"The best way to feel empowered during your pregnancy and birthing experience is through education on the process and exercising your right to choose. This starts with making your first prenatal appointment. Making that appointment is imperative, but can feel scary if you do not know what to expect. 

Here are eight steps to help you feel empowered during pregnancy and as you enter into parenthood.

Contact your Insurance Provider

If you do not have insurance at the time of pregnancy, you have options. Please reach out to your local social service agency for assistance with State Assisted Medicaid in order for you to have access to prenatal care.

If you already have health insurance, it is time to do some research. Contact your insurance provider to understand your benefits during pregnancy, which may cover the cost of a birthing center or doula support. Also, speak with your insurance company to discuss preferences for your doctor such as sex of the doctor, ethnic preference, language preference, location preference, etc. You have a right to request what you would like; do not be afraid to ask!

Prepare to Meet Your Provider

Now that your insurance has provided you with options and you have your first appointment scheduled, it’s time for a visit. When getting ready for your first appointment prepare some questions for your provider to help you determine if it’s going to be a good fit. The best way to do this is by having them prewritten on good old fashioned paper or on your phone.

You might be wondering what to ask. Here are a few questions to start:

• Is there a nurse line that I can call if I have questions?
• If I experience bleeding or cramping, do I call you or the nurse?
• What do you consider an emergency?
• Will I need to change my habits regarding sex, exercise, nutrition?
• When will my next prenatal visit be scheduled?
• What type of testing do you recommend and when are they to be done? (In case you want to research the tests to decide if you want them or not.)

Know Your Rights

You made it to your first visit, and the receptionist gives you a clipboard to complete information and documents to sign. Be sure to read the informed consent and pay close attention to your rights as a patient. Learn what to do if you ever need to file a grievance, feel pressured by the doctor, midwife, or staff to participate in testing, or if someone refuses to explain procedures. You have a right to file a complaint with your insurance company and with your state’s medical board if the violation you experienced is egregious.

Ask for Clear Explanations of all Procedures

Now that you have read your informed consent and have your prepared questions for your provider, they will call you back to your appointment. Once you go behind that closed door, ask your provider to explain what will be done during this appointment. It is important for medical professionals to explain what procedures will be done during the visit.
If at any time you feel uncomfortable, please speak up! If you plan to bring a support person such as a partner, friend, or family member to this first visit, it might be helpful to think of a code word beforehand, so your support person can speak up for you if you become overwhelmed.

Don’t forget to ask the questions that you prepared. Feel free to take notes as they answer your questions. Notice how they respond to questions. Do you feel heard or is the provider rushing you? After the visit, take time to reflect on whether or not you felt comfortable with the provider during your appointment. This is a huge deal because if you are not comfortable, it is going to be hard to ask questions or feel as though you are receiving quality care. If you did not feel comfortable, it is okay to search for a different provider. You will be in the care of this individual for 9 months, so it is important to have the right team of people supporting you. You want to feel empowered during your pregnancy.

Bottom line: Tune in to how you feel. As a birthing person, you have choices and rights no matter what birthing environment you choose. If you don’t feel comfortable at any point during your pregnancy, it’s not too late to find a new environment or provider. 

Take Advantage of Opportunities for Education

What creates an empowered pregnancy? Education, education, education! Education allows you to make the best decisions for yourself and your family. Search online for different birth techniques and methodologies, and then find a class at your hospital, with a local organization, or even online!

Take time early in pregnancy to think about how you want your labor and delivery to go. Do research on classes that are in alignment with what you desire during the birthing process. There is something out there for whatever you want your birth to look like. Attending various classes can help you learn about different decisions you will have to make once the baby is born. Classes can help you think through decisions like knowing when you want to cut the cord, what newborn procedures you want your baby to have, when to do baby’s first bath, and infant feeding. Education allows space to have conversations and ask for help where needed so you can have an empowered pregnancy.

​Find a Community of Support for an Empowered Pregnancy

Nothing says empowerment like community. Join a group in your local community or online for additional support. Find a group of expecting pregnant people so you can add to your support team. Every new parent needs support, so do not be afraid; get involved. There is so much power in feeling understood by someone who has been through what you’re experiencing.

Prioritize your Physical Health

Proper nutrition before, during, and after pregnancy can improve birth outcomes and has significant implications for maternal health. Focusing on whole foods especially fruits and vegetables, eating enough protein and limiting processed food can play a role in reducing the risk of pregnancy-related complications, such as preeclampsia. Preeclampsia is a condition that disproportionately impacts Black pregnant people and can be a result of the long-term psychological toll of racism as well as current systemic barriers to proper treatment that delay the diagnosis or treatment of the condition. If this all sounds like a daunting task, you are encouraged to seek guidance from your doctor, midwife, doula, or support team.

Doulas can support your nutrition by offering suggestions for healthy meals and providing accountability and support. They can also make sure you’re being monitored for early warning signs of pregnancy-related complications.

Last but not least, physical exercise is another important aspect of prioritizing your physical health. Yes, it is safe to exercise while pregnant! Walking regularly, stretching, and yoga have been found to have significant benefits during pregnancy for both you and your baby. Being idle and sedentary during pregnancy presents its own risks, so do not be afraid to get your body moving. There are modified workouts that are readily available to pregnant persons. It is important for pregnant persons to speak with their provider about exercises that are safe for them.

If you need help finding easy, delicious recipes that focus on healthy fats, protein, and fruits/vegetables, check out our 5-ingredients or less recipe generator. Click to learn more about the benefits of doing a Whole30 while pregnant!

Prioritize your Mental Health

Focusing on your physical health during pregnancy is important; however, do not neglect your mental health. Venturing into parenthood is wonderful and stressful at the same time. If you are feeling overly anxious or depressed, ask for help.
Mental health professionals can equip you with tools for how to manage your stress, learn how to better communicate with your partner, heal emotional wounds, and help you replace toxic thoughts with more positive ones. Look for a trained perinatal mental health professional."

Photo: Katherine Streeter for NPR

​Menopause Can Start Younger Than You Think: Here's What You Need To Know

By Emily Vaughn & Rhitu Chatterjee

"Would you recognize the signs that your body is going through the big hormonal changes that lead to menopause? Here's what to look for-and what you can do about it."

"Sarah Edrie says she was about 33 when she started to occasionally get a sudden, hot, prickly feeling that radiated into her neck and face, leaving her flushed and breathless. "Sometimes I would sweat. And my heart would race," she says. The sensations subsided in a few moments and seemed to meet the criteria for a panic attack. But Edrie, who has no personal or family history of anxiety, was baffled.

She told her doctor and her gynecologist about the episodes, along with a few other health concerns she was starting to notice: Her menstrual cycle was becoming irregular, she had trouble falling asleep and staying asleep, and she was getting night sweats. Their response: a shrug.

It wasn't until Edrie went to a fertility clinic at age 39 because she and her partner were having trouble conceiving that she got answers. "They were like, 'Oh, those are hot flashes. It's because you're in perimenopause,' " she says.
​
If you haven't heard the term "perimenopause," you're not alone. Often when women talk about going through menopause, what they're really talking about is perimenopause, a transitional stage during which the body is preparing to stop ovulating, says Dr. Jennifer Payne, who directs the Women's Mood Disorders Center at Johns Hopkins University."

HOW PUBERTY, PREGNANCY AND PERIMENOPAUSE AFFECT MENTAL HEALTH

Listen to the four podcasts below:

"January 14, 2020 • NPR's Morning Edition explores the key reproductive shifts in women's lives — puberty, pregnancy and perimenopause — and how the changes during those times could impact mental and emotional health."

"​January 16, 2020 • Women with a history of depression and anxiety are at a higher risk of having a flare-up during the time leading up to menopause. And getting doctors to take the issue seriously can be challenging."

"​January 15, 2020 • Nearly 1 in 7 women suffers from depression during pregnancy or postpartum. But very few get treatment. Doctors in Massachusetts have a new way to get them help."

"​January 17, 2020 • NPR's Rachel Martin talks to menopause expert Dr. JoAnn Pinkerton, division director of the Midlife Health Center at the University of Virginia, who answers listeners' questions."

Setting meaningful goals can help manage symptoms of anxiety and depression. By setting meaningful goals, you eliminate feelings of being lost or stagnant in life and create a clear path for achieving your goals. This clear path and your connection to the "why" will help you stay motivated by keeping your focus on achieving such a meaningful goal. You'll have the ability to visualize your success. 

​By: Katty Kay and Claire Shipman

“Evidence shows that women are less self-assured than men-and that to succeed, confidence matters as much as competence. Here’s why and what to do about it.”

Confidence in Women
Although women have worked hard and have made great strides including the following:

1. Women now earn more college degrees than men
2. Women make up half of the workforce
3. Women are closing the gap in middle management
4. Companies that employ women large numbers out perform their competitors on every measure of probability

 
**Men still get promoted faster and paid more. Women still struggle to make it to top positions. The number of women in top positions is very small and barely increasing.
 
Women are lacking in confidence, including women who are highly successful in the professional world. There is a vast confidence gap that separates women and men. Compared with men:
 
*Women don’t consider themselves as ready for promotions.
*Women predict they’ll do worse on tests.
*Women end up going into less competitive fields like human resources or marketing.
*Women generally underestimate their abilities.
*Women feel confident only when they are perfect…or practically perfect.
 
"The confidence gap is important because success correlates with confidence just as much as it correlates with competence.  Having talent isn’t merely about being competent; confidence is a part of that talent, you have to have it to excel."
 
“Confidence is the stuff that turns thoughts into action. It is the factor that turns thoughts into judgements about what we are capable of, and that then transforms those judgements into action.” –Richard Petty (Psychology professor at Ohio State University who has spent decades studying confidence.)
 
"Women also suffer from the perfectionism mentality. Women strive to be perfect in all that they do. Women have fixating thoughts on their performance at home, at school, at work, at the gym, and even on vacation. Women have obsessive thoughts about every role in their lives because we want to do them all perfectly, but perfectionism is another confidence killer. Striving to be perfect actually keeps women from getting too much of anything done.  
 
Is this to say that men don’t suffer from thoughts of doubt?
 
No, men do suffer the occasional thought of doubt, but not with such exacting and repetitive zeal, and they don’t let their doubts stop them. Women often times let their doubt or lack of confidence get in the way of trying. Women can do just as well as men when taking tests or performing in top positions, but they choose not to try because they don’t feel confident in their ability to perform. This is what holds women back. Women avoid taking risks because they fear making mistakes and strive to be perfect. When we hesitate because we aren’t sure (low confidence), we hold ourselves back.
 
The good news is that we are capable of performing just as well as men do! The evidence is implicit, to become more confident, women need to stop over thinking and just act! The more that we do this, the more confidence we will build. By shifting our thought patterns and behavior, by keeping at it, channeling our talent for hard work, we can make our brains more confident prone."
 
“What neuroscientists call plasticity, we call hope.”

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