Seattle's Child

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newborn reality check

Birth and newborn reality check

Where to turn when having a baby doesn't go as planned

The dreaming starts the moment your pregnancy is confirmed. The dream goes like this: you’ll enjoy nine months of carefree eating and your libido will go into overdrive; your birth will come off exactly as you outlined in your birth plan, right down to your partner in tears as he catches the baby and cuts the cord; you will bond with your newborn instantly, the very moment she arrives; breastfeeding will feel completely natural and comfortable and result in a cherubic and healthy baby; and finally, the relationship between you and your partner will rise to new heights as you work together to raise a happy, healthy child.

If you are really lucky all of these dreams may come true; your labor, birth and the months after baby arrive will go exactly this way. But, for many of us, the hopes of a perfect pregnancy and early parenting hit a wall called “reality check” at one point or another.

Reality could look like any or all of these: The pregnant partner’s blood pressure spikes and they finds themselves on bed rest for the last two months of waiting. That long-planned natural birth suddenly and frighteningly turns into a Cesarean section. And the rush of bliss you expected at birth feels more like a shocking numb or, for those blessed with that rush, it dries up quickly as lack of sleep and fatigue take their physical and emotional toll on both partners.

What’s a parent to do when ideal meets reality? Below are some insights and resources aimed at making the transitions into parenting a little easier – or, at the very least, reassure you that you are not alone, you are not going crazy as you navigate the joys and challenges of a new baby, there is help.

Reality check

Ideal 1

Your family practice doctor, who has cared for you since you were born, will deliver your baby.

Reality

Your family practice doctor may not do obstetrics due to the high cost of malpractice insurance these days or you may find you want to explore all of your options from delivery at home to a hospital birth. Family practice doctors, obstetricians and certified nurse midwives all deliver babies in hospitals in Washington. Licensed midwives, who deliver babies at home or at a freestanding birth center, abound in the region thanks to stellar midwifery training programs in King County. NOTE: Most obstetricians, nurse midwives and licensed midwives work in practices with two or more providers. That means the doctor or midwife you love and most want at your birth may or may not be the one who is on-call when your baby decides its time.

Resources

  • To find an obstetrician or family doctor, go to the websites of hospitals you are considering for your baby’s birth and use the doctor search tools provided there. Word of mouth is a powerful referral system. If you have friends who have recently given birth, ask them for a frank assessment of their providers and the places where they delivered their babies, then take a tour of facilities to see which feels best to you if your insurance allows you to choose.
  • Certified Nurse Midwives (CNMs) are Advanced Registered Nurse Practitioners and deliver in hospitals, including Virginia Mason, Kaiser Permanente, Swedish Medical Center, UW Northwest Hospital, EvergreenHealth Medical Center, and Valley Medical Center. Ask your medical provider or the hospital you hope to deliver at how to set up midwifery care with a CNM.
  • Licensed midwives (LMs) are highly trained providers who deliver babies at home or in freestanding birth center births for parents with low risk pregnancies. To find a midwife or birth center near you, go to the Midwives Association of Washing-ton State at www.washingtonmidwives.org.
Reality Check

The top of a two-page birth plan template from The Bump

Ideal 2

You draw up your perfect birth plan with your partner it works out just the way you planned it from the first contraction to the last. Exactly. Not a glitch.

Reality

Very few births go exactly as planned. Even the most committed hope of birthing at home can turn quite unexpectedly into a hospital birth — or vice versa. Suddenly the dream of a vaginal birth must give way a necessary C-section.

It’s an important way make sure you and your providers are on the same page, especially when surprises arise, which is where a birth plan fits in. Birth plans are a way to be an active partner in your care. Writing down the things you feel strongly about and the things you are more flexible on will help you and your providers achieve a birth as close as possible to the experience you wanted. So, explore your options, write your plan, believe in it, make sure your provider supports it, and then leave some wiggle room for both you and your provider if there is a medical or other need that changes your plan.

You will increase your chances of the birth experience you want by working with a provider you trust to support your ideal, whether you dream of going completely natural or want an epidural the minute labor starts. (Reality check: Most hospital providers want to see a laboring person reach 4-5 centimeters of dilation before administering an epidural, which can take several hours to achieve so alway be prepared to spend time laboring without pain relief).

A note about birth plans. They should include only what you truly care about and should be no more than one page front to back. They are not meant to be a list of every detail of your birth dream. If you have special concerns, for example a history of high anxiety and know of ways that help you calm, note them. If there is anything you do not want done to your baby, for example bathing, vaccines, or pacifier, write it down. If you don’t want to be asked about an epidural, consider writing “I may be open to an epidural, but please don’t ask me about one. I will let you know” to relief the nurse of their obligation to check on pain control. Be specific about your absolutes.

Resources

Although many hospital-based providers offer birth plan templates, these often reflect hospital policies and politics and not parent ideals. Online templates tend to be more thorough in terms of outlining all the options for care that parents may want to consider. Just go to the site, fill in what you’d like in your plan and print

Ideal 3

The baby’s other parent will be clear-headed and know exactly how to help you cope with your labor and delivery. They will provide physical, emotional and information support.

Reality

Your birth partner is in labor too. And all the emotions, stress, and concerns about your and baby’s safety and about the huge life change you are both about to experience will be welling in them as well as you. If your partner is male — even the most attentive, supportive, gentle male — they will be at a loss as to how to help you get though the discomforts at some point. Not to mention, watching someone you love go through labor is stressful. Unless your partner is well-trained and experienced in labor support and/or has had a baby themself, they cannot know what you will experience.

Consider hiring a birth doula to provide emotional, physical and information support before, during and after the birth of a child. Research shows that the presence of a doula reduces the chances of major birth interventions, including C-section, and increases parent feelings of self-confidence during labor. Doulas work in all birth settings, using hands-on comfort measures, nurturing assurance and clarifying information to help you make informed decisions. Average fees range between about $700 and $3,000 depending on a doula’s experience, and many provide sliding scale or pro bono care. If you have no family nearby to assist with your postpartum care, including food preparation, cleaning up while you both get to know your baby, and assisting in other ways, you may also want to consider a postpartum doula. Average hour fee for postpartum care is $40 to $60 per hour.

Resources

Find doulas:

Book: “The Birth Partner,” by Penny Sim- kin, PT, CD, with Katie Rohs $19.99. This book is intended to help the partner of the woman giving birth although it delivers everything a family needs to know to prepare for birth and support the laboring person throughout. Equally important, all content is evidence-based. It may also be purchased on Amazon.

Reality check

Ideal 4

Your birth will be an amazing and joyous experience from start to finish.

Reality

Unfortunately, births can sometimes be upsetting. While you hope this won’t happen to you, it’s good to know about resources to help you deal with an experience you did not want or plan, a provider who did not meet your expectations or, in the worst circumstances, a traumatic labor and delivery for you, for baby or both.

What is a traumatic birth? In truth, it’s different for every woman. Multiple factors include loss of control, loss of dignity, hostile medical providers, stress caused by family and others in the birthing suite, surgery, or unexpected, and unwanted interventions. When a woman feels she is not being heard or is not given the opportunity to give truly informed consent for medical procedures, she can feel traumatized. Additionally, for victims of sexual or emotional abuse, birth can be either liberating or traumatic. According to research done by local birth expert Penny Simkin and others, few women ever forget their birth experience. A traumatic past experience or a traumatic birth can lead to long-term distress and anxiety.

Several therapists in the region now specialize in counseling women and partners through pregnancy and birth-related issues.

Resources

To locate a therapist who specializes in birth trauma, miscarriage, neonatal loss, infertility, postpartum mental disorders, or preparing abuse survivors for birth go to Perinatal Support Washington.

Book: “When Survivors Give Birth: Under- standing and Healing the Effects of Early Sexual Abuse on the Childbearing Woman” by Penny Simkin, PT, CD, $32.95. It may be purchased on Amazon or at Simkin’s site: www.pennysimkin.com/products.htm.

 

Source: verywellfamily.com/common-problems-of-breastfeeding-431906

Ideal 5

Breastfeeding will come naturally, easily, perhaps with a little discomfort, but not much.

Reality

Breastfeeding is a learning process for both mom and baby and it takes time and patience to get it just right. A bad baby habit, like a poor latch, is very hard to break, causing pain for mom and frustration for both mom and baby. For breastfeeding success, get adequate support from day one. Attend breastfeeding classes before baby arrives and take the time now to check out the number and whereabouts of your local La Leche League breastfeeding support group.

Contact lactation consultant before you go into labor to get on your roster and make an appointment within the first few days of nursing. If you are in the hospital, get a lactation consultation – if they don’t offer one, ask for one. If you are at home, you can get support from a private practice consultant (average cost between $50 and $80 per visit.) Some pediatric clinics in the area also offer breastfeeding support. Note: Having a consultant come to your home allows an assessment and adjustments to be made on baby’s nursing schedule and the furniture you’ll mostly be nursing on —  a big benefit.

Resources

Ideal 6

Your relationship with your partner will stay exactly as it was before baby — or get even more romantic!

Reality

That’s possible. But the truth is a new baby puts pressure on even the best, most stable relationship. Pure exhaustion and constant worry about all the responsibilities of parenting take their toll. In fact, according to researcher Dr. John Gottman, 70 percent of couples experience profound stress, conflict, and a decline in marital satisfaction during the first years of parenting.

What’s the best thing you can do to buck the trend? First, be ready to cut your co-parent a lot of slack and remember that you are the best parents your baby ever had. Second, prepare yourself. You and your partner (and your baby) need each other to get through this early parenting phase with your sanity intact. Well before baby comes, read books that offer a realistic look at the impacts of new parenting on a couple. Sign up to attend local workshops focused on nurturing your relationship through what can be a very trying time. Make a plan with your partner about how you will deal with common concerns and pitfalls when they occur, write it down and refer to it when things come up.

Resources

  • Bringing Baby Home is a workshop that walks expectant parents through the many challenges of new parenting while providing useful constructs for understanding your partner’s experience. It also offers tools for mitigating the hard spots and keeping intimacy and romance alive.
  • Book: And Baby Makes Three,” by John Gottman, Ph.D. and Julie Schwartz Gottman, Ph.D., $14.93.

Ideal 7

Your mother in Missouri and your FWCs (friends without children) will provide all the support you need as a new parent.

Reality

The truth is some friends without kids will fall out of your life completely, and distant family won’t be able to provide you the regular assurance you need that your baby is developing just fine and that what you are experiencing – the tiredness, the lack of sex, the body changes, and the change in identity from working woman to leaking mom – is absolutely normal. So, no better time than a new baby to start creating community for your new family – new friends, seasoned parents and child development experts – who support your parenting journey, give you ideas and help you flesh out your own. A support group for new parents is a great place to start. Groups are available for just moms, just dads or for couples.

Resources

  • Program for Early Parent Support (PEPS) brings together “Newborn Groups” of 10 to 12 parents and their babies. The groups begin when babies are under 4 months and meet once a week for three months with a volunteer leader. PEPS also offers Baby Peppers for parents of babies 5 to 12 months old, and Little Peppers for families with two children under age 3.
  • Conscious Fathering – Offered at various locations in King County, this popular program provides basic infant-care skills and encouragement to men on the eve of fatherhood.
  • Eastside Mothers of Multiples – Support group for parents of twins and other multiples on the Eastside
  • King County Family Ways is a program supporting pregnant persons, parenting families and children up to age five. All services are culturally relevant, participant-centered, and strengths-based. Our Peer Community Specialists represent the communities we currently serve.
  • Listening Mothers offers support groups to new parents, led by professional therapists with a focus on the emotional experience of the early parent-child relationship.
  • Seattle Families of Multiples offers support for parents who have twins, triplets or other multiples/
  • Parent2Parent is a program of The Arc of Seattle and believes that the most valuable form of support comes from other parents who have traveled the road before you, in this case as parents of kids with disabilities.
  • Becoming Parents – This program for couples having a first child offers 21 hours of classes during pregnancy, with three-hour “booster sessions” when the baby is 3 to 6 weeks old and 6 months old.
  • Community colleges offer group activities, playtimes and parent education programs for those with children from birth through age 5. Contact your local college to find out what is available in your area.
  • Postpartum Support International offers various free support groups throughout the area.

Ideal 8

You’re a happy person and you are so thrilled to have the new baby in your life, depressed after baby arrives is impossible.

Reality

One in 10 moms and 10 percent of all dads and partners experience postpartum mood disorders (PPMD) like depression or the more dangerous form of this, postpartum psychosis. PPMD is more than just the “baby blues,” the common episodes of sadness or anxiety in the first two weeks after birth, that about 14 percent of moms experience as hormones return to normal levels and breastfeeding is established.

Know the signs of PPMD. If any of these symptoms during and after pregnancy last longer than two weeks, they are signs of depression and you should speak to your provider: feeling restless or irritable; feeling sad, hopeless and overwhelmed; crying a lot; having no energy or motivation; eating too little or too much; sleeping too little or too much; trouble focusing, remembering or making decisions; feeling worthlessness and guilt; loss of interest or pleasure in activities; withdrawal from friends and family; having headaches, chest pains, palpitations or fast and, shallow breathing.

Resources

  • Call your maternity provider.
  • For support call Postpartum Support International at 1-888-404-7763.
  • Book: Beyond The Birth: What No One Ever Talks About is a short booklet that describes the emotional transitions to motherhood, and the difference between “baby blues” and more serious Postpartum Mood Disorders. It discusses causes, risk factors and treatment options in easy-to-understand terms, and features a list of resources and further reading; $6.50. To order go to www.ppmdsupport.com/publications.html.

Being prepared for difficulty will make the ease sweeter

Wonderful, gentle, non-traumatic births happen. They happen a lot and they can happen to you. Beautiful, blissful months without a stress in the world are possible after a baby arrives. Couples do get closer, breastfeeding can be a joyous, close experience. So do hope for all these things and believe in your dream. At the same time, a little preparation, knowledge and planning can go a long ways when issues that do arise. And even if you don’t need any of the resources you’ve set up, knowing that they were there will build your confidence and make your success all the sweeter.

More at Seattle’s Child:

Eye exams 0 to 18: What parents need to know

What are Washington’s current favorite baby names?

The PUMP Act: A win for babies and businesses

About the Author

Cheryl Murfin

Cheryl Murfin is managing editor at Seattle's Child. She is also a certified doula, lactation educator for NestingInstinctsSeattle.com and a certified AWA writing workshop facilitator at Compasswriters.com.