I am often asked if I would recommend an organization using the ACE Questionnaire. Generally folks are asking because they are interested in screening for trauma in some way. Which is so fabulous! The question is a great one. But here's why using the ACE questionnaire is not a good idea.
Read moreWhat are you carrying?
And I don't mean diapers and Cheddar Rockets. I'm talking about your emotional baggage.
I talked to a group of pregnant women and their partners on Tuesday morning at Women's Health Alliance in Durham about expectations and worries postpartum. Like the rest of us, most had done a really good job of taking care of the essentials before the baby arrives: getting the car seat installed, setting up a crib or co-sleeper, taking care of the responsibilities of work before we take our leave, etc. What was missing, for them, is preparation for the essentials that come after the baby arrives. Sure, we or friends have set up a meal "service" like Take Them A Meal but what about other essentials? Essentials like support from other new moms, permission to let the housework slide, time to take deep breathes, heal and be present with the emotions that we are experiencing.
Pregnant or not, as women, we've been conditioned to believe that we can do it all and that we should do it all. And that's our first mistake. This impossible promise, though, is much more realistic (or feels that way) when we don't have a child in the picture. As soon as the baby arrives, however, the gig is up. It quickly becomes clear that the social expectation of having it all/being it all/doing it all is not only unrealistic but also tightly packed with more shame, guilt and anxiety than we had ever imagined when we'd first stepped into those tight shoes. But once we're got them on, they're hard to just kick off.
In order to live with peace, be present with our children, sleep soundly at night, stay in good health and leave work behind when we shut down our computer, we must get rid of off these awful shoes. No matter how hard we try, they will never really fit us. And we are not the problem! They don't fit any woman. We need to shrug off what's not working because it's costing us a lot. Even as I type these words, I know how hard this is for me. Unless I get the pinwheel of death, for example, I never actually shut down my computer. I'm not alone on this one. It saves me time to keep the computer on, to just open it and begin to type. Doesn't it? And, is that short-term timesaver "enough" to balance what I'm giving up long-term?
To start casting off what's not working, we need to look carefully at (state aloud, document, get an accountability partner, etc.) what our essentials actually are. And that's a small, tight list! Once we know that, then we can start eliminating some of the emotional baggage of the "stuff" that we carry with us that prevents us from spending time on those essentials. There are additional costs associated with carrying emotional baggage which doesn't serve us. Intangibles like energy, creativity, money, focus.
We will talk about some of this in Toddler Group because the baggage that we carry also affects our relationships with our toddler, our partner of course, and other important people in our lives. When you're overwhelmed and feeling guilty, how do you think you'd deal with our impetuous toddler? Yeah, kind of like that.
What can you stop carrying?
{new #OutsideTheMomBox post} 5 important questions #pregnant #women should be asking themselves
There are so many things that women need to juggle on a regular basis but I feel like when you're pregnant, the issues just multiply like rabbits. You have information coming at you from every possible perspective, including the unwanted viewpoint of perfect strangers and anyone else whose opinion you're not interested in but who feels compelled to share it anyway: coworkers, cousins, perhaps even your mother-in-law. It can be hard to parse through what's important and what's noise. So, below are five questions that truly are relevant and timely:
If I were to go into labor right now, am I ready?
Do you have a carseat installed? Are work related projects tied up? Is care for your existing child squared away? Do you have a labor bag packed? Do you know where baby will sleep when you get home? These questions matter regardless of where you are in your pregnancy but obviously take on a greater sense of urgency the closer you are to your due date. Babies come late but some babies do come early. You being ready right now if you were to go into labor means less worry and work for you, if it does happen.
How will I best feel supported when I'm in labor?
All attention and care needs to be on you during labor, not your partner. So, if you're worrying about how your partner might deal with your contractions or the blood or the lack of sleep that he will get, then you likely need additional support during childbirth. You also might consider getting additional support during labor if your partner is a medical doctor or nurse (these folks often have a harder time separating their training from what you might want or need in the moment i.e. not to be induced, even if your OB suggests it). It's all about you, your wants and needs during your labor. You cannot be spending time taking care of your partner, even though you normally do this. I cannot recommend enough a birth doula as your exclusive labor support. Birth doulas exist entirely for you and your needs during childbirth. Oh, yeah, they also increase satisfaction with childbirth experience and lower the chance of a csection. Pure gold.
If your doctor tells you that you need a medical intervention, do you have the information you need to respond in a way that honors your preferences for your childbirth experience?
In other words: have you taken a childbirth ed class yet? Understanding that birth is a natural, normal experience (in spite of how medicalized it has become), that women can go into labor on their own and how medical interventions can affect your labor are all part of any good childbirth education class. The two Lamaze based childbirth ed classes (traditional and survivor specific) that I teach are open to women at pretty much any week of pregnancy because I think this information in the class is valuable immediately. Say for example, after learning about how one intervention often leads to a cascade of interventions in labor in your childbirth ed class, you realize that your OB has a very high csection rate and you don't want a csection: you're likely not going to feel as nervous changing providers at week 18 for example than you would at week 28. Prep early rather than later.
Whose job will it be to care for me when the baby comes home?
Just in case you need to hear it: your job is to care for the baby. Nothing else. If you're breastfeeding that means that you exclusively are keeping that baby alive. If I sound serious, it's because I am. Feeding a newborn is no joke; it's a round the clock job that you can't even imagine would take as long as it does until you're actually doing it. For those who are formula feeding, you may not be whipping out a breast a million times a day but you are working just as hard to sterilize bottles, measure formula, heat bottles and get baby fed. Yes, your partner can do these things too but you know as well as I do, just like we both know who does the majority of the household chores in your house, that you will likely be doing the bulk of this work. In other words, you need someone to take care of you. I didn't understand this when I had my daughter. Trust me on this, please identify someone now to be your caregiver when you get home. That can mean a postpartum doula or relative but make sure someone is there exclusively for you.
What household responsibilities can I turn over to someone else BEFORE I go into labor?
Along the same lines, you don't want to be dictating how to give the dog her meds to your neighbor in between contractions. Okay, that's a little extreme but you get what I mean. There may be a learning curve involved for whoever is stepping up or taking over. Honestly, just assume that there will be a learning curve. Again, you will rest easier and will worry less if you can hand off household care and maintenance to someone else.
New moms, have I missed something? What essential question would you suggest a pregnant woman ask herself? Leave me a comment below.
Book Review: Body, Soul & Baby
During one of my early visits with my ob, I asked her for a recommendation for a good pregnancy book to read. She told me about Body, Soul and Baby by Dr. Tracy Gaudet, the former director of Duke Center for Integrative Medicine. I've read a dozen pregnancy books since then and this is still the best one.
Perhaps from the title you can tell that _Baby Body and Soul_ is a different sort of pregnancy preparedness book. The emphasis isn't "just the facts" although there are plenty of those. And its' focus isn't "touchy feely" or overtly spiritual although those factors are also present. Gaudet talks about the book as a guide to becoming aware of the transformation that a pregnant woman is undergoing. Not only physical but also emotional and spiritual. _Baby Body and Soul_ urges the reader to look at her whole person. Gaudet argues that by examining all aspects of ourselves (emotionally, physically, spiritually, etc) we will take care ourselves in a way that nourishes us authentically, from within and not in a perfunctory, automatic way. The difference between these approaches can be explained this way. Consider the woman who gets to know herself during her pregnancy, pays attention to what her body is saying, and what her emotional self needs vs. the woman who goes into autopilot when pregnant, dutifully taking prenatal vitamins and going to her doc visits. Both may start out feeling overwhelmed, surprised, etc. but one takes the time & energy to explore those feelings while the other sort of hopes they go away with time.
Tanya & team at Daisy Cakes made these lovelies for one of my baby showers.
Early on in my pregnancy, I felt alone and scared. I didn't know any other "older" pregnant women and we decided we wouldn't tell anyone that we were pregnant until we were well out of our first trimester. Other than our conversation, there wasn't much connecting my pregnancy to reality. As a result, I felt unattached to the baby. _Baby Body and Soul_ is full of exercises that are designed to connect you to your baby, even if it feels unsafe or scary. In Chapter 3, "Ten Tools for Tuning In", Gaudet talks about "dialoging" and "baby quick pics". It was with the help of these tools that I first connected with our daughter. This was a huge turning point in my pregnancy, from an emotional perspective. Suddenly, she was real. With these exercises, I begin to see the baby as a warm, yellow sun (before we knew her sex). From that point, until her delivery I called her "Little Sun".
There are only two gaps to this book in my mind. The first is that it hasn't been updated since it's publication in 2007. The information is still timely and relevant but best practices in prenatal care change all the time so it would be wonderful to have a new edition. The second is that for all its holistic approach, there is no mention (that I can recall) of how past trauma like sexual abuse or domestic violence can affect not only the choices that a pregnant woman makes but also how she does "pay attention" (Gaudet's language in the introduction) during pregnancy, childbirth and the postpartum period. As an educator and speaker about how issues like DV and SA affect a pregnant woman, this is a huge miss in my mind. That said, it likely wouldn't be a miss for others and non-survivors.
If you're the kind of pregnant woman who wants facts but also a little more in terms of emotional exploration and building connection to this new small life, _Baby Body and Soul_ might be a good choice for you. _Baby Body and Soul_urges you to slow down, take the time to feel what you're feeling and then make decisions based on those internal matrixes. It's not a Thanksgiving meal to be stuffed on; it's more of a dessert tasting menu at your favorite cafe which encourages you to savor and taste deeply.
Outside The Mom Box rating: 5 stars out of 5
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