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Hospital Checklist: Part 1 Labor and Delivery

October 16, 2019November 20, 2019 BraveSteps

As labor day draws nearer, most families begin preparing for the things they want to bring with them to the hospital, both for during labor and also for after labor. It can be a daunting task with all the variables of birth. Most people are left feeling like they don’t want to bring too much, but are also worried that they might not bring enough and every person you ask has a different list of must-have items, which can further complicate the packing process. Below you’ll find some information about things you might need or consider when packing your labor bag, but keep your own personality, needs, and situation in mind when making your final lists.

Things for labor

Food and Drink: Labor can be a long, draining process, and many hospitals have done away with the old idea of only allowing laboring people ice chips. The current evidence shows that there is no medical harm or benefit for healthy pregnant people to eat during labor, but being able to eat can certainly help make a person feel better. Bring things that can be eaten easily between contraction and provide good nutrition for the hard work of labor! Hard candy or honey sticks can also give you a quick burst of energy, and can sometimes be just the thing you need to get you to your baby. Drinks should be offered between each contraction and should be consumed as the laboring person desires, It can be helpful to have a water bottle with a straw for ease. Water can be a great option or some people make a LaborAide drink with vitamins and nutrients to help sustain the work of labor.

Socks or slippers: Many people find themselves walking the hospital halls or around their room while in labor to let gravity help things along. While shoes might not be uncomfortable, most people may find treading in bare feet inadvisable in a hospital. Socks, especially those with grippies on the bottom, or slippers can be the perfect middle ground. You can even find socks with labor affirmations or cute jokes (PUSH IT REAL GOOD!) on the bottom.

Birthing outfit (if desired): it is not necessary to wear a hospital gown at all while you’re giving birth. Many people wear their own clothes or even make or buy a special labor gown. If you’re wanting to forego the hospital gown, make sure your own outfit is easily accessible where needed. Most people find a flowy dress or nightgown sufficient, especially one that buttons down the front for easy access to breastfeed. Snaps or buttons on the back can be helpful if an epidural is chosen. Many people also find they wind up spending a lot of their time laboring naked or semi-naked, and that’s ok too.

Clothes for the water: if you plan to use a labor or birth tub or shower, you may also bring items specifically to get wet. A two piece swimsuit or a sports bra is often the clothing of choice as they aren’t likely to get in the way or be uncomfortable when wet.

Bathrobe: With all the hormones of labor, it isn’t unusual to be burning hot one minute and then freezing cold the next. A bathrobe can easily be worn or shed as your temperature needs change.

Labor tools: Labor tools are things you want to bring to help you cope throughout labor. There are many things you might bring like massage oil, heating pad, tennis balls in a sock, essential oils, or even hair combs. There are many websites and books that can give you some ideas of things you can try. Your doula might also bring labor tools for you to use in her doula bag.

Phone Charger: You’d hate to have your phone with your labor music give out just as you go into transition. Birth can be a long, slow process, especially if you have an induction, so tucking an extra phone charger gives you the assurance that you can get a little more power when you need it the most.

Copy of birth plan: If you have something written out, put at least one copy in your bag. This is something you can hand to each nurse or anyone that is helping you in your birth space get an idea of what your goals and hopes are while you labor. Try to keep it brief, with the most important points clear and easy to identify.

Things to think about: Chapstick, as hospitals are often dry, and you’ll be doing a lot of breathing during labor. Extra hair ties, since labor is not usually a time you want hair in your face. An eye mask, to help keep your world dark and peaceful. Depending on your hospital, you might need to bring official ID and you insurance card.

Things you likely won’t need: a birth ball or peanut ball. Many hospitals have a large selection of these items.

Things for partner

Your birth partner will also be with you and might want to pack their own bag. It’s impossible to tell how long labor will take, so a little planning can make everyone feel more comfortable and confident.

Snacks and food: It’s hard work being the birth partner, and you’ll need plenty of energy too. You may find it difficult to leave your laboring partner to grab something to eat, so coming prepared is important. Focus on quick, easy items like sandwiches and trail mix that give you a lot of sustainable energy and can be eaten quickly between contractions. Bring a water bottle or other cup for drinks. Consider including your favorite instant coffee or other caffeine source. You may have access to some vending machines, so some loose change or dollar bills might be helpful as well. Be mindful, however, of the smells you bring into the labor room. Many people find they are extra sensitive to smells while in labor, and may not appreciate your tuna fish sandwich.

toothpaste/gum/mint: You may find yourself very close to your partner’s face while in labor. And remember how they might be more sensitive to smells? Having something to freshen your breath can be a huge help! You might also bring some deodorant for other smells too.

Extra Clothes: Did I mention that birth can be a LONG process? Having a fresh pair of clothes after being up all night can help you feel like a whole new person. It can also be nice to have something to change into after the birth if you don’t want to go home. If your partner is planning a water birth or to use a tub or shower during labor, you might want some extra clothes in case your first pair gets wet or something specifically to get into the tub with your partner.

Phone charger: You may want to take pictures, call family, or have access to your music and other apps on your phone. You might be using your phone a lot during labor, so having the option to recharge your phone may be very important!

Copy of the birth plan: You might be the first contact person for nurses, doctors, and other people in the labor room. You should know the birth plan and be able to share a copy with the birth team.

Other things to consider: a printed list of people to call (in case your phone does die). A camera for photos.

Coming up next week: What to bring for your postpartum hospital stay. I’ll be including a free downloadable hospital checklist too!

Dos and Don’ts of Early Labor

June 28, 2019 BraveSteps

Expectant families spend a lot of time at the end of pregnancy feeling anxious. The anticipation and trepidation of impending labor and an expanding family brings a mixture of feelings from many expecting parents. Every blip, bump, and cramp is interpreted as a possible sign that labor is imminent, and the constant living on high alert sometimes predisposes people to take too much action too soon when labor finally begins.

A pregnant woman at the start of her labor stretches for a moment between contractions. She looks a bit nervous about the delivery ahead.

Early labor has many names: prodromal labor, pre-labor, or false labor. This is the first phase of the first stage of labor and is often the longest, lasting approximately twelve hours for a first time parent but sometimes lasting for days. Most practitioners define early labor as contractions up to four centimeters, though many other cervical changes may be happening during the early stages of labor too, so don’t get too hung up on the number. A few simple tips can help get you through early labor and get you into the best place possible for active labor.

Don’t stay up all night

Labor tends to begin at night when it’s dark, you’re relaxed, and your body knows it’s safe. It can also be really easy to want to jump into action when those first twinges of labor begin, but resting is one of the best ways to set yourself up for labor. Labor is more of a marathon than a sprint, so taking it easy and sleeping or resting while you can is going to do you more good in the long run. Early labor can last a long time, and you don’t want to start active labor already exhausted. If you really need help relaxing so you can get some sleep, taking a nice bath can help you relax and can even slow your contractions down enough for some good rest. Check with your healthcare provider, though, if you’re water has already broken.

Don’t time every contraction

Time will seem to take forever if your eyes are fixed on the clock and timing every contraction. Early labor can take a long time, and staring at the clock can make it feel much much longer. You can time a few contractions every few hours or when your contraction pattern seems to change. You’ll want to especially take note when you can’t talk through your contractions anymore or they require your full attention to cope. Even better if you can put your partner in charge of timing things so you don’t have to focus on the numbers at all.

Don’t call everyone immediately

You may have friends, family, doula, midwife, or dog sitter you need to or want to notify when labor begins. But unless you specifically need to have someone come immediately (out of town family, history of fast labors, other complications) no need to get all hands on deck immediately. Having more people in your home watching you is more likely to stress you out and slow labor down than help things. You could also put yourself in the situation where your friends and family are constantly texting and calling you for updates when you should be sleeping or focusing on labor. You should, however, follow your healthcare provider’s protocols on when to call them and when to come in. Your doula should also provide information about when and how they would like to be contacted when you are in labor.

Don’t start all your coping techniques

You may feel excited heading into early labor and eager to finally get to use the coping techniques you’ve been learning and practicing as you prepare for labor. But, immediately pulling everything out of your bag of tricks may desensitize you to the effectiveness of these coping techniques once active labor begins and you need them the most, making active labor more difficult and may lead to unwanted interventions. Keeping calm and relaxed in early labor is your better alternative and only using the coping techniques you absolutely need to manage contractions.

Do:

Ignore

Ignore what is happening for as long as you can. Go about your day as normally as possible for as long as possible. Go to the grocery store, complete those errands you were going to run, even go to work if you feel up to it. Remember, early labor can last for awhile, and it’s best to keep as close to your usual routine as possible. So, as long as you are able to ignore your contractions, ignore them.

Woman ignoring the world around her with headphones

Distract

If you’re finding it hard to just ignore your early labor, try distraction. Watching your favorite comedy show (I wouldn’t recommend a horror film), going for a walk, or some activity that requires your full attention can be especially helpful. Many people in labor make protein rich labor snacks or freezer meals for after the baby comes. Others work on craft projects they’ve been meaning to start. During the day, going for a nice walk can provide a nice distraction while simultaneously help baby move into a more favorable position, just don’t overdo it.

Relax

Relaxation can help you rest as well as encourage the production of labor inducing hormones. Try whatever is relaxing to you (within reason). Taking a bath is a common suggestion, especially if you’re having a hard time getting to sleep. Other suggestions can be a massage, a relaxing meal, meditation, or listening to relaxing music. A truly relaxing environment will make you feel safe and calm, which can nudge your body into active labor.

Young pregnant woman having massage in spa salon

These tips may not guarantee an easy labor, but it they will help you enter active labor as calm as and rested as possible, which will help your energy and mood.

Want some more help or support for your labor? Set up a free consultation to see how doula could benefit you and your birth.

How to Make Your First Day Back to Work Less Stressful

February 23, 2019 BraveSteps

Having a baby is stressful. Having a job is stressful. The first time you combine working after you have a baby can compound these stressors into one of the most worrying transitions in a person’s life that can cast a shadow over your precious maternity leave. But the return back to work doesn’t have to be so stressful with some prenatal preparation and a plan in place. Below are some of my top tips for returning to work.

Be confident in your childcare choices

There are so many different childcare options, it can be hard to know what is the right choice for you and your family. Exploring your options before you give birth and having a solid plan can really put your mind at ease as your return to work draws near. There are many different ways to make sure your baby is loved and well cared for such as working off hours from your partner, have family watch your child, home-based daycare, or center-based daycare. You can also hire a nanny to come to your home to watch your child or send your child with a fellow parent to watch while you work. Exploring several options through interviews or tours of different facilities may take a lot of time and effort, but you’ll likely feel much better about your choice if you’ve seen many options before making your final choice.

Take the extras to your chosen childcare

If you’re childcare is outside your home, you’ll have a lot of extras things to make your baby’s transition as smooth as possible. Dropping these things off ahead of time will make that first day feel less rushed and more smooth. The following items can easily be taken to your care provider a few days before you begin care:

Diapers
Wipes
Diaper cream
Crib sheet
Extra formula or frozen milk (check your care provider’s policy on how much and how long they can store consumables)
Finger food and snacks (if you’re starting with an older baby who is already eating solids)
Extra clothes (at least 2 sets)
Weather appropriate outside clothes (sun hat, sunscreen, winter hat, mittens…)
Any other comfort item for your child (pacifyer, favorite toy, blanket, etc).

Bringing these items in advanced also gives you a buffer day in case you forgot an item or realize you need to buy extras to stay with your care provider. This extra time will also help you talk to your care provider about any policies or procedures you may want more information about regarding the care of your child.

Finally, don’t forget to label all items before sending them to a care facility that may have many children with the same or similar items. Permanent marker is easy for consumable products like wipes or disposable diaper packages. Marking clothing tags or using stick-on labels can make less permanent marks for items that may be used if you have multiple children or wish to preserve resale value of some items.

Ease your way into a routine

A day or two before your actual first work day, a practice half day, can be a perfect way to ease yourself and your child into your new routine. Practice getting up and seeing how much extra time it takes to get ready and out the door. If possible, take your child for a half day with your childcare provider. Your practice day can gives you time to say goodbye to your child without feeling rushed or distracted by work start times. If you realize there are extra things you still need for childcare, you have some time to run to the store to pick up these last minute items. If you are planning to pump at work, this can also give you some practice with your pump to see how long set up, pump time, and clean up takes. I’d also suggest wearing your work and pump gear so you can work through potential problems without feeling guilty for missing work time.

Other possibilities to make the transition back to work less abrupt can be actually working half-days for the first week or two. It’s much easier to manage being away from your child for four or five hours and work your way up to eight or nine hours instead of starting with the nine hours right away. It can also be helpful to start back to work on a Thursday or Friday (or whatever day comes before your day/s off). It’s much easier to manage a few days knowing you’re going to have a weekend to reconnect with your child than to start off with a long, full week of work.

For pumping at work: have a pumping plan and practice

Nothing is worse than needing to pump, fumbling trying to get all the parts together, and working to figure out how to your new, unfamiliar pump turns on. Your breasts are swollen, heavy, and tender, but you just can’t seem to get it right.

Before you return to work, you should look through your pump’s manual and follow any cleaning instructions necessary prior to first use (many require sterilizing some parts before first use). You should also check that your flanges fit your breasts correctly. Most breastpumps come with medium sized flanges, but small and large sizes are available with most models, and having the right size can make a HUGE difference on milk output.

Practicing actually using your pump a few times at home when your baby is close can also help you find and correct any issues without being separated from your baby for hours at a time. This practice will also help you build up a stash of milk to ease the pressure to pump enough while you’re getting the hang of your routine. Wear your usual work attire (at least tops), so you can see how easily accessible the clothes you have are with pumping as well as practice using any hands-free pumping bras you might have. There are many options to when is the best time to practice. You can try pumping both breasts directly after any (or many) feeds. Or, after a feed, when you baby is napping, pump using just the last breast your baby nursed on (aim for a time you think will be a longer nap). When baby wakes up, use your unpumped breast to feed first. If building your supply and stash is your main need and concern, milk production is highest in the early morning hours, especially middle of the night, so adding an extra pumping session in the morning will give you more than an evening pumping session. I wouldn’t, however, recommend you make 3AM your first practice pump! Remember that the amount of milk you get pumping is not the same as the amount of milk your baby is taking in, especially if your added extra pumps in if your baby is still feeding 100% from you. It is very common to pump less than an ounce until you are actually replacing meals with pumping sessions.

For pumping while you are working, plan to pump at least as often as your baby will be eating while you are away, especially as you are just getting your pumping rhythm going. You will likely want to pump every two to four hours, depending on how old your baby is and how responsive you are to your pump. You should attempt to have a plan for where to pump before you return to work. If you don’t know where you can go, talk to your boss or other people in the office that might have recently been pumping for their baby. There might be secret work spaces that you aren’t aware of that will be a nice private place to pump.

Depending on the flexibility of your work, you might need to get creative with pumping times. Pump during your lunchtime and any other breaks you have. If you can pump at your workspace, you might only need to pause briefly to set up and clean up in between continuing to work. If you are having difficulty keeping up with your child’s needs, you can try pumping on your commute if your pump has a battery option or car adapter. If you still can’t keep up, you could try extra pump sessions at home or during the weekend or supplement with formula (breastfeeding and pumping doesn’t have to be all or nothing).

You’ll also need a storage and cleanup plan for your milk. Using a community fridge or mini fridge works well for storing milk pumped while at work. You can also get small coolers made specifically for breastmilk (many fit your pump bottle perfectly) with ice packs, which can safely store milk for up to 24 hours before needing to be transferred to a fridge or freezer.

With some preparation and planning, your return to work can go smoother than you ever imagined. If you’re still worried about your specific circumstances, schedule a free consultation or look into the back to work planning and support package.

Fertility: Tools of the Trade

January 9, 2019January 14, 2019 BraveSteps

Expecting a baby comes with a lot of excuses to shop and prepare, but there are a lot of things you can purchase or learn to prepare for trying to conceive. This is a list of the best tools to help you achieve conception.

Chart for tracking your cycle

This can be a paper chart, like the one found here, or there are many apps that help you track your cycle. Charting helps you keep track of all your fertility information as well as gives a visual for interpreting this information. Some health care practitioners will take the information from your charts to help guide the next steps in fertility treatment or to get a more accurate due date once you achieve pregnancy.

cervical mucus and cervical height

Now, these aren’t exactly things that you go out and buy, but your cervix gives you important information when determining your most fertile days. In a usual cycle, your cervical mucus gets wetter and stretchier as you approach ovulation until it reaches a consistency similar to egg whites. This sticky, stretchy cervical mucus usually appears on the days surrounding ovulation and helps sperm survive longer and move quicker to the egg. Seeing this kind of mucus is a sign that you are at your most fertile and is the best time for sex to achieve pregnancy.

Your cervix height also changes throughout your cycle. When you are infertile, the cervix is usually low, firm, and closed. As you approach ovulation, the cervix softens, may open slightly, and feel higher in the vaginal canal. While this fertile symptom often takes some practice to determine, it can be a helpful hint if you are in your fertile window.

A Thermometer

This isn’t just any thermometer, but a basal body thermometer for determining your basal body temperature (BBT). A basal body thermometer gives you a more accurate and precise temperature reading than a fever thermometer, and you need the more accurate reading to determine your BBT, the temperature of your body at it’s resting. Your BBT can be used to detect small changes in temperature without the influence of physical activity interfering with the results, so you should take your temperature first thing in the morning, after at least four hours of continuous sleep. You shouldn’t get up or make any big movements, so make sure to have your thermometer within arms reach as you sleep.

This temperature is the most helpful way to see if and when you ovulate in a given cycle. The dominate hormone at the beginning of the cycle (pre-ovulation) is estrogen while the dominate hormone at the end of the cycle is progesterone. Progesterone is a warmer hormone and will raise the your basal body temperature at least .2 of a degree in comparison to the beginning of your cycle. A cycle with this temperature shift almost always indicates ovulation has already occurred. This shift confirms your other fertility symptoms did lead to ovulation and lets you know that successfully ovulating is not a problem. 17 consecutive days of high temperatures also is a good indicator of pregnancy achievement, which leads to…

Pregnancy Tests

While the common suggestion is to wait until a missed period or 17 consecutive days of high temperatures to take a pregnancy test, many people find it hard to wait that long to take a home pregnancy test. But the cost of taking several pregnancy tests a cycle can add up, especially if you’re springing for the digital tests. Luckily there are cheaper options that are just as sensitive and accurate as the more expensive options. These cheaper versions work the same way as their expensive counterparts but usually come without the plastic packaging around the test strip. Some of my favorites are Wondfo (found on Amazon) or the Dollar Tree HPTs. Many people sometimes follow up a positive inexpensive test with a digital test that has the unambiguous “pregnant” or “not pregnant” just to be certain they really are pregnant. Just remember first morning urine will give you the most concentration of HcG (the pregnancy hormone) and gives you the best chance of getting an early positive.

Honorable mentioned: prenatal vitamins and preseed

Neither of these are necessary for fertility, but could still be important when trying to conceive. A prenatal vitamin, especially one that has folic acid or folate, can help build up important vitamins in your system before conception. Taking folic acid in early pregnancy has been shown to reduce neural tube defects like spina bifida by 50%. Some studies also suggest it can take several months to build up the proper amount of some vitamins, so go ahead and begin taking those vitamins now.

A lot of people don’t know that many sexual lubricants can actually get in the way of conception. Many lubricants make it difficult for sperm to survive and slow down it’s ability to move towards the egg (though lube should not be used as a contraceptive). Preseed and other fertility friendly lubricants are designed to mimic cervical mucus and aid in conception. While preseed isn’t necessary, it can make sex easier and more enjoyable than going without a lubricant or can help improve the possibility of conception if you’re concerned about the quality of your cervical mucus.

Pels.com

While there are many other things that might be helpful or even necessary for conception, I’ve found these are the best things to focus on and master to help you understand your fertility and get the best results for the most people.

Still confused or need some help getting started with fertility charting? Or maybe you have hit a road block and want some help troubleshooting. Check out my one on one fertility support packages or join the new fertility coaching course to learn more about your body and fertility charting. Remember, for the month of January, get your second month of fertility support free when you buy your first month.

What is an E-Doula?

November 29, 2018 BraveSteps

I had my first child almost five years ago while I was living and working in Japan. I didn’t know anyone in my city that had given birth recently, so I took to the internet to find pregnancy and birth information in a language I clearly understood. I also wanted and found emotional support from fellow pregnant people in online forums and eventually in a small due-date group that is still an integral part of my parenting support team.

It was through these groups that I really understood what a birth doula does, and I was so upset that I wouldn’t be able to have one. Even if there was a practicing birth doula in my city, I had no idea how to find her, and it would be unlikely that she would speak English. So I went without, and muddled through learning about pregnancy, childbirth, and the postpartum period on my own while simultaneously trying to inform my husband on what he would need to know for the birth as well. It went OK, but after a much more informed and relaxing experience with the birth of my second child, I knew how different it could have been, and I know working with a doula could have made a huge difference as part of my preparation and plan for my first birth.

When I began my doula training, I learned about so many different fields and services that different doulas offered. One of the more unique ideas was providing E-Doula services, and I immediately knew it was a service I was going to offer.

An E-Doula provides many of the same services as an in-person doula, but offers these services through video conferencing, text, and e-mail. This service is perfect for someone who lives in a rural area, those living in a foreign country, or someone that may not be comfortable inviting someone to their birth space but is looking for more personal informational or emotional support than a childbirth education class would offer. Below are some details of what E-Doula Services look like.

Most doula services include several prenatal meetings. During these meetings, doulas provide informational about your birth options and guidance and support for creating a birth preferences list to help you achieve your ideal birth. A doula also educations and supports you and your labor partner’s understanding of what birth looks like and how to cope with changes your body goes through. An E-Doula can provide these same services over video conferencing. She can support and train your labor partner to be your biggest supporter through your labor so you all enter into labor confident in your knowledge and skills.

Late pregnancy is also a time of excitement as you make the final preparations for your new arrival. It’s also a time of uncertainty as you wonder if each twinge is a sign that baby is ready to come. A doula often works as your emotional support through the end of your pregnancy, giving you a sympathetic ear as you worry about being pregnant forever or when you need someone to remind you it’s OK to slow down and take care of yourself. A doula is also armed with up-to-date information to give tips and tricks to deal with any pregnancy concerns as they arise. An e-doula is no different from a traditional doula, offering unlimted emotional and informational support through e-mail, text messaging, and phone calls.

During labor is where E-Doula support really starts to look different. While an E-Doula can’t show up to support you physically through labor, she can be on call for anything you need or questions you or your labor partners might have. Video conferencing is also an option during labor to give you and your doula a good picture of what is happening and can give0 suggestions and help to you or your partner. Your doula is a great option to have someone to call for a quick adjustment when things don’t quite feel right and can guide you and your partner through the stages and phases of labor.

Finally, and E-Doula can help support you through the first few weeks of your newborn’s life. The transition to being a parent is a steep learning curve and can feel especially lonely and difficult if you live in an area without other parents of newborns to talk to. An E-Doula can provide needed emotional and informational support for all your needs postpartum. From something like umbilical stump care to a listening ear to process the birth experience, your E-Doula is just a text or phone call away.

Interested in learning more about what E-Doula services might look like for you? Check out services and pricing or send me a message.