This post isn’t a fun family update, but it’s about our family in the sense that the experiences I have encountered with my boys, and the knowledge I have sought, frequently too late, has culminated in a set of opinions on pregnancy, labor, delivery, and the early days of child rearing. I did some thinking today and sent an email to a friend, who is expecting her first child. It would have been left at that, but since I’m losing delicious sleep over a headache, I got to thinking, why not put it out there. Not my headache — as much as I’d like to send it away — but, my opinion list. Perhaps you are someone or you know someone who could use this metaphorical midnight snack to chew on while baby is “baking.”
What to Expect When You’re Expecting will take you only so far, but I’ve discovered there is a sort of “underground” info lurking in the crunchy birthy community that would have probably saved me a couple cesarean sections. This is not a research paper, but my advice was feverishly researched and/or experienced, and my opinions are based on the assumption of “healthy, normal” pregnancy and baby. This isn’t here to argue a point, but to suggest the most important topics for you to research. Here are the first 15.5 things that came to mind:
1. Research like you are planning both a c-section and home birth (find the white papers on c-sections, learn about belly mapping, positions, midwives. Watch midwife birth videos.) BUT, intend to have a natural-as-you-can-stand birth, probably in a hospital or birth center. Start with the International Cesarean Awareness Network online. There is frequently a local chapter and the ladies active on the site’s web boards are very bright. Hospital c-section rates these days are frequently a sickening 30-40%. Get to know what you don’t know!
2. Read all the talk on hospital interventions that may be presented to you and your baby. What covers “their” backsides and what is appropriate for you are not always the same. Learn what “they” might do (induction, IVs, labor position, shots, eye goop,etc) and know you have the right to refuse.
3. Read The Womanly Art of Breastfeeding (or similarly respected book) and determine to do it, and know it is rarely “easy” to start. Rule #1 = supply and demand — start by nursing every 2 hours around the clock and nurse on demand. Learn what a good latch is. Whether by baby or pump, your nipples need frequent stimulation to establish and maintain your supply. Throw away all the formula samples from the hospital. Supplementing is the enemy.
3.5. Learn the heck out of the properties of breast milk. Look at a side by side comparison of mom milk ingredients versus formula (http://www.bcbabyfriendly.ca/whatsinbreastmilkposter.pdf). Formula, in my crude opinion is a fourth-rate substitute that, like a c-section, should be reserved for emergencies. It jeopardizes, albeit minimally, baby’s immune system (even a single serving), intelligence, nervous system, respiratory system and future risks of problems like diabetes and obesity. Yes, I said this is not a research paper, but since I made a big statement like that, here is a small example of why it’s not a bunch of hooey. I know that was unpopular and not very diplomatic of me to say. But, first best is milk straight from mom. Second, milk pumped from mom, third, donated milk, fourth, formula. Breast milk has live active cells that interact with baby’s digestive system and immune system to do amazing things. Its composition varies by minute, hour, day and year and is tailor made for your baby, including even antibodies from an illness you are currently fighting. Here is a very cool compilation of info, very heavy on brain-scrambling sciency stuff, but you’ll get the idea on just how cool breast milk is.
4. I personally find staying home with baby the world’s most rewarding, frustrating and important job, and recommend you consider it. 🙂
5. Please don’t cut your boy. If you are considering it, please watch a video of it. Circumcision produces enough stress hormone to change his brain (as the video may do the same to yours), interferes with breastfeeding, and has underwhelming medical benefit (in my opinion, particularly considering I don’t find the African studies to be well-done or culturally pertinent). Most of the so-called benefit that exists is meaningless until at least adolescence, or is the equivalent of lopping off a fingertip to treat a hangnail. He is too small to be properly anesthetized regardless of what “they” tell you. It exposes a raw wound to urine and feces and is NOT easier to take care of. It dramatically impacts his sexual future, and can be done easily and safely, by his choice, if he wants to as an adult. I’m all for letting a person make their own permanent body modifications. There are sites like circumcision.org that have great info.
6. Understand that even if you really click with your doc, MOST docs seem to be trained and encouraged to handle only “normal” births and how to cut the baby out, usually safely, otherwise. Rapport or friendship really could be lower on the priority list. There’s no reason to believe your pregnancy, labor and delivery won’t be normal, but it’s best to know what you will do and know what your doctor will do in the event of various situations, such as breech positions, and their views on internal exams, water breaking, and such. To contrast the norm, I know a doctor who has had about a 6% c-section rate, because he is not overly interventional, personally attends his patient’s births and knows how to handle breech, multiples, etc. You know if he cuts you, you truly need it. Consider a midwife.
7. Hire a doula. You need someone to help you stay in your zone, labor in helpful positions, squeeze your back, remind you of your wishes, and educate you on your options. Your husband will be there holding your hands, encouraging you, fetching you ice chips and supporting you every bit as importantly, and a good doula will not be in the way of that.
8. Learn about Bishop score and how it relates to the success of induction. Remember, a baby’s lungs are believed to secrete a chemical when they are “ready” that helps initiate labor. The cervix is NOT a crystal ball (neither is a due date), so exams matter little, other than to satisfy curiosity and potentially introduce germs. Dilation can happen very quickly or very slowly. Baby comes when he is ready and at his own speed.
9. The back is the worst labor position. Something resembling squatting or hands and knees is best.
10. Some practitioners favor perineal massage during pushing. My understanding and experience is that it causes swelling and leads to tears. Tearing heals as well or better than episiotomy. Perineal support, however, is groovy.
11. If you’re worried you’ll give birth at home, or in the car, generally a surprise delivery (or planned home birth) is not an “emergency.” There is no need to rush to cord clamping (as in extreme example, Google “lotus birth”), and in fact, delayed clamping is beneficial. Baby immediately skin to skin with mom and covered with a blanket is perfect. Messing with cords and baths and weighing and such can come later.
12. C-section risks include: endangering future pregnancies and deliveries by scarring uterus, getting bladder or other organs, or baby nicked, bleeding, lung trouble for baby, as the squeeze of the birth canal helps expel fluid, immune trouble for baby, as passage through the birth canal introduces good flora to the baby’s body, risk of premature delivery, and others.
13. The first week(s) are insane and awesome. He will amaze and confuse the heck out of you. Plan to hole up on a bed, with baby next to you, with water and snacks nearby, and help in the house to feed you and do everything else. Toss hospitality out the window. Really. Sleep and snuggle with.your.baby. Sleep with your baby. Really. Having baby in the crook of your arm or in the curve of you on your side, or on your chest, in convenient latching position is so so easy. You both get sleep. Your senses (if not on meds, smoking, or alcohol) will be extremely in tune with baby and you’ll probably notice every twitch. Get bed rails, or roll towels under the edge of the fitted sheet if you feel nervous about the edge. [ETA: This isn’t just very convenient; it’s very stabilizing for baby’s nervous system – the stuff that helps him regulate his breathing]
When you get up, wear your baby in a cozy wrap or ring sling. Wear him all the time, everywhere. It’s very very good for him, and very helpful for you. You can cook and nurse or clean while he naps happily on you. Breastfeeding will probably stress you. The doctors will probably stress you because many breastfed babies lose about 10% of their birth weight. That’s normal, and what babies are built for. Colostrum is minimal, but is a powerhouse, and their tummies are teensy. You can probably let the scary doctor talk fall out your other ear and just keep baby at your breast. Have an experienced breast-feeder on speed dial and consult her frequently about those “weird things” your baby and breasts will do. Your milk will increase just in time, if you let him demand it (nurse) often. Then you’ll be bulging and sore for a day or two, during which you may text your friend for engorgement advice. Making early contact with a good lactation consultant and/or La Leche League leader is invaluable too.
14. Ignore the “spoiling baby” junk. Babies are most secure, develop best and grow most independently the closer they are to you and the more frequently they are held in the early years. Crying-it-out also produces big stress hormones in the little guy and he is not developmentally ready for any “training” for quite a while. Right now what he learns is simple trust vs. despair – does help come when he cries?
15. Know you are already the best mamma for this little guy and your instincts won’t fail you. Do what feels right. If it twists up your gut to think about it or do it, none of the facts matter. You’re gonna do just fine!
Well, that’s it! I know there is a gaping wide range of opinions on these matters. Feel free to comment with suggestions for additions or to correct any wild fallacies or dizzy-eyed grammatical errors I have presented 🙂
[ETA: p.s. Allow me to reiterate that this post is to help focus decision-making, regarding pregnancy, birth and very early child care. If you are past that, you have done a great job loving your child and this is not intended as a critique of your decisions.]