Six Things to Look for in a Prenatal Provider

April 11, 2019April 11, 2019

Six Things to Look for in a Prenatal Provider

A prenatal care provider is the medical professional who oversees your care during pregnancy, birth, and postpartum. Most providers are obstetricians or midwives, but they can also be family practitioners or even a chiropractor.

Ensuring that they are trained and licensed should be a no-brainer, and that’s not what I’m going to talk about here. You absolutely need to trust that they can keep you physically safe during and after labor.

What I’m talking about is the kind of person they are and the kind of support they give you in order to make you feel emotionally safe. As with many other things, it’s crucial to your well-being in this phase that you feel entirely loved and supported. Seriously.

So, when looking for a prenatal care provider, seek out someone who is:

1) Emotionally Supportive

You are an entire woman, not just a body, and the experience you’ll have during birth has as much to do with how safe you feel emotionally as with how well prepared you are. I wouldn’t say I was skeptical of the impact emotional safety can have on labor, but after personally experiencing a stalled labor because of an abrasive OB that made me feel emotionally unsafe, I am a firm believer.

During my third labor, the OB on duty treated me poorly and condescendingly while giving me a speech about all the things that could go wrong during labor and concluded with the thought that she might have to remove my uterus. Whaaaaaat! Yep, baby decided to cool her jets after that last part. Fortunately, labor picked up again when that OB turned over and the new doctor on duty was supportive and in tune with my emotional well-being, not just what my body was doing.

2) Open to discussion and questions

Who knows all the things about pregnancy and birth before starting a family? NO ONE. You’ll have questions. You’ll have a lot of questions! And your preferences for birth will develop as you research labor, breastfeeding, and infant bonding. Your provider should be open to the questions you have and patiently answer them with objective concerns and options. They don’t have to agree with all your preferences. Remember, they are a member on YOUR birth team; they are not giving birth, you are.

3) On the same page

Ideally, you and your provider will have similar sentiments and values when it comes to birth. Want to do it unmedicated? Don’t choose an OB who caveats all scenarios with the option of a cesarean or induction. Want a planned C-section? Don’t sign on with a super hippie, let’s-give-birth-in-a-field midwife who keeps hoping you’ll go into spontaneous labor before your scheduled surgery. You want your team aligned in most things, but don’t think you’ll have to agree on everything. Shoot for 80% and I think you’ll be fine, as long as respect is still there.

4) Willing to give you options, not pressure

Birth is unpredictable, we all know this. Even if you’ve given birth before, you can’t say how this time will go. This is why we call them birth preferences. Even when labor gets derailed and your original hope is no longer viable, choosing a provider who is going to support your decisions in the moment is far more valuable than a doctor who is going to pressure you because of hospital policy or the way they prefer to do things. Your provider should be willing to give you options before and during labor, but understand that they are not the one making the decisions – YOU are.

Birth trauma is becoming better documented as awareness increases. Often, birth trauma is caused when doctors start making medical decisions for the mother, instead of informing and educating her to make them herself. Your medical care provider is essential for advising you medically, but it is inappropriate for them to decide for you or pressure you into a certain path without medical necessity.

5) Eager to know you

The perinatal phase is a year-long relationship. I’ve been blessed so far with active duty Navy midwives that were eager to get to know me and give me the best care they could. We both looked forward to my appointments to catch up and talk birth! I felt truly cared for; they were simultaneously my medical provider and friend.

Ideally, you will feel a bond with whomever is assisting you in birth. That emotional connection is important, really! Find someone who prioritizes building a relationship, not content just being your medical provider. This paves the way for my point above about establishing emotional security before entering labor and experiencing a truly supported birth.

6) Will accommodate a variety of postpartum care options

If you loath putting your newborn in a car seat to run errands as much as I do, going to see your doctor is no less unpleasant. But there is hope on the horizon. ACOG Committee Opinion No. 736 discusses how medical providers should provide more ways to care for postpartum women other than the traditional office visit.

“Assessment need not occur as an office visit, and the usefulness of an in-person assessment should be weighed against the burden of traveling to and attending an office visit with a neonate. Additional mechanisms for assessing women’s health needs after birth include home visits, phone support, text messages, remote blood pressure monitoring, and app-based support. Phone support during the postpartum period appears to reduce depression scores, improve breastfeeding outcomes, and increase patient satisfaction, although the evidence is mixed.”

Is your provider on board with other options that don’t require you travel to them and tax yourself? You’ve got yourself a winner.

How does Marabou support women?

We live in culture where “bouncing back” is more valued than proper rest. As admirable as it may be for a sports star to get back on the field, the same rules don’t apply to postpartum recovery. The traditional resting period has been stolen from women through pressure to get back to their job or simply through lack of presence.

Grandmas, sisters and best friends who otherwise would have been there to help a woman transition into motherhood often live too far away to be of any help. Household chores and caring for older children inevitably fall on the mom. But she just delivered a new life! She needs rest.

Marabou Services is a unique gift registry which provides services instead of stuff. Most mom’s get too many onesies, too many baby blankets and not enough helping hands. Break out of a destructive cultural norm and start a Marabou registry today.

Start a Marabou Gift Registry!

With a Marabou registry you can sing up for any service which will benefit you or someone you know during the postpartum recovery period.

Postpartum doulas for a first time mom

House cleanings for moms of multiples

Childcare for moms with older children!

Once your registry is created, add it to any other registry or post it to your Facebook and ask friends and family contribute to your postpartum service, rather than buying you more stuff.

More and more moms find they have to figure out postpartum alone. Is it any wonder why PMDs are on the rise? Or women are embittered by the journey of motherhood? We can change that by giving the gift of peace.

April 4, 2019April 11, 2019

The Basics of Breastfeeding

Quick disclaimer: I’m not an IBCLC. I don’t have professional lactation training. I have only my own experience nursing 3 babies into toddlerhood: 15 months, then 14 months, and most recently 2 years. This post is about the basics of breastfeeding that served me in my early days of motherhood. I knew I wanted to breastfeed and was determined to succeed. I knew it was natural but challenging, and my two greatest tools were preparation and patience. Here are the things that helped me:

I read La Leche League’s The Womanly Art of Breastfeeding during pregnancy.

This resource is bomb! I used it as a reference book, but it’s easy to read cover-to-cover to familiarize yourself and get the tools in your mind beforehand. It also shares things you can do before birth to promote a positive and empowered birth mindset. I cannot recommend this breastfeeding resource enough!

I took a breastfeeding class.

We were stationed overseas at the time of our first pregnancy, and the Fleet & Family Support Center (great resource to use for all you military wives out there) offered free classes for new parents. Hospitals, doula organizations, and community centers also offer classes for mothers who wish to breastfeed and it’s easy enough to find ones that are free. If you can chat with an IBCLC or Certified Lactation Counselor to pose questions and increase your understanding you will increase your success tremendously.

I requested an IBCLC in the hospital.

Even before birth, it never hurts to make appointments and ensure you have all the help you can get! IBCLCs are important when breastfeeding isn’t going well, to troubleshoot issues. But they’re also important when breastfeeding is going well, to ensure you have an ideal latch and are nursing as much as baby needs.

I planned for skin-on-skin contact immediately after birth.

Skin-on-skin contact encourages breastfeeding (see the next point for how!). Apgar scores and vitals can be taken while the baby is on you, and all other stats (weight, height, etc.) can wait! Trust me, it’s worth it to have skin-on-skin immediately after birth if your and baby’s health is not in danger. There is no need medical reason to weigh the baby immediately after birth.

I gave baby a chance first.

Babies have instincts to find the breast shortly after birth, and if left unhindered, they will latch themselves (Google the “breast crawl” – NSFW)! I let my son squirm around on my chest in search of the breast, and he found it on his own. In that way, his instincts were fostered and we were able to have a good start. You both have to learn how to breastfeed! This is a critical time for patience. They don’t just come out and look for the breast, you kind of have to let them discover it without getting in their way.

I followed a specific approach to my latch.

Ok, here’s the meat of this whole post! This was my process whenever I latched my newborn for a feeding:

I held baby across my body with the opposite arm of the breast I was feeding him on, arm along his back and hand supporting his neck. This was to leave his head unhindered. It’s often hard to latch a baby while their head is in the crook of your arm.
This allowed for the ability of baby’s head to tilt back (as opposed to his jaw pulling down) and get a wider, deeper latch.
I would then make a “booby sandwich” and squeeze my breast slightly parallel to his mouth, like he was about to eat a sandwich. 😉
With this booby sandwich, I would brush the nipple on baby’s tip lip or nose to encourage him to open wide and reach his head upwards.
After latching, I’d ensure baby had fish lips – both top and bottom lips are facing out. If not, I would gently pull his bottom lip out.
While nursing, I’d make sure baby’s chin was buried but his nose was open. After let-down, I’d start to hear the “keh” sound of him swallowing. Success!

I latched, re-latched, and then re-latched again.

If it ever pinched or hurt, I would try again as many times as it took to get a good latch. It’s really worth the effort to get a good, deep latch – your nipples and your supply will thank you! Except for a little soreness in the first few days, breastfeeding shouldn’t hurt. If it does, seek professional advice; don’t think it’s normal and just grit through the pain. Nobody wants that, and no one is benefitting from it, not even baby.

I didn’t follow a schedule.

My babies always have access to the breast. This helped us establish a good supply and a good bond. Their stomachs are so small, they need to eat frequently; I don’t pretend to know what my baby is feeling, when he’s hungry, or when he “should” nurse. I’m fairly certain babies can’t tell time.

I bed-shared.

This is a controversial topic (feel free to see my post from last week). Bed-sharing supported our bond and our nursing relationship. Baby always had access to the breast and nursed when he needed to because I was right there. Dr. James McKenna of the Mother-Baby Behavioral Sleep Laboratory at Notre Dame often promotes infant arousal patterns in the presence of the mother. See here. Thanks for reading about breastfeeding! What made breastfeeding successful for you? Especially tips and good practices for breastfeeding at work (a situation I haven’t experienced). Please share so other moms can learn and we can get more mamas breastfeeding. If you’re a visual learner like me, watch the video below:

How does Marabou support women?

Start a Marabou Gift Registry!

With a Marabou registry you can sing up for any service which will benefit you or someone you know during the postpartum recovery period.

Postpartum doulas for a first time mom

House cleanings for moms of multiples

Childcare for moms with older children!

Once your registry is created, add it to any other registry or post it to your Facebook and ask friends and family contribute to your postpartum service, rather than buying you more stuff.

More and more moms find they have to figure out postpartum alone. Is it any wonder why PMDs are on the rise? Or women are embittered by the journey of motherhood? We can change that by giving the gift of peace.

March 29, 2019March 29, 2019

The 8 Things We Did to Safely Co-sleep

In America, the idea of co-sleeping is faux pas to the nth degree. Taboo. Don’t do it. Get that craziness out of your mind.

Having been through three intentionally co-slept babies (why does that feel like a confession?!) I now believe this black-and-white advice is actually harmful.

Moms are told that co-sleeping – in all its forms – is dangerous. You’re going to roll onto your baby. Your baby will suffocate. Or be strangled or fall. This fills your head with countless nightmares so of course moms are ashamed to consider co-sleeping. They never prepare to do it safely, and – often – it happens spontaneously, in desperation, at 3 am when their baby won’t sleep alone for more than 20 minutes.

Around 46% of parents lie about co-sleeping with their children (see here) and the stigma associated with co-sleeping causes some parents to deny or avoid discussing it with their family or their doctor. And yet, over half of parents report to have co-slept in some form for a period of time while raising their children (see here). It’s important to prepare parents for safe co-sleeping even if you’re intent on baby sleeping alone.

Before you throw out co-sleeping, review these headers so you at least have an idea of how to safely co-sleep when it’s the middle of the night and you haven’t slept in days. Here’s what was important to us as we prepared to co-sleep:

Put the mattress on the ground

We fell into this style of sleeping when living in Japan for a number of years, where futons on the floor are common sleeping arrangements. After three babies, we’ve only had one fall off the bed (at 18 months). Having our mattress on the ground made that fall barely memorable.

Take away excess pillows and choose the right mattress

Choose a firm mattress with no pillow-top or anything too soft for baby. And for pillows, we each got however many we actually use at night. One for him, two for me. There’s no need for any more, and they would only increase risk.

Simplify your bedding

Much of the worry over co-sleeping is suffocation from mom rolling on top of baby or the bedding covering their face. Heed this advice and make your bedding “crib appropriate.” We nixed the duvet in favor of layered, thin quilts. Our layers included: one top sheet, one thin quilt, and one additional quilt folded over at the foot of the bed, far from baby but warm on our feet.

Simplify your side tables

No cords, no knick knacks, no excess. Our side tables are light-weight cubbies (see here) with a small lamp and maybe a book. It moves easily and can’t wedge baby.

No pets in the bedroom

We kicked our cat out of the bedroom, for obvious reasons! Pets in the bed can pose harm to baby by smothering and animals aren’t exactly hygienic for a newborn. They’re wonderful snugglers, but not for babies.

Learn to side-nurse

I’m a breastfeeding mom, so co-sleeping is wonderful. Having the baby nurse in the crook of my arm while I laid on my side was advice given to me by our primary care providers and turned out to be safe and comfortable. After a few weeks postpartum, all I would do for a night feeding was roll over, switch baby to the other breast, and fall asleep. Baby could nurse as much as he or she wanted and we both slept well.

Don’t drink and don’t smoke (this includes your partner)

I know, you just went through nine months of these restrictions, but if you’re going to co-sleep, keep it going! Drinking can impair your awareness (no shocker there) and inhibit your sensitivity toward your baby while you’re sleeping. The risk just isn’t worth it!

Smoking lingers on your skin and clothing and can be very harmful on the developing body of an infant. My husband did become a bit of a teetotaler, but because we had discussed no drinking and smoking before going to sleep with an infant, he would choose to sleep somewhere else if he had anything to drink that evening.

No other children in the bed

This may be tough to enforce if your kids are already used to sleeping with you. Our toddlers or pre-schoolers were never allowed to sleep in the bed where there was a baby. They sleep too deeply and have no awareness about how much they move. My husband usually ends up sleeping with them in their own bed to help with the transition until they are ready to sleep on their own. We start this practice long before a new baby arrives just to make sure they’re ready when they have a new sibling.

The first year of my first son’s life, it was easy to co-sleep because my husband was mostly deployed. I didn’t have to worry about the awareness of my partner while we slept in the same bed with our baby. Now, since our kids are really close in age, I sleep alone with our youngest (I call it my “postpartum suite”) and he sleeps with whichever older kid(s) still need it.

Much of the guidance we followed came from Dr. James McKenna. His book (find it here) was really helpful in learning what safe co-sleeping is and why it should be considered. I also appreciated Dr. Sears’ The Baby Sleep Book (here) and Elizabeth Pantley’s The No-Cry Sleep Solution (here).

Co-sleeping isn’t just a list of things to take away from your sleep area. It’s a good, nurturing experience for you and your baby. It’s leads to better maternal bonding, breastfeeding success, and better sleep patterns! Scientific studies have been exploring how it promotes safe breathing in baby and good arousal patterns so they can eat often (see here). It helps you, the mother, survive sleep regressions and nurture baby’s emotional and mental health when it’s not obvious they feel scared, nervous, or unhinged. Although you may not commit to co-sleeping day-in and day-out like we did, don’t neglect knowing and preparing for safe co-sleeping.

How does Marabou support women?

Start a Marabou Gift Registry!

With a Marabou registry you can sing up for any service which will benefit you or someone you know during the postpartum recovery period.

Postpartum doulas for a first time mom

House cleanings for moms of multiples

Childcare for moms with older children!

Once your registry is created, add it to any other registry or post it to your Facebook and ask friends and family contribute to your postpartum service, rather than buying you more stuff.

More and more moms find they have to figure out postpartum alone. Is it any wonder why PMDs are on the rise? Or women are embittered by the journey of motherhood? We can change that by giving the gift of peace.

March 20, 2019March 21, 2019

Cherry on Top: Roasted Veggies!

Our family does what it can to add as much nutrition to existing dishes as we can through an approach we like to call Cherry-on-Top. As in our previous Cherry on Top blog posts (see here and here). One of our go-tos, especially during the summer months and the CSA bounty is overflowing, is roasted vegetables. It’s easy to throw spare veggies into any recipe after roasting them. My favorite, but really my kids favorite, to add them to is Mac and Cheese!

Yum yum yum!

Here’s my recipe for stove top mac and cheese. Get creative and add any roasted vegetables you’d like!

Here’s what you’ll need for the mac and cheese:

1/4 cup butter
1/4 cup flour
3 1/2 cups milk
1 pound cheddar cheese, grated
Salt + pepper to taste
1 pound macaroni, cooked

For the roasted veggies, all you need are the spare vegetables in your fridge or whatever you choose from the grocery store. This time I went with: brussels sprouts, broccoli, and red onion.

Chop up your vegetables and add them to a baking sheet. Add your preferred oil and spices (for this one, I used avocado oil* and paprika, salt, and pepper). Roast them in the oven at 450°F for 15-20 or until brown and crispy.

Tip: When my veggies are ready, I simply turn off the oven and let them sit until the rest of dinner is ready. While sitting in the cooling oven, they soak up all the oils and spices, and they stay warm! I learned this trick from my mother-in-law. Hi, Barb!

And for the macaroni and cheese itself:

In a large saucepan, melt the butter over medium heat. Add the flour and cook for 3 minutes, stirring or whisking constantly.
Add the milk and cook for 10-15 minutes, stirring frequently, until thickened.
Off the heat, stir in the cheese, salt, and pepper.
Stir in the cooked macaroni and roasted vegetables

SO EASY, right? AND it’s macaroni and cheese, so kids LOVE it. Find a printable of this recipe here.

*I prefer avocado oil because of its high smoke point and ability to remain unchanged at high temperatures. Choose whichever oil you’d like; in my mind, olive oil is a close second.

Get creative! Add in anything you’d like. This is a very cherry-on-top-friendly meal. Other ideas might include:

Roasted butternut squash and thyme
Black beans, corn, diced tomatoes, and crushed tortilla chips
Broccoli, cauliflower, and cherry tomatoes
Any veggies left over in your fridge!

What else could you add to a macaroni and cheese dish?

How does Marabou support women?

Start a Marabou Gift Registry!

With a Marabou registry you can sing up for any service which will benefit you or someone you know during the postpartum recovery period.

Postpartum doulas for a first time mom

House cleanings for moms of multiples

Childcare for moms with older children!

Once your registry is created, add it to any other registry or post it to your Facebook and ask friends and family contribute to your postpartum service, rather than buying you more stuff.

More and more moms find they have to figure out postpartum alone. Is it any wonder why PMDs are on the rise? Or women are embittered by the journey of motherhood? We can change that by giving the gift of peace.

March 15, 2019March 15, 2019

How I Run Errands With My Kids Gracefully: Paired Outings

One of my own major struggles as a mother is errands! Ack! Do you remember the days you used to go grocery shopping with ease? Do you remember dropping off your library books and dry cleaning at your leisure, instead of needing to literally schedule it based on nap and snack and the tender balance of mood?

Yeah, me neither.

And it sometimes feels like your children are out to sabotage your errands from the start. For you, it’s necessary life function. For them, it’s an adventure, the goody store full of colorful boxes and food samples and DONUTS (oh, and the occasional enormous $40 stuffed bear, whyyyyy?).

I realized their sense of adventure during errands was not a character flaw. They’re supposed to be curious and bold! But in the grocery store? It’s misplaced and inconvenient, at the very least.

So, I decided to start giving them their adventures first and embracing paired errands.

When we go out, we do two things: one fun thing for them and one needed thing for me. Their fun thing is meant to get their wiggles out, their energy (somewhat) depleted, and their bladders empty (there’s always a potty break at the tail end). If there’s an adventure before what I need to get done, we can usually do our work with more grace.

Here are some examples of my paired outings:

Year-round:

Library with kids play area + grocery shopping
Story time + target
McDonald’s PlayPlace + post office (bonus: I get coffee!)
Mall park + Michael’s or other specialty store

In the summer only:

Playground or park + grocery shopping
Beach + library run
OR a long walk to your errands, if possible. Fresh air does a lot in and off itself!

It helps if your two locations are close to each other. My library and grocery store are right across the highway from each other. This grocery store also has a playground across the road that’s easily walkable in the summer months (I’m just waiting for that snow to melt!).

I’m cautious about doing this with big indoor play parks, however. At these places, my kids usually want to play for at least two hours (and because of the fee, I’m usually a fan of maximizing their play time). At that point (and depending on the ages of your kids), the outing is too long and everyone is tired. Your grocery run won’t be enjoyable anyway! I keep play parks for fun days and use more simply adventures for days we need to run errands.

Onward, mamas!

How does Marabou support women?

Start a Marabou Gift Registry!

With a Marabou registry you can sing up for any service which will benefit you or someone you know during the postpartum recovery period.

Postpartum doulas for a first time mom

House cleanings for moms of multiples

Childcare for moms with older children!

Once your registry is created, add it to any other registry or post it to your Facebook and ask friends and family contribute to your postpartum service, rather than buying you more stuff.

More and more moms find they have to figure out postpartum alone. Is it any wonder why PMDs are on the rise? Or women are embittered by the journey of motherhood? We can change that by giving the gift of peace.