8 Things You Wish You Had Known About the 4th Trimester

Thursday, August 17, 2017

Boston, MA, USA

What is the Fourth Trimester?

It's just as it sounds. Each trimester of your pregnancy was three months. The fourth trimester is the first 90 days after your baby is born. This can be a lovely and exciting time, but it can also be a time of overwhelming emotion and one of a fine balancing act.  Between the sleep deprivation, having a tiny human depend on you for everything, the emotional whirlwinds, and the constant flow of visitors, the fourth trimester can seem very intense. Having a game plan in place, or at least knowing what to expect, can be helpful. 

1. Ask for Help 

Society expects too much from new parents, especially birthing parents. There, I said it. It's too much. It's overwhelming. And it affects the way parents think about themselves as caregivers. 

Let go of this societal idea that a new mom has to do it all from day one. It is a slow ramp up. First and foremost, your body is healing and this requires you to rest, so let the laundry pile up (or at least have someone else do it for you). Second, there is no shame in asking others for help if they are offering. When visitors come over, don't be afraid to ask them to help you. Most people will offer by asking, "Is there anything I can do?" Instead of the obligatory "No thanks," say, "Yes, do you mind swapping the clothes from the washer to the dryer? That would be so helpful." Other things that visitors can help with is walking your dog, writing a list of needed items as you rattle them off from the top of your "baby-brain" head, load or unload the dishwasher, bring you something to eat or drink, hold the baby while you shower, fold the laundry, set out the frozen dinners you prepared beforehand so it is thawed when dinner time comes around, and the list goes on and on. People who are stopping by your home and offering to help truly care about you. Let them help. Allow them to help ease the weight of having a newborn. One suggestion is to keep a running list of things that need to be done around the house or errands that need to be run. When someone asks if they can help you, refer to your list! 

Part of asking for help is knowing your personal boundaries. This may look like saying "no" to visitors in the first few days or weeks to help your family adjust to life as it is now. That is okay. Having the first few days reserved for yourself, your baby, and your partner (or close friends/family of your choosing) is okay. Let them know that the first few days are boring and filled with constant breastfeeding, resting your body, and quiet time. Politely explain that all your baby does right now is feed, cry, sleep, and poop. They aren't missing anything earth-shattering. People will understand that your new family needs space to adjust. Plus, who wants all that unwanted advice in the first few days in combination with raging hormones anyway? 

2. It's Just as Uncomfortable as the Last Trimester 

While pregnancy is different for everyone, most birthing parents would agree that the end of pregnancy was quite uncomfortable. The end of pregnancy held physical discomfort as well as emotional feelings that you may or may not have been prepared for or expected to emerge. Once your baby gets here, it is common to still be physically and mentally uncomfortable. For the first few days or weeks after your birth experience, you will have to allow your body time to heal. This means that you won't be able to do certain things such as sex, exercise, use tampons, and lifting things. Sometimes, it is even recommended that you delay showering or bathing depending on the nature of your delivery. Sometimes you are sore in places you didn't even know you could be sore. Birthing a baby takes efforts from your entire body. Therefore, you entire body is subject to aches and being in need of restorative rest.

You will still worry during this time, too. You will be worried that you're doing everything "right." You will worry that your baby is safe. You will worry that your baby is getting enough to eat, enough sleep. You will worry when they are awake and you will worry when they are asleep. This is common in new parents, especially for first time parents. However, trust your instincts. Pregnancy has a funny way of instilling gut instincts in parents. You are the expert on your child. You know your child better than anyone else. You know when things are right and you know when things are wrong. Trust yourself.

3. Wear Your Baby 

Baby wearing has an infinite amount of positive outcomes associated with it. For starters, it helps to free up your hands to do other things such as drinking your coffee, brushing your teeth or warming up a bottle. Research also shows it helps your baby remain soothed and relaxed--a good state for a newborn to be in. It also helps your baby bond with you. Skin-to-skin (wearing your baby with only a diaper on and you without a shirt on) has been proven to increase milk production in breastfeeding and chestfeeding parents, improve the heart and lung function of your baby, stabilize your baby's temperature (Did you know your body will adjust its' temperature to accommodate your baby's temperature needs?! How cool is that!), provide you and your baby with pain relief due to the release of hormones initiated by skin-to-skin contact, and has even been shown to reduce the risk of postpartum depression.

4. Having a New Baby Can Be Isolating

Get out and about! There are many ways you can do this: join a new parents class, go on a daily stroll with your baby in the local park, reconnect with the parents you took Child Birth Education classes with, join an online forum (this one seems like cheating, but having interaction with other parents, no matter how you do it is a good thing!). In all major cities, there are meet-up groups for hundreds of groups of people: new moms, new dads, new non-binary parents, second time parents, parents of children born between this date and this date, crunchy parents, anti-vax parents, military parents, nervous parents, and free-range parents. Again, this list goes on and on. It helps to know that other parents are experiencing the same things you are going through. Being around other like-minded people will build your confidence in your skills as a parent. You will see what's happening with your baby is "normal." 

5. Create a Sleep Routine for Your Partner and Yourself 

You will have never been as tired in your life as you are after your baby is born. Communication between you and your partner (or any support person) is essential in the fourth trimester. Nailing down a sleep schedule for you (adults, not the newborn) can be challenging and it look different for each family. Some parents choose to sleep in shifts: 7pm-1am are managed by parent 1 and 1am-7am are managed by parent 2. Some families choose to alternate night feedings while other families alternate entire nights altogether.

Finding the right balance for you and your partner is crucial to mastering the fourth trimester. Play around with different strategies for a few nights and check-in with one another to see how you both feel. If something isn't working, tweak that aspect and keep what is working. There is no right or wrong. There is simply what works for you and your family's needs. It's important to note that as your child's sleep patterns change, your sleep routines will most likely need to be adjusted to accommodate this change. But that another quest for another day. 

6. Think Routines, Not Schedules 

We've all heard it before: "When can I put my baby on a schedule?" Research shows that newborns thrive best in an environment that is tailored to their needs. This means letting them sleep when they are tired, snuggling them when they are fussy, changing them when they are soiled, and feeding on demand. As adults, not having a structured schedule can be so challenging that some find it paralyzing. The thought of not having a schedule to follow can cause feelings of anxiety. Often times, parents fear that without a schedule, important things will be forgotten such as brushing their teeth or changing the baby's diaper. To this I say, create a routine. For example, everyday when you baby wakes up, you would change their diaper, feed them, burp them, put them in a wrap to baby-wear, and then proceed with taking care of yourself: brushing your teeth, going to the bathroom, eating, drinking your coffee, answering your emails; whatever taking care of yourself may look like for you. The beauty of a routine (versus a schedule) is that it may happen at 5:30am or 7am, but the routine is the same ensuring that your child is getting everything they need on their own time.  

7. Forget The Housework 

The housework can wait, but snuggles can not. The housework can wait, but your baby will only smile for the first time once. The housework can wait, but watching your baby peacefully sleep is not a moment you want to miss. Enough said.

This might mean communicating to your partner that the household responsibilities will need to be split. For some this looks like, one partner doing the housework and one partner with baby. For others, this looks like assigned responsibilities around the house. Some families, have designated parent 1 and parent 2 nights where that particular partner is in charge of taking care of baby and the house while the other partner enjoys some much needed time to him/herself.

If you have the means, it may also mean hiring some household help temporarily until you have mastered your new routine taking care of your baby and can begin to {slowly} take on housework. A postpartum doula may be a nice middle-ground to helping you care for your newborn and keeping your independence. 

8. Take Time for Yourself 

This is by far, hands down, the hardest one to accomplish...for many reasons. Mom guilt, it's real. The feeling of "nobody else will be able to get my baby to sleep." The exhaustion tricks you into thinking your needs aren't as important. Plus, the sheer lack of time--when is there ever 5 minutes you can take to yourself?

Estrogen plays a huge role in the after-effects of birth concerning the emotional ups and downs. This hormone peaks in the third trimester, yet in the 24-hours following birth, it drops drastically...like jumping off a steep cliff. Between the hormonal changes and the sleep deprivation, taking care of yourself is imperative. It's like this... how well can you deal with a fussy baby, mood swings, constantly breastfeeding, and the everyday challenges of being a new parent if you don't take care of yourself? However, if you are able to carve out just a few minutes of "me-time" each day or an entire hour each month, you will be able to handle life stressors of being a parent much better. 

Washington Post just published an article discussing the importance of self-care in parenting. Click here to check it out.

Lasting Thought:

Embrace your new body! Your body created, grew, birthed, and is now caring for a tiny human. You earned those stripes! Those full, heavy breasts are nourishing you little one. That postpartum belly is just more of you to love. You are a beautiful, human-making Goddess..so own your new title! You earned it! 

This too Shall Pass

This brief moment in time (but what might seem like forever) will soon be behind you and your baby will be rolling over, sitting up, walking, and talking before you know it. Relax and embrace this chaotic time of parenthood. This transition is difficult for everyone. Learning how to care for a tiny human and reshape the family dynamics is tough. Let go of the expectations that you are supposed to be perfect. Instead, be perfect for yourself and your baby. The perfect parent doesn't spend time worrying about what society thinks, rather rests assured that their baby is loved and well taken care of. Things get easier as your baby gets older and as you get the hang of being a parent. Don't focus on your mistakes, but focus on all the great things you do and provide for your baby. Focus on the fact that you were chosen to be this child's parent and you made this baby wonderfully and beautifully with your own body. Take time to care for yourself and reflect on the fact that you are a wonderful parent.

Tranquility by HeHe, A Concierge Birthing and Doula Service in Boston, Massachusetts
"We can't wait to pamper you."

5 Things You Want With You at Your Birth: Engaging Your Senses

Wednesday, August 2, 2017

Boston, MA, USA

Doesn't the hospital have everything?

Yes and no. The hospital has everything that you will need medically to have your baby. This is true. But think about the environment of a hospital--bright lights, sterile environment, potential for loud noises, unfamiliar faces, that distinct hospital smell, and incessant beeps from medical equipment. Neel Shah recently did a podcast interview with the Harvard School of Public Health and he said, "It's not a ventilator that defines an ICU. It's the ability to have one nurse take care of one patient. So if you go to the cardiac ICU of my hospital at Beth Israel, you'll see one nurse per patient. You go to my labor floor, you'll see the same thing. You know they can track vital signs in real time in the cardiac ICU. So can we. The only difference between the ICU and the labor floor is that our operating rooms are attached." For the entire interview, check it out here

So what can you do to ease the feel of such a regulated and regimented environment to help you feel comfortable and safe? You can bring along a few (or a lot) of comfort items. Some parents choose to bring one comfort item and some choose to bring everything down to a rug for the labor room floor. I was recently featured by Malka Ahmed Photography explaining the essentials that I always recommend clients bring with them to their birth. Check that article out here.

What do I bring to the hospital with me?

Packing for your senses can help guard the environment in which you give birth. Bring things that appeal to your senses. You want to create a gentle environment that reminds you of a safe place, often home.  Having things that can make the environment seem gentle and encouraging can have a huge impact on your birth experience. 

I try to help my clients think through 5 distinct categories: your senses! That's right- hearing, tasting, seeing, feeling, and smelling all play vital rolls in your birth! The combination of comfort items that are brought along vary vastly from client to client just as all other things in birth. When planning items to take in your hospital bag, think about things that appeal to your senses. 

I was recently featured in a Huffington Post article explaining the best things to advise parents to pack when preparing for a birth. This got me thinking why? Why do those things make the list? What makes those items the necessary items? So I broke it down to a basic level. 

The Pain Gate Theory

The theory behind packing sensory items is to block the pain receptors by stimulating multiple sensory receptors at one time. Pain Gate Theory suggests that it can control signals from the Nervous System by using non-painful input to close the "gates" which block painful input from being received or it is received at a lower intensity.

Here's how it works:

1. Sight – Bring thing from home that are comforting. You can literally transform your birthing room into your own personal space. Take advantage of this aspect. Comfort items from home can be pillows, rugs, pictures of loved ones, your own clothes, your favorite blanket, your robe, your slippers and anything else you think will provide you with comfort and help keep you in the right headspace. Any items that are comforting and remind you of the safety of your home has the potential help your labor progress. 

2. Sound- Hospitals can get noisy and trying to concentrate (and being in pain) in a loud environment is sometimes distracting. Some people find music encouraging. because it is able to block some of the noise and this ranges from “Eye of the Tiger” to calm relaxing, classical music. Some laboring parents prefer earbuds, so it can be louder and more intense like the contractions (make sure to keep the safety of the parents ears in mind). On the opposite end of the spectrum, some people prefer it to be silent so they can connect and remain connected to their bodies. These parents will need earplugs to block out hospital noise.

3. Taste- Snacks! Anything that can be eaten with one hand such as pretzel sticks, cheese sticks, granola bars, and fruit (banana and apples) is so important for birth. Imagine running a marathon and having not prepared by eating. Also, imagine not being able to stop running that marathon for 36 hours.. you would want snack to help keep your stamina up.  Both, you and our support team will want snacks to help keep your energy up. Make sure to avoid any food that have strong odors as labor can bring on a heightened sense of smell. 

4. Touch – Anything than can provide physical comfort such as lotion for massage, a back massagers, a rebozo (a Mexican shawl-like garment used for pain relief), heat packs, and ice packs are useful in birth. Especially for parents who are trying to have an unmedicated birth, finding physical comfort will be imperative to helping the laboring parent stay comfortable and able to manage the pressure of each wave/contraction. 

5. Smell- Things from home will provide a comforting smell, but this won't combat the smell of birth which can be intense. A lot of bodily fluids are expelled during childbirth, plus you have the sterile environment smell of a medical facility. Too help keep the smell of the room pleasant and gentle, parents can bring essential oils. Hospitals do not allow you spray perfume, like candles, or use air freshenersSome hospitals will allow you to use a battery operated diffusers for short amounts of time to make the room smell more relaxing. For experiences in hospitals that don’t allow diffusers, place a few drops of the essential oil on a paper towels hold it close to the birthing parent’s face. Have the laboring parent take deep breathes. This works for any support people too, as long, as they are using an EO fragrant that is okay with the laboring parent and safe in pregnancy and for newborns.

HeHe’s Secret Sauce: Water bottle with a bending straw! This is to ensure you can drink water to stay hydrated in any position. There wont be any reason to move in order to drink because the bending straw will be able to prevent you needing to be in any certain position unlike a cup or open top water bottle. Again, imagine running a marathon and not drinking water form start to finish. This would most likely end in having to receive medical treatment. Staying hydrated during your pregnancy and especially during labor is important. 

Don't forget the little things: 

Except for a water bottle and things particularly from their homes, these are all things I bring to the birth for my clients. On top of these items, I try to remind them to gather (beforehand) everyday items such as phone chargers, eyeglasses, medications, change of clothes, toothbrushes, and deodorant.

You can successfully have a beautiful birth and healthy baby without all of these things. The most important thing you can have is a support person. The more the better. They will act as your personal cheer team and make you feel comfortable in an otherwise foreign environment.

{ Snag your seat in our FREE TRAINING to master your mindset for birth without the fear and anxiety! }

Tranquility by HeHe, A Concierge Birthing and Doula Service in Boston, Massachusetts
"We can't wait to pamper you."

I Love Me, I Love Me Not - How Self-Reflection can Help Prepare for Childbirth

Boston, MA, USA

Am I planning a wedding or a birth?

Whether your'e planning a wedding specifically or any large event, you know how much work goes into the preparation. First, a venue--finding a place to hold this event is crucial. Next, nailing down a menu that is most satisfying to your pallet (and others in attendance). Finally, creating an invite list and sending out invitations. The venue and guest have everything to do with the style or environment, so choose carefully.

You can only prepare so much, but whatever is going to happen that day will happen. You can only control so much. At the end of the day, a lot of factors go into whether or not this event goes off without a hitch. Prepare for what you can and trust the process to take care of the rest.

Are you confused yet? Wedding or birth?

Plan vs. Prepare

Like a wedding, it can be helpful to hire someone that has been to many births and can help you know what options you have as well as the resources available to you. They are also there to help you get everything in order by the big event. You can't truly plan, you can only prepare. You can put as many pieces into place before the big day gets here, but ultimately things could still go wrong or they could go in a blissful direction you never even imagined before. Some things will be out of your control such as the caterer getting stuck in traffic or a medical emergency. You will try your hardest to make sure nothing goes wrong and that includes having made clear your preferences and trusting the process. Trusting that everyone you've relied on to play a role in this special day with do what is in your best interest. 

Where: Your Venue 

Dr. Neel Shah, Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard School of Medicine, found that your birth outcomes has very little to do with your body, rather mostly to do with your choice in healthcare provider and birthing place. He found that choosing one hospital over another could mean a tenfold increase in your risk of having a cesarean section as some hospitals have a 7% rate while others have a 70% rate, both in the US. Check out his research here

Your venue will be filled with their own staff. You don't get to choose the venue rules. However, depending on which hospital you choose, you may have a lot of flexibility with in those rules such as wearing your own clothes rather than a hospital gown or being able to move around rather than be confined in a bed. Touring your venue before the day of the event is important so you know what to expect. This is also a good time to meet some of the staff that may be there when you have your baby.

Does this sound, oh so, familiar to anyone who has planned a wedding?!

The Menu: Is it the right fit? 

I consider your healthcare provider the menu. Or maybe an item on the menu. What if your pallet craves Italian, but your doctor is Greek flavored? It may have looked like an Italian dish until you bit into it and -WHAM- it's greek. That would be so disappointing. Fully exploring providers in your area is imperative. What's the providers c-section rate? Do they support skin to skin? Do they support natural births? Do they help you think outside of the box when it comes to managing labor? Is the staff supportive of the birth experience you're hoping to have? What are the mandatory protocols/procedures? The optional ones? How much choice do you have in things that happen? It's a good idea to ask parents who have recently had a birth experience with that doctor or at that hospital/birthing center. Make sure you clarify if a provider is "tolerant" of certain aspects of birth or truly supportive- they are different. 

Asking the correct questions, while finding your birthing place and medical provider can be crucial. Your event planner (doula) can help you know of questions to ask during your search and interviews. You should find a provider and birthing setting that is supportive of the birth you would like to have. 

Who: Your birth Team 

This is such an important part for your event. This is not a community event. This is a very intimate, special event. This is an event that only those of highest honor get to attend. Your birth team should be people who you trust and will help support this event to go off without a hitch. Your birth team will help keep the energy on the right track as well as help you have the birth experience you wanted. Some hospitals may limit the number of birth team members you can have. Often that number is limited to 2, sometimes 3 team members, plus the birthing parent. Homebirths may allow more support people depending on the midwife.

Your birth team should be aware of your fears. It's important (if you know) to share why you hold these fears? It will also be helpful to know what may help you feel less fearful. However, even with very little information, your birth team will make accommodations to help you feel comfortable and confident.

The Star: Love Yourself 

Love yourself enough to prepare for your child's birth. Take some time each day to practice self-care, self-comfort and self-love so that you can diminish the fears and connect with your body and mind. Practice using positive language and surrounding yourself with energizing people. For additional tips on how to mentally prepare for baby, check out this blog post. This experience is about you, your body, your baby, and your partner. Educate yourself on your choices. Take some time to watch positive, uplifting birth stories or to attend local events that are focused on sharing empowering birth stories. Trust in the process and your body. Know that your body knows what to do and truly believe it. Finally, prepare yourself to let go and surrender to birth. Surrender control and find confidence in the power of your body. Allow yourself enough grace to love yourself through your birth experience.

Weddings and Childbirth hold very similar factors and characteristics. People all over the world put months of planning into a weeding or large event. Just think about how spectacular your birth could be in we put the same amount of consideration and preparing into birth experiences!

{ Snag your seat in our FREE TRAINING to master your mindset for birth without the fear and anxiety! }

Tranquility by HeHe, A Concierge Birthing and Doula Service in Boston, Massachusetts
"We can't wait to pamper you."

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