Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood—and Trusting Yourself and Your Body

by Erica Chidi Cohen

Pregnancy is a prime opportunity to edit your script, because you’re already moving through an incredible change. Why not change the way you talk to yourself, and the way you talk about yourself? Editing your script and moving from a negative internal conversation into a more positive one is a huge part of feeling that you’ve got this.

I am not my past; I am unfolding in every moment.

Until you become pregnant for the first time, your body has always been only your own. Every decision you have made for your body has been motivated by your own needs and desires (possibly as influenced by societal expectations, media images, and peer pressure—still, the only person directly affected by your decisions was you). When you learn that you’re pregnant, suddenly you are motivated in two different (and sometimes opposing) directions as you begin to consider, “What’s best for me and what’s best for my baby?” It can take time to find balance in your mind—which may be the only part that still feels like you—and your body, which begins devoting more and more of itself to the needs of your baby.

You’ll start feeling like yourself—whomever that ends up being—very soon.

Create space for imperfection; in fact, welcome it. Becoming a mother is in part about releasing the need for control and accepting yourself just as you are.

Share how you’re feeling with your partner using “I” statements, which tend to make the speaker take responsibility for their emotions. This makes sense; after all, we can truly know only our own feelings. When we talk about anyone else’s feelings, thoughts, or behaviors (“you don’t love me” or “you don’t understand”), we’re just assuming these things are true. Share what you know—yourself—and wait openly for your partner’s answer.

An unexpected challenge creates space for unexpected strength.

“I am enough, my body is strong, my baby is strong, and we are surrounded by what we need.”

All birth is natural. It’s as simple as that. Growing a baby (or multiples!) in your belly, giving a new person(s) life and bringing them into this world is an act of nature, no matter what your means of delivery: unmedicated, medicated, or cesarean birth.

Intuition is: neutral, objective, subtle. Intuition is not: critical, shaming, fearful.

These are the medical reasons an induction might be offered to you: • Your amniotic sac has broken, but contractions have not begun after six to eight hours. • Your pregnancy is “post dates” (forty-two weeks or beyond). • Your amniotic fluid is low; this is assessed via ultrasound. • You have a health problem, such as high blood pressure, preeclampsia (characterized by both high blood pressure and protein in the urine), or gestational diabetes, that can be treated only once your baby is born. • You have chorioamnionitis, a bacterial infection of the two (amnion and chorion) amniotic sac membranes. • Your baby has a problem that can best be treated after birth. • Your baby has some problem that needs specialists present for the birth.

these reasons are not given as the basis for your induction, ask these questions: • Is there a clear medical reason for an induction? • What are the risks of induction for my baby and me? • What are the benefits for my baby and me? • What method of induction would be recommended? • What would happen if we decided not to induce labor? What protocol would I need to follow to have more time?

Prior to Surgery • If you cannot be conscious, ask that your partner hold the baby skin to skin immediately after birth, barring any medical complications with baby. • Request that your anesthesiologist use nondrowsy medications, so that you can be as present as possible. • So as not to interfere with breastfeeding, request that the blood pressure cuff be placed on your nondominant arm and the EKG placed on your back. • If you’d like to have music playing, create a playlist for the operating room.

Take three deep breaths into your belly and let your body begin to relax. Close your eyes, take another deep breath, and allow the relaxation to deepen. Touch your thumb to your index finger, think of the easy feeling you have right before you fall asleep, let your body be loose.

Touch your thumb to your middle finger, think of the best hug or loving touch you’ve ever received, feel the touch through your body. Touch your thumb to your ring finger, think of the sweetest compliment you’ve ever received, hear it right now, listen, and accept the compliment. Touch your thumb to your pinkie finger, visit the most beautiful place you’ve every been, your spot. Notice the temperature there, the warmth or coolness, the quality of the light, the smells. Stay there for a while and take a nice deep breath. BEGIN AGAIN Touch your thumb to your index finger, allow your pelvic floor to relax, breathe down through your belly. Touch your thumb to your middle finger, imagine your cervix opening and making space for your baby to descend into your pelvis. Touch your thumb to your ring finger, imagine a warm pink light connecting your heart to your baby’s heart. Take a breath to nourish yourself with that love; feel it pulsating.

Touch your thumb to your pinkie finger, think about holding your baby in your arms, stay with this feeling for a while, and breathe into your belly. REPEAT Visualizing your body opening and relaxing can empower you and make you feel like an active participant in your labor even as you relax. Remember, labor isn’t just happening to you—...

Know your limit, and know when to ask for help. Remember, soon you’ll have to care for your newborn baby—do what you need to do for yourself today in order to be up to the task for her tomorrow.

Housework With intermittent periods of bustling activity followed by crashed-out couch sleeping, you may find yourself looking around your home and wondering how everything got so chaotic. Even so: don’t do housework, for at least the first week. Right now, this is one of those chores that is best handled by delegation. Ask a close friend, family member, or your partner if they can shoulder it for the next few weeks—or, again depending on financial parameters, this is a great time to budget in some element of housekeeping. If you don’t have support, it’s helpful to limit your scope—keep one room or one area of the house clean, so that you can go there, away from the rest of the mess, to recharge and gather yourself in a calm environment. This is preferably the place where you’re nursing or feeding your baby, so you can relax and drop into that space without any distractions. If you do end up taking on a bit of housework, continue to keep in mind that your abdominal and pelvic organs are still healing; therefore, if you have to work, lie down on your belly for ten to fifteen minutes afterward to help support and soothe your uterus as it heals.

Take a deep breath. It’s OK, go ahead and supplement with formula for a few days. But here’s how you protect and boost your milk supply while you supplement. 1. Before each feeding, try and breastfeed first to give you and your baby another chance. If after five minutes the struggles you’ve been experiencing crop up, offer formula, preferably with you and your baby skin to skin. 2. After offering formula, pump for 15 to 20 minutes and hand express briefly to help stimulate your supply. 3. Repeat these steps at every feeding (so every 3 to 4 hours) until you start to see colostrum when you pump or hand express.

When to Get Help Call a lactation consultant or pediatrician immediately if your baby has: • A day with no wet diapers or bowel movements • Dark-colored urine after day 3 (should be pale yellow to clear) • Dark-colored stools after day 4 (should be mustard yellow, with no meconium) • Fewer wet diapers and stools, or nurses less frequently, than the goals listed in the Satisfied section (page 346) Or if you have: • Plugged ducts • Mastitis

In general and if all is going well, two to three weeks post-partum is a great time to introduce a pump (especially if you’re preparing to return to work). Of course, there are other factors that could get you pumping earlier: baby isn’t latching well, you’re experiencing mastitis, or if you need to relieve engorgement. Aside from those, it’s best to wait until you and your baby establish both your milk supply and a daily feeding rhythm.

Pumping one to two times per day should suffice to get a nice stock of milk for your baby. I like to advise new mothers to pump in the morning after the first feed and then again right before going to bed.

Aim to pump for at least ten minutes, but no more than twenty minutes. Ten minutes is enough time to stimulate

Warranty Choose a pump with a least a one-year warranty on the motor. Fit Your nipple will elongate and change in size as you pump. Make sure that the pump you choose comes with various sizes of breast shields so you can find the best fit (more on that shortly). Suction and speed The more adjustable your pump suction and speed are, the easier it’ll be for you to customize and find your unique settings. Look for a pump with at least two adjustable knobs. Power Choose a pump that can be run by batteries, a car adapter, and an AC adapter. Cleaning Check how many parts need to be washed and whether the hard-to-clean tubing ever needs to be cleaned.

Also, hand pumps are fairly inexpensive, so it’s a good idea to have one and be familiar with how it works in case of a power outage or as a general plan B.

Your milk can stay . . . . . . at room temperature for six to eight hours. . . . in the refrigerator for five to eight days. . . . in the freezer for two to six months. . . . in a deep freeze for six to twelve months. Bottles or Bags?

Gently swirl the milk to incorporate the fat deposits that may have separated.

Never shake the milk, as that can damage the molecular structure that is vital to your baby.

If your baby is under a month old, go with the formula recommended by your pediatrician, which will likely be ready-to-feed because powdered formula isn’t sterile, making it potentially taxing to young immune systems.

Do use filtered water and invest in a good carbon filter. If that’s not possible, use distilled bottled water. Three-gallon water containers with a spout at the bottom are an easy way to use purified water for your baby.

check the expiration date on the formula container; make sure it is not damaged, and write down the lot number in case of recalls.

Do store your mixed formula in the back of the refrigerator, where it is coldest.

Do discard any unused prepared formula after twenty-four hours in the fridge.

Don’t ever freeze formula.

Don’t use formula that has been at room temperature for more than two hours. If your baby doesn’t finish a bottle, discard the leftovers.

Hold your baby semi-upright or upright. Tap her lips with the nipple or gently drag the nipple from her nose to her upper lip until she opens wide. Never force the nipple into her mouth.

Hold the bottle at a slight angle, so the flow isn’t too fast. • Take a break every few minutes by tilting the end of the bottle so milk runs out of the nipple back into the bottle. Attempt to burp your baby during this break. Two to three breaks per bottle is ideal.

If you start feeding your baby on his left side, halfway through the feed switch sides and feed him on his right side. This simple move promotes visual stimulation and development of eye muscle strength.

Standard moist cleansing wipes shouldn’t be used on a newborn baby for at least the first two weeks. Their skin is simply too sensitive, even if the wipe is mostly water or marked for sensitive skin. Instead, use water on a cotton swab with a bit of grapeseed oil to remove anything particularly difficult like meconium. You can keep grapeseed oil in a pump bottle on your changing table. You can also make your own homemade wipes with the recipe that follows. When you do choose wipes, try to choose ones that are organic or have very few moisturizing ingredients.

While wonderfully soothing for your baby, pacifiers shouldn’t be used until after two to three weeks of life.

Don’t use pacifiers in the half-hour to hour before your next feed, so that you can observe hunger cues.

Once your baby’s umbilical cord falls off you can start by gently rolling baby into the tummy-down position after being placed on her back.