- My Wife And I Are (Both) Pregnant >>
- Nine Beauty Ingredients To Avoid In Pregnancy >>
- Consumer Reports’ New Ratings Help Consumers Choose the Right Hospital and May Lower C-Section Rates >>
- Your Complete Guide To Prenatal Testing >>
- Pregnant Women's Medical Care Too Often Affected By Race >>
- Midwives Not Medicine Rule Pregnancy In Sweden With Enduring Success >>
- The Brutal Truth About Being a Pregnant Worker in 2016: It's Pretty Awful >>
- The Secret Sadness Of Pregnancy With Depression >>
- Pelvic Floor Health >>
- What Every Pregnant Woman Needs To Know About Cesarian Birth >>
- Having A Baby: Help with managing your money before, during and after the birth of your baby. UK >>
- How do pregnant women use quality measures when choosing their obstetric provider? >>
- Pregnant & Disputing The Doctor >>
- Preparing for the biggest change in your life: How preventive couples counseling can protect your relationship after baby >>
- Giving Birth In Different Worlds >>
- What is the Evidence For Perineal Massage During Pregnancy To Prevent Tearing >>
- Midwife Explains The Spiritual Side Of Birth >>
- Why I Had My Babies With a Midwife Instead of a Doctor >>
- Labor Induction: The Low Down On Natural Approaches From A Midwife-MD >>
- How To Have A Positive Caesarian Birth >>
- Protecting Your Perineum - Birthful Podcast >>
- C-Sections Are Best With A Little Bit Of Labor >>
- When A Baby Isn't So Big >>
- Every Pregnant Woman Should Have A Doula >>
- Five Things You Didn't Know About Giving Birth In A Hospital >>
- Why Women Who Fear Birth Spend More Time In Labor >>
- Avoid Giving Birth On Your Back And Follow Your Body's Urges To Push >>
- 10 Reasons Why More Parents Are Choosing to Have A Natural Birth (Without An Epidural) >>
- Most Healthy Women Would Benefit From A Light Meal During Labor >>
- Why Are Due Dates Usually So Wrong? >>
- I Never Thought I'd Hire A Doula, But I'm So Glad I Did >>
- Your Biggest C-Section Risk May Be Your Hospital >>
- New York County Hospital Maternity Information >>
- Doulas From The Dads Perspective >>
- Why Are Medical Professional Who Deliver Babies In Hospitals Choosing To Have Their Own Babies At Home >>
- What To Reject When You're Expecting >>
- How to Cut Your Odds of Having a C-Section When You Don't Really Need One >>
- Here's Another Way Midwives Make C-Sections Less Likely >>
- Natural C-Section Video >>
- Laughing Gas Changing The Way Women Endure Labor Pain >>
- Fighting Gravity During Labor Makes Birth Harder For Mom And Baby >>
- Routine episiotomy is harmful. Consent is essential. >>
- Are Women's Birth Sounds Silenced in the Hospital? >>
- Why I Write Birth Stories >>
- Medications For Pain Relief During Labor And Delivery >>
- Are Women Pushing Too Hard And Too Soon In Labor? >>
- Torn Apart By ChildBirth >>
- Failure To Progress, The Simple Solution Nobody Knows >>
- This Is Birth With Lisa Ling >>
- Cervical Dilation And Effacement GIF >>
- When To Say No To A C-Section, How To Talk To Your Doctor About Your Delivery Options >>
- Variation in C-Section Rates By Labor & Delivery Nurses >>
- Too Many Opioids After Cesarian Delivery >>
- What Does A PostPartum Doula Do And Why You Might Hire One? >>
- Why Every New Mom Needs Physical Therapy >>
- Grieving Over An Unnatural Childbirth >>
- The Dos And Don'ts Of Diastasis Recti >>
- When It All Comes Together, Diastasis Recti Healed >>
- Inside The Painful, Lonely Experience Of Birth Trauma >>
- Women More Afraid Of Childbirth Than Previously Thought >>
- Millions of Women Are Injured During Childbirth. Why Aren't Doctors Diagnosing Them? >>
- A Tale Of Two Births: How The U.S. Fails To Deliver Adequate Postpartum Health Care >>
- Caring For Your Core, Back And Pelvic Floor After Birth >>
- Vaginal And C-Section Scar Massage >>
- Are Hospitals The Wrong Place To Give Birth? >>
- When Evidence Says No But Doctors Say Yes >>
- The Birth Of A Mother >>
- Breastfeeding: One Man's Perspective >>
- Breastfeeding The Microbiome >>
- Traumatic breastfeeding experiences are the reason we must continue to promote it >>
- Considering Breastfeeding? This Guide Can Help >>
- The More I Learn About Breast Milk The More Amazed I Am >>
- Support For Breastfeeding In A Multitude Of Ways >>
- Breastfeeding Services Lag Behind The Law >>
WORK AT HOME AND AWAY FROM HOME
- Your Back To Work After Motherhood Stories - WNYC >>
- What the woman out on maternity leave wants everyone back at the office to know >>
- Why Companies Have Started To Coach New Parents >>
- Why It's So Much Harder For Mothers To Start Businesses >>
- Most Major U.S. Employers Fail on Paid Paternity Leave. The ACLU Says That’s Illegal. >>
- Motherhood and Marginalization: The Oppressive History of the Birth Industry >>
- These Are The Best Countries To Be A Woman >>
- Maternal deaths worldwide drop by half, yet shocking disparities remain >>
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- Why Is U.S. Maternal Mortality So High >>
- How Doctors Take Women's Pain Less Seriously >>
SHOP SMALL, ECO-FRIENDLY, NON-TOXIC, ETHICALLY MADE & SOURCED, MINIMALIST PRODUCT RECOMMENDATIONS
WHY SHOP SMALL?
By shopping small, we support local businesses and small ventures. We build relationships with our neighbors. And we keep our neighborhoods, communities, and cities healthy and vibrant. Additionally, when we shop small, we make an active choice not to support large corporations that all too often are responsible for deepening economic inequality, evading taxes, driving down wages, engaging in monopolistic behavior, and ravaging the environment.
There is a high economic, social, and ecological price to pay for the low cost of mass-produced goods, and we can help build a better world by being more conscious consumers. Paying a few dollars extra might make a minimal difference to you, but when we collectively make conscious choices about our spending, those choices can have significant positive impacts on our communities and beyond.
WHY SHOP ETHICALLY MADE AND SOURCED?
All too often, the cost of low-priced, mass-manufactured goods is human suffering. In today’s global economy, most manufacturing is done in factories remote from end consumers with little transparency regarding processes, sourcing, worker wages and conditions, and environmental impact.
By shopping ethically-made and sourced, we leverage our power as consumers to demand accountability from producers. Especially when it comes to goods and services related to pregnancy, birth, and parenthood, it is incumbent upon us to hold ourselves and others to a higher ethical standard. After all, what we model in our choices will shape our children and the future they inhabit.
WHY SHOP RE-USABLE & ECO-FRIENDLY?
Speaking of our – and everyone’s – children, we face an unprecedented global climatic and ecological crisis. For our own sake, and for the sake of future generations, we absolutely must take rapid action to slow and reverse the damage that has been done to the Earth. Shopping reusable and eco-friendly is one simple, if modest, way that we can all help reduce our ecological footprints as we fight to slow global warming and prevent climate breakdown, and each small step we take to keep material out of landfills and reduce emissions of harmful greenhouse gasses is a step in the right direction.
WHY SHOP NON-TOXIC?
Sadly, major corporations have a long history of negligence and contempt when it comes to our collective health. Although significant strides have been made in consumer protection, far too many everyday products still contain endocrine disruptors and carcinogens.
By shopping non-toxic, we do our small part to protect ourselves and others from the toxins which are now alarmingly plentiful in our day-to-day environments. None of us should be exposed to harmful substances without our knowledge, but it is especially important to protect children from toxic substances as they grow and develop. By shopping non-toxic, we signal with our dollars that a healthy and safe environment is a priority, now, and for the future.
WHY SHOP MINIMALIST?
A recent study found that the choice to have a child has a far greater climate impact, on average, than choices we make about diet, transportation, and travel. Given that parents are major consumers – even if that consumption is driven by love and concern – it is essential that we seek to minimize the impact of our consumption.
By shopping minimalist, we can reduce our ecological and carbon footprints while helping to maintain and restore a healthy Earth that will nourish humans and others for generations to come. Additionally, we might just find that, by consuming less, we enjoy our lives more, and find more time for the things – and most importantly, the people – who really matter.
- Maternity Pants
- Sleeping Pillow
- New Bras (preferably nursing bras so you don't have to get more)
- Yoga Ball
- Coconut Oil
- Services to Set Up: Birth & Postpartum doula services, Set up placenta encapsulation, Explore and set up Cloth diaper service, Order breast pump from insurance, Set up lactation support, Set up Meal Train & Housekeeping Help for after birth.
- Try on baby carrier with a doll before baby arrives.
- Sticky socks
- Hair tie/Head band
- Heating pad
- Water Bottle
- Panty Liners
- Immediately After Birth - Maternity pads, High Waisted Underwear, Nipple Cream, Nursing Bra, Nursing Pads, Nursing Clothes, Newborn Outfit, Car Seat.
POSTPARTUM & THE FIRST MONTH
- Lidocaine Spray
- Tucks Pads
- Stool Softener
- A place for baby to sleep (co-sleep / bassinet)
- Cloth Diapers
- Cloth Diaper Bin
- Reusable wipes
- Newborn Salve/Diaper Cream
- A place to change baby's diapers (changing pad and/or table)
- Newborn Outfit (tshirt / loose kimono onesie / long sleeves with mittens)
- Wrap Infant Baby Carrier (learn how to use the wrap before birth)
- Baby Nail File
- Wash cloths for burping, spit up and towel bath
- Manual breast pump
- Sound Machine.
- For cold weather Humidifier, Maternity Coat Extender, Baby Snow Suit, Stroller Muff, Gloves & Cover.
- Services: Meal Train, Lactation Consultant on call, Postpartum Doula on Call.
4 - 12 WEEKS
- Breast Pump
- Baby Bottle with preemie/infant nipple
- Baby Bath
- Baby Soap & Shampoo
- Baby Oil / Coconut Oil
3 - 6 MONTHS
- Bibs for drool
- Organic teether
- wooden rings (don't bother with toys - they'll play with anything)
- Soft Structured baby carrier
- Baby monitor
- Baby pajamas without footies so that baby wearing is more comfortable.
6 - 12 MONTHS
- Food Bib
- Puree Maker
- Fabric or board book
- Loose comfortable clothes to help movement
- Back carrier so you can start wearing baby on your back or hip
Learn all your options - Sling / Wrap / Soft Structured Carrier when you’re pregnant, take them out of the box, try them on before you buy one and try it on before baby arrives.
Take a baby wearing class - Go to a baby wearing meet up / Have a private consult / Don’t rely on YouTube videos, get in person help!
Start wearing them as soon as possible - slings or wraps are lifesavers around the house, for soothing baby and easier to go out and navigate steps, small spaces even if it's just getting coffee.
Breastfeed in the carrier - this may seem like a pro move, but once you try it may be a life saver, especially for babies with reflux.
Face them outward - Start facing babies out at around 4 months so they can explore the world. However it's recommended that you only for do so for 20 minutes at a time because they might be overstimulated and sleep poorly and also because you may not be able to read their cues.
Learn how to wear them on your hip or on your back - Start wearing babies on your hip or back when they can hold up their head and sit upright. The best part is that it'll help your posture - no more slouchy shoulders!
Learn all the pro the tips and tricks - Most carriers have 4 or more ways of carrying. Read the manual, try out all the different positions and seek out a pro to help. For example, most people don't know that you can cross the straps in the back for soft structured carriers - no more low back pain!
Proper positioning for baby - Make sure baby/toddler's legs are always in the squat or M position to avoid hip dysplasia. This is a common problem when forward facing.
Proper positioning for you - Make sure to the carrier hugs your hips and not your waist and that it sits comfortable on your shoulders. If using a middle strap across the back in soft structured carriers, lower it to be just under the shoulder blades.
Practice Practice Practice - Tying a wrap / back carrying a baby can be really awkward at first but after the first few times, it'll get easier and you'll do it without thinking. Also, just because a baby doesn't like a position early on, they may change or grow into it so keep trying.
Support the small businesses - Take the trouble to learn the wraps and ring slings, you’ll find that you get better posture and more convenient for you and baby than the big brands!
Carry toddlers - Common myth is that a toddler is too old to be carried, when actually you can carry children up to 50 lbs! Most positions are hip and back and often kids can even sleep in the carriers.
COMMON BABY WEARING MISTAKES
- Facing front for over 20 min
- Not correcting for hip dysplasia in baby
- Not having baby at the proper height so as to be able to kiss their head
- Suffering with bad posture
Ring Slings - Mamaway / Sakura Bloom
Wraps - Solly / Lille / Moby
Pre-Sewn Wrap - Baby K'Tan
Soft Structured Carriers - Infantino / Boba / Tula / Ergo / Lille
Spinning Babies: For all things related to baby's position in utero.
Science and Sensibility: Evidence based information on Prenatal tests and Birth Interventions
Evidence Based Birth: Evidence based information on Prenatal tests and Birth Interventions
Birthful Podcast: A podcast of Birth stories and other resources.
Kelly Mom: For all things nursing and breastfeeding
We all have a separation between our 6 pack rectus abdominal muscles. If the separation is more than 2.7cm, then it is considered to be ‘diastasis recti’. It can occur in pregnancy, but also in men who lift weights without engaging their core and in newborns. It’s measured in finger widths. A 1 - 2 finger separation is pretty common and 3 - 4 finger separation is considered ‘big’.
There is no way to know how much your separation is/will be until after you give birth. It’s very very common in pregnancy, we see it all the time, it’s not painful and definitely not something to worry about for the moment. We resolve any diastasis issues in postnatal workouts!
It can happen for many reasons. For some people who have a really strong core, they’ve only focused on building strength in their abdominals but haven’t focused on flexibility. Our abs, just like our hamstrings ideally are strong and flexible. In pregnancy, ab muscles have to stretch to accommodate baby and if they’re not flexible, the cartilage between them begins to separate instead. For others it occurs just as the belly grows bigger, or not being careful enough about turning over to one side and getting up form laying down. But you could be really careful and still have diastasis!
There are many good reasons to try to minimize the separation - it weakens abs, can cause low back pain, it affects baby’s position and causes the little pooch that many people have after kids. But if you do have it, it should clear up on it’s own 6 weeks postpartum. Your doc will let you know at your post-birth check up if you have it. If it you do have it, then we would start to make modifications in postnatal exercise.
While you’re pregnant, exercises to avoid are any ab work that causes your belly to bulge and cone - sit ups, crunches, boat pose. But the biggest culprit is lurching straight up from laying down rather than turning on your side. The best thing you can do to prevent a separation, a separation from worsening or to heal the separation is the ab exercise we do in class - belly pulls on all fours, and the breathing exercise - nose throat chest belly.
Make sure your core (diaphragm, pelvic floor, transverse abs and multifidus muscles) are working together in sync. That means, hands to belly, as you inhale, feel belly expand, lengthen and release pelvic floor. As you exhale, feel transverse abs (the ones that go all the way around your waist) engage and draw in and feel slight lift of pelvic floor. If you're pregnant, you can do this exercise on all fours. If you're postnatal, on your back with knees bent and feet on the floor.
By Neelu Shruti
The benefits of yoga are far-reaching. In an hour of downward facing dogs, sun salutations, and other poses, we can exercise while releasing stress and becoming more mindful. While we can all find benefits in the practice of yoga, there are exceptional benefits to the practice for pregnant women.
Prenatal Yoga is designed to build strength and flexibility in your body to help you carry your growing belly more efficiently, so you can feel your best — preventing low back pain, hip pain and round ligament pain and other common pregnancy aches and issues. Yoga while pregnant is safe in all stages of pregnancy and is recommended as long as you avoid deep twists, deep backbends, any abdominal exercises that compresses the uterus and laying flat on your your belly or back.
More significantly, prenatal yoga targets the muscles you will use in labor and birth helping you build strength, flexibility and stamina where you’ll need it the most and offers tools to aid in labor and birth. Whether you have a vaginal or a cesarian birth, practicing yoga while pregnant will significantly aid in your postpartum recovery.
A few of the benefits of prenatal yoga are:
Get a good workout: Exercise is great for you and your baby! Whether you’re a regular runner, spin cyclist, or yogi, keeping up your active lifestyle can be more challenging when you’re pregnant. For starters, your tendons and ligaments become a lot more flexible during pregnancy due to the influx of relaxin in your body, and you’ll want to build muscular strength to prevent injuries from hyper-flexibility. Prenatal yoga offers all of the benefits of maintaining your exercise routine (including helping to reduce stress, control weight, improve health and well-being, maintain a positive mood, boost energy, and get better sleep) while being safe for you and your baby. And if you’re not an exercise junkie, or have let your routine slip a little, now is a great time to start because the healthier you are and the better shape you’re in, the better it is for your baby! There’s even evidence, according to recent studies, that exercising regularly when you’re pregnant can boost your baby’s brain function!
Strengthen your abdominal pushing muscles and learn to relax your pelvic floor: Another incredible benefit to prenatal yoga is that incorporated into the sequence are targeted exercises to help strengthen, and improve flexibility in key muscle groups. Doing crunches and plank is neither very comfortable, nor recommended when you’re pregnant, and prenatal yoga offers an excellent alternatives to tone your transverse abs (your deep corset pushing muscles) in a safe manner. Additionally, prenatal yoga targets the key muscle group known as the pelvic floor. The importance of both strength and flexibility in the muscles of the pelvic floor cannot be overstated. The pelvic floor muscles are muscles in the bowl of your pelvis. It is essential that they are strong enough to allow the baby’s head to rotate when descending, and to prevent pelvic organ prolapse, but also that they are flexible enough to open and release to allow the baby through. Labor involves the unique combination of flexing and pushing with your abs while relaxing your pelvis which can be tricky, and prenatal yoga incorporates ab work, pelvic floor exercises, and breathing exercises, all of which can help accomplish this challenging balance during birth. Not only are you learning how to target those areas, you’re learning how to synchronize them, while building strength and flexibility where you’ll need them most.
Learn to deal with discomfort: The therapeutic benefits of yoga are far-reaching. Prenatal yoga can help prevent and address common issues such a lumbar lordosis (lower back pain), sacro-iliac pain, sciatica and piriformis pain. The poses can also create space in the torso for better breathing, and include movements that can help to alleviate carpal-tunnel syndrome and charley horses, as well as demonstrate positions for better sleep. By working through discomfort with breathing techniques and a focus on mindfulness, you are able to alleviate discomfort, and the practice of challenging yourself and building muscle strength builds your tolerance to pain. In prenatal yoga, the poses are designed to challenge, but not strain your body. Learning to breathe and maintain calm in an intense stretch teaches your body how to react to and manage a stress, so you’ll be better-equipped to handle stressful situations during your pregnancy, and of course, more prepared for labor.
Get baby in the optimal position: Compared to the benefits of other forms of exercise, the really exceptional benefit of prenatal yoga, is that poses like down dog, cat/cow, and puppy pose gently guide your baby’s head down, facing your spine, the ideal position for birth. That’s right, the more cat/cows you do, the more you’re encouraging your baby’s head down toward optimal fetal position! Prenatal yoga counteracts the long periods of laying back on your couch or sitting at a desk — which have the exact opposite effect and can encourage breech or posterior (sunny-side-up) babies and result in longer births times and sometimes lead to medical interventions — and helps have you and your baby exactly where you need to be when the time comes.
Breathe: Often, we don’t pay attention to our breath which tends to be shallow as we go about our day-to-day activities. In yoga, we begin to pay attention to our breath, and to teach ourselves to focus on maintaining deep, full breathing. The benefit of the yogic breath is that we become aware of our diaphragm’s movements and begin to use our lungs to a greater extent, engaging their full capacity and allowing a larger intake of oxygen. This focused method of deep breathing calms our mind and allows us to relax and use our muscles more efficiently. Breathing and active relaxation exercises taught during a prenatal yoga class help reduce stress for overall better physical and mental health for you and for your baby.
Bond with baby: Recent studies have shown that the practice of mindfulness allows parents to recognize, appreciate, and connect with their babies. Embracing a few minutes of quiet time where the distractions of the day fade away allows you to focus all of her attention inward and on the baby, and can help you to zoom out, see the big picture, and be less bogged down by the day-to-day frustrations. It also allows you to notice changes in the growing baby and in your own body. The practice of mindfulness and building a bond with baby prenatally can aid in preventing postpartum depression.
Build confidence: When dealing with a growing belly, hormonal changes, back pain, swollen feet, and constantly having to pee, it’s easy to get frustrated with the constant physical changes in your body. It’s important to remember that your body (even with all the discomfort you feel) is strong, healthy, and capable. Practicing yoga — whether it’s finishing your regular sequence, or doing a particularly challenging pose when you’re pregnant — can give you great feeling of accomplishment, and build your confidence and trust in your body and its innate ability to labor and give birth.
Be part of a community: The first few minutes of a prenatal class usually consist of introductions where you’ll be able to discuss issues, discomforts, and concerns with others. As the conversation goes around the room, you’ll hear how others are dealing with the same issues that you’re facing. This creates a space for sharing and learning from each other, and also allows the instructor to customize each class to fit your needs. Most of all, you’ll meet other parents who are experiencing the same challenging, wonderful changes as you, while pursuing a practice that helps ensure the safest, healthiest, and most joyful outcome for you and your baby.
If your pregnancy is categorized as low risk and you are hoping to give birth with minimal interventions, but still have access to emergency hospital services, a birth center is a fantastic option.
Why choose a Birth Center?
- Birth Centers offer more pain relief options such as a jacuzzi and nitrous oxide (laughing gas) which is very common in Europe and U.K. but not offered in many NYC hospitals.
- Birth Center environments tend to be a bit more homey with lighting options, bigger beds and friendly furnishings. All their medical equipment is usually hidden in closets rather than displayed.
- Birth Center cesarian section rates tend to be much lower and they perform fewer interventions.
- Birth Centers allow for intermittent fetal monitoring or will conduct monitoring with a hand held doppler which means that your movement isn’t restricted.
- Birth Centers allow for a variety of pushing positions - squatting or all fours for example which tend to cause less tearing. Often in hospitals you are required to push laying down on your back or on your side.
- Birth Centers allow partners to stay overnight after birth. (This is not always the case with shared rooms in postpartum but is allowed with private rooms at hospitals)
- Birth Centers within a hospital still offer all the expertise and options a hospital would provide such as and epidural or NICU facility. Free standing birth centers are located a short distance from their partner hospitals.
What’s the rush?
Birth Centers are in high demand and many care providers who have privileges at a birth center don't take clients after the first trimester. Some will take clients up to 20-22 weeks.
Are you a good candidate for a Birth Center?
Ask yourself -
- Are you low risk?
- Are you comfortable with trying alternate pain management techniques either in liu of or before an epidural?
- Birth centers require that you are at least a few centimeters dilated before being admitted so you’ll have plan to labor at home for a bit until you’re in active labor before being admitted.
- Birth centers will dismiss you after 24 hours after birth which might be too soon for some, but can be a relief to others.
How do I know if I’m low risk?
- Singleton, term, vertex pregnancies, and the absence of any other medical or surgical conditions is defined as a low risk pregnancy.
- If any conditions present in the course of pregnancy and is classified as ‘high risk’ appropriate steps will be taken by care providers to recommend or transfer care. For example, if baby turns breech close to term, midwives will often transfer care to OBs they have a relationship with and may also be present at time of birth.
Are Birth Centers equipped to handle emergencies?
- Your care providers will continue to monitor you closely but if any predictable issues occur, (pre-term labor, gestational diabetes), you may be required to give up the birth center option and give birth in L&D instead, with your same providers.
- When you check in to a Birth Center when in labor, if any of the tests are non-reassuring (high blood pressure, presence of meconium, fetal heart rate irregularity) your care provider will determine whether you’ll be able to give birth in the birth center or whether to transfer you to L&D.
- In case of an emergency (emergency c-section, postpartum hemorrhage or if baby needs NICU) during birth, you will be transferred to the L&D floors, again with your care provider.
What if I change my mind and want an epidural?
- You’ll be transferred to L&D and be able to get one.
Where can I find a Birth Center?
There are many different kinds of birth centers - free standing Birth Centers and Birth Centers located within a hospital, right next to labor & delivery units.
- Mt. Sinai Birth Center - Birth Center located within the Mt. Sinai St. Luke’s Roosevelt Hospital near Columbia Circle.
- New York Presbyterian Downtown Birth Center (LOMA) - Birth Center located within the New York Presbyterian Lower Manhattan Hospital near Wall St.
- Birth Center at Metropolitan Hospital with Village OB & Midwives - Birth Center located within the Metropolitan Hospital on the Upper East Side
- Brooklyn Birth Center - Free standing Birth Center located near Sheepshead bay in Brooklyn, supported by Maimonides Hospital.
- Birthing Center of New York - Free standing Birth Center located in Bay Ridge, Brooklyn.
Which care providers have privileges at Birth Centers?
If you’d like to give birth at a birth center, you have to work with a care provider who has access. Not all care providers are designated for the birth center, so please be sure to check with yours.
- You can work with an OB Practice, an OB & Midwifery Practice, a group of Midwives or a single OB.
- Below are a list of care providers who offer services at Birth Centers:
Dr. Katrina Bradley, Dr. Nabizadeh & Dr. Shulina at Mt. Sinai Birth Center & Hospital
Dr. Anna Rhee at Mt. Sinai Birth Center & Hospital
Dr. Gae Rodke, Mt. Sinai Birth Center & Hospital (doesn’t take insurance)
Dr. Paka, Mt. Sinai Birth Center & Hospital
Village Maternity, Metropolitan Hospital (Birth Center) (backed by Village OB)
CBS Midwifery, Mt. Sinai Birth Center
Central Park Midwifery, Mt. Sinai Birth Center
Community Midwifery Care, Mt. Sinai Birth Center
Risa Klein Midwifery, Mt. Sinai Birth Center
Sarah Jensen, CNM, Mt. Sinai Birth Center
Sabine Jeudy, CNM Mt. Sinai Birth Center
Midwives at NYP Downtown Birth Center
Dr. Hanna, NYP Downtown Birth Center
By Dr. Alexandra Garcia
As an acupuncturist I’ve seen a recent rise in interest in acupuncture for fertility and pregnancy. As more doctors learn about the research supporting the efficacy of acupuncture, more patients are being referred by their care providers for conception support, back pain during pregnancy, and breech presentation.
I’m encouraged to see that the word is getting out - and I’d like to share some of the other great ways that acupuncture can help people during and immediately following pregnancy.
First, let’s talk about what acupuncture actually does.
Acupuncture has ancient roots and now science has a modern explanation for its mode of action. Traditionally acupuncture is explained as a means of manipulating the energy that flows in channels through the body. Today scientists are discovering that the channels are intricately intertwined with the modern concept of fascia - a connective tissue that wraps through the body and generates electricity under pressure. Acupuncture has been shown to shift the nervous system into a "rest and recover" state. From here a range of imbalances can be righted: muscle pain, digestive difficulty, insomnia, conception challenges, and others.
When it comes to pregnancy, labor, and the postpartum period acupuncture can be a powerful resource for some common complaints. Here are just a few ways it can be used:
In the last month of pregnancy there's a wave of physical and biological changes preparing the body for labor. As the days count down, people feel this physically in the final weeks as braxton hicks contractions. My teacher has a way of explaining this stage of pregnancy: “It’s like when you’re in a stadium practicing to do the wave. The first time it’s kind of sporadic, with different pockets of people joining in. Eventually, everyone realizes what’s happening and you get this big coordinated effect. Your body is calling on all systems to choreograph the perfect wave: the birth contraction.”
Acupuncture excels at syncing the body’s systems: Endocrine, Muscular, Nervous. By switching off our internal “fight-or-flight” system, acupuncture lets the body know that it’s a safe time to start practicing for the big day.
Studies have shown that people who have acupuncture in the last month of pregnancy are less likely to need chemical inductions; and of those who do still need an induction, the people who use acupuncture end up using smaller doses of those medications.
Labor & Delivery
Acupuncture can be a wonderful resource during labor. Of course acupuncture is excellent for pain management but there’s a whole lot more that it has to offer. In hospitals that provide acupuncture during labor, the practitioner can help support a smooth progression through each of the phases of labor. Acupuncture techniques can be used to encourage regular contractions, progress cervical dilation, and sustain a laboring person’s energy through the process.
Traditionally, acupuncturists view pregnancy in 4 steps: The three trimesters (12 weeks each), and the postpartum period (a fourth trimester of 12 weeks). They are all considered equal parts in the big picture of pregnancy.
In the weeks after birth, the parent’s body is intensely focussed on recovery. This creates a great opportunity for overall rejuvenation. Acupuncture can help you harness this postpartum energy to reset your body’s foundation. It’s a unique chance to address issues from before the pregnancy - things like painful PMS patterns, digestive difficulties, and neuromuscular pain.
With weekly acupuncture and a good self-care practice, the weeks after labor can be channeled to build the strong foundation you need for the joyous challenges of the adventure ahead: parenthood.
People are often surprised to learn that acupuncture can be used to treat infants and children. In fact, acupuncture has a long history of treating children - the Chinese recognized pediatrics as a separate area for training and medical specialization several hundred years before western medicine stopped treating children simply as mini-adults. As research is emerging about the value of (often needle-free) acupuncture for newborns, toddlers, and children, more hospitals are starting to include practitioners on their pediatric staff.
Acupuncture can be used in all stages of life as part of a comprehensive wellness strategy. During pregnancy, labor, and postpartum it can be incorporated into a healthcare plan to complement the work you do with your obstetrician or midwife.
If you’re in NYC and interested in trying out acupuncture you can book an appointment right here at Love Child.
But for those of you reading from other cities, here are some tips for finding a qualified practitioner near you. When considering acupuncturists you’ll want to be sure that you chose someone who is licensed to practice in your state. This indicates that they’ve gone through several years of training in a master's level program and that they’ve completed state and/or national board exams. You should also check that they have experience working in the area of obstetrics and/or pediatrics. Your doctor, midwife, or doula may be able to refer you to someone who they regularly work with. Finally, look for a practitioner conveniently located so that you can easily make time for regular visits, and - most importantly - chose someone who makes you feel comfortable and cared for!
Dr. Alexandra Garcia holds a doctorate in acupuncture and East Asian medicine. Her practice focuses on pediatrics and obstetrics. She also has training in facial rejuvenation, pain management, and general wellness.
Before earning her doctorate, Alexandra completed a B.A. at Middlebury College and an M.S. from Pacific College of Oriental Medicine. She currently splits her practice time between Love Child Yoga and NYU Lutheran’s Labor and Delivery Department in Brooklyn.
Alexandra supports her clients using a holistic approach. Her treatments weave together a variety of modalities including acupuncture, cupping, herbal formulations, bodywork, and dietary guidance using the frameworks provided by Traditional Chinese Medicine.
Cardini, F. & Weixin, H. (1998). Moxibustion for Correction of Breech Presentation: A Randomized Control Trial. JAMA 11, 1580-1584.
Gaudernack, L.C., Forbord, S. & Hole, E. (2006). Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the lengths of birth and use of oxytocin: A randomized control trial. Acta Obstetrica et Gynecologia, 85, 1348-1353.
Greenspan, M. (2005). Acupuncture as a Means to Promote Full Term Vaginal Delivery (Doctoral Dissertation). Yo San University, Los Angeles.
0u, H., Greeven, A., & Belger, M. (2016). The first Forty Days: The Essential Art of Nourishing the New Mother. ABRAMS, New York.
Scott, J. & Barlow, T. (1999). Acupuncture in the Treatment of Children. Eastland Press, Seattle.
There were two things I wanted for my daughter's birth. I wanted her to be able to choose her own birthday (no induction) and I longed for a non-traumatic birthing experience. I knew delivering in a hospital could have the odds increased of unwanted medical interventions, so I prepared the best I could. That meant hiring a doula team my husband and I loved, prenatal yoga, taking birth prep classes and re-reading the wisdom of Ina May Gaskin.
My due date of 5/31 came and passed. I kept going out to brunch and walking a ton to pass the time. I made a big batch of laboraide and froze some into popsicles. As my next OB appointment and talk of a scheduled induction approached, I set up an acupuncture session 1 day past my estimated due date to stimulate the points that could kickstart labor. The very next evening bloody show made an appearance. It was followed by the loss of my mucus plug about 12 hours later. Very irregular contractions started around this time and lasted for 24 hours.
On the evening of 40 weeks, 4 days my contractions kicked in at a more regular frequency around 1am. I remember my doula advised me to relax and go to bed early that night and I decided to stay up and watch the series finale of a television show I watched over the past few years. I now regret this as I couldn't focus on the show and I could have used all the rest I could get. My husband and I didn't sleep at all that evening and when we woke up at 40 weeks, 5 days, the contractions were more frequent and intense at around 4 minutes apart. That morning we asked that one of our doulas join us at home.
When our doula arrived around 11am I was halfway into the shower thinking it would help with my contractions. It did help me take my mind off of things. I was glad the doula joined us as my breath was veering off into hyperventilation territory and I had lost my mindful breath. She got me back on track. My doula, husband and I breathed through so many contractions mainly with me leaning over an exercise ball.
As we approached 3-1-1 (3 minutes apart, 1 minute in length, for 1 hour) and I started to wonder when we should go to the hospital. Our doula mentioned there was still some work to be done at home. She was right. I was still talking in between contractions, trying to make jokes. It didn't take long for me to go to a deeper place where I was in my own zone.
This helped when we called a car to drive us from Brooklyn to our hospital in Manhattan. I labored so loudly in that car. I was on my knees, with my body facing the rear of the car holding on the car seat headrest. As we drove over the Williamsburg Bridge I remember opening my eyes at one point and looking out the back seat window to make eye contact with a driver right behind us. I didn't even care at that point.
We finally made it to the hospital around 1pm. I remember I had two contractions (with me moaning very loudly) before I could even make it to the check-in desk upstairs. In triage I learned I was already 8cm dilated and fully effaced. This didn't mean I would get to my labor and delivery room anytime soon.
I was still stuck in triage for about two hours. While there I had two medical inventions I didn't initially plan on (my water being artificially broken and internal fetal heart monitoring being attached to my daughter). I also was initially feeling an urge to push when an anesthesiologist showed up and wanted to discuss options with me. I remember it was so easy to block him out and sign whatever paperwork he wanted so I could focus on my contractions.
At one point I started crying because I thought I'd be giving birth in triage it was taking so long. My doctor, who was also in her 3rd trimester of pregnancy, advocated for me to get into my labor and delivery room. When we finally moved to the room, I remember complaining as to why so many fans were blowing as it was distracting and making me cold. Turns out they were frantically trying to dry the floors as they had just finished cleaning the room. I'm glad I was too deep in my contractions to notice how close we were to not getting a room to deliver in at all.
Once we were in the room it felt like things moved rather quickly. I waited for my daughter to get to the proper station while on my knees in the bed, leaning over the back of it. When it finally came time to push, my doctor convinced me to get on my back with my feet in stirrups and they "broke the bed" and encouraged me to push when I felt the urge with each contraction.
Pushing was the hardest part of labor for me and I ended up doing so for 50 minutes. The whole idea of pushing extremely hard without expelling any breath was foreign to me and I wasn't prepared for the sensation and intensity. The doctor asked if I wanted to reach down and feel her head while she was crowning and I surprised myself by doing so. I don't think I realized how close I was to being finished at that point.
A few last pushes and Adeline was born at 4:10pm, approximately 15 hours after my regular contractions started. The doctor let me naturally tear which was fine except for the fact a resident did the repair afterwards and I felt the teaching moment took what felt like forever. It also made me so uncomfortable that Adeline was eventually taken from me and given to my husband while they finished up.
Looking back, my labor and delivery experience makes me so proud of myself. I had told myself beforehand that the sensations associated with labor are normal. It's not pain. It's my body doing what it naturally knows to do. Accomplishing the birth I wanted was due to my prep work, but I know it was also up to a little luck as there are often circumstances out of one's control.
If I decide to have another child, I've already decided to look to do so at home given it's a low-risk pregnancy. Even though my labor and delivery was what I had in mind, the postpartum period in the hospital setting was uncomfortable and unsettling. The hospital room I had was shared and if I stuck my arm out into the curtain right next to me, I'd be in my neighbor's bed. Not really the best environment to rest and get your bearings. I was so happy when it was time to leave and return back to our safe haven at home to start recovery and spend time alone as a new family.
PRIDE brings rainbow-filtered Facebook profiles, multicolored corporate messaging, and some of NYC’s best summer celebrations. And I must say, I think this is a fabulous development. The fact that everyone wants to be included in PRIDE is beautiful. But when it comes to healthcare, rainbow swag in the waiting room doesn’t necessarily equate with LGBTQ+ competent providers. During pregnancy, birth, and postpartum, it can be especially challenging to feel fully supported as an LGBTQ+ parent.
The birth world is so steeped in hetero- and cis- assumptions, that it can be hard to imagine what an LGBTQ+ inclusive birth team would even look like. So let’s begin by talking about what makes an LGBTQ+ competent provider:
Inclusive language: At the most basic level, a practitioner should have the vocabulary to discuss your health. Fluency in relevant terminology shows a commitment to making sure LGBTQ+ people don’t feel like an inconvenient anomaly in the birth world
Asking the right questions: An intake form allows clients to share their basic medical history but, only if the right questions are being asked. A competent provider recognizes that a person’s identity as LGBTQ+ is relevant to their health preferences, needs, and expectations.
Relevant resources and referrals: Clients count on their birth team for all sorts of referrals and resources during pregnancy and postpartum. An LGBTQ+ friendly provider may not realize that the majority of books and facts sheets are heteronormative and don’t reflect their LGBTQ+ families. But a competent provider will consider the extra financial hurdles that parents may have gone through just to become pregnant, and will take into account the impact this may have on options for services during the pregnancy.
Commitment to continuing education: LGBTQ+ competency, like any type of expertise or specialization, takes training and ongoing education. The resources, legal rights, and medical research for the LGBTQ+ community is constantly growing and changing. To offer full support to LGBTQ+ people during pregnancy, birth and postpartum, providers need to be committed to ongoing education.
Now that we have this picture of an ideal provider, where do we find them? How can we pull together this queer competent birth team? Here are some ways to begin building a list of options:
1. Ask other LGBTQ+ parents.
Families who have been through the birth process are an amazing resources. Queer parent groups are a great way to hear about people’s experiences first hand. They’ll be able to tell you who was the all-star on their birth team, and who you might want think twice about working with. Personally, I can recommend the groups at Brooklyn Acupuncture Project and here at Love Child Yoga.
2. Ask the hospital or birthing center for a list.
If you’re doing a tour of a hospital or birthing center, ask for a list of LGBTQ+ competent providers. Not all institutions will have this, but it’s a good reflection of how much effort they’ve put into making sure that all birthing people and families are supported in their space. You may also want to ask for clarification on whether the list differentiates between “friendly” and “competent” providers.
3. Going to a LGBTQ+ inclusive childbirth education class.
A childbirth education class is a great place to start asking questions and collecting referrals for all your pregnancy, birth, and postpartum needs. An LGBTQ+ inclusive course will be designed to meet the needs of a broad range of expectant people. Some that I would recommend are Bilen Bernahu, (Love Child Yoga), Morgane Richardson (Juniper), and the educators at Manhattan Birth.
4. Contact LGBTQ+ competency trainers
There are a handful of people who offer trainings to health care providers in LGBTQ+ cultural competency. They’ll know who's done the work and who is just offering rainbow colored swag. Morgane Richardson trains OB’s, midwives, nurses, and doulas around the US; and the Birthing Beyond the Binary team looks like an amazing initiative as well.
If you have other tips about how to find your LGBTQ+ competent birth team, please do send them in! We would love to hear about your ideas and advice so that we can include them here.
About the author:
Dr. Alexandra Garcia is a doctor of Acupuncture and Chinese Medicine working with the Love Child team to support new and expectant parents and their children. She also provides acupuncture and acupressure to laboring people at NYU Lutheran Medical Center in Brooklyn where she serves on the hospital’s LGBT+ Advisory Board. She is working toward becoming an LGBTQ+ competent provider; She gives great thanks to her wife Morgane V. Richardson who has encouraged her to constantly challenge her own assumptions about the world of birth.
They should give you a due-range, rather than a due-date.
When October 5th came and went with no contractions, no sign of baby, and a fully nested-and-back-again apartment, I was beginning to think she’d never arrive. I’d already packed up my desk and begun staying home from work in anticipation of my little girl’s arrival. I was excited to meet her. And more than a little bit impatient.
Eight uneventful days after that uneventful day, I took a nap. In any other context, this was a marker of a good day. And that nap followed a vigorous prenatal massage, so as any sleep-deprived new parent will attest, this was indeed a Good Day.
My post-massage-and-nap glow was cut short when something occurred to me: I couldn’t remember when I’d last felt baby kick. I’d felt something at breakfast, again during the morning massage. But then – nothing. And it was now close to 5pm.
They say that you, as the mum, get to know what’s normal for your baby in terms of movement. And you do. It’s important to be aware of any deviations from the norm. My doctor had said previously that “moms often leave it too late.” On that chilling line, I followed up no further.
My baby liked to move though – pretty much nonstop tumbling and kicking - with two exceptions.
The first one was on a business trip I’d taken to San Francisco. My baby was eerily still for a couple of hours, and unresponsive to juice (the sugar is supposed to wake them up). My doctor, who’s usually pretty laid back, instructed me to go to a hospital with a labour-and-delivery unit right away. Embarrassingly, and magnificently, the baby kicked as they were checking me in to the hospital (which, as an aside, took way too long given how urgent the matter could have been).
All was well, and I cried a tear (or a hundred) of relief. My husband was on the point of driving from NYC to San Francisco without stopping, so the good news was particularly welcome.
The second time was on this day, 8 days after my due date, post massage and post nap.
I tried to remain calm.
At this point, it’s worth noting that I’d recently read a story from a woman who shared my due-date on TheBump.com. She had tragically lost her baby around week 40. After the baby stopped kicking, which she hadn’t really noticed.
So, you could say that my state of mind was quite dark.
Guilt flooded my body. What kind of selfish, spoiled person – lounging around her home on a work day following an indulgent massage - takes a nap and forgets to count kicks? A terrible mother, I told myself. (No one really tells you about the wildly irrational guilt involved in this kind of thing. But it’s not unusual.)
Anyway, I called my doctor after only a minute’s hesitation (“Stop being so British and polite all the time,” I could practically here my husband saying – though I was sparing him the news until I’d spoken to the obstetrician).
“Come to the hospital right away,” she said.
I could see that my husband was parking the car after work (thanks, iPhones), so I waited to tell him in person a few moments later. In the meantime, I texted my doula.
My husband arrived. He snapped into action right away, trying to reassure me and be practical, but clearly worried sick himself. This isn’t the ending either of us had pictured.
He reached for the overnight bag I had packed so many weeks before – but I stopped him. I pictured myself grieving over my lost baby (getting a little ahead of myself to be sure) and unable to face the task of unpacking those unworn baby clothes at the hospital. In that surreal moment, it felt like taking the bag with us would jinx everything. Apparently this intense and scary episode brought out a superstitious side of me.
We headed outside to hail a cab. The cab driver, unlike every other New York taxi driver I’d encountered in my 15 years of visiting and residing in the city, stopped for every amber light and yielded to every other car, bus, and cyclist on the road.
But we got there. We were checked in quickly and they hooked me up to various machines. I had to click a little button every time I felt a kick, which mercifully didn’t take long. Baby was doing OK.
At this point, my doctor appeared. “We’re not sending you home tonight. You’re 41.5 weeks. It’s time.”
I’d had my heart set on a natural delivery, with minimal interventions. No induction, no epidural. That’s why I had a doula. (Who was still MIA and failing to respond to texts, by the way. This was out of character for her.)
They hooked me up to a Pitocin drip. Pitocin is synthetic oxytocin, and it’s one of a few ways hospitals try to induce labor. I was apparently already having mild contractions, but I couldn’t feel them in all the excitement. They picked up to a noticeable level when they gave me a saline drip. In all the post-nap commotion, I’d neglected to hydrate.
So there I was in the delivery room, getting comfortable. My husband left to get the bag we’d packed, and to make sure our dog was looked after.
The room was large and had a TV, which the nurse switched on.
“I don’t really want too much Pitocin,” I said.
She answered, “Don’t worry – we start on a super low dose, and try to only increase it as your contractions grow.” This was cheering.
The TV was showing the Democratic presidential candidates’ debate, which felt so quotidian on what was an exceptional day for our little family.
At first, the sensation felt like menstrual cramps. The contractions grew, and came quicker. I was managing, but they were definitely getting more noticeable as the Pitocin dose was increaed.
My husband returned and I was delighted to see him. He’d brought our suitcase, a nursing pillow, and some contraband snacks to sustain us both.
My doula texted apologetically. Another client was in labor and she wouldn’t be able to join us. She encouraged me to call on her back-up doula. To do it over again, I would have. But already flustered and feeling as though a few things out of my control were happening, I didn’t want to introduce another variable – a doula I didn’t feel 100% comfortable with.
So my husband and I soldiered on alone. The gaps between nurse visits felt long, and we didn’t see a doctor all night (this is normal, apparently). Both of us being new to labor, we weren’t sure we were doing it right. We’d taken classes and read books, but no one had really prepared us for the hospital experience, replete with its long waits and rigid but apparent-only-when-broken rules.
Apparently we were doing something right, because the contractions were coming faster and with more force. I later learned that one of the main disadvantages of medically induced contractions over natural ones is that the latter are accompanied by endorphins, and therefore significantly more bearable than their synthetic counterparts.
Another quirk of induction is that you are likely to be constantly monitored (i.e., hooked up to various machines) so it’s harder to move around. And standing/gravity helps labor progress, so this felt a little bit handicapping. My husband mentioned this to the nurse – I refer you to my aforementioned “damn Britishness” and aversion to anything akin to “making a fuss” – and she helped me out of the bed so I could stand up and try to get more comfortable. Standing helped – I felt like I was actually doing something to help the process along, versus just lying there.
The other wonderful part of this interaction was the news that “Other women on the ward have been dropping like flies for the epidural. You’re our hero.” Call it reverse schadenfreude, but this sustained me for another hour or so.
The pain continued to increase. At no point did I find myself emitting low, therapeutic moans like I’ve heard other women talk about. I was screaming and cursing and falling apart a little bit.
I was struggling with my breathing exercises for a maddeningly simple reason: I’m allergic to dust, which didn’t seem relevant in a hospital environment, but 100% was – the hospital’s birth center was under construction and my room neighbored the worksite. Had I known this, I’d have asked for an antihistamine hours prior. I got one eventually, other concerns overtook my respiratory issues.
It’s hard to describe the pain. I was in “back labour,” which I became convinced could make even a hardened terrorist speak under questioning. It felt like I was both outside my body and feeling pain more acutely than I’ve ever felt any sensation in my life. I’d crossed over from managing the pain to it managing me. In effect, I was fighting it – bracing hard for every coming contraction and feeling them at full force, with tears in my eyes.
As it was, eleven hours in, I started asking for an epidural. The nurse calmly explained that the anesthesiologist had just gone into surgery and would be at least an hour and would that be OK?
I not so calmly shouted “WELL WHAT CHOICE DO I HAVE!?”
Who was I?!
She returned much earlier than planned – anesthesiologist in tow. He worked quickly. We will never know the extent to which this might have been due to her having violently pulled him out of someone else’s operation to quiet down the woman who was screaming in room three.
I was still feeling the pain, but the sight of this man and his glorious cart of drugs sustained me as they prepped me for the procedure. My husband was given a surgical mask and told to look away. (Our childbirth educator mentioned that partners fainting was one of the main hazards of epidural delivery.) He was fine.
I perched on the edge of the bed and leaned towards the nurse while the anesthesiologist prepared the needle for my spine. I’d always had an aversion to the very idea of a needle near my spine, so that in itself attests to the pain I was feeling.
He did it. And the pain accompanying each contraction seemed to recede into gentle nothingness. The best thing about this? I could sleep! The second best? My husband could sleep! It was morning, and we’d essentially pulled an all-nighter in which one of us had run a marathon while the other had jogged alongside the other, worrying about the other’s health throughout. We’d earned a nap.
I woke a few hours later, feeling refreshed and ready to push.
They’d shown me a button to press which might as well have been labeled “MORE DRUGS”, but I didn’t use it. The initial dose was plenty, and began to wear off in time for the pushing. I was glad: I could feel a bit of pressure when I needed to push, but no pain.
It’s worth mentioning here that the morning crew wasn’t as competent as the overnight one. Doctor and nurse each had a trainee with them, and seemed more interested in showing their apprentice the ropes than providing my baby and me with medical care. Case in point: my husband had to ask for the nurses’ help each time I was ready to push because one was showing the other how to inventory the supply cupboards and neglecting to look at me or the monitors.
I heard the overnight nurse remind them to catheterize me so I could urinate at a particular time, but they forgot. A small error, but one with serious repercussions: baby’s heartrate was falling and it was only when they helped me empty my bladder that it picked up. They laughed at this. We did not.
Every time I pushed, my baby’s heartrate dropped again before picking up between contractions. This was stressful, and made worse when the doctor dropped by to simply say “Baby does not like your pushes” then left. Thanks for the vote of confidence, lady.
They gave me oxygen to use between pushes, and had me roll over to my left side in between each one as this helped baby’s heartrate recover. Again, my husband had to prompt me each time as the nurses were otherwise engaged.
After 1.5 hours of this, the doctor arrived to oversee the actual delivery. During a contraction, I thought I heard her say quietly, matter-of-factly, “Let’s cut now.” And it turns out I did, because I later learned they’d elected to give me an episiotomy.
Emergency medicine doesn’t always allow for explicit patient consent, but I only wish they had told me – if not asked me or my husband - at any point before, during, or after. But they didn’t. I never learned why it happened and how urgent the matter was, if at all. Simply but directly informing me of what they were doing to my body would have made the experience significantly easier to process after the fact.
Anyway, back to the pushing. They asked if I wanted to feel the baby’s head as she crowned. I surprised myself by saying yes. It was oddly cheering – a surreal reward for having made progress. The cord was wrapped around her head – they unwrapped it, and after pushing the head out, the rest of the labor felt quick.
Baby was born after 12 hours of labor and 2 of pushing. They put her on my chest and she latched fairly quickly. They had to clean her up and examine her, so I gave her to my husband after he cut the cord, and he took her to the other side of the room to be examined. I watched this process from my bed as I delivered the placenta and got stitched up.
Because of the epidural, I couldn’t feel my legs and therefore couldn’t stand up. I also learned that gravity has bearing on this: my leaning to the left during contractions meant my right leg regained feeling faster than the left. A funny sensation.
Despite the challenging night (and morning), I was happier than I’ve ever been.
The endorphins that eluded me during the night flooded my body. I was ecstatic. I was a mum to a beautiful daughter. And I’d do it all again – but perhaps a little differently.
By Avi Klein
In my psychotherapy practice and many others, it’s become commonplace to receive calls from couples who want to work out the issues in their relationship before they get married. They want to better understand themselves and their partners before they hit the kinds of big road blocks that are inevitable in any long term relationship. I always applaud and encourage those couples because I think they have insight into something that is at the heart of relationships: the true measure of a good relationship isn’t about how good it is at any moment, it’s about how flexible it is. Couples counseling cultivates that flexibility by creating more intimacy and knowledge about yourself and your partner. But, if I had to suggest one time when preventive couples counseling could really be needed, it's when you're about to grow from a couple into a family. It’s no coincidence that studies show that many couples become dissatisfied with their relationships when they become parents. Not much really changes when you get married, but for many couples, everything changes when you have kids. Every parent wants to give their child everything in the world. I would encourage every expectant parent to consider the advice of renowned couples expert John Gottman: "The greatest gift you can give your baby is a happy and strong relationship between the two of you."
A few common questions people ask about couples counseling:
1. How can I tell if it’s a good time to go?
There is no bad time to go, but don't make the mistake of waiting until it's unbearable. It's much easier to work on your problems when you can still appreciate and enjoy your partner. Some couples seek therapy as a last ditch effort before divorce, which is obviously much harder to fix since months or years of hostility and hurt feelings need to be dealt with first. For soon-to-be parents, it's also worthwhile to ask when you'll have time and energy after your baby arrives.
2. Does couples counseling mean we have a bad relationship?
Not at all! Going to couple counseling means you love your partner and value your relationship. You're spending time and money to make it better for you and your kids. That's something to be proud of. The truth is, everyone knows that relationships take work and effort. It's more efficient to do that work with an expert. Is your relationship something you really want to improve through trial and error?
3. What if my partner doesn’t want to go?
In about 75% of the couples I see, couples therapy is initiated by one partner not mutually agreed on. It’s normal for someone not to want to go to couples therapy. They might think that it means their relationship is worse than they thought or that their partner is saving couples therapy to surprise them with a list of complaints. Two helpful things to try when your partner is on the fence: 1. Reassure them that this is to make things even better, not that things are in a bad way. 2. Suggest that you go once or just speak to the therapist on the phone together for a brief consultation - giving it a test drive is a good way to get over any apprehension. 3. If your partner is on the fence, it’s worthwhile to find a therapist that you think they’ll get along with.
4. How do I find the right therapist?
There are a lot of therapists out there, so it can help to add a personal connection to find the right fit. If you know someone that had a positive experience in couples therapy or you’ve seen a therapist individually, that’s a great place to start. Consider asking on a community message board. Your MD or midwife may also know some good therapists as well. Consider speaking with more than one therapist to make sure you’ve found a good fit for both you and your partner. When you speak with them, what kind of information is important? While qualifications or geographical convenience matter, the most important thing is to trust your gut: you’ll be able to tell immediately if you feel comfortable with them, if you’re open to trusting them, etc. Lastly, don’t be afraid to ask them directly how they think they can help you. Therapy shouldn’t be an endless process - they should be able to explain the steps that you will take in your work to make a meaningful difference in your relationship.
5. How long will it take?
Every couple is different, so it’s impossible to say. It’s better to measure it week by week and to check-in with yourself and your partner: is this making a difference? Can you feel the difference and point to incremental changes that are happening? Couples therapy is different than individual therapy - it has always been intended to be short-term and to have the couple take what their learning from therapy out into the rest of their lives. When I speak with a couple that is on the fence about committing to therapy, I usually ask for a commitment of several weeks to give a good faith effort to see if it’s helpful. Four weeks should be enough time to notice a shift and twelve weeks should feel like you’ve done a good amount of work. Everyone has their own timeline, so this isn’t intended to apply to all cases but just to serve as a general benchmark. And remember: it’s always okay to check-in with your therapist and partner about your progress. Discussing why things aren’t changing is often a very productive conversation.
6. How can we get the most out of going?
A few suggestions: 1. Take care of yourself and your issues: Work to better understand yourself, your reactions to things and how your partner experiences them. Much of couples therapy is about helping each partner understand things from the other’s experience. Learn to walk in their shoes. 2. Make it something enjoyable both during and after: make every effort to be open and kind and honest in your therapy sessions and then do something nice together afterwards. Many couples that I see often go on a date after their session with me. It’s a nice ritual and will leave you feeling closer after working hard together in therapy. 3. Try and make a conscious effort to take something from each session and bring it into the rest of the week. If your partner feels ignored or under-appreciated, make an effort to give them that attention their craving. If you’ve learned that your feelings are hurt when your partner makes plans without you, take a risk and share that experience with them the next time it happens.
The best part of a relationship is the feeling of being connected with someone - of sharing important moments, having new perspectives and being exposed to new things with someone you deeply care about. But the worst part? It's when those different perspectives don't easily align with yours, when new interests or attitudes not only don't feel supportive, they feel invalidating or leave you feeling neglected. One of the times of greatest strain on a couple is that transition into parenthood and it’s easy for many new experiences to pull you apart. If you’re worried that this could happen to you, talk to your partner about discussing these worries together with a therapist. Those conversations will bring you closer and more connected at exactly the time when you and your new family need it most.
Avi Klein is a psychotherapist, father of two and native New Yorker practicing in Union Square. Avi has been working with individuals and couples since 2009. He is trained in AEDP (Accelerated Experiential Dynamic Psychotherapy) and EFT (Emotionally Focused Therapy), two forms of therapy that emphasize the power of emotion, healing & transformation in relationships. He has a special interest in supporting new families and is currently working on a workshop to support new and expectant parents. If you are interested in upcoming workshops focused on preparing your relationship for postpartum, sign up here.Inquiries can be directed at email@example.com or at his website https://www.aviklein.com If you are interested in upcoming workshops focused on preparing your relationship for postpartum, sign up for updates here: http://eepurl.com/cK0UI5
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One of the more common aches that shows up in pregnancy is a piriformis / sciatic pain.
Most often it shows up as a low back pain, specifically on one side, deep in your butt muscles and sometimes shooting down your leg as you walk.
It's caused because when you're pregnant, you're more flexible in your joints and in your pelvis. With the additional weight that the pelvis bears, our glute, quad and piriformis muscles have to work harder and sometimes tighten up to pinch the sciatic nerve. Pain can be relived by helping stretch and lengthen the glute and piriformis muscles and outer hips.
Here are 5 poses to help you stretch to alleviate piriformis / sciatic pain.
1. Squat: Great to build strength in your legs to help avoid hip and low back pain. Squats also help you stretch your glutes and pelvic floor.
2. Gomukhasana: Wonderful stretch for the outer hips and especially great for those who spin and run and have tightness in the IT band.
3. Ankle to Knee: Targets both hips at the same time.
4. Pigeon Pose: Stretches the outer hip and psoas.
5. Wide Leg Straddle: Lengthens your hamstrings and low back in addition to the glutes and piriformis.
You can also foam roll, use a tennis ball against a wall or the floor or mini butt punches. If the pain is intense and persistent, see a chiropractor that specializes in working with pregnant people.
Imagining Parenthood - How to have a conversation about how having a kid is going to change your partnership and what to expect.
One of the small moments that stood out for me as a new father was our first flight together as a family. My oldest daughter was just 6 months old and my wife and I were not looking forward to flying with a baby for six hours. Most of us have flown so frequently that we ignore the in-flight safety instructions. I was well on my way to tuning it out when they got to the part about putting on your oxygen mask first, before you help your child. It jumped out at me: “That’s me now. I have to do that.”. I’m thinking about it now because it really summarizes a paradox of parenthood. We think of parenthood as a relationship in which we’re prepared to give a lot, especially when they’re young and helpless. But in order to give, you have to take care of yourself first. Sometimes part of taking care of yourself also involves being able to receive care from others. It seems obvious but we forget: you have to have something before you can give it. Ifwe want to be parents that extend love and care to our children, we would do well to make sure that we can access it before we start giving it. For most new parents today, the person we look to for love and care is our partner. A strong, nurturing and supportive relationship is incredibly important to building the family life that many of us want.
I work with parents who have lost sight of this everyday in my psychotherapy practice. It happens naturally and for many understandable and valid reasons, but ultimately many people in relationships end up turning against the one person they really need to rely on. It follows that the less support we get, the more depleted we feel, the less we can give to our kids. A snowball effect starts to happen and each negative thing reinforces the next. The more depleted we are from caring for our kids, the less we have to offer our relationships (which only leads to more arguing, less support, etc.) until hostility pervades your relationship. All of which is the last thing any of us needs, since starting a family is always hard. Letting your relationship crumble is like deciding to have a mutiny while your ship is getting tossed in a storm. If you don’t pull together now, how do you know you’ll survive this? And even if you do survive, how do you get back to a place where everyone in your family can thrive and flourish?
Fortunately, there are many ways to fix this. Up until now, I have devoted my time to helping individuals and couples who have already found themselves in unfulfilling relationships and that’s still the majority of the work I do. More and more, though, I see the merit in frontloading some of that work, in helping couples anticipate what they will struggle with so that they are better able to turn toward each other rather than against each other. The more you can anticipate what might go wrong, the easier it will be to adjust things on the fly and reconnect. Even better than that, in my opinion, is that drawing this map is a wonderful way to develop deeper intimacy with your partner at a time when you’re really going to need them. The better you understand who they are, what their hopes and fears are, the closer you’ll feel to them. And, if you can summon the courage to let them in on what your hopes and fears are and trust that they’re going to be there for you? Having that kind of support and security can be life changing.
With that in mind, I’ve developed a simple exercise to help expectant or new parents begin to develop the skills they need to protect their relationship during early parenthood. This is obvious, but let’s start with the basics: before you go on any journey, you need a destination, right? Your destination isn’t just have a baby and figure out the rest as it comes. We all have expectations, hopes and fears about what early parenthood is going to look like. This is an opportunity to make those thoughts explicit and learn about what’s on your partner’s mind as well. It’s also okay if you don’t completely share the same vision. You may find that there are some things that need to be worked out or altered and you may find that some aspects complement each other. This exercise is about learning some of the terrain. Future posts will help you figure out what to do with what you’ve learned.
Step 1 - Getting started
- Discuss this with your partner ahead of time and set aside time to do this. I’d strongly recommend doing it at the same time since the conversation that can come out of this will be very valuable.
- Once you’re ready to do it, answer these questions on your own first and give yourself a moment to connect to what feels good and what makes you anxious without worrying about what your partner might be thinking.
- If you find that you’re feeling nervous or having a strong physical response when you answer certain questions (chest tight, heart races, finding yourself distracted), just notice that. Your reaction is telling you that this issue is especially important. Make a little note next to that question to remind yourself. When you feel ready, you’ll definitely want to talk about that with your partner or give yourself more time to think about why you had such a strong reaction.
- If you find yourself dreading the moment when this shifts from working on your own to becoming a conversation, that’s important to notice too. Do these kinds of talks inevitably lead to arguing or one of you feels misunderstood, criticized or dismissed? The best place to start is right there: talk about why it feels so hard to talk about this stuff! Something like, “Can we talk about something? I want to talk to you about some things, but I’m nervous that it won’t go well” is a good place to start.
Step 2 - The Questions
Below are 16 questions that can help you to focus your vision of life as a family. Take your time with them. I’ve broken them up into four sections based on shared themes, but you can approach them any way you want. You could take an hour and answer all of them and then make time later for a conversation or you could move through them section by section, answering a few and then discussing your answers. After each conversation, take a moment to reflect together: What was it like to do this? How were you feeling at the beginning? How do you feel now? Are there areas of agreement? Areas of disagreement? Remember, the two of you will continue to work on this together. This is just the beginning.
- What are you most looking forward to as you become a parent? List everything that comes to mind.
- What are you least looking forward to? Again, list everything that comes to mind.
- How do you like to take care of yourself now? How will having a baby impact your ability to do this? Think about this as expansively as possible - physically, mentally, spiritually and any other way that occurs to you.
- How does your partner like to take care of themselves? How will having a baby make it harder for them to take care of themselves?
- You may find yourself in a position of needing to ask for help - is that something that comes easily to you or is difficult? Are there certain people that you feel more or less comfortable asking? What about your partner?
- You might be asked to help even when your tank feels empty or low - do you imagine that will feel easy or hard to do? How does it feel to set limits when you can’t give any more? If you can, try and imagine what those limits would be?
- How do you imagine sharing household responsibilities going forward? What’s your vision of partnership around this?
- Think about your extended family - how do you imagine they’ll be involved in your life once your baby is born. What kinds of feelings come up for you when you think about it? How do you imagine your partner will feel about their involvement?
- Repeat the same exercise, this time thinking about your partner’s family.
- What kind of changes do you envision for your social life? For your partner’s?
- How might your career be impacted by having a baby? How might your partner’s career be impacted?
- What financial changes do you anticipate with having a baby? How do you feel about that?
- What do you appreciate about the way you were raised? Are there qualities or values that you want to have in your family?
- What did you disagree with about the way you were raised? Are there things you want to do differently?
- Many couples have much less time to spend together in the years after having a child. What aspects of your connection are most important to you? What will it be not to have time to cultivate them in the same way?
- Many couples experience different kinds of disruption to their sex lives, sometimes in ways that can’t anticipate. How do you imagine feeling if the quality or quantity (or both) of your sex declines? How comfortable are you talking about this with your partner?
Avi Klein is a psychotherapist, father of two and native New Yorker practicing in Union Square. Avi has been working with individuals and couples since 2009. He is trained in AEDP (Accelerated Experiential Dynamic Psychotherapy) and EFT (Emotionally Focused Therapy), two forms of therapy that emphasize the power of emotion, healing & transformation in relationships. He has a special interest in supporting new families and is currently working on a workshop to support new and expectant parents. Inquiries can be directed at firstname.lastname@example.org or at his website https://www.aviklein.com
Valentine’s Day 2017 went a little something like this (9 days past my due date):
I woke up and began my day just like normal -- I started to respond to work emails. However, by 9:30am my Braxton Hicks contractions were turning into something more regular. By 10am they were coming every 6 minutes and becoming more intense (I could no longer speak through contractions). By noon they were happening every 5 minutes and I was really focusing on trying to let my body move in a way that felt good (for me, leaning on a table and swaying my hips worked best). At 12:45, I got in the bath, on all fours, hugged a yoga ball with a towel under my knees while my husband, Mike, kept the shower head on my lower back...at 1pm most of my water broke (luckily in the tub). It was a little brown which meant that meconium was present so I knew I couldn't labor at home too much longer.
Mike had been in constant communication with Neelu and Jessica that morning; Neelu was now on her way up to our apartment. After my water broke the contractions became even more intense and were happening every 3 minutes. At this point, I seemed to be making low deep moaning sounds to get me through the contractions (the moans seemed to just happen instinctively). The moans helped me get in “the zone” (a place where you need to be mentally to take on each contraction). Once Neelu arrived at 2pm, we took a cab to Weill Cornell (my contractions were less than 3 minutes apart and about 1 minute long at this point). I had three contractions in the 10 blocks to the hospital -- we tipped our cabbie well. While waiting to get registered, the rest of my water broke...in the lobby.
I went straight to triage where the nurse placed fetal heart monitors on me for ~30 min. I was 3 cm dilated. It's at this point where the nurse in triage wanted to put an IV in me. We made sure to tell her that I was trying for a natural birth and wanted a heplock (a port in case they need to give you anything later) instead of a constant IV. The heplock is a way to allow yourself not to be connected to an IV machine. With the heplock, I knew I had to drink lots of water in between contractions. I had discussed getting a heplock with my OB/doctor beforehand; the triage nurse asked me if I had done this which reassured her to comply with my wish.
I was finally brought to my delivery room where I continued to labor with the help of Mike and Neelu. The nurse that I first had was really nice. We told her that I was trying to have a drug-free/ natural birth; she never asked about an epidural. (Side note: The only person to ask about an epidural was the cord blood representative who unsuccessfully tried to discuss cord blood donations to me.) To appease the nurse, I wore fetal heart monitors for at least 45 minutes before I could take them off for intermittent monitoring. I was still able to labor by standing up. I swayed a lot and pushed my head and weight into Mike's chest during each contraction -- he was so supportive, both physically and emotionally. Neelu was there to remind and coach me to relax into each contraction.
When the new nurse (who was equally as supportive as the first one) came in for her shift we asked if I could labor in the shower (this was Neelu’s suggestion and one that I think played an important part in my successful labor). Because the fetal heart monitors didn't show any distress with the baby and possibly because my doctor happened to be the one on call that night at the hospital, I was allowed to labor by standing/holding the rails in the shower for one hour. This was crucial because I wasn't hooked up to anything for a good chunk of time. While in the shower, active labor kicked in...this is when it feels like the baby is starting to descend. These contractions made my knees buckle. They were rough...but I was able to get through each one by breathing slowly and deeply, groaning through them, and moving how I wanted to. It was really about trying to force myself to relax and take control at the beginning of each contraction.
Eventually, I moved back to the bed. I was on all fours, the back of the bed was tilted up and I held onto the top of the mattress and pretty much buried my head into the mattress for each contraction over the next 2 hours. I’m pretty sure I frizzled the hair on the top of my head with all the friction. Neelu and Mike made sure to talk me through each contraction. I was getting to the point where I was instinctively starting to push. My body was shaking and I was experiencing the most intense surges of pain I have ever felt...but they were just surges. I tried to let my body go limp in between to regain some strength.
At 8:15pm my doctor came in, took a look and said, "ok, lay on your back I see the baby's head". At this point I was screaming in my head “OMG it's happening, it's happening!!”. With Mike holding one leg and Neelu holding the other, it took me three hard pushes to bear down but in 12 minutes my little Ian was born. After Mike cut the cord (we chose to have a delayed cord clamping), Ian was placed on my chest, the nurses rubbed him with a towel, he let out a cry and instinctively tried to breastfeed. I was given a shot of Pitocin to help push out the placenta which happened within a few minutes of giving birth.
One thing that happened, that in retrospect I wish hadn't happened, was that my doctor gave me Lidocaine shots in my perineum right before the baby came out. I ended up tearing a little and had to be stitched up, but I didn't feel it bc of the shots. I suppose it was nice to be a little numb but everything felt rushed and there was no pause between when his head emerged and when his shoulders came out (I believe the Dr typically applies a warm compress and lets you regroup before the shoulders come)...which is why I think I tore. I think my doctor was just trying to help but I wish I had been more aware of what was going on to have said “no” to the shots.
In any event, I had a healthy 8lb 2oz baby boy! The memories of labor pain and exhaustion were quickly thrown aside once Ian was in my arms and tried to nurse, just seconds after breathing his first breaths of air.
As far as pain over the next 1-1.5 weeks, I will definitely say my vagina hurt...and back. Every time I nursed, my uterus would contract which felt like intense period discomfort. Even sitting hurt a lot so I did a lot of side lying. I had lots of swelling and took a combination of Advil and Tylenol, ice packs, used numbing spray and occasionally used a topical lidocaine gel for the first few days (which I came home with from the hospital). It’s been two weeks and I feel much better. I haven’t taken Advil in a few days and the blood seems to have tapered off.
Naps are life savers.
Diastasis recti is the separation of your 6 pack abdominal muscles. It often occurs in pregnancy but can also occur in men from improper lifting and workout techniques. If the 6 pack abdominal muscles aren't able to expand as the baby grows, the small cartilage connecting the two sides can separate. It is measured in centimeters or fingers. It’s usually painless and can be fairly common occurring in ‘cross fit moms’. It’s why we don’t recommend crushes and sit ups in pregnancy. It’s also why we always recommend that you turn to one side and use your hands to help you sit up rather than lurching forward from laying back.
You can check if you have diastasis by laying down, lifting your head and shoulders to engage abs and feeling along the line of your 6 pack abs.
If you have a separation, wearing a belly band and doing the belly pull exercises can help reduce the separation. It’s important to do so because the separation weakens your core and can cause low back pain and hip pain but also potentially a malpositioned asynclitic baby that could make labor more challenging.
Separation is treated postpartum with targeted exercises to knit the abdominal muscles back together. Make sure to get the help of a specialized PT before you start your regular workout because you again want to make sure to avoid sit ups and crunches until the dialysis has healed.
The reason why pregnant people are asked only to lay on their left side is because of a condition that can occur called vena cava syndrome. Your vena cava, the vein that takes blood back to your heart is on the right side of your body and pressure from the uterus and baby when you’re laying back or on your right can sometimes constrict this vein causing breathlessness and nausea for you. Some people find it extremely uncomfortable to sleep on their back and others are okay. For the most part, being on your back or on the right side for a short amount of time is usually okay and fine to do.
Many people tell me they wake up in the middle of the night panicking that they’ve been on their back. If everything feels okay, you’re probably okay. Usually we wake up for a reason, it could be our body telling us to turn over or to go to the bathroom :) Listen and trust your body and your intuition and do what feels right for you.
For stomach sleepers, it’s not safe to lay flat on your stomach however, you can fashion your snoogle into a circle around your belly and lay on top of it. You can also use half inflated pool floats or a maternity raft under your belly. Place a pillow under your ankles to ease any strain on your legs and low back.