practitioner over a pediatrician.  Typically, these doctors are less concerned with well visits as long as the child is thriving.

No matter what you think you will want for your child in regards to well vs sick visits, you need to decide ahead of time what type of care you think you will want, and what your plan for care for your child will be.  If you will do well visits, it is a good idea to choose a pediatrician or family doctor ahead of time.  If you will not, where will you take the baby if he/she does need medical attention?  Will you have a specific doctor already established?  Will you utilize emergency rooms, urgent care or minute clinics?  What choice do you think will work best for YOUR family?

* Think about where baby will sleep.  Trust me, this is far more complicated than it sounds!  First of all, your newborn is going to sleep tons.  So, not only do you need to plan where baby will sleep at night - when you are supposedly sleeping also, but you will also need to plan for where baby will sleep during the day.  And then, your baby will come along and have his or her own opinion about the whole thing too!  Sofi, for example, started out in a cradle next to our bed.  We were living with my husband's parents when she was born, and we had to share a room (although I had planned on it anyway).  Micah likes to tease me that Sofi slept in that cradle for at least 10 minutes before I tucked her into bed beside me and she rarely left afterwards.  But, that was at night.  During the day, Micah worked second shift, so Sofi sleeping in the room where he was still asleep didn't work.  Besides, she was rarely willing to let me put her down during the day.  What we finally found that worked, besides me just holding her while she slept, was putting her in her swing, where she slept happily for 20 minutes or so at a time.  Walter was planned to sleep with us from the get go, but during the day he went back and forth between preferring to sleep in the bed upstairs or the crib downstairs.  So, figuring out where and how everyone will sleep best is something to consider now, but it is best to be open to what baby will think as well.

There are many advocates of baby having his or her own room, here in America.  If you are planning on this, you will want to be sure that you can adequately hear baby from your own room, when you are asleep.  If the rooms aren't very close together, a monitor can be helpful.  Also, be certain to research your baby bed to be certain that it meets all safety standards and doesn't have any active recalls.

There are equally as many advocates for baby sleeping in his or her own bed in the same room as the parents.  Many studies suggest that baby sleeping in the same room as the parents (specifically the mother), decrease the risk of SIDS (some studies have found up to 10 fold protection from SIDS).

And there are also many advocates of baby sleeping directly in bed with the mother.  This approach, however, is one that does need to be researched if it is going to be done.  There are practices that make this arrangement safe, and practices that make it a time bomb.  It is best to at least read through the guidelines for safe bed sharing ahead of time, because most parents in America take their baby to bed with them at least occasionally.  And the risk of having an accident when you aren't used to having a baby in your bed is much higher than if you usually have the baby in your bed.  You can read about safe bed sharing, and why some families choose to practice it, at these links.  (1, 2)

* Start thinking about what day to day life is going to look like with baby.  How will you handle mundane daily tasks with a little one?  Do you plan to have a baby in a bouncy seat or swing much of the day?  Is your floor safe for baby to play on? Will you need to consider pets when you are considering what baby will be doing?  Do you see yourself using a baby carrier like a ring sling, wrap or mai tei?  The best way to do this is simply to think, as you go through your standard day, what your baby will be doing while you handle each of your daily tasks.

This may sound silly, but with our first baby, she simply lived in the sling until she was old enough to sit on the floor and play - around 6 months or so.  I never had to think about what to do with her because she would not tolerate being put down.  Easy peasy.  Plus, I had the support of my in-laws to accommodate regular tasks.  Our second baby was literally in my arms before I realized that there was not one safe place that I could set him down on the first floor of our house and just go to the bathroom by myself!  We had a two year old, two cats and a dog.  I couldn't just lay him on a blanket on the floor without risk of some mishap.  I couldn't lay him on the couch.  Our swing is a travel swing, which we love, but it has a low profile - again not safe from a toddler or pets.  We did not have a bouncy seat or any other baby holder.  After I realized this, Micah got the cradle and put it up in a corner of our living room.  Then I could lay him down when I needed to attend to something else and know that he would be safe!

* Create a birth plan.  This might seem trivial if you have never before had a baby, but it is really important to plan how you would LIKE birth to go.  Now, no birth goes completely according to plan, but there are some things you CAN plan for.  You can plan whether or not you would like the OPTION of eating or drinking during labor, what positions you are interested in pursuing (or not pursuing), what pain relief options you would like to use, who you would like to be present or not present during delivery, what post birth interventions you would like to use and when you would like them to be administered.  These should all be written down and discussed ahead of time with your care provider.  Print out a copy and give to your provider ahead of time for your file, and bring a copy or two along to the hospital to share with your nurses.

This is a nice article with a sample birth plan to look over.  And this is my natural birth plan, written when we were expecting Elliott.

* Prevent a c-section.  No, really.  You don't want a c-section.  The estimated healthy rate for cesarean births is >15% of all births.  The rate of cesarean birth in the United States is roughly 33% of overall births.  However, this doesn't mean that all practitioners have a 33% cesarean rate.  My practitioner was close to 10% when I had Sofi and Walter, yet the national average was much higher.  This means that for my doctor whose rates were 21% below normal, there was a doctor who was 21% above normal - or had a cesarean rate of 52%.  So, just because you assume that you won't have an unnecessary cesarean birth, doesn't mean that your doctor is assuming the same thing.

Talk to your practitioner ahead of time about his or her c-section rate.  Find out about what his or her general practices and policies are.  Find out if you will be forced to birth on your back (the scientifically documented worst position for birth, and most often used by doctors).  Find out if you will be allowed to push with your urges or if the doctor is going to tell you when to push.  All of these things are contributing factors in a cesarean birth.  Also, check out ICAN (International Cesarean Awareness Network) for some great information about avoiding a c-section, or a repeat c-section.  If you have chosen a provider with a low c-section rate, you've talked to him about your preferences, and you have researched how to avoid a c-section - and you end up with one anyway, then you will at least feel good knowing that you did everything you could to prevent it and that you were probably one of that >15% who truly needed the intervention - and go for your VBAC next time!

* Prepare meals and snacks ahead of time for after baby comes.  Freezer cooking is a great way to make the transition easier on your family!  Make double batches of food that you are already cooking and freeze the second batch.  When baby comes, you can just reheat a pot of chili, or pop a dish of enchiladas in the oven, without the fuss of cooking.  Those first few months when you are trying to figure out how to juggle getting a glass of water with taking care of baby are going to be overwhelming enough already.  Taking care of dinner and some snacks ahead of time will make this so much easier.

* Pack a hospital bag.  You don't want to try to remember what you need and pack it while you are laboring.  Just get this done ahead of time and feel good about it!

* Take a hospital or birthing center tour, if you will be birthing at one of these.  Don't come in laboring and try to figure out where to get checked in, where Labor and Delivery is, and what you will need to do to be admitted.  Do this all ahead of time, and it will ease some of that birth day anxiety.  Also, this is a good time to pre-register with the hospital so you don't have to fill out a bunch of paperwork while you are distracted later.

* Put baby's carseat in your car - before you need to use it.  Not all carseats work with all cars.  And sometimes even the second go round for the same car and seat doesn't work out!  When we had our second baby, Micah took the carseat out to install it in our Golf and found that both of us were too tall to drive with two rear facing carseats in the back!  We could not fit them both and still have the driver seat back far enough!  We literally had to go buy a new car two weeks before our second child was born.  That would have been quite a hassle if we hadn't discovered this until we were trying to leave the hospital.

Also, you can call the local police precinct and make an appointment to have a specialist check your installation to make sure you've done it properly.  And research carseat laws and use.  The laws about what seats can be used for what age/size children are different in many states.  And it is not as simple as buying a seat, putting the baby in, and driving down the road.  The straps need to be installed properly, the clips need to be in the correct position, and some clothing worn in carseats is dangerous.  Know all of these things before you put your baby in the seat for the first time.

* Plan for your labor and getting to your delivery destination.  If you or your partner are at work, how will you get home or to your destination?  Who will care for your older children?  Do you have pets that may need attention while you are away?  Have these things covered ahead of time.

* Research newborn interventions for baby and decide what you are comfortable with.  Most hospitals, birthing centers, and even midwives will have their general list of newborn interventions that they routinely use - or not.  As a parent, you will have to decide which of these you are comfortable with, and which you are not.  These interventions include cord clamping and cutting, vitamin K, antibiotic eye ointment, Hep B vaccination, bathing, and separation from mother.

Cord clamping can be done immediately, or it can be delayed.  Many practitioners prefer to cut immediately, for different reasons.  If you are planning on banking your baby's cord blood, you'll need to clamp and cut immediately.  Some practitioners will claim to cut immediately to keep mom from losing too much blood.  However, delaying clamping can allow baby to receive up to 40% more blood - which can give baby higher iron stores.  This can be very important for a breastfed baby, as breast milk doesn't contain excess iron.

Vitamin K is routinely given to all babies after birth because it helps blood to clot and newborn babies have very low supplies of vitamin K.  Their blood levels of vitamin K reach full levels at about day 8 or 10.  This can be important for babies who are going to be circumcised in the days following birth, to make sure they don't bleed out during or following the procedure   It is also important if your baby has had birth trauma, like severe bruising or a forceps birth.  It is also important if your baby is one of the 1 in 100,000 babies who suffers from a genetic disorder which can cause cerebral hemorrhage.  So, there is a lot of support for giving babies vitamin K.  However, the part that most practitioners won't tell you is that the amount of vitamin K given and the preservatives in the injection have been associated with raised levels of Leukemia and an increased possibility of jaundice.  So, some parents opt out of vitamin K supplement altogether.  Some opt for an oral dose of vitamin K, at a lower level than the shot.  And some opt for the shot itself.

Antibiotic eye ointment, often referred to as "eye goop", is administered to a newborn's eyes to prevent blindness caused by encountering gonorrhea in the birth canal.  If mom has gonorrhea, eye goop should be on your yes list!  If not, and she will have an STD test as part of her prenatal care, then the eye goop becomes more of a question mark.  If mom (or dad) is indulging in behaviors that may have caused an STD after the last test, then eye goop should probably be considered.  If mom is not at risk of an STD, then applying antibiotics to a newborn's eyes may not be the best choice.  At the bare minimum, it makes the baby's vision blurry for an hour or two during a critical bonding time with mother.  If baby can't see mom, it is hard for baby to identify mom's face.  Also, the eye ointment causes burning, irritation, and even swelling.  And antibiotics should be reserved for essential use - not overused for daily concerns.

Hepatitis B vaccination is another newborn procedure that causes a lot of turmoil for new parents.  This vaccine is recommended for babies at birth OR at 2 months.  This means that if you are torn about the Hep B vaccine, you can delay it until the 2 month appointment and still be "on schedule".  If mom has Hep B, it is recommended that the baby get the vaccine at birth.  If not, it can easily be delayed, if the parents just don't feel right about a vaccine at birth.  Hep B should be researched along with all other vaccines.

Bathing seems so trivial, doesn't it?  Why not wash a newborn baby?  I mean, they are all covered in slime and goo, right?  Just let the nurse wash baby off and it will be fine!  Right?  But, believe it or not, there are a few things to be considered here.  First of all, bathing lowers baby's body temperature, which is something that baby is already working hard to maintain.  This can lead to baby being carted off to the nursery to be monitored and put under heat lamps.  Also, the vernix that coats the baby's skin is a natural lubricant and protection for baby.  It provides a barrier between baby and the germs of the outside world.  And in a hospital, having a barrier between baby and germs doesn't seem like such a bad idea.  Also, many baby toiletry products are not as gentle and safe as they claim to be.  The products used at the hospital may not be as safe for your baby as you would like.  If you do choose to have baby bathed at the hospital, you may choose to bring your own toiletries to the hospital with you for the nurses to use.  If you are wondering which baby products are safest for baby, check out the Skindeep database at EWG.

Separation from mom is standard operating procedure at many hospitals.  Under normal circumstances, at a healthy birth, baby is often allowed to bond with mom for a few minutes, then whisked away to the nursery for an hour or two to be weighed, measured, bathed, and inspected.  All of these sound like good things, right?  Except for what they don't take into consideration.  To begin with, when a baby is born, he or she will experience an hour or two of quiet alertness.  During this time, baby will be bonding with mom, learning to nurse, studying mom's face, and imprinting his or her caregivers.  After this time, baby will become sleepy, and will remain so for the next several days.  If baby is taken away from mom during this quiet alert phase, that time is just gone.  Plus, mom is imprinting the baby during this time.  Her hormones are primed to be bonding with baby.  The hormones are also keeping her feeling good and alert, provided it was a good birth.  These hormones will also dissipate over time, and mom will not be as primed for bonding after these wear off.  Also, she will be tired from labor and birth.  So, either having these procedures delayed or done in the room is a benefit to both mom and baby.

For more information about newborn procedures, here are some good articles.  (1, 2, 3)

* Have some short term projects ready for the days/weeks leading up to baby's birth.  You will want something to distract yourself from obsessing over every twinge and movement.  At the same time, a large project may not get finished before baby comes - and may not get finished for a long while after!

For the printable, short version of the checklist, click here.

What else would you add?

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Tuesday, March 12, 2013

A Difficult Conversation

Welcome to the March 2013 Carnival of Natural Parenting: Tough Conversations
This post was written for inclusion in the monthly Carnival of Natural Parenting hosted by Hobo Mama and Code Name: Mama. This month our participants have spoken up about how they discuss complex topics with their children. Please read to the end to find a list of links to the other carnival participants.
The most difficult conversation with my kids is the one we've never had.  It's the one about our inferior bodies, inferior genes, inferior looks, inferior performances.  It's the one about how I don't love myself as much as I love other people.  It's the one about how there is a tiny wrinkle between my eyebrows, and how I wish that my earlobe wasn't split.  It's the one about how I struggle so much to keep weight on that I have spent cumulative years feeling like a cancer victim, or like others think I have an eating disorder.  It's the one about how my body hair is so dark and course that while I would LOVE to stop shaving, I cannot stand the sight of my own legs with that dark fuzz on them.  It's the one about how I wish that I didn't have food allergies because I still remember what cheesecake tastes like, even if it is going on 5 years since the last time I had any. It's the one about how I wish I were stronger, but I am afraid to work out because if my metabolism kicks it up a notch, I could go down to 110 lbs (at 5' 9").  Or, that I am afraid to work out because I won't be able to breathe.

The reason we have never had these conversations?  Because I chose, when I had children, to stop hating my body.  I decided to love my children enough to model for them that our bodies are wonderful.  I decided to show my children that there is no need to look at themselves critically.  I decided that I could shut my mouth, look away from the mirror, and be happy with what God gave me.  And that I could teach my children to be happy with what God gave them, as well.

And I realized a few weeks ago, that it worked.  I have a 6.5 year old girl who has no concept that she may be too fat, thin, tall, short, or ugly.  She has no concept that people might look at her physical body and judge her negatively for being herself.  She loves herself, and thinks she is beautiful.  Because she is.

I have a 4.5 year old son who cannot eat or touch dairy, soy, corn or gluten.  I have never once heard him say that he wishes he could eat any of those things.  Instead, he wishes that people didn't make so much stuff with that stuff in it.  Because his body is not to blame.  His body works as it should.  But birthday cakes should all be made gluten free, dontcha know?!

They don't live in a bubble.  They know that their outward appearance does draw conclusions that they may not like.  Walter has just chosen to cut his long hair off because he was tired of people thinking he was a girl.  But, he did it with no self-loathing.  He did it because he wanted people to KNOW that he was a boy, and this was the way he saw fit to do so.  And before that, he grew his hair out because that was how he liked it.  Because some parts of our body we can experiment with, change, and play with.
And, the other upside to not nitpicking myself in front of my kids, I have stopped having the internal dialogue with myself about whether or not my body measures up.  I actually love my body these days.  My body gave birth to 2 amazing babies, with no intervention.  My body has nourished 3 amazing children.  My body knows what it needs, when I take the time to listen to it.  It is the only body I have, and I am grateful it is mine.

So, while it isn't always easy to shut my mouth about my hair, my wrinkle, my weight, my allergies, or my weaknesses, it is definitely the most worthwhile conversation I've had in a LONG time.


Carnival of Natural Parenting -- Hobo Mama and Code Name: MamaVisit Hobo Mama and Code Name: Mama to find out how you can participate in the next Carnival of Natural Parenting!

Please take time to read the submissions by the other carnival participants:

(This list will be updated by afternoon March 12 with all the carnival links.)

  • A Difficult Conversation — Kellie at Our Mindful Life is keeping her mouth shut about a difficult topic.
  • Discussing Sexuality and Objectification With Your Child — At Authentic Parenting, Laura is puzzled at how to discuss sexuality and objectification with her 4-year-old.
  • Tough Conversations — Kadiera at Our Little Acorn knows there are difficult topics to work through with her children in the future, but right now, every conversation is a challenge with a nonverbal child.
  • Real Talk — Jennifer at Hybrid Rasta Mama explains why there are no conversation topics that are off limits with her daughter, and how she ensures that tough conversations are approached in a developmentally appropriate manner.
  • From blow jobs to boob jobs and lots of sex inbetweenMrs Green talks candidly about boob jobs and blow jobs…
  • When Together Doesn't Work — Ashley at Domestic Chaos discusses the various conversations her family has had in the early stages of separation.
  • Talking To Children About Death — Luschka at Diary of a First Child is currently dealing with the terminal illness of her mother. In this post she shares how she's explained it to her toddler, and some of the things she's learned along the way.
  • Teaching 9-1-1 To Kids — Kerry at City Kids Homeschooling talks about the importance of using practical, age-appropriate emergency scenarios as a springboard for 9-1-1 conversations.
  • Preschool Peer PressureLactating Girl struggles to explain to her preschooler why friends sometimes aren't so friendly.
  • Frank Talk — Rosemary at Rosmarinus Officinalis unpacks a few conversations about sexuality that she's had with her 2-year-old daughter, and her motivation for having so many frank discussions.
  • When simple becomes tough — A natural mum manages oppositional defiance in a toddler at Ursula Ciller's Blog.
  • How Babies are Born: a conversation with my daughter — Justine at The Lone Home Ranger tries to expand her daughter's horizons while treading lightly through the waters of pre-K social order.
  • Difficult Questions & Lies: 4 Reasons to Tell The Truth — Ariadne of Positive Parenting Connection shares the potential impact that telling lies instead of taking the time to answer difficult questions can have on the parent-child relationship.
  • Parenting Challenges--when someone dies — Survivor at Surviving Mexico writes about talking to her child about death and the cultural challenges involved in living in a predominantly Catholic nation.
  • Daddy Died — Breaking the news to your children that their father passed away is tough. Erica at ChildOrganics shares her story.
  • Opennesssustainablemum prepares herself for the day when she has to tell her children that a close relative has died.
  • Embracing Individuality — At Living Peacefully with Children, Mandy addressed a difficult question in public with directness and honesty.
  • Making the scary or different okay — Although she tries to listen more than she talks about tough topics, Jessica Claire of Crunchy-Chewy Mama also values discussing them with her children to soften the blow they might cause when they hit closer to home.
  • Talking to My Child About Going Gluten Free — When Dionna at Code Name: Mama concluded that her family would benefit from eliminating gluten from their diet, she came up with a plan to persuade her gluten-loving son to find peace with the change. This is how they turned the transition to a gluten-free lifestyle into an adventure rather than a hardship.
  • How Does Your Family Explain Differences and Approach Diversity? — How do you and your family approach diversity? Gretchen of That Mama Gretchen shares her thoughts at Natural Parents Network and would like to hear from readers.
  • Discussing Difficult Topics with Kids: What’s Worked for Me — Deb Chitwood at Living Montessori Now shares parenting practices that enabled discussions of difficult topics with her (now-adult) children to be positive experiences.
  • Tough Conversations — Get some pointers from Jorje of Momma Jorje on important factors to keep in mind when broaching tough topics with kids.
  • Protect your kids from sneaky people — Lauren at Hobo Mama has cautioned her son against trusting people who'd want to hurt him — and hopes the lessons have sunk in.
  • Mommy, What Does the Bible Say? — Amy at Me, Mothering, and Making it All Work works through how to answer a question from her 4-year-old that doesn't have a simple answer.
  • When All You Want for Them is Love: Adoption, Abandonment, and Honoring the Truth — Melissa at White Noise talks about balancing truth and love when telling her son his adoption story.

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