“We may have different religions, different languages, different colored skin, but we all belong to one human race”. –Kofi Annan (Ghanian Diplomat, 7th UN Secretary-General, 2001 Nobel Peace Prize winner)

What is exactly childbirth? Some people compare it to a miracle, a heroic act, or a surge of love accompanied by strenuous and intense hours of labor. It’s absolutely one the most unique experiences that can happen to a woman’s body. The time when she is particularly vulnerable and in need of much support and care.

For me, a nurse practitioner student on labor and delivery floor at Massachusetts General Hospital, witnessing childbirth was something that I would never forget. Thrown into the action on a first clinical day, I had mixed feelings of joy, excitement and a slight nervousness. I felt extremely privileged and grateful to witness a natural delivery and I was hoping to help a future-to-be mom during the process.

From the morning report I found out that the woman I was assigned to follow was a recent immigrant from Guatemala who belongs to the indigenous Mayan population. Mayan was the patient’s native language but she was also able to understand Spanish. Her husband had been residing in the United States for 5 years. She moved here a year ago and the family has finally reunited.

My patient was accompanied by a traditional nurse midwife known as comadrona. Comadronas are trusted women leaders in their communities who accepted a spiritual calling. They usually don’t receive any formal training but have years of experience delivering babies. Comadronas regard birth as a natural process and rely heavily on God and prayers. The nurses established a plan of care recognizing my patient’s spirituality and personal support system. The Mayan midwife was present during labor and helped with comfort measures. The nurses also invited a qualified interpreter.

When I entered the room, a nurse and a midwife, along with the comadrona, surrounded the tiny woman. One of the nurses was checking her vital signs and the nurse-midwife was encouraging the woman to take slow deep breaths and relax. The comadrona, wearing a traditional colorful embroidered dress, was gently massaging her back. The room was dimly lit and the scent of fresh lavender floated in the air. My patient’s contractions were increasing steadily and were becoming more regular. This was active labor –she was ready to give birth.

The whole atmosphere struck me. There was no other language present in the room but the language of trust, respect and compassion between these women. I immediately wanted to become connected with what was happening- just by holding this woman’s hand and talking to her.

Reflecting back on this experience, I understood that nurses not only created the environment that made this woman feel comfortable and that was respectful of her spirituality but that the environment also had a significant impact on the labor and birth process. Although childbirth is unique and at the same time a unifying biological event for any woman; providing therapeutic communication, physical, emotional, spiritual care and comfort during the labor process is crucial.

The comadrona shared her knowledge and experience with the American nurses. It was important for my patient to have a traditional midwife near the bedside who comforted and prayed with her. There was interplay between modern and traditional medicine that contributed to the positive outcome. Nurses in this particular case were not only culturally sensitive and able to understand cultural values, beliefs and attitudes of clinicians and patients, but also culturally competent and had knowledge, capacity and skills to provide high-quality care (Jernigan et al, 2016).

It’s essential for any nurse in such a unique, heterogeneous country like the United States to be cognizant and open-minded of cultural diversity and the patient’s cultural perspectives. I will take this amazing experience to my future nursing practice and strive to always treat my patients with dignity, respect and compassion. I also hope to continue to integrate a holistic model and culturally sensitive care into our modern childbirth practices.

This woman gave birth to a beautiful baby daughter whom she named after a nurse taking care of her during her labor and birth.

Additional Resources & References
http://prontointernational.org/
https://he-he.org/en/
http://www.mayamidwifery.org/
http://midwivesformidwives.org/guatemala/
http://www.birth-institute.com/study-abroad-guatemala/
http://www.acog.org/
Jernigan, V. B. B., Hearod, J. B., Tran, K., Norris, K. C., & Buchwald, D. (2016). An Examination of Cultural Competence Training in US Medical Education Guided by the Tool for Assessing Cultural Competence Training.Journal of Health Disparities Research and Practice, 9(3), 150–167.

Evgeniya Larionova received her Bachelors of Science in Nursing from MGH Institute of Health Professions. She is a founder and an Artistic Director of AMGITS Drama&Poetry Club at the Boston Living Center. She is a member of the student Leadership Committee of the Harvard Medical School Center for Primary Care. Evgeniya is passionate about infectious diseases, community health and integrating holistic care in modern practices.  In her spare time she plays in the Russian theater, enjoy reading, playing the guitar and hiking.

There is a moment after labor when you realize that not only is your sweet little baby a patient, but that you are too. At least for me, that was something that hadn’t really registered. On the day that my little baby girl Isla was born I very quickly began to understand we would both need a ton of care in the hospital and at home.

You would think from all the books I read, articles I scoured, and the numerous second hand accounts from friends I received, it would have sunk in. But it just didn’t. It literally never occurred to me that I’d be a patient too during and after labor and birth.

It all became extremely clear while my little bundle of joy was on the scale being measured and weighed, when the doctor said “okay, I’m going to work on you now”. Work on me, I thought? What does that mean? The hard truth was that it meant stitching up my episiotomy and sewing a tear on the inside of my vagina. All of this, the aftermath of an hour and half of pushing out baby Isla.

The patient theme was echoed again when I made it to the mother-baby unit and my nurse said she’d be back to check on me every hour for the next three. And when she came back to check on me, boy did I need her help. I needed her help not only to get out of bed, but to go to the bathroom, and to reapply the “padsicle” of support I had in-between my legs.

The padscile was just the start of my postpartum care. The below are the six most helpful things I needed as “patient mom,” once I arrived home.

1. Mesh underwear from the hospital, your new best friend: The mesh underwear they give you really helps at home. Take all of them; ask for more if you have to. This underwear is great because they give your “parts” room to breathe while also holding in place the biggest maxi pad or padscile you have ever seen.
2. Maxi pads: For me I had to buy the large over-night ones. They filled up my underwear and covered everything front to back. Choosing the big ones helped keep them from sliding around. These were also very helpful when I was sitting in bed nursing while leaking from below.
3. Sitz bath: The idea of this did not work for me, and the contraption they sent me home with just did not fit in my toilet. So instead I used the portable showerhead. It worked marvelously. I stood in the shower and oscillated the shower head back and forth on my nether region. I felt clean and appreciated the water and other liquids running away from me into the shower drain.
4. Squirt bottle: The bottle they give you at the hospital becomes your trusted ally. Fill it with warm water and use it EVERYTIME, you have to go to the bathroom. I even continued to use it long after leaving the hospital, as many areas down there are not easily cleaned when sensitive.
5. Witch hazel pads: I was lucky enough that I didn’t get hemorrhoids but my perineum, the area between the vagina and anus, was still extremely inflamed. The cooling of the pads really helped alleviate itching and tenderness. Every time I went to the bathroom, I changed the maxi and witch hazel pads.
6. Stool softeners: The fear of going number two after pushing out a baby is real. Stool softeners really helped me to literally “smooth the way.” I continued to use them for months, as every time I had to go the pressure was an all too familiar feeling.

A combination of the above, rest, and cuddling with my newborn is really what got me through my recovery. As a mom that is finally feeling semi-back to her old self, I only wish that more people understand how long it really takes “patient mom” to feel better. Recovery is slow but if you have the tools at home to help, it will be a road less painfully traveled.

Did you know most infant sleep-related deaths are considered preventable? This is good news worth sharing! Because most babies are born in a hospital or birthing center, nurses are uniquely positioned to interact with virtually every new parent. This means nurses play a critical role in helping prevent these deaths. We know that parents trust us (we are the most trusted profession!), watch us, and listen to us. We have a responsibility to make sure we give parents safe sleep recommendations along with the evidence behind them. We have a responsibility to problem-solve with parents about accomplishing safe sleep situations, all while simultaneously respecting their right to decide what is best for their family. The bad news is too many babies are still dying. October is SIDS Awareness month and a perfect time for nurses to spread the good news and advocate for our smallest patients!

Just for clarity, infant sleep-related deaths include Sudden Infant Death Syndrome (SIDS), Accidental Suffocation and Strangulation in Bed (ASSB), and an “Unknown” category where typically risk factors are present or the infant was in an unsafe sleep environment but ASSB is not known with certainty.

These sleep-related deaths, once generally labelled SIDS, are now more commonly referred to as Sudden Unexpected Infant Death, or SUID. In 2013 there were 3,434 SUID deaths, almost 10 per day, in the United States.

The topic of safe sleep can be tricky. There are barriers to some of the recommendations, and discussions have the potential to become controversial. Suffice to say, nurses are aware this is not always an easy topic, and some may prefer to skip it entirely. Hopefully knowing how much influence we can have will motivate us to talk to parents about this important safety issue. It could be a matter of life and death, and the majority of parents are grateful for the information.

The issues surrounding safe sleep are being discussed among healthcare experts and suggestions are emerging about how to better connect with parents. One idea is to acknowledge that parents take risks (we all do!) and adopt a more risk-reduction approach instead of a risk-elimination approach. This change might be simply rephrasing our recommendations from using terms like never and always to something like the safer or safest way for your baby to sleep. As an example, some parents, despite hearing the recommendations against these activities, will choose to continue to sleep with their baby or they might decide to continue to smoke. Our responsibility is to educate and then encourage the safest sleep situation possible, while also respecting the parents’ choices. The best comparison may be with breastfeeding: We all know that exclusive breastfeeding for the first 6 months is best, but we also know that some is better than none, and we readily help parents, if it’s what they choose. Similarly, our job is to advise and help parents do the best they can by providing safe sleep recommendations, being willing and open to discuss their unique situation, and problem-solve with them; all without being dogmatic or rigid. Our job is to educate and encourage, not coerce.

Parents who choose to sleep with their baby might be provided further information on the situations that are especially dangerous (such as with a baby less than 3 months, or with an intoxicated parent), or we can suggest other sleep options such as a co-sleeper that connects to the parent’s bed or setting a timer for moms concerned about falling asleep while breastfeeding. A parent who smokes might be open to smoking outside the home and wearing smoke-free clothes around the baby. Are these the safest ways and environments to promote safe sleep? No, but they are safer and may be what is needed to prevent a death.

ADDITIONAL INFORMATION For nurses

Common Questions/Concerns from Parents and Suggested Responses from Nurses (.pdf)
Tips for Nurses Teaching Safe Sleep in the Hospital Setting (.pdf)

Safe Sleep Strategies (.pdf)

References/Resources

Centers for Disease Control and Prevention . (2015). Sudden unexpected infant death. Retrieved August 20, 2015, from http://www.cdc.gov/sids/aboutsuidandsids.

Hitchcock, S. (2012). Endorsing safe infant sleep: a call to action. Nursing for Women’s Health, 16(5) 386-396.

Horne, R. S., Hauck, F. R., & Moon, R. Y. (2015). Sudden infant death syndrome and advice for safe sleeping. BMJ, 350:h1989. doi.org/10.1136/bmj.h1989

Moon, R. Y., & Fu, L. (2012). Sudden infant death syndrome: An update. Pediatrics in Review, 33, 314-320. doi: 10.1542/pir.33-7-314

Patton, C., Stiltner, D., Wright, K. B., & Kautz, D. D. (2015). Do nurses provide a safe sleep environment for infants in the hospital setting? An integrative review. Advances in Neonatal Care, 15, 8-22.

Shaefer, S. J. (2012). Review finds that bed sharing increases risk of sudden infant death syndrome. Evidence Based Nursing, 15, 115-116. doi.org/10.1136/ebnurs-2012-100750

Volpe, L. E., & Ball, H. L. (2015). Infant sleep-related deaths: Why do parents take risks? Arch Dis Child, 100, 603-604. doi.org/10.1136/archdischild-2014-307745

There are few things more memorable in life than the birth of a baby. No matter where in the world, what socioeconomic background she comes from, or how many times she has given birth, a woman can probably tell you every single detail surrounding her birth and the early days thereafter. She can tell you the exact moment each baby was born, how long it was and how much it weighed. I have been honored and privileged through the years of working with moms, dads, and babies to hear their birth stories and bear witness to the one of the most important moments in their lives.

Living abroad over the last five years has given me a unique perspective of birth culture. I live in the second largest city in Sweden, Gothenburg. It is an international city that welcomes students and workers from all over the world. Gothenburg boasts international universities and large companies such as Volvo and Ericsson. It offers refuge to asylum-seeking immigrants from war-torn regions past and present including most recently Syria. I have met and cared for babies whose parents come from all parts of Europe, Africa, and The Middle East. One of the first questions I have always asked goes something like, “where are you from, what is your baby’s name, and what is something unique to your culture around the birth of your baby?” The answers are interesting and varied.

Join me on my journey of birth traditions around the world as I compare birth models and customs. Bear in mind is that most of the highlighted countries use a midwife model of care during pregnancy and birth. We will end our tour in the U.S. where we find that what may be the norm for us, may not be the norm everywhere else in the world.

Iran

Toktam, an engineer at Volvo, in Gothenburg, comes from Mashad, Iran. She recently gave birth to a baby girl, Hannah. She gave birth naturally and is the first in her generation of women to do so. Most women give birth by cesarean in Iran, but Toktam delivered her baby in Sweden where cesareans are reserved for emergencies and when medically indicated. When I asked her about birth traditions in Iran, she began talking about a shower. I immediately pictured the American baby shower with a group of women playing games and eating the latest Pinterest-inspired edibles. I was way off. A shower in Iran traditionally happens around 10 days after the baby is born or when the umbilical cord has fallen off. The mother’s sister, mother or aunt showers the mother. She is then massaged with special oils, given a facial, and painted with henna. It is reward for all her hard work and the pain she had to endure in labor. After the mom is showered, baby is bathed. Following the shower, friends and family are invited for a special lunch, called Valimeh (traditionally lamb). Guests bring gifts such as clothes and blankets while close relatives often bring something made of gold.

Australia

Rebecca is a nurse from Australia who has two little ones. Her first was delivered by emergency cesarean and the second by VBAC (vaginal birth after caesarean). Yay for VBAC options! Rebecca shared that in Australia it is common for family and friends to fill the new parents’ freezer with pre-made meals such as soups, casseroles, and lasagna. It gives the new sleep-deprived parents the precious time needed to rest between feedings and allows for more bonding time. She also shared a tradition new fathers share with their friends after the baby arrives. “Wetting the baby’s head,” means having a drink in honor of the new member of the family. It is a common tradition in England as well.

Italy

Amina, a postdoctoral researcher, comes from Parma, Italy. Yes, Parma where they make the most delicious cheese on the planet! She delivered her baby girl naturally. Amina shared the tradition known as “camicino della fortuna” in Italy. It is a jacket for the baby given to the mother to be after her third month of pregnancy. It is made of either silk or cotton and most commonly is white. It is worn right after birth as it is thought to bring good luck. It is usually passed on by a friend of family member whose baby wore it. Once worn, it is put away unwashed until it is time to pass it on to the next lucky mom.

Spain

One more stop in Southern Europe. We meet Astrid from Spain, mother of Sebastian. Astrid is a researcher at Ericsson, Sweden. She delivered Sebastian naturally. In Spain, it is traditional to pierce a newborn baby girl’s ears soon after birth, thus distinguishing that she is, in fact, a girl. It is very common for random strangers to approach new moms and babies in the streets to exclaim over the sweet little baby. It shouldn’t come as a surprise that these complete strangers will move in and give your baby a little peck.

Germany

Emma, a consultant, delivered her baby boy, Finn, naturally. She shared a common birth tradition after the baby arrives called Babypinkeln, which literally translates to baby pee, but is actually a party to welcome the baby. Historically, the naked baby was passed around and it was considered eternal luck to be the person that the baby peed on. It eventually became a party that occurred while mom and baby were still in the hospital to allow the mother to recover after birth. The father would get together with friends, family, and neighbors to eat, drink, and celebrate the new baby. Sometimes even cigars were passed around. These days, the party is usually planned when the mom and baby come home to join in the celebration.

Sweden

We move onward to Northern Europe to Sweden. Saga, a doula, preschool teacher, and artist, was part of a reemerging birth model in Sweden and the world for that matter, when she gave birth to both her children at home. While most Swedes give birth in the hospital with assistance of a midwife, a growing number opt to birth at home. Saga shared that it is frowned upon to bring flowers received in the hospital home after a baby is born because it is thought to be bad luck. A tradition I find most interesting and have witnessed in the years since moving to Sweden is the culture of leaving babies outside to nap. Even in the dead of winter, as far north as the Arctic Circle here in Sweden, and in minus degree temperatures, babies are bundled (Swedes know how to bundle) and their stroller is pushed outside for a nap. It is not unusual on any given day to be strolling downtown and see a line of strollers with sleeping babies outside a cafe while their moms have lunch or coffee (fika) together inside. It is thought the fresh air keeps the babies healthy and it seems to work.

U.S.

We end our tour in the U.S., my home country. Mandy (massage therapist and mother of two) recently gave birth to her baby girl, Mollie via repeat cesarean. Two traditions come to mind when it comes to having a baby in the U.S. including preparing a nursery (the baby’s room) and having a baby shower. American baby shower culture gained popularity towards the end of World War II. Women are “showered” with gifts and essentials needed in preparation for their baby. The host is usually a sister or best friend and the shower traditionally invites women only though more and more women are opting for a coed shower.

As we sum up our tour of birth models and culture, we can see that traditions vary widely. It is fascinating to hear about and share these women’s stories and learn a little about their country’s birth customs. Thank you to all who shared their special ways of celebrating mothers and babies.!! Merci! Cheers! Grazie! Gracias! Danke! Tack så mycket! Thank you!

Lori 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

An open letter to all the moms, soon to be moms or family supporting moms!

On December 31st, 2011 I gave birth to a beautiful baby girl! It was something I had dreamed about for so long. I remember the day after she was born crying on the phone with my midwife because I was so overwhelmed. She was so little and I didn’t really know what to do.

Being a little overwhelmed is common, medical specialists call it the baby blues. Post-birth, most moms (as many as 85%!) experience some form of the baby blues. This could be feeling irritable, exhausted, needing to cry for no reason or worrying that you won’t be a good mom.

I did not have that. I had something that damn near sucked the life out of me.

Once we returned home from the hospital, I rarely got off of the couch for 30 days. I got up to feed the baby and change her…I didn’t even eat. I remember just feeling so weird. Everything was robotic. Must feed baby, must change baby…I don’t even remember enjoying any of it.

I remember my husband picking me off of the couch giving me a hug and saying babe, you do not smell good…I am going to take you to the shower. He literally stripped me down and put me in the shower and helped wash me. Many times with post-partum depression (PPD) the mom is too tired to notice the symptoms, and it is a husband, partner, a family member or friend that shares that something just isn’t quite right.  I am thankful for my supportive system every day.

One night I was so tired that I actually Googled how many sleeping pills I could take without dying. I didn’t want to die, but I did want to be pretty close so that at least I would sleep for a few days. I literally had a bunch of pills laid out on the ottoman. I started to down them and then I thought. What if I am unconscious and she starts crying?! Nobody will hear her. I didn’t want her to cry and not have help. So I begged God to let me fall asleep and I threw the pills away. She saved my life.

Then the paranoia set in. I started to think that something very terrible was going to happen. So I started to place emergency items around the house. Things I would need to run away with. I made sure not to be too obvious because I didn’t want my husband to be on to me. One day he left to go to the store. I remember it so clearly, “babe I’m running to the store be back in a few.”

He stepped out of the house and I threw all of my emergency items in a bag, grabbed the baby and ran.

My grandpa was staying in a nursing home at the time and I knew nobody would look for me there so I went to his house and I hid out. I had NO contact with the outside world for days. Yes, I kidnapped my own child because at this point I was pretty unstable.

My husband and best friend were texting like crazy. Finally about ten days in I received a message from best friend which said, “I love you, but right now I have to love your baby more and I will call the police because I know you need help.” I finally told her where I was but begged her not to come. She sent a family friend who is a nurse to see me.

The nurse showed up and told me I had postpartum depression. I had no idea that 15% of new moms experience PPD which is way more intense than the blues, and encompassed so many of the things I was feeling and thinking. But at the time I didn’t know any of that, all I knew is that I just wanted to disappear. I hated everything, I couldn’t function and I was mad that I wasn’t connecting with such a precious little baby.

I never wanted to hurt my baby but I know many women who suffer from PPD do, and I would be lying if I said that I never wanted to hurt myself.

I don’t even remember when I started feeling better. There is so much about that time that scares me, so much more that I could share, but even writing about it makes me feel horrible. It’s a place I NEVER want to return to, and I would NEVER wish it upon anyone.

There were periods of time where I felt that I was bordering on insanity.

Follow the rest of my story in my Part 2 post publishing October 9th – National Depression Screening Day. Take care of yourself!
Danni Starr
Danni Starr works daily as co-host of the nationally syndicated “The Kane Show.” Danni fell in love with radio at 19 and 11 years later, she still considers it her first true love. As a Mother and wife Danni is the “Den Mom” to the show & offers open, honest, opinions and advice.

The above story is adapted from Danni’s original post: https://www.facebook.com/notes/danni-starr/take-a-walk-in-my-postpartum-shoes/572481839449596

Get Support

Postpartum Support International: 1-800-994-4773 or postpartum.net
National Postpartum Depression Hotline: 1-800-PPD-MOMS

References and Learn More at

AWHONN’s Mood and Anxiety Disorders in Pregnant and Postpartum Women Position Statement

“But we had this for dinner LAST night” the five year old says.  My joke with the nine year old falls flat because he’s too busy sighing over his lack of clean socks.  “That’s IT!” I tell my husband with a wink, “I’m running away from home and going to work where I’m appreciated!”

I’m one of the luckiest nursing students in the world.  By day I drown in books and deadlines and elementary school paperwork and laundry, but by night I work as a CNA at the birth center of my local hospital.  I know, while the little efforts at home might go unnoticed, no small kindness is missed by our patients. 

We tuck those small kindnesses into our hearts and carry them around, forever grateful.

As a young first time mom I was lying in a military hospital room staring at a pepto bismal pink wall and a broken television.  I was waiting for what I was pretty sure was The Best Baby Ever to be Born after The Most Painful Delivery Any Human had Ever Withstood to come back from the nursery, where a tech had taken him for his 2am vitals.  The door finally creaked open, and the young tech pushed my sweet baby back to me.  He began to leave, and then turned back.  He looked at the bassinet.  “He really is a cute little dude,” he said before closing the door.

Nine years later I can’t quite remember the exquisite pain of unmedicated childbirth or the sound of that baby’s perfect first cry...but I remember the tech—An Expert in Newborns, mind you–telling me that my baby was cute.  It affirmed every suspicion I had that my baby was the best baby ever.  And in those days of rollercoaster hormones and constant feedings and sleep deprivation, I held that gem of praise and encouragement tight.  It’s been nine years and I haven’t dropped it.

My story is one of so very many.

Jenn Osario never thinks of breastmilk without thinking of the nurse whose words encouraged her through the long days of pumping for her twins in the NICU. “When your milk comes in and you refrigerate it, you’ll see the cream settle at the top,” the nurse told Jenn.

I was totally ready to give up on pumping and I remember opening the fridge to bring what milk I had pumped that night to the NICU for the girls and there it was, the cream on the top.  It’s silly, but it really helped encourage me to keep pumping.

Allison Morgan secretly wanted an unmedicated birth, but when she arrived at the hospital she wasn’t sure she could handle the pain if the contractions got worse.

The nurse was very calming and said “You seem to be doing great and you really aren’t feeling any pain, why don’t you just wait and I will check in on you.”  She told me if I felt like pushing or my water broke to call her.  I was like, “Yeah, okay… that isn’t going to happen.”  Two minutes later my water broke and I was desperate to push.  She rushed in and checked me and I was 9.5 cm. I was totally freaking out (exactly what I was trying to avoid) and she was very good with helping me breathe and wait the few minutes for the doctor to arrive and fully dilate. Two rounds of contractions and two pushes and Dallon was born.  

I was so grateful that she was in tune with what was needed rather than just going with whatever I wanted to make her job easy.  I attribute that entire birth experience to her and every time I talk or think about his birth, she is in the forefront of my mind and I say a little thank you to her each and every time.

After a long labor Melissa Scholten-Gutierrez gave birth to a baby with low blood sugar who was more interested in sleeping than eating.  The doctor wanted to give the newborn formula, but Melissa wanted to establish breastfeeding.  The doctor threatened a NICU admission and IV feedings.  Melissa’s nurse proposed a compromise between physician and patient—allow the baby to breastfeed first and then top that off with a formula feeding.

She told me that she would try to help me find a way to do it that would really foster our breastfeeding relationship.  She spent a lot of time with us over my son’s next few feedings helping us find a way to get him to wake up enough to nurse, and then a way to get him to take the formula. At shift change, she made sure that we had another nurse that would be supportive.

Ultimately, this nurse helped me make it through a very stressful first three days, and allowed me to have confidence in my ability to breastfeed. (Of note, my son was a great nursling and still loves it at 16 months. And, I wound up having an oversupply and was able to donate to four other babies!)

Earlier this summer my sister-in-law, pediatrician Dr. Heather Henne, delivered two of the most perfect baby girls ever to be born. (I might be a tiny bit biased.  Except that they really are.)  Early in the day Heather confessed to her labor nurse at the University of Washington Medical Center that she was nervous about pushing.  The nurse had recently given birth, and shared her own experience with what effective pushing felt like.

Listening to her story made it possible for me to visualize my own experience and gave me so much confidence.  In fact, when the obstetrician asked if I wanted to try a couple of practice pushes I agreed, but felt like it wasn’t even necessary.  I felt like I’d already worked through it with the nurse by hearing her experience.  It was incredibly generous of her to share her own personal story instead of just saying “some patients find that this works” or “many patients feel this way”—making it personal made it real to me.

Heather’s positive experiences continued into the postpartum unit where her nurse’s proactive approach made her more comfortable and confident in her first days as a new mom.

My nurse knew what I needed before I needed it.  And I don’t just mean the Q6 Motrin, but things that I wasn’t even thinking about showering. She asked me if I wanted to take a shower and it hadn’t occurred to me to take one so soon after delivery, but it was amazing.  It was the best shower of my life.  It made me feel so much better.  It was incredible to have someone there who was not only with you, but two steps ahead of you.  She knew what I needed before I knew what I needed, and she was so right about it all.  I had been nursing the girls individually, but she suggested and helped me to do a tandem feed.  Never in my imagination did I think I would be tandem nursing on day one in the hospital.  That suggestion meant that when I went home I felt so much more successful and confident because I had tried tandem feeding in the hospital and wasn’t just doing it on my own.”

So as I walk into work every night, I do so with a smile.  I’ll never know what it is that sticks with a new mom, but each shift is an opportunity to pass on a kindness that will glow bright through many sleepless nights.

While pregnant with her first child and serving in the Air Force as an aircraft maintenance officer, Traci dreamed of returning to school and eventually becoming a Certified Nurse Midwife. A decade later, Traci is finally in nursing school and is delighted to be working as a CNA at the Birth Center of Penrose St Francis Hospital in Colorado Springs.

You’ve heard it time and again: Breast is the best. But many moms-to-be express concerns over breastfeeding, from doubts about their abilities, to time constraints, and everything in between. However, moms who have experienced challenges and broken down breastfeeding barriers will tell you this—it’s worth it.

Same goal, different struggles

Pictured above: Erin and Hung Lee with Emersyn, Paxten and Mylo

Pictured above: Erin and Hung Lee with Emersyn, Paxten and Mylo

“Just because something is natural doesn’t always equal easy,” says Erin Lee, RN, BSN, IBCLC, mother of three. As a registered nurse (and now a board-certified lactation consultant), she was fully aware of all the benefits and knew that she would breastfeed. What she couldn’t predict, though, was how many bumps in the road she would encounter.

“I had a long intense labor, and they had to use some suction to get my daughter out,” she explains. “She had a strong oral aversion, and I had flat nipples, which made latching almost impossible. On top of everything else, she was extremely jaundiced. I wanted and needed to breastfeed her, and I was determined to—but it wasn’t easy to get started.”

Lindsey Grissett knew before her daughter was born that she would breastfeed. “It was just something that made enough sense to me not to question,” she says. “I was further encouraged to educate myself on it by both my doctor and my husband.” Birthing at a Baby-Friendly® hospital meant Lindsey had a lot of support. “I was signed up for breastfeeding classes well in advance, and I don’t think I had a single question go unanswered,” she says. “I felt both mentally and physically prepared.” Shortly after giving birth, baby Emma latched right on as both mom and baby got the hang of things.

Breastfeeding wasn’t without its challenges for Lindsey, though. “There were times when I would stand in the shower, stare at the wall, and wonder how it was possible for an individual to function on so little sleep,” she recalls. It felt like the baby was hungry all the time… I was exhausted.” Lindsey learned a lesson in patience and teamwork as mom and baby found their rhythm. “It’s a process—you have to use different hand movements, massaging your breast to get the milk flowing while trying to get her mouth in the right place… or else all that hard work literally just leaks away.”

Finding help when you need it

For Erin, having the support of an International Board Certified Lactation Consultant® (IBCLC) made it easier to focus on one thing at a time. “Even though I’m a nurse, she saw things I couldn’t see,” Erin says. “She realized my daughter was jaundiced. She also helped me establish smaller goals instead of worrying about getting her to latch. I pumped my milk so we could focus on feeding her and getting her to gain weight. Then we worked on overcoming her oral aversion, and then… she latched!”

Pictured above: Lindsey and Raymond Grissett with Emma

Lindsey agrees that a lactation consultant was a huge help. “They called a few days after being discharged, asking if everything was going okay. They set up appointments for me to come in, show them my progress, and make sure she was taking in enough.” It was a lactation consultant who recognized that Lindsey’s baby girl was also jaundiced, she adds. “Several months after I had Emma, I still received phone calls to see how I was doing. I was so well taken care of!”

An indescribable feeling

While you can read a bundle on the benefits of breast milk, there’s one thing that you can’t find in a class or a book—the physical and emotional closeness that develops between mom and baby. “The bond you feel while you’re feeding your baby… it’s incredible,” Erin says. “Until you experience it, you can’t know how powerful it is.”

“The most valuable thing about breastfeeding was definitely how close it brought me to Emma,” Lindsey says. “There so many times when I just wanted to sleep, or eat, or shower in peace… but even when I was at the end of my rope, it was such a great feeling knowing that she needed me. That was my motivation to keep going.”

Turning lemons into… breast milk?

After a difficult breastfeeding journey, Erin knew she could use her experience to help other women. “I was working in pediatrician’s office, and I shadowed the IBCLC there, seeing the moms and babies come in, some of them having the same issues I did. I wanted to help them overcome it—I became very passionate about it.” She became an IBCLC in 2013, and in 2015 she cofounded a private practice lactation business.

“Most people will encounter some sort of struggle,” she says. “For some it might be a few days or weeks, others might take months to get the hang of it. Just because the baby doesn’t latch right away, or you have a little discomfort at first doesn’t mean it’s the end. With the right support system, you can do it. It’s so empowering—being able to provide this essential need for your baby.”

Summer Hunt is the editorial coordinator for publications at AWHONN.

Resources for Moms

Ask Our Nurses: How Will My Baby and I Begin Breastfeeding? (video)
Ask Our Nurses: How Do I Prepare For Breastfeeding? (video)
How to Overcome the Challenges of Breastfeeding (article)
Breastfeeding Fixes (article)
Download our brand-new Breastfeeding Parent Pages here.

Erin Lee, RN, BSN, IBCLC has worked as a registered nurse in the Pediatric Intensive Care Unit at Boston Children’s Hospital, Georgetown University Hospital and All Children’s Hospital, among others. She is the cofounder of Suncoast Lactation Consultants in Bradenton, FL, where she lives with her husband and three children.

Lindsey Grissett is a mental health community court liaison in Anniston, AL, where she lives with her husband and daughter. She enjoys working out, traveling and hanging out with her family,  and watching her little girl grow.

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.

On 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!

As 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 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.

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!

Top 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!

1. No one wants you to have the birth you want more than we do. Except maybe you, of course… We want to support you to stay healthy and have a healthy baby. If you end up with an unexpected birth experience, we mourn the loss of the idealized birth with you, and are here to help the experience you have be the best possible.
2. Most providers will not stay with you during labor. Many times when a woman is admitted, she’ll ask when her provider is coming. Providers have busy offices to keep up with and demanding surgical schedules. Your nurse will be the one that stays by your side. Your provider will check in on you frequently and we give them continuous updates throughout your labor.
3. We will not remember what your stretch marks looked like, how much cellulite you had, or what your vagina looked like once we walk out of your room. Guaranteed.
4. Labor is painful. Everyone thinks their labor is different than everyone else’s, that no one could have labor pains as bad as yours. But the truth is, labor hurts for (almost) everyone. The best thing you can do is take prenatal education classes so you know what to expect. A lot of fear and pain comes from the anxiety of not knowing.
5. Educate yourself on the benefits of breastfeeding. By now, everyone should know that there are a million and one reasons to breastfeed. There is so much evidence out there that supports all of the benefits of breastfeeding. No one comes to the hospital with a plan to breastfeed thinking that they may not be successful. So educate yourself prior to having your baby. Know what the most common problems are, success strategies and what to expect the first few weeks. Commit yourself to breastfeeding your baby!
6. Designate someone as your photographer. Your partner will be caught up in the moment. They’ll probably forget all about the camera. Before you go into labor, designate someone as your personal photographer or hire a professional birth photographer. You will not remember the way your partner looked at you. You may not remember how your partner looked at your baby for the first time. You want to make sure you’re able to look back and remember all of the little details you may later forget.
7. Talk to your provider. Your doctor and your midwife work for you . It’s a privilege that you’re allowing them to be a part of the birth of your baby. Don’t forget that. Discuss in advance things you would like, and ask questions. You want to know early in your pregnancy if you picked a provider who you aren’t comfortable with so you can change providers if you need to. No question is too silly. Trust me; they’ve heard it all before!
8. Don’t be afraid to speak up. Frequently, women are admitted to the hospital and they feel as if they have no say in the care that is provided. But you can speak up! You have the right to ask questions, to get those questions answered, and you have the right to say no.
9. Don’t get induced unless you have a medical reason. Even if your back hurts, and you have trouble sleeping at night, and you’re going to the bathroom 500 times a day, remember that your baby is baking in there! Every minute matters. So find methods to distract you if you’re very uncomfortable, and aim to go the full 40!
10. Take it all in and cherish the moments. Every day, nurses take care of women who can’t get pregnant, who can’t stay pregnant and we care for women who will not get to take their baby home after delivery. Having a healthy baby is a lifelong, priceless gift. Cherish every moment, because before you know it, the toddler playing with your car keys will be the 16 year old asking to borrow your car.