Monday, January 25, 2010

Questions to Ask Your Doctor or Midwife

I am routinely asked this question: "What kinds of questions should I ask my doctor/midwife?" There is a great list put out by CIMS (Coalition for Improving Maternity Services) titled: "Having a Baby? Ten Questions to Ask." I would strongly recommend you look those over if you are expecting a baby.

I would like to add a question though: "What made you decide to become an OB/Midwife?"

Recently, I was reading a local magazine article about an OB-GYN and she was asked this question. Her answer, in my eyes, raised a huge red flag. She said she was doing her medical rotation and it was during a c-section that she decided that this was the profession she wanted to be in. It wasn't witnessing a natural, unmedicated birth and the awe of a woman's body that she felt inspired by -- it was a surgical procedure where she "rescued" the baby from the woman's body. This is what she enjoyed -- surgery!

Ultimately, this question will let you know if they feel the need or desire to intervene in the natural process with lots of testing and procedures. You'll know if they view pregnancy, labor, and birth as a normal healthy process, or if the medical profession improves upon the natural process. (Sometimes this is true, but in less than 20% of pregnancies.) It's all about their viewpoint.

It's a harmless question full of enlightening information.

Saturday, January 16, 2010

The Sense of Smell Connects Babies and Mothers

When Vena (#2) was born, she was immediately placed on my chest where she remained for 2 hours, breastfeeding like a champ. We were skin to skin and eye to eye. It was an amazing period of bonding. We remained together for most of the day and took her home that same night.

After a few days, I started to notice that in the morning after I showered, she absolutely refused to breastfeed. She would cry and hardly even wanted me to hold her. It broke my heart, but it was the only time of the day she would act like that. As I put the pieces together, I realized that I smelled different after I showered and maybe that is what angered her.

From there on, I would be sure she was well-fed before I showered so that I could start to smell like myself before she would be ready to nurse again. The experience was quite funny, but I've always known that babies know not only their mothers voice and face, but also her smell.

Mothering Magazine had a great article this issue about this exact topic. I just wanted to relay a few key points that I found fascinating. If you've read anything I've written about those first couple of hours after your baby's birth, you know how strongly I feel about you and your baby remaining together.

Did you know that your baby can smell amniotic fluid for up to a week after its birth? This is (another) good reason to place your baby skin to skin after its birth. It transfers from the baby to its mothers breasts and the baby is naturally attracted to the smell. This becomes a good reason not to bathe the baby or mother too soon.

If unmedicated babies are placed on their mother's chest after birth, they will crawl to the breast and begin to breastfeed. Experiments have been done with smell preference of the breast, and babies consistently prefer the unwashed breast over the washed breast. A breast with amniotic fluid odor is even more enticing than a "plain" breast.

In other studies, babies placed in a bassinet with a breast pad with his mother's breast odor, will "crawl" towards that pad over a clean pad.

Even formula-fed babies prefer the smell of breastmilk. A recent study in Japan was trying to find the effects of breastmilk odor and babies response to the pain of a routine heelstick test. There were four different groups -- 1) exposed to the smell of their own mother's milk, 2) another mother's milk, 3) formula milk, 4) no scent at all. Their responses were monitored and, no surprise, the babies who were exposed to the scent of their own mother's breastmilk had significantly less crying and other signs of distress. Baby's cortisol levels were also checked before and after the heelstick, and babies not provided with any scent experienced increased coritsol levels. Babies who were exposed to their mother's scent experienced stable levels.

What about mothers and the smell of her infant? One of the most magical, intoxicating things I love about having a newborn, is the smell of their breath and their head. Watch a mother holding her baby for a few minutes, and she will inevitably smell her baby's head. Rubbing my check against the check of my newborn... I can't hardly stand to write about it. I feel my heart rate increase and tears come to my eyes. Oh, how I miss that! We just don't do that with our big kids. They wouldn't stand for it! Plus, they don't smell so good anymore!

Within six days after giving birth, a mother can smell the difference between an article of clothing worn by her baby and that worn by another baby. Along those same lines, blindfolded women can tell which baby is theirs when they smell the heads of three different newborns.

I wasn't breastfed, but I do remember, as a small child, laying next to my mother for a nap and her distinct smell. Smell can take us back in time. I have an old trunk that belonged to my grandmother who died when I was almost 6 years old. When I open it, I am standing in her old log cabin in Southern Illinois. I hope this sense of smell will remind our children, even when they are grown, of where they come from and who loves them most.

Monday, January 11, 2010

Having Baby #2

It is such a joy to watch my couples from my childbirth education classes families grow. I usually do have a few couples in class that have had previous children, so I try to address a couple of issues that parents are typically concerned with when have that second baby. Most do not voice these concerns, but once we get to talking, nearly everyone has them.

Think back to being pregnant with the first baby: the excitement (hopefully!) of seeing that pee- stick tell you that you were going to have a baby, picking a doctor or (hopefully!) a midwife, reading all the books, listening to countless birth stories and wondering what your own birth would be like. That first time around is just magical. Feeling the baby move, laughing at your baby's hiccups, thinking that Braxton-Hicks contractions were the baby doing a major somersault.

The first time you tried to breastfeed, all the worrying about if you were doing things right. What kind of mother you'd be. You watched your baby's every move. Recorded all the firsts. There are a million pictures on your computer of your baby doing everything from sleeping to smiling to crawling to eating solid food. It was all so new and amazing to watch this little person grow. He had your undivided attention, often much to dad's dismay!

When you found out you were pregnant with baby #2, you probably felt excited that you'd get to do this again. This time, you promise yourself that you'll remember what it feels like to have a baby inside you move their little feet. Hopefully you won't be sick, whether you were or were not the first time around. Being sick with a little one in tow is quite different that being sick by yourself! So, no guilt when your child watches Sesame Street over and over! Survival mode might kick in! And that is okay. It's all for a good cause.

A lot of second time parents don't read for a couple of reasons: 1) they think they already know what they are doing (this is even more true with the 3rd baby), or 2) they just don't have the time now. For me, I wanted a different birth, so I read like crazy and got a babysitter for the weeks of childbirth classes. I see this a lot with my couples that already have children. It's about commitment.

You may or may not remember the first time you felt the baby #2 move and even if she moved very much. You are mostly dealing with the baby you already have!

In the back of most parents' heads at this point is, "Can I love another baby as much as I love this one?" It's so hard to imagine. A lot of parents have expressed that if the baby is a different sex, it will be easier for them to be excited -- to feel like it's something new. More worry if it's another boy, or another girl. More comparing.

Parents typically are much more confident in taking care of the second baby. The other child has survived somehow, so we must be doing something right! Once the baby is actually here, the parents find out that, yes, I can love this baby just as much as the first baby. Oddly, it seems to only occur with baby #2, this worry. You'll find yourself protecting baby #2 from baby #1 and trying to help him understand why he has to be quiet when the baby is sleeping or why he can't throw balls in the house.

There is often guilt in those early months, as baby #1 wants -- and has been used to -- your undivided attention. I always put my babies in the sling and they became almost invisible to the other kiddos. Baby was happy, mama was happy, and other children were happy. Win, win, win. It's ok that your older child is having to learn patience. You have given him a playmate and while they can't play yet, in just a few short months, they will. Let's face it, as great a playmate as I'm sure you were, another child is so much better! They will learn negotiation, sharing, fun, and hopefully will get a best friend out of the deal. That guilt you initially feel will hopefully be very short-lived.

Shortly after Vena (my #2) was born, I remember David had been at work one night, and I must have been feeling adventurous and decided to bathe both children at once. We were in a tiny BYU apartment at the time. Daymon (#1), 2 1/2, was in the big bathtub and Vena was in the baby bathtub on the floor. I don't remember all that transpired in those few moments, but I do remember that David came home to find us all three crying, the two kids on my lap, on the bathroom floor. He looked in, and just turned back around and shut the door! There were days when I was convinced that this was a huge mistake to have another baby!

Vena was an interesting baby, and still, my most interesting child. She would smile at me and David, but no one else. Everywhere we went, people would talk to her in the sling and tell her how beautiful she is. My dad used to say that she could stare a hole through you. No expression. The only person that could ever make her laugh was her big brother. I am not exaggerating. Eleven years later, this is the sister that he is most bonded with.

In fact, going from 2 to 3 kids, for me, was much easier because #1 and #2 would play together while I dealt with #3. My words of caution with #3 is to not be cocky or over-confident -- with the pregnancy, and especially the labor and birth. I've talked with midwives who say that 3rd babies make them the most nervous. Not just the labors, but the parents. They tend to have a know-it-all attitude and do not prepare themselves appropriately. This was definitely our case. Stay humble!

Middle child is a tough place to be. I'm a middle child. I always felt that my mom's favorite was my brother, being her firstborn. He was also 8 1/2 when I was born, so they had been together for a long time before I came along. And my dad's favorite was my sister, two years younger than I. All those pictures of #1, and you swear that you won't be like your parents. You will record all those firsts and have equal amounts of pictures of all your kids. Impossible! I'm just like they were.

My experience with #2 is that it has been very easy to ignore her. #1 demands so much attention because they are used to it. Second babies tend to entertain themselves easier, or be entertained by big brother or sister instead of mom or dad. I have often used the phrase, and everyone has heard it, "The squeaky wheel gets the oil." The children that don't squeak as much need just as much attention as the squeaky ones. Vena has had a lot of issues -- self-soothing issues, I'll call them -- that I think could have been avoided had I not relied on Daymon to entertain so much. Pay attention to those non-squeakers!

Love those babies. I can hardly hold my baby anymore. She's almost 5. They will grow. No matter how many babies you choose to have, you'll be amazed at how much love you'll have in your heart. Try to remember every single sweet moment, even though you know you won't!