To The New Dads Out There...

So fellas, the last blog was for single girls, and this one is for you men who have a little one on the way, or even plan on having one on the way at some point in your lives.

After a conversation I had last night with a couple who are expecting their first any day now, I thought I might need to give the guys some advice about what its like on their end, where to stand, what to say (and not say), what to watch and not watch, etc.

So here are some tips for upcoming fathers during labor and delivery.

1. Do whatever your wife/partner needs. Get her ice. Rub her back, or don't touch her, depending on what she says. She needs you to be available and she needs you to not get your feelings hurt if she tells you to stop talking while she's having a contraction. She means it, but in a good way.

2. Ask questions of your nurse and provider as to how you can help. It makes you feel more involved and it helps us too. We love helpful poppies.

3. Don't let your wife/partner watch any medical shows during her labor, which she might want to do after her epidural. They are OK at home, but watching "Emergency Birth" or "ER" or even "House" is a bad idea in the hospital. Not good for the soul.

4. Don't let the pain your wife is experiencing freak you out. Its awful to watch someone you love hurt so bad, but remember, its normal and natural and YOU CAN'T FIX IT. You can support her and love her and say sweet things, but let me say again, YOU CAN'T FIX IT. Unless she gets an epidural, its going to hurt the whole way through. Just be there, and pray a lot.


5. When mommy finally gets to start pushing, stand up by her head and support it while she pushes. That gives you closeness with her, and if you are squeamish, it'll help block your view of the action taking place a little further down. Sometimes a nurse might ask you to hold a leg, but that definitely gives you more of a front row seat. Its OK to say no or sit down. No passing out please. We already have two patients and definitely don't need a third at that point.

6. The nurse might ask you if you want to see the head as mom is pushing (we can usually start to see the top of the baby's head after a while). You can always decline. Like I said before, no passing out. Often we ask if mommy wants to touch the top of the head when it gets low enough. Don't be weirded out if she does--I mean, like the fact that she's pushing another human being out of her body isn't weird enough.

7. Encourage your girl as she's pushing--use phrases like, "Go Mama go!" or "You're doing it, you're doing it!" or "I can see the head!" help a lot. If mom has an epidural, she's usually be very sweet and responsive. If she's going "all natural" (emphasis on the "al"), she might not be as sweet, so don't say things like, "Enjoy these last moments of pregnancy" or "I'm almost sad its over". Yeah, not helpful. There's nothing enjoyable about that part except that its almost over. That's all she's shooting for at that point.

8. Cut the cord if offered by the provider unless its going to make you puke. Its a cool gesture, and honestly, after what your girl just did, its a fairly easy way to say, "I was with you baby, all the way, and I still am."

9. Unless you are super geeky and into science, don't watch the placenta come out. Its unexpected and weird and kind of gross. You just had a baby--don't let the afterbirth ruin your day.

10. If at any time you need some fresh air, by all means take it. If you need to sit, then sit. If you need some juice or coffee, get yourself some. Your girl is going through one of the hardest and best days of her life. She needs you to be on your game.

11. Try not to be weirded out by everything that happens in and around your girl's va-jay-jay. It means some very different to nurses and docs than it does to you. For us, its where something very important has to come out--totally opposite of your experience. We don't blink an eye about having to feel all around up there. Its an odd thing, I'm sure, to have strangers poking around, but remember, we do this every day to dozens of women we've never met. The only one who might think its weird is you, so get over it and support your girl.

12. When its all said and done, hold your baby and kiss your woman. I think she deserves it!

So there you have it. Now dads, you know what to do and what not to do. So go out there and have some babies!

To my single girls

Being single has its perks--something you really learn AFTER you are married--but personally, I love being married way more than I liked being single. And while I sometimes remember what it was like to come home after a long day and not have to answer to anyone, I'll take having someone to come home to over an empty house and pint of Ben and Jerry's any day.

Being married means having a partner and a friend all the time, during the big things like moving and jobs and life goals to the mundane things like grocery shopping, cooking, and sleeping. I haven't been lonely since getting married. I haven't gotten bored. I've laughed way more. I've learned to fight better. I've loved someone for who they are and received that same love back. I've seen God's grace played out on a daily basis. Who wouldn't want that?

This is why I pray for my single friends--so they too can know what its like to be loved in a very tangible way, so the longing in their hearts for a mate can be relieved and overwhelmed by love and commitment, so they can come home to someone that is committed to them for life and not just through the end of their lease.

For some girls, they are OK not being married, but for most, this is something they long for deeply. Deeply. Its something they've asked God to take away because it hurts. Its what they are afraid to talk about for fear of crying real hard at Starbucks into their Chai Tea Latte. Its personal, and its painful.

Its hard getting into your late 20s and 30s and not see any prospects. You wonder if there is something wrong with you. You wonder if it will ever happen. You wonder how on earth you will meet anyone who meets your standards, which you know are reasonable and not too high. You want to trust God, but that trust waivers with each wedding you attend and with each friend that calls to say that he finally asked her out.

Dang. When's my turn. Surely I have something to offer, right? I'm kind and gentle and compassionate and passionate...I'd be a good wife, I just know it. We could do great things together and have adventures and raise our kids to love God. Why am I alone at home every weekend, watching Bridget Jones's Diary again?

But I regress...

Having been that girl and now not being that girl, I pray real hard that God will raise up men who will take a chance on my girl friends who aren't just out of college, who are pretty and sweet and independent but not too independent, who have big goals like missions and church planting and hard core ministry in hard core places. These are girls who will sharpen a man and hold him accountable to his responsibilities before the Lord. They are Proverbs 31 women, and they are amazing. They are the girls I look at and wonder, "Why are guys so blind?"

So girls, you are in my prayers, intently and consistently, and until the big prayers for husbands and families are answered, I also pray for courage, peace, and love. And just know that in those moments when you have a hard time trusting God, someone else is trusting Him for you.

Family History

Ever since visiting my sister a few weeks ago, I've wanted to write a little ditty about our family history b/c its unusual and interesting and it involved one of my favorite things ever--the Appalachian mountains.

I'll start with my mom's side of the family, the Johnston side, b/c that is shorter and sweeter. The Johnston clan originated on the English/Scottish border hundreds of years ago as "Johnstone" and ended up moving to the States during colonization, eventually landing in rural, western Kentucky where my mom was born, 1 of 7 kids, to a farmer and his sweet wife Katie, my grandmother and name sake. They were poor and backwoods--my mom still remembers using an outhouse and chamberpot and getting water from the well. Up until a few years ago, the well and outhouse were still standing at the farm, though unused for years. Grandpa took to storing chicken wire in the outhouse, which I'm sure was not its original purpose. And for those of you wondering, it was only a 1 seater.

My grandparents farmed until they passed away--growing soy beans, corn, tobacco, pigs, and cows. I saw my first birth there (baby pigs), my first death (a deer get shot), caught my first fish, ate my first bite of squirrel and turtle (yes, turtle), learned how to snap peas, can strawberries, make peach preserves, clean a fish and fry it up, and remove ticks. That farm was a haven for learning, and my grandparents and parents were great teachers. What I gathered there didn't necessarily improve my SAT scores, it vastly improved my life, and that matters a little more than stupid SATs.

Now on my dad's side, this is where it gets a little more interesting historically, and its how the Appalachians tie in. My great grandmother was a Cable, and she married a Carringer, which is my maiden name. Now during the Revolutionary war, John Cable arrived to fight the colonist turncoats for the English, though he was German, a Hessian hired to fight by the mother country. John ended up defecting after the war and settling down in the heart of the Appalachians, in what is now east Tennessee. Other families joined around the settlement, and the area became known as Cade's Cove.

For years, Cade's Cove thrived and grew, until the Civil war, when the settlement became suspicious of outsiders, gathered their ranks, and shut off from the rest of the country. There was a little cousin on cousin marriage, I'm sure. These people perfectly fit the "hill billy" mold--poor, uneducated farmers who lived mostly off what the land provided them. My dad still remembers visiting his grandmother, Fanny Cable, up in the holler where her fridge was a cold spring under a rock and she sang "Angel Band" as she cooked in her apron. Fanny had 11 kids, one being my grandpa, at her home there in east Tennessee.

Cade's Cove still exists as a state park, and if you visit there, you can see Cable's Mill, started by John Cable, where my great grandma, Fanny, worked as a young woman. It even has a water wheel.

As a kid, we moved a lot, and no where ever felt like home to me until we landed in North Carolina, where my dad grew up, and especially when I went to school in Asheville. That was my first time really diving in to Appalachian life, with the music and dancing and craft and food. Up there you can still find Carringers and Cables and Crisps, names you don't see too often outside the hills of North Carolina and Tennessee. There, you find people who are country, and sweet, and use muscadines for cider and possum grease for croup. That's where I feel most at home. As much as I love my parents and love being at their house, its the mountains that call my name.

Chris and I talk about moving there one day, somewhere in the Appalachians. We want our kids to play in the woods and have animals and grow a garden. I want those things for me too. I'd like to have a life a little like my great grandmother and my grandparents in Kentucky--a little less money, a little more faith, and a lot more of God's creation around me.

Maybe one day...

All the pregnant ladies...just put your legs up!

In response to comments about the last blog, I'd like to take a second to talk to the pregnant ladies out there who might be wondering what its like to have a baby, and to answer Lauren's question, what it takes to be a great labor patient both for your sake, and for all you nurses out there too.

If you are having your baby at a hospital, you will find that your labor nurse is one of your best assets to having the delivery you hope to have. Labor nurses are with you through the thick and thin of labor from 3 centimeters to completely effaced to epidurals to pushing. We're there with two gloved fingers and a watchful eye. We take care of you and your baby, and most of us love our jobs and want to make the experience great for you and your growing family.

Still, there are some things that you, the patient, can do to make the relationship between you and your nurse blossom. Here's a list, off the top of my head, of things I love about labor patients, and things that can be difficult to manage.

1. Don't be afraid to ask for things, but try to do it nicely, even if you are in pain. We don't mind answering call bells or getting you some ice, but saying thanks in between contractions is just icing on the cake.

2. We love when husbands/partners/family members help out. Our jobs are hard and busy, so it helps makes things go more smoothly and quickly if family members take initiative and get a cool wash cloth for mommy's forehead. Trust me, we don't mind at all.

3. Try not to throw up on the nurse or your partner. At least aim for the floor, please. Lots of women puke in labor, and if you feel even a little nauseous, please please please ask for a bucket.

4. Don't worry about pooping while you push. We would much rather you push great for 1 hour and take a big 'ole poop then push bad for 3 hours and remain poop free.

5. Tell your nurse if something changes, like you all of a sudden feel pressure or this big urge to push, or if you want pain medicine. We can't read minds, and we want to help you, and we definitely don't want to miss your delivery because you pushed and we weren't there. Its like I tell my hispanic moms, "No empuja sin enfermera. No quiero bebe en la cama or el piso por favor." (Translation "don't push without the nurse. I don't want a baby in the bed or the floor please."

6. Its never too soon for an epidural, but it might slow things down. Epidurals make our jobs as nurses easier, but if you don't want one, we're OK with that. If we think you need one because you are freaking out or it looks like your baby isn't tolerating labor, then we'll tell you.

7. Birth plans are great, but its also great to hold them with open hands b/c labor is rarely predictable, no matter what the experts say.

8. If you are trying to decide to come to the hospital b/c you think you are in labor, try to avoid coming at 7am or 7pm. That's shift change, and its always chaotic. Its for your best interest.

9. Just be sweet to your nurse. We're here to help. We have rules we have to follow, like the number of people in the room at a time and what not. Please obey them. They aren't just arbitrary.

10. Trust your nurse and don't be afraid to try weird stuff we might suggest, like the birth ball or squatting or pushing on hands and knees. We do this all the time. Pushing is our deal, and we're usually pretty good at it.

11. When its all over and you are headed to recovery, saying thanks makes our day.

So there's ten things you can do to enhance the relationship you have with your labor nurse. Cussing doesn't bother us, screaming is OK, moaning rules, and pushing hard is awesome.

On behalf of all labor nurses out there, thanks for letting us share in your birth experience, and don't worry, we forget what it all looks like after the baby is in your arms.

The NIght Shift

So I haven't written for awhile, and I'm not sure why. The only thing I can reckon is that I've been working nights and life is just weird when you sleep all day and work all night for three days in a row, then try to have a normal life again for the rest of the week.

In light of that, I'd like to take a moment to describe life on nights...the highs, the lows, and the dark.

Let's start with a simple overview of the shift. We generally arrive between 6:45 and 7pm, with coffee in hand, though some prefer Mountain Dew or Coke Zero. I'm a triple shot iced Americano kind of girl, with room please.

We all want to know what the "board" looks like, which translates into, "Will I have just one nice, normal labor patient, or should I pee now because I won't have a chance again until I get home in the morning." We change quickly into green OR scrubs that are required for the unit and line up to get our assignments. The day shift folks are only too happy to hand over their patients. We get report on our assignment (or assignments, if its busy) and get to work.

Whether its labor, pre-ecclampsia, or cesarean, there is an unspoken rule on night shift that you work together and you always always always know that someone else is watching out for you. Its such a relief when a baby crumps on the monitor to turn around and see 2 or 3 other nurses stepping into your room and pulling on gloves to get things right again.

If things aren't too crazy, it can get pretty quiet around 3 or 4 am, and we find ourselves sitting together at one of the nurses stations, wrapped in blankets b/c its cold, drinking something, and chatting away, always eyeballing the monitors to tell us how each baby and mommy is doing.

Around 5am is when things start to get silly. People are tired, but we know that only 2 more hours are left until daylight, and better still, shift change. Someone will make a "that's what she said" joke, or start quoting their favorite movie lines. Another RN will join in with some story about their patient, like how room 2 just pooted on the nurse's hand during a cervical check, or how room 7 spit out a 10 pound baby with 2 pushes. You hear phrases like "vaginal bypass" or "hosed" or "FLK" (which stands for funny looking kid). Almost everyone has a story from their night.

By 6, we're pretty much home free, except for that one lucky nurse who will have a change of shift delivery that leaves her with loads of documentation to catch up on. It happens to everyone, and if the patient is sweet, then we usually don't mind at all. I mean, its another life brought into the world, right? So what if its at 6:58.

The day team starts to arrive at 6:45 or so, looking fresh and clean, compared to us, who are ragged and barely able to formulate a thought. Sometimes I find myself waddling around the unit because I'm too tired to pick my feet up any more than I have to. Usually I have to sit down and really think through all my charting and the work I did to make sure its all been done. It seems easier to forget stuff at 4:45am than at 4:45pm. Why do you think that is???

By 7:15am, I'm usually out the door and heading to my car, the sunshine hurting my eyes that have grown accustomed to the dark halls and rooms on the unit. Now that I park in the same place, I don't have to wander around, trying to remember where my car is, which happened a few of my first nights.

Driving home is always a time for prayer, mostly to stay awake and not kill anyone on the road. I usually call home and talk to my parents because they are interesting, and Chris is still asleep. Once I couldn't get a hold of anyone, so I called my friend Michelle, another nurse who had worked that night and was also driving home. She didn't answer, and I left her this ridiculous message about struggling to stay awake at the wheel and how I hoped she was still awake and not asleep since she didn't answer her phone. She called me back a few minutes later, worried that I'd be dead in a ditch because she didn't answer and I had no one to talk to. I was eating toast at home when she called, so I was ok.

Then I sleep all day, usually with the help of Benadryl or Ambien. Ambiem made me hallucinate once, so its been Benadryl since then, and there are no more can can dancers in my room nor has the laundry started coming to life.

Then I get up. Then I eat, then I go back to the hospital to do it all over again.

So there's the night shift in a nutshell. I wish everyone could experience it at least once. Its a joy and its hard and its fun and its exhausting. But I love it, and I'm glad to be there. The patients are (usually) great, and the staff is even greater. That combination is worth staying up for.