What to Pack in Your Hospital Bag

Packing a hospital bag is exciting, but can be a little overwhelming. Where to start? Think of it like packing for a weekend vacation, plus bringing along a few extra items. A large tote bag or small suitcase works fine. I like to use a carry-on suitcase with wheels, because it’s more convenient for my husband to help support me and easily wheel it behind him instead of having to also carry a heavy bag. Pack your bag about 3 weeks from your due date, and you’ll be ready when those first few contractions start.

Snacks

If the hospital allows it, snacks are nice to keep on hand to munch on during labor, to keep your energy up while waiting for baby. Your partner might want some too. After delivery, food is essential. I am always starving after all that hard work and depending on the time of day, the cafeteria might be closed. Keep a few substantial protein-filled snacks on hand.

Birth Preparations

  • Birth plan: Keep a few extra copies of your birth plan in your bag for nurses and doctors, especially in case of a shift change. 
  • Birth Affirmationswords, quotes or phrases you’ve written down to encourage and empower you throughout labor.
    birth affirmations

Electronics

My first two deliveries were so unexpected we only had flip phone photos. So sad! Keep these electronics on hand and accessible, because anything can happen!

  • Phones and chargers
  • Ear phones if you plan on listening to a playlist or birth affirmations (wireless noise cancelling ones can be worth the investment)
  • Portable speaker
  • Laptop and charger
  • Camera, extra memory card, and extra battery charger

Clothes to bring to hospital birth

  • Robe: Hospital gowns are nice to wear the first day or so, as you are leaking and bleeding, and getting used to postpartum recovery. You don’t have to worry about getting your own nice clothes dirty. However, it’s nice to slip on a robe if you need to walk to the bathroom or around the halls, since they are not too modest in the back. This one is short and SO soft!
  • Sleeping/nursing bra: Although your milk will most likely come in in about 3-4 days, your breasts can still feel tender and engorged, especially as you are nursing often. It sometimes feels nice to have some support rather than nothing at all.  Make sure you bring something soft, breathable, and comfortable.
  • Socks: Hospitals can be cold, and it’s also nice to have some cozy socks to help you feel more at home.
  • Slippers: Merely a comfort item for walking around the room and for trips to the bathroom.
  • PostPartum Band: I have heard people swear by these, as they help support your weakened core muscles after birth and help you get back to pre pregnancy size sooner. It also can help with diastasis recti (the separation of abdominal muscles during pregnancy) as it encourages the core muscles to come back together.
  • Loungewear: Comfortable, loose pants are best. Maternity leggings are a great option too.
  • Sweater: Hospitals can get cold and you generally don’t have control of the temperature. This one is SO comfy, nursing friendly and comes in tons of colors. 
  • Large, comfortable underwear you don’t mind getting bloody
  • Your own hospital gown (optional): Advantages—you feel cute, you know it is clean and fresh. Disadvantages—you might get blood or bodily fluids on it. This is a great option! 
  • Coming home outfit for mama: choose something extremely comfortable. Stay away from tights or skinny jeans, especially since you’ll be wearing large pads and underwear. Stick to a simple nursing-friendly maxi dress or lounge pants.hospital bag

Toiletries for Hospital Birth

  • Hair supplies: It’s so nice to get that first shower after delivery. If you can, skip the hair washing and use some dry shampoo to save time.
  • Hair tie or clips
  • Lotion or moisturizer
  • Makeup: You will be basking in the glow of meeting your baby and women look like goddesses after giving birth! If you feel comfortable with some makeup on, by all means pack your favorite items! 
  • Hand mirror: In case you want to have someone hold it so you can watch as your baby is being born!
  • Make-up removing wipes: These are golden to keep on hand when you want a fresh face but are holding the baby, nursing, or just too dang tired to get up.
  • Toothbrush and toothpaste
  • Nipple cream: some hospitals provide this, but if you have a brand you prefer, or your own for home, bring some to apply. We love this nipple balm and this lanolin option. 
  • Cold gel packs: These can really help in those first few days when your nipples feel raw and sore as they are getting accustomed to breastfeeding. They also help with engorgement.

Entertainment

  • Books/magazines/kindle
  • iPad for watching Netflix if you end up waiting around a lot

For Baby

  • Nursing pillow: You may stack a few pillows on top of each other to assist in nursing, but if you’d rather bring a boppy or my breast friend, feel free.
  • Wipes: many hospitals these days do not have wipes available, either because they irritate baby’s skin or because they are trying to cut costs. I’ve heard both reasons. Bring some unscented and sensitive skin brands just in case.
  • Binky: hospitals tend to use soothies and if your baby doesn’t like them that could be frustrating. I like this one and this one for newborns far more than soothies.
  • Coming home outfit: Bring two in case the baby has a blowout. Make sure they are comfy and soft and have the hand covers to keep him from scratching himself. I love these gowns. Include socks (or stay-on booties) and beanies to keep him nice and warm.
  • Blankets: bring a swaddling blanket so you can practice swaddling with the nurses, and a medium weight blanket to spread on him in the car seat for the ride home.

Happy Packing!

This post was written by Austyn Smith.

How to find a good OB & Questions to Ask BEFORE You Hire Them

You’ve decided to go with an OB/GYN. There are several advantages to using an OB for your care and delivery. Physicians tend to have experience with and knowledge about high-risk pregnancies and complications. If you know you are high risk due to advanced maternal age, diabetes, or any medical condition, you can have peace of mind knowing your OB is equipped to handle it and to manage medications if needed. If your intuition is telling you that you feel more comfortable knowing you have access to all the medical procedures and personnel a hospital offers, this is the route to go. OBs have access to advanced medical testing and screenings, and are connected in a network of specialists and colleagues. If you’re still considering a midwife, there are many midwives that work in collaboration with OBs so you don’t necessarily have the rule that out either. Talk to your care providers and come up with a plan catered to all of your needs.

Where to start in finding the OB that’s just right for you? You’ll definitely want someone you feel completely comfortable with, and that you trust to take care of you and your baby. This is your life (and emotional well-being) and your baby’s health in someone else’s hands, so it’s a big deal. Here’s some ideas to help you get started.

Where to look first

Ask around. Your best bet is going to be word-of-mouth. Talk to everyone you know and trust about their OB/GYNs. What things did they like/dislike about them? What was their prenatal care like? How was their delivery experience? Would they go back to this same person? The more details the better, just start asking. Of course it’s important to keep in mind that not everyone wants the same type of birth experience so the doctor that was a good fit for your sister may not be right for you.

Join Facebook groups in your area. There are many Evidenced Based Birth local groups that you can join where the admins and members are knowledgeable about the OBs in your area and which ones follow evidence based practices. What is Evidence Based Birth?

If you don’t know many recent moms personally, get in touch with your hospital’s Childbirth Educator.  She or He should be familiar with doctors and nurses at the hospital, and know the ins and outs of the kind of care they give (and their bedside manners). She’d be able to give a few recommendations that you can then do more research about. Of course keep in mind that they work for the hospital so may not be able to be completely forthcoming.

Ask for statistics. Hospitals keeps track of things like induction rates, episiotomy rates and cesarean rates so asking for these facts will give you a good idea of hospital practices. Unfortunately, even if you love your OB sometimes the hospital policies limit their ability to provide the care that you may be imagining.

Do you currently have a gynecologist that you like? Do they practice obstetrics as well? Asking a few additional questions can help you get a feel for if it would be a good fit or not. If they don’t deliver babies, they could recommend some colleagues to you, that you could then check out. Keep in mind that prenatal and birth care is MUCH more involved than an annual exam so don’t just go with your current doctor because it’s convenient. You want to make sure it’s a good fit and that their maternity care is in line with what you want for your birth.

Once you have a few names of potential doctors, there’s a lot of things to mull over before the interview process.

Here’s a few considerations:

Your health history

Do you have specific concerns about your pregnancy that not every doctor would have experience with?  Plus-size pregnancy, previous recurrent miscarriages, diabetes, or trying for a VBAC (Read more in our post What you need to know about VBAC?) can be uncharted territory for some practitioners.  Look at the websites and reviews of doctors to find out if they have specific experience in the areas you are concerned about.

Physician’s philosophies

What does the provider value? What is their overall outlook on pregnancy, birth, and labor? Are they super medicalized or do they lean toward the more natural route—and which do you prefer? What are their opinions on certain medical procedures like continuous electronic fetal monitoring, scheduling inductions, episiotomies, and epidurals? Do they tend to take control of how a labor is progressing, or allow the mother to take the lead? How pushy will they be?

choosing an ob

Male or Female

Think about your past interactions with doctors and whether you’ve been more comfortable with a male or female physician. It may not matter to you, but if it does, then you can quickly narrow your search down as most health insurance databases have the option to filter your search results based on gender.

Personality

Do you click? Do you feel comfortable? I had a friend who went in for a breast exam and the doctor chatted for a few minutes and then said, “Okay, flash me.” That exchange made her feel so uncomfortable she never went back. Bedside manner and professionalism matter! Do you trust their experience and judgement? Do they listen to your concerns and questions or just plow through the appointment as fast as possible? Are their credentials up to date? What does your gut say?

Support

Are they supportive of you having a doula with you during labor/delivery? How comfortable are they with extra people in the room in general, and does your partner get a good vibe from them as well?

VBAC/C-Section Rates

This is public information that you can request from your hospital. However, doctors don’t usually post their own personal stats. You can get an idea of how things go by calling the front office and asking some questions. Many offices don’t give out specific numbers, or may not even keep track, but you can get an idea by saying something like, “Out of the last 10 deliveries this provider performed, how many ended up being c-sections?” Or “Out of the last 10 attempted VBACs, how many were successful?” Get an idea of how willing they are to work with you. Keep in mind that specific hospital rates are higher than others for cesarean. Which brings us to our next item…

Hospital Policies

What are the c-section stats? You can search online to find this info. In general, what is the hospital like? Do they have natural birthing accommodations and tools if you’d like to go that route? Birthing tubs to labor in? Is the hospital friendly to natural delivery? Do they require IVs, continuous electronic fetal monitoring? Do they have VBAC policies? What are their standard procedures right after the baby is born? Do you get to have skin-to-skin bonding for a while? Does the baby get to stay in your room? Calling the Labor and Delivery floor is your best bet to getting answers to these questions. A nurse can help you out, or refer you to someone else who knows the specifics. Nurses generally want you to be informed about the hospital policies so that there aren’t any surprises when you come in.

obgyn

Office Protocol—Questions to Consider

  • What is the OB clinic experience like?
  • How easy was it to get an appointment?
  • How many doctors are in the practice?
  • Are you a number who is shuttled through the routine, or are you treated like an individual?
  • How long do you typically wait in the office?
  • What are the after hour policies?
  • Will your OB be the one to deliver you, or do they rotate who is on-call, and will that bother you?
  • Is there an on-call nurse that is available to answer questions?
  • What is the staff like?

Think about how you feel about all of these things.

Once you’ve thought about all of these issues, and researched a few doctors, narrow it down to a couple. You can either take the plunge and make your first appointment with the one you want, or you can be even more thorough and schedule a consultation, where you can bring your list of questions.

Above all else, keep in mind that you are not stuck once you make your choice. If at any time you start to feel uneasy about your care giver, or feel like you don’t align with their philosophies, shop around. It’s completely acceptable, and it happens all the time. If you feel uncomfortable firing your OB, simply call the front desk and ask them to transfer your files to your new doctor. You don’t even have to speak to the doctor you are leaving. This experience will be one of the most important of your life, and you deserve to feel as safe and as comfortable as possible. Follow your gut!

Interview Questions for Potential Obstetricians

General Basics

  1. What is your general philosophy on pregnancy, labor, birth, and postpartum care?
  2. What is your role as physician? What is your role during labor and delivery?
  3. How long have you been practicing? How many births have you performed?
  4. How many births do you anticipate attending month? Is there a limit to the number of patients you take on?
  5. What is the chance of you delivering my baby? Who delivers when you are not available?
  6. What is your c-section rate?  
  7. If there is a complication beyond your expertise, who would you refer me to?
  8. What is your after-hours policy? Are you reachable during an emergency?
  9. How often am I required to meet with other doctors?

Pre-Natal Care

  1. How much time do you spend with each patient during an appointment?
  2. Are you available in between visits if I have a question or concern?
  3. What is your view on nutrition and weight gain?
  4. What prenatal tests do you require and/or recommend?
  5. What childbirth education resources do you recommend?
  6. How do you feel about birth plans? Do you help with writing them?  
  7. What experience do you have with high risk pregnancies?  
  8. What would the procedure be if I become high risk?

Labor and Delivery

  1. When will you arrive on scene? Who will support me in the meantime? How often will you be with me during labor?
  2. If you have two simultaneous labors/deliveries, what do you do?
  3. How do you feel about a support team? A doula? Other friends and family?
  4. What if I approach my due date without going into labor? How long will you let me go past? What is your induction policy?
  5. Do you ever recommend induction for an estimated large baby?
  6. How long will I be able to labor after my water breaks if no signs of infection?
  7. What routine policies during labor do you recommend/require? What does the hospital require? (Continuous fetal monitoring, IVs, etc.)
  8. Am I allowed to move around during labor? Eat and drink?
  9. What are your views on pain management during birth, both medicated and unmedicated? Will you recommend different positions and coping techniques?
  10. What percentage of your patients deliver without an epidural? What resources are available to me, should I want to labor without drugs?
  11. What percentage of your patients get epidurals? What is your view on epidurals?  
  12.  How do you handle a “stalled labor”? What do you consider a stalled labor?
  13.  What birthing positions do you allow for labor and delivery? What is most common for you?
  14.  Do you perform episiotomies? How often? How often do you use forceps or vacuum extraction?  
  15.  Do you encourage and support VBACs? How many VBAC attempts have been successful? (60-80% is norm). What is the hospital policy for VBAC?
  16.  At what point in labor do you recommend c-sections?
  17.  Have you ever performed a vaginal breech birth? Twins?
  18.  What procedures do you perform on the baby? What can wait?  
  19.  Is delayed cord clamping okay?
  20.  What happens if there is postpartum hemorrhaging?

Post-Partum

  1. Will I have uninterrupted skin-to-skin bonding time immediately following birth? For how long?
  2. Will the baby stay with me in my room?
  3. Do you assist in breastfeeding? Is there someone else available to help me?
  4. What if I hemorrhage?
  5. Can my partner stay in my room?

Questions to ask yourself after the appointment

  1. Do I feel comfortable with this person? Are they flexible?
  2. Do our philosophies line up? Or are they willing to work with me? (You want them to enthusiastically support your wishes not just be “willing to let you try that”)
  3. Do we have a mutual respect?
  4. Do I trust their expertise and judgement?
  5. Is the office staff friendly and helpful?
  6. What was the wait time? Did I feel rushed in and out?

 

This guest post was written by Austyn Smith.

7 Practices for a Natural Birth

Interested in a drug-free birth? Here’s are some tips!

It’s amazing to me how quickly the mothering instinct sets in. Perhaps when the pregnancy test shows up positive, or seeing that tiny little body on the ultrasound screen, or especially feeling baby kick for the very first time. Something changes inside us at some point and there is an undeniable urge to protect, nurture, and sacrifice for the health and wellbeing of our babies.  

There’s an article published in the Journal of Perinatal Education entitled “Safe, Healthy Birth: What Every Pregnant Woman Needs to Know”  in which Dr. Judith A. Lothian describes six practices to ensure the safe arrival of that sweet bambino through the miracle of birth, we’ve added a bonus seventh!

Let Labor Begin on its Own

As the baby nears the end of gestation it puts on layers of protective fat, it moves down into position, and the cervix ripens on its own. The uterine muscles also prepare for that approaching influx of oxytocin. Inducing labor before these vital things happen naturally can really put a lot of strain on mother and baby as things are forced into motion (sometimes unsuccessfully). There is a greater risk of shoulder dystocia, birth augmentations, c-sections, and fetal heart distress. If the pregnancy is progressing normally, it’s best to wait it out until mom’s body and baby’s body are ready and ripe all on their own. Read more about Types of Induction—Risks and Benefits

Move During Labor

labor support

Nature intended for women to move during labor. Strong contraction waves and pain are signals to mom that moving to more comfortable positions will help labor progress. And it will, as more oxytocin is released in response. Moving has been associated with shorter labors, less injury and harm to baby, and less blood loss for mom. Walking in early labor can also decrease the chances of birth interventions like forceps, cesarean, or vacuum extraction. Types of Medical Interventions—Informed Consent and Risks/Benefits

Get Some Labor Support

If a woman is surrounded by a trusted team of people who can advocate, support, and empower her, it provides an almost sanctuary for her, even in a sterile hospital room. She will be able to better relax, cope, and focus on laboring, all resulting in less interventions and complications.  Women who labor with doulas, midwives, friends, or family present have higher rates of spontaneous vaginal birth, less requests for pain medication and an overall positive view of her birth experience. Emotional support is as vital as physical support during labor. If you’re on the fence about getting some extra help, do it! Read Do I Need A Doula and How to Find One?

movement in labor

Decline Unnecessary Interventions

These days hospitals and OBs can find themselves on autopilot, motivated by policies and procedures, rather than the reality of what is really going on. Continuous electronic fetal monitoring (EFM) is pretty standard in hospitals. This can result in unnecessary c-sections for moms. Contrastly, intermittent monitoring has no increased risk for the baby, and decreases incidence of instrument vaginal delivery and c-sections.

Epidurals, and listen up because this is very interesting, interfere with labor because there is no pain. The brain, not processing pain, does not receive the signal to keep releasing oxytocin, therefore moving things along. Labor slows down. Pitocin is needed to induce labor. Pitocin induced contractions are unnaturally strong. Baby and mom don’t respond well, more interventions are needed. Epidurals are associated with more tearing, longer labors, instrument delivery and increased cesarean risk.

Avoid Laying on the Back to Birth, and Wait to Push until you Feel the Urge

Giving birth while laying on the back is so convenient for doctors, but can be bad for mamas.  The pelvic opening narrows and it’s much harder to get the baby in the right position to make its entrance, not to mention it puts mom at greater risk of tearing.  Doctor-directed pushing (“Push NOW!  Hold it for 1-2-3-4….”) puts incredible strain on the pelvic floor muscles and is stressful for baby. Find a better position—side lying, squatting, kneeling, all fours, etc. Baby will let you know when to push, and you’ll be in better shape when it’s all said and done. That being said, some women DO find being on their back to be the most comfortable and some really thrive with a little directed pushing so as always be informed of your options and follow your instincts in the moment.

Mother-Baby Bonding is Vital

mother baby bonding

It’s ideal to keep that sweet little babe right next to mama for the foreseeable future. It’s better for baby as it results in better body temp regulation, stable heart rates, better nursing. And it’s better for mom as it results in less hemorrhaging and lots of oxytocin-induced bonding with baby. Plus, you get the added bonus of staring in awe at those sweet baby cheeks. Who doesn’t want that?  

Listen to Birth Stories

We constantly receive messages of thanks from mothers who benefitted from listening to The Birth Hour during their pregnancy. It helps them feel prepared and pull from the experiences of women who have face similar birthing experiences.  

There it is! Seven key practices for a natural birth experience. Good luck mamas. You can do this!

 

This guest post was written by Austyn Smith.

What is Evidence Based Maternity Care & Birth

Why evidence based maternity and birth care are important

Simply put, evidenced-based maternity care and birth are policies and procedures based on proven scientific evidence from medical research and peer-reviewed journals. It is the practice of effective care with the least amount of harm. Unfortunately in many parts of the world, standard hospital care is not practiced in this way. In fact, many hospital procedures go in direct contrast to recent medical evidence, and increase the risks for healthy mothers and babies.  

Standard care in hospitals can be intervention-intensive. IVs, continuous electronic fetal monitoring, epidurals, restricting food and drink, restricting movement, and having mothers push in the supine position all increase stress to the mother and baby, disrupt the natural flow of hormones, and may lead to complications.  

There are a few reasons for this dichotomy between research and practice

Tradition

Many birth practices in America, were put in place in the 1950s and 60s, using research based on the past rather than looking forward. Although more information and education is now available, it is a challenge to turn research into practice. Traditional methods are simply easier to continue.

Profit

It benefits hospitals financially to use interventions like induction, pitocin, epidurals, c-sections, and lengthened recovery stays.

Liability

OB/Gyns can be nervous about being sued, and for good reason.  They are the second highest sued doctors after neurosurgeons. If worry creeps in to a doctor’s mind about the “traditional potential dangers” of labor (say, if water has been broken for a while, baby’s heart rate is decelerating, labor has stalled at a certain point, or the pushing phase is getting long), he can choose to order a c-section. If he is potentially sued, he can make the case that he took action by doing all he could, rather than waiting it out. The same can happen with other worries before labor—if a woman measures big, or has some minor concerns, a doctor may order induction to prevent possible negative outcomes and being sued.

Convenience

Unfortunately, these situations happen more commonly than they should. An OB might have a vacation coming up and therefore will push an induction to have the birth before he leaves. He might be at the end of a very long shift and ready to go home, so may order some pitocin to be administered to speed up the labor. It’s a sad reality, but it does occur.

Reliance on Specialists

Although doctors are traditionally trained to handle higher risk pregnancies and use many interventions, healthy women with low-risk pregnancies often choose to be under their care. This is certainly a woman’s prerogative and she should go wherever she feels the most comfortable. However, this can contribute to the slow progress of change being implemented in birth. A woman with a low risk pregnancy might be in better care with a midwife.

Lack of education

More support is needed in terms of evidence based maternity research, not only in the healthcare field, but for patients as well. Many women are simply not informed of the data and their options when they meet with their healthcare providers. In addition, there needs to be more awareness and implementation requiring performance measurement, improvement, and reporting in hospitals.

There is great need to close the gap between the evidence and the standard practices in hospitals, especially in the United States. Consider this table.

evidenced based care

There is, however, progress being made in certain parts of the country. Some hospitals are starting to encourage natural pain relief methods and utilize tools like birthing tubs, birthing balls, squat bars, showers, and supportive nurses on hand. A local hospital in Portland, OR has midwives deliver the majority of babies, and the doctors handle only the high risk cases and emergencies. These things are certainly encouraging, and a sign that change is possible, no matter how slow.

How to know if your care provider is using evidence based birth methods of care

Get familiar with the science. Here is a great article about evidence based birth and 6 key practices to a safer delivery for mother and baby. Essentially, induction, epidurals, and c-sections are overused, whereas labor tubs, labor support, changing of positions, eating and drinking during labor, and delayed cord clamping are all underutilized. Know your options for these procedures. Learn about other standard procedures like vitamin K shots, failure to progress, the science about mothers over the age of 35, the truth about waterbirth, etc,  Evidence Based Birth is a great resource with many scientific articles.

Discuss your findings with your current care provider. How do they feel about each of the practices? What are the local policies if you will be delivering in a hospital? Is your doctor flexible and willing to allow modifications to certain “standard” procedures? The better informed mothers become, the easier these implementations will be for communities.

Resources for learning more about Evidence Based Maternity Care and Birth

Evidence Based Maternity Care: What it is and What it Can Achieve

The American Congress of Obstetrics and Gynecology

Biomed Central

Evidence Based Birth

When it comes to evidence based maternity care and birth practices, education is key.

This guest post was written by Austyn Smith.

What Does It Mean to be High Risk in Pregnancy?

High Risk vs Low Risk Pregnancy

It goes without saying that all women want a healthy pregnancy and ultimately safe arrival of their babies. A woman is considered to have a low-risk pregnancy when it is free from complications or worry, and she is otherwise healthy. However, sometimes unforeseen circumstances can arise that warrant the label “high-risk pregnancy,” meaning there is an increased risk of complications. Being labeled “high risk” definitely doesn’t mean that there will be health problems with mother or baby. It simply means doctors will want to monitor her closely for specific concerns during the course of her pregnancy. Here we discuss what conditions indicate a high-risk pregnancy, what course of action to take afterward, and how to decrease the odds of a high-risk pregnancy from occurring.

high risk pregnancy

What conditions constitute a high risk pregnancy?

Some pre-existing conditions that occur prior to pregnancy can automatically put someone on the track for high-risk pregnancy. These include:

Being underweight or overweight

Being underweight prior to conceiving can be dangerous to both a developing fetus and the mother. There is an increased risk for preterm birth, fetal distress during labor, and a low birth weight baby. Adequate nutrition is vital for both mother and baby. Achieve a healthy weight by eating large meals, adding good oils and fats to dishes, and drinking juices. Nutrient-dense foods are always preferable to junk food.
Being overweight prior to pregnancy also poses some risks for mother and baby. Mothers with a higher BMI have a greater chance for developing high blood pressure or preeclampsia and gestational diabetes. Likewise there is an increased risk for preterm birth, birth injury, c-section, and birth defects (specifically neural tube defects). Being overweight does not mean a woman will automatically experience these distressing complications. It is certainly possible to go on to have a healthy pregnancy. There are many ways for plus size women to take care of themselves prior to and during pregnancy. Find good support and education at Plus-Size Birth.

Infertility/History of miscarriage or preterm labor

Women who have used fertility drugs to achieve pregnancy have a higher chance of complications arising during pregnancy, specifically with the placenta and vaginal bleeding.

Repeated miscarriage or preterm labor puts a woman at high risk as the odds of recurrence are higher. A doctor will want to investigate the cause of recurring loss or premature birth to prevent complications in current and future pregnancies. At any rate, difficulty conceiving or previous loss can cause great anxiety for mother. Close monitoring for both mother and baby can put your mind at ease.

High blood pressure

If left unchecked or uncontrolled, high blood pressure during pregnancy can lead to kidney damage in the mother or pre-eclampsia, which is a very serious condition.  High blood pressure, managed carefully can lead to a healthy delivery and baby.

Autoimmune disease

Autoimmune diseases like Lupus and Multiple Sclerosis can cause complications during pregnancy. Lupus in particular puts a mother at higher risk for preterm labor and stillbirth. Some women’s conditions tend to improve during pregnancy while others worsen. It can be helpful to consult a doctor prior to conception to ensure conditions and factors are under control. Medication may need to be adjusted to a safe dosage or weaned off of completely, or doctors might recommend waiting until remission to conceive.

advanced maternal age

Advanced maternal age (over age 35)

First time mothers over the age of 35 have an increased risk for cesarean delivery plus a number of other potential complications. These include excessive bleeding during delivery, prolonged or stalled labor, high blood pressure, premature delivery, and increased risk of genetic disorders in the baby. Certainly women of advanced maternal age go on to have otherwise completely healthy pregnancies and deliveries—increase odds by practicing healthy lifestyle choices and seek out a care provider that doesn’t automatically classify you as high risk simply based on your age.

Family history of genetic disorders

A family history of certain conditions puts a woman at higher risk during pregnancy, specifically: pregnancy loss or death, chronic diseases like diabetes, high blood pressure, and mental illness. Pre-conception appointments can offer genetic counseling so you know the likelihood for potential complications

Lifestyle choices

Smoking, drinking, or using harmful substances are very dangerous for a fetus as well as the mother. The Center for Disease Control (CDC) recommends women do not consume alcohol while pregnant or even while trying to conceive. Drinking during pregnancy increases the chance for miscarriage, stillbirth, and the baby developing Fetal Alcohol Spectrum Disorder (more about FASD here). There are varying viewpoints on this in terms of whether the occasional glass of wine is okay or not— consulting with your care provider will be your best course of action.

Smoking can lead to birth defects as well, and there is a strong link to SIDS (sudden infant death syndrome). Even second hand smoke while pregnant can increase risk for health problems.

Your own medical history

Previous c-sections, low birth weight babies or preterm delivery can all put a woman at greater risk for repeat occurrences. Doctors will want to monitor closely to prevent any further complications.

Conditions that  may arise during pregnancy that constitute high-risk

Some complications can develop during pregnancy that could project a woman into the high risk category. These include:

Structural complications

Problems with uterus, cervix or placenta might arise. These could include a heart shaped uterus, or bicornuate uterus (divided in two halves); placenta previa (when the placenta is covering the cervix); or cervical insufficiency. Likewise, structural complications in the fetus discovered during anatomy scans might warrant further testing and very close monitoring.

Abnormal amniotic fluid levels

During pregnancy, too much (polyhydramnios) or too little (oligohydramnios) amniotic fluid can develop. Doctors will usually notice these anomalies during routine exams. A uterus might measure too big or two small, there might be excessive swelling in hands and feet, or fluid might be leaking from the vagina.

Restricted fetal growth

A baby can begin to exhibit signs of restricted growth during the course of pregnancy. Doctors will schedule continuous monitoring and possibly even an early induction (if the baby is post 34 weeks).

Rh factor issues

The Rh factor is a protein that can be present on the surface of red blood cells. Just as a person has a blood type (A, B, O, AB) they also either have the Rh protein (positive Rh factor) or they do not (negative Rh factor). A mother is only at risk if the she is negative and the father is positive, potentially resulting in an Rh positive baby. When the mother’s blood comes in contact with the baby’s, it will cause the mother to produce Rh antibodies to attack the fetus’s blood as if it were a foreign substance, which can cause severe anemia in the baby. Mother and baby would need close monitoring—a blood transfusion may be given through the umbilical cord if need be, or the baby may need a transfusion after delivery. Rh factor issues can be prevented through early screenings. If a mother is Rh negative, and the baby is positive, she can receive a shot to prevent her from developing Rh antibodies. Read more about Rh factor here.

Multiples

high risk multiples

A mother is at greater risk of complications if she is carrying twins or more. You will come up with a care plan to address multiples early on in your pregnancy.

Ways to promote a healthy pregnancy

Although many conditions cannot be helped, there are many ways to decrease your chances of becoming labeled “high risk.” Here’s some things you can control.

Preconception appointment

It is wise to meet with a healthcare provider prior to becoming pregnant. Your doctor can do a complete physical, review your personal and family medical histories, and provide council on any potential problems. They can help you adjust any current medications to a safe level, or help wean you off of them. They can discuss the things to do to ensure a healthy lifestyle and help you provide the best physical environment in which the baby can grow.

Keep all pregnancy appointments

pregnancy doctor appointments

@mel_jensen

It’s wise to have regular appointments with your practitioner while pregnant, not only to make sure things are going well with the baby, but with you as well. A good doctor or midwife will spend adequate time listening to any concerns you may have, answering questions, offering counsel, and making sure you are doing okay mentally and emotionally as well.

Practice good nutrition habits

It’s more important than ever to be conscious of what you are eating. The developing baby gets all his nutrients from you, and it’s important to make sure what  he is receiving is high quality. Focus on eating large amounts of fruits and vegetables in a variety of colors, and good fats like nuts and avocados. Eat food close to its natural form and cook things from scratch rather than reaching for processed packaged items. Get enough protein from high quality sources, and eat a variety of leafy greens for iron. Remember water as your beverage of choice. Staying hydrated is essential for you and baby.

Keep weight in check: Eating right and good nutrition will help to ensure a proper amount of weight gain during pregnancy. A good rule of thumb to follow is to listen to your body. Eat when you are hungry, and stop just before you are full, when you are satisfied. This can be more effective than following “rules” of eating three square meals a day at certain times. Ensure you have healthy food on hand for when hunger strikes, and let your body communicate with you. You might find you are starving only an hour after breakfast, or that you are satisfied well beyond. You can’t go wrong when you listen to physical cues.  Keep in mind that all women gain weight differently during pregnancy and as long as you are eating healthy food and visiting your care provider regularly you shouldn’t worry too much about the number on the scale.

Exercise

Physical activity also helps keep your weight in balance before, during, and after pregnancy. This is another opportunity to listen to your body. You do not have to be intensely pumping iron til exhaustion for 2 hours each day. In fact, quite the opposite. Ask yourself, “How would my body like to move today? What would feel good?” Use a variety of activities to keep your program well rounded. Some good exercises for pregnancy are: walking, swimming, elliptical machines, gentle strength training, yoga, stretching, hiking, low-impact aerobics, and pilates. Do what is enjoyable and what will help you stay motivated to move.

Avoid harmful substances: smoking, drinking, and illegal drugs are all very harmful while pregnant and have potentially damaging effects on a fetus. Stay away from them, and tell your doctor if you need help weaning off. There are good resources, so speak up.

Educate yourself

One of the most empowering tools you can have as a new mother is the gift of education. Arm yourself with knowledge about pregnancy, birth, breastfeeding, mental/emotional health, and more. There are endless resources available. Start with what you are interested in, or the phase of pregnancy you are in. The more you know, the more options you will have available to you, and the better equipped you will be to handle the demands of a changing body, and the challenges up ahead.

What happens if I become high risk?

If you are seeing a midwife, depending on the nature of your conditions, you will potentially be passed to an OB’s care. There are certain circumstances where a midwife will continue seeing a patient, but it really rests on the midwife’s comfort level and the specific case of the patient. Homebirths are generally not recommended or in some cases aren’t legal for midwives to attend once you become high risk, but again, it depends on the individual case. No matter who your current care provider is, you may also be referred to an MFM (maternal fetal medicine) doctor.

Depending on what has developed during the pregnancy, your OB may suggest the following tests/screenings: specialized ultrasound, amniocentesis, chorionic villus sample, umbilical cord sample, lab tests, routine ultrasounds or stress tests. You may be asked to go on bed rest or pelvic rest, or to otherwise take it easy physically.

Continued monitoring will be important to doctors treating a pregnant woman at high risk.  Even if nothing alarming is happening, he will want to continue regular appointments, stress tests, ultrasounds, and extra appointments to ensure optimal health up until delivery.

Ask your doctor about specific risks with your condition. What warning signs do you need to be aware of? Things like bleeding, sharp pains, early contractions, decreased fetal movement, headaches and vision changes can all be warning signs. When should you call? What constitutes an emergency? Educate yourself about situation.

A low-risk pregnancy is certainly preferable, but be aware of the possibility of high-risk conditions and complications. Pregnancy, and delivery, and motherhood for that matter, can all be unpredictable. Do your best to take care of yourself and stay informed, and try to be flexible with what comes your way. Never be afraid to speak up and follow your intuition!

This guest post was written by Austyn Smith.

Sources

  1. The American College of Gynecologists. September 27, 2013. The Rh Factor:How it can affect your pregnancy. American College of Gynecologists, Frequently Asked Questions (027). [September 27, 2013; January 17, 2017]. http://www.acog.org/Patients/FAQs/The-Rh-Factor-How-It-Can-Affect-Your-Pregnancy
  2. 2008. Understanding Pregnancy and Birth Issues. NIH Medline Plus (winter 2008). [winter 2008; January 17, 2017]. Volume 3 (issue 1): https://medlineplus.gov/magazine/issues/winter08/articles/winter08pg22-23.html
  3. The American College of Gynecologists. March 2015. Good Health Before Pregancny: Preconception Care, Frequently Asked Questions (056). [March 2015; January 17, 2017].http://www.acog.org/Patients/FAQs/Good-Health-Before-Pregnancy-Preconception-Care#being
  4. Goldmuntz, Ellen and Penn, Audrey S. July 16, 2012. Autoimmune Diseases Fact Sheet. Office on Women’s Health (e-publications). [July 16, 2012; January 17, 2017]. https://www.womenshealth.gov/publications/our-publications/fact-sheet/autoimmune-diseases.html
  5. Centers for Disease Control and Prevention. July 21, 2016. Atlanta, Georgia. [July 21, 2016; January 17, 2017]. https://www.cdc.gov/ncbddd/fasd/alcohol-use.html

Essential Baby Gear—What You Need and What to Skip

Having a baby can be a big financial stress. Not only are doctor appointments and delivery fees expensive, but all the things you are told that you need to take care of the baby when you get home can add up. The good news is that the majority of the things on most baby registries aren’t actually essential (although they can be very nice!), so with some careful planning, you can easily lighten your financial load.

So what do you really need for the baby? And how can you make it affordable? Here’s a simple way to space out purchases by trimester.

Put some money aside for

  • A doula (if you plan on having one)
  • A photographer (maternity, birth, or newborn). Putting aside money each month can make this priceless opportunity affordable. My birth photos are some of my most prized possessions.
  • You can also register for these things through a universal registry like BabyList or Amazon.

Ongoing Purchases Made Over the Course of Pregnancy

essential baby gear

Baby Clothes

Babies go through A LOT of clothes but you are also going to be doing laundry every day (trust me!) and you are likely going to be gifted clothes more than anything else. Because just like you, friends and relatives can’t resist those tiny outfits.

A common mistake new moms can make is to buy too many “cutie” outfits for the first few months. The photo ops alone can send you rushing to the store, but it’s just not practical. The first few months of life, babies will have lots of diaper blow-outs, spit ups, and milk leaks. You will be changing their diapers up to 12 times a day and changing their outfits multiple times as well.

I recommend sticking to comfortable, breathable cotton clothing (a few basics packs like these is all you need) that are cozy for baby, and easy to change. Infant gowns are also extremely useful for middle of the night changes. And honestly, a sleeping swaddled newborn is swoon-worthy no matter what they are wearing! Then if you really are itching to up the style game, 6-9 months is a great time to get some trendier things.  

Baby Shoes

Shoes can also wait until they are 9-15 months depending on when they start walking. Until they are walking, I recommend sticking to socks paired with this invention that is one of my favorite baby products ever!

Here’s, how to space out the clothing purchases:

Shop the BIG sales. Good annual sales are usually in July and January when companies start trying to clean out their inventory to make way for the upcoming seasons. Take advantages of the big sales and buy seasonal clothes in the next year’s size.  Shop the sales, and then throughout the pregnancy pick up items here and there when the prices are good.

What will you realistically need?

  • Onesies, onesies and more onesies. Avoid buying many of the newborn size because if you have a 9lbs baby they will only wear those for about 5 days! You can always wait and rely on my best friend, Amazon Prime (hello free 2-day shipping!) to get the size you need.
  • Sleepers — a few in each size and always go for zippers over snaps (trust us!).
  • Cotton tops and bottoms with elastic pants especially helpful for the first 6 months. I like the footed ones so you can skip socks altogether.
  • Accessories like socks, headbands, shoes, hats—depending on where you live you might need some seasonal items (beanies, mittens, hats).  Buy them when you see a good price.

Diapers and Wipes

Brace yourself.  You will go through an astounding number of diapers in the first few months of your baby’s life.  This is an ongoing item to keep an eye out for.  If you are planning on disposable diapers, add them to your baby registry starting now, and you can build up a great supply. Use coupons and you can get some packages for a decent price.  Amazon Prime also has some great deals that can be delivered straight to your door on a monthly basis. You can even ask for an Amazon Prime membership as a gift—send this link to your loved one that hates shopping!

You’ll need several big packages of newborn diapers—I like these because they have a cutout for the umbilical cord so it doesn’t get irritated—but don’t overdo it. Babies always tend to outgrow these the fastest, plus a newborn can squeeze into the bigger size if they need to. Stock up on the 1-2 size.  Once you have a good supply of those sizes, just keep an eye on your baby’s growth and fit and move up to size 3 when they are ready.

First Trimester Purchases

stuff you need for baby

Bathtub

Having the right supplies can make the difference between an enjoyable bonding experience or major frustration for mom and baby!  One of my favorite bathtubs is a Puj Baby Tub. These are made from “soft foam that conforms to almost any sink,” so it’s much more comfortable than leaning over the tub when your baby is too floppy to sit up. It’s comfortable for baby, it lays flat for storage, and it’s a hip cool design. I also love the unique Tummy Tub that simulates the mother’s womb and worked like a charm to soothe my babies when they were fussy. And finally Stokke came out with a new tub that folds up easily for storage/travel and has a newborn accessory that mimics mama’s arm.

Bath products

Baby’s skin can be pretty sensitive, especially in the newborn phase when they are adjusting to living outside of a warm wet womb and being exposed to continuous air. Some high quality mild soaps can help.

  • Earth Mama Angel Baby — This body wash is detergent-free and mild enough for delicate newborn skin and hair. I actually use it to shave as well.
  • Mustela Newborn Foam Shampoo — This is my favorite newborn shampoo for dealing with cradle cap. It lasts forever (like years!) and has that irresistible new baby smell.

First Aid/Hygiene Supplies

Many companies make baby first aid/hygiene kits. Make sure it has the basics like:

  • Nail clippers
  • Thermometers (digital ear or rectal)
  • Baby brush or comb
  • Cotton balls for cleaning eyes, ears, and nose
  • Petroleum jelly—for rectal thermometer lubrication or circumcision care
  • Gauze
  • Rubbing alcohol—for cleaning thermometers, tweezers, clippers
  • Tylenol or equivalent (only safe after 12 weeks)
  • Snot Sucker — The bulb syringe that comes in most kits is basically useless. I know the snot sucker sounds gross but you don’t actually get snot in your mouth and it works like a charm. You’ll likely become addicted to it!

Nursing Bras

Save some money now while you can kill two birds with one stone. Your breasts will be growing and getting sore and you will likely need a new bra, so if you plan on breastfeeding, a nursing bra is a great idea but keep in mind what fits while pregnant may not fit when your milk comes in.

Get a comfy bra that stretches for now, and you can use it during pregnancy and also after you give birth!  You can buy a larger one later with more support if you need it. Your breasts will constantly change size in the first year after giving birth, depending on how much nursing is happening at a given time. My favorite nursing bra for larger chester moms (like myself) who want REAL support is this one.

Burp Rags  

Buy at least 10 plain and practical ones and expect to receive plenty cutesy ones as gifts too. You’ll want to keep these all around the house, always at arm’s reach for spit up, breast leaks, and diaper explosions.

Binkies and clips  

If you plan on using a pacifier, try a few different kinds since your baby might gravitate towards certain styles. Here is a non-toxic, chemical free option to start off with that my kids ADORED. The only other pacifier that actually stayed in my baby’s mouths were these. I’ve also heard great things about these animal pacis that help baby find a binky during nap time or at night. They come in every type of animal; I’m partial to the longhorn and penguin!

Second Trimester Purchases  baby gear

Nursing Cover  

If you plan on breastfeeding, you may want to just take it easy for the first month or so. This will be a critical time for you and your baby to get the hang of nursing. You can walk around in a robe for a while and not worry about modesty or being stressed while you are figuring things out. When you feel ready to venture out into the world, a good nursing cover might make you more comfortable. Covered Goods has a great option that also serves as a car seat cover, infinity scarf, and grocery cart cover. Keep in mind that some babies might not tolerate a cover and we are also all about empowering women to nurse whenever and however they want. Normalize breastfeeding!

Breastfeeding Supplies  

You will need a few things to ease your way into the wonderful (and sometimes painful!) world of breastfeeding.

  • You’ll want some good quality nipple cream to keep near your bed, in your purse, in the nursery, basically everywhere! Remember your baby will be putting his mouth here, so make sure it’s safe for him to ingest. Earth Mama Angel Baby makes an organic nipple butter. And many people swear by lanolin nipple salve as well.
  • Booby tubes can be heated up or chilled for soothing purposes if you are engorged or getting blocked ducts.  
  • Breast pads. Buy disposable or reusable. My favorite reusable ones are these, which look enormous but they keep your nipples warm (very important in the winter or well air conditioned buildings) and cover the whole breast so you can avoid the often noticeable ring around your nipple from typical breast pads. You will need to buy lanolin wash and at least two pairs so you have one pair to wear while the other is being cleaned. Like all wool products they are self cleaning so don’t need to be washed very often. If you prefer disposable pads these are great.
  • I didn’t know before I became a mom that the breast you are not currently nursing on also leaks milk! This is my all time most recommended product. Not only does it protect you from soaking yourself, it also allows you to save every precious drop of breastmilk. I built up an entire freezer stash without ever pumping using this thing. Just trust me, every mom I tell about it ends up thanking me! This is a nice accessory to go with it.

Baby Wrap or carrier  

The first three months are a great time to use a baby carrier. Lots of babies are restless sleepers and just seem to do better when they are being held. That can be a recipe for one tired momma…who is already exhausted.  A good quality baby carrier can be a life saver when you just need a break and want some hands-free moments to make some food, go for a walk, or tend to another child. And as a bonus, if your baby gets used to a carrier early on, they are more likely to be happy in there as they get older. You can take them on hikes and walks, and shopping trips all over town. It’s a fun bonding time. Solly Baby makes a great wrap up till 20lbs, and Ergo and Boba are both popular structured carriers.

Baby Monitor  

Oh how I wish I was smart enough to get a video monitor my first time around as a mom. I knew the baby was not making noise, but what if the blanket is over his head? Was he breathing? If he was crying, was his arm or leg stuck in the crib somehow? I spent so many hours sneaking back to the baby’s room on a creaky floor, trying to quietly open the door to peek at him and would wake him up accidentally about 80% of the time. Soooo frustrating! A video monitor can give you peace of mind that everything is okay, and the baby is comfortable and safe. These are some popular ones—make sure you get one that pans and tilts so you can continue using it once baby is out of the crib and moving around the room. I recommend getting one from Amazon because they will take care of any malfunctions you encounter along the way. 

Baby Blankets

You’ll want a good stash of these, and luckily this is one of the most common baby gifts, especially from grandma.  

  • Swaddling blankets can be vital in the first 3 months. Depending on the month your baby is due, you’ll want to get some lightweight breathable fabric swaddled, and also some cotton weave swaddlers. If you need some warmer stuff, you can swaddled and then layer a heavier fleece or wool blanket on top.  
  • Photo-op blankets are a fun way to document your baby as he grows. Here’s some cute options.
  • If you end up with a baby that can escape swaddles, this one works well even on the wiggliest little ones. At $30, it’s a little pricer than other swaddles but we were able to use it to contain our son until he was 6 months old! Well worth the money spent for extra sleep in return!

Third Trimester Purchases

baby registry list

Diaper Bag  

Want to stay chic and also have a practical bag to carry around as a mom? Lily Jade is your answer. With an option to wear as a backpack (all I do these days) or on your shoulder there are many styles to choose from, all with designer looks.

Breast Pump  

If you plan on nursing, you’ll also want a good-quality breast pump. Before you purchase one, check with Aeroflow Breastpumps that can help you get a pump for free through your insurance company to see if they provide them free of charge or at a discounted rate. I got one free with my last pregnancy and was able to choose from a few options. You also might want to meet with a lactation consultant first—they are knowledgeable about pumps and how to fit one to your to your body. You’ll specifically want to make sure the phalanges (the part that’s connected to the cup that your nipples go into) are the right size, and that you can hook everything up comfortably. I personally like electric pumps best, and a hands-free option is always a plus. If you plan to go back to work you, a breastpump bag that is professional looking and can hold all your other stuff including your laptop would be a worthy splurge.

Bottles and Bottle-Washing Supplies  

Many pumps come with storage bottles, or complete bottle sets. That is always a bonus but your baby may end up liking a different type of bottle. If you are looking for some separately, it’s can be helpful to buy bottles manufactured specifically for nursing moms. The nipples are shaped more like breasts, and are even made to mimic a real nipple. Here’s a couple of options.

Make sure that you purchase BPA free bottles and nipples, or glass bottles, to avoid toxins leaking into milk. Also buy some bottle brushes, and make sure it has a nipple brush attachment.

recovering from baby

Postpartum Supplies for Mom  

I really wish someone had prepared me for recovery after birth. This is a tender time physically and emotionally. The better prepared you are, the smoother recovery can go. Stock up on some self-care items. Things like:

Earth Mama Angel Baby has a postpartum package that I recommend as an awesome gift for a new mom.

Immediately after giving birth, mesh boyshorts that the hospital or your midwife provide will be your best friend. Once you are ready to move past mesh, invest in some comfortable and supportive, yet stylish underwear. Let’s face it, you might not feel sexy, but grandma panties will only make you feel worse. These high waisted, pooch-hiding options will give you an extra boost when you feel so crummy.

Big Ticket Items and Baby Shower Gifts    

These are the items to put on your baby registry, or hope your parents will chip in for, or that you can get from a group gift at baby showers. If you think you’ll have limited support, start setting aside a bit of money every month to purchase these, wait for a sale, and space them out toward the end of your pregnancy. They are expensive, so do the research, read reviews, and think hard about what things will fit best with your lifestyle and budget.

Crib  

The good news is that the actual crib is not necessary at all, specially if you plan on getting a bassinet or pack and play. It’s recommended to keep the baby in your room for a few months, at least until they start sleeping through the night. More peace of mind and easier access. And once you decide to move them to their own room, a pack n play works just fine (my daughter slept in hers until she was two and I’ve never owned an actual crib). If you are a mom that just knows they definitely want a crib, here are some tips.

  • Do your research. Style is usually important when you are excitedly decorating the nursery, but make sure you check the recalls, that it’s a safe crib, and see what others say about it. In general, you want a fixed side (not the kind that drop down) and slats that are no wider than 1.5″.  
  • You’ll also need a mattress—get a firm one! Be careful with bumper padding as these can lead to suffocation. They do make breathable thin bumpers as a good alternative.

Stroller

This is such a tricky purchase. You can do zillions of hours of research on this, yet sometimes it’s not clear what works best for you until you’ve used the wrong stroller for a while. So think through your lifestyle needs and preferences. Do you love to walk? Perhaps a jogging stroller would work best. Are you a city dweller? Take that into account. Do you really want a sturdy and spacious stroller system complete with car seat? Go for it. Read lots of reviews and make a pro/con list. Ultimately, it’s not the end of the world if you don’t buy the perfect stroller. I personally have been through 5 different kinds with my 3 kiddos. Last piece of advice—splurge on this one. It’s worth it to get what you want, and it will likely last for many many years.

Another idea is to hold off on the stroller purchase for a few months, and use one of these frames that the car seat just clicks into. They are small and lightweight and work well. After a few months when the baby has a little bit more muscle control, you can upgrade to a bigger stroller and take him with you to the store to test some out.

Car Seat  

This was such an exciting purchase for me, I couldn’t wait to install it in my car, and even drove around with it empty while I waited for baby’s arrival. You will need a rear facing car seat for the first 2-3 years of life (each seat has different height/weight recommendations and generally the longer you can keep them rear-facing the safer your child will be). Typically an infant car seat works best up to 12 months, and then when they are bigger, upgrade to a convertible seat that can face both rear and forward. These can last up to 5 years old (again depending on height/weight) so they are long term purchases. I love this one because it fits nicely in smaller cars, like mine. Again, do your research, read reviews, and get shopping!

Noise Machine  

In my opinion, these are GOLD. My babies have always slept much better when there is white noise near the crib. It blocks out all the other random sounds around the house, and also soothes the baby to sleep, as it is apparently similar to what things sounded like inside the womb. This one is the one I used (after trying several duds) and this is an awesome portable/bluetooth option.

Swing

Some babies like them and others don’t. For me, the swing was one of my absolute favorite items for getting a good nap! You don’t need a super expensive one since babies don’t use them all that long but do make sure and get one that plugs in or you will go through batteries like it’s your job!

Bouncer  

Another purchase that is hit and miss. It can be really nice to place the baby in a semi-reclined position to nap or look around when you need your hands free to fold some laundry or make dinner. Some babies love it and some don’t. They are relatively inexpensive, make good registry items and can often be found second hand. I actually kept mine in the bathroom so I could put baby down in it while I showered or even peed!

There you have it!  With a little planning, you can prepare for baby without breaking the bank or losing your sanity.  There’s nothing quite as fun as shopping for babies, so enjoy yourself! Happy shopping!

This guest post was written by Austyn Smith.

Third Trimester Body Changes

Entering the third trimester is a great milestone. You are two-thirds through your pregnancy, and will soon meet your baby! The third trimester is basically comprised of you and your baby growing! There are not too many major changes from the second trimester to the third, except for a list of possible ailments. Keep in mind that although the following discomforts are common, they are not inclusive to all pregnant women. Here are some things to possibly expect during this phase.

Body changes during the third trimester

pregnancy books

Swollen Ankles, feet, hands and face

An increase in body fluids during pregnancy softens the body and allows room for the baby to grow. This increase can cause swollen body parts (edema), and most women will experience it to some degree.  

Ways to combat pregnancy induced swelling

Frequent breaks from sitting or standing periods will help circulation. When sitting or resting, it can be helpful to prop feet up on a stool or chair to elevate your legs and keep fluid from pooling in your lower extremities. Wear comfortable shoes, flip flops, or no shoes at all to ease restriction. Keep legs uncrossed when sitting.

When to worry about swelling

Edema accompanied with other symptoms can indicate preeclampsia (pregnancy induced high blood pressure), so keep an eye out for the following symptoms. Edema associated with:

  • One leg more swollen than the other- can indicate a blood clot
  • Chronic headaches and vision changes
  • Chest pains and difficulty breathing

Any of these symptoms are cause for calling your doctor right away.

Itchy skin during pregnancy

Pregnancy hormones accompanied by growing, stretching skin can lead to skin irritations and itchiness. Dry skin and eczema are also common. Treat itchy skin by avoiding hot temperatures in baths and showers that can promote dryness. Use mild unscented soaps, moisturizer, cool wet compresses, and wear loose fitting clothing. An occasional oatmeal bath can also help to soothe irritated skin.

When to worry about itchiness

In about 1% of pregnant women, a condition called cholestasis can develop. This is a liver disease that causes intense itchiness, usually starting with the soles of feet and palms of hands that worsens at night. Call your doctor right away if you experience these symptoms. Listen to a birth story of a Birth Hour mama who experienced this.

PUPP is another semi-common skin condition that affects about 1 out of 150 births. Itchiness in the abdomen is accompanied by a rash or hives that can radiate to the thighs, buttocks and back. This condition is not dangerous, but is uncomfortable. Your healthcare provider can prescribe topical creams to treat the affected areas.

Braxton Hicks Contractions

These can be fun to experience for the first time. Your body is essentially “practicing” labor contractions, and these kind do not hurt. This tightening of uterine muscles can be a strange sensation to experience, but are nothing to be worried about. Most women have Braxton Hicks Contractions at some point, and they can be felt as early as the beginning of the third trimester. Some women, however do not experience them until they are very close to delivery.  

How to tell the difference between Braxton Hicks and real contractions

Braxton Hicks contractions do not hurt, do not last for long periods of time and are random. If you are close to your due date and suspect contractions might be the real thing, start timing them. If there is a pattern to them, they do not stop upon laying down or changing positions, and they are uncomfortable or painful, those are good clues that you might be in labor.

“Baby Brain”

Although not scientifically supported, many women claim to have “baby brain” during pregnancy, meaning they are affected by a pregnancy fog of absentmindedness and forgetfulness. This could be due to hormonal changes, sleep deprivation, or the stress of a big life change approaching. There is suddenly more to think about, so focusing on normal daily tasks can be muddled with distractions. If you find yourself losing your car keys more often or unable to think of the word you need in the moment, know you are not alone!

Hemorrhoids during the Third Trimester

Hemorrhoids are swollen veins that are present in the anal area that can cause itchiness, bleeding, and discomfort, especially when having a bowel movement. The increased pressure on your large intestines from the weight of your uterus, which can further affect the sensitive area.  

Ways to treat hemorrhoids

  • Avoid straining when having a bowel movement.
  • Eat a diet rich in fruits and vegetables containing fiber to avoid constipation. Broccoli, bok choy, kale, brussel sprouts, and cabbage are all good options.
  • Drink lots of water.
  • Do kegels exercises
  • Sleep with a pillow between your legs.   
  • Don’t stand up or sit for long periods.  
  • Keep moving around.  
  • Apply cold pack to area.  
  • Use Tucks pads—total lifesaver!

Increased fatigue

You might start to feel tiredness similar to that of the first trimester. It’s a normal response to the increased weight you are carrying, and your body hard at work supporting an extra life. Couple that with sleep disturbances and the grind of daily life and it can leave pregnant mamas pretty wiped out. Try to listen when the exhaustion strikes. Take rests whenever you can, go to bed early, and slow down in general. Conserve the energy you do have and spend it on a few priorities per day. Here’s some reminders of how to get some extra rest and some ideas of how to meet your needs as a mother or mother-to-be!

Appetite changes during the third trimester

With your uterus expanding and pressing on your stomach and intestines, you may find your appetite decreasing. It may be harder to eat (and digest) large meals. Break up your meals into 4 or 5 smaller meals and snacks throughout the day. This can also help if you are experiencing indigestion or heartburn.

Third trimester sleeping challenges

third trimester body

Restless Leg Syndrome

Occurring in 20% of pregnant women, RLS occurs during sleep when there is an intense urge to move your legs. It can be quite uncomfortable and frustrating to continuously try to find a position that feels good to sleep in. Doctors aren’t sure of the exact cause, but some theories are: iron deficiency, a disturbance in the brain’s dopamine system, or a low blood cell count. There is increased risk if you have had it before, or have a family history of RLS.  

Unfortunately there is currently not much to offer in terms of treatment. Exercise, good sleep habits, and keeping your mind active during the day all seem to help improve the condition. Restless Leg Syndrome does seem prone to striking mostly at night, so if you can, sneak in a nap to make up for lost sleep.

Insomnia in the third trimester

This can be due to discomfort or the ailments mentioned above, the increased frequency in urination, or your hormone changes. As frustrating as it is not to be able to sleep, there are some strategies that seem to help.

  • Get up and do something. Sometimes just by giving in and changing scenery, our body is able to process and move on.
  • Eating a snack, reading a book, listening to music, or browsing your favorite websites can offer the perfect distraction. You might even find that after a short amount of time you are tired again.
  • Buy a body pillow for added support, or extra pillows to put in between legs. Make your bed as cozy as possible. Keep the air temperature cool.
  • Practice regular sleeping habits and rituals. Eat a small snack and drink something warm prior to bed. Do a meditation or some breathing exercises. Keep the same bedtime every night and don’t allow any screens an hour or so prior to bedtime. Use some oils or lotions and do some gentle stretches. Train your brain to realize it’s time to sleep. Try some of these same rituals if you awaken in the middle of the night as well. The routine can help trigger muscle memory that now it’s time to relax.

Third trimester Leg Cramps

Doctors aren’t quite sure why involuntary muscle contractions in legs and feet sometimes happen during pregnancy. The episodes usually strike at night and awaken you with a massive charlie horse. When you are in the middle of a cramp, try flexing the muscle, which can sometimes release the contraction.  

Preventing leg and feet cramps

  • Do some daily calf stretches, as well as stretching the arches of your feet.  
  • Stay active. Keep muscles in shape and blood circulating by daily exercise.
  • Drink enough water
  • Wear comfy shoes
  • Make sure you are getting enough magnesium in your diet which can help with muscle cramps. Some good sources are bananas, grains, beans, dried fruit, seeds, and nuts

Breast changes in the 3rd trimester

Your breasts are hard at work preparing to feed your baby. Colostrum, the nutrient-dense yellowish liquid that is present before your milk comes in has already started forming, and can start leaking. Wear some nursing pads to prevent staining and keep things dry.

3rd trimester pelvic pain

Your pelvis can widen 3-4 mm in prep for birth, causing pelvic soreness and pain (Gaudet, Tracy W. Body, Soul, and Baby: Bantam Dell, 2007. Print.). For relief, try acupuncture, massage, pelvic tilts, cold packs, or warm baths.

Occasionally the ligaments holding the pelvis in place will relax even further, making the pelvic joint unstable and causing intense pelvic pain. This is called Symphysis Pubis Dysfunction, or SPD. It causes pain while in upright positions or weight bearing activities, especially when lifting legs, like to put on a pair of pants. A pelvic support belt can be used to take the pressure and weight off of the ligaments and joints. Here is a good option.

Bladder changes at the end of pregnancy

Pregnant women are at greater risk for urinary tract infections due to increased glucose levels. Use good hygiene, wash with unscented mild soaps, and remember to wipe front to back in the bathroom. Drinking a lot of water also helps. If you feel one coming on take some cranberry pills to stop it in it’s tracks.

You may continue to notice some bladder incontinence. This is common as greater pressure is put on your bladder and pelvic floor muscles. Continue to do kegel exercises and use sanitary pads for protection.

Pregnancy vaginal bacterial changes

A normal amount of good bacteria resides in your vagina, but during pregnancy, extra estrogen may cause things to get out of whack. In fact, 1 out of 5 women will get a bacterial imbalance at some point during pregnancy. Here are two infections to be on the lookout for.

Bacterial Vaginosis

Occurring when bacterial balances are overthrown, bacterial vaginosis is a serious occurrence. It can cause preterm labor and birth, a lower weight baby, and uterine infections after delivery. Symptoms include discharge with a foul or fishy smell, most noticeable after sex. Get checked out if you suspect you might have it. Otherwise practice safe sex, do not douche or use scented soaps.

Yeast infections

Yeast infections are fairly common during pregnancy. Symptoms include white lumpy discharge, itching and burning around the outside of the vulva, and swollen or red skin. These infections are pretty harmless and easily treatable with over the counter antifungal medicine. However, be watchful—if you are close to delivery, the infection can be passed to the baby in the birth canal, causing thrush. This is a major pain to treat as it can be passed back and forth between baby and mother during breastfeeding! So get that infection under control as soon as possible. Prevent infections by wearing breathable, cotton underwear; taking showers instead of baths; and limiting sugar intake.

What to expect from your doctor or care provider

homebirth home visit

Group B Strep test

This test is usually performed around 35-37 weeks. About 40% women test positive (Gaudet, Tracy W. Body, Soul, and Baby: Bantam Dell, 2007. Print.), and there is nothing you can do to prevent it. Keep in mind that your chance of getting it is the same with each pregnancy. Just because you tested negative before, does not mean you will not have it with subsequent pregnancies. There is no genetic component. Group B Strep can cause serious/fatal infections in the baby, but luckily it is simple to treat. If you test positive, you will need antibiotics during labor, about 4 hours before the baby is born. If you are planning an out of hospital birth this may be handled differently so please check with your care provider and make a plan.

Third trimester cervical checks

If you would like, healthcare providers offer to check your cervix starting at about 36 weeks. Use your discretion about getting this done. It may provide a false sense of excitement that the baby is coming early, or discouragement that it’s not coming for a while. I, myself was at 5cm for two entire weeks before ever going into labor! This tool is merely used as a potential sign of impending labor but honestly doesn’t mean anything at all, can be uncomfortable for some women and could potentially introduce infection.

Action items for the third trimester

third trimester

Look for a pediatrician

Start asking around about who your friends and colleagues use for a pediatrician. If you give birth in the hospital, you’ll be taking the baby for his first checkup a couple of days after discharge, so it’s best to have this done well before your first contractions begin. Set up some interview appointments and make a list of a few doctors you like before making a final decision. If you are under the care of a homebirth or birth center midwife, they will likely handle newborn care for the first six weeks, even coming to your home for the first few visits!

Pack your Hospital Bag and/or Prepare your Homebirth Supplies

Do this early! Deliveries can come as big surprises. It’s much nicer to have things you need (like a camera!) handy and ready to go as soon as you need them. Here’s a great post about what to put in your bag. 

If you’re giving birth at home you’ll likely have your midwife home visit at 36 weeks when you can go over all of the supplies and preparations needed for your baby’s arrival. It’s a good idea to pack a hospital bag too for that just in case scenario.

Install the carseat

It’s such an exciting event to install your baby’s car seat, and to drive around town for a few weeks without a baby in there. It gets you used to the idea that you will soon be a mom! Here’s a sobering statistic—95% of parents install a car seat incorrectly! The instruction manuals can be confusing and hard to decipher. Take heart—Did you know fire stations offer to install car seats free of charge? Use this tool to find a station near you. There are also car seat expert installers that volunteer their time.

Take some final belly photos

You may feel huge, but after it’s all over, you will really cherish any pictures you have of your precious baby belly after the baby arrives. Get a photographer or grab a friend and do a photo shoot.

Prepare for postpartum recovery

Taking time to think ahead to the postpartum period will be a godsend after delivery. Many women are surprised at how difficult recovery can be physically, mentally, and emotionally. Plan ahead to really be able to nurture yourself for a few weeks, with these suggestions.

Make a list of people to help with babysitting, dog-walking, bringing meals, cleaning, or running errands. Many people want to help after you’ve had the baby, but may not know how. Be proactive about asking before the baby is here. Give them some options and see what they’d most like to do. I once saw a spreadsheet passed around at a baby shower in lieu of gifts. What a genius idea. Babylist can help you sort out your post-delivery needs.

Make freezer meals. About a month or so before your due date, take a couple weekends to cook and freeze some nourishing casseroles and comfort foods. It’s so nice to have them on hand when you are exhausted, and chances are you will eat better if something is already prepared than if you have to think of something and then muster up the energy to make it…this usually ends up in a take-out run.

Stock up on supplies for breastfeeding, and set up a breastfeeding station, if you plan to nurse.

Buy some self care items for yourself. Some essential oils, candles, creams, cold packs, heat packs, or soft robes and clothes can all add some comfort and care when you are sore and tired. Purchase a tv series to watch for late night nursing sessions, or get some new books to keep you company. Full list of postpartum supplies here!

You are at the final stretch of the pregnancy. Hang in there and take extra care of yourself before the baby arrives.

This guest post was written by Austyn Smith.

Second Trimester Body Changes

You are now entering most people’s favorite trimester! This is sometimes called the “honeymoon period” of pregnancy and for good reason. Your morning sickness will likely be subsiding soon (or already has), your energy is coming back, and you are starting to feel like your old self again. That little “food baby belly” is now starting to grow a bit bigger and look like a real pregnant bump! There’s lots to look forward to this trimester, and a few potential discomforts.  Here’s what you can expect.

Exciting Happenings

Quickening: This is one of the best parts of being pregnant—when you start to feel your baby move! This can happen anywhere from about 16-22 weeks depending on where your placenta is positioned. At first it feels like slight flutters or “butterflies” in your tummy. As baby grows you’ll start to feel more distinct kicks and jabs. You might even notice slight rhythmic “taps” from time to time. That’s the baby hiccuping!  

20 Week Ultrasound and Anatomy Scan

This is the big ultrasound where the doctor checks out the baby’s entire body and organ systems—even down to four tiny chambers of the heart. It’s so fascinating to see all the tiny little organs already formed and functioning. The best part? You can find out baby’s gender, if you wish. That’s when the real fun begins. You can plan a gender reveal party, and get shopping for some cute baby clothes and gear!!

Pregnancy Hair changes

A big bonus from pregnancy hormones is great hair. It may appear thicker, shinier or have textural changes. Normally, we lose about 100 strands of hair per day, but the increased progesterone levels during pregnancy slows down the process so less falls out. Hair can feel much fuller, and appear shinier too! After birth, things normalize, and many women report losing large amounts of hair, so enjoy the luxurious locks while you have them!

second trimester body changes

Continuing Breast Changes

Soreness and tenderness should be subsiding during this phase, as your body is adjusting to being pregnant. Breasts may continue to grow in size, so another shopping trip may be in order.  

Increased vaginal discharge

You may start to notice an increase in clear or milky-white substances when you use the bathroom or in your underwear. Increased estrogen and blood flow to the vaginal area are at play here, as the cervix and vagina slough off old cells. This is completely normal, and not cause for concern unless you have any of the following signs.

Signs of Concern with vaginal discharge

  • Itching or burning associated with urination or sex, or a swollen vulva (this could indicate a yeast infection).
  • Greyish discharge with a foul, fishy smell (signs of bacterial vaginosis).
  • Green or yellow discharge associated with swelling, redness, or itchiness (could be a sexually transmitted infection).

Preventing bacterial infections

Keep your vaginal area clean by washing regularly, wiping from front to back when going to the bathroom, and wearing breathable (cotton) loose fitting underwear (no thongs!). Avoid scented soaps, lotions, and bubble baths.  

Vivid Pregnancy Dreams

This is an interesting side-effect of pregnancy. Experts aren’t clear on the exact reason pregnant women have more vivid dreams but it might have to do with the increased hormone levels again. There are many changes happening in your brain, and our emotional, mental, and physical selves are all woven together.

It could also be due to changes in sleep patterns. REM (rapid eye movement) sleep occurs when your body is in a very deep sleep state. This is when dreams usually occur. Restless sleep, and frequent awakening for trips to the bathroom can interrupt this REM sleep, thus the dreams are remembered clearly.  Dreams can range from bizarre, anxiety-based, and intense, to sweet little predictions of your baby to come. Keeping a pregnancy journal near the bed can be a fun way to record the things you dreamt about the baby before he or she comes!

Bleeding Gums

Good oral hygiene is especially important during pregnancy. Increased blood flow and hormonal changes can cause swollen, bleeding gums when you brush and floss.  Watch for signs of gum disease (red, swollen, tender and bleeding gums, associated with pain and difficulty chewing).  

Prevent Gum Disease

Make sure you take the proper precautions to preventing gum disease by:

  • Brushing and flossing daily
  • Scheduling regular dental cleanings
  • Eating a balanced diet and keeping sweets to a minimum
  • Brushing gently

Congestion/ nose bleeds

Increased blood flow to nasal capillaries can sometimes cause irritation, stuffiness and bleeding.  Accompanied by an increase in mucus production, these nasal changes can prompt more nose-blowing, further irritating the area. Nose bleeds can occur as a result. This is not cause for alarm unless it is happening frequently and a substantial amount of blood is lost. If so, contact your doctor for treatment.  

Treat nasal irritation

Provide nasal relief by using a warm-air humidifier while sleeping. This can keep passages moist and prevent dryness and cracking. Over the counter medications may also work to relieve congestion and mucus production. Make sure to check with your doctor first about what is safe.

Second Trimester Skin Changes

Hormones are at work again when it comes to skin changes. A potential effect is called the “mask of pregnancy,” or chloasma. This is a slight pigment darkening around cheeks and eyes.  It can be exacerbated by sun exposure, so wearing a hat for protection or good sunscreen can prevent it from becoming too noticeable. Another skin change some women get is called the “linea nigra,” or the dark line that appears vertically down the belly. These skin changes will lighten or subside completely after birth when hormones return to normal.

linea negra

Stretch marks are another common effect of pregnancy. These pink, purple, or brownish stripes can appear on breasts, hips, stomachs, buttocks and thighs as bodies change and grow. Some lotion and oil companies make claims to prevent these marks, but in reality, there is nothing to prevent them from occurring, although lotions can certainly be soothing with stretching skin. We recommend this Stretch Oil. Take heart as most marks fade significantly after pregnancy. Think of them as a badge of motherhood. The Fourth Trimester Bodies Project helps women to love and accept their bodies and all the post-baby changes and provides empowerment and support for moms everywhere.  

Spider and varicose veins affect women differently, and seem to have a genetic component. Not all women end up getting them, but they can be uncomfortable and embarrassing. You can prevent them somewhat, or lessen the discomfort by taking frequent breaks from long periods of sitting. Ten minutes every hour is good. Likewise, take sit breaks from long periods of standing, or better yet take a little walk and get some blood flowing.  Support hose also help keep circulation in good health. Afton socks are a cute alternative to support hose that we’ve tried personally.

Heartburn during Pregnancy

Progesterone relaxes muscles in pregnancy. Unfortunately it can also relax the sphincter connecting the esophagus to the stomach, leaving small openings. Acids used to digest food in the stomach can back up through the gap and into the esophagus. It’s exacerbated by a growing belly that puts pressure on the digestive organs, resulting in painful heartburn.  

Tips to combat heartburn

  • Eat smaller meals frequently rather than 3 large ones.
  • Eat slowly to aid in digestion and prevent overeating.
  • Sip water throughout the day rather than gulping large amounts at a time.
  • After meals, go for a walk, or sit up rather than lounging or reclining. Keep that esophagus upright.
  • Avoid eating right before bed.
  • Pay attention to which foods worsen your symptoms. Common triggers are citrus, chocolate, caffeine, and high-fat foods.
  • Wear loose-fitting clothing.
  • Use ginger—Drink ginger ale, ginger tea, or snack on raw ginger or ginger drops.
  • Take antacids, but make sure they do not contain aluminum as it can cause constipation and high levels are bad for the baby.
  • If all else fails, talk to your healthcare provider about prescription meds.

Back pain during the Second Trimester and Beyond

As your uterus grows, accompanied by weight gain and progesterone-relaxed muscles, increased strain is put on your lower back. Your lumbar spine also tends to sway in to compensate the displaced weight.  

back pain in pregnancy

How to relieve lower back pain during pregnancy

  • Wear good foot support. Put those heels aside for a while and lace up some comfy tennis shoes with arch support or flats. This aids in good posture, and puts way less strain on your back. These lightweight and supportive shoes saved my back through my pregnancy!
  • Consider using a maternity support belt like this one.
  • Use good body mechanics. When lifting things, bend with your knees and hinge at the hips, keeping your back straight. Then use your legs rather than your back to lift. Better yet, ask someone else to lift things for you!
  • Try heat packs and ice packs. Experiment with which offers better relief.  Ice tends to reduce inflammation, and heat can relax muscles further.  
  • Massage. Schedule a prenatal massage with someone who has experience with lower back pain. At the very least, this is great self-care for mama.
  • Use a tens machine. Tens machines send little electrical pulses to the area of your body experiencing pain. like little electric shocks. This can help to ease pain in pregnancy and even labor. A Birth Hour mama talks about relying on hers heavily in her birth story. I use this one regularly and love it.
  • Stay active. My physical therapist always says, when things hurt, our instinct is to hold still and not move. What we really need is movement, but the right kind of movement to encourage relief. Try a leisurely walk, do some gentle stretching, go for a swim. See which kinds of movements feel good.
  • See a specialist. Seek a professional’s care who knows about pregnancy. A good physical therapist, chiropractor, or doctor can be the answer.

Increased frequency in urination while pregnant

Blood volume during pregnancy increases by about 50% during pregnancy, and hormones cause that blood to flow more quickly through the kidneys. Thus, frequent urination occurs.  Couple that with a heavy uterus resting right on top of the bladder and your bathroom will be your new best friend. Continue to drink lots of fluids. It’s important to stay hydrated. This is just one of those things that has to be endured. Like many other pregnancy symptoms, this will subside shortly after birth.

Round ligament pain during the second trimester

Two round ligaments are located in the pelvis, and their job is to hold the uterus in place. In non-pregnant women they are short and thick. As a woman becomes pregnant, and her uterus grows, the ligaments thin out and stretch, similar to a taut rubber band. Sudden movements can make them to tighten suddenly, pull on nerves, and cause spasms that radiate from the abdomen and hips to the groin. These sharp pains can be alarming for moms. Keep calm and try to remember this is normal. It should only last several seconds to a few minutes and then subside. Pay attention to what triggers these spasms—coughing/sneezing, turning over in bed, standing up too fast, or certain physical activities. Try to move smoothly and slowly. Do gentle stretches, yoga, take warm baths, and rest on a regular basis.  

These pains would be worrisome if they don’t subside after a few minutes, or if they are accompanied by fever, chills, bleeding, or difficulty walking.  

Action items during the second trimester

Take advantage of this trimester, because most moms feel really good! Try to get a big chunk of baby stuff done before the tiresome third trimester sets in. Here’s some good things to check off your list.

Schedule your glucose screening (typically done at 24-28 weeks)

Your doctor will probably recommend this diabetes screening toward the end of the second trimester. You will have to drink a concentrated glucose drink and wait a period of time and then have blood drawn. It can be an important precaution for early detection of gestational diabetes. If you are planning a midwife attended birth she may forgo the glucose drink in favor of orange juice and certain foods but the concept is the same.

Start a regular kegel exercise routine to strengthen your pelvic floor muscles

The muscles you use to start and stop the flow of urine are your kegel muscles. Every time you go to the bathroom, take a few extra minutes to practice tightening these muscles, counting to ten, and then releasing. Build up to ten reps at a time several times a day. Not only will these muscles aid in the pushing phase of delivery, they are a good part of pelvic floor health after birth as well to help muscle tone return to normal.

Continue or start a gentle exercise program

Hopefully you’ve been active already, but if first trimester sickness made it difficult, or you just haven’t started, now is a good time to get moving. Be sure to check with your doctor if you have not had a consistent exercise routine before now. It’s not a good idea to take up a new sport, but the general rule is you may continue most exercises and activities you participated in before you were pregnant (as long as they are non-impact). Listen to your body. You might have to modify intensity and duration. Take frequent breaks, stay hydrated, and make sure you are breathing comfortably. The second trimester is a great time for brisk walks, swimming, aerobics classes, gentle strength training and yoga. Your belly isn’t too huge yet, and you’ve got some energy, so take advantage!  Fitness during pregnancy not only helps during labor, it aids in recovery and helps you lose baby weight after.

swimming while pregnant

Plan and take a babymoon

The second trimester is the best time to take a babymoon (a “last hurrah” trip with your significant other before your life changes drastically). Again, your belly is growing but not restricting, and your energy is up! Airlines can restrict air travel after about 35 weeks due to risk of preterm labor, so squeeze in a trip during the second trimester while you can.  

Travel precautions during pregnancy

  • Check the Zika virus updates and choose vacation spots that are considered “safe.” Cover arms and legs to protect against bug bites and maybe invest in a pregnancy-approved bug spray. Remember that Zika can be sexually transmitted, so make sure your partner takes proper precautions as well.
  • If you are flying to your destination, keep your circulation going. Stand and walk every hour or so, do heel raises and calf flexes, and wear some support hose/socks.

Start your baby registry

Go to Amazon or to Babylist and start selecting items you’ll need for baby. Check this post for what you really need. (**link to post about baby essentials**)

Research child care options

If you plan on returning to work, review your company’s maternity leave policy. Factor out when you will be coming back, and start looking for child care options you feel good about. You might want a nanny, a daycare center or in-home child care. Ask around to friends and family that you trust and start visiting facilities to get a feel for what it would be like. This is a sensitive and emotional thing for mamas to do. Make sure you really do your research and talk to lots of references. This is your precious baby, and you want to feel very comfortable and confident that your child is very well cared for in your absence.

Still feeling anxious?

Get creative with your options. Would your employer allow you to work from home a few days a week? Is your partner’s schedule flexible where they can help share the childcare load?  Perhaps your work would allow you to bring your baby for a month or two while she is still small.  Do you have a friend who is also looking for a babysitter? Maybe you could do a swap. Is it an option to work part time for a while and help watch her baby while she works and vice versa?  I’ve seen all of these options work well for me and my friends. Think outside the box and do what feels right inside.

Sign up for a childbirth education class

Your hospital or birthing center are great resources for finding a class but it’s also a good idea to look for an independent class that won’t be biased to the policies of the institution putting it on. Bring your partner with you and learn as much as you can. Start thinking about your birth plan, and make any adjustments you need to in regards to health care providers.  The more educated you are, the better prepared you will be for your big day. Read books (here’s a good list!), and read and listen to all kinds of birth stories.The Birth Hour podcast is great for hearing a wide range of scenarios and outcomes. You might be planning a textbook natural delivery, but keep in mind that sometimes labors take an unexpected turn. It’s important to listen to/watch/read about c-sections, epidurals, and natural births so you know what to expect should those situations arise.

Welcome to the glorious second trimester! Prepare and enjoy is the name of the game!

This guest post was written by Austyn Smith.

First Trimester Body Changes

The first trimester can definitely be a physical and emotional roller coaster. You’re elated! You’re exhausted! You’re pumped up! You’re sick as a dog! Take heart. Many women have survived this before you, and many women continue to do it over and over again, so it must be worth it all in the end.

Here are some possible changes to expect during the first trimester, and some tips to get you through.

Extreme Exhaustion

Like flat out passed out by 7:30 pm. That little embryo may be smaller than a pea, but he packs a powerful punch. Your body is going into overdrive releasing bucketloads of pregnancy hormones, creating a life-sustaining placenta, and developing a tiny organ system for baby. Your blood volume is increasing and your metabolism is speeding up a bit, while your blood pressure might drop to a lower rate. All of these combined can lead to one tired mama. The good news is that this doesn’t last the entire pregnancy. By the time the second trimester sets in, you should get a surge of energy and feel more like your normal self.

1st trimester body changes

How to cope with Exhaustion—Listen to your body

Tiredness is a signal from your body to force you to slow down. It’s letting you know that there is a big important change happening, and you need to take it easy. Try not to live too rigidly to the normal rules and routines you had for yourself. That 6 mile jog or 12 hour workday can take a little hiatus. This work of growing a life inside you is even more important.

Just say “no” and ask for help

It can be hard to find yourself unable to perform at the same level as before, but knowing your limits is key. It’s alright to say no to requests or obligations you just don’t feel up to. There will be time for all of that in the future. Ask for help from friends or family if you just can’t seem to muster up the energy for a day of laundry or errands. Chances are they are happy to help, and it allows them to show their love for you and that bambino!

Rest and Sleep More

If you are feeling utterly exhausted, find ways to catch some extra z’s. Increased nighttime sleep can be the key to getting a bit more energy. There is no shame in going to bed at 7:30 pm. You might be surprised at your new-found ability to put in 12-14 hours a night! Daytime rest can be a lifesaver as well. Find ways to sneak in a few winks during your workday, like a lunch-time cat nap in your car. Even women who have never been nappers find themselves relying on naps when pregnant — plus it’s good practice for the “sleep when baby sleeps” recommendation postpartum.

Snack on Some Power Foods

Eating nutrient dense snacks, especially those containing protein can help keep your energy up. Try a handful of nuts, apple slices with peanut butter, or some beef jerky. Whole foods are usually a better choice than shakes or drinks, so keep little baggies easily accessible in your fridge and purse. You may find it easier to eat lots of small snacks rather than a large meal.

first trimester stomach

Morning sickness could set in…or evening sickness…or all day sickness

Your pregnancy hormone levels are rising at an astronomical rate, and it can throw your stomach for a loop. No one knows exactly what causes nausea, but that new concoction of hormone surges might have something to do with it. Every woman and every pregnancy are different. Some women are queasy off and on for a few hours, while others can’t seem to leave the side of the toilet bowl. A lucky 24% of women dodge the sickness bullet, so cross your fingers. But if you find your stomach’s churning, here’s a few ways to cope.

    • Eat smaller meals and snacks more frequently, rather than 3 big meals. Again, whole foods are best, so reach for the whole grain crackers, fresh fruits and veggies, yogurt, and nuts.
      If mornings are worse for you, keeping crackers by your bed to eat first thing in the morning before even getting up can stave off the queasiness for a bit.
    • Eat mild foods that are more tolerable for your body. Spicy, fatty, or heavy foods may not sit as well, and take longer to digest.
    • Stay hydrated. Lots of water is vital during the entire pregnancy, but sip it often throughout the day rather than chugging huge amounts at a time. Keep a water bottle nearby at work, in your car, and at your nightstand.
    • Experiment with prenatal vitamins. Sometimes prenatals can affect queasiness. Try taking your pill right before bed rather than first thing in the morning, and see if it helps.
    • Get moving. It sounds counter-intuitive, but sometimes a walk outside can do wonders. Breathing fresh, crisp air, enjoying the sunshine and the sights and sounds outside can not only lift your spirits, but lift your nausea as well.

Intestinal Changes

Oh the joys continue! Those hormones can wreak havoc on your GI tract. Progesterone affects the muscular contractions of the intestines, slowing things down. This can make it harder for food to pass through, and cause gassiness and bloating.

Constipation and Hemorrhoids

Eating high fiber foods and staying hydrated will help some. Constipation is common and straining can lead to hemorrhoids. Be patient and allow yourself some extra time in the bathroom, and maybe more frequent visits to encourage things to keep moving. Many moms report that the Squatty Potty has worked wonders. If you have extreme discomfort, ask your doctor or midwife for some suggestions. There are many safe products (natural and medicinal) that can offer relief.

Breast Changes

It sounds fun right? Increased blood flow and changes in the tissue will cause your breasts to grow a size or two (or 5!) during the course of pregnancy. Unfortunately, it usually isn’t all fun and games when you (and your partner!) quickly realize the girls are off-limits as they will likely be sore, painful and extra sensitive. They might feel swollen, tingly, tender, or itchy as the skin stretches. Some suggestions:

  • Buy a few new comfortable bras with some extra room to grow (both in cup size and circumference), that don’t have seams near the nipple. Get breathable cotton with good support, and even consider buying and wearing a nursing bra now to save money later on.
  • Keep in mind that your size will continue to change throughout pregnancy and even more so once baby arrives and you are breastfeeding so don’t stock up on bras until things have leveled out. I suggest buying one or two new bras each trimester and then waiting six weeks after baby arrives to get a nice stash of high quality nursing bras.
  • Invest in a good sports bra. Not only will this provide comfort and extra support while exercising, but can be used while you are sleeping to relieve some soreness. Speaking of sleeping, this is my favorite sleep bra that doubles as a nursing bra later on.

Emotional highs and lows

1st trimester couples

One moment you might find yourself on cloud nine at the thought of your baby coming soon, the next you are crying at a commercial…that’s not even sad. The next, seeing your husband’s socks on the floor irritated you beyond belief. Those pesky hormones are busy at work again. Besides, this IS an emotional time for you. Your former self will be no more, or at least very different, as you get ready to take on the responsibility of a new little darling. There’s a broad range of emotions as you process that. It can be a time of mourning the loss of yourself or you worry about your relationship with your partner changing. Couple this with the anticipation and joy of meeting your baby and the fear and uncertainty of meeting your new baby, and that’s quite a load to process. Try to go easy on yourself.

  • Allow yourself to truly process what you’re feeling. Try to resist the urge to push away or bury uncomfortable emotions. Instead, be curious about why they are there, and what they are teaching you. Being present and honest with how you feel will help you to understand what you’re going through.
  • Meditate. Many women who have never considered meditation find it helpful during pregnancy. We love guided meditations specifically targeted by trimester through Expectful.
  • Get some space if you need it. Sometimes there really isn’t a deep explanation for what’s behind the tears or rage. And it’s okay.
  • Use a journal. Buy a special pregnancy journal or daily soul sessions book and when you are feeling especially strong emotions (be they happy or sad), write out what you are experiencing. Try to be completely honest—you don’t have to show this to anyone. It’s just for you. Writing is usually cathartic, and you’ll feel lighter afterward.
  • Ask for understanding. Explain to your partner what is going on and ask for his patience. Chances are, he’s having similar feelings of his own.
  • Reach out to other pregnant women, or talk to your friends who have been there. A big support system is going to be an invaluable tool in the upcoming months. A good doctor or midwife will be asking you about your emotional state (and your partner’s) along the way. Be open and they will likely have some great guidance.
  • Seek a therapist. I’m a firm believer that all of us can benefit from therapy, especially during these monumental life changes.

Your relationship may be strained

These sudden physical and emotional changes can cause some distance in your relationship with your significant other. Survival mode does that to a person. Try to be mindful of this potential bump in the road. Be open and communicate often about how you are feeling. Try to plan some time together to do some low-key activities that you can physically tolerate. Make that time to connect. Your relationship will be tested and strained in the months ahead, so the work you put in now will pay off in the long run. Here’s some tips.

  • Get creative. If you have terrible evening sickness, plan a brunch or lunch date together. If you are completely zapped of energy, do something low-key like listen to a book on tape and snuggle. If you are even too sick to leave the couch, watch a movie or ask each other some intimate questions. Here’s a good set!
  • It may seem like this is the new normal, but you will likely feel better! You will have more energy, and you will feel like your old self soon. Be patient—the second trimester is often the one women enjoy most!

There can be some challenges in the first trimester, for sure. However, it’s evidence of amazing things happening inside your body. Above all else, try to stay positive. Use some good pregnancy affirmations, and be patient and gentle with yourself.

This guest post was written by Austyn Smith.