3 Questions to Ask When Your Birth Plan Changes

Whether or not you write it down, you probably have some sort of a birth plan or general idea of how you hope your birth will go.

…and you’ve probably also realized from talking with friends and coworkers, reading things online, and hearing birth stories of others that you can’t always count on those plans and preferences coming to fruition. Birth can be unpredictable, and while it’s important to learn about the process and think through your preferences for different scenarios outside of your ideal, it’s also important to be able to adjust in the moment.

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Doulas and childbirth educators often use the acronym BRAIN to help with decision making, encouraging clients to weigh their options based on the following:

Benefits
Risks
Alternatives
Intuition
Nothing (what happens if we do nothing?)

There’s nothing inherently wrong with this tool, especially when used in the context of a trusting relationship and honest dialogue with your care team, but it can feel cumbersome and overwhelming in the moment.

What happens when your plans need to change?

Maybe you were dreaming of waking up in labor close to your due date, sitting on the ball at home and relaxing through early labor, heading to the hospital when things got more intense, and having a smooth delivery…but instead you find yourself wanting or needing to have an induction. Or maybe you were hoping to skip the epidural, but labor takes much longer and you’re much more tired than you anticipated.

As our situations change and expectations shift, sometimes we find ourselves needing to alter our plans. Here are 3 Questions you can ask yourself, your partner, and your care team to help you make the right decision in the moment:

1. Is it safe?

Throughout pregnancy, you trust your doctor to help keep you and your baby safe. During labor, you may find yourself in a position where your care teams suggests an intervention or change in position because they want to ensure your baby’s safety. There is often more than one safe choice and your care team will help you continue with whatever you choose.

2. Is everyone healthy?

In the hospital, your doctor and nurses will monitor you and watch out for any complications that may occur during your labor. Once your care team has determined that what you’d like to do is safe, they are also making sure that everyone is healthy. If you and your baby aren’t showing any signs of infection or distress, there is often more than one safe, healthy choice and your care team will help you with whatever you choose.

But everyone’s safe and healthy, and I still feel conflicted about my options. How do I know that I’m doing the right thing?!

If you’re in a situation with more than one safe, healthy option, asking yourself this final question will help put things into perspective:

3. Does this make sense for me, for the labor I’m having right now?

Sometimes, staying on your current path is safe, healthy, AND makes sense. There are also times where a particular choice made sense during one part of your labor, but your circumstances have changed and a different option (perhaps one you originally thought you’d never choose) winds up making the most sense and preserves the most of your ideals and preferences.

Cultivating flexibility in your decision making can help bridge the gap between expectations and current reality.

It can be hard to shift expectations, particularly if your current situation is far from anything you planned or envisioned. You can cultivate flexibility during pregnancy by talking through your preferences for scenarios outside of your ideal. For example, if you’re planning for an unmedicated birth, it’s also a good idea to talk through your options during an induction, or what your choices are in the event of a cesarean delivery.

Your doctor and the rest of your medical team wants you to have a safe, healthy delivery and a positive birth experience.

Making sure your doctor is on board with your preferences and asking questions prenatally about their practice style and policies can help eliminate conflict or confusion during your labor and delivery. If your plans need to change, know that your medical team will do what they can to keep you safe and help you achieve an outcome that is as close to your original plan as possible.

At the end of the day, keeping lines of communication open and remaining flexible will help you with confident, logical decision-making.

What nobody tells you about sex after baby

You've had your six week checkup and gotten the green light to have sex again after birth. Okay, well...now what?

Aside from the occasional jokes about over-eager husbands (hey, women have sex drives too) and horror stories about how bad it's going to hurt, you don't really hear much about what it's really like to have sex after baby. We're going to have a pretty frank discussion about sex and the things nobody tells you about how that works post-baby, so feel free to skip this one if that's not your thing.

sex after baby
sex after baby

Just because your OB clears you for sexual activity doesn't mean you have to jump in before you're ready.

As always when it comes to intimacy with your partner, communication is important. When you are ready, it's okay to feel a little apprehensive. While it might be a little uncomfortable the first time or two, sex after baby doesn't have to hurt, and if it hurts for more than two weeks after you've started back, talk with your doctor. That pain isn't normal and you may need pelvic physiotherapy to help address the underlying problem.

Lube is your friend.

No, really. #allthelube. Those first few times, don't be afraid to lubricate with abandon, even if that wasn't your norm before. Breastfeeding and other hormone changes can cause vaginal dryness, which can in turn cause discomfort during intercourse. If you're using condoms, remember to choose a water-based condom-safe lube to be on the safe side.

Don't skip the foreplay.

Your body has been through a lot, and pregnancy changes things down there even if you didn't deliver vaginally. Going slow with lots of massage (remember, lube is your new BFF), especially in the perineal area, will help you relax and enjoy yourself more. Even if you aren't quite ready to jump back into sex with penetration yet, massage and taking the time to connect with your partner is never a bad call.

If you're a partner reading this, some new turn-ons to add to your repertoire are helping make sure mom is rested, has had a chance to shower, and putting in some extra help with household tasks. Real talk: it's hard to get in the mood when you're exhausted, covered in spit-up, and thinking about all the things that need to get done around the house.

Your boobs might leak.

If you're breastfeeding, you might experience some leaking during sex or orgasm.  That's normal, and throwing down a towel before things really get going is a good idea. If it's close to your baby's next feeding, you might be a little engorged and any position that puts pressure against your breasts might feel uncomfortable. Your nipples will probably feel sensitive and it could be awhile before they have another purpose besides feeding your baby. They'll adjust to their dual-purpose life soon enough.

You're going to get interrupted.

Nothing kills the mood quite like a screaming baby.

It's going to happen, and nobody really talks about how strange that can be for first-time parents. It's hard to flip the switch from "sexy time" to "oh wait, I have to parent now" and back again. You may have to stop in the middle, tend to your baby, and get back to things, or your baby might thwart that plan entirely. Be patient with yourself if you find that switch difficult and have trouble getting back into the mood.

You will get used to it as your adorable interrupter gets bigger and keeps interrupting (That's a thing now, btw. They will keep doing that- ask a fellow parent). Chalk it up to the joys of parenting, laugh it off, and try again soon. If you haven't already, this might be a good time to start helping your baby get used to sleeping in their crib. Even if you aren't ready to transition full-time, having the option to start there is handy.

Get creative!

The end of a long day of momming might not be the best time for you to have sex right now. Morning or afternoon may be better for you if your partner is available. Baby asleep in your room? Get creative with other locations. Intimacy is important, and sometimes as a parent you have to get it when you can and where you can. Don't worry, you'll figure it out. Have fun!

The Six Week Checkup

The six week checkup is the last vestige of your pregnancy and an important appointment you don't want to miss.

Besides the much-anticipated (or feared) "all-clear," what's the point? We'll break it down for you so that you can get the most out of your appointment.

six week checkup postpartum
six week checkup postpartum

Why six weeks?

That initial post-birth Mack Truck feeling has subsided, you've stopped bleeding, you might even be getting a little more sleep (if not, we have a doula for that!), and you're starting to get used to your new post-baby body.  You're entertaining the thought of having sex again one day. Maybe. You might feel fine, but remember that birth left a placenta-sized wound in your uterus, and that wound takes around six weeks to fully heal. Introducing anything into the vagina before then increases your likelihood of infection, which is the last thing you need with a newborn to care for!

What happens during the six week checkup?

During your visit, your OB/GYN will sit down with you and ask you questions about your postpartum recovery. If you have any questions about your delivery, now is a good time to ask. If you had any kind of perineal or internal tearing, or had a cesarean delivery, your OB may want to take a look to make sure everything is healed correctly.

If you are struggling with incontinence or pain, you can ask your OB for a referral to a pelvic physiotherapist to help get your muscles back in shape.

Your OB will discuss contraception with you if you are trying to avoid another pregnancy. Remember, you can ovulate before you have that first period, and breastfeeding is not a reliable form of birth control.

Your OB will also give you a questionnaire called the Edinburgh Postnatal Depression Scale to screen you for any kind of postpartum mood disorders.

About that postpartum depression questionnaire...

The Edinburgh Scale is a tool to screen for postpartum mood disorders, but don't be afraid to speak up if you're struggling but don't identify with the questions. Your mental health as a postpartum mother is extremely important, and your OB is there to help. If you feel like you would like medication, most OB/GYNs are familiar with standard first-line treatments. He or she may want to monitor you for hormone changes as well.

Having a baby isn't all sunshine and rainbows. Sometimes it's loneliness, scary thoughts, mood swings, anxiety, feeling hopeless and misunderstood, resentment, crying spells, or a whole host of other not-fun symptoms.

Please hear us when we tell you that you do NOT have to struggle alone. Your feelings aren't silly or insignificant and you matter! There are moms who have been there and there is help available. If you are in Memphis, Appleseeds, Inc. is a local non-profit that specializes in maternal mental health and provides affordable individual therapy, support groups, and workshops.

Should I bring my baby?

Up to you! Your OB/GYN and staff will probably be thrilled to meet your baby and see how much they've changed since birth. This is a fun photo-op, especially if you have a great relationship with your doctor. If you feel like you want to take that time for yourself without any distractions, there's nothing wrong with that! Your partner or a friend/family member can keep the baby or go with you, or your postpartum doula can help if you prefer.

You don't have to wait six weeks

If you have a question or a concern before six weeks, don't wait! Call and make an appointment if you feel like something needs to be addressed before your scheduled six week visit.

How to diaper a newborn | Bitty Baby Basics

Diapering a baby seems pretty straightforward, right? Ask a new parent and you'll find that's not quite the case.

Sure, the basic concept is simple, but how do you know if you've got the right fit, if you're using the right size, common culprits for those pesky leaks and blowouts? And what's the deal with cloth diapers? We're talking about diapering in part 3 of our Bitty Baby Basics Facebook Live video series with our tiny newborn co-host (who had a lot to say this time!) and co-owner Lindsey Hanna.

How to make sure your baby's diaper fits

When checking for fit with a disposable diaper, you want to make sure that the waist is neither too loose nor too tight. A good rule of thumb is that you should be able to fit your finger between the diaper and the baby, but not much else. The legs should have no gaps, and make sure you have fanned out the elastic so that it's not inside the diaper. If you have a boy, make sure the penis is pointed down or the diaper will leak out the top. The gussets in a diaper are the protective barrier and what keeps the poop off of your baby's clothes ;).

It's time to size up when the diaper fits well, but you start to experience leaks and blowouts. With longer, leaner babies you may start to see a bit of "plumber's crack" as they outgrow the diaper in length, and with more chunky babies you might see their bottoms coming out the sides at the leg. When you size up, or if you're between sizes, make sure the diaper is tight around the waist to ensure that there aren't any gaps in the leg.

What's the deal with cloth diapers?

Cloth diaper tutorials abound online, but in our video we give a basic overview of different kinds of cloth diapers available.

All-in-one diapers: The diaper is in one piece, and there's nothing to stuff. It goes on much like a disposable and can only be used once. All-in-ones are available in both newborn and one-size diapers for bigger babies.

Pocket diapers: These diapers have a soft inner layer and can be stuffed with an insert or other absorbent materials. You can find them with snaps or velcro closure, and they are highly adjustable to your growing baby. A standard one-size pocket diaper will last your baby from the disposable equivalent of size 1-2 all the way up to size 6! With a one-size pocket diaper, there are snaps to adjust both the waist/leg and the rise of diaper (how tall it is).

Newborn pocket diapers: A smaller version of the pocket diaper. These will often come with a couple of settings and last from about 8lbs and until 3-4 months old.

Diaper cover: In our video, we show a one-size diaper cover. There is no soft inner layer and you place your baby's diaper directly onto the waterproof layer and against the baby's skin. You can put absorbent material in a cover, or put it over a disposable to prevent blowouts.  Options to go in a cover include an insert made of cotton, bamboo, or charcoal bamboo, prefolds, and flats/flour sack towels. Prefolds and flat diapers can be folded to lay in or folded and fastened onto your baby.

https://youtu.be/aSkPitRQvJk