Herstory Blog Series

This week, LaNae and I were asked to be on a panel about feminism. Every student in the class we spoke in had submitted questions about feminism and one question struck me in particular, "In what ways has taking on a feminist identity shaped your view of how you view history, especially during an era before feminism became an ideology?" I've been thinking about this a lot lately and what I've come up with is that most history focuses on the triumphs and tragedies of men because men are the ones that typically write the history books we know. But women have stories to tell as well, so I want to help them tell it. For the next few months, I'll be writing a blog series about Herstory (Get it? Not History, Herstory).

   

Every Friday, you'll have a chance to read more about women whose names you might recognize and women you may have never heard of, contemporary women and women from centuries past, women old and young. Sometimes the quietest voices, once heard, can speak volumes.  

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Pregnancy, Babies, and Birth: From Theory to Practice

I have been blogging about the Theory of Babies & Birth for months. But sometimes the theory is very different from the practice. So I thought it would be appropriate to wrap up the "Pregnancy, Babies, and Birth" blog series with one woman's real-life experience with birth and baby: my own.

While I was pregnant, I spent countless hours reading books and articles about pregnancy, birth, and the transition to parenthood. Not to mention spending hours writing posts for this blog series! So I thought I had a pretty dang good idea of what giving birth would be like, what things I wanted and didn't want, and exactly how I thought it was going to go. I had a 3-page birth plan with all my preferences listed concisely: I imagined a medication-free birth where I weathered my contractions like a fierce warrior, a quick pushing period, a smooth delivery where they placed my perfectly healthy baby on my chest, and a rapturously happy bonding period where my husband and I stared down at the beautiful little life we brought into the world. I imagined myself resting for a couple of days when I got home, then jumping enthusiastically back into my role as homemaker, wife, and mother.

Things didn't go as planned.

Even though I had spent months preaching on this blog about how unpredictable the birthing process was, I never thought it would be that way for me. I naively believed that I would be the exception; my labor and delivery were going to go exactly as I wanted. It would be beautiful and natural, painful but quick, and I would be a perfect new parent. Everything was going to come naturally to me, my mothering instincts would kick in right away, and I would know just what to do and what was best for my baby. I had done all the research, so I was totally prepared, right?

Not quite . . .

It was a long and difficult labor and there was a constant threat of danger to my baby. I had to have Pitocin to kickstart my labor and eventually was in so much pain that I was ready for an epidural. When the time came, I was able to push efficiently, but my baby got stuck. So exhausted, I opted for an assisted delivery to avoid a C-section. The forceps did some damage to both me and my baby. When my baby was finally delivered 24 hours and 25 minutes after my water broke, he wasn't crying like he should, so they whisked him away to the NICU. My husband and I weren't able to hold him until almost 9 hours later when he was stable enough to come to stay in our room.

My postpartum recovery was incredibly difficult and painful, both physically and emotionally. I couldn't sit or walk without debilitating pain, which made it hard to even hold my son for long. I spent weeks laying in bed or laying on the couch praying for God to take away the pain. Simple tasks were too much for me to accomplish, so my husband had to take over everything around the house. I couldn't leave the house, I couldn't have visitors, and I started to get cabin-fever. I felt like it would never end.

About 5 days postpartum, I started to develop postpartum depression. I felt numb. I lost my appetite completely. I felt indifferent to my baby. I had inexplicable crying spells. I had an overwhelming urge to run away. I had never felt so inadequate in my entire life. In my worst moments, I was absolutely convinced that I would never be happy again. It made it almost impossible for me to care for my baby. After my husband returned to work, I had to reach out for help from my parents, which they graciously gave. I felt envy and disappointment as I watched others caring for my newborn instead of me. But mostly, I felt horribly, horribly guilty.  

I have to say, there is no guilt quite like Mommy Guilt. There are all these things that we are supposed to do as mothers that we may or may not be able to do.  When I wasn't able to do all of the things that I knew I "should" have been doing as a mother, I felt like a complete failure. I remember thinking how my baby deserved a mother that could give him all of the things that I couldn't. I was convinced that he deserved better than me.

It took many weeks for me to heal physically and emotionally, in fact, I'm still healing.  If it hadn't been for my amazingly supportive husband and the Atonement of our Savior Jesus Christ, I don't know how I would have gotten through the entire process. But things got better little by little. I started feeling a little less pain and less depression with each passing day. I bonded with my baby. I learned what his cues meant and developed my parenting skills. I held my husband a lot tighter. I prayed more sincerely than I ever prayed before. I began to accept that all my preconceived notions about parenthood were less important than giving myself room to be imperfect. I started to see that being a good mommy DOES NOT mean being a perfect mommy.

As I got back to myself, I wanted nothing more than to share my experience with other women. I didn't (and don't) want pity for what I went through, but I did (and do) want to share these things because I know there are other women out there who have had similar experiences. And I know there are women who will have similar experiences in the future. It is incredibly lonely to feel like you are the only woman in the world who doesn't have a perfect "A Baby Story" delivery and recovery. Even though my husband was beyond incredible, he just couldn't understand all of the things I went through. It wasn't until I spoke to other women, like my own mother and my mommy-friends, that I began to feel peace and relief about what I was going through. Ladies, you are not alone! I firmly believe that sharing our struggles with each other can only serve to strengthen one another. We need each other. So, please, if you are struggling similarly, reach out for help!

We live in a culture where there is so much expected of us as mothers but we just can't meet all those expectations. Perfection is impossible. And that opens the door to a lot of feelings of inadequacy and guilt. But I have good news, Sisters. Our Heavenly Father doesn't require perfection from us. He knows our circumstances and He knows our hearts. The expectation of perfection comes from ourselves and sometimes from other women in our lives. Do I think my Heavenly Father blames me for not doing "enough" in those first few difficult weeks? Absolutely not. He knows that I did the best I could with what I had been given. And that was enough.  

I was enough.

For all of the women out there doubting your abilities, feeling guilty and inadequate, pushing yourself to run faster than you are able, YOU ARE ENOUGH. Don't let the Adversary convince you otherwise. Self-doubt steals so much away from you. Work as hard as you can on learning self-acceptance and self-love, all the while remembering that you have a loving and forgiving Heavenly Father cheering you on, not One who is chastising you from on-high for being imperfect. And if you need someone to talk to, someone to encourage you and lift you up, come visit us here at Women's Services. We have a lot of practice at being imperfect! Heck, I'm getting better at it every day.

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Pregnancy, Babies, and Birth: Adapting to Parenthood

Bringing Home Baby

You've gone through the intense process of bringing your sweet little miracle into the world! But . . now what?!  "You mean, we have to take our baby home now? By ourselves . . . without a call button and Labor and Delivery nurses to help us and answer our questions? What are we supposed to do now? How are we supposed to know what our baby needs? What's the difference between a hungry cry, a hurt cry, and a tired cry? I don't know if we can do this..."

For a lot of couples, there's a small panic moment when leaving the hospital and striking out on their own in the realm of parenting for the first time. If this happens to you, don't feel bad! You are embarking on a huge new adventure that doesn't come with a road map or an instruction manual. For the first time, you are in charge of a tiny, helpless little being that is completely dependent on you for all of its needs and wants. That can be an overwhelming prospect, to say the least. Add that to recovering and healing from birth and shifting hormones for mommy, it can seem downright impossible! But remember, the best thing you can do is to take things a little at a time. Don't let yourself start worrying about baby's first day of kindergarten; instead, just focus on meeting one need at a time, one hour at a time, one day at a time.

Baby's Basic Needs

For the most part, your hospital staff will do the best they can to prepare you to go home and tend to the basic needs of your baby. They will probably teach you the best way to give baths, how often you need to give baths, how to change diapers, how to properly care for the umbilical cord until it falls off, how to care for your son's penis if you choose to circumsize, tips on breastfeeding and bottle-feeding, how to swaddle and hold baby, and lots of other stuff. My suggestion is to write down questions that you have about newborn care throughout your pregnancy and then bring that list with you to the hospital. When baby comes, you'll probably have lots more questions to add to the list. Don't be afraid to ask anything and everything; there is no such thing as a dumb question. If you don't know the answer, ask! Also, you are likely to get overwhelmed by the amount of information that you are given, so write it down or have your partner write it down as you go along. You definitely won't be able to remember everything, so don't stress yourself trying to memorize the long list of things they tell you to do and not to do.

When you bring baby home, some women find it comforting and incredibly helpful to have a female relative or close friend come stay with them for a few days or weeks while they adjust to parenting. A loving, experienced "been there, done that" mom friend or family member can be a great comfort and wonderful source of information. Even if you don't have someone who can come stay with you or you prefer to try things on your own, feel free to call your mom, your sister, your neighbor, your Relief Society President, your best friend, or any other mom you trust for advice!  Additionally, make sure you choose a pediatrician for your baby so you have someone to call if you have any questions about your baby's health. Again, it is completely normal to feel overwhelmed and to have a lot of questions as you learn how to read your baby's signals and develop a routine that works for your new little family.

The Transition to Parenthood

The early stage of adjusting to parenthood is often the most difficult. This stages usually last around 4 months or more and is characterized by feelings of losing control, anxiety, uncertainty, feeling overwhelmed, and feeling physically and mentally exhausted. The next stage of parenthood has you focusing on rebuilding your day-to-day routine and your personal and familial identity. You begin to make more conscious decisions instead of "just trying to survive" and feeling a greater sense of control. This stage can last a couple of weeks to a few months.  The final stage of adjusting to parenthood is when you begin to feel adjusted to the change.  You will feel like you are back to normal and feel like yourself again. You have fully integrated the new roles and responsibilities that come with having a baby into your daily life.

Another huge transition when you become a parent is the cognitive transition, which includes learning to conceptualize yourself as a parent. I find myself constantly thinking, "I'm going to be a mommy . . ." and that thought blows my mind. I don't think it will actually sink in until I have that little infant in my arms. Seeing yourself as a parent means learning to constantly sacrifice your wants and needs to meet the needs of your child. You can't just spontaneously run to the grocery store while your husband is at work without taking the time to get baby ready, work around naps and feedings, etc. What would have been a 10–15 minute errand before you were a parent is now a 30-45 minute (or more!) errand. You must learn to sacrifice a certain amount of your independence in order to be a good parent. Both you and your spouse will go through the process of seeing yourselves, and each other, in a very different light.

If you want more information about the transition to parenthood, I found this amazing website by Dr. Stephanie, who has a Ph.D. in Sociology and emphasizes in studying parenthood and motherhood. Check out her website HERE.

The Marital Relationship

When it's just you and your husband, there is only one other person in the equation that is the focus of your attention; they get 100% of your attention at home. When baby #1 enters the picture, that goes from 100% down to 50%, at the least, so your spouse is losing a huge chunk of your time and attention for the first time. With each additional child, the attention gets split more ways, but never as drastically percentage-wise as with that first child. Going from a 2-person family to a 3-person family is going to require quite a shift in your marriage. Both Mom and Dad may find that they feel like they are being ignored by their spouse; for example, Dad comes home from an 8 hour shift and Mom is excited to see Dad, but Dad heads straight for baby. Moments like these can leave each spouse feeling a little sensitive and hurt.

The key to surviving this transition in your marriage is the same key to any successful marriage: positive communication!  If you haven't already been practicing how to communicate in healthy, effective ways, start now. It will serve you so well after you become parents. Some basic tips on positive communication are as follows:

• For the Speaker
• Use "I" Statements: This means saying something like, "I feel [emotion] when you do [action]," instead of, "You make me so [emotion]." This way, you are taking ownership of your own emotional experience rather than trying to blame it on your partner. Blame language will almost always create defensiveness in the Listener, which sets a conversation up for failure.
• Avoid name-calling: There's nothing that sabotages a conversation quite like belittling your partner by calling them a name. If you feel the urge to say, "You're such a jerk! Why would you say something like that to me?!," try to express what you are feeling in a different way. How about, "It really hurt my feelings when you said that to me. I feel pretty angry that you would make that comment."
• The Soft Approach: If you want to talk about a topic that you know is sensitive, use what we call the "soft approach." Approach your partner kindly and lovingly, use "I" statements, and willingly take responsibility for your part in the issue. This will help your partner remain non-defensive and listen to what you have to say. The alternative to this is running into a conversation already riled up and leaving your partner feeling like they've just been hit by a freight train. A soft start-up is like the old saying, "You catch more flies with honey than vinegar." Remember, you love this person, so approach them with respect and care.
• Avoid "Always" and "Never": Let's get this straight—no one "always's" or "never's."  It's tempting to say things like, "You always do [this]," or "You never do [that]."  The truth is usually somewhere in the middle; they may do something more or less than you like, but they don't "always" or "never" do it. Using these little words has the same effect as name-calling and blaming, it creates defensiveness in the Listener and makes it more difficult for them to listen to and validate your experience and/or concern.
• For the Listener
• Give the Speaker your full attention: Nothing is more frustrating than trying to talk to your partner when they are glued to their cell phone, watching TV, or playing on the computer.  If your partner approaches you and wants to have a serious conversation, put everything else aside that you can or suggest a time that would work better to talk if you can't give them your full attention in that moment.  Remember though, your relationship with your spouse is the most important thing in your life, so if you can set what you are doing aside for a moment, do it. It's especially hurtful if they approach you and are brushed aside because you want to finish this one TV show or this part of your game. Unless you have a pressing reason to continue doing what you are doing (a due date for work or school, or a fussy baby to attend to), give them your attention.
• Really listen, don't half-listen while you think up your own argument: This is super common in all relationships. The next time you are in a conversation with one of more other people, pay close attention to how long of a gap there is between one person finishing a thought and the next person starting up on their own thought. Most often, the next person begins to speak before the first person's last sentence is finished. We are so eager to share our own thoughts, feelings, and experiences that we often spend more time thinking up what we are going to say back and we miss a lot of what they other person is saying to us. When I begin teaching couples how to communicate, we take turns being the Speaker and the Listener. The Listener doesn't get to argue their side at all; their only job is to LISTEN. Successful communication hinges on each person's ability to be an attentive, responsive listener.
• Ask questions to clarify meaning: One of the biggest reasons that people struggle with communication is they misunderstand what the other person is trying to say or they make assumptions about what they are really trying to communicate. If you find yourself thinking the Speaker is trying to communicate one thing, ask, "So, what you're saying is _______?" and give them a chance to clarify if that is or isn't what they mean.
• Validation, Validation, Validation!!!: As a marriage therapist, the biggest complaint I get when teaching couples how to communicate effectively is, "My partner just doesn't understand/care what I say." There is only one way to avoid this very common pitfall: VALIDATION. If your partner says, "I feel sad when you snap at me," instead of getting defensive or explaining why you snapped, simply say, "I can see how that would make you upset. I would feel that way too if you snapped at me."  The BIG key here is to validate your partner's feelings and experience even if you don't agree with it or understand it. Validation=/=Agreeing! Even if you don't feel like you snapped at him/her, they feel like you did. You can say, "It wasn't my intention to come across like I snapped at you. I can see how that would be hurtful and I'm sorry that your feelings are hurt." I can't emphasize the importance of this skill enough: VALIDATE, VALIDATE, VALIDATE!!!

Finally, it is important to really make an effort to stay connected to and close to your partner. Spend some uninterrupted time together each day to talk or just be with each other. When baby goes to bed, it's a great time for Mom and Dad to talk, cuddle, kiss, engage in a shared activity that you both enjoy, do the dishes together, whatever. Make each other a priority! If you can, continue to go on dates (even if the date is a picnic in the middle of your living room floor). Communicate with each other using the tips listed above. Reach out to each other for help and support, especially to get your emotional needs met. Remember, you are still a husband/wife, not just a Mommy/Daddy, even if it feels like your new parenting role takes up your whole life!

Disclaimer: The "Pregnancy, Babies, and Birth" blog series is meant as a source of general information only. Its intended use is to encourage women to further consider and discuss reproductive and birthing decisions themselves, with their partners, and with their medical care providers. Information included in this series is not intended to be professional medical advice or a substitution for a relationship with a licensed physician or practitioner. Any serious questions or concerns about reproductive, prenatal, and/or perinatal health should be directed to your primary care physician or other licensed specialist. Women's Services and Resources does not promote any particular brand, medical provider, birthing location, or any other specific birthing decisions. We strongly encourage women to become as educated about their choices as possible so they are empowered to make educated decisions for themselves and their babies.

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Pregnancy, Babies, and Birth: Breastfeeding Basics

Breastfeeding is a potentially sensitive and extensive topic to try to cover in one post, so I have just included the very, very basic information available. Please, seek out and read other resources on breastfeeding as well as reading this simplified post. Additionally, I highly recommend taking a breastfeeding class. I was able to attend one at UVRMC that was taught by a certified lactation consultant and I learned a ton even though I had already done a lot of research on the topic. I feel much better prepared to make educated decisions about breastfeeding now that I have that foundation.

Breastfeeding, Formula-feeding, or Both?

Deciding whether to breastfeed, bottle-feed, or some combination of both is another important personal decision to make before having your baby. Just like any other aspect of pregnancy or parenthood, we advocate that women educate themselves as much as possible on the topic, then make the decision that they feel is the best for themselves, their baby, and their family. Both breastfeeding and formula-feeding offer unique advantages and disadvantages. Some mothers prefer to breastfeed exclusively without introducing a bottle, some mothers prefer to pump and then bottle-feed with breast milk, some mothers prefer to breastfeed and supplement with formula, and some mothers prefer to exclusively bottle-feed using formula. As long as your baby is getting adequate nutrition, all these choices are great! However, there are some unique benefits to breastfeeding that stand out enough that they necessitate extra discussion.

Benefits of Breastfeeding

The American Academy of Pediatrics recommends that babies be exclusively breastfed for the first six months of life due to the immediate and long-term benefits for the baby. Exclusively breastfeeding means that you offer no other form of food/drink to your baby other than breast milk (no water, no formula, no foods). Even if you are not able to breastfeed from the breast for the first six months (for example, if you have to go back to work or school, or if your baby rejects the breast at any point during those first six months), you can still express breast milk by using a pump and feed it to your baby using a bottle. If you want to feed using both the breast and the bottle, most lactation consultants recommend that you exclusively feed from the breast for at least the first four weeks to avoid nipple confusion; then slowly introduce the bottle (using a slow-flow nipple).

Did you know that your breast milk is perfectly tailored to suit the individual needs of your baby? Breast milk contains all the vitamins and nutrients that your baby needs in those first vital months of life. Additionally, it passes on substances that help supplement their delicate, developing immune systems and helps them fight bacteria and disease. Research has shown that breastfed babies are typically less susceptible to certain diseases (including some cancers) later in life. In addition to the numerous benefits that breastfeeding has for your baby, it also has lots of benefits for you too, mommy! Breastfeeding has shown to reduce stress, reduce occurrence of postpartum depression, facilitate bonding between mommy and baby, reduce the risk of breast and ovarian cancer, and help mom return to a healthy weight quicker after delivery. I could probably do a whole post on the benefits of breastfeeding, but for more information on this topic, visit the La Leche League website.

How to Get Started

Is breastfeeding a natural process? Yes. But, it is also a learning process. It's something that you and your baby will have to learn together in order to be successful. Learning as much about breastfeeding as you can before your baby is born is a great way to prepare yourself for this transition. I highly recommend taking a breastfeeding class from your local hospital or independent lactation consultant before you give birth. Once you have delivered your baby, the best time to try to breastfeed is within the first hour after birth when baby is most alert. If your baby is healthy, you may even attempt to begin breastfeeding right in the recovery room. If you want to breastfeed as soon as you can after birth, make sure to tell your doctor and nursing team so they can help and encourage you.

The key to successful breastfeeding is to get the right latch. There are certain ways that you can position your baby, regardless of the kind of hold you use, that will facilitate a better latch than others. Make sure you bring your baby in to latch when their mouth is wide open (it may look like they are yawning), not when they are just opening up slightly. You want them to get as much of the breast as possible; if they just have the nipple in their mouth, you are going to end up with sore, bleeding, and cracked nipples. Again, getting just the right latch is key! This brings me to a hugely important point: Talk to a lactation consultant while you are in the hospital. Most hospitals these days will have a certified lactation consultant on staff that will visit each mom and baby during their recovery time. If you want/need help before they come to you, go ahead and ask that they visit you sooner. Also, most nurses will be able to assist in breastfeeding support while you are learning. Let your lactation consultant offer tips and observe your methods so she can help you avoid common mistakes and set you up for successful breastfeeding.

Seek Help Early if you Struggle

Some women feel ashamed if they are having a hard time with breastfeeding. They may feel like they should already know how to do it without help or they may feel embarrassed about having someone help them because it requires a relative stranger to see an exposed breast. If you feel like the first, don't be ashamed that you aren't magically endowed with amazing nursing skills. You are just learning something new, so it is okay to have a learning curve and ask for advice. If you feel like the second, it's understandable to feel a sense of unease, but remember that you are dealing with a trained professional that is there to help you, not to make you feel uncomfortable or exposed. One of the biggest issues that lactation consultants see is women who are coming to them when they are at the end of their rope. What they really hope to see is a mother coming for help at the first sign of difficulty. If you are experiencing pain, if your breasts are becoming inflamed or engorged, if you see signs of a blocked duct, if you worry that your baby isn't getting enough to eat, then call or visit a lactation consultant for help right away rather than waiting until you want to give up.

What if I Can't Breastfeed?

For several unknown reasons, there are some women that cannot physiologically breastfeed. Sometimes their milk doesn't come in or it doesn't come in with a strong enough supply to adequately meet baby's needs. If this happens to you, first, visit with a lactation consultant to see if there is anything you can do to pinpoint and alleviate the problem. If you find yourself still unable to breastfeed, you have to be easy on yourself.  Don't think that you are a bad mother or an incomplete woman if you struggle! You still love your baby and will provide the best you can for your baby in terms of meeting his/her needs. Seek out support from other moms that have experienced similar issues. Talk openly with a trusted friend or family member about your feelings or seek out a professional counselor to help you through the transition. It's perfectly normal and understandable to feel disappointed, sad, angry, confused, helpless, whatever it is that you are feeling. Do the best you can, and if it doesn't work out for you, your baby will still be healthy and happy with the proper nutrition from other sources. Get help and support, then give yourself permission to let it go and move forward.

For more information about breastfeeding, visit http://www.babycenter.com/breastfeeding-basics

Disclaimer: The Pregnancy, Babies, and Birth blog series is meant as a source of general information only. Its intended use is to encourage women to further consider and discuss reproductive and birthing decisions themselves, with their partners, and with their medical care providers. Information included in this series is not intended to be professional medical advice or a substitution for a relationship with a licensed physician or practitioner. Any serious questions or concerns about reproductive, prenatal, and/or perinatal health should be directed to your primary care physician or other licensed specialist. Women's Services and Resources does not promote any particular brand, medical provider, birthing location, or any other specific birthing decisions. We strongly encourage women to become as educated about their choices as possible so they are empowered to make educated decisions for themselves and their babies.

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Pregnancy, Babies, and Birth: The Stages of Labor

There is a common misconception that being in labor = having contractions. True labor, however, is when you are progressing towards giving birth; meaning that your cervix is changing (either effacing or dilating progressively). Pregnant women can start having "practice" contractions, also known as Braxton Hicks contractions, as early as the second trimester, but this doesn't necessarily mean they are in labor. Labor itself is divided into three separate stages:

• First Stage: This is the stage of labor that we most commonly associate with "being in labor." This stage starts when contractions cause progressive changes to the cervix and ends when you are completely dilated and effaced. The first stage is often divided into 3 phases: early labor, active labor, and transition. Early labor is when your cervix gradually begins to dilate (widen) and efface (thin out); usually between 0–4 centimeters (cm) dilated. Active labor is when contractions come on stronger and closer together; usually between 4–7 cm dilated. Transition, which is the most difficult and painful part of labor, is when you have the most intense contractions and your body moves from 7–10 cm dilated (10 cm is fully dilated). You may notice an increase in mucusy discharge from your vagina that may be tinged with a small amount of blood. This is completely normal and is known as "bloody show." This is your body shedding your mucus plug, the literal plug of your cervix that developed to help keep foreign particles out of your uterus while your baby grew. Additionally, your water may break at this point, either in a gush or a slow trickle. If your water breaks, call your care provider immediately and ask when he/she wants you to go to the hospital. Most providers will want to have you come in right away after your water breaks.

• Early labor can sometimes be difficult to distinguish from the Braxton Hicks contractions that you may have been having for several weeks now. You will be able to tell the difference between false labor and true labor by monitoring your contractions. True labor contractions will become longer, stronger, and closer together and they will not go away with a change in position or change in activity. False labor contractions are irregular and sporadic and will oftentimes diminish or go away completely if you change your activity (If you are laying down, get up and walk around. If you are walking around, lay down on your side). As you approach the end of your pregnancy, talk to your doctor about recognizing signs of true labor and when he/she wants you to head to the hospital. If you've had a healthy pregnancy, expect to go through early labor at home. Most providers will have you rest comfortably at home until your contractions get to a specific frequency and duration (usually between 3-5 minutes from the start of one contraction to the start of another and usually lasting about 30-60 seconds for each contraction). It's important not to wear yourself out during early labor because you'll need all the strength and endurance you can get for the later stages of labor. Avoid strenuous activity and even try to sleep in between contractions if you can. Also, stay hydrated and empty your bladder often because a full bladder may impair the ability of your uterus to contract as much as it needs to.

• Active labor is when things really get rolling!  If you haven't already gotten to the hospital, get there as soon as you can.  At this point, most women who are going to have a medicated birth will be in enough pain that they will ask for an epidural or other medications.  Baby may start descending into the birth canal now, but may not get all the way down into the position he/she needs to be in for the pushing stage until after transition.

• Transition is the most intense part of labor for most women, but also the shortest phase of the first stage. At this point, your contractions may be occurring very frequently and lasting a long time (sometimes only 30 seconds apart and contractions lasting up to 90 seconds). You may begin to shake, shiver, or feel nauseated and vomit at this point as well. If you are trying for an all natural birth, you may begin to lose faith in your ability to manage the pain. Reach out to your support person for extra coaching and support and focus on getting through one contraction at a time. If you change your mind or find that the pain is too intense, consider your backup plan (medications that you may be comfortable with). Having a medicated birth does not make you any less of a woman or your birth experience any less important! Do what is right for you, whether that be pushing through transition med-free or choosing pain relief through medication. Additionally, you may begin to feel some rectal pressure as your baby gets lower in the birth canal. Some moms report the beginnings of the urge to push, but it is important to avoid pushing until your nurses/doctor gives you the okay. The cervix needs to be completely dilated and effaced and baby needs to be in the right position in the birth canal before any pushing is beneficial. Pushing before your body is ready will only wear you out and sap you of whatever energy you have left.

• Second Stage: From the point that your cervix is completely dilated and effaced to the point where you actually give birth to your baby is the second stage of labor. This is often referred to as "the pushing stage" because this is when women get to become a more active participant in the labor process as they push their baby through the birth canal. Your contractions may slow down at this point, offering you a chance to get some much needed rest. If your baby has not descended all the way into position yet, you may have a while before you are ready to push. If baby has descended, you may feel pressure in you bottom and an urge to push. Make sure to communicate this to your nurses. You can choose to have your nurse coach you on when to push or wait until you feel the spontaneous urge to push. With the combined effort of your contracting uterus and your abdominal muscles, your baby will slowly make his/her way down the birth canal. For first time mothers, baby's descent through the birth canal is usual gradual, lasting about 1 hour. It can feel like a slow, "two-steps forward and one step back" process. But, eventually, your sweet little boy or girl will enter the world!

• Third Stage: The third stage of labor typically occurs about 5–15 minutes after the birth of your baby when the doctor delivers the placenta. After the baby is delivered, the body receives a signal to detach the placenta from the uterine wall and through a series of contractions, the placenta is delivered in much the same manner as the baby. Don't worry, this isn't like giving birth to another child! Most of the time, mom is so elated and wrapped up in her new little miracle that she barely notices this part of labor. The doctor may ask her to give one or two pushes to help deliver the placenta, but it is nowhere near as painful as the rest of labor. After the placenta is delivered, your uterus will clamp down to stop up the blood vessels where the placenta was previously attached in order to prevent you from bleeding too much. Your doctor or nurses will make sure your uterus continues to do this by checking and even massaging your uterus (by pressing down on your belly). If you tore your perineum or had an episiotomy, your doctor will deliver a local anesthetic to the area and then stitch up the tear or cut. 

Every birth and every woman are different, so it's difficult to say exactly how long each stage of labor will last.  For most first time moms, it typically takes between 10–20 hours to go through all 3 stages of labor (some moms go quicker and others are in labor for much longer). Similarly, each mom will spend different amounts of time in each stage of labor, but each stage should be progressively shorter than the last (first being the longest and third being the shortest). Remember that birth can be a very unpredictable process, so be flexible in your expectations and be open to suggestions from your care team. The most important result, regardless of the methods, is a healthy mom and healthy baby.

Source: www.babycenter.com

Disclaimer: The "Pregnancy, Babies, and Birth" blog series is meant as a source of general information only. Its intended use is to encourage women to further consider and discuss reproductive and birthing decisions themselves, with their partners, and with their medical care providers. Information included in this series is not intended to be professional medical advice or a substitution for a relationship with a licensed physician or practitioner. Any serious questions or concerns about reproductive, prenatal, and/or perinatal health should be directed to your primary care physician or other licensed specialist. Women's Services and Resources does not promote any particular brand, medical provider, birthing location, or any other specific birthing decisions. We strongly encourage women to become as educated about their choices as possible so they are empowered to make educated decisions for themselves and their babies.

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Pregnancy, Babies, and Birth: Pain Management Methods During Birth

Making the Decision

Deciding on how to handle the pain of labor is an important personal decision. Nothing gets women more passionate about labor than talking about their beliefs concerning pain management techniques. However, keep in mind that the choice should be yours to make, in conjunction with your partner and with guidance from your care providers. Throughout your pregnancy, you will undoubtedly get unsolicited advice from a lot of sources regarding whether or not to use pain medication during labor. Take what they have to say with a grain of salt because your experience will differ from their experience(s).

Labor is such a diverse experience for each and every woman that you can never really go into it with a solid idea about what labor will be like for you. Some women go in expecting to use medication and end up making it through labor without it, while others go in not wanting medication but end up changing their minds during labor. The best thing you can do to prepare in advance is to gather as much information about pain management techniques beforehand and make an educated decision about what you would and would not like to try. Feel free to incorporate these preferences into your birth plan if you are creating one. Also, share your preferences with your primary care provider (doctor, OB/GYN, or midwife), your partner or birth coach, and your care team at the hospital (labor and delivery nurses, specifically).

Keep in mind that labor can be an unpredictable process, so if you go in with an open mind and flexible expectations, you can avoid some unwelcome surprises. If complications arise, like the need for an emergency C-section, you may not have a choice in terms of medications used. This doesn't always mean that you will be forced to make decisions that you did not want. So, be as true to your own preferences as the situation allows, but trust those you have chosen to provide your care if they offer alternative suggestions. Feel free to ask as many questions as you want, whenever you want, if you are being encouraged to make a decision that you wanted to avoid, then make your decision. If you are in a vulnerable state or in no state to talk at all, encourage your partner or birth coach to ask questions for you (prep them for this beforehand so they know how to be a good advocate for you).

Non-medicated Labor

There are a variety of different methods that are currently in use in terms of dealing with pain during labor without the use of medication such as Lamaze, the Bradley Method, and Hypnobirthing. Click on these links or see our previous post on Childbirth Classes in order to learn more about these specific methods. The main focus during an unmedicated labor is to listen to your body and provide it with what it needs. You can choose to follow the guidelines of a certain method during labor, or you can use a combination of any of the following techniques to facilitate pain management during an unmedicated birth. Additionally, should you choose a medicated birth, you can still employ any of these methods to keep yourself calm and focused during labor.

• Deep breathing exercises: Most childbirth classes that you take will offer at least basic training in breathing techniques. Yes, we've all been breathing long before we have the opportunity to take a class on it, but a class will teach specific techniques that increase your awareness and focus your attention on your breathing. Breathing techniques include taking a deep, cleansing breath before an after each contraction and patterned breathing that is rhythmic and comforting (such as the stereotypical hee-hee-hoo breathing).  
• Massage/Counter-pressure: Ever heard of back labor? If not, you might be in for a surprise if your back hurts just as much as your front during labor. One of the best ways to manage back labor is to have your partner or birth coach massage your back or apply counter-pressure. Massage and touch can be a great way to manage pain, especially if delivered from your partner since it can provide both physical relief and emotional connection during labor. Have your partner massage whatever part of your body that feels good, whether it be your back, your arms, or your feet. Some women, however, find that they don't want to be touched at all during certain points in labor, and that's perfectly okay.  Be flexible and communicate with your partner (in the kindest way that your contractions will allow, haha).
• Warm or cold compresses: If you get overheated during labor, ask for a cold compress to put on your forehead. Likewise, you can have your partner or birth coach apply cold or warm compresses to your lower back to manage back labor. Just see whether cold or hot feels better at the time, or alternate between the two if you like.

• Movement/Changing positions: Some women find that getting up to walk, moving around on a birthing ball, or simply changing positions can offer some measure of relief. For the most part, hospitals have women in a semi-reclined position to give birth, but if other positions (squatting or on all fours, for example) feel better to you, go ahead and shift. If you choose to get up and walk around, you may find it helpful to stop and lean against something or someone during the hardest part of your contractions.
• Visualization: You can picture yourself in a calming place, imagine yourself as a female warrior, or visualize yourself holding your baby. Whatever you choose to do, visualization can often help to distract you from the pain or hold out through each individual contraction by focusing on a specific goal or image.
• Self-hypnosis: This method often involves getting some sort of training from a professional before you employ it. It is often used to create a deep sense of relaxation to manage pain, fear, or anxiety during labor.

• Aromatherapy: Some women like to use essential oils or something similar to help them relax and create a soothing environment. You can even combine aromatherapy with massage and have your partner or birth coach rub essential oils onto different parts of your body. Feel free to bring these kinds of things from home, but remember, no candles (no open flames!). If you are wondering what is okay and not okay to bring from home, call your hospital and double check with them.
• Listening to music: Just like with aromatherapy, listening to music can help foster a calming environment. Whether you choose to play it as ambient background noise in the room or you pop in/on your headphones, music can help you focus your attention elsewhere. Feel free to create a playlist of your favorite calming music (or rockin' music, if you prefer) in preparation for birth.
• Distraction: Most women will try this method during labor, whether they are aware of it or not. This doesn't require any special technique or anything like that. It can be as simple as joking with your husband or chatting with your L&D nurses. You can also play cards, watch TV/movies, update your blog, surf the internet, take a walk, or any other number of things. This method may be more effective during earlier stages of labor and more difficult to employ as contractions intensify, so be sure to have other methods in mind to manage pain.

• Taking a bath or shower: The impact of the water during a shower or the warmth of a bath can have very calming effects on a laboring woman, so much so that this method is often referred to as the "midwife's epidural." Jacuzzi tubs are a popular pain reliever because it offers some of the weightlessness and warmth of a tub in combination with the massage of the jets. You can take a warm bath or shower at any point during labor; some women even choose to give birth in a birthing tub.
• Having a focal point: This is simply choosing something in your environment to focus on during contractions. It can be a picture, a flower, a spot on the wall, or your partner's eyes. With this method, you focus your energy outside yourself and onto something else. This can be especially comforting if you are feeling panicked or anxious; you can lock eyes with your spouse or birth coach and throw your focus there. However, some women prefer to have an internal focus and close their eyes during contractions. Find whatever works best for you and go with it!

Medicated

There are several classes of medication that can be employed during the labor process, namely regional anesthesia, systemic medication, and general anesthesia. Following are brief descriptions of each class of medication, their general uses, names of common drugs or techniques in each class, and the differences between the three classes. Both advantages and disadvantages/risks are discussed for each class.

• Regional Anesthesia: These kinds of medication are used to numb or relieve pain in only a specific part of the body, which is why they are administered into the lower back during labor to target that area of the body. They cannot be administered by nurses, like other forms of medicated pain management may, but instead must be given by an anesthesiologist. The most commonly used regional analgesics are epidurals, spinal blocks, and the combined epidural and spinal block. 

1. Epidurals: A woman either lies on her side or sits up in a hunched position to expose the lower part of her back. The area is cleaned and then a small needle is used to numb the area where the epidural will be administered. A larger needle is then used to inject the medication into the epidural space (the fluid that surrounds your spine) and then a small tube—called a catheter—is inserted and left in the woman's back in order to allow for adjustments in the amount of medication or continued administration of the epidural throughout the labor process. Epidurals allow you to get pain relief in the lower part of your body without affecting your conscious state and can be given at any point during active labor (usually around 4 to 5 centimeters dilated--sooner than that, there may be a concern of slowing the labor process). Very little of the medication will reach your baby because it isn't introduced into your bloodstream. Some of the disadvantages of getting an epidural are being confined to your bed for the remainder of labor (you will get catheterized in that case to allow for emptying your bladder), being monitored more closely and frequently (both mom and baby), possibility of weakening the "bear down" response during the pushing stage which may extend how long it takes to push the baby out, risk of reducing your blood pressure and subsequently baby's heart rate, increased risk of itchiness and nausea, and small possibility of a bad headache that may last for several days. 
2. Spinal Blocks: A spinal block is similar to an epidural, but differs in two main ways.  Instead of being delivered into the epidural space, the medication is delivered directly into the spinal fluid. Secondly, a spinal block is given in a one-time administration, usually right before the pushing stage, instead of being continuously administered through a catheter. A spinal block will usually last about 2- 2 1/2 hours, which is why it is usually give near the end of labor. The benefit of a spinal block over an epidural is that the pain relief is more fast-acting, but it won't last as long as the relief you may get from an epidural. Like with an epidural, only a small amount of the medication will reach your baby. You may benefit from a spinal if your labor is progressing really rapidly or if you ask for pain relief at a very late stage of labor. The disadvantages and risks of a spinal block are similar to an epidural.
3. Combined: A relatively newer approach is the combined epidural/spinal which offers the fast-acting relief of the spinal with the longevity of the epidural. It is administered in much the same way as the epidural except that 2 needles are used instead of one (they put the smaller spinal needle inside the larger epidural needle so you only have to be stuck once). The spinal needle is then used to inject medication into your spinal fluid, then it is removed and the catheter is put in place so medication can be administered as needed. During earlier stages of labor, this is often referred to as a "walking epidural" because it tends to lead to less lower body weakness so you can continue to walk around for the first few hours, should you desire to do so. The disadvantages and risks are the same as those listed above.

• Systemic Medications: Systemic medications, such as narcotics (specifically morphine, Demerol, Fentanyl, Stadol, and Nubain for labor), are medications that are used to alter your perception of pain. Unlike regional anesthesia, which are used to specifically target the uterus and pelvic area, systemic medications are delivered directly into your bloodstream via an IV or into a muscle and will affect your entire body. These medications will dull or numb your pain, but they will not eliminate it altogether since a low dose is required to minimize the effects on your baby. They may make you feel sleepy, but unlike general anesthesia, it will not render you completely unconscious.  In some cases, you may be given the option of patient-controlled pain relief where a small pump is hooked up to your IV and by pushing a button, you can increase the amount of medication that is being delivered to you; there are limits programmed into the pump so you don't have to worry about self-delivering too much medication. Systemic medications are a less invasive form of medication and don't require the services of an anesthesiologist. Additionally, women who use systemic medication instead of an epidural or spinal block are less likely to need pitocin or delivery assisted by forceps or a vacuum. The disadvantages of systemic medication are as follows: must be given in smaller doses so it may not offer as much pain relief as regional anesthesia, will cross the placenta and can affect the baby, unpleasant side effects such as nausea or dizziness, can slow labor if given too soon, can affect baby's heart rate, may make mom and baby less alert after birth so it can interfere with breastfeeding, and in rare cases it can affect mom's breathing and baby's breathing after birth.

• General Anesthesia: The most rarely used form of medication during labor is general anesthesia. This kind of medication is employed specifically to promote loss of both sensation and consciousness. The reason that it is used so rarely during labor is because the mother's participation during the process is key during most kinds of deliveries and the risks of general anesthesia usually far outweigh the benefits. The only time a general anesthetic would be used would be in the case of a Cesarean section, never in the case of a vaginal birth (doctors cannot facilitate a vaginal birth while the mother is unconscious). Some of the rare cases where this method is used are emergency C-section where very rapid loss of sensation is necessary, when an epidural or spinal block cannot be placed, and when a women cannot tolerate a regional anesthetic. When general anesthesia is used, the woman is given a muscle relaxant through an IV, which relaxes her and renders her semiconscious. She then inhales nitrous oxide which facilitates total loss of sensation and consciousness. A tube is inserted into the mother's trachea to maintain an open airway for breathing and to avoid inhaling vomited material should the mother throw up while unconscious. Research has shown that maternal and fetal death rates using this method are at least double those of regional anesthesia, therefore, the use of general anesthesia during birth has all but been eliminated in the U.S.

Questions to Ask Your Health Care Team Regarding Medications

• What's involved in the method?  How will the medication be delivered into my system?
• How will it affect me?
• How will it affect my baby?
• What are the possible side effects?
• How quickly will it work?
• How long will the pain relief last?
• When is this method available to me during the labor process (at any time, after I have progressed to a certain point, only near the end of labor, etc.)?
• What happens if it doesn't work in the way it was intended or not at all?
• Will I be able to remember everything?
• Will I be able to breastfeed my baby right after birth with this medication in my system?

Sources: www.babycenter.com, www.mayoclinic.com, www.americanpregnancy.org. www.anesthesiologyinfo.com

Disclaimer: The "Pregnancy, Babies, and Birth" blog series is meant as a source of general information only. Its intended use is to encourage women to further consider and discuss reproductive and birthing decisions themselves, with their partners, and with their medical care providers. Information included in this series is not intended to be professional medical advice or a substitution for a relationship with a licensed physician or practitioner. Any serious questions or concerns about reproductive, prenatal, and/or perinatal health should be directed to your primary care physician or other licensed specialist. Women's Services and Resources does not promote any particular brand, medical provider, birthing location, or any other specific birthing decisions. We strongly encourage women to become as educated about their choices as possible so they are empowered to make educated decisions for themselves and their babies.

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Pregnancy, Babies, and Birth: Developing a Birth Plan

As women become more educated about the process of giving birth and decide to take a more active role in planning details of their birthing experience, birth plans have become increasingly popular. A birth plan is a set of basic guidelines, hopes, and desires for when a woman goes into labor. It allows a woman to have a framework set up with her partner, her doctor, and the hospital staff present during labor. Some women have very basic birth plans while others can develop birth plans that span several pages. The most important aspect of a birth plan is that it allows for flexibility. There is no way we can control all aspects of labor, no matter how much we want to or how hard we try, so being flexible in your birth plan is key to a less stressful experience.

Common Aspects of Birth Plans:

• Who you want present at the birth (your spouse, mother, siblings, etc.).
• What activities you would like to do during labor such as walking around the halls, sitting on a birthing ball, sitting in the tub, etc.
• Are there certain things you would like to bring to the hospital with you such as music, your own clothing to labor in, or pictures and video equipment.
• What positions you would like to try during the pushing stage (semi-reclining, side laying, hands and knees, squatting).
• Pain relief preferences-whether you would like to go all natural (such as using massage, self-hypnosis, breathing, or other medication-free methods) or whether you want to avoid certain kinds of pain medications while you are willing to consider others.
• Your preferences for fetal monitoring.
• If you would like to eat or drink some things during labor-keep in mind that some hospitals may not allow you to eat in case there is a need to a C-section.
• If you are willing to consider an episiotomy and what methods you would like to try if you want to avoid it.
• Your preferences during a vaginal delivery such as having a mirror to watch your baby being born, or reaching down to feel his/her head, or having your partner help "catch" the baby.
• Your preferences right after delivery like holding your baby right away if he/she is not in need of immediate medical intervention, breastfeeding as soon as possible, or if you want your spouse to cut the cord.
• What your preferences are in the case of a C-section.
• If you would like to room-in with your baby or have your baby taken to the nursery during specific times.
• Your plans for feeding, whether you plan to breastfeed or formula feed, or if you don't want your baby to be given formula unless absolutely necessary.
• If you plan on circumsizing your son or not and where you plan on having the procedure done (in the hospital or later at a clinic or doctors office).
• Plans for Discharge from the hospital.

You can create your own birth plan or look up birth plan templates online.  Baby Center has a birth plan that you can print out and check the boxes that apply to you.  It is wise to print out a copy for yourself, provide one for your primary care provider (family physician, OB/GYN, or midwife), then bring a copy to the hospital with you to be added to your file there.  

Remember, the key is to allow for flexibility in your birth plan because it does not always go according to plan. When it comes down to the decisions regarding your birthing experiences, honor your own preferences, but trust your doctors, nurses, and other professionals to use their best judgment during delivery. If they ask or encourage you to do something that you may not want, ask them to explain to you why they are suggesting it and what your other options may be. The most important thing, regardless of the method of delivery, is that both you and your baby are healthy and well-cared for.

Disclaimer: The Pregnancy, Babies, and Birth blog series is meant as a source of general information only.  Its intended use is to encourage women to further consider and discuss reproductive and birthing decisions themselves with their partners and with their medical care providers. Information included in this series is not intended to be professional medical advice or a substitution for a relationship with a licensed physician or practitioner. Any serious questions or concerns about reproductive, prenatal, and/or perinatal health should be directed to your primary care physician or other licensed specialist. Women's Services and Resources does not promote any particular brand, medical provider, birthing location, or any other specific birthing decisions. We strongly encourage women to become as educated about their choices as possible so they are empowered to make educated decisions for themselves and their babies.

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Pregnancy, Babies, and Birth: Finances and Baby Costs

One of the most important things to consider pre-pregnancy, and consistently during your pregnancy, is the estimated cost of having a baby. The following is a list of baby-related expenses that you should plan into your budget for your pregnancy, delivery, and then after you welcome your sweet baby into the world!

1. Prenatal Care: This will be one of the first big costs associated with your baby.  In 2007, the average cost of prenatal care, uncomplicated delivery, and 3 months postnatal care was about $10,652. If you can, thoroughly read over your insurance plan to determine what kind of coverage your plan offers for maternity care before you get pregnant. Some plans may not come with maternity coverage (like individual policies), so you may end up paying the entire cost of a pregnancy if you aren't aware of that in advance. If you don't have maternity coverage, you may be able to add a maternity rider to your coverage before you get pregnant (some require you be covered under that maternity coverage for a certain amount of time pre-pregnancy in order for coverage to apply; usually 6-12 months), but if you are already pregnant, it counts as a "preexisting condition" in the eyes of most insurance companies and you can be denied coverage. If you are already pregnant, don't have insurance, and are at or below 133% of the Federal Poverty Level, you can qualify for Medicaid. If you are pregnant, uninsured, and don't qualify for Medicaid, call around to different maternity care providers in the area and see if any of them offer special discounts to women that have to pay out of pocket.

If you already have maternity coverage under your health insurance plan, check to see if there is a separate maternity deductible on top of your regular yearly deductible. If you have a relatively cheap health plan (low monthly rates), you're more likely to have really high deductibles (some maternity deductibles I have researched are upwards of $7,500; meaning you would pay that much money before your coverage would even kick in, potentially paying almost the entire cost of your pregnancy and delivery before your benefits apply). After you've determined what your deductible is, check to see how much your insurance covers vs. how much you pay for coinsurance/copays. Most plans will cover 70-80% of the costs for covered providers, leaving you to pay the remaining 20-30%. Make sure that you choose a healthcare provider and delivery location that is covered by your insurance company (go on to your insurance company's website and search their list of covered providers before choosing your doctor).  If you choose a provider that is not within their approved network, you could end up paying a lot higher percentage of the costs (50%+). 20-30% may not sound like a lot that you are paying, but if your doctor charges $4,000 for your prenatal care, cost of delivery, and 6 week follow-up appointment, you are still paying $800 (20%)-$1,200 (30%) just for your doctor's costs.  Hospital costs will be billed separately from your doctor's costs.

2. Cost of Delivery: If you choose to give birth in a hospital, the cost of your delivery can range from $6,000 for an uncomplicated vaginal delivery, to upwards of $25,000 for a c-section. Again, if you don't have insurance, this can be an incredible financial burden. Talk to your local hospital about payment options several months before you deliver. Some may even let you start paying in advance rather than paying it all after the birth. Also, discuss if the hospital offers any discounts for uninsured women. If you are insured, again, thoroughly check your plan so you know in advance what the plan covers vs. what you will pay. Remember, you will be billed separately for your baby's costs (between $1,500-$4,000), so remember to add baby to your insurance plan within the time limit in order for his/her costs to be covered by your insurance as a dependent (you will have to pay the additional premiums when you add a dependent to your plan before coverage will kick in). In addition to separate costs for your baby, if you have pain medication delivered by an anesthesiologist, you will be billed for that separately as well (around $2,500 without insurance).

3. Baby Essentials: This area will differ for every individual family, so I found a very cool little tool called the Baby Cost Calculator. All you have to do is customize the different areas for what you will and will not be using after your baby is born (think childcare, diapers, feeding, college savings, healthcare, and one-time costs like car seats and cribs). After you've put in all that information, you'll get an estimate of how much your baby's first year will cost you. I put in my information based on the costs of the items that I have selected, savings plan, health care costs, etc., and it totaled about $3,992. Keep in mind that this is just an estimate, however. There are several ways that you can reduce the cost of baby essentials.  If you need to do daycare, see if there is someone in your area that you can "baby swap" with, meaning you babysit for each other to "pay" for babysitting services. When it comes to baby supplies, there are certain items that you should never buy secondhand due to use and safety standards (like car seats and cribs). Otherwise, see if you can get hand-me-downs from mommy friends and relatives, look on craigslist (shop safely when buying directly from unknown sellers), and look at stores that sell gently used kids clothing and toys (like the D.I. or Kid to Kid). Don't go too crazy with all the bells and whistles that companies tell you that you NEED when having a baby. For example, when building your baby registry, put only real essentials like diapers, bottles, car seat, crib, etc., instead of filling it with toys and adorable outfits that your child will grow out of in a matter of months.

So, with all of the costs I've mentioned above, we can approximate the cost of pregnancy, delivery, and baby's first year. For prenatal care, an uncomplicated and non-medicated vaginal delivery covered by insurance with a 20% coinsurance, low baby hospital costs, and a modest baby's first year, mom and dad could end up paying around $7,500. Worst case scenario, uninsured prenatal care and c-section delivery, high baby care costs (like having a baby in the NICU) and a modest baby's first year, mom and dad could be stuck paying around $40,000+.

The best thing you can do is to sit down with your partner and get a good idea of what your finances look like well before you get pregnant. If you haven't already had this important discussion and you are already pregnant, it's even more important to talk about money and budgeting together. Having a realistic idea of what your baby will cost you in advance will save you from a lot of unpleasant financial surprises and hopefully prepare you to pay the bills associated with your pregnancy, birth, and baby without getting deep into debt trouble.  

Disclaimer: The "Pregnancy, Babies, and Birth" blog series is meant as a source of general information only. Its intended use is to encourage women to further consider and discuss reproductive and birthing decisions themselves, with their partners, and with their medical care providers.  Information included in this series is not intended to be professional medical advice or a substitution for a relationship with a licensed physician or practitioner. Any serious questions or concerns about reproductive, prenatal, and/or perinatal health should be directed to your primary care physician or other licensed specialist. Women's Services and Resources does not promote any particular brand, medical provider, birthing location, or any other specific birthing decisions. We strongly encourage women to become as educated about their choices as possible so they are empowered to make educated decisions for themselves and their babies.

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Pregnancy, Babies, and Birth: Maternity Wear

First Trimester

For the majority of your first trimester, you may still be able to wear your regular clothes. It's usually not until the second trimester that your uterus grows large enough to rise above your pubic bone and have a significant impact on what you can and can't wear. However, bloating may create an uncomfortable "phantom tummy." If that's the case, pull out some loose fitting jeans and billowy or stretchy tops that don't put pressure on your stomach. Skirts and stretch pants are a great choice, especially if they have an elastic waist band that offers you a little more "give." As your tummy starts to grow and the rest of your body starts to change, there are some little tricks that can get you through a lot longer in your regular clothes:

The rubber band trick  

If your pants are getting a little slug, try looping a rubber band through the button hole of your jeans and then hooking it on to your button. This creates a little more "give" for your growing tummy. Just make sure you wear a shirt that covers the unzipped section of your jeans. You can also incorporate a long tank underneath your shirt or add a belly band (see below).

Bra-extenders  

As your chest starts to grow, you may find your bra fitting a little tighter. It can get really expensive to buy a new bra each time you grow or your cup size increases throughout your pregnancy (not to mention buying maternity bras and nursing bras after you give birth), so try buying bra extenders to give a little extra longevity to your current bras. Just attach them to the clips on your bra to add a few extra inches to your support strap.

Belly bands  

Belly bands are stretchy pieces of fabric that can add extra length to you t-shirts and tops in order to cover up the little gap created by the rubber band trick (see above). They come in a variety of colors and are a cute and functional fashion addition to your wardrobe.

Second and Third Trimesters

As the option to wear your regular clothes disappears, even with the tips and tricks provided above, it's time to jump into the world of maternity wear. As you begin to shop for clothes that fit you comfortably, there are a couple of things to keep in mind:

• If you are shopping on a budget, avoid the "specialty" maternity stores. You'll recognize them when you see them because they only sell maternity wear and will often have the word "maternity" in their name. Unfortunately, the prices can get pretty steep there. Try shopping at regular chain stores that almost always have a maternity section. You'll find things that are cute, comfortable, and fit better into your budget.
• Buy a few things at a time rather than buying a bunch all at once. It may be tempting to run out and buy a bunch of new clothes as soon as your belly starts to poke out, but avoid the temptation! Remember, you will continue to grow and change throughout your pregnancy, so unless you have the money to outfit yourself through several different stages of pregnancy and tummy size/breast size, slow and steady wins the race. Start off with really basic essentials like a pair of jeans, a skirt, slacks, some stretchy maternity tanks, and some basic tees. I'm over 6 1/2 months into my pregnancy and have yet to need to purchase any new tops because my pre-pregnancy wardrobe included some flowly and stretchy tops that I still fit into comfortably. I know the time will come when I can no longer get away with non-maternity tops, but I've saved a bunch of money by incorporating pre-pregnancy clothes as much as possible.
• Purchase items that you can grow into. When you do make your first trip to buy maternity wear, make sure you are buying items that allow you to continue growing. Anything with the built in maternity band (like most maternity pants, jeans, and skirts) will be flexible enough to last you throughout many different tummy sizes. You never know just how big your tummy may (or may not) get, so don't try to guess your future size.

• Buy things you can wear post-pregnancy, too. There are some items that you can wear even after your baby comes. A few perfect examples of this are the maxi dress or empire-waist dress. There are also some tops, like ones with rouching on the sides, that can be part of your post-baby wardrobe as well. Remember, your body won't just snap back like a rubber band to your pre-pregnancy size after you give birth. It will take several months for your body to begin getting "back to normal," so you may still be in your maternity clothes for a while after you give birth.
• Don't just buy bigger sizes of regular clothes. I'll admit, I love nothing more than pulling on one of my husband's shirts when I get home at the end of the day. Bigger sizes of non-maternity wear can be useful for some occasions and purposes. If you're just hanging around the house, then go ahead and slip on those baggy workout pants and a large t-shirt. But remember that maternity wear is specifically designed with the proportions of a pregnant woman in mind. Regular clothes may not provide the same kind of support that maternity clothes do. Additionally, a bigger size may accommodate your growing tummy, but be baggy and uncomfortable in the shoulders and chest, or bigger jeans may be looser in the waistline, but have bad fit throughout your legs. Like previously mentioned, buy some basic necessities in maternity wear like a pair of jeans, some tanks, and a few shirts that are designed for pregnant women for appropriate occasions (work, school, date night, etc.).
• Buy maternity clothes that you love and feel great in. Let's face it, pregnancy doesn't always feel like the most glamorous time of your life. Sometimes you may feel uncomfortable, awkward, and big. So don't be afraid to pamper yourself in small ways by buying clothes that you really feel great in. So even if you are having a rough day physically, you feel comfortable and beautiful in the clothes that you are wearing.  

Disclaimer: The Pregnancy, Babies, and Birth blog series is meant as a source of general information only. Its intended use is to encourage women to further consider and discuss reproductive and birthing decisions themselves with their partners and with their medical care providers. Information included in this series is not intended to be professional medical advice or a substitution for a relationship with a licensed physician or practitioner. Any serious questions or concerns about reproductive, prenatal, and/or perinatal health should be directed to your primary care physician or other licensed specialist. Women's Services and Resources does not promote any particular brand, medical provider, birthing location, or any other specific birthing decisions. We strongly encourage women to become as educated about their choices as possible so they are empowered to make educated decisions for themselves and their babies.

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