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Saturday, 05 April 2014 23:41

Postpartum Hair Loss

Many moms who have spent the first six months or more of their child's life exclusively breastfeeding can report how exhausted they become, how when they're not feeling well, it actually makes them feel worse when their child drains their breasts--as if the life-force is literally being sucked out of them. According to Traditional Chinese Medicine (TCM), this is somewhat true, and because of it, moms may feel extra fatigued, lose the hair on the head, and even experience dramatically reduced body weight.

In Traditional Chinese Medicine, hair is an extension of the supply of blood in the body (Pitchford 388). One of the extraordinary vessels identified in acupuncture theory is the Chong, or Penetrating Vessel. This is the vessel that holds the uterus and passes over the breasts. Its nickname is “the Sea of Blood” and its job is to store and regulate the blood of the whole body (Ni 116). It is obvious how important this vessel is during pregnancy as the mother rounds out and her blood volume increases to support a growing baby. The Sea of Blood is then drained as the mother loses a significant amount of blood during childbirth. After birth, her body also uses the Sea of Blood to produce an endless flow of breast milk to sustain the new life she has just birthed. Both activities lessen not just the amount of blood available postpartum, but also the mother's energy (or qi) which assists in creating the body's blood supply. Worry, stress and depression can also impair the mother's ability to generate healthy qi and nurture her blood (Dharmananda par. 3). During the postpartum period, when a mother is susceptible to depression and worry, has been expending her energy caring for a newborn, not getting the adequate sleep to replenish her own energy, and is endlessly supplying the gift of nourishment to another little being, she begins to feel tired, a little weaker, and her hair's luster dulls and large quantities fall out in the shower.

The TCM view is complementary to the Western medical understanding that due to hormonal changes during pregnancy, hair does not shed as frequently. Then, as the hormones return to their pre-pregnancy levels after birth, the hair returns to its regular growth and shedding pattern (Pierard-Franchimont and Pierard par. 11). For some women, a reduction in the blood's iron stores (iron-deficiency anemia) can also complicate the postpartum period and add to the expected hormonal hair loss. Anytime a woman experiences blood loss, there is a slight risk that she can become deficient in iron, which can also lead to fatigue and loss of stamina with daily activities (Beers et al 1033).

Even though the body is making the very wise decision to redirect its stores of blood to the breast milk, rather than the hair, this can still be incredibly upsetting for some mothers. Chinese Medicine has several ways to remedy this situation outside of your doctor's suggestion of taking iron supplements.

  1. First and foremost, EAT MORE! You're feeding two people, and the newest one is growing SO rapidly that they need tons of nutrition. Your breast milk can provide this, but only if you're eating enough food. Don't worry about your “baby weight” for now. Nourish yourself and your child.
  2. Secondly, pay attention to WHAT you're eating. Many easy-to-prepare foods are incredibly nourishing to the blood. Eat dark colored and red fruits, beets, green vegetables, meats, and black-strap molasses. Eat warm foods--they are easier for your digestive system to transform into readily usable energy. Warm foods even feel more nourishing: broth soups, stews with root vegetables, roasted vegetables, oatmeal, eggs.
  3. Thirdly, if you just can't get back to feeling like yourself, go see an herbally trained acupuncturist. Acupuncture alone can help you feel more energetic, but Chinese herbal formulas can be created specifically for your constitution and will assist your body in boosting your qi and blood,bringing more luster to your skin and hair.

Sources:

Beers, Mark H. et al. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2006. Print.

Dharmananda, Subhuti. “Treatment of Alopecia with Chinese Herbs” Institute for Traditional Medicine Online. N.p., June 1999. Web. 25 July 2012.

Ni, Yitian, O. M. D. Navigating the Channels of Traditional Chinese Medicine. San Diego, CA: Complementary Medicine Press, 1996. Print.

Pierard-Franchimont, Claudine; Pierard, Gerald. “Alterations in Hair Follicle Dynamics in Women.” National Center for Biotechnology Information. 24 Dec. 2013. Web. 5 Apr. 2014.

Pitchford, Paul. Healing with Whole Foods: Asian Traditions and Modern Nutrition. Berkeley, CA: North Atlantic Books, 2002. Print.

Published in Postpartum Health
Sunday, 05 January 2014 22:50

How to Heal Your Your Mummy Tummy

Binding, Nutrition, Exercise & Posture

Are you getting conflicting information about the best way to fix your stomach muscle separation after the birth of your baby?

It's important to get the healing process started as soon as possible in order for you to not only get back in shape, but also to prevent back and hip pain during your recovery. It is not unusual to get different opinions from friends and family but also medical professionals.  

So let's have a closer look at the 4 main options that are often offered to women and see what really works. I will discuss the pros and cons of each one.

Binding

An old and ancient tradition of wrapping the stomach muscles to increase recovery and healing postpartum. There are now specific binders available which are more comfortable for women to wear and there are some that are suitable post a C-section.

Do they Work?

Using a belt/binder or wrap will work initially as it can help to bring the abdominal muscles together. It will also help support your torso during the first 7-10 days post birth. Following surgery it will reduce pain and help a women move around much easier.

How Long Should you wear it for?

Women will benefit from a type of binding post birth but you only really need to bind if your Diastasis is wider than 3-4 cm or you have had a C-section. I strongly advise wearing a binder asap post a C-section to aid recovery.

You should wear the belt for no more than 3-4 weeks reducing the amount of hours you wear it for each day over this time period.

Pros:

The belts can feel awesome on as they offer support and most are now comfortable. Healing is improved and there is reduced pain following a C-section. Other benefits include assisting with shrinking the uterus, supporting internal organs the lower back and hip muscles, reducing diastasis.

Cons:

Over wearing a binder can significantly reduce the the strength of already weakened abdominal muscles. Women learn to rely on the belt for support instead of contracting their own muscle belt.

Nutrition

How can good nutrition help heal a diastasis?

Poor nutrition along with excess weight gained during pregnancy will decrease how well the nervous system can connect with weak muscles in order to regain muscle strength.

An increase in abdominal bloating caused by either a food intolerance or excess weight will also prevent adequate contracting of the muscles. Diet definitely needs to be addressed in order to heal your stomach muscles.

Does it work?

80% of how we look is related to the food we eat. So the food you have eaten during your pregnancy and what you are eating now will definitely affect your results.

If you know you are still 10kg over your pre pregnancy weight then some of that extra pregnancy weight is going to be sitting on your stomach. So its not rocket science that you are still going to have a mummy tummy if you are 10 kg overweight.

Good nutrition also helps to promote cellular and muscle tissue repair, helping to heal a diastasis.

Pros:

Good nutrition postpartum will help return your body back to its pre pregnancy weight, will reduce excess weight and abdominal bloating speeding up the recovery of your separated stomach muscles. 

Cons:

Need to be prepared and find time to make and eat it! 

Exercise

Exercise post birth is essential for you to regain the strength and stability of your 'core'. If you can't contract weak core muscles then you are putting stress on the spine and hip joints which can lead to all manner of pain and discomfort.  39 weeks of being stretched as baby grows has serious side effects. Diastasis recti is one consequence of the stretching and must be healed properly if you are to regain your pre baby shape and core strength.

Does it Work?

Yes with specific postnatal exercises women can completely close a diastasis and regain core strength.

Pros:

Correct rehabilitation exercises done soon after giving birth will help heal your diastasis, promote better posture, improve pelvic floor muscle strength and general well being.

Cons:

Finding the time and also remembering how to do the exercises may prove challenging. The wrong exercises like crunches and frontal planks will prevent and cause further separation.

Posture

Poor posture pre and post pregnancy will increase diastasis and prevent it from healing. If you go about your daily activities constantly sticking your abdominals out, the muscles are not going to knit back together.

Any benefits of your exercise program will be undone if you are not thinking about your posture.

Does it work?

Yes, thinking about your posture during the day will help heal your diastasis but this alone will not heal a diastasis.

Pros

Improves recovery if following an exercise program and can reduce pain.

Cons

Holding good posture alone will not fix a diastasis

What You Need to Do to Heal Your Mummy Tummy

They all work together in helping you heal your separated abdominal muscles. You won't see the results by just doing one.

  • Binding certainly doesn’t work without contracting weak core muscles and activating your own natural muscle belt.

  • Good posture can’t work by itself unless the muscles are strong enough to offer support to help correct alignment.

  • The best nutrition won’t help strengthen weak core muscles.

  • Exercise can be undone without thinking about correct posture.

  • Doing a combination of the above will ensure that you heal your diastasis recti. Depending on the size and depth of your separation will effect how quickly it heals.

Give yourself time to recover as it may take anywhere from 6 weeks to 9 months to completely heal. I would suggest you follow a specific postnatal exercise program to ensure you are doing safe exercise which will promote recovery and healing. Have a look at the 12 week postnatal exercise and wellness program Birth2FitMum on my website.

Further reading: How Binding Helps Post A C-Section

Published in Mom's Recovery
Monday, 25 November 2013 10:53

Pediatric Massage

We all know how good a massage can feel. It can help decrease muscle tension after a long day at work, minimize headache pain, and help facilitate the healing of soft tissue injuries. So, if it feels good and can help us heal, what about our little ones?  

We can incur tissue trauma at any stage of life, in the womb, during the birthing process, and of course, all the bumps and bruises we get as we learn to crawl, walk, and run. All of this trauma, as small as it may seem, can have physical (as well as mental) effects on the body. These effects can manifest themselves later on in life, creating postural change, undue stress on ligaments, tendons and nerves, and muscle tension, as well as some mental health disorders. Massage Therapy can be very beneficial throughout the pediatric years to help with tissue healing, postural concerns (scoliosis, leg length discrepancies, etc.), latching difficulties, digestive issues, restlessness and insomnia, as well as many other issues.

How does pediatric massage differ from regular massage?  Depending on the symptoms that your child may present with, many of the same techniques can be applied to the infant that would be applied to an adult but with a much gentler touch and treatment intention. Treatments can involve simple Swedish (relaxation) massage techniques, or be more specific. CranioSacral techniques can help a newborn latch onto the mother’s breast or decrease intracranial pressure that may be high due to some birthing processes such as C-section delivery. Visceral (organ) mobilization techniques may be used to help with digestion. These techniques should be performed by an experienced CranioSacral Therapist or Visceral Therapist that has had specific education towards pediatrics.

How do I know if my baby needs Massage? Obviously a newborn cannot express through voice that he/she has an upset tummy or that they are experiencing tension throughout their body. But noticing movement patterns that seem unbalanced from side-to-side, such as one arm reaching higher than another, or excessive arching of the back when being picked up, can be signs of tissue tightness within the body. Latching problems can be another sign that there may be some problem with the palate and/or the muscles that help with latching (possibly due to a difficult/long birthing process, C-section, or breech position). An overly fussy baby can be telling us that something may be uncomfortable also. Our little ones communicate in many different ways without speech. As long as you are attentive and trust your parental intuition, you will pick up on these little communication cues. Even if you think everything is okay, your baby can always benefit from massage.                

When can massage be done on an infant? Massage therapy can be very effective and applied at any time from the moment of birth onwards. Pre-natal massage experienced by the mother can create a more comfortable pregnancy as issues with postural change, mood, and overall health can be addressed. This has a direct impact on the birthing process as a relaxed mother with very little discomfort going into child birth is more likely to succeed at providing a positive birthing experience for her and her baby.

It is also important to note that massage therapy is a great bonding tool for parents and their newborn. Touch builds trust for the newborn towards his/her parents, it helps to comfort, and is a great tool to be used for bedtime routines. Infant massage classes can teach parents the basics of applying massage to their infants and is something I highly recommend.

Pediatric massage can help with a variety of issues and can be done at any time. It is an amazing tool to help parents bond with their child and can be very beneficial with the developmental process of the baby. There are a variety of techniques that can be applied by the parent or massage therapist, and some that need advanced education to help our little ones developmental process flourish.

 

Jason Dvorak, RMT, NSCA-CPT

 

 

Published in Newborn Health
Sunday, 10 November 2013 10:09

Puerperal Psychosis

Puerperal psychosis, also known as Postpartum Psychosis, is defined as postnatal being a period after childbirth and psychosis as a serious mental illness in which a person loses contact with external reality. It is the most severe form of mental health conditions following birth and is a psychiatric emergency where the woman needs to be seen by a perinatal psychiatrist immediately following diagnosis. A perinatal psychiatrist is a medically qualified physician who specializes in the study and treatment of mental disorders from twenty two weeks gestation until ten days postpartum. Puerperal Psychosis is a rare condition, occurring in 0.1% of women (1 in 1000 births). Over half of these women will go on to have further mental illness not related to childbirth, such as Bipolar Disorder, Schizophrenia, or Clinical depression.

When Does Puerperal Psychosis Occur?

Puerperal Psychosis has a sudden and dramatic onset. Some research suggests that Puerperal Psychosis has a symptom free period in the first few postpartum days, although the majority of research conducted proposes that symptoms begin in the first few postpartum days and fully presents itself within the first two to three weeks after birth. The majority of the symptoms presented by Puerperal Psychosis occur by the 16th postpartum day and although it is rare, it can take up to several weeks for the illness to occur.

Symptoms of Puerperal Psychosis

Symptoms are variable and can change rapidly from hour to hour and from day to day. Early symptoms of Puerperal Psychosis include depression, rapid mood fluctuations, confusion, behavior that is out of character, being withdrawn, irritability, anxiety, irrational behavior, restlessness and neglect of basic needs. Severe symptoms of Puerperal Psychosis are where a woman will feel paranoid, suspicious, fearful, unreal, like she’s in a dream world, disorientated, and become detached from her environment. These symptoms may cause the woman to experience agitation, insomnia, disorganized behavior, and cognitive impairment. Puerperal Psychosis has a dramatic presentation of psychotic symptoms which includes delusions and hallucinations. Delusions are believing things that are untrue, sometimes morbid thoughts, the woman being in contact with God, being dead, or experiencing death. They can sometimes relate to her baby, such as thinking her baby has a different identity, is possessed, has been exchanged, has magical powers, or is dying. Delusions commonly cover catalepsy, a condition characterized by lack of response to external stimuli and muscular rigidity. Hallucinations are seeing and hearing things that are not really there, which may often include hearing voices telling the woman to harm herself or her baby. Everyone around the suffering woman should be able to identify her abnormal behavior to know that there is something wrong, that she is not herself, and her behavior is abnormal. Symptoms are so severe they require urgent psychiatric treatment.

Who is at Risk of Puerperal Psychosis?

There may be no warning for the onset of Puerperal Psychosis and it can happen to any woman, including women who have not been ill before. Those at high risk of puerperal psychosis are women who have experienced puerperal psychosis before, women with a family history of Bipolar Disorder or Puerperal Psychosis, or women with existing mental health disorders such as Bipolar Disorder and Schizophrenia. High risk women have a 25-50% risk of experiencing Puerperal Psychosis. There is a high risk of Puerperal Psychosis re-occurrence in subsequent pregnancies and research suggests that 50% of women go on to experience it again.

Why Does Puerperal Psychosis Occur?

Biological Model

Puerperal Psychosis presents itself during the changing levels of hormones after birth causing an imbalance which suggests it is caused by a biological factor. The hormones estrogen, progesterone and cortisol have been suggested as precipitators. 

Psychosocial Model

Puerperal Psychosis can be caused by psychosocial factors. A previous diagnosis of puerperal psychosis, pre-existing mental health disorders, or a family history of Puerperal Psychosis or mental health disorders increases a woman’s vulnerability to emotional and psychological problems during pregnancy and following birth. Women who have experienced early emotional distress from being separated, physically or emotionally, from their own mother from an early age may result in a poor mother–infant attachment or if a woman becomes socially and emotionally withdrawn from her environment, especially after the absence of a partner, close relative or close friend (divorce, separation, bereavement, relocation) and low levels of social or partner support, including lack of affection and emotional support, can contribute in increasing a woman’s vulnerability. There are existing debates whether postnatal mental health disorders are pathological illnesses or an understandable response to difficulties of motherhood.  

Treatment of Puerperal Psychosis

A rapid diagnosis of Puerperal Psychosis is essential, as the condition requires prompt medical intervention to allow immediate treatment of the mother. This will ensure that the safety of the woman, her infant, and her family is not jeopardized. There should be an immediate referral to a perinatal psychiatrist or the local mental health team as the condition can sometimes warrant hospital admission. 

Medical Interventions

Medical interventions are in the form of medication, usually antipsychotic. A combination of anti-psychotics, antidepressants, mood regulatory drugs, and hormone therapies (the use of synthetic progesterones and transdermal estrogen) can be used to treat Puerperal Psychosis. Psychotropic drugs (sedatives or tranquilizers) or electroconvulsive therapy may also be used, depending upon the severity of the condition. If the woman requires hospitalization, mother and baby should ideally be kept together at a local mother and baby psychiatric unit, although this depends on the availability as there are only twenty units throughout the UK. It is rare for a child to be taken from the mother if Puerperal Psychosis occurs. 

How do Mother and Baby Psychiatric Units Help?

All the mother and baby units in the United Kingdom have the same aim of helping the mother recover from Puerperal Psychosis. The objectives of the units are to help women to manage stress and relax, manage anger and irritability, help build support networks, and help to bond with their infant. The mental health professionals do this by teaching baby massage, which will encourage the mother-infant attachment, engaging women in activities (gardening, swimming, creative art classes, cooking classes) to improve cognitive behavior, providing parenting skills groups, to boost their confidence in parenthood, as well as providing clinical care plans, which are regularly reviewed ensuring they are tracking the mother's progress and providing the most effective care possible. Clinical care involves Psychotherapy, Occupational Therapy, Family Therapy, Cognitive Behavior Therapy, and Counseling.

Psychosocial Interventions

Psychotherapy (talking therapies) will aid the recovery of the woman through the use of individual or group counseling, non-directive counseling, interpersonal therapy, and cognitive behavior therapy. Family focused therapy, such as couple therapy and interaction focused therapy, is available to assist in improving the quality of relationships with mother and partner or mother and infant retrospectively. Patience ensures a full recovery of Puerperal Psychosis and care should also always be given to the woman’s partner and family by all health professionals involved.

Recovery of Puerperal Psychosis

It can take six to twelve months to fully recover from Puerperal Psychosis, but some sources propose with effective treatment the majority of women clinically recover within two months and go on to make a full recovery. Puerperal Psychosis is often followed by a lengthy period of depression and anxiety.

How Puerperal Psychosis Differs From Postpartum Depression

Many women experience mild mood changes after childbirth and it is common for women to feel many different emotions. Puerperal Psychosis is a mental health condition at the other end of the spectrum, being a more severe illness than Postpartum Blues or Postpartum Depression.

Effects on Mother, Infant, and Family

Puerperal Psychosis can be a frightening, shocking experience for all involved. The suffering woman may feel worried about what’s occurring which may cause her to feel alone and isolated from others. She may feel resentment towards the infant which can cause her to feel guilty or a failure from being able to holistically function as a mother. 

Current Policies in Place to help with Puerperal Psychosis

Organisation - Department of Health 

Policy - Making mental health services more effective and accessible 

Pathway – Maternal Mental Health Pathway 

https://www.gov.uk/government/policies/making-mental-health-services-more-effective-and-accessible--2

Organisation - Department of Health 

Policy - Giving all children a healthy start in life 

Pathway – Maternal Mental Health Pathway 

https://www.gov.uk/government/policies/giving-all-children-a-healthy-start-in-life

 

Maternal Mental Health Pathway

Published 9th August 2012

The Maternal Mental Health Pathway focuses on the role of the health visitor but indicates the importance of the role of the midwife in the first 28 days of the postpartum period. It endorses the practice of working with other health professionals by setting out the principles and benefits for health visitors, midwives, specialist mental health professionals, and General Practitioners working together during pregnancy and in the first postnatal year, in order to meet the physical and mental health well-being of parents, babies and families. It provides a structured approach to addressing the common issues associated with the journey that mothers experience in relation to their mental and emotional well being from midwifery to health visiting services. The pathway is drawn from two government policies; Giving all children a healthy start in life and Making mental health services more effective and accessible. It is put in place to guide health professionals to build on good practice as identified by the professional consensus The Healthy Child Programme, NICE Guidance and The Frank Field Report (a systematic solution focused approach on which to base local practice on). The pathway is underpinned by understanding the importance of pregnancy and infancy in respect to the infant’s neural development, laying a blueprint for the infant’s future health. 

Guidelines Related to helping women with Puerperal Psychosis

  • NICE Guideline Postnatal Care Guideline 37 
  • http://publications.nice.org.uk/postnatal-care-qs37
  • NICE Guideline Antenatal and Postnatal Mental Health Guideline 45
  • http://pathways.nice.org.uk/pathways/antenatal-and-postnatal-mental-health
  • NICE Guideline Quality Standard of Antenatal Care Guideline 22 
  • http://publications.nice.org.uk/quality-standard-for-antenatal-care-qs22
  • NICE Guideline Antenatal Care: Routine Care for Healthy Pregnant Women Guideline 62
  • http://guidance.nice.org.uk/CG62

References

 

  • Baston, H., & Hall, J. (2009). Midwifery Essentials Volume 4 Postnatal. London: Elsevier. 
  • Department of Health. (2012). Making mental health services more effective and accessible. Retrieved from https://www.gov.uk/government/policies/making-mental-health-services-more-effective-and-accessible--2
  • Edge, D. (2013) National Perinatal Mental Health Project Report. Retrieved from http://www.nmhdu.org.uk/silo/files/national-perinatal-mental-health-project-report-.pdf 
  • Gundersen, D. C. (2001). Postpartum Psychiatric Disorders. Retrieved from http://www.mdconsult.com.libproxy.lib.unc.edu/das/book/body/172005763-9/0/1167/1.html
  • Healthcare Improvement Guidelines Network Scotland. (2013). Postnatal Depression & Postnatal Psychosis. Retrieved from http://www.sign.ac.uk/guidelines/fulltext/60/section3.html 
  • Heron, J. Mcguiness, M. Robertson Blackmore, E. Craddock, N. Jones, I. (2008). Early Postpartum Symptoms in Puerperal Psychosis. BJOG. 115. Page 348-353.
  • Hunter, A. (1998). The Queen Charlottes Hospital Guide to Pregnancy and Birth. London: Vermilion. 
  • Kingdon, C. (2009). Sociology for Midwives. London: Quay Books Division. 
  • Martin, E. (2003). Oxford Dictionary of Nursing (4th ed.). Oxford: Oxford University Press. 
  • Medforth, J., Battersby, S., Evans, M., Marsh, B., & Walker, A. (2011). Oxford Handbook of Midwifery (2nd ed.). Oxford: Oxford University Press. 
  • NHS.UK (2013) Postnatal Psychosis. Retrieved from http://www.nhs.uk/Conditions/Postnataldepression/Pages/Symptoms.aspx 
  • NICE. (2013A). Postnatal Care. Retrieved from http://publications.nice.org.uk/postnatal-care-qs37
  • NICE. (2013B). Antenatal and Postnatal Mental Health. Retrieved from http://pathways.nice.org.uk/pathways/antenatal-and-postnatal-mental-health
  • NICE. (2013C). Quality of Antenatal Care. Retrieved from http://publications.nice.org.uk/quality-standard-for-antenatal-care-qs22 
  • NICE. (2013D). Antenatal Care: Routine Care for Healthy Pregnant Women. Retreived from http://guidance.nice.org.uk/CG62
  • Paradice, R. (2002). Psychology for Midwives. Wiltshire: Quay Books Division. 
  • Royal College of Psychiatrics. (2013). Postpartum Psychosis: Severe Mental Illness after Childbirth. Retrieved from http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/postpartumpsychosis.aspx
  • Sit, D. Rotherschild, A.J Wisner, K.L. (2005). A Review of Postpartum Psychosis. Retrieved from http://www.pandasfoundation.org.uk/?gclid=COCD4saJx7oCFe7HtAod6mYAEA 
  • The National Archives. (2013). The Mental Health Act 2007. Retrieved from http://www.legislation.gov.uk/ukpga/2007/12/contents 
  • Waite, M., & Hawker, S. (2009). Compact Oxford Dictionary and Thesaurus (3rd ed.). Oxford: Oxford University Press.

 

 

Published in Postpartum Health

 

What if?

 

I  love working with new families, watching them develop and grow as they get to know one another. I love to see a new mother grab hold of their instincts,  I adore watching her confidence grow,  seeing her hold on to herself, and never let go. Newborn mothers are just as amazing as the children they bear, the have so many new experiences to adapt to, so many new things to learn, and so many parts of themselves that are opened up for exploration. 

 

But newborn mothers, just like their tiny babes, can be vulnerable. They have doubts, fears and can be unkind to themselves. For many women, that path into motherhood can also be a time of sadness as they let go of the person that they once were, and create space to become familiar with the person that they are becoming. 

 

On top of this, they have a whole new human being to care for. One whose very survival is laid at her feet, who thrives on love and connection, warmth and peace. But one that can also create storms of uncertainty within her. One who can push her to the edge like no other. 

 

What if you knew your words were the last thing a newborn mother repeated in her head before she went to sleep?

 

What if everything we said mattered, mattered deeply, and mattered profoundly? Would we be so haphazard with the things we say to others? Would we throw our advice around so non-chalantly? 

 

So what if you knew that the last thing that this mother heard, when she closed her eyes at night are your words? Would you still be so firm with your advice? 

 

What if your words replayed in her mind every time she went to pick up her crying newborn? Would you still be so harsh in your criticism?

 

What if, at that time of indecision, of wondering what to do, of thinking about how the future would unfold, of hoping, what if yours was the advice she heard?

 

Would you still tell her not to make a rod for her own back?

Would you still tell her that she was spoiling her baby?

Would you still question her decision, her instincts, her expertise?

 

Darkness can be a lonely time for mothers. Darkness brings the vulnerability, the doubt and the fear, and so often with it the words, the advice and the sentences. What if yours was last voice that she heard? Wrapped in darkness and alone, what if your voice was the one that played in her mind? Would you change your words? Would you choose different advice? Would your sentences look a little more like this?

 

Whatever you think - you are enough.

Whatever you are told - you are enough.

Whatever you decide - you are enough.

Even when you are struggling - you are enough. 

You are enough, listen to your voice, listen to your heart, listen to your child.

because you are enough, always and forever.

 

 

When words become sticks and stones, they may not be able to break your bones, but when thrown around without care, they can wedge into your consciousness and break your heart. So often, I hear of women whose confidence is torn to shreds by these unskillful words, by pieces of advice whose only goal is to justify someone else’s experience and to parade righteousness. So often these words are fired at these women by those who are hoping to help, to provide assistance, by those who love them the most. 

 

Words can also be the sticks and stones we put together to build a shelter, to build confidence and to build strength. So often when we share our experience,  our doubts and fears, all we want is for someone to tell us that we are enough, that we already have the answers, that we already know what is right. When a mother is truly seeking help and advice, would it hurt to ask her what she thinks first? I am not saying that advice is the enemy here, but often the way that it is delivered is. 

 

What if...

 

What if we wrapped our newborn mothers in the warm, gentle arms of our words?

What if our advice became the pillow, atop which they can rest soundly amid their own instincts?

What if our sentences provided her a soft place to fall, a place where she can doze in the tranquility and contentment of her own self?

 

 

What if?

Published in Baby's First Year
Sunday, 27 January 2013 15:37

Who Uses A Doula?

A Midwife, Doula, and Postpartum Help for Healthier, Happier Mom, Dad & Baby

Who uses a doula, midwife, and postpartum help?

Barefoot hippies? Hollywood divas?

Yes, and millions of everyday, hardworking people around the world who have decided either through their cultural heritage or personal research that for them, a natural childbirth and postpartum care with the support of a midwife, doula, and other services makes for the healthiest, safest, and happiest ways to give birth to and care for the new spirit in their lives.

Natural childbirth in a hospital, homebirth, and postpartum care have become so uncommon in the U.S. (and increasingly in other countries) that they are now considered by many to be too difficult, unnecessary, or even frivolous.

But, just a glance at the number of women in the U.S. who fail to have a natural childbirth (when that’s what they intended), fail to breastfeed (even when they wanted to and tried), and who suffer from mild to severe postpartum depression offers a clear indication that the now standard, mechanical template of childbirth and postpartum care is gravely inadequate.

And it’s not that millions of women wouldn’t want a natural childbirth or magical postpartum time of healing and bonding.

It’s that a great majority have no idea what hospital protocol they’re up against when they enter Labor & Delivery, or what kind of postpartum care is considered standard and necessary in countries around the world (and that women experiencing loss—miscarriage or stillbirth—also have postpartum leave and care[i]).

Countless women go into labor having said for nine months, “I want a natural childbirth.” And they mean it. But then what happens?

Here’s a look at just a few of the standard procedures upon entering the hospital[1]:

  • When you enter the hospital, you will either be placed in a wheelchair or you will walk to a labor room. The routine is being hooked up to an IV, one or several monitors, denied food and even beverages (other than ice chips, which in many cultures are considered something to avoid in labor). Depending on how “progressive” the hospital and staff are, you will be allowed or encouraged to walk around and work different labor positions to encourage the baby into the correct position and allow labor to progress, or you will simply be advised to stay flat on your back—which is considered by many in the birthing world to be one of the most painful and least effective ways to labor.
  • Around the time you start experiencing stronger contractions and the pain sensations are increasing, hospital staff [strangers] will appear at your door encouraging the use of drugs.
  • You will be checked periodically by doctors, residents, and/or nurses and student nurses [more strangers]. When you’re dilated far enough, they will move you to the delivery room where your doctor, or a stand-in if he or she has been called away to more pressing matters, will stay with you as the baby and the placenta are born.

This is all assuming that you’re not put on additional drugs to speed labor (if in their estimation you’re taking too long). While 24 hours or longer is a common length of time for a mother to labor—especially with her first baby—many hospitals encourage drugs to speed the process if it passes 12 hours.

It is also assuming that nothing has happened to encourage the doctor to perform a cesarean section (now at 30-50% of deliveries in the States, varying by doctor and hospital).

  • All in all, as Jennifer Block states in her book Pushed: The Painful Truth About Modern Childbirth and Maternity Care, a mother—even in a “routine” birth in a hospital—may have “up to 16 different tubes, drugs, or attachments.[2]
  • After the baby and placenta are born, they are both taken away in most instances. The baby to be washed (unnecessary and considered by many to be stressful for the newborn who’d rather be on her mother’s chest and latching!), weighed, measured, and treated with various pharmaceutical products.

The placenta will be taken to an incinerator.

Postpartum care?  Women are sent home from the hospital with a few formula samples and a diaper bag.

That’s how we care for new families?

The most sacred rite of passage has become cold, mechanical and offensive.

Fortunately, the pendulum is swinging back. 

Many new parents are discovering the mind/body/spirit benefits of hiring various support/services to help them on their journey either at home or in the hospital.

There are many (and increasing numbers of) people who serve new mothers in pregnancy, delivery, and postpartum, and I wrote about several—doulas, midwives, postpartum doulas, maids, cooks, and nannies—in my book New Mother.  Since publication and through interaction with readers, I’ve discovered even more services.

For example, a service called Best Fed Babies offers breastfeeding support with a certified lactation consultant 24/7 via phone or Skype to mothers anywhere in the world.  I would have loved to call them when I woke one morning at 3:00 AM with a plugged duct—and how many of us have similar questions or issues in the early days and wee hours of nursing!

Mother’s Concierge services are another wonderful and flexible source of help.  One company called Pampered Mamas in Baltimore, Maryland offers in-home pre/post natal massage; nap Nannie; in-home baby proofing consultations and much more.

A company in Los Angeles, CA called MotherBees doesn’t just deliver any old regular meal to postpartum mothers, but combines traditional postpartum foods with locally sourced seasonal ingredients. Replenishing and restorative foods—at your door!

In our modern culture with nuclear families living in isolation, many new parents lack knowledge of what will happen during childbirth, what procedures they can accept or decline (in the hospital), what they’ll need postpartum, or what is available to support them.  Just knowing the names and types of services will help mom and dads-to-be to research better and find exactly what they need to create their childbirth vision.

Ora na azu nwa, or It takes a village to raise a child, is a Nigerian Igbo proverb made popular by Hillary Rodham Clinton’s book published in 1996. Birthing and raising healthy happy children does require support, but we don’t live in villages. 

However, we can create our village—hopefully with the support of nuclear and extended family members and long-time friends, and also with the help of people trained, experienced, and specializing in mother and baby care. With so many different services available, everyone can find the perfect fit for their needs, budget and desire.

May you be surrounded by love and support, and may you experience abundant peace and joy on your blessed journey of motherhood!

*No affiliation or compensation associated with the services mentioned in this article.
Illustration, I See You, used with license from Healing Art, Jane Delaford Taylor



[1] Abridged excerpt from New Mother, by Allie Chee, Hestia Books & Media, 2012

[2] Pushed: The Painful Truth about Childbirth and Modern Maternity Care, Jennifer Block, Da Capo Press: A Member of the Perseus Books Group, 2007

 

Published in Birthing Assistance

Do this only if you feel it is necessary but listen to your body. You may be subjected to a number of procedures you may not want, and they may take your baby from you and admit him or her to the NICU.

This largely depends on the hospital, the staff, and perhaps if you were to have a tiny baby or not.  Child Protective Services may or may not become involved  if you refuse any treatment they want to do to your baby as this has occurred in other unassisted birth instances.  Remember your rights.

At this point, you can also call your midwife to come check in on things.

Here is the story my unassisted birth with my twin girls.

 

Go back to Step #13: Cutting the Cord

Go next step Step #15: Whether to See a Pediatrician

Go to Birthing Methods Menu

Published in Mom's Recovery

Engorgement and plugged ducts are very common problems that occur during breastfeeding. They can be painful and inhibit the baby's ability to latch on and eat from the breast.

Here are some good tips from fellow moms:

  • Nurse, nurse, nurse! Sometimes, you have to take a break on one side to let the breast fill, then there would be enough force to get the plug out but it works!
  • Get some Lecithin supplement and feed with baby's nose or chin pointing in clog's direction (even if it means upside down). **Note: Lecinthin has been known to work but the direction of feeding the baby has been known to work in some cases and not others. http://www.kellymom.com/nutrition/vitamins/lecithin.html
  • Massage the area lightly after feeding and apply a slight pressure while baby is nursing. Using a warm compress to the area also helps when massaging, especially in a shower.
  • Try going bra free for a period of time.

This video has some great additional tips to relieve the pain and fix the issue.

Published in Feeding Baby

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