A Guide For Parents-To-Be: Part 2 (Interventions)

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Interventions in Labor

When you go into labor you will be so excited, THIS IS IT!!! Many women time every single contraction and anticipate the moment they get to go to the hospital. Lets talk about some things that may happen once you get there. What can you anticipate? 

Many interventions are used in Hospitals today. For example, About 81% of women who birth in a hospital receive Pitocin. Pitocin can double your chance of a cesarean birth. That's where education comes in. The more you know, the more control you can have during your labor. Below are common interventions used. I encourage you to do further research on your own in order to help make educated decisions. 

Always remember, you have choices.

1. Induction

2. Electronic Fetal Monitoring

3. Other Interventions

Here is a sample document to help you share how you feel about each intervention.

1. INDUCTION- Labor should only be induced if it is more risky for baby to remain inside the uterus than to be born. (American College of Obstetricians and Gynecologists)

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• Artificial Rupture of the Membranes (AROM)- AROM is when the care provider breaks your bag of waters.  The care provider will insert a tool called an amnihook and 'catch' the edge of the amniotic sac. This method is often used to induce labor, allow the care provider to see if there is meconium (baby's first poo) present, and for use of an internal fetal monitor. 
• Pro's- Labor may be shortened by an hour, allows amniotic fluid to be examined for presence of meconium which could cause fetal distress. 
• Con's- Baby could turn into breech position making birth more difficult and cesarean birth more likely (if head isn't engaged), umbilical cord could slip out first (prolapsed cord), possibility of infection increases, more intense contractions.

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• Prostaglandin Gel- Medication applied to the cervix prior to induction. Used to thin and shorten (efface/ripen) the cervix which prepares it for birth. There are three types, a gel, oral dose and a tampon-like dose . Prepidil is a gel while Cervidil is applied like a tampon. If over stimulation occurs cervidil can be easily removed, Prepidil can be wiped away but the oral form cannot be removed.
• Pro's-  Minimally invasive, No IV required, Can be an overnight administration (administered, then sent home).
• Con's- Ripens cervix but does not induce. Possible symptoms, oral form cannot be removed in case of over stimulation

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• Cytotec- Cytotec or Misoprostol is intended to soften, efface, and assist in dilation as a means of induction. The dose is given in pill form. The pill is placed vaginally against the cervix and cannot be removed once given. It is NOT approved by the FDA for use in labor but still used today. Below are two links, an FDA warning and the Cytotec label.
• FDA Warning
• Cytotec Label
• Pro's- Fast acting, considered reliable
• Con's- Not FDA approved for use in labor, Has highest reported incidence in all of induction methods, Used with continuous fetal monitoring, cannot be removed once administered
• Side Effects-  fetal cranial nerve palsies, fetal death, maternal death, severe postpartum hemmorhage, uterine tetany, decreased uteroplacental blood flow, uterine rupture, necessitating hysterectomy, amniotic fluid embolism, placental retention, maternal and fetal shock, fetal bradycardia, uterine tachysystole, higher incidence of infection vs Pitocin and higher incidence of c-section

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• Pitocin/Oxytocin- Pitocin is a synthetic form of the natural hormone Oxytocin. It is used to induce labor and is considered the safest method of induction as it can be regulated. Pitocin is administered through an IV to initiate and regulate contractions. It can be accelerated, reduced or stopped at any time. Many care providers will start an induction using Pitocin then turn it off when things get moving. Many others administer Pitocin after baby is born to stop/prevent hemorrhage.
• Pro's- Considered safest form of induction, can be mobile, low risk of infection, can stop post-natal  hemorrhage
• Con's- Aggressive and invasive, Continually administered (use of IV pole and bag), Usually used with continuous fetal monitoring or intermittent monitoring, Labor can progress quickly resulting in need of pain medications, Side effects

2. ELECTRONIC FETAL MONITORING- When admitted into a hospital you will typically go into triage and have monitors strapped to your belly to monitor babys heart beat (typically for about 20 minutes or so). If all looks well some will allow intermittent monitoring. If fetal distress is evident or if mom is high risk, continuous monitoring will be used. 

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• Continuous Fetal Monitoring- Continuous monitoring for low risk women has a lack of benefits. It has shown to increase use of other interventions such as vacuum extractor, forceps use and cesarean section. For high risk women though, continuous monitoring can be the safest way to labor. It can let the care provider know whether baby is in distress or an emergency may arise.
• Pro's- Safe way of monitoring baby in high risk women, can be reassuring to parents, lets doctors and nurses measure contraction length and duration.
• Con's- False positives are very common, confines you mom to bed, may be uncomfortable, sometimes machine gets more attention than laboring mom
• Alternatives- Intermittent monitoring, hand held doppler

Doppler Monitoring- Source

• Intermittent Fetal Monitoring- Intermittent monitoring is safer for low risk women. This involves monitoring baby for 15-20 minute intervals every hour. Mom is often confined to bed for the time of monitoring. Occasionally hospitals have mobile units but you must ask for them and the nurse must be compliant. 
• Pro's- Helps doctors and nurses keep track of contractions and determine whether fetal distress may be present. Can be reassuring to parents. Easier on mom than continuous monitoring.
• Con's- False positives are common, confines mom to bed for intervals, can be uncomfortable.
• Alternatives-Hand held doppler

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• Internal Fetal Monitoring- Requires the amniotic sac to be broken and at least 2-3 cm dilated. A scalp electrode is entered through the birth canal and placed on the baby's head. This from of monitoring is the most accurate. Often mom can be mobile with this form of monitoring. 
• Pro's- Most accurate form of fetal monitoring, can be mobile while in use, can  determine whether baby truly is in distress.
• Con's- Water must be broken, increases chance of infection, can be uncomfortable

3. OTHER INTERVENTIONS

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• IV (Intravenous drip)- An IV is a clear plastic tube inserted into a vein in the hand or arm. They are often given in labor to hydrate women and to keep the vein open for administering medication in case of an emergency(ICE). Some OB's and midwives routinely use an IV on all laboring women. 
• Alternatives include hydrating with clear liquids, ice chips, Popsicles, etc. (some hospitals have a nothing by mouth policy). Another alternative is using a Heparin Lock, which keeps the vein open in case of emergency but is not accompanied by an IV bag or pole. 
• Pro's- Keep mom hydrated, Keep vein open ICE, Easy access ICE
• Con's- Fluid overload resulting in fluid in mom and baby's lungs, diluted blood/anemia/reduced blood oxygen supply to baby, newborn jaundice, hinders moms movement in labor, usually used with continuous monitoring.

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• Heparin Lock- Also known as a Hep or saline lock. Most facilities require having at least a Hep lock when in labor. Usually it is inserted into the vein on the top of your hand. It can be uncomfortable at times but is a nice alternative to an IV. Like an IV, a Hep Lock is used to keep a vein open in case of emergency. It can also be used to administer pain medication, administer antibiotics if the Strep B test was positive, or Pitocin in case of induction or postpartum hemorrhage.  
• Pro's- No pole/bag unlike IV, Easy access ICE, Keep vein open ICE, Administer antibiotics then close for remaining labor.
• Con's- Can be uncomfortable

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• Vacuum Extractor- A vacuum extractor is used to assist in birth. This tool uses suction to either turn the baby's head or pull baby through the birth canal. As shown above, it looks like a suction cup attached to a handle. This is often used if the mother has an epidural, is physically exhausted, the baby is in a difficult position or the baby is getting a lack of oxygen.
• Pro's- Helps baby descend through birth canal in case of an emergency or if mom is not able to push him/her out on her own.
• Con's- Baby may have a red area or small bruises on face. Scalp may have blood blister or small bruises. There rarely can be trauma to the facial nerves.

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• Forceps- Forceps are also used to assist in birth. This tool looks a bit like salad tongs which are placed around baby's head and baby is gently pulled from the birth canal. These are often used if the mother has an epidural, is physically exhausted, the baby is in a difficult position or the baby is getting a lack of oxygen.
• Pro's- (See Vacuum extractor)
• Con's- (See Vacuum extractor)

If you really want to see an episiotomy, google it!

(I'm thinking about those with a weak stomach)

• Episiotomy- An episiotomy is a surgical incision used to enlarge the vaginal opening to help birth baby. At one time it was common practice to perform a routine episiotomy with first time mothers. Some old-school doctors still follow this procedure! Ask your OB or midwife how they feel about them to determine your chance of receiving one. 
• Pro's- Quicken delivery in case of emergency. Used in an assisted delivery (forceps/vacuum extractor). Easier to stitch up than a tear.
• Con's- Infection, bruising, swelling, bleeding, longer healing time, painful scarring, a period of remaining abstinent, incontinence. Raises risk of tearing.
• Alternatives- Place clearly in your birth plan that you do not want to have one unless absolutely necessary. Perineal tear. 
• Prevention- Kegals, exercise (including squatting), controlled (by mom) pushing, perineum massage, avoid  lying on back while pushing, warm compresses

If you really want to see a perineal tear, google it! 

(I'm thinking about those with a weak stomach)

• Perineal Tear- A perineal tear is a tear in the tissue found between your vaginal opening and anus. They range from small nicks to deep lacerations. Often, women would rather tear than have an episiotomy. 
• To illustrate: Try to tear your shirt in half, it is pretty hard to do right? You have to put forth A LOT of force in order to do so. Now put a little cut in it and try to tear it in half again. It happens so much easier now right? 
• Pro's- Heals faster than an episiotomy. 
• Con's- Can take longer to stitch up than an episiotomy. Uncomfortable or painful healing, Swelling, bleeding, bruising.
• Alternatives- Use prevention Techniques in  preparation of birth, Episiotomy.
• Prevention- Kegals, exercise (including squatting), controlled (by mom) pushing, perineum massage, avoid  lying on back while pushing, warm compresses

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Interventions aren't always needed. However, in case of an emergency it is best to be educated in what is going on. Doctors don't always clue you in so make sure your partner or support person is paying close attention in order to intersect any unwanted interventions. Knowledge is your friend. Don't forget to check out the free download above to help you convey your wishes!

Sending Easy Birth Dust Your Way!!

Covered in part 1: Important Decisions to Consider -

                              (Vaccinations, feeding baby, circumcision, discipline, and routine procedures)

Covered in part 3: Pain Management and Pain Medication in Labor

To be covered in part 4: Making Decisions on Raising Baby
                             (Babywearing, Day Care, Montessori Method, Co-Sleeping, Introducing Solids)

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So she has a bun in the oven...

First things first: forget the bun, focus on the oven.

I'm at the age now where all of my friends are getting pregnant (Not to mention I'm jump starting my career as a doula) so I see a lot of little ladies with a bun in the oven. I always want to jump in and talk them to death, ask questions, recommend my favorite baby gear, 'talk shop' in a way. I always have to take a deep breath and hold it, for awhile. I have to remind myself that no one wants to hear THAT much advice especially when it's unsolicited. So what could they ACTUALLY use?

Voila... the perfect pregnancy gift basket!

(I got these free printables from over at The Handmade Home, cute right?)

Here are a few ideas I've thrown together. Of course each should be personalized to give it that extra oomf.

• Belly Butter/Vitamin E/Rose Hip Oil- Every expecting mama worries about stretch marks. Eventually they'll realize that they earned their tiger stripes, but in the mean time they want to avoid them. The old trick cocoa butter will work but now-a-days there are better ways to prevent the lovely mommy marks. Homemade belly butters, vitamin e and rose hip oil are all great! We'll call this one Preventative Maintenance. (Can you tell I'm married to a technician? haha)
• Massage Gift Card/Foot or hand massage- If you've ever carried a little monster in you, you know how hard it is on your body. Everything hurts by the end of the day. All you want to do is relax. What better way to relax than a massage? For those of you who can't afford to give out massage gift cards all willy-nilly (coughmecough) give the gift of a foot/hand massage. Don't forget to get in between those fingers and press on the sole of the foot! These acupressure points are great for relieving stress and pain. We'll call this one the Tune Up Special. 
• Rice Pack- A what?? A RICE PACK can't you hear? Ok, ok I'll explain. A rice pack is like a little heating pad but without the electricity and fear of falling asleep and burning down the house. These are very simple to make, even if you don't sew! Grab a sock (preferably a new one please), fill with white rice and tie off the other end! You can add a drop or two of your favorite essential oil if you'd like. To use it, pop in the microwave for about a minute and BAM relief from a long day. It'll stay warm for over an hour and it's great for those prego back aches/sore feet. Give the gift of a quick fix. We'll call this one the Repair.
• Chocolate- I'm kicking myself for not putting this as number one. This one is pretty self explanatory. What girl doesn't love chocolate? Cookies are a bonus! Give the gift of Indulgence. We'll call it Fuel.
• Free Maid Pass- Let's face it, when you have a baby your house goes ballistic. It will look like a tornado hit it for those first few weeks. Though the tornado is small and cute, it comes with a ton of stuff. People will come by to see the baby, drop off food, even stay and talk for a bit. Rarely does anyone offer to clean the house. Give the gift of a clean home. A week or so after mom and dad come home, offer to let them take a nap. Wear baby around while you clean up! They'll wake up to a clean home, happy baby and feeling refreshed. We'll call this one Squeaky-Clean Service.
• Pregnancy Pillow- Mama's to be need sleep and lots of it! I mean, they are growing a human being, probably not the easiest job out there. Truth is, it's hard to get comfortable. Their new found bulk and achy joints make it hard to find a way to sleep in peace. Enter the pregnancy pillow. You can find a cheap one on Amazon for $39 or for the cheapo's (like me) make one yourself! It doesn't take much to make a long rectangle and stuff it with batting. Give the gift of a good nights sleep. We'll call this one, a Ladies New Best Friend (sorry dad)!
• Tips for a beautiful lady- Everyone will be quick to give tips on parenting, sleep training, nursing, blah Blah BLAH. But what about mom?!?! After all, she is the one doing all the hard work here. I've compiled a few tips for mom to stay as comfortable as possible and enjoy her temporary state. Here it goes!

1. Pregnancy is hard on the body. Massages feel good at the moment but sometimes those aches and pains stick with you. Accupressure and accupuncture are great for relieving back pain, headaches, and all those other 'icky feelings.
2. Ever heard the expression "opinions are like... noses, everyone has one, they all smell." No? That's because I just made that up. Anyway, it applies here too. E-V-E-R-Y-O-N-E will give you advice and only some will work for you. Just nod and smile and do what you think is best. After all, nothing tops moms intuition. 
3. Sleep. Sleep and more sleep.  Your body needs it, I mean you are making a human being after all.
4. Excercise, squats especially! They will help you when it's time for the birth and it will make you feel great throughout your pregnancy!
5. View your due date as "estimated", in reality you could be pregnant for 42 weeks. That's right 42 WHOLE WEEKS.
6. Drink water.
7. Drink LOTS of water.
8. Did I mention drink water?? This is by far the best tip I could give you. You need around 1 gallon of water a day when pregnant. It is very easy to get dehydrated which will make you even more uncomfortable and put baby in danger. Drink, drink drink (water silly).
9. Keep a journal. It's nice to be able to look back and reminesce over your pregnancy. Take lots of belly pictures and try to enjoy the time you have left as a couple.
10. Treat yourself. This can either be enjoyable or horrible. You deserve it, go get that maternity top and adorable swimsuit for (over your budget)!  It'll make you feel better than you ever thought you could feel!

Pregnant ladies have it hard, whether they want to admit it or not. Treat them to a good start and help them pamper themselves for once in their lives!! 

SO what did I miss? 

What do you give to your pregnant friends? 

What do you wish people gave you?

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10 Breastfeeding Tips to Make Life a Little Easier

When I was pregnant, the one thing that scared me the most was being unable to breastfeed my baby. Everyone seemed to have an opinion. Some were horror stories and always emphasized how hard it was. Some told me it's easy and the only reason some people have problems is because they are selfish. Here are some myths I heard over and over again. A note to all those people out there, that doesn't help. (Here are some positioning and latch tips that WILL help). But breastfeeding was and is very important to me so I did my best to understand what was about to happen to my precious boobies. I started doing research, stocking up on tips, taking classes and reading books! In just a few months I had learned enough to educate a village. Even then, I was scared. According to many researchers, only 1%-3% of women truly can't breastfeed their children. With that statistic I decided, I CAN do this, no matter what.  So below I am going to tell you the truth, the whole truth and nothing but the truth. Then I am going to give you ten tips that will make your life SO much easier.

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The Truth:
        Breastfeeding can be hard. There are moments where you are exhausted, your breasts hurt, and you just want your body back. But breastfeeding is also very rewarding.

Some benefits for baby include:

• Reduced risk of SIDS
• May protect from allergies and long term illnesses.
• Boost IQ points
• Protect from childhood obesity.

Some benefits for you include:

• Reduce stress and chance of postpartum mood disorders (formally known as postpartum depression)
• It's free!!
• Weight loss (You burn about 500 calories a day when exclusively nursing)
• Helps uterus return to normal size
• Reduces your risk for some types of cancer
• Easier night! (no having to get out of bed and make bottles)
• Bonding moments
• (My favorite one) You get a little time without a Period WOOOO!
• Helps with keeping you NOT pregnant (doesn't prevent, you WILL need birth control of some sort)

The lists could go on. There are so many reasons that breastfeeding is worth it. So why does it have such a bad reputation? Why do people think it is SO hard? Learning to breastfeed is the hardest part. Like I stated above, there are nights when you are exhausted. However, this comes whether you are formula feeding or nursing. Those first few weeks are hard as you try to establish a good latch and are nursing on demand. I had a few break downs myself. A baby makes you exhausted no matter what but add sore nipples and that is some women's breaking point. At first, you and baby have to learn a good latch. If you don't, your nipples may chafe, crack and even bleed. You never want to get to this point. If it really hurts, break the latch and try again. A good latch should not bring you to tears. <<Ha. That statement is so funny to me because any nurse or lactation consultant will tell you, "if it hurts it isn't right!". THEY LIE!!!!!!!!!!!!!!!!!!! Any breastfeeding mom will tell you, it hurts at first. Initially you will feel a stinging sensation but it should go away within a minute or so. Regardless, your breasts will be sore. They will feel heavy and when your milk comes in, they will get engorged. My best advice, stick it out. in a couple weeks, this will pass. Once you establish a nursing relationship, breastfeeding is pretty easy. The hardest part for me is pumping. If I have a birth to go to (as a doula) or a long class, I have to prepare weeks ahead of time. I don't mind pumping, but nursing is simply so much easier I have been spoiled. Despite the moments when I want my body back, I wouldn't change a thing. Breastfeeding is so much easier than formula feeding for me. I do not have to make any bottles, wash or disinfect any bottles, or run out of formula in the middle of the night and have to run to the store. Plus, the diapers don't smell so bad ;)

See that belly? Looks like I didn't make enough milk ;)

The honest truth: Breastfeeding is worth it if it means enough to you. Never let others scare you into thinking you aren't making enough milk. If baby has wet diapers daily, you ARE making enough. Weightloss in baby means nothing. (Most baby's lose weight right after they are born but then gain it back a couple weeks later, this is normal.) As for the lovely ladies who breastfed when we were babes, they mean well but we have learned so much about breastfeeding since then that recommendations have changed.

Ten Tips to Make Life Easier:

1. Take a breastfeeding class. As I emphasize in all of my posts, education is KEY in making life easier. A breastfeeding class will help you understand how the breast functions, what a good latch is, what a bad latch looks and feels like, different positions, etc. The information I learned in my breastfeeding class was priceless!! There are also some informative videos you may want to check out.
2. Do NOT keep formula in the house. It is too easy to 'supplement' if you are worried you aren't making enough milk, if your breasts hurt or even if you are tired and want to give dad a shot. Those first few weeks are the hardest, but of you supplement with formula, it will be harder. Your milk supply will drop. Baby's virgin gut (hey there's that phrase again, HINT: research) will disappear and all that hard work will go to waste.
3. Have a pump available from day one. Once your milk comes in, your breasts will get engorged. Having a pump helps relieve even the worst pain and helps you store up a stock for later. When buying a pump there are some things to think about. The brand DOES matter. The only two brands I would ever recommend are Ameda and Medela. Pumps made by formula companies rarely work (they are produced by formula companies, think about it for a minute...). Ameda and Medela pumps work very well and usually come with warranties. This is important. Also, please remember that how much you pump has no reflection on how much milk you are making. Baby sucks in a different way than a pump therefore producing different results!
4. Have/Create a good support network. Support is just an important as education. If no one supports you and people constantly either brush nursing off as easy or push supplementing/quitting, you will get discouraged. You need support. Why I say have/create is because many new mama's don't have a good support network. Our parents grew up in a time where formula was a luxury. Many of our moms never breastfed and others breastfed differently. (I was one of the lucky ones with a great support system, my mom was the bomb diggity!) If you do not have the support you need, you can create a network for yourself. La Leche League has some wonderful forums where you can talk to other moms struggling and often times, there are breastfeeding support groups in your area. Do some research :)
5. Nurse when and wherever you are comfortable.  Know your state laws on breastfeeding, they protect you. Do not let others dictate how you feel about breastfeeding. You may be comfortable nursing in public with or without a cover. You may want to nurse in your car or in a private stall, however YOU make that decision, not anyone else. I would never eat my dinner or feel comfortable feeding my child in a bathroom public or not. Each state has their own laws that protect breastfeeding moms. In the state I live in this is the law:  Find out your state law here.
   ________ permits a woman to breastfeed her infant in any public or private place and prohibits anyone from restricting or limiting this right.   Find out your state law here.
6. Cluster feed for a few hours before bed time. This is one I wish someone told me in the beginning. Remember those 'break downs' I mentioned having earlier? Funny story, one night my daughter was up every forty five minutes and eating for about a half hour each time. Resulting in, well you do the math. I started crying and trying to wake up my husband because I just needed something (I had no idea what it was). I was at the end of my rope. Picture me, holding a newborn, hunched over, half asleep and just letting it all out. It was so pathetic. So I did some research, I found out about cluster feeding. Nurse every hour, or even closer together, for about 4 hours. I nursed every half hour from 7-10 when my babe was a newborn. This resulted in longer stretches of sleep. (aka instead of waking every forty five minutes and feeding for thirty, I would get about a 3-4 hour stretch of sleep.) I feel like cluster feeding saved my life haha.
7. Keep baby close at night. Even if you decide not to bed share, keep a bassinet or pack n play next to your bed. This way you can pick baby up, latch them on and snooze while they eat. Remember that adorable nursery you decorated? Forget about it for a couple months. Which leads to the next tip...
8. Learn different positions, ESPECIALLY side lying. Side lying has a bit of a learning curve, but once you master it there is no going back. Sweet sleep will return to your life and all will be well. Side lying is a position where you and your babe face one another whist lying on your sides. Baby latches and you fall asleep all cuddled up. Peace will return in your life.
9. Before sitting down to nurse, prepare. There is nothing worse than that moment when you are nursing and realize "OH MAN, I have to pee" or "I am soooooo thirsty". Keep snacks, water, entertainment, pillows and your phone close by. Having a designated area helps reduce the chaos when baby gets hungry. 
10. Check your breasts often. Is there a lump or hard spot? Try to massage it out. Many breastfeeding woman get blocked ducts, mastitis and other painful issues. Keep track of cracked nipples and use Lansinoh Lanolin (purple bottle) on them. You have to take care of yourself. Stay hydrated, eat enough, pay attention to any changes.

More information:

12 Signs of a good latch.

Latching and positioning resources.

Side lying position.

Baby led Breastfeeding.
How long can you store breastmilk?

Remember, it gets easier with time. Only 1%-3% of women truly can't breastfeed, so if this is important to you, you can do it!!!!! If you ever need personal support, there is always a lactation consultant somewhere or feel free to contact me. I am a good listener and may be able to help.

Good luck with your little nurslings, may the milk be with you.

What did I miss? 

Any tips you've learned over the years?

Comment below with your thoughts!

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A Guide For Parents-To-Be: Part 1 (Important Decisions to Consider)

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Once you get pregnant there are a million things to think about. It can seem overwhelming, especially when you do your research and find all the conflicting views. This guide is here to help simplify and organize those decisions neutrally! I urge you to take the following options and research each side. Try to find neutral articles and studies (I know it's hard to do), so you can make the decision for yourself and not feel bullied into it! A large part of making the right decision for you and your baby is education. I cannot emphasize enough that research is your best friend!!

Remember, There is no right or wrong here. What YOU decide for your child is what is right for your family.

Below is some un-biased information on:

1. Vaccinations

2. Feeding Baby

3. Circumcision

4. Discipline

5. Routine Procedures

Here is a sample document to help you express your wishes. (Enjoy!!)

1. Vaccinations: These can be very controversial now-a-days. Some decide not to vaccinate at all, some vaccinate on schedule, some make their own schedule and some partially vaccinate! As stated above, there is no right or wrong decision here. I urge you to do your research on EACH and EVERY vaccine. Talk to your partner and make the decision that is right for your family. Here are some sources that may help!

• Dr.Sears Vaccine Book, available at your local library! This book talks about the pros, cons and ingredients in each vaccine. He also recommends a schedule however I feel that each family should decide on their own schedule.
• Here is the recommended vaccine schedule for children birth-6 years.
• A break down of some ingredients in vaccines.
• ASK QUESTIONS. If you are concerned about a vaccine or have any questions, please ask a doctor you trust!! Remember, most of the vaccines can be seperated (ie dTap, Pertussis alone is available for you to order but most Doctor's wont order it themselves.)

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2. Breastfeeding vs Formula Feeding: Another controversial issue. Breastfeeding is natural and is made for baby. The health benefits it has outweigh formula feeding. However some woman cannot nurse or simply don't have the desire to. Formula is not poison, although some would have you believe it is. Formula is a good alternative for those who cannot nurse. I urge you to do your research on both and make an educated decision. Some will nurse until baby self weans, some nurse for a year, some nurse for the first week!! (HINT: Research the virgin gut) What works for you may not work for others so you must make this decision as the parents. Here are some sources that may help in making your decision:

• Le Leche League is a breastfeeding organization in which you can get breastfeeding support, answers to your questions and a lactation consultant's help! 
• Which is best and how to deal with the guilt if you can't successfully breastfeed.
• Some good articles from American Academy of Pediatrics on breastfeeding.

 (SORRY NO PICTURE FOR THIS ONE)

3. Circumcision: That's right, I said it. One of the most controversial subjects on the net today. When researching this one you will find a lot of "if you circumcise your baby you are MUTILATING HIM!" and even more "eww he needs to look like his daddy." I'm stating on record right now. Your baby, your decision. Just please make an educated decision. Here are some good articles on circumcision:

• American Academy of Pediatrics on circumcision. 
• CDC Fact sheet on circumcision.
• Facts.
• D.O.C.

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4. Discipline: This one can be tough. Parents don't always agree on how they want to raise their baby which can lead to a rift in their relationship and confusion for the child. It's best to talk about this before having the baby so you can get on the same page, if you aren't there already. Discuss whether you agree on the cry it out method, sleep training, spanking, time outs, positive reinforcement, etc. I'm not going to add any links to this one, I don't want to appear biased on any of these subjects. There is so much information floating around that educating yourself and following your intuition is the best thing you and your partner can do. 

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5. Common procedures at birth: These procedures are usually over looked by parents because they are so routine! Education is key. YOU HAVE CHOICES. You can refuse or delay each of the following even if they are routine in your medical facility. Consider each aspect and make an educated decision with each:

• Suctioning
• Cord Clamping
• Vitamin K Injection
• PKU Test
• Antibiotic Eye Ointment
• Hep B Vaccine
• Bathing baby
• Circumcision

A couple of these have been covered above but I am going to break down each bullet point.

*Suctioning- As soon as baby's head emerges most care providers will reach for the bulb syringe and suction the nose and mouth to reduce the chance of aspiration on mucous or meconium. This isn't always necessary though. I urge you to research pros and cons of suctioning vs not suctioning.

*Cord Clamping- When baby is born he/she is still connected to the placenta through his/her umbilical cord. The common practice is to automatically clamp and cut the cord. There are many medical advantages to delaying the cord clamping though. I urge you to research pros and cons of delaying the cord clamping.

*Vitamin K Injection- Each baby that is born in a hospital will receive an injection of a large dose of Vitamin K. When babies are born they do not have the ability to clot in the case of bleeding. Vitamin K is administered to prevent any significant bleeding. It is recommended to give the injection if you plan to circumcise or get the PKU test. Some disagree with this practice however. They feel it is an unnecessary shot of a very large dose of Vitamin K. It is also advantagous to look into alternatives such as the oral dose. Once again, I urge you to do your research. 

*PKU Test- There are many metabolic disorders that are tested for after birth. Each is tested for by a blood test via heel prick. This is one of the least controversial procedures as the benefits clearly outweigh the risks. You have choices however, so you may decide to delay or refuse after some research!!

*Eye Antibiotic Ointment- (Or silver nitrate drops) Each state has their own law concerning this ointment. Many of them require the administration of the antibiotic however, your baby, your choice. You have choices no matter what your OB/midwife tells you. The antibiotic is administered routinely to prevent an infection in the eyes that is caused by a bacteria that cause gonorrhea and chlamydia. Even if the mother tests negative for the STD's in her pregnancy this ointment is given routinely. If the baby does get an infection of the eyes it can cause blindness. The flip side, it is very rare to contract the infection, you can watch for symptoms of an infection and if they turn up give the ointment. This cream may cause burning, swelling and blurred vision in the first few days of life.  I encourage you to do your own research and make an educated decision.

*Bathing Baby- Bathing Baby is usually never considered an option by families. They think the baby is covered in goo, it's gross and it needs to be cleaned off. If that's how you feel, good for you! Go bathe that baby haha! Recent studies show that the white goo (called Vernix) is actually a very good moisturizer  that protects baby from infection if massaged into the skin. Bathing baby right away can also cause a sudden drop in temperature which may force baby to stay in the warmer and out of mommy's hand a little longer. Another thing to consider here would be skin on skin contact. You may want to delay the bath for an hour or so, so mama can get some bonding time with baby and have immediate skin on skin contact. This helps jump start milk production and a good latch right away (if breastfeeding). Once again, I urge you to do some research and make an educated decision. 

*(Hep B Vaccine and Circumcision covered above)

Source

These are some hard decisions to make. I emphasize researching and making an educated, personal decision.Don't feel guilty when other don't agree. These are all very controversial subjects and some people feel VERY strongly about each of them.

Did I miss anything? 

What were you concerned about while pregnant? 

Would you like me to discuss something more thoroughly? 

Let me know!

Covered in part 2: Interventions
Covered in part 3: Pain Management and Pain Medication in Labor
To be covered in part 4 : Making Decisions on Raising Baby
                             (Babywearing, Day Care, Montessori Method, Co-Sleeping, Introducing Solids)

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Deliver vs Birth

A peak into my mind...

Source.

I use the word "birth" instead of "deliver" for various reasons.

• The first definition under the word deliver in the dictionary states as follows:  "to carry and turn over to the intended recipient or recipients".  
• The first definition under the word birth, however states this:  "the act or process of bearing or bringing forth offspring".  
• The term 'deliver' takes the focus off the mom while the term 'birth' as a verb shows the very hard work a mother goes through to bare a baby. Lets give the power to the mom!

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5 Things I love about Birth- A doula's perspective.

1. The most obvious reason, birth is a miracle. Let's just break this down a little bit. You do the deed, get pregnant (a miracle all in itself) then somehow you squish a placenta, a baby AND all of your internal organs in this small cavity (See above). Suddenly there is no more room and your smart body gives the tiny tenant an eviction notice. It goes into obvious action to eject the little thing and all it's 'furniture'. It knows exactly what to do, contracting the uterus all while putting the tenant into position and turning them so they will fit out of the (small) exit door perfectly. Next step, the furniture. Suddenly your body realizes that the ex tenants fridge is still chilling in there and it separates from the wall and plops out onto the 'doorstep'.  Now its time to restore the apartment, a few more contractions and bam EVERYTHING GOES BACK TO NORMAL! Somehow our bodies know exactly what to do and can sustain this little life for as long as it needs. It's an amazing thing. (Yes I realize this is incredibly simplified and takes a little longer but by golly, it's a good analogy.

This beautiful little gem has been floating around pinterest lately.
(Although your oxytocin and adrenaline levels are much higher when in labor.)

2. It helps you learn what you are really capable of. I often hear people say "I have a low pain threshold" or "I could never handle that". But you never know what you can handle until you experience something that actually tries your body. I read a study which concluded that everyone can handle the same amount of pain physically, it is the mental state that will determine how much you can truly handle. When it comes to birth, there is no way around it. You will probably learn your REAL pain threshold at one point or another. Now to the awesome part, it will make you feel like a super hero once you realize how much you really CAN handle.

Picture found at  http://tinyurl.com/c2ex9af




3. It shows who you really are. When you are in labor or giving birth you strip away all inhibitions and turn inwardly. Think of it like the weather. When you are home alone and the ac isn't working, it 90 degrees and nothing can cool you down. So you strip away your clothes. You find comfort in being completely exposed. It's the same when birthing, It doesn't matter who is in the room or what someone thinks of you, it is all about YOU. You strip away anything blocking you from your real inner self. You learn so much about yourself in this one experience. When you share a birth with someone, like a doula, you usually have a connection for life. They see you at your most vulnerable, they know YOU. In those moments when you are figuratively (and probably literally) naked you learn the most about yourself.



Picture found at http://nevehowe.wordpress.com

4. There is nothing more beautiful than the moment you hold your baby and gaze into their eyes. You go from being a mama to a protector, a strong and loving force in this baby's life. That moment you realize what you just did, that this is your baby, that moment is the most beautiful moment in a moms life. Not to forget the dad. For dad to see his beautiful partner go through the hardest trial anyone could handle, to bring forth this gorgeous little being, this is a magnificent moment that can't be topped.    
 
5. The most amazing thing about birth is it changes a woman. The change is so subtle that you may not realize one has occurred! I'm not talking about the oh-so-common baby blues. I'm talking about your every day perception of things. This one experience will change you forever. One day you may be laying back on the couch, watching your baby crawl around on the floor when you realize, "this isn't me, I hate kids!" or maybe "that thing has made my life complete." or even "How did I help make something so____!" (fill in the blank)-this is in case the crawling baby is tearing apart your living room floor, that you JUST picked up.


I will leave you with a thought to ponder:
Why do women want to 'jump start' labor when they know it's gonna hurt like the dickens!!?
(Don't you lie to me, I know you searched 10079785678 different ways to naturally induce labor the second you hit 37 weeks!!!)


What about you? What do you love about birth?

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100 Reasons: I love my Daughter

Back in May I wrote this list of 100 reasons I love my husband. Two months have gone by and it's time to brag about my daughter, Lily. So here it is, 100 reasons I love my daughter.

1. She gives me random hugs.
2. She loves and depends on me unlike anyone else.
3. She is so curious.
4. She taught me what love was all about.
5. Wet kisses.
6. The way she takes over our bed, who knew a 9 month old needs so much space!
7. She loves animals.
8. Her smile lights up my whole world and anyone else who is around her.
9. Did I mention her smile is gorgeous??
10. She puts up with my singing.
11. She looks at her daddy with stars in her eyes.
12. She is very social and loves other kids.
13. Her sense of humor can lighten any dark day.
14. She is so innocent.
15. When she's quiet, she's in trouble!!
16. She can entertain herself.
17. She knows when I need some love.
18. She has taught me right from wrong, over and over again.
19. Everyday she teaches me something new.
20. She enjoys the simple things in life.
21. She says 'mama' and crawls to me for comfort.
22. She knows what she wants and goes for it.
23. She has the most beautiful, unique eyes.
24. She puts up with people swarming over her and pleasures them with a smile.
25. Her skin is so soft.
26. She acts interested in what I say.
27. She babbles on and on.
28. She is open to new foods.
29. She often stops and thinks before reacting.
30. She is a water baby.
31. She shares really well (so far).
32. Her baby biceps.
33. Her funny faces make me laugh.
34. She rarely cries.
35. Her laugh.
36. I can't imagine a day without her here.
37. She is delicate.
38. She is cautious.
39. She is a good sleeper.
40. She is a good eater.
41. She makes me feel better when times are tough.
42. She gave me a new new outlook on life.
43. She opened up a whole new world for me.
44. She is playful and free.
45. When she knows she isn't allowed to have something she packs it in her jaw like a squirrel.
46. She is smart.
47. She is independent. She is dependent.
48. She makes me venture out and try new things.
49. She shows me what is important in life.
50. She helps me practice patience.
51. She is silly.
52. She is strong willed.
53. She gives me something positive to focus on.
54. She taught me that I have no limits.
55. She makes me a better person.
56. She is so sweet, even when sick.
57. She has my nose.
58. And my toes. (Sorry baby)
59. She goes from sad to happy in moments.
60. She showed me who I really am.
61. She lets me dress her up, in even the most ridiculous outfits.
62. She brings joy to her grandparents.
63. And aunts and uncles.
64. And cousins and friends.
65. But especially her parents.
66. She doesn't hold her shots against me.
67. She loves to cuddle.
68. She loves to swing.
69. She loves new people.
70. She showed me a new side to her daddy.
71. She can make anything a toy.
72. She is always there, always.
73. She'll choose the free spoon over the $50 toy any day.
74. She is an easy baby.
75. She knows 'no'.
76. She knows how to make me smile.
77. She does a special pilates move made by her.
78. She always wants to be involved.
79. She is so social.
80. Her crazy hair.
81. Her love for nature.
82. Her eagerness to be involved.
83. Her sweet smells (minus the potty smells).
84. The personal touch on each and every one of her signs.
85. Her derp face.
86. The way she throws toys over her shoulder when she is finished with it.
87. The way she drops her pacifer out of her mouth when she wants some food you have.
88. Her love of music.
89. How she has her own music taste.
90. Her goofy dance moves.
91. Her ability to make a room full of people smile.
92. Her daddy-like personality.
93. Her sense of calm, even when in distress.
94. Her ability to tear apart a room in seconds.
95. Her feet that are so unique, they don't fit in shoes!
96. Her will to go Go GO!
97. The chance to dress up on mommy and me clothes ;)
98. She is very loving and easy going.
99. She is so beautiful.
100. She changed my life in the best ways possible.

We got very lucky. Lily is an easy, overall good baby. It is impossible not to love her! Pin It Now!

June in Pictures

Lily loves her new push toy!
She is wary of falling but gets so excited when she uses it!

It's been a rainy month! 

Every chance she gets, she pulls herself up on whatever is around her.

She loves to stand at the door and
 'dream' about playing outside.

She loves her new dress and blankey from Oma!

She has discovered that even though we are out of sight,
we are still there!

She has learned that if she shouts into her stacking
cups her voice will echo!

THERE YOU ARE MOMMY!!

A few cuddles from someone just her size and she is out!!

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