Birth Plans, Nurse's Perspective

This post is written with sympathy to all expectant mothers. Giving birth is beautiful, empowering, and certainly the most special day of your life. It seems, however, that many of you come to the hospital with certain expectations that I would like to analyze. These "rules" are sent to you with love from labor nurses everywhere, in the spirit of sisterly sharing. These guidelines apply to full-term labor and delivery, and only touch on key points. This should not be taken as any medical advice, but merely sister-sharing from someone who has been in the trenches! Here are recommendations from someone with 10 years of experience in Labor and Delivery, and three births of my own:

We can do it!  Image copied from http://copperkitten.files.wordpress.com/2010/06/motherhood_manifesto.jpg

1. The first rule of motherhood is to stay flexible, and it starts before birth. The goal of every childbirth from your health care provider's viewpoint is a SAFE and HEALTHY delivery for both mother and baby. THIS IS NOT NEGOTIABLE. Get your head around that for a second, because while you may want to use Lamaze or Bradley methods to labor and push out your baby it becomes a moot point if your baby is not tolerating labor (or if you have a necessity for induction of labor). Things change so quickly; we do our best to explain what's happening but we like to act quickly for your safety and your baby's.
2. If you have never pushed a human being out of your body but want an unmedicated labor and delivery, DO YOUR HOMEWORK. Practice the method of your choice all the time, make it second nature--do it on the toilet, or during lunch, or when you have your daily run of Braxton-Hicks contractions. Plan on doing it alone, because unless your baby-daddy is Mr. Awesome, he is going to need a break and you might end up breathing through many contractions alone. Get your focal point and use it early. If you tell the nurse not to offer you pain medication, don't blame her for following your wishes. And don't feel guilty if you change your mind.
3. Understand that labor is a MARATHON for most people, with a SPRINT at the very end when you are the most exhausted you have ever been. (And then after that you get to take care of a baby...more on that later).  We are going to be "coaching" you through every contraction during pushing, so don't hold back and give us all you can.
4. If you have medical conditions like preeclampsia, gestational diabetes, or other chronic pre-pregnancy conditions, please make room to accomodate them in your birth plan. It is likely that pitocin will change your mind about things, and so will magnesium sulfate. Refer to rule one. If you have preterm labor with an infant born and sent to Neonatal Intensive Care (NICU), we will encourage you to pump shortly after delivery, visit baby often, and will support your care of the baby as much as possible. Refer to rule one. This may be completely opposite of what you expected.
5. If you look up a birth plan to borrow from online, please pick only the five most essential options. If you pick more than five options, and you are very rigid, we will see you in the operating room. It's nothing personal, but Murphy's Law tends to dictate those cases more often than not. Again, see rules #1 and #2 above. Flexible and prepared. This mainly refers to the big things--pitocin, pain management, food, movement, etc. The little things like when and who cuts the cord are usually easy to accomodate in any birth.
6. You have been with your OB/GYN for some time now. It's your job to build a rapport, to understand their dictates and preferences, and to accept them as they apply to your own birth experience. We know your doctor quite well, and we will advocate for you as needed, but you have had 8 or so months to propose and agree upon a plan for this baby, while we just met you. If you don't trust your care provider-- get it worked out sooner rather than later! 
7. If you plan to breastfeed, have your OB/GYN take a look at your nipples. While this is very personal and private during pregnancy you can rely on the fact that some nurse is going to have her hands all over your boobs trying to get your baby to latch, and it's a lot easier if your nipples stick out. Wearing nipple shells during pregnancy can help. Rule 2: Prepared.
8. In the end, if you are healthy and your baby is healthy then MISSION ACCOMPLISHED. Do not look back and dissect how things went, you are somebody's Mother and that is no small thing! Get sleep while you can, enjoy your baby, and take good care of yourself.

With love, from a Labor Nurse.

ADDENDUM: #9 (recommended by a friend) If for some reason your labor is really fast, and you wanted an epidural but couldn't get one in time, quit complaining. You have been blessed, the pain is over now, and we are happy for the safe and healthy delivery on your behalf. There is no need to write a letter of complaint to the hospital blaming us, we have no control over your labor unless we are running pitocin...and even then, honestly, it could go in any direction.

ADDENDUM #10: Please stop scaring your friends, neighbors, sisters, and distant foreign relatives with your birth story. It is what it is, hold your baby and be glad. Save the drama for your husband, he should be the only one you are scaring with that story. There is no need to make a first time momma feel more frightened of labor and delivery than she already would normally be. With that being said, women do this every day and while it is a rite of passage, and sacred, be realistic. Tomorrow you have to get out of bed and start caring for yourself again no matter how you gave birth. Keep your perspective and get on with life.



(This blog will return to its usual topic at a later date).

This Old, Busted Ass is HURT.

Boy am I having trouble with this blog tonight. All my pictures are out of order and orientation and everything. Not much of a story this way! I was going to slip this photo in last as a reminder of the moments I miss when I am doing all those extra shifts (see below). Me and Big G snuggling on the couch before I got called back to work last week. The weight loss has been VERY disappointing in the last week, between hormones and lack of sleep, working too much and eating a boatload of crap. I have lots of setbacks and I keep telling myself that I am doing this for my own physical fitness not to be "skinny" so why worry so much? Because. I am a woman, and we worry about things that guys never have to even process.

Seriously. Most guys never have to think, evaluate, and make a decision before they have a bite of something. It's pretty much "Mmm, cookies, om nom nom". In the meantime I am supposed to push a bowl of chips away in favor of greek yogurt. How does that even correlate? So as the family were enjoying molasses cookies the other night, I ultimately ate two after giving myself a complete complex about the consequences in which I now find myself--that of having gained back 3.5 lb which is most likely water. And the ugly truths of how I eat and why, how I don't want that pattern handed down to my three little loves, and how I don't need to be responsible for my DH's own food issues. He has to deal with them himself, but we still have a chance to teach the younguns about fitness, healthy eating and snacking, and why special treats need to stay special (and only occasional).

So the running. I finished Week 2 of C25K and my left knee is screaming, all up behind my patella, and I am thinking that even though I can scarcely call myself a runner I nevertheless find myself suffering from what is likely a case of Runner's Knee. Apparently I have been pushing way too hard after being way too sedentary for pretty much the entirety of my adult life. It has been suggested to me that I try to rest it for a month, which actually might be okay since it's canning season.

I have already started, with the bulk of my recent cucumber crop in yonder jars soaking up the tasty bread and butter juices. I can just about imagine crunching into one of those babies as it nestles atop a freshly grilled cheeseburger...(I have no idea why this photo is sideways, or how to correct the matter, or why these last two paragraphs were suddenly centered instead of left-justified). 




Beautiful, sweetly crunchy tangy pickles. 4-6 weeks until you are all mine.

 

In other news you may not be aware that I have disappeared from the world into the void that is my workplace. I worked 66 hours a week for the last two weeks and on Thursday, it will all be worth it. I made up in two weeks all the cash we were missing in July. And as you might notice in the photo below, I will be making it happen again if the flow of business allows. By the time my kids board the school bus in September I will probably croak from exhaustion. It has been suggested by the people who love me the most in life that I am overdoing things--the job, the exercise, the canning/gardening. I promise we will get to the point where I am feeling more like my Wench self soon. But for now, affairs of state must take precedent over affairs of State (with thanks to Mel Brooks, I have always loved that quote). Ah I see we are back to the left-justified margin. Very interesting indeed. It's almost like I have no control over formatting tonight.

This here is the demon schedule. Only two extra days this week, but check out next week. This is in additon to my regular shifts!



Kickin' A** and Naming Names!

C25K Week 1 Complete!

Actually it was more like ten days...but I lost 7 pounds already. One of my buddies said it was just water weight (BabyRN) but I am the most hydrated person on the planet on any given day, so I say NO. It's for real. I double-checked. FIVE TIMES.

Today (That would be Sunday for you day-walkers) I started Week 2, it was a rough one but I did finish it. I had to dial back the effort a bit when my heart rate hit 200, but I felt pretty good after. Think I may give it a few extra days on this "week" installment also. I am not on any time-bound schedule to complete a 5K race or anything, just for fitness' sake so I don't mind being off schedule.

I ate pretty clean this week although I did treat myself to some real bacon, a piece of cake, and a couple pieces of cheddar cheese during the week. I felt like I was dropping pounds too fast, and I am trying to be pretty rational about myself for the long run. I do not plan to EVER give up bacon and cheese, but to have a more deliberate approach to food over all.

And now to name some names. I wanted to give a shout out to the people who did not laugh or mock me when I mentioned my plans to run. Big thanks to Michelle, who inspired me in the first place! Thanks also to Sharon, Kari, Virgil, BabyRN, OctoOOPS, Scooter, and all my other friends and family.

Hopefully after Week 2 I will have some significant numbers and measurements to post. Check back soon!

Running with the Devil on my shoulder!

So before we talk about the nitty gritty I want to brag a bit. Two Thursdays ago I passed a very difficult test with my work wyfe and we both passed! So pleased to announce that I am now a Registered Nurse - Certified In-Patient Obstetrics! (RNC). While I am not able to get a higher rate of pay it is pretty satisfying to have completed the course successfully and it's good for my career to ultimately move forward.

So in the spirit of forward progress, I decided there is no time like the present to get moving. The Hubs is on the same page and plans to kick his act into gear this week physically as well. But as for me, I started running on Sunday and although I did not finish my first installment (a planned 30 minutes of interval training known as "Couch to 5K"), I felt pretty good about it. I still feel pretty good. Hopefully I will not succumb to injury or laziness. The picture below was taken right before I started my jog.

Bad angle, my legs do not normally appear to have cankles...in fact they are quite shapely!

My new favorite place to be this summer has been out in my garden. I never realized what an earthly delight it is to watch your own food grow, through your own diligence and efforts. The kids have been so excited about it that they voluntarily started eating spinach. Right off the plant. If I was a man I might have dropped a nut in astonishment. But I digress! The next few photos are right from the garden. It got a little rocky about one month ago when cabbage worms started to take over, and I was forced to dust. I had hoped to avoid it by placing mantis egg cases in the garden to hatch but they took longer than expected. We did control the loss of inventory and I would like to introduce you to one of my new little friends, Melvin.

Melvin and his siblings are destroying the japanese beetle population in my yard, along with a large number of other leaf munchers! I now have sunflowers and basil to enjoy, not to mention the protection of the leaves on my peppers, sweet potatoes, tomatoes, etc. Melvin is pictured perched upon a tasty Swiss Chard leaf. We have been eating salads of Chard and Bibb lettuce, and the occasional saute of chard in olive oil. So tasty and filled with lutein!

This is Melvin the Terminator!

Cabbage. Gonna eat this bad boy soon.

The cabbage above does show a small amount of leaf destruction from the cabbage worms but they seem to have vanished along with the broccoli...either from the dust or the vigorous attention of 200-300 praying mantis juveniles. We hatched 4 egg cases! Notes for next year's garden include hatching the mantis' earlier in the season, along with placement of a soaker hose prior to maturation of the plants.

Already ate this one. Yum.

Eggplant, soo tasty. Shared with my parents, delicious!

Harvested two of these butternuts on Sunday morning.

I am pretty excited to eat some butternut squash but am told they must cure for a week in a low-humidity, cool environment. So I shall stick them in the basement for a bit and update you all later. Stay tuned for delicious meals incorporating the butternuts as a puree, or as oven fries, or stew additives...

Tomatoes ready to go wild.

I have an almost worrying amount of tomatoes ripening on the vines. There is a large amount of Roma tomatoes pinking up, along with a healthy number of Big Boys getting bigger by the day. I am dreaming of fresh marinara sauce, stewed tomatoes, tomato sandwiches, grilled cheese with tomato, bruchetta, and possibly canning up some green tomato relish at the end of the summer!

Still anticipating a nice crop of cucumbers, potatoes, sweet potatoes, onions, green peppers, and possibly carrots. I snuck a carrot out of the ground yesterday and it's already bigger than last year's crop so I may just have some normal sized carrots to speak of. We've been eating plenty of green beans every 2-3 days, they are so tasty and fresh! The 5-yr-old loves to harvest fresh beans every day, and I love to have him helping me out. Actually all of them, even the 2yr-old, have pitched in around the yard to help grow food. What a treat to have that time with my beloveds!

You might correctly suppose that we have been eating well lately, and it's true, but Daddy has been doing more of the shopping and he has a sweet tooth. Well, more of a generalized snack tooth really. So no weight loss despite the influx of fresh produce, because we have all been snacking. I stepped on the scale at work and was horrified by the number: 228. This is unacceptable. I think I am finally at breaking point over my weight. I am giving the running program 2 months to be successful and could really use some encouragement. You can follow me on Twitter @beckyaul76 and gimme a shout out! (I am kinda loving Twitter even though I said I never would!) Enjoy!

Winter gone, Spring evaporating, Summer ACK!

So here we are, another birthday gone (37 for me!) and it's rapidly turning into summer here in the hills of PA. I do not really know where the time has gone! In three weeks, #1 son will be done with school and my pool is still not open. #2 son turns 5 in a few days and my spring cleaning is still not done. #1 daughter (#3 spawn) is 2.5 years old and still not potty trained...although neither one of us feels particularly motivated at this point. Those are only a few things on the to-do list, and does not include special projects like organizing the kitchen cabinets, the dining room, cleaning the hall closet, or interior house painting. Or diet and exercise, for that matter. So here's what I have been doing INSTEAD of diet and exercise:

My Mother's Day gift from the 3 spawn, for mucking around in the garden.

We completed a refinance to save some money, and treated ourselves afterward!

I added paint to the master bathroom. Still no color in the bedroom.

Spring sprung up all over outside. These are the bleeding hearts the boys bought me last year and planted for Mother's Day!

Painted daughter's room, along with both of the boys' rooms (this being the girly pinkish lilac color chosen by my gal).

This used to be a fire place! Very inefficient, so we reformatted for a wood stove and covered the bricks with stone. LOVE!

Hubs built me a few raised garden beds as additions to the one we had already. I slapped on the boots and got planting! The amount of time and care is not so bad once everything is in the ground but then again the weeds haven't started...

Happily married for 10 years! Out on a fondue date with my parents.

So the scale today said 217.4, and there were dimples in places where there ought not be dimples, at least after 4 years old (and fo shizzle not at my age, dammit). I had a brief burst of exercising in January/February but my low hemoglobin didn't let me get anywhere so I did something about it, started taking iron, etc. It's been about 6 weeks now and I am thinking I should try again. Needless to say we have not been just sitting around during that time either. Hopefully I will be able to start making headway on the exercise front now that I have 2 school-age children!

The next step, our diet as a family, is going to hopefully be greatly augmented by the foods we grow and pick ourselves, with a few supplements at the farmer's market. I have been making a few runs at baking bread as well, with some success. Here is a list of our garden contents:

• basil
• broccoli
• butternut squash
• cabbage
• carrots
• cauliflower
• chives
• cucumbers
• eggplant
• green beans
• green peppers
• lettuce
• onions
• potatoes
• spinach
• strawberries
• swiss chard
• tomatoes
• thyme
• watermelon

I have never grown some of these things, and no idea on the proper amounts to plant so it's a big experiment but seeds are fairly cheap so why not? And under that same heading I had no success last year with carrots or melons, limited success with potatoes, a pumpkin (needs too much room) or tomatoes (topsy turvy was dumb!), and whole bounty of cucumbers. Right now I am just happy to see the seeds sprouting and the plants flourishing. Will be even happier when the potatoes start to shoot up too!

We will likely be supplemented by habaneros, zucchini and yellow squash from the dear MIL, tree fruits from my bestie, and whatever else we need from local u-pick places as desired for canning projects.  Not sure if we are going to purchase part of a meat source this year or not, since we still have abundant deer meat available. Right now we are deciding if we would like to raise chickens or ducks starting possibly in the fall for eggs and the occasional poultry.

This past year I have been refining my personal goals a bit. I don't know how likely it is for me to be down to a size 12 again (let alone maintain it!), but I could be happier with improved cardiovascular health. I could be thrilled with a smaller grocery bill. I could be ecstatic to harvest fresh food right out of my back yard! And speaking plainly, I will be wearing a swim suit whether people want to look at me or not. I have three kids, and a busy life, and things will come together when they come together. In the mean time I hope I can improve our family health and well-being with these few small steps. And hopefully document it along the way.

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