60 Tips for Healthy Birth: Part 6 – Keep Mother and Baby Together – It’s Best for Mother, Baby, and Breastfeeding

In this six-part series, we are sharing 10 tips for each of the Lamaze six Healthy Birth Practices that help guide women toward a safe and healthy birth. The Lamaze Healthy Birth Practices are supported by research studies that examine the benefits and risks of maternity care practices. Learn more about each practice, including short, informative videos at Lamaze.com. To read the rest of the 60 tips, check out the other posts in this series.

10 Ways to Keep Mother and Baby Together after Birth

1. Learn why keeping mother and baby together is healthy for you, your baby, and breastfeeding.

2. Ask your care provider about routine practices after birth. Does she encourage mom and baby to stay together?

3. During your hospital tour, ask the tour guide what nursing staff does to help mom and baby get off to the best start after birth. Do they promote skin-to-skin care? Do they delay routine newborn procedures until mom and baby have had a chance to feed?

4. Include on your birth plan that mom and baby should be kept together after birth. Share your birth plan with your care provider and the nursing staff at your place of birth.

5. Let your partner and birth support team know that you would like to keep your baby with you after birth. With the chaos that generally happens after birth, they can help facilitate your wishes.

6. Take a good childbirth class to learn how interventions can affect birth and your baby, and how they can be avoided. Many interventions can lead to separation of you and your baby.

7. When you are moved to a postpartum room after birth, keep your baby in the room with you instead of sending her to the nursery. Babies sleep best when mom is near, and you will get the best start with breastfeeding when you are close enough to see and hear their early hunger cues.

8. Take a good breastfeeding class, which will provide information on how to get breastfeeding off to a good start, including skin-to-skin care and tips for the first latch/feed with your baby.

9. If you must be separated from your baby after birth, spend time skin to skin with your baby once she is back in your arms.

10. If you have a cesarean, ask your care provider about bringing your baby skin to skin immediately after he is out. Some hospitals perform “family centered cesareans,” where mom and baby are kept skin to skin and breastfeeding is initiated in the OR. If your hospital does not permit you to hold your baby skin to skin in the OR, ask that your partner or birth support person hold baby skin to skin while you finish out your surgery and get moved to the recovery room.

World Prematurity Day: What to Know About Premature Birth

Yesterday, November 17, marked World Prematurity Day, an event created as part of the March of Dimes Prematurity Campaign along with several other participating organizations to raise awareness of premature birth and remember premature babies who died. Worldwide, 15 million babies are born prematurely. Prematurity is the leading cause of death among newborns in the United States, and causes complications at birth and lifelong illnesses. You may be surprised to know that our preterm birth rate is 12 in 100 babies — the United States is tied with Somalia, Thailand, and Turkey. (Source: Born Too Soon: The Global Action Report on Preterm Birth)

 

 

Sometimes, in cases of true complications, preterm labor and birth is unavoidable. In many cases, however, preterm birth can be prevented. If you are pregnant, you can proactively lower your risk of preterm birth.

Lowering Your Risk of Preterm Birth

Prenatal Care – Seek ongoing prenatal care from a reputable care provider. Whether your preference is for a midwife or obstetrician, be sure to research your care provider’s history and practices. Ask about their rate of induction. If they don’t know it or report a rate ranging from 20-30+%, consider finding another care provider.

Induction – Inducing birth or scheduling a cesarean surgery prior to 39 weeks of pregnancy can lead to premature babies. Even if friends and family tell you different, every week counts! Babies undergo vital development up to the very moment of their birth. And, because your due date is just an estimate, it can be off by up to two weeks in either direction. So, a baby that is induced at 38 weeks may only be at 36 weeks gestation. If your care provider is pushing for early induction, ask questions! Learn what counts as true medical indication for early induction or cesarean surgery. If being “so done with being pregnant” is getting to you, hold tight and think of the babies born at 28 weeks, with mommies who would have given anything to make it to 40 weeks.

Education – When it comes to making informed decisions in pregnancy and birth, the Internet is a good place to start, but not a good place to stop. Sign up to take a childbirth education class from a childbirth educator certified by a reputable childbirth education organization (there are many, but we really think Lamaze is tops!). Childbirth education provides the foundation for educated, evidence-based decision making for you and your partner throughout pregnancy and birth.

 

To get receive updates, follow World Prematurity Day on Facebook.

Resources for Pregnancy and Infant Loss

October 15 is National Pregnancy and Infant Loss Remembrance Day. Families who experience the loss of a child need special resources and support. Following is a list of resources for parents who are expecting or have experienced a loss.

 

Now I Lay Me Down to Sleep (NILMDTS)

NILMDTS is a non-profit remembrance photography organization that provides free-of-charge photography services local to your area. Photographers in their network are specially trained to assist and support grieving families through photography of their child.

Solace for Mothers

Solace for Mothers is an organization that focuses on providing support, in the way of online communities and resources, for women who have experienced traumatic childbirth.

Still Birthday

Still Birthday is a site that provides informational resources on miscarriage and loss, support stories from other parents, and a directory for finding a Still Birthday Doula who can assist and support you in or after the birth of your child.

MISS Foundation

The MISS Foundation provides resources, including counseling, advocacy, research, education, and support, for grieving parents who have lost a baby or child of any age.

October 15th

October 15th is the official site that commemorates the national day of remembrance. The site provides education and resources for families, as well as local fundraising events.

Facts about Miscarriage

This site is dedicated to providing comprehensive information about miscarriage, including information on emotional healing and physical recovery.

Grieving Dads

Grieving Dads is a project designed to reach out to and support dads who have experienced loss through sharing stories.

Share Pregnancy & Infant Loss Support

National Share’s site provides support, information, and education for parents who have experienced pregnancy loss, stillbirth, or loss in the first few moments of life.

 
photo credit: Www.CourtneyCarmody.com/ via photopin cc

Safe Sleeping Tips for Newborns

By Jeannette Crenshaw, DNP, RN, IBCLC, NEA-BC, FAAN, LCCE, FACCE, and Linda J. Smith, MPH, IBCLC, LCCE, FACCE

Ask anyone how much sleep you’re likely to get after your baby is born and they’ll all tell you the same thing: “Not much.” But ask where your baby should sleep and you’ll probably get several different answers. Even the professionals can’t agree. The American Academy of Pediatrics (AAP) advises parents not to take their babies with them to sleep at night (called “bed-sharing”) due to the belief that this increases the risk of sudden infant death syndrome (SIDS). The AAP recommends that babies have a separate but nearby place to sleep, such as a crib in the parents’ bedroom. No research is available to support the notion that it’s safer for babies to sleep alone, or that those who do become more independent than babies who sleep with their parents. In fact, some experts suggest that bed-sharing may actually promote self-reliance and self-esteem. At the end of the day (literally), the choice is yours.

Skin-to-Skin & Rooming-In

Since the beginning of time, women have needed and wanted their new babies close to them. Today we know that this yearning for closeness is a physiological need shared by both mother and baby. Studies have shown that newborns who are placed skin-to-skin on their mother’s chest right after birth will adjust more easily to life outside the womb, stay warmer, cry less and breastfeed sooner than newborns who are separated from their mothers.

So it’s important that your baby stay as close to you as possible in the days following birth. When you share the same space (called “rooming-in”), you’ll soon learn your newborn’s needs, as well as how to best care for, soothe and comfort her. Rooming-in also offers the best start for breastfeeding. The nearer your baby is to you, the sooner you will make more milk and the more likely you are to breastfeed longer and exclusively. (Experts recommend exclusive breast‑feeding – no other foods or liquids – during the first 6 months of life.)

Bed-Sharing

Many new parents are concerned that if they sleep with their baby, everyone will wake often and no one will sleep deeply. This may be beneficial. Scientists with expertise in infant sleep believe that lighter sleep states and frequent awakenings are normal and healthy for babies and may be related to a lower risk of SIDS and suffocation. They agree that, despite frequent awakenings, a baby who sleeps in her parents’ bed spends more total time asleep, since she falls back to sleep more quickly than if she were in a separate room. Plus, bed-sharing can harmonize sleep and wake times between the mother and baby.

Bed-sharing also is linked to successful breastfeeding, since the baby is right beside you and nighttime nursing is more convenient. Sleep researchers found that a breastfeeding mother usually sleeps on her side, encircling her baby with her upper arm above the baby’s head and her knees bent below her baby’s feet. This natural position keeps her baby near her breast – and safe.

Safe Sleep

It’s safety that should concern you most. No matter where your baby sleeps, always put her on her back when you lay her down. This is the best known SIDS prevention tactic. Keep the bedroom at a temperature you find comfortable when lightly clothed, and dress your baby for sleep the same way. Overheating can be dangerous. Her crib, bassinet or cradle should meet current safety standards and be free of soft bedding and plush toys, which are suffocation hazards.

If you choose to bed-share, remember that adult beds are not designed to keep babies safe. Be sure that you have a firm, flat mattress that fits tightly against the headboard, bed frame and wall, so your baby won’t get trapped or stuck. Cover the mattress with a light sheet and remove heavy bedding and soft objects like comforters and pillows before you go to bed. Take steps to reduce the chance that your baby will fall out of bed (such as pushing the bed snugly against the wall).

Be sure your partner knows your baby is in bed with you. If an older child shares your bed too, you or your partner should sleep between your child and your baby. Never let your baby sleep alone in an adult bed, with a pet, or with anyone who is overtired, smokes, drinks, abuses drugs or takes a drug that may cause drowsiness. And don’t forget that it’s not safe to fall asleep with your baby on a water bed, sofa, recliner, or armchair.

The safest choice for your baby to sleep? A place near you. She may share your bed or just your room, sleep with you some nights and in her crib on others, or fall asleep in your bed with you after nursing. What’s most important is that you and your baby are near each other and get some sleep.

Additional Resources

Simple Pleasures, Shared Discoveries – Getting to Know Your Newborn

By Allison Walsh, IBCLC, LCCE, FACCE Adapted from the original article by Joy Rittmayer, PhD, LCCE

Congratulations! You are beginning one of life’s most exciting journeys—parenthood. Some days are as effortless as a day at the beach, and others are as challenging as hacking through uncharted jungle. Sometimes the rewards of parenting are obvious, and others are realized later. Along the way, discoveries about your baby and yourself make sure life with a little one is never dull!

Growing Confidence

Understandably, many new and expectant parents worry about caring for their baby and understanding the baby’s needs. The early stages of life with your baby will go more smoothly if you let your baby be your tour guide. She will show you when she’s hungry, sleepy, or needing comfort. When you respond promptly and with love, your baby learns that the world is a safe place and trusts you to be there to meet her needs. In turn, you will grow to trust your parenting ability as you learn to read your baby’s cues – both the obvious and the subtle. Feel her whole body relax when she is snuggled on your chest. Notice how she turns away when she has had enough time looking at something. Listen to the smacking sounds she makes when she is getting hungry. Watch your baby’s signals and her responses to your actions and learn as you go.

Early Recognition

The easiest way to think about interacting with your baby is that you are your baby’s favorite everything place to be, face, voice, food source, snoozing spot and more. It’s fun to think that before and after birth, you are your baby’s natural habitat! Even though some parents need a few days to feel connected to their baby, babies come to us already in love. They are ready for interaction and are deeply connected to their parents. So take pride and delight in how soundly the baby sleeps on your chest and how your baby settles down in your arms after being fussy with a visitor.

Since he has been listening to you talk and laugh for the last months of pregnancy, your voice is familiar and comforting. Indeed, no matter what your singing abilities, to him, yours is the sweetest of voices. Also, he knows the rhythm of your body and may enjoy snuggling up to hear the symphony of breaths and heart beats. Hold your newborn close, and within days of birth, he will recognize your smell. He will be mesmerized by your face, which he will see clearly when nursing or being cradled in your arms. Believe it or not, you know many ways to comfort him just by being you!

What Do Babies Really Need?

When asked this question, most people respond with the obvious answers—food, cleanliness, comfort, safety, and sleep. Equally important are the emotional needs of babies. Just like us, they need to feel loved, secure, and connected. Human babies are hard-wired to interact. This interaction takes on many forms – enjoying moments of gazing into each others’ eyes, kissing her feet during a bath, holding her while dancing and singing along to your favorite music, reading out loud, or playing peek-a-boo just to name a few. Think of all of this loving interaction as food for your baby’s brain! Humans need this connection and stimulation, just as they need food to survive. As long as you follow your baby’s cues, you can’t be too responsive or playful, so have fun.

Understanding Crying

Crying is a part of life for human beings. Just like us, when babies cry, they are reaching out for help and comfort. This might be in response to hunger, a dirty diaper, loneliness, or boredom to name a few. Whatever the reason, parents should respond to their baby’s cries promptly. Tuning in to your baby’s cues will help you to differentiate his cries, and sometimes help you to meet his needs before he even begins to cry.

Making sure your baby feels secure is one way to diminish crying. Many babies like to be swaddled, which likely reminds them of being snug inside during pregnancy. When babies cry vigorously, they tend to flail their arms and kick their legs. Maybe this is where the expression “kicking and screaming” came from! If your baby seems to stress during diaper changes, try gently holding her arms to her chest to simulate that snug feeling and help her settle down.

When babies cry after a long day of overly stimulating visitors, they need just what we do after a difficult day at work— to feel comforted and heard. Unlike us, they can’t make a polite excuse to leave the room and take a break for a few minutes. This often leads to crankiness later. When you have checked your baby’s diaper and offered a feed to no avail, click into your knowledge about how to comfort people. Hold your baby close, take her to a quiet place where you can really focus, talk, and listen. Babies often respond to compassion in our voices, so go ahead and say what you would to an upset friend. We don’t always understand why a baby is crying, but decreasing the stimuli (lowering the lights, turning off the TV or radio, and speaking in a quiet voice while moving around slowly) often helps.

Daily Discoveries

You are your baby’s best and most important teacher and there is learning in every day. The opportunities for interaction are infinite, and you’ll likely find it easier to get more done. In life, it is rare for a day to be pure fun – family and work responsibilities are ever present. It’s great for children to gain this understanding early and learn to find the joy in every day even if it is just laundry day!

Apart from a few essentials, your baby doesn’t require much in terms of equipment. When choosing baby gear, stick to the items that foster your closeness and engagement. Since everything is new to and interesting to him, don’t worry about creating a stimulating environment. Including him in your activities, educates him through exposure to different sights, sounds, and smells. Wearing your baby in a sling or front carrier is especially entertaining since he can see from an adult’s vantage point. As you move throughout the days, tell him what you are doing and thinking. At around three months of age, your baby will babble back at you. Pause for his reply after speaking and you will be helping him to learn the rhythm of conversation. As he discovers his voice, he will delight in the variety of squeals, growls, and coos especially if you mimic the sounds back.

Enjoying the Ride

Our babies offer us a second chance to discover the joys found in simple things – blowing bubbles, splashing in the tub, walking barefoot. Many parents are thrilled to re-read their favorite childhood books, and sing long forgotten rhymes and songs. Allow yourself to be guided by your baby and trust that he will give you the cues you need to take great care of him. Above all, remember to enjoy your baby. The one guarantee we have as parents is that our babies will grow too fast!

Pregnancy and Postpartum Mental Health: Safety in the Storm

By Wendy Davis, PhD

 

The proper support of new mothers, babies, and their families requires a whole chain of care that goes from the earliest prenatal care all the way through the first early years of a child’s life. We are all links in that chain — families, providers, and communities:  we work best when we are collaborating, working together, creating nurturing environments for infants and their families.  The most important message about mental health and self-care for new parents is that it is a natural need to receive support during pregnancy and postpartum, and that includes emotional as well as physical and practical support.

How can families help when a mom has postpartum depression or anxiety? How do we learn about signs and symptoms in a way that feels empowering and not shaming? Sometimes it seems that our heaviest burden is our own self-criticism and judgment, our own expectations that a “good mom” would never feel any emotional distress.  Women who are depressed or anxious during or after pregnancy tell us that friends, family, and perfect strangers directly influence how they feel, whether they reach out, and even how they communicate with their partners. How a family responds to a new mother’s emotional and mental health can affect her through pregnancy, pregnancy loss, postpartum, and her developing self-image as a mother.

Here’s a good illustration.

I am standing in line at the grocery store and overhear a conversation between the two women in front of me. One is there with two children – a baby in the cart and an older child who calls her grandma. She is taking care of the little ones and talking to the silver-haired woman behind her, comparing notes about grandchildren. I hear the woman with the children mention that she’s helping because her daughter-in-law has “Postpartum Depression.” They pause and look at the kids. I wait…I wait for the inevitable: the rolling of the eyes, the talk about how women these days just want the easy way out, how everyone and her sister seems to have “Postpartum Depression.”  I ready myself, getting ready to tell them that it is real, it is rough, and that we are lucky to have real resources, volunteers who can help her connect, find resources, not feel alone. I want them to understand, to know that they should not judge. I want to tell them that it actually is almost true that “everyone and her sister” has it, and that we need to listen to them, not judge, and help them. I’m ready. I take a breath.

They surprise me.

The woman in front of me shakes her head. “Oh, I only wish we had help back in my day. I wish… She’s a lucky girl, your daughter-in-law. If I had been able to ask for help and have someone take the kids to the store….You know, she’s lucky to have you.” They smile at each other, and look down at the children. I feel like crying, with relief. If the grandmothers at the store understand, then we might just have a chance.

Times have changed, and they will continue to change. Although another day could have brought an insensitive conversation about depressed new moms, this day in this store reminded me that our families and communities are beginning to understand. New moms do get depressed and they get anxious. Pregnant women have as much chance of becoming depressed or anxious as their postpartum moms, and teenage moms have a greater chance than any. Even adoptive moms and dads can become depressed and anxious after a new baby arrives. We have been ignoring it and as a result families have suffered. Fortunately, communities around the world (and the internet)  are working together to create a safety net that includes raising awareness, connecting families with resources, educating providers, and forging partnerships to help families.

The earliest references to depression, fears, or psychosis around childbearing were recorded in the 4th century BCE!  In modern times, we stopped talking about them. Acknowledgement of despair seems to have been replaced by pretty media pictures of mommies and babies and shallow reassurances by families and doctors who tell mom to get a haircut, buy a new dress, or wean the baby. Traditional rituals to support new mothers and fathers were replaced by baby-shower games, and built-in help for new parents gave way to expectations that one parent will go to work and the other stay home to keep up with housework, her appearance, and the bliss of new motherhood. In this modern world, where is the language to describe mornings filled with anxious fears, dinner that remains uncooked,  and nights disrupted by mommy crying as much as the baby?

Organizations like Postpartum Support International believe that we can prevent a crisis if new parents receive reliable information, resources, and adequate support before the baby arrives. If families learn that symptoms of emotional and mental distress during pregnancy and postpartum are common, treatable, and temporary, then they will not be consumed by fear or shame if it occurs. They might find ways to rest more, reach out sooner, and engage with informed providers and support services to prevent their distress and facilitate their recovery. Most importantly, by finding resources, they can make contact with real mothers, fathers, and grandparents who have gone through their own difficulties around childbearing, and they will learn that they are not alone and not to blame. Women should know that they can contact support organizations like PSI for support around any stress, adjustment, or distress related to childbearing; they don’t need a diagnosis and they won’t be pushed into any particular treatment.

Although we most often hear about “Postpartum Depression” when we talk about mental health around childbearing, there are in fact several ways that emotional distress commonly arises – not only depression, but anxiety, bipolar cycles, grief, trauma, and psychosis. The most recent research shows that more than 1 out of 8 pregnant and postpartum women develop significant depression or anxiety, and up to 1 out of 10 fathers also have depression after a new baby arrives.  Postpartum Psychosis, the most serious postpartum psychological disorder, occurs in 1 to 2 per 1000 births.

This means that one in eight women has enough disruption in her moods, sleep, appetite, confidence, and ability to function that she could be diagnosed with a clinical mood disorder. You can’t tell who it is by looking: moms will smile on the outside while they are feeling lost, scared, and emotionally numb. Our cultural taboo against maternal depression has thwarted us from talking compassionately about our emotional lives as mothers.

There are identifiable risk factors such as a history of PMS, depression, anxiety, or bipolar mood disorders, recent loss, or life stressors. Symptoms might include feeling overwhelmed, inadequate, anxious, or detached, and in some cases the difficult anxiety symptom of repetitive, intrusive thoughts that include unwanted images of harm to their babies. If the family and their caregivers do not have reliable information to help them distinguish between anxieties that are not dangerous and delusional thinking that is, anxious mothers live in fear and their symptoms increase.

If a mom is fortunate, people around her will remind her that she is worthy of care, treatment, and help. If she has emotional difficulties, they will tell her that these are symptoms of distress, not a sign of her inadequacy. Having negative feelings about becoming a mother is a symptom of depression; it is not a cause. We can be open to the truth about the difficult adjustment of becoming a parent. Can we accept that depression, fear, anger, and loss might exist side by side with love and attentive parenting? If we can become a culture of truth-tellers and fair listeners, we will make our families stronger and healthier, and change the environment into which children and their parents emerge.

So, let’s hear it for the grandmothers in line at the store. Thank you for listening, providing safety in the storm, telling the truth.

 Contact Postpartum Support International for support, information, resources, and volunteer opportunities at www.postpartum.net or 1-800-944-4PPD  (1-800-944-4773).

 

Wendy Davis, PhD, provides counseling, training, and consultation for mental health related to pregnancy, birth, loss, postpartum recovery. She was the founding director of Oregon’s Baby Blues Connection and is the Executive Director of Postpartum Support International.

 

How to Screen Yourself for Postpartum Depression

May is Mental Health Month. As childbirth education advocates, Lamaze believes that mental health during and after pregnancy is critical to the health and safety of moms and their babies. If you are experiencing depression, anxiety, psychosis, or any other mental health issues, contact your care provider and seek support and resources from Postpartum Progress and Postpartum Support International. You don’t have to suffer alone — and you don’t have to suffer. There is support and treatment available for mental health disorders. Also know that you are not alone — it has been found that 1 in 7 women will experience postpartum depression, though that rate is thought to be higher for all postpartum disorders.

So how do you know if you are experiencing a postpartum disorder? Many moms downplay or dismiss their feelings, chalking them up to “hormones,” but it’s important to take notice and check in with yourself. A postpartum disorder is more than just a “bad day,” and even if you feel as though you are coping, a postpartum disorder ultimately affects your quality of life. If you feel as though something is “off” or if your partner expresses concern about your state of well-being, you can take a free, quick, confidential, online screening quiz to determine whether you may be suffering from postpartum depression.

The Edinburgh Postnatal Depression Scale (EDPS) was developed in 1987 to help doctors determine whether a mother may be suffering from postpartum depression. The scale has since been validated, and evidence from a number of research studies has confirmed the tool to be both reliable and sensitive in detecting depression. The EPDS Score is designed to assist — not replace — clinical judgment. If you feel you may be at risk or suffering from post natal depression, please share the results with your care provider.

A Mother’s Essay: “I ‘Have it All’… Just Not All at Once”

By Jennifer Marshall

There has been a lot of talk on the interwebs lately about women and work and family and can we really “have it all?” Some argue yes, we definitely can. Others argue, well sure, if you have unlimited income then, yes, you can. But I think it’s safe to say that it’s definitely not the reality for most working Americans.

For me, it’s all about bursts of “having it all.” You know, those days when you finally get the kids tucked into bed at 8pm and you sit down and realize: “Wow. Today was really awesome.” I know — doesn’t happen all that often, but when it does, I like to savor every drop of it.

Those are the days when the kids are happy and smiling when they hop out of bed for breakfast. When they play together so sweetly as I buzz about the kitchen making them french toast because it’s what they said they were craving. My coffee is perfect and I sip it as I cook. Everyone loves their breakfast and eats it all up without any spills and I even have a conversation with my little ones as they tell me excitedly about what they’re going to do at school that day.

The morning routine continues to go smoothly as I dress my younger one and the older one practically dresses himself after I lay out some clothes. Teeth are brushed, shoes and jackets put on without having to ask ten times, and bookbags are ready so that we make it to school with three minutes to spare. My big kid remarks on the drive to school, “Today was a good morning, Mommy.” And I drive on with a smile.

Back at home, I dive into cleaning up the breakfast dishes and marvel at how it only takes fifteen minutes when there aren’t little ones underfoot. I settle in to get some work done and have a leisurely lunch, actually tasting each bite, before picking up the kids. Their shining smiling faces are so full of joy when I arrive to pick them up. It’s been a good break, but I am ready to have them back again, to hear all about their adventures at school. The afternoon sails by with a nap for baby girl and quiet time for big brother while I finish up where I left off with my work.

We play some board games together and read a few books before I realized it’s already time to make dinner. My husband arrives home around 6pm, and the kids are sitting at the table in the kitchen eating their meals because they were so hungry from all the play that they couldn’t wait for Daddy. I wrap my arms around him for a cozy “welcome home” hug and the kids both smile at our little display of affection. As he goes upstairs to change out of his work clothes into something more comfortable, I think to myself, “How did I get so lucky?”

Now, don’t get me wrong, there are plenty of days when I am counting the seconds until bedtime because it’s been such a rough and draining day. Those are the days when I feel like a terrible mother because I forgot my patience and yelled at the kids too much or because work was so busy that I barely had time to play with them let alone feed them a proper meal. But when the days come where I have juggled everything with ease and I look around me and am in complete awe at all that I have, I am filled with an immense gratitude for life and motherhood.

Makes me want to push my luck and just go for one more. But that’s another post altogether.

Finding a balance has been a lifesaver for me. I enjoy my first career and appreciate the flexibility I have in working from home. For me, trying to “have it all” – all at once – is way too stressful. It makes life miserable for me and my family which is not fair for anyone, myself included. Instead, I have come to terms with the reality that it is better to go with the flow of life than to try to arrange all the responsibilities of work and family into a perfect package. If I work on a contract for 9 months and then want to take five or six months off to give my family my complete and undivided attention, then I’m going to work hard at our family budget in order to make that happen. It’s worth it in the end and the balance it provides our family with gives me sanity.

Balance is the key for me in life and work and I am very thankful for being able to “have it all” even if I don’t always have it all at once.

Jennifer is a 34-year old wife and mother of two young children. Over seven years ago she suffered her first manic episode. Several months and many doctor’s appointments later, she was finally diagnosed as having Bipolar Disorder – Type I. Jennifer’s blog, www.bipolarmomlife.com, documents her progress, and keeps her accountable and healthy for her family. She is currently blogging for WhatToExpect.com’s Word of Mom community and is also working on a memoir. Along the way, she hopes to help fight stigma and inspire other people who are struggling with the same feelings, fears, and insecurities that she was at one point. There is a light at the end of the tunnel. You just need to keep fighting hard to get there. You can email Jennifer at bipolarmomlife@gmail.com.

Last Firsts – An Essay in Motherhood

The following is written by our former Great Expectations columnist and regular contributor, Meagan Church. 

Seven years ago, I was newly pregnant and, honestly, a bit freaked out. Matt and I had been married for seven years and we knew we wanted kids. I just wasn’t sure I wanted to be a mom. You see, I liked my life as it was. I liked my job, I liked my freedom, I liked being in control, plus I wasn’t much of a baby person. I knew having kids would change things and I wasn’t sure I wanted to make those changes.

Fast-forward seven years. Last week we celebrated Adelyn’s first birthday. Addie, our third (and last) baby, is technically not a baby anymore. And that makes me sad. For the past few weeks, I’ve found myself paying more attention to the last moments of Addie’s baby stage. I have been taking more joy in her giggles, rocking her for a few extra minutes and just taking the time to recognize that these moments won’t last forever, and much to my surprise, that saddens me a bit.

With our first two, I often found myself wishing away the early months and years. What got me through the first few months of our colicky first child was setting mini-goals. Okay, if we make it to six weeks, things will get better. Okay, now we just need to make it to three months. Okay, now six months…. The adjustment to motherhood was a tough one and my high-needs baby didn’t make it any easier for me.

When baby number two came along, I was still worn out from the first one. I once again spent most of that first year hoping to speed through it, so we could get back to “normal” life. Then we had our last baby. Suddenly I began to enjoy the baby stage and not wish it away quite so quickly.

Don’t get me wrong; there have been moments along the way that I’ve wanted to speed through. For instance, I very clearly remember that in those last moments of labor before she was born, the mantra that got me through it was, “Just push her out and you will never have to go through labor again. It will all be over. Just push. Just push.” There were also fussy breastfeeding sessions that made me long for toddlerhood when she would be weaned.

Yet overall, I have been enjoying her babyhood more than with the first two. I’m sure some of that has to do with the fact that I have a few years of experience under my belt. But I think a greater part is that I realize this stage of life we are in is about to change and we will never return to it. With every milestone Addie reaches (signing, crawling, talking, walking), I can’t help but think these are our last firsts. This is the last time one of our kids will reach this milestone for the first time…just when I felt like I was actually getting the hang of things.

I know they must grow up and that things will continue to change. But for just a few minutes longer, I want to hold on to my baby and rock her and sing to her and kiss her full cheeks. Seven years ago, I had no idea that I’d ever want those things so strongly. Seven years ago, I was afraid of how motherhood would change me. Yet, seven years later, I realize how blessed I am to get to experience it, and to grow and learn right alongside my kids. Who knew these last firsts would happen so quickly?

Finding Renewed Trust & Confidence: A Birth Story

I am a childhood abuse survivor and so I didn’t have confidence or trust in my body. That lack of confidence was reinforced when my first birth, a planned natural birth, resulted in a painful and highly medicated induction. I suffered post-partum depression for over a year after the birth. But I am blessed because though I was defeated in spirit, I had great support. When I told my husband, Rob, that I was changing my care to a group of Certified Nurse Midwives who deliver at a local hospital he stood behind me. We did not know it at the time, but the choice to change my provider became one of the pivotal moments in my recovery as a survivor, and monumentally improved my joy in mothering and my marriage.

 

When I discovered I was pregnant again, I fearfully avoided my first prenatal appointment for 12 weeks. My previous doctor wasn’t nurturing. When he checked me he did it in such a way that I was left feeling violated. No “cold touch.” No “gentle pressure.” No bed-side manner. He just walked in, “I’m going to check your cervix.” Check. “Everything looks normal.” It wasn’t his intention to make me feel bad, but when you’re an abuse survivor it’s not unlike being abused again. My midwives gave me care which chipped away at my fears. They talked with me about my feelings about my past birth and my future hopes and concerns, not just my medical history. They treated my whole person. I was more than a body which happened to be wrapped around a baby. Our first appointment lasted over an hour. I felt safe in their care. But I still didn’t feel confident in my self.

 

My due date came and went– nine days, ten days, eleven, twelve– I feared I was unable to go into labor. My midwives gave me the best standard of care and monitored my baby’s health. They trusted my body to go into labor eventually and encouraged me to be patient. On the evening of my thirteenth day post-due my contractions finally started, 15 minutes apart, and I tried to prepare myself to welcome my baby to the world.

 

I called Rob from work, and I drove my daughter to my in-laws’ home and called the midwife. She told me to hang out at  home until I felt I needed more support or contractions were coming very close together. Bedtime came, and Rob put our daughter to bed. I labored quietly in the living room while my husband’s family went to sleep. Everything was normal, peaceful.

 

In the back of my head I feared things progressing, feared going to the hospital and what would happen to me once I got there. Would my body do its work? Would I have spent 7 hours in labor just to be dilated to 2 cm when we finally arrived? As night turned into early morning we decided to make the trip to the hospital. My fears escalated as we arrived. I was defensive towards the nurses and Rob, nervous my labor would stall.

 

When my midwife arrived, she brought her calming presence with her. Within thirty minutes she had the lights turned down, and every unnecessary person removed from the room. She gave Rob instructions on how to rub my back. The three of us fell into a rhythm. Rocking, massaging, humming, moaning… finally I relaxed. Finally I felt like things were the way they should be. I joked between contractions. I was actually enjoying being in labor!

 

Suddenly, I felt the urge to vomit and my contractions started bashing on top each other. I had been lying on my side in bed and I called out for help. While I lay shaking and panting in the bed, my midwife and nurse filled the labor tub with warm water. I climbed in as soon as I could. Laboring wasn’t fun anymore, it was harder work and I had to focus, but I was still calm and relaxed. My midwife leaned against the side of the tub and talked me through contractions, Rob poured warm water down my back with each one and I focused on the sensation of water going down. It was just an hour until I began feeling the urge to push.

 

I don’t know if it’s because of my past abuse, or if it’s common to become fearful during the pushing phase of labor, but I suddenly became panicked. I was thrashing around the tub crying, “Help me!” splashing everywhere. I tried to get up and leave. I was holding back against the pushes, trying to escape my own urges. I will be forever thankful for what came next. My midwife grabbed my arms and looked right into my eyes saying, “Hold it together. Your body is strong, and you can do this. You need to hold it together and your baby will be here.” I started to sob in her arms, “I need to you help me. Help me please.” My heart was breaking because I was so afraid of what I would think of myself if I couldn’t push my baby out on my own. “Moan low. And push into the pain. Push your baby through the pain.” Ten minutes later my beautiful daughter was born into the water and placed on my chest. I rested there with her, relief and joy in my heart. She barely even cried, she just nestled in to me. Rob beamed with pride. We had overcome the obstacles and done it.

 

The next morning the second midwife from the practice came to visit me to see how my birth had gone. I told her how it had been so peaceful except the end. But I had managed to keep it together and go naturally. Besides my pride in my accomplishment, her words built me up: “You are powerful. You birthed a baby. You can do anything.” That was truth.

 

I took that confidence and power home with me from the hospital. Unlike after my first birth, I suffered no post-partum depression. I started to trust my instincts more. I began to be more open-hearted to Rob and my daughters. I don’t want to pretend that one event changed my whole life, but in some ways it did. My natural birth experience was the first time someone other than my husband trusted and respected my body. I was expected to be powerful, and I was! My daughter’s birth was a foundation of confidence that I can build my strength upon. It can’t be taken from me.

 

Devona Brazier is a wife and mother of three lovely daughters living in Akron, OH. She works to support pregnant and breastfeeding women through La Leche League membership and studying to her Lamaze Educator Certification. She enjoys kickboxing, running, hiking and sewing. She blogs at tobravebirth.com