January 20, 2017

What to Pack in Your Hospital Bag?

What we did was use the diaper bag for baby and then used a carry on bag with wheels for our things. Pillows wouldn't fit in the carry on, so they were in a separate big bag (highly recommend the Homegoods or Ikea sized bags!). The breast pump had it's own back pack, so we carried that separately as well. We also had a cooler for snacks and drinks.

Also note our baby arrived in December, so some of the items you will not need if born during during a warmer season, like a car seat cover.

I have provided a list below of what we had packed and I have also crossed out whatever we ended up using, so you can see what we used and did not use to help you plan your own bag. I always tend to over pack since I prefer to be safe rather than sorry! However it would have been nice to have brought less so we didn't have so many bags to carry! Luckily the hospital we delivered at lends you a cart to put all your items on and push to your car.

Here is what we packed in the baby's bag/diaper bag:
  • 2 Hats - didn't need as hospital gave us 2
  • 1 Set of mittens - didn't need as the shirts they use in the hospital have folded sleeves and so did the take home outfit we brought
  • 2 Pairs of socks - didn't use as hospital used blankets to swaddle and take home outfit had footsies
  • 2 Newborn outfits  - only used 1 for going home
  • 1 0-3 Month outfit - baby was just under 7 lbs, so didn't use
  • 2 Burp cloths - didn't use
  • 2 Receiving blankets  - only used 1 for going home
  • 1 Fleece blanket 
  • 2 Pacifiers and 1 pacifier clip - didn't use, not recommended till breastfeeding is established
  • Extra disposable newborn diapers - didn't need, hospital provided
  • Extra baby wipes - didn't need, hospital provided
  • Grooming kit (hair brush, nail clipper, etc) - didn't use
These items weren't in the bag, but in our car ready to go!
  • Car seat base and car seat
  • Car seat cover
  • Infant head support for car seat

Here is what we packed in our bag:
  • 1 Robe for mom
  • 2 Nursing tanks
  • 2 Nursing bras  - Now this is one item I wish I had brought more of!
  • Disposable nursing pads - didn't need, milk didn't come in till day 3
  • Pajama bottoms for mom
  • Socks with grips for mom
  • Toiletries for both mom and dad (shampoo, toothpaste, etc - anything you would bring on an overnight trip basically)
  • Towel wrap for mom (for laboring in tub) - didn't use, labor was too fast, didn't even labor in tub!
  • Going home outfit for mom
  • Hair brush, hair ties and bobby pins
  • Pajamas for dad
  • 1 extra outfit for dad 
  • Heavy overnight pads and adult diapers  - used only 1 for the trip home!
  • Camera
  • Suckers
  • Granola bars
  • Breath mints
  • Breastfeeding pillow (My Brest Friend)
  • 2 Pillows - we just used the hospitals
  • Breast pump - didn't use, found breastfeeding easier
  • Energy Drinks  - My husband drank one. I actually only had water.
As you can see we didn't use a lot of what we brought, mainly because I had a really quick labor and because the hospital provides so much! They even gave me a bag of supplies to take home! I also ended up wearing the hospital gown because postpartum bleeding is messy and I didn't want to ruin my own clothes. Plus the snaps made breastfeeding convenient. 

January 13, 2017

Should I Have a Birth Plan?

Labor and birth is unpredictable, so it may seem silly to try and have a plan. However, I felt it was good to have one because it gives your doctor a heads up as to what you want, though always know it may not be what you need at the time. This way, when you are in labor and in so much pain, you don't have to worry about trying to voice your wants and needs. This is where also having a Doula can come in handy.

For us having the birth plan was more so for our Doula and midwife, so they knew what we wanted. When I was in actual labor, I totally forgot about the plan. I had 3 copies in our hospital bag, but when we arrived I was already 6 cm dilated and in too much pain to care about anything else, so they never got pulled out and placed on the counter for the nurses and doctors to see. 

However, most of what was in the plan was followed, thanks to my awesome Doula and midwife! So I think having one is worth it just so everyone in the room is on the same page, but just know that you might forget all about it when the time comes and be prepared for things to change.

I have included our birth plan below, just so you can get an idea of what you might want to include in yours or talk to your doctor about. (It is always a good idea to talk to your doctor since your hospital or doctor may not allow or offer some of the options that mine did).

Our Birth Plan

Hospital Admission

 If medically possible I would prefer:
·        To delay artificial induction of labor for a reasonable period of time and only after all natural methods have been exhausted.
·        To remain at home as long as possible before heading to hospital.
·        To be assigned a nurse/hospital staff partial to natural birth.
·        To be allowed to drink and eat as desired.
·        To self hydrate and decline IV.
·        To have only intermittent monitoring.

Labor
If medically possible I would prefer:
·        To have only my husband, doula, and necessary hospital staff present during birth. No students, residents, or interns present.
·        To wear my own clothes.
·        To have as few interruptions as possible.
·        To eat and drink as desired.
·        To be able to use a fitness/birthing ball.
·        Freedom to walk and move around.
·        Intermittent and external monitoring by Doppler only
·        To be able to change positions and assume labor positions of choice.
·        No vaginal exams unless medically necessary.
·        Freedom to labor in shower or tub.
·        No epidural, but am open to other pain relief suggestions if needed.
·        To have lights dimmed.
·        To be able to listen to music if I desire (I will provide).

Birth
If medically possible I would prefer:
·        To push as my body tells me or as suggested by midwife.
·        To push without time limits as long as the baby and I are not at risk.
·        To birth in a side lying position or whatever position feels natural at the time.
·        Not to have an episiotomy, even if it means risking a tear.
·        To avoid the use of forceps and vacuum extraction.
·        A C-section to be a last resort – only if all other options have been exhausted.

Following Birth 
If medically possible I would prefer:
·        Immediate skin-to-skin contact.
·        Delayed cord clamping.
·        That father holds baby after skin-to-skin for bonding.
·        To deliver the placenta naturally.
·        Local anesthetics for any stitches - if needed.
·        For doula and husband to be allowed to take photos using our cell phones or camera.
·        For husband to have unlimited access to my room and be able to stay the night.
·        To breast feed as soon as possible with help from a lactation specialist and to use my breast pump at least once during my stay to learn how to use it correctly.
·        To have as few interruptions as possible during the “golden hour.”
·        To be given the option of pain medication after birth, such as Tylenol, for any pain or discomfort.
·        To be able to shower and change into my own clothes.
·        To be able to leave the hospital as soon as possible.

In the event of a C-section:
·        To be put under (not awake) during the procedure if possible.
·        For husband to be allowed to remain with me in the operating (if not put under) and recovery room.
·        For husband to hold the baby as soon as possible.
·        To be able to hold baby and breast feed as soon as possible in the recovery room.

For Baby
If medically possible I prefer:
·        Baby to remain with us in our room.
·        For baby to be in our sight at all times.
·        No antibiotic eye drops or eye ointment to be administered.
·        Hepatitis B vaccine shot to be given to baby.
·        Vitamin K shot to be given to baby.
·        Breastfeeding or pumped milk only.
·        We are expecting a girl, but if baby is a boy, he will not be circumcised.
·        To allow vernix to absorb into baby’s skin, delay first bath.
·        For either my partner or me (or both of us), with assistance, to give baby’s first bath.

If baby is not well:
·        My husband and I would like to accompany baby to the NICU.
·        I would like to breastfeed if possible or be able to provide pumped milk.
·        We would like to be able to hold baby whenever possible.

January 6, 2017

What is a Doula?

What is a Doula?

A Doula, also known as a labor coach, is someone who helps you through labor and acts as an advocate for you. Usually they are female and their main focus is supporting the mom during labor and childbirth. Some may even stay to help out afterwards and many offer additional services such as Hypnobirthing and placenta encapsulation. If your partner is involved, the Doula will often work with them and teach them some pain relief techniques, so they can take turns supporting the mom.

Doula's are great for anyone, but especially if you plan on going the more natural route. They will go over your birth plan with you so once you are in the hospital or birth center, they know what you want and will talk to your doctor for you. They basically act as the messenger between you and your doctor in order to follow your birth plan as close as possible, but remember things can change as birth is unpredictable.

I plan on giving birth in a hospital with a midwife, but all my midwives recommend having a Doula since they are not able to be with us 24/7, like a Doula can. It wasn't something we really considered until they mentioned it and it sounded like a good idea, especially since this is our first and we have no idea what to expect. Many of my family members, surprisingly, have had Doula's and highly recommend having one, so thus began our search for a Doula.

How to Choose a Doula?

First, I highly recommend using Doula Match to find a Doula in your area. Doula Match will search by availability for you due date and will give you profiles for all the Doula's in your area along with their price point. If not Doula Match, then my second go to would be family and friends to see who they used and recommend, or you can ask your midwives or OBGYN for their recommendations.

Doula prices range dramatically from as low as $100 to has high as $1500. This is because they often work privately so they can set their rates, and the higher the rate, the more experience the Doula tends to have. In some cases you may qualify to have a free Doula, but that depends on if your area has a program like that available to you.

Once you figure out your price point, you will want to make a list of Doulas that fit your budget and research them. Once you find one you like, you will want to interview her to make sure she is a good fit for you and your family, and that you feel comfortable around her. I have provided a list of some interview questions below.

Doula Interview Questions
  • Why did you become a Doula?
  • How many births have you attended? What is your experience?
  • Do you have a back up in case you are unable to attend the birth? 
  • Do you offer a refund if you can't attend?
  • Are you able to help with breastfeeding?
  • What are your views on pain medication?
  • Will you meet at our home while in early labor or will you meet us at the hospital while in active labor?
  • Am I able to contact you at anytime with questions?
  • How long will you stay after the birth?
  • Do you do prenatal and/or postpartum visits?
  • How do you work with and involve my partner during the birth process?
  • How many clients do you take per month?
  • How do you take payment? 
  • Would you be willing and able to take photos using our camera during and after the birth? 

Our Doula Experience

Our Doula was amazing and I am so glad we chose to have one. My labor went super fast and it was intense. I don't think I could have managed without her. She was there helping to relieve the pain and also advocated for us. This allowed my husband to stay by my side and comfort me, while she did everything else from grabbing ice chips to talking to the nurses. 

After the birth she even ran out to get Epsom salt so I could take a bath later (recommended by midwife to help with healing as I suffered a second degree tear) since the hospital didn't have any on hand. She also took photos for us after the birth.

Overall I highly recommend having a Doula. Having that extra support makes the birth experience a lot better. 

December 31, 2016

Our Birth Story

On December 24, 2016, our baby girl decided she was ready to enter the world! What I thought were Braxton hicks on the night of December 23, turned out to be real contractions, but because they didn't bother me, I went to bed not expecting to wake up around 2 AM to some intense contractions.

I ended up waking my husband around 3 AM when I noticed they weren't going away. Around 4 AM We agreed it was time to call the doctor. The doctor said it sounded like I was in early labor, but to give it an hour to see if the contractions continued or would come to an end. They only got more intense and closer together, so we decided to head to the hospital at 5 AM. We decided it was better to be safe and if we got sent home, it wasn't the end of the world.

When we arrived, It turned out I was already 6 cm dilated! Pain got even worse and the nitrous oxide gas was not working (not sure what happened here, but we weren't confident that the nurse actually had it working right), so I requested pain relief through an IV, but that didn't work either. I broke down and wanted an epidural, but by the time the epidural was ready, I only had 5 more minutes to wait for the midwife to arrive, so I chose to skip it at that point. I am actually glad that they took so long because I originally didn't want an epidural and caved due to the pain.

When the midwife arrived, I was ready to push and 10 minutes later, baby girl entered the world! I only suffered a 2nd degree tear.

I had a really fast labor, which was unexpected, especially since this was our first child. She also was a week early, which most first born are late! My midwife almost didn't make it in time, but so glad she did!

 Our Doula also wrote this lovely birth story for us:
"It began around ten o’clock at night on Friday, December 23, 2016. Mom began having mild contractions. She thought these were nothing to worry about, and after relaxing for awhile, she decided to go to bed. Mom never suspected that she would soon meet her sweet baby girl.

Around 2am, Mom awoke from her sleep and realized that these contractions were becoming more frequent and stronger. After a few hours, Mom and Dad agreed that it was time to call the midwife. The midwife suggested that they head to the hospital to get checked on progress. Was this labor?

With bags already packed, Mom and Dad headed out the door, hoping they would soon return home cradling their beloved baby girl. When they arrived at the hospital around 5am, they were surprised to hear that baby would be coming very soon! When the nurse checked Mom, she was already 6 cm dilated. Mom had completed her first stage of labor already—mostly while she had been sleeping!

Mom and Dad prepared themselves for the final leg of the race to meet their early Christmas gift. Dad encouraged Mom as contractions grew stronger, almost unbearable. But Mom was a warrior and endured the pain for another three hours until the time came for her to push baby out.

About eight o’clock in the morning, Mom’s water broke and she began pushing their little girl out into the world. Mom was determined to meet her quickly, and within ten minutes, Elsa Luna entered the world. She measured a healthy 6 lbs 12 oz and stretched to 19.25 inches. Overcome with joy, Mom and Dad embraced Elsa wholeheartedly and began their new journey as a family together!"

December 23, 2016

The Flu Shot When Pregnant

If you are going to be pregnant or give birth during the cold and flu season, you should get a flu shot and you should enforce anyone who plans to hold baby after birth to get a flu shot as well.

Here is why you should get the flu shot when pregnant according to the CDC website:
Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy make pregnant women (and women up to two weeks postpartum) more prone to severe illness from flu, as well as to hospitalizations and even death. Pregnant women with flu also have a greater chance for serious problems for their developing baby, including premature labor and delivery. (source)
A common myth with the flu shot is that it gives you the flu. This is false because you are given a dead virus:
The flu vaccine injection contains no live virus, only viral proteins, said Dr. Dennis Cunningham, an infectious disease specialist at Nationwide Children's Hospital in Columbus, Ohio. 
"It's impossible to get the flu, and it's impossible to spread the flu," from the injection, Cunningham said. (source)
The nasal spray on the other hand (which is NOT recommended for pregnant women), does have a live virus, but it has been weakened to the point that it can't harm you:
The flu vaccine that is delivered as a nasal spray, rather than as injection, does contain live viruses, but these viruses have been weakened, and so they also cannot cause the flu, according to the CDC. (source)
Another common myth floating around in the forums that I often see is that the flu vaccine contains mercury that is harmful, however that isn't entirely true:
Thimerosal — a preservative that contains mercury — has never been shown to be harmful, Cunningham said. The type of mercury linked with nervous system damage is methyl mercury, he said. Concerns over methyl mercury levels have led to recommendations that pregnant women avoid eating large amounts of certain types of fish, such as swordfish. (source)
Basically the mercury in fish is more harmful to you than the mercury in the flu shot, yet many pregnant women won't give up their sea food but will happily choose not to get the shot. I guess food is more important than health to some pregnant women.

However, for those concerned about thimerosal, you will be happy to know that not only is it safe, but you can get a flu shot that doesn't contain it:
While all vaccines carry some risk of adverse effects, such as an allergic reaction, no research has shown an increased risk of complications associated with the flu shot for pregnant women. Women can get the flu shot at any time during pregnancy. There also is no evidence that adverse effects occur in the children of women who receive vaccines with the mercury-based preservative thimerosal during pregnancy. However, it's possible to get a flu shot that doesn't contain thimerosal. Talk to your doctor if you're concerned. (source)
Not only should you get the flu shot if you are pregnant, but anyone who plans on holding baby after birth should also get the flu shot because babies can't get a flu shot until 6 months of age, so it's up to you, your family, and your friends to get the shot to prevent them from getting the flu, to help protect baby from the flu, which can have serious consequences:
Children younger than 5 years of age – especially those younger than 2 years old – are at high risk of serious flu-related complications. CDC estimates that since 2010, flu-related hospitalizations among children younger than 5 years ranged from 7,000 to 26,000 in the United States. Many more have to go to a doctor, an urgent care center, or the emergency room because of flu.
Complications from the flu among children in this age group can include pneumonia (an illness where the lungs get infected and inflamed), dehydration (when a child's body loses too much water and salts, often from not drinking enough fluids/liquids), worsening of long-term medical problems like heart disease or asthma, encephalopathy (inflammation of the brain), sinus problems and ear infections. In rare cases, flu complications can lead to death. (source)
To me it seems silly to refuse to get the flu vaccine as all evidence points to it being completely safe and will help protect your baby. Also, as someone who has had the flu before, the shot is totally worth it. Feeling like you are going to die for two weeks is no fun, and that was with medication! I don't know how pregnant women who get the flu survive!

Sources