Birthing Loss

HOPE 

I found out during our first routine anatomy scan that our baby had very serious developmental issues.We were about 19 weeks into our pregnancy and already had begun to feel her kicking inside me by this point.  The maternal specialist used so many technical words, I could only gather at the time that our baby’s lung had not developed at all, the heart was pushed into a position it shouldn’t be in, something with her diaphragm, neural tube, cystic hygroma, a cleft palate… the list went on. I was told the baby will likely not make it and given the option of termination. I was strongly against invasive prenatal testing, but in that moment, I chose to have the amniocentesis performed. I needed to know with absolute certainty what was happening. 

We thought we had done everything right. My husband and I each took a genetic test for nearly 300 genetic conditions and I didn’t have a gene for any of the genetic conditions tested. My husband’s results were quite stellar as well. He only had one test positive. We felt pretty confident with our first attempt at pregnancy with those results. 

But chromosomal abnormalities can still happen regardless of genes. While we were waiting for the amniocentesis results to come back, my husband and I sought another maternal neonatal specialist for a second opinion on the anatomy scan. This time, the doctor revealed even more issues while confirming the results of the initial scan. 

Our hope for her survival diminished when the amniocentesis results confirmed that our baby had a very rare chromosomal abnormality in which all her cells were affected. She had non-mosaic tetrasomy 9p. According to the British based Rare Chromosome Disorder Support Group, this disorder in all cells either resulted in miscarriage or the baby survived only during the newborn period

Did I do something wrong? Did I eat too many sugary treats? I snuck in a couple bits of tuna tartar and took baths at home. Did I cause this demise with my lack of willpower to push off cravings? I asked every doctor the same questions, and the responses were unequivocally “no” without hesitation. What was happening with our baby’s development was beyond our control.

It took a couple weeks to find a supportive hospital team to conduct a follow-up anatomy scan and to receive the amniocentesis results from our genetic counselor, but it also provided deep understanding and validation for the next step we were about to embark on. Only after receiving multiple confirmations that our baby would not survive did I begin to feel termination would be a compassionate ending to the inevitably short time together with our baby. 

RESILIENCE 

When we first learned we were pregnant, we chose to have the most natural and safe birthing option available to us. This was our first pregnancy and we sought care with a midwifery group affiliated with a hospital known for its mommy-focused birthing unit. We joined Love Child a doula-owned and operated wellness group for expecting and new parents in the city and later, planned to hire a doula to support our birth. There is nothing more incredible about our capacity as human beings than the capacity to adapt to change. 

After being advised to terminate, I asked what my options were to end the pregnancy. It came down to two options: an induction or a surgical procedure called dilation and evacuation (D&E). We were constantly pressured by doctors, regardless of which practice, to consider D&E. It would be a short 30 minute out-patient procedure with very little risk to the mother. However, there would be no guarantee that the baby would be intact and therefore, we would not be able to see our baby after the procedure. 

Each time we were pressured to consider the surgery, I would spend the rest of the day crying. By this point, we had hired a referred bereavement doula, who had guided me to reflect on what is causing me to grieve whenever the possibility of D&E surfaced. What I realized was that procedure just didn’t align with my immense desire to hold my baby after the delivery. As it was, to even talk about ending my baby’s life while she was still kicking inside of me broke my heart. But once we committed to take D&E permanently off the table, I finally felt relief. 

That relief was short-lived when I found out, regardless of which procedure we chose, hospitals required all late-term terminations to first stop the baby’s heart before induction or surgical evacuation with an ultrasound-guided intracardiac Potassium Chloride injection (commonly just referred to by its chemical composition, KCl). It’s a procedure very much like an amniocentesis, where a long needle is inserted into the baby’s heart and injected with potassium chloride. I did not want it. Unfortunately, our midwifery group called to tell us they couldn’t find a clinic or hospital that would induce without the injection. They left me with one final contact to call and apologetically left us to find a hospital or clinic on our own. 

I found myself cold-calling a handful of hospitals and quickly realized most hospitals wouldn’t take patients for termination by induction even with the KCl injection. Only one hospital I called agreed to schedule us in for an induction with KCl. The process the staff described seemed so rushed, with KCl injection to be done immediately after the follow-up anatomy scan. I felt so pressured by the lack of hospitals available for induction that I agreed to be scheduled into their only available slot which would be in just a few days - only a week after our initial anatomy scan. I reached out to Love Child in distress. 

Thank goodness, with the help of Love Child, I was able to find a very compassionate hospital team who even had a specialized social worker on-site specifically for bereavement cases. We canceled our appointment with the previous hospital and agreed to move forward with this hospital at our pace. Either way, we would have to have the KCl injection done. Our procedure was set for February 12th 2020.

While finding a hospital to induce without the KCL injection seemed impossible, I do want to mention one hospital that did allow induction without KCl injection for pregnancies 19 weeks or less. Unfortunately, we were already near 21 weeks by this point. 

Adding pressure and challenges to our loss is that late-term abortions after 24 weeks are banned in New York. One hospital said given our condition we could go to 26 weeks. However it involved more paperwork from doctors to justify the termination legally, but it seemed like we were entering a grey area as we were also told after 24 weeks, the hospital was legally required to report the birth to the state for permanent record and we would receive both a birth and death certificate. We didn’t want any government involvement during our loss and chose to end the pregnancy before the 24th week. 

My investigative search also revealed that despite what is legally allowed by the state, hospitals and clinics have their own policies and protocols further limiting patients' choices.   

REMEMBERING LIFE  

Agreeing to end the pregnancy was by far the hardest decision I have ever made in my life. Before we began the termination process, there were a few items I knew I had to check off my intuitive list of must-do’s. My heart just demanded I take the time to prepare my spirit before moving forward, and I am so glad I did. These turned out to be very crucial steps for me to move forward with the procedure and later, grieve with compassion for myself, my lost baby and my husband. 

First, I needed to create memories with my baby with me and my husband together as a family. I knew myself well enough to know these pictures and videos would be something I not just wanted, but needed to help me during the grieving process. So we booked a weekend trip, visited the place where we got married, and just spent time as cheerfully as possible while our baby was still with us. We spoke to her everyday and made sure she knew she was loved deeply. First thing my husband would do when he woke up each day was lean over, kiss my baby bump and whisper “good morning” to our little one. Those memories are precious to me. 

The second thing was finding my peace with death and termination. With my baby still kicking about inside, this was painfully difficult. A challenge that left me in an ocean of tears. Despite knowing my baby wouldn’t survive, the K-Cl injection just felt like a deeply unnatural end to my baby’s life. From my religious upbringing and many years of Catholic school, once I found an ideology of life and death that brought me comfort and a sense of peace, I didn’t need to keep searching. 

In fact, I would discourage it because my bereavement doula offered me another perspective on the morning of my scheduled procedure, (with my consent), that led me to a temporary state of confusion. It didn’t help. 

The person who brought me my peace was my mother. It took me a couple weeks before I confessed my overwhelming emotion around this termination to my mother. I was trying to find my peace on life and death on my own. I played a Buddhist mantra on repeat for hours during my hardest times but after buying books, reading articles, I finally turned to my mother, a woman who has eagerly meditated for over three hours a day for nearly thirty years. She responded with such warmth, as I explained through my sobbing hiccups, that… this was our destiny. My baby’s destiny was to give me this experience, and it was my destiny to receive it. At that moment, my baby was my teacher. My mother also explained that life and death are in equal realms. Death does not mean my baby has gone to some horrible place. Her spirit would be free. She would exist within us all and could choose to come back in a new form... a better form. My mother’s words comforted me. Suddenly, this became an opportunity to release my baby from a body that would inevitably fail her upon leaving my womb. 

In the five months we’ve been together, my baby allowed me to discover my potential as a parent. My desire to hold onto my baby when my baby wanted to go was a lesson I breathed in deeply. It reminds me of a poem written by Kahlil Gibran in his book The Prophet, a book everyone should own in my opinion. She was my baby, but she was her own person as well. 

“Your children are not your children.

They are the sons and daughters of Life’s longing for itself.

They come through you but not from you,

And though they are with you

yet they belong not to you.

You may give them your love but not your thoughts,

For they have their own thoughts.

You may house their bodies but not their souls,

For their souls dwell in the house of tomorrow,

which you cannot visit, not even in your dreams.

You may strive to be like them, but seek not to make them like you.

For life goes not backward nor tarries with yesterday.

You are the bow from which your children as living arrows are sent forth.

The archer sees the mark upon the path of the infinite,

and He bends you with His might that His arrows may go swift and far.

Let your bending in the archer’s hand be for gladness;

For even as He loves the arrow that flies, so He loves also the bow that is stable.”

—Kahlil Gibran, “On Childrenfrom The Prophet

 

While I learned much about the birthing process and the challenges mothers face while pregnant, what I didn’t expect to learn is not to assume every pregnancy would result in a live birth and to hold space for that possibility with encounters with pregnant couples. During this time I also realized I was attached to a politicized idea that termination was murder. I let it all go. This experience was just between me and my baby, and the peace I felt after letting my mother’s words sink into me was almost immediate. Now I was ready. 

HONORING DEATH 

I once read an article about a mother orca whale who swam with her dead calf for over two weeks before finally letting the carcass sink into the ocean. The weeks before for the procedure, I kept thinking of other mothers, both human and animal, who struggled to let go of their fallen baby, especially during the initial stages of mourning. My doula had sent me a beautiful story of one mother who delivered her stillborn lovingly at home with a midwife and buried her baby in the woods. A place she could visit when she wanted or needed. 

Regulations in NYC, where we lived, prevents parents from taking their stillborns or dead babies for private burials. The lost baby can only be transferred out of the hospital by a licensed funeral home for permitted burial in a cemetery or for cremation in which sprinkling of ashes is also regulated. Both private options are very costly cremation options a little less.

After speaking with several funeral homes about cremation, we learned that it is not guaranteed to be returned ash when a baby is so small. One funeral director kindly explained that babies and young children are mostly still soft tissue and ash is produced from the carbon of hard tissue. We’ve all heard growing up that the human body is mostly water, H2O molecules. It turns out children are more so than adults, which means even less carbon molecules. We finally understood the challenges of getting ashes from a fetal baby less than 23 weeks. I found this resource about the science behind cremation helpful.

My husband and I didn’t want to risk being disappointed with an empty box returned to us weeks afterwards so we reluctantly agreed to have our baby cremated through the standard hospital procedure offered as a free service. In the end, our baby would not come home with us and I still needed something for myself from my baby to physically hold onto while I mourned her. With the support of hospital staff and friends, we created a few momentos and activities to allow us to remember our baby after the loss. 

We ordered two foot molding ornament kits online. These are now objects I really treasure. I made several in case one broke, and to touch the grooves of my baby’s paws, brings me such immense comfort still today. I honestly wish I was a little more creative with it and made foot prints like she walked across the molding. 

We were so fortunate to have a hospital with a dedicated staff for bereavement. We went through a list of questions with the hospital staff: How long could we spend with our baby after the delivery? Do they offer a CuddleCot, a refrigerated bed that helps preserve the baby’s body after birth? This was specifically created for parents to grieve with their stillborn or lost baby after delivery. Can we have both our bereavement doula and husband with us during the delivery and recovery? Can we use an electric heating pad? Can we have her umbilical cord to take home? We also asked many of the typical questions asked for regular deliveries. Can we have music and therapeutic aromas? Can we bring birthing tools? 

With the support of a local organization called Forget Me Not Foundation based in New Jersey, we were gifted at the hospital a kit with a beautiful angelic outfit that was handmade out of old wedding dresses for our tiny fetal baby, a beautiful 5” x 7” card with an ink pad to stamp her paws onto, a sympathy card signed by the entire hospital staff, and a pamphlet about the organization and support groups we may want to join later. The amount of love in this kit was extremely touching, and have since donated to them to continue their support for families who find themselves in similar positions as us. 

Our bereavement doula and friends also shared some ideas that we decided against but they included making a necklace pendant with our baby’s footprint, creating an email address with our baby’s name, and writing poetry/prayer to read our baby. 

Honoring our baby’s death is a process that has no known end date. Our emotions are unpredictable and we will never know when the need arises to hold space for grief. I believe my husband and I had the best farewell possible given our options and circumstances with incredibly loving support from bereavement professionals as well as family and friends, yet months later, I found myself becoming unexpectedly emotional after receiving kindly intentioned “Happy Mothers Day” messages from friends and family. My husband and I decided to plant a tree with our baby’s umbilical cord that day. Then learning about K-Cl injection, I found myself yet again with newfound guilt, anger and sorrow. A friend, who also experienced miscarriage earlier this year, guided me into speaking directly to the spirit of my baby through a self-made ritual where I wrote her an apologetic letter and read it where we buried her umbilical cord before burning the letter in a moment of silence. Activism by writing this article and reaching out to my local congressional representative to spread awareness about the obstacles we face has also helped me grieve. There is no right or wrong way to grieve, but I know with absolute certainty that it is a process, and we all need to channel it without judgment and criticism. 

T - 1 DAY 

I remember being told each time before the day of a big test or competition to get good rest the night before. To eat well and come feeling ready. During our call the night before the scheduled procedure and induction, we got the same reminder from our bereavement doula, but we had so much to prepare still before leaving for the hospital, we wouldn’t go to sleep until about 2am. 

What people forget is that getting induced is exactly the same as every other birth. We still needed a hospital bag with a change of clothes, toiletries and basic necessities for the unknown length of time we would be at the hospital. We also needed to arrange care for our pets while we were at the hospital. 

A few months prior, we had booked this week for a romantic Valentine’s getaway in the Florida Keys, so it was a bit amusing to find ourselves packing for a different kind of trip. A true example of how life can be so unpredictable. 

We packed our inflatable CUB birthing stool, which I will say we didn’t use at all because of all the tubes I was hooked up to. It became more useful as part of a makeshift bed for our bereavement doula. 

The jar of pure unrefined shea butter was used for everything from moisturizing my body, my chapped lips, my hair… my bereavement doula was noticeably surprised by how nourished I looked on the hospital bed, which made me somewhat proud of myself. 

My husband packed a bluetooth speaker for us to play music and mantras on with a pre-downloaded playlist ready to go on his phone. Earplugs were not a bad idea either since the equipment is constantly beeping and people coming in and out around the clock. 

We packed my favorite air cleansing spray, Cloud of Protection, by a small shop in northern California called ByNieves. This really helped minimize the incredibly strong smell of disinfectant that permeated throughout the hospital floor and room. 

Throughout my entire time at the hospital, I wore a red jasper, turquoise stone necklace that a friend gifted me during my first trimester that brought me good vibes and her loving energy. Frankly speaking, I dressed up in a delivery-appropriate way that made me feel amazing. This was the day my baby was moving onto her next debut. I wanted to send her off feeling and looking my best. I loved that the nurses noticed and lauded my efforts. 

Our bereavement doula also brought along some incredible game-changing tools. Her long orange shawl to drape over the harsh fluorescent hospital light created such a calming aura in our labor room. She was so kind to offer her hot water body warmer that played a huge role in regulating my body temperature. The hospital room was cold and despite having multiple blankets, we were all cold throughout the night. February is the coldest month of the year in New York City, so I really appreciated the heat source. 

The ambiance in our hospital room was so on point, even the nurses commented on how nice it was to come into the room. It couldn’t hurt to have the staff appreciate the aura of our room, but it was really all for her, Lily Brassica. 

THE DAY

It was 9am when we met with our doula in front of the clinic. The way this would happen was, we would first go to the maternal neonatal clinic for the K-Cl procedure, have lunch in the area, then walk across the street to the affiliated hospital’s labor and delivery unit. 

We had our suitcase of necessities and a rolling cooler filled with hydrating liquids, such as coconut water and miso broth, and a plethora of snacks for my husband and doula to munch on. 

We brought it all up to the clinic and waited in the waiting room for the K-Cl procedure, which was supposed to be short and simple. The doctors assured me it would be very much like an amniocentesis. How wrong they were. 

When we were called into the exam room, we dropped off all over belongings in one corner. My doula gave me a scented bangle to wear around my wrist and a small oval stone that fit perfectly in my palm to hold. I figured it would be a good distraction to play with in my right hand at best. How wrong I was. 

Just as I had revealed my abdominal area in the exam room for the amniocentesis, my tummy exposed. The doctors rubbed a layer of reddish-colored sterile gel on my tummy to begin the procedure. I requested the live screening to be turned off. My husband sat right next to me holding my left hand and the only thing I was interested in looking at was him. His presence brought me such immense comfort. We tried to stay spirited and positive to stifle the growing fear for the procedure that was about to take place. 

Although I read several articles of women who have gone through K-Cl before termination, I had not read of one where a women was conscious throughout the procedure. I didn’t think anything of the fact that I was never given an option to be put to sleep, but today I wish I was. 

A little after 11am, the procedure began. There was a tech at the ultrasound screen and two doctors working together to locate Lily’s heart via ultrasound to insert the needle into her heart. Lily was known to be an active one during ultrasounds. Perhaps that was the reason I stayed on that exam table longer than I anticipated. As the doctors swirled the needle about in my uterus, my husband and I continued to look into each other’s eyes and talked about how good Lily was. We continued saying how much we loved her and that she was a strong baby, who was going to move on to a better place. 

Suddenly, I felt incredibly burning spreading throughout my uterus. It was immense raging pain that continued to spread. The pain was so shocking to my body that I nearly lost consciousness. From this point on, I rely on my husband to share what he witnessed. 

My husband said I closed my eyes and began squirming “it’s burning” over and over again. My breathing changed. He said it seemed like I stopped breathing all together and then turned into quick shallow breaths. When my eyes opened again, he said my eyes looked back at him with a form of emptiness that scared him. My palms were really sweaty, yet my head and skin became cold. 

I remember, in that moment, the intensity at which I looked at my husband’s eyes the moment I finally thought I was going to die. I needed to see his eyes, but he couldn’t look at me anymore. He closed his eyes. I begged him to look at me and tell me a story. So, with all his strength, he continued to look into my eyes and tell me about the happy place our baby was going. 

A few months after this procedure, I sat with my neighbors who also struggled with fertility issues enjoying the warm springtime weather and exchanging stories of our loss in their back patio. It was then that I learned that K-Cl injection is the final chemical injected to complete a three step procedure for legal executions in the U.S. After reading about the how each drug of the lethal execution works on the condemned person, I was in horror to relate my experience in the exam room as a pregnant mother to the descriptions of the final potassium chloride injection used for lethal injection. 

 In Ben Bryant’s BBC article, Life and Death Row: How the lethal injection kills, he describes the final injection of K-Cl as such: 

“To stop the heart, potassium chloride is administered directly after the vecuronium bromide. Without proper sedation, this stage would be extremely painful. The feeling has been likened to 'liquid fire' entering veins and snaking towards the heart. If the inmate is not fully paralysed, their muscles will also spasm uncontrollably, causing them to buck on the gurney, according to Dr Morley. This is because potassium sends signals to every muscle in the body to contract. When the potassium reaches the inmate’s heart, it disrupts the delicate balance of sodium and potassium ions that keep the heart beating. The inmate’s heart would begin beating irregularly - and then stop.”

Back in the exam room, as the potassium chloride had begun spreading outside my womb, my doula found herself at the foot of my exam table. My legs were thrashing about as my body was responding to the K-Cl. She held onto each of my feet, squeezing my toes for added pressure. This did help, but nothing could have prepared my body for the shock this injection caused. The thoughts racing through my head narrowed to one question: What kind of torturous end did my baby just go through?? 

When the procedure ended and pain dissipated, I looked down at the stone in my right hand. It was completely drenched in sweat. My husband’s hand was crushed by the involuntary clenching of my fists. I felt like I survived death, and perhaps I did. While the medical community continues to share confidence in this procedure as safe and effective at stopping a fetal heartbeat for pregnant mothers, studies around the safety of K-Cl are continuing to be conducted. One reported case of Maternal cardiac arrest associated with attempted fetal injection of potassium chloride in the International Journal of Obstetrics Anesthesia in 2004 is enough for me to believe we should offer more options to women, especially those who can naturally deliver fetal babies unable to survive outside of the womb. 

The technician on-site said she was scared that “we were going to lose you” and that my face turned pale white during the procedure. Well, I thought I was going to lose me too. When I asked the doctors what that burning pain was all about, they said it was just me. That I basically hyped myself up. They didn’t offer any further explanation. All I knew was this procedure was nothing like an amniocentesis. Their response was incredulous but I didn’t pursue it either. Regardless of what slip-ups may have occurred, these weren’t malicious doctors. Ending a baby’s life can’t be the dream job these doctors pursued when entering the obstetrician field. They were women who were obligated to conduct this procedure on fellow women because the greater system evolving around the hospital policies and government regulations mandated it. This procedure served none of us in the exam room. 

To this day, it is the most traumatic memory and experience of my life. Keep in mind, this procedure was required before any termination route available to us: induction or dilation & evacuation, it didn’t matter. K-Cl was a required prerequisite to termination. And I don’t understand how we as a society could force this procedure on people already fated to have stillborn births. We should be given alternatives to deliver without stopping our babies’ heartbeat when the chances of survival after delivery are already extremely low. We should be provided more information about possible side effects, options to be put to sleep, long term impacts of this procedure, before being obligated to an invasive procedure like this. I wanted my baby to have a peaceful departure and I feel like I failed her by agreeing to this unnecessary procedure.

After exploring K-Cl injection more deeply, I have also learned the highest rate of botched executions in the U.S. resulted from legal injections. The stories compiled of the botched executions by lethal injection by Prof. Michael L. Radelet on Death Penalty Information Center confirm this form of execution is absolutely inhumane and cruel, and having experienced this “liquid fire” personally, I simply cannot support the use of this chemical on women, their fetal babies, or condemned inmates on death row with or without more conclusive studies.

About an hour after the procedure began, we left the clinic. My world felt different as I stepped out of the building. My face was red and eyes swollen from the post-procedure trauma sobbing. My husband held me in his arms and continued to reassure me that we did the right thing as we walked. It was a moment we both needed to believe in ourselves. 

INDUCTION

After our last pre-delivery meal, we returned to the clinic to pick up our belongings and walk across the street to the hospital to begin the delivery process. Thanks to our bereavement doula who took quick notes throughout, we can share more details on what medications we were given during this induction. 

By 3pm, we crammed into our labor room and a nurse immediately prepared my arm for IV fluids. She presented us with a pile of paperwork that needed to be signed before the induction began. We were then visited by the residents on call, the bereavement social worker with the lovely bereavement kit, the attending nurses… we had many new faces coming in and out of the room, and before I knew it, I had tubes coming out of me in every direction like some kind of Matrix cyborg. 

The first medication I was given was Mifeprex to help detach the sac from the uterine wall. We were informed that we would be induced using a vaginal insertion of Cytotec at 400mg every 4 hours. (Incidentally Cytotec is not approved by the FDA for inductions) To keep with our circadian rhythm, I asked we begin the induction in the evening so we could all sleep as decently as possible through the night and aim for delivery in the morning. The first round of Cytotec was administered at about 6:30pm. Contractions started about an hour later. 

My intention was to avoid chemical painkillers, but after the traumatic experience with K-Cl, I couldn’t tolerate any more physical pain. By 7:45pm, I opted for epidural. The anesthesiologists arrived at 9:30pm and inserted the epidural needle. 

Shortly afterwards, I came down with a fever of 102F. At 11pm, the doctors decided to place a catheter in me. By this point I had an IV needle in one arm, a blood pressure monitor around the other, a contraction monitor around my waist, an epidural tube in my back, and a catheter out from my urinary meatus. It was impossible to move in any direction in this state. Thank goodness, the only thing left to do now was sleep. 

At 4:20am, the nurse came by to check my temperature. It was this 102F. I was now given broad-spectrum antibiotics: 2g of ampicillin and 320mg of gentamicin with Tylenol. 

After my fourth dose of Cytotec at about 5:30am, we were able to squeeze in our last few hours of sleep before the morning shift arrived. I also snuck in several large bites of a tuna sandwich my husband had bought the night before and kept in the cooler. It was very satisfying, especially after seeing the “breakfast” served in the hospital included zero-nutrient sugary foods I wouldn’t eat even on my most rebellious sweet-craving days. 

The replacement crew introduced themselves shortly after 9am. They were all very kind with wonderful dispositions. The doctors decided to switch from Cytotec to Pitocin and foley balloon at 9:25am. I was provided compression socks before receiving my second hit of Pit at 10:30am. 

BIRTH

Just after 3pm on February 13th, Lily Brassica was born. With loving humor, I say she was a face only a mother could love. She had the cutest cleft lip, little button nose and eyes shaped just like her mommy. She was cleaned and dressed angelically in the handmade outfit from the bereavement kit by the nurses before being presented to me. It was wonderful. 

My doula, who witnessed the birthing, cleaning and dressing in the back room with the nurses, came back unusually excited to share that Lily had been born fully encased in her amniotic sac. Apparently a very rare event that only a few birthing professionals get to witness in their lifetime. She shared that this kind of birthing was considered good luck and holy leaders, like the Dalai Lama, were known to be among those born en caul. That put a smile on my face. 

At 1lb 3 ozs, her body was a precious size. We were so excited to hold her and spend time with her. We had planned to spend several hours with her. We prepared our footprint kits and bonding activities. What we didn’t plan for was the side effects of the pain medications. Only later did I learn that opioids are most commonly used for epidural analgesia in form of fentanyl, hydromorphone, or morphine.

Given how little we know about the impacts of opioid-based epidurals on women and their newborn babies, I am baffled by its widespread use and find myself wondering again, why wasn’t I informed of this drugs’ contents and side effects before use? Although I asked for very low doses of anesthesia, my body couldn’t handle the strength of the medications. Out of nowhere, I found myself holding back vomit again and again. With Lily still in my arms, my doula rushed a plastic bed pan below me just in time for the beginning of a series of regurgitations that smelled of tuna fish. It was only a matter of time before the nurses would find out I had taken bites of solid food against hospital protocols to starve laboring mothers. 

Now with the vomiting, I also started going in and out of consciousness with Lily still in my arms. All this effort to finally meet my baby had come to a swift end because my drugged body failed to support my planned intentions. I handed my precious Lily over to my doula who took the baby outside to the nurses. The work of our bereavement doula had also come to an end, and after we said our goodbyes, I fell into a deep sleep. 

VALENTINES DAY

The following morning, we received a visit from the bereavement social worker. She wanted to know how everything went. If we got to do all our planned activities with the baby and such. In no time, I was in tears expressing disappointment in myself for my inability to stay conscious after her delivery. After all this effort, I missed the opportunity to spend the time I wanted with her. Without hesitation, the social worker prepared to make arrangements for us to see Lily again. If clouds could part and rays of sunshine stream down on demand, this was the moment. This woman instantly became my greatest hero. 

This social worker ruled this hospital staff with authority I have never seen, and I liked it. She seemed to have connections with everyone throughout the various departments of the hospital. She was able to influence doctors, nurses, staff at the morgue, etc to accommodate us with care that only confirmed my belief that we chose the right hospital. When she was around, I felt the difference. We were protected by her advocacy. Without her, we were just another patient. A belief we were able to confirm later. 

I spent the entire morning getting ready. I was able to get unhooked from the equipment temporarily and wash up for the first time since arriving at the hospital. I wanted to look my best for our second meeting with Lily. A doctor came down and let us know we met her in a room near the morgue. They just needed to prepare a room before they took us down to the morgue. 

A few hours passed since the doctor had visited us, and it was nearing the end of business normal hours, so we called our social worker to inquire about the delay. The delay was that we were forgotten. Our social worker made a few calls and apologized to us profusely. Shortly afterwards, a different doctor came down and said the same thing the first doctor did. She, however, did return with a wheelchair and brought us downstairs to a conference room with Lily waiting for us inside. 

She was dressed in a different cute outfit. Her body was more stiff and cold, but she was still my Lily. We spent several hours creating various foot moldings, telling her stories, taking photos, giving her kisses and holding her tiny hands. This was perhaps the best Valentine’s gift a mourning mother and father could have ever received, time with their beloved angel. Happy Valentines Day, my love. 

RETAINED PLACENTA 

We were discharged from the hospital on Sunday morning. It was a relief to have the IV needle out of my arm and to be finally off the antibiotics. I still had to wear large diapers, but within days, my body seemed to recover quickly from the vaginal delivery. There was no perineal tear during the delivery. Nor were there issues with breast milk formation, clogged milk ducts or breast pain. We were getting incredibly nourishing food prepared specifically for postpartum recovery from a Taiwanese kitchen called Chen Mommy Kitchen in Flushing, New York. They delivered to us breakfast, lunch and dinner with two herbal desserts each morning. I was walking about a mile around the neighborhood each day and everything seemed great until Friday night. 

We were back in the emergency room on Friday night when I began bleeding red blood and experiencing extreme cramping pain. It felt like I was going into labor again. It turns out I was. No one told us to watch out for retained placenta. Shouldn’t we have been given a heads up that the likelihood for retained placenta increases for women over 30, who induce their baby pre-maturely or have stillborn birth? I fit the criteria for all three. 

By Saturday afternoon, we were able to get confirmation from the ultrasound results that we had retained placenta and it was getting infected. Ultimately, we had to get dilation and curettage (D&C) surgery to scrape clean the uterus and go back on antibiotics to fight the infection. Since I had just eaten, we had to wait for the food to digest. We were scheduled to go into surgery in 8 hours, 9pm. 

When time came, I was wheeled into a room with about 10 specialists standing around a table with a bright light centering in on it. Lying on that table was quite intimidating, but my doctor comforted me as I was put to sleep. An hour later, surgery was over. When I woke up, the doctor wheeled me back to my room and explained I had lost a lot of blood during the surgery. She said, to her surprise, she found my cervix still open at the start of the operation, which means she didn’t need to administer a cervix opener. Maybe that would’ve been the appropriate time to ask why I was checked out of the hospital at all while my cervix was still open, but I just was so darn content I didn’t die yet again, the question must have skipped my mind. Doc said my uterus was floppy. I didn’t know a uterus could be described as floppy. Online search results for floppy uterus came back as uterine prolapse. Another condition to explore. We stayed at the hospital Saturday and left for home just before midnight the next day with a prescription for 2 weeks worth of oral antibiotics. 

This time, the recovery was brutal. It was what I imagined postpartum recovery to be. It took me a month to regain my strength and walk comfortably again, but finally everything was behind us and with COVID-19 stay-at-home orders in effect, my husband and I were able to recover together. 

MOVING FORWARD

These days, we struggle to protect even the most basic reproductive rights in this country. Even in the state of New York, a rather progressive state on reproductive rights, we are limited. The Reproductive Health Act that was proudly passed in January of 2019 expands women’s rights to termination at any time of pregnancy if her health is at risk. It also authorizes physician assistants, nurse practitioners, and licensed midwives to provide abortion care to patients, but we are still without palliative and end-of-life care for newborns and infants. We still have to stop our baby’s heartbeat by K-Cl injection and if the baby survives, doctors must place the baby on life-saving measures prolonging the suffering to the baby and witnessing parents. 

I am incredibly grateful to the National Association of Neonatal Nurses (NANN) for voicing their support for this thoughtful care. In their first two recommendations, they identify everything I’ve wished for during this loss. They recognized what was missing for families facing miscarriage or stillborn delivery. What’s frustrating is, despite this position statement being released in February of 2015, grieving parents are still without options in 2020. What’s the hold up? 

My newfound aspiration is for all hospital administrators, political representatives, medical practitioners in the birthing field, and parents take the time to read the recommendations in NANN’s position statement. The first two reads: 

“1. Palliative care should be offered at any period in which the infant’s life may be limited—prenatally, at the time of birth, and after the birth—and in any location, including in the labor and delivery suite, in the NICU, and at home following discharge. 

2. When a prenatal diagnosis is made, palliative care should be offered prior to delivery. Families should be supported in decision making for a pregnancy termination, an early induction of labor, or continuing the pregnancy with a live birth, and supportive palliative care should be provided for any live births (Wool, 2013).” 

This level of patient care is still lacking throughout this country. We loved our unborn baby. An abortion clinic as an outpatient was not what we wanted. Dilation and curettage was out of the question. We wanted to hold our baby and spend time with her after the delivery. We wanted to induce and deliver our baby without stopping her heartbeat. It would have been a gift, in fact, if we could have spent time with her alive even if it was for a few seconds. This was not a choice we had. 

Some may also argue that providers know better and the patient should just follow orders. But with 30 maternal deaths per 100,000 live births, the US has the worst maternal mortality rate compared to the rest of the developed world, according to the Institute for Health Metrics and Evaluation database. While standardization of medical procedures to prevent maternal mortality can be life-saving measures, the US does not have national guidelines to protect maternal health. Because hospital administrators in this country create their own set of institutional guidelines, there is no consistency with patient care and patients are limited to providers covered by their health insurance plan. Treatment and quality of care vary based on accessibility and wealth. In this country, we have to fight for the dignity we deserve. 

Based on my personal experience and conversations with other bereaved parents, I believe providers’ current systematic approach to late termination contributes to postpartum trauma and depression. Late-term loss of a wanted pregnancy is often very hard for parents. Preventing parents from accessing dignified termination practices and mandating women to receive intracardiac potassium chloride injection before the termination procedure easily adds to the pain and trauma. In a 2016 study published in the Journal of Women’s Health, researchers in Michigan surveyed 377 bereaved mothers and found they were 4 times more likely to experience depression and 7 times more likely to experience a form of post-traumatic stress disorder than the women who delivered healthy babies.

Bereaved parents should be given options to terminate their fetal baby with dignity and love, and dignified termination will look different for each parent. So long as humans are spiritual and emotional beings, we will never appreciate a ‘one-size fits all” approach to issues revolving around life and death. 

I didn’t think anything of my fetal baby’s reddened body and her clenched fists at the time of delivery. It was odd but I assumed it was normal. I had never seen a newborn before to compare. Some time after the delivery, I remember my doula asking me how I felt when I saw how red her body was. I didn’t understand the purpose of her question until I read about the potassium chloride injection used in capital punishment. Now that I look back, the memory of her body is a painful one that needs healing. I continue to do rituals asking my baby for forgiveness. A part of me feels that I failed as a mother to protect her from unnecessary harm. I don’t know how long it will take to release my sorrow, grief and guilt, but I do know this could be avoided for other parents if we begin incorporating palliative and end-of-life care options in hospitals and birthing centers as mentioned by the National Association of Neonatal Nurses. 

As I am writing this article in support of better care for families facing miscarriage or stillborn births, we must acknowledge the unbelievable attacks against bereaving parents as well. There are a number of innocent women throughout this country, who have been charged with murder for their miscarriage or stillborn birth, and are currently behind bars. Imagine, with the way the laws are now, if I had gone ahead and induced my pregnancy without stopping my baby’s heartbeat? I, and the licensed medical practitioner who assisted me in the delivery, may very likely be in jail as well. But is it a crime to want to spend time with my baby before she died on her own? It is an outrageous abuse of power against women. 

I am thankful for organizations like the National Advocates for Pregnant Women and Center for Reproductive Rights for actively fighting for our dignity as grieving parents, but I hope every person who comes across this article can continue to spread awareness of the challenges we face as a society and reach out to political representatives to create legislation in favor of women’s reproductive rights. When I really think about reproductive rights today, it seems like we’re not asking for anything more than basic human rights. If we believe this country to be the centerstage of human rights and civil liberties, we can do better. 

Resources to support the Black Lives Matter Movement

Events: 

Articles:


Books: (I typically borrow e-books from NYPL)

Support, Follow and Donate

Independent News

TED Talks

Call Elected reps & Sign Petitions: 

  • Recognize the importance of reparations for slavery in the fight for racial justice, and take action by urging your U.S. House Representative to support a commission to study and develop reparation proposals for African Americans. Read more about the H.R. 40 bill here.

  • See where your state is at on taking action to prevent police violence here—plus, you can find your representative and see how they’re voting on the subject.

  • Send a message to congress to protect Black voters here, and follow the prompts here to find out who to call and what to say in order to support protections for Black-owned businesses.

  •  Find your local, county, state, and/or federal representatives and call or email to support criminal justice reform, allocation of taxpayer funds towards community services, and call for civilian oversight of police.

  • Sign the BLM Petitions

Gentrification:

Corporate Boycotts: companies that have donated to the current President of the US’s campaign

  • Amazon & Whole Foods

  • Instacart

  • Uber & Lyft

  • Facebook & Instagram

  • Bed Bath and Beyond

  • Forbes

Kids:

Re-Opening Guidelines

Love Child is open for Acupuncture and Pelvic Floor Therapy appointments.

All practitioners and clients must agree to abide by the guidelines below.

  • Only one client and practitioner in the studio at a time.

  • Appointments will be booked every 75 minutes so there is no overlap or waiting.

  • Clients must book appointments, fill out intake forms and complete payment online.

  • All clients and practitioners must wear a mask at all times. (Unless a facedown treatment is being performed, in which case the headrest will be changed after each client)

  • All clients and practitioners must practice social distancing at all times. (Unless the treatment requires physical contact)

  • All clients and practitioners must follow strict hand-washing and sanitation.

  • As soon as practitioners and clients enter, they must put all their belongings (shoes as well) in a dedicated bin and head straight to the treatment room. Bins will be disinfected after each use.

  • Please refrain from touching railings, doors and walls unless necessary.

  • Please do not bring or leave coffee cups, water bottles or food containers. Think of this as a leave no trace appointment and space. All trash, tissues (as well) must be taken outside with you.

  • Linens will be changed out after each appointment.

  • All surfaces including the massage tables, pillows, chairs, door handles and bathroom will be disinfected after each appointment.

  • Hand soap and disposable paper towels will be provided.

LIVE STREAM CLASSES FAQ

How do I sign up?

Sign up on MINDBODY just like you would for in person classes. Just make sure to select the online streaming class. Please sign up at least a half hour before the start of class. Please note that if you do not sign up , you will not receive an email invite to the live-stream.


How do I log in?

We will email you a link to join class 15 mins before the start of class. We are using the Zoom video service which has an app and is easy to use on phones, tablets and laptops. 

What are some of the technical details I should know?

  • We have found that logging in from your laptop gives you better audio and video quality than a phone or iPad.

  • When you call in, you will dial into the audio, you can choose internet audio or if you are calling from a phone, dial in.

  • Your audio will connect but your video will not. If you would like to join via video, please turn your video on. During class, you have the option to mute your microphone as well as your video, if you would like.

  • You can leave the meeting and join back in as you would like.

  • Double tap the screen to pin the Love Child camera (so that the video doesn’t circle from participant to participant) for a yoga class. If you would like to see everyone like in a kids class, select the participation screen so that you can see a grid view.

  • Holly or Neelu will be administrating all classes so you’ll see us online as well, just like the studio!

  • Please let us know how the live stream worked for you, we are very receptive to feedback and want to continue to make improvements!


Are all classes available to stream?

Yes! All of them! We also have individual consults that you can use to sign up for doula, breastfeeding and baby wearing consults.

What do I need for class?

  • Prenatal Yoga: A yoga mat, two blocks and a bolster. Speaker to play music. You can choose a playlist here. If you don’t have blocks, if you can stack your books to a height, on either side of your mat, that will work for you to be able to step forward and back that would be great! You can sit up or lay on your side for the beginning during the breathing and use a pillow or couch cushion instead of a bolster for forward folds, pigeon or ankle to knee. If you don’t have two blocks you can use books, paper towel rolls, tupperware, anything that is about 8” in height. Please join a few minutes before class so we can check to see if you have any aches/pains/ issues and to see how you’re doing. After class ends, please stay for a few minutes to let us know how the class was and say goodbye just like we would at the studio!

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  • Postnatal Yoga & Postnatal Strength: Yoga Mat & Blocks. If you don’t have blocks, use books or see above for alternatives. Speaker to play music. You can choose a playlist here.

  • Baby & Me Yoga: Yoga Mat (you can join with or without baby!). Speaker to play music. You can choose a playlist here.

  • Itty Bitty Baby Yoga with Sarah Grace: Ball, Mirror, Scarves, Massage oil/lotion, Yoga ball for tummy time, Swaddle, Bubbles You  can play any music but our playlist is located here.

  • Singalong with Alex: Scarves, Egg Shakers & Instruments. (You can use scarves and t-shirts you already have at home, and make a DIY shaker by putting beans / lentils / orzo into a container, and a DIY Guitar by using rubberbands over a tissue box or toilet paper roll.)

  • Toddler Movement & Acrotots with Melissa: Balls, Scarves & Bubbles. Speaker to play music. You can find the playlist here.

  • Jazz Baby & Music Mood with Mariella: Scarves, Shakers, Animal Soft Toy Friends & Bubbles.

  • Kids & Toddler Yoga with Neelu & Tayma: Yoga mat, Scarves (optional), Blanket, Lavender Lotion / Essential Oil, Meditation Bowl or Bell. (You can also use a metal bowl and spoon.)

  • Aventura Musica & Pequeñas Estrellas with Music Mood: Scarves, Shakers & Bubbles.

  • Oui Bébé Sensory Art with Neelu & Holly: Crayola washable finger paint (available at Stevdan Stationers on west 12th & 7th ave). (You can also use colorful purèed food like sweet potatoes, carrots, blueberries, oranges, raspberries, peas, broccoli, spinach; or colorful yogurt.) A flat surface that can be easily cleaned like a high chair or foam pads. Welcome to messy baby-led weaning :)

  • Baby Boogie with Sarah Grace: Scarves. You can find the playlist here.

  • Sensory World with Melissa: Art Supplies like Paper, Crayons, Markers, Playdough, Paper or Paper Plates & Stickers.

Is it ok to login when I’m in my pajamas?

Yes! And if you prefer, you can mute your video and audio. When you log in, your video will automatically be muted, please turn it on to join us.

How do I make my home conducive to a peaceful yoga class and safe for a kids class?

  • For yoga classes, we recommend finding a low traffic spot in your room, setting up your space, putting on music on a speaker, and communicating to everyone in your house to not disturb you for the hour. Set up your device so you can see the screen, but a little but out of the way so it's not directly in your face. The audio is more important than the video!

  • For kids classes, we recommend using their familiar play area, preferably on a rug or foam tiles, moving anything they can bump or fall down on out of the way. Give them the option to free play and interact with the class as much or as little as they would like. If they aren’t doing the activities, you still can, so you’re showing them what to do and they can follow your lead. There isn’t any expectation for them to sit still and to be perfect participants! Even if they hear our voices, smile and wave, we will consider that to be a success!


What if my baby has not been introduced to screens yet?

Unfortunately screens are ubiquitous and between FaceTime and taking pictures and videos even the youngest babies intuitively understand screens. If you are concerned about screen time, we would recommend treating screens in these online classes like you would when you call a loved one. You can call in, say hi, wave to the instructor and your friends and then switch over to audio or turn baby away from the screen. You can then turn the video back on as class is ending to say goodbye. We of course also are not fans of unnecessary screen time but hope that seeing your and our familiar faces will bolster your spirits in these challenging, unprecedented times. We know it will, ours!

What is the cost to attend online?

For yoga classes, the cost is included in your membership. For kids classes it’s $5 per invite. For each additional child/sibling tuning in, there is an additional cost of $5/child. This amount will be charged on Mondays for classes attended in the previous week. For special classes like Baby Sign Language, Science Baby & Puppet Shows the cost is $10/invite and $5 for each additional child.

Will the class be available online for viewing after the live stream ends?No, we will only broadcast live so as to maintain our class schedule and community interactions as much as possible. If you’d like access to our prenatal yoga video or baby and me yoga video, you can request those to use at your convenience. 

What are your late cancel and no-show policies?

  • For yoga classes, we do not have any penalties for late canceling, but please do remove your reservation in case if you are unable to attend so we aren’t waiting for you online.

  • For our kids classes, you will be charged $5 sign up fee for the online invite that is sent out 15 minutes before the start of class. This fee is non-refundable and non-transferable to other classes. If you are a late cancel or no-show the $5 sign up fee still applies.

  • A late cancel is a cancellation that occurs 15 minutes before the start of class.

What if I’m tuning in late? It’s totally ok, please jump right in!

What if I forgot to sign in but want to join? Please text us at 646.494.4251 to receive an invite. A $5 fee for not signing up 15 minutes before the start of class will apply.

What if I’m having technical difficulties? Please text us at 646.494.4251.

Can I invite my friends and family to join? For yoga, a family member is welcome to join you! For kids classes, we are still reserving all our services to members only. However if you’re having a playdate at home or a sibling, cousin or loved one would like to join, the $5 / child rate will apply. Please do not share class links with others. We will be administering and managing classes making sure that your privacy is protected and that only Love Child members are in the “room”.

Are there privacy concerns?

We picked Zoom (rather than YouTube or Google) because they are a leader in this space, have better data security and, because it is a paid service, won’t sell our data to a third party. The link to join and option to livestream is by invite only and only available to our members. We know everyone (and their emails) personally, so will only share the invite if it’s appropriate. A unique link for each class so it can’t be shared, reused or replicated.  The videos also cannot be re-shared or saved anywhere. 

SUBSCRIBE TO COMMUNITY SOLAR

 As a small business in NYC, we believe in the importance of seeking alternative and clean energy sources, but the cost can be quite prohibitive. Here at Love Child, we work with PowerMarket, an organization making clean energy more accessible. PowerMarket works with ConEd and an array of community solar developers to get more solar power on our electrical grid. As a business that works with expecting and new parents and kids, we are thrilled to find projects like these that invest in clean energy for a more sustainable future. 

PowerMarket allows individuals to support local solar farms without buying your own solar panels and installing them on the roof. Instead, you subscribe to a small piece of a large, shared renewable energy project in the city.. (Love Child is subscribed to the PowerMarket Bronx project!)

After signing up, you’ll start to receive deductions on your electric bill each month. It costs you nothing to join, you save money on electricity, and support new solar projects being built right here in the city where we need them the most.

More information and subscribe here using code LOVECHILDYOGA. When you do, you’ll receive $50 off one month’s Love Child Membership and support two great initiatives—Love Child and Community Solar!

GVSHP Celebrates 50 years!

Village Preservation (The Greenwich Village Society for Historic Preservation) was founded in 1980 to preserve the architectural heritage and cultural history of Greenwich Village, the East Village, and NoHo. Village Preservation is a leader in protecting the sense of place and human scale that define the Village’s unique community. 

GVSHP’s programs include: Educational outreach in the form of public lectures, tours, exhibitions, and publications; a school program that teaches children about Greenwich Village history and architecture; leadership on expanding landmark and zoning protections in our neighborhoods and fighting inappropriate development; preservation projects that promote an understanding of the Village's historic importance, such as the Greenwich Village Preservation Archive, our oral History Project, and our Historic Plaques Program; small business promotion, through our business of the month program; recognition of the community leaders, institutions, businesses, and additions to our streetscapes which add to the special quality of our neighborhoods through our Annual Village Awards; and our Continuing Education program, which teaches real estate professionals about the value of historic preservation.

Village Preservation (GVSHP) has successfully advocated for the landmark designation of more than 1,250 buildings in our neighborhoods, and has helped secure zoning protections for nearly 100 blocks. Each day GVSHP monitors more than 6,500 building lots in our neighborhood for demolition, alteration, or new construction permits, so the organization can notify the public and respond if necessary. And each day GVSHP also monitors the more than 3,000 landmarked properties in our neighborhood for applications for changes which must go through a public review and approval process, to also notify the public and respond as needed. GVSHP also reports and advocates for appropriate resolution of landmarks and zoning violations in our neighborhood, to help protect the special built environment and character. 

Established in 1980, the Greenwich Village Society for Historic Preservation works to protect the cultural and architectural heritage of Greenwich Village, NoHo, and the East Village. 

Although a large portion of the Village was designated in 1969 as part of the Greenwich Village Historic District, many worthy buildings outside of the district’s boundaries were left vulnerable to demolition and insensitive change. In the past few years, the Society has fought for and won protections for much of the area. The Gansevoort Market Historic District was designated in 2003 after a successful campaign by the Society. More recently, the Society led the push to both downzone and landmark much of the Far West Village, which resulted in height limits for new construction in the neighborhood and the first extension of the Greenwich Village Historic District and the first new historic district in the West Village in nearly forty years. Several early nineteenth-century Federal-style houses near Washington Square, in the East Village, and in Lower Manhattan have also been landmarked as a result of the our efforts. GVSHP has also managed to block or alter plans for inappropriate development in our neighborhood, including a plan for a 500-foot tower in the Gansevoort Market Historic District. 

Love Child was proud to be recognized as GVSHP’s January 2019 Business of the Month.

Take part in GVSHP’s 50 year anniversary celebrations!

Find out more about donating, becoming a member, volunteering and staying connected with GVSHP.

PARENTS & OUR PLANET - A Guide To Making Simple & Impactful Changes To Combat Climate Change

We all know that being a parent is hard work. Unfortunately, parenting also often involves a huge amount of consumption – especially in the United States. Those of us who live in the United States and other rich countries are responsible for a disproportionate share of consumption, greenhouse gas emissions, and waste, so if we worry about the future for our own sake, we have to worry about the future even more so for the sake of our children.

Obviously, we are in the midst of a climate and ecological crisis. Thankfully, there are plenty of reasons for optimism at the moment, but sometimes it can all still feel overwhelming, and as individuals, we can find ourselves uncertain what it is that we can do.

So what can New York City parents do to help shape a better future for themselves and their children and grandchildren? There is a spectrum of actions you might take which range from the strictly personal to the more broadly institutional and political.

Starting simply, we can all consume less. That means fewer flights, less driving, less plastic, turning the lights off, turning the thermostat down in the winter and up in the summer, giving up meat, not buying things we don't need and then landfilling them, and a whole host of other simple lifestyle adjustments. You might consider giving up Amazon Prime; using Postmates, Caviar, Seamless, and other on-demand services less; or avoiding single-use plastics for a month to see how doable it is.

To the extent that some consumption is unavoidable, you might consider composting your organic waste (which the city is now making much easier!); cloth diapering; buying sustainably-sourced, locally-made, and recyclable products or even just buying second-hand; avoiding wasteful packaging (like single-serve food pouches); and supporting our local small businesses and farmers market rather than big-box stores and major corporations.

Building on consumption reduction, we can transition to using renewable energy to the fullest extent possible. Obviously, in New York this can be a bit complicated! If you’re not in a position to install your own solar panels or windmill, then you might explore community solar or reputable energy services companies (ESCOs) that offer the opportunity to buy renewable energy certificates (RECs). If you rely on an automobile, go electric if possible. (Incidentally, on this front, Love Child is a proud community solar subscriber with PowerMarket, an initiative that offers NYC residents the opportunity to support local NYC solar energy projects. You can sign up to get 10% off your monthly electricity bill and and $50 off one month of membership using code LoveChildYoga.)

Another simple step you might take is to donate – for example to environmental nonprofits – if you can afford to do so, although of course you have to be realistic about the actual impact and cautious about where your money is going.

Not only can donations go to environmental nonprofits, but towards political candidates, which brings us to another potential action item – voting for climate sanity! This means being informed about local, state-wide, national, and global climate issues. In New York State, we can look to organizations like NY Renews, Sane Energy Project, and We Are Seneca Lake for guidance on issues like moving New York towards 100% renewable electricity generation and stopping the ongoing buildout of fracked gas infrastructure in New York State and across the region. (For more about preventing the construction of a fracked gas pipeline under New York Harbor, visit Stop the Williams Pipeline.)

If you are feeling motivated to take public climate action beyond the relatively passive acts of donating and voting, there are no shortage of opportunities to get involved in climate action and activism. Not everyone is prepared to protest in the streets, but you can be on the phone to your elected representatives, at community meetings, and in conversation with your friends, neighbors, and loved ones about how essential climate issues and climate action are.

We can also audit our own investments and financial commitments. New York City and State have made significant progress on fossil fuel divestment, but sadly, we have a long way still to go, especially when it comes to the role that our banks and financial institutions play in funding the fossil fuel industry and deepening the climate crisis. The bad news is that J.P. Morgan Chase, Bank of America, Wells Fargo, and Citigroup – indeed all the major American banks – are pretty terrible on this front as this new report documents.

If you happen to be in a leadership position of any organization, you can look to reshape your organization with climate sanity and climate justice as key pillars; however, this will no doubt present some serious challenges, so be prepared for the obstacles that will arise.

At an even broader scale, we can support civic initiatives, for example the renewal of New York City's mass transit or the retrofitting of our building stock to radically improve energy efficiency. Few things make a bigger ecological and climate impact then having and using excellent mass transit at scale, so for the future of the City and the world, we should all use our trains and buses as much as possible – even though the MTA has been struggling mightily in recent years – and perhaps even more, throw our collective weight behind restoring and renewing our transit system so that we can leave the next generation a system that is truly world-class. After all, part of what is great, and uniquely democratic, about New York is our mass transit!

Bold initiatives extend beyond our great city too, of course, and you can also throw your energy behind a Green New Deal or something like it to help move the country and the world in the direction we need to be going. There is a huge amount of work to be done, not least in figuring out how we accomplish the necessary transformations (electrification, decarbonization, re-imagination of our food system, etc., etc., etc.) at the massive scale and with the urgency required.

Finally, as we educate ourselves, we can also look to educate our kids and others around us. As you take action, make a point of sharing with your child why you are doing what you're doing. Keeping plants at home, engendering an appreciation for non-human animals and nature, and looking to consume and waste less and take responsibility for the consumption for which we are responsible can all be learning and teaching opportunities. There is a power in seeing others take action, and we have great opportunities to learn from each other, and to model for young people what a better world might look like.

Tom O’Keefe is a writer and educator based in New York City. You can read more of his climate writing at Climate / Change. He is also responsible for Love Child’s thriving garden, greenery and adopt a plant program and hosts Love Child’s monthly Partner’s Meet Up.

PRENATAL YOGA - A NATURAL PATH FOR MIDWIFERY & PREGNANCY CARE

by Risa Klein, CNM, OB/GYN NP, M.S.

The Yoga minded pregnant person will find a natural and spontaneous connection to midwifery care, as yoga and the midwifery model of healthcare share similar values and disciplines. If you reflect on your own unique life story, which has inspired you to become a member of the Love Child Yoga Community as your pathway to pregnancy wellness, you will find parallels between your Yoga mindset and practice, and midwifery care.

Parallels between Yoga and Midwifery

“Feel your shoulders release. Gently open your hips. Take a breath. Let your jaw soften. Feel your baby as your center.” Sound familiar? This kind of instruction given in your prenatal yoga class, is also the language of midwifery. As a nurse midwife, I am always excited to meet clients who practice prenatal yoga, as they understand how to cultivate awareness which helps to move their bodies and breath. In my many years of midwifery practice, I believe students of yoga have an easier time while in labor and are better able to hear and implement changes suggested. Women are flexible, open-minded, calmer, and better connected to their babies, when they have awareness of how to let go. It comes more naturally for women who practice yoga -  to attempt a recommended posture or position I present as her midwife. After all, if I want to move the baby - I need to move the mother! Working with a midwife will feel second nature because there is a similar mindset in midwifery as yoga practice.

Just as yoga gives you opportunity to connect with and align with your body, midwives are inclined to take this concept to another profound level and help you focus inward and align yourself with your baby. When I was five months pregnant I took my first prenatal yoga class, and had never felt closer or more in touch with my growing babying body. Accomplishing a challenging yoga asana is something I never anticipated doing in my lifetime, never mind starting the practice during my pregnancy – and yet my instructor patiently guided me through what I called my pregnancy yoga orientation. I was grateful to her for preparing and aligning me for my birth. Looking back, it was as if she was midwifing me, however I didn’t realize it at the time. If only my own back up obstetrician in the day applied such awareness and warmth during my delivery, perhaps I would have felt better taken care of. My birth propelled me to become a midwife.

Students of yoga know the benefits they feel over time as they become more in tune with their bodies, movement, rhythm, and their breathing. Same level of progression occurs while under a midwife’s care. Pregnant people get in tune with their bodies and babies and each prenatal visit is like a childbirth class of inspiration, education, as you integrate pearls of midwifery wisdom, into your vision for birth.

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So who will guide you during your gynecological care, pregnancy, labor, birth and postpartum? A midwife, or an obstetrician? To determine which provider is best suited to you, it is important to have a good understanding of your own health history, philosophical viewpoint, and the differences between the midwifery and the medical models of care. Regardless of who you decide will be the best healthcare provider for you -  an OB/GYN or midwife, this information can help you decide who is best suited to carefully tend to yours and your baby’s health.

CNM’s (Certified Nurse Midwife) work with healthy women. They do not take care of women who have high risk medical conditions such as Diabetes, Heart or Liver Disease, or some auto immune disorders. Rather, obstetricians do because they are trained surgeons – experts in their specialty field when a woman or fetus encounters a high risk medical problem and needs procedures requiring initiation and adjustments of medications, surgical procedures including Cesarean sections. Midwives do not perform cesarean sections, although some are certified to first assist. While obstetricians are trained in medicine, disease, and abnormality – midwives are trained to recognize variations in pregnancies, using screening and diagnostic tests to uncover potential health challenges that may require an obstetrician, maternal fetal medicine specialist, genetic counselor, or other medical provider, thus risking them out of midwifery care. When medically indicated, midwives refer their clients to the appropriate physician, and consult, collaborate and co-manage with these practitioners on an individual basis. Midwives co-manage women who desire a VBAC (vaginal birth after cesarean section), or twin pregnancy.

Midwives do not see birth as an illness and have a more holistic approach to pregnancy, labor and birth, than the traditional obstetrical medical model.

Midwives are independent health care providers with expertise in annual gynecologic well woman care, pregnancy, childbirth, the postpartum period, care of the newborn, common primary care issues, and family planning. Midwives graduate from accredited midwifery schools and receive their master’s degree, while some go on for their PhDs. A CNM is educated in two disciplines of nursing and midwifery. Midwives practice in accord with the Standards for the Practice of Midwifery, as defined by the American College of Nurse-Midwives. They are licensed by their individual states, and have prescription privileges. You can give birth with a midwife at home, in a free standing birthing center, an in an in hospital birthing center, or on a hospital labor and delivery floor. Midwifery care is reimbursed by most health insurance companies. You can reap many benefits by working with a midwife if you are not a high-risk patient:

1. Nutrition and Education. You will become educated in how to stay healthy and low risk during the course of your pregnancy. Midwives take a significant amount of time throughout your pregnancy to address how optimal and balanced healthy nutrition serves as the foundation for achieving better outcomes. You will learn about and be validated for the naturally occurring changes that are happening in your body as your baby gestates in inside you. This orientation continues during labor and birth, with a mindful understanding of your body’s innate potential. Midwives teach clients to become mindful of their body, breathing, postures, balance, timing, and rhythm as important assets.

2. Emotional Support. Prenatal visits are the time when your midwife will take the time to get to know you, your medical and reproductive health, job, family history, lifestyle, and how each facet of your life may impact your pregnancy and birth outcome. From the first day you meet your midwife, she or he will impart confidence in your natural abilities to give birth by virtue of your own innate capacities, rather than looking outside of yourself. Fears, concerns, and feelings are explored and women are encouraged to share them as their bodies change and their babies grow.

3. Patience. “I didn’t feel rushed,” is what my clients often share after their labor and birth experience. (I do not wear a watch during labor so women do not feel rushed). Midwives honor birth as a process and give time for labor to unfold, guiding their clients patiently with specific postures and positions to promote optimal movement and fetal heart rate for baby. If you are in a small practice, midwives are apt to devote and maintain continuity of care before, during and after your birth.

4. Epidural. Yes, you can have one if you birth in a hospital, not at home.

5. C section. If medially needed your midwife is with you during the procedure. The attending or collaborating obstetrician will perform the procedure. If you need to work with an obstetrician for medical reasons, and have a planned c section, you can still apply your yoga awareness to help you during your delivery. Your midwife will support you on breastfeeding and teach you a proper latch on right from birth in the O.R.

6. When Your Health Requires Transfer to an Obstetrician: If you or your baby’s medical situation in utero become high risk, your midwife can help make referrals to a compassionate, skilled physician.

To learn more about midwifery, check out The American College of Midwives website, www.mymidwife.org.

Risa Klein, CNM, is a highly experienced private practice senior CNM. She brings her home birth approach to her midwifery practice with privileges at Mt. Sinai West. She promotes peaceful pregnancy, empowered birth, and individualized care. She is a graduate of the Columbia University School of Nursing Midwifery Program. Check out her website at www.manhattanmidwife.com.

JEN'S BIRTH STORY

“Some of you may know that once I found out I was pregnant I opted to give birth at a birthing center in Rhinebeck. I finally was able to switch providers at about 24 weeks and started the long journey taking the Amtrak with all my prenatal appointments. I did not regret my decision one bit as each interaction was amazing, the providers in the practice were really attentive and allowed you to really get a sense of ownership in your pregnancy. This practice has about 5-6 midwives and 3 OBs so I really learned to love them all. I had interviewed one doula in the area and after much consideration I decided not to move forward as I felt like I had a bit more experience than her in terms of breastfeeding in which we decided Peter would be my main support person. I bought Peter a copy of the Birth Partner and had him reading away, learning all about the birth process.

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My pregnancy had been smooth sailing, until about 36-37 weeks in which I started to show signs of high blood pressure. I then was on the watch list for preeclampsia but all my lab results would indicate just gestational hypertension for some time. My midwives/OBs were great and allowed me to move forward but just on high alert, I wasn't really worried about it as I never expressed any real signs of preeclampsia except the blood pressure. I finally got to 38/39 weeks and other than some really bad indigestion I was feeling great. Very anxious and excited to meet the baby. I started to exhibit signs of early labor like bloody show, but no full mucus plug, general fatigue, slight back ache. Then on Sunday March 3, I threw up. I attributed it to the really awful indigestion but once that happened I felt so much better! I had an OB appointment on Monday and felt great but still exhibited signs of gestational hypertension and they decided to issue another full blood panel and an ultrasound for Tuesday morning with the next appointment scheduled for Wednesday. I never made it to my Wednesday appointment...

Tuesday March 5 I had an early ultrasound to check fluid levels and fetal movement—all was well! I went back home and decided to take a nap since I was so exhausted. I woke up to list of text messages and missed calls. One from my OB and Peter both urgently requesting me to contact her. She sent me a message from her personal cell so I called her right away and she asked me how I was feeling. Again, not really feeling any symptoms and she said that my blood panel showed insane kidney and liver function levels indicating that overnight my gestational hypertension had developed into the most severe form of preeclampsia, known as HELLP Syndrome. I kissed my birth center dreams goodbye as she said I needed to go to Vassar right away, the other local medical center with NICU capabilities. I was devastated but listened as she told me she had consulted with the Head of Maternal Fetal Medicine as well as the on call OB at that location who thought that the transition would be best. Luckily, I had met both individuals and trusted the decision. I finally spoke to Peter and let him know I was going to drive there; the car was already packed with all of our things and it was only 10 minutes away. He thought I was insane, but I didn't care so I parked the car in the lot, walked into the hospital and into labor and delivery. 

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I completely skipped triage. The entire staff on-hand already knew I was on my way and I was checked into a room. This was around 12.30pm. Peter left the city and was on the train back upstate. It was a lot of waiting and they wouldn't let me eat, as the nurse hinted that if I needed a C-section then I needed to make sure I wasn't full of food. The ongoing frustration continued as I waited to see the OB and the Head of Maternal Fetal Medicine for the verdict. Peter arrived around 3pm and the doctors came in around 4.30pm. They said that really there were only two choices: an automatic C-section due to the severity of my lab results OR an induction could be possible, but only in timeframe of 6-8 hours, which could then lead to a C-section if things didn’t progress. I was devastated but also determined. I knew my body was already showing signs of labor so I wanted to at least try the induction. They checked my cervix and I was dilating close to 2cm so they allowed for the induction by Pitocin alongside a constant flow of magnesium and a catheter. This started at about 6pm, and so the clock began ticking.

I started to feel contractions and they weren’t that bad…I could breathe through them. I was worried as I didn’t have much to eat that I really needed to sustain my energy so I wasn’t making any large movements and mostly stayed leaning towards the left side while Peter fed me ice chips. Then around 7.30pm I progressed to 4cm, and they were happy with progress. The contractions started to get closer together and more intense. I just kept looking at the clock knowing I needed to keep focused. I never thought about any pain management previous to this and decided I’d just see how far I could get without an epidural. About 9.30pm the nurse checked me again and I was at 9cm. They asked if I wanted an epidural and I said I didn’t think so. At that point they called a nurse to change the bed and the OB—we were having a baby.

The contractions were so severe that I feel my entire pelvis shake and it seemed like they were a minute apart but I don’t think we were really keeping track and I was barely making any guttural noises. The nurse was amazing—coaching me to bring the baby down so I wouldn’t need to push for that long. Then suddenly it seemed like 10 people flooded the room, one woman said she was going to catch the baby and everyone was so excited. I was still so focused and could barely move unassisted. I was then turned onto my back to hold my legs up and instructed to push. Then they said they saw the head, asked me if I wanted to touch the head and I said no because I just wanted it to be over. A few minutes later the baby’s hand came out first then the head and was placed on my chest, barely crying. Peter was able to cut the cord! I had a sneaky episiotomy and couldn’t keep my placenta which I released at that moment due to the preeclampsia.

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Baby John Felice Manzi Doro was born on March 5, 2019 at 10:22pm, 6lbs, 7oz and 19.5in length!”

-Jennifer Jolorte Doro

Everything You Need to Know About Diastasis Recti

Many birthing people notice that their stomachs don’t look or feel the same after birth, and not just because of changes in weight. Care providers may dismiss it as a purely aesthetic concern, but dealing with the poorly-named “mom pooch” or “mummy tummy” is more than just an attempt to return to the look of a pre-pregnancy body. If you feel like you can no longer connect to your core muscles, diastasis recti could be the culprit. Yes, it causes a bulge in the midsection, but it can also lead to low back pain, pelvic pain and incontinence. And moms are not the only ones to have this condition—men and babies get diastasis recti, too!

Luckily, whether you are pregnant now, gave birth weeks or years ago, there are ways to heal diastasis recti and bring your abdominal muscles back together again. Below, you’ll find more information, tips and tricks to stay ahead of diastasis recti and care for your core muscles throughout your reproductive journey.

If you’re concerned you have DR, talk to your care provider and seek out a specialized pelvic floor physical therapist for the most well-rounded recovery!

THE BASICS

What is diastasis recti and how do you know if you have it? Doctors diagnose the condition when the distance between the two sides of the rectus abdominis muscle is two centimeters or more, though it is commonly measured in finger-width distances. The finger-measuring technique makes it easy enough to check yourself for DR. There’s a great description of the DIY diastasis recti test here.

The separation of your abs is caused by the overstretching of the linea alba, the tissue at the center of your six-pack muscles AKA the rectus abdominis. While being pregnant can certainly put too much pressure on the linea alba and lead to DR, people who exercise improperly, people with large bellies, and children can all have diastasis recti as well.

It’s believed that about 60 percent of women have diastasis recti six weeks after giving birth. However, there is no standardized screening for DR in postpartum people, meaning it is likely underreported and undertreated. The best way to know for sure if you have diastasis recti is by visiting a care provider that specializes in pelvic health, like a physical therapist or urogynecologist.

CAN I AVOID DIASTASIS RECTI?

There’s no surefire way to avoid DR, and worrying about it is an unnecessary stress on you and your body during pregnancy. The best things you can do for you and your core muscles during pregnancy are:

  1. Avoid doing crunches or sit ups.

  2. Always roll to one side when you get up from lying down. Do not lurch forward.

If you do have diastasis recti during your pregnancy (which about 33 percent of pregnant people report around 21 weeks gestation), those weaker core muscles can lead to low back pain and may impact baby’s position. Factors that make it more likely that you will have DR after birth include carrying large babies or twins, having super-rigid ab muscles before pregnancy or giving birth multiple times.

WHAT CAN I DO TO HEAL POSTPARTUM?

Our bodies are intelligent and a natural reversal of the abdominal separation begins to happen around 4 weeks postpartum. Any separation remaining after that must be managed with targeted ab exercises, which do NOT include crunches or sit ups as those can make the separation worse. And while you will be busy with a new baby, simply ignoring your diastasis recti postpartum could result in back pain, weak core muscles, pelvic pain and weakness, and incontinence later on.

After birth, continue to roll to one side and avoid lurching forward, as well. Focus on reconnecting with your core muscles (which include your diaphragm, pelvic floor, lower abs and postural muscles along the spine) to give you that increased stability necessary for caring for baby and yourself long term. Do not rush back into a postpartum exercise program without connecting and engaging abs properly, as this can worsen DR and lead to problems like prolapse in the future.

When you are cleared and ready for exercising again, we rehab our core muscles in postnatal yoga, with safe abdominal breathing and other super targeted exercises. (The belly pulls practiced at Love Child are some of the most helpful exercises you can do!) A pelvic floor professional will likely also prescribe a regime of exercises to help improve your diastasis recti.

To keep reading and learning about diastasis recti, here are a few resources:
When It All Comes Together: Diastasis Recti, Healed
The Do’s & Don’ts of Diastasis Recti

POSTPARTUM PLANNING & RECOVERY

Usually the excitement and anxiety from one’s birth plan causes any postpartum planning to be overlooked - but for many new parents this is the time that planning can be most helpful. This time is known as the fourth trimester, once baby arrives and the first few months following. And remember, this is a plan. It is not a requirement that everything goes as planned, just that you've thought about your options ahead of time, and tried to set up your first few months with baby to be as smooth sailing as possible. Physical and emotional recovery, and taking care of yourself, but also how to care for baby!

SPACE

Is the house ready? This means something different for each family, but often includes things like tidying up, doing that one last load of laundry, setting up a space for you and baby, and overall making sure your home is clean, and a space you want to be in, when you have baby/come home with baby.

POSTPARTUM CARE KIT

  • Maternity pads

  • High Waisted Underwear (Mesh Underwear from the hospital)

  • Nipple Cream (Earth Mama Angel Baby Nipple Cream)

  • Nursing Bra (Have a few different sizes, without underwire, we recommend Boob design's clipless ones)

  • Nursing Pads (Bamboobies reusable pads are much more absorbent)

  • Nursing Clothes (You'll mostly be topless for the first few weeks but get button down shirts and outfits you can easily nurse in, preferably dresses. For c-section avoid pants if you can, especially tight waistbands. Continue wearing maternity clothes!)

  • Lidocaine or dermoplast Spray

  • Tucks Pads

  • Stool Softener (often given to you by your care provider)

  • Manual breast pump (We recommend the Haakaa)

  • For cold weather: Maternity Coat Extender, stroller gloves

RECOVERY

  • Belly wrap

  • Stool softener

  • Advil / Tylenol

  • Coconut oil

BREASTFEEDING

  • warm compress

  • cabbage leaves for engorgement

  • Earth Mama Angel Baby butter & herbs

  • Epsom Salt water wash for sore nipples

  • Nursing bra & clothes

  • KellyMom.com

  • On Demand Lactation Support

ESSENTIALS FOR BABY

  • A place for baby to sleep (co-sleep / bassinet)

  • Cloth Diapers (If you're planning to cloth diaper - set this up around 34 weeks)

  • Cloth Diaper Bin

  • Disposable Diapers for nights

  • Reusable / Flushable wipes

  • Newborn Salve/Diaper Cream (We recommend Earth Mama Angel Baby or DiaperKind)

  • A place to change baby's diapers (changing pad and/or table)

  • Swaddles

  • Newborn Outfit (tshirt / loose kimono onesie / long sleeves with mittens, avoid buttons - snaps and zippers as much as possible)

  • Wrap Infant Baby Carrier (learn how to use the wrap before birth)

  • Baby Nail File

  • Wash cloths for burping, spit up and towel bath (you will find thousands of other ways to use washcloths!)

  • Sound Machine

  • For cold weather: Humidifier, Baby Snow Suit, Stroller Muff & Cover.

FOOD

Is your fridge/freezer stocked? Having some meals prepped (or just making sure to have all your favorite meals/snacks on hand!) can be a great way to simplify an already new and often chaotic schedule, and its another way for people to help you without overcrowding you and your baby when you first get home! People often get ravenously hungry when breastfeeding so keep snacks, food and water always within arms reach.  We recommend nuts, lactation cookies, fresh and dried fruit, yogurt and oatmeal.
Stock the freezer with your favorite casseroles, soups and broths. 

  • Bone broth

  • Antioxidant rich foods

  • Iron rich foods

  • Lactation rich foods - Oatmeal / Barley / Millet / Fenugreek / Mothers Milk Tea

  • Aim to drink at least 2 litres of pure water a day (on top of teas and broths). This is essential for rehydrating after surgery and a hospital stay which can be notoriously drying for the body. It also helps prevent infection, flush out inflammation and traces of analgesia and antibiotics, help keep the bowel and urinary tract moving and flushing, along with providing enough hydration as your body begins to produce breastmilk too!

  • A varied, well balanced diet rich in protein, good fats, minerals, vitamins and fiber will help your body attribute the necessary nutrients to all the different bodily functions happening at once. Foods which help to fight inflammation are also helpful for your body right now.

  • Raspberry Leaf Tea – whilst after any other type of birth I would encourage the use of Raspberry Leaf Tea, following a Cesarean I would encourage caution. Longer term certainly helpful as it is such a wonderful uterine tonic at any stage of a person’s life, however for the first six weeks following the operation I would personally be limiting this tea to once every few days.

  • Fennel, cardamon, ginger; all helpful should there be any trapped gas, or constipation. If you’re feeling a little warm or your temperature is up then fennel with it’s slightly cooling properties would be a wiser choice. The other blessing here is that all three of these herbs and spices are traditionally used as galactagogues – substances that promote and enhance milk production.

  • Magnesium - Many people get constipated after surgery and this can be especially painful after a cesarean (or a vaginal birth!) take some magnesium to help loosen stools and prevent constipation.

If food planning and preparation seems overwhelming with a newborn, you’re not alone. Love Child offers the following Postpartum Food Services

  • Love Child Postpartum Chef : Wholesome home-cooked meals with the ease of ordering take out tailored for your postpartum experience. Personal chef and nutritionist, Jennifer Jolorte, will come to your home once or twice a week and prepare an array of healthy, wholesome, delicious meals - taking care of all the shopping, cooking, cleaning up and leaving you with a week's worth of meals. $605 / week

  • Love Child x Green Top Farms Postpartum Meal Delivery : 10 Wholesome organic, fresh, healthy meals delivered to your door. $250 / week.

CHORES

  • It can be overwhelming to try to grocery shop, plan, prep and cook a meal all at once. Split things up so you or a support person is helping you do one thing a day. 

  • Dog walker? Cat sitter? Babysitter? Both for the birth itself, but also for the first few weeks afterwards, having that help set up or just having the option, can give new parents a little more ease of mind, and allow you to focus on yourself and baby

  • Cleaning the House, Laundry & Folding - have a set regular time when someone comes by to help.

  • Task friends and family or hire professional help. 

  • Have the phone number of lactation consultant / postpartum doula or baby sitter on fridge so you can call immediately.

MANAGING VISITORS

  • Preemptively communicate with friends and family about ways they can help once baby arrives, or during baby's arrival. This can be great for situations where your birth plan maybe doesn't go as expected, having a few people on call to bring food (or company!) to you at home and/or where you give birth.

  • Set boundaries; most people don’t want 10 people in a hospital room with them or in their home the week after baby comes!

  • Creating notes around the house for visitors as they enter - eg. Welcome, our baby is excited to meet you. Please take off shoes and wash your hands. Please don’t be offended if our baby is sleeping or breastfeeding and you don’t get a chance to hold them.

  • Adding a bowl of notes that have different chores on them so when visitors come, they can pick one.

  • Have your preferred grocery list written down so that someone can buy them for you.

  • A good rule of thumb is to only have people over you’re comfortable breastfeeding in front of! There will be plenty of time for visiting with people later on! Take the first few days and weeks to bond as a family, get into a routine, and get as much rest as possible!

  • Accept help if you need it! There is no shame in having help, especially if it helps you (and partner!) to recharge or take a quick break! If people are only offering help that doesn’t actually serve you, rather than turn it down, you can suggest other, more useful ways for people to help you. 

How to be a respectful visitor: 

  • Ask when a good time to visit is

  • Check in just before to confirm don’t ring the doorbell in case baby is sleeping

  • Ask about leaving shoes outside

  • Wash hands as soon as you enter

  • Keep phone on silent

  • Ask how you can help

  • Keep company while breastfeeding

  • Focus on the parent - how are you / how was your experience/ how are you feeling,

  • Don’t visit when you’re even a little sick,

  • Leave after an hour -90 mins, don’t over stay,

  • Don’t ask to meet outside at a set time - offer to visit them at home at a time set by the new parents,

  • Bring food even if they say don’t bring food.

SLEEP

Dealing with sleep deprivation can be one of the most challenging aspects of a new baby.

  • You've probably heard, sleep when the baby sleeps. It's true up to a point but newborns eat every two hours.

  • It gets a lot easier if you're able to take turns with partner, family or support person and sleep in shifts.

  • Baby’s longest sleep is usually 8pm - midnight. Have someone else care for baby then. Or if you really hate the 3am shift, have someone take that so that you can rest.

  • It’s not that babies act differently at night, they’re just getting used to new rhythms and we have less patience at night than during the day.

PROFESSIONAL SERVICES

  • Meal Train

  • Lactation Consultant on Call

  • Postpartum Doula on Call

  • Postpartum Chef

  • Cloth Diapering Service (launder and return clean set)

  • Babysitter / Nanny / Baby Nurse

  • Postpartum Meal Delivery Service

PHYSICAL RECOVERY

What to expect:

  • Postpartum Bleeding - Postpartum bleeding occurs regardless of whether you delivered vaginally or not, and the intensity and length of time of the bleeding can vary - but it should become less and less intense as time goes on. It typically resembles a heavy period, sometimes with clots. When to be concerned: If you’re having any low blood level related symptoms (shortness of breath, dizziness etc), are fully soaking pads every hour for multiple hours, or if you have a high fever, call a doctor.

  • Contractions

  • Sweats

  • Hair changes

  • Vaginal Tearing (in varying degrees)

  • Post surgery pain

  • Contractions

  • Hemorrhoids

  • Incontinence

  • Painful to sit

  • Sweating and hot flashes

  • Pain while peeing and pooping

  • Diastasis recti

  • Pelvic floor weakening

  • Shakes

  • Hair falling

  • Skin changes

  • Call and/or see your doctor if you have headaches, blurry vision, blood pressure, urinary retention, clots, or a fever

Vaginal Birth

  • Padsicles: Witch hazel + Aloe + Lavender on a Maternity Pad and freeze

  • Spray Bottle while you pee / pee in shower

  • Laxatives for first elimination

  • Exercise - 4 weeks

  • Witch Hazel, Aloe, Lavender Essential Oil and Ziplock bags to make Padsicles. Padsicle Recipe :

    - Heavy, extra thick overnight pads
    - Witch hazel (without alcohol!)
    - Aloe vera gel (without any additives/preservatives, try and find 100% aloe gel!)
    - Optional, lavender essential oil
    - Ziploc bag
    Open the pad, but leave the adhesive wrapper on. Mix the aloe, witch hazel and a few drops of essential oil together, and saturate the pad with it (how much you want it saturated is up to you, so adjust your mix accordingly!) Place the pads into the ziploc (you can fold them back up, or freeze them flat, based on the space in your freezer and what kind of wrapper your pad has) and stick them in the freezer until they’re cold to your liking
    Tip: make a big batch of them! When you want to use one, take it out to thaw for a little.

  • Spray bottle / Peri bottles

  • Ice packs

  • post birth donut pillow (can also use the boppy)

  • Adult diapers/mesh underwear that hospitals provide (certainly get them regardless of where you give birth, but if you have access, stock up!) are really great for recovery, especially for c-sections because the band is above the scar. Many people swear by the disposable mesh underwear, its super soft and stretchy while also being breathable, holds thick pads in place comfortably, and of course prevents ruining expensive underwear!

  • Peri bottle - Essentially works as a less fancy bidet. It can burn/sting to pee, and having a steady stream of water can help calm It also makes sure you get clean without having to wipe, which right after birth can feel too harsh

  • Sitz baths - This is simply sitting in a small amount of water in the tub - think just enough to sit in and have your bottom submerged. The water is soothing, some people find pain relief in hotter water, some colder, so see what feels best, and it increases blood flow, which aids in healing. It’s also just an easy way to clean an area that may feel incredible tender! Sitz baths are also really helpful in healing hemorrhoids. Finally, the benefit of making yourself sit alone for maybe 20 mins a day (or more if possible)! Use this as alone time to read/watch something you haven't been able to, call a friend, or relax in whatever way you want!

  • How to take a Sitz bath: Have someone make sure the tub is clean, and removed of any grime!
    Add ins: witch hazel, essential oils (lavender most notably) and epsom salts which all aid in reducing pain and swelling, and aid in healing
    If peeing is really painful, sitz baths may be the only time it doesn't hurt - pee in the bath before you get out if that's the case!
    Wear something on top to stay warm
    Very gently pat dry your bottom using a clean towel 

C-SECTION BIRTH

  • Take it slow

  • High waisted maternity underwear

  • Soothing salve

  • Stay on top of painkillers

  • Lots of anti-inflammatories & warming spices, Bone broth and Water

  • Scar suture wire

  • Raised scar

  • Height of bed

  • Firm bed rather than too soft

  • Exercise - 6 weeks

  • Try to avoid sitting straight up, use your hands to press yourself up to sit.

  • Get something to step up onto your bed if it’s high, something strong and sturdy to hold on to as you lower yourself if it is low.

  • Set up an adequately sized bedside table which is big enough to house a big bottle of water, a tea pot full of tea, a breast pump or a baby bottle, your mobile phone and it’s charger, a lamp suitable for use in the night, a muslin cloth, pain meds, and a little bowl of healthy snacks – think fresh fruit, nuts, crackers, dried fruits, dark chocolate.

  • Pain medication: Keep on top of the dose for the first few days. Double check with your healthcare providers if the pain relief you are prescribed is compatible with breastfeeding. Set an alarm to remind you when you are due to take the next dose so that you don’t get caught unaware by intense pain.

  • Mesh Underwear: When lying naked in bed skin to skin with baby isn’t possible for whatever reason – use big underwear. At least 5cm above your belly button, 100% cotton, at least two sizes larger than you would normally wear (they will help keep the sanitary towels in place too!) Additionally, tear up or cut up an old cotton sheet – get it washed in a hot hot wash (60 degrees plus) and tear it into strips about 15cm x 25cm in size, to fold or roll up and to tuck between your wound and the underwear.

  • Especially while stitches are still in place, clothing should be soft, and ideally not have waistbands, (avoid tight/rough waistbands that sit right at the hips/scar level). Many people find that they continue to wear maternity leggings/bottoms as the waistband goes much higher than the scar, and won’t cause as much irritation!

  • Binding -You can also consider belly binding around your belly to help keep abs together. You would want it to feel supportive and strong, not too tight like a corset. Using light pressure and compression can lessen the pain and speed healing after a c-section. In fact, this can be helpful for non cesarean births as well since it helps reduce pain and helps the uterus return to normal size more quickly.

  • Keep moving. Slowly but surely, a little bit more each day. Keeping moving helps our whole body to heal, regulate and keep functioning optimally through good circulation and good flow of the lymph and other fluids. Keeping mobile can also help to prevent a build up of trapped gases. You don’t need to head out of the door if you don’t feel ready, but stroll around the house, if you have a garden have a wander in the garden. Don’t carry or lift anything heavier than baby though remember, and do what you need to do to help your body feel safe and supported; even if that means physically holding your abdomen with your hands as you walk for a few days.

  • It takes a village - Every family needs extra help after the birth of a newborn, but following a Caesarean birth, with rest being as fundamental to physical healing as it is - organizing a meal train, or someone to come and entertain siblings or the dog, someone to do laundry can really make a difference to your peace of mind and the logistics of those early weeks. Postpartum doulas are great for this, If not: reach out to those friends in your circle who can offer some support and get used to asking for what you need during the coming few days, weeks and months.

  • Find the position that works the best for you and your baby. Maybe it is sitting upright holding baby in the football position. Perhaps you can lie on your side with baby adjacent to you (this might not be possible immediately after a Cesarean). If you are sitting cross legged it can be really wonderful to put a cushion or pillow underneath each of your knees as it takes the strain off your abdomen. Use a breastfeeding pillow if it’s helpful.

  • Milk Production/Pumping – milk production can take a little longer following a Caesarean (and analgesia); and so pumping might well be suggested to “improve” or hasten milk flow. Make sure to consult a well recommended Lactation Consultant or Peer to Peer Breastfeeding Counselor to iron out any issues before they take route. Lastly; due to the IV fluid that you receive when you undergo a Cesarean birth combined with the fact that baby doesn’t withstand the compression of a vaginal birth; babies born via C section can have a slightly higher birth weight than their vaginally born counterparts. This can in turn mean a slightly elevated weight loss in the early days...remember to bring this into any conversation about baby’s weight loss (even if it’s just a personal reminder to reassure yourself) and perhaps consider waiting one more day before intervening with supplementation.

  • Skin to skin is so helpful for promoting bonding, breastfeeding hormones, improving the micro- biome of the infant and birthing person, regulating temperature of birthing person and baby. Make sure your room temperature is warm enough, and snuggle up together in bed – include your partner too! Skin to skin promotes oxytocin and promotes your milk supply.

  • Top Anti-Inflammatory Food Sources: Wild Alaskan Salmon, Extra Virgin Oil, Cruciferous Vegetables, Blueberries, Turmeric, Ginger, Garlic, Green Tea, Sweet Potato

  • Nettle tea, dandelion tea, fennel tea and breastfeeding teas such as the Weleda tea will all help to promote breastfeeding but also assist your body in flushing out all the excess fluids your body produced during pregnancy, as well as help your body cleanse out all the pain med- ication, anesthetics, antibiotics and IV fluids that you may have received during the Caesarean and immediately afterwards.

  • Warming spices: ginger, cardamom, turmeric. Turmeric is not only a warming spice but one of nature’s greatest anti inflammatory substances (over the counter anti-inflammatories include Advil/Naproxen), and is a galactagogue (a substance which encourages the production of breast milk) so turmeric can truly have a multitude of highly beneficial side effects. Turmeric is best absorbed by the body when paired with black pepper.

  • Peppermint Tea or Peppermint Oil – whilst normally both peppermint tea and oil would be wonderfully helpful after surgery on or around the abdomen for gas or trapped wind, following a C-section during the period of time where you are likely to be trying to initiate breastfeeding – peppermint oil is understood to interrupt milk supply and production. Same with Sage and Cinnamon.

  • Glutamine - check with your doctor but taking glutamine in the weeks following surgery as there can drastically speed recovery: Glutamine is a key substrate for fast-growing and multi- plying cells, including white blood cells. Glutamine stimulates the proliferation of fibroblasts, thereby helping in wound closure. It is the major amino acid lost during any tissue injury, implying a significant role in the preservation of lean body mass. According to researchers, glutamine possesses anabolic properties, which are effective in wound healing only when present in amounts 2 to 7 times greater than required in healthy persons. You can usually get enough glutamine without taking a supplement, because your body makes it and you get some in your diet. Certain medical conditions, including injuries, surgery, infections, and pro- longed stress, can lower glutamine levels, however. In these cases, taking a glutamine supplement may be helpful.

  • Bone broth is packed with amino acids like proline and glycine, which are needed for collagen production and great for skin healing. Broth also contains gelatin, which is beneficial for wound healing and for the skin. Traditional broth can really help recovery from c-sections and as a bonus, it helps digestion and can ease the digestive discomforts and constipation that sometimes come after cesarean birth.

  • Probiotics – after having been exposed from the inside out to bacteria which are so different from our own micro-biome in an operating theatre, and then receiving a big dose of antibiotics; taking probiotics in the form of supplements, or drinking yoghurt or water kefir, or eating fermented foods like sauerkraut readjust the micro-biome from the inside out. Studies are show- ing us that our guts are fundamental to good health, and unfortunately also show that having a c-section can have a detrimental effect on our babies’ gut health. Probiotics have a great impact on breastmilk milk quality but also on our internal healing as they can help to reduce gas, constipation and bloating which are common post surgery side effects. Of course if you choose to feed formula then supplementing your baby with a dose of probiotics for babies is a healthy supplementation. Check with your care-provider.

  • Scar care - It's important to remember that the scar you see on the outside is just a fraction of the full scar! The soreness from the cut in the muscles and deeper layers often lasts longer than the pain of the superficial scar, but just remember that whatever scar you see on top, the actual incision to get baby out was probably about 3x that size. Scars often tend to itch as they heal as well, which can be pretty irritating, and you of course don’t want to interfere with it healing properly. This means that your core is having to do a lot of reconnecting and healing (which is why proper engaging of the core is vital - to bring everything back together), which is why c-section recovery is often more immobile.

  • Following the first 6 weeks of healing the wound should be healing nicely – or certainly appear to be doing so from the outside. From the six week point in the healing process, gentle massage and wound care on the skin can be supportive in successful longer term healing. Once again; go gently with the dosage – start with just one drop of whichever oil you choose in a teaspoon of carrier oil. Also, go gently with your touch and pressure – be mindful of how your wound is feeling. Start out for the first couple of months with light touch massage once or twice a week gently increasing if it feels comfortable; and then 3-4 months postpartum introduce massage with an electric toothbrush or a vibrator if it feels comfortable for you. The gentle pulsation of the toothbrush or vibrator is thought to discourage adhesions from forming amongst tissue and organs.

  • Soothing Salve - A cesarean is major abdominal surgery and there is a substantial incision. Using this healing salve after delivery (http://wellnessmama.com/3520/homemade-healing- salve/) can help remove them and speed scar healing. It can also be used on the perineum after a vaginal delivery.

  • Air to the wound as much as possible - Lie down whilst baby sleeps or is carried by your partner and just let clean dry air reach the wound – in the very immediate days that might mean that you need to hold the belly up off the wound as your body begins to reacclimatize to not having a full pregnant belly anymore.

  • In the first couple of weeks water is all that is needed to wash the wound; and the most important thing: dry it scrupulously (moist patches of skin can be breeding ground for fungal infection; see aromatherapy hacks for anti fungal oils)

AROMATHERAPY

  • Rose, lavender, and chamomile to relax and restore. Bergamot and/or neroli to lift the spirits during the day. These essential oils could be used on a warm or cool compress on your face or your neck, or could be diffused gently in the room. Again; less is more.

  • Frankincense – a healing essential oil with antiseptic, antibacterial and anti fungal properties, it is also a cicatrisant (which means it promotes effective healing and regeneration of the skin/ wounds/scars). It is also an effective digestive oil; when used externally through massage it can help to relieve trapped gas.

  • Lavender – wonderfully calming (but not necessarily the best essential oil to promote sleep as it actually improves mental function), antibacterial, antiviral and proven to be an effective essential oil for pain relief. It has also been understood to speed up the healing process of wounds, cuts, burns, and sunburns because it improves the formation of scar tissue.

  • Chamomile – antidepressant, antispasmodic, sedative, anti-inflammatory, and cicatrisant (see above), wonderful for promoting skin healing and regeneration too; calming properties for even the most sensitive skin.

  • Carrot Seed Oil – antiseptic, antiviral & disinfectant, carminative (removes stubborn trapped gases), It stimulates both circulation and metabolic function; which in turn can promote good healing. Carrot Seed essential oil stimulates the growth of new cells and tissues. It also tones the skin and prevents it from hanging loose or showing signs of aging. It has a soothing earthy aroma and is known to promote relief from stress and anxiety, which having a refreshing effect on the emotions.

  • One last word of caution; even after the 6 weeks...go gently; especially if you are breastfeeding. One or two drops in a heaped teaspoon of carrier oil (jojoba, vitamin e, almond, argan, coconut etc) is more than enough. The body is so sensitive for the first 4 months after giving birth; and whilst essential oils are natural, they are powerful and can impact on the function of the uterus and the production and regulation of hormones amongst other things, so over use can result in heightened sensitivity. 

HOMEOPATHY

The Helios Homeopathic Childbirth Kit It has five powerful remedies in an adequately potent dose to assist inside out healing following a Cesarean Section too.

  • Arnica: a common addition to many first aid kits, Arnica is useful for all new injuries, and can help reduce soreness, bruising, tissue damage, and bleeding related to surgical procedures. Very helpful for alleviating bruising, swelling, and soreness during recovery from most surgeries. You can find many slaves and healing creams with arnica in them already.

  • Bellis perennis: commonly referred to as Bellis Per. Useful when bruising and trauma occur to soft tissue, and/or to deep internal tissues after surgery involving the abdomen, breasts, or trunk-especially if a feeling of stiffness or coldness has developed in the area.

  • Calendula: to help complete the healing of deep wounds along with preventing inflammation, suppuration and infection at the site of the wound. Calendula also helps prevent keloid forma- tion of the scar.

  • Staphysagria: useful when pain persists at the site of a surgical incision, or after procedures that involve the stretching of a sphincter muscle. It is also indicated after surgeries involving reproductive organs (prostate surgery, hysterectomy, C-section, episiotomy) or the abdomen, stomach, and rectum (including hemorrhoids). Staphysagria may also help after operations on traumatic injuries.

  • Hypericum: particularly useful for injuries, wounds and surgeries involving nerve rich areas of the body.

  • The Helios Childbirth Kits include the remedies at a very potent dose (200c), recommended dosage for two weeks at the strongest dose as included in the kit, then acquiring the same remedies at a lower potency (30c) for an- other week or two. For more specific advise on any other symptoms you are experiencing I recommend finding a qualified homeopathic practictioner in your area.

  • Rescue Remedy: This is very helpful for the emotional side of the healing and coming to terms with the experience, along with those moments of potential overwhelm which come with just having had a baby, and are exacerbated by the intense aches and pains that come with Cesarean recovery. A few drops under the tongue when you feel like you need it; as an added bonus it is very cleansing for the body too.

PSYCHOLOGICAL & EMOTIONAL HEALING

  • Acceptance and Integration – these are simple, commonly used words which psychologically are the foundations of a healthy processing of any difficult experience in life, including difficult or traumatic birth experiences. First of all, tell your story as often as you feel comfortable sharing it. Seek out your partner, your friends and family, your healthcare providers, a therapist, your doula (or postpartum doula), the neighbor...anyone who can listen to you unconditionally and simply allow you to recall things one by one to make sense of how it all unfolded. This is a very important step for your brain in processing the experience; this is one of the primary ways in which it organizes difficult or traumatic events.

  • Journaling – could you find the time to write down a few words each day about your feelings about the Caesarean, your recollections, what you’re grateful for from the experience, how you feel you are healing each day, what disappointments and concerns have come up for you that day? It might just be a list of words, it may be a collection of pictures or diagrams, you could use video or voice notes. Again, journaling in this way can be incredibly helpful in assist- ing the brain to process the experience and not file it away as a trauma. The three feelings you should pay keen attention to and treat with extra special care are guilt, shame and fear; if these feeling persist then consider getting a referral to a therapist.

  • Support Groups – there is a lot of support, empathy and healing to be found in the experience of sharing birth stories with others who have gone through a similar kind of birth experience (particularly if that experience was far away from the experience that you were hoping for). It is important to find a group which is facilitated by someone who you feel safe with, and who can hold space for all members of the group, and who can be relied upon to maintain healthy, non judgmental, mature and open communication in the sessions.

  • VBAC/ Vaginal Birth After Cesarean – one of the most difficult things I have read about people who give birth by Caesarean Section is that they are significantly less likely to choose to have more children because for many the experience of having the surgery, and recovering from surgery is too much to imagine going through a second time. I do maintain that some of that is because there is so little follow up care from health care providers, and somehow such a stigma attached to Cesarean birth that there are few resources out there on successful short, medium and long term strategies for healing successfully from a C-Section. Please keep in mind that the outdated adage “Once a Caesarean, always a Caesarean” is NOT TRUE. Many people go on to experience vaginal birth following a C-Section; so please don’t let your experience of having had a C section put you off planning a VBAC.

EMOTIONAL CHANGES

  • When baby comes home, the family dynamic shifts! You now have a new person in your home, and joining your inner circle! It's completely normal for you and your partner to have a shift in dynamic, either negative or positive. Communicate as much as possible about your needs (both partners!), especially as hormones and temperament (lack of sleep or other stress) are delicate at this time.

  • Mood swings or changes in emotions in general are very common

  • Body image issues may appear or shift (It took you 10 months to grow baby!! Give yourself at least 10 months before you even begin to compare yourself to pre baby!)

  • Brain changes

  • Hormonal Changes

  • Dealing with lack of sleep

  • Dealing with loneliness and repetitive days

  • Anxiety and depression can appear in degrees (in either partner)

  • Body image changes

  • Feeling touched out, not yourself, not wanting to be touched is common, communicate your needs!

  • Crying and blues

  • Not loving baby immediately

  • Moments of regret are normal! It doesn’t mean you’re a bad parent, or that whatever stress you’re dealing with won’t end! Take a step away if you can, change of scenery, take a walk, call a friend, read a chapter of a book.

  • Change in feelings toward partner, both positive and negative emotions, are very common. Communication is vital not just for your relationship but to make taking care of baby and healing postpartum body the smoothest it can be

SAMPLE POST[ARTUM PLAN

Birth person

  • Breastfeed

  • Recover

Partner

  • Diapers

  • Swaddle

  • Bottles prep & clean

  • Baby soothing

  • Communication with Family & Friends

  • Bring Baby to be fed

  • Burp

  • Postpartum doula when partner goes back to work

Friends / Family

  • Food (Food delivery when family leaves)

  • Laundry

  • Clean House

  • Other Chores

Professional

  • Lactation Counselor

  • Craniosacral Therapist

  • Pelvic Floor Therapist

What does your ideal postpartum look like?

  • At 2 weeks:

  • At 1 month:

  • At 3 months:

  • At 6 months:

  • At 1 year:

  • What major areas need attention? (E.g. Family Leave, Managing Family, Food)

  • Who do you want around and for how long? Communicate your plan to them.

  • What’s the difference for you between professional vs support from friends and family?

  • What is services and things are available immediately and what do you need to plan for in advance (E.g. Bottles can be bought immediately from the store but cloth diapering needs to be planned in advance)

  • What qualities can you bring into you postpartum and parenting from other parents that you admire?

  • Who is in your like-minded support network as a new parent?

  • What is your plan in case of the unexpected / in case of an emergency?

  • Who can you call if you need help with: (Friends & Family & Professional)

RELATIONSHIPS & PARTNER TIPS 

  • Check in with each other daily, weekly and monthly.

  • Make decisions together.

  • There may be resentment as one partner returns to work while the other is taking care of baby. Share and talk about feelings recognizing that work inside the home is just as important and work outside the home.

  • Set boundaries and expectations with one another’s family. Asking family to respocet the parenting decisions you have made together as well as keeping the focus on the parent’s wellness.

  • Be equally involved with baby care

  • Be equally involved with house hold chores

  • Take initiative - don’t wait to be asked, ask how you can help

  • Ask and determine daily priorities

  • Not expecting person at home with baby to complete other tasks such as booking tickets or a babysitter.

  • Sex & intimacy - feeling ‘touched out’

  • Ask before touching when breastfeeding

  • Learn your own ways to soothe baby

  • Manage communication with family, how can they be helpful

  • Visitors - have signs, only invite people you’re comfortable breastfeeding in front of

  • Don’t take it personally - highs and lows are common

  • Second shift when getting back from work

LONGER TERM HEALING

  • Body work – consider seeing a chiropractor, an acupuncturist, an osteopath, a cranio sacral therapist

  • Therapist, a somatic coach, an energetic healer.

  • Massage or cupping – one of the potential complications with longer term healing following a C section is adhesive scarring (internally). By massaging the area directly around the scar (as mentioned above with an electric toothbrush, or vibrator), the adhesions are understood to be less likely to form. Gentle cupping around the scar after a few months can also discourage adhesions (extensive scar tissue) from forming. It can also be very beneficial for gently removing any inflammation and/or stagnation in the area of the scar; improving sexual response, improving the functioning of the uterus, and bringing blood flow, lymph flow and warmth back into the region.

  • Scar Massage - Anytime there is a major incision, there is a potential for adhesions to form where tissue fuses where it isn’t supposed to. To help avoid this, you can try a gentle scar massage once the wound had fully closed and the scab had gone away.

  • Doing one thing for yourself a day (even if it's taking a shower, which you can do with baby and/or partner)

  • Step out of the house to go to the bank, get coffee, or a walk.

  • Have a conversation with an adult!

  • Listen to podcasts or audiobooks!

  • New parent circles/parent groups. Many new parents report that not joining a new parent circle immediately was a regret, and find that a parents group is incredibly helpful in making connections with other new parents, setting fears and worries at ease, and getting advice on all things parenting and baby.

  • Professionals such as acupuncturists, chiropractors, cranio-sacral therapists

  • It’s important to remember that growing and birthing a baby (regardless of how baby makes their entrance!) is incredible taxing on the body. And once baby arrives, new physical changes arise. Taking care of your body is a long term benefit, as birth related physical issues often pop up later in life with pelvic floor, back problems or loss of core strength. Acupuncture specifically is starting to be covered by more and more insurance companies, so these types of services don’t necessarily mean breaking the bank.

  • Postpartum depression usually arises months after baby, and is generally noticed by partner first. It’s marked by a significant shift in your personality, not just bad moments or days. Download the app, Take PPD ACT test every 4 months. It can also occur in partners and in men. PPD also varies in degrees; check in with you and partner about emotions and changes, and don’t be afraid to voice concerns/fears… you’re not alone!

Adapted from: https://www.burrelleducation.com/2012/c-section-recovery-an-holistic-viewpoint/ http://wellnessmama.com/25482/c-section-recovery/ https://ilenajoannestandring.com/2016/04/05/holistic-healing-hacks-post-c-section/
 

ALL ABOUT ABDOMINAL MASSAGE

Massage for Pre/Post Natal and Preconception: Unlocking the Belly

Have you ever had low back pain or sciatica?  What about leg swelling? Acid reflux? Pain during ovulation or painful cramps during menstruation?  Irregular cycles? Skin outbreaks? Painful sex? Constipation or diarrhea? Shoulder pain? Bloating? Incontinence? Hemorrhoids?

Living in our bodies, and in particular bodies with uteruses (or that once had uteruses) is an amazing gift, but can also feel complicated or even painful*.  The above symptoms can affect everyone, but can be especially persistent during pregnancy, post-partum, menopause, and in pre-conception. And despite the fact that these experiences are very common, it can be hard to find relief, and our bodies are stigmatized in such a way that we might even feel too embarrassed to ask for help.

The Abdomen: Starting from the Center

What all of the symptoms above have in common is that they often originate in the abdomen.  The abdomen starts at the very top of the pubic bone and extends up to the top of the bottom of the ribs and is the seat of many major body functions, including digestion, respiration, chemical processing and integration, and creation.  Different spiritual traditions describe the belly as the origin of creativity, connection to self, and as the place where we connect to our ancestors. Emotionally, the belly holds hope, fear, anxiety, protection, strength, and vulnerability.  Our abdomen is greatly impacted by our emotions. If you’ve ever had a “sinking feeling”, a “knot” in your stomach, or “butterflies” you know what I mean. Conversely, tension or pain in the abdomen can lead to a fuzzy brain feeling, depression, and anxiety.  

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Why is it that this area has so many meanings, and can be related to so many feelings of joy and pain?  From a physiological perspective, the abdomen contains the liver and gallbladder (processing all chemical reactions in the body), the stomach and spleen, the pancreas, the intestines, the uterus, and the prostate**.  The abdomen is bordered by the respiratory diaphragm (which is responsible for controlling and allowing breath) at the top, the pelvic diaphragm (which holds up your reproductive organs, rectum, and intestines) at the bottom, and your aorta and vena cava (responsible for delivering all blood to your body and returning it to your heart) as well as the kidneys in the back. Muscularly, your abdomen is held together on the outside by a complex set of muscles that hold everything up as well as together and allow you to sit, stand, bend over, and keep your organs intact.  Your abdomen also contains portions of the powerful iliopsoas muscles, which extend from your mid back, travel through your respiratory diaphragm, and attach at the front of your hips and inner thighs (iliopsoas challenges can lead to symptoms ranging from severe low back pain to trouble breathing). Your abdomen also carries blood and lymph circulation to your upper and lower extremities. As if that wasn’t enough, your gut has its very own nervous system, the enteric nervous system, and has been found to play a significant role in the regulation of emotion.

TL;DR-Your abdomen connects to every major metabolic, reproductive, and nervous system function in your body, from the top of your brain to the tips of your toes!

Connection to Cycles, Fertility, and Transition

Whether you’re trying to get pregnant, never plan to be pregnant, or are going through transition to menopause, abdominal massage still has life-changing benefits.  Part of living in a patriarchal society means that people socialized as girls are given messages from even before puberty that they are insufficient, faulty, and need to be controlled.  It’s no surprise then that when people have painful menses, missed or changeable cycles, endometriosis, or fibroids the immediate answer they are often given is to take strong hormonal medications or to have surgery. While there are absolutely times when these forms of medicine make sense, they are often pushed on people without first providing adequate education and agency.

Hormonal differences, blood and lymph stagnation, and varying uterine position can all contribute to symptoms of infertility or cycle irregularities, as well as increased symptoms during life transitions.  Rather than pathologizing the person, abdominal massage works to support the entire system. By gently bringing circulation and metabolic activity to the cells of the reproductive and digestive organs, these symptoms—even something as severe as large fibroids—can be reduced and sometimes even eliminated.  Did you know that a uterus moved slightly to the back can cause menstrual cramps, constant yeast infections, and low back pain? Or that tight fascia around the intestines can lead to IBS? While the pain can be severe, the healing can be quite simple, and easy to access through self-care. For people who have had or who find they need or desire surgery and medication, massage can be an extremely supportive modality, and help a person connect to their bodies more deeply and increase the healing capacity of the other modalities they are engaging.  

Massage During Pregnancy

During pregnancy, the entire body goes through amazing changes.  As tendons and ligaments loosen to allow the bones to separate to accommodate a growing baby and a birth, our skeletal muscles might get tight to compensate and make sure we don’t fall forward or backwards.  In addition, the 5 ligaments that hold the uterus in place have to move and stretch, most notably the infamous round ligament, which attaches from the top of the uterus to the outer labia (no, you are not imaging that your labia hurt!There’s a reason!) and grows from just a few centimeters to up to 14 inches during pregnancy.  In addition, as your belly grows, even just a small amount, it changes the relationship to your intestines, stomach, liver, bladder, and lungs. Depending on the position of your uterus before and during pregnancy, even small changes can cause digestive, urinary, and respiratory symptoms as early as 5-6 weeks.

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In addition to changes in your abdomen, the growth of your uterus and the influx of hormones in your body can lead to pain and discomfort in your hips and back.  Most pregnant people (or anyone around pregnant people!) are familiar with the phenomenon of sciatic nerve pain--severe pain and numbness in the hips, low back, and legs. While many people find relief from releasing gluteal muscles, pain along the sciatic nerve can also be caused by the shifting of weight into the front of your body, and pressure on the nervous and blood circulation to your legs.  Similarly, leg cramps (charlie horses), numbness, and swelling can be caused by a restriction of blood and lymph to the lower extremities as pressure in the abdomen and pelvis increase. Pressure in the top of the abdomen can lead to shortness of breath, but also digestive challenges as the stomach, spleen, and liver change shape and the esophagus musculature becomes more lax. Finally, many pregnant people suffer from extreme pain in the pubic bone and groin, incontinence, and constipation.  While some people might be told their hips are “too small” or their babies “too big” this is almost never true. What is more often the case is that the uterus is in a position where the baby is pushing on the pubic bone, cervix, rectum, bladder, or intestines.

Abdominal massage can address all of these issues and more.  Before 20 weeks of gestation, abdominal massage is indicated for the upper abdomen only, and can help the liver process the large increase in hormones, the stomach move through difficult constipation and nausea, the diaphragm expand to accommodate easier breathing, and the relax tissue around the esophagus to ease acid reflux.  After 20 weeks, abdominal massage on the lower abdomen focuses not on moving the baby, but instead on the ligaments, muscles, and circulation surrounding the uterus. The principal is to provide more circulation and space for the uterus to do its important work, and more room for the baby to move into a comfortable position for you and them.  Abdominal massage can even help a breach or posterior baby turn!

Post-Pregnancy and Beyond

Fortunately there has been a significant increase in the amount of attention paid to birth giving people after labor over the past several years thanks to the hard work of birthworkers and advocates.  However, many still find a lot of isolation, pain, and lack of information following delivery. Difficult births, unplanned cesareans, epidurals, and other occurrences during labor and birth can be traumatic, with many people being pushed into feelings of shame or embarrassment if things did not go as they planned, or as family or community wanted.  Terminations and losses of pregnancy carry their own complex emotions, and people often are not given room to process these complexities. Conversely, people who have “easy” births can feel their own sense of shame for not having the same experience as their peers, and might feel unjustified in talking about their own discomfort, emotional challenges, and fears.  

Massage following a pregnancy can release both physical and emotional pain, and can help people deeply connect to a part of their bodies they may have felt cut off from, or simply have felt changed.  Massage for any type of incision after it has healed can cause a dramatic reduction in scar tissue. Abdominal massage when there hasn’t been an incision can help the uterus tone and be situated in the pelvis, and can help heal pelvic floor challenges such as prolapse, hemorrhoids, post-partum incontinence, and diastasis.

People often ask “Am I still post partum after...1 year...5 years...40 years?” My answer is absolutely yes!  You are post partum as long as you feel that way. While you are not defined by your pregnancies, they can also have a lasting impact, and it is never too late to care for yourself.

And finally, people without uteruses can benefit from abdominal massage as well! Whether you used to have a uterus (or more than one), or never had a uterus, the abdomen is still home to all of your other crucial organs and is still a spiritual home for creativity and self-actualization.

Cindy Samantha. Cindy is a certified prenatal massage therapist, cranio-sacral therapist, and a certified practitioner of the Arvigo Techniques of Abdominal Therapy ®.

*This post was written with a certain population in mind, particularly, people who at some point have or had uteruses, for the purpose of describing symptoms particular to that anatomy.  However, many of these principles can be applied to any one, with any type of body and regardless of gender identity, gender expression, coercively assigned sex at birth, hormone therapy, or surgery (affirmation or otherwise). Other treatment principles are specific to people with prostates, and with a range of anatomies.

**This is a general description of abdominal anatomy.  Not everyone’s internal organs are arranged in this way, and not everyone has all of these organs.  The pictures similarly are meant to provide a suggestion and framework for understanding abdominal anatomy, and do not reflect a universal, correct, or “normal” abdomen since there is no such thing.  

 

 

TYPES OF CARE PROVIDERS

Differences between OBs, Midwives and Doulas : their roles and how they work together in NYC.

 

Types of Providers:

Midwife - medical professional who helps with care from preconception, abortion, birth control, pap smears, bimanual exams, birth, postpartum, breastfeeding and menopause. They attend to patients at home, clinics, birth center or hospital. In hospitals, midwives are required to be connected to an OB.

Doula - non-medical professional who provides emotional support and comfort techniques. Doulas work in all settings – hospital, home or birth center. Doulas can be specifically for preconception, birth, postpartum, miscarriage, loss or abortions.

OB / OBGYN - works at clinic, birth center or hospital

  • OB or obstetrician - physician who delivers babies (OBGYN is just another common name for an OB; they are the same).

  • GYN or gynecologists - physician who specializes in female reproductive organs. Note, all obstetricians are trained gynecologists, but not all gynecologists are obstetricians

Maternal Fetal Medicine Specialist - OBGYN who has done extra education and training in order to attend to high risk, complicated pregnancies and births

 

A few difference between OB care and midwifery care:

  • OBs can perform surgery, and manage high-risk/complicated births as well as low-risk clients
  • Midwives offer birth services for low-risk clients, and generally do not work with high-risk pregnancies

  • OBs usually actively manage care while midwives will usually offer fewer interventions

  • Prenatal care with an OB will often involve more ultrasounds and tests than prenatal care with a midwife

 

Midwives tend to view birth as a natural biological process with focus on the health of the birthing parent and baby, finding and resolving issues early on, and the intersection of emotional, physical, and mental health in pregnancy and birth. Midwives are there to guide the birth and keep things safe while allowing baby and parent(s) to follow their own instincts, interfering as little as possible.

Medical models of birth focus on the treatment and diagnosis of complications, and employ much more frequent interventions. Medicalized births generally involve more protocol constraints and less freedom – for things like visitors and movement during laboring/pushing, for example – than do midwife-assisted births, and medicalized births often involve interference with progression of labor, often owing to hospital insurance rules.

It’s important to remember that these philosophies can also vary from provider to provider, so interviewing or just chatting with your possible provider(s) to get a sense of their personal methodologies is essential.

 

Types of Midwives

  • There are multiple paths that midwives take to receive training and licensure, and although they are more similar than they are different, the distinction is especially important to recognize in terms of insurance coverage and cost. Below are descriptions of the the various types of midwives, and some general information about what the distinctions between midwives mean, their training, and how they work.
  • The varying types of care work can be daunting, but it's important to remember that all midwives are focused on women's birth care, and have all received training in the field; it's only price and legal licensure by state that varies.
  • Choosing a midwife and/or doula to fit yourself and your needs is what counts; speak to multiple people, ask any questions you have about pre/post-natal care and birth itself, and choose someone you trust and who services fit within whatever financial guidelines you may have. If you can, ask around for recommendations! Word of mouth goes a long way!

 

Certified Nurse Midwife (CNM):

  • Certified, registered nurses (during or prior to midwifery training)

  • Graduated from a nurse-midwifery program, and passed the midwifery board

  • Practice in all birth settings

  • Legally recognized in every state (in 18 states, they are allowed to diagnose and treat without supervision; the rest require a collaborative practice with a physician, and insurance reimbursement is mandatory)

 

Certified Midwife (CM):

  • Graduate of a recognized midwifery program, who has passed the midwifery board

  • Practice in all birth settings

  • Legally recognized in NY, NJ, RI, DE, MA, MI

  • Sometimes called Direct Entry Midwife (DEM)

 

Certified Professional Midwife (CPM):

  • Newest type of certification (introduced in the 1980s); licensure is changing, and varies by state; many states have active bills currently to grant CPMs legal recognition

  • Certification is not reliant on academic degree, but proof of competency, work experience and specialized education. These midwives take an exam in addition to completing an apprenticeship  

  • Meet qualifications set by the NARM (North American Registry of Midwives) standards (and are still required to take the science classes required for nursing programs; many also have other doula and childbirth training)

  • Practice only in homes and birth centers

  • Required to receive additional non-hospital education and experience

  • State licensing and practice laws vary; some states don’t recognize any midwives (CMs or CPMs) without a nursing degree, while others are in the process of changing licensing laws to include CPM’s

 

** (Price varies greatly based on factors such as experience level, insurance, location of birth, etc, so it is important to discuss this with your care provider and your insurance company.)

 

How to find a midwife in NYC

NYHomebirth.com

List of Midwifery practices in NYC:

Midwives in the hospital:

Mt. Sinai West (has a birth center with midwives within the hospital as well *closing January 1 2019*)

Metropolitan Hospital: Village Maternity

Brooklyn Hospital

Bellevue Hospital

Maimonides Hospital

Methodist Hospital: Park Slope Midwives

Mt. Sinai East

 

Midwives at Birth Centers:

Birthing Center of New York

Brooklyn Birth Center

 

List of OB & Midwife groups at hospitals:

Dr. Hanna, Dr. Moritz

Downtown Women OBGYN

Dr. Bradley, Shulina & Nabizadeh

Dr. Guirguis

 

What does a Doula do?

Doulas are not medical providers, as they haven’t (necessarily) received any medical training; however, they play a vital and essential role in birth and reproductive care. They provide informational, physical and emotional support before, during, and after birth. Some doulas work with hospitals and birth centers, but generally they are hired directly by expectant mothers and families. Their job is to advocate for expecting parents and their wishes and provide as much support as needed.

  • A doula is usually either a birth doula, a postpartum doula or both. A birth doula provides prenatal support and support during the birth (vaginal or c-section). A postpartum doula assists in feeding, baby parent bonding, sleep schedules and general physical and emotional recovery from birth.

  • Receives formal training and certification through national organizations such as DONA (Doulas of North America International) / DTI (Doula Training International)

  • Price varies by practice and experience level. (especially how many births they’ve attended; the more experience they have the more they charge). Fee per birth typically ranges from a few hundred to a few thousand dollars, and insurance companies don’t usually cover the cost of doula services, but you may use your Flexible Spending Account to do so. Many insurance companies are beginning to recognize the benefits of doula services, and are beginning to cover the costs; it varies widely from provider to provider though, so you should call and ask. Postpartum doulas usually charge hourly witt cost depending on experience level, additional trainings such as lactation support and whether support is for hours during the day as well as overnight packages.

  • In working with a birth doulas, it is standard to have two prenatal meetings, support for birth at home and place of birth, and some amount of postpartum support, agreed upon in advance

  • With postpartum doulas it is common to have one prenatal meeting and after the birth they will be available as per your agreement with them.

  • Additionally, there are doulas who specialize in abortion, miscarriage, infertility, adoption, and stillbirth work

  • Doulas usually have additional trainings in Prenatal Yoga, Hypnobirthing or in Lactation support so you can choose one that’s right for your needs.

 

How to Find a Doula

  • Contact Love Child here!

Further resources!

  1. Doulas of North America International - https://www.dona.org/

  2. American Midwifery Certification Board - https://www.amcbmidwife.org/

  3. American College of Nurse Midwives - http://www.midwife.org/

  4. North American Registry of Midwives - http://narm.org/

Finally, the site below includes each state’s midwifery guidelines, plus information on contacting the various organizations that can get you connected with midwives of different kinds in different states, as well as information about licensing agencies in the various states:

https://mana.org/about-midwives/state-by-state