Why a birth plan should be called a birth WISH LIST

As I have written about on my Blog previously, my first biological delivery went horribly wrong in every sense of the word. (Click here to read a flashback from JB who was obviously there.)  My pregnancy with Abigail was equally challenging (an appendicitis and quick flight out to Germany is proof of that.) Seeing that firsthand made me quite aware how go-with-the-flow you must be in both pregnancy, childbirth, and parenthood. I continue to hear from mom's asking me how they can plan for their birth. I asked my friend Tara, a family medicine OB in California to share her opinions on this with my readers. I find her post incredibly interesting and enlightening.

Enjoy!

My friend Tara on her job as a family physician. Tara became one of our good friends during JB's years in medical school at The Mayo Clinic. We also travelled to Nigeria and South Africa together for six week. Tara will not tell you this, but she is truly one of the most brilliant women I have EVER met. I encourage you to read her post below and share it with everyone you know! Tara and her husband Kelvin (also a doctor) have an adorable little son -- Iver -- Hannah's twin brother lost at birth I think.

I am a family physician and see patients of all ages in my practice, but my passion is delivering babies. I believe in and support women choosing natural childbirth if they wish (had one), breastfeeding if they desire (still going strong, after 19 months), and have even used essential oils on myself (all while believing wholeheartedly in vaccines. You know what is natural?? Dying of smallpox and polio is "natural."). I am also a planner.

That being said, it is my opinion that, effective immediately,  birth PLANS should be renamed "birth WISH LISTS." While we all have an "ideal" (mine is a child who sleeps through the night and doesn't kick and scream with every diaper change and attempt at getting him in a carseat), a good "birth wish" might include:  spontaneous labor that is only a few hours long, with contractions that are strong enough to dilate you steadily and push a baby out without causing pain with which you can't cope, without any need for an IV, complications or antibiotics, and which ends in a vaginal birth without tears, this is not the norm. 

• Sometimes preterm labor starts and gives you a 24-weeker who stays in the NICU for another five months. 

• Sometimes the water breaks preterm and you need to be on bedrest with monitoring in the hospital for weeks.

• Sometimes the water breaks prematurely, before any signs of labor, and it's safer to induce labor than to, well, just hang out waiting for infection to set in.

• Sometimes there is hypertension, or low amniotic fluid, or growth-restriction, or baby is late (42 + weeks), and it is safer (for the baby and/or mom) to induce labor than to wait.

• Sometimes, the body and the uterus (and the mind) get tired and there is need for medical "augmentation" (strengthening of contractions) with Pitocin or by rupturing the membranes artificially.

• Sometimes there is a large tear which can cause pain, and even pelvic floor issues later.

• Sometimes there is bleeding (catastrophic) like an abruption, which can lead to maternal hemorrhage, and fetal death if an emergency cesarean is not performed.

• Sometimes there is a uterine rupture, or a cord prolapse, which requires the same, prompt action.

• Sometimes the head is not down at term, and a safer delivery choice is an elective cesarean (if other maneuvers have failed).

• Sometimes, after 6 hours of pushing, it's time to "call it."

Just in the past five years, I have had many patients refuse many of the above recommended management plans, because they conflicted with their "birth plans."

I know I have an M.D. behind my name, and it may be tempting to feel threatened by hospitals or medical providers who learned their medical knowledge from Mayo Clinic and not Jenny McCarthy or Google University. However, please remember that I am also a moral person (and a mom), and we are all wanting the same goal-- a healthy mom and a healthy baby, and that I would be devastated by the loss of either patient.  I feel that the only thing about labor and birth that is predictable and that you can "plan for," is that labor, birth, AND PARENTING, are unpredictable. It is my opinion that birth plans need to go out the window because being flexible and relinquishing control is the first thing you need to learn about being a new parent.

I have seen babies, whose moms refuse antibiotics or didn't get adequately treated for group B strep, become septic, and need multiple lab draws, IV antibiotics, and hospital/NICU stays.  At my hospital, women still routinely refuse penicillin (or even screening for GBS), to my disbelief. 

I have not personally seen vitamin K-related bleeding in a neonate, because of widespread use of intramuscular vitamin K given at birth.  But another provider in my clinic had a case last year, because, in their birth plan, parents had decided to withhold this shot for their newborn (an alternative that some parents request, oral vitamin K, is not very effective. There is a good article, and more information on a variety of topics, on the website Evidence-Based Birth).

One of my pediatrics patient was a neonate who had to be hospitalized at UCSF NICU for apnea due to pertussis, which can be prevented, or its incidence drastically reduced, by maternal TDaP vaccination between 27-36 weeks with each pregnancy (this anti-vaxx mother had refused vaccines for her older child from birth, too).

• I support women's ability to walk, move, and eat and drink in labor and think that the advantage of position changes and gravity are helpful for labor progress and pushing; that being said, I fully support a woman who opts for an epidural in labor, because, if it helps her cope and helps her baby arrive safely, that's all that matters (even if the original "birth plan" says otherwise).

• I catch babies underwater for those low-risk moms who want a water birth, even though the bodily fluids (and solids) in the tub sometimes gross me out, and I fear falling in, and of having back pain from crouching awkwardly.

• I do delayed cord clamping routinely, because it has benefits for reducing infant anemia, even though it adds a few minutes to the third stage of labor, and often makes me late getting back to clinic (or to my family).

• I support breastfeeding, but I also support moms who for whatever reason (they couldn't, it was too difficult, or they didn't want to) chose to formula-feed (a FED and growing baby is all that matters).

• I have routinely been performing "Gentle Cesareans", where we drop the drape and hold up baby to let mom see the baby as he/she comes out, do delayed cord-clamping on the surgical field (if baby is vigorous), and promote skin-to-skin time (and breastfeeding) and with baby on mom's chest in the operating room until the case is finished, even if it's a bit harder for me to sew sometimes with mom's head of the bed up.

• I allow women to do anything they want with their placenta, even though I tend to gag a little when I see them chugging down placenta smoothies in the delivery room (yes, this happens).

• If parents want to deliver the placenta attached to baby ("Lotus-birth") and keep the baby connected for weeks, that's ok by me, because I don't have to smell it daily, and the baby is out.. and presumably doing well.

• I take care of moms who choose home births after weighing risks and benefits knowing that, for most women, it will go well, although it's still safer for the baby to be born in a hospital.

• I want women to make empowered and informed choices for themselves, and their children, but I want them to be safe choices.

• I just want a healthy mom and a healthy baby.

So please, if you have a "birth plan," please rename it a "birth wish list," and know that obstetrics, birth, and parenting are unpredictable and, at times, even dangerous. We are on the same team.

https://www.mcsweeneys.net/articles/jamie-and-jeffs-birth-plan

The Past We'd Like to Forget

By Wendi Kitsteiner

Reflection hurts. And I have a few spots in my past that make my heart hurt when I think about them.I imagine we all have something like that in our lives. Memories that cause us pain. Either because of something we did or something we didn’t do or something that happened to us or something that we caused to happen to others.

I imagine we all have something like that in our lives. Memories that cause us pain. Either because of something we did or something we didn’t do or something that happened to us or something that we caused to happen to others.A sickness. A betrayal. A death. A disappointment. A mistake.

A sickness. A betrayal. A death. A disappointment. A mistake.

After two years on an Air Force base in Turkey, our family was relocated to a nineteen-by-twenty-one-mile island in the middle of the Atlantic Ocean. Part of Portugal, Terceira Island in the Azores was, without a doubt, one of the most beautiful places I had ever seen. Picture Ireland surrounded by water. Greener than anything you can imagine. Rolling hills. Beautiful volcanic rock coasts. Cows meandering through the streets. Bullfights. A café in every town.

But despite the beauty surrounding me, my heart and body were in unspeakable pain.

After years of infertility treatments, we had a few remaining embryos that we wanted to give a chance at life. I had undergone IVF four other times, but this time, the medications I was on caused me to spiral into a depression. I lost twenty pounds and found myself pregnant and terribly sick .....

You can read the rest of my post at The Glorious Table. 

17 years and pregnant!

A c-section mama processes

I've always felt a little "robbed" when it came to my birth experiences.

But after ten years of infertility, I simply told myself to suck that up. How amazing that I got to have a baby at all. The fact that it didn't go as planned? Keep that to yourself.

(Click here if you want to read what happened during Elijah "Sidge's" birth that started off all this c-section nonsense.)

I still think that fact is mostly true. It truly doesn't matter how your babies get here when it really comes down to it.

However, I recently read this article: Three Truths About C-Section Mamas shared with me by my Turkey friend Sarahbee. It was written by a woman who photographed section births. And it really got me thinking. 

April is C-Section Awareness Month (they have a month for everything, don't they?) and so I figured now was a good time to share.

I went through a range of emotions with each of my three sections. With my first (Elijah "Sidge") I didn't even have time to process these emotions since it was unplanned and of an urgent nature. But with my last two planned sections, I had much more time to think about things as we went along.

There were two main things that always "bothered" me about having a c-section. 

1. Being prepped for the surgery: This is probably the one that has always stuck with me the most. I really never realized, until reading this article, how much my emotions were normal and expected. Sitting on the operating room table, waiting for them to put in the epidural while everyone scurried around and JB waited outside and knowing I was soon going to be cut open and recovery was going to begin has always caused me to not WANT to think back on the birth of my kiddos.

The author captured what I felt so vividly when she wrote:

Being prepped for a c-section is not a walk through the park. Many times, a mother’s partner is not allowed in the OR until after the epidural has been administered and everyone has “taken their place.” This means that while doctors and nurses move about, readying the operating room for delivery (maybe talking about their lunch or what movie they saw over the weekend) a strong pregnant mama sits on a cold operating table considering what lies before her - often scared and often feeling very alone. 

And in these moments, a c-section mama must hold onto the strong and fierce love she has for her baby. She lets fear wash over her...and then she lets it drift away. She know that in this moment, this is what is best for her child, even though “what’s best” means a major surgery with real wounds and scars. Even though “what’s best” means letting go of a dream or a vision of birth that she’s been building up for the last nine months.

If you haven’t had a c-section before, I encourage you to let the stark reality of this moment settle in your mind - put yourself in her place, on that table, waiting, possibly fearful.. When you do, I think you’ll quickly realize how brave c-section mamas are.

2. Not holding my baby (or really wanting to) after the baby was born: When Sidge was born, he was in BAD shape, and we thought we were going to lose him. Holding him was the last thing on my mind. But with Abigail, we were in Germany, and they didn't have their OB recovery room available. So JB had to go with our daughter to one room while I went to a different section of the hospital. When they asked me if I was okay with that, I told them I was. (What else could I say?) And honestly, after everything that happened with Sidge, I didn't really feel the freedom to ask for more. After Hannah, I had some hypothermia set in that caused me to feel very ill. Each time I couldn't hold the baby or just didn't feel like holding the baby or was in too much pain from the section to hold my babies. So different from so many pictures I see online on Mamas and babies.

There aren’t many mothers who will say that a c-section was what they had first envisioned when they thought about giving birth. A c-section is a medical necessity in the best of situations; in the worst cases, it can be due to the outdated practices of a doctor or his/her desire for convenience.

Some c-section mamas have weeks to mentally prepare for a change in their plans, but many only have days, hours, or minutes. Suddenly, everything she envisioned when meeting her child has changed. Her birth plan has been thrown out the window. Surgery lies before her. She doesn’t know how long she’ll have to wait after birth before she holds her baby in her arms.

We humans don’t tend to do well in situations of sudden change. And yet c-section mamas find a way to let go of their pride and connect with an inner-strength that allows them to enter the OR and give birth to their child.

And then the actual surgery happens. The actual cutting and suturing. Full recovery often takes months. And while most of us would like to curl up with a bowl of ice cream and a stack of movies after a major surgery, c-section mamas do just the opposite. They nurture and love and bond with their needy, beautiful babies.

Emotionally and physically, these women are SO strong. And this strength isn’t just necessary on delivery day; this strength must endure in the weeks and months and years ahead - as their bodies and souls heal, crafting new dreams with their little ones in their arms. 

I'm appreciative of this article and to Sarahbee for letting me say, "I'm not happy I had to have c-sections." This article gave me permission to say, "I wish I could have done it a different way." And I also felt allowed to say, "That part was really hard."

But at the same time, I am so incredibly THANKFUL for modern medicine. I am quite aware (and my doctor at Eglin reiterated this to me) that had I not lived in the place I did and at the time I did, I would have most likely died in childbirth with Sidge. Or he would have died in order to save my life. 

And that means my girls wouldn't be here.

This article made me realize that I am blessed. But it is okay to feel free to admit that this is a part of my story I wish could have been written another way.

It's okay.

Our story (with three more kids)

I keep having people post this story on my facebook and blog. Like us, this couple was infertile. They adopted. Then they got pregnant. Exactly our story. Only they adopted triplets. And got pregnant with twins. Can I imagine this? No. It literally gives me heart palpitations to think about it. Click here to read this story for yourself.

 

I'm admitting it ...

... I stink at being pregnant.

There I said it. And if you want to judge me. Go ahead.

I struggle with this. I struggle with admitting it. I struggle with thinking it. I struggle with saying it. I struggle with feeling it.

And if I do, someone else does. And that someone else needs to hear it from someone like me so that they stop feeling guilty for feeling guilty. That's why I am writing this.

There are women who are made for being pregnant. They love it. They do it well. They glow. They grieve when the baby is on the outside and not inside them anymore.

That ... is ... not ... me.

Some people are made for this.

Some people are not.

I am not.

After ten years of infertility, we adopted. And then got pregnant. I had dreamed ... for years ... of having one of those big bellies.

Now I had one.

And I didn't like it.

And that is hard to admit. It's hard for anyone to admit. But infertility is woven into the fiber of my being. It will always be a huge part of me. Many people who read my blog are still battling this. It's a horrible affliction of which I would not wish on my worst enemy. I was forever changed by it. I will never forget it.

During each of my three pregnancies I faced complications. The small things like leg cramps and insomnia and heartburn. With my third, I was sick until 27 weeks and battled depression and anxiety related to the continual sickness.

And there were big complications too. Bleeding. Early labor. Heck, even an appendicitis which had to be operated on in a Turkish operating room while I was awake.

I wanted the baby of course. I wanted each of my babies with every molecule of my being. But the side effects of pregnancy? I didn't want those.

But to say that? Out loud? Especially me. A woman who wanted this and begged for it and pleaded for it.

If I admitted to my group of infertility sisters that I didn't like being pregnant, they would be hurt. I know if I were in their shoes, I would be hurt too. And while some of my mom friends encouraged me to "be real", there was an always present level of fear surrounding admitting that anything was anything but "perfection."

I feared that if I admitted I didn't feel cut out for pregnancy ... if I admitted I didn't feel good ... if I admitted that I just wanted my body back ... that people would consider me ungrateful. They would judge me.

That Wendi. She begged God for years for a baby. Now she has one. And she's complaining. She is whining. She isn't loving every single minute of this pregnancy thing.

I confided in a few choice people and got burned. I realized that I was held up to a different measuring stick because of the infertility. That people expected me to behave a certain way. That they didn't think being honest was appropriate.

It's like playing Division I Basketball in college (which I did.) You have a full ride to college and are fawned over and travel the world. How dare you complain?

Okay but still. I don't want to get up at 5:30am to run on the track. I'm sick of taking four showers a day. I'm sick of the gym. How do I keep on my schoolwork? I'd like more than four days at Christmas to spend with my family. I want to go on a vacation during the summer instead of continuing to work out.

Isn't it okay to feel tired and worn out and grateful and blessed at the same time?

I argue that it is. And I'm not going to pretend ... anymore ... that real is not okay. I don't want someone else to feel the way I have. To feel afraid to share their heart.

A friend. A neighbor. She admitted to me that her two pregnancies were terrible. That she and her husband wanted more children but not if it meant being pregnant again. That after her daughter was born, there was no instant bonding. That it took many months for her to feel attached. Nothing came natural. Everything felt awkward.

She admitted the truth. She was real with me.

What if she wasn't? What if she lied? What if she pretended that everything was great? And what if I did the same thing? And we all did? And no one felt they had permission to be real? And we kept this cycle of dishonesty going? And new moms everywhere felt alone and that they were the only one?

Because ladies and gentlemen of the jury, I want to argue that what begins with pregnancy continues into motherhood and there are way too many women who are comparing themselves to fake other mothers. Be your child adopted or biological you need to know that you are normal. You need to know that you are not alone.

This pregnancy and motherhood thing is tough to figure out. Especially after wanting it so badly. But wanting it doesn't mean you love every minute of it. Wanting it doesn't mean that you don't feel overwhelmed some days. I have a huge belly and three children already out of the womb. None of whom will go to school in the fall. That's a lot. And some days I honestly think to myself: God? Did you get me confused with some other woman who is totally capable of this?

Certainly having moments where you wonder if you can do it or if you are cut out for it or if God got you confused with some other woman who was capable of doing this job -- pregnancy and birth and raising a child or children -- certainly doubting your ability in these moments does not mean you are not grateful.

I am grateful. I am on my knees thanking the Lord grateful. Not a day goes by that I do not think I cannot believe I got this opportunity. Not a second goes by that I do not remember that there are women everywhere would give anything to switch places with me. Women who want to have a baby with every fiber of their being.

I was that woman.

But the opportunity does not change the fact that I have hard days. That opportunity does not mean I am not scared, overwhelmed, frustrated, unsure, and just plain tired some days.

Both in pregnancy.

And motherhood.

Heck even in life.

I stink at being pregnant. I'm so glad that others have paved the way and admitted this and allowed me to not feel alone in not feeling good and counting off the days until this blossoming miracle of life is on the other side of me. People like Joy Gabriel who wrote on her blog:

Pregnancy is not easy for me. I'm pretty sure I'm allergic to it because my whole mind and body just kinda freaks out. This last one was brutal and and my body is still shouting that story from the rooftops. Six months of bed rest and 60 lbs, agonizing hormone shots, early labor, depression, migraines, insomnia, stretch marks (just to name a few). I will probably never look or feel quite the same again and that's exactly as it should be. I'm not the same. Bearing children has brought me a wealth of insight and experience I wouldn't trade for the skinniest pair of jeans.

I refuse to pretend and be fake and make others think that I have it all figured out.

So I'm admitting it. Whatever your "it" is, remember that you can admit "it" without being a complainer.

You can say "this is hard."

You can be real.

Here's the truth

Right now, I don't feel well. Battling morning sickness and headaches/migraines. Neither of my previous pregnancies hit me this hard of that I am certain.

However, this will probably be the last time I mention anything related to not feeling well on my blog. I will let you all know when I am feeling back to normal, but otherwise, you can simply stand alongside me with prayers. You can pray for good sleep, extra-big doses of daily endurance, and healing from the headaches and the nausea that have knocked me on my rear end a bit.

However, I am choosing to turn my focus to other things.

What I instead feel "lead" to do is write my blog for those of you struggling. My plight is not a hard one. It is for a time. A brief season. Maybe it will last one more day. Maybe a little longer. Tomorrow may be the end. While sometimes it is hard to remember when you are in the midst of the storm, it is important to remember that storms do not last forever. But some of you, are dealing with plights that might be a bit longer, a bit harder, a bit more difficult to see your way out of.

If it is a daily struggle to remember the truth behind my plight, how much more difficult must it be for someone facing a terminal illness diagnosis, the death of someone they love, the news of something much more tragic that effects there body, soul and/or spirit.

Isn't that what the whole "theme" of my blog has always been about? The scripture, plastered on the blog itself is from Habakuk chapter 3.

Though the fig tree does not bud and there are no grapes on the vines, though the olive crop fails and the fields produce no food, though there are no sheep in the pen and no cattle in the stalls, yet I will rejoice in the LORD, I will be joyful in God my Savior.

And the next verse continues this encouragement:

The Sovereign LORD is my strength; he makes my feet like the feet of a deer, he enables me to go on the heights.

In my life right now, there is no empty fig tree or vines. There are simply some, difficulties, if you will, in my early pregnancy. Far from that of the Jews in concentration camps. Of POW's. Of victims of war or violence.

Some of you, out there, are dealing with some, difficulties, if you will, and the vines are empty. You are fighting an illness. You are grieving a loss. You are hurting. You are healing. You are lonely. You are empty.

It is for YOU I plan to write my blog over the next few weeks, months, years -- however long. For me and for you. While I encourage myself in the day-to-day life, I hope to encourage you.

There will still be glimpses into our family life. Nothing much will change. But you will find even more encouragement. (I hope.) Scriptures that are ministering to me as I attempt to be the best mom and wife I can be while not feeling the person I want to be.

I am so blessed. So blessed in so many ways.

• Blessed to have this tiny life growing inside me.
• Blessed to have my Aunt Connie here for a season that only God could know was coming.
• Blessed to have a husband who is stronger than any other man I know.
• Blessed to have friends both near and far encouraging me.
• Blessed to have the three children (and fourth) that the Lord has given me.

I also want to tell all those who love me -- friends and relatives -- that I am sorry I am not quite as "active" online and on the phone and in letters or emails. I am really having to focus on the things we need as a family. Extra things are being cut out. We have three young children. We live on an island in the pacific. My husband is a busy doctor. We have to focus on close-to-home.

It is "difficult" to not be the Wendi I know is in there. I would usually consider myself a "Tigger" in personality and energy level. I'm not Tigger right now. More Pooh-like. But that's okay. It's okay. I'm okay. God's okay. We're okay.

And as I encourage myself, I hope to encourage you too.

I cannot "listen" to the worry in my mind. That someone might misunderstand my motives. That anyone might think me complaining. That anyone might think I am ungrateful. I know my heart. And as I write this blog and process my thoughts, I must trust that the core of Wendi will be evident.

Blessings everyone.

C-sections

This post is a little motherhood-heavy. Feel free to skip and join in tomorrow if it will hurt your heart for any reason.

I have often felt a bit "robbed" by my inability to deliver vaginally. I used to hear people say this and remember thinking, "Well, that's silly. You have a baby. No big deal." And that is true. Obviously I am incredibly thankful for the opportunity to be a mom and would gladly do it all again, via c-section, to have my beautiful children.

But there is a bit that I feel I lost out on in those early moments with my children.

During Elijah's birth, I was in labor for a day and a half, dialated fully, and pushed for three hours. But baby was not coming through. It didn't really have to do with how big he was. It had to do with the fact that my pelvis was not big enough to have a baby come through. But then his heart rate started being bothered by the contractions, and they decided to do a STAT c-section. So off I went.

I had no idea that in a normal c-section, like the one I would have with Abigail a few years later, that the mother typically gets to see the baby right after he or she emerges from the womb. The staff pulled down that drape and I saw a beautiful, crying baby girl, and I started crying. Crying more because that hadn't happened with Sidge. With Sidge, he was doing so badly when he was born that they whisked him away. It would be many hours before I held him. He would fight a hard battle (apgars of 1 at birth and 2 at 10 minutes) and I would be dealing with drugs used to calm me down as well as too much bleeding and a worry about needing a blood transfusion.

A day later, the problems hadn't ceased. I then got very sick with an illeus and infections. We had a really rough start. Abigail and I had a much better start.

But recently someone sent me this video: Mother friendly c-sections. I thought this was going to be some "mother Earth" video -- way to granola for my tastes. But it wasn't. After the difficulties in having Sidge and then seeing how much better it could be with Abigail, I agreed with the theories and suggestions in this video. I had seen how different I felt after just that one moment of getting to see Abigail cry. It had etched itself permanently on my heart. Early moments were important.

This video shows some of the efforts being gone to in order to allow mothers a more "traditional" birthing experience despite the fact that their baby's birth is not traditional. I am basically against birth plans and trying to "control" your birth experience too much. You really have to be flexible. But I do think attempting to get a bit more control of your c-section experience is something to consider.

Guest Post : Exercise for a Better Body After Giving Birth

“Katie Moore has written and submitted this article. Katie is an active blogger who discusses the topics of, motherhood, children, fitness, health and all other things Mommy. She enjoys writing, blogging, and meeting new people! To connect with Katie contact her via her blog, Moore From Katie or her twitter, @moorekm26.”

Ample time and plenty of energy are exactly the things I did not have as a new mom. A new baby in the house takes a lot of energy, a lot of time, and a lot of effort, which often left me feeling exhausted. I wanted to lose my baby weight and get back to the way I looked pre-baby, but without any energy or time I found myself struggling and wondering how I was supposed to work out. Hitting the gym for hours at a time wasn’t feasible for me with a new baby. Fortunately, I discovered there were exercises I could do at home!

Talk to the Doctor First 

Medical professionals have two warnings about post-partum exercise for new moms. The first is that every new mom should check with her doctor to inquire about a safe exercise plan. Just like they told you about pain management medicine, circumcision, and cord blood banking for a delivery plan, they know all about post-partum exercise as well. Some moms have difficult deliveries and their doctors worry they will hurt themselves if they take on too much too soon. A specialized program can be created with your doctor if you were someone who had a difficult or C-section delivery. The second warning is that women need at least 30 minutes of moderate exercise each day to maintain the best body and optimal health. These 30 minutes can be broken up into smaller time segments if needed to achieve that goal.

Exercises
Walk. Not only is this a great way for women to ease themselves back in, it’s also a great form of exercise. Load the baby into the stroller and get to walking. New moms can take an easy walk around the neighborhood or park, or they can look for a street with a lot of hills to push the stroller up. Furthermore, women who have a baby Bjorn or other carrier can walk with their baby on their back or front so their arms are free to swing as they should when walking.

You can also get to work on that pre-baby body by investing in a few fitness DVDs and pop one in when the baby is sleeping. I had a pile of workout DVDs after I had my daughter and learned so many new, fun exercises from them. Yoga, my favorite, is a great way to work out, strengthen a woman’s core and build muscle as well as relax and rejuvenate her mind and body. Zumba exercises are another great form of DVD workout for moms. The upbeat dancing always improved my mood as well as my body.

Nutrition
Working out does a great job of getting the heart rate and muscles going, but it isn’t nearly as effective on its own as it is combined with a healthy diet. New moms should make sure to eat plenty of fiber and vitamins. Foods such as fruits and vegetables, whole grains and dairy products are good for the body and make it easier to lose weight and get healthy.

As a new mom, I did not have a lot of free time to work out on my own, which is why at home exercises and exercises that allowed my baby to tag along became my preferred way of working out. Combined with a healthy diet, I started to see results in no time!  

Interested in writing a guest post for my Daily Blog? Email me at wendi@wendikitsteiner.com. You don't have to have a blog or be a writer. I'd love to share smoething you are passionate about. The topics are limitless. (The thoughts and ideas presented in the post above are not necessarily that of Wendi Kitsteiner.)

For Patty

What a joy it is to host a baby shower, now, on the other side of infertility. It has taken many years, but I can honestly say that now, I do not covet this miracle any longer. I pray for those of you who are still in the throngs of the sadness which can accompany barrenness. Whether you be barren of the womb, as I was for so many years. Barren of a spouse. Barren in your soul due to a great loss. Or barren of the spirit due to the absence of our Lord Jesus Christ, I am thinking of you today. Anytime I am celebrating, and especially when I post the pictures later, I think of all those who may be hurting today. I pray that the Lord hears your hurting heart today.

This is a baby shower post though. And while I am always selective in the pictures I put on my blog, feel free to skip this post if it is not a good time for you. 

Angelica and I threw a baby shower for my friend Patty. We had a dinner for men and women alike at the downtown Adana Hilton -- one of the only "America-like" places you can find off of the Base. What a beautiful evening it was. Enjoy the snaps:

My friend Heather (who was born in Nigeria) waiting for the guests to arrive. Heather is a nurse who works with JB and Yamil.

Angelica sporting some high heels. She makes it look so effortless -- but if you ask her, she'll tell you how effortless it is not!

Patty & Yamil plan to decorate the nursery in "Space" theme due to their mutual love of STAR WARS.

Thus the blanket Angelica and I had made for little Troy.

 Patty and Yamil were at Eglin with us and what a great time it was to spend a year with them here in Turkey! They will always be a special part of our family.

And so will they -- Dr. "Winda" and Mr. Shane.

The fact that they put candles on the cake was very Turkish. The fact that I had to do all of the communicating as well. (There were no other Turkish speakers in our group.) But the night itself was truly an escape from the life we all live. 

Patty with her co-shower-hosts.

 JB goofing around with our goddaughter Reese. The hotel provided champagne for our celebrations.

Patty is a hugger. We hug every time we see each other and every time we part. I will miss her hugs.

 Today, the truck came to begin packing up Angelica's things. She and Dan will be the first family to leave in our circle of friends. This picture so perfectly captures her beauty -- both inside and out.

With Linda, Angelica, and Reese.

Angelica made this adorable shower cake. You can barely see the "que' pasa" t-shirt in the front. Patty and Angelica share a mutual love of the Spanish language even though Patty is from Peurto Rico and Angelica from Spain.



Post-partum

In attempting to open my own door of communication in regards to Post-partum depression, I thought I would start by just outlining how I have been feeling in a more general context. This is hard for me to talk about, but I have been encouraged by many of you and do feel that me sharing will allow other people to be aware of this condition.

One of the things I most struggle with is anyone perceiving how I am feeling to a lack of gratitude for the miracle of my daughter's birth (or my other children.) I know these things are not related but I don't want anyone to even contemplate them being intertwined.

I have learned a lot about post-partum sadness in the weeks since Abigail was born. I did fight some post-partum depression with Elijah but it was much further out (six months) and was much more on the anxiety end of the spectrum. This time, depression has been a much bigger factor and anxiety more of a secondary characteristic. 

I have learned that sadness in the immediate two weeks after baby is born is referred to as "Baby blues." This does not last long and passes as soon as it comes in. I had all of the symptoms (taken from Mayo Clinic's website) below:

• Mood swings
• Anxiety
• Sadness
• Irritability
• Crying
• Decreased concentration
• Trouble sleeping 

As I left Germany, I felt the baby blues departing, and I thought I was on the mend. However, while I did feel initially better, since the blues had passed, I felt myself slowly going down again as I settled into life here in Turkey. With the baby blues, my primary issue was just crying. But with the post-partum, the symptoms were greater and weren't going away. Some of the symptoms are listed below. (The ones that most effected me are in bold.)

• Loss of appetite
• Insomnia 
• Intense irritability and anger
• Overwhelming fatigue
• Lack of joy in life
• Feelings of shame, guilt or inadequacy
• Severe mood swing
• Difficulty bonding with the baby
• Withdrawal from family and friends
• Thoughts of harming yourself or the baby

You don't have to see a doctor for the baby blues. However, in my case, it became obvious that I had left one thing (blues) and entered another (depression). If these symptoms are occurring, you need to see your doctor. (The ones in bold effected me.)

• Don't fade after two weeks
• Are getting worse
• Make it hard for you to care for your baby
• Make it hard to complete everyday tasks
• Include thoughts of harming yourself or your baby

Personally, I was/am most dealing with:

• The inability to make decisions
• Worry that something would happen to my children
• Sadness that my children were growing up too fast
• Feeling overwhelmed by meaningless tasks
• Lack of pleasure in things that normally brought me joy
• Easily frustrated or irritated
• Guilt about time for each child
• Worry that people would misunderstand my feelings
• Feeling like life isn't worth living
• Feeling that life was too sad to bother with
• Discomfort with social situations

I plan to write more in the future but wanted to start with this overview. I am feeling better already after starting medication and am hopeful that this trend will continue.

An Unexpected Announcement...

Hold onto your hats folks. This infertility blog from the freezing Polar North has moved to Turkey and has found that after one adoption and one pregnancy, there is more news to share.

Here we go.

We are pregnant.

Believe it or not, I think this pregnancy announcement comes with more emotional weight than Elijah's did. More emotions. The first announcement was only joy. It left me with no guilt. I did not feel badly telling my infertile friends of our news, although I still did it in a tender way. This was what all IF gals dream of -- a pregnancy after five years of trying! I had put in my time on the IF side after all. It was time to celebrate.

But to be pregnant, again? While incredibly excited and amazingly blessed, this message is given knowing that it will hurt people I love. They are not upset at me. But they are sad for themselves and the fact that while we will have three littles ones, they are still praying for just one. They question God's fairness. And to be honest, I do too. We have a few very close friends and family members still waiting on their miracle while we have three miracles.

I remember lying on the operating table for my fourth IVF and turning to my doctor. "I just want one!" I said to him. "Just one!"

So to have three?

I have spent days trying to formulate in my head how I will write the specific word on this blog yet again. It wasn't until a friend of mine emailed me the words below that I felt things had come into focus clear enough for me to write this blog. This friend has faced many losses. There are still no children in her home. She is waiting for God's perfect completion to her own story. And yet she had the ability to share the words above with me when I shared my news with her.

"I know it may seem random or unfair to you, but this IS God's design, His purpose. Therefore, it is not random or unfair, but His perfect will in His perfect way, in His perfect timing. The Lord has given you a unique gift of being able to communicate with others through your writing in a way that draws others to Him. The Lord is the author of your story, you are the teller. The Lord is writing your story for the display of His glory to draw others to Him and give encouragement to those who are hurting. Rest in His perfect will. You do not need to be fearful of hurting others, I really do believe this news will be an encouragement to many."

Bless you friend for helping me to tell people that JB and I are, in fact, pregnant. Again. Bless you for those words. It has stuck with me. This is our story. We are not the authors of this story. God is the Author of this story. God is in charge. All we can do is pray and praise and allow Him to guide our days.

We have received many questions in response to this news, which we have been sharing off-the-blog for a few weeks now. I will be back, soon, with answers to those questions. But for now, a huge hallelujiah for another life growing inside me.

We confirmed today that we are 7 weeks and 3 days. We saw a heartbeat -- 141 beats per minute.

Even more amazing? 7 weeks and 3 days was the exact date that we saw little Elijah on ultrasound for the first time. Due, July 24 of 2011.

In 2007 we got Scrubby. In 2008 we held Isaac for the first time. In 2009 we met Elijah. And in 2010 we found out about yet another amazing gift.

Miracles are cool. Thank you, Jesus, for this new little life.

More to come.