Clipping Baby’s Nails

So, this isn’t exactly birth related, but it is one of those things that new parents find frustrating and I thought I could offer some help.  Parents are often scared of cutting skin and making their baby bleed, which can be a bit of a shock to a new parent.  Some parents resort to biting their baby’s nails, and, although this can be easy – it is also easy to bite too far down.  Additionally, when you’re putting baby’s fingers in your mouth, you’re adding moisture to the area, and the combination of moisture and getting the teeth underneath the free edge (that part of the nail that extends over the nail bed) can cause the nails to lift, which is not a good thing.

Many times, the baby grooming kits or the first aid kits come with emery boards and these are a big no no in my eyes.  An emery board is the cardboard-style nail file.  They tend to have a gritty sand-paper like feeling and if they get wet, they’re ruined.  The rough filing side is actually a little more corse than what I typically prefer, and it tends to rip at the nail rather than smooth the nail down.  Likewise, a baby’s nails are so thin and delicate, it is hard to even file them with a good grooming file (like a 100/80 grit).  Emery boards, contrary to what most believe, are a one-time use nail tool.  They cannot be washed, let alone sterilized, and should be thrown away with each use.  Nail fungus is not fun to mess with, so if you want to go the file route, grab a washable file.  They work better, and they last a really long time.  Just don’t go the metal route, because these rip at the nails, too.

I, personally, don’t go nuts about clipping nails.  They are there for protection and tend to wear down rather easily.  However, as a baby starts moving their hands they end up scratching themselves (or others), and this is no fun either.  You can keep socks over them for a little while, but they do tend to fall off, so getting the skill down is valuable.

OK, OK, so, enough of all that technical nonsense.  How do you easily clip a baby’s nails?  You need to hold their hands and feet firmly.  You CAN can do this without hurting them!  Maybe, as a nail tech, I’m used to this, so it doesn’t bother me, but you’ll be comfortable with it after the first few times.  Just like polishing someone’s nails, you have to make sure you’re in control of not getting polish anywhere, or clipping their skin and harming them.   I once painted Disney characters on a toddler… she was probably one of my easiest clients ever… but I also knew I had to hold her hand firmly, and I did so in the most gentle way and she loved it.

You can clip their nails while they’re sleeping, but sometimes this does wake baby up – and for a baby that may not sleep like you would prefer, you might not want to take the chance.  You can also clip their nails while you’re nursing, but this takes a little finesse to keep both hands free to clip, and the nipple comfortably inside their mouth.

First, you’re going to want to hold baby over your shoulder and bend their legs at the knee while holding their foot somewhere near their butt – you want to hold back away from the toes so that you’re not pulling the skin on their toes (which can cause you to clip too far back) then clip the toenails.  This makes them feel secure up against you, they might suck on your shoulder or arm while you’re doing this, staying content, but most importantly, it prevents them from kicking like crazy – thus, no worries on clipping their skin.  Of course, don’t pull on their limbs and only clip the free edge – the part that looks like a whitish color.  Having their feet still makes this much easier. 

Next, keep your baby over your shoulder, and gently put their hand behind their back – yes, this is similar to how someone would place someone in hand cuffs – but, just do this slowly and gently and you will not hurt them.  Again, hold back on the finger so their finger wraps a little around yours and you’re not pulling the skin.  Sometimes, we tend to want to hold really close to the end of the finger to pull the skin back so that we don’t cut their skin, but this can cause you to clip too much of the nail, and pull the nail bed away from the nail – which hurts them… and may hurt them worse than accidentally clipping a small bit of skin).  Now, you can clip the free edge of the finger nails without them grabbing and waving their arms.

If there are any sharp edges after the clipping, just gently file or let them wear on their own.

Interviewing a Home Birth Midwife

When choosing to have an attended birth (i.e., not unassisted), finding a provider is very important.  You want to find the location that supports your birth situation in the best way, and in many situations this is at home.  Though evidence-based studies may indicate safety in one direction or another, you still need to look within yourself and determine what your priorities are and what your comfort level is, and how your choices affect your ability to birth biologically.  Having a provider that matches your birth philosophy will be a very important decision.

People tend to throw around titles like they actually mean something, and I really want to stress that birth is a natural event – there are rare situations that need medical assistance when birth is able to continue as nature designed.  So, what is important when finding a care provider for your birth?  Experience, of course.  A certified nurse midwife who hasn’t been practicing home births very long will likely not have nearly the experience of a lay midwife who’s been practicing 30+ years.  Likewise, a midwife who has been in practice for a long time doesn’t simply mean she is a good attendant.  You have to ask questions. Period.  Without asking questions, you can’t know how she is going to attend your birth.  You also need to talk to other mothers that have used that attendant, and get their feedback on the whole experience, making sure you ask if there is anything they would do differently next time. 

Many questions will come from your own thought process and concerns depending on previous birth experience, or not, but here is a basic list that I recommend parents ask when interviewing a home birth midwife.  And, yes, emphasis on the “patrentS” – as in the mother and her birth partner need to go together.  Too many times moms talk with a midwife, and daddy is at home or work and doesn’t get all his fears taken care of and questions answered… mom goes home ecstatic about her home birth, and dad still says “eh, I don’t know.”  Such a common scenario that can easily be worked out with a little bit of rescheduling. 

• Why are you a midwife?  What do you feel your role is during pregnancy, labor, birth, and postpartum?
• Do you come to my house for prenatals and other appointments, or will I visit you?
• Do you have an OB backup?  Would I transfer to them during labor if complications arose?
• Do you recommend moms hire a doula?  (Which ones?)  How do you feel your role differs from a doula? 
• How many births have you attended?  How many have been home births?
• What prenatal testing do you require?
• Do you use a fetoscope or Doppler?  Would any situation cause you to use something different than your routine option?
• What are your procedures for things like Group B Strep & Gestational Diabetes?
• At what point during my pregnancy would I be required to see an obstetrician? 
• At what point during labor would you suggest transferring to the hospital?
• What is your transfer rate?  Cesarean rate?  Episiotomy rate?  Breastfeeding rate at birth?  Are you aware of your breastfeeding rate at 6 months?
• How would you handle a hemorrhage during labor/birth?  How would you handle a hemorrhage after the placenta has been birthed?
• How close do you feel a mother should be to a hospital in case of an emergency?
• How would you handle newborn resuscitation? (Are you capable of providing resuscitation with room air?)
• Do you routinely provide natural cord clamping?  In what instances would you require clamping the cord before it has stopped pulsing?
• When would you come to me in labor, and how should I contact you?
• Do you offer water birth? (Do you have a tub available, if not, how could I obtain one?)
• For what reasons do you perform vaginal exams?  Are you comfortable with no vaginal exams before or during labor?
• Do you recommend your mothers take herbs to “prepare” her for birth, or do you believe a good diet and exercise will allow her body to work efficiently?
• Do you allow your moms to instinctively labor and birth?  At what point do you start suggesting positions and pushing?
• Do you perform perineal massage?  Why?
• Do you stitch?  If not, and I require stitches, how is this handled?
• If transfer during labor is required at any point, how is this handled?  Will you stay with me?  At what point would you leave?
• IfI transfer during labor, do you still see me for postpartum visits?
• What do you do to ensure mom has uninterrupted bonding with her baby?
• How do you help moms with breastfeeding immediately after birth and during postpartum?
• When will you visit after the birth?

Then, finally, talk about fees.  Discuss any contracts the midwife would require, ask about payment plans, and don’t be afraid to ask about bartering/trade if necessary.  Be sure to ask how fees are handled if you should transfer during pregnancy and/or labor, birth, or immediately afterwards.

 

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Babywearing

Babywearing provides an easy way to integrate baby into your life by offering options to keep the little one close to your heart where they’re comfortable, skin-to-skin to regulate temperature, easy nursing access, and flexibility so you can be hands free for cooking, cleaning, shopping, eating, and many other tasks new mothers may find difficult while adjusting to life with a new baby.

Babywearing is a beneficial type of kangaroo care that keeps babies close, stimulates physical, emotional, and mental development and helps babies, particularly preemies, where studies show they gain weight and are healthier than those who are not worn.

Many moms are getting into the trend of high quality carriers to ensure their child’s safety, but aren’t quite sure which one to buy.  There are a variety of carriers to choose from; finding your style only takes a little bit of research.  It is best if you can try a few before buying them, but here is a breakdown of the basic styles:

Wrap

A wrap is super soft and flexible with a lot of versatility.  There are adjustable types as well as pre-wrapped styles offering something for everyone.  These wraps distribute the weight very well, and have no points that compress the body creating extreme comfort at almost every stage of wearing.

The adjustable types consist of a very long piece of fabric that allows multiple wrapping methods and easily grow with the baby from birth (even preemies).  The pre-wrapped are easier to get the hang of, and have much less fabric, but only fit the baby well at one stage, and may not go between care givers easily because of body shape differences. 

Wraps are often the best for the newborn stages, but are not recommended for back-carrying because of safety. 

Sling

A sling style carrier seems less intimidating than a wrap and is worn over one shoulder and across the body.  These may be a pouch-type of just fabric, or may have a clasp, like a ring, to adjust and tighten to fid the child.  They often require some support of the care giver with an extra hand, but are super fast to get on and off.  Be cautious of low-grade slings that don’t allow the baby’s head and neck to extend or their back to be fully supported.  These may not be great for extended wear because the weight isn’t distributed, but make short shopping trips much easier, and safer, than carrying the baby in the car seat. 

Soft Structured Carrier

These carriers are typically the easiest and support the baby well – especially as the baby gets older and into toddlerhood.  These carriers are often preferred by the dads.  They usually have a large panel of fabric, some adorned with pouches and hoods, and are tied or buckled to stay secure.  These adjustable carriers are excellent for extended wear like hiking, and many are useable from newborn through about 45lbs (though many need a newborn insert for those smaller stages).  Be sure to avoid the “crotch-dangling” carriers that support the baby by the groin rather than separating the legs as they would naturally go when holding your child.  This is especially important for a newborn as it is easy to dislocate the legs/hips and prevent proper physical development.

Once you’ve found the style (or often styles) you prefer, there are just a few basic safety guidelines (which may seem a little too logical, but they need to be pointed out) you’ll want to think about when you wear your baby:

• Use your carrier according to the manufacturer’s instructions including baby’s height and weight and inspect for defects before wearing.
• Practice with a doll to get comfortable with your carrier.
• Be sure baby can breathe – their chin should not fold against their chest & fabric should not cover their face.
• Be careful of your activity using the same activity precautions as you would while pregnant.
• Do not wear your baby while driving or riding in a vehicle or sleeping.
• Be sure baby’s exposed areas are protected from outside elements.
• Be cautious of what baby can reach, and what can touch your baby especially while cooking or if baby is worn on your back.
• Be sure anyone carrying your baby can assess risk, knows how to use your carrier, and understands babywearing safety.
• Position your baby close enough to kiss & in a way that mimics how you would naturally hold them with just your arms.  Baby’s back should be straight & the head and neck well supp­­orted.

So, those are the basics.  My personal favorites are the Moby or Boba Wrap and the Boba Soft Structure Carrier, and if I were going to pick just one, I would pick a wrap like the Moby or Boba Wrap (formerly known as the SleepWrap).  I recommend parents attend a babywearing workshop, or get together with a group of babywearing moms and try on a few styles.

An Instinctual Birth

Gabriel Blayne - 8lbs 15oz
Born at Home – October 3, 2011

“Deep within each woman,
lies the knowledge to give birth
without outside interventions.”

My 2nd birth – the birth I’ve been dreaming of for so long.  Bell’s birth was incredible and life changing.  This birth was as close to biological as I could have ever wished for my family.  It was the birth that I talk about so much.  It was perfect.

After a week of on and off again mild regular contractions, the night before my birth I started feeling strong cramps in my cervix.  They were irregular, then slowed, and stopped before bedtime.  I had turned off the ringers at the house for the weekend, and each night took a long warm shower, and fell asleep listening to Tibetan Bells and relaxing to the scent of Lavender aromatherapy oil.  I had been waiting…. anticipating a past “EDD” birth – but not imagining I would go 2 weeks past.  I was ready to welcome labor with open arms.

I woke up each hour to pee – just like always.  But, around 2:00, I was feeling strong cramps, and felt like these were different than the contractions I’d been feeling throughout the past week.  I called James (who was on his 3rd midnight shift of the weekend) to let him know my contractions were regular and that I was going to call Donna (Donna Spellman, CPM) to see what she thought before he came home.  Donna said to call her back in an hour and we’d see how the contractions were, so I also let James know I’d call him back in an hour.  I sent a heads up message to Allie (our birth photographer with Allie B Photography), and gave Crysta (our doula with Gentle Beginnings) a call.  I was feeling like these contractions were pretty close, and was starting to feel like I wanted someone with me.  Bell was sleeping, and if things got intense, no one was here to attend to her if she would wake.  I told Crysta I’d call her back in 1/2 hour – but I was afraid to have anyone come if things were just going to stop.

Things weren’t stopping.  But I did take a moment to snap a picture of myself.

I’m a nut about documenting events.

I called James, Crysta, & Allie in 1/2 hour.  I wasn’t waiting an hour to get someone here.  I was ready for companionship.  I just wanted someone nearby.  I was really needing to concentrate during contractions, and had to quickly finish my message to Allie because that one was getting too intense to talk.  Yes, these were progressing fast…. but – wow, don’t I have at least 6 more hours of this… then transition… and still pushing?  These are one on top of the other, I’m moaning, and I’m getting a little nervous.  I’m not doing so well am I?  But wait, this is the exact same way I felt when I was in transition with Bell.  Am I in transition???

All the sensations and movements were running through my head.  I got the birth ball out to lean on… nope, that didn’t help – I needed to walk.  All the birth scenarios were running through my head.  Thinking of someong pushing on my back was running through my head.  Every direction of the baby, every little foot movement.  I could sense all of them – I could feel the whole birth.  I knew my body was working, and the baby was doing OK because I could feel him move. 

I called Donna.  I think it had been 45 minutes.  It was time.  She had over an hour drive, and this wasn’t stopping.  I still felt bad.  It was the middle of the night – and everyone was going to come out, and this was just going to stop.  I don’t care.  I need presence.

James gets home.  Relief!  Wow, I’m getting loud.  I really don’t need to be this loud – but it just feels good, so I went with it.  But, I’m still talking and doing just fine between contractions… gosh, am I going to have to deal with this all night?  Can I handle it?  I really don’t want to…  I’m kind of done – these are intense.  James is a little panicked.  I asked him to move Bell back to her bed, and get the bed ready.  He wasn’t putting the sheets on right – and that annoyed me a little.  I just wanted it prepped – and fast.  He started getting glasses of water, straws, and putting all our birthy-needs in place.  “I need you to HELP me!”  Yup – that same scenario with Bell’s birth was coming up.  James is a prepper… but doesn’t do so well with support.  When is Crysta going to get here?  Why did I tell her to wait?  I hope Allie gets my message.

I have to pee.  It hurts to sit on the toilet.  Same feeling I’ve had for 2 weeks.  I have to pee – and I can’t.  I constantly feel like I have to poop… I’m totally pooping when this baby comes out.  I just accept it.

I decided getting in the shower will let me stand and pee.  I try the water on my back.  It was incredibly distracting.  I’m just not a water birther.  I’m a walker.  I couldn’t imagine sitting in a tub – I need to move.  I turn the water off.  Pacing – my same ritual I used with Bell.  It brings baby down, and it helps me deal with the sensations.  Oh WOW, those sensations!  I paced in our little standard 5′ tub.  “James, get the camera.”  I leaned on the bathroom wall with each contraction.  Really?  More hours of this?  Oh my gosh – someone just tell me I’m in transition and I’m doing OK.  “You can do it.”  “I can do it.”  “You’re OK… You’re OK.”  Nope – those don’t work.  Moaning… totally works.  And I was MOANING.  Bell is going to wake up, surely.  MOAN….MOAN…..OOOOOHHHHH…..I remember my deep noises this time, though.  Yup – bring that baby down, Danielle. 

“You’re doing good.”  What was that?  I thought…. James was telling me I was doing a good job….  He was taking pictures, and then just sitting by the tub watching.  He was so nervous… but this was great.  NEVER underestimate the power of encouragement and presence!  I AM doing good.  I’m loud – but I’m doing this!  And, I don’t have to get in my car and drive anywhere.  This is going to happen at my home!!!

I really need to pee.  Baby is pushing down and squishing stuff out with each contraction – but I just want to pee.  James, get me the peppermint oil on a tissue… nope, that didn’t work.  Worth a try.  Oh well, I’ll just stay in the tub.

Oooh… I am still doing this…  but how much longer?  I want to squat.  Wow, that kind of works.  I want to squat, and…. am I grunting?  A few squats with James supporting me (I almost knocked him in the tub with me) and my water broke.  Am I pushing???  No way…. no way am I already pushing.  I’m grunting.  Maybe there is a lip, I think.  These grunting pushes are good.  No one has even checked me – how awesome is that?!!  Oh, yea, I’m pooping.  Hey, at least I’m not going to feel like I have to poop anymore…Baby must be really moving down now…maybe if I poop it will make room for the baby.  (Seriously, you’ll think of all kinds of stuff when you’re in labor).  Where’s my labor land?  I so am not in labor land.  I am completely here – completely feeling everything, completely conscious and aware… but I’m doing it.  There’s no way I’m already in 2nd stage.  But, contractions were easier to rest through.  Still close – but I was getting a break.  Wow, this is awesome – totally intense, and I’m really ready to just be done.  James thinks about cleaning up the poop.  That’s love… that’s comfort.  Birth with someone who is OK cleaning up your poop!  But, I kept moving around, so he couldn’t get to it.  Wow, that stinks.  A few more pushes, and there went my water.  Oh NO!!  Meconium.  Wow, this bathroom really stinks now - and everyone is going to smell it.  Oh well… “James, call Donna… there’s meconium.”  Donna was about 15 minutes away.  I’m still squatting and grunting.  I’m going to have this baby!  Yes, I’m in 2nd stage.

James prays.  I think I pray at some point, too.

I want to stop standing.  Squatting just feels so much better. James lays down a towel and a chux pad.  Ahhhh – this is better.  I can lean… All 4s – what a powerful position.  Rest and birth at the same time.  Oh, I’m really pushing now.  No one is telling me to do anything – no one is touching me – I AM doing this all by myself!!!  James is just sitting behind me and waiting.  He’s nervous.  I’m DOING this!  I don’t care that no one else is there – I have a presence with me and I am DOING this!  I reach down… no head yet.  Oh, how long is this going to take?  A few more loud pushes – yeah, yelling just feels great.  I think of that carved stone face of the woman birthing – I totally look like her.  I’m POWERFUL!

Azstec Goddess Tlazolteotl Giving Birth - although I'm not keen on the idea of the "Goddess of Filth" this was, nevertheless, how I was picturing myself.

More pushes.  I reach down again.  I want to know how far the head is… I feel something squishy – but it is small.  It is that same distinct feeling I felt when Bell was crowning, just smaller.  OK, baby IS moving down… I AM doing this!  “Crysta is here,” James says.  I look out – she’s just quietly leaning by the wall in the bedroom.  Wonder what she’s thinking…. I’m LOUD!  Wonder if she thinks I’m nuts and not doing well… oh well… yelling just feels good!  More pushes, a little high pitched, but that’s OK.  Remember to just breathe, and you’ll be fine.  More pushes, and I’m feeling the head.  Oh, there’s that ring of fire.  I can do it – I think… I don’t want to – I think some more…  Just push – you CAN do it… you just HAVE to do it.  I only pushed for a few seconds with each contraction.  Not getting out of breath this time.  That was perfect – exactly what I could handle – no one telling me to do any more than what my body was ready to handle.  I could feel the baby moving down, then back up – wow, that’s crazy - doing the baby dance.  OK, I know we’ve still got more to go… baby is still moving up.  Oh, then there’s full on crowning.  My perineum is stretching, but I don’t think it is tearing.  Baby stops dancing.  Oh, we’re almost there I thought, and no one is interfering!!! 

A few more pushes and the head was out.  I DID it!  I DID it… and all I have left to do are the shoulders (oh, not fun) and the body!!!  “Can someone get Bell?”  Crysta says “she’s here.”  OH, cool!  I was SO glad she was able to be there – that meant the world to me!  I was worried she wouldn’t be able to see because of the small space – but James said she was watching.  I hear Donna, “There’s the head… but I’m sure you already know that!”  That was funny… I didn’t have the energy to laugh, but it was funny.  I feel her hold the baby – that was a little intense.  I knew I had to get the shoulders.  “Next contraction, I want you to reach down and hold your baby.”  OH – it is almost over… it is almost over!!!  I CAN do the shoulders – and my scar is giving me no issues (shoulders are what made me tear with Bell - that and directed pushing).  This is great!!!  I try to reach down, but I need to support myself, so I stop.  Donna holds the baby with the next few pushes, and AHHHH, relief – there’s that squishy body!

Crysta is taking pictures – AWESOME!  This birth was fast, and Allie wasn’t quite here yet.  The video camera’s battery was dead, but at least I’m going to have some pictures.  I move around, try to get into a better position, and then Donna hands me our little….  Its a boy!  A boy. I knew it!  I feel elated with this one – I didn’t have that instant feeling with Bell.  But, this was perfect – this was exactly the birth I wished for.

“Let’s cut the cord,” Donna says.  I check to see if it has stopped pulsing “Can we wait?”  “Do you still feel a pulse?”  I wasn’t sure – I was shaking – so she waited a minute or two longer.  She took the baby, and I moved to the bed.  We still had the placenta to go – but it was OVER.  2.5 hours from waking up to birth…. WOW!

We didn’t have a name picked out yet.  Interestingly, I was the one in a hurry to name him.  He was 8lbs 15oz – over a whole pound bigger than Bell.  But, was only 19.5″ long.

photo by allie b photography

photo by allie b photography

The cord was wrapped around his shoulder, which caused a little bit of cord compression, and likely the cause of the meconium staining.  He was fairly blue and limp at birth – alarming to me, but Donna checked him and he was doing well.  Funny – he has favored the ROA/ROP positions, flipping to LOA occassionally, but always back to the right.  I did some optimal fetal positioning, but felt like he was on the right for a reason.  I believe he was there because the cord was on his shoulder – and that the birth went fast so that he would do well throughout, and not have to deal with the compression for longer than he could handle.  God was watching over us.  He was well.  Not much bleeding from me, and he pinked up quickly.  He has a strong urge and suck to nurse – just like his sister did.  Now, just transitioning to a family of 4, and encapsulating my placenta next!

photo by allie b photography

What a magical experience.  Allie was able to make it for the placenta birth, and she got some beautiful pictures of our family – thank you so much for taking the time away from your family to document this special time in our lives you can watch the slideshow here – I’ve only watched it about 100 times http://gabriel.alliebphotography.com/).  Crysta was there with love and support… and she ended up cleaning up my poop.  Thank you Crysta, for being there – for being a wonderful presence – for being patient – for cleaning up my poop.   I was SO glad to have people there for 3rd stage and immediately after – just perfect! 

photo by allie b photography

Thank you Donna – thank you for no dopplers, for no vaginal exams this entire pregnancy.  Thank you for such wonderful care and advice – you are an absolutely amazing midwife!  Thank you to James for sitting patiently – for those small words of encouragement – I love you and am so glad to have been able to experience this birth in this way – even though you were nervous. 

photo by allie b photography

Thank you Bell – for starting my life over, and putting me on the path to experiencing this amazing birth. 

photo by allie b photography

Thank you God, for watching over our family and our birth team.  I didn’t need an unassisted birth… I needed THIS birth!

photo by allie b photography