{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} Expanding bellies, empowering steps

I read this article via NPR recently about inductions declining. Which is of course, a good thing so yay, but I was struck by the language in the title, the content of the article and the comments. 

Here's what I mean-

• "fewer women are having labor labor induced earlier," - title

• "There has been a major effort in the past several years to reduce the rate of early elective deliveries." - first sentence of story

• "the overall drop in induction rates may be fueled by doctors cutting down on their use of elective early induction as awareness of its potential hazards has spread." - middle of story

• "It's important that women who have a real medical reason for delivering early aren't scared off from doing that, he says. But for everyone else, he advises giving the baby an "extra edge" of those last few weeks." - end of story

Fascinating how in the title the blame for early inductions seems to be dropped squarely on mom, "fewer women being induced earlier", but the credit for this shrinkage in inductions goes to doctors and hospitals. The massive effort on behalf of childbirth educators, the March of Dimes, birth doulas, even women themselves, to lower the number of inductions goes completely unmentioned. 

To me, this seems like such a typical example of the double standard that we place on women, a double standard that can be especially challenging for pregnant women. Pregnant women are just trying to do the right thing for themselves and their baby/babies but pregnancy can be a vulnerable time. Everything you know to be true of yourself and your life is changing or will change. At what other point in our lives is this the case? So it feels crappy even to me, a non-pregnant woman, to read an article like this. The message seems to be: don't get induced but if you do, it's likely your fault.

The reality is so much different. Everyday I hear stories from new moms about their birth story and all too often a part of that story is not feeling heard or respected. Whether that's the mom who says that she was induced because she was "too small" to deliver vaginally or the mom feeling traumatized because of what one nurse said or by the med students in the room. The list goes on. I will never forget the new mom who told me, "I wish that I had been told that I could be a bitch in the delivery room." And by this she meant, someone who would be relentless when it came to questioning what was happening and saying exactly what she wanted. This mom didn't feel as if she had that power. Many of us in the exact same place, scared and uncertain, don't either.

One problem is that most childbirth education classes, especially the larger ones that are hospital-based, offer very little in the way of practical tips or coaching on how to respond or deal with hard conversations. Such as when your ob asks about scheduling a csection when you're hoping for a VBAC. Or how to find out how long your ob's practice usually lets women "go" if they are an "older" mom. Or what your options are if progress has slowed. These can be hard conversations! While the topics are introduced, ways to address them with your provider usually are not. More traditional childbirth ed classes offer outstanding, current information but not a lot of support beyond the facts. Even the chairs generally suck! So women may end up feeling more informed but sometimes not any more empowered with real tools in which they can advocate for themselves, in the moment, than they did before the class.

So, lets not throw the pregnant mom under the proverbial blame bus with articles like this. All too often the medical professional in charge is the one wielding the magic wand of decision-making power. Instead let's move toward the use of inclusive, empowering language when it relates to pregnant women so they are part of the conversation...and not just in title alone.

Starting in September, I will offer a multi-week, weekday evening, "traditional" (for couples) Lamaze-based childbirth ed class for expecting parents. Among the usual topics (stages of labor; pain theory; non-pharma pain management; labor support, etc.), I will also include coaching around how best to advocate for yourself in the moment, how to challenge your ob, how to ask better questions, how to make your voice heard, etc. If you'd like to be emailed when registration opens or for more details, click here to head to my contact page. As always, thanks for reading. To leave a comment, click the bubble icon below.  

{new #OutsideTheMomBox post} My Story

I didn't expect to be able to get pregnant, or get pregnant easily. I was 38 and just imagined that I was likely "too old". But luckily for us, we did get pregnant and luckily for me, my pregnancy wasn't difficult. Physically I felt good. I was exhausted in the early weeks of the first trimester but when that faded. Most of the time, I had good energy, slept well and while I stopped going to the gym early on, I remained active with walking and yoga. Emotionally, however, I was a different story.

I had been a confident woman for decades so it was strange to feel like that was all gone. Suddenly, I felt anxious about every little thing. I felt sure that I was the oldest mom-to-be in Durham. There was no "First Time Moms Over 40" Durham Meet-Up at that time. I didn't know anyone else who was pregnant! On my daily drives to Chapel Hill, I found myself angry with careless drivers on 15/501 and wished aloud many times for a "pregnant lady on board" sign for my car so they might be extra careful around me. I felt unsupported and stressed emotionally about my job and uncertain, even what it would be, when I returned from my leave. There was no "pregnant women support group" that I could find. I felt alone and vulnerable often.

...until about the seventh month! My husband and I took a childbirth ed class where we finally met other expecting parents. There wasn't much time set aside to talk among ourselves or debrief in general but I really appreciated the weekly company. We also hired a birth doula which was reassuring for both of us. I'd come full circle with my job, too. I had originally planned on returning after my three month leave (1/2 of which would be unpaid) but ended up deciding it would be best to give notice and find something else at the end of the summer. I began to feel my confidence come back.

My daughter was born in the summer of 2012.  Neither my husband or I had much experience with babies and I remember thinking, through my fog of sleeplessness, worry and physical pain, “it shouldn’t be like this.”  When I learned about post-partum doulas a few months later, I decided that I wanted be one of these amazing women: a special blend of confidante, sister, nurse. But was that the answer? I'd already began to wrestle with this new identity.  I was someone's mother while still 'Elizabeth'. "Elizabeth", as I knew her, had to be in there somewhere, I thought. And it didn't seem to be "just" a matter of finding a new career.

I began to realize that it was about more than wanting to offer support and help as a postpartum doula, I realized that we moms need to give ourselves permission to count again. I needed to. And not just in the professional sense, as it seemed I was trying to. It felt wrong to go off and have a coffee with an old friend but common sense and a good sense of self told me that was exactly the thing I needed to recharge and return ready to tackle a hungry baby.  I was still important as an individual with different needs (including professional ones), even if I was now someone's mom. This permission to count again, to see one's self as important and to be seen as important -separate from being a mom - seemed to be completely missing from conversations that I was part or anything that I read.

I started Outside The Mom Box about eighteen months after I had my daughter. And with it, I started to have the permission conversation on a smaller level, in blog posts, support groups and informally. Grounded in that piece, I started to offer all the services and support that I wanted and couldn't find when I was pregnant and a new mom:

• Pregnant women and new moms support group? Check!

• Short-term coaching services to normalize feelings of anxiety, offer a reality check from someone who's been there before and won't judge? Check!

• Short term counseling and 

In the works for 2015 are educational trainings, a new mom workshop and more.

If you're a pregnant woman or new mom, let me know by visiting my contact page or leaving a comment below if there's something you are seeking but cannot find. If it's not on my resources page, I might be able to help you find it. 

~~

Before I had my daughter, I worked with in the non profit world with survivors of intimate partner violence, as a counselor, coordinator of a 24-hour crisis line and as the chief trainer of crisis counseling and intervention skills to over fifty volunteers and interns. My career also includes time spent in corporate America and small business. I'm attended the University of Connecticut for my undergraduate work and Southern Connecticut State University for my graduate degree in Women's Studies. Head here for my complete resume, list of recommendations or to connect with me..

{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.