Our Birth Plan

Obviously this is what it all comes down to!

Anyone who knows me would say I am pretty type A. I like to have a plan and be organized and know what to expect and be in control. My poor husband. 😉 He is definitely not like this. The ying to my yang. He puts up with it well.

I knew I wanted to have a birth plan so that Matthias, myself, my doula and midwife would all be on the same page about some of the bigger decisions that are made “in the moment”. I wouldn’t want to leave Matthias in the thick of it to make some hard decisions when I am so blissfully out of it in labor, so I thought it would be best for us all to have a discussion before hand so that we know if complications do arise how to handle them and in what progression we would like to proceed with medical intervention.

I don’t need to be told that labor and delivery never go according to plan. That’s not what creating a birth plan was about for me. I am aware of the things that go on in delivery rooms, the complications that can arise, and the various ways that health care providers can treat these things. For me, creating a birth plan was a method of communication for consistency, so that our wishes can be heard, even if they don’t come to fruition. So without further ado, here is our birth plan! (P.S. I know it looks long and detailed, but a lot of this stuff was already discussed with my midwife prior to, it’s just all in one central place now!) :)

Birth Plan

The safety of the Baby and Amie precede any requests in the list below.

Labor

  • Please do not offer narcotic analgesia or an epidural
  • People present in the labor room: Amie, Matthias, Doula, Midwife, and second Midwife for delivery. Amie is okay with having another nurse present if required
  • Amie would like to be able to eat and drink as she feels appropriate
  • Amie would prefer natural pain relief techniques and the use of the birthing pool/tub
  • The only medication Amie feels comfortable using to manage pain is Entonox/Laughing Gas
  • Amie would like to avoid all artificial forms of induction including the use of Cervidil and Oxytocin
  • Amie would prefer to not have internal fetal monitoring, she is okay with EFM (External Fetal Monitoring), including continuous and intermittent auscultation
  • Amie would prefer to only have her midwife, Melissa, do internal exams
  • Amie would prefer to not have an IV, unless required for a specific procedure or treatment of GBS (Group B Strep)

Delivery

  • Amie is open to all pushing positions, and ideally, would like to push in the birth pool/tub
  • Amie would prefer spontaneous pushing, but coaching on method/technique is welcomed
  • Please do not let Amie push for longer than 2 hours. Unless birth is imminent, after 2 hours she would like to discuss her options for safe delivery of the baby
  • Amie would like to avoid having an episiotomy, and the use of the vacuum and forceps. If these are required, she would prefer vacuum over forceps

Immediately After Delivery

  • Please delay cord clamping until after the cord has stopped pulsating
  • Amie would prefer to have the baby immediately brought skin to skin and to breast feed as soon as possible after delivery
  • Matthias will cut the cord
  • Please do not give Erythromycin Eye Ointment to the baby, Vitamin K injection is Okay
  • Amie would prefer to deliver the placenta naturally, but is okay with interventions if necessary
  • Please save the placenta for encapsulation, we will provide a cooler

Postpartum Recovery

  • Amie would like to be discharged home from the hospital as soon as deemed safe by the midwife
  • Amie would like to perform the initial baby bath with Matthias
  • Please no formula – we will provide EBM (Expressed Breast Milk). If low CBG’s (Blood Sugars) are a concern, please discuss options with Amie

Unplanned C-Section

  • Amie would like to be awake for the Caesarian
  • Matthias will remain with the baby at all times, upon return to Unit 25 he will do skin to skin until Amie comes back from the Recovery Room
  • If necessary, please give EBM to baby prior to the use of formula
  • If possible, please use sutures instead of staples
  • If possible, please delay cord clamping

Will I be upset if all of the things on this list don’t happen? Of course not. At the end of the day, I know that labor and delivery require me to give up control over the situation and trust that my body and the team around me will make the right decisions to get our little girl out safely. Will I be upset if I end up having a c-section vs. a vaginal delivery? Absolutely not. Thank goodness we have that option available to us to ensure the safety of ourselves and our baby’s. And if it happens to me, well I can 100% rest assured that my midwife and doula and husband and myself tried very hard to have a vaginal delivery and that doesn’t always work out. NBD. :)

I’d love to hear your feedback and/or questions! Did you have a birth plan? Did it help or hinder your labor and delivery experience?

Organic & Local

Have you heard of Michael Pollan?

If not, you should google him, and then buy a couple of his books. 😉

Michael Pollan is an American author and journalist who “writes about the places where nature and culture intersect: on our plates, in our farms and gardens, and in the built environment.” (source)

I have read 3 of his books so far, Food Rules, In Defense of Food, and most recently The Omnivores Dilemma.

Since beginning my “healthy living” education 5 years ago, my dietary choices have undergone many evolutions. When I started out, I still regularly ate fast food like McDonalds, but counted points on Weight Watchers to teach myself proper weight-loss “portions.”

Then, in an all-or-nothing move, I decided to become a Vegetarian without much research because I wanted a way to say “NO” to fast food. This is when I was first introduced to Michael Pollan and his work. I started to research what it actually meant to be a vegetarian, how to make sure my diet had a broad range of proteins, carbs, and fats, ext…

Then I saw Forks Over Knives, and decided I should try to be a Vegan. I was never very good at being Vegan. I really like Yogurt and certain chocolate that has milk. Not to mention Cream Cheese on Bagels and Honey in tea. Yes, I have come to the conclusion that Veganism is not something I can sustain while maintaining a healthy and happy relationship with food.

All the while I meticulously tracked e.v.e.r.y.t.h.i.n.g on My Fitness Pal. And would have anxiety if I strayed from my “plan” or couldn’t track something. All the while I was over exercising, sometimes up to 3 hours a day, but my disordered brain rationalized this, that I was “just” walking my dogs for an hour and a half after a long run and that was “okay”. I rarely ate my exercise calories back. I wanted to keep the number as close to 1200 a day as I could.

Do you see a pattern here? More and more restriction. More foods that I “couldn’t” eat for one reason or another. This was my thinly veiled “eating disorder” or is it just “disordered eating pattern”?

When I finally sat down to reassess all the damage I had done, I realized I needed some professional help to break my food habits being tied to my emotional instability surrounding my relationship with my biological parents.

Enter counseling and all the grueling emotional work I had to do with myself to get to a healthier place. I gained weight. I lightened up my restrictions. I took bites of Matthias’ meat here and there at restaurants. I ate McDonalds French Fries (a small) and didn’t feel the need to binge.

In fact, I can’t remember the last time I had an emotional reaction to overeating. Certainly I have eaten my fair share of entire tubes of Pringles over my pregnancy. But the emotional turmoil I had associated with eating has been “gone” for some time. Does this mean I liked being 160lb vs. 120lb and that I would rather wear a size 8/10 vs. a size 2/4? Absolutely not. Those numbers occasionally creep in and make me feel some sadness and loss about the fact that I will likely never see the smaller numbers again. But I’ve learned to cope with that sadness in healthy ways (sans binge) and have found a relationship with my emotional self and physical self that is maintainable and happy.

Okay, so throw pregnancy into the mix, and extreme nausea and daily vomiting. I couldn’t look at Kale, Spinach, Almond Milk, or Eggs, I couldn’t cook, I couldn’t get out of bed in the morning without eating a granola bar first. I couldn’t even LOOK in my fridge. All that sounded “good” (read: easy enough to microwave so I didn’t have to spend very much time in my kitchen) was Beefaroni. So being a vegetarian went out the window pretty quickly in my first trimester.

I always thought, “Yeah, I will get back to it once I am feeling better,” but here I am, 35 weeks into pregnancy, with a freezer full of freezer meals made with meat, and chicken in the fridge that I am going to cook tonight.

Do I eat meat with every meal? No. Do I eat meat every day? No. But I do eat it about 4 times a week.

I still thought, “I want to raise my daughter as a vegetarian.” That was, until I read the Omnivore’s Dilemma.

What should we have for dinner? The question has confronted us since man discovered fire, but according to Michael Pollan, how we answer it today, at the dawn of the twenty-first century, may well determine our very survival as a species. The omnivore’s dilemma has returned with a vengeance, as the cornucopia of the modern American supermarket and fast-food outlet confronts us with a bewildering and treacherous food landscape. What’s at stake in our eating choices is not only our own and our children’s health, but the health of the environment that sustains life on earth. (source)

When I took a closer look at the food choices I was making as a vegetarian, I realized that no, I wasn’t always making healthy food choices by buying produce grown halfway across the world sprayed with chemicals and grown with genetically modified DNA so that it could kill the “pests” that might damage the crop. Even though I wasn’t eating “meat,” I was still buying milk, yogurt and eggs treated with hormones and produced by animals that are treated so awfully that when you learn some of the details about their life you feel sick to your stomach.

So where did that leave me? I had never been faced with the “ethical” argument of being a vegetarian because I chose to look the other way. I had also never considered the impact I was still having on the environment by saying yes to produce that was still using fossil fuels to travel halfway around the world.

Matthias is pretty much on board with whatever I say we are going to buy at the grocery store, but he does like to eat meat, so he would always add that into the cart wherever we were.

I’ve recently committed us, as a family, to purchasing (more) local and organic whole foods. I say this because in Alberta, with our wonderful winters, it is unsustainable to think that we can buy a full range of local fruits and vegetables all year round. But we can make the choice to purchase organic, which eliminates some of the unknowns about GMO’s and Chemicals. In terms of meat, poultry, eggs, milk and cream, that we will try to always buy local and organic/free of hormones and antibiotics. I also want to focus on buying meat that is raised ethically. I don’t mind eating a cow that has lived as a cow. A cow that has grazed on pastures with other cows and lived as it was meant to. Same with chickens. I don’t mind eating chicken that was able to wander and peck at the ground and have enough room to (theoretically speaking) spread its wings and move freely. But those things seem extremely hard to find.

Two solutions to this particular dilemma are The Big Bend Market and R Farm Lacombe. I am very excited that these options are available to us in Red Deer, and I feel confident that making these changes in our diets will have a positive and educational impact on our family.

Will it ever be perfect? Probably not. Ignorance is consumer bliss. And the food conglomerate controls a lot more in our government than we realize. But it’s a step in the right direction. :)

Life is About to get Crazy (again)

Hey! Hi! Hello.

It feels like it has been a loooong time since I have done a legitimate post. Has it been? I don’t really know. :) Guess life has kept me pretty busy. I’ll just do a quick update and be on my way then!

Eating/Healthy Living – I’ve been just “Okay” in this department recently. I know I need to get my butt in to gear and somewhat get myself off of sugar/coffee because I am pretty sure they don’t serve both those things in Yandara 😉 Lord help me.

I have also been tossing around the idea of trying to lose a bit of the emotional weight that I gained back a year ago. When I first lost the weight I became so obsessed and fearful of what would happen if I gained it back.

Well, I gained some of it back. But I also worked through a lot of the emotional issues that were underlying my struggle with weight loss/weight gain/weight maintenance. And you know what? I survived. Actually, I would say I am “thriving” now. I’ve maintained my weight for close to a year now (hovering around 160lb – sometimes above that, sometimes below that). I don’t weigh myself too often because I don’t really see a point, but I am interested in lowering my weight by about 20lb to bring me to 140ish. I feel like that is a very sustainable weight for me in terms of balancing healthy eating and exercise. Unfortunately I have a sneaky suspicion that the amount of chocolate and other sweets I eat is preventing me from getting there and instead just letting me hover where I am at.

I don’t have too much of a plan in place as of yet, but I do plan on decreasing the amount of sugar that I am eating and hopefully that will in turn lower my weight. I am 100% aware of the reasons why I became obsessive and super restrictive before, and I can confidently say those issues do not effect me at this time. I also know how to handle them if/when then do poke their heads out, and I feel good about finally (maybe) bringing my weight down just a bit over a longer period.

Yoga – I am signed up for a 40 day Yoga Challenge at the Breathing Room, which for me is actually a 36 day Yoga Challenge because I am going away to Yoga School in 33 days (Holy Shit.). I have been working on my form and alignment for a lot of poses as well as working on sanskrit names and yogic philosophy. I am equal parts excited and nervous.

Work – BUSY. Wowwza. I have 2 Conferences/Meetings in May in Edmonton, then I go away for 18 days for Yoga School, then I come home for a day and then go away for a 4 day Nursing conference in Winnipeg. I only have 5 scheduled shifts in June 😀 YESSSSS. Working Days/Nights is actually going well, I have figured out how to fuel my body appropriately without starving or over eating.

Running – Hasn’t been happening. I ran 2 miles 2 weeks ago and that was fine, I could have kept going but just didn’t have it in me. I wish I still loved running like I used to, but right now, I don’t. I won’t be running in the Woody’s Half Marathon, but I will likely volunteer (Lindsey or Becky – Want to Volunteer with me?!) Maybe as the weather continues to improve I will feel the desire to run again? Maybe not. In the mean time, I am sending my running vibes to Leigh, so that her knee can heal fully.

Matthias – For those of you that don’t know, Matthias works away 2 weeks and then is home for 1 week. He has done this since October and he has finally gotten a job back in Red Deer! We are SO excited because we can hopefully spend more time together and he can actually have a life and hobbies again as opposed to just recuperating on the 5.5 days he was home on his days off (the other 1.5 were spent traveling).

Dogs are good, Cats are good, Life is good :)

Eating for Shift Work @FitApproach #SweatPink

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I no longer follow the strict structure that I used to enforce with myself about eating. I ate at certain times of the day only, and I ate certain foods during those certain times. When you give up that structure at first you are left in a bit of a limbo, which is scary, but passes.

I eat more to my hunger now, and of course, to my work schedule.

Shift work is a challenging thing. It impacts all parts of your personal life, including your recreation, your intimate relationships, and your friendships. The hardest part about adjusting to shift work full-time was with eating. Eating for balance, health, and energy.

Working psych is not a physically demanding job. A lot of my 8 hours was often spent sitting, either charting, doing 1:1’s or sitting at the nursing desk during groups. For me, an idle mind leads to a hungry mind, so I struggled with mindless eating.

Now that I have switched back over to Maternity, I am so thrilled to be on my feet more! Walking to and from rooms, standing to help with breastfeeding and assessments, standing while I bath a baby, helping moms walk to the bathroom after a c-section, all things I get to do on my feet! Not to mention that the pace is way higher and I am MUCH busier. This leaves me less time to snack, but also means I need to plan my meals smarter so that I don’t get hungry in between my breaks.

Here is a typical Day or Evening shift:

Breakfast:

Day shift breakfasts are a bit weird. I hate eating at 6am because I feel like I am starving the rest of the day, but I have also come to embrace that eating at 6am means I won’t get hypoglycemic when working on Maternity, so I do it :) I will eat a smoothie, yogurt and fruit, or oatmeal before a day shift on Maternity. Sometimes I don’t get away until 10:30am for a break, so my body thanks me for the early fuel. If I am working Psych, I will wait until my first break to eat, because I don’t get as hungry as quickly and breaks are generally at 9am-9:30am.

If I am working an evening shift I will eat when I get up for the day, which is anywhere between 9-10am.

Lunch/Supper:

shiftwork

Planning really is key when working shift work. If you don’t plan, you will most definitely be eating at the cafeteria, or pizza at the coffee shop daily. I see it regularly and I feel sad for their wallets!

I try to pack lots of vegetables, a fruit or 2, and a protein of some kind. A balance between carbohydrates, fat, and protein keeps me the fullest, but I don’t count calories or macros so I don’t know the ratios I am eating.

For tonight’s evening shift, I am going to eat roasted asparagus and steamed broccoli, 1 fillet of a fish we had in the freezer, steamed/sautéed in a pan with Salt, Pepper, Ghee, and random fish seasoning (I am not a great fish cooker :( it is unfortunate). I also ALWAYS bring a bag of organic baby carrots to munch on if I am bored. My current favorite hummus is Fontaine Sante Garlic – OMG so good. I eat copious amounts. I think I go through 2 tubs a month (and that is just me, Matthias doesn’t really eat hummus). Fruit today is Grapes, it is usually what I have on hand – Apples, Bananas, Oranges, Grapes or Berries, STONE FRUIT IN THE SUMMER <3 I like to drink tea when I work, so I have a bag of Vanilla Earl Grey, but I also have a Dark Hot Chocolate K-Cup, if the mood strikes 😉 For a sweet treat I have a Chocolate Truffle.

I wont always pack chocolate when I work Maternity because the new family’s seem to always drop off goodies and I have a hard time saying no, so if I just don’t pack one, I will take a few bites of whatever is on the lunch room table.

This is just what I PACK, often what I eat will differ slightly; A pack of PB with my Apple, an extra chocolate, sometimes I will forgo my chocolate and buy a cookie, other times I am just not feeling what I brought and will go out to buy something on my break (Most often happens at the Remand Center, and we will get Vietnamese takeout – YUM).

Just as I get Days/Eves figured out I am going to be jumping head first into a Days/Nights line, with slightly more Nights than Days.

Night shifts call for a whole other post of their own. Plus, I gotta figure out what works best for me at this point in my life and at this body size (Last time I worked nights I tended to not eat too much food because I didn’t want to go over my Calorie goal. No wonder I lost weight working them).

What type of work do you do? How do you eat during your work period? Has it changed over the job or over the years?