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pregnancy

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Real Food for Pregnancy: A Book Review

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When I was pregnant in 2012, I was overwhelmed by the conflicting “Do not eat!” lists for pregnancy. One would advise against chamomile tea, another wouldn’t say anything about tea but would list lunch meat, seafood, and common allergens to avoid exposing baby to, etc. I just wanted to eat well for my baby and hopefully not throw it up. At my first OB-Gyn appointment I asked my doctor about the lists, and what I should be eating. His only answer was to avoid fish with mercury.

That was it.

Luckily, I had some knowledge of general nutrition, but everything made me sick. Later in the pregnancy, I had viscous heart burn. It was years until I could even look at orange juice. It would have been nice to have advice beyond the typical old wives tales.

Earth Mama - Organic Third Trimester Tea

I had hoped over the years to find a good resource on nutrition. I was asked to review Real Food for Pregnancy by Lily Nichols RDN, CDE.

It did not disappoint.

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Heavily researched and evidence based, this book is the most definitive guide on what to eat during pregnancy and postpartum that I have come across. The book is broken down into macronutrients, pregnancy expectations and complaints, lab testing, and postpartum.

Having an outline of the nutrients to focus on and encouragement to reach for whole foods, is what helps to decrease the pregnancy complaints of nausea, heart burn, and serious complications of hypertension and gestational diabetes. By starting with exercise and proper nutrition, we can feel better and build a healthier pregnancy. I feel like this is lacking in our health care system.

The information on lab testing was so informative, and is a must read for those planning to get pregnant. Nichols breaks down hormone testing, thyroid, A1c, glucose, and nutrient testing. Each one has its benefits and resulting effects on pregnancy and postpartum health for mom and baby. For example, an elevated A1c in early pregnancy results in 98.4% of cases being diagnosed with gestational diabetes (Nichols p. 171). Doing this test in early pregnancy can allow mothers to make necessary dietary changes from the get go, instead of waiting for the glucose tolerance test at 26 weeks. Nichols gives the pros and cons of the glucola testing and alternatives that may be beneficial to some patients. The rate of false positives or ways to, “beat” the test may not give a real picture of a patients health picture.

THINX Period-Proof Underwear. Earth Mama Organics - Organic Nipple Butter

What I find nice about all of this information, is that it is not often offered by care providers. Knowing your full options is the beginning of true informed consent.

Grab a copy of Real Food for Pregnancy here, and gift an extra copy to your care provider.

What nutrition advice did you receive during your pregnancy? Share in the comments below.

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Postpartum Doula Support: Filling the Gaps in Healing After Birth

In January I began studying for a postpartum doula certification with Birth Arts International. This would allow me to continue supporting my clients as they transition to the next part of their journey. As expecting parents we tend to focus our time and energy on the pregnancy and birth process.  As a result, postpartum plans often get the short end of the stick. After coming home with their babies, many parents may feel as though they don’t have the support or resources to feel confident in what they are doing. We are questioning ourselves while trying to learn how to make our newborns happy and healthy, all while sleep deprived and often times neglecting our own needs. Frequently too, we have older children at home that are adjusting to the new baby and the change in household. We still have laundry. We still have to eat. We desperately need sleep, a real shower, and maybe a moment or two just for ourselves.

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That's where I come in.

Postpartum doula support fills in the gaps of what the family might need. These services include light errands, light house cleaning, meal prep, infant and sibling care, breast feeding support, postpartum healing guidance, debriefing support of your birth experience, and connecting families to local resources. Best of all is the emotional and mental support of another person who understands exactly where you are and what you are going through. This is someone who listens, knows birth intimately, and can help you process your experience of birth and new motherhood. When we are able to feel whole and have the details of our home taken care of, we have opportunities to heal faster, have improved breastfeeding success rates, and decreased severity of postpartum mood disorders.

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1 in 5 mothers experience a postpartum mood disorder, including anxiety and depression. 1 in 10 fathers will experience anxiety and depression as well. These feelings not only impact the individuals health, but the health of the family and community. Currently suicide is the second leading cause of death in perinatal women, with a rate of 1 in 5 postpartum deaths being contributed to suicide. The risk is increased through the first postpartum year. These statistics are a heart wrenching wake up call in how we treat parents, our postpartum care, mental health support, and often the ability of our village to see a struggling parent and know what to do. Having a knowledgeable professional help take off the weight of some of the daily burdens can create space for that family to heal.

It’s not about luxury.

It’s not about being demanding.

Postpartum doula support is about giving families and communities what they need to feel like better confident versions of themselves.

To learn more about how postpartum doula support, please contact me for a consultation at Living Heart Doula.

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You Got This: What it should mean

“You’ve got this. Deep breath Mama!”

If you’ve ever been one of my clients, you’ve probably heard me say this. It’s something I say to remind my moms when labor begins to get tough, and it’s a matter of getting through one contraction at a time.

You got this. Now here are all the things I want to say... 

You got this. Now here are all the things I want to say... 

A simple phrase, a warm touch of reassurance, but it means a lot more to me when I really dig in to why I say it. When I'm trying to convey something stronger I often stumble over my words, trying to verbalize all the emotions that I cannot always express without getting tripped up and choked up.

All too often this phrase is getting used as a trite comforting gesture. It's become the proverbial knock on the shoulder, and "You stay chipper!" 

"You got this!" really means: 

  •        Let go of the nagging fears that are no longing serving you.
  •       You are so strong. I see it, and want you to feel it in your core.  
  •       This birthing thing… you’re rocking it!
  •       Dad, who is so unsure of what to do and think right now? Let her hold on to you. You’re a rock for her.
  •       Breastfeeding is hard sometimes, and it feels like you have a million new questions everyday. Ask them. Trust your gut if something feels off and you want another opinion.
  •       Parenthood is wild and hard. Don’t doubt your abilities to raise these little people. If you do, call a friend. Guaranteed they feel the same. Try again tomorrow.
  •        You may have only had two hours of sleep, and there’s a long day ahead of you. One step, one minute at a time.
  •       Sometimes postpartum hormones are really mean, and anxiety is a dirty rotten liar. Let's talk about how you're feeling. 
  • Going back to work after maternity/paternity leave is so hard. How are things going to be for our routine? How am I going to feel? Take it one day at a time, and bend when the wind blows. Be flexible where you can, and give yourself and your family all the grace you need during this season. 
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Deep breath.

 

You got this.

 

Earth Mama Organics

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Holy Moly Where Has the Time Gone: A recap of 2017 and what's coming up for 2018

Hey friends! It's been several months since I've been able to update the blog with a new post, but it's been for some of the coolest reasons. October was the start of a very busy season for my doula business. I was honored to serve at several births in October and November, as well as represent Doulas of Central Maryland at the Frederick Birth and Baby Fair, teaching at newborn care workshops, and beginning to design a postpartum planning workshop (you guys know how much I care about the postpartum period, it's a doozy that needs way more attention than we give it.) 

While on call, my phone is always in hand. Especially at night!

While on call, my phone is always in hand. Especially at night!

It was a great season with a few, "Jesus Take the Wheel," moments. I learned something new at each birth, and was really stretched at some moments. So much growth happens in hard moments, and it reminds me why I LOVE this work so much. 

So back to why there hasn't been a post in three months. I typically do all my blogging late at night after my kids and husband are asleep. It means I get blissful uninterrupted silence, but I stay up well past midnight to get it done. Staying up so late while being on call for my families just wasn't smart. I needed to get proper sleep at night, be present for my kids during the day, and let some aspects of work take the back burner for a bit. 

Now I am back and ready for the new year! I wanted to recap what I learned this year, some changes, and what's going to happen for 2018. 

Earlier this year I injured my stomach, and got a crash course in Diastasis Recti, pelvic floor issues, and the red tape that goes along with insurance and some care providers, There are tons of resources out there friends! Don't get discouraged and keep looking for help! I can now share that my DR is down to a one finger gap, and I'll be seeking out pelvic floor therapy later in the season. I'll be writing about the experience, so you guys get all the information on it. Because no one should deal with peeing when they sneeze, painful sex, or just plain pelvic pain. 

Sleeping more has been a priority. Can't take care of mamas if my eyes can't stay open. 

Sleeping more has been a priority. Can't take care of mamas if my eyes can't stay open. 

I also signed as a contractor with Deborah Bailey's doula agency, Doulas of Central Maryland (check us out here: www.doulasofcentralmaryland.com). Having a team behind me, has given new life to my doula practice. The wisdom, support, and back up of these three women have helped me to hone my skills. So what does this mean for clients coming to Living Heart Doula? You can still have me as your doula with all my support, but with the agency we can offer you more services including placenta encapsulation, belly binding, photography, and postpartum doula support. 

For the coming year, I am looking at the ways I can serve my readers and clients better. I will be adding an email newsletter to share more information, new blog posts, and find new products and services that serve pregnancy and parenting. I love the local businesses in our area, and want to share their offerings with you guys. (Who doesn't love awesome service with a friendly discount!) In these newsletters, I may  be polling and asking for feedback. What services are you looking for? What would you like from your doula services (aromatherapy vs massage)?

I am hoping to design and host more workshops this year. Postpartum planning is near and dear to my heart, so that is my starting focus for the new year.

I want to do lots and lots of blogging.  

Most of all, I want to serve my growing families and support their births. Loving on families and babies is the best. 

So tell me friends, what do you want to see from LHD this year? What are  you learning about? What are your plans for 2018? 

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Diastasis Challenge Update

For the month of September I attempted a 30 day exercise challenge to heal my diastasis recti. I generally stink at making exercise a priority in my day, and thought the challenge would be a good way to start making it a daily habit. The exercises were gentle, and slowly built up in number of repetitions.

 

Most days I did them as soon as I got up in the morning, and I literally got it out of the way in a matter of minutes. Some days I needed to handle something with the kids, and put it off until bed time. A few times I forgot until I was climbing into bed. I got down on the floor and got it done!

 

About halfway through the challenge my belly started hurting. Not in a way that was telling me I was just exercising muscles that hadn’t worked in a while, but that something was still strained.

 

I’m back to the drawing board. Healing doesn’t happen overnight, as much as I’d like to will my body to. For now, I’m working on posture, walking and hiking more. When I can I’m doing low rep gentle exercises for the pelvic floor and transverse abdominal. Some of these include heal slides, toe taps, and bridges.

 

The former 20-something gym rat in me is rolling her eyes. But in reality, this body is not the same.

One step at a time. 

One step at a time. 

 

I’m treating it gently this time around.

 

What are your goals? How do you heal, patiently?

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Jacob's Birth Story: A fast breech vaginal birth

Before I begin my most recent birth story, I need to give some background information about myself. I am a Neonatal Nurse Practitioner and work at the same hospital that I receive my OB care; therefore, I have a close professional relationship with my OB providers. I also have a uterine anomaly called a bicornuate uterus. This means that my uterus is divided into two sections. This was discovered at my 13 week nuchal transluceny ultrasound with my first pregnancy. The complications associated with this anomaly are cervical insufficiency, preterm labor, preterm delivery, growth restriction, and breech presentation. The risk of breech presentation is due to the limited space for the baby to turn. Because of this anomaly, I was followed very closely by the high risk OB and had approximately 13 ultrasounds with my first pregnancy. My son was born by vaginal delivery after spontaneous labor at 37 weeks and 2 days. At every ultrasound he was head down.

With my second pregnancy, my son was in breech presentation at every ultrasound. I really became concerned about this around 26-28 weeks, given the limited uterine space and that my first son was always head down and this time my son was always breech. Everyone (both medical and non-medical) tried to reassure me that “there’s plenty of time for him to flip.” It was at this point that I began my research on getting a baby to turn. I googled, youtubed, and read a lot of articles and blogs. I tried anything and everything to get my baby to turn, with no avail. At 34 weeks I had a discussion with my OB about attempting an external cephalic version (ECV); however, I am not a candidate for this procedure given my uterine anomaly. It finally started to sink in that I was going to have a c-section. My OB decided not to schedule me for a c-section, rather we would wait until I went into labor in order to give me every opportunity for the baby to flip.

Breech presentations include:

  • Frank Breech (Bottom down, feet are up by the head)
  • Footling breech (One or both feet are by down)
  • Complete breech (Bottom is down and legs are crossed. Imagine baby sitting Indian style.)

During a casual conversation one day at work with the high risk OB director, I expressed my concern for having a c-section and how much I did not want to have one. He agreed that I was not a candidate for an ECV and what I thought was jokingly, he said,“Well you could always do a breech vaginal, the only problem is I would have to be at your delivery, and that might be uncomfortable for you.” My response was that I would not have a breech vaginal because of the risks associated with it. That was the extent of our conversation. I did not have any conversation with my primary OB about a breech vaginal delivery.

So what are the risks with breech birth?
- Placenta being compressed
- Head getting stuck
- Some incidence of large limb fractures
Biggest issue currently is finding a provider who is experienced and educated in delivering a breech!

At 37 weeks I went to my routine OB appointment, and again had a discussion with my OB about a C-section, and again expressed my feelings and anxiety about it. She was very empathetic, but tried to reassure me that it wouldn’t be as bad as I thought and also gently brought me to reality that this baby would most likely not flip at this point. I was 1 cm dilated and 50% effaced at this appointment and not having any significant contractions.

The next morning, at 37 weeks and 1 day, I woke up with some intermittent cramping back pain. It wasn’t very painful, but it was certainly noticeable. Shortly thereafter I began to have some lower abdominal cramping similar to that of a period. I didn’t time the cramping but thought something might be happening given that it was intermittent and not a consistent discomfort. At this point I didn’t want to call my OB, because I knew she would want me to come in right away given the breech presentation and I didn’t want to have my husband come home from work and call my childcare if this wasn’t, “the real thing.” But, I did get my (almost) 2 year old set up with breakfast and hopped in the shower, did my hair and makeup, and got myself all ready “just in case” this was it. I packed the car with our bags before heading out with my son. Throughout the pregnancy I constantly thought about the, “last day” that it would be just, “us.” My son loves ice cream, so I wanted to take him out on an ice cream date. We got to the ice cream parlor a little before noon just to find out they didn’t open until noon. We went next door to the grocery store to kill a little time. By this point the cramping was occurring more frequently, but not necessarily with more intensity. I stopped in the bathroom on our way out and that’s when I had my bloody mucousy show. It finally sunk in at that time that I was in early labor. We got our ice cream and I just sat and enjoyed those last minutes with my son before my attention was going to have to be shared.

Megan the morning of Jacob's birth.

Megan the morning of Jacob's birth.

We got out to the car around 12:15 and I called my OB to report my symptoms. As I expected, she told me to come to the hospital to get evaluated. I called my husband who was working an hour away and my sister who was going to watch my son. By the time my husband got home and we got out the door it was around 1:30. We weren’t in the car more than 5 minutes when the intensity of my contractions increased and I was unable to talk during them. The ride to where we were meeting my sister was about 25 minutes. Just as we pulled up my water broke. I called my OB again to give her an update and that we were about 20 minutes away. By the time we arrived to the hospital I could barely think or talk due to the pain of the contractions which were now about a minute apart.

I was immediately taken into a room (the PACU was full) and my OB checked me and said I was 6 cms. There were so many medical professionals in my room working diligently to get me prepared for my c-section since I had progressed into labor so quickly and was continuing to have very strong contractions every minute. That was when my OB told me that the hospitalist was on service and she has experience with breech vaginal deliveries and asked if that was something I wanted to consider. I could barely focus on her words so she decided to get me my epidural and get me comfortable before we had any further conversation. As soon as I got my epidural she checked me again and I was 9 cms (that was about 30 minutes after the first time she checked me). I had to make my decision very quickly after having a brief but serious conversation with the hospitalist. I knew in my heart that this was the right decision for me. My husband was against it, but said he trusted me and my OB and knew that I was very aware of the risks associated with this type of delivery given my medical background.

So we moved into the OR, which is where I had to deliver in case they had to do an emergency c-section. As was explained to me before making my decision, I labored down for about an hour before I started pushing in order for the baby to optimally move into the birth canal vs pushing him into position. I pushed for 18 minutes until I heard the most beautiful sound in the world which was that of my baby crying. He was placed skin to skin with me and I just cried tears of joy and relief. He weighed exactly the same as my first son, which was 6 lbs 13 oz. I had no tears and felt so wonderful during my recovery. Every day I thought about how different my recovery would have been if I had a c-section.

On the way to the hospital when I was contracting so painfully I thought to myself, “Why did I wait so long to call my OB? I should have called this morning! This pain is so unbearable I could have avoided this if I hadn’t waited!” Afterwards, I was so thankful that I did wait to call, because my delivery experience would have been so different. Everything happened to just fall into place to make this all possible. The OB that I had such extensive conversations with was on service at the hospital so she knew my anxiety about having a c-section, the hospitalist who will do the breech vaginal delivery was on service, I was in spontaneous labor with contractions every minute with very fast cervical dilation, and my baby was tolerating the labor. Had any one of these factors been missing or different, I would have had a c-section. I absolutely love my birth story and I hope you enjoyed reading it!

Jacob meets his big brother.

Jacob meets his big brother.

 

 

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So What's a Doula? Answers to the top three questions about birth work

Often when someone hears that I am a doula, the first questions about my field are:

Is that like a midwife?

That's for home births, right?

But then what does the dad do?

 

Let me address these questions, then I'll share exactly what a doula does for her clients.

 

Is that like a midwife?

Nope. A midwife is a medical professional that oversees your and baby's medical care through pregnancy and birth. Midwives are typically low intervention, and are great advocates for natural birth. A midwife can practice in a hospital, birthing center, or private home birth practice depending on the state.

Midwife checking on baby. Midwives can serve births at hospitals, birth centers, and at home. If you are having a low risk, healthy pregnancy, midwifery care may be for you.

Midwife checking on baby. Midwives can serve births at hospitals, birth centers, and at home. If you are having a low risk, healthy pregnancy, midwifery care may be for you.

 

A doula does not dispense medical advice, and it's out of their scope of practice to perform any medical procedures (temperature, cervical checks, manually feeling your belly for fetal position, etc.) Instead, a doula is a wealth of resources and knowledge. If you are faced with a procedure during your pregnancy and you are unsure of your options, a doula can help you to research the procedure and suggest questions to bring to your provider. We don't want to make decisions for you, but help to empower you in your decisions. We offer resources and support both prenatally and during birth.

 

When you begin to labor, you can call your doula to be with you whenever you want her. A doula can help you to labor at home longer and more comfortably (A well trained doula knows the signs in labor to transfer to the birthing location. However, whenever mama wants to go, is when we head in. We can also make transferring more comfortable too!) We are equipped with birth balls, rebozos, essential oils, and massage techniques. We can help with positioning, counter pressure for back labor, grabbing snacks, and making suggestions for other coping strategies. We are also there to support you emotionally, and can help with any mental blocks. Labor can be a crazy, emotional, messy time, and we are there to protect that space and see you through it. I reassure clients that she can release on me in a way that maybe she couldn’t with her mother-in-law around.

Airlia is sitting on the birth ball while I help keep heat and pressure on her lower back. Even while being monitored, there are ways to keep moms comfortable and not just in bed.

Airlia is sitting on the birth ball while I help keep heat and pressure on her lower back. Even while being monitored, there are ways to keep moms comfortable and not just in bed.

 

A midwife will usually come as you are heading in to active labor if you are birthing at home. If you are at a hospital or birthing center, they will be around to check in with you, but won’t likely be with you the entire time. They will be with you during pushing, and can aide with protecting your perineum with stretching or counter pressure. Your midwife is the other half of the equation to your birth team.  Midwife + doula + partner = Fully Supported Mama

 

That’s for home births, right?

You may be hearing about doulas from your crunchier mamas. While I do support mamas that choose to birth at home, I also happily support families that birth at the hospital or birthing center. If you are planning a natural birth, opting for medication, or scheduled cesarean, I fully support you in your best birth. That looks different to different families, and no mama is the same in what she needs to birth with confidence. What matters to me is that you have options, and are fully supported in your choices.

 

But then what does the Dad do?

Doulas do not replace partners. Dads, partners, and other support people all have a role to play in supporting the mama. As a doula, I care about their needs as well. I can offer tons of support to Dad who may be nervous about how the labor is progressing, and pull him in with tips on how to offer counter pressure on a sore back, show him how to use a rebozo on mama’s belly to help a posterior baby turn, and I can be the one running to reheating the rice pack so he can be with you. It’s a team effort, and I am here for both of you! 

 

Here’s the nitty gritty on what a doula does for you:

  •          Meets with you in the weeks before your due. Meetings are usually to go over any health issues, any problems from previous births, and any lingering anxieties or fears about the labor. This allows us to develop strategies to help you cope during labor, and to develop your birth plan. We want to get to know you, so we can better support you.
  •           Having your doula present can:

o   decrease pain

o    decrease the need for epidural or pain meds

o   Shorten labor

o   Improve parent-baby bonding

o   Lower rate of postpartum depression

o   Lower caesarian rate 

 

  • While we aren't birth photographers, we will happily snap photos and video of the birth if you'd like us to.
  •  Doulas can help with the first breastfeeding session, and can help support you in the early days as well. If you choose to bottle feed, we are happy to support you with that too!
  •  Once you are home from the hospital, your doula will check in with a postpartum visit. This visit is usually to go over the birth, discuss how you and baby are doing, and help with any issues you may be facing. Having a baby is life changing, and no one understands this more than your doula. Birth is beautiful, hard, emotional, transforming work.

 

So to recap, doulas offer non-medical support for birthing families, offering education and physical and emotional support through the birthing process. We support all kinds of birth, and can act as guide through the experience.

 

 I am honored I get to witness it. I am honored to serve the growing families in my community.

 

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5 Ways to Cope with Morning Sickness: because no one enjoys nausea

When I became pregnant with my first daughter, I knew right away. Food tasted weird, and my usual go-to meals would give me heart burn or make me sick. Orange juice was the worst. It was years before I could drink it again without a mental connection to vomiting.

 

I had brutal morning sickness for almost six months of that pregnancy. I lost fifteen pounds and needed to go on medication for a while to be able to keep anything down. It made me nervous for my baby and about my nutrition.

 

I learned a lot from that pregnancy, and was much more educated and prepared for my second. When you know better, you do better. And in this case, you throw up less. Here are my five tips for feeling better when you are dealing with morning sickness:

 

1)      Eat!

It may seem counter-intuitive, but eating high protein mini meals will help keep the nausea at bay. When your stomach is empty is when the nausea is at its worst and will reek havoc when you do have your next meal.

Eat little nibbles constantly. A scrambled egg and piece of toast. A few apple slices and nut butter. Crackers and hummus. Trail mix.

Eat small meals around the clock.

Eat small meals around the clock.

Anything combining protein with some carbs will keep you going, and your blood sugar stabilized. This includes nighttime. Keep snacks on your night stand, and eat when you wake up to use the bathroom or adjust pillows.

Sharing my own personal truth here: eat what sounds good. Odds are if you actually crave that item, it’ll stay down. Even if it's Sour Patch Kids and McDonald's French fries. Do the best you can, but at the end of the day you need your food to stay down.

 

2)      Sea bands

Available at any drug store, these are bracelets with a small bead that applies acupressure to a specific point on the wrist. Used mainly for motion sickness, it did help take the edge off my nausea. However, if you are waiting to announce your pregnancy these are a dead give away.

3)      Essential oils

Oils are neatly packed power houses of help. The two to focus on are lemon and peppermint. Just smelling both kinds of oils will stop the nausea. When I was out running errands I'd put a few drops of peppermint oil on to a tissue, and kept it at the ready in my coat pocket. Lemon essential oil can be placed on the back of the neck and collar bone, using a carrier oil like coconut or almond. For a better explanation of how essential oils can help, check out Young Living Essential Oils (https://www.youngliving.com). ,

(I'm not an affiliate, but I like their oils and find the website to be a nice resource.)

4)      Magnesium

There's a lot I can say about magnesium and all of its benefits, but I'll try to limit myself for the sake of this post. It's very easy to become deficient in magnesium, especially when you're having a hard time eating already. By increasing your magnesium, you'll sleep better, decrease muscle aches, improve digestion and decrease your overall nausea. You can take magnesium orally with supplements like Mag Calm, but what's way cool is you can also increase consumption transdermally!  So if your worried that a supplement may not go down well, you can receive benefits by soaking in an epsom salt bath or making a magnesium lotion like this one: http://dontwastethecrumbs.com/2016/12/magnesium-lotion/

 

5)      Ginger!

Candied ginger. Ginger ale. Ginger tea. Ginger snap cookies. Preggy Pops. However you want it, ginger is pretty well known for its ability to stabilize a rocky stomach. Keeping ginger snaps or ginger ale handy can also help when blood sugar is low, and nausea is at its worst.

 

If nothing is helping, don't hesitate to talk to your provider. In some cases medication is necessary. If you ever have questions regarding your health, supplements, etc. please contact your provider.

 

What helped you the most with morning sickness?

 

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Baby Wearing: The Ins and Outs

When I was pregnant with my first baby, my doula and friend, Julie,  introduced me to baby wearing. She bought me a Boba as a shower gift, and let me borrow her Maya wrap. Baby wearing keeps your baby close to you, which is great for bonding, nursing, and generally surviving life with a baby. My babies would nap, nurse, enjoy the scenery as we walked the dog, and enjoy being, “held”, as I cleaned the house. Some days it was seriously how I managed to do anything!

 

I learned a lot about different carriers through the years, and through a lot of test runs have figured out what works for me and also for each individual child. Here's the skinny on each type of carrier, with some tips for each kind as well.

Ring sling: Made of large cloth swatches, secured with two metal, plastic, or bamboo rings.  These are great for fast in and out, and are great for hip carries. The only down side is you kind of feel like you need to keep a hand on baby, so you aren't totally hands free. It's much easier to use with an older baby that has head and neck control, but can still be used with a newborn. Slings have  a bit of a learning curve at first, and I needed help with getting started and fixing my sling when the fabric would get bunched.  

Ring Sling: Hip carries take the weight off of moms arms and core. 

Ring Sling: Hip carries take the weight off of moms arms and core. 

 

Soft structured carriers (Ergo, Boba, and Tula): Soft structured carriers (SSC) are generally easy to wear, adjust to almost all body types, and can be worn on the front or on the back as baby gets larger. These are great for baby naps, and allow your hands to be completely free. With a SSC you want to look for one with wide berth for hips; this prevents hip issues as baby grows and takes strain away from their back, unlike typical front facing carriers (bjorns). SSC can be used with newborns with special inserts depending on the brand. Ergo sells a newborn insert for their specific carrier, allowing it to be used from birth through toddler hood.

 

Soft wraps (Moby, K’tan): Best used during the early newborn weeks, wraps are soft and snuggly, and are great for naps, walks, etc. Your hands can be completely free, and with a little adjustment you can nurse while wrapped. It may take a few viewings on YouTube to get the wrapping right. A few styles of wrapping let you set up the wrap beforehand, so your wrap becomes an extra accessory. Bonus! The K’tan comes in different sizes. I'd suggest trying one out at your local natural baby store first.

 

Soft stretchy wraps work well up to 18 lbs, but are uncomfortable any heavier. Move onto a woven wrap or SSC after you're done with the Moby.

Moby Wrap: Front carries are cozy and can be pre-wrapped.

Moby Wrap: Front carries are cozy and can be pre-wrapped.

 

Woven wraps: These babies are the Cadillac of baby wearing. Super versatile, comfy for mom and baby. And. So. Beautiful! However, there's a catch. These wraps come with a hefty price tag, and there's a lot to learn about wrapping. My kids were always too wiggly and wanting up and down all the time for me to even be tempted to wrap. But by god, do I want one just because they are so stinking pretty!

Woven wrap: Lenny Lamb brand. Look how cool this is!

Woven wrap: Lenny Lamb brand. Look how cool this is!

 

 As with all the carriers, consider them an investment. They will last you through multiple children, and majority retain their resale value. If cost is prohibitive, buy used! (The straps will be soft and broken in.) Utilize your baby registry as well!

 

A few rules to remember when baby wearing:

1)      Chin is away from the chest. This ensures that the airway is open.

2)      Baby should be high enough that you can kiss the top of their head. Too low, baby could fall.

3)      Always keep buckles and straps done tightly. Wraps should always be secured with a double knot.

4)      Wait to wear baby on your back until they have good head and neck control.

Keep your babies close, and enjoy your carrier!

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A Postpartum Checklist: Planning Ahead for a Better Recovery

There's a thing about birth that other moms don't tell you about. Recovery can be hard. You're sore and possibly torn in your most sensitive spots, your organs are rearranging themselves after pregnancy, and odds are pretty good that you haven't had more than a few hours sleep at a time for days. Not to mention nursing, trying to maintain your household and take care of any older siblings too. This period can be really hard, and we don't always have family and friends around to help out.

Planning and preparing for post postpartum in the last months of pregnancy can make a huge difference in the time spent resting and healing versus stressing over the to do list.

Here are my favorite tips:

Food:

  • Stock your freezer with extra meals that can be thrown in the crock pot or oven. (Ask friends to set up a meal train or have people bring freezer meals as a part of your baby shower!)
  • Stock snacks that are shelf stable and nutritious. (Trail mix, protein bars, granola bars, muffins.) Bonus points if it can be eaten with one hand.
  • Bottles of water or good cups with straws for easy access during nursing. Keep them stashed around the house!

Healing items for mama:

  •  Rice bag or heating pad for after pains. (And its true what they say, after pains get stronger after each baby!)
  • Witch hazel (Add to your Peri bottle to soothe angry tissue and stitches. You can use to make your own cooling pads, or you can purchase Tucks.)
  • Lavender essential oil. Add to the Peri bottle when you rinse, and the oil will help to heal any tears and help prevent infection.
  • Aloe, straight from an aloe plant! Will help sooth stitches. (Can you tell I've dealt with some nasty tearing?)
  • A boppy  pillow or hemorrhoid ring, because sitting on your sore bottom can be torture. As often as you can, lay down. Nurse on your side lying down or reclined. If you need to sit up for visits, don't be afraid to keep them short.
  • Earth Mama Angel Baby has a great line of products, including Happy Bottom spray, Postpartum Bath Herbs, and nipple cream. I loved them with my second baby! The bottom spray was heaven on stitches, and  the bath herbs can pull double duty. Save the liquid for your Peri bottle and use the herbal pack as a warm or cold compress, or use as a typical sitz bath.
  •  Padsicles! Ice packs feel awesome in those first swollen days and a padsicle can help with both swelling and irritation. Check out this recipe here: http://just-making-noise.com/pregnancy-notes-soothing-postpartum-pads-recipe/
  • If you had your placenta encapsulated, break those babies out! They'll start to help with healing and replacing lost nutrients.
  • Have extra large granny panties, in dark colors, because leaks are bound to happen. I suggest having a larger size to accommodate the large pads and ice packs in the early days after birth.
  • Have super comfy jammies. I had no shame and bought extra large sweat pants. I just needed comfort and room to heal; I really didn't care about being cute. (I may still have some of these in my drawer. A girl has to hold on to some things for a Maryland winter.)

Nursing:

  • Have some nursing tanks on hand, but in my humble opinion hold off on buying nursing bras until baby is born and nursing is established. I was shocked by how much my breasts changed. We are talking three cup sizes! Wait and see what your milk does before you go to the trouble of buying bras.
  • Have a good breast pump and parts ready to roll. You don't want to be sterilizing parts while engorged. (Ask me how I know.) if you're using a pump from a previous baby, ask for new parts from your hospital. My lactation consultant gave me a bag with new tubing, flanges, etc. for free! This is also a good time to make sure bottles, nipples and pacifiers are cleaned and ready for use.
  • This is where all the food prep will come in handy! Eat and a drink a ton, more than you think you might need to. Your body is doing a lot of work in repairing and also making milk for baby.

For Baby:

  • Besides all the usual items for baby, I suggest having a carrier or wrap for those newborn days. I love the maya wrap or a ring sling to help keep them snuggled while you keep your hands free.
  • Sleeping arrangements for baby to be close by, whether in a co-sleeper, bassinet, or pack n play, keep baby in the room with you. Everyone will sleep easier.

For the home:

  • Netflix. If you don't have it already, do it. There will be days where you will be nursing the baby non-stop on the couch. Binge watch and rest!
  •  Set up baby station baskets around the house. Any where you'll be spending time with baby, but also in places like your bedroom. Include a change of clothes, diapers, wipes, easy open  snacks, bottle of water, breast pads, toy/book to entertain an older sibling, and a magazine or book for you. I often found myself, “stuck”, under a nursing and napping baby while starving and thirsty. Having these in reach made things very easy. I felt like I had anything I could need within easy reach, without having to go up and down stairs for items. I seriously just used whatever baskets I had on hand around the house.

What was helpful for your family in the weeks following birth?

 

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Using Water During Labor and Birth

          Humans have an integral relationship with the element of water.  It runs through our veins, we are born of it, and it is necessary for our survival. We are drawn to it for escape, adventure, release, and cleansing. As a woman is preparing to give birth, water is a means of release from the weight of her growing belly, and the means to ease her aching muscles. Water is a great coping tool in labor, whether through a shower or tub. (For the sake of this paper we will only be mentioning the use of a tub.) The use of water in labor can aide in pain management by increasing relaxation, decreasing strain on muscles, and creating freedom of movement.

 

         The mother’s ability to relax her muscles during labor can affect the length of labor and the intensity of contractions. The more a mother fights and tenses her muscles the worse contractions may feel. Especially in active labor, the mother may need as many coping strategies as possible. The birthing tub offers a great respite, and a simple way to relax. The birthing tub is often called, "The midwife’s epidural”, for its effectiveness (Drichta, Owen p. 257). The warmth of the water helps to ease the pain felt from contractions, relaxing muscles of the pelvic floor and back, and creates a mental space that creates privacy (Drichta p. 258). It is recommended to maintain water temperature at 96-98 degrees. Using higher temperatures could cause increased blood pressure, dehydration and lethargy (Drichta p. 258). The bath is also deeply engrained as a place of mental release in daily routines. Our bathtubs are typically places of retreat to relax, and the mental association during labor holds true.

 

          Labor is a physically demanding process. From hours of walking, lunging, squatting, intense contractions, and the possibility of little sleep can make for a grueling marathon on the mother’s muscles. The warmth of the tub eases both the pain of the contractions and the work of her remaining muscles (Drichta p. 257). Being in a large tub that covers her belly, the mother is buoyant and freed from the gravity of dry land. Her pelvic muscles are relaxed and her cervix will continue to dilate, often with more ease as she relaxes. A mother that is able to relax and mentally release her tension, will have an easier time laboring than a mother that is fighting each contraction.

 

        Being weightless allows the mom to assume positions that could be too taxing on land, such as deep squats using the side of the pool, that will help baby to descend and turn. She's able to easily move from one position to the next in response to her labor, while remaining warm and relaxed. The ease of movement allows the mother to find her own rhythm and coping responses that she would not have had if she was limited to a bed. Her ability to move through labor gives the mother more control and autonomy during the birth. She's able to push in the position that suits her, catch her own baby, and bring baby to chest without outside help or others manipulating her body. She has full confidence and control.

 

          Relaxation, decreased strain on muscles and freedom of movement are gained for the birthing mother with the use of water during labor. The three work together as a pain management strategy, addressing both mental and physical tension that could hinder a birth. The birthing tub is used at its greatest advantage during late stage active labor throughtransition. It is recommended that for every hour spent in the tub, the mother spends at least thirty minutes out of the tub. This is to ensure that contractions do not slow down, as can sometimes happen. Often contractions may just feel less intense, but are still actively working. According to Water BirthInternational, “Getting back in the water after thirty minutes will reactivate the chemical and hormonal process, including a sudden and often marked increase in oxytocin.” (Harper p. 2) As with other labors, hydration is of the utmost importance. Keep a drink with a straw nearby so the mother can drink at will. The birth can be completed in the water as well, depending on location (some hospitals only allow laboring in the tub) and as long as the labor is not having any complications (ex:meconium, shoulder dystocia).

           

 

                                                     Works Cited

Drichta, Jane E., CPM and Owen, Jodilyn, CPM. The Essential Homebirth Guide for Families Planning or Considering Birthing at Home. 2003. Simon and Schuster.

 

Harper, Barbara. "Guidelines for Safe Waterbirth.”Waterbirth International. p. 2

https://www.youtube.com/watch?v=aQVM36r1rvw#action=share

https://www.youtube.com/watch?v=U6KHW7TNiCk#action=share

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Birth Balls, Best thing ever

Birth balls, commonly recognized as exercise balls, have been used for many purposes over the last ten years, including physical therapy, abdominal exercise, and most recently to aid pregnancy and labor. Its shape and durability allow it to be used by a variety of weights and heights, and in multiple positions. Birth balls can aide in pregnancy and labor to improve fetal positioning, fetal descent and maternal comfort.

Fetal positioning can make a huge difference in how labor develops. A baby facing in the posterior position in the womb may have a slow descent, and can also cause painful back labor (Spinning Babies). Poor fetal position can also cause very slow dilation, often resulting in unnecessary interventions. In some cases, the baby may have a difficult time turning and become stuck, requiring surgery or forceps delivery (Spinning Babies). Fetal positioning can be improved by having good posture. Often pregnant women are sitting on cushy couches or less than ergonomic driver seats, causing poor posture (Spinning Babies). By sitting and resting on the ball, the posture is upright and forward leaning, engaging abdominal muscles while relaxing the pelvis area. The back is comforted and strengthened by ball use, supporting the pelvis. With proper alignment and a relaxed pelvic area, the baby will have room to position properly, and begin to drop into the pelvis (Spinning Babies). It also encourages the baby to settle into an anterior position that is optimal for labor (Spinning Babies). Often a posterior baby can be encouraged to turn during labor by sitting on the ball.

Fetal descent is defined as entrance of the presenting portion (usually the head) into the birth canal. Descending takes time and hard work from both mom and baby.The use of gravity and squatting positions are helpful in this process, but can be taxing on the mother’s muscles over a long labor. The birth ball is a great tool in this scenario, as it allows mom to sit in a squatting position, allowing the use of gravity and an open pelvis to bring the baby down, but also allows for rest. The mother can also lean forward while sitting, and receive a massage or counter pressure. The ball can also be hugged while deeply squatting on the floor. It allows mom a greater balance and ease in the position, one that can be utilized in the pushing stage.

The birth ball is a great comfort tool for mothers in labor. It allows the mother to rest while still engaging an open pelvis. The birth ball can be a great break from walking, while still remaining active (Birth Arts Handbook p.187). It allows the mother to do pelvic circles and rhythmic movements that help her ease the pain of contractions. These movements often help the baby to navigate the turns in the pelvis before crowning (Birth Arts International p.187).  The birth ball also creates a counter pressure against the perineum and buttocks that can ease the sensations of early transition, which can be a difficult time for the mother. Having the birth ball as a comfort tool the mother can find a coping mechanism and rhythm through her contractions. By having support and a rhythm to help her cope, the mother can navigate her labor and have a mental place to return to when labor gets hard.

By utilizing the versatility of the birth ball, a mother can improve fetal position, while encouraging fetal descent and increasing comfort during labor. By improving these aspects of birth, unnecessary intervention can be avoided, as well as the use for drugs. This can greatly improve outcomes for mothers and babies, especially in a hospital setting where the mother is out of her comfort zone.

Works Cited

Birth Arts International, Certified Doula Education Program. Demetria Clark. 2000-2015. P.187

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