Pelvic Pain During Pregnancy

Some time between peeing on a stick and packing your hospital bag, pregnancy discomforts creep in. Pregnant people say things like

"Oh, it hurts so bad when I get out of bed!"

"By the end of the day, I can hardly get out of the recliner. My partner has to help me."

"It feels like I'm getting kicked in the center of my pubic bone!"

![Img](https://a.storyblok.com/f/70793/4627x3085/3616cb5d80/depositphotos_166611412_xl-2015.jpg)

 We sometimes hear this pain referred to as SPD, [symphysis pubis dysfunction](https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/symphysis-pubis-dysfunction). Our first suggestion is always, always pelvic floor physical therapy.  (Click here for a list of Kansas City pelvic floor pts). 

You're starting to notice your core is fatigued from supporting your pregnant belly all day. Core muscles give up, leaving pelvic floor, low back, and glute muscles scrambling for support and stability.  That sharp kicked in the crotch feeling? It's your pubic bone and pelvic floor muscles trying to maintain balance. After that stability is compromised (while sitting, getting out of bed, etc.), your pelvic floor muscles freak out trying to keep everything together. OW.

What can you do for relief?

Dos:
- do keep knees together when sitting
- do use [this log roll move](https://youtu.be/MYQo970ilDY?t=35) to get out of bed.  
- do bring knees together when getting out of the car, open the door, turn both knees toward the door, and then step out.
- do stack your hips when sleeping on your side, use a pillow or 10 between your knees to keep your top leg level with the hip.  

Don'ts: 
- don't sit cross-legged
- don't hang out with knees wider than shoulders width apart (including yoga, sex, exercise ball, etc.)
- don't suffer through! Pain or discomfort during pregnancy is your body's way of asking for something different.

![Img](https://a.storyblok.com/f/70793/500x500/bbc2563c08/pelvic-pain-blog.png)

Still need more ideas? 
- take a bath and use all the Epsom salts (5-7 cups for a deep tub, 4-5 in a standard tub).  The magnesium will increase your comfort and help you sleep.  

- see a [Kansas City chiropractor who specializes in pregnancy care](https://l.facebook.com/l.php?u=https%3A%2F%2Fdocs.google.com%2Fdocument%2Fd%2F146QTzi28w8peM8yXGX9fs_GaUuWbT_E26EkDMC0SI80%2Fedit%3Fusp%3Ddrivesdk%26fbclid%3DIwAR06qUUm1GeJuSkxwSGbZIzd5orcHfl28_0wRfQUk2ojfXrcSABa7YiHl1g&h=AT0zMirsbvZV-Uv_S5YFIJUQag_FzIoFMbOistlR_w-Ydm8pcw1RAOkPN9-H56s6bMHmNmTuPs_89N8CWLmJTBGdnBbPp04TTbo-6KQcGHq1REeIxQ-xu9bPYimf345Vm4At1jL2TOl-viQYHpg)

- ask your maternity care provider for a referral to a pelvic floor physical therapist. 

You'll be feeling more like yourself in no time!

*Want more information and encouragement as you navigate pregnancy, birth, and parenthood? Please join our free online community, [Welcome Baby KC Support](https://www.facebook.com/groups/889275864760247), where we provide a steady stream of information relevant to your unique needs AND live, interactive help from our team of doulas and birth professionals.*

Some time between peeing on a stick and packing your hospital bag, pregnancy discomforts creep in. What can you do for relief?

Newborns Don't Need Much

Open a registry with any of the major baby gear retailers, and you'll be flooded with a barrage of STUFF. Here's the thing: Babies don't really need a ton of stuff. I know, I know. It really seems like you might need all of that stuff even though I said you don't. Go ahead and build an epic registry anyway simply because it's so fun and special to dream of all the ways you'll care for your sweet little baby. If you receive everything on your wish list: great! If not, don't fret. Check out this reasonable, smart list of newborn essentials I've curated with you and your baby in mind:

![Img](https://a.storyblok.com/f/70793/940x788/63cf499ae0/4th-trimester-essentials-4.png)


# Clothes

In this doula's opinion, cotton zipper sleepers are king the first three months of baby's life. They're comfortable, quick, easy to launder, and just the right temperature regardless of season. They don't press on a newborn's umbilical stump like separates do. My favorite brand is [Target's Cloud Island](https://www.target.com/p/baby-3pk-llama-love-zip-sleep-n-39-play-pajama-cloud-island-8482-6-9m/-/A-54508662?ref=tgt_adv_XS000000&AFID=google_pla_df&fndsrc=tgtao&CPNG=PLA_Kids%2BShopping_Brand&adgroup=SC_Kids&LID=700000001170770pgs&network=g&device=c&location=9023159&ds_rl=1246978&ds_rl=1246984&ds_rl=1241788&gclid=CjwKCAjwr7X4BRA4EiwAUXjbt0pdUm3tPi6zuzZVCdEYX0daLegz48kZQ-rkbSCAL5K8uYuHfMgo9RoCPl8QAvD_BwE&gclsrc=aw.ds) because they have a reverse zipper. Instead of zipping from bottom to top, these zip from top to bottom. This is helpful for those middle of the night diaper changes; just unzip baby's feet and bottom, leaving their torso and arms snuggly warm. Whatever type of clothing you prefer for your baby, plan on 10-14 outfits total. This gives you plenty of options in the early days when baby spits up everywhere and/or has multiple blow outs.

# Milk

Baby's gotta eat! There are so, so many feeding products out there. Honestly, most of the them are a waste of money, resources, and space in your home. 

If you plan to breastfeed or chestfeed, skip the pillows, creams, milk catchers, covers, freezer bags, supplements, etc, and instead scope out an Internationally Board Certified Lactation Consultant (IBCLC) near you. A skilled IBCLC is way more important and less expensive than all of that other stuff combined. According to [this study](https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2013.301360), "women regularly counseled by IBCLCs with instruction and support for breastfeeding were more than four times as likely to exclusively breastfeed their infant at one month and nearly three times more likely to do so at three months, compared with the control group." Can a Boppy pillow do that? No it cannot. If you're located in Kansas City, please check out [Liz Levy](http://www.lizslactation.com) or [Kay Miller](http://www.heavensentsupport.com/). Both are experts in lactation and can support you in reaching your feeding goals, and they even take insurance. You may not end up needing their help, which would be fantastic! But if you do need support, you'll already have arranged for help, which significantly eases your stress and boosts success rates.

If you plan to bottle feed, I recommend starting with a small variety of bottles. Every baby is unique, and you may be surprised to learn they have preferences about their bottle! Choosing a variety box like the [Babylist Bottle Box](https://www.babylist.com/gp/babylist-bottle-box-v4/16613/338379) takes the guesswork out of finding your baby's favorite bottle. Once baby is here and you've identified the favorite, then you can buy 6 or 7 more of those and then sell the ones baby didn't prefer.

# Diapers

In the world of poop-catchers, there are 3 basic choices: cloth diapers, disposable diapers, or [elimination communication](https://godiaperfree.com/elimination-communication/). 

If this is your first time cloth diapering a baby, consider signing up for a cloth diaper trial program like [this one](https://jilliansdrawers.com/products/changing-diapers-changing-minds-program). There are a ton of various cloth diaper options, and everyone has their own favorite. It can be overwhelming trying to wade through the various terminology, types of cloth diapers, and people's opinions about them all. Take the guesswork out, and try out several different types of diapers until you find the kind you like that meets your family's unique diapering need. 

If disposable diapers are more your style, I recommend jumping on the subscription train. Not only are diapers delivered to your door, but the subscription service typically discounts the diapers. Score! I like [Amazon's Subscribe & Save](https://www.amazon.com/Disposable-Diapers-Subscribe-Save-Eligible-Diapering/s?rh=n%3A166772011%2Cp_n_is_sns_available%3A2617006011) program for diapers.

If EC interests you, you may prefer to have a handful of cloth prefolds on hand for messes and diapering on-the-go. I like [Green Mountain Diapers](https://www.greenmountaindiapers.com/collections/prefolds-and-flats/products/cloth-eez-prefold-diapers-organic) for this.

# Bed
Sleep. Every new family needs sleep. Trying to choose a baby bed may have you wondering: Where do babies sleep the best? What's safest for my baby? What sleeping arrangement is best for my family? 

The [AAP recommends](https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/safe-sleep/Pages/Safe-Sleep-Recommendations.aspx) baby sleep in your room for the first six months of life, in a crib or bassinet, on their back, with no blankets or pillows or cute nursery accessories in the bed with baby. 

My clients have been raving about the [SNOO](https://www.happiestbaby.com/products/snoo-rental), and it's not hard to see why. It's beautiful and highly effective at soothing baby back to sleep when they wake up or feel upset. The purchase price is hefty, but the rental fee feels more reasonable and is worth the excellent sleep for many families. Whether or not SNOO complies with the AAP's safe sleep guidelines is up in the air, though. The [HALO bassinet](https://www.halosleep.com/shop/bassinest-swivel-sleeper/) is also a client favorite because unlike other bedside bassinets, this one can swivel over the edge of your adult bed, making accessing baby in the middle of the night quick and easy. And unlike the SNOO, it is definitely AAP-compliant.

If your family plans on bed sharing, check out the [Safe Sleep 7](https://www.llli.org/breastfeeding-info/sleep-bedshare/) to reduce risk of SIDS and suffocation. (Sorry, heavy topic, I know. It's important.) Some families also prefer to use a bed rail like [this one](https://www.amazon.com/Regalo-54-Inch-Reinforced-Anchor-Safety/dp/B005EHNL3M/ref=sr_1_5?dchild=1&keywords=bed+rail&qid=1594921899&sr=8-5) to keep baby safe from falling. When in doubt, discuss safe sleep with your baby's healthcare provider.


# Honorary Mention

Last but not least, your newborn most likely needs a car seat, unless you live in a metro where you rarely utilize cars. All car seats sold in the United States meet high levels of safety standards, and therefore I don't have one specific seat to recommend. There's a great seat for every budget! However, I DO recommend checking out [Car Seats for the Littles](https://csftl.org/) for comprehensive information on choosing a car seat, how to install and use car seats, why to use car seats, etc. It's an amazing, free resource to keep your newest little human the safest they can be.

That's really it! Are there other gadgets out there that are awesome and helpful? Yes. (I'm looking at you [Sakura Bloom](https://sakurabloom.com/), [Hatch](https://www.amazon.com/Hatch-Baby-Machine-Monitor-Nightlight/dp/B07WFXGNGF/ref=sr_1_3?dchild=1&keywords=hatch+baby&qid=1594923033&sr=8-3), [Elvie](https://www.amazon.com/Elvie-Pump-Double-Electric-Breast/dp/B07G375DHR/ref=sr_1_1_sspa?dchild=1&keywords=elvie+breast+pump&qid=1594923085&sr=8-1-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUEyTkFMUjFLTDYxSFhIJmVuY3J5cHRlZElkPUEwNzU5Mjc3MTIwWEZXVFBVOE01QyZlbmNyeXB0ZWRBZElkPUEwMzE4MzIxWjhWUU5PNVUyUElWJndpZGdldE5hbWU9c3BfYXRmJmFjdGlvbj1jbGlja1JlZGlyZWN0JmRvTm90TG9nQ2xpY2s9dHJ1ZQ==), [BabyBrezza ](https://www.amazon.com/Baby-Brezza-Formula-Pro-FRP0046/dp/B07N64KKR7/ref=sr_1_4?dchild=1&keywords=baby+brezza&qid=1594923131&sr=8-4)and [Ollie](https://www.amazon.com/Ollie-Swaddle-Bundle-Lavender-Meadow/dp/B083ZN9GV6/ref=sr_1_6?dchild=1&keywords=ollie+swaddle&qid=1594923165&sr=8-6)). Are they necessary for baby's survival? Not really. Prioritize these 4ish items, and you'll have everything you need to welcome your baby into the world.

Skip the miles-long baby registry checklist--these are the essentials your baby needs their first 3 months of life.

Busy Bags for Busy Families

When you bring home a new baby, life is turned upside down for older siblings. Suddenly parents are very busy taking care of all the baby’s needs. An older sibling may be feeling bored or ignored. What’s a family to do? Busy bags to the rescue!


# What’s a busy bag? 

[Busy bags (activity bags or quiet boxes), are essentially simple and engaging activities that your child can do *independently *](https://teachingmama.org/busy-bags-101/)while you attend to other things—typically baby. That means you will want to scale the activities to fit the skills of your child. Most busy bags use inexpensive materials, often found around your house. Prepare them in advance so they are ready at the moment you need them. 

Another trick to busy bags is to only include materials that can be cleaned up easily and won’t cause permanent damage. (Don’t ask us how we know!) This excludes typical art supplies like crayons, markers, and scissors for many kids. Save those for times when you are able to provide a little more supervision. 

![Img](//a.storyblok.com/f/70793/4032x3024/fcc1a01379/20200212_115244.jpg)

# How do you make a busy bag? 

Like most things in our world nowadays, you can check Pinterest and find about a billion, okay, maybe only a million, ideas for busy bags. But to save you some time, we have included some of our favorite ideas below. 

There are many storage options. One of the easiest is for each activity to go into its own large Ziploc bag. Some people prefer pencil pouches or boxes. It doesn’t really matter how you store them, just that you have them ready when you need them. 

# Homemade Busy Bags

These busy bags use items that you have around the house or can purchase easily and inexpensively. 

**1. [Pushing Pipe Cleaners](http://mamaot.com/toddler-fine-motor-skills-pipe-cleaner-colander-photo-friday/)**
Kids love pipe cleaners! All you need are pipe cleaners and a colander. Grab that one you never use from the kitchen or hit the dollar store. They will have a blast pushing the pipe cleaners into the colander holes. An alternative option is to remove the label and wash out an old parmesan cheese container. Yep, the kind with the green lid. Cut the pipe cleaners in half and watch your toddler have a blast inserting the pipe cleaners into the container. 


**2. Pipe Cleaner Letters**
If your kid is learning letters, print off some large-print alphabet pages. Let your child use the pipe cleaners to either cover the letters on the page or [re-create the letters](https://www.makeandtakes.com/learning-letters-with-pipe-cleaners) next to the page. 


**3. Tongs and Pom-Poms**
The possibilities of this simple combination are almost endless. Your child can use tongs to put pom-poms in a water bottle or to transfer from one bowl to another. If your child is working on matching colors, take an egg carton and paint or color the bottom of each spot. Have your child put the pom-poms in the corresponding color spot. [Mama OT offers 50 ideas of things to do with tongs!](http://mamaot.com/ways-to-play-with-tongs/) 


**4. Bean Box ([Sensory Boxes](https://littlebinsforlittlehands.com/our-favorite-sensory-bin-fillers/))**
These can’t be kept in a bag, but the bean box is a favorite with children who are past the put-everything-into-the-mouth stage. You will need a large plastic tub. Buy some beans in bulk and dump them into the box along with a variety of small trinkets, cups, spoons, and whatever else you find around the house. Kids will play in the box much as they would in a sandbox, but it is so much easier to clean up. Some people use rice or shredded paper in place of beans, but we find beans easiest to clean up when we’re done. 


**5. [Velcro Popsicle Sticks](https://teachingmama.org/busy-bags-101/)**
It might surprise you how long kids will sit and play with these. All you need to do is get some large popsicle sticks (the colored ones are more fun) and self-adhesive velcro dots. Add a soft dot to one end and a scratchy dot to the other of each popsicle stick. Voila! Kids can make shapes, letters, or whatever their little hearts desire. 


# Store-Bought Busy Bags

If you’re short on time, many toys make for great busy bags!


**1. Mr. Potato Head**
Instead of leaving this classic toy on the shelf for any time play, make it into a busy bag. [Mama OT explains that not only is Mr. Potato Head fun, but it’s also a great toy for development!](http://mamaot.com/30-developmentalbenefits-of-playing-with-potato-head/) Keep an eye out at garage sales and other resale shops to keep the cost low. 


**2. Lacing Cards**
These are another great option, especially for older toddlers and preschoolers. Whatever your child loves, from animals to princesses, you can probably find a set of lacing cards to fit that theme and capture your child’s attention. 


**3. Perler Beads**
Did you know that Perler beads come in two sizes? Those tiny ones are perfect for older preschoolers, but there are [bigger ones](https://www.amazon.com/Perler-439458-BIGGIE-Assorted-Colors/dp/B003L2ECE4/ref=sr_1_4?keywords=perler+beads+large&qid=1577491789&sr=8-4) that even some toddlers can enjoy. They can make their own design or follow templates. They can create a project to keep or to dump, depending on how they feel that day. 


**4. Beads and String**
You can buy these as kits or assemble them yourself. Young children will love the[ large wooden beads to string on a shoelace](https://www.amazon.com/Melissa-Doug-Deluxe-Wooden-Lacing/dp/B000GIJ4Y4). Older children will enjoy stringing [pony beads to make necklaces and other creations](https://www.amazon.com/JPSOR-Alphabet-Jewellery-Bracelets-Necklaces/dp/B01LZGJNU6/ref=sr_1_3?keywords=pony+bead+kit&qid=1581526423&s=toys-and-games&sr=1-3). It is easy to scale to your child’s ability. 


**5. Dollar Spot at Target**
We know we aren’t the only ones who get caught looking through the dollar spot at Target. Next time, go with busy bags in mind. You might be surprised at how many great items there are to keep your kids busy and for very little cost. You might consider checking your local dollar store for more ideas. 

However you use them, busy bags are an all-around win. Your older child will feel special as you pull out new activities just for him or her. You will be able to take care of the other things calling your attention. 

For more information and encouragement for your pregnancy, birth, and postpartum, please join our [free online support group](https://www.facebook.com/groups/889275864760247/)!


When you bring home a new baby, life is turned upside down for older siblings. Busy bags to the rescue!

What's Missing from Your Birth Plan

In your preparation for a great birth, you’ve definitely gone through the list.

[Doula](/)? Check.

[Birth class or prep](/classes)? Check.

[Great supportive provider](/blog/questions-to-ask-your-ob) ? Check check check.

Birth plan…

What about that Birth Plan? Scouring the interwebs, you’ll find all kinds of mixed opinions on a Birth Plan.  Online pregnancy forums list formats and tips while others scoff at the premise. Mean spirited maternity care professionals say a plan will never be read – or worse, it’s an indicator of Birth Doomsday.

Let’s call it birth preferences. You’re not planning your birth. You’re letting your team know what you prefer, what’s important to you, if everything is going smoothly.

Low-intervention birth preferences probably look a bit like this….

**Thanks for coming to my birth! These are our preferences to welcome our baby. If anything unexpected comes up, we’ll be happy to discuss alternatives.**

**We prefer:**

* **freedom of movement throughout birthing** 
* **intermittent monitoring during the birth process** 
* **minimal vaginal exams**

**During the birth we’d like:** 

* **self directed pushing** 
* **optimal cord clamping** 
* **immediate skin to skin with baby**

And that’s it! Short and sweet, just like the blogs, birth boards, and baby class suggest. Newborn preferences are on a separate index card. Copies made for doctor/midwife, nurses, and birth partner. Backup copy in the birth bag. Check check check. There’s something missing, something just as important as freedom of movement, intermittent monitoring, and self directed pushing. Maybe even more important.

Your baby’s birth. The actual birth itself when your baby is descending, crowning, and emerging. What’s going on then? What are your preferences in that moment? You’ve researched the heck out of choices and talked to your provider about all of your options… no one said anything about pushing/birthing preferences!

This is a great chance for more discussion with your doctor or midwife. You want to know what the moments leading up to birth and what the actual birth itself look like. You can ask your provider, “Can you walk me through this?”

“Tell me what a typical birth looks like from the moment you walk through the door.” (Since most providers are arriving just as birth is imminent.)

“Doctor, where are your hands as baby’s moving down?”

“Midwife, are you using warm compresses and oil?”

“And are you using your fingers to stretch me or supporting my perineum?”

“What position am I in?”

“How much are you touching or turning baby?”

“Do you use traction to assist in the birth?”

And then…baby arrives! While you enjoy that “Oh Baby” glow and skin to skin with this new little one, what’s your provider doing? Massaging your uterus, ordering pitocin, watching to see if your baby’s cord has stopped pulsating, keeping an eye on bleeding? When does your provider clamp the cord? Do they wait for the placenta to arrive on it’s own or do the practice active management – applying traction to the cord to remove the placenta?

What do birth preferences for pushing/birthing (also known as second stage) look like?

**During birthing, as baby is descending and emerging:** 

* **please support my perineum with warm compresses** 
* **I will be pushing in whatever position in most comfortable to me at the time** 
* **please allow our baby to be born without pulling or turning baby’s head**

**Following the baby’s birth:** 

* **I prefer spontaneous delivery of the placenta without traction or pitocin**
* **after the cord has stopped pulsating, my birth partner or I would like to cut the cord**
* **I’ll be breastfeeding and using nipple stimulation to reduce my risk of bleeding**

There’s something missing, something just as important as freedom of movement, intermittent monitoring, and self-directed pushing.

Us vs. Them

I recently read about a newly pregnant person surrounded by messages about how awful it would be to birth with an obstetrician. What a terrible idea it was to birth in a hospital. How a pregnant person was just asking for a fight if they wanted a low intervention birth birth anywhere but home. Hospitals were horrible and dangerous. The new parent’s yoga instructor, childbirth educator, and even their doula didn’t build them up with confidence in making decisions for their family. They tore them down with fear.

There’s a strange kind of Us vs. Them mentality with some who support low intervention birth. Some truly believe that a gentle birth with the new parents making educated and informed decisions isn’t possible in a hospital setting. They tell parents that the nurse (or the doctor, or the nurse midwife, or heck, even the parking lot attendant) is going to undermine their intention for a certain birth. People hear they should birth at home or at a birth center to make things easier. If they want to do things the hard (read: hospital) way, they and their partner will have to fight. They’ll have to hire a doula as a bodyguard (hey, that’s not what doulas do!). There might even be some fierce face paint involved.

But…what if…the new family could birth where they felt most confident? What if a family could choose a provider and birth place that truly believed in the same vision of birth? What if….that was (gasp!) a hospital? A hospital where the birthing person knew the provider attending their birth, felt supported by the nurses, had their wishes respected, enjoyed the complete attention of a prepared birth team and… had a great birth? Crazy, right?

Not crazy at all. That’s why Us vs. Them isn’t working. We don’t have to fight Them. Especially in a large metro area, we have options. We have all kinds of providers! From the most conservative OB to the lay midwife and everything in between. If your provider doesn’t agree with your birth preferences, don’t fight. Find a provider who does support you. Find a birth place that can help you welcome your baby the way you imagine it. It’s not You against Them. It’s You *with* Them.

You have to take the responsibility, though. It’s Your Birth and Your Baby. It might mean interviewing lots of providers and switching to someone new (no…they’re not going to cry if you leave their practice!). It might mean finding a new birth place. It might even mean looking at payment options, insurance coverage, out of network costs, gap exceptions or driving an hour to your birth place. But you and your baby are worth it. If you really like a good argument, channel all those feelings before baby arrives. When it’s your birthing time, your only thought should be how confident you feel and how excited you are to meet your baby.

Us vs. Them isn’t working. We don’t have to fight Them. 

Minimalist Birth Bag

[Welcome Baby KC](/) is so very happy to have a guest blogger this week! Everyone, please meet Abigail Wagner, a doula, with A Loving Welcome Doula Services.

Do you have a whole Pinterest board dedicated to what to pack in your hospital bag? I did too! Until I attended my first birth.

Let’s get real – you won’t have the time to finish knitting that sweater you started the moment you found out the sex of your baby. Those fashion and celeb magazines that you love so much, they may just get thrown across the room if someone tries to hand them to you at the wrong time (saw it happen once – hilarious). I consider myself a minimalist with very loose standards. So here is my recommendation for a loosely minimalist hospital bag:

For the Birthing Person:
- 2 changes of clothes & underwear (whatever you’re most comfortable in. For me, this is 
a few pairs of leggings, loose tee shirts, and granny panties)
- 2 nursing bras/tanks
- Toiletry bag with your essentials (For me, this would have chapstick, face towelettes, 
mascara, mints, deodorant, toothbrush & toothpaste)
- Water bottle
- Easy to eat snacks

For Partner:
- Change of clothes and underwear
- Comfortable shoes (they will be on their feet, by your side for a lot of your stay)
- Toiletry bag (separate from yours) for their essentials (For my husband, this would have been deodorant, more chapstick, mustache wax, pomade, cologne, toothbrush & toothpaste)
- Snacks
- Drinks

For Baby:
- 2-3 sleepers (I prefer newborn gowns, no zippers or snaps to mess with while you’re both learning how to change diapers)
- Swaddle blanket (I’m obsessed with bamboo, so soft on new baby’s skin)

Miscellaneous Extras:
- Phone chargers (at least two! Your phones may run low at the same time)
- Coconut oil (great for nipple cream, and an excellent poop repellent for that sticky meconium)
- Car Seat (properly installed into your car)

Optional/Less minimalist
- [Birth Preferences](/blog/birth-plan-basics)
- “Going Home” outfit
- Hats/mittens for baby
- Nursing pillow (great for use at home, less essential in the hospital)
- Camera (other than your phone)
- Slippers
- iPad/laptop
- Nursing pads

This list may not be perfect for everyone, some will have more “essentials” and some will have even less! (Will I use the mascara? Probably not. But it’s important for me to have it.)

Do you have a whole Pinterest board dedicated to what to pack in your hospital bag? I did too! Until I attended my first birth.

Early Signs of Labor… and Why You Should Ignore Them

In and parenting group or forum, especially a due date club, there comes a time for the “How do I know if I’m in labor?” posts. Lots of well meaning experiences, random information and links like this post from [Pregnant Chicken](http://www.pregnantchicken.com/pregnant-chicken-blog/how-do-i-know-if-im-in-labor) are shared in response. And it’s easy for a full term pregnant person to get really excited about an app to time their contractions, or to over-analyze their cramping, or even find themselves doing a Google search for mucous plugs. (Don’t look it up. You’ve been warned.)

With all these possible signs of impending birthing and random tips and encouragement from the interwebs, sometimes an impatient pregnant person just needs to stop.

Stop timing contractions; stop analyzing undies; stop texting her partner every time she feels a shift or a hiccup. It might be early signs of birthing. Or it might just be late pregnancy signs! No way to know until baby arrives. The exciting news is most babies don’t sneak out. At some point, the contraction timer doesn’t matter. The parenting groups don’t matter. The cramps and hiccups go by the wayside because your “Is this it?” suddenly shifts into THIS IS IT.

Your body is ready, your mind is ready, and your baby is ready: It’s go time!

What should you do with those ambiguous early signs of labor? Ignore them. Check in with your birth team (your midwife or [doula](/)) and then? Turn off your phone. Take a nap. Relax in a bubble bath. Go for a fun date with your partner. Binge watch your favorite funny series on Netflix.

What should you do with those ambiguous early signs of labor? Ignore them. 

Early Signs of Labor… And Why You Should Ignore Them

Considering an Induction 

With the holidays approaching, we often see an increase of labor inductions. When medically indicated, inductions are a very useful option. But when done out of  convenience, they can come with additional concerns and risks for the birthing person and baby.

So how can you make an informed decision? The obvious answer is to talk to your care provider! Ask questions. Most care providers have no problem addressing your concerns. After all, they are working for you.

1. Why are they recommending induction? Are there health concerns?

2. How favorable is your cervix? This is a pretty big one actually. What is your [Bishop Score](http://perinatology.com/calculators/Bishop%20Score%20Calculator.htm)?

3. What are the methods of induction do they prefer to use? What are the benefits and risks of each method?

4. Will you be given the opportunity to [eat and drink as needed](https://evidencebasedbirth.com/evidence-eating-drinking-labor/) during the induction?

5. Can you get out of bed and move about to find positions that are comfortable to you? Is the tub/shower an option with induction?

6. What is their policy about possibly turning off the Pitocin once things get going? Are they open to slowly increasing the Pitocin?

7. Are you on a time limit? What sort of circumstances might affect that time limit?

These are just a few suggestions for what to ask your care provider when/if the topic of inducing your labor is brought up. Remember this: It is your body and your baby. 

Ultimately the decision is yours. With a supportive birth team, you can make informed and educated decisions regarding the birth of your baby.

How can you make an informed decision about induction? The obvious answer is to talk to your care provider! 

Considering an Induction

Birth Plan Basics

Don’t write a birth plan. Or do write a birth plan. But if you write one, make it thorough. But not too long! And not too short. Maybe a checklist? Make sure you’re not too friendly. Or too direct. Or….can’t you just skip this all together? So confusing! Let’s look at why you want to write birth your own preferences, what format works best for hospital births, and what to include. (Hint: No need to mention enemas.)


Your birth preferences are similar to a birth plan; they share what you want for your birth.  You’re not planning how to have a baby. You’re letting your birth team know what is most important to you and your family. In a hospital, the birthing person may have never met the nurse, midwife, or the obstetrician attending their birth. Birth Preferences introduce the family, sharing who we are, why we’re here, and what we need from you. If you’re fortunate enough to have your own provider attending your birth, you’ll have a quick and easy cheat sheet to share with them. Let your team know your expectations in writing.

So what should your birth preferences look like? What format to use? Online, we can find countless checklists or multi-page options. Your provider or birth place may even supply a sample. In reality, the best birth preferences are short, sweet, and customized for each family.


**Patient Information:** Name, DOB, Birth place, provider’s name, and people joining you go here.


**Introduction:** Share a little of your family’s story. What number baby is this? Does baby have a name? Are there special things the birth team needs to know about you or this birth?


Disclaimer: No matter how you phrase it, be certain to add in a phrase along the lines of, “These are our preferences in the event of a normal birth and postpartum. If for any reason a change of plans is needed, we’re happy to make different decisions after the briefest of consultation about options.”


**Labor/Pre-Birth for a planned cesarean:** Pick 3-4 things that are really important for your medical care during the time that you’re at your birth place, preparing for an imminent birth. They don’t need to know about your plans for Enya and burritos while you’re laboring at home. Just tell them what medical care is most important to you for labor or pre-op once you’re checked in at the hospital.


**Pushing and the birth of baby:** Again, choose 3 things or so to highlight here. Not sure what your options are for pushing? Check out [What’s missing from your birth plan](/blog/what-s-missing-from-your-birth-plan).


**Delivery of placenta and immediate postpartum:** What few things are most important to your medical care here? 


There are a multitude of medical care options for hospital births. Here’s where some of those online check lists or hospital samples come in! Browse through samples to identify which care options are most important to you and your family during your baby’s birth. Things to be sure to include:

* Positive language (I would like, I prefer, etc.) 
* Preferences for comfort (epidural, water, movement, etc.) 
* Preferences for medical care (saline lock, Pitocin, monitoring, etc.) 

Leave off:

* Automatic options that your birth place offers (skin to skin with baby, delayed cord clamping, rooming in, etc.)
* Obsolete options. I promise, there will be no enemas or shaving. Even if you ask nicely. Many online checklists are outdated. Check with your birth place for current options.
* Newborn preferences: Leave these off your birth plan. Instead, write them on an index card. Hand the card off to your baby nurse or place the card in the baby warmer before baby arrives.


Do write your birth plan; do make it short and sweet; and do prepare it well in advance of your actual birth. You’ll want to begin discussing these preferences with your provider at each appointment by 34 weeks of pregnancy or sooner.

The best birth preferences are short, sweet, and customized for each family. Here’s how to write yours.

Questions to Ask Your OB

Imagine you’re about to leave for your dream vacation. Sunshine, new places to visit –
you’re so excited for this trip! Since you’ve never been there before, you want an 
experienced tour guide. It’s your dream vacation and you want only the best! You’ve got a specific budget in mind. Tour Guide Mary (who has 5 stars on TripAdvisor) is on board 
with exactly what you want. You hire her,and now that you’ve got the top travel guide to 
handle the details, you sit back and daydream about warm weather, museums, and 
unique restaurants.

Unfortunately, when you arrive at your dream destination, it’s Tour Guide Mary’s day off. 
Tour Guide Tony is filling in for her and says he knows exactly what you want: the 
Typical Tour package. Instead of your ideal itinerary, the Typical Tour includes only touristy spots with big crowds and cheap souvenirs, and it’s three times the price of your dream vacation. There’s no room for negotiation, though. Tour Guide Tony is ready to go!

You feel disappointed and uncertain. This wasn’t what you had prepared for. You 
really got along great with Tour Guide Mary, and you thought she’d handle all the 
details. You really thought she’d be there for your special trip.

Your baby’s birth day isn’t exactly like a dream vacation… It’s much more important. It’s a day you’ll remember every year while you celebrate with this new person in your 
life! How do you want to remember that day?

Welcome your baby with the support and experience you’ve prepared for by asking 
these three simple questions at your next visit.

1. Hey, Doc, what do you think about…

Insert anything you’re considering for your birth here. You’ve been researching your 
options or you’ve heard from your friends or birth class about all kinds of things. You’d 
like to know what they mean for you and your birth. Open the discussion with your 
provider in a neutral way, and you’ll get your doctor’s honest perspective! What do you 
think about… cord banking? Birth photographers? Skin to skin with baby? Epidurals?

2. How many of your patients want the kind of birth I want? 

This is your chance to find out your doctor’s area of expertise. How many of your patients want an epidural/induction/unmedicated birth? Then, follow that up with, “How many of those patients get the birth they want?” Especially for families looking for a specific experience, this is important. If a provider says only about 10% of his patients want an unmedicated birth and only 1% of those 10% actually go on to have an unmedicated birth, is unmedicated birth this doctor’s area of expertise?

3. Will you be there?

Much like Tour Guide Mary, you have a chance to build a great relationship with your 
provider before your baby is born. You click! You like him or her, and that person you’ve 
selected specially knows what kind of birth you’re anticipating (since you’ve already 
talked about questions #1 and #2). But on baby day, will your provider be there? If not, 
who will be? Does the backup doctor(s) know what sort of birth you’re wanting? What is 
their area of expertise?

These questions will open positive communication with your provider. This is your birth and the first time you’ll meet this new little person in your life. Create a 
dependable birth team that supports your wishes. Your OB and your birth doula can 
help you experience a great Birth Day.

Welcome your baby with the support and experience you’ve prepared for by asking  these three simple questions at your next visit

Choosing Your Baby’s Lactation-Friendly Healthcare Provider

*Welcome Baby KC wholeheartedly supports however you need or want to feed your baby! Successful baby feeding looks different for every family. Lactation-friendly does not mean anti-formula. You’ll not hear us preach Breast Is Best or Fed Is Best. We’re not here to decide what’s best for you--only you can do that. We’re here to equip you to make informed decisions for yourself and your family so you can meet your unique goals.*

![Img](//a.storyblok.com/f/70793/4353x2902/e40aafe773/depositphotos_23072480_xl-2015.jpg)

“Looking for a pediatrician. Who do you recommend? I want someone who’s breastfeeding-friendly.” I see this question all the time. On social media, from my clients, in my personal circles. And if you ask the Internet, you’ll probably get a variety of recommendations because everybody wants to be helpful and thinks highly of the provider they selected for their baby.

But all of those recommendations can get confusing and might not answer YOUR questions. *Who’s going to support me and my baby with feeding? What if breastfeeding/chestfeeding is hard and I need help? How do I know which doctor is the best for us?* Keep reading to learn what defines “lactation-friendly” and to learn how to ask the right questions to get the answers you want.

Let’s unpack what lactation-friendly care looks like at the pediatrician’s or family doctor’s office:

* A lactation-friendly provider knows that **babies nurse for more reasons than just hunger** (tired, overstimulated, cold, cranky, etc) and won’t bat an eye when your baby wants to latch during the appointment. They may even offer you a pillow or may offer to continue baby’s exam while baby is latched!
* A breastfeeding/chestfeeding-friendly provider knows the **basics of lactation**: [Milk is made by supply and demand](https://kellymom.com/hot-topics/milkproduction/). The more the baby empties the breasts, the more milk the breasts will make. For this reason, a lactation-friendly doctor will recommend that you [follow your baby’s feeding cues](https://www.breastfeedinginsheffield.co.uk/mum-and-baby/baby-feeding-cues/) around the clock, including at night when your milk-making hormones are highest.
* We all love numbers. We like ounces (mLs for our international friends). We like baby tracking apps. We like filling up a bottle and seeing a baby drain it because then we know baby’s getting enough to eat. Breastfeeding/chestfeeding doesn’t work that way, though, and a lactation-friendly doctor knows and respects that! Instead, they’ll know baby is **getting enough milk** by asking about baby’s diaper count (5-6+ wets per day), their growth (5-7 ounces per week for newborns), their general mood (hungry babies are usually very upset or very lethargic; happy babies are generally content), and whether baby is meeting milestones.
* Most doctors and nurse practitioners receive very little (if any) education in lactation in medical school. But don’t freak out! That’s okay. A lactation-friendly provider knows their limits, and if feeding challenges arise, they’ll **give you a referral to a lactation specialist** called an Internationally Board Certified Lactation Consultant (IBCLC). They may even have IBCLCs staffed at their office! Bonus points if they give you information about the various FREE baby feeding support groups in your area.
* Sometimes baby really isn’t getting enough milk. A lactation-friendly provider will recommend nursing more frequently and/or **supplementing your own milk** before they recommend formula. And then they’ll get you into an IBCLC right away!

![Img](https://a.storyblok.com/f/70793/800x800/94cb245d25/lactation-friendly-versus-tolerant.png)

So how do you put that all together to find the **provider of your dreams**? Identify 3-5 providers close to your home who take your insurance or are within your budget. Schedule a prenatal consultation with them, and come prepared with your questions. *Well, what questions should I ask?* Choose some or all of the following to ask to gather more information about your selected providers:

* What percentage of your patients exclusively breastfeed/chestfeed? At 6 months? At 1 year? (for reference, read about national lactation goals for the US [here](https://www.cdc.gov/breastfeeding/data/facts.html))
* How do you handle feeding during baby's appointments?
* What do you think about nighttime feeding versus sleep training (teaching a baby to sleep all night)?
* How will we know my baby is getting enough milk?
* What percentage of your patients supplement lactation?
* If I need extra feeding help, which IBCLCs do you recommend?
* Which support groups do you recommend?
* What lactation education or experience do you have?

At the end of each consultation, jot down what you liked, what you didn’t like, and any new questions you might have. Once you’ve finished interviewing your selected providers, compare your notes and then choose one! If at any time you disagree with your baby’s provider or feel uncomfortable with a recommendation, it’s okay to suggest an alternative course of action, to ask more questions, or to ask for a referral to see an IBCLC or other specialist. It’s also okay to try out a completely new pediatric care provider. With these tools in hand, you’re well on your way to meeting your feeding goals!

How to find a lactation-friendly doctor or NP to support you and your baby.

RESOURCES

Pelvic Pain During Pregnancy

Lauren Letterman

Newborns Don't Need Much

Amanda Casey

Busy Bags for Busy Families

Welcome Baby KC

What's Missing from Your Birth Plan

Lauren Straight Letterman

Us vs. Them

Lauren Straight Letterman

Minimalist Birth Bag

Abigail Wagner

Early Signs of Labor… and Why You Should Ignore Them

Lauren Straight Letterman

Considering an Induction

Lauren Straight Letterman

Birth Plan Basics

Lauren Straight Letterman

Questions to Ask Your OB

Lauren Straight Letterman

Choosing Your Baby’s Lactation-Friendly Healthcare Provider

Amanda Casey, Postpartum Doula and Lactation Educator

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