PRENATAL YOGA - A NATURAL PATH FOR MIDWIFERY & PREGNANCY CARE

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

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

Parallels between Yoga and Midwifery

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

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

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

image1.jpeg

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

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

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

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

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

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

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

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

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

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

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

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

JEN'S BIRTH STORY

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

IMG_6125.jpeg

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

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

IMG_1128.jpg

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

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

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

IMG_1150.jpg

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

-Jennifer Jolorte Doro

Everything You Need to Know About Diastasis Recti

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

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

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

THE BASICS

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

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

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

CAN I AVOID DIASTASIS RECTI?

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

  1. Avoid doing crunches or sit ups.

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

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

WHAT CAN I DO TO HEAL POSTPARTUM?

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

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

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

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

POSTPARTUM PLANNING & RECOVERY

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

SPACE

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

POSTPARTUM CARE KIT

  • Maternity pads

  • High Waisted Underwear (Mesh Underwear from the hospital)

  • Nipple Cream (Earth Mama Angel Baby Nipple Cream)

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

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

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

  • Lidocaine or dermoplast Spray

  • Tucks Pads

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

  • Manual breast pump (We recommend the Haakaa)

  • For cold weather: Maternity Coat Extender, stroller gloves

RECOVERY

  • Belly wrap

  • Stool softener

  • Advil / Tylenol

  • Coconut oil

BREASTFEEDING

  • warm compress

  • cabbage leaves for engorgement

  • Earth Mama Angel Baby butter & herbs

  • Epsom Salt water wash for sore nipples

  • Nursing bra & clothes

  • KellyMom.com

  • On Demand Lactation Support

ESSENTIALS FOR BABY

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

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

  • Cloth Diaper Bin

  • Disposable Diapers for nights

  • Reusable / Flushable wipes

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

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

  • Swaddles

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

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

  • Baby Nail File

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

  • Sound Machine

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

FOOD

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

  • Bone broth

  • Antioxidant rich foods

  • Iron rich foods

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

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

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

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

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

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

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

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

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

CHORES

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

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

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

  • Task friends and family or hire professional help. 

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

MANAGING VISITORS

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

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

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

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

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

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

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

How to be a respectful visitor: 

  • Ask when a good time to visit is

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

  • Ask about leaving shoes outside

  • Wash hands as soon as you enter

  • Keep phone on silent

  • Ask how you can help

  • Keep company while breastfeeding

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

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

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

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

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

SLEEP

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

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

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

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

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

PROFESSIONAL SERVICES

  • Meal Train

  • Lactation Consultant on Call

  • Postpartum Doula on Call

  • Postpartum Chef

  • Cloth Diapering Service (launder and return clean set)

  • Babysitter / Nanny / Baby Nurse

  • Postpartum Meal Delivery Service

PHYSICAL RECOVERY

What to expect:

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

  • Contractions

  • Sweats

  • Hair changes

  • Vaginal Tearing (in varying degrees)

  • Post surgery pain

  • Contractions

  • Hemorrhoids

  • Incontinence

  • Painful to sit

  • Sweating and hot flashes

  • Pain while peeing and pooping

  • Diastasis recti

  • Pelvic floor weakening

  • Shakes

  • Hair falling

  • Skin changes

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

Vaginal Birth

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

  • Spray Bottle while you pee / pee in shower

  • Laxatives for first elimination

  • Exercise - 4 weeks

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

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

  • Spray bottle / Peri bottles

  • Ice packs

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

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

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

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

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

C-SECTION BIRTH

  • Take it slow

  • High waisted maternity underwear

  • Soothing salve

  • Stay on top of painkillers

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

  • Scar suture wire

  • Raised scar

  • Height of bed

  • Firm bed rather than too soft

  • Exercise - 6 weeks

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

AROMATHERAPY

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

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

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

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

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

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

HOMEOPATHY

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

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

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

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

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

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

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

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

PSYCHOLOGICAL & EMOTIONAL HEALING

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

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

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

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

EMOTIONAL CHANGES

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

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

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

  • Brain changes

  • Hormonal Changes

  • Dealing with lack of sleep

  • Dealing with loneliness and repetitive days

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

  • Body image changes

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

  • Crying and blues

  • Not loving baby immediately

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

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

SAMPLE POST[ARTUM PLAN

Birth person

  • Breastfeed

  • Recover

Partner

  • Diapers

  • Swaddle

  • Bottles prep & clean

  • Baby soothing

  • Communication with Family & Friends

  • Bring Baby to be fed

  • Burp

  • Postpartum doula when partner goes back to work

Friends / Family

  • Food (Food delivery when family leaves)

  • Laundry

  • Clean House

  • Other Chores

Professional

  • Lactation Counselor

  • Craniosacral Therapist

  • Pelvic Floor Therapist

What does your ideal postpartum look like?

  • At 2 weeks:

  • At 1 month:

  • At 3 months:

  • At 6 months:

  • At 1 year:

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

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

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

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

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

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

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

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

RELATIONSHIPS & PARTNER TIPS 

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

  • Make decisions together.

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

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

  • Be equally involved with baby care

  • Be equally involved with house hold chores

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

  • Ask and determine daily priorities

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

  • Sex & intimacy - feeling ‘touched out’

  • Ask before touching when breastfeeding

  • Learn your own ways to soothe baby

  • Manage communication with family, how can they be helpful

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

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

  • Second shift when getting back from work

LONGER TERM HEALING

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

  • Therapist, a somatic coach, an energetic healer.

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

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

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

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

  • Have a conversation with an adult!

  • Listen to podcasts or audiobooks!

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

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

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

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

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

ALL ABOUT ABDOMINAL MASSAGE

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

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

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

The Abdomen: Starting from the Center

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

iliopsoas-tendon-anatomy-the-iliopsoas-the-irresistible-center-of-existence-the.png.jpeg

 

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.

Screen Shot 2018-08-16 at 2.30.12 PM.png

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

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

Post-Pregnancy and Beyond

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

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

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

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

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

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

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

 

 

TYPES OF CARE PROVIDERS

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

 

Types of Providers:

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

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

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

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

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

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

 

A few difference between OB care and midwifery care:

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

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

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

 

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

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

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

 

Types of Midwives

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

 

Certified Nurse Midwife (CNM):

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

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

  • Practice in all birth settings

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

 

Certified Midwife (CM):

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

  • Practice in all birth settings

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

  • Sometimes called Direct Entry Midwife (DEM)

 

Certified Professional Midwife (CPM):

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

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

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

  • Practice only in homes and birth centers

  • Required to receive additional non-hospital education and experience

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

 

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

 

How to find a midwife in NYC

NYHomebirth.com

List of Midwifery practices in NYC:

Midwives in the hospital:

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

Metropolitan Hospital: Village Maternity

Brooklyn Hospital

Bellevue Hospital

Maimonides Hospital

Methodist Hospital: Park Slope Midwives

Mt. Sinai East

 

Midwives at Birth Centers:

Birthing Center of New York

Brooklyn Birth Center

 

List of OB & Midwife groups at hospitals:

Dr. Hanna, Dr. Moritz

Downtown Women OBGYN

Dr. Bradley, Shulina & Nabizadeh

Dr. Guirguis

 

What does a Doula do?

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

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

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

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

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

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

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

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

 

How to Find a Doula

  • Contact Love Child here!

Further resources!

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

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

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

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

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

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






 

ARTICLE & RESOURCE ARCHIVE

 

PREGNANCY

  • My Wife And I Are (Both) Pregnant >>
  • Nine Beauty Ingredients To Avoid In Pregnancy >>
  • Consumer Reports’ New Ratings Help Consumers Choose the Right Hospital and May Lower C-Section Rates >>
  • Your Complete Guide To Prenatal Testing >>
  • Pregnant Women's Medical Care Too Often Affected By Race >>
  • Midwives Not Medicine Rule Pregnancy In Sweden With Enduring Success >>
  • The Brutal Truth About Being a Pregnant Worker in 2016: It's Pretty Awful >>
  • The Secret Sadness Of Pregnancy With Depression >>
  • Pelvic Floor Health >>
  • What Every Pregnant Woman Needs To Know About Cesarian Birth >>
  • Having A Baby: Help with managing your money before, during and after the birth of your baby. UK  >>
  • How do pregnant women use quality measures when choosing their obstetric provider? >>
  • Pregnant & Disputing The Doctor >>
  • Preparing for the biggest change in your life: How preventive couples counseling can protect your relationship after baby >>

BIRTH

  • New York County Hospitals Maternity Information >>

  • Giving Birth In Different Worlds >>
  • What is the Evidence For Perineal Massage During Pregnancy To Prevent Tearing >>
  • Midwife Explains The Spiritual Side Of Birth >>
  • Why I Had My Babies With a Midwife Instead of a Doctor >>
  • Labor Induction: The Low Down On Natural Approaches From A Midwife-MD >>
  • How To Have A Positive Caesarian Birth >>
  • Protecting Your Perineum - Birthful Podcast >>
  • C-Sections Are Best With A Little Bit Of Labor >>
  • When A Baby Isn't So Big >>
  • Every Pregnant Woman Should Have A Doula >>
  • Five Things You Didn't Know About Giving Birth In A Hospital >>
  • Why Women Who Fear Birth Spend More Time In Labor >>
  • Avoid Giving Birth On Your Back And Follow Your Body's Urges To Push >>
  • 10 Reasons Why More Parents Are Choosing to Have A Natural Birth (Without An Epidural) >>
  • Most Healthy Women Would Benefit From A Light Meal During Labor >>
  • Why Are Due Dates Usually So Wrong? >>
  • I Never Thought I'd Hire A Doula, But I'm So Glad I Did >>
  • Your Biggest C-Section Risk May Be Your Hospital >>
  • New York County Hospital Maternity Information >>
  • Doulas From The Dads Perspective >>
  • Why Are Medical Professional Who Deliver Babies In Hospitals Choosing To Have Their Own Babies At Home >>
  • What To Reject When You're Expecting >>
  • How to Cut Your Odds of Having a C-Section When You Don't Really Need One >>
  • Here's Another Way Midwives Make C-Sections Less Likely >>
  • Natural C-Section Video >>
  • Laughing Gas Changing The Way Women Endure Labor Pain >>
  • Fighting Gravity During Labor Makes Birth Harder For Mom And Baby >>
  • Routine episiotomy is harmful. Consent is essential. >>
  • Are Women's Birth Sounds Silenced in the Hospital? >>
  • Why I Write Birth Stories >>
  • Medications For Pain Relief During Labor And Delivery >>
  • Are Women Pushing Too Hard And Too Soon In Labor? >>
  • Torn Apart By ChildBirth >>
  • Failure To Progress, The Simple Solution Nobody Knows >>
  • This Is Birth With Lisa Ling >>
  • Cervical Dilation And Effacement GIF >>
  • When To Say No To A C-Section, How To Talk To Your Doctor About Your Delivery Options >>
  • Variation in C-Section Rates By Labor & Delivery Nurses >>
  • Too Many Opioids After Cesarian Delivery >>
  • Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries >>
  • Birth in the United States: an overview of trends past and present >>
  • The Most Common Childbirth Practice in America Is Unnecessary and Dangerous >>
  • From A Dad's Point Of View: Feeling Helpless During A Difficult Birth >>

POSTPARTUM

  • What Does A PostPartum Doula Do And Why You Might Hire One? >>
  • Why Every New Mom Needs Physical Therapy >>
  • Grieving Over An Unnatural Childbirth >>
  • The Dos And Don'ts Of Diastasis Recti >>
  • When It All Comes Together, Diastasis Recti Healed >>
  • Inside The Painful, Lonely Experience Of Birth Trauma >>
  • Women More Afraid Of Childbirth Than Previously Thought >>
  • Millions of Women Are Injured During Childbirth. Why Aren't Doctors Diagnosing Them? >>
  • A Tale Of Two Births: How The U.S. Fails To Deliver Adequate Postpartum Health Care >>
  • Caring For Your Core, Back And Pelvic Floor After Birth >>
  • Vaginal And C-Section Scar Massage >>
  • Are Hospitals The Wrong Place To Give Birth? >>
  • When Evidence Says No But Doctors Say Yes >>
  • The Birth Of A Mother >>

NEWBORN CARE

  • The Fourth Trimester - Why Newborns Hate Being Put Down >>
  • The Troubled History Of The Foreskin >>
  • Some Babies Are Just Easier Than Others >>
  • Rub It In: Making the Case for the Benefits of Vernix Caseosa >>

BREASTFEEDING

  • Breastfeeding: One Man's Perspective >>
  • Breastfeeding The Microbiome >>
  • Traumatic breastfeeding experiences are the reason we must continue to promote it >>
  • Considering Breastfeeding? This Guide Can Help >>
  • The More I Learn About Breast Milk The More Amazed I Am >>
  • Support For Breastfeeding In A Multitude Of Ways >>
  • Breastfeeding Services Lag Behind The Law >>
  • Breastfeeding: One Man’s Perspective >>

PARENTING

  • How To Get Dads To Take Parental Leave? Seeing Other Dads Do It. >>
  • How To Strengthen Your Relationship For Parenthood >>
  • Revolutionary Parenting >>
  • Dear Ijeawele, Or a Feminist Manifesto In Fifteen Suggestions >>
  • Twenty-First Century Victorians >>
  • The Privatization Of Childhood >>

WORK AT HOME AND AWAY FROM HOME

  • Your Back To Work After Motherhood Stories - WNYC >>
  • What the woman out on maternity leave wants everyone back at the office to know >>
  • Why Companies Have Started To Coach New Parents >>
  • Why It's So Much Harder For Mothers To Start Businesses >>
  • Most Major U.S. Employers Fail on Paid Paternity Leave. The ACLU Says That’s Illegal. >>

FEMINISM

  • Motherhood and Marginalization: The Oppressive History of the Birth Industry >>
  • These Are The Best Countries To Be A Woman >>
  • Maternal deaths worldwide drop by half, yet shocking disparities remain >>
  • What's Behind The Increase In Maternal Deaths In The U.S. >>
  • Why Is U.S. Maternal Mortality So High >>
  • How Doctors Take Women's Pain Less Seriously >>

LOSS & MISCARRIAGE

  • The Internet Still Thinks I'm Pregnant >>
  • What's Killing America's Black Infants >>

THE BEST BABY STUFF FOR YOU, YOUR BABY & THE PLANET

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 inequalityevading taxesdriving 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.

MINIMALIST BABY REGISTRY - ALL THE ESSENTIAL STUFF & SERVICES YOU'LL ACTUALLY USE

PREGNANCY

  • 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. 

BIRTH

  •  Sticky socks
  • Hair tie/Head band
  • Chapstick
  • Heating pad
  • Water Bottle  
  • Snacks
  • 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) 
  • Swaddles
  • 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
  • Pacifier
  • Baby Bath
  • Towel
  • Baby Soap & Shampoo
  • Baby Oil / Coconut Oil

3 - 6 MONTHS

  • Crib
  • 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

Evidence Based Pregnancy and Parenting Blogs

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

The Longest Shortest Time: A podcast on Modern Parenting. We especially recommend the 'touched out' episode on intimacy after baby. 

All about Diastasis Recti

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. 

The Many Benefits of Prenatal Yoga

By Neelu Shruti

IMG_3455.JPG

 

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.

Birth Centers: The Best of Both Worlds

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?

  • Yes
  • 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.

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