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Birth Sensations & Protecting The Perineum Through It All

15 Mar

Birth-Sensations-&-Protecting-the-Perineum

Let’s talk about the perineum! (Yeah, high-five if you’ve got one – okay, it’s no secret everyone has one.) It’s a big concern among expectant moms, will my perineum make it out alive?

Sometimes in my childbirth classes I can literally see a huge floating question mark sitting on the tops of women’s heads. Like a thought bubble pleading silently, “Can you talk about vaginas, now!? Will mine ever look the same!? Will I be normal after birth? What will happen to my perineum during childbirth?”

Well, before we answer those questions we need to understand some of the sensations women may experience during childbirth and what we can do to protect the perineum through it all.

Alright, let’s dive right in, shall we? First let’s examine the vagina, or rather the vulva, and talk about the perineum and what happens towards the end of labor:

Screen shot 2013-03-14 at 1.33.42 PMThe perineum is the skin between the vagina and the anus, which thins out and stretches over the baby’s presenting part (usually the head) as it is born. (Source) During second stage (pushing) the perineum plays an especially vital role in the birth of the baby.

Okay, let’s talk about what’s going on down there as we approach second stage!

(“Down there” and “bottom” are lite and easy words that I use to describe the vagina, vaginal opening, vulva, perineum and rectum. These are the words my midwife used with me and I will use them with you! Okidoki?)

Building Pressure:

As baby descends and engages and labor deeply progresses, a woman will experience increasing pressure in her bottom as her pelvic passage begins to stretch open. Often, the stimulation sends a signal to a laboring mother’s brain that she needs to have a bowel movement. And sometimes that’s exactly what a laboring mother may do.

I’ve worked with a lot of moms who, while in the thick of labor, look up at me with urgency and quickly move to the bathroom. Baby’s decent stimulated her bowels. On occasion the laboring mother may have a genuine need to go (this is nature’s lovely way of making sure that doesn’t happen during second stage), or other times the mom may simply relax on the toilet, letting her muscles soften till she becomes more comfortable with these new sensations. Either response is totally normal.

Keep in mind, the pressure felt during birth is sometimes really alarming, because, let’s be honest here, we’ve spent our whole life learning to be discrete about the urge to poop. But in the case of childbirth (and possibly a few other occasions!) this sensation is cause for celebration, it tells us baby is descending and the mother is moving closer towards holding her baby in her arms.

Grunting:

Often at this stage in labor, you’ll begin to hear mothers grunt at the peak of their contractions. Imagine, mom is moaning through her contraction and suddenly her breathy bellowing goes like this, “ooooooooooooooh, oooooooooooooooooh, ooooo uh, uh, uh, uh, uhr, uhr, uhr, oooooooooh, oooooooh, oooooh”

Aha! That’s a great sound! Those short little grunty noises that mom just made in the middle of her contraction signal that her body is beginning to involuntarily push at the peak of her rush.

Stations-of-Presentation

As baby descends, increasing pressure is felt in the bottom and the rectum is stimulated.

Supportive Hands:

You’ll also sometimes see, as a laboring mother begins to feel that all-consuming pressure, that she will place her hands right on her bottom, cupping her groin and supporting her vulva. That’s wonderful and absolutely normal! Besides for giving her bottom additional support during this stage, it also allows the laboring mother to stay more in touch and in control of her body’s response to labor. What’s not to love!?

Pressure, grunting, and supportive hands are clear signs that birth is progressing…

Does that mean it’s time to push yet? No, not necessarily. It only means what she’s telling us from her body language: her bottom is feeling pressure, things are being stimulated, baby is descending and birth is progressing normally.

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Enjoy, Accept, Relax

At this transitional stage between first and second stage of labor, it’s ideal for mom to not add additional force (just yet!) as she begins to feel those early urges to push. As her uterus contracts, the bands of muscle thicken at the top of the fundus and begin to push down on their own, expelling baby further into the birth canal, this is the beginning of what will soon become a very strong urge to push.

It’s a good idea at this cross-road in labor to encourage mom to enjoy knowing just how well her body is working, accept the intensity of the change in sensations she’s feeling, and relax into her rushes a little more fully. This provides mom with an opportunity to wrap her brain around the idea of what the pushing urge feels like before diving right into it.

Powerful Pressure | Second Stage | Pushing

As labor thickens into heavy travail (an old Biblical word that I feel really adequately describes transitional labor) the intensity of pressure a woman begins to feel increases exponentially.

Baby’s head is now stretching the vaginal and pelvic floor muscles. Receptors in these tissues trigger involuntary pushing, and signal more oxytocin to the body – a complex hormone which stimulates contractions. (Source) A woman will now begin to feel the urge to push through almost the entirety of her contraction and not just the peak of it.

Mom will need reassurance at this point that she is okay, she needs to know that the pressure she feels is normal, and that even if she’s absolutely convinced she will birth her baby out of her butt, she will not. (Yeah, I said it.)

The intensity of the pressure is admittedly scary, but it’s also needed in order to bring forth baby into the world. And while it’s like nothing any first-time mother will have felt before, and can be utterly overwhelming, it is still very normal in terms of childbirth and not to be feared.

This is a doorway in labor that mothers walk through, there is no way around this passage of birth intensity, only through it. It is time to push!

Your-Baby's-Birth---Dr.-Miriam-Stoppard's-New-Pregnancy-and-Birth-Book

Please note, while these illustrations are fantastic, the information on step four regarding suctioning a baby is now contraindicated and outdated. Evidence now states that unless baby is unresponsive, suctioning is not necessary. Source: //www.ncbi.nlm.nih.gov/pmc/articles/PMC2666857/

Two Steps Forward, One Step Back

As mom pushes her baby down and out in that wonderful “J” shape of pushing, we’ll often see a little two-step dance, baby descends during the contraction, pressing on the perineum and the perineum begins to bulge and expand, and after the contraction ends, baby moves up and the perineum softens and relaxes. This happens over and over again.

This is a process my own midwives and mentors taught me to refer to as “two steps forward, one step back.” This dance is very important for the integrity of the perineum. It allows the skin to stretch slowly and gently, giving the perineum time to accommodate the baby’s head without tearing.

Ring of Fire

Once the head of the baby has firmly ducked under the pelvic bone, crowning will begin to take place. We use the term “crowning” to describe how the vaginal opening and vulva stretches around baby’s head looking like a crown.

As baby crowns, the labia and perineum begin to expand and bulge, this point is often referred to as the “ring of fire.” There is a lot of stinging and burning accompanied with the ring of fire, fortunately, it doesn’t last for too long, although we shouldn’t rush through it. This stinging sensation sends a message to the woman’s body to hold off on pushing. (Source)

(On a side note, sometimes as an exercise to describe the ring of fire to my students, I’ll ask them to stretch open the sides of their mouth with their fingers. I find this gives a good sense of the type of stinging that’s felt in birth. As a bonus, everyone looking ridiculous together usually gets us all laughing, which is always good when talking about crowning!)

During crowning it’s good for the laboring mother to stop adding additional force to her body’s own urge to push. Instead she should breathe out her baby and allow her body to do the work on its own. (This is something she has already practiced in birth during the transitional stage mentioned above. See, it all comes together now!)

You see, after the baby’s head is through the pelvis, only the tender perineal tissues are holding baby in (Source), and the mother needs to be mindful of not pushing too forcefully in order to protect this area of a her body.

How does she do that? She breathes her baby out…

Breathing Baby Out

Gentle, easy breaths that resemble panting allow the baby’s head to emerge slowly and tenderly, helping to keep the perineum intact. Actually, for many mothers breathing out her baby is an innate response to the ring of fire.

Think about it: a base response to pain, for all ages, are quick short breaths. I see my children do this all the time. A little high-pitched panting expression that happens when they’ve smashed their finger or stubbed their little toe.

Likewise, when mothers are left to labor without heavy coaching, at the point of crowning, you’ll sometimes see this panting and high-pitched breathing technique occur. (Watch some birth videos, and listen for that quick high-pitched breathy howl at crowning, and then you’ll start to see it all the time.)

Supporting The Perineum

Also, a mother’s hands may instinctively reach down again and apply pressure to her own perineum. Although, I should mention it’s quite common that you’ll see the midwife or OB apply slight counter pressure to a woman’s perineum at this stage too. Also, some care providers will apply a warm compress or olive oil to a mother’s perineum to assist in preventing tears.

To view a photograph of a crowning baby and a perineum stretching out beautifully in birth click this link from wisewomanchildbirthPerineum stretching in birth.

Once the baby’s head has fully crowned, it will only be another couple of pushes before baby is born. After the birth of the baby’s head, baby’s shoulders are delivered, and the rest of the baby’s body pours out from its mother shortly after.

It’s miraculous to see and testifies to the function and beauty of the female body.Women’s bodies are just amazing, y’all!

Mother-catching-her-baby

Image source unknown

There are a lot of things a woman can do that will increase her chances of having an intact perineum, here are a few of my tips, please note this list is not exhaustive or comprehensive:

  • Diet and hydration play a valuable role in the health of a woman’s perineum, for a great post on this go here: Protecting Your Perineum From The Inside Out
  • Practice pelvic floor exercises during pregnancy. (You may want to rethink Kegels, here’s a link that says why: Pelvic Floor Party, Kegels Are Not Invited)
  • A mother should avoid birthing on her back, but rather birth on her side, in an upright position, or on her hands and knees.
  • Warm compresses (not hot!) on the perineum during labor.
  • Avoid power pushing. Power pushing, or what is known as purple pushing, is when a woman holds her breath for long periods of time and pushes beyond what feels comfortable or natural to her body. This type of pushing increases a woman’s chance of tearing.
  • Avoid widely flexed legs. Knees should be pointing forward and not to the sides. Source | Source
  • Follow her own body’s cues during crowning and slow down her pushing.
  • Use a mirror, if she’s comfortable with that. Seeing what’s happening during second stage can help the mother connect to her body, and allow her to direct her body’s urges better.
  • The laboring mother should move to positions that are most comfortable for her during second stage. For example, the mother could say, “Before my next contraction starts, I would like to turn to my left side. Would you help me do this, please?”
  • Hire a doula! A doula reduces a woman’s need for an epidural and for forceps delivery, both of which increase the laboring mother’s odds of perineal damage.
  • The mother should find a care provider who supports birthing in ways which allow for an intact perineum.

Related articles

What You Don’t Know About Episiotomies Can Hurt You (parenting.blogs.nytimes.com)

Get Through Childbirth in One Piece!

Avoiding Tears and Episiotomies

Perineal Protectors (read the comments, too!)

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How I Learned to Support A Mother’s Choice Not To Breastfeed

10 Feb

bottle fed baby

It was a blazing summer evening two years ago and our weekly childbirth class was filled to the brim with parents laughing and talking over their meal. The last session of our six-week birth education course had arrived – it was graduation night (everyone could go have their babies now, we always joked). In celebration we all brought food and shared a meal together before the onset of class.

While all the expectant couples were enjoying their BBQ, lost in conversation and anticipation over how their lives would change, the midwives pulled the other instructor and me aside. They had something they needed to share with us.

There was one expectant mother in our group who was choosing not to breastfeed. The CNMs urged us to keep this mother’s choice in mind as we approached our teaching session on breastfeeding and the nutritional needs of a newborn. We were asked to use the phrase “feeding your baby” when we could instead of “breastfeeding” to help this mother, who already felt guilty and ostracized for her unusual choice in this natural birthing environment, feel included in the conversation.

I bristled at the idea that we were coddling a mother’s poor decision. I thought it was irresponsible of us to not speak openly and directly as we always did on the amazing and overwhelming evidence-based benefits of breastfeeding. Besides, if she’s going to make a choice to deny her newborn the very best nutrients he needs then she should at least face it full-on. My job isn’t to white-wash anything. Breast is best.

But she knew that, I was told, rather sharply. She was well-informed on the benefits of breastfeeding, even so, she had personal reasons not to breastfeed her son. (None of which they shared with me, by the way.) Besides, no one was asking me to shelter her from breastfeeding benefits, only to make room in my conversations for formula use.

I was reminded that my job in that moment was to offer the best education I could to this mother to fit her needs and choices, without judgment. After all, do I support birthing mothers, or do I only support mothers who birth the way I see fit?

After all, do I support birthing mothers, or do I only support mothers who birth the way I see fit?

As we taught our class and covered our material, Sarah (I’ll call her Sarah, but that is not her real name) sat quietly through it all. I tried not to give her eye-contact as I went over warning signs of things that she wouldn’t ever deal with, things like thrush, clogged milk ducts, and mastitis. (Or would she?)

That night, as couples said good-bye and we hugged each round-bellied mother, offering hopeful hearts that the seeds we’d sown would blossom into beautiful birth stories for each family, Sarah stayed behind.

The midwives suggested we spend some personal time after class explaining to Sarah how to dry up her milk and offer further resources to her on bottle-feeding. Sarah and her husband sat in the living room waiting sweetly for us to talk her through it all.

Knowing she could not control birth, knowing she could not control motherhood, but knowing she could control this: the choice to breastfeed.

Hot tea was poured into our mugs and we all sat cross-legged on the floor and began to discuss the best technique for drying up her milk. At some point, after everything had been said, Sarah looked up at us, a circle of women gathered around her, and with an open heart, shared her story.

With brief and sharp details, Sarah explained how she was a survivor of sexual abuse and that it was a dark line that cast a shadow over her body. For this reason, she could not bring herself to breastfeed her baby. The emotional memories connected to certain parts of her body were still all too real.

She loved her son, and she wanted the very best for him, and in her case, she knew the best for him was to allow these memories – which were deeply rooted into her body – to stay quiet. She could do this by keeping (some of) her body to herself.

Knowing she could not control birth, knowing she could not control motherhood, but knowing she could at least control this: the choice to breastfeed. Sarah understood that by making the choice to bottle-feed, she would be in a better place to bond with her son, giving him a love untouched by resentment.

I knew her name, but I did not know her story

I realized something that evening that I feel indebted to always remember in my work with women: after six weeks of classes with Sarah, I knew her name, I knew her due date, I knew the gender of her child, but I did not know her story.

We can never fully know the stories of the mothers we serve. As a doula and a birth educator, I’m privileged only to what a woman shares with me, and often it is simply a picture of her present life, not her past.

And if a woman shares her past with me, it is by comparison, only a tiny glimpse into the story that really occurred – a condensed version that she feels comfortable expressing on that day, at that particular time – there is much left unsaid.

The words left unspoken tell a deeper story than the words that are spoken. And because of this, I must trust that when a woman makes an informed choice not to breastfeed she’s doing so because she knows ultimately what is best for her and her baby.

In return, I must offer the best support I can give without judgement or assumptions – something that every mother is deserving of.

Our birth prejudices get in the way

Too often in the natural childbirth community we reward a woman with our support when she births like we do and breastfeeds like we do. And if she does not birth or breastfeed in ways we feel are best, we turn our back on her with our judgment, proving that we hold our birth ideologies in higher regard than the women we are committed to serving. We allow our birth prejudices to get in the way of our care.

(I hope you’ll read that statement again.)

I understand and support the unequivocal benefits of breastfeeding. I want to see breastfeeding normalized and embraced in our culture. I hope to see access to breastfeeding resources become more readily available. I happily celebrate that milk-banks are becoming slowly more common in the US. I’m a breastfeeding advocate to the core.

But first and foremost, I’m an advocate for women.

When a mother feels fully cared for – equipped with confidence and security in her abilities and choices – she is then enabled to offer better care to her baby.

I see no outcasts. I see no second-class mothers with bottles in hand. I only see mothers with babies who are in need of support and love.

And maybe when I offer her care that is free of judgment or pretense, she’ll tell me her story.

I hope so, because I’m listening.

………………………………………………………….

Something to think about:

How to Give Up Breastfeeding And Not Feel Guilty About It – Porch Philosophy

Links to explore for Bottle-Feeding Support and Education:

Baby-led Bottle Feeding

Bottle Babies

Fearless Formula Feeder

How I Survived Babydom | 17 Must-Have Baby Items

14 Nov

Ah, babydom, that magical time in a mother’s life where everything she buys, wears, eats, drinks, touches and even sleeps in has something to do with her baby. Babydom is an intensive season for new and experienced mothers alike, and just when you think you have babydom all figured out, along comes another child to create havoc on your delicate babydom ecosystem. Take heart, you will get through it – even if it’s with a little help from your friend crazytown. :)

You and I both know every mother has a unique sense of what items are needed for her particular family’s well-being. It goes without saying your must-have baby items might be completely different from mine, but one thing is for sure  – having certain items (ahem, a swing or a stroller) do not indicate how well a woman mothers her child (it’s the internet I have to say this, cuz there are crazies out there, y’all). Okay, with that disclaimer out of the way, let’s get to it. In no certain or particular order, I give to you my 17 must-have baby items:

1. Arms Reach mini co-sleeper: Having your baby near you at night is just common sense, especially if you’re breastfeeding. This co-sleeper is the right size and shape, not too big and not too little. It slides up snug against your bed, and keeps your little one within arms reach. (Get it?) A bonus for me was that I was able to keep my night-stand at the top of my bed and then add the co-sleeper just underneath it without it taking over the entire room.

2. Phil and Teds Double Stroller: I love, I mean really, really love my Phil and Ted’s stroller. There are so many ways this stroller can be used, including varieties that my kids can sit in, or even lay down in. Plus, it moves through tiny spaces on a dime, it’s compact, sleek, and I can maneuver it with just one hand while both my kids are in it, and while I walk my dog on her leash with my other hand, so what’s not to love! I’ve even jogged with mine…on rare occasions…like when stuck in rainstorms and stuff. Anyway, if you’ve got more than one child, or plan on having more than one, get this stroller.

3. HoMedics Sound machine: This hot little number has saved my sanity. I’ve tried several sound machines and this one is my favorite. It has 6 different sounds available, including a heart-beat (which most newborns love) rain, and ocean (just to name a few). Your new baby is programmed from the womb to be comforted by rhythmic shushing noises (think dishwasher). After all, imagine what they’re hearing as they sleep tight inside your tummy: your heart beating, muffled noises from the outside, and your blood pumping through your body, it’s loud in there! White noise mimics that noisy, comforting environment for your baby and helps them fall asleep and stay asleep. Plus, it’ll drown out the noise of the neighbors dog barking, or maybe it’s your dog barking.

4. Dunstan Baby Language: Not every mother is gifted with an innate ability to understand her newborn’s cry. If you’re one of them, then you need to write a book and make some money. If you’re like the rest of us, who during those first few weeks struggled to make heads or tails of the cries of your little love, then this DVD is for you. Essentially, your newborn, and every newborn on the planet, has five universal cries. This DVD teaches you how to identify and decipher these five cries, allowing you to better understand your newborn’s needs. For instance, a “neh” sound in your baby’s cry means they’re hungry, and an “owh” sound in your baby’s cry means they’re tired. Dunstan Baby Language sets you on the right track for those first 12 weeks of a newborn’s life.

Don’t just take my word for it, check out this video clip to get a better idea of Dunstan Baby Language!

 

5. The Baby Book, by Dr. Sears: This book is the grand poobah of baby books. Inside you’ll find tips for sleep, and breastfeeding, and understanding your baby’s cues, and even what to expect and when. It’s a great general resource to have on hand for any parent – no matter your parenting philosophy. Actually, I recommend all of Dr. Sears’ books (you can find a list of them here). He writes in simple everyday english, keeps his writing charming and to the point, and offers a clinical aspect that’s tempered with a parent’s heart. Make sure this book is in your library before you have your baby!

6. Aden + Anais Muslin Swaddle Blankets: Ack! I love these blankets. They’re big, they’re light-weight, they’ve got adorable non-babyish prints, they wash and dry in a cinch, they’re not too hot, and they swaddle like a dream. Go get you some, momma!

7. Mei Tai Babyhawk carrier: This is my favorite baby carrier, and I’ve used a lot out there! I like how light weight it is and how it’s easy to use. I like that I can wear my baby on my front or my back. Plus, I can throw mine in the wash (gentle cycle), not to mention, it fits easily in my diaper bag. Oh this too –  I can wear my newborn in it or my toddler. Did I mention it comes in great colors and prints? Are you sold yet?

8. Howling Wolf Herbs Bottoms Up Salve: If a girl could have a love affair with an all natural diaper cream this would be the one I would run away to Costa Rica with. I’ve written about Regina’s products before, Regina is the Owner of Howling Wolf Herbs and she doesn’t pay me to rave about her work. I believe in her products and have seen the amazing difference her care line makes. Especially this diaper salve. It’s all natural, smells a little like lavender, isn’t a white sticky cream, and it glides easily on to your little baby’s bum. And it seriously delivers! After a long and tiring battle fighting diaper rash with my first baby, I tried everything I could get my hands on – even an RX. After one application of Bottoms Up Salve, the volatile rash on my daughter’s tush started to fade dramatically. Since I’ve used Bottoms Up Salve I’ve never had a problem with diaper rash with either of my kids. Plus, you can use it with cloth diapers.

9. NoseFrida: This is the best invention that has ever happened to babies with drippy snots and the mothers who love them. If you don’t believe me, just go read these reviews on Amazon.

10. Olive Oil: When babies are fresh from the womb, for the first few days of their life, they have a very strange type of poo called meconium. This poo, while very normal for newborns, is black and tar-like, and sticks like burnt cheese on a frying pan to your baby’s soft little buns. In other words, it is a chore to clean. However, if when you change your newborn’s diaper, you apply with your finger or cotton swab, an ample coating of olive oil to their clean tushy, the next time they poop, the meconium will wipe up easily – making your diaper change a hundred times faster, and you’ll be so happy about this that you may come back and write me a thank you note – and I hope you do.

11. Kiddopotamus SwaddleMe Blankets: Swaddling is getting some mixed reviews in the childbirth community, and with reason. For one, there is a lot a baby can tell us about how they’re feeling based on what’s happening with their hands. Open palms with tense, rigid fingers mean that your baby is distressed, you’ll miss this cue if your baby is swaddled. On the other hand, soft, open, gentle fingers when nursing mean that your baby is getting full. In general it’s not a good idea to keep your baby swaddled all the time, especially when nursing – that’s actually when you want your baby skin-to-skin. However, my personal judgment tells me there is a time and place for a swaddle, and for my babies, swaddling at the end of the day calmed them down and helped them sleep. That said, sometimes my swaddles wouldn’t last the whole night through, but these SwaddleMe blankets with their velcro tabs kept the swaddle in place and kept my little ones from jerking awake with those random sleepy newborn arm waves (trust me, you’ll know what I mean when you see it happen).

12. Waterproof Lap Pads: You know how I slept with my babies right next to me, right? That meant that in the middle of night I would change their diaper right there on my bed, and these waterproof pads made that possible. I kept a small stack in my diaper caddy, (which I kept on my night stand) and at three in the morning after that 20 minute nursing session when the baby’s BM would arrive shortly after, I would lay this waterproof pad on my bed, grab a diaper and get ‘er done.

13. The 90 Minute Baby Sleep Program: Why isn’t this book more well-known? I just don’t know! It offers practical and sure-fire ways to get your baby to sleep without tears and gnashing of teeth. You can read Mommypotamus’ review and her experience with this book’s sleep suggestions here. I love this book so much – I think I loaned it to someone a while ago, because it’s been burning a hole in its empty spot on my book shelf. If you have it, can I have it back now, please?

14. Happiest Baby on the Block:  You would be surprised at how many of us out there aren’t savvy to the brilliant concept of the fourth trimester this book shares and why this matters to us and our little ones.  Essentially, the fourth trimester is the first three months of your baby’s life, and these 12 weeks or so need to mimic the life your baby experienced in the womb as much as posible. So how do we do that? With the five “S’s”: swaddling, side/stomach position, shushing, swinging and sucking. These simple comfort measures trigger our little one’s calming reflexes and allows our baby to find their happy place. The author teaches us exactly how to do the five “S’s” and explains why they’re necessary for our babies during their first three months of life. To learn more about the fourth trimester and the five “S’s”, click here for a great blog post.

15. Baby Swing: While not everyone agrees that swings are necessary, most everyone can agree that they’re useful. With my first child, we didn’t need a swing much – if ever, but with my second it gave me a chance to have uninterrupted quality time with my daughter. Plus, it was pretty much the only way I could get my son to take extended naps during the day when he was very young.  My favorite swings are the kind that swing from side-to-side rather than front-to-back. Consumer Reports has a great piece on finding quality baby swings here.

16. Radio Fuzz: Can white noise on the radio be considered a baby item? Well that depends on if your baby cries like it’s doomsday every time they’re inside a moving vehicle. Try this trick out and let me know if it works to calm your baby like it did mine. Find a non-station on your radio dial – you know that white-fuzz-static noise station and add it to your radio’s memory. The next time your wee one begins to cry at full volume in the car while you’re driving 70 miles an hour down the highway – switch the radio to your white-noise station and turn it up … loud. Your little one should stop crying very quickly and your cortisol levels should begin to decline in moments.

17. Baby Glider: Every mother should have a corner set up somewhere in the house that is her designated love, rock, nurse, and gaze at the baby station. Mine has always been in my baby’s room. I love having one spot that I can take my baby to when it’s time to sleep and nurse. In order to make my spot comfy, I looked for a great baby glider. Simple right? Well, not really. If you know me very well at all, you know I don’t make any purchase without researching it first, including rocking chairs. And according to Consumer Reports, there’s a few things you need to know when choosing one for your nursery. Look at the seat of the glider, pick up the cushion and look under it. Are there springs there? If so, perfect. If it’s just wood, it’s going to make your tush sore – especially directly postpartum. So find a quality rocker that has springs on the seat. Next, look at the arms. Are they just plain wood? If so, that’s going to be uncomfortable for you and your baby. Find a glider that has padded arms. Also, don’t do what I did and buy a white glider…children and white just don’t mix, find a nice dark shade that hides the grub and you’ll be just fine.

There you have it! My 17 must-have baby items. Did you see anything you liked? Did you see something that didn’t work for you? What are your must-have baby items? Let me know what worked for you and why!

P.S. Stay tuned for my must-haves on postpartum care and breastfeeding – coming soon!

Facts on Postpartum Depression and My Responsibility as a Childbirth Educator

4 Nov


I attended the 2012 Lamaze Conference this year in Nashville. I gained a great deal of insight on a number of topics, but the one that won’t leave me alone was the lecture I sat in on postpartum depression taught by Genae Strong, PhD, CNM, RNC-OB, IBCLC 

Having dealt with postpartum depression with both my children, and as Lamaze certified childbirth educator, I was curious to see what would be shared. I’ll be honest, the information surrounding PPD left me unsettled.

Did you know?  

  • PPD is a potentially debilitating mood disorder usually detected between 2-6 weeks after birth. (Zauderer, 2009)
  • 10-25% of women are affected during their pregnancy or postpartum period with PPD. (Bansil et al, 2010)
  • PPD is the most under-diagnosed obstetrical complication in the United States. (Earls, 2010)
  • The mother generally doesn’t have an actual estimation of the severity of her illness.
  • “PPD is a treatable mood disorder but it is not preventable.” – Genae Strong, PhD, CNM, RNC-OB, IBCLC  (Please note, there is a difference in prevention vs. preparation.)

Higher Risk Factors for PPD include (but not limited to): 

  • Smoking
  • Bottle feeding
  • History of depression
  • A family history of PPD
  • A previous episode of PPD

What’s the difference between Maternal Blues (MB) and PPD

MB includes: 

  • 50-80% of mothers experience MB (almost every mother)
  • Appears within the first few days – 2 weeks
  • Mood swings
  • Feeling sad, anxious or overwhelmed
  • Crying spells
  • Loss of appetite
  • Trouble sleeping

PPD includes:

  • 13-20% of mothers experience PPD
  • Usually detected between 2-6 weeks after birth
  • Little interest or pleasure in doing things
  • Feeling down, depressed or hopeless
  • Disturbed sleep patterns
  • Not wanting to socialize or join in – social isolation

(Womenshealth.gov)

PPD has long-term effects on the infant, including (but not limited to):

  • Sleeping difficulties
  • Eating difficulties
  • Unusual sensory sensitivities
  • Depression
  • Social withdrawal
  • Anxiety
  • Separation distress
  • Extreme inhibition
  • Shyness

(Conroy, 2012)

As a childbirth educator I need to:

  • Teach the difference between what normal and abnormal emotional and physical responses in the postpartum period look like.
  • Encourage women who stop smoking during pregnancy to continue with their efforts.
  • Encourage breastfeeding.
  • Encourage women to attend at least one postpartum care visit with a health worker.
  • Provide handouts with local support information for mothers and families.
  • Describe treatment methods for PPD (both medical and non-medical methods) and encourage their use.
  • Carefully express the reality that PPD touches not only the mother, but the most vulnerable victim – the child.

For more resources, please visit Postpartum Progress.

To screen yourself for PPD, please visit: Postpartum Support

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