Momcentral.com is running a photo contest in honor of the publication of The Working Woman’s Pregnancy Book, and I get to be a judge! First prize is a $100 Babies “R” Us gift card and a copy of the book, and the next five runners up will get copies of the book. We are looking for interesting photos of pregnant women in the workplace.

Just email a photo to info@momcentral.com by September 1st, 2008.  If you have a story to go with the photo, please send that as well. Moms whose photos are selected as winners or features will be asked for permission to publish the photos.

Any questions? Email info@momcentral.com.

I am looking forward to seeing you at work! 

I have written a lot on birth plans–the pros and the cons of putting one together, how to write one that will be helpful for you, and what factors to think about when you write one. So I was particularly interested to see the personal birthplan from one of our labor and delivery nurses posted (with her permission) on the bulletin board at work. I got Jenn’s permission to share it here because it is an example of a birthplan written by someone who really knows the ins and outs of the birth process AND who had exactly the labor she wished for–arriving at the hospital 7 centimeters dilated and proceeding with a totally natural unmedicated joyous birth.

NOTE: Please don’t be offended when you read this –you have to understand that she wrote it while she was home in early labor as a letter to her friends who would be caring for her. I tried to clarify some of her insider’s terms with [brackets]

 Jenn’s Birth Plan

Continuous IV or IV heplock:  For the love of God, just put one in.  I will not whine about it.  Draw all the blood you need or want. Fetal Monitoring:  Make sure the baby [heart rate] is reactive.  If I wish to ambulate, go ahead and use portable monitors.  I will stay close to my room (or wheelchair alcove) so I don’t go out of range and you have to hunt me down like a lost puppy.  If you’re good with only intermittent monitoring, so am I.  Any whopping decels, put in internals [fetal heart rate monitor]-just let me know ahead of time.  If you plan on putting in one internal monitor, just put them both [heart rate and contraction pressure] in.  This will be easier on us all. AROM [assisted rupture of membranes]:  If I need it, do it.  Please have lots and lots of bed pads.  I will change them as I need to because I know it can get nasty quickly.  I would love a stack of big peri pads and mesh underwear to change often if I wish to ambulate.  I don’t want that junk dribbling down my legs. Augmentation [making labor stronger]:  I’m up for it if I don’t make ANY change over 2 hours.  I would prefer AROM first if I haven’t already ruptured.  If that doesn’t work, nipple stimulation would be great.  Just give them a tug every once in a while.  Just kidding.  No man-handling of the boobs.  Pitocin is just fine.  Give my body a good fighting chance first, though. Exams:  Check me as often as you think is necessary.  Or less often if that’s better.  Whatever you want to do. Foley vs. Straight cath [to empty bladder]:  If I have an epidural and need to be cathed, please just put a foley [indwelling catheter] in.  It saves me a little bit of dignity, and it’s easier on you.  Obviously, if I’m being cathed right before delivery, straight cath is just fine. Pain relief:  Trying to go NCB [natural childbirth], but I realize that I’m a wimp.  I would like to ambulate, get in the shower, and sit on the birthing ball.  Please sterilize the ball first.  No way would I ever request getting in the tub.  If I ask for nubain, give me nubain and phenergan.  I want it all AND the maximum dosage.  Just give it slowly so you don’t burn a hole in my vein.  That would not be appreciated.  If I eventually ask for an epidural (or straight off the elevator) try to convince me that I don’t need it.  If I give you the evil eye, just call anesthesia.  I don’t care who places it, just make sure they do it quickly. Students:  I’ll get back to you on this one. Residents:  If I like you, feel free to join the party.  Depending how much pain I’m in, I will be very blunt if I don’t want you in the room.  If I haven’t met you before (or have had only limited contact with you), introduce yourself and try to win me over. CNMs [nurse-midwives]:  You guys are the best with people going NCB (sorry everyone else, this is just my point of view), if you have time, I would love your assistance and guidance.  If you don’t have time, do not feel obligated to stay with me.  I know you can get very busy in a hurry.  By the way, any CNM will do, you’re all great in my book. Attendings:  Please just tell me your opinions and thoughts in front of me.  If you think I need something, let me know instead of keeping me in the dark.  I’m a big girl, I can handle it. Vaginal Delivery vs. C/Section:  Vag delivery is the goal.  Unassisted would be great.  If I have an epidural and am not feeling the urge to push, let me labor down until I feel something.  I would rather not push for hours upon hours, but I do understand that we can’t wait forever either.  If I push for a long time, I’ll let you know if I’m up for vacuum, forceps (if the head’s low enough), or c/section.  I would prefer forceps first, but I understand some people are not comfortable using them.  Vacuum would be the second choice, and I have brought a Dyson from home to assist (they never lose suction).  Obviously, c/section is bottom of the barrel.  Of course, if baby is breech, in distress, if I fail to progress or descend, I understand c/section is the only way to go.  Be gentle, make sure I’m nice and numb, and be careful not to nick anything important.  That’s all I ask.  No staples.  I think they are the lazy way out of a c/section. Episiotomy:  Don’t really want one.  If you think my butt’s going to split open if I don’t have one, by all means, cut away.  If there’s enough time before hand and I’m still going NCB, do me a favor and numb the area first. Enemas and shaving of the pubic region:  I understand that we don’t do these, but every birth plan still includes them, so I didn’t want to deviate from everyone else.  No enema.  If I poop, I poop.  I’m sorry.  I know it’s disgusting.  I’ll try my best not to do it.  If I do, just try to wipe it away without gagging in front of me, and keep some spray handy so I don’t stink up the entire floor.  That would be so embarrassing.  Shaving.  I think I’ve done a fairly good job staying trimmed up.  Don’t tell me if I’ve missed a spot or that I have the most bumps you’ve ever seen.  It’s hard to see what’s going on down there, so be happy that I tried at all.  If you’ve ever given birth, you know what I’m talking about. Once the baby is out:  Hold the crotch area up so that Chris (my husband) can announce the sex.  Don’t laugh if he fumbles or get’s it wrong.  If the kid looks good and doesn’t have any mec [meconium], I would like it up on my chest for exactly 12 minutes.  I’m just kidding.  I just want it long enough to see what it actually looks like.  I do not expect the baby nurse to do the entire assessment while the kid is latched onto the boob.  I would like my husband to cut the cord.  You do not have to wait until the cord stops pulsating.  I couldn’t care less about this.  If the kid looks crappy, feel free to cut away and send it over to the warmer.  Once there, if Chris is able to at least trim the cord, we’d be cool with that.   Cord blood donation:  I would like to do public donation if I deliver when the cord blood donation people are in house.  They don’t even have to ask, just take it. Video Recording:  Not an issue, we’re not even bringing the camcorder. Vitamin K and erythromycin:  Give it. Breastfeeding:  I’m going to give it a go.  This is the only thing that I REALLY want to accomplish.  Please give me any words of wisdom and encouragement that you have.   Circumcision:  If the baby is a boy, whack away.  Just make it tidy.  I don’t want a son with a botched penis.  I would never forgive myself. Visitors:  The only person I want in the room (besides all of those caring for me) is my husband.  If family comes up to the floor, you have my blessing to send them away.  They have been informed of this, and they are well aware that I may be in labor for a long time.  When they need an update, Chris will give them an update.  If I change my mind and want additional people in the room, Chris will let them know.  You should not feel obligated to keep track of them.  Let me know if they get annoying so that I can yell at them after I deliver.   Eating:  If I want to sneak a little bit of food, I will.  I just won’t tell you about it.  Don’t hate me.  If anything else comes up that is not touched upon here, just ask.  We just want a healthy baby and healthy, happy mom.  I can’t wait for everyone to meet this munchkin.  You’ve been looking forward to this as much as we have.  I love you all and make sure everyone gets the chance to send around this birth plan.  It may be the only one that makes sense to us.

In celebration of World Breastfeeding Week, I decided to jump ahead in my “to do” list of topics and talk about combining breastfeeding with returning to work. This article is adapted from The Working Woman’s Pregnancy Book. Many mothers and babies really enjoy nursing, and the moms find a way to continue to nurse upon their return to work—whether by running out to the baby during the day or having the baby brought in, pumping milk, or breastfeeding during just the morning and evening. A lot of different arrangements have allowed mothers and their babies to enjoy the intimacy and wonderful health benefits of breastfeeding even around a busy work schedule.Pumping milk from the breast isn’t like sucking fluid through a straw—more suction doesn’t equal more milk. Instead, nursing depends on “letdown,” the milk ejection reflex, which is triggered by touch and emotions, and mediated by hormones. When letdown occurs, muscles in the breast contract and the ducts widen, pushing milk toward the nipple. You may feel tingling or a sudden heaviness in your breasts. Unfortunately, anxiety, tension, and distraction can interfere with the flow of milk. In order to successfully pump, you will need to feel relaxed and in the nursing groove.

Click here to see the show.

I was going to write another article on work and pregnancy today but I want to interrupt that train of thought with this report: Women’s Digest, a Florida-based magazine for women, just came out with a list of six books for moms-to-be.  I am thrilled because The Working Woman’s Pregnancy Book made it to the list with this review.

The Working Woman’s Pregnancy Book
By Marjorie Greenfield, MD
Yale University Press Health & Wellness

This book could easily be titled “Everything You Wanted to Know About Working and Being Pregnant that the Other Books Didn’t Tell You.” Written by an obstetrician who is also a mother, it is chocked-full of information useful to all mothers, not just for the corporate woman. There are interviews with a wide variety of working women such a FedEx courier, labor workers and even a governor. And as Greenfield acknowledges right up front, every pregnant woman is a working woman. She takes the reader through the life-changing process starting with a pre-pregnancy life survey and shares fundamental advice for every demographic, not just married heterosexual women. The Working Woman’s Pregnancy Book is an in-depth A+ resource guide.

They recommended the list as helpful for all moms–not just those having their first babies. Click here for the full list on the Women’s Digest website.

When we were doing the interviews for The Working Woman’s Pregnancy Book lots of moms told us stories and gave advice on the subject of telling work that you are going to have a baby. Today I am going to write on the decision about when to tell work. In a future post I’ll write about how different moms did it, and how it worked out for them. But first, when to take on the task.

Here are factors that moms said played a role in chosing early disclosure at work:

• Not wanting to hide something from their boss and coworkers/friends at work
• Having obvious evidence that they were pregnant, like vomiting every day, or bursting out of their clothes
• Requiring accommodations at work early in the pregnancy, because of symptoms or complications
• Needing to plan well in advance for maternity leave
• Bursting with excitement and not being able to wait to share the news
• Not wanting the boss to hear about the pregnancy indirectly

But here are the factors that led moms to try to hide the pregnancy for as long as they could:

• Worrying that they would not be treated the same once the pregnancy was public–in promotions, job assignments, or just socially in the workplace
• Wanting privacy–hoping to get through the first trimester risk of miscarriage or past any genetic testing (with possible termination of the pregnancy) before sharing the news
• Fearing what the reaction might be

So how do you figure out when to tell? Obviously it is a personal decision based on your own work environment, relationships,  personal beliefs, and pregnancy experience. While some moms that we interviewed said they were relieved to share the news and that they got support once they disclosed their “condition”, others did feel that it affected how they were treated and the assignments that they got. My best advice is to look at how pregnancy has gone for other women in your workplace, and combine that with how your pregnancy is going and what feels right to you. And don’t stress over this too much–because they are clearly going to find out at some time–it is just a decision about when!

I just did such a fun interview about pregnancy and work for a writer for the Schenectady (NY) Daily Gazette. For those who live in that area, it will come out Sunday July 6. Joann McFadden, the writer, asked me open-ended questions, so I got to talk about all my favorite topics–timely too because I have to prepare a short talk on this subject for my book signing at Joseph Beth Booksellers this Thursday.

So what are the issues related to pregnancy and work? These are the topics that people keep asking me about–

• Pregnancy symptoms in the workplace
• When to tell work that you are pregnant
• How to tell your boss, and what to expect
• Occupational risks and toxic exposures
• Maternity leave laws and policies
• Returning to work after maternity leave
• Breastfeeding and working
• That balancing thing

Over the next few weeks I hope to write a little about each of these topics.

Today let’s talk about pregnancy symptoms.  In researching The Working Woman’s Pregnancy Book, some moms told me that it was harder to work in the first trimester than it was when they were in their ninth month. Early pregnancy fatigue and (for the unlucky 70% of women who experience this) nausea and/or vomiting can make working quite a challenge–particularly if you don’t want to tell everyone yet that you are pregnant.

Here are some suggestions that I got through my interviews and published in my book:

For fatigue

• Take a power nap at your desk for 15 minutes when you get tired
• Take a brisk walk when you get sleepy
• Bring a power bar or other healthy snack to eat as you start to fade
• If your job is flexible, consider going home for a nap in the afternoon and working at home in the evening

For relief of (or at least less consipicuous) nausea and vomiting

• Bring snacks like crackers or dry cereal or whatever works for you to settle your stomach
• Combine bathroom trips with other expected activities, like going to the copy machine or mail room
• Sit near the door at meetings so your coming and going isn’t so conspicuous
• Consider telling one close coworker so you can get some support
• Some moms told me that they had to tell work earlier than they planned because it was just too obvious that they were pregnant, or because their performance was so affected by their pregnancy symptoms
• Take a vacation or medical leave for a few weeks if necessary
• Check out the early pregnancy relief kit on page 74 of The Working Woman’s Pregnancy Book for more ideas

I don’t want to sound like pregnancy is always awful! Many moms-to-be feel pretty good, and function just fine on the job for the whole nine months. These suggestions won’t be needed by everyone. But planning ahead for how to manage (and knowing that lots of moms have survived this before you) can be helpful if you are having a hard time. I’d love to hear what you would add to these lists!

In my next post I’ll tell you what I have learned about “when to tell the boss” and invite you to tell me your stories.