{new #OutsideTheMomBox post} 13 #stress busters for #pregnant #women

Anxiety isn't good for any of us but it can be especially detrimental to pregnant women. For pregnant women extra stress can cause high blood pressure which can trigger preterm labor. Preterm labor can lead to a host of issues for baby: including intellectual and developmental delays, hearing and vision challenges and more. This March of Dimes article articulates many of which here. So, let's all calm down! Here are 31 ways how to reduce stress:

1. Avoid information overload. DON'T Google everything! Find a trusted friend, educator that you can depend on for quality information. No, they won't have all the answers but they will be able to refer you to someone equally awesome when they get stumped.
2. Find a support group. Connecting with other women is so important at this often scary, vulnerable time. Hear that they are feeling the same and learning from each other. 
3. Start saying "no" now. I know you're a helper. I get it, I do. But the best person you can help now is YOU. Practice saying "no" to whatever doesn't feel like the uber-best fit for you and your new family. Trust me; you'll get a lot of use out of this new habit down the road.
4. Sit on a birth ball. I can't say enough about how much I love birth balls. They keep you moving, keep your hips fluid, get you off your feet, keep your pelvis in a good position. And they just feel good! Try it.

5. Take a warm bath. During my last trimester, I must have taken a warm bath 5 out of 7 nights a week. I listened to my breathing CD, took deep breathes, talked to Little Sun and slowly dripped warm water over my big belly. It felt great and allowed me to sleep better.

6. Go for a walk. I didn't do a lot of exercise when I was pregnant but I did walk nightly. It helped me calm down from the craziness of a work day and kept me active and mobile,even when I didn't want to be. It felt good.
7. Drink more water.  A dehydrated body can lead you to confuse cravings with real hunger pangs. Also a dehydrated uterus is a crampy uterus which is an unhappy uterus. You want a happy uterus. Happy = healthy and feeling good!
8. Hit the sack earlier. Rest now because it feels so good and because you won't have as much time. If I hear one more story about a pregnant woman heading out for a jam-packed day, with nary a nap in sight, I swear! Take it easy, please. Trust me on this one.
9. Talk to a coach. Most of my Outside The Mom offerings are ones that I wanted. Wellness Coaching is no exception. One session (or a handful!) includes simply talking to someone who has been there before can bring much relief as well as education, resources and support.
10. Journal. In Baby Body and Soul, Tracy Gaudet recommends journaling. It was really helpful to me to write down some of the anxieties that I was feeling about the pregnancy and what I still felt like I needed to sort out before I had her. 
11. Enjoy a chiropractic adjustment. For three-four months leading up to my daughter's birth and for over a year, I received regular chiropractic adjustments at Imagine Chiropractic. They felt great but also reminded me that I was doing good prep work for labor. 
12. Enroll in a childbirth class. Prep and information reduces stress now...and down the road. I have a seven week, Sunday afternoon class starting in September in Durham for couples and September online for survivors. I also have other local resources for childbirth here.
13. Ask for help more often. Boy, do I wish that someone had strongly encouraged me to start asking for help when I was pregnant. You will need help. I did. We all do but it's hard to ask. Start that vulnerable act with someone you trust & see how that goes.

New moms, what would you add to this list? P.S. Your 13 comes up in a few weeks. I didn't forget about you!

{new #OutsideTheMomBox post} Touring The Birth Place at #Duke Regional Hospital - Part II

In this post, we continue where we left off and will tackle what happens from delivery to discharge. Part I of this post was published here.

After you have delivered your baby, you will spend only about 2 hours in your labor & delivery room. Then onto the mom & baby rooms. Before that your nurse will help you get up at some point and use the bathroom. At Duke Regional, the labor and delivery rooms are separated from the mother and baby rooms by the nursery. It's a nice quick jaunt to get from one to the other. However you'll likely be in a wheelchair. If you delivered vaginally, you may find yourself to be ravenous (I was!) and you are encouraged to eat. Your IV will be removed. If you delivered via csection, it will be a slower progression to get to foods but the goal is to get you back on a regular diet. 

This is a L&D room from the 1960's. Thanks News Tribune Attic for this photo.

Once you are in your new room, you can expect to stay there for 2 nights if you delivered vaginally or 3-4 if you delivered via csection. It is your right to leave after 24 hours but this is discouraged for many reasons, not least of which is due to helping you figure out breastfeeding. An IBCLC at Duke Regional will come after the first 24 hours because after the first 24 hours is when a feeding challenge might show up and because newborns are super sleepy in the first 24 hours so may not be as interested in feeding. These rooms are private and simple, not fancy. They don't offer much in terms of comfort for your partner i.e. there are "reclining chairs" not a sofa for them to rest on. There were be pretty regular interruptions as staff come in to check on your and baby's vitals but they will try to be mindful of your rest. The nurses will teach you how to swaddle, diaper, bath baby and also help with breastfeeding. They will likely show you the movie "The Period Of Purple Crying" and perhaps offer a copy for you to take home or...share with your nanny or other caregiver. Circumcision, if you have decided to go that route, can happen anytime but like the hearing test, baby will be removed from the room for this. The newborn screen includes a bilirubin test as well as the hearing test. Finally, the carseat will need to be brought into the hospital on the last day of your stay. You cannot leave the hospital without a carseat so my guess is this extra schlepping is simply to prove you have one.

A couple of other miscellaneous bits of information:

• If you do't have a breast pump, you can buy one at the gift shop at Duke Regional with a 35% coupon that comes in your tour packet. I advise checking which brands they stock and the price. THEN comparison shop a bit at places like Buy Buy Baby or somewhere similar to make sure you are getting the best deal.
• There are options for photography in your room, at the hospital, if you are interested in that. It's free, easy and confidential. I've blogged about wishing I had more photos of myself and Elisabeth during the first few days so I think this is just a terrific service.
• There are no set visiting hours at The Birth Place but there is a very strict security system. Your baby gets a little bracelet that, if it falls off or is removed, will alert staff to come and check on baby as well as lock down doors (although perhaps not immediately). 

As always, one of the most important bits of advice I can offer is to make sure that you have good support before, during and after childbirth. That means a birth doula, childbirth educator, postpartum doula and IBCLC. But good support i.e. a birth doula, during labor, increases your satisfaction with your birth. Greater satisfaction with the birth process (feeling heard, listened to, appreciated, understood, comforted) helps decrease the chances of a postpartum mood disorder. 

What have I missed? If there is something you wish I had included here, please leave me a comment below and let me know. Thanks for reading.

{new #OutsideTheMomBox post} Impact of maternal #childhood #sexualabuse on #babies

Childhood sexual assault (CSA) survivors have a different set of challenges than new moms who aren't survivors. [For perspective, about 1 in 7 girls will be sexually abused before her 18th birthday.] These challenges can manifest themselves in different, often unexpected ways, not just in mom, but also in baby. As the first in a new series here dedicated to raising awareness about the realities that survivors face as pregnant women and new moms, I'm going to highlight three ways that a history of CSA in mom can impact a newborn's health and well being:

1. From the strange new feeling of your milk letting down to the realization that your breasts really aren't your own anymore, breastfeeding can be a very triggering act for a survivor. Add in factors like an infant's roving hand, pain of any sort, feedings at all hours and you can start to see why some survivors don't breastfeed. For survivor moms, it's usually less of a "choice" and instead often related to not being able to tolerate breastfeeding or the fact that it just doesn't work for them. And yet, we all know that breastfeeding is ideal for baby. Studies that confirm this are numerous; check out the first paragraph here for details. 
2.  Failure to thrive (FTT) is a state of undernutrition due to inadequate caloric intake, inadequate caloric absorption, or excessive caloric expenditure. There are two types of FTT: non-organic (a non-medical reason the infant isn't thriving) and organic (a medical reason that the baby isn't thriving). With both types, the bottom line is that baby isn't getting fed enough. There are many reasons why FTT can occur: lack of success breastfeeding, emotional overwhelm in mom, misunderstanding or a lack of understanding about basic infant needs in mom/parents, lack of attachment to baby by mom, etc. Each of these above reasons can be by-products of mom's past history of abuse. Dr. Kathleen Kendall-Tackett, IBCLC talks a bit about this here.
3. Not all women bond immediately with their baby.  For survivors, however, that bonding may take even longer, even if the baby is "just" a normal, dependent infant. If the baby is special needs, is "difficult" or has other challenges (colic, etc.) then bonding may be even harder. "Mere" insistent neediness of a baby may stir up past feelings of vulnerability and powerless that mom associates with the perpetrator of her abuse. It's normal: the perpetrator took what he wanted from the survivor and when a new baby enters the survivor's world, dependent and unable to feed or care for herself, the survivor's body is once again at the whim of someone else. This lack of bonding can become problematic though if FTT (see #2) develops and/or if mom begins to have ideas of harming her baby.

What does all of this mean? Well, simply due to their past abuse, survivors carry with them challenges that can complicate their ability to provide the best care for their baby. Add in factors like poverty, a lack of education, an absent or abusive partner, and you have a survivor mom who may barely be hanging on. This is something that should concern all of us. But here's what we can do:

• Keep in mind the challenges of survivors that we discussed above when you hear the ever-present "breast is best" motto. Click here for a bit more on this issue. Not being able to breastfeed a child can be devastating for a new mom's fragile mental health but what is often more detrimental to mom and baby is the societal guilt that moms are made to feel by not doing the "best" they can for their child i.e. breastfeeding.
• Provide support. Support is continually named over and over one of the best resources that you can give a new mom. Good, informed support helps new moms feel less alone, more normal and more accepted. Not to mention provide them with trusted resources that they trust when they need more help or advice. All of this is why I offer free groups. What can you do? Attend a group, help make a group happen for those who need it, or volunteer in a way that feels right to you.
• Rise above the "mommy wars". It can be so hard to sit back and mind your own business. That's true for me too! But we really must. When we accept that we can't ever know someone's whole story and therefore have no place to judge them, then we are removing ourselves from the insidious "us vs. them" battle. It's a battle that neither side will win, even if we "lean in" so let's just opt out of it altogether.

Starting this fall, I'll offer my first virtual program: a childbirth education class specifically for survivors. Open to any survivor, living anywhere, we will meet weekly over a conference call line for seven weeks. First names only. If you'd like more details, head over here to give me a call or message me. Thanks for reading.