Hiring a surrogate to carry the pregnancy is becoming more available/popular. The Today show recently featured a ‘gestational carrier’ who has brought eleven babies into the world for other people; she is known as a ‘super surrogate’ (retiring her uterus this year, as she has had fourteen pregnancies including her own!)

As a mother of two and a labor and delivery nurse, I think that surrogacy is an alternative option for people who otherwise might not have children of their own. Without question scrupulous research is needed to be sure that this is a carefully arranged and agreed to situation

Father of the baby or your sister, mother or lover…the point is that they are equipped to provide support during labor and at home with the baby. This does not mean that health care professionals: doctors, midwives, nurses, lactation consultants and pediatricians are not needed…it is the TEAM approach that supports her to get through the challenges that accompany labor and newborn parenting.

Scary to look down at your panties, or the toilet tissue after you pee to see bright red bleeding! Is this normal or a problem? Here are some tips to help distinguish between the two:

-Vaginal Exam: can cause spotting due to the sensitive nature of the cervix as you approach your due date: NORMAL

-Sexual Intercourse: definitely can cause some spotting afterwards, due to the “boom-boom” effect (penis contacting sensitive cervix, can result in spotting.) NORMAL

-Vaginal Discharge: Thicker, mucousey brownish- pinkish discharge is usually okay- particularly when there are no symptoms of discomfort.

-Bleeding: During pregnancy, bright red, steady or heavy bleeding is a potential emergency and needs immediate follow-up. (In contrast to active labor, when there will be small amounts of bleeding as the cervix dilates.)

If there is any concern of any kind related to the pregnancy- better to be safe than sorry- contact your health care professional or labor and delivery directly.

Last night’s SF childbirth class was packed with lovely, socially graceful pregnant women who are in denial about the physical aftermath awaiting them…they thought pregnancy took it’s toll – my response is: “hang on for postpartum!”

Expectant moms are typically so focused on the birth, that they don’t stop to consider the rest of the story. All new families should be prepared for some degree of discomfort as the body heals from delivery and adjusts to caring for a newborn.

The only good news is that postpartum is a temporary state that can include:
• Hemorrhoids, “skid marks” and/or an incision or tear in the perineum
• Swollen, sore breasts, twice their normal size; cracked and bleeding nipples
• Fussiness or babies who will not wake to feed – both baffling and frustrating

Know this- the way had been paved a few years ago by the twelve-pound older brother! The airwaves were abuzz with the news of a virtual toddler born “naturally” aka vaginally.

The medical concerns here include:
-Nine days past the due date – amnionic fluid levels are decreasing, placenta not functioning as well and the baby is just putting on weight.
-Pushing for SIX hours is alarming and potentially dangerous- stressful on mom and baby, not to mention the uterine muscle…two hours is the average time for a woman to spend pushing.
-To accomplish this birth vaginally- there HAD to have been an episiotomy and possibility instrumentation to assist the baby out vaginally…all with potential risks.
-Newborn’s this size often need assistance to regulate their blood sugar- this means blood tests and careful monitoring to be sure they are stable and adjusting to the outside world.

Big babies? Anyone else have experience delivering “toddlers” into the world?

So, what are the issues? It is much harder to achieve pregnancy at this age- which is why it is raining twins- many pregnancies occur with the help of in vitro fertilization (IVF) which often result in more than one baby. After 40, chromosomal malformations are higher, increasing the odds for downs syndrome and possibly autism.

Additionally, the pregnancy risks increase, including: gestational diabetes, preeclampsia, placental abruption, placenta previa and premature delivery.

No need to be dismayed or discouraged- it is possible to deliver a healthy baby into the world at an “advanced” maternal age. It does, however, require more testing, ultrasounds and prenatal care with an Obstetrician who has high - risk experience.

Sarah McMoyler RN

recently watched a program on Oprah’s network about incarcerated mom’s giving birth. Did you know that a few progressive prisons are investing in ‘baby wards’ where women and their babies can live together? Trained healthcare and counseling staff are teaching these moms’ care-taking skills they themselves may never have received. Additionally, there are ‘nannies’ – carefully screened female inmates who surround this new family of two with support…a win/win/win. The mom gives love, the baby is with its mother while others experience the benefit of giving to someone outside of themselves.

What a fascinating concept! Rather than taking the baby away from her (which has to be devastating) provide the opportunity for maternal instincts to emerge in a supportive environment.

ALL mother’s want the same thing- healthy babies.
Visit www.millionmomschallenge.com to find ways, large and small, to make a real impact through simple, inexpensive solutions that make a real difference for mothers and children around the world.

Sometimes a mother (yours or his) can be a Godsend…other times a disaster. It is your decision and your decision alone as to who will be there to support/witness the birth of your baby – and you can change your mind! You may think you want her there and then change your mind…your nurse can clear a room, delicately and directly- neither you or your partner has to be the bad guy- just keep the nurse posted – she will take care of the rest!

Birth As Performance Art?

36-year-old Marni Kotak is a NYC performance artist who plans to give birth in a Brooklyn art gallery. ‘In combining the birth of her child with artistic expression, Kotak said she wants to show this amazing life performance that is essentially hidden from public view.”

While I agree with the artist that birth is a transformative experience; is her next gallery performance going to be lovemaking? Are some close encounters better left as cherished memories and not a spectator sport?