Working Mom’s Pregnancy

Is it possible to be a bread winner and a bread baker too? Majorie Greenfield, M.D. shares her bold and honest assessment of working pregnancy — how to live a balanced life, while honoring both personal and professional aspirations.

MA: What advice do you give to mothers who are returning to work soon after having a baby?

MG: It’s hard! It’s hard to go back to work right after you have a baby—especially in the beginning – and different people go back at different times.  I stayed home for seven-weeks when I had my son 20-years ago, but a lot of people can still only get six-weeks of maternity leave (or even less than that).

Mothers need enough time to bond with their baby at home and to establish breastfeeding if that’s what they choose to do.  But everyone is different. Going back to work for some people is really satisfying.  I have had lots of people say “I’m just not a newborn person” or “I was so happy to have adult conversations again.”  I think for some of us, work is such a big part of our lives that the adjustment to being a mom is actually pretty hard.

When I went back to work, people said to me “you’re going to be so sad – your heart’s going to be broken going back to work”. I didn’t feel that way.  I missed him, but I was really still very glad to be at work.

Most women in the United States have living situations that are incredibly good compared to what women around the world experience – or what women over the centuries have experienced. We have a lot of luxuries in our lives and I personally believe that happiness has much more to do with our attitude than it does with the circumstances.  We have a lot of power now that we didn’t have before (for the most part).  We have the power to create our own lives. It may not be perfect every minute along the way, but we’re making choices!

MA: How can moms ensure a successful transition back to work?

MG: Part of where people get stuck is not asking for help, or expecting that they’re going to do every “mom” thing that their own mother did, PLUS every “work” thing that everybody else at work does – as if that is somehow humanly possible.  It’s crazy.

One of the things that came out in the interviews I did for The Working Woman’s Pregnancy Book was that a lot of moms still want to be that primary parent. They assumed that they would be the same kind of mom their mother was, or that they would be the primary parent — that they would always take their child to the doctor, or be the one to interact with school or day care.  Granted, some dad’s don’t contribute as much as they could, but sometimes it was the mom becoming the expert so quickly that dad got left out of that learning curve. If mom is jumping in there too often,  then the dad can begin to feel left behind.  You really have to let him become the expert too.

MA: Do you have any recommendations for ways to find that balance?

MG: The last chapter in my book is all about balance.  We conducted free-form interviews and looked for common trends.  “Taking time for myself” as a general theme came up over and over again.  Solutions to this common parenting delimma may look different for each mom – one interviewee said that she likes to “take a bath”, another recommended “yoga stretches while the coffee is brewing in the morning.”

Things like this, where you’re just carving out a little bit of time for yourself, can go a long way.  Sometimes moms don’t feel like they deserve that.  They feel that everything should be for the children, which leads them to feel deprived.

I like to challenge people to think about what kind of role model you want to be as a mom and as an adult.  Are adults people who deprive themselves of things in order to do for everybody else and are miserable all the time?  Or do you want to show your kids an adult who has a balanced life and who feels good – even if that means that you work full time and you get a babysitter on Saturday?

Marjorie Greenfield is a board-certified obstetrician-gynecologist and fellow of the American College of Obstetrics and Gynecology (ACOG). She has practiced and taught obstetrics and gynecology since 1987, and is currently associate professor on the full-time faculty at Case Western Reserve University School of Medicine. Her writing career started in 2000, when she became director of obstetrics and gynecology for the Dr. Spock Company, a health and parenting multimedia enterprise. In 2002, drspock.com was one of only five Internet health sites nominated for a Webby Award, the oscars of cyberspace. While working with the Dr. Spock team, Marjorie wrote Dr. Spock’s Pregnancy Guide, published in 2003 by Simon and Schuster and subsequently translated into Bulgarian, Romanian, Lithuanian, Estonian, Russian, Italian, Chinese, and for the UK edition, the Queen’s English. Marjorie practices general obstetrics and gynecology with a specialty of pediatric and adolescent gynecology, but loves obstetrics and have a large adult OB practice.

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Pssst: The Baby is Not Coming Out of Your Butt

How do you make birth education enriching and funny? Karen Brody, playwright of BIRTH and founder of BOLD – a global movement to make maternity care mother-friendly — talks about “butt humor!” Through the genius combination of truth and laughter, Karen’s message of facing fears and connecting to your intuition is loud and clear.

If you’re a mom with young kids, any mention of bodily parts and their sounds (butt farts and mouth burps for example) has the potential to produce roars of laughter that could be heard on a boat off the Swahili coast of Lamu. In 2005, when I wrote my play “Birth”, a portrait of how low-risk mothers are giving birth in America today, the cesarean rate was 25% and rising. Not hugely uplifting material to present to an audience. I needed a laugh desperately. And that’s when I met a mother who gave me playwright mana-from-heaven: butt humor. If it could work on my kids surely it could work on audiences. And it has.

Meet Vanessa: “Women always say, ‘you’ll forget the pain’. Trust me, even with an epidural, you don’t forget about the pain of a baby coming out of you. How could I forget a sensation that felt like the baby was coming out of my butt? Nobody tells women this. Believe me, you never forget a baby coming out of your butt.”

The irony is, that for all the belly laughs Vanessa gets from the audience, there is a deep truth in her message: mothers are scared out of their butts to give birth.  Of course a baby is not going to come out of a woman’s butt, but how the baby will navigate through the birth passage is a source of endless worry for many pregnant moms.

As a result, moms are running to epidurals and other interventions.  Roughly 50-70% of mothers today have an epidural for pain relief. (Midwifery Today, Issue 95, Autumn 2010). Among the 100+ mothers that I interviewed before writing my play “Birth”, most told me they chose an epidural simply because everyone else was having one.

Nearly 100% of my interview subjects had not researched the risks/benefits of epidurals.  As Judy Slome Cohain, a midwife, points out: “Women get epidurals for one of the main reasons so many women smoked pot in the 1970s – their friends are doing it”. (Midwifery Today, Issue 95, Autumn 2010).

Wait – you mean that a woman who has a PhD in physics and flies all over the world impressing audiences with her knowledge had no idea that epidurals can cause a fever in mother and baby? Probably.

A growing number of doctors tell us pregnant moms are asking for more intervention and that’s why the cesarean rate is now over 30 percent. This may be partly true. But the deeper questions we must explore are these: What is it about our culture that feeds a pregnant mom’s blind rush to grab an intervention? What is the baggage that prevents women in the United States from having powerful births?

One word: Fear

Again, Vanessa: “GIVE ME THE EPIDURAL!!!! I thought I was going to die. Yes. Honestly, I don’t know how women go natural. You don’t get a medal for doing it natural so why do it?”

It’s true.  Women don’t get a medal for giving birth naturally. There is no powerful birth award. So why do it?

One word: Faith.

The clear antidote to counter fear is faith.  The more faith we have in our bodies – the more we connect to our inner knowing that birth is normal process – the quicker our fear subsides. Try it. Every time you feel fear connect to your body (dance, laugh, take a nap) and what happens? Less fear.

Instead of feeding fear, I vote for pregnant mothers feeding connection and embracing truth. Here are three suggestions to help pregnant mothers connect to the truth that pregnancy is a normal process:

1.     Movement. Spend at least 10-15 minutes every day doing some form of movement even if it’s just to close your bedroom door when you get home and dance around the room with your eyes closed. Look for CDs/DVDs that specifically help you connect to your body, like Toni Bergen’s Journey Dance.

2.     Yoga Nidra (otherwise known as: sleep!). Every pregnant woman needs sleep! Yoga nidra is a powerful, guided meditative practice that gives you quality sleep and allows your body to welcome emotions and beliefs for “tea and conversation”. It has helped many people overcome trauma, stress, and connect to their inner knowing. Commit to 10-20 minutes every day. You can purchase CD’s online. Robin Carnes’ CDs are great for the beginner.

3.     Journal. Free-write for 10-15 minutes every day.  Just put your pen down on the paper, no topic, and let your hand write away! You will be surprised where you go. (thank you, Natalie Goldberg!).

Want a transformational challenge? Do one of these three suggestions for 40 consecutive days. Then ask yourself what kind of birth you want.

Karen Brody is the playwright of BIRTH and founder of BOLD, a global movement to make maternity care mother-friendly. She also runs The My Body Rocks Project where she teaches workshops, gives talks on “How to Creatively Empower Birthing Women”, and trains doulas, childbirth educators and activist in her My Body Rocks method for having a mother-centered birth. She is also a passionate napper and has written about the importance of sleep for mothers in the Huffington Post and Mothering Magazine. She is currently registering mothers for her two online courses: My Body Rocks Pregnancy class and a 40-Day Nap Challenge for Moms and in April will offer a teleseminar outlining her new new mother-centered birth trainings. For more information visit:  www.boldaction.org and www.mybodyrocksproject.com.

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Elective Cesarean vs. Spontaneous Labor

Does early elective birth impact fetal development?  Kristen Oganowski — doula, blogger, aspiring childbirth educator, PhD candidate and mother of two — weighs the risks associated with early induction.

As women near the end of their pregnancies, many encounter an onslaught of questions and comments from friends, family members, and even their care providers about when their babies will be born:

“So, when are you going to induce?!”

“Do you have your c-section scheduled yet?”

“Since 37 weeks is ‘full term,’ why don’t you just schedule and induction already?”

“Babies really only gain weight during the last few weeks of pregnancy, so we can schedule your induction or cesarean section as soon as you’re technically full term!”

But as casually as people discuss scheduled birth in everyday conversation, current research shows that the topic might deserve a bit more seriousness after all.  In fact, the topic of early elective birth has been buzzing throughout the world of maternity care advocacy lately.

Early elective births are scheduled cesarean sections or inductions of labor that occur prior to 39 weeks and without medical indication.  And while many care providers and moms choose to schedule birth before the 39th week of pregnancy, one message has become increasingly clear in recent years:

Because of the risks associated with early elective induction, women and their care providers should avoid scheduling elective inductions or cesarean sections before 39 weeks.

Research shows that when babies’ births are scheduled before 39 weeks, they are at an increased risk for respiratory problems, NICU admission, and even neonatal and infant death.  These risks are serious, and they have even prompted various hospitals in the United States either or to require onerous paperwork in the event of an early scheduled birth or to prohibit early elective births altogether in order to minimize these risks.

Acknowledging both the seriousness of these risks and the fact that the induction and cesarean rates have been growing with alarming frequency over the past two decades, The Leapfrog Group (a hospital quality watchdog group) recently released the results of a survey documenting the rates of early elective births at hospitals across the United States.  Setting a target rate of 12%, the Leapfrog Group found that the hospitals’ rates varied from nearly 0% to well over 50%.  Notably, the wide variations in these rates even occurred in hospitals within the same city or region.

On the one hand, these results (which hospitals offered voluntarily) demonstrate just how crucial it is for women to know not only their own care provider’s induction and cesarean rates but also the rates and patterns of early elective birth at the location where they will give birth.  On the other hand, they also demonstrate just how important it is for women to know why they should think twice about scheduling their babies’ births before 39 weeks.  Avoiding early elective birth isn’t about trying to make busy families’ lives more inconvenient—it is about protecting their new babies from the harms of scheduling their births too early!

This doesn’t mean that inductions and cesarean sections should never happen before 39 weeks.  When scheduling birth is medically indicated—when a mother and/or her baby’s health would be compromised by continuing pregnancy—then the benefits of an early birth certainly outweigh the risks.  To this effect, Childbirth Connection has published a resource on labor induction that outlines the instances in which the evidence does  support induction of labor as a way to improve outcomes for mothers and/or babies.  This resource also defines the circumstances in which research is either inconclusive regarding the effects of labor induction or clear about the ineffectiveness or even harm of induction.

But without a medical indication for an early scheduled birth, there is the chance that a baby will miss out on the important fetal development that occurs up to and perhaps even beyond the 39th week of pregnancy.  This information is especially significant considering that many women are told erroneously by others (including some care providers) that babies “only gain weight” during the last weeks of pregnancy.

As a final note, it is also important to remember that unless an induction or planned cesarean is medically indicated, there are benefits to waiting for labor to begin on its own—even after the 39 week mark.  Induction and cesarean section at any time carry risks and thus should not be taken lightly by mothers or by care providers.  For unless otherwise indicated, waiting for labor to begin spontaneously is healthy for mothers, and it’s healthy for babies too!

Kristen Oganowski, CD(DONA) changed career paths from academic philosophy to maternity care advocacy after being utterly awed and inspired by the births of her two children: one born via cesarean, one born via VBAC.  Now she is a doula, blogger, aspiring childbirth educator, PhD candidate and mother of two in Columbus, Ohio.  You can find her speaking up for healthy pregnancy and birth on Twitter (@BirthingKristen), on Facebook, and on her blog, Birthing Beautiful Ideas

 

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Your Baby’s Consciousness at Birth

The healthy birth practices we support lead to mothers and babies having the safest, healthiest, most satisfying births possible. This advocacy is now more important than ever, as evidence supporting the theory that babies are conscious at birth continues to grow. We are pleased to have Dr. Carrie Contey, a prenatal and perinatal specialist, join us to discuss optimizing your birth environment for the benefit of both you and your baby.

Thanks to the pioneers of prenatal and perinatal psychology, we are gaining awareness of how birth profoundly imprints itself on our lifelong health and behavior. In one landmark study, children under hypnosis were able to recall the very minuet details of their birth experiences. These stories were matched to the reports given by their mothers, who were also under hypnosis. Babies are undoubtedly conscious — physically, mentally and emotionally — at birth. This fascinating discovery confirms that facilitating a better birthing experience for all mothers and newborns is absolutely essential.

Sensory Consciousness

Physically, an emerging newborn is well aware of his or her environment during birth, as most senses have developed weeks prior. During birth, a child is capable of hearing, touching, tasting and smelling everything around him or her. So, how can we care for baby’s senses at birth?

Seeing: Because a baby’s eyes are so sensitive and used to seeing light filtered through mother’s belly, the lights should be dimmed. We must allow baby’s eyes to adjust to the outside world slowly and without shock.

Hearing: Likewise, a baby is used to hearing sounds that are muffled by flesh and fluid, so speech should be soft and noises should be kept to a minimum.

Tasting: If possible, nothing should be placed in the newborn’s mouth before he or she has a chance to breastfeed. Babies are prepared for and expecting to taste their mother’s breast milk soon after birth. Imposing bottles or syringes on them during the perinatal period is invasive and detrimental to bonding.

Smelling: Babies are precisely sensitive to smells. The birth environment, especially in a hospital setting, can be overwhelming to the olfactory system. We must be mindful of the potency of all natural and non-natural agents used around baby during birth.

Touching: Through touch, we communicate love, fear, tenderness, violence, confidence and ineptitude. Within seconds after birth, mother’s hands should be the hands that welcome her children, and reassure them that they made it, and they are safe and loved. Anyone else who has contact with the baby should use respectful, loving touch when handling the newborn.

Mental & Emotional Consciousness

More and more parents are talking to, playing music for, and bonding with their unborn babies. If babies can learn in utero, one could easily infer that they are also learning during birth. Babies are not only affected by the words said to them during birth, but the emotions surrounding the event, as well. Creating a powerful and positive birth setting is key to bringing baby into this world peacefully. So, how can we foster baby’s mental and emotional health at birth?

Through re-birthing and other therapeutic techniques that allow people to re-experience their births, we know that birth is often scary, stressful and painful for the newborn. Addressing the baby and telling him or her what is happening — to both baby and mother — during the birth is key, and especially crucial during any invasive procedures. Verbally reassuring babies that they are safe and supported during their journey can alleviate some of the fear they might experience.

Leaving the womb is a profound transition, and can be disorienting and shocking to the system. Once the baby is born, everyone in attendance must be thoughtful of how they place their attention on the baby. The birthing environment should be filled with love, joy and reverence for the newborn child.

Bonding With Baby

Upon delivery — and before the child is taken away from the mother for bathing, weighing and other interventions — baby should be placed naked on the mother’s abdomen. In that position, the child can smell her smell, feel her warmth and hear her voice. Once again, they are together, yet seeing each other for the first time. Shortly after birth, the child enters a quiet alert state. During this time, the newborn is very still and often molded to the mother’s abdomen — but able to see, hear and respond to his or her new environment. Both newborn and mom are instinctually prepared for and expecting this time to bond — face-to-face, skin-to-skin and mouth-to-breast — immediately after birth and for the next several months. This initial bonding period is crucial for a mutually healthy and fulfilling birth experience.

No longer can society afford to ignore the consciousness of babies at birth, and the detrimental effects caused by many current methods of birthing. It’s important that anyone present at a birth — mothers, birth support persons and care providers — honor and respect the birthing process, and yield to the innate wisdom of the newborn.

Carrie Contey, M.Ed., M.A., PhD, received her doctorate from Santa Barbara Graduate Institute in clinical psychology, with a specialty in prenatal and perinatal psychology. She has been passionate about birth, babies and parenthood since she was a child herself, and has dedicated her adult life to pursuing the academic study and hands-on art of early parenthood and optimal human development. Carrie is a nationally-recognized early parenting coach, consultant, speaker and educator. She is also the co-founder of the Slow Family Living Movement, and has served on the board of directors of the Association for Prenatal and Perinatal Psychology and Health (APPPAH). She lives, works and plays in Austin, Texas. To learn more about Carrie Contey, please visit her Web site.

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