Learn everything you need to know about the RIE method from Dr. Christina Cohen.Read More
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!
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
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
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
Advil / Tylenol
cabbage leaves for engorgement
Earth Mama Angel Baby butter & herbs
Epsom Salt water wash for sore nipples
Nursing bra & clothes
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)
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!)
For cold weather: Humidifier, Baby Snow Suit, Stroller Muff & Cover.
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.
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.
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.
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.
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.
Lactation Consultant on Call
Postpartum Doula on Call
Cloth Diapering Service (launder and return clean set)
Babysitter / Nanny / Baby Nurse
Postpartum Meal Delivery Service
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.
Vaginal Tearing (in varying degrees)
Post surgery pain
Painful to sit
Sweating and hot flashes
Pain while peeing and pooping
Pelvic floor weakening
Call and/or see your doctor if you have headaches, blurry vision, blood pressure, urinary retention, clots, or a fever
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
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
Take it slow
High waisted maternity underwear
Stay on top of painkillers
Lots of anti-inflammatories & warming spices, Bone broth and Water
Scar suture wire
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)
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.
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.
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!)
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
Bottles prep & clean
Communication with Family & Friends
Bring Baby to be fed
Postpartum doula when partner goes back to work
Friends / Family
Food (Food delivery when family leaves)
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/
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.
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.
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.
The days of safety pins are gone, and cloth diapering is now easier than ever; however, with the wide variety of materials, packages and systems for cloth diapering, it can be overwhelming to find an option that is right for you. Here's a rundown of what cloth diapering consists of – to help you feel better equipped to make your own choice – and also a few companies we really love! Of course, think about what's best for your lifestyle and budget, among other things, as you approach this decision.
First… why cloth diaper?
Environmental impact: Diapers and wipes go directly into landfills, and sit for hundreds of years. If you consider the number of diapers a child goes through before transiting to the potty, thats hundreds of thousands of pounds of plastics and waste. Cloth diapering keeps waste from landfills, but is also healthier and cheaper than conventional diapering. Around 20 billion disposable diapers land in the landfill each year, the third largest consumer waste item, and 3% of all solid waste. Biodegradable diapers are a better alternative, but only slightly so, as they don’t get to actually decompose properly in a landfill.
Health Concerns: Disposable diapers are usually bleached, often dyed, and have materials such as sodium polyacrylate (the gel like absorbing crystals in the diaper pad), dioxin, phthalates and dozens of other hormonally disruptive and carcinogenic materials, many of which haven’t been in wide use long enough for a full understanding to have been developed of their impacts.
Price: Cloth Diapers are expensive upfront, but the overall cost is considerably cheaper than that of disposable diapers when you think about the 2+ years your baby will likely be diapered. Disposable diapers might cost an estimate of $1,500-2,000 per child, while cloth diapering (if laundering at home) might cost as little as a few hundred dollars during a child’s diapering years.
Anatomy of a Cloth Diaper
Prefold - a piece of fabric with extra absorbency in the middle – many people already have these as they are commonly bought as spit up cloths! They are held in place using safety pins, or the newer more common stretch hooks (you may be familiar with the Snappi brand of hooks, which stretch to each side, and down the middle). You may also see the term “flat” this simply refers to the more old fashioned insert which was a plain piece of fabric, without the extra layers in the middle. There are dozens of ways to fold the cloth around baby! Play around until you find what you prefer; this may also change as baby grows!
Covers - waterproof cover that snaps over the cloth diaper. They have snaps on them to adjust sizing (leg hole, waist, and length), which allows baby to grow with the cover.
There are also other types of cloth diapers (hybrids, pockets etc) which are modifications of the original cloth diaper, but have all the parts attached as one, or include room for excess padding. Try and get your hands on a few different types, or watch some videos of them in action, in order to decide what's most convenient for you!
What about when I’m out and about?
Wet/Dry bag - you can buy these online, or just use any sort of waterproof zip bag; when you’re out and about, you’ll put soiled cloth in the waterproof bag, so as to carry home for cleaning. This is the main difference that you’ll notice in cloth diapering – not disposing of the diaper while on the go. With a secure wet bag, this won’t be a hassle, and you may find that you feel better not constantly leaving diapers behind as you go about your day.
The benefit with cloth diapering is that, unlike disposable diapers, cloth diapers can be sized perfectly for your baby. Accommodating your baby’s stride and waist helps prevent blowouts and leaks. Unlike disposable diapers, which will have to be sized up every few months, cloth diapers are much more size forgiving, and you may only need to get a new size of covers/inserts a few times as baby grows
At home - Each family will have to sort out what routine is best for them, but generally you collect dirty diapers/covers/wipes (having put solids in toilet first!) just as you would normal laundry; some people wash every day (or maybe every other day), but you will get a feel for the volume and frequency of cleaning that is right for you.
When it’s time to wash, use a pre-wash cycle on cold, then a normal hot cycle; it’s always best to use a gentle detergent to keep your diapers lasting as long as possible (and for baby’s skin)! Finally, tumble or hand dry, according to instructions.
For stains or deep soiling, many people swear by a baking soda and vinegar rinse! You can also sprinkle baking soda into your diaper bag/pail to pretreat and keep odors away
There are also services that can do the work for you - diaperkind is an NYC-based laundering service that will pick up soiled diapers and wash and return them to you. They are a one-stop shop for all things cloth diapering as well, with all of the products and FAQ’s you could ask for! Check them out here.
Fabric squares/washcloths - simply use water or a very mild, natural baby soap (diluted), wipe and then dry baby. (water wipes are a good option for disposables, but again we recommend reusable wipes!) This would be added to the wet bag while out, and washed just as the cloth diapers are washed. This type of wipe is more absorbent, and much gentler on baby. You can keep a batch in a container pre-wet, or simply keep a spray bottle and stack of fabric at your changing station!
There are also recyclable/more natural wipes, and flushables; we just recommend avoiding the commercial wipes which go straight to the landfill and have many ingredients too harsh for baby’s skin! Again, using a mix of these is better than using all disposable wipes. Maybe for you its best to cloth wipe at home, but use disposables on the go – every diaper and wipe kept from the garbage makes an impact!
Air baby out if you have the time and space - a dry clean bum prevents diaper rash, yeast infections and irritation. Diaper rash is caused by excess moisture, so change baby often and keep everything as dry as possible. You really only need to wipe after poop, with pee, just dry baby off.
Too many options?
Most, if not all cloth diaper companies sell bundles which consist of the inserts and some covers, or whatever arrangement of diaper they offer, which is a great set for starting. It eases the stress of making sense of the overwhelming variety of choices; another great idea is to buy a few different brands (on eBay or at a baby sell/swap forum, for example) and test them out. But do not get intimidated by the many options; it only means that there's an option that will best fit you, and ultimately, cloth diapers are more similar than they are different.
You also do not have to swear off disposables completely! You can do a combination of cloth and disposable diapers. Just make a plan from the start, and if and when you need to adjust your routine, do so. Obviously, you aren’t locked into your choice, and it's always hard to know what will be best before baby comes.
Interested in further reading? Here are some additional resources to check out:
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
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
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
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!
Doulas of North America International - https://www.dona.org/
American Midwifery Certification Board - https://www.amcbmidwife.org/
American College of Nurse Midwives - http://www.midwife.org/
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:
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SHOP SMALL, ECO-FRIENDLY, NON-TOXIC, ETHICALLY MADE & SOURCED, MINIMALIST PRODUCT RECOMMENDATIONS
WHY SHOP SMALL?
By shopping small, we support local businesses and small ventures. We build relationships with our neighbors. And we keep our neighborhoods, communities, and cities healthy and vibrant. Additionally, when we shop small, we make an active choice not to support large corporations that all too often are responsible for deepening economic inequality, evading taxes, driving down wages, engaging in monopolistic behavior, and ravaging the environment.
There is a high economic, social, and ecological price to pay for the low cost of mass-produced goods, and we can help build a better world by being more conscious consumers. Paying a few dollars extra might make a minimal difference to you, but when we collectively make conscious choices about our spending, those choices can have significant positive impacts on our communities and beyond.
WHY SHOP ETHICALLY MADE AND SOURCED?
All too often, the cost of low-priced, mass-manufactured goods is human suffering. In today’s global economy, most manufacturing is done in factories remote from end consumers with little transparency regarding processes, sourcing, worker wages and conditions, and environmental impact.
By shopping ethically-made and sourced, we leverage our power as consumers to demand accountability from producers. Especially when it comes to goods and services related to pregnancy, birth, and parenthood, it is incumbent upon us to hold ourselves and others to a higher ethical standard. After all, what we model in our choices will shape our children and the future they inhabit.
WHY SHOP RE-USABLE & ECO-FRIENDLY?
Speaking of our – and everyone’s – children, we face an unprecedented global climatic and ecological crisis. For our own sake, and for the sake of future generations, we absolutely must take rapid action to slow and reverse the damage that has been done to the Earth. Shopping reusable and eco-friendly is one simple, if modest, way that we can all help reduce our ecological footprints as we fight to slow global warming and prevent climate breakdown, and each small step we take to keep material out of landfills and reduce emissions of harmful greenhouse gasses is a step in the right direction.
WHY SHOP NON-TOXIC?
Sadly, major corporations have a long history of negligence and contempt when it comes to our collective health. Although significant strides have been made in consumer protection, far too many everyday products still contain endocrine disruptors and carcinogens.
By shopping non-toxic, we do our small part to protect ourselves and others from the toxins which are now alarmingly plentiful in our day-to-day environments. None of us should be exposed to harmful substances without our knowledge, but it is especially important to protect children from toxic substances as they grow and develop. By shopping non-toxic, we signal with our dollars that a healthy and safe environment is a priority, now, and for the future.
WHY SHOP MINIMALIST?
A recent study found that the choice to have a child has a far greater climate impact, on average, than choices we make about diet, transportation, and travel. Given that parents are major consumers – even if that consumption is driven by love and concern – it is essential that we seek to minimize the impact of our consumption.
By shopping minimalist, we can reduce our ecological and carbon footprints while helping to maintain and restore a healthy Earth that will nourish humans and others for generations to come. Additionally, we might just find that, by consuming less, we enjoy our lives more, and find more time for the things – and most importantly, the people – who really matter.
- Maternity Pants
- Sleeping Pillow
- New Bras (preferably nursing bras so you don't have to get more)
- Yoga Ball
- Coconut Oil
- Services to Set Up: Birth & Postpartum doula services, Set up placenta encapsulation, Explore and set up Cloth diaper service, Order breast pump from insurance, Set up lactation support, Set up Meal Train & Housekeeping Help for after birth.
- Try on baby carrier with a doll before baby arrives.
- Sticky socks
- Hair tie/Head band
- Heating pad
- Water Bottle
- Panty Liners
- Immediately After Birth - Maternity pads, High Waisted Underwear, Nipple Cream, Nursing Bra, Nursing Pads, Nursing Clothes, Newborn Outfit, Car Seat.
POSTPARTUM & THE FIRST MONTH
- Lidocaine Spray
- Tucks Pads
- Stool Softener
- A place for baby to sleep (co-sleep / bassinet)
- Cloth Diapers
- Cloth Diaper Bin
- Reusable wipes
- Newborn Salve/Diaper Cream
- A place to change baby's diapers (changing pad and/or table)
- Newborn Outfit (tshirt / loose kimono onesie / long sleeves with mittens)
- Wrap Infant Baby Carrier (learn how to use the wrap before birth)
- Baby Nail File
- Wash cloths for burping, spit up and towel bath
- Manual breast pump
- Sound Machine.
- For cold weather Humidifier, Maternity Coat Extender, Baby Snow Suit, Stroller Muff, Gloves & Cover.
- Services: Meal Train, Lactation Consultant on call, Postpartum Doula on Call.
4 - 12 WEEKS
- Breast Pump
- Baby Bottle with preemie/infant nipple
- Baby Bath
- Baby Soap & Shampoo
- Baby Oil / Coconut Oil
3 - 6 MONTHS
- Bibs for drool
- Organic teether
- wooden rings (don't bother with toys - they'll play with anything)
- Soft Structured baby carrier
- Baby monitor
- Baby pajamas without footies so that baby wearing is more comfortable.
6 - 12 MONTHS
- Food Bib
- Puree Maker
- Fabric or board book
- Loose comfortable clothes to help movement
- Back carrier so you can start wearing baby on your back or hip
Learn all your options - Sling / Wrap / Soft Structured Carrier when you’re pregnant, take them out of the box, try them on before you buy one and try it on before baby arrives.
Take a baby wearing class - Go to a baby wearing meet up / Have a private consult / Don’t rely on YouTube videos, get in person help!
Start wearing them as soon as possible - slings or wraps are lifesavers around the house, for soothing baby and easier to go out and navigate steps, small spaces even if it's just getting coffee.
Breastfeed in the carrier - this may seem like a pro move, but once you try it may be a life saver, especially for babies with reflux.
Face them outward - Start facing babies out at around 4 months so they can explore the world. However it's recommended that you only for do so for 20 minutes at a time because they might be overstimulated and sleep poorly and also because you may not be able to read their cues.
Learn how to wear them on your hip or on your back - Start wearing babies on your hip or back when they can hold up their head and sit upright. The best part is that it'll help your posture - no more slouchy shoulders!
Learn all the pro the tips and tricks - Most carriers have 4 or more ways of carrying. Read the manual, try out all the different positions and seek out a pro to help. For example, most people don't know that you can cross the straps in the back for soft structured carriers - no more low back pain!
Proper positioning for baby - Make sure baby/toddler's legs are always in the squat or M position to avoid hip dysplasia. This is a common problem when forward facing.
Proper positioning for you - Make sure to the carrier hugs your hips and not your waist and that it sits comfortable on your shoulders. If using a middle strap across the back in soft structured carriers, lower it to be just under the shoulder blades.
Practice Practice Practice - Tying a wrap / back carrying a baby can be really awkward at first but after the first few times, it'll get easier and you'll do it without thinking. Also, just because a baby doesn't like a position early on, they may change or grow into it so keep trying.
Support the small businesses - Take the trouble to learn the wraps and ring slings, you’ll find that you get better posture and more convenient for you and baby than the big brands!
Carry toddlers - Common myth is that a toddler is too old to be carried, when actually you can carry children up to 50 lbs! Most positions are hip and back and often kids can even sleep in the carriers.
COMMON BABY WEARING MISTAKES
- Facing front for over 20 min
- Not correcting for hip dysplasia in baby
- Not having baby at the proper height so as to be able to kiss their head
- Suffering with bad posture
Ring Slings - Mamaway / Sakura Bloom
Wraps - Solly / Lille / Moby
Pre-Sewn Wrap - Baby K'Tan
Soft Structured Carriers - Infantino / Boba / Tula / Ergo / Lille
Spinning Babies: For all things related to baby's position in utero.
Science and Sensibility: Evidence based information on Prenatal tests and Birth Interventions
Evidence Based Birth: Evidence based information on Prenatal tests and Birth Interventions
Birthful Podcast: A podcast of Birth stories and other resources.
Kelly Mom: For all things nursing and breastfeeding
We all have a separation between our 6 pack rectus abdominal muscles. If the separation is more than 2.7cm, then it is considered to be ‘diastasis recti’. It can occur in pregnancy, but also in men who lift weights without engaging their core and in newborns. It’s measured in finger widths. A 1 - 2 finger separation is pretty common and 3 - 4 finger separation is considered ‘big’.
There is no way to know how much your separation is/will be until after you give birth. It’s very very common in pregnancy, we see it all the time, it’s not painful and definitely not something to worry about for the moment. We resolve any diastasis issues in postnatal workouts!
It can happen for many reasons. For some people who have a really strong core, they’ve only focused on building strength in their abdominals but haven’t focused on flexibility. Our abs, just like our hamstrings ideally are strong and flexible. In pregnancy, ab muscles have to stretch to accommodate baby and if they’re not flexible, the cartilage between them begins to separate instead. For others it occurs just as the belly grows bigger, or not being careful enough about turning over to one side and getting up form laying down. But you could be really careful and still have diastasis!
There are many good reasons to try to minimize the separation - it weakens abs, can cause low back pain, it affects baby’s position and causes the little pooch that many people have after kids. But if you do have it, it should clear up on it’s own 6 weeks postpartum. Your doc will let you know at your post-birth check up if you have it. If it you do have it, then we would start to make modifications in postnatal exercise.
While you’re pregnant, exercises to avoid are any ab work that causes your belly to bulge and cone - sit ups, crunches, boat pose. But the biggest culprit is lurching straight up from laying down rather than turning on your side. The best thing you can do to prevent a separation, a separation from worsening or to heal the separation is the ab exercise we do in class - belly pulls on all fours, and the breathing exercise - nose throat chest belly.
Make sure your core (diaphragm, pelvic floor, transverse abs and multifidus muscles) are working together in sync. That means, hands to belly, as you inhale, feel belly expand, lengthen and release pelvic floor. As you exhale, feel transverse abs (the ones that go all the way around your waist) engage and draw in and feel slight lift of pelvic floor. If you're pregnant, you can do this exercise on all fours. If you're postnatal, on your back with knees bent and feet on the floor.
By Neelu Shruti
The benefits of yoga are far-reaching. In an hour of downward facing dogs, sun salutations, and other poses, we can exercise while releasing stress and becoming more mindful. While we can all find benefits in the practice of yoga, there are exceptional benefits to the practice for pregnant women.
Prenatal Yoga is designed to build strength and flexibility in your body to help you carry your growing belly more efficiently, so you can feel your best — preventing low back pain, hip pain and round ligament pain and other common pregnancy aches and issues. Yoga while pregnant is safe in all stages of pregnancy and is recommended as long as you avoid deep twists, deep backbends, any abdominal exercises that compresses the uterus and laying flat on your your belly or back.
More significantly, prenatal yoga targets the muscles you will use in labor and birth helping you build strength, flexibility and stamina where you’ll need it the most and offers tools to aid in labor and birth. Whether you have a vaginal or a cesarian birth, practicing yoga while pregnant will significantly aid in your postpartum recovery.
A few of the benefits of prenatal yoga are:
Get a good workout: Exercise is great for you and your baby! Whether you’re a regular runner, spin cyclist, or yogi, keeping up your active lifestyle can be more challenging when you’re pregnant. For starters, your tendons and ligaments become a lot more flexible during pregnancy due to the influx of relaxin in your body, and you’ll want to build muscular strength to prevent injuries from hyper-flexibility. Prenatal yoga offers all of the benefits of maintaining your exercise routine (including helping to reduce stress, control weight, improve health and well-being, maintain a positive mood, boost energy, and get better sleep) while being safe for you and your baby. And if you’re not an exercise junkie, or have let your routine slip a little, now is a great time to start because the healthier you are and the better shape you’re in, the better it is for your baby! There’s even evidence, according to recent studies, that exercising regularly when you’re pregnant can boost your baby’s brain function!
Strengthen your abdominal pushing muscles and learn to relax your pelvic floor: Another incredible benefit to prenatal yoga is that incorporated into the sequence are targeted exercises to help strengthen, and improve flexibility in key muscle groups. Doing crunches and plank is neither very comfortable, nor recommended when you’re pregnant, and prenatal yoga offers an excellent alternatives to tone your transverse abs (your deep corset pushing muscles) in a safe manner. Additionally, prenatal yoga targets the key muscle group known as the pelvic floor. The importance of both strength and flexibility in the muscles of the pelvic floor cannot be overstated. The pelvic floor muscles are muscles in the bowl of your pelvis. It is essential that they are strong enough to allow the baby’s head to rotate when descending, and to prevent pelvic organ prolapse, but also that they are flexible enough to open and release to allow the baby through. Labor involves the unique combination of flexing and pushing with your abs while relaxing your pelvis which can be tricky, and prenatal yoga incorporates ab work, pelvic floor exercises, and breathing exercises, all of which can help accomplish this challenging balance during birth. Not only are you learning how to target those areas, you’re learning how to synchronize them, while building strength and flexibility where you’ll need them most.
Learn to deal with discomfort: The therapeutic benefits of yoga are far-reaching. Prenatal yoga can help prevent and address common issues such a lumbar lordosis (lower back pain), sacro-iliac pain, sciatica and piriformis pain. The poses can also create space in the torso for better breathing, and include movements that can help to alleviate carpal-tunnel syndrome and charley horses, as well as demonstrate positions for better sleep. By working through discomfort with breathing techniques and a focus on mindfulness, you are able to alleviate discomfort, and the practice of challenging yourself and building muscle strength builds your tolerance to pain. In prenatal yoga, the poses are designed to challenge, but not strain your body. Learning to breathe and maintain calm in an intense stretch teaches your body how to react to and manage a stress, so you’ll be better-equipped to handle stressful situations during your pregnancy, and of course, more prepared for labor.
Get baby in the optimal position: Compared to the benefits of other forms of exercise, the really exceptional benefit of prenatal yoga, is that poses like down dog, cat/cow, and puppy pose gently guide your baby’s head down, facing your spine, the ideal position for birth. That’s right, the more cat/cows you do, the more you’re encouraging your baby’s head down toward optimal fetal position! Prenatal yoga counteracts the long periods of laying back on your couch or sitting at a desk — which have the exact opposite effect and can encourage breech or posterior (sunny-side-up) babies and result in longer births times and sometimes lead to medical interventions — and helps have you and your baby exactly where you need to be when the time comes.
Breathe: Often, we don’t pay attention to our breath which tends to be shallow as we go about our day-to-day activities. In yoga, we begin to pay attention to our breath, and to teach ourselves to focus on maintaining deep, full breathing. The benefit of the yogic breath is that we become aware of our diaphragm’s movements and begin to use our lungs to a greater extent, engaging their full capacity and allowing a larger intake of oxygen. This focused method of deep breathing calms our mind and allows us to relax and use our muscles more efficiently. Breathing and active relaxation exercises taught during a prenatal yoga class help reduce stress for overall better physical and mental health for you and for your baby.
Bond with baby: Recent studies have shown that the practice of mindfulness allows parents to recognize, appreciate, and connect with their babies. Embracing a few minutes of quiet time where the distractions of the day fade away allows you to focus all of her attention inward and on the baby, and can help you to zoom out, see the big picture, and be less bogged down by the day-to-day frustrations. It also allows you to notice changes in the growing baby and in your own body. The practice of mindfulness and building a bond with baby prenatally can aid in preventing postpartum depression.
Build confidence: When dealing with a growing belly, hormonal changes, back pain, swollen feet, and constantly having to pee, it’s easy to get frustrated with the constant physical changes in your body. It’s important to remember that your body (even with all the discomfort you feel) is strong, healthy, and capable. Practicing yoga — whether it’s finishing your regular sequence, or doing a particularly challenging pose when you’re pregnant — can give you great feeling of accomplishment, and build your confidence and trust in your body and its innate ability to labor and give birth.
Be part of a community: The first few minutes of a prenatal class usually consist of introductions where you’ll be able to discuss issues, discomforts, and concerns with others. As the conversation goes around the room, you’ll hear how others are dealing with the same issues that you’re facing. This creates a space for sharing and learning from each other, and also allows the instructor to customize each class to fit your needs. Most of all, you’ll meet other parents who are experiencing the same challenging, wonderful changes as you, while pursuing a practice that helps ensure the safest, healthiest, and most joyful outcome for you and your baby.
If your pregnancy is categorized as low risk and you are hoping to give birth with minimal interventions, but still have access to emergency hospital services, a birth center is a fantastic option.
Why choose a Birth Center?
- Birth Centers offer more pain relief options such as a jacuzzi and nitrous oxide (laughing gas) which is very common in Europe and U.K. but not offered in many NYC hospitals.
- Birth Center environments tend to be a bit more homey with lighting options, bigger beds and friendly furnishings. All their medical equipment is usually hidden in closets rather than displayed.
- Birth Center cesarian section rates tend to be much lower and they perform fewer interventions.
- Birth Centers allow for intermittent fetal monitoring or will conduct monitoring with a hand held doppler which means that your movement isn’t restricted.
- Birth Centers allow for a variety of pushing positions - squatting or all fours for example which tend to cause less tearing. Often in hospitals you are required to push laying down on your back or on your side.
- Birth Centers allow partners to stay overnight after birth. (This is not always the case with shared rooms in postpartum but is allowed with private rooms at hospitals)
- Birth Centers within a hospital still offer all the expertise and options a hospital would provide such as and epidural or NICU facility. Free standing birth centers are located a short distance from their partner hospitals.
What’s the rush?
Birth Centers are in high demand and many care providers who have privileges at a birth center don't take clients after the first trimester. Some will take clients up to 20-22 weeks.
Are you a good candidate for a Birth Center?
Ask yourself -
- Are you low risk?
- Are you comfortable with trying alternate pain management techniques either in liu of or before an epidural?
- Birth centers require that you are at least a few centimeters dilated before being admitted so you’ll have plan to labor at home for a bit until you’re in active labor before being admitted.
- Birth centers will dismiss you after 24 hours after birth which might be too soon for some, but can be a relief to others.
How do I know if I’m low risk?
- Singleton, term, vertex pregnancies, and the absence of any other medical or surgical conditions is defined as a low risk pregnancy.
- If any conditions present in the course of pregnancy and is classified as ‘high risk’ appropriate steps will be taken by care providers to recommend or transfer care. For example, if baby turns breech close to term, midwives will often transfer care to OBs they have a relationship with and may also be present at time of birth.
Are Birth Centers equipped to handle emergencies?
- Your care providers will continue to monitor you closely but if any predictable issues occur, (pre-term labor, gestational diabetes), you may be required to give up the birth center option and give birth in L&D instead, with your same providers.
- When you check in to a Birth Center when in labor, if any of the tests are non-reassuring (high blood pressure, presence of meconium, fetal heart rate irregularity) your care provider will determine whether you’ll be able to give birth in the birth center or whether to transfer you to L&D.
- In case of an emergency (emergency c-section, postpartum hemorrhage or if baby needs NICU) during birth, you will be transferred to the L&D floors, again with your care provider.
What if I change my mind and want an epidural?
- You’ll be transferred to L&D and be able to get one.
Where can I find a Birth Center?
There are many different kinds of birth centers - free standing Birth Centers and Birth Centers located within a hospital, right next to labor & delivery units.
- Mt. Sinai Birth Center - Birth Center located within the Mt. Sinai St. Luke’s Roosevelt Hospital near Columbia Circle.
- New York Presbyterian Downtown Birth Center (LOMA) - Birth Center located within the New York Presbyterian Lower Manhattan Hospital near Wall St.
- Birth Center at Metropolitan Hospital with Village OB & Midwives - Birth Center located within the Metropolitan Hospital on the Upper East Side
- Brooklyn Birth Center - Free standing Birth Center located near Sheepshead bay in Brooklyn, supported by Maimonides Hospital.
- Birthing Center of New York - Free standing Birth Center located in Bay Ridge, Brooklyn.
Which care providers have privileges at Birth Centers?
If you’d like to give birth at a birth center, you have to work with a care provider who has access. Not all care providers are designated for the birth center, so please be sure to check with yours.
- You can work with an OB Practice, an OB & Midwifery Practice, a group of Midwives or a single OB.
- Below are a list of care providers who offer services at Birth Centers:
Dr. Katrina Bradley, Dr. Nabizadeh & Dr. Shulina at Mt. Sinai Birth Center & Hospital
Dr. Anna Rhee at Mt. Sinai Birth Center & Hospital
Dr. Gae Rodke, Mt. Sinai Birth Center & Hospital (doesn’t take insurance)
Dr. Paka, Mt. Sinai Birth Center & Hospital
Village Maternity, Metropolitan Hospital (Birth Center) (backed by Village OB)
CBS Midwifery, Mt. Sinai Birth Center
Central Park Midwifery, Mt. Sinai Birth Center
Community Midwifery Care, Mt. Sinai Birth Center
Risa Klein Midwifery, Mt. Sinai Birth Center
Sarah Jensen, CNM, Mt. Sinai Birth Center
Sabine Jeudy, CNM Mt. Sinai Birth Center
Midwives at NYP Downtown Birth Center
Dr. Hanna, NYP Downtown Birth Center
By Dr. Alexandra Garcia
As an acupuncturist I’ve seen a recent rise in interest in acupuncture for fertility and pregnancy. As more doctors learn about the research supporting the efficacy of acupuncture, more patients are being referred by their care providers for conception support, back pain during pregnancy, and breech presentation.
I’m encouraged to see that the word is getting out - and I’d like to share some of the other great ways that acupuncture can help people during and immediately following pregnancy.
First, let’s talk about what acupuncture actually does.
Acupuncture has ancient roots and now science has a modern explanation for its mode of action. Traditionally acupuncture is explained as a means of manipulating the energy that flows in channels through the body. Today scientists are discovering that the channels are intricately intertwined with the modern concept of fascia - a connective tissue that wraps through the body and generates electricity under pressure. Acupuncture has been shown to shift the nervous system into a "rest and recover" state. From here a range of imbalances can be righted: muscle pain, digestive difficulty, insomnia, conception challenges, and others.
When it comes to pregnancy, labor, and the postpartum period acupuncture can be a powerful resource for some common complaints. Here are just a few ways it can be used:
In the last month of pregnancy there's a wave of physical and biological changes preparing the body for labor. As the days count down, people feel this physically in the final weeks as braxton hicks contractions. My teacher has a way of explaining this stage of pregnancy: “It’s like when you’re in a stadium practicing to do the wave. The first time it’s kind of sporadic, with different pockets of people joining in. Eventually, everyone realizes what’s happening and you get this big coordinated effect. Your body is calling on all systems to choreograph the perfect wave: the birth contraction.”
Acupuncture excels at syncing the body’s systems: Endocrine, Muscular, Nervous. By switching off our internal “fight-or-flight” system, acupuncture lets the body know that it’s a safe time to start practicing for the big day.
Studies have shown that people who have acupuncture in the last month of pregnancy are less likely to need chemical inductions; and of those who do still need an induction, the people who use acupuncture end up using smaller doses of those medications.
Labor & Delivery
Acupuncture can be a wonderful resource during labor. Of course acupuncture is excellent for pain management but there’s a whole lot more that it has to offer. In hospitals that provide acupuncture during labor, the practitioner can help support a smooth progression through each of the phases of labor. Acupuncture techniques can be used to encourage regular contractions, progress cervical dilation, and sustain a laboring person’s energy through the process.
Traditionally, acupuncturists view pregnancy in 4 steps: The three trimesters (12 weeks each), and the postpartum period (a fourth trimester of 12 weeks). They are all considered equal parts in the big picture of pregnancy.
In the weeks after birth, the parent’s body is intensely focussed on recovery. This creates a great opportunity for overall rejuvenation. Acupuncture can help you harness this postpartum energy to reset your body’s foundation. It’s a unique chance to address issues from before the pregnancy - things like painful PMS patterns, digestive difficulties, and neuromuscular pain.
With weekly acupuncture and a good self-care practice, the weeks after labor can be channeled to build the strong foundation you need for the joyous challenges of the adventure ahead: parenthood.
People are often surprised to learn that acupuncture can be used to treat infants and children. In fact, acupuncture has a long history of treating children - the Chinese recognized pediatrics as a separate area for training and medical specialization several hundred years before western medicine stopped treating children simply as mini-adults. As research is emerging about the value of (often needle-free) acupuncture for newborns, toddlers, and children, more hospitals are starting to include practitioners on their pediatric staff.
Acupuncture can be used in all stages of life as part of a comprehensive wellness strategy. During pregnancy, labor, and postpartum it can be incorporated into a healthcare plan to complement the work you do with your obstetrician or midwife.
If you’re in NYC and interested in trying out acupuncture you can book an appointment right here at Love Child.
But for those of you reading from other cities, here are some tips for finding a qualified practitioner near you. When considering acupuncturists you’ll want to be sure that you chose someone who is licensed to practice in your state. This indicates that they’ve gone through several years of training in a master's level program and that they’ve completed state and/or national board exams. You should also check that they have experience working in the area of obstetrics and/or pediatrics. Your doctor, midwife, or doula may be able to refer you to someone who they regularly work with. Finally, look for a practitioner conveniently located so that you can easily make time for regular visits, and - most importantly - chose someone who makes you feel comfortable and cared for!
Dr. Alexandra Garcia holds a doctorate in acupuncture and East Asian medicine. Her practice focuses on pediatrics and obstetrics. She also has training in facial rejuvenation, pain management, and general wellness.
Before earning her doctorate, Alexandra completed a B.A. at Middlebury College and an M.S. from Pacific College of Oriental Medicine. She currently splits her practice time between Love Child Yoga and NYU Lutheran’s Labor and Delivery Department in Brooklyn.
Alexandra supports her clients using a holistic approach. Her treatments weave together a variety of modalities including acupuncture, cupping, herbal formulations, bodywork, and dietary guidance using the frameworks provided by Traditional Chinese Medicine.
Cardini, F. & Weixin, H. (1998). Moxibustion for Correction of Breech Presentation: A Randomized Control Trial. JAMA 11, 1580-1584.
Gaudernack, L.C., Forbord, S. & Hole, E. (2006). Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the lengths of birth and use of oxytocin: A randomized control trial. Acta Obstetrica et Gynecologia, 85, 1348-1353.
Greenspan, M. (2005). Acupuncture as a Means to Promote Full Term Vaginal Delivery (Doctoral Dissertation). Yo San University, Los Angeles.
0u, H., Greeven, A., & Belger, M. (2016). The first Forty Days: The Essential Art of Nourishing the New Mother. ABRAMS, New York.
Scott, J. & Barlow, T. (1999). Acupuncture in the Treatment of Children. Eastland Press, Seattle.
There were two things I wanted for my daughter's birth. I wanted her to be able to choose her own birthday (no induction) and I longed for a non-traumatic birthing experience. I knew delivering in a hospital could have the odds increased of unwanted medical interventions, so I prepared the best I could. That meant hiring a doula team my husband and I loved, prenatal yoga, taking birth prep classes and re-reading the wisdom of Ina May Gaskin.
My due date of 5/31 came and passed. I kept going out to brunch and walking a ton to pass the time. I made a big batch of laboraide and froze some into popsicles. As my next OB appointment and talk of a scheduled induction approached, I set up an acupuncture session 1 day past my estimated due date to stimulate the points that could kickstart labor. The very next evening bloody show made an appearance. It was followed by the loss of my mucus plug about 12 hours later. Very irregular contractions started around this time and lasted for 24 hours.
On the evening of 40 weeks, 4 days my contractions kicked in at a more regular frequency around 1am. I remember my doula advised me to relax and go to bed early that night and I decided to stay up and watch the series finale of a television show I watched over the past few years. I now regret this as I couldn't focus on the show and I could have used all the rest I could get. My husband and I didn't sleep at all that evening and when we woke up at 40 weeks, 5 days, the contractions were more frequent and intense at around 4 minutes apart. That morning we asked that one of our doulas join us at home.
When our doula arrived around 11am I was halfway into the shower thinking it would help with my contractions. It did help me take my mind off of things. I was glad the doula joined us as my breath was veering off into hyperventilation territory and I had lost my mindful breath. She got me back on track. My doula, husband and I breathed through so many contractions mainly with me leaning over an exercise ball.
As we approached 3-1-1 (3 minutes apart, 1 minute in length, for 1 hour) and I started to wonder when we should go to the hospital. Our doula mentioned there was still some work to be done at home. She was right. I was still talking in between contractions, trying to make jokes. It didn't take long for me to go to a deeper place where I was in my own zone.
This helped when we called a car to drive us from Brooklyn to our hospital in Manhattan. I labored so loudly in that car. I was on my knees, with my body facing the rear of the car holding on the car seat headrest. As we drove over the Williamsburg Bridge I remember opening my eyes at one point and looking out the back seat window to make eye contact with a driver right behind us. I didn't even care at that point.
We finally made it to the hospital around 1pm. I remember I had two contractions (with me moaning very loudly) before I could even make it to the check-in desk upstairs. In triage I learned I was already 8cm dilated and fully effaced. This didn't mean I would get to my labor and delivery room anytime soon.
I was still stuck in triage for about two hours. While there I had two medical inventions I didn't initially plan on (my water being artificially broken and internal fetal heart monitoring being attached to my daughter). I also was initially feeling an urge to push when an anesthesiologist showed up and wanted to discuss options with me. I remember it was so easy to block him out and sign whatever paperwork he wanted so I could focus on my contractions.
At one point I started crying because I thought I'd be giving birth in triage it was taking so long. My doctor, who was also in her 3rd trimester of pregnancy, advocated for me to get into my labor and delivery room. When we finally moved to the room, I remember complaining as to why so many fans were blowing as it was distracting and making me cold. Turns out they were frantically trying to dry the floors as they had just finished cleaning the room. I'm glad I was too deep in my contractions to notice how close we were to not getting a room to deliver in at all.
Once we were in the room it felt like things moved rather quickly. I waited for my daughter to get to the proper station while on my knees in the bed, leaning over the back of it. When it finally came time to push, my doctor convinced me to get on my back with my feet in stirrups and they "broke the bed" and encouraged me to push when I felt the urge with each contraction.
Pushing was the hardest part of labor for me and I ended up doing so for 50 minutes. The whole idea of pushing extremely hard without expelling any breath was foreign to me and I wasn't prepared for the sensation and intensity. The doctor asked if I wanted to reach down and feel her head while she was crowning and I surprised myself by doing so. I don't think I realized how close I was to being finished at that point.
A few last pushes and Adeline was born at 4:10pm, approximately 15 hours after my regular contractions started. The doctor let me naturally tear which was fine except for the fact a resident did the repair afterwards and I felt the teaching moment took what felt like forever. It also made me so uncomfortable that Adeline was eventually taken from me and given to my husband while they finished up.
Looking back, my labor and delivery experience makes me so proud of myself. I had told myself beforehand that the sensations associated with labor are normal. It's not pain. It's my body doing what it naturally knows to do. Accomplishing the birth I wanted was due to my prep work, but I know it was also up to a little luck as there are often circumstances out of one's control.
If I decide to have another child, I've already decided to look to do so at home given it's a low-risk pregnancy. Even though my labor and delivery was what I had in mind, the postpartum period in the hospital setting was uncomfortable and unsettling. The hospital room I had was shared and if I stuck my arm out into the curtain right next to me, I'd be in my neighbor's bed. Not really the best environment to rest and get your bearings. I was so happy when it was time to leave and return back to our safe haven at home to start recovery and spend time alone as a new family.
PRIDE brings rainbow-filtered Facebook profiles, multicolored corporate messaging, and some of NYC’s best summer celebrations. And I must say, I think this is a fabulous development. The fact that everyone wants to be included in PRIDE is beautiful. But when it comes to healthcare, rainbow swag in the waiting room doesn’t necessarily equate with LGBTQ+ competent providers. During pregnancy, birth, and postpartum, it can be especially challenging to feel fully supported as an LGBTQ+ parent.
The birth world is so steeped in hetero- and cis- assumptions, that it can be hard to imagine what an LGBTQ+ inclusive birth team would even look like. So let’s begin by talking about what makes an LGBTQ+ competent provider:
Inclusive language: At the most basic level, a practitioner should have the vocabulary to discuss your health. Fluency in relevant terminology shows a commitment to making sure LGBTQ+ people don’t feel like an inconvenient anomaly in the birth world
Asking the right questions: An intake form allows clients to share their basic medical history but, only if the right questions are being asked. A competent provider recognizes that a person’s identity as LGBTQ+ is relevant to their health preferences, needs, and expectations.
Relevant resources and referrals: Clients count on their birth team for all sorts of referrals and resources during pregnancy and postpartum. An LGBTQ+ friendly provider may not realize that the majority of books and facts sheets are heteronormative and don’t reflect their LGBTQ+ families. But a competent provider will consider the extra financial hurdles that parents may have gone through just to become pregnant, and will take into account the impact this may have on options for services during the pregnancy.
Commitment to continuing education: LGBTQ+ competency, like any type of expertise or specialization, takes training and ongoing education. The resources, legal rights, and medical research for the LGBTQ+ community is constantly growing and changing. To offer full support to LGBTQ+ people during pregnancy, birth and postpartum, providers need to be committed to ongoing education.
Now that we have this picture of an ideal provider, where do we find them? How can we pull together this queer competent birth team? Here are some ways to begin building a list of options:
1. Ask other LGBTQ+ parents.
Families who have been through the birth process are an amazing resources. Queer parent groups are a great way to hear about people’s experiences first hand. They’ll be able to tell you who was the all-star on their birth team, and who you might want think twice about working with. Personally, I can recommend the groups at Brooklyn Acupuncture Project and here at Love Child Yoga.
2. Ask the hospital or birthing center for a list.
If you’re doing a tour of a hospital or birthing center, ask for a list of LGBTQ+ competent providers. Not all institutions will have this, but it’s a good reflection of how much effort they’ve put into making sure that all birthing people and families are supported in their space. You may also want to ask for clarification on whether the list differentiates between “friendly” and “competent” providers.
3. Going to a LGBTQ+ inclusive childbirth education class.
A childbirth education class is a great place to start asking questions and collecting referrals for all your pregnancy, birth, and postpartum needs. An LGBTQ+ inclusive course will be designed to meet the needs of a broad range of expectant people. Some that I would recommend are Bilen Bernahu, (Love Child Yoga), Morgane Richardson (Juniper), and the educators at Manhattan Birth.
4. Contact LGBTQ+ competency trainers
There are a handful of people who offer trainings to health care providers in LGBTQ+ cultural competency. They’ll know who's done the work and who is just offering rainbow colored swag. Morgane Richardson trains OB’s, midwives, nurses, and doulas around the US; and the Birthing Beyond the Binary team looks like an amazing initiative as well.
If you have other tips about how to find your LGBTQ+ competent birth team, please do send them in! We would love to hear about your ideas and advice so that we can include them here.
About the author:
Dr. Alexandra Garcia is a doctor of Acupuncture and Chinese Medicine working with the Love Child team to support new and expectant parents and their children. She also provides acupuncture and acupressure to laboring people at NYU Lutheran Medical Center in Brooklyn where she serves on the hospital’s LGBT+ Advisory Board. She is working toward becoming an LGBTQ+ competent provider; She gives great thanks to her wife Morgane V. Richardson who has encouraged her to constantly challenge her own assumptions about the world of birth.
They should give you a due-range, rather than a due-date.
When October 5th came and went with no contractions, no sign of baby, and a fully nested-and-back-again apartment, I was beginning to think she’d never arrive. I’d already packed up my desk and begun staying home from work in anticipation of my little girl’s arrival. I was excited to meet her. And more than a little bit impatient.
Eight uneventful days after that uneventful day, I took a nap. In any other context, this was a marker of a good day. And that nap followed a vigorous prenatal massage, so as any sleep-deprived new parent will attest, this was indeed a Good Day.
My post-massage-and-nap glow was cut short when something occurred to me: I couldn’t remember when I’d last felt baby kick. I’d felt something at breakfast, again during the morning massage. But then – nothing. And it was now close to 5pm.
They say that you, as the mum, get to know what’s normal for your baby in terms of movement. And you do. It’s important to be aware of any deviations from the norm. My doctor had said previously that “moms often leave it too late.” On that chilling line, I followed up no further.
My baby liked to move though – pretty much nonstop tumbling and kicking - with two exceptions.
The first one was on a business trip I’d taken to San Francisco. My baby was eerily still for a couple of hours, and unresponsive to juice (the sugar is supposed to wake them up). My doctor, who’s usually pretty laid back, instructed me to go to a hospital with a labour-and-delivery unit right away. Embarrassingly, and magnificently, the baby kicked as they were checking me in to the hospital (which, as an aside, took way too long given how urgent the matter could have been).
All was well, and I cried a tear (or a hundred) of relief. My husband was on the point of driving from NYC to San Francisco without stopping, so the good news was particularly welcome.
The second time was on this day, 8 days after my due date, post massage and post nap.
I tried to remain calm.
At this point, it’s worth noting that I’d recently read a story from a woman who shared my due-date on TheBump.com. She had tragically lost her baby around week 40. After the baby stopped kicking, which she hadn’t really noticed.
So, you could say that my state of mind was quite dark.
Guilt flooded my body. What kind of selfish, spoiled person – lounging around her home on a work day following an indulgent massage - takes a nap and forgets to count kicks? A terrible mother, I told myself. (No one really tells you about the wildly irrational guilt involved in this kind of thing. But it’s not unusual.)
Anyway, I called my doctor after only a minute’s hesitation (“Stop being so British and polite all the time,” I could practically here my husband saying – though I was sparing him the news until I’d spoken to the obstetrician).
“Come to the hospital right away,” she said.
I could see that my husband was parking the car after work (thanks, iPhones), so I waited to tell him in person a few moments later. In the meantime, I texted my doula.
My husband arrived. He snapped into action right away, trying to reassure me and be practical, but clearly worried sick himself. This isn’t the ending either of us had pictured.
He reached for the overnight bag I had packed so many weeks before – but I stopped him. I pictured myself grieving over my lost baby (getting a little ahead of myself to be sure) and unable to face the task of unpacking those unworn baby clothes at the hospital. In that surreal moment, it felt like taking the bag with us would jinx everything. Apparently this intense and scary episode brought out a superstitious side of me.
We headed outside to hail a cab. The cab driver, unlike every other New York taxi driver I’d encountered in my 15 years of visiting and residing in the city, stopped for every amber light and yielded to every other car, bus, and cyclist on the road.
But we got there. We were checked in quickly and they hooked me up to various machines. I had to click a little button every time I felt a kick, which mercifully didn’t take long. Baby was doing OK.
At this point, my doctor appeared. “We’re not sending you home tonight. You’re 41.5 weeks. It’s time.”
I’d had my heart set on a natural delivery, with minimal interventions. No induction, no epidural. That’s why I had a doula. (Who was still MIA and failing to respond to texts, by the way. This was out of character for her.)
They hooked me up to a Pitocin drip. Pitocin is synthetic oxytocin, and it’s one of a few ways hospitals try to induce labor. I was apparently already having mild contractions, but I couldn’t feel them in all the excitement. They picked up to a noticeable level when they gave me a saline drip. In all the post-nap commotion, I’d neglected to hydrate.
So there I was in the delivery room, getting comfortable. My husband left to get the bag we’d packed, and to make sure our dog was looked after.
The room was large and had a TV, which the nurse switched on.
“I don’t really want too much Pitocin,” I said.
She answered, “Don’t worry – we start on a super low dose, and try to only increase it as your contractions grow.” This was cheering.
The TV was showing the Democratic presidential candidates’ debate, which felt so quotidian on what was an exceptional day for our little family.
At first, the sensation felt like menstrual cramps. The contractions grew, and came quicker. I was managing, but they were definitely getting more noticeable as the Pitocin dose was increaed.
My husband returned and I was delighted to see him. He’d brought our suitcase, a nursing pillow, and some contraband snacks to sustain us both.
My doula texted apologetically. Another client was in labor and she wouldn’t be able to join us. She encouraged me to call on her back-up doula. To do it over again, I would have. But already flustered and feeling as though a few things out of my control were happening, I didn’t want to introduce another variable – a doula I didn’t feel 100% comfortable with.
So my husband and I soldiered on alone. The gaps between nurse visits felt long, and we didn’t see a doctor all night (this is normal, apparently). Both of us being new to labor, we weren’t sure we were doing it right. We’d taken classes and read books, but no one had really prepared us for the hospital experience, replete with its long waits and rigid but apparent-only-when-broken rules.
Apparently we were doing something right, because the contractions were coming faster and with more force. I later learned that one of the main disadvantages of medically induced contractions over natural ones is that the latter are accompanied by endorphins, and therefore significantly more bearable than their synthetic counterparts.
Another quirk of induction is that you are likely to be constantly monitored (i.e., hooked up to various machines) so it’s harder to move around. And standing/gravity helps labor progress, so this felt a little bit handicapping. My husband mentioned this to the nurse – I refer you to my aforementioned “damn Britishness” and aversion to anything akin to “making a fuss” – and she helped me out of the bed so I could stand up and try to get more comfortable. Standing helped – I felt like I was actually doing something to help the process along, versus just lying there.
The other wonderful part of this interaction was the news that “Other women on the ward have been dropping like flies for the epidural. You’re our hero.” Call it reverse schadenfreude, but this sustained me for another hour or so.
The pain continued to increase. At no point did I find myself emitting low, therapeutic moans like I’ve heard other women talk about. I was screaming and cursing and falling apart a little bit.
I was struggling with my breathing exercises for a maddeningly simple reason: I’m allergic to dust, which didn’t seem relevant in a hospital environment, but 100% was – the hospital’s birth center was under construction and my room neighbored the worksite. Had I known this, I’d have asked for an antihistamine hours prior. I got one eventually, other concerns overtook my respiratory issues.
It’s hard to describe the pain. I was in “back labour,” which I became convinced could make even a hardened terrorist speak under questioning. It felt like I was both outside my body and feeling pain more acutely than I’ve ever felt any sensation in my life. I’d crossed over from managing the pain to it managing me. In effect, I was fighting it – bracing hard for every coming contraction and feeling them at full force, with tears in my eyes.
As it was, eleven hours in, I started asking for an epidural. The nurse calmly explained that the anesthesiologist had just gone into surgery and would be at least an hour and would that be OK?
I not so calmly shouted “WELL WHAT CHOICE DO I HAVE!?”
Who was I?!
She returned much earlier than planned – anesthesiologist in tow. He worked quickly. We will never know the extent to which this might have been due to her having violently pulled him out of someone else’s operation to quiet down the woman who was screaming in room three.
I was still feeling the pain, but the sight of this man and his glorious cart of drugs sustained me as they prepped me for the procedure. My husband was given a surgical mask and told to look away. (Our childbirth educator mentioned that partners fainting was one of the main hazards of epidural delivery.) He was fine.
I perched on the edge of the bed and leaned towards the nurse while the anesthesiologist prepared the needle for my spine. I’d always had an aversion to the very idea of a needle near my spine, so that in itself attests to the pain I was feeling.
He did it. And the pain accompanying each contraction seemed to recede into gentle nothingness. The best thing about this? I could sleep! The second best? My husband could sleep! It was morning, and we’d essentially pulled an all-nighter in which one of us had run a marathon while the other had jogged alongside the other, worrying about the other’s health throughout. We’d earned a nap.
I woke a few hours later, feeling refreshed and ready to push.
They’d shown me a button to press which might as well have been labeled “MORE DRUGS”, but I didn’t use it. The initial dose was plenty, and began to wear off in time for the pushing. I was glad: I could feel a bit of pressure when I needed to push, but no pain.
It’s worth mentioning here that the morning crew wasn’t as competent as the overnight one. Doctor and nurse each had a trainee with them, and seemed more interested in showing their apprentice the ropes than providing my baby and me with medical care. Case in point: my husband had to ask for the nurses’ help each time I was ready to push because one was showing the other how to inventory the supply cupboards and neglecting to look at me or the monitors.
I heard the overnight nurse remind them to catheterize me so I could urinate at a particular time, but they forgot. A small error, but one with serious repercussions: baby’s heartrate was falling and it was only when they helped me empty my bladder that it picked up. They laughed at this. We did not.
Every time I pushed, my baby’s heartrate dropped again before picking up between contractions. This was stressful, and made worse when the doctor dropped by to simply say “Baby does not like your pushes” then left. Thanks for the vote of confidence, lady.
They gave me oxygen to use between pushes, and had me roll over to my left side in between each one as this helped baby’s heartrate recover. Again, my husband had to prompt me each time as the nurses were otherwise engaged.
After 1.5 hours of this, the doctor arrived to oversee the actual delivery. During a contraction, I thought I heard her say quietly, matter-of-factly, “Let’s cut now.” And it turns out I did, because I later learned they’d elected to give me an episiotomy.
Emergency medicine doesn’t always allow for explicit patient consent, but I only wish they had told me – if not asked me or my husband - at any point before, during, or after. But they didn’t. I never learned why it happened and how urgent the matter was, if at all. Simply but directly informing me of what they were doing to my body would have made the experience significantly easier to process after the fact.
Anyway, back to the pushing. They asked if I wanted to feel the baby’s head as she crowned. I surprised myself by saying yes. It was oddly cheering – a surreal reward for having made progress. The cord was wrapped around her head – they unwrapped it, and after pushing the head out, the rest of the labor felt quick.
Baby was born after 12 hours of labor and 2 of pushing. They put her on my chest and she latched fairly quickly. They had to clean her up and examine her, so I gave her to my husband after he cut the cord, and he took her to the other side of the room to be examined. I watched this process from my bed as I delivered the placenta and got stitched up.
Because of the epidural, I couldn’t feel my legs and therefore couldn’t stand up. I also learned that gravity has bearing on this: my leaning to the left during contractions meant my right leg regained feeling faster than the left. A funny sensation.
Despite the challenging night (and morning), I was happier than I’ve ever been.
The endorphins that eluded me during the night flooded my body. I was ecstatic. I was a mum to a beautiful daughter. And I’d do it all again – but perhaps a little differently.
By Avi Klein
In my psychotherapy practice and many others, it’s become commonplace to receive calls from couples who want to work out the issues in their relationship before they get married. They want to better understand themselves and their partners before they hit the kinds of big road blocks that are inevitable in any long term relationship. I always applaud and encourage those couples because I think they have insight into something that is at the heart of relationships: the true measure of a good relationship isn’t about how good it is at any moment, it’s about how flexible it is. Couples counseling cultivates that flexibility by creating more intimacy and knowledge about yourself and your partner. But, if I had to suggest one time when preventive couples counseling could really be needed, it's when you're about to grow from a couple into a family. It’s no coincidence that studies show that many couples become dissatisfied with their relationships when they become parents. Not much really changes when you get married, but for many couples, everything changes when you have kids. Every parent wants to give their child everything in the world. I would encourage every expectant parent to consider the advice of renowned couples expert John Gottman: "The greatest gift you can give your baby is a happy and strong relationship between the two of you."
A few common questions people ask about couples counseling:
1. How can I tell if it’s a good time to go?
There is no bad time to go, but don't make the mistake of waiting until it's unbearable. It's much easier to work on your problems when you can still appreciate and enjoy your partner. Some couples seek therapy as a last ditch effort before divorce, which is obviously much harder to fix since months or years of hostility and hurt feelings need to be dealt with first. For soon-to-be parents, it's also worthwhile to ask when you'll have time and energy after your baby arrives.
2. Does couples counseling mean we have a bad relationship?
Not at all! Going to couple counseling means you love your partner and value your relationship. You're spending time and money to make it better for you and your kids. That's something to be proud of. The truth is, everyone knows that relationships take work and effort. It's more efficient to do that work with an expert. Is your relationship something you really want to improve through trial and error?
3. What if my partner doesn’t want to go?
In about 75% of the couples I see, couples therapy is initiated by one partner not mutually agreed on. It’s normal for someone not to want to go to couples therapy. They might think that it means their relationship is worse than they thought or that their partner is saving couples therapy to surprise them with a list of complaints. Two helpful things to try when your partner is on the fence: 1. Reassure them that this is to make things even better, not that things are in a bad way. 2. Suggest that you go once or just speak to the therapist on the phone together for a brief consultation - giving it a test drive is a good way to get over any apprehension. 3. If your partner is on the fence, it’s worthwhile to find a therapist that you think they’ll get along with.
4. How do I find the right therapist?
There are a lot of therapists out there, so it can help to add a personal connection to find the right fit. If you know someone that had a positive experience in couples therapy or you’ve seen a therapist individually, that’s a great place to start. Consider asking on a community message board. Your MD or midwife may also know some good therapists as well. Consider speaking with more than one therapist to make sure you’ve found a good fit for both you and your partner. When you speak with them, what kind of information is important? While qualifications or geographical convenience matter, the most important thing is to trust your gut: you’ll be able to tell immediately if you feel comfortable with them, if you’re open to trusting them, etc. Lastly, don’t be afraid to ask them directly how they think they can help you. Therapy shouldn’t be an endless process - they should be able to explain the steps that you will take in your work to make a meaningful difference in your relationship.
5. How long will it take?
Every couple is different, so it’s impossible to say. It’s better to measure it week by week and to check-in with yourself and your partner: is this making a difference? Can you feel the difference and point to incremental changes that are happening? Couples therapy is different than individual therapy - it has always been intended to be short-term and to have the couple take what their learning from therapy out into the rest of their lives. When I speak with a couple that is on the fence about committing to therapy, I usually ask for a commitment of several weeks to give a good faith effort to see if it’s helpful. Four weeks should be enough time to notice a shift and twelve weeks should feel like you’ve done a good amount of work. Everyone has their own timeline, so this isn’t intended to apply to all cases but just to serve as a general benchmark. And remember: it’s always okay to check-in with your therapist and partner about your progress. Discussing why things aren’t changing is often a very productive conversation.
6. How can we get the most out of going?
A few suggestions: 1. Take care of yourself and your issues: Work to better understand yourself, your reactions to things and how your partner experiences them. Much of couples therapy is about helping each partner understand things from the other’s experience. Learn to walk in their shoes. 2. Make it something enjoyable both during and after: make every effort to be open and kind and honest in your therapy sessions and then do something nice together afterwards. Many couples that I see often go on a date after their session with me. It’s a nice ritual and will leave you feeling closer after working hard together in therapy. 3. Try and make a conscious effort to take something from each session and bring it into the rest of the week. If your partner feels ignored or under-appreciated, make an effort to give them that attention their craving. If you’ve learned that your feelings are hurt when your partner makes plans without you, take a risk and share that experience with them the next time it happens.
The best part of a relationship is the feeling of being connected with someone - of sharing important moments, having new perspectives and being exposed to new things with someone you deeply care about. But the worst part? It's when those different perspectives don't easily align with yours, when new interests or attitudes not only don't feel supportive, they feel invalidating or leave you feeling neglected. One of the times of greatest strain on a couple is that transition into parenthood and it’s easy for many new experiences to pull you apart. If you’re worried that this could happen to you, talk to your partner about discussing these worries together with a therapist. Those conversations will bring you closer and more connected at exactly the time when you and your new family need it most.
Avi Klein is a psychotherapist, father of two and native New Yorker practicing in Union Square. Avi has been working with individuals and couples since 2009. He is trained in AEDP (Accelerated Experiential Dynamic Psychotherapy) and EFT (Emotionally Focused Therapy), two forms of therapy that emphasize the power of emotion, healing & transformation in relationships. He has a special interest in supporting new families and is currently working on a workshop to support new and expectant parents. If you are interested in upcoming workshops focused on preparing your relationship for postpartum, sign up here.Inquiries can be directed at firstname.lastname@example.org or at his website https://www.aviklein.com If you are interested in upcoming workshops focused on preparing your relationship for postpartum, sign up for updates here: http://eepurl.com/cK0UI5
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