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?
BONUS: Is there someone who is familiar with infant nutrition or breastfeeding who I can speak with?
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.
Nothing makes people smile like pictures of babies and baby animals, right? We go nuts for the big eyes, the tiny fingers, the various forms of baby fluff. There are whole galaxies of the Internet devoted to kitty porn because I firmly believe it is the only known remedy for the tragedy in the daily news and boredom in the corporate office.
So why oh why aren't new mamas the Happiest People On Earth?
First, Grumpy Cat doesn't cry, poop, or make your nipples bleed. So there's that. Second, there are some truly incredible things that have to happen in order for two people to make one more. These things involve hormones.
Most of the time, the making hormones are awesome, otherwise we would have gone extinct long before slicing bread. The hormones of breastfeeding and morning nuzzles are equally awesome. But this hormonal hootenanny can leave mama awash in a brave new world of ups, downs, and fun-house-mirror-sideways.
You've read about postpartum depression, but (like most things) what you've read through the popular medial lens is... um... not fully accurate. Before you stop reading and go back to the kitty porn, here are a few things I think you might like to know about postpartum depression.
It Ain't All Sad: technically, postpartum depression is one of many postpartum mood disorders. Even those diagnosed with this condition aren't necessarily sad in the sense that they are weepy, withdrawn, and no longer interested in joyful activities. More women experience anxiety and hyper-vigilance than overt sorrow. It is normal but you don't have to buck up and take it. If you know you're prone to anxious thoughts, or you start to make rules about how many times grandma must wash her hands before touching your little one, it's time to make a phone call.
Crazy Ain't Likely: most women who struggle with postpartum mood disorders avoid seeking treatment because they are afraid that someone will take their baby away. There is a mood disorder called postpartum psychosis, which the media have lovingly mis-labeled postpartum depression in some famous cases. This is certainly terrible, but the overwhelming majority of women with a postpartum mood disorder do not fall into the category of postpartum psychosis (that said if you are ever in a situation where you think you might be a danger to yourself or your baby, please call a friend and keep calling until someone answers, or call 911).
Don't Hold Your Breath: for whatever reason, we think of the postpartum period as the first six weeks after baby is born. If you make it through this time with just a little case of the baby blues as your hormones readjust to pre-pregnancy style, groovy. But that doesn't mean you're out of the woods. Postpartum mood disorders can creep up on you later in the first year of life.
Treatment Helps: learning that your feelings are normal and that there are ways to cope with them (other than laminating everything in your house or crying alone in the bathroom) is empowering. I think it is wise to connect with a therapist every three months even if you're feeling jolly as an elf. There is always something they can offer you, even if it has to do with your romantic relationship, your family, or your future.
Get Out of the House: the secret-agent aspect of Mom & Me yoga? You get to meet other mamas, especially those you've known from prenatal yoga. You get to learn what other mamas worry about and support one another. The instructor can also give you a little guidance and support if it looks like that's what you could use most.
The first year of your baby's life might be totally joyful, but you're likely going to experience some bumps as well. It's kind of like four-wheeling*. Sometimes the bumps are fun, and sometimes they are more than you are equipped to manage on your own.
*I know literally nothing about four-wheeling.
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.
Loving lists? Check out my meal-sharing tip sheet and my A/B Listfor postpartum job delegation.
More registry suggestions....
I recently watched the documentary series "More Business of Being Born" and it made me think yet again about how birth begins. Do you know? Let me explain.
Your body is working very hard to support your baby right now. Not only have you grown an entirely new organ (the placenta) you are getting ready to make milk for when baby is born. You might feel excitement about the upcoming birth, or a little trepidation that you aren't ready and can't quite keep a good handle on time.
There is nothing wrong with you! As luck would have it, you're not supposed to decide when your baby is born. You're not supposed to have ANY IDEA! Women in my class are frequently frustrated when they don't "feel" any different once they hit the magical 40 week "due date" marker. The dirty secret? Women have never known (and neither have men).
In the "old system" (and by old system, I mean the one used from 3.3 million years ago until about 100 years ago) went like this:
Miss a period?
Count nine moons. (yes, actual moons. Like full moons. In the sky).
Sometime between the ninth and tenth moon, you'll have a baby!
I'm sure that ancient and not-so-ancient women all gazed at the moon and cursed the sky when they started to feel really uncomfortable. But they had only one option: wait.
So if you don't decide, who does? There is something on the border of science and magic that happens when baby is ready to be born. Baby moves into a good position, pressing his head against your cervix. Some complex chemical changes start to happen in his body once he is ready to start breathing. Those changes signal your uterus to start contracting, and once things really get moving your water may break and baby will slide down even further.
Under normal circumstances, baby decides, mama goes into labor and all is well! Occasionally, there are unusual circumstances, like an illness that mama has or some signs of fetal distress that warrant an earlier birthday. Thank goodness we live in a time when we have so many options when something goes wrong!
So what's the deal with induction? You probably have friends who have had their labors induced for a variety of reasons. Some doctors will offer an induction even before your due date, and for a mama who is uncomfortable, this can sound like a great option. However, labor that is chemically induced can cause incredibly intense contractions that are very painful for you and baby. You can get an epidural, but your baby will not get any pain relief from it.
It is worth asking some questions before you decide that an induction is right for you.
1. How will an induction affect my labor? I've heard it can make it much more painful and possibly more dangerous for me. What are your thoughts?
2. What are the possible effects for my baby? I've heard that babies who aren't ready to be born have more difficulty breathing and breastfeeding, and that the induction process is more traumatic for my baby.
3. Is there a medical reason why I should consider an induction now rather than waiting until I am 42 weeks?
4. I've heard that there are many ways of inducing labor. Can you please tell me about my options?
This is a great time to use your B.R.A.I.N.:
What are the BENEFITS of induction (for me and baby)?
What are the RISKS of induction (for me and baby)?
What are the ALTERNATIVES to induction?
What does MY INTUITION tell me about this decision?
What would happen if we were to do NOTHING right now? When would we need to decide?
Want to read more? Check out the Mayo Clinic's article about Induction.
I'm one of those people who loves making your life easier (and I believe in you). I am an experienced registered prenatal yoga teacher and a lactation educator.
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