Finding Out You Are Pregnant

Finding Out You Are Pregnant

How To Diagnose
"the embryo releases a hormone called the human chorionic gonadotrophin (HCG)...present in your urine approximately six days after conception...peak about 60 days after conception..." (p. 22-23)

"After perhaps one conception in every ten, the fertilized egg does not manage to embed itself in the lining of the uterus. In this case, a pregnancy test will give a positive result, but a second test a few days later will be negative. For this reason, some packs carry the recommendation that you always wait three to five days and then retest, and two tests are included in each pack so you can do this." (p. 23)

"If it is more than six weeks since the first day of your last period, they can feel the already softening lower part of the uterus, which is also slightly enlarged. The neck of the uterus, or cervix, which protrudes into the vagina, is felt as firmer than the lower part of the uterus, and it is about the same consistency as the tip of your nose...this internal change is known as 'Hegar's sign.'" (p. 23-24)

Dating Your Pregnancy
"The length of the average pregnancy is some 266 days from conception." (p. 24)

Conceiving While Using Contraception
"If you conceive with an IUD (intrauterine device or coil) still inside you, your chances of miscarrying are increased...Sometimes doctors advise termination. This is certainly not necessary...many women deliver the IUD with the placenta after an uneventful pregnancy and birth." (p. 25-26)

"If you conceive but continue to take the pill for several months while pregnant, there is a slightly increased risk to the baby of congenital abnormalities, though the vast majority of women who have taken the pill while pregnant give birth to babies who are healthy and normal." (p. 26)

Pregnancy and HIV Infection
"85 percent of babies of HIV-positive mothers are born healthy" (p. 26)

"testing a baby after 6 to 18 months will more accurately tell if a baby has become infected." (p. 26)

"The safety measures usually proposed to help avoid transmission include not breast-feeding; having a Cesarean section, because babies often pick up the infection as they come down the birth canal; and being treated with antiviral medications during the last six months of pregnancy. With these precautions, the transmission rate can be reduced to 2 percent." (p. 26)

Early Signs of Pregnancy
Nausea--"Women who experience pregnancy nausea are less likely than others to have miscarriages." (p. 27)

Pregnancy Week By Week

This is the first post from the book The Complete Book of Pregnancy & Childbirth by Sheila Kitzinger. Fourth edition published in 2008.

Week 11--"The amount of blood circulating through your body has started to increase, and will go on increasing until about the 30th week." (p. 12)

Week 15-- "Your enlarged heart has increased its output by 20 percent." (p. 13)

Week 17-- "Baby weighs more than its placenta." (p. 13)

Get Ready Now: What Really Happens Postpartum

"You have to function as a responsible adult; there's no going back." (p. 218)

"...according to La Leche League, feeding a newborn takes forty hours a week or more. You'll change multiple diapers a day, wash several loads of laundry, and you will handle these new responsibilities in a sleep-deprived state." (p. 219)

Postpartum Plan

"The things that help most are fairly low tech and designed to get your basic needs met: sleeping, eating, connecting with your baby, and making sure that your emotional support system is strong." (p. 220)

"Usually it takes at least three to five months (but sometimes longer) to establish a pattern...first long nighttime sleep (five to six hours)." (p. 220)

"...sleep when your baby sleeps." (p. 222)

"If you are serious about sleep and can budget for it, night nurses, overnight nannies, and nighttime postpartum doulas are available to lovingly handle your baby through much of the night. They also help teach you about healthy sleep routines, scheduling options, swaddling, and other skills. Consider hiring a service for even one night a week through several weeks or asking a friend or relative to do an overnight." (p. 224)

"...stay in bed until (you) amassed the correct amount of (sleep) hours..." (p. 225)

"SLEEP, DEPRESSION, AND WELL-BEING

Up to 85 percent of all new mothers in the U.S. experience postpartum 'blues' during the first ten days or so after birth...during the first twelve months, between 10 and 20 percent of new mothers, as many as 850,000 women in the U.S., experience diagnosable postpartum depression. Sleep Disorders in Women: A Guide to Practical Management (Current Clinical Neurology), 'Increased sleep, which can be improved with daytime activities such as light exposure and exercise, may be more therapeutic in treating the depressed state than counseling, psychotherapy or antidepressant medication.'...being in labor during the night, coupled with sleep disruption at the end of pregnancy, might result in a higher incidence of postpartum blues. ...survey 2007 called 'Sleep in America,' National Sleep Foundation...'Poor sleep is associated with poor mood.' Among postpartum women in the study, 42 percent report that they rarely or never get a good night's sleep...what awakens them most during the nigt, 90 percent of postpartum women say giving care to a child. Nearly one-half of postpartum women say that they have no one helping them with child care at night. Sleep also helps strengthen your emerging role as a primary caretaker. ...2007...Journal of Perinatal & Neonatal Nursing...four overlapping stages...'committing, attaching and preparing for the infant during pregnancy; becoming acquainted and attached with the infant, including learning how to car for the infant and restoring maternal health; moving toward a 'new normal'; and achieving a maternal identity.'" (p. 226-227)

FOOD

"You need protein, carbohydrates, fresh fruits, vegetables, and calcium in the form of tasty, healthy snacks...this is not the time to diet. You need energy! ...before you have the baby, prepare some simple dishes that can be doubled--lasagna, burritos, soups, potpies--and freeze the extra portions. Stock up on simple, nutritious foods: yogurt, baby carrots, fruits, nuts, hard-boiled eggs." (p. 227-228)

CHORES

"Decide in advance who is planning to come 'visit' and who is planning to come 'help.' The visitors can wait a few weeks until you've gotten to know your new baby..." (p. 228)

"...you are not a hostess right now." (p. 229)

STAY CONNECTED (Personally, I like BSF. It is a wonderful way for moms to get and stay connected with other women.)

YOUR RELATIONSHIP

"...2000...Journal of Family Psychology...two-thirds of couples experience a significant decline in marriage satisfaction--including less-frequent or less-satisfying sex, more conflict, and more emotional distance--after the first baby arrives." (p. 230)

"...most studies suggest men want sex--and more of it--shortly after birth while women need more time." (p. 231)

"When your body has recovered, sex--even quick, less-than-fabulous sex--can help give both of you a viseral memory of the romance of life before kids. When you're ready, start thinking about regular date nights." (p. 232)

CALL IN THE EXPERTS

"If harmonizing your sleep, meals, chores, and key relationships still seems too overwhelming, look into hiring a postpartum doula." (p. 232)

"Postpartum doulas charge around $25 to $40 an hour in big U.S. cities." (p. 232)

WHEN THE UNEXPECTED HAPPENS

"One in three women in the U.S. now gives birth by cesarean section, major surgery that significantly lengthens postpartum recovery time. These mothers won't be able to drive for about a month and lifting will be difficult for some time. In this situation it is even more important to have backup help. Doulas will give you ideas on how to get this support, for instance a father might be eligible for a longer family medical leave from work if the mother underwent surgery." (p. 234)

Birth Plans and Birth Essays

"...inquire with your provider about the rates of various procedures the use, including rates of natural birth, epidurals, VBACs, and cesareans..." (p. 200)

Interview providers to find one whose approach matches your own. (p. 200)

"To search for information about your provider or hospital, or to share your experince, visit" here. (p. 201)

"Have your doula make sure that each doctor, midwife, and nurse who is caring for you takes a look at your plan." (p. 202)

"...fetal scalp blood sampling to determine fetal distress before doing a cesarean." (p. 207)

ACOG, "3 percent of all births consist of multiple babies." (p. 211)

"ACOG has stated: 'there are retrospective case series that validate vaginal delivery as a potential mode of delivery, especially for triplet gestation.'" (p. 212)

"ACOG and the Society of Obstetrics and Gynecologists of Canada, most of these protocols are not suppored by scientific research, but have nonetheless come to be accepted as the standard of care... Routinely inducing labor before thirty-seen weeks... Routinely inducing labor at thirty-seven weeks... Requiring and epidural... Requiring the mother to be constantly attached to a monitor for the babies' heartbeats, rather than listening at regular intervals... Routinely scheduling a cesarean even when the first baby is head down... For a vaginal delivery, having the mother push in the operating room rather than a normal labor room, because of a slightly increased need for cesearean sectins. Routinely using interventions to speed up pushing of the second twin... You have the right to decline their routine use after discussing the benefits, risks, and alternatives with your provider." (p. 212-213)

"Parents of twins may want to consider having two doulas (for) additional emotional support may help diffuse some of the extra tension that can be present." (p. 214)

For support with a multiple pregnancy, especially twins, visit here.

THE BIRTH ESSAY

A birth essay allows/encourages a mom-to-be to write all of her feelings about her pregnancy and upcoming labor down and then share them with those who are/will be caring for her throughout this time. Questions to get you writing... "What do you imagine it will be like going into labor, giving birth, and being with your new baby right after birth? What will giving birth mean to you, your baby, and your family? What are your dreams for your birth? What are your fears giving birth?" Moms should be encouraged to fill more than a "page or two." "Many providers are not familiar with the idea of a birth essay. However, it is fine to let your caregiver know that you have emotional concerns you would like to discuss, which may arise from writing your essay. You might want to read the essay aloud, or tell your provider what you wrote about, without presenting the actual pages to her." (p. 215-216)

When Epidurals and Cesareans Are Unplanned

"...cesarean is scheduled in advance for medical reasons, studies show her chances are also good for feeling positive after her birth." (p. 175)

"...natural childbirth...at home, where 90 percent do so..." (p. 178)

"Approximately 80 percent of mothers birthing in hospitals have epidurals." (p. 178)

"...whether a mother sees her birth as positive, negative, or traumatic. The most important factors are:
1 Whether a woman's expectations of birth match the reality of what happens
2 Whether a woman feels involved in decisions about her care, even if her expectations cannot be met" (p. 178)

"In fact, a potential risk of any surgery is depression..." (p. 181)

From Dr. Gayle Peterson...
Acknowledge fear can deepen our reserves and help us discover fresh meaning and commitment in our lives. Do not judge your fear or anxiety. Confront and befriend the fear, and it will yield an inner treasure.
Ask yourself these questions:
1. Imagine that an epidural is necessary during your birth. What feelings do you think would arise for you?
2. If an epidural is needed, what would help make this the best possible scenario for you?
3. Now imagine that a cesarean is necessary. What emotions do you think would arise?
4. If a cesarean is needed, what would help make this the best possible situation for you?
5. What fears or anxieties do you have about these situations? (Be sure to give them a voice before your actual birth.)
6. How have you (and your partner) responded to unexpected stress at other times in life?
7. What would you want your doula, and your doctor or midwife, to remember about your needs in case of unplanned events during birth?" (p. 182-183)

"...90 percent of U.S. mothers are instructed to lie on their back or recline during pushing. Only 4 percent push on their sides; yet side-lying may result in more successful pushing, according to New Zealand midwifery expert Jean Sutton." (p. 184)

"...remember to continue incorporating labor support techniques after an epidural, especially massage." (p. 184)

Take time, if it is not an emergency, to, "process the decision...provider to take additional time to explain the need for the procedure, its benefits and risks, and details about how it will be performed...want extra reassurance that the baby is still healthy, and a pep talk to help you keep going in good spirits." (p. 185)

Some mothers may feel "empowered moving forward quickly." (p. 185)

"A mother who has general anesthesia can ask for her medical records later." (p. 186-187)

"As for a cesarean section, whether it is needed due to a medical problem or because today's intervention rates are unavoidably high, it is never the mother's fault when it occurs." (p. 188)

"To underscore this point, in 2008 the journal Midwifery Today hosted a seminar with doula leader Penny Simkin titled 'There's More to Birth Than Coming Out Alive.' A woman's feelings of dignity, emotional security, and her need to experience birth as the celebration of a major life passage are also important. When these aspects of birthing are compromised, her confidence about functioning as a new mother can be weakened." (p. 188-189)

"Post-traumatic stress disorder (PTSD) after a difficult birth is getting attention as a condition that affects as many as 7 to 18 percent of new mothers..." (p. 189)

"Ways to assist with healing include the following:
1. Speak to a counselor or therapist...
2. Contact organizations that offer support... (iCAN)
3. Write your birth story...
4. Share your story with other moms...
5. Talk with your doula, your midwife, or doctor..." (p. 191-192)

Epidurals and Cesareans affects on nursing...
"Milk can be delayed from coming in, and babies' behavior can be more disorganized for several weeks." (p. 193)

"When it comes to unplanned interventions, open communication is one of your greatest tools..." (p.194)

(Note to self: Check out the self-evaluation scale in appendix. Possible tool to give at reunions?)

Co-Sleeping

Pro co-Sleeping article.

Labor Techniques Anyone Can Use

"Studies show that nurses need to spend 90 percent of their time on medical procedures and note-taking, with little left over for labor support." (p. 157)

"The most basic technique...get out of bed. Yet over 75 percent of U.S. women report that after they are admitted to the hospital, they never leave their beds." (p. 157)
Childbirth Connection survey found, "women who walk in labor report fewer cesareans." (p. 158)
"The positions and movement options available are many, including standing, walking, climbing stairs, swaying, lunging, sitting, crouching or squatting, leaning forward, being on hands and knees, kneeling, and side-lying." (p. 159)

Only 10 percent of American mothers ever try a warm shower, bath, or jacuzzi for pain relief...For the most pain relief...stay in for up to ninety minutes at a time. (p. 165)

Only 20 percent of women try touch and massage...although, by "Mothers who use touch and massage rate it the second-most effective natural birth relief method." (p. 166)
"Touch Research Institute at the University of Miami show that women receiving massage in labor report less pain, less anxiety, and have shorter births." (p. 167)

*Note to self try page 161