1 What s inside Page 03 Page 04 Page 16 Page 22 Page 27 Page 29 Page 34 Page 39 Page 43 Page 45 Page 47 Page Oh Shit, I m Pregnant i. Options 2. Before Baby Comes (Prenatal Stuff) i. Doctors & Stuff ii. Vitamins iii. Milk iv. Food v. Cleanliness vi. Tips 3. STI s 4. Using While You re Pregnant 5. Working the Street 6. Getting Ready for Labour 7. Stages 1, 2, & 3! 8. Hospital Staff 9. Not Taking Baby Home 10. Taking Baby Home 11. Baby Blues 12. So Now What? See the diagrams on page 51!
2 So I ve missed my period for 2 months now. I remember one time a nurse told me that using dope can make my periods come and go. And I ve been using a lot more dope because I need to be out there working so that I have a place to stay. So I take my ass over to the clinic and see one of the nurses there. She does a pregnancy test and says Yep you are pregnant. How do you feel about that? Well that s a good freaking question isn t it? I m excited. I m nervous. I m sad. I m scared. What will my old man think? Am I going to keep it? Have I hurt my baby by using? Can I keep working? I need a better place to live. There s so much to know. 02
3 Oh Shit, I m Pregnant... This might be the first time you have ever been pregnant. You might think it s a good thing, or a not so good thing. But no matter what, there is a lot of stuff to know and you will probably have a lot of questions. In this book, we want to let you know some of the things we have learned and help you be healthy while you re pregnant, when you deliver, and after you have the baby. If something doesn t make sense to you, or you have more questions, try to find a nurse, doctor, or outreach worker you trust to talk to. OPTIONS Some women know that it s not a good thing for them to be pregnant right now. Most cities have a place where you can go to find out about your options around ending your pregnancy. Most times, you gotta make that decision before you are about 16 weeks pregnant, or it gets more complicated. The best thing you can do is either talk to a support worker, a nurse you trust, or a friend who has been through it. They can help get you ready so you know what to expect. There is other stuff you need to know about too, like making sure you have photo ID when you go. So whether you call to make an appointment, or your nurse phones, make sure you get all the info you need. Or maybe you want to have the baby and give it up for adoption or to someone in your family. There are lots of different options for that too. Like sometimes you can have visits with baby, or the family can send you pictures of the baby. Talk to a health person that you trust about what things gotta happen for adoption. 03
4 Before Baby Comes (The While-You-Are-Pregnant Stuff ) DOCTORS & STUFF Prenatal really means before baby comes. This is stuff like ultrasounds, regular appointments, and vitamins. It s important for both you and your baby s health, and it s really important so that you can show the hospital staff and your supports that you can take care of your baby. Here are some things we know about prenatal care. - You should see your doctor or pregnancy nurse at least once a month when you are first pregnant and then more often when you get bigger. - At your first visit to the clinic, they will weigh you, take your blood pressure, check your urine for anything weird like kidney problems and probably do a pelvic exam (check your uterus and cervix). - The first ultrasound will be when you are about 5 months pregnant, but might be sooner depending on how healthy you are. This is where they will show you your baby on a screen. - When you are about 12 weeks pregnant, the nurses can start showing you the baby s heart beat. They use a little machine on your stomach so that you can hear the thump thump! - Always be honest with your doctor about your pregnancy. 04
5 Write down the questions that you want to ask your doc. Even if it s not your first pregnancy, you might have tons of things to ask. - If you are having funny pain, changes in the stuff coming from your vagina (discharge), or other weird symptoms, don t wait for your next appointment; either talk to a nurse or go see your doc again. Remember: you know your body best! If something doesn t feel right, go get checked out! Bring someone you trust to go with you to the appointments. The doctor can talk fast and say a lot of fancy doctor terms so it s good to have someone else there to help remember everything. VITAMINS A pill a day All women who are pregnant need to take prenatal vitamins. The reason you need these vitamins is because some of them help your baby s spine and brain develop. Some of the other ones are good for your bones, and baby s bones. They help make you and your baby big and strong! We know that sometimes they can make some women sick to their stomachs. But it helps if you take them with some grub! So this means you gotta try to keep a granola bar or something in your bag. If none of that works, talk to your nurse or doctor. 05
6 You should always try to carry some change with you to make a phone call if something weird is going on. This could be to call someone you trust for support, or if you need to call your nurse or doctor for health advice. MILK Mooooooo... Milk is so important while you are pregnant. Depending on where you live, there are special programs for pregnant women. They give out prenatal vitamins, bus tickets, support, and milk coupons or free milk. With the milk coupons you can go to a grocery store and get milk cheaper or for free. It s so important for your baby s growth while he s inside of you to get milk. It s also important for your bones because your baby will take the calcium from you to grow, so you need to get extra by drinking lots of milk. Sometimes the milk coupons give you the huge jugs of milk. So if you don t have a home or a fridge, it makes it kinda tough to drink the whole thing. 06
7 Street Talk * We know this one girl who would pick up the big jug of homo milk and carry it around for a few hours. She would drink as much as she could before it got warm. She drank it when she could, where she could, and however much she could. Then she would toss whatever she couldn t drink. Any milk or other dairy items you can eat is good for you (cheese, yogurt, ice cream). If you have the choice, and you don t mind the taste, drink 2% or homo (whole) milk. Street Talk * We know another chick that was living in the river valley in a tent with her dude. The nurses from the drop-in center gave her milk and she didn t have a place to keep the milk cold until she got her place. So she dug a hole that was deep enough to put a jug of milk in. She kept it in there overnight and during the day and the hole kept it cold enough for her to drink. 07
8 08 They tell me to eat healthy. Easy for them to say. Do they know how hard it is? Food isn t the first thing on my mind. I know I need it. There are a lot of things I need. A banana or down. Hungry or dope sick. So hard to choose.
9 FOOD Getting good, healthy grub is really important too. Sometimes when you re living on the streets, it is easier said than done to get food often enough and food that is healthy. Street Talk * Drink juice instead of pop when you can. * Eat lots of fruits and veggies so you can crap easier. * Find out where meals are served, what time they are served, and what kind of food is at each shelter. Some shelters have more dairy and meat than others. * It never hurts to mention to the staff at the shelter that you are pregnant; it might help you get more food. They might even give you some extra food to take for later. Sometimes it depends on who the staff is and how busy the shelter is that day. * Since shelters normally get their food from the food bank and donations, they don t have a lot of fruits and veggies. But it s important that you and your baby get some of those. You can normally get them at corner stores if you have any spare cash. Dried fruit works too. 09
10 * When you are staying at shelters, or eating your meals there, ask for care packages for later. If they have food that goes bad (like pastries and meat), they might give you the extras. * Make friends with the outreach vans, downtown agencies, and churches. Lots of these guys can help you out with food, and tons of other things. Most women will gain about 25 pounds while they are pregnant. Some might gain less, and some might gain more. It depends on your body type and stress in your life. CLEANLINESS YOU Time When you re pregnant, you might be more aware of your cleanliness too. Like if you re living outside, how do you shower and get new clothes? 10
11 Street Talk * Drop-in centers have showers and sinks most times, so use them when you can. If you are staying in a shelter, make sure you use their showers; some of them have washers and dryers to do laundry. * Remember, T-P-A. Tits, pits, and ass. If nothing else, make sure those parts aren t all sweaty and that they are clean. You will feel better if you feel clean. * You can get changes of clothes and stuff like toothbrushes and deodorant from drop in centers, outreach vans, shelters, and churches. * It s important to take good care of your teeth and mouth. Brush them often and keep them clean. Unhealthy gums can make your baby come too early! * If you look good you feel good, so be consistent. Don t let your hygiene go for days; keep on top of it. * If you re at a place where there s a cat, let someone else touch the cat litter, it s bad for you and your baby. Street Talk * One of our friends started talking to a church. She let them know she was pregnant and that she didn t have much cash flow. They helped her with vouchers for clothing, food, and helped her get her bills paid. They really just wanted to help. 11
12 12 He knows I m pregnant. I told him last night. He doesn t think it s his. I m sure it is. He told me to quit using. While he sat there and lit up. Is he going to leave me? But he said he wouldn t. Will he stop hitting me? He said he would.
13 TIPS Other Stuff to Keep Baby Healthy Being homeless makes it really hard to get baby to come home with you when you leave the hospital. Getting a stable place is a really big step in making sure that once you have your baby, you can take her home. Here are some other things we have learned that will help you get your baby to come home with you: - The best chance you have of taking baby home is having many supportive people in place, and a plan for you and baby. - Get supports in place before you have baby (family, friends, support workers, a nurse you trust). - Go to all of your prenatal appointments (they check on this to see how committed you are). - Write down everything you do with your social worker or children services worker (phone calls, visits, how long you spent with them, what you talked about). - Try to cut down or stop using dope as soon as you can. - If you are using, children services is going to want to see that you are working towards a plan like drug rehab, family support, and in some cases a safety plan. 13
14 - The more programs you go through while you are pregnant, the better it looks (parenting, addiction, money). - Talk to social services about getting more money when you are in your third trimester. - You have every right to ask for more information to what Children Services wants you to do. They can explain why they want you to do these things. If they want you to do something and you don t think it will work for you, explain why and suggest something else. Or, you can talk to a lawyer. - Even when you are struggling, try not to yell at the people you are dealing with, STAY CALM!! Yelling and swearing will upset them and make it harder to get them to help you. Stay Calm! - It s good to be honest, but don t tell them more than they ask. - Ask a nurse what the rules are about car seats. Some hospitals need you to have one to take baby home, even if it s on a bus. So ask before your baby is born. We know that housing is a big issue for women. It s really hard to get housing you can afford in a part of the city you want to be in. The best thing you can do is to be well connected to a family program or a worker before you even have your baby. 14
15 Street Talk * We know a girl who had her baby and her worker put her and baby in a hotel for a week until they could get her housing. She got to keep baby and still has baby! She was able to show that she had a plan and talked to her worker about getting extra money to get a hotel. That s the best thing you can do; show the nurses and workers that you have a plan about what you are going to do once you and baby leave the hospital. Cut down on using. Go to rehab. Get a place away from my friends. Go to programs. And STAY CALM? Asking too much. I can do it. With help. 15
16 STI s STD s or STI s you know that stuff. STI s (sexually transmitted infections) and other stuff going on down there can suck anytime, but when you are pregnant they can really be crappy. Some STI s can get worse and some can effect your baby. Syphilis And you probably heard about syphilis lately it is a big deal. It can cause huge problems for you and your baby. Here s some info that might help: - You can get it from oral (blow jobs), vaginal (lays), or anal sex (bum sex), even if you can t tell that they have it. - Sometimes there are no symptoms, but sometimes you might get a weird rash on your body. - Sometimes the symptoms might be the same as if you are using lots of dope - like getting hives and feeling so tired. - Even if you have had the antibiotic for syphilis, you can get it again. - If a baby is born with syphilis, he can die or have physical and mental problems. Sometimes the baby may be treated for syphilis if he is born with it. 16
17 - It s totally treatable, so if you have sex without a condom while you re pregnant, make sure you get checked again for syphilis before you have baby. - You should get checked at least 3 times for syphilis while you are pregnant; at the beginning, middle, and near the end of your pregnancy. Chlamydia and Gonorrhea Chlamydia and gonorrhea. It s easy to confuse them. If you do have symptoms, it will be some burning or discharge. But most guys and chicks don t have any symptoms at all! - You can get them from oral (blow jobs), anal (bum sex), or vaginal sex (lays). - If you get treated for it, your dude needs to get the antibiotics too. Or else he will just give it back to you. - Both of these can give your baby health problems if you don t have it treated when you re pregnant. If someone s got pills they used when they had an STI, don t use them. You might have something different then they did, or a different type of it. It s best to get your own prescription. 17
18 Yeast Infections & BV So you got some white, cheesy stuff coming out of your vagina. It s got a nasty smell, it s really itchy, and it s kind of grossing you out. It might be a yeast infection or BV (bacterial vaginosis). They look and feel kinda the same. - It s not really sexually transmitted (you don t get it from sex), but it can make sex really annoying and itchy. - It can be caused by some antibiotics, hormones, and from douching (putting stuff inside your vagina to clean it). - Yeast grows when something is wet and dark, and it doesn t get fresh air! That s why men don t get this kind of yeast infection; the penis isn t wet on the outside. - You are more likely to get a yeast infection if you are pregnant; it s because of all the added hormones in your body. Street Talk * If you can t buy the medication to treat your yeast infection, you can put plain, unsweetened yogurt on a pad, and wear it while you are sleeping. If you re not pregnant, you can put yogurt on a tampon and put it in. But if you are pregnant, don t use a tampon, use a pad. If that doesn t help, see a doc or nurse. - BV is more serious, it will probably need to be treated with antibiotics. BV can cause the baby to come out too soon and the baby might be really small. So don t assume it s a yeast infection, it might be BV. - Remember though, only a nurse or doctor can truly tell what it is. There might be other stuff going on too. 18
19 Herpes Or maybe you ve been told you have herpes. You re thinking, What do I do now that I m pregnant? - Whether or not there are blisters that you can see, you can get herpes or pass it on when you are having sex. - The first couple of outbreaks of herpes are really painful! It might hurt to pee, sit, and wear panties! It might feel like your vagina is on fire! - If you have herpes, you need to be on pills, especially when you have an outbreak. - If you had herpes before you became pregnant, your doc will probably put you on pills for the last month of your pregnancy. This will help prevent a herpes outbreak, and you might not even need a c-section. - If you don t get on meds, you might need a c-section so that the baby doesn t get herpes when you go into labour. 19
20 HIV What about HIV? Can I pass that to my baby? Well yeah. Since it travels in blood and from sex, babies can get it from their moms. - You gotta go see a doctor, because having HIV when you re pregnant makes it a little trickier. You ll need some new medications and have someone monitor you and your babe. - If you take the right meds in the right way from the doctor while you are pregnant, there is almost no chance your baby will get HIV. - If you are HIV positive, don t breastfeed, use formula. HIV can go through breast milk. - And remember, if you have herpes or any of those other STI s we talked about, it s easier to get HIV. Hep C And finally what about Hep C? What if I have it, how will that affect my baby? - There is a very small chance that your baby can get it from you Your baby will be tested when she s born to see if she has to be treated for Hep C.
21 - If you want to breastfeed, you totally can! Hep C doesn t go through breastmilk. But it s important to have good nipple care so there is no blood in your breast milk. With HIV or Hep C, the best things you can do to help you have a healthy pregnancy are to eat the best food you can get, sleep when you can, and cut down on whatever you are using. There s other STI s too, we just mentioned a few. The best things you can do to protect you and your baby s health while you are pregnant are to use a condom when you re having any kind of sex, and see your nurse or doctor for regular check ups. This way they can catch something early so it doesn t affect your health or your baby. Street Talk * It doesn t matter if you re having sex with tricks or with your old man; you need to wear a condom while you re pregnant no matter what. No matter when it happens, if you have sex without a condom, you need to get checked for STI s because your baby is at risk for getting an infection. So try to always use a condom, and be honest with your nurses and doctors so they know what to be checking for. 21
22 Using While You re Pregnant If a woman is pregnant, anything she puts into her body might also be given to the baby. This could be food, alcohol, cigarettes, dope, vitamins, and medications.a whole lot of stuff. Some are more dangerous to the baby than others. The safest option for your baby is to not use alcohol, cigarettes, or any drugs while you re pregnant. What you should know is that the two worst things to use for your baby are alcohol and tobacco. Both of these have really long term effects on your baby, and the less you can use of them, the better. If you take drugs, the risks for your health and your baby s health depend on the type of drug you use, its quality, how much you use, how often you use it, and your lifestyle in general. Downtown If you re using down (morphine, codeine, heroin), there are some options for you. First of all, try not to come off down cold turkey - it can be tough on you and your baby. Make sure you talk to a health person you trust before you quit. 22
23 - Women who use down while they are pregnant can go into labor early and have really small babies. - Some women go on methadone while they are pregnant so that they don t go through withdrawal. Methadone is safe for you and your baby while you are pregnant. - You can also talk to a doctor you trust about getting bridged to something safer than street dope. - Eating your pills is the safest way to go rather than injecting. You can t get the abscesses and infections from eating them and there is less chance of getting Hep C or HIV. - If you haven t stopped using during your pregnancy, or you re on methadone, the hospital will give your baby medicine that will help your baby come down. Don t believe all of the street rumours you hear about methadone. A lot of people really like it, so talk to a doctor or nurse about the good and bad about methadone. 23
24 Uptown If you are using up (crack, meth, coke, ecstasy), here s some stuff to know. We hear from a lot of people that it s all cut with a lot of crap that you don t know, so your baby is getting more than just the drug. - Crack and cocaine can make the placenta pull apart from your uterus during your pregnancy. They can make you go into early labor too. - If you are using up, make sure you are still getting sleep and eating well. Up gives you so much energy that sometimes it s easy to forget to sleep and eat. - If you can, try to not use up at all. - If you can t quit, try to cut down as much as you can. You can try a treatment program too - some are just for women. - If none of these sound exciting to you, talk to someone you trust and see if you can figure out a plan. We know that treatment programs are really tough. They can bring up a lot of feelings that were hidden. Finding a treatment that fits you is really important. So are having a lot of supportive people you can talk to. 24
25 The Problem with Booze Fetal Alcohol Spectrum Disorder (FASD) And then there s alcohol. Like we said, alcohol causes the most problems for your baby s health throughout their lives. Women who drank alcohol before they found out they were pregnant should try to stop drinking as soon as they find out, but don t beat yourself up if you did. - Drinking while you are pregnant can cause your baby to be really small when he is born, have some brain damage and have problems learning as a kid and as an adult. - There are lots of myths out there like one drink a day is ok or wine is better than beer, but we don t know what the safe amount is while you are pregnant, so the best thing to do is not to drink any beer, wine, or hard liquor. - We know it s hard to quit drinking, especially if you drink a lot. If you want to quit, talk to someone you trust that can hook you up with the right supports. Your baby can be born with lots of problems in the way they look and the way their brain works; like being really small, coming too early, or born addicted to drugs. It can be dangerous for you too! You might bleed more while you are in labour. 25
26 26 There are so many stories. It s hard on my bones. One drink is ok. Is there really crack babies? It s fine as long as you smoke it. What am I supposed to believe? How am I supposed to quit? Quit everything? But my thoughts My thoughts will come back.
27 Working the Street Whether you re out working most of the time, or just for extra cash, it s important to remember a few things while you are pregnant. Street Talk * Being pregnant makes you sore all over anyways; working while you re pregnant is even more tiring and might make you even more sore! Standing, standing, standing. Getting in and out of cars. Your feet get sore. So take breaks often, and have a safe place you can go relax your body. * Some dates might not notice you re pregnant, some might pretend to not notice, and some might say nevermind when they notice. * Some dates are really interested in pregnant women and might ask for weird stuff! Most tricks will treat you the same whether you are pregnant or not, which can be good and bad. You still need to use a condom every time while you are pregnant. It will protect you from all those STI s we talked about. Keep a stash of condoms on you. 27
28 And it s always important to remember your own safety when you re working, whether you re pregnant or not. - Don t go with more than one guy, it can become dangerous for you. - Don t go with someone you don t know. - You pick the spot. Make it a well lit area. - The smallest things can be used as a weapon, like keys. - Be very aware of things going on around you. - Don t work being really high or drunk; your ability to make good decisions is way lower. - Don t go with a dude that s high or drunk. - Don t fight over pay phones or corners with guys or girls. Keep yourself safe. Don t carry anything that can be used as a weapon against you. 28
29 Getting Ready For Labour As you are thinking about all the stuff we talked about, you probably also have some questions about when it s time for baby to come. Some babies come really early (like when you ve been pregnant for only 6 months)! This happens because of things like stress, using dope, or reasons we don t know about. If the baby comes this soon, she will be really small and will probably have to stay in the hospital longer than normal. But most times, you will start to go into labor when you have been pregnant for about 9 months. One of the early signs that it s getting close to the time for baby to come is you start to nest. This means that you start really caring about how clean your place is. You become really restless and want everything clean and ready for when your baby comes. This sometimes happens to women about one week before they go into labour or just a couple days before. You might want to start fixing stuff, cleaning stuff, or getting a place ready for the baby. But don t go to the hospital you re not in labour yet! 29
30 Here Comes Baby! Already? But I m just getting my shit together. I don t know if I m ready. How will I know. Who will be there with me. What s it going to be like. What if my baby is sick. Have I done everything right. 30
31 The whole idea of getting that baby out of you when the time comes can be pretty scary for any woman. We will try to tell you all we know to make it not so scary. The first question that women normally have is how they will know when they are going into labour. Well that s a pretty tricky question. Health problems sometimes feel like labour. A girl we know was in the hospital on and off for the 3 months before her baby was born because she had gallstones (they can be really painful!). Urinary tract infections (bladder infections) can be confused for going into labour. Using up or down can make labour confusing too. It s a really crappy feeling going into labour while you are high. It makes you even more scared, confused, and worried than normal. Some women say that they just couldn t get comfortable before they went into labour. No matter how hard they tried, sitting, standing, laying down, they just couldn t get comfortable. Some women say it feels like they have to take a crap really bad, but there is nothing to come out. 31
32 Street Talk * We know one girl who started getting really bad cramps. She went and took a hot shower, tried walking around, and nothing helped. Finally she told her friends she might be in labour, they called an ambulance, and by the time they got there, she was already pushing out the baby! Lots of movies show that when a woman goes into labour, her water breaks and water leaks all over. The water that they talk about is really called the amniotic fluid. It is the liquid that floats around the baby when he s inside of you. It helps protect him in your stomach, helps him grow, and gives him vitamins and nutrients. Some women s water break on their own, but sometimes it needs to be broken by a doctor. If you feel like you peed yourself, your water might have broken and you might be going into labour. If you think your water broke, you need to go to the hospital soon. The longer you wait, the bigger chance you will get an infection. 32
33 Some women know that they are in labour because of contractions. Contractions are a really big pain in your lower stomach, where your uterus is. At the beginning of your labour, they will come and go. It will feel really tight, get worse, and then go away. The time between the contractions becomes shorter and shorter. As the contractions happen more often, the pain gets worse and makes you really squirmy: you just can t get comfortable! You can get contractions in your abdomen or in your back. Once you get to the hospital, they can give you meds to help with the pain. Street Talk * Using any sort of dope can make it really hard to know if you re in labour. You might not feel the contractions, or might not understand when your water breaks. So you have now probably figured out how you will know you are in labour. You know your body best, so talk to someone you trust, and go to the hospital. It might seem totally scary to go to a hospital to have your baby, especially if you are afraid that they won t let you keep your baby. But if you or your baby get sick while you are giving birth, it s really important that there are doctors and nurses there to help you guys. Because the most important thing is that you and baby are healthy. And Children s Services will be less than impressed if you have your baby at home it is a sure way to get baby taken away from you. 33
34 Stages 1, 2 and 3 Once you are at the hospital, don t go to emergency; go straight to the labour & delivery unit. If you are in labour, you will be put in a room and they will start getting ready for the big event! Street Talk * We know a girl who had her water break in a cab, and didn t tell the driver. Her phone was disconnected, and her cramps were starting. She got to a payphone to call a friend. An ambulance came and she delivered in the ambulance. Fifteen minutes start to finish! But most are longer than that! Sometimes labour is short and sometimes it s long. Just so you know there are three stages of labour. In the first stage, you will be having contractions, your water might have broken, and you might see something called bloody show. It means that your cervix is opening and a thick, blood colored chunk of discharge will come out of your vagina. This is normal, and means your labour is happening! The first stage lasts the longest, and it is the most painful because that s when contractions are the worst. Now is the time to ask about something for the pain! You have quite a few options for the pain: 34
35 - An epidural is a needle that is put in your lower back (near your spinal cord) and will give you pain medication during labour. It will keep giving you the medicine until after the baby comes. - Another way to help control your pain is laughing gas. Yes, really, laughing gas. Some women said that it really helped them forget about the pain, some say they didn t feel any labour pain, but some women say it didn t work for them. - Some women still want meds to help with the pain, but don t want the epidural in their back. You can still get the pain medication; the nurse or doctor will give it to you either into your muscle with a needle, or into your IV. - Some women don t get any sort of pain control, they either choose to go into labour naturally, meaning no drugs are given for pain, or the labour just happens so fast that the doctors and nurses don t have the chance to give you anything. If you decide you don t want any thing for the pain, and then the pain gets worse, you can always change your mind. 35
36 Your cervix is a part of your uterus that connects with your vagina. It s the part that opens while you are in labour so that your baby can get out! It looks kind of like a donut. When the nurses say you are 5 cm dilated, this means that s how big your cervix has opened. When it s at 10 cm, baby is coming! While you re at the hospital, the nurses and doctors will check on you and your baby a lot. They will check your cervix with their fingers, check your baby s heart rate, and ask you about your pain level. The next part that happens is called stage two. Stage one might have taken a few hours or many hours. Stage two is usually a lot faster. This means that this is the time where you will be pushing a lot. Listen to your own body, when you feel the urge to start pushing the baby out, it s time to start pushing unless the nurses tell you not to. Push when you feel you need to push and stop pushing when you feel like you need to stop. Then you can take a breath, and start again. Push as if you are taking a crap and concentrate on your bum. Sometimes the nurse will put her finger where she wants you to push to help you know. Put your chin to your chest, and focus on pushing. The most work is getting the baby s head out. Once that s done, his body will come too. 36
37 Here she is. They put her on my chest. She s beautiful. This is too much. I m freaking out. Is she hungry? Is she healthy? She s so beautiful. 37
38 The last stage, the third one, is when the baby has already come out and the doctor needs to get the placenta out. The placenta is a big sac like looking thing that grew with the baby inside of you. It moved oxygen and nutrients between you and your baby while she was inside of you. It might take a while to get the placenta out (less than half an hour normally) and you might still feel some contractions. Once that is done, the doctor will see if you need to have anything stitched up if you tore your vagina muscles while you were in labor. They will keep giving you stuff for pain if you want it or need it. Don t be afraid to ask. Most doctors are pretty good about giving you stuff for pain. Sometimes it seems like the nurses and doctors are pushing the meds on you, but they just want to make sure you don t have any pain. Watch out if you are given Tylenol #3 s! Any opiates can make you really constipated, so drink lots of water, and eat stuff with fiber in it like fruits and veggies. It can be hard on your liver too if you have Hep C. 38
39 Morphine: it might make you really sleepy or really awake! It s different for everyone. Demerol: some women say it helps with their pain, and some women say it just makes them feel really crappy!! Don t let the pain get too bad before you take something for it. If the nurses are offering it and you don t think you need it right then, ask them if you can save it for later if you do get pain. Hospital Staff Just like anywhere in life, some people will treat you really nice and some people aren t so nice. In the hospital it s like this too. In all parts of the hospital, you will find some staff that really wants to help you out and are really friendly to you. This includes nurses, doctors and social workers all of them really! You might also see that some staff isn t as friendly and you might butt heads with them. Some women have faced some pretty bad times where they have felt really judged in the hospital. Some staff might accuse you of being high, even if you re not. Some might make you feel guilty about your baby being sick. And there might be a lot of assumptions made by the staff. It s really hard to deal with that kind of judgment, even if you have heard it before. 39
40 Street Talk 40 Some things we have learnt about dealing with hospital staff are. * Have a friend or someone you trust with you to help support you, especially when you are in labour! * They don t know what you are going through, so tell them. Don t let them assume. * Know that you have rights. Rights to have a visitor with you, rights to have pain medication, and rights to bond with your baby. * Nurses can be good support for you; show them your parenting skills, and how you bond with your baby. * The doctors and nurses sometimes use fancy medical language. Ask questions about what they mean. * You don t need to tell them everything if you don t want to. Answer their questions if you feel comfortable. Questions about your sex life and where you get your money from are too personal. You can tell them that nicely. * The important stuff to tell them is about what drugs you have been using and your health stuff. * Try to be friendly and calm. Say things as nice as you can; it might affect the way nurses and doctors talk to you.
41 * Ask lots of questions about your baby and your own health. * Don t let them walk all over you. * Have a support worker with you when you talk to the social workers; this way words can t be changed and you won t feel pressured. * Hospital social workers can t apprehend your baby. They can tell Children s Services what they have seen and if they have any concerns, but they can t take your baby from you. * The nurses and doctors will judge you by watching who comes to visit you and baby. Make sure your visitors are on their best behaviour. * Let the staff know who your community supports are, including Children s Services workers if you have them. * Even if the nurses say they will change baby s diaper and feed baby, if you want to do it, then you do it. Be persistent. This shows that you can take care of baby when you take her home. * If you need help with diapers and feeding, ask the nurses to teach you. * Your past isn t the same as what s happening right now. If they bring up stuff from your past, tell them that. Just because you might have used with other pregnancies, doesn t mean you are now. 41
42 42 She was in me for 9 months. Now I have to leave. Without her. Without her? Where is she going to go. But I m her mom. Is this better for her? But I m her mom.
43 Not Taking Baby Home This can rip your guts out. Or maybe you thought this would happen and you want to work in getting her back. Either way, if you want baby at home with you, you gotta talk to Children s Services about what you need to do. It might be stuff like getting a stable place, cutting down on dope, or doing some parenting programs. Until you get baby back, your emotions are going to be all wild. You might feel like you want to use more or go back to using to forget about everything. Or you might start to blame other people in your life. Some women want to be alone and not see any of their family or friends. But it s really important to stay healthy now and keep doing the positive things that you have always done. Talk to people in your life who are supportive and do things that keep you happy. Remember, your baby wants to be at home with you too. Even when worse comes to worse and your baby is taken away, it is not the end. It could be a chance for you to get some of your stuff back together and get your baby back. 43
44 44 Here s your baby. Put her in the car seat. They wave as we leave. It s just us now. Just us. So now what? Do I know what a good mom is? Can I be one?
45 Taking Baby Home This is the time to remember who all your supports are. Who was it that helped you while you were pregnant? These are the people who might now be able to help cook some meals, maybe help clean your place, or maybe give you a rest if your baby is being really fussy. It s so important to know when to ask for help with your place and with baby. Don t wait until you are too stressed out before you ask for help. Have some sort of safety plan so that you know if you start feeling stressed, you can call someone who can come and give you a break for a few hours. 45
46 * Sleep when baby sleeps (no matter what time of the day it is). * It s ok to put baby down on a blanket to play; you don t need to hold her all day. * If you are formula feeding, have a bottle ready made in the fridge so that if baby gets hungry, it s ready for her. * Put your baby on her tummy to play, and her back to sleep. * Keep the things you use a lot in one spot (bottles, toys, diapers). This way, you aren t running around all day trying to find stuff. * Ask for help!! Street Talk * The first 6 weeks that you have baby home with you is the time when things are going to change the most. For the first few weeks, you feed baby when she s hungry, let her sleep when she s tired, and cuddle and play for the rest. You will get used to her routine. A lot of times when trouble happens, it s because of other people, not you. Make sure people know that they can t party at your place or it can really screw things up for you. 46
47 Baby Blues Touchy Feely This is also the time when all of your emotions will be going so many different directions. You might have times where you feel on top of the world and so happy about what s happening. But there might be other times where you start feeling sad and it might seem likes it s for no reason. Your hormones change after you give birth, and it is normal to feel sad around 3 days after you have baby. Whether or not you have baby at home with you or she is in care, you can get something called postpartum depression. This is different than feeling sad or down for a couple of days. Postpartum depression doesn t go away right away and makes it hard to want to get out of bed, see your baby, or do things you normally would like doing. Most of the women we know started to get these sad feelings around 4 or 5 weeks after they had baby, but it can happen anytime from 2 days to a year. They have thoughts like this is too much or I m not doing enough for my baby. 47
48 You might cry a lot, not eat or sleep as much as you normally would, feel overwhelmed, or feel worthless. A couple things to remember are to call someone you trust and let them know about the feelings you are having, and go see a nurse or doctor that you know you can talk to. Sometimes women have to go on medications to help with the depression, but it will get better. The sadness can be really bad if you didn t get to take your baby home with you from the hospital or if he was taken away. It s important to remember that you might still have those feelings, even if you don t have your baby. Talk to someone about your feelings. 48 Street Talk * You can get pregnant again really quick after you give birth! But it s important to let your body heal. This is a good time to talk to a nurse or doctor about what kinds of birth control work for you. * Don t do lays with anyone for 6 weeks. Not your old man or any tricks. This is important because your cervix is really sensitive after having your baby, so you have to keep your body safe from infections.
49 So Now What?... Even once everything is cool with your baby and you are getting on a routine with him, it s still important to keep your supports close to you. Cause if shit hits the fan, these are the people you can go to for help. If you start to feel stressed or you noticed that little things are getting to you, talk to your supports before things get really crappy. 49
50 50 It s hard. But it s exciting. I m tired. But I love him. Am I a good mom or a bad mom? Is this normal? So much to know. But it s exciting.
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