Adventures along the journey to parenthood

Pregnancy Tips, Advice, and Research

Maximizing the odds for a happy postpartum

With our first child, we focused our energy on the pregnancy and birth experience. With our second child, we are focused on the postpartum experience. In hindsight, what we do with her after she arrives seems far more important (and long lasting) than how she arrives.

We are 12 days away from our due date… which means her arrival has as good a chance of happening today as it does three weeks from today (anywhere between week 38 – 42 is considered “normal” arrival time and only 5% of babies are born on their due date). I continue to oscillate between anxiety/dread and excitement/acceptance. When I focus on her (preparing her clothes, diapers, writing thank you notes), I’m excited. Most of the time I’m not focused on her at all. Instead I am consumed by the to-do lists, details, and non-stop busy activities of my daughterless life. People ask “Aren’t you excited?” or “Are you ready?” and I think “About what? Oh, this pregnancy? I don’t even have time to remember that I’m pregnant.” Let alone think about the fact that Archer doesn’t have an overnight bag packed… and did I tell my parents I plan on them keeping him for 3 days while we’re at the hospital? And how do I even reach Ted to tell him I’m in labor now that he’s at his new job? These are details I haven’t thought through yet… and clearly they are important ones! Between Archer, chores, clutter, and my career, I often feel overloaded. This is what makes me apprehensive about her arrival – I sadly just think of her as one more enormous complication to deal with, rather than actually focusing on her, as a person. Thankfully, my heart warms when I do stop and give her the time of day for a moment.

I’ve been having more frequent and intense contractions for the past week. I’m excited (and hopeful) to experience the “typical” onset of labor and have been enjoying this slow progression in “practice” contractions. With Archer, my water broke prematurely before contractions were anywhere in sight. Then they had to be brought on by pitocin which was like taking a rocket from 0 to 100 in an instant. I’m hoping to avoid that route again.

Today I made the decision to encapsulate the placenta after our daughter is born and take it as a daily supplement. Ingesting the placenta is supposed to fend off postpartum mood disorder and milk supply issues, as well as boost energy. I struggled with all of the above when Archer was born and these interconnected challenges took a heavy toll on us both. It delayed our bonding for a few months. Last week when we had our first meeting with our doula, we talked about it for the first time in quite a while. As Ted put it, my only association with Archer was intense anxiety and failure and often I dreaded being near him. I was so stressed about being able to meet his needs and couldn’t help but blame and resent him for my wrecked state of being. He could sense my intense stress and freaked out accordingly. I was envious of Ted for having such a (relatively) sweet and easy relationship with him – I felt broken when it came to maternal instincts, love and ability. It was a relatively short period (about 14 weeks before it began to dissipate), but holy God, it was so terrible.

Hindsight provides a lot of insight and wisdom on the whole experience that allows me to give myself a lot more flexibility, credit and forgiveness this time around. Terrible aspects of the postpartum experience I had assumed were totally normal for all new moms, but now I recognize them for the problems they were.  I know round 2 will be much easier with this perspective in place, but I can’t help but feel nervous that those terrible dark feelings will return. I had a few intense cries early in this 2nd pregnancy just considering the possibility of those negative emotions returning. We watched “The Happiest Baby on the Block” instructional video in class a few weeks ago and I had what felt like PTSD flashbacks. Ugh, just uploading the clip brings on shudders (though the “5 S’s” techniques are actually really helpful).

According to my doula and midwife, no scientific studies have been conducted to prove or disprove the effects of ingesting the placenta, but there is a great deal of anecdotal evidence over centuries and through many cultures. Which is why I figure placenta encapsulation is worth a shot, even with the price tag of $200. At least I know I’m being as proactive as possibIe. I remember reading a NY Times article a few years back about recipes for placenta brisket and similar dishes.

A few things I plan to do differently in addition to the placenta supplements:

– Make well-wishers wait to visit until we’ve been at home for a day or two. Set firmer boundaries and say “no” more often to visitors. No visits at hospital. My kid and I need a few days to just get to know each other before we start hosting.

– Be more willing, specific, and direct in asking for help from friends, family, healthcare providers. This time rather than saying people can bring any kind of meal any time, I’ve got specific meal requests with specific directions for drop off protocol. No more feeling guilty for expressing my needs.

– Be quicker to attend a support group, see a therapist, seek advice from my doula when I’m feeling bad – as opposed to sucking it up and toughing it out. I’ve got a therapist lined up, should I need her, who specializes in postpartum depression. I’ve got the date/time/location of the PPD support group.

– Not be as concerned about how many times my newborn daughter has eaten or for how long – just feed her more often based on instinct and her cues rather than a schedule. When in doubt, nurse.

– Spend more time skin to skin for us to bond. I’m hoping to just keep her under my shirt for periods of time. Check out these shirts designed just for this purpose! I didn’t buy one, but have ideas for how to create my own version.

– Not stress out (as much) about moving to formula if needed.

– Recognize that the intensity of the newborn stage (a.k.a “non-stop snuggling, needy, attached to you every moment stage”) is short… and I may not experience it again.

The below articles give some useful descriptions of that experience and some suggestions for having a happy postpartum.

How To Have a Happy Postpartum

FAQ About Placenta Encapsulation (this is the woman we’ve hired to complete our PE)

The Sound (of the Crying Baby) and the Fury (of the Exhausted Parent)

How to Have a Happy Postpartum :: Prepare for Your Best Postpartum Experience
by Jodi Selander

Having a baby is a tremendous life transition. Most couples prepare for this transition by reading books about pregnancy and birth, taking childbirth education courses, and discussing the myriad of options for the accompanying baby gear. However, having the best postpartum experience possible involves more than just making decisions about the proper gear to buy and which set of grandparents get to visit first.

Eighty percent of women experience some sort of postnatal mood disorder, the mildest of which is called the “baby blues”. Symptoms of the baby blues include weepiness, sadness and anxiety, and these negative emotions can last for the first several weeks of the new baby’s life. With proper preparation, the majority of women can avoid the baby blues.


Everyone comes with pre-conceived notions of how life with a new baby “ought” to be. Women spend the pregnancy imagining their sweet little bundle of joy’s hair, eyes, nose, tiny fingers and even tinier toes. It is difficult, if not impossible, to truly anticipate how different life after baby will be. Having the proper expectations of yourself as a mother, as a wife, and as a housekeeper will be key. Understand that the housework will be put on the back burner – it will not be a priority, nor should it be. In those first few weeks postpartum, life will be a whirlwind, and you will be amazed at how the hours in a day can fly past in a blur of baby needs. Do not expect to accomplish anything, and when you have a free moment, spend your time on activities that rejuvenate you – a hot bath, reading a few pages from a good book, a NAP.

Do not expect your partner to know what to do for you or the baby automatically. If you’re hungry, ask for something to eat. If you are out of those little onesies because of the incredible amount of fluid a baby can eject from all orifices, ask him to toss in a load of laundry (and don’t complain when they are not folded into the perfect tiny mounds in the brand new dresser, like you had them when you folded them over and over during your pregnancy because they were so cute… and tiny). If the baby just ate and needs to be burped or changed, Daddy can handle it. Hand over the baby and don’t hover over his shoulder sharing your critique of how he’s doing. He’ll figure it out, and baby will survive – even if the diaper is on backwards.

Do not expect your baby to eat on a schedule based on the clock, or sleep for five hours in a row. Breastfed babies eat every 1.5 to two hours, and all babies wake frequently. Sometimes baby will want to nurse again, and it will seem like you just got done. Hold your baby. Feed your baby. Expect baby to need you constantly. That’s what babies do, and yours is perfect.

Family Support

Support is an incredibly important part of the postpartum recovery. The last thing you need is criticism, when you are still trying to get the hang of the whole baby and mothering routine. If your mother or mother-in-law does not support your choices, don’t invite them to stay for a week as soon as the baby is born. There will be plenty of time for Grandma to bond with the new little sweetheart in three weeks when you are getting a bit more sleep, are more confident in your abilities, and when you have gotten to know what this new little person needs at any given time. Surround yourself with people who will help build your confidence and the budding relationship with your child, not undermine it.


A babymoon is a wonderful way to get the support and help you need in the first weeks postpartum. There are native tribes who have a wonderful tradition of keeping the mother sequestered with her baby for 40 days, and she is not allowed to do any work other than tend to her newborn. The pair is completely cared for by the other women in the tribe. While our modern lives do not provide us the luxury of a full 40 days, there are things we can do to simulate this support.

Choose a period of time for your babymoon; one week would be great, two would be even better. Make it clear that you will not be entertaining visitors during this time (no, not even Grandma). Visitors are allowed to come for brief visits if they understand that they are there to help you, not just to ooh and aah over the baby. Visitors can bring meals – feel free to leave them by the door, thank you. Come on in and do a load of laundry, thank you. Yes, there are dishes piled in the sink, we’d really appreciate a hand with those, thank you. I’ve got the baby, thank you.

      The benefits of a babymoon include:
  • Intimate bonding as a family.
  • No outside influences or criticism.
  • No pressure to look good – stay in your pajamas all day if you want, and nobody cares that you haven’t showered yet today (or yesterday).
  • Skin- to-skin contact is easier – you can walk around the house topless with your newborn without worrying who will be dropping by.
  • Breastfeeding is easier, since you’re not worried about Grandpa being offended if your nipple pops out of the baby’s mouth at an inopportune moment.

Attachment Parenting

Practicing Attachment Parenting (AP) not only helps the postpartum period go more smoothly, it will help make parenting easier overall. Attachment parenting means responding to your baby’s cues instead of trying to fit the baby into your routine and schedule. Newborns can not manipulate their parents; they can only communicate their needs. Responding to those needs will make baby happier, it will reduce your stress, and it will build your confidence as a mother and caregiver. Wear your baby – holding baby close is comforting to you both, and there are numerous health benefits for the baby as well. Invest in a comfortable sling; it is one of the truly indispensable pieces of baby gear that you should not be without. There are many other tenants of AP, and a great resource for more information is Attachment Parenting International.


Breastfeeding is not only the best nutrition for your baby, but it also releases wonderful “happy hormones” during the nursing process. It makes mama feel good, it makes baby feel good. Providing for your baby’s nutritional needs with milk that is made perfectly for them by your own body helps build confidence in yourself, and your ability to care for your baby. The close physical connection during nursing, eye contact and skin contact all help with bonding. If you are worried about being unable to nurse your baby, there are many fabulous lactation professionals in your community that would be happy to help you when the baby is born. They will take as much time as necessary to ensure that you and your baby are working together for a positive breastfeeding experience. If you do not breastfeed, you can still take advantage of feeding as a bonding experience by holding your baby close, maintaining eye contact, and promoting skin-to-skin contact.

There are many resources available that will help you breastfeed successfully. You can even download an entire eBook on the subject.


Sleep deprivation is a fact of life after the baby is born. If you are used to getting a solid eight hours of sleep, adjusting to life with less can be difficult. But it can be harmful to just accept a total lack of sleep. Fatigue is the leading indicator for the development of postpartum depression later down the road. Fatigue has also been linked to postpartum psychosis. Adequate rest is an absolute necessity.

Do whatever it takes to make sure you are getting at least one four-hour stretch of sleep every single night. Your partner will play a key role in making this happen for you. Your baby will likely not sleep for four straight hours, and even if it does happen, the stars must align perfectly for you to both fall asleep simultaneously and sleep the same length of time. So, enlist your partner’s help. Your partner can take over baby duties while you rest during the night. Feed your baby right before you are ready to lie down, even if you need to wake them to do so. Your need for rest is important too. Expressed breastmilk can be given to the baby if they wake hungry. If you don’t want to use bottles so early in the nursing relationship, babies are able to slurp milk from a cup.

Sleeping with your baby will give you more rest throughout the night, but it is difficult for mothers to sleep once the baby wakes up. Plan to sleep separate from baby for this one part of the night.
Your partner can sleep with the baby in a separate room, or you can sleep in another room of the house that is comfortable and quiet for you. Once you wake from your four-hour rest, you can return to the family bed and sleep with your baby for the rest of the night. The first few weeks, plan on sleeping when the baby sleeps. If you have never been a “napper”, now is a great time to discover the joys of crashing out during daylight hours.


Just because your baby has arrived does not mean that your physical needs disappear, even though they may be pushed onto a different schedule. Make time to eat. Plan on your baby waking up as soon as you sit down to a meal, so make sure your microwave is working. Wearing your baby can make meal times easier – come to the table with your baby in the sling. They will stay happier for longer, allowing you to finish eating. Plan in advance, and have meals stored up in the freezer. Businesses such as Dream Dinners can help make this a snap – you spend a couple of hours there and prepare a variety of delicious meals that are frozen, then thawed and prepared when you need them.

Enlist the help of friends and family – designate a particular person to be in charge of meals. That person can call your friends and set up a schedule for meals, so you have a fresh meal arriving at your house around dinner time each night (and it saves you from having to call and ask, which may be awkward for you). Have a supply of meal replacement bars on hand – they should not be your main mode of nutrition, but if you have not had time to fix lunch, you’re starving and the baby needs to eat, you can grab one of them and a bottle of water and head to the couch.

Products such as Super Greens have fabulous nutrition that your body needs and will help you stay healthy and nourished. Drink adequate amounts of water; not coffee, not juice, not soda – water. It is easy to become dehydrated, particularly if you are breastfeeding.


Continue taking your prenatal vitamin after the baby comes, for as long as you are nursing. Use the placenta to help with your postpartum recovery. Your own placenta, made into capsules, is incredibly nutritious and beneficial to you. Women who take their placenta capsules tend to have better postpartum experiences, avoid the baby blues, have an increase in energy, and an increase in milk production. Traditional Chinese Medicine has used placenta for centuries to treat issues such as fatigue and insufficient lactation, and scientific studies have bolstered the use of placenta for these conditions. Using the placenta for your postpartum recovery is a very easy and natural way to help you feel better after the birth.

Motherhood is an amazing time in our lives, but it is a major transition and can be stressful. Be prepared, make use of every available resource (even the unconventional ones), and the stress of this time will be reduced. Every baby wants a happy mama, and your family deserves the best of you.


Latest Parenting Trend: The CTFD Method

My last post was sweet and instructive. This post isn’t so sweet, but it’s definitely instructive. WARNING to my relatives: The following has vulgar profanity. Don’t judge me too harshly.

The following is from David Vienna’s blog “The Daddy Complex”. It’s better to read the blog itself so you can see the fantastic accompanying commentary. I haven’t checked out the rest of the blog yet but it looks pretty great and has been recommended by several websites.

The CTFD Method

I know many people want to stay current with the latest parenting trends—attachment parenting, minimalist parenting, Tiger Mother parenting, et al. Well, I’ve stumbled upon a new technique that will guarantee your child grows up to be an exemplary student and citizen. It’s called CTFD, which stands for “Calm The Fuck Down.” And that’s not a message to give your kids. It’s for you.Using CTFD assures you that — whichever way you choose to parent — your child will be fine (as long as you don’t abuse them, of course). To see it in action, here are some sample parenting scenarios and how CTFD can be employed:

  • Worried your friend’s child has mastered the alphabet quicker than your child? Calm the fuck down.
  • Scared you’re not imparting the wisdom your child will need to survive in school and beyond? Calm the fuck down.
  • Concerned that you’re not the type of parent you thought you’d be? Calm the fuck down.
  • Upset that your child doesn’t show interest in certain areas of learning? Calm the fuck down.
  • Stressed that your child exhibits behavior in public you find embarrassing? Calm the fuck down.

Yes, using the CTFD method, you’ll find the pressure lifted and realize your child loves you no matter what, even if they’ve yet to master the alphabet. You’ll also learn that whether or not you’re the best parent in the world, as long as you love your child, they’ll think you are and that’s what matters. Plus, CTFD makes you immune to those that prey upon the fears of new parents, like pseudoscientists and parenting authors.

To use CTFD, just follow these simple steps:

  1. Calm the fuck down.
  2. There is no second step.

So, ignore all those other parenting trends and stick to CTFD. You’ll be glad you did and so will your kid.


To my new parent friends: You’re welcome! Now CTFD and pour yourself a drink.

Great article on approaches to discipline

I’ve written about our discipline quandaries before and I’m sure they will continue to be a major source of exporation and study for Ted and I as Archer continually develops and changes in his behaviors, attitudes, abilities, etc. A friend posted this article on “natural” disciplining — the term “natural” is used ad naseum in American parenting culture these days, but in this case the author is referring to the child’s natural developmental growth.

This article and many others are listed on Recommended Resources page.

Natural Discipline for the Early Years

When it comes to children’s difficult behavior, a parent’s first question is usually, “What should I do?” We tend to want to eliminate it, fix it, or get it under control. But it’s important to understand that the behaviors we see in our children are merely the tip of the iceberg; the bulk of behavior issues stem from below the surface.

What we see is just a natural extension of the development occurring underneath. Rather than fight against it, parents will find more success in working with a child’s development to teach behavior. Take a look at these four examples of the earliest stages of child development to understand a “working with” approach rather than a “doing to” approach to natural discipline.

Age 1:
My baby doesn’t listen to “No!”

From birth to age two is a child’s sensorimotor stage of development. During this age, children are hard-wired to explore their environment using all of their senses. This means they will touch, pick-up, grab, bite, pinch, throw, smear, and put absolutely everything they can into their mouths in an effort to understand the world around them. This exploration may mean that someone gets hurt, property is destroyed, or the child’s own safety is compromised. It’s not purposeful, and it’s not malicious. It’s simply a baby’s underdeveloped instinct to learn.

It’s tempting to think that the more often or more firmly you tell a young child no, the more she will remember it and behave differently next time. But a one-year-old child does not have mature enough brain development to stop herself from adhering to a no. So, no matter how many times you tell her, she simply does not have the neural connection to stop, remember your words, think through the options, and decide not to act. It’s not that babies don’t listen, it’s that they lack sufficient brain development to acknowledge, comprehend, and think logically about a “No.”

“Working With” Tips

Try working with your baby’s natural inclination to explore and learn by being proactive. Create a “yes” environment. Baby-proof, block, pad, and lock away all of the no’s so you’re left only with yesses. Yes, you can climb on this furniture. Yes, you can explore these cabinets. Yes, you can throw any of these soft balls. Yes, you can touch anything in this room. Support her learning while keeping her safe.

There will be times when keeping your young child in a yes environment is not possible. In those cases, stay close to her to physically prevent her unsafe behavior. Knowing that she cannot logically understand why she shouldn’t throw a rock, ensure that you are close enough to step in and physically remove the rock from her hand. Gently undo her grip from her sister’s hair. Move her to another area to prevent her from touching Grandma’s knick-knacks.

Be available to redirect her energy when necessary. If she’s focused on throwing, give her something safe to throw. If she really wants to clang glass figurines together, substitute something noisy and unbreakable in her hands. If she is inclined to reach out and swat, pinch, or grab whoever is nearby, give her a small toy she can manipulate with her hands. Rather than stand firm and assert, “No!” take that same energy she has for using her senses, and refocus it on something that is safe and appropriate. Turn a no into a yes.

Age 2:
My toddler is constantly throwing fits!

As children enter the twos, so begins the age of autonomy. Toddlers become self-assured in their increasing mobility, and they are able to accomplish many more tasks for themselves. They are developing confidence in themselves and a sense of awareness in their bodies. They are becoming capable. Along with this newfound sense of independence comes a natural increase of limits; toddlers are not able to make logical decisions, so we help them by setting limits around health and safety.  Still, our well-intentioned limits don’t always agree with what our little ones have in mind. The difference between a toddler’s priorities of, “I want to do it!” and our priorities of, “No, you may not,” combines with his burgeoning sense of autonomy to create the perfect recipe for a tantrum.

During the twos, the midbrain (the emotional brain) and the prefrontal cortex (the logical brain) have poor connection and communication. So while a child’s emotional brain is capable of experiencing strong feelings, his logical brain is not capable of appropriately acting on those feelings. The resulting behavior is a “flipped lid,” or emotional meltdown in which he expresses his feelings in the only way his brain is capable: yelling, crying, and carrying on.

“Working With” Tips:
Remember that while it is unpleasant, a tantrum is normal and very appropriate for a two-year-old; so do your best to stay calm. A child’s brain has mirror neurons that pick up on the emotional state of his environment. In other words, calm begets calm. It’s OK to step away from the fit for a few minutes to collect yourself and refocus.

Allow for tears. It is important to teach children that their feelings are always OK and are not something to suppress, hide, or be ashamed of. Trying to stop a toddler’s tantrums resists his natural development and only causes more friction in your relationship. Instead of punishing a child for having a tantrum, accept the feelings you’re hearing, and let him know that it’s OK to cry. This is the first step for him to learn the skills to handle such feelings.

Teach your child the language for the feelings he is having by empathizing with him.  You are mad…It’s OK to feel sad right now…You really wanted this and you’re angry you can’t have it. You don’t have to change the limit you set (meaning: give the child what he wanted). You are only acknowledging his feelings and being emotionally available to support him through them as his brain chemistry restores. Your empathy teaches emotional intelligence as your toddler outgrows a tumultuous age.

Age 3-4:
My preschooler hits!

Though the age of frequent tantrums may be over, life’s frustrations are not. And what once may have triggered cries and tears of epic proportions may manifest differently in an older child: aggression. Aggressive behavior is rooted in frustration. When a child encounters frustration in her life—from small problems like not getting the dessert she wants, to larger issues such as an extended absence of a parent—her feelings will inevitably surface.

Parents often want to address occurrences of aggression with a “doing to” approach; a consequence. They adopt a “you hit, you sit” approach with timeouts, punishments, or other imposed consequences intended to teach the lesson that hitting is unacceptable. True, hitting is not OK. It’s also not the problem to be addressed. Hitting is the manifestation of unresolved feelings of anger, fear, and frustration. It is due to an immature prefrontal cortex and poor communication between the logical brain and the midbrain. Most importantly, it stems from a child’s inability to adapt to futility. The key to finding a solution to hitting, then, becomes about addressing the child’s adaptive process, not the behavior itself.

“Working With” Tips:

Be close with her often to help prevent her hitting. If you see your child is getting frustrated, quickly move closer to help. Realize she has an immature brain and is physically unable to control her aggression when her emotions are running strong. Get between her and the other person and let her know, “I won’t let you hit.”

Empathize with her to draw out tears instead of aggression. I can tell you are really frustrated right now….You’re very angry that your friend knocked over your tower….It is so sad to lose a game, isn’t it? Let her cry. Encourage her to cry. Tears facilitate the adaptive process by providing an emotional outlet. The brain is able to adapt to adversity without moving to aggression.

Once you’ve addressed her feelings, address her needs. You were feeling hurt; you need to be included with your friends. You felt annoyed; you need to be able to make your own choices. Identifying valid needs is the first step for a child to be able to understand how to solve problems. From there, you can pose the question, “OK, what can we do about that?” and brainstorm alternate solutions to hitting.

Age 5-7:
My child argues about everything!

You say, “Yes,” he says, “No.” You say, “Please pick up your toys,” he says, “I don’t want to.” You say, “Time to get ready for bed,” he says, “You can’t make me!” It seems that whatever you say, your child says and does the opposite. Life has become a battle of power. Power struggles are an expression of a need to be heard and regarded. Growing children experience a phase of initiative and individuality; that is, they are autonomous, they have a voice, and they need to use it. There are things you can do to help strengthen your relationship with your child so that he’ll be less argumentative and more cooperative.

“Working With” Tips:

Regularly ask your child questions. Make sure they are not just yes-or-no questions, but open-ended questions that encourage him to share his thoughts. What do you think about this? How did you make a decision? What are your ideas? Show your child that you are interested in hearing his perspective. Then, the other half of this step is to actively listen to the answers. Show that you understand by echoing back what you hear and paraphrasing his thoughts. Oh, so you decided to…That must have been difficult…You felt…This communicates that you value his thoughts and take him seriously.

Enlist your child’s help to create routines and habits. Routines are conducive to cooperation because of their predictability. And power struggles are less likely to occur when your child has had a say in how those routines are created. Regular family meetings are perfect opportunities to elicit input from children on the functions of the household. Ask for a child’s input and incorporate some of his ideas so that he will have a stronger sense of significance and belonging in the family.

Carve out regular, special time to connect. Make sure your relationship stays strong. Schedule regular time together in which your child is “the boss.” He chooses the activity, he directs the playtime, and he leads the topics of conversation. Even just 15 minutes a day, this type of interaction adds incredible closeness to a relationship and greatly diminishes the amount of daily power struggles.

Teaching children behavior is much more effective with a natural approach. By working with a child’s development, parents can bypass much of the resistance encountered with traditional discipline methods. Consistently responding to children in a proactive, connective way creates an environment of acceptance. It is this acceptance that allows for a child’s healthy social and emotional development.

Kelly BartlettAuthor Kelly Bartlett is the author of “Encouraging Words For Kids.” She is a Certified Positive Discipline Educator and freelance writer with a focus on child development, family relationships and discipline.

Empowered Birth: Class #1

One of the best things we did in preparing for Archer’s arrival was to take a 7-week “Empowered Childbirth” class that was recommended by a colleague. It was great because:

– It’s goal was not for couples to give birth in a certain way or use a certain method. The goal was to learn about all the options for birth and some of the technical stuff: What causes pain in childbirth? Which components of pain can be avoided or mitigated and how? What are the potential good and bad consequences of using various pain-relieving techniques? If you have to get a C-section, what exactly will occur, what choices need to be made?

– All of this knowledge helps couples adapt their plans on the spot as needed, which is more common than not. Many people have a plan for how they want their labor and birth to proceed, and rarely does all go according to plan. The class is designed to give couples the knowledge to make decisions as needed and still feel in control of the process and know the likely outcomes of various decisions.

– “Expect the unexpected”. I’m a control person. I like to feel competent. The more information and organization and planning, the better as far as I’m concerned. All of the info helped me feel informed and a lot less anxious about my upcoming birth experience. It also helped me let go of control more easily as my labor took many (expected) unexpected twists and turns; I knew what to expect in unexpected situations.

So now it’s round two. We decided to go back to refresh our info, practice laboring positions, and dedicate at least 2 hours of the week to giving our unborn daughter some attention in our otherwise hectic lives. I’ll endeavor to post something after each class and share with my many friends who are expecting their first kids this fall.

Class #1: What causes pain in labor? What eases pain? What worsens pain?

– I was reminded that movement and changing positions in labor is not just a technique for coping with pain; it actually helps progress the labor along and helps baby get into optimal positioning to move through the birth canal.

– Stress, anxiety, clenching: Normal reactions to being in pain, yet ironically make pain worse – the release of adrenaline slows down the labor process, tight muscles (typical physical response to anxiety and fear) only make it harder and more painful for the muscles to expand and contract. The more relaxed and comfortable you are, the less intense the pain will be. win-win. The article copied below is on pain theory.

– So many options and ideas for laboring positions! I learn by doing and in class we completed this worksheet of exercises titled “How Open is Your Pelvis?”which was really helpful to me.

ARTICLE: What causes pain in labor?

Natural Result of Physical Processes. During labor and birth, there are several physical processes occurring that lead to childbirth pain: the strong uterine contractions and the tension they place on supporting ligaments; pressure of the baby on the cervix, vagina, urethra, bladder, and rectum; stretching of the cervix, pelvic floor muscles, and vagina. These processes are unavoidable, and the pain caused by them is a positive sign that labor is progressing. We don’t want to stop these processes from happening, we just have to figure out how to minimize the pain we experience as a result.

Pain-intensifying factors that we can influence.

  • The stretching of the pelvic floor muscles can cause pain; it helps if you’ve been doing your Kegel exercises in advance.
  • Pressure on bladder causes pain, going to the bathroom regularly during labor helps.
  • Emotional and psychological issues from our past can influence our attitude toward pain, and our ability to cope with labor pain. Awareness of these issues, counseling prior to labor, and supportive companionship during labor can help with this.
  • Reduced oxygen to uterine muscle increases pain; breathing techniques help.
  • Muscle tension increases pain, fear and anxiety make you more sensitive to pain; relaxation can help with these.

Gate Theory of Pain

The nerve fibers which transmit labor pain sensations are unmyelinated and carry nerve impulses more slowly than the nerve fibers which carry sensations of light pressure, soft touch and vibration. If you transmit pleasurable impulses (such as light, soft touch), those will reach the brain first, and that can modulate, or interfere with, the pain sensations.

  • Merkel’s disks are nerve endings which transmit sensations very quickly to the brain. They are most focused in the palms, the soles of the feet, and the lips. Thus, having partners hold a mom’s hand, rub her feet, or kiss her can all help interrupt the pain sensations. Moms can also grip the rails of the bed, or stand up to activate some of these sensors.
  • Meissner’s corpuscles are found in the fingertips, and sensations from them are transmitted quickly. Having the woman move her fingertips in circles on the sheet, or finger soft textures like velvet or stuffed animals, or feel her partners face, can help minimize pain transmission.
  • In general, sensory input can distract us from pain perception. This can be seen from common experiences, such as going to a movie and forgetting about a headache until the movie is over; or finishing up work on a focused project and then realizing that it’s been hours since you’ve gone to the restroom. Therefore, any sensory input the mom finds pleasant and relaxing can help: massage, light touch, music, a focal point to look at, aromatherapy, etc.

Fear –Tension – Pain Triangle

During labor, fear and anxiety can worsen our pain: they cause the release of stress hormones (catecholamines: epinephrine, etc.) which place us in a hyper-aroused state that makes us hypersensitive to pain. Catecholamines increase our heart rate, increase blood pressure, slow down digestion, and shunt blood supply away from internal organs and toward skeletal muscles and skin. All of these things in excess can cause complications in labor, and prolong the labor.

Fear also leads to muscular tension, which increases our experience of pain. Using relaxation techniques can help to reduce the muscle tension.

The concept of the fear-tension-pain triangle has arisen: when fear increases, tension increases, which then increases pain. Then the increased pain increases fear, and the situation continues to worsen.

The uterus contains two opposing muscle groups – one to induce and continue labor, and another to stop labor if the birthing mother is in danger and afraid. When we are frightened, we release adrenaline, which causes the short, circular muscle fibers in the lower third of the uterus to contract, stopping labor by closing and tightening the cervix. At the same time, the long straight muscle fibers of the uterus are contracting to dilate the cervix. The two powerful muscles pulling in opposite directions during every contraction causes more severe pain. (Griffin)

Thus, anything that can be done during labor to help the mother feel calm, relaxed, and safe can help to minimize the pain that mother’s experience in labor. Some specific things you can do. Prior to labor: educate yourself about labor so there’s less fear of the unknown. Throughout labor: Think about environmental factors such as dim lights, quiet music, and nice smells. Bring to the hospital: favorite clothing or blanket, etc. Use relaxation techniques and breathing techniques.

Janelle Durham, 2002

Sources: Pregnancy, Childbirth, and the Newborn by Simkin, Whalley, and Keppler (2001 edition). “Epidural Express” by Nancy Griffin, Mothering, Spring 1997. “The Pain and Discomfort of Labor and Birth” by Nancy Lowe, JOGNN, 25: 82-92, 1996. “Nonpharmaceutical Pain Relief” by Hilbers and Gennaro, source unknown, perhaps published as conference proceedings.

Germs are our friends

The New York Times had an article today I was happy to see: It’s OK to pass your kids a bunch of germs! Every time Archer eats a mysterious who-knows-how-old food particle off the floor, or licks a toy at the library that has been licked by 10,000 other kids, or walks into the room with one of our filthy shoes in his mouth — part of me cringes, but then I shrug and think “well, it’ll just build his immune system”. Ha! I’m right!

My wonderful and caring mother-in-law works for the Kentucky Dental Association and takes great concern with everyone’s oral hygiene. It’s great, Archer has 3 different cool baby toothbrushes! This new research flies in the face of what she’s been preaching about sharing saliva/spoons, but it makes me relax just a little more about the whole germ thing. Though I have to say, I never “sucked my kid’s pacifier clean” – I don’t get the logic to this thinking: I have no illusions that my spit is any cleaner that whatever gunk was on the paci in the first place.

Interesting side note mentioned in the article: “Studies show that the microbial world in which a child is reared plays a role in allergy development, seemingly from birth. Babies delivered vaginally accumulate markedly different bacteria on their skin and in their guts than babies delivered by Caesarean section, and that in turn has been linked in studies to a lower risk of hay fever, asthma and food allergies.” One more reason it’s preferable to avoid a C-section if possible.

Sucking Your Child’s Pacifier Clean May Have Benefits


For years, health officials have told parents not to share utensils with their babies or clean their pacifiers by putting them in their mouths, arguing that the practice spreads harmful germs between parent and child. But new research may turn that thinking on its head.

In a study published Monday in the journal Pediatrics, scientists report that infants whose parents sucked on their pacifiers to clean them developed fewer allergies than children whose parents typically rinsed or boiled them. They also had lower rates of eczema, fewer signs of asthma and smaller amounts of a type of white blood cell that rises in response to allergies and other disorders.

The findings add to growing evidence that some degree of exposure to germs at an early age benefits children, and that microbial deprivation might backfire, preventing the immune system from developing a tolerance to trivial threats.

The study, carried out in Sweden, could not prove that the pacifiers laden with parents’ saliva were the direct cause of the reduced allergies. The practice may be a marker for parents who are generally more relaxed about shielding their children from dirt and germs, said Dr. William Schaffner, an infectious diseases expert at Vanderbilt University who was not involved in the research.

“It’s a very interesting study that adds to this idea that a certain kind of interaction with the microbial environment is actually a good thing for infants and children,” he said. “I wonder if the parents that cleaned the pacifiers orally were just more accepting of the old saying that you’ve got to eat a peck of dirt. Maybe they just had a less ‘disinfected’ environment in their homes.”

Studies show that the microbial world in which a child is reared plays a role in allergy development, seemingly from birth. Babies delivered vaginally accumulate markedly different bacteria on their skin and in their guts than babies delivered by Caesarean section, and that in turn has been linked in studies to a lower risk of hay fever, asthma and food allergies. But whether a mother who puts a child’s pacifier in her mouth or feeds the child with her own spoon might be providing similar protection is something that had not been closely studied, said Dr. Bill Hesselmar, the lead author of the study.

In fact, health officials routinely discourage such habits, saying they promote tooth decay by transferring cavity-causing bacteria from a parent’s mouth to the child’s. In February, the New York City health department started a subway ad campaign warning parents of the risk. “Don’t share utensils or bites of food with your baby,” the ads say. “Use water, not your mouth, to clean off a pacifier.”

In the new study, doctors at the University of Gothenburg and elsewhere followed a group of about 180 children from birth. The children were examined regularly by a pediatric allergist, and their parents were instructed to keep diaries recording details about food introduction, weaning and other significant events.

By the age of 18 months, about a quarter of the children had eczema, and 5 percent had asthma. Those whose parents reported at least occasionally cleaning their children’s pacifiers by sucking them were significantly less likely to develop the conditions — particularly eczema — and blood tests showed that they had lower levels of a type of immune cell associated with allergies. Analyses of the children’s saliva also showed patterns that suggested the practice had altered the kinds of microbes in their mouths.

The researchers then looked to see if the method of childbirth provided any additional protection.

It did. The children who were delivered through Caesarean section and whose pacifiers were rinsed or boiled had the highest prevalence of eczema, nearly 55 percent. The group with the lowest prevalence of eczema, about 20 percent, were born traditionally and had parents who cleaned their pacifiers in their mouths.

But are these parents also transmitting harmful infections to their children?

The bacterium that causes dental cavities, Streptococcus mutans, is highly contagious. Studies show that children can be infected at a very young age, and that the strain they pick up is usually one that they get from their mothers. That is why health authorities tell parents to do things that can lower the rate of transmission to their children, like not sharing utensils or putting their mouths on pacifiers.

But Dr. Joel Berg, president of the American Academy of Pediatric Dentistry, said those efforts are misguided, since parents are bound to spread germs simply by kissing their children and being around them. “This notion of not feeding your baby with your spoon or your fork is absurd because if the mom is in close proximity to the baby you can’t prevent that transmission,” he said. “There’s no evidence that you can avoid it. It’s impossible unless you wear a mask or you don’t touch the child, which isn’t realistic.”

Dr. Berg, who does salivary research at the University of Washington, said the new findings underscore something he has been telling his patients for years, that “saliva is your friend.” It contains enzymes, proteins, electrolytes and other beneficial substances, some of which can perhaps be passed from parent to child.

“I think, like any new study, this is going to be challenged and questioned,” he said. “But what it points out pretty clearly is that we are yet to fully discover the many and varied benefits of saliva.”

Sleeping on the left

Sleep is increasingly a struggle (which is why I’m awake right now and writing this) and thus a topic of conversation. I’ve been surprised by how few people are familiar with the benefits of sleeping on your left side. I’ve done this since childhood whenever I have any sort of belly discomfort — I remember seeing something about it on the news at my grandparents house when I was really little. (Weird, the things we remember). So for those of you who have been asking, here’s some more info about it – Sleeping on the left can be beneficial for anyone, pregnant or not, and for pregnant women this is the recommended sleeping position.

New York Times: Lying on the Left Side Eases Heartburn

excerpt: “… sleeping position affects heartburn pain. Studies show that sleeping on your left side is best.

The reason is not entirely clear. One hypothesis holds that right-side sleeping relaxes the lower esophageal sphincter, between the stomach and the esophagus. Another holds that left-side sleeping keeps the junction between stomach and esophagus above the level of gastric acid.”

American Pregnancy Association: Sleep Positions During Pregnancy

excerpt: “The best sleep position during pregnancy is “SOS” (sleep on side). Even better is to sleep on your left side. Sleeping on your left side will increase the amount of blood and nutrients that reach the placenta and your baby. Keep your legs and knees bent and a pillow between your legs.”

The Guardian: Link Found Between Stillbirth and Sleeping Position in Pregnancy

excerpt: “Mothers who sleep on their back or right-hand side on the night before giving birth are twice as likely to have a stillborn child compared with those who slept on their left, according to a study.

Researchers found that the risk of stillbirth for those sleeping on the left side was 1.96 per 1,000 births, and 3.93 per 1,000 births for any other position.

Tomasina Stacey, a midwifery lecturer at University of Auckland, who led the study, cautioned pregnant women not to be over-concerned by the finding. “It was an observational study, not one that can show cause and effect – all it does is show an association. It would be premature to jump up and down and say that everyone has got to sleep on their left. It’s a starting point for future research.”….

“The researchers wanted to examine the effects of sleep disorders in pregnant women, such as sleep apnea or snoring, which could be a factor in stillbirths, because these conditions can reduce the amount of oxygen getting to the baby.

Instead, the study showed that sleep position on the night before birth was the decisive factor. Stacey said a possible explanation could be that when a woman does not sleep on her left side, the foetus could compress her inferior vena cava taking blood back to the heart, and a reduced flow means less oxygen gets to the mother’s – and in turn the baby’s – other organs.

“If you’ve got a strong healthy baby, then the slightly reduced blood flow is fine; but if you’ve got a baby that is compromised in some other way, then maybe that reduction in blood flow can be the tipping point,” said Stacey.

The left lateral position is known in clinical settings to be the optimal position for looking after a woman in labour and is associated with foetal wellbeing in labour, she added.”


Now that I’ve taken time to write this, maybe I can go back to sleep!

P.S. We’re at 30 weeks! Christmas day will mark 7 months. I’m gaining a pound a week now and I’m feeling the difference. Impressive belly photos coming soon.