Author: The Association of Women’s Health, Obstetrics & Neonatal Nurses (AWHONN)

Pregnancy test

Trying to Conceive After Miscarriage

Aimee Patrick and Charlieby Aimee Poe

My husband and I always wanted a family. The summer before I turned 29, we decided to start trying. Little did we know there would be a roller coaster of a journey ahead.

I got my first positive pregnancy test in September. I knew my life was about to change. I quit smoking, which was a huge deal for me. My husband and I were thrilled. At my first ultrasound, there was silence. The verdict was devastating: I was miscarrying due to a blighted ovum.

My doctor advised me to wait two full cycles before trying to conceive again. I didn’t track anything; I just guessed at when I was going to be ovulating. In February, I got my second positive test. Though nervous, I had a better feeling, thinking the odds were low I would have a second miscarriage.

We picked out names, I looked at birth plans, and at 8 weeks I started building a baby registry. We were cautious to share the news, waiting to tell even our parents. On March 20, one week after announcing our new addition, I went to the restroom and noticed blood. I immediately fell on the floor crying. In that split second, my dreams of our family were crushed.

When they did the ultrasound in the emergency room, they wouldn’t let me see the screen, saying only that they couldn’t detect a heartbeat. I felt like I died inside. My doctor ordered a D&C (dilation and curettage) and told us to wait two cycles.

This time, I took ovulation and trying to conceive (TTC) seriously. I continued taking prenatal vitamins, educated myself, and tracked my ovulation with digital ovulation predictor. The moment I saw the little smiley face letting me know I was ovulating, I told my husband it was go-time! The two-week waiting period after that felt even longer than the two cycles we had to wait to start trying again.

Aimee and PatrickOn July 11, I got my big fat positive! I called my husband, and then I called my mom, who was so supportive. I had a form of PTSD after dealing with two miscarriages, and I didn’t want to tell anyone I was pregnant, so as to avoid the embarrassment.

At 6 weeks, I had my first ultrasound. When we saw that tiny little heartbeat, I cried. My doctor put me on progesterone. We had our next ultrasound at 11 weeks, and there was our baby, active and wiggling around. It was amazing! I wasn’t used to seeing my ultrasounds. Every time I saw my baby felt like a miracle. We learned my due date was March 20—the date of my second miscarriage. Everything was coming full circle. Even more exciting, it was a boy!

CharlieAs badly as I wanted to meet my son, he was even more anxious: At 34 weeks and 4 days, Charles David Poe made his appearance. His birthday is February 9, the same date I had my second positive pregnancy test the year before. Tiny but strong, Charlie came into our lives so fast and has made it indescribably beautiful. It was beyond worth it to have gone through all the turmoil of TTC to get to this amazing part of my life.

Aimee and Patrick maternityAimee Poe is an experience specialist at Verizon. She loves playing video games, watching movies, hanging out with her family, and flexing her creative muscle with various projects.

 

 

Nurse expert and Healthy Mom&Baby Editorial Advisory Board member Susan Peck, MSN, APN shares her best tips for those trying to conceive.

  1. Timing is key. “Many women don’t know there is a small window of opportunity each month for conception to occur. Talk to your health care provider about how to predict ovulation based on the length of your menstrual cycle—there’s an app for that!”
  2. Quality, not quantity. “Couples may not realize that having sex multiple times a day can actually lower sperm counts. I usually recommend daily or even every other day during the few days before during and after ovulation.”
  3. Patience is a virtue. “If you don’t get pregnant right away after going off birth control, that doesn’t always mean something is wrong. Most couples will take 4-ish months or so before conception occurs.”
  4. Plan ahead. “Preconception care is so important. Talk with your health care provider about any health problems you have that could affect pregnancy as well as the safety of any medications you take.  You may need to switch medications while trying to get pregnant. You can reduce your risk of neural tube defects by beginning a prenatal vitamin which includes 0.4 mg of folic acid before getting pregnant. Now is also the time to quit smoking.”
  5. Leave the lube. “Using a lubricant during sex can make it harder for the sperm to swim the long distance to the fallopian tube. If you must, try using a sperm-friendly lubricant like Pre-Seed instead.”

5 things that nurses wish all parents knew about newborn screening

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by Emily Drake, PhD, RN, FAAN

  1. Newborn screening saves lives.  In the first few days after birth, clinicians screen newborns for over 30 rare but serious diseases, most of which are easy to treat with diet changes or other treatment.  This screening, along with early intervention, can save babies from death or disability. Your baby’s pediatrician works with the state health department to ensure that this screening is done.  Many professional organizations including the Association of Women’s Health, Obstetric and Neonatal Nurses support newborn screening.

Continue reading →

Postpartum Recovery Tips for Moms from Our Nurses & Midwives

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In preparation for your new arrival it is likely you will take classes, read books and get advice from friends and family on how to take care of your new baby.

What you can easily forget in all the excitement is that you take care of yourself too!

To help you focus on YOU, we recently asked our nurses and midwives what postpartum recovery advice they give their patients.

We received advice for you from over 100 nurses!

Take note of the clear themes – limit visitors to take that time to bond with your new baby, accept help from others, do skin-to-skin and sleep when the baby sleeps!

Good luck in all your new parenting adventures!

Postpartum Care Tips from Nurses and MidwivesTop 20 tips from our nurses and midwives:

  1. Absolutely choose a hospital for the care you will receive and not the new beautiful building. You’re much more likely to receive a positive birth experience and the education you receive from your postpartum nurses will make all the difference in the world.
  2. As a former postpartum nurse, I noticed how often new mothers put their needs last. It seems often families look at postpartum time as party time. I have seen c-section moms sleeping in the same room as 15-20 family members talking loudly and passing baby around for hours. My best advice is for new mothers to have 1-2 designated family helpers to be there to help care for baby while she gets much needed naps throughout those exhausting first days. Baby’s hunger cues are often missed when there are too many visitors for long stretches of time. It is difficult for new mothers to set limits.
  3. Don’t be afraid to ask people to leave. I have seen so many new mothers that are worn out from feeling like they cannot turn people away. Turn off your phone too. I wish I did for the first couple of days.
  4. Breastfeeding is an acquired skill for you and baby, be prepared to be patient and try, try again. It is a wonderful thing for you both, but needs to be learned. Do not suffer in silence, please contact your OB/midwife for lactation nurse help/referral if you are having difficulty with latching and/or very sore nipples.
  5. Sleep when baby sleeps.

  6. If you had a cesarean, take a pillow for the car ride home to support your incision for the bumps in the road.
  7. Use the Dermoplast (benzocaine topical) spray before having a bowel movement…it’ll make the process a whole lot more comfortable and a lot less scary.
  8. If someone offers to come over so you can shower, take them up on it.  For c-section moms remember not only did you have a baby, but you had major surgery.
  9. Trust yourself and your instincts. Pick and choose the advice, tips, expert advice etc. that works for you. And know that if you’re worried about being a good mom, you already are.
  10. Padsicle! Pad, ice pack, tucks, then a spray of Dermoplast.
  11. Know your body. When you get home, use a hand held mirror to look at your perineum or you cesarean section incision. This way, if you experience problems, you will have a baseline to know if something is different, for example: increased swelling, redness, tenderness, or drainage from incision. It is helpful in knowing when to contact your physician with these issues.
  12. Limit your visitors. You will not get this time back. Use it to bond as a family, seek help with breastfeeding. Skin to skin is the best bonding tool! We want to help you succeed with breastfeeding. You can press your call light for every feeding if you need to. Your baby needs your love and protection. You are your baby’s primary advocate. Not all mothers’ choose to or are able to breastfeed. How you feed your baby is your decision and your nurse will support you. Ask visitors to wait until you’ve been home for at least a couple weeks. Settle in, recover. Don’t be afraid to ask for help. If someone wants to visit, ask them to leave their little ones at home.
  13. Sleep when the baby sleeps. Keep drinking water to flush out the excess fluids and keep hydrated. Accept help from anyone willing to cook a meal, run errands or do housework so you can rest and spend more time enjoying your new baby. Get outside for a walk. Fresh air and activity help to restore and rejuvenate sleep deprived minds and bodies as well as improve the blues!
  14. While planning your new routine, ask someone to watch the baby for an hour of each day for you to spend as you please.
  15. Good nutrition is key. Have a healthy snack each time you feed baby if you don’t have an appetite. Try to get a good four hour blocks of sleep several times a week. Ask support people to change, burp, comfort baby and only bring baby to you for breast feeding to extend your sleep when tired. Have a good support system and don’t be afraid to ask them for help. Soak up the sun when you can. Have an enjoyable activity to look forward to each week. Try to get out of the house, but if you can’t do something you enjoy at home or pamper yourself. Relax and enjoy your baby. Use what works for you and don’t try to follow everyone else’s advice.
  16. Accept offers of help and assistance with meals, cleaning etc. I tell father’s to give moms one uninterrupted hour to herself each day. She can bathe, sleep, read, or anything that she wants for that hour. Daddy needs time to get to know baby too!
  17. When you get home, set visiting hours and have each visitor bring groceries or food (they’ll be thrilled to get what you need). And stay in your pajamas. Most people will be less likely to overstay their welcome.
  18. Once “settled” in with the baby reach out to a Mother’s group ( stroller club, baby sitting co-op, Mommy and me Gym or Yoga class), to get out of the house and receive and provide support to other new Mom’s.
  19. Give yourself a break. Sit at the bottom of the shower and cry if you need to every now and then, parenting is hard work. Learning to breastfeed is hard work and so is incorporating another member into your family. Sleep deprivation and shifting hormones will, in fact, make you feel crazy at times but it will get better. You will find your new norm. It’s not all cute onesies and hair bows, it’s more like poopy onesies and newborn rashes, and that’s ok.
  20. You’re stronger than you think! Don’t worry about what others might think. Enjoy every moment.  Parenthood is a beautiful experience. Allow yourself grace & room to grow.

Do you have advice for new moms as well? If so let us know. We’ll keep rolling out the advice.

For additional resources for mom visit our Healthy Mom&Baby website!

Tools for Survival as a New Nurse in the NICU

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By Lori Boggan, RN

It has been an amazing eleven year journey working as a neonatal nurse. The journey has taken me across the United States and beyond. Being a nurse has enriched and changed my life in so many ways. For that I am eternally grateful.

I still recall my first job. I felt like an impostor in my uniform.

I didn’t feel like a nurse because in my mind a nurse was someone who could start an IV blindfolded, resuscitate a patient while sleeping, and recognize all the signs and symptoms of septic shock at the drop of a hat.

Little did I know that there is no perfect nurse. There are nurses who are born skilled, those who are walking encyclopedias, and those who have the kindest hearts.

Combine all this and it’s almost like catching a glimpse of big foot, the tooth fairy, or even a leprechaun. With this in mind, the following are just a few recommendations for new nurses in the NICU…

Find your mentor
A mentor is a nurse that takes you under their wing and guides you. It may not be the mentor you were assigned to on your new unit, but you will find him/her. It often happens naturally. You find that nurse that loves to teach and your personalities just click. They are part teacher, part life coach, part parent or sibling, and eventually friend. They are the nurses you aspire to be. I have a trail of them across the globe.

Lori and her mentor Mary

Lori and her mentor Mary

You will be tested
The doctors will test you, the nurses will test you, the respiratory therapists will test you, and the parents will test you. It’s ok. It is normal. You have to prove that you have some clue, which you do! Trust me, you do! And with that, always trust your instincts.

Take care of yourself on your days off
Use your days off to enjoy your life outside of work. You work in intensive care. You need to find some outlet that has nothing to do with your job. Meet up with your friends, get a massage, run if you run, yoga if you yoga.

Handle with care
Our tiny patients are so delicate. No matter how stressed or rushed you are, handle them gently. Handle the parents gently. They are in shock and grieving. They need you.

Wash Your Hands
Hand washing still is the single most important thing you can do for your patients. Patients are still contracting and succumbing to hospital-acquired infections even in our most technologically advanced units. Our tiny patients have little to no immune defense.

Don’t Forget
When new nurses come through the door after you’ve worked a year or two, remember that you were there not long ago. Welcome them, mentor them, don’t talk about them when they leave the room. Be the positive example in your unit.

Welcome to the nursing profession! Best wishes on this exciting journey!

img006Lori is a NICU Staff Nurse  at Sahlgrenska University Hospital in Gothenburg, Sweden. After becoming a nurse, Lori traveled across the country to work a three-month travel contract in San Francisco, California.  Nearly five years later her journey continued to Gothenburg, Sweden, where she now lives and works.

5 Q&A about Inducing Labor from our CEO

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We asked moms what questions they had about inducing labor and Lynn Erdman our CEO answered back.

  1. My girlfriends told me that having labor induced is the safest, and certainly most convenient, way to have my baby, but my nurse is saying that waiting for labor to start on its own is the safest. Which is true?

Many people don’t realize that undergoing labor induction for any reason is associated with immediate and long-term health risks. Induced labor can lead to excessive postpartum bleeding (or hemorrhage), which in turn, can increase the risk for blood transfusion, longer hospital stays, hysterectomy, more hospital re-admissions and, in the worst cases, death. Induction is also associated with an increased risk for cesarean birth. Cesareans increase a woman’s  risk for infection, problems with how the placenta implants in future pregnancies, and life-long pain from abdominal adhesions.

AWHONN recommends against inducing labor at any time during pregnancy unless it is medically necessary, because a woman or her baby have problems. The medication used to induce labor is a manufactured hormone and a type of drug that bears an increased risk for causing serious patient harm when used in error. With the increasing use of labor induction and its resulting complications, it’s more apparent than ever that we must improve our understanding of the health consequences of administering artificial hormones, especially to vulnerable populations like pregnant women and infants. The short- and long-term health risks are just too serious to undergo labor induction when there is not  a medical need. Continue reading →

Happy Father’s Day

by, Gerald A. Lowe, MSN, RN

Gerald A. Lowe I first became a father in July, 17 years ago, with the birth of my daughter. After 39 weeks and 6 days, I was the father of a little girl. I really cannot explain how I felt. It was better than being a child on Christmas and getting everything you wanted! I fell in love with her at first sight!! Almost three years later, my son was born. I again experienced the same set of emotions, instant love and excitement for him. Continue reading →

My First Experience at the 2015 AWHONN Convention: Day 3

by, Bree Fallon, BSN, RNC-OB, C-EFM

LisaMillerBree

Bree and Lisa Miller!

When I was a baby nurse at the beginning of my career, we ran high dose oxytocin at my institution. On occasion a patient would not reach an adequate contraction pattern despite the high titration of the medication. Nurses would say, the patient’s oxytocin receptors were saturated, turn the medication off, and let them rest.

Since arriving at Convention, the steady stream of information has completely saturated my brain. Continue reading →