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Monday, 15 September 2014 13:49

Belly Bound

Reviving an Ancient Prenatal Art

In my personal research for options for supporting new mothers physically, I came across a few articles that mention prenatal belly binding, but these were scarce. I believe this ancient art has been lost and needs to be passed on to today's modern women as well as future generations.
 

What is traditional Prenatal Belly Binding?
Belly binding is the practice of wrapping your belly while pregnant for the external support of pelvic muscles, hips and back. Binding may help with Diastasis recti, round ligament pain, and loosening ligaments around the pelvic joints. It may also assist in improving the mother's posture and can help with optimal fetal position. Wearing the bind over your shoulders as a sling can help keep baby in an upright, head-down position and can take some pressure off your hips. Belly binding can also provide support for mothers with older children by providing support while bending, lifting, reaching, and playing, especially as her belly grows bigger.

The practice of belly binding has been traditionally used and passed down through generations by cultures in West Africa, South America, and Asia, as well as many others. There have been few or no written records, as this practice has been passed down from mothers/grandmothers to daughters. In the west African cultures belly binding 
celebrates the pregnant female form and is said to keep out evil eyes. In Japan belly binding is performed as a prayer for safe pregnancy and birth, in China to provide baby with familiarity by using the same cloth  for both belly binding and babywearing after the birth. 


Who can benefit from belly binding?
It is thought that any mother can benefit from belly binding. A pregnant mother can begin binding around 20 weeks, or when she feels she needs more support in her pregnancy, and can continue binding until the end of pregnancy. Women of all sizes can bind their bellies for support. On average, women gain around 30 pounds during their entire pregnancy, most of which is carried in their abdomen. Binding can help carry some of this weight. 
 The baby benefits from prenatal belly binding by providing them with a better sense of security, better position for birth and closeness to mother which will translate to better connection after birth.  Binding can be used in labor with the assistance of a trained professional. 

As with anything in pregnancy, women know their bodies the best and should be listening for any sign of problems or discomfort. Check with your health care practitioner if you have any concerns anytime throughout pregnancy. Also take special precautions when unsure of baby's position, or if baby is in a position such as breech or transverse. Anyone can bind when following a few easy steps and safety precautions, it’s not difficult.

 
Material used to bind:
The most common material used to bind with is a hybrid baby-wearing wrap. The material is a stretch cotton, a cross between a woven wrap and a stretchy wrap. This material provides the perfect amount of stretch and support without being too hot or restrictive. Other wraps and materials maybe used with wearer’s discretion. The material used for stretchy wraps is not recommend when belly binding as it can be hard to get the right fit, and can then make the warp unsafe for future baby-wearing. 
 

Traditional binding vs modern support belts?
Modern support belts are usually made from a spandex or lycra material and come in small, medium and large sizes. The sizing needs may be different for each mother depending on factors such as the amount of time the belt is worn, the amount of support needed, and the mother's  body type. While traditional wraps can be suited to any body type, lycra support belts will only fit certain women and more sizes will need to be purchased as your body grows. Wraps are more versatile and can be changed and moved to support different areas on the body. Wraps are safer because they will shape to your body, and when properly wrapped, won’t restrict your circulation. 

Postpartum Belly Binding:
Postpartum belly binding differs from prenatal binding because the body changes after giving birth. The material for postpartum wrapping does not have any stretch; instead, it provides support as your muscles and organs return to their pre-pregnancy positions. This practice also provides good back support for nursing mothers. Caesarean section mothers should take caution when binding until their body is ready. 


Pregnancy and birth is a time of great opening, carrying and welcoming a new being in to the world. The female body opens and gives its whole self. No matter how you give birth, your body and spirit must open for your baby to come out. Postpartum binding can help to close this part of your journey.


Personal consultations for pregnant mothers and select advanced Doula training sessions are now available on this topic, in person and online. For more information or to book an appointment please contact.

 
 
Tracy Nagy, Labour Doula
Essential Birth Doula Services 

Tracy is located in Vonda, Saskatchewan. She is not a medical professional. Information in this article is intended to advise not treat or diagnose medical conditions. Please seek medical help if you require assistance.

Tuesday, 10 June 2014 14:34

Plan A, B, C, D . . .

When I was working on my birth plan I had a discussion with a coworker about making a plan. Her argument was that you can't plan a birth because there are too many unknowns. I countered that that was the very reason every woman needed a plan.  

This is not a birth plan:

I will start labor on my due date at 9AM after ten hours of sleep and a well-balanced breakfast. After four hours of early labor, spent watching TV and receiving a back massage, we will have an uneventful trip to the hospital. Upon arrival at the hospital, I will consent to a vaginal exam determining I am 6 centimeters, 80% effaced, and 0 station. An epidural will be administered promptly because there is a readily available and unoccupied anesthesiologist waiting for me. After four hours I will begin pushing and have my 7 pound, 7 ounce perfect bundle of joy after a mere five pushes. The doctor who attended me throughout pregnancy will be there to deliver my baby. There will be no tearing. We will be discharged by the next morning, only staying a night so that I can have the assistance of the nurses so I can sleep and establish breastfeeding. Before discharge my milk is in and our latch is perfected. While we were at the hospital my mother cleaned my house and has lasagna in the oven.

 

Okay, I hope with all of my heart that every woman can have a birth like that - simple, easy, painless, textbook (whose textbook?!).

 

My birth plan included rules like don't eat near me, let me roam freely (I ended up spending about 24 hours laboring on my toilet because it felt like I was trying to poop a railroad tie past three feet of rebar) I only wanted one cervical check, and don't rupture my membranes. I made rules because I didn't want any interruptions - we forgot to unplug our house phone and it rang mid-contraction and now when it rings I am filled with the same rage I was that morning.

I planned a homebirth but had a hospital transfer plan, and a Cesarean Section plan. 

It was important to me to labor unmedicated but wanted an epidural in the event of a transfer to the hospital. When we transferred I was glad I had pre-planned an epidural otherwise my birth team and I would have been on different pages: they might have encouraged me to continue unmedicated, oblivious to my wishes. Quite the opposite, a mother might think to herself that she believes she can have all-natural childbirth but fails to let her partner and care provider know - at 3AM she might discover a needle in her back not because she was tired, but because her husband was. Afterwards, she might be left yearning for what she knew she was capable of. With every intervention comes risks and benefits: it is important for every woman to know where she stands prior to entering the delivery room, lest she be faced with a decision when her limbic system has taken over.

 

Some important items to consider in a birth plan:

What methods of pain relief would you like? A hot shower? Massage from your doula or partner? Epidural? Nitrous oxide? A TENS machine? Be sure to know and understand the risks and benefits of each.

If augmentation of labor is suggested, what will you do? How do you feel about synthetic oxytocin? Do you know and understand the risks?

Who would you like present in your labor?

Do you want to eat and drink freely?

Do you want an IV?

How frequently do you want your baby monitored in labor?

How frequently would you like to be checked for dilation?

Your doctor might offer to rupture your membranes, how will you respond?

Under what circumstances would you consent to a Cesarean? Vacuum or forceps delivery? Know and understand the reasons for each - some are genuine emergencies, sometimes it is simply impatience.

Would you like to be encouraged to labor and push in different positions?

When would you like the umbilical cord clamped and cut? Do you want immediate skin-to-skin?

Erythromycin is often put in the newborn's eyes - is it necessary for your baby?

Oral or injectable Vitamin K? When and where will the baby's first bath be?

 

Knowing how you feel and letting your birth team know ahead of time will ensure your wishes are known. Things can change in a second, and so can your plan. Planning ahead will help you be more flexible - augmentation may have been off the table, but when someone mentions an impending Cesarean you will be able to weigh the risks and benefits and alter your plan accordingly and with genuine informed consent.

 

Remember this is your birth, your baby, your body. You have the right to refuse and the right to request. You are the boss.

 

 

Published in Birthing Styles
Tuesday, 15 April 2014 16:06

Vegan Pregnancy - Part 2

My last post discussed eating a vegan diet during pregnancy. Now let’s talk more about specific nutrients you need.

Protein should be a focus in the diet of a vegan pregnant mama. If you eat three meals a day and two snacks, I suggest protein with every meal and at least one snack. However, if you eat four smaller meals a day, include protein at every one.

There are many vegan protein sources to choose from. Although there are good options — that include fiber, iron, folate, and choline, etc. — they’re a bit harder to digest than meat, fish and eggs.

Vegans also have increased iron needs because many vegan iron sources contain phytates — antioxidant compounds that bind to the iron and make it harder to absorb.  So I recommend a vegan prenatal multivitamin that also contains iron. 

Through a blood test, your healthcare provider can tell you if you need an iron supplement over and above what you get from food and your prenatal multivitamin.

Vegan diets are usually high in Vitamin C, which increases iron absorption. If you take a prenatal multivitamin and eat high iron foods throughout the day, I don’t recommend an iron supplement unless your healthcare provider recommends it.

Remember that both caffeine and calcium can negatively affect iron absorption.

Zinc is another important mineral during pregnancy. Vegan foods high in iron are typically also high in protein, zinc, folate and choline. 

In pregnancy calcium needs don’t increase — your body absorbs calcium more efficiently.

Vegan diets often have low amounts of calcium. In addition, some vegan foods have phytates and oxalic acid that also affect calcium absorption. However, this is easy to remedy if sources of calcium are made a focus of the diet. Remember that caffeine can also affect calcium absorption.

Although many people meet their calcium needs with dairy, this is not the only way. Good sources of calcium include almonds, sesame seeds, fortified milk alternatives, blackstrap molasses, tofu (if calcium sulphate is listed in the ingredients), collards, figs, kale, turnip greens and broccoli.

Vegans, whether pregnant or not, most frequently ask if they’re getting enough vitamin B12, which typically comes from animal products. However, vegans can get it in fortified products such as red star nutritional yeast (be sure to check as not all nutritional yeast is fortified with B12), vegan meats and fortified milk alternatives.

I always recommend eating whole foods and avoiding packaged and processed foods as much as possible. So I point out that, although vegans can choose fortified foods to get their B12, these are all packaged foods.

However, using B12 fortified nutritional yeast is great because it is easy to add to foods that you are eating throughout the day.

To meet your needs with fortified foods you need to eat at least three fortified foods with B12 each day. A variety of B12 supplements are available. Depending on the dosage you choose, you may not need to take it every day. But don’t worry too much about getting more B12 than needed — you will just pee out any excess amount you take in.

That said, there’s no sense “peeing your money away” on unnecessary vitamins. So base your decisions about supplements on what you get from foods and what works with your lifestyle.

It’s a good idea for every future mother to boost stores of omega 3 before getting pregnant; and while you are pregnant it’s important to conserve them. This is especially important for vegans, who tend to have lower levels of DHA.

For this reason omega 3 is one of the most common supplements I recommend before, during and after pregnancy. Often it’s taken in the form of DHA, one component of omega 3.

Most omega 3 supplements are from fish sources, although you can find vegan forms made from micro-algae — the same source that gives fish their DHA. Taking the micro-algae form is a good option as it reduces concerns about mercury and other contamination.

There are also vegan food sources available, including flax seeds (if they’re ground or in the oil form), chia and hemp seeds, and walnuts.

Omega 3 has another component, EPA, that is readily found in supplements. Both it and DHA are important to both mom and baby, although DHA tends to get the spotlight, as it helps in baby’s brain development.

Fish sources seem to be better absorbed and utilized by the body and there is also debate as to how much the foods listed above actually have in them. Our bodies actually convert plant sources of omega 3 to DHA and EPA, making them not as efficient sources of these fatty acid components.

Chia and hemp seeds also contain omega 6. North American diets tend to provide more omega 6, so it is important to ensure a ratio of omega 6 to omega 3 fatty acids in the range between 2:1 and 4:1. Many plant-based vegan oils contain omega 3, 6, and 9, making it even more important to think about the ratio of omega 6 and omega 3.

Some things also affect our body’s ability to make DHA. This includes trans fats — another reason to avoid processed and packaged foods. Alcohol and smoking also have negative effects.

In short, it is possible, with a little planning, to eat a healthy vegan diet during pregnancy.

If you have further questions, please contact Jill, Nurture The Future’s Registered Dietitian, at This email address is being protected from spambots. You need JavaScript enabled to view it.

Monday, 10 March 2014 03:00

How to: Contact a Doula

Once you've found a doula whose availability, area, and available information looks like it might fit, Your next step is making contact. What follows are some rough guidelines for how to do that in a way that will help you gauge early on if you’re a good fit for one another.

Most of the time, your initial contact with a doula will be through a contact form, by e-mail or phone. In either case, you want to cover your basics—usually focusing on availability and setting up a consultation. Your first contact isn’t about whether or not you want to hire them. It’s about whether you want to set up an interview to get to know each other further.

E-mail gives you a little bit more room to explain what you’re looking for than a contact form, but your first e-mail should usually still be fairly concise. I personally find it difficult to have in-depth conversations by phone in a world where mobile reception on both ends is often a very real barrier to communication, so I often ask that people who’ve contacted me by phone first follow up with me by e-mail.

Things to Include in Your First Contact by Phone, Contact Form, or E-Mail:

  • Your estimated due date. Even if you’re choosing not to consider a due date very firmly, which can be wise, we need some idea of when you’ll need us so we know whether or not we have other clients expecting around the same time.
  • Your home location—be specific. Whether or not you’re planning to birth at home, most doulas will meet you there for early labour. You probably don’t need to give your exact address, but I usually ask for post codes or neighbourhoods to make sure I can get to you.
  • Your planned birth location, and if you’re planning a home birth, the hospital where your midwives have admitting privileges for you in case you require a transfer. We need to make sure your birth location is also accessible to us, as well as confirming that there are no restrictions or special requirements for doulas supporting clients in that location.
  • What kind of medical support do you plan to have? Most doulas support births attended by either midwives or doctors. Some will support otherwise unassisted home births, but if that’s your plan, you’ll want to be up-front about it to avoid surprises later on.
  • Do you have any special concerns? Things like multiples, VBAC/HBAC, or other particular needs are worth mentioning right away. Some doulas may refer you to someone with more experience with certain kinds of births.
  • Any particular birthing method you plan to use, if you’re hoping the doula will be able to help you with it. For example, if you’re using hypnobirthing, you want a doula who is, at minimum, familiar with the basic concepts of that plan.
  • Questions about fees, if this is unavailable on the doula’s website. If you see fees listed, assume those are her starting point, and if you don’t know if you can afford them…
  • Any concerns about your ability to pay her fees as listed. Just asking about fees will usually only get you the same summary she gives anyone and has listed online. If you’re concerned you can’t afford her, say so. Ask if alternative payment schedules are available, or if she accepts alternative forms of compensation. See this post for more on affording a doula on a tight budget.
  • Ask what the decision time will be following your consultation, especially if you plan on interviewing more than one doula; you'll want to know what your time frame is for getting all your options before you have to decide.


Leave These Topics for Your Consultation

Although most doulas will happily answer the following questions, they’re usually best left for a time when you have an opportunity to discuss them at length, with time for follow-up questions as they arise naturally. They’re important questions you’ll probably want answered before you hire her, but they’re not usually the best for your very first inquiry. You'll also be better able to evaluate what the answers mean to you after you've spent some time together.

  • What is your philosophy?
  • What is your experience?
  • How many clients do you take at once?
  • Do you arrange back-up?
  • Can you give a basic outline of what your packages look like in terms of services?

 

Published in Birthing Assistance

      1) Figure out what your health coverage insures.  If it is slim or nothing for a home birth or midwifery care, go over your finances and consider what you can afford (keeping in mind that some midwives offer income based sliding scales as well as payment plans.).

2)  Interview Midwives and Doulas:

-It is good to interview several before deciding on one. In some areas home birth midwives may be scarce so it will be easy to find their names and plenty of reviews. In other areas, there may be a lot of midwives that service the area and it is a good idea to do lots of research, read reviews, along with speaking with them in person. A good way to find positively reviewed midwives and doulas is on birth community sites that have forums for specific locations (IE: mothering.com offers “tribes” that connect you to mothers in your area of the world).  Most midwives and doulas offer a free consultation before they become “yours”.

               Examples of what to ask at a Midwife consultation:

                - Who certifies you? Are you a CPM, CNM?

                - What is your training background?

                - What is your educational background?

                - Why did you become a midwife?

                - How long have you been in practice?

                - What is your whole cost, do you offer a sliding scale?

                - What is your transfer rate?

                - Do you do any “routine” screenings, tests, etc and how do you process them?

                - Do you have any hospital affiliation?

                - For what reasons would you suggest I don’t deliver at home or need a transfer?

                - What equipment do you come with to a birth (and in case of emergency)?

                - Do you bring a nurse or apprentice to births?

                - Do you offer birth tub rentals if I desire a water birth?

               

                Examples of what to ask at a Doula consultation:

                -Who certifies you? (CAPPA, DONA, CBI, BAI, etc)

                -What techniques do you use to help me cope with labor/birth?

                -How many times do we meet before/after birth?

                -How long will you stay with me during/after labor/birth?

                -How much is your whole cost and do you offer a sliding scale or bartering system?

                -Do you have a lending library or other resource rentals (birth tub, birth balls, etc)?

                -Can you help me write a birth plan?

                -Do you offer any other services (placenta encapsulation or preparation, childbirth classes, Blessingway hosting, etc)

3) Prepare yourself with information as you deem appropriate. There are lots of great books and resources to help you prepare for birth. Below is a list of books that may be worth a read:

                - “Ina May’s Guide To Childbirth” by Ina May Gaskin

                - “The Thinking Woman’s Guide To A Better Birth” by Henci Goer

                - “Childbirth Without Fear” by Dr. Grantly Dick Read

                - “Gentle Birth Choices” by Barbara Harper

                - “Homebirth” by Sheila Kitzinger

                - “Spiritual Midwifery” by Ina May Gaskin

                - “The Complete Book of Pregnancy and Childbirth” by Sheila Kitzinger

There are many, many wonderful home birth resources on the internet as well. As a pregnant woman it is best to work under the philosophy that images and words will greatly affect how you feel and view birth during this childbearing year. So, although there are plenty of things to discover on the world-wide web, discretion is always good. Some sites that I recommend are below (these sites have categorized headings so you can navigate what will be useful and what you wish to see and avoid what you wish not to see):

-          www.thebirthingsite.com

-          www.birthwithoutfearblog.com

-          www.mothering.com

-     www.birthingnaturally.net

-     www.givingbirthnaturally.com

Consider hiring a private childbirth educator (or speak with your Doula-they often offer crash courses in childbirth for their clients) to meet you and your partner in your home for a childbirth class. (Or even split the cost with an interested or other pregnant friend!) .  You could also find a class through hospitals or ask your midwife or doula if she knows and recommends any childbirth courses in your area or online.

Some find attending a natural childbirth class to be just what they need to feel comfortable with home birth while others find their own research and support of their doula and midwife to be enough to prepare. Whatever you choose to help inform yourself, do so at a level that is comfortable to you-over researching and under preparedness have both posed issues for pregnant mothers as our minds can be particularly vulnerable during this time. If you find the more you dig for information the more anxious you become (or the more tempted you are to absorb negative stories and visuals), take it down a notch, tell your support people and advert your attention back to the positive thoughts for YOUR birth.

4) Speak openly with your partner. Decide what your hopes and wishes are for who will be present at the birth of your child, what roles you hope them to play. Discuss your partners comfort levels and work together to become comfortable with your plans. Think about the possibility of having a water birth, what music you may want, anything special you wish to be used to enhance or mellow your birth environment, sit down and consider all the aspects you wish to cover in your birth plan, specifically what roles everyone will play.  Enjoy this part of the planning, find common grounds with those you intend to include and make sure the people who support you believe in the process.  Reading a book together or sharing helpful articles can be a nice way to bond while preparing for your home birth. If you intend to include your older children, introduce them at age appropriate levels to the idea of mommy having her baby at home. There are several children's books out there that talk about what they can expect. 

5) Make an “in case of emergency” transfer plan with your midwife and inform everyone that will be present of the plan.  Prepare a separate birth plan for the event of a transfer if you feel it suites to calm you.  Most midwives will have you fill out a form that will include what hospital you wish to transfer to if possible, ambulance service if you are rurally located, etc.

6) Trust in the process and have faith that you picked people who will support you. This step is consuming affirmations, day-dreaming, picturing your birth, connecting with your baby, enjoying the fact that you are going to join the ranks of every mother that has ever lived(for the first or subsequent time), as well as give birth in the comfort of your home like so many generations before us. Cool, huh? Remember, you are strong, you are capable, the hands around you offer healing knowledge and support, the space around you offers peace, and your baby knows how to be born just as you know how to birth him. Allow yourself to feel the spiritual aspect of your pending home birth and enjoy every second! 

Published in Birthing Places
Thursday, 30 January 2014 19:57

Centering Pregnancy

“CenteringPregnancy" incorporates the three components of prenatal care - education, risk assessment and supportive care - into one entity and encourages women to take responsibility for their own health...The CenteringPregnancy Model ‘centers’ the three components of prenatal care into a whole and helps a woman ‘center herself as she moves through pregnancy.’” - Karen A. Baldwin "Comparison of Selected Outcomes of CenteringPregnancy Versus Traditional Prenatal Care" http://www.centeringhealthcare.org/forms/bibliography/Baldwin_2006.pdf, Volume 51, No. 4, July/August 2006, pg 266

My pregnancy started off with a terrifying miscarriage scare.  A trip to the emergency room and several trips to an ob/gyn later, I knew that kind of invasive, highly medicalized care was not what I wanted for my pregnancy.  At the advice of our natural family planning instructor, I set up a “get to to know you” visit with a local midwife.  I left the visit positive that she was “the one” for my pregnancy and birth.  Before I knew it, I was setting up my first appointment and the scheduler enthusiastically asked me if I would consider doing Centering for my prenatal care.  

Huh?

My midwife also excitedly brought this “centering” up at our first appointment, and I began to get interested.  Everyone at the office seemed so excited about it.  They acted like it was the best thing in the world.  

Basically, they explained, Centering is prenatal care done in a group setting.  I would be placed in a group of 6-10 women due roughly around the same time.  I could bring a support person (husband, close friend, etc) if I wanted.  Appointments were 2 hours long (imagine - having my healthcare provider at my disposal for 2 whole hours!).  There were ten meetings; they started out once a month and later moved to every other week.  At the end of our pregnancies, when we needed to be seen every week, we would make individual appointments to be seen.

I was hesitant to join.  It sounded so...different. What if the women I was grouped with were really out there?  I’m not exactly very crunchy, or much of a group person.  Despite all that, I decided to join.  Everyone at the office seemed so delighted to have me - how could I tell them no?  

To my surprise and delight, I quickly came to love centering.  I was introverted in group, yes.   In fact, the moderator often asked if I was enjoying my centering experience, but I looked forward to those Thursday morning meetings as the highlights of my very pregnant existence.  Come to find out later, most of the other women had reservations going into centering, too.  One of them hesitantly asked the scheduler, “Do they even shave their legs?”

There were six of us. Five were expecting girls. Two of us - the youngest and the oldest - were first time mommies. Two of us had the same due date.  One of the ladies was pregnant with twins.  

We started every session the same way.  The six of us would waddle in at around 9:30am and hit the scale.  That was usually the worst part of the morning.  Because centering encourages women to take responsibility for their own health, it was our job to take our weight and blood pressure, which our midwife monitored.

We snacked on healthy foods as we chatted while waiting for everyone to arrive.  When our midwife showed up she would start “tummy time”.  This was individual time with each of us to listen to baby and feel around.  She would answer any very personal concerns, (aka, “pst, I think I may have a yeast infection - can you take a look afterwards?”) but anything else she told us to write up on our parking lot.  Our "parking lot" was a white board where we posted anything we wanted to talk about - questions, concerns or general pregnancy topics.  The idea was that if one of us was concerned about something or had a question about a topic someone else probably was, too.  Such is the beauty of centering.

Nothing was off limits for discussion.  Sex, birth control, whacky hormones, pain management, hemorrhoids, you name it - we wrote it up on our discussion board and talked each problem and concern through.  We shared a few tears, lots of laughter, and loads of support.  The dynamic our group had was incredible.  Groups of women (sometimes deservedly!)  have a terrible reputation for being catty, but that was never the case with us.

Some weeks we had guest speakers come.  We had a lactation consultant, a massage therapist, and a doula speak.  For one of our later meetings, the moderator dressed up in a bathrobe, stuffed postpartum supplies in her pockets, and made us each take one out so that we could discuss them.  It was a fun, laughter packed way to learn about the often not-so fun quirks of postpartum life.  

I went into my pregnancy terrified of birth.  With the support of my centering friends and midwife, I came to love it.  There was so much positive energy in all of our meetings. I couldn’t help but feel empowered.  Our midwife gave us so much information about everything pregnancy, labor, and birth related in a fun and positive way.  She made me feel like I could face the challenges facing me in my pregnancy and birth, and I loved downing the information she gave us for two hours straight.  My husband would come home at night and I’d babble on and on to him about everything I’d learned at centering that day.  He was incredibly informed.         

Our last meeting, about two weeks before any of our due dates, was unbelievably sad.  I felt incredibly let down when I continued to go to weekly check ups.  Thirty minutes or so  - which is a generous time allotment by any standard - and I was done.  No group of friends to chat with.  No snacks.  No funny stories.  I couldn’t  believe how much I missed it.  I felt so blessed that I’d chosen to do centering.  I couldn’t imagine what my pregnancy would have been like if I’d just come to “regular” checkups.  

All my “centering friends” became friends on facebook.  One by one, I watched their posts go up about their brand new, beautiful babies.  Two of them were born on the same day.  

I was the last one to give birth and, sadly, it wasn't “our” midwife who was there for it.  I was the only one she wasn’t there for.  I was disappointed, but it made our centering reunion, about three weeks after my daughter’s birth, even more special.  We got to show off our babies and tell our birth stories.  Everyone had such wonderful, empowering, special and sometimes funny stories to share.  

Our story doesn’t end there, though.  After almost nine months of regular get-togethers, we are all fast friends.  We get together on a regular basis and one of the ladies created a facebook page for us to keep in touch.  We continue with our loving, supportive group atmosphere where we can say anything without fear of being judged.  It’s amazing and such a blessing.  

I am looking forward to doing centering again with my next pregnancy.  Midwifery care is amazing, yes, and so much more than the quick, medical checkups I got with an ob/gyn.  But comparing “regular” midwife checkups and centering, there’s no way I could go back.  It’s just that good.  

For more information on centering, check out http://www.centeringhealthcare.org/ and the “Centering Video” http://www.centeringhealthcare.org/pages/media/centering-video.php

Wednesday, 04 December 2013 08:04

What Are Your Core Beliefs About Pregnancy?

Core beliefs are things that we believe about life that are etched into our subconscious mind. Many times we do not even know that we have these core beliefs; let alone that they are running aspects of our lives. As a woman, we receive many messages about pregnancy throughout our lives from our families, friends, the media, and our culture. By the time we find ourselves pregnant we have certainly developed some core beliefs about pregnancy.

Core beliefs are very powerful messages. They deeply influence how we perceive ourselves and the world around us. When we have positive core beliefs, we approach things in a positive way. When we have negative core beliefs we are likely to approach things in a negative way. We are likely to find evidence to support our core beliefs, and exclude evidence that does not support our core beliefs. Therefore, we find ourselves in a cycle where we are reinforcing our core beliefs. We continue to attract the people, attitudes, and experiences that support our core beliefs. This is why it is so important to discover what your core beliefs are.

If your core pregnancy beliefs are positive, and are working for your greater good, bravo! But if your pregnancy core beliefs are negative, you may find yourself in a cycle where you are reinforcing those negative beliefs.

You have the power to change your pregnancy core beliefs, and we will work on that later. But first you have to know what your current pregnancy core beliefs are.

So how do you know what your pregnancy core beliefs are?

An easy exercise you can use to discover your pregnancy core beliefs is to write a list of all of the things you have heard about pregnancy. They may be things that your mother told you about her pregnancies. They may be things you’ve learned from watching TV, or reading magazines. They may be things you’ve learned from friends. Just give yourself the time and space to write out a list of things that come to mind when you think about pregnancy.

Here are some sentence starters that can help you get going. Put one of these sentence starters at the top of your paper and see what comes to mind. Then move on to the next one, and so on.

Pregnancy is ______________.

Pregnant women are ______________.

Pregnant women can/cannot ____________________.

Pregnant women should/should not ______________________.

Once you have your list, you can separate it into positive statements and negative statements. Often our negative statements use terms like always, never, should, should not and cannot. They may also include negative words such as difficult, painful, ugly, etc.

Looking at your list of negative statements about pregnancy, ask yourself whether these statements are impacting your pregnancy in a negative way. You will need to get honest with yourself, but be gentle. You are uncovering things that you didn’t know were impacting your mindset around pregnancy. Now that you have uncovered the belief, you have the power to release the negative belief that’s causing problems for you.

In order to release a negative belief it can help to understand where this belief has come from. For example, you may have seen, “Pregnant women are moody and irrational” on your list. Why do you believe that? You’ve seen this stereotype on TV, movies, in books, and magazines. Possibly, when your mother was pregnant with your younger brother, you remember her crying a lot and yelling at you for no reason. Between the stereotyping in the media and your personal experience as a child you have developed and reinforced that belief.

Now think about your pregnancy. You have been moody and irrational. That’s what you have believed about pregnant women, so you have embodied that belief to some degree.

Following this process has helped you to discover your core beliefs about pregnancy and identify your negative core beliefs. I will help you release your negative core beliefs and replace them with positive beliefs in my next article

If you’d like help with any specific negative core beliefs, please share below.

Why women experience morning sickness and nausea during pregnancy

 

Anyone thinking that morning sickness and nausea during pregnancy is rare is gravely mistaken. As much as 90% of the pregnant population experience morning sickness during at least the first trimester. Some may experience symptoms in the morning, and feel increasingly better throughout the day. Most feel nauseous for the majority of the day, and may vomit consistently throughout the day and evening. Experiencing nausea throughout the entire pregnancy is not as common, but still happens. Every woman and every pregnancy is different.

 

Although the root cause for morning sickness still baffles doctors and scientists alike, there are many factors that can contribute to the discomfort:

 

  • Being stressed. Researchers have found that having a higher level of stress promotes stomach aches and nausea. That goes for everyone, not just for pregnant women.

  • Typically, if a woman already has a sensitive stomach and/or digestive system, the major hormonal changes that occur during the first trimester can easily cause irritation. Women with an increase in bacteria in their stomach or digestive tract are also more likely to have morning sickness.

  • Having a sensitivity to smells, which increases drastically during the first trimester, may lead to nausea.

  • Pregnancy involving more than one baby.

  • Those harrowing hormones. During the early stages of pregnancy, hCG (Human Chorionic Gonadotropin) levels rise. Although not directly linked to morning sickness, hCG levels spike when nausea does, which leads scientists and doctors to believe that they are related.

  • As estrogen levels increase, accordingly, so does the intensity of nausea.

 

Even if a woman does not experience vomiting during pregnancy, nausea may be a pesky problem. Higher instances of fatigue can cause an increase in muscle aches and cramping, which may lead to nausea and/or vomiting. “Mind over matter” is easier said than done, especially for a blossoming belly and its effect on mom, but when that proves too difficult a feat, there are other saving graces for that upset stomach! There are many ways to relieve nausea naturally while pregnant.

 

Ways to relieve morning sickness and nausea

  • Mint. Mint tea (with pure mint oil/extract) is a great way to ease nausea and heartburn during pregnancy. You can use fresh mint in tea, or buy already made tea. If tea is not your cup of… well, tea, then, try sucking on a mint. Teas infused with other natural antioxidants are great, like green tea mint. Or, ginger mint...

  • Ginger. Ginger tea, ginger bread, raw ginger, ginger chips, ginger snaps, ginger ale... Regardless of what form it takes, as long as it is made from real and pure ginger, it will help with nausea, and double as a natural pain reliever. Some health food stores sell chewable and/or hard ginger candies, which are perfect to keep in your purse, desk, or car.

  • Clear liquids. Drinking a plentiful and consistent amount of clear fluids throughout the day will aid in hydration, which will help decrease nausea. As for an increase in trips to the bathroom? Look at it as practice for the last few weeks of pregnancy.

  • Eat small meals more often. Try to avoid overeating, as this can upset the stomach. Eat smaller meals more often to maintain blood sugar levels. Make sure to eat lots of protein and avoid excess sugar. Try healthier snacks like kale chips or coconut crackers.

  • Avoid fatty, spicy, and acidic foods. Foods high in fat tend to take longer to digest, and spicy and acidic foods can upset the stomach and cause heartburn and acid reflux, which may lead to nausea and vomiting. It may be best to ignore those cravings, and reach for a bowl of grapes instead of a burrito.

  • Get out of bed slowly. Take it easy sitting up in the morning, and again with getting out of bed.

  • Crackers or other potassium and sodium-rich snacks like pretzels. Keep some next to your bed to munch on before bed if you tend to have nausea and vomiting at night. If you tend to vomit early in the morning, try to eat something small before starting the day.

  • Sleep. Taking small naps and getting adequate sleep at night will not only help with fatigue, but with nausea as well, as being tired can increase the intensity of stomach aches. Your body needs rest now more than ever, anyway. Get those zzz’s while you can!

  • Vitamin B6. Scientists are a bit dumbfounded by how vitamin B6 helps first trimester nausea, but it indeed does! Not only does it help with nausea and morning sickness, but it helps with fat metabolism, which leads to decreased fatigue and increased energy. Every mama could use natural energy, right?

  • Magnesium helps in a multitude of ways during pregnancy, starting with easing muscle tensions and nausea. One can soak in a bath of magnesium flakes, consume magnesium naturally in foods like spinach, pumpkin seeds, and avacados, or take it in powder form (mixed with water). Additionally, most prenatal vitamins should have magnesium. However, that magnesium is typically canceled out by the calcium in the prenatal, as the body best absorbs one at a time. Therefore, taking magnesium a few hours before/after taking/consuming calcium is best.

  • Light exercise. As little as seven minutes of exercise at a time can decrease stress, put the mind at ease, and decrease nausea and fatigue. Prenatal yoga, dancing, swimming, and biking can all be helpful for gaining and maintaining strength, which will help lessen nausea when your body is stretching and moving to make room for the baby. Make sure not to overexert yourself, and do not allow your core body temperature to rise to an uncomfortable level. Make sure to remain cool and drink plenty before, during, and after exercising.

  • Relax. Take a soothing, warm bath, or read a book. As previously mentioned, stress can work numbers on the stomach (and just about everything else). Make sure to take breaks while at work, and stop to breathe or meditate throughout the day. Centering oneself can relieve stress and help the body to relax.

  • Aromatherapy. Combat nausea and morning sickness with fresh scents, like that of lavender, rose, chamomile, and thyme. Using essential oils or dried herbs in satchels, baths, or the like can help relax the soul and stomach.

 

Other ways to relieve morning sickness during pregnancy

Accupuncture, massage, and seeing a chiropractor can help ease morning sickness, as well as other aches and pains associated with pregnancy. Accupressure wrist bands have been rumored to decrease the likelihood of nausea during pregnancy too. Sleeping sitting at an angle instead of flat may help to ensure that stomach acids do not move up the esophagus, which can cause heartburn and nausea. If certain foods or vitamins trigger nausea, avoiding them will probably remedy the problem. The same goes for smells, pictures, or movies.

Persistent vomiting may be a sign of something more severe, and should not be ignored. Consult a professional if nausea and/or vomiting are relentless and long lasting, or if natural remedies do not help.

Though one can not control hormonal and physical changes during pregnancy, the effects can be lessened - if not eliminated - by being proactive and taking advantage of all that nature has to offer.

Saturday, 16 November 2013 20:00

I Have Fever! What Can I Do?

When it turns out that you are expecting a baby, you try to avoid everything which can be harmful either for you or for your baby. As the immune system does not work as efficiently and effectively, a pregnant woman's defences are down, making her a walking target for any viruses. We know it, but it causes a shock when we realize that we caught something terrible. From these the most fearful one can be fever. We have to handle it - we learned it as children. But should we reduce fever in any circumstances? When? Anyway what is fever?

Fever is the result of an immune response by your body to a foreign invader. [1] It is not by itself an illness, it’s usually the symptom of an underlying condition.[2] Behind it there is always another illness. First we have to treat that. As a pregnant lady the most common infections you can get are flu, cold, tonsillitis and/or pharyngitis (especially in winter). “We speak about fever if your body temperature is higher than 100.7 degrees Fahrenheit (38.2 degrees Celsius).” [3] So when we start feeling panic it is just low fever. I know by myself that I would take any medicine to help when my “fever” is just 98.9ºF (37.2ºC). Then I’m standing in the kitchen with the box of the antipyretic and I can’t decide to take it or not, which is better or worse. But it is good to know that “fever can help our body fight against viruses and infections and help it cure itself. Up to a certain extent it can be useful because it creates a so hot environment for the pathogens which is unbearable for them. What’s more in certain countries (e.g. Canada, the Netherlands) it is not advised to ease fever, if it is - just because of your well-being.”[4] But during pregnancy if you have fever, you AWAYS have to regulate it! The fetus is very sensitive for fever, so your temperature can’t be higher than 100.4ºF (38ºC)![5]

If you experience fever, first try to ease it physically. You have to wear loose, thin, breathable cotton clothes. Don’t creep under a thick blanket! Drink (or sup) lukewarm or cold drinks, the best ones are non-fizzy sport drinks or fruit juice and lemonade. If we suffer from nausea (or vomiting) don’t force eating, just drink! If it is also problematic, try sucking ice cubes (can be made from lemonade!). With frequent showers you can cool yourself. Don’t use cold water, as not the temperature of the water will cool your body but the evaporation of the water drops will help you.[6]. A cooling bath is not forbidden but I’m not sure whether I would try it. Unfortunately it is said that cold compresses on your wrists, ankles or forehead use not too much, although they helped me when I was last ill. The most important thing is to relax, as physical activity also raises your temperature, not to mention you can decrease the risk of fainting and hitting your belly.

If nothing helps from the above mentioned methods, you have to take medicine. Don’t be afraid of its leaflet “In most of these leaflets it is written that they are not acceptable during pregnancy. But just only a few of them has real effects on the baby.”[7] As they are not tested on pregnant ladies (Who dares to try unknown medicines during pregnancy?), factories have to write this information. It is a fact that you cannot take anything, but if it’s necessary you can take those which contains paracetamol, acetaminophen (Tylenol)[8], of course you have to check its amount very carefully. If you’re worried about taking Tylenol while pregnant, remember this: if your baby was born today and he had a fever, the doctors and nurses would give him Tylenol.[9] Before taking any medicines always consult with your doctor!!!

If you have controlled your fever, and your well-being is well, you have to “just” deal with your illness.

I’ve collected some home-made treatments which usually help me:

A great amount of Vitamin C, if it is possible in natural form – many liters of lemonade can also cover your need for liquids.

  • for cough: onion tea (made from the outer reddish shells)
  • for cold: steaming with chamomile tea
  • to get rid of the ooze from your throat or tonsils put a slice of lemon into sugar and eat it

The most important of all is if the symptoms are still there or become more serious, visit your doctor forth with!

Sources: 

[1]John P. Cunha ( DO, FACOEP): http://www.medicinenet.com/script/main/mobileart.asp?articlekey=361&page=1 2013-11-22

[2]Fever Facts (WebMD) http://www.m.webmd.com/a-to-z-guides/fevers-causes-symptoms-treatments2013-11-22

[3] Emese Szabó: Fever (Lector: Dr. János Kádár s internist-immunologist) http://www.hazipatika.com/betegsegek_a_z/laz/481 2013-10-28

[4]Fever (Wikipedia) http://hu.wikipedia.org/wiki/L%C3%A1z_(%C3%A9lettan) 2013-10-28

[5]Emese Szabó: Fever (Lector: Dr. János Kádár s internist-immunologist) http://www.hazipatika.com/betegsegek_a_z/laz/481 2013-10-28

[6]How to reduce fever during pregnancy? http://www.wikihow.com/Reduce-Fever-During-Pregnancy2013-11-02

[7]What do pregnant women have to be aware of? http://www.origo.hu/egeszseg/terhesseg/20101213-terhesseg-laz-natha-influenza-a-lazcsillapitas-fontos-de-natha-ellen.html 2013-10-28

[8] same as 5. interview with Dr. Zoltán Gasztonyi, leader of Istenhegyi Géndiagnosztikai, Nőgyógyászati és Családtervezési Centrum („Istenhegyi” Genetic, Gynecologic and Family Planning Centre)

[9] Jennifer L.W Fink:Fever During Pregnancyhttp://m.thebump.com/pregnancy/pregnancy-symptoms/articles/fever-during-pregnancy.aspx2013-11-22

Friday, 15 November 2013 01:38

I'm Pregnant: What Now?

You’re pregnant! Congratulations! Maybe you’ve been trying for a long time, or maybe you’ve been taken completely by surprise, but either way, there’s a lot to do! We’ll trust you to handle the fun stuff like shopping and showers; here’s the low-down on the logistics: 

First Trimester (conception through week 13)

 

The first trimester is all about making sure your body is a good one to live in for both you and your baby. It can be tough to keep up with it all, especially when common early pregnancy symptoms make doing healthy stuff like eating well and exercising really hard. Just remember that small steps are bigger than no steps, and even small victories are victories! Places to begin:

 

- Pick up something to use to record information and ideas throughout your pregnancy. You don’t need the fancy baby book just yet, though. Just start with a notebook and use it to keep track of anything you experience: test results, things you want to ask your doctor about, ideas for names, etc.

 

- Start taking a prenatal vitamin, if you aren’t already. Even if you’re just a few weeks along, there’s already some crucial development going on in the nervous system, and it’s important to have adequate amounts of things like folic acid to make sure this development gets off on the right track. This is important for most pregnancies, but especially so if your diet doesn’t have a good variety of fresh fruits and vegetables. If you’re just planning to get pregnant, it’s a good idea to start taking your prenatal vitamins before you start trying. If you’re not sure what you need, your doctor or pharmacist can point you in the right direction.

 

- On that note: start trying to eat well. You probably don’t feel too great, either because the nausea has set in or because you’re exhausted, and both of those things make getting a balanced diet difficult, but do your best. Eat frequent small meals to keep your stomach calm (having an empty stomach makes the nausea worse) and try to make those snacks the healthiest thing you can tolerate. If the healthiest thing you can tolerate is “well, plain toast has grains in it, right?” don’t worry, but do your best.

 

If you’ve been smoking, drinking, or consuming other drugs, it’s time to work on quitting. If you’re worried you won’t be able to do it on your own, talk to your doctor or an addiction center for a plan that you can stand by. Try not to worry if you were doing any of these things for several weeks before you found out you were pregnant. Just know that the sooner you quit, the more you reduce your chances of harmful side effects for you and your baby.

 

Exercise: Birth is hard work, and apart from that, recent studies have shown that regular exercise, even if not especially rigorous, leads to better birth outcomes and healthier babies. If you’re new to this, chat with someone about working out a healthy and realistic exercise plan throughout your pregnancy. Your medical caregiver is a goodplace to start, but other options include nutritionists, personal trainers, or workout instructors, as long as their practice specializes or has some training in pregnancy (ask for credentials, though—there are special considerations for different stages of pregnancy, and it’s important that whoever gives you advice knows what they are).

 

Doctors, Midwives, and other Medical Care: regardless of where you live and what kind of birth attendant you’re planning to have, you’ll probably need what’s known as confirmation of pregnancy to start going through the next “official” steps, like getting a provider referral, handling insurance, and getting services if you need them. Your family doctor or general practitioner can usually do this, but if you don’t have one, any walk-in clinic should also be able to help. If you’re worried about the cost, sliding-scale clinics like Planned Parenthood offer reduced fees to uninsured patients (in both the US and Canada) and may even be able to provide your early prenatal care while you look for an OB or midwife. Your first prenatal visit may also involve a pelvic exam and PAP smear, a breast exam, and some blood work to test for STIs and other potentially harmful conditions. If you need a referral for other providers, they can usually offer this as well.

 

If your usual doctor doesn’t provide maternity care or you’re hoping to work with a midwife or other provider, you’ll need to start looking right away. This is true whether you’re planning on an OB, a family doctor, or a midwife. In some areas, people find themselves wait-listed even when they’ve started making contact in the first weeks of their pregnancies, so don’t put this off, especially if you’re looking for care from a practice that’s in high demand or want to give yourself more than one option. This is especially true if you’re seeking midwifery care.

 

Find out what your insurance will cover in terms of prenatal care, your birth, and postpartum. You may need to add to your current plan to get full pregnancy and birth coverage, which can take time. If private insurance isn’t for you, find out what your options are for government-funded prenatal and birth care. In most cases, having some amount of coverage will save you money on the overall costs.

 

- See the dentist, especially if you’ve had dental concerns prior to pregnancy. Pregnancy can weaken your teeth, so good dental hygiene and regular check-ups are especially important during and just after pregnancy.

 

- If you know you're going to take a prenatal class, don't worry about taking it at a specific time in your pregnancy. Although some programs ask you to wait until a particular point in your pregnancy, if you feel like you need more information now, look for a class you can take now. Knowledge matters, and there is no wrong time.

 

 

Second Trimester (weeks 14-26)

 

The second trimester tends to be the easiest on the symptoms front for most people, so take a breath and catch up! Once you've gotten a few good meals down and are feeling a bit more energetic, it's time to tackle the next set of tasks:

 

- If you haven’t already, start researching your birth options. Pick up a few books and start thinking about the kind of birth you’d like to have. Ask your friends if they have any favorite books or if they had a prenatal class they just loved. If you aren’t sure where to start, I highly recommend books by Penny Simkin, Ina May Gaskin (especially if you’re hoping for an unmedicated birth) and Ann Douglas (who writes good guides in both US and Canadian editions). Unless you’re very comfortable with the medical model of birth, skip the What to Expect books. They’ve got good information, but tend to assume you have a doctor that you trust completely, which doesn’t suit everyone.

 

- Consider meeting with a financial adviser—this may be a service provided by your bank, or you can find a private adviser. They will help you set up your budget to make sure you save enough to get through on reduced incomes during parental leave, help you redistribute your existing income to meet the expenses of a new baby, or discuss how having a baby will fit into your other plans for your financial future. This can be a stressful step, and it’s one most people put off, but in the end you’ll probably be better off with some professional advice.

 

Talk to your employer about parental leave plans as soon as you feel comfortable (if you're worried, know that it's usually best to tell them before someone else does), and look into your government-provided options for leave and benefits. Now is the time to figure out the timeline for applying for benefits, even if you don’t have to do the actual applications for a while.

 

If you’re planning to hire a doula, start looking now. This will give you time to interview several options and plan together, as well as leaving some flexibility if you are worried about costs. You generally want to finalize these plans sometime near the end of the second trimester or beginning of the third.

 

Start thinking about your birth plan. It’s perfectly ok to start with a checklist to guide you through your research and information-seeking phase, but your final document should be more personalized. Talk about your plan with all members of your birth team, including your medical caregiver. Include some details about what you’d like to have happen if your plans change: how you might make a cesarean a better experience, for example, or what accommodations would make it better for you if your planned home birth needs to be transferred to the hospital. Discuss these plans with your team, as well.

 

If you are living abroad or your baby will have dual citizenship, contact your embassy or consulate for information about this process. It is often time-sensitive, and if you don’t live near the embassy, you may need to plan for a visit.

 

Find out what you need to do to set up your baby’s health insurance, whether government-issued or private. Some plans cover baby’s first few weeks of well-baby care under your coverage; others require baby to have their own coverage once you’ve left the birth site.

 

- If you're having a home birth, ask your midwife or doula for advice on finding supplies. Either or both of them may have some items they can provide, but most of the time, you'll need to stock up on at least a few supplies, and if you're hoping for a water birth, you may need to arrange a tub rental. Give yourself plenty of time!

 

 

Third Trimester (week 27-birth)

 

You've made it to the home stretch! You're probably getting ready to meet your baby, but there's still just a little left to do:

 

- If you haven’t taken a prenatal class yet, do it now. If you’re going with a private prenatal class, arrange a tour of your birth location or your backup location, if you’re planning a home birth. You don’t want the first time you walk through the doors to be when you’re in the midst of labor. If a traditional class doesn't suit you, know that there are options for online classes, individualized classes, and other options, but I strongly advise against neglecting this important step. Even if you're perfectly content to go along for the ride and do what your caregiver thinks is best, knowing what to expect makes a big difference. A good prenatal educator will take input from the class on what their information needs are and will help make sure they're met. As an added bonus, keeping in touch with other members of your prenatal class means you'll have a built-in group of parents who are going through the same stages you are. That support will be important later on.

 

- Make your postpartum plan. Talk about it with your partner, family members, and other supportive roles. Build up your network, and talk with family and friends about who can help you and how they can help. Consider tools like MealBaby or the services of a postpartum doula, nurse, or other support person, and make a list of resources in your area that you can turn to for support if you have issues. Key points for this are breastfeeding (both peer and professional support options), 24-hour nurse hotlines for help with questions, a few support options for if you face postpartum mood disorders, and support for any special needs you anticipate you or your baby might have after the birth. Tack the list of phone numbers, websites, and/or email addresses on the fridge to have handy if you need them.

 

- Find a pediatrician for your baby. If you already have a family doctor, they may also be able to take on your child. If not, you’ll want to look for a pediatrician or a family doctor soon. Many states and provinces have systems in place to help connect you to providers. Also ask your pregnancy caregiver if they have any advice.

 

- Talk to your provider about your finalized birth plan, and update it as needed if anything changes in your pregnancy. Leave a copy to be kept with your records, and have extra copies on hand to take with you to the place of birth. Even if you are planning a home birth, it’s good to be prepared in case you need back-up care.

 

- Get your car seat installed properly so it's ready when you need it. If you're not sure about your installation, have it checked. There are many local resources for this. Consider baby stores (the store where you bought the seat might be a good option), public health and safety offices, or even your hospital. If they don't have seat check programs of their own, they can almost certainly refer you to somewhere that does.

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