Pressing the Panic Button

I'm currently at 39 weeks and starting to feel the anxiety kicking in. My hormones haven't been too bad, but lately they seem to be changing and kicking into high gear. I feel scared about the birth now, and felt so comfortable about it before! I am constantly worrying about how my decisions are going to affect others rather than focusing on how I am feeling, and I know that it's not helping or healthy. I'm trying to stop by actually telling the people I'm having trouble with what is going on with me.

Since my last post (two weeks ago, I believe) I have had three appointments. The first was a great consultation at my house to make sure that if I were to want to stay home to deliver I could. Everything on that front is just fine. Our rental house will be suitable and my midwife would like to discuss inducing if I go later than ten days which is right at the end of the month (May 1) anyway. We will labour at home for as long as possible and then decide when the time comes whether to head to the hospital or stay at home. I would LOVE to stay at home, but this is where the thinking of others plays in. I know that I can list probably at least five people that will actually be angry at us if we were to make that decision. I should not have to think about that, but yet it occupies much of my thoughts.

My next appointment was interesting as I surprised myself by agreeing to an internal when I thought I would say no unless absolutely necessary. It was a positive experience. My midwife was incredibly gentle and even though my cervix is posterior she managed to do what she needed to without any pain. She said that the baby's head is down so low that it was almost difficult to get past it to even reach my cervix! I obviously googled posterior cervix to make sure I understood what she was explaining about it, and it's both common and nothing to worry about. Apparently, the cervix can move about with ease and tends to come forward during active labour.

Then at my most recent appointment I surprised myself yet again and agreed to strip my membranes. I am concerned that this will be a big baby and from what I could research about stripping the membranes it can help bring on labour if you are close already and doesn't seem to be unhealthy with a pregnancy that is progressing normally (such as no placenta previa etc.). Because my cervix is still posterior it was a tad more difficult to accomplish, and interestingly it didn't actually hurt, but there was alot of pressure in my tummy at the front. I bled alot and there was a moment of concern, but as I had just had an ultrasound we knew that my placenta was nowhere near the danger zone. I stopped bleeding fairly soon after, and everything was fine.

Then I had cramps through the night (normal) and woke up to my mucous plug coming out! Wow, I know it's normal, but that was pretty gross... That was yesterday morning so now I'm just waiting to see what will happen next :)

In the crazy life areas our rental house is being shown now, and it's terribly annoying to have to make sure that I tidy up constantly when I'm EX.HAUST.ED. Especially because I am still working full time (plus some OT) and there is really no time between trying to finish last minute things, working, and both houses...

Our rental house is mainly packed but for what we are still using... the new house is coming along great but as with all renos it could be faster... could always go faster.... I am almost done all the main cleaning but it's so difficult to do when there is still some of our stuff in there! Ryan thinks that the painting should be done this week, so I hope to get our stuff moved by the end of the weekend (the stuff we aren't using) and therefore create less to worry about later...

Physically I feel good once I am up and out of bed in the morning, but nighttimes are getting progressively worse. My pelvis and hips seem to lock up in the night and I can't get out of bed without some serious work. It hurts so badly and it's a sharp breath-taking pain that shocks me pretty badly when I'm half asleep and dying to pee. In some ways I need to have some major discomfort because I'm still comfortable enough at this point to keep the little guy inside for another month or so... I need to start to feel that agonizing get this kid out of me- I'll do anything feeling so that I will ready for labour. Right now I feel like work and the house are too crazy to throw the kid in the mix right now!

Have a good week everyone and I'll update again soon!

The Best Appointment in History, and 32 Weeks! Hurray!!

I. AM. SO. RELIEVED.

I could hardly wait to write this post! I have sounded so unlike myself in my last posts that I was hardly recognizable, even to me! Now I am filled with hope and joy, and much more ME!

I had my midwife appointment yesterday afternoon, and had written down all the burning questions that I felt I could not live another day without asking. I didn't even have to. I mentioned at the beginning of the appointment that I had some concerns about the actual process of my labour, my midwife took it from there and led me through the exact experience of birth I had dreamed for. I actually had tears in my eyes I was that relieved.

Now, I don't for one second live in the delusion that everything goes exactly as planned. I am not that foolish, but if things come up that I would prefer to avoid I would like to be informed and an active participant in the decision making process. I truly believe that my midwives are exactly what I need.

Some of the burning questions I had included:

Q. Will I be able to stay at home for as long as possible until we go to the hospital?

A. Yes, in fact we can even plan tentatively for a home birth just in case you change your mind at the last minute and don't want to leave because you are laboring so well at home. When your contractions become regular one of the midwives will come to your house to be with you and help you make the decision when the right time to leave would be.

Q. What will the experience be like upon arriving to the hospital? Will I be checked internally a thousand times and have people in and out of my room constantly?

A. No. You go straight past admitting into a room after signing one document and won't have to see anyone but the midwife (barring complications) until the time to push. When that time comes a nurse will come in to be a second pair of hands.

Q. Will the baby be taken from me and have tests and the weight done immediately or will I be able to hold the baby and potentially nurse if the baby wants?

A. Absolutely not. The only time the baby would be taken away is if there are respiratory concerns and the baby is struggling to breathe, and even then it would be taken to the warmer which is very close to you. The baby comes out and is placed on you and all tests and weight etc will be done fairly leisurely. There is no hurry.

So to confirm there will be no "scrubbing" down of the vernix, and I can just let us both relax and "bond"?

A. While the midwife takes care of any tears and delivers the placenta the baby will be with you and your husband.



Wow. Everything that I was so scared to have happen aren't the way these ladies think at all. I am so incredibly thankful that I chose them and that they have such a great working relationship with the hospital I chose. The weight has been completely lifted from my shoulders and I no longer am thinking about having to "protect" myself while I am most vulnerable. I feel confident and reassured that my body will have the patience and guidance I need to be able to deliver naturally and as enjoyably as possible. I feel so happy.

If my appointment could get any better after that.... I would have been so surprised! And of course it did!!!!

My blood pressure was within normal range on the first try. This has NEVER happened it always takes three tries for it not to be super high.

The baby is no longer breech! He is head down and low which indicates that he fits well in my pelvis! So, at the risk of sounding incredibly rude...... All of the people in my life that have been using the "scare tactics" to inform me that I "would" be having a C-Section- YOU can suck it! Ahhhhhhh that felt good.

Also, I am measuring normally again! I am 32 weeks and measuring 33 cm so I'm not far off exactly where I should be :)

Then things got even better! Without even asking my midwife volunteered that my weight gain is completely within normal range and that I have gained only baby so far! I feel like a giant heifer, but it certainly felt good not to be incredibly worried about it for a while. I have gained 23 pounds in total so far, but I was a little heavy before I got pregnant.

My appointments start every two weeks now, and it felt like I would never get to this stage, and unfortunately was actually even dreading getting to this stage. I feel much different now. I feel calm and ready to take on both the challenge of labour, but also motherhood. I feel like this baby and I are on the same side now rather that fighting against each other. I feel like it's time to start embracing the joys of this pregnancy rather than focusing on the negative. Because realistically it's a miracle that it even happened and a much unexpected one as well.


Thank you for everyone's comments on my last post. I am still grieving, but I know it will get better. I am still struck by the force of missing him when I least expect it. I love you and miss you Mister Monster and I just hope you are having a great time in cat heaven :)

Making a plan

Today marks the beginning of week 30, which means that I'm starting to seriously think about what's going to happen when these babies are born, especially since it could be in as little as 5 or 6 weeks! I started drafting a birth plan ages ago, but hadn't really firmed it up or finalized it before now.

My goals for my plan were:
1) that it could fit on one side of one piece of paper, as I don't want anyone to have to search for ages to try to find my preferences for something;  
2) that each item could fit on one single line, using bullet points because I believe that simpler is better; and
3) that it should cover both a vaginal birth and a c-section, since I don't know at this stage which I'll be having - even if both babies behave themselves and we can start with a vaginal birth, there is still a chance that I may end up needing a c-section to get the second twin out.

I know that many readers will have their own opinions and preferences on some matters (such as pain relief or having the baby in the room with you all the time vs in the nursery part time), so please remember: this is my birth plan. I am not insisting that this is the only way to do things, since I believe that what may be right for one woman won't be for another. Now that's been said, here's the plan as it stands today:

Birth Plan for Bibliosaur (TWIN PREGNANCY)
Due Date    3 May 2008
Patient of    Dr H (XXXX Hospital) and Dr S (XXXX Medical Centre)

These preferences presume a normal pregnancy/birth; we may change our thinking as labor ensues.

Labor
Mr Bibliosaur (husband) present at all times.
No visitors or observers such as students or unnecessary staff at any stage.
Freedom to walk and change positions as needed/desired.
To stay hydrated by drinking water.

Pain Relief
If I request medication, I would like an epidural.

Episiotomy
I would rather tear than have an episiotomy.
Please use local anaesthetic for any repairs.

Delivery
I would like the freedom to push and deliver in any position I like.
Mr Bibliosaur would like to help catch the babies if possible.

Immediately Following Delivery
Mr Bibliosaur would like to cut the cords if possible.

Newborn Care
Please evaluate and bathe the babies at my bedside.
Mr Bibliosaur would like to accompany the babies should they need to go to the NICU, if possible.

Postpartum Care & Breastfeeding
If available, I would prefer a private room.
I would like the babies to room-in with me during the day and be in the nursery overnight (brought for breastfeeding during the night as necessary).
I will breastfeed/pump milk and would like to meet with a lactation consultant.

Cesarean Section Delivery
Mr Bibliosaur to be present during the surgery.
I would prefer an epidural rather than general anesthetic.
We would like the babies to be held by Mr Bibliosaur immediately and to be with me in recovery, if possible.

You may notice that there are a lot of "if possible" statements in there. That's because some of these things simply may not be possible with twins - for example, we may not have the option of holding them right away if they need to go to the NICU (and Mr Bibliosaur may not be able to accompany them there), and it may not be an option for Mr Bibliosaur to catch the babies - so we need to understand the potential limitations of our situation.

You also may notice that, compared to a lot of sample birth plans (like this one), it's short. This was both intentional - as I said, I wanted it to be able to fit on one side of a single sheet of paper - and because I don't have anything that I feel "it must be this way!" about. I simply don't care about many of the little things that are on some birth plans - for example, playing music or wearing my own clothes. Perhaps I should, but I don't.

Other things that are on some checklists - like stating that you don't want an enema upon admission - are outdated, since most hospitals don't normally do that these days anyway, so there's no point in bulking out your birth plan with things that won't happen or things that your hospital already does/allows as a matter of routine procedure. And there are yet more things - like wanting the lights dimmed - that I am confident I will verbalize (possibly rather loudly, haha!) at the time, and thus don't need written down.

I think that it's absolutely fine to have strong desires for your ideal birth plan, but that flexibility is important as well. My entire goal is to have a good outcome with healthy babies and a healthy mama, and I'm open to doing whatever I need to in order to accomplish that. If I go into labor and decide that I can do it drug-free, then that's great. If I go into labor and decide that I want drugs OMG NOW GIVE THEM TO ME NOWWWW, then that's great too. If we can do this vaginally, fantastic. If I need a c-section to get these babies out, then that's fantastic too.

If you don't know where to start with drafting a birth plan, there are a lot of websites out there that make it easy, like this birth plan creator from SheKnows - you just tick the boxes to indicate what you'd like, and the end result is your customized plan. This one from the Bump is fairly comprehensive, and I also like this simpler version from Bubhub, which is a bit less wordy than the SheKnows version.

Thirty Weeks (and my 35th Birthday)

Today is my 35th birthday and I am 30 weeks pregnant. Only 10 weeks to go! I cannot believe it. I remember when I was 8 weeks pregnant and feeling like this would take forever. Now it seems like it's not quite time to end!

It's been 10 days since I started on the Gestational Diabetes eating plan. I have been sticking to it perfectly but, unfortunately, my fasting numbers are still higher than they'd like to see. At my OB/GYN appointment yesterday, she mentioned needing to add in insulin shots in the evenings. So I have an appointment with an endocrinologist tomorrow afternoon. I am not happy about that. I know it's nothing that I am doing to cause this (other than being pregnant), but the fact that I cannot control it with diet and exercise has made me feel like even more of a failure. With insulin shots comes non-stress tests on baby at every appointment. And there's an increased risk of low blood sugar with insulin, so I'll have to carry glucose tabs with me, just in case.

I know it could be worse and I am grateful that it isn't, but this has still been hard. I am a very sturdy person and have never been sickly, save for the occasional sinus infection or bout of strep throat. I have certainly never required medication on an on-going basis or regularly scheduled doctor's visits. Thank goodness I have great insurance coverage and can get the best treatment available without worrying about how I'll afford it. This certainly would not have been the case a couple of years ago when I was a self-employed artist and that fact is not lost on me in the least.

So this will be the first birthday in about 20 years that I am not having chocolate cake and vanilla ice cream to celebrate. My sweet husband did find some frozen mini profiteroles (cream puffs) that meet my limited carb count requirements, so I will get to enjoy six of those instead of big slice of frosted layered chocolate cake and vanilla bean ice cream. I am really fine with this, since my entire focus right now is on keep Libby safe and healthy.

image source
Guess I'll have to save the chocolate birthday cake for Libby's birthday celebration!

We got a sneak peek at her yesterday. She's measuring at 3 pounds, 10 ounces and has a heart rate of 133 bpm. She's been head down since our last appointment (two weeks ago) and the doctor predicts she'll stay that way. Seems to be a very long time to be upside down, but I guess it's totally normal.

Here's a look at her face...she was wiggling all around and stuck her tongue out at us!

Yesterday we did share our birth plan with our doctor and she said that she will only induce if I go past 40 weeks or if the baby seems stressed before that or if my health is at risk, but not automatically because I have GD. That was reassuring. She also was fine with all of our preferences except waiting for delayed cord clamping (she said waiting could cause jaundice, which I had never heard before and need to research further) and not administering Pitocin to deliver the placenta (she said the majority of women require it, even if they breastfeed immediately). I don't agree, but at this point, I am picking my battles and can live with those two concessions (I think).

We've also completed our crash course in the Bradley Method and have decided to hire our instructor to be our doula. She is a registered nurse and has been a certified doula since 2000. She also has given birth to seven of her own children! The last three were home births! So she has a wealth of knowledge and experience and we feel very comfortable with her. From here forward we just need to practice daily (relaxation techniques, rehearsing contractions in the the difference stages of labor, etc.) and prepare ourselves mentally and physically for labor. For me this includes 200 elevator Kegels each day, tailor sitting, pelvic rocking and walking at least 30 minutes. I am personally also practicing daily affirmations and positive visualization and meditation so that I can be confident moving forward towards a natural birth. Most of all, I am getting very exciting to finally meet our little girl.

According to BabyCenter, here's what's going on with her this week:

image source

Your baby's about 15.7 inches long now, and she weighs almost 3 pounds (like a head of cabbage). A pint and a half of amniotic fluid surrounds her, but that volume will decrease as she gets bigger and takes up more room in your uterus. Her eyesight continues to develop, though it's not very keen; even after she's born, she'll keep her eyes closed for a good part of the day. When she does open them, she'll respond to changes in light but will have 20/400 vision — which means she can only make out objects a few inches from her face. (Normal adult vision is 20/20.)

image source

I Don't Like This Game...

... the waiting game, that is. Today is my due date and there are still no promising signs of labor on the horizon. I've had contractions for the last 3 weeks. Earlier in my pregnancy, I had asked another pregnant mom how she was able to differentiate Braxton Hicks contractions from real contractions (I've been having BH contractions since week 20). She said that real contractions sort of take your breath away and the pain is very similar to bad cramping during your period. My uterus gets so hard and tight with the BH contractions I was concerned that I wouldn't be able to discern the difference, but once I started having real contractions, I definitely knew what they were.

One evening a few weeks ago I started having contractions 15 minutes apart for an hour, then 10 minutes apart for an hour, and then they just stopped. I swore after that happened that I was going to see the doctor at 37 weeks and she would tell me that I was dilated and ready to deliver this baby soon! Alas, I was not.

Image Source
Then there was another evening when I had contractions every 5 minutes for an hour. They say to call if you have contractions every 5 minutes lasting for over an hour, or if your water breaks, so I thought surely I was going into labor. Silly me, because as soon as the one hour mark hit, the contractions stopped! Still, with all those contractions I thought I would definitely be at least a little dilated at my next appointment at 39 weeks but all the doctor could tell me was that my cervix was starting to soften.

I just went in again yesterday at 39 weeks and 6 days and I'm apparently making some progress. Not much, but a little....today I was "a fingertip dilated" and my cervix is softer than it was previously. The baby has dropped a little further and my doctor said she could easily break my water at this point if she wanted to. She also said she could feel my pelvis "opening up." So, the baby could come at any time now, or she could take her sweet little time.

At this point, I am so ready for this baby to be here. I can hardly walk anywhere without getting winded (though I'm trying to walk a lot to induce labor) and I just cannot get comfortable enough at night to get some decent sleep. I toss and turn, and once I am finally able to fall asleep, I am woken up by the urge to pee again. I've heard lots of moms say that this is common and it's nature's way of getting you used to all the sleepless nights that come with taking care of a newborn. That's probably true, but that doesn't change the fact that I would love to get a good night's sleep right now!

Image Source
Only 5% of all babies are actually born on their due date - most are born somewhere between 38-42 weeks. I can't reliably wait on my water to break as an indication of the start of labor, as only 8% of pregnant women have their water break before they go into labor. So for now, I just get to hang around, over-analyzing every contraction and wondering when this baby will come.

We've decided to schedule an induction for next Monday if the baby doesn't come on her own sooner. I will be 40 weeks and 5 days at that point. It's my understanding that some doctors won't even induce labor until after 41 weeks, but my doctor said that she doesn't like to let her patients go beyond 41 weeks because the baby's risk of meconium aspiration are much higher then. We had originally discussed inducing as early as tomorrow, but have decided to give the baby some more time to come out on her own.

If you do some research or ask around, you'll find all sort of methods out there that are supposed to induce labor. Shopasaur blogged about it here. I'm not entirely sure that I believe in any of them, but we're going to give some of those methods a shot (can't really hurt, right? Except for the castor oil - blech!). We'd really prefer for this baby to come in her own time, but if it's better for her to be induced next week then that's what we'll do. Either way, you should be hearing an announcement from us any day now...

Thoughts on the birth plan

image source

I met with our Bradley Birth instructor yesterday to pick up some books that she wants us to read before our private classes with her in early November. It turns out she is also a doula and is available for our EDD. So I really want to book her. DH has his reservations, but I am convinced that having her there for our labor and delivery would be awesome. Right now, I cannot tell if he's worried about coming up with another big chunk of change before the baby arrives (to pay for her services) or if it runs deeper, like he's afraid she might take his place or something. For now, it's on the table for discussion and I hope that, in time, he'll be more open to my desire to have her there.

From before I was pregnant I knew that I wanted to plan for an unmedicated and intervention-free birth. I hesitate to use the world "natural" since I feel that ALL mothers who give birth, in whatever form they end up doing so, have gone through a natural process in that their body produced another living being (or two or more)! That said, what I want is a natural birth in the conventional sense of the meaning of that term. No scheduling. No induction. No pain medications. No IV. No continued monitoring. No instruments. And certainly no surgery.

I know it can be done. Women have done it for generations and two of my best friends have done it recent years. Both delivered in a hospital setting with obstetricians and both had limited interventions. But I also know many women who hope for an unmedicated/intervention-free birth in a hospital setting often end up with exactly the opposite. And that scares me. And angers me too.

I have just read "A Thinking Woman's Guide to Better Birth" by Henci Goer and am also finishing up Ina May Gaskin's "Guide to Childbirth." Both have just reinforced my belief that birthing is a natural and normal process that our bodies are built to handle, given the right environment and plenty of time. So, in talking with our Bradley instructor who's a trained RN and doula, I want to hire her to come to our home and help me labor for as long as possible here, before transferring to the hospital (which is 7 minutes away).

image source

Honestly, I'd prefer a home birth or even one at a birthing center (they just recently opened one up in Tulsa), but it is cost prohibitive. It would cost several thousand dollars and just doesn't make sense when my insurance will cover my birth at the hospital for $15. Add to that, this is my first baby and although I am not considered "high risk" I will be 35 when I deliver and I am considered obese, two factors that some doctors consider on the riskier side of "low risk."

Of course, this means I may be risking a birthing process riddled with medical interventions, especially because my hospital is tied to a Level III NICU and therefore is used to dealing with higher risk deliveries overall. The rate for epidurals here is 90% and for inductions is 70%. Those odds alone leave me in a very small minority from the start. I wonder how experienced the staff is with "natural" childbirth? When I interviewed my OB/GYN at my pre-conception visit, she said she will support my desire to have an intervention-free birth. But now that I am close to the third trimester, I want to broach that subject more in-depth, so that if, in the end, she really isn't in line with my wishes, I have the time to come up with a plan B, which will probably mean finding a new provider.

All of this is very overwhelming and sometimes I feel myself questioning my desires in the first place. It's so easy to justify an epidural and pitocin drip. Everyone (seemingly) does it. And I certainly wouldn't have to fight to have them at my hospital (where their use is very routine). But I don't want to just "give in" because I am afraid of being perceived as high-maintenance or difficult. I want to allow my body to experience the birth process and then, if need be, make decisions along the way, always with the intent that it be as minimally invasive as possible. Being from San Francisco, I feel overwhelmed by the lack of support here in Tulsa. But I know it's here. In little nooks and crannies, and I am seeking it out. I have four months to get my support team and plan in place. And if it just comes down to my DH and my mom and our doula, well then so be it. We will proceed as planned and see where it takes us...naturally.

So here's how it's going to go down...

Well, since I'm still here, I figured I'd keep blogging! In case you missed the BIG DAY, it was yesterday. Yup, I was DUE YESTERDAY. And, no, I did not deliver yesterday. Hence I am here blogging and NOT on Cloud 9 with my new baby! Not that ya'all aren't great. But anyway.

So I figured I'd share my Birth Plan. My first draft was very simple. It read:

Get the baby out fast & healthy. Please and thank you. NFT...

Then, I figured there were a few other things that I needed to say... So I came up with my current draft, which is still pretty simple and really just lays out a few things that I've already discussed with my doctors in writing. I think you'll see, I have attempted to be as flexible and open-minded about this as possible. This plan is more for me and DH than anything because it helps us FEEL ready and sort of expect what will happen... Here goes:

Birth Plan for Politisaur

• Remain at home for beginning of labor.
• Call Doctor (Insert Number) when contractions are 5 minutes apart for an hour or as soon as water breaks. Time contractions from start of one to start of the next.
• Arrive at hospital. Check in (we are pre-registered). Note pediatrician choice on form. Request a single postpartum room. When we arrive, our doctor will be notified.
• I would like to walk around while laboring. I understand that I'll be monitored each hour and that I will be confined to the bed once I get the epidural. But before then, I'd like the freedom to move about. (My doctor said this was fine.)
• I plan to bring our laptop with iTunes, an exercise ball and tennis balls. I expect massages from my DH (Insert Name).
• I understand that I won't be allowed to have any food at the hospital except ice chips. However, Dr. (Insert Name) said that I can bring popsicles and hard candy.
• I assume I'll get an epidural at some point.
• For the final stages of labor (when the pushing starts), I want to have ONLY MY HUSBAND (Insert Name) present in the room, other than medical personnel. All other family, friends to wait outside in waiting area.
• I will remain flexible and look to my doctor's expertise as to what is medically necessary. However, I do want to be told explicitly what is being done and why (medication to induce labor, c-section, etc.) Just keep me informed.
• Obviously, I would prefer not to have an episiotomy or have forceps or a vacuum extractor used. But do whatever you need to do for a healthy baby. Just tell me.
• I MIGHT want to have a mirror to watch the birth, so I'd like to have one on hand in case I do. Also, if he's not in the doctor's way, it is OK for my DH (Insert Name) to watch the baby being delivered from any vantage point.
• My husband (Insert Name) would like the OPPORTUNITY to cut the cord, if medically possible.
• We have decided NOT to do private Cord Blood Banking.
• I would like to have the baby placed on my chest upon delivery, if medically possible.
• I would like to attempt to breastfeed as soon as possible after giving birth.
• I would like either myself or my husband (Insert Name) to be present for any exams of the baby by the nurses or medical staff. (It's all done in the room, unless baby goes to NICU)

Post-Partum Checklist

• Someone from my pediatrician's office should examine baby in the first 24 hours. Otherwise, call (Insert Number) and make sure they do.
• Call my employer's insurance at (Insert Number) and file for maternity leave to start.
• DH to call/file paperwork for baby to be added to our family health insurance plan (he has 30 days to do this, but we should do it asap).
• File paperwork for her name/SS number. Find out how to get expedited birth certificate.
• Make sure we get copies of all medical records for both myself and the baby after checkout.
• DH has e-mail lists already saved to send out our birth announcement. (He has a call list for immediate family that he'd use first.)
• I have phone numbers of photographers so I can sked our newborn session asap for the formal mailed birth announcements.