My BFF's husband, Brian. Holding a walnut.
If you're expecting a baby or have a new baby at home, you might feel slightly overwhelmed? No? You might feel like it is imperative that you know absolutely everything about pregnancy, breastfeeding, motherhood, immunizations, daycare, and kegels?
I know these are understatements, because every time I meet a new mama or a mama-to-be, I see a wild-eyed, information-starved, overloaded woman who just wants to know everything.
I can relate to the overwhelm and the constant drive to learn more. A few years ago I worked as a patient advocate for clients living with HIV, and I remember frantically searching the internet for answers, calling pharmaceutical reps so that I could confirm suspicions before confronting doctors, and literally standing in the doorway to keep a doctor in the room until he gave me what I wanted: one more test for my client. This is the Mother Lion behavior, a true testament to one's willingness to find their voice on behalf of someone else. Are you thrilled about being a mother lion? I'll wager you'd say half yes, and half no. And you're right on target. I'm about to give you the skills to be the mother lion on behalf of your child and for your own health as well, and it thankfully involves little internet research, bargaining, bribing, or accusations of wrongfully detaining a physician against his will. Which may or may not be a crime in Colorado.
I recently took a training from CAPPA to become a certified lactation educator, and during that training I learned a very important acronym that sums up exactly what you need to know. Because I'm afraid of intellectual property and all that jazz, I've modified it a bit to become my own.
CAPPA encourages clients to use their BRAIN when they must make a medical decision, so I'll recommend you ask BRIAN. My version comes with a handy cop-out, should you ever need to leave the room. Instead of saying, "I'll have to consult my brain" you can easily say out loud to yourself or to your partner, "I'd like to run this by BRIAN." Hint. Hint.
When confronted with a medical decision (someone suggesting a procedure, medication, or other treatment), ask BRIAN. Well, BRIAN E. And remember, if there are two patients involved (you and baby) make sure to ask the question for BOTH of you. Often mamas defer to what is healthy for baby without asking what she might experience, too. If you want your baby to have the best care available, you must make sure your baby has a mother well enough to deliver that care!
Benefits. What are the benefits of this treatment? This is something the person will likely list for you automatically, but occasionally they do not articulate the benefits because they believe the treatment to be the best option out there, or possibly accept it as common practice. No harm in getting the skinny (with sources, if you're hesitant or want to do your own research).
Risks. What are the risks of using this medication or treatment? This is also something they are likely to disclose, but not always in conversation. Usually these are the items listed on a release waiver, informed consent paper, or literature from the manufacturer of the medication or treatment.
Intuition. What does your gut say about this treatment? This is why you might need a few minutes away from the person offering the treatment so that you can gut-check. Does your gut check matter? Only to you. This isn't some wacky hippy yoga instructor gobbledygook. This is actual science, from a medical anthropologist. People must believe that the treatment/medicine they will take can work. Even clinically tested medications do not work all of the time, and they work less well and less often if the patient has no faith in them. You will actually know how you feel instantly, but it might take you a little while to articulate how you feel. Give yourself a little time, if you can (see N).
Alternatives. Ask what other possibilities exist besides the recommended course of action. Perhaps there are a few that have their own benefits and risks, but if you'd like to be an informed consumer, ask for the names of other medications or treatments so that you can do a little of your own research. This is also a great time to ask the provider why they would select the option they are recommending instead of these procedures. Sometimes it is because they believe the course of action is the best for you, and sometimes it is because they are more familiar with what they are suggesting. If their answer is "I don't feel comfortable performing that procedure myself," you probably don't want them to perform it, either! That doesn't mean the procedure itself is inherently flawed, it may mean you need a referral to someone else.
Nothing. What would happen if you took no action? Are there risks for waiting to do this treatment or start this medication? When will the window of opportunity close?
Expert. This is my bonus addition. I know it makes Brian a little tougher to remember, but you can write it on your hand if you must! Ask the person who is suggesting this medication or treatment to refer you to an expert on the topic. Even if they are an expert, there is nothing wrong with a second opinion.
Now, to play through in two FUN scenarios to drive the point home.
Pregnant mama is experiencing lots of discomfort during her early labor. Her nurse suggests she try taking a shower.
What are the benefits of taking a shower?
What are the risks of taking shower (to me AND to my baby)?
What does my gut say about a shower right now?
Are there other things we can do or medications we can take?
If I don't feel like taking a shower now, will I be able to take it later? What might limit my opportunity to do so?
BONUS: Is there someone who is familiar with pain relief techniques that I can speak with?
New mama is concerned about how much her baby is eating. Her pediatrician suggests offering baby a bottle of formula once a day.
What are the benefits of using formula? (for me and the baby)
What are the risks of using formula? (for me and the baby)
What does my gut say about using formula?
Are there other alternatives to using formula?
What would happen if we do nothing? How will we know when we need to do something or come back and see you next?
You're on a wonderful journey to be a mother, and no one will expect you to turn around and deliver the next baby! Your job isn't to be an expert about everything you could possibly confront on this journey.
Every time you meet with a doctor, midwife, therapist, nurse, or practitioner of any kind, put BRIAN E. in your bag. It will save you from Doctor Google and information overload.
I'm an expert list-maker.
If you are the list-making type, you may notice that your pregnancy has pushed you into overdrive. Never made a list in your life? This is a great time to learn how to manage one or two.
Everyone is, or will be soon, asking you about where you are registered for baby items. You may have no clue what you really need, and might therefore default to the list the store gives you, what your mom/best friend says, or worse (in my humble opinion)anything you can train your scan gun onto. I've addressed the bare-bones pre-baby list in my Registry List, so you know what I think you need.
Before you panic, remember the two things you must have before baby is born are boobs and a carseat. If you're currently pregnant, you're halfway there.
But for number three, I recommend a couple of ways to get what you need and not much that you don't.
1. Poll your friends. Not the friends you wish you were like, or the friends who have twice as much disposable income as you do, but the friends you think you might be most like as a parent. Ask them what they use most, enjoy most, wish they had received.
2. Find out why they like it. Maybe you've forgotten that you bought them an infant xylophone in a half-hearted attempt to fulfill a registry request but they remember. The reason might be relevant to you, or it might not. Diapers might be gender specific. Strollers are car, carseat, activity, and region-specific.
3. Ask them what they never use/thought they would use/have extra of. Most of the new mamas I encounter are thrilled to purge anything they aren't using. There are truly only so many swaddling blankets that one baby can use, and some babies might use pacifiers while others never take to them.
4. Forget the big-box registry. I know this is sacrilegious, because you don't have the opportunity to use the scan-gun. But I will bet you that the items your friends recommend will not come exclusively from one or two stores. Do you want to lock your family into shopping at one large retailer? Or would you like a few unique items from local stores?
There may be other sites like this, but I've heard great things aboutmyregistry.com. You can register for items found anywhere online, and your friends and family can find the item that suits them best. This list can absolutely be your new BFF.
More registry suggestions....
I'd like to think I know a thing or two about birth. I've attended dozens of births, read hundreds of birth books, and observed a number of birth classes. In fact, I wrote my undergraduate thesis on how what "we" say to pregnant women can affect their perception of the outcome of their labor.
So when students ask me what kind of birth class to take, I have a few opinions on the subject.
Consider the benefits of live, in-person childbirth classes:
- In contrast to books and media classes, live classes are interactive which means you get your questions answered, but also those of other students. Questions you didn't even know you had!
- You get to move around. Rather than just looking at pictures or video of birth positions, you can actually move and get feedback from the instructor.
- Accountability to attend each class for you and possibly your partner, too. Even the best-laid plans to read books or finish seminars at an individual pace can quickly be usurped by the parts of birth preparation you think are more fun, like baby registries, showers, and assembling baby furniture.
Five reasons to look beyond the hospital (for class):
Sometimes hospitals offer a very inclusive and tremendous birth class, but often they are short and focus on the hospital procedure rather than the robust variety of topics and perspectives you're likely to get at an independent childbirth class.
1. You learn about birth (which is a normal thing, BTW). Literally everyone walking around out there was born, so this happens.... every day! You will learn about how your body will move through different stages of labor, learn tricks and tips to make yourself as comfortable as possible, and so will your partner.
2. You will meet other couples who you will get to know for many weeks. Most hospital-based classes are a little shorter and much larger in numbers than the other classes, which means you don't get the opportunity to connect with the other couples. This is great for partners who don't get the connection at prenatal yoga, and often don't seek out other parents-to-be. Many times these childbirth classes hold reunions a year later. If you don't yet have a village, this may be a great place to start forming yours.
3. Lending Library. Your hospital may also have a lending library, and certainly your local library has hundreds of books about birth. How will you choose? An out-of-hospital childbirth instructor often has a few go-to books that they know students appreciate and will typically lend them to their current students at no additional cost.
4. Personalization. Hospital classes typically need to cover a list of particular objectives, which may or may not be relevant to you. Independent childbirth classes are more fluid and customizable. Depending on where you live, you can find classes for high-risk mamas, first-time mamas, single mamas, mamas of multiples, lesbian mamas and more. Even if your class isn't specific for a particular group, your instructor will quickly learn about your values and help offer the information you're looking for.
5. They acknowledge that birth can happen outside of the hospital. They will not force an out-of-hospital agenda on you, but if you are the kind of person who is curious about the differences, they will share them with you. I know several mamas who planned their births in the hospital and wound up spontaneously delivering outside of the hospital because they could not transport in time. An independent childbirth class prepares you for the spectrum of birth possibilities.
Questions to ask the teacher:
Do you have any preference about where I choose to birth my baby?
Can I ask you questions outside of class, via email or phone?
Do you have a lending library that I can use?
How many mamas/couples will you accept in a particular class?
What is your birth-background?
Where were you trained as a childbirth educator?
How to tell if the teacher is one of your people:
Do you welcome same-sex couples?
Is there a faith background that you utilize in your teaching?
Will I be uncomfortable in your classes if I do not share your faith?
Will we be using art in this class?
When you leave a meeting with your doctor or midwife, do you feel fantastic? Questions answered, worries allayed, empowered and ready for the next step?
If you're like many of my prenatal yoga clients, the answer isn't always yes. For many women, their choice in maternity care provider was based on a rogue recommendation or internet search, the "preferred" list on an insurance provider page, or the person you were already seeing for your gyn-needs. Sometimes a woman winds up with the provider who was able to accommodate her first prenatal visit in the shortest amount of time. As your visits progress, if you're starting to feel uncomfortable for any reason, it's time to look outside the box.
You may have a misunderstanding of the "rules." Do you think so? Let's check.
Rules About Switching Prenatal Providers in the United States:
1. There are no rules.
Well, that was easy! Often women feel trapped with one provider even though their gut is telling them that the provider isn't the best fit. Sometimes there is nothing wrong with the current provider, but the woman meets another provider and feels so much better about that person that she's tempted to switch. And sometimes there is a poor fit between a woman and her provider and she's (interested in) running for the hills.
How to Decide Whether to Switch:
Visualize Your Birth. It's ok, I'm a yoga teacher, I'm allowed to tell you to visualize your labor and delivery. I promise, you won't hurt yourself. First, visualize with your current provider. Imagine how they will want to interact with you during your labor and delivery. Will they take charge or let you take charge, as you prefer? Will they consult you for options and make sure you are heard, or do what they are accustomed to without asking your permission/opinion? Write down how this imagined birth made you feel. Then, imagine either the provider you'd like to work with or your ideal provider and go through the exercise again. Write. Compare/contrast.
DTR: Define the Relationship. My BFF and I agree that everyone should DTR with everyone they know, weekly. We're borrowing the practice from the Mormon faith, but we think it applies to everyone equally. Before jumping ship and changing providers, have a conversation with your current provider. Tell them what is worrying you and how you'd like them to interact instead. They can tell you whether or not your wishes are possible, and that will give you grounds for a stronger relationship with them, or a new partnership with someone else.
Explore the Green Grass... with a fine toothed comb. In your current state, you might actually think that your newly preferred provider is exactly as you imagine. Before terminating the relationship with your current provider, make an appointment with this new person and DTR with them. Make sure you're getting the interactions that you wanted.
Face Value. Get honest about your reasons for switching, especially if you can't seem to find anyone that lives up to your standards. The cards you've been dealt might limit some of the options you're seeking. For instance, if you are having twins, a home birth isn't going to pan out this time. If you have certain complicating factors, explore all of the options available, but know that no provider will be able to deal you a new deck of cards.
If you decide to make the switch, know that you'll have some paperwork to do. Have a conversation with the office staff for your new provider, your insurance company, and your partner. Make sure you keep clear receipts, get the full copy of your chart and lab work from your previous provider, and keep your perspective focused on what money cannot buy: your (and your baby's) health.
Have you seen People magazine lately? Do they always have so many photos of pregnant celebrities or stars with their brand new babies? We know the babies are cute, but the celebrities themselves can often make us feel, well, ordinary.
This is because they have personal trainers, nannies, nutrition professionals, tailors, and other artists whose job is to make them look this way. I promise you, if you had personally custom-tailored maternity clothing, you'd look like that too. Have you ever seen what a celeb looks like first thing in the morning? Take a look in the mirror, love, because that's what they see, too.
In the 1950's doctors recommended that pregnant women gain 15-20 pounds during pregnancy. Many of our mothers and grandmothers (who lived through this era) hold that mentality as their fundamental belief and might not support the healthy changes that your body is making. Tell them that they are not helpful, and then tell them (lovingly) to go sit on a tack.
Want to know the current recommendations? They build upon your pre-pregnancy body and depend on how many buns are in the oven.
Body image is no small matter these days, and if you've always been fit it can be particularly disconcerting to watch your body grow in new and profound ways.
Wear clothes that fit: Nothing makes you feel worse about how you look than ill-fitting clothes. This is true whether or not you are pregnant, but it is much more noticeable when nothing in your closet fits. Unless you are a seamstress, it doesn't make sense to alter your clothing, but it does make sense to find clothing that makes you feel good about yourself. Maybe that is a scarf or sweater, or some lovely jewelry that will fit no matter what. You might consider renting something for a special day, or even for a period of time if it will help you feel more comfortable and confident.
Focus on nutrition: This is no time to restrict calories or adopt a limited diet, so focus on eating according to the recommendations of your provider. They are most likely to suggest lots of vegetables, fruits, beans, nuts, seeds, and water because these are the most nutritious foods. Try cooking new recipes that focus on nutrition and consider what you are really hungry for. If you are eating to cope with stress, try something else to remove the stress because baby is feeling it too.
A few of my favorite recipes?
Aloo, Gobi and Chard
Hurry, Curry (lentil dip)
Believe in miracles: Because you are one. No, I'm not being a silly yoga instructor here, you are literally creating another person out of the food that you eat and the thoughts that you think. What impression do you want to give to your child? That they wrecked your body, or that they were your first experience of a true miracle?
You know how much I love doulas... I think they are just about the COOLEST people on earth. A doula takes the best part of a superhero and the best part of a best friend and makes something twice as good as both.
So how do you choose someone who will come into your house, share in one of the most important days of your life, see you vulnerable and nude, and possibly lay hands on you? Selecting a doula is easy, but it isn't simple.
Research First: Do the doulas in your town have regularly scheduled meet and greets? My guess is that they do, because they want to meet you just as much as you want to meet them. Find a time when you can attend a gathering, or do some research online. If you attend prenatal yoga, you might be able to ask about who the other participants are using, have interviewed, or think about birth support.
Keep Your Mind Open: You might have a very concrete sense of what you want for your birth (you can read my opinion about birth plans), but what is more important than the "plan" are the values. If you are strongly interested in one manner of birth, it is important that your doula supports you. However, your doula may be able to offer you more guidance than you thought you needed, if you keep your mind open to additional information and opinions. Listen to what they offer and most importantly why they provide the services they do. This is why...
You Must Meet and Interview THREE: Some doulas have gorgeous websites, lovely photos, and lists of helpful resources. Some have a modest online presence. Some aren't online at all. Regardless of how much you like someone's persona on the interwebs, you're not birthing your baby there, so meet them in person.
Trust your GUT: You know what they say about mother's intuition? Let yourself try some on. If all the signs point 'yes' but your stomach or your heart say 'no' then listen to yourself. The doula will not be personally offended if they are not selected, because they know they are likely to be one in three that you're choosing from. This is part of the business.
Look Early, Book Early: If you think you'll want to use the services of a doula, start researching early (like immediately, if you're already pregnant). Once you find the one you want, book early. A doula can only attend one birth at a time, so be aware that a great doula might have a very full calendar. Understand their rates and guarantees in terms of availability and make the right choice for you.
Back up: Doulas, superhumans that they are, can get sick. They can experience a death in the family, or wind up with two mamas in labor at the same time no matter how well everything else is planned. Ask your prospective doula(s) what they do when they're not able to attend a birth and how they will offer support, or who they will send instead.
What else did you do when selecting your doula? Were there questions you wish you would have asked?
Ok, maybe they don't say the sailing bit, but it makes just about as much sense. You can't possibly hold onto every moment that goes by, because if you did you wouldn't have time to watch it (or you would be making a video of you watching a video). It is the slimy paradox of easy camera access these days. Have you traveled to any of the local wonders in your town and experienced the tourists taking in the beauty of the Garden of the Gods or Malibu Beach or the Biggest Gumball in Texas? Have you noticed that each one is hiding behind a small, squarish box made of metal and glass, squinting one eye?
This may be how your child remembers you, if you're not careful.
Now, I'm not saying you shouldn't take pictures of your children. You should. You should take lots of pictures, videos, sound recordings, and you most certainly will want to encase parts of them (the children) in cement or dough (briefly) to preserve just how tiny that little hand or foot was. But you should also write stories, do interpretive dances (together), have private moments and just be. Because the beauty of a photo is that it remains the same forever. It can be touched up to hide those unsightly wild hairs or colorized and digitally remastered to appear old timey or even more fabulous. But it can never get any sweeter, the way true memories do. Unless you're steadfastly attached to grudges about all of your exes, you probably think better of them today than you did the day you broke up, right? The same may be true of your favorite memories.
Just as yoga exists between the asana, the beauty of life exists between the photographs.
Hire a pro. I know that there are dozens of apps for taking and forging images out there, but nothing compares to the quality that a professional can get. That's why they are professionals. They will make sure you look natural and fabulous, and you'll be glad you did.
Spend at least as much time on each side of the lens. Even Hitchcock made an appearance in each of his films, and so should you. Otherwise when baby looks back 50 years later they will wonder what you looked like and why you were so intent on harassing them in every moment of their lives.
Back them up. Print them, email them, store them on hard drives. You decide your privacy factor, but make sure that whatever you're doing doesn't live exclusively in your iDevice or at one place or another. One of the best games for a rainy day? Look at old photographs (this requires old photographs).
Share the LOVE. However you choose to do this is up to you. Perhaps private albums on Picasa or Facebook, or publicly as the face of your product. This helps those of us who live far away avoid the "Oh my GOSH have you GROWN UP!" comments that every child fears.
Give them the power. In the hands of a child, anything is possible. Once they can manage the complexity of iPhotography, hand them the brick and let them shoot. See the world through their eyes. You might be surprised by what you see!
What my baby looked like, except she had pants.
I was so excited when my parents came home from this hospital with my new baby brother (I was five years old and had had a baby of my own for years at that point, and thought it was about time my mom had one, too). As soon as he got home, I tried to share my expertise in baby handling, but was frequently informed that I was "too small" to hold the baby or that the baby was "too big" for me to carry around.
After a few weeks, this became rather tiresome. While my parents made a concerted effort to keep me in the loop, I remember feeling sad that I now had to share my adoring audience with a baby who, unlike my baby, cried, pooped, and did not go into the bath with me. Two particular memories bring me back to this trying time:
The Apocalyptic Meltdown: Immediately after his baptism, we opened the family home to (what felt like) three thousand of our closest friends. They all introduced themselves to me and immediately asked "How do you like your new baby brother?" I was a mostly polite child, and I liked when people talked with me, so I was kind and generous for the first 1,500 visitors. But the turning point came about an hour into the party (and before cake, if there was any cake) when I announced to the room that, "If one more person asks me how I like my new baby brother I'm going to my room and never coming out." You know how this ends.
The Great Escape: A few weeks later, my mother on her last nerve and I on mine, I decided to illustrate my maturity and acrobatic strength and agility by scaling my brother's crib, removing him, and carrying him about 100 feet around the house and into the kitchen. When my mother tells this story, she says I "... missed hitting his head on the edge of the kitchen doorway by an eighth of an inch."
In all fairness, everyone was right. I was a very small five year old, and he was a BIG baby. But no one anticipated the sheer force of my will.
Tips for Keeping the Big Sibling from Absconding with the Baby
Use your words. Tell the big sibling about how things will change with the new baby. This implies that you have a plan, which you should (separate post to follow about this).
Prepare your friends. Encourage (or demand that) your friends and relatives greet the older child first when they come to see the baby. They don't need to bring a toy for the older child, but suggest that they plan to spend five minutes with the older sibling and then either have the older child introduce them to the baby, or have them break the conversation and move along. You're also training your older child to be great at cocktail parties!
Practice with a puppy. (don't actually get a new puppy in the same year that you are welcoming a new baby into the house) Find a friend who has a newer baby animal that you can go and visit with your older child. Practice sitting quietly, perhaps on an adult's lap, and learning how to hold and be gentle with the puppy. This sets the stage for how you will later allow the older child to hold the baby (on an adult's lap, being gentle).
Schedule special time. Baby gets lots of attention, particularly in the first six weeks. If you can utilize the services of a postpartum doula to give mom respite, then she can have special time with the older child. Same is true for her partner. Also be sure to schedule baby holding time if the child wants to hold the baby.
Stock up on bribes. I don't recommend rewarding anyone with food, but this is a good time to bring in some special new toys or books for the older child. Regardless of the older child's gender, you might introduce a baby doll with all of the fixin's like diapers, bottles, nap blankets, and changes of clothes. If you are looking for other toys, I recommend those that make no noise, require no batteries, and are easy to enjoy alone. Building toys, puzzles, books, and art supplies are great options.
A little-known fact about me? I'm not a huge fan of baby showers. I know, I teach prenatal yoga. Yes, I get invited to a lot of baby showers. And yes, I go. But while everyone else is cooing over the frilly clothes or decorative wall hangings, I'm thinking about baby's future.
You see, in a previous life I worked in college admissions. I've spoken with thousands of families who wondered where they would get the money to send their teenager to college. Some opted to take out a plus loan, or a second mortgage on their house. Others hoped that athletic talents would win their student a free or discounted education. A handful (truly, a small handful) knew with great confidence that their student would have access to whichever education they wanted because they had been saving for it from the beginning. I'm not talking about the independently wealthy, but families with modest incomes, like teachers, nurses, and public servants, who had socked money away starting when their child was born.
Maybe you're not a saver, or don't know much about how money works in this world. But this is an amazing opportunity to learn and to take advantage of the many different ways you can start funding your baby's education starting now. For some people, a 529 plan is the right choice. For others, a Coverdell Education Savings Plan. There are many options you should discuss with your partner and possibly a financial advisor. Even a simple savings account in your child's name is better than nothing, because it will get you saving.
Tips for Saving for Baby
1. Include a college fund on your registry. Let shower attendees know that you'll have a container to receive cash gifts that will go towards baby's future education costs. Let attendees know that they will have the opportunity to take pride when baby goes to school, rather than just when they see the crib skirt they purchased.
2. Commit to an annual contribution to baby's account as a gift from you or you and your partner. Invite grandparents and others to contribute as well. A smaller toy/book gift will be just as meaningful (kids usually prefer playing with the box anyway).
3. Learn more about how money works. It's a shame so many Americans graduate from high school with almost no understanding of how to save, spend, invest, and how to manage debt. Make sure YOU teach your baby the ways of the financial world.
4. Avoid the Curse of the Trustafarian. A lot of children who enter college with a savings account feel entitled to spend it however they choose (usually on beer). Regardless of the size of the account, strongly consider having the child take out a student loan in her name. This will keep her accountable for her own education, encourage her to pursue her passions (rather than taking the classes she thinks you want her to take), and encourage her to use all of those financial lessons you taught her over the years.