We’re linking up today with Ooh Amanda’s Top Ten Tuesday. Check out her blog for more fun and practical top ten lists.

10. The First Flicker

When a patient comes in for their first pregnancy visit, I usually do a sonogram.  At 6 weeks, when the baby is smaller than a grain of rice, the heart beat is first visible as a tiny flutter. Miscarriages are very common, so I’m always a little nervous for the patient as I turn on the machine, but when that flicker pops up on the screen, both myself and the patient both exhale a little. Sometimes they tear up, other times they smile and stare in wonder at miracle life growing inside them. No matter the patient response, seeing that tiny flicker signifying the beginning of life, makes me grin from ear to ear.

9. Patients Who Follow Directions

Doctors get a lot of flack for being ‘pill pushers.’  I read a recent FB post where a women was complaining that her doctor never talks to her about diet or nutrition, he only prescribes her medication. {Ironically she had posted a picture earlier that day of the giant cheese burger and fries she was eating}.  I have the opposite complaint.  For every 50 people that I discuss exercise,  lifestyle changes or quitting smoking, probably only about 1 actually does it.  When I see someone back for their annual and they have quit smoking, finally lost the weight or started exercising it’s all I can do to contain myself from breaking out into a happy dance.  It makes me want to hand out gold stars.

8. Surgery

People think of OB/GYNs as delivering babies and doing pap smears all day, but we also do a lot of surgeries: cesarean sections, hysterectomies, laparoscopies, etc.  This is something I really enjoy. Surgery is interesting intellectually and fun to do.  It’s also satisfying to be able to solve a problem:  you have a giant cyst that hurts? I cut it out, you feel better.  All done!

7. When an Appointment Type Changes from ‘Discuss Infertility’ to ‘New OB’

We always run a pregnancy test when patients come in for infertility testing.  Every once in while it will come up positive.  That is always a great day!

6. Relationships

At the beginning of each day I scan my list of patients to be seen that day and some names just bring a smile to my face. I’ve been in practice for almost seven years now, so I have gotten to know some of my patients pretty well.  I’ve seen them get married, have a couple babies and watch their babies grow through the pictures they bring in at their visits.  When you have taken care of women through 2 or 3 pregnancies you get to know them pretty well.  Then, when they come back later for their checkups, it’s so fun to catch up on their lives.  I have to watch myself that I don’t get too chatty or I can run behind, but I do really enjoy the relationships I have formed over the years.

5. The Perfect Call

Those of you that already have babies are probably familiar with that slightly panicked feeling you get the first time your baby sleeps through the night. You wake up (on your own), glance at the clock  and realize with a shock that it’s morning. “Wait? but I never got up with the baby,” you think as you run to the baby’s room to make sure he’s OK.  Did my husband get up with him? Did I sleep too soundly and not hear his cries? Then you see him sleeping peacefully in his crib, and you realize that a wonderful, wonderful thing has occurred:  your baby has slept through the night!

I’m on call every 4th night. Most of these nights include middle of the night phone calls and/or deliveries at 4 am.  That is fine. That’s my job. I love delivering babies… even at 4 am. But once in a blue moon there is a magical call night. I will awake in the morning with a feeling of  slight panic as I check my phone to make sure I didn’t sleep through any calls, only to realize that it was a perfect call.  No pages. No babies. Just wonderful precious sleep.

4. Never Being Bored

As a child, one common complaint I had for my mother was, “I’m Bored!”  This is not a phrase I have uttered in a long time. This morning as I was eating my cereal, I got a call form the hospital, ” Your patient just arrived and she feels like she needs to push!”.  Twelve minutes later I was in a hospital room delivering a baby as I caught my breath, having literally run from the parking lot.  I enjoy the variety of things I get to see, and if I am truly honest with myself, the excitement as well.

3. Surprise Gender Births

Growing up I, like everyone else,  would watching people have babies on TV shows.  The TV doctor (who was always a man) would hold up the baby and say, “Its a Boy!” and the room would cheer.  Nowadays, most couples find out the gender of the baby at the ultrasound appointment, so the ultrasound tech is the one who gets to tell the fun news.  I feel a little betrayed by TV doctors on this matter.  On the rare pregnancy that a coupe has kept it a surprise until birth, I get really excited.  I FINALLY get to say, “Its a Girl!” to a room full of cheering family. This is a job I take very seriously and get very excited about. I encourage  patients not to find out… but alas they usually don’t listen.  However, on the rare occasion they do, it’s really fun.

2. Telling Someone They are Having Twins

There is something so very fun about telling someone they are having twins.  They almost always freak out.  When you point to those TWO flickers on the ultrasound screen, it transcends all language barriers. People just go into joyful shock.  I once had a woman scream so loud that the entire office rushed into the room thinking something was wrong. Sometimes incredulous, joyful laughter occurs, other times they are speechless. Whatever the response it is the best thing ever, well at least the second best…..

1. First Breath

I’ve delivered a lot of babies over the years, but I still love it when the miracle of life happens before my eyes:  the baby takes its first breath of oxygen and begins to cry.  In those precious moments of birth I have a lot going on, my mind is going through multiple checklists to make sure mom is healthy and doing well.  But for a few seconds, as I lay that precious baby in the mom’s arms, I just let myself soak up the parents’ joy and wallow in the miracle of life.  I still shed a tear from time to time (especially when the dad starts bawling, that always gets me). I continue to count it a privilege that women honor me by allowing me to be a part of their births.

My Mommy & Me

Dear Mom,

I’m so SORRY for all the times I THREW UP on you, POOPED on you, WOKE you up in the middle of the night, JUMPED on my bed after you repeatedly told me not to, acted BORED when there was plenty for me to do, REFUSED to eat the food you worked so hard to provide, acted UNGRATEFUL or SELFISH, blatantly DISOBEYED, INTERRUPTED when you were trying to talk, thought you DIDN’T KNOW ANYTHING, acted like I DIDN’T NEED YOU, FORGOT to say ‘I Love You’. . .

I finally know how you felt.

Please forgive me.

Well gotta go, the kids are screaming. . .

Love,

Your older and (hopefully) wiser daughter

7 Week Ultrasound

Dr. Rupe shared a wonderful, comprehensive list on what to know while waiting for your first OB appointment last week. It was chock full of helpful medical facts and guidelines for you to follow even before you ever set foot in a room with the person who will deliver your baby. For all you information junkies, this list will hopefully fill your craving for knowledge as you wait for your 6-10 week check up.

As I was considering what to write about this week, I felt an overwhelming pull to follow up Dr. Rupe’s post with encouragement on what to set your mind on while waiting for that first appointment. If, like me, you have suffered pregnancy loss you may be very guarded during these first few weeks.  Perhaps you’ve never experienced loss but this is your first pregnancy and you’ve heard so many stories about loss that thoughts of the possibility are consuming your mind. Your reservations and your fears are understandable but they do not have to rule your heart.

5 Things Your Heart Needs to Know While Waiting for Your 1st OB Appointment

1. He is holding your baby’s life together in his capable hands {Colossians 1:16-17}.
2. He knows every concern in your mind but bring them to him so he can help you deal with it.
3. Worrying about it will not change anything. It will only make you miss out on the miracle happening inside you.
4. Now is the time to begin praying fervently for every little piece and part of your growing baby. These early stages of growth are so intricate. Cover    them with prayer instead of fear.
5. Faith and fear cannot dwell in the same place. Let faith in to push fear out.

{from, The Pregnancy Companion Introduction}

Now, before we jump into all of the stats, rules, and regulations, here’s what I want you to do. I want you to take a deep breath. In and out. Slowly. (This is good practice for your impending labor.) Breathe in slowly. And with that breath, I want you to take in a fresh infilling of the Spirit of God. Allow him to permeate your entire being and fill you with fresh faith, peace, and perspective. Now breathe out. Slowly. And with that release, I want you to let go of every concern or fear you’ve carried up until this point and every concern or fear you might be tempted to carry over the next nine months. Let go of every question, every symptom, and every insensitive, stupid thing your friend or family member will say to you. Let it go. Let it all go.

You see, when you allow God to come and fill you with his peace, there is no longer room for your fears. Faith and fear cannot dwell in the same place. So let him in and push fear out. Remember this exercise every time you encounter fear on this journey. You will likely encounter fear or worry or anxiety at some point. The important thing is not to give it place in your mind or your heart.

We are always praying for the mommies-to-be in our community so know that you are covered during this time of waiting. I know it can be hard, believe me! But a peaceful body is the best place for your baby to flourish so commit yourself to promoting peace within your heart and mind.

Rejoicing in the miracle with you,

Jessica

From the first moment you see the test turn positive until you sit down with your doctor for the initial appointment, the waiting can sometimes feel like an eternity. Some of you will spend those weeks worrying if you really are pregnant since you feel so normal.  For others, the pregnancy symptoms will be so severe that you will be desperate for some relief. The following is a list of common concerns that I get asked about at the first pregnancy appointment as well as some helpful hints for common symptoms.

Vitamins
If you are not already on a prenatal vitamin, then please start one as soon as you find out you are pregnant. Folic acid is the most important ingredient in a prenatal vitamin. We recommend 1 milligram of folic acid per day during pregnancy. Taking folic acid can significantly reduce the risk of birth defects like spina bifida. If someone in your family has had a baby with spina bifida you may need to take higher doses of folic acid, so talk to your doctor.

One common question of expectant mothers is “Do I need a prescription prenatal vitamin?” The main difference in over the counter and prescription prenatal vitamins is a higher dose of the all-important folic acid that is included in a prescription vitamin. They have 1 mg, whereas most over the counter prenatals have 600 micrograms. Other “extras” that come with a prescription strength prenatal vitamin are stool softeners, special coatings to help you swallow, DHA (for brain development) and a special form of iron that causes less stomach upset. It’s usually easier to take the prescription prenatal because it has everything you need and it’s easier on your stomach. If it’s too expensive you can take the over the counter prenatal and simply add a folic acid and DHA supplement. It is important to note that folic acid is best absorbed as a supplement rather than its natural source.

You can take too many of some vitamins (like vitamin A) so you should not add additional supplements in pregnancy without talking to your doctor first. I’ve heard lots of women say that their prenatal vitamins upset their stomach so they took ‘a few’ Flintstone’s chewable vitamins instead. This is probably not a great idea because as I said, you can have too many of some vitamins. A better option would be to take one Flintstone chewable and then an additional folic acid supplement if you really can’t tolerate prescription prenatals. Here is link to a company that sells prenatals by mailorder for less than you can usually get them at the pharmacy: http://www.vitamedmd.com

Nutrition
Pregnancy should be a time of very purposeful, deliberate eating. Look at how many calories your body needs, and fill those calories with the most high yield nutritious foods. There are several websites that will tell you the amount of calories you need for your height and activity level. www.choosemyplate.gov is a good site that will give you a sample food pyramid based on your caloric needs. The best strategy is to plan ahead. Focus on getting 5 servings of fruits and vegetables a day with at least one of those vegetables being a dark green or leafy vegetable (sorry pickles don’t count). Drink lots of water. Around 8 glasses a day is ideal. Also make sure at least half of your grains are whole grains. You only need an additional 100 calories a day in the first trimester, so you not need to increase the amount of food eaten at this point.

Food Precautions:

Meat. All  meat should be well cooked. Raw sushi should be avoided as well as rare and medium-rare steak.

Alcohol. There is no known safe amount of alcohol during pregnancy so please discontinue all drinking.

Fish. Shark, swordfish, king mackerel, and tilefish contain high levels of mercury. It is recommended that they be avoided while pregnant. Salmon and tuna should be eaten in moderation. Please note that fish sticks and fast food fish sandwiches are in general made from low mercury fish. See the following link for a complete breakdown of fish safety. http://womenshealth.gov/publications/our-publications/fish-facts.pdf

Caffeine. Caffeine intake should be limited to 200 mg a day during pregnancy.

Unpasteurized food. Cheeses, milk and juices should all be fully pasteurized.  Soft cheeses such as feta and bleu cheese are some times sold in the unpasteurized form, so read labels.

Listeria associated foods. Several different foods have been associated with outbreaks of Listeria bacteria, which can be associated with miscarriage and bad pregnancy outcomes.  While the overall incidence of this bacteria is extremely low, precautions should be taken to make sure that all vegetables are thoroughly washed.  If a food cannot be well cleaned (such as fresh sprouts) it should probably not be eaten. Deli meats should be eaten only if fresh and for added precaution can heated in the microwave until sizzling to kill any possible contaminating bacteria.

Other precautions:

Smoking. Please stop smoking immediately when you find out you are pregnant. Smoking is associated with an increased risk of miscarriage, stillbirth, preterm delivery and fetal growth restriction. If you smoke more than a pack a day and are having difficulty quitting, talk to your doctor about whether the nicotine patch would be appropriate for you.

Cats. Toxoplasmosis is a parasite that can live in cat feces. If it is contracted during pregnancy it can cause severe pregnancy complications. You should avoid handling cat litter or being in the room when the cat litter is being changed. You can still pet your cat and be in the same room as the cat litter if needed.

Exercise. We recommend you stay active during pregnancy. This helps you maintain your overall stamina, avoid excess weight gain and decreases your risk for gestational diabetes. If you are not already active, then I recommend you start walking or swimming 30 minutes daily, or at least 5 times a week. As you exercise, you want to maintain your heart rate at under 150 beats per minute. This is an exertion level of about 6-7 (on a scale of 1-10). At this level you should still be able to talk.

If you are already active in an exercise routine such as running or aerobics, you can usually continue with the above modifications. Make sure to keep your heart rate under 150. It is also a good idea to maintain your flexibility and strength. A prenatal yoga or pilates class (or DVD) can help you maintain your core muscles to help reduce the back pain associated with mid-pregnancy. After 15 weeks, exercises that involve laying flat on your back should be avoided. Additionally weight lifting should be limited to under 40 pounds.

Heat. There are a few things that are known to cause malformations at this stage of development. One of them is extreme heat. This is a time when it is especially essential to avoid hot tubs or very hot baths (higher than body temperature). Having a high core temperature in early pregnancy has been shown to cause malformation of the spinal cord. If you have a fever at this time it is best to take acetaminophen (Tylenol) to help keep your temperature down. If that does not lower your temp, call your doctor.

Medications. Be cautious of taking any medications that might interfere with the development of the baby. Check with your doctor before taking any additional medication: prescription, over the counter, herbal supplements and/or additional vitamins. Thyroid medication and asthma medications are probably the most common medications that women can take in pregnancy. They are safe for the baby and can be harmful if discontinued suddenly.  If you care taking any other mediation, then notify your doctor’s office to determine if it is safe to continue.

Medications that are generally accepted as safe in pregnancy:

Tylenol

Benedryl

Guafenesin

Throat lozenges

Tums

Volace

Milk of magnesia

Immodium

Other things that are considered safe:

Hair dye has not been proven to cause malformations because it is minimally absorbed by the skin. Coloring your hair is considered safe, but if you want to be overly cautious you can wait until you are 12 weeks along.

Self-tanning lotions are also minimally absorbed and are considered safe to use. We always recommend you stay away from tanning beds and this applies during pregnancy as well.

Regular cleaning supplies are fine (sorry, I can’t give you an excuse to get out of your housekeeping). Just make sure you keep all areas well ventilated while cleaning. Avoid solvents such as paint thinner. Use common sense, if a chemical requires specialized disposal, you probably shouldn’t handle it while you are pregnant.

Most cosmetics and lotions are safe. If you use Retin-A, you should probably discontinue use during pregnancy. If you have questions about any prescription lotions, ask your doctor.

Sex is safe as long as you are not having any bleeding or complications.

Symptoms

Cravings. If you are craving a specific fruit, then go with it. If you need a Hershey’s bar every afternoon then you may need to slow down. I tell patients to give into their ‘bad’ cravings once or twice a week, just not once or twice a day!

There are weird cravings that could be a signal that something abnormal may be going on. For instance if you crave plain ice all the time, you could be anemic. Also some women will crave dirt or laundry soap, as well as other non-foods. This could be a signal of specific vitamin deficiencies. If this is the case inform your doctor. Needless to say, don’t give in to these ‘bad’ cravings!

Fatigue. I think fatigue is the least discussed early pregnancy symptom. Everybody knows about the “morning sickness,” but sometimes fatigue can be the most debilitating symptom in early pregnancy. The source is thought to be a combination of the high levels of HCG and Progesterone. But whatever causes it, from about 6 weeks to 12 weeks most pregnant women just want to sleep. Like 12 hours a night…and then take a nap later. If you can get away with it, go for it. The good news is that fatigue and nausea seem to get better after 12 weeks.

Links to discussions on other symptoms:

Nausea

Constipation

Vaginal Discharge

In our book I go into greater detail on all these issues and symptoms, with Jessica adding a faith based perspective on how to journey through pregnancy without fear. If you are looking for additional resources,  I also recommend the ACOG Pregnancy Guide.

Hopefully this post will help fill the information gap that may crop up during those weeks between peeing on the stick and your initial pregnancy appointment. As an obstetrician, I love seeing patients for their first pregnancy visit. The joy and excitement on their faces when they see that first tiny flicker of the heart beat on the sonogram, still melts my heart.  Thank you for letting us be a part of your journey and congratulations during this exciting time in your pregnancy.

If you ‘like’ us on Facebook or follow us on Twitter, you’ve seen my New Mom Tool of the Week posts over the past 6 months. These are items that I have loved having around since welcoming baby #2 back in July. It’s funny how, as a brand new mom welcoming baby #1, we have a long list of must have items that we see online or in magazines. I think with each subsequent child, however, we learn that less is more and we tend to gravitate towards the absolute ‘must haves’. There are many items I thought I needed when my first child was born that I am doing just fine without the second time around.

Those ‘must haves’ will vary from mom to mom because, let’s face it, we all have different lifestyles and preferences. We could probably sit around and chat for hours about our favorite baby items and why we just can’t live without them. I’ve asked several moms of multiple young children and these are the items we simply can’t live without. I’ve noted the approximate cost of these items along with some money saving tips as well as the time frame you are likely to use the item. So much of your baby gear is used temporarily (like 2-6 months) so it’s helpful to know how long your invest is going to last.

This list is, of course, in addition to general items such as clothing, various linens, a crib, bottles (if bottle feeding), etc. If you have our book, these special items would fall under the “Would Be Nice To” haves or the “Everyone In Hollywood” haves that I write about in Chapter 7.

Thank you to Facebook friend Bethany for the wonderful reminder that above all else, grace and wisdom are the two most important tools for any new mom. And you can’t find them at Babies R Us or your local consignment sale. Those tools come only from your relationship with God so remember to pray first and foremost as you go throughout your day with baby!

1. Graco Snap & Go Stroller – Twitter friend @mommyzabs seconds my vote that this is the way to go for an infant stroller. The Snap & Go is a frame that carries your infant seat so you simply pop the seat out of the car and into the frame without moving or disturbing baby. I found this much easier than a separate stroller and very compact. Several companies make these frames so find one that is compatible with your preferred infant seat. For baby #2 I purchased the double Snap & Go stroller and we love it! There is a place for my preschooler to sit and once baby is out of the carrier, there is a full seat for him up front.

Approximate Cost: $50-$75 (for the single) depending on where you buy and what brand you land on. These are pretty easy to find at consignment sales or wait for a sale or coupon at Babies R Us.

When You Will Use It: 0-9 months, possibly longer if baby is small.

2. Baby Monitor/Video Monitor - Facebook friends Carrie and Shawn love their baby monitors. Shawn shared that although the video monitor is more of an investment, it’s worth it to be able to see baby while they are sleeping. Either way, the peace of mind that comes with hearing (or seeing) your baby while they are sleeping is worth the investment.

Approximate Cost: $35-$200 depending on brand (video monitors are between $100-$200). This is a good item to look for on Craigslist but make sure it works well before purchasing. I would not recommend buying an item like this at a consignment sale because there is no way to ensure it works before purchasing. Sign up for Amazon Mom and watch for weekly deals on high dollar items like this.

When You Will Use It: We still use a monitor for our 3 1/2 year old. It’s just helpful to hear her, especially when she is sick.

3. Swaddle Blankets – Our mommies love their swaddle blankets and it’s pretty unanimous that Aden + Anais are the blanket of choice. Facebook friends Claire and Colleen shared how much they love their Aden + Anais blankets. I couldn’t agree more. I don’t know what I did with baby #1 before they were around. These muslin blankets are soft, lightweight and worth the price. Target sells a few exclusive packs or you can purchase directly off of their website (more choices). Perfect for summer babies since they are light and breathable! They are a great, larger size so you can use them as baby grows.

Approximate Cost: $35-$50 (pack of 4)

When You Will Use Them: As long as possible!

4. Boppy - If you think the Boppy is only for breastfeeding, you are missing out! Facebook friend Brandi shared how she uses her Boppy for everything. Once again, I couldn’t agree more. Brandi used her Boppy as a neck pillow in the hospital (brilliant) as well as for nursing, sitting support and tummy time support for her little one.

Approximate Cost: $35-$50 for new pillow and cover but this is a great item to pick up at a consignment sale.

When You Will Use It: 0-10 months

5. Hylands Teething Tablets - This is one of my picks for mommies. Hylands went away between my two little ones but are back and better than ever with a new formula (perfect timing for me). These homeopathic tablets really do sooth teething babies.

Approximate Cost: $6-$10

When You Will Use Them: Approx 3-4m until baby stops teething

6. Sheet Savers – This is one of those items that some new moms don’t know about. I want to shout it from the rooftops and I think Facebook friends Angela and Carrie would join me. No one wants to change a crib sheet in the middle of the night (believe me it’s hard). Sheet savers are truly life savers! You can use the small size or the ones that cover the entire surface (I write about these in the book). Either way, they will save you the trouble of changing a hard-to-remove crib sheet at 2am enough times to warrant their price!

Approximate Cost: $8-$20 depending on size

When You Will Use Them: 0-12 months at least

7. Infant Carrier/Wrap – With my first baby, I didn’t use an infant carrier. She simply did not like it. With my second the need for two hands to care for my 3 year old outweighed his resistance to it. Many moms swear by the convenience and comfort of infant carriers and would recommend using them from the get go. Like anything, the more you use it, the more baby will become comfortable with it. There are many types of carriers on the market including wraps and slings. Facebook friends Mindy and AnnRose love the Moby Wrap (this is the one I used for my baby boy) while friends Adina, Kemmely and Grace @ourarmswideopen love the Ergo Baby carrier. You will need to do your research and find what works best for you. But we definitely recommend taking the time and making the investment in this helpful tool. . .especially for baby #2 and beyond!

Approximate Cost: $40-$200 depending on carrier (wraps are less expensive options). These are great items to pick up at a consignment sale. I got my Moby Wrap for 1/2 the price used. Just make sure with more involved carriers that all pieces are in proper working order.

When You Will Use It: 0m-2years depending on carrier choice and baby’s size. Wraps can typically be used sooner however the Ergo Baby has an optional infant insert.

8. Breast Pump - If you are planning to breastfeed your baby then a breast pump in a must (unless you plan on never leaving their side during the first year). They are expensive but worth the investment. If you have trouble with your milk supply, a pump can also aide to keep you flowing until your supply picks up. Since I knew I would have trouble with my supply due to a surgery I had years ago, I used a breast pump for a month after baby was born to get as much milk as I could for my babies. I chose to rent a pump from our hospital medical supply since I knew I wouldn’t be using it long term. Breastfeeding moms would tell you to invest in an electric (non manual) pump if you can. And a double pump is much more efficient than a single. Believe me, you’ll appreciate getting it done in one shot when you are juggling a million things as a new mom. Twitter friend Grace @ourarmswideopen loves her Lansinoh pump and @SarahCaitS chose Medela. Once again, do your research and find the pump that you think would work well for you and is in your budget.

Approximate Cost: $200-$400 for double, electric breast pump, $60-$150 for single electric. $40-$50 for single or double manual pump.

When You Will Use It: 0-12m or as long as you breastfeed

9. Nursing Cover – Facebook friends Claire and Colleen could not live without their nursing cover. If you want to be discreet while feeding in public, a nursing cover is a must!

Approximate Cost: $30-$50

When You Will Use It: 0-12m or as long as you are breastfeeding

10. “Baby Stations” – A swing, a bouncy seat, a playmat and/or an exersaucer. . . I like to call these items “baby stations”. Because baby’s attention span in only a few minutes, you will find yourself moving throughout these stations with baby as you go through your day. If you have room in your budget, I recommend purchasing a few of these items to offer baby variety and you as much time hands free as possible. But these tools are not only about passing off baby for a few, sacred, hands-free moments. These toys help baby explore color, shapes, sounds and the world around them. Twitter friend @SarahCaitS chose her swing as a favorite. Facebook friend Bethany loves her bouncy seat while Kristy recommends a playmat and Crista swears by an exersaucer. These items vary in cost and appropriate age of use so think about your budget and what you will need throughout baby’s first year when deciding what to purchase.

Approximate Cost: Swing $75-$200 depending on size, Bouncy Seat $30-$70, Playmat $25-$75, Exersaucer $50-$120. These are all good items to pick up at a consignment sale or to borrow from a friend who is not currently using them.

When You Will Use Them: Swing 0-9m, Bouncy Seat 0-6m, Playmat 0-12m, Exersaucer 3-12m

11. Soothing Sounds – One of the most important tools you can have in your tool box for baby is anything that promotes peace in your home. Babies can sense stress and tension so the more peaceful you make your environment, the more peaceful they can be. As I write this, my 6 month old is watching a Praise Baby DVD. Twitter friend @mommyzabs and Facebook friend Crista both shared that they love worship music for their baby.  Kemmely shared that her baby loved their womb sound machine. Whether going throughout your day with worship music as your soundtrack or putting baby down for a nap and nighttime with a sound machine or lullabies, soothing sounds are a must for every mom. One of my personal favorites is the Rock A Bye Baby Collection. Sweet and soothing renditions of YOUR favorite music mom, including Coldplay, U2 and others!

Approximate Cost: Sound Machine $20-$50, CD/DVDs $10-$15

When You Will Use It: At least the first 3 years!

12. Baby Schedule Tracker – While in the hospital after having my second baby, the nurse instructed me to write down when baby ate, slept and pooped. She told me to do this for about a week. Then she jokingly said, “If you do it any longer than that, you need to get a life.” Facebook friend Shawn and I would definitely disagree with that statement. With the horrible effect that having a baby has on the brain, new moms cannot be expected to remember anything. . .even the last time they fed their little one. I found a schedule tracker so valuable for at least the first 3-6 months. Once baby was sleeping more consistently and eating regular meals, I was able to transition out of this practice. But before then, I simply had to write everything down. My personal favorite schedule tracker is The Essential Baby Organizer while Shawn loved her electronic Itzbeen Baby Timer.

Approximate Cost: $15-$25

When You Will Use It: 0-6m or possibly longer

Some other items suggested by our moms for baby’s body. . .Facebook friend Jessice loves California Baby Calendula Cream for babies with Eczema and Carrie loves Aquaphor for everyday use. I personally have really enjoyed Johnson’s Natural line this time around for baby wash, shampoo and lotion.

We’d love to hear from other moms on essential items that did not make this list. What other tools do you believe new moms (especially moms with 2+) need in their toolbox?

{No, we are not closing the blog or taking the book off the shelves. Keep reading and you’ll see exactly what “shop” I’m closing up this year.}

My sweet miracle boy

As I write this, I am sitting in Dr. Rupe’s office waiting for a procedure that will permanently prevent me from becoming pregnant again. It seems oddly monumental to be putting an end to my season of infertility and child bearing. After all of the longing and waiting and struggle, it’s almost ironic to be “closing up shop” as I like to say.

I hope that this post does not create controversy. I’m simply sharing my story, not trying to posture my beliefs on birth control and pregnancy prevention. It’s an extremely personal decision that should be deeply covered in prayer. My husband and I feel very peaceful about our decision. We believe the Lord has completed our biological family (we are open to adoption in the future) and with my history of miscarriage, it feels almost irresponsible for me to get pregnant by surprise. So we are taking the steps we feel led to take in order to close this chapter of our lives and peacefully move forward.

Part of me is excited to move on…to put all of the energy I used to spend on hoping and praying for children into loving and leading them. Yet, there’s a part of my heart that is grieving…the hope, the excitement and the joy of new life. Never again will I feel those tiny baby flutters inside my belly. Never again will I experience the breathtaking miracle of childbirth. As long as it took to travel this road and as hard as the journey was, in hindsight it was a mere blink of the eye.

“So as the sufferings of Christ overflow to us, so through Christ our comfort also overflows.” 2 Corinthians 1:5

My dad and I were talking this morning about how suffering was built into the cross of Christ. It was part of his story and thus it is part of ours. But the purpose of our suffering is to bring deeper intimacy with Jesus. I’ve said it before but I’ll say it again…I often miss the sweetness that came with the sorrow of infertility and loss. It drew me so close to Jesus. As I stand here, at a major crossroad of my adult life I pray that I can take what I’ve learned about suffering and carry it with me through every season ahead of me. In those moments when I feel like a mothering failure…when I think my children will never “get it”…someday if I lose a loved one…or if we hit a financial hardship…may I allow the reality of his presence to carry me through. Whatever it takes to keep me desperately clinging to him, that I will joyfully bear.

Thank you for allowing me to share my journey so openly here. It’s been wonderfully therapeutic to get it all out in the blogosphere and I feel like I’ve been surrounded by a community of women – some on a similar journey and some on an altogether different path – all cheering me on from the sidelines. I pray this blog does the same for all of you no matter where you are. We are in this together and once we are on the other side of child-bearing, we can hopefully walk together in child-rearing {Man, do I need support there! And I thought getting pregnant was hard…}.

My deepest desire for this blog is to use what he has taught me through this journey to love and support all of you. I am committed to hearing from him on all he has for me to share in the future. But that does NOT mean we will stop talking about infertility, miscarriage and trying to conceive. That is part of both my and Dr. Rupe’s hearts and stories and it’s a large part of the reason we wrote the book and started this ministry. I suppose this post is a bit self-indulgent. I just felt I needed to express my innermost thoughts and utmost gratitude to you, my Pregnancy Companion community. Thank you again for walking with me.

Looking forward to where he leads next,

Jessica

With all of my patients, as they enter the third trimester, I discuss what their contraceptive plans are for after the baby is born.

Many smile a beautiful, blissful, glowingly pregnant smile and say, “Oh no. I don’t think we will ever use contraception again.  Hopefully we will get pregnant again right away!”

Fast forward to their postpartum visit. A sleep deprived, exhausted new mom sits before me. Her first topic of conversation: contraception.  While she is madly in love with her new baby, the thought of having another right away is a little overwhelming. She is not physically ready to go down that road again.

Some women are ready right away. I once had a women ask me at delivery when she could try for another baby. My answer, “Well, you at least have to wait for me to get the placenta out!”

The decision on when to try for your next child, obviously depends on many factors. Finances, age, personal goals and beliefs on contraception are just a few. I was recently asked on our FB page what the ideal timing between pregnancies is from a medical stand point. According to studies looking at pregnancy outcomes, it is best to conceive 18 months to 4 years after your last delivery.

I find it interesting that the ‘optimal’ time for conception of the next child is about 18 months since this is when children are truly at their most adorable. Full of toothy grins and giggles as they toddle around.  This stage of ultimate cuteness entices people to have another baby. They then proceed to conceive before their child hits the ‘terrific twos.’ Which while adorable, at least in my house, is a challenging time.

Pregnancies conceived less than 18 months since the last delivery have an increased risk of preterm delivery and low birth weight. Pregnancy takes a lot out of your body, and it takes time for a woman to recover from the stress and for her nutrient supplies to get back to normal. The theory is that the body has not fully recovered at less than 18 months causing the baby’s extra risk of not growing as well (low birth weight). The risk of preterm delivery is further amplified in teens who conceive again quickly, since teens have often used their nutritional supplies on their own growth as well as their baby’s.

VBAC: Women who attempted a trial of labor after a cesarean section have an increased risk of uterine rupture if the pregnancies are less than 18 months apart.

Pregnancies conceived less than 12 months since the last delivery have an increased rate of placental abnormalities, such as placenta previa and placental abruption. Placenta previa is a condition where the placenta covers the opening of the cervix making vaginal delivery unsafe and increasing the risk of hemorrhage. Placental abruption occurs when the placenta begins to detach from the uterus before the baby is delivered.  It can result in hemorrhage and fetal distress.

Pregnancies conceived less than 6 months from delivery have an increased rate of neural tube defects and autism. Neural tube defect is associated with low maternal folate levels, so most likely in pregnancies less than 6 months apart, the mother has not had time to fully replenish those supplies.

Pregnancies conceived greater than 4 years from the last delivery  have an increased rate of preeclampsia, fetal growth restriction and cesarean section. It is unsure why this increased risk is seen other than the possible health changes in the mom over this time.

The actual ‘increased risk’ in each of the cases is statistically significant but overall low for the average woman. Take preterm delivery, the risk increase with conceiving early is 20%. For the average mom with no history of preterm birth, this changes her risk from 1% to 1.2%, which is negligible. However, a woman with a previous preterm delivery sees her risk go from 15% to 18%. These increased risks are most significant for those moms who already have risk factors for these conditions.

For the average healthy mom with no medical problems and a vaginal delivery, the increased risks of these complications with conceiving again soon are extremely low. Women with a cesarean section should wait 18 months for their scar to fully heal, especially if they desire a trial of labor (VBAC). Those with a history of pregnancy complications listed above are advised to wait the suggested interval before conceiving.

Lots of prayer and being on the same page with your spouse should be at the forefront when you are making the decision on when to have another child. But knowing the medical facts is equally important for making sure you are ready – both body and mind – to grow your family.

From a practical standpoint, we’d love to hear from our readers who have multiple children on how the timing worked for you.

I can hardly believe this year is almost over! It’s been a very full year for my family….including sad loss, miracle life and a ton of transition. The fact that we’ve come to the end of 2011 in one piece, full of joy and excited about the future is a great testimony to the grace of God!

Earlier in the fall I wrote a post about family prayers, sharing how the Lord led me to write and pray specific prayers over my husband and children in order to contend for specific things in their lives while celebrating the uniqueness of each of them. I want to revisit the idea and challenge us all to write and pray specific prayers as we turn the calendar and enter 2012. I can’t think of a better time to focus on the power of prayer in our family life. What are you believing for your husband and children in 2012? In what areas do they need growth and breakthrough? What challenging personality traits do you need to embrace and celebrate? I find that writing an honest and heartfelt prayer for these things allows me to focus my otherwise busy mind on what matters most.

I encourage you…take an hour or so over the next few days…sit down with your journal and a cup of something warm…and write your heart out to God on behalf of your family.

First, ask him to reveal to you the wonderful uniqueness of each family member. Thank him for their life.

Next, ask him to show you how you can stand in the gap for them this year. Areas of growth, challenges, awaited miracles.

Then, write a prayer for each of them.

Try to keep each prayer to a paragraph. 4-6 sentences. This way you can print them out and keep them in your bible or maybe on your bathroom mirror or in the car. Somewhere you will see them daily and remember to pray. Try making a prayer card for each one {like this one}. You can write answers to your prayers {with the date} below your prayers throughout the year. Then, put them together to make a prayer journal for each of your family members.

I am committed to walking through this process again because I believe these prayers may need to be adjusted on a regular basis. I look forward to 2012 with great anticipation of all God has in store for my family. Let’s do our part moms to cover our loved ones and expect great things for them in the coming year.

Praying with you,

Jessica

Trying to pick the perfect tree

About a month ago, a very sweet patient who had only recently moved to the US, asked me, “Dr. Rupe, we need to talk about scheduling my delivery since I’m due near the holidays. I don’t want to go into labor while the hospital is closed for Christmas.”

“No,” I informed her, “the hospital is always open.”

This made me chuckle, and longingly wish that was the case. But, there is no way to predict when those babies will arrive, pregnant uteruses have a mind of their own.

This has been one the busiest months for me that I can remember. I normally deliver between 8-10 babies per month, but have already delivered about 20 and the month’s not over yet. I have still found time to enjoy some of the Holiday festivities with my kids: cutting down the tree, baking cookies and reading Christmas books each night. Other traditions have gotten skipped. I missed several Christmas parties and did not get Christmas cards sent this year for the first time ever. I have had to really steward my holiday time this year and that means anything that doesn’t include the family has had to be cut from the schedule.

There is stress that I can’t control at work, but any busyness that I can control, I have tried to. I am thankful for God’s grace and strength that He has blessed me with this month. That same grace is available for all of you too.

I am on call this weekend, so yes it would be nice not to have any Christmas babies and to get to spend the day at home with my family. But if I do deliver a baby on Christmas, how awesome is that too? To help be a part of the miracle of life, on the day that we celebrate the ultimate miracle of life, the birth of our Savior.

I am so very thankful for my family who has traveled from Oklahoma to be here with us for Christmas. I am also thankful to all my patients who have entrusted me with the honor of helping bring their babies into this world. I was flooded with beautiful Christmas cards at the office. It is so great to get to see pictures of these little miracles growing up. Also several lovely patients brought Christmas gifts of homemade sweets that severed as snacks as we stayed late waiting for babies to come.

I am also thankful for the blessing of my children. I, like Jess, remember many Christmases that felt not quite complete, due to the pang of loss as my heart ached for another child. 

For those who are believing to be able to share your next holiday with a child, I pray that you will find peace this season. I leave you with Luke 1:45 which describes Elizabeth as she visits her cousin Mary and recently felt her miracle baby leap in her womb:

“Blessed is she who has believed that what the Lord has said to her will be accomplished!”

Now to get it home!

“…they found Mary, Joseph and the baby who was lying in a manger…but Mary treasured up all these things and pondered them in her heart.” Luke 2:16-19

Moms-to-be. . .take a moment to ponder the miracle growing inside of you. Consider Mary and the unfathomable joy she experienced knowing the life she bore would save mankind. The life you are carrying may not be the Savior but with his help, you can guide your child to an amazing destiny. Praying for him to prepare your hearts to steward the life you will bring into this world. Amazing!

Waiting mommies-to-be. . .I know that holidays can be hard, thinking about your longing for a little one to share the joy with. I remember those days. They could have ruined me. I pray you will allow the peace of Christ to dwell in you this holiday season and as you consider the awesome miracle of his life, be filled with the HOPE this tiny baby brought to Earth. That HOPE is for you.

And may we all experience true peace and joy leading up to Christmas this week. I want to honor the savior by choosing HIM instead of busyness and stress. It’s a daily choice I am trying desperately to make. Will you join me?

Today I am linking this post up with a new blog I recently discovered. Check out Imparting Grace this week to read lots of other encouraging posts about Christmas!

Merry {week before} Christmas!

Jessica