A Smashing Success!

We are long overdue for a post about our big event of the year–the inaugural Growing Families Expo! On June 3rd, B. Lime and Gentle Transitions worked together to put on the Growing Families Expo at Presence Covenant Medical Center. It was an awesome event targeting young and expectant families, and we hosted 30 awesome vendors in our community. Businesses and Non-Profit organizations came together to share their products and services with families in the area. We had tons of amazing raffle giveaways, mini photo shoots with Echolight Photography, storytimes from the public libraries and Usborne Books, coffee and treats provided by Espresso Royale, Uncrustables from Smuckers, gift bags full of coupons and freebies from Meatheads, LuLaRoe, Teeccino, Preggie Pops and many more (see complete listing below!). We are so thankful to all of our vendors for partnering with us and hanging in there as we worked out the kinks of our first year. We are looking forward to being in a larger space next year, and offering more tables and larger spaces to the waiting list of vendors who have contacted us already!

We want to thank all of our amazing participants and guests–we couldn’t have done it without you!

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We had such an incredible group of vendors to work with this year. Businesses and not for profit groups from all over CU came to share their services and products. Here is the complete list of 2017 Vendors!

vendors

Our gift bags were stuffed!! Along with what is pictured below, we had information/coupons/freebies from Preggie Pops, Nurtured Beginnings, Dragonfly Meadows Therapy, Espresso Royale, Postpartum Support Group, and the Illinois Microbiome Study.

gift bags

We had *so many AMAZING* raffle prizes to give away! Thank you so much to all of the community partners and businesses who contributed so many products and services to our raffle giveaways!

raffle prizes

If you haven’t already, please “like” our Growing Families Facebook page in order to find out about next year’s expo! Preliminary planning is already in the works, and we can’t wait to bring you an even bigger and better expo in 2018. Thanks again to all of our participants this year!

Getting Breastfeeding Off to a Good Start

by Theresa Hardy

breastfeeding pic for blog

At my monthly breastfeeding class, I always open with a discussion of concerns that expectant moms might have about breastfeeding. The top two concerns are avoiding nipple pain and establishing a good milk supply. I always reassure the moms that they have made an excellent first step towards breastfeeding success, and that’s coming to a breastfeeding class. Knowledge is power! By the end of our two hour class, we have gone over what to expect in the early days and weeks, how to improve baby’s latch, how to tell baby is getting enough milk, using good physical supports to reduce your fatigue, waking a sleeping baby, managing return to work and breastfeeding, as well as pumping and milk storage.

Your journey to successful breastfeeding begins with lovely, uninterrupted skin to skin contact with your newborn, which is simultaneously soothing and stimulating to baby. Skin to skin contact reduces crying, regulates their temperature, and brings them “right up to the dinner table” for a nursing. Newborns are often wide-eyed and alert immediately following their birth. Cuddled against your breast, baby may just latch on her own, or she can be assisted to latch. Take advantage of this alert time, because after an hour or two, baby gets really tired, and often needs to be coaxed to feed for the next several feedings.

There will come a time when your little one will need almost no assistance or supports to latch effectively, but newborns can’t reach or hold. They (and you) definitely benefit from physical support such as nursing pillows, rolled blankets to lift baby’s head and shoulders, and a nursing stool. You will be spending many hours a day nursing your little one, and those physical supports will reduce your fatigue as well as promote the best latch possible.

Since breastfeeding is new to you and your baby, you will be wondering how to know if baby has a good latch, and if he is drinking enough. Though your nipples will be tender in the early weeks, if baby has a good latch, you should feel a gentle tugging, and not pain. When baby is latched well, your nipple floats freely in baby’s soft palate. A shallow latch feels “pinchy” or painful. Baby makes a characteristic “kuh” sound when he is drinking. We like to see 10-15 minutes of active drinking each breast each feeding. You will hear more drinking as the early days go by. When your full volume of milk is coming in, you will hear gulping! Baby should be very content after a nursing sessions. We also expect to see more wet diapers and stools each day until about day five, then at least 4-5 stools a day.

Babies learn to breastfeed by breastfeeding. When your friends tell you how much easier breastfeeding is than bottle feeding, they’re not talking about the first few weeks. Over time, baby gets more and more efficient, and feedings get spaced out a bit. Feedings are shorter and more effective, and you will get lots of milky smiles. Perhaps the most important thing you can do is to get good help if breastfeeding isn’t going well. Most hospitals have lactation consultants on staff. I am a lactation consultant/pediatric nurse practitioner in private practice, and can do both home and hospital visits. At a consult, latch will be fine-tuned and adjusted, drinking will be assessed, and you will be shown how to position the baby so both of you are comfortable. Together, we will come up with a plan for breastfeeding success!

 

A Day in the Life of a Doula

Some days as doulas are totally normal… Other days we are hyper vigilant because a client could go into labor at anytime. Or maybe you weren’t expecting a client to go into labor and you have to quickly figure out and change the days plans to accommodate your client’s needs.We aren’t ever far from our phones and the phrase “I’d love to come, as long as I am not at a birth!” comes out of our mouths often. This is from a day last year when I had plans but knew a client was in the early stages of labor.

My morning started by gathering all of our booth supplies. Gentle Transitions was a vendor at our local Cloth Diaper Expo. My daughter loves to come with me and help set up and meet people, so we ran through Starbucks and went to set up for our show. Thankfully I have wonderful team members and I was able to leave early for a family event while they finished the expo.

A client had texted me the night before that she was having some contractions so I wasn’t surprised to hear from her at my cousin’s bridal shower that day. We talked through what she was feeling and some other positions to try and get relief/comfort.

I checked in with her once I got home- she was still doing good at home! But she could tell things were progressing and getting harder to handle.

We had dinner and my husband prepared to go out for a night with friends. He had planned to carpool with someone but had to let them know they might have to come back early if I had to leave.

He left and called me about 2 hours afterwards from a number I didn’t recognize. He was worried wondering if I had tried to call. His phone didn’t have good service where he was and he was concerned that I called or would need to and he wouldn’t get it. So he called me from a friends phone so I had an alternative number. You never know when you will need to go- these babies run the show! 😉 I am also thankful for a husband who cares about my job and all the little things that go along with it.

Around 2am my client decided to head to the hospital and continued to check in with me throughout the night… Until about 4am when they decided they were ready for me to come. I gathered my things and left for the hospital. When I got there she was on her hands and knees over the bed. She let me know most of her pain was in her back and she wanted to rest but the back pain became much worse while laying down. We worked on a few other positions that were restful but more upright. She continued laboring while her husband and I took turns applying pressure or massaging her lower back and fanning her while changing out cool washcloths for her neck and forehead. She was doing great and the hospital staff was so helpful. Not long afterwards she felt the urge to push slightly with her contractions. We followed her lead as she pushed and breathed as her body led her through each contraction. Soon, we could see much more of the baby’s head and before we knew it our nurse was making phone calls and asking to get the delivery set up finished quickly. Just minutes passed until that sweet girl was born. The new parents were so thrilled!

We got mom and baby skin to skin and baby started nursing pretty easily with just a few tips.

I got home in time for lunch and to hang out with some friends before heading off to meet another couple for our prenatal meeting. It was a great weekend full of babies, clients, friends and family! And I slept really well that night!

Pit: Labor and Postpartum

This is the 4th and final blog post on our series about pitocin. Check out our introductory post about pitocin here, our post about the differences between pitocin and oxytocin here, and pitocin in inductions here

We’ve talked about the role of pitocin during inductions, how pitocin differs from oxytocin, and how pitocin works in the body  biologically. Pitocin is not only used during inductons, but also to augment, or speed up, the labor process.

The most common use for pitocin during labor is what many providers deem “failure to progress.” What FTP means depends on the care provider. Often times providers base labor progress on something called the Friedman’s Curve. The Friedman’s curve was created in 1955 (over 60 years ago!!) that plotted the average woman’s dilation time, which came out to approximately 1cm dilation per hour of labor. For a GREAT detailed evaluation about the Friedman’s curve, please check out this post over at Evidence Based Birth. The most important thing to realize about the Friedman’s curve is that it cannot apply to every woman (that’s the nature of a bell curve!), and that so much has changed in the labor and delivery process since it was created so long ago. Thankfully, here in Champaign-Urbana, there are very few, if any, providers who still expect all of their patients to progress at the rate of the Friedman’s Curve. However, that does not mean that FTP no longer exists. It is still often diagnosed when mom is not dilating as quickly as their care provider would like (for a myriad of reasons).

No two labors are the same, and labor can speed up or slow down based on so many factors. Some of these include:

  • Malposition of baby
  • Epidural use
  • Mom feeling stressed/scared/anxious about her labor/location/people around her

There are obviously many factors at play, but in my personal doula experience, these are the most common reasons that labor seems to slow down, or “fail to progress.”

Labor slowing down, or stalling, does NOT mean that a mom needs pitocin to help it progress. Let’s look at some ideas that mom can try in order to get things moving again.

Malposition of Baby

If baby is positioned “perfectly” in the pelvis, and mom’s pelvis is properly aligned, generally labor and delivery will go very quickly. If the baby’s head is not aligned in the pelvis properly, her head will not be engaged properly on the cervix to increase dilation. Then, if mom does get to 10 cm, the baby can get lodged into the birth canal at a less-than-ideal angle, causing problems during pushing and delivery. So what can we do to help make sure baby is aligned properly? The biggest one that we doulas recommend is chiropractic care during pregnancy, and even labor. Seeing a Webster-Certified chiropractor during pregnancy can help keep everything aligned (and also relieve a lot of typical pregnancy discomforts!). Even in labor, a chiropractor can gently manipulate the pelvis to help create the right space for baby’s head to be engaged in the pelvis. (Check out our Community Partners page for some great chiropractors in C-U).

Additionally, we also recommend all of our clients check out Spinning Babies. Spinning babies is a series of exercises and body positioning to help encourage the baby to be in the best position for labor and delivery. If a mom is in labor and her care provider or doula thinks the baby is not in a great position, there are different positions that a mom can try to encourage the baby to turn even in labor. Check out the spinning babies “In Labor” page for more details on those!

If a baby truly is malpositioned in the pelvis, pitocin is only going to make things worse by intensifying contractions on the baby and for the mom, and potentially wedging baby into the pelvis even more tightly, rather than letting labor slow down to give the baby an opportunity to turn and get into a better position for birth.

Epidural Use

Epidural use in labor can also slow down labor, because the laboring woman is confined to the bed and not up and moving. Think about gravity–if a mom is up and moving, gravity is going to help the baby engage the cervix and move down. The opposite is also true–laying in bed, not upright, does not work with gravity, and can make the labor longer and slower. Additionally, mom’s reduced movement doesn’t allow ample opportunity for the baby to turn into the best position for birth. If a mom does choose to have an epidural during labor, it does not mean that she is doomed to have pitocin, too! In fact, one of the more recent labor tools that we have been using has been shown to drastically help reduce the length of labor and the risk of c-section: a peanut ball! Peanut balls come in different sizes to fit different women, and are used especially if the mom has an epidural. The peanut ball allows care providers and doulas to help get mom into different positions that will open her hips and pelvis, and allow more room for baby to move through the pelvis and into the birth canal in a good position. I remember after one particularly challenging labor, we tried using the peanut ball as a last ditch attempt to get mom to rest and open her hips. Less than an hour later she pushed out her baby, and the nurse exclaimed to me (in the hallway), “the peanut ball saved that birth!!” She was shocked and surprised, and to be honest, so was I! We couldn’t believe how quickly things started moving after 30 minutes of hip opening positions while mom was resting with the epidural in place. If your hospital doesn’t have peanut balls, consider getting one to bring with you in labor–you won’t regret it!

 

Emotional Blocks

Emotional blocks in labor are one of the more difficult things to discuss, purely because we can’t know exactly how a mom is thinking and feeling. Only SHE can know that! She may try to explain it to us, but when a woman is in the throes of labor, explaining how she feels emotionally in a given moment is difficult, to say the least! However, as doulas, we can help watch and observe our clients, and if we notice that mom is starting to appear nervous, or suddenly stressed, or uncharacteristically anxious, we can broach the subject and try to help. Sometimes it can be because mom had to move from a location where she felt comfortable to a less comfortable place (like moving from home to the hospital). This can disrupt the labor flow, and make the mom feel unsafe. When a woman feels unsafe, and her cortisol (stress hormone) levels rise unrelated to labor, her labor will slow or stall–it’s biology’s way of trying to give us the greatest odds for our baby’s survival. Talking through (ahead of time) what it will be like to get out of the house, into the car, and into the hospital can help alleviate some of those concerns ahead of time. In the moment, it’s important to do sort of a reality check. Am I really unsafe? What is scaring me? What can make me feel safer right now? These are all questions to ask yourself (if you can), or that a doula will ask you to help facilitate a smooth emotional transfer, and get labor back up and running again.

I heard someplace, sometime (super specific, I know) that for every additional person in the labor room, the length of labor increases by an hour. I have no idea if this is statistically true, but on paper it makes sense! If a woman is being watched during one of the most vulnerable experiences in her life, she’s bound to feel a little bit uncomfortable, or even unsafe depending on who the person is. It is ALWAYS okay to ask people to leave your labor space, be it at home or the hospital. If you don’t feel comfortable with that, your doula can help you get people out! Decide ahead of time who you’d be most comfortable with in labor, and either stick to your guns or remove people from that list! Once you start to feel safe and less “watched,” chances are good that your contractions will kick back in and start making progress.

If labor is slowing or stalling, running through these three categories can absolutely help get things moving again. There are lots of things to try before pitocin becomes the only option.

 

Postpartum

Immediately after birth, it is very common and sometimes protocol for women to have an injection of pitocin. It’s given so that it can help the (presumably tired) uterus to start clamping back down and healing the wound that is in there from the placenta, which slows blood flow and helps to prevent hemorrhage. Many women are less opposed to pitocin postpartum because it is not going to affect their labor or delivery (and is safe for nursing). Speaking of nursing, that’s the best way that you can prevent needing pitocin postpartum. When a mom nurses, the bond she is creating is created because of the release of oxytocin. That oxytocin helps the uterus contract, to encourage it to heal it’s own wound. Yet another reason to start breastfeeding right away after birth!

 

Conclusion

While I hope that you have learned a little bit (a lot!) about pitocin through this series, I hope that you take away the most important message, which is to be educated and not be afraid to talk with your own doula and care provider about your feelings on pitocin.  If interventions/options exist  for labor, delivery, and postpatum, but are not discussed ahead of time, very people know they are options and can be implemented. Make sure to keep the lines of communication with your care provider open, and discuss your wishes for labor and delivery at one of  your prenatals. Don’t be afraid to speak up if pitocin is being offered to you and you don’t understand why. Most importantly, feel empowered to enjoy your birth!

 

Pit: Inductions

This is #3 in a series of posts about pitocin. Check out #1 here and #2 here.

Inductions are a hot topic in the “birth world.” Are the necessary? Sometimes, absolutely. Are their unnecessary ones? Sometimes, absolutely. This post isn’t going to be about whether or not your induction is/was necessary, instead, I would encourage you to check out ACOG’s stance on inductions, as well as head over to Evidence Based Birth and check out her posts about inductions (they are awesome, and so thorough). What this post IS going to be about is pitocin during inductions, and other induction options that you might have. I say “might” because every situation is different, every care provider is different, and every hospital is different. As always, we are not care providers, so please discuss anything that you read here with your provider regarding your specific situation.

Inductions happen for many, many reasons. All induction methods are not equal, but one thing that IS something every woman who is facing induction should consider is her Bishop Score. The Bishop Score is a scoring system that providers can use to determine how likely an induction is to succeed, and also the liklihood of spontaneous pre-term labor. The Bishop Score is determined by scoring from 0-3 each of the following: cervical dilation (0-10 cm), cervical effacement (0-100%), cervical consistency (firm to soft), cervical position (anterior to posterior), and fetal station (how high the baby is in the pelvis).¹ For a great chart with this scoring system on it, check out Wikipedia. The higher a woman’s score, the greater chance of a successful induction (successful meaning ending in a vaginal delivery). A score of 8 or higher is generally considered to be favorable for induction. If a woman’s score is not “favorable,” it does not mean that she will be unable to have a successful induction, it just means it’s less likely. If you have a lower Bishop score, and are facing an induction, have a chat with your care provider to see what options you might have to make your chances of an successful induction better (waiting, for example, or possibly going home if induction doesn’t start labor).

If you and your provider agree that an induction is the best course of action for you, make a plan for how you would like your induction to proceed. You have options about how to start the induction process. These include a cervix ripening suppository, if necessary, which often takes more than one day to make an effect on the cervix. Cervidil and Cytotec are both used to help soften the cervix, but we strongly encourage you to look into the medical indications for using cytotec. If you choose a cervical ripening suppository, you will be checked into the hospital and stay (usually overnight) while the suppository is in place. Sometimes these cervical ripeners also start contractions, in which case you may need nothing else to get labor going! After doing the cervical suppository, often pitocin is the next option. Pitocin is usually started off slowly, and increased as labor goes on. Sometimes if a woman’s body appears to take over all by herself, pitocin is turned off. If your cervix appears favorable for induction, but you want to avoid pitocin, another option  is AROM (artificial rupture of membranes). This is sometimes done in addition to pitocin is the pitocin doesn’t seem to be doing the job on its own, but could also be done without pitocin. This basically means that your care provider will break your water, which hopefully signals to your body to start contractions. Another option for starting an induction is a Foley bulb catheter. This is a catheter that is inserted into the opening of the cervix. The catheter is slowly filled with water to dilate the cervix. Once the cervix is dilated to 3 centimeters, the catheter falls out or is taken out, and hopefully will have encouraged a woman’s body to start contractions and continue the dilation process.

Inductions do not always have to be an all-or-nothing process. We have all had clients and know others personally who have gone in to attempt an induction, have it not work, and leave to come back and try another day. Pitocin can be turned off and the induction can be halted, as long as a woman’s water is not broken. Once a woman’s water is broken however, the induction needs to proceed forward due to the risk of infection for the longer the induction process goes on. Have the discussion about what you would like to do if the induction does not work ahead of the induction, so that you and your care provider are on the same page.

There are also more “natural” methods for potentially inducing labor. We are not endorsing any of these, and none have been scientifically proven to work, however they are options that you can talk to your care provider about, should you be interested in them. The first, and most often recommended method of starting labor is by having sex. The prostaglandins from semen can help ripen the cervix, and an orgasm causes contractions of the uterus, which can also start labor. This will only work if a woman’s body is ready to go into labor, however. Having sex at the end of pregnancy is not going to put you into labor if your body is not ready for it! Other options are nipple stimulation (manual or breast pump) and taking castor oil. There are also plenty of opinions about which foods can also induce labor– we have never seen any of these necessarily work, but many of them are worth a shot (spicy foods, pineapple…you name it 🙂 ) Natural methods of labor induction can be used in addition to medical options for induction, as long as you have the discussion with your care provider ahead of time.

Next up in our blog series about pitocin, we’ll be discussing pitocin during labor for augmentation, as well as pitocin used postpartum. Stay tuned!

 

¹https://en.wikipedia.org/wiki/Bishop_score

Pit: Oxytocin vs. Pitocin

This is #2 in a series of posts about pitocin. Check out the first one here!

pitocin

Oxytocin, AKA the “love hormone,” is a hormone released in a woman’s body during sex, childbirth, breastfeeding, and plays a HUGE role in our bodies. It promotes bonding between partners and children, gets labor started, signals to the baby’s brain in utero that it’s about to be born, helps regulate fear and anxiety, produces an anti-depressant like effect, can inhibit drug addition and help with withdrawal symptoms, and in one study, the missing oxytocin recepter gene was linked to autism (source). WOW. Talk about a powerful hormone! Since this is a blog hosted by doulas, we’re going to focus here on the effects of oxytocin and pitocin during labor, delivery, and postpartum.

We still aren’t sure what exactly kicks labor into gear, but there are many postulations. Regardless of what starts labor, oxytocin is the critical hormone during labor and delivery. Oxytocin signals to the uterus to start contracting by increasing oxytocin receptors in the uterus, and keeps contractions going strong during labor. (Without sufficient oxytocin receptors, the uterus does not contract efficiently). It also helps reduce fear and anxiety, which is crucial during labor and delivery. Oxytocin is present in small amounts at the beginning of labor, and peaks at delivery, giving mom a sense of euphoria when baby is born, which immediately helps mom bond with her baby. It also contributes to the ejection of the placenta, and helps the uterus clamp down after birth, preventing postpartum hemorrhage.

Pitocin is a drug that is given intravenously during an induction of labor, during labor to augment (“help”) labor, and immediately postpartum. It is given continuously, and is increased manually throughout labor if deemed necessary. Oxytocin naturally comes in waves throughout labor, giving mom a break in between contractions. Pitocin, on the other hand, often causes contractions to be longer and stronger with smaller breaks in between due to the continuous nature of the IV drip. When a woman is in labor, oxytocin also works in harmony with other hormones in the body, including endorphins. With the increasing waves of oxytocin, mom’s brain is signaled to increase the level of endorphins released, helping cope with the pain and intensity of labor. Pitocin does not have this effect on endorphins (due to it not crossing the blood-brain barrier easily) which means pitocin augmented labors are often described as more painful and more intense than when labor is naturally progressing. At the end of labor, oxytocin peaks, causing the fetal ejection reflex, or Ferguson reflex–that “freight train” feeling that mom can’t fight–baby is GOING to come out. Pitocin is regulated by a pump, which means that peak is not going to happen. Once baby is born, a rush of oxytocin floods the brain, causing the new mother to immediately start bonding with her baby. The constant pump of pitocin interferes with the body’s signal to release that flood of oxytocin, so she doesn’t necessarily get that rush of “love” hormone right as she begins holding, cuddling, and nursing her baby. Oxytocin also signals the uterus to contract more, preventing excessive blood loss. One study showed that if a mother is exposed to pitocin during birth and immediately postpartum, the levels of oxytocin in her body 2 days later were actually LOWER than if she had not used pitocin. This can effect her postpartum recovery as well as her breastfeeding relationship with her new baby–both emotionally and physically, as oxytocin surge is needed to trigger milk let down.

Long-term, the same study is actually asserting that the more pitocin is used, it could actually have an effect genetically on the baby–essentially “turning off” the oxytocin recepter genes, meaning that when that baby goes to give birth as an adult, their body may not respond well to their natural oxytocin surges due to a lack of functioning oxytocin recepters.  Naturally occurring oxytocin in the mother would not have the same effect on the baby.

Pitocin, while able to physically give a desired result (assisting in functional uterine contractions), is not the same as oxytocin. It effects the mother, the baby, the labor, delivery, and postpartum time differently than it’s natural counterpart. These differences should not be taken lightly, and should be considered when discussing whether the addition of pitocin during a labor and delivery are necessary.

 

Stay tuned for part 3: Pitocin and Alternatives During Labor.

Standard Disclaimer: Doulas are NOT medical professionals, and anything that is suggested or mentioned as an option on this blog should always be discussed with your care provider.

Pit.

This is the first of 4 posts about pitocin use, and alternative options that a mom might have during induction, labor, and postpartum. 

“She’s on pit.”

“Are we doing pit?”

“Did you get the pit started?”

“Is she doing a pit induction?”

“The pit is running.”

 

Pit, or pitocin, is one of the most commonly used medical interventions in childbirth. I have seen estimated statistics as high as 60% of births using pitocin to induce or augment labor. Pitocin is used to induce labor, “speed up” labor, and routinely after birth to help prevent hemorrhage. Pitocin can cause labor patterns to be unnaturally difficult for mom and baby, often leading to other medical interventions and eventually even c-sections sometimes, that could have been avoided had pitocin not been administered in the first place. Is this always the case? Absolutely NOT. We completely recognize the need for labor induction and augmentation sometimes, and have personally seen pitocin-augmented deliveries go smoothly. But it’s not often the case, and many care providers don’t mention the difference between synthetic oxytocin (aka Pitocin) and natural oxytocin produced by mom’s body when she’s in labor. There are differences, and they effect mom and baby and labor differently. In fact, in 2013, ACOG released a statement about a study regarding Pitocin and the negative effects on newborns:

“As a community of practitioners, we know the adverse effects of Pitocin from the maternal side,” Dr. Tsimis said, “but much less so from the neonatal side. These results suggest that Pitocin use is associated with adverse effects on neonatal outcomes. It underscores the importance of using valid medical indications when Pitocin is used.” (source).

Just a few weeks ago, another study was released indicating a significant relationship between the use of pitocin and postpartum depression in mothers. The study results showed that, for women with a history of anxiety or depression, exposure to synthetic oxytocin during birth increased their chances of having postpartum depression/anxiety by 36%. In women with no previous history of anxiety or depression, their risk was increased 32%. These are not small numbers, folks. And keep in mind, this is only the percentage of women who were diagnosed and treated with medication. How many thousands of women struggle through their postpartum time with undiagnosed PPD or anxiety because they are afraid to tell anyone, or don’t even recognize it? I know I am one of them.

So, what’s a woman to do? When her care provider is suggesting induction, or her natural labor pattern is not “fast enough” or “progressing well,” or her care provider uses pitocin as standard protocol post-delivery, is she supposed to just say no and hope for the best? No! While we absolutely recognize the need for pitocin sometimes, I think we can ALL agree that it is significantly overused, and often leads to a string of events commonly called the “cascade of interventions.”

Over the next few weeks, I hope you’ll join me as I discuss some alternatives to pitocin for induction, labor augmentation, and post-birth, as well as share some resources for moms who are struggling with PPD. Stay tuned!

Standard Disclaimer: Doulas are NOT medical professionals, and anything that is suggested or mentioned as an option on this blog should always be discussed with your care provider. 

When Life Isn’t Manageable (AKA Life as a Mom)

overworked-women

There are seasons in life when the winds are gusting and the leaves are swirling, when the storms rage and the rain pours down. There are times when life can no longer be handled, period (much less so with any sort of ease). Nothing seems to be taken care of adequately…house, kids, relationships, yourself…you name it. In these labored times, when what you are doing to survive no longer works, you might feel yourself starting to sink. I know I am not alone in this. It appears to be one of those inseparable elements of the human experience. So, what’s a gal to do?

While I am by no means an expert, below are steps I’ve utilized during my own days of tohubohu. (Look it up…I promise it is a real word!) If you are currently hanging by a very bare thread, may these be of some value to you.

  • Reach out & connect.

If you are like me, when stress piles on and anxiety or depression creeps in, you pull back from life; you turn inward. Depending on the amount of stress, you may do a full out retreat!  The bigger predicament? Life with kids = an inevitable amount of stress, which may result in a regular merry-go-round of disappearing from regular life routines and re-emerging later when you feel like you can breathe again….only to swirl half-way around, hit a stress wall and tuck back once more into the safety of your own figurative shell.

turtle-in-shell

(Me comfy inside my shell)

I love my shell. Shell = safety. Shell = quiet. Shell = security. These are all so alluring when we feel out of control and lost. Being in the shell has clear benefits. Sometimes, we need to hang inside there awhile as we re-group. It’s okay to be in the shell! But even while you are in your shell…shielding yourself, resting, silencing the sounds of the outside world…make a small effort to let someone around you know you are in there. We are social beings, made to live together in communities, villages, tribes. Just as we cannot survive without food, water and adequate shelter, neither can we survive without connection. Reach out to someone you trust, let them walk with you on this leg of your journey and receive love from them. You will feel less alone, even if still inside your safe shell.

  • Prioritize & scale back, waaaayyy back if need be.

When life gets to be too much (which is OFTEN for women in modern day America), it is time to cut out the chaff. When your days feel too heavy, it’s your cue to release some of the stones you are carrying in your jar. (If you are unfamiliar with the reference, watch this 2-minute video!)

Step 1: Figure out what is truly *essential* to your daily life and make a list of your priorities. Things like physical nourishment, hydration, light activity, some minimal self-hygiene might go here. (Definition of “minimal” may vary from person to person, or even within one individual during different stages of life.) Include only what is imperative to your survival at this point. What is essential to you living and breathing every single day? In other words, what are your big rocks?

Step 2: Look at the list from step 1. Does it already feel overwhelming? If so, stop there and let go of everything else for a time. Really, I mean it. Cut out everything that is not directly contributing to your survival and take it one day at a time. Put one foot in front of the other; repeat endlessly. Surviving the day is your priority. When days begin to feel consistently lighter, it may be time to review your list and see if it can expand.

On the other hand, if the “essentials” list feels comfortable from the get-go, make a second list. Consider it a “bonus” or “nice to have” list of things to incorporate in your daily life. This could be time with friends, engaging in hobbies (e.g. writing, painting, crafting, music, etc.), quiet time with coffee. (If you are me, this is definitely an essential and not just a bonus!) Select one or two items at a time to incorporate. RESIST THE URGE to include too many bonus items. Continue to make additional lists that go higher up in the luxury scale, as needed. If someday, you get to regularly enjoy extravagant activities that contribute to your well-being, hooray! Until then, only add in the pebbles and sand that are allowed by the big rocks in your jar.

Step 3: Maintain vigilance regarding your priorities. It is so very tempting in 21st century life to do all of the things and wear all of the hats. But that is not sustainable, and definitely not manageable for most. Know your priorities in life and stick to them. Be on guard against things that seep in and weigh down your jar unnecessarily.

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(It’s okay to be on guard with less slobber and barking and sharp teeth.)
  • Love yourself.

When you feel like you can’t breathe, it is time to put on your oxygen mask. I know we’ve heard this one before, but reminders are necessary. Too often, we plow through life without remembering that extra support is needed at certain times (like when the atmosphere of air surrounding us is thinner, or less supportive, or the burdens we are carrying weigh us down more quickly). Stopping to breathe is not selfish; breathing is good self-care. Getting extra oxygen is necessary at times.

Now, take a moment to think of how you show love to those around you. Ask yourself: do I do these same things for me? If not, today is a great day to start. Put at least as much effort into showing yourself kindness and charity as you do to others.

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(Photo credit Patrick Cheng)
  • Keep your eyes ahead of you.

Sounds impossible sometimes, doesn’t it? I get it, I do. I am a constantly-looking-back kind of gal…re-playing scenes from my life…analyzing thoughts, decisions, actions I have already made…wondering how they could have been perfected…evaluating where I fell short. You know where this leads, right? I end up wallowing in every possible past mistake I have ever made, while simultaneously adding to the burdensome weight of foul life-slime I am already drowning in for that particular moment in time.

The problem with looking back is that all we end up with are strained eyes and a crinked neck. No amount of peering behind us or classifying previous behaviors will lead to a changed story. It only keeps our eyes on the garbage of the past and our noses in the current stench of overwhelming feelings. Yet, when we dare to look ahead, we are providing an opportunity to potentially see the soft glow of a new horizon. When we keep our eyes forward, we prevent our past from continually whipping us and our present situations from paralyzing us. Tomorrow will probably not be instantaneously better or more manageable, but it does bring hope. And with hope, comes possibilities for renewal.

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  • Surrender.

On the spectrum of personal authority, there are certainly components of life that we have more control over than others. The foods we eat, the people we associate with, the type of clothes we wear – all of these are fairly governable and areas where we get to call the shots for the most part. (I recognize this is not 100% true for all segments of a population, but I am generalizing here for the sake of simplicity.) However, life in all its beautifully chaotic and unbridled energy, also provides us with unlimited instances that smack us across the face with the knowledge that we have absolutely zero control in this world. These are circumstances that no amount of planning, of bargaining, of mighty effort or sheer willpower can change. Instead, we are forced to accept what we are given (or live in perpetual denial). Childrens’ temperaments, sudden changes in health, natural disasters are examples of what I would put at the other end of the spectrum.

This begs the question….what the heck do we do with the end of the spectrum that is not subject to our whims and desires? What do we do when we are ambushed with seemingly insurmountable and unexpected obstacles in our path? WE SURRENDER. We allow things to be as they are, rather than what we hoped or planned for or anticipated. We permit things to unfold freely. We surrender when we loosen our knuckle-white grip on the life we believe we should have and open our hands to the life sitting in front of us. Grant yourself permission to grieve, yell, cry and feel your feelings along the way of the unexpected; that’s a healthy response. But ultimately, we have more space to breathe, less weight to carry and more ability to manage when we open ourselves up to life as is. Much easier said than done, for sure. Good thing life gives us repeated opportunities to surrender over and over again.

(Please know I wrote this post just as much for myself as for our blog readers. These words are every bit for my heart, as they are for yours. Take comfort in knowing you have at least one companion on this journey of insanity, friends!)

by Shannon Morber

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Surviving 3rd Trimester

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Third trimester. Weeks 27-40 (and beyond). The most joyful time in your life! You’re about to meet your baby! I bet you can’t wait! …or not. If you’re enjoying your pregnancy in 3rd trimester, and feeling the love and joy and glowing and rocking that bump still, more power to you! For the rest of you…we feel you.

For many moms, 3rd trimester is just not all that glowy. Your baby is growing and gaining about 1/4 to 1/2 pound a week until birth. That means more weight throwing off your balance, pressing on your bladder (yay for peeing a hundred times in the middle of the night!), smooshing your other organs, and generally making you feel huge (tried rolling over lately?). The hormone relaxin is really kicking in, causing your hips, pubic symphysis, back, and knees to feel wobbly and out of whack. Your breasts may be starting to leak colostrum, your nether-regions may be experiencing increased leukorrhea (a fancy way of saying you have a lot more discharge going on down there), and your sex drive has probably taken quite the plunge. You’re exhausted. Your other kids have memorized the theme songs to just about every kid’s show on Netflix because you just.can’t.anymore.

Not to mention the mental game.

Oh the mental game.

The first question people ask now is when you’re due, either surprised by how big or small you are. Once you hit 37 weeks, the first question people want to know is if the baby is here yet, or how much you’re dilated (and can I just. When at any.other.point.in.life. is it okay to ask someone how their cervix is doing??). There is no more even attempting to hide that belly, and hands start reaching for it from every direction (and again, I ask…when is this ever okay??). Not only are you trying to just handle the day to day discomforts of being that pregnant, you have to start reminding people that your baby will come when s/he is ready to, or choose to share your induction or c/s date a zillion times. That your cervix is none of their business. That no, they may not touch/rub/pet/pat/stroke your belly.

Oh and also? You have to birth that baby.

One way or another, that baby has to come out.

Add birth to the list of things going on in your head, and it’s no wonder pregnant women even survive the 3rd trimester without a mini (or major) breakdown!

LUCKILY FOR YOU, there are ways to get through it, and, dare I say, even enjoy it a little bit.

 

Physically

While there is no magic button that you can push to help your body just sail gracefully through the physical demands of third trimester, you can make it easier on yourself.

  1. Invest in a pregnancy pillow. There are a bunch of different kinds to choose from, but the basic premise is that they support your belly, back, hips, and neck while that bump is beginning to take over the bed. They help keep you laying on your side so that you and the baby both get optimum blood flow. They help prevent your joints from waking up stiff and sore by keeping them in a good position while you sleep. Waking up in the morning not feeling like you’re 80 can help you get off to a great start to your day and prevent any extra morning grouchiness from waking up sore after a bad night’s sleep. Don’t want to spend the money on the pillow? Steal pillows from everyone else in your house to wedge between your knees, under your belly, and behind your back to help keep you in the optimal position for comfort at night. Don’t worry, they can’t say anything about their missing pillows…you’re very pregnant. They wouldn’t dare.
  2. Exercise. What?! Seriously?! Yes, seriously (with your care provider’s “ok”). Low-impact exercise is your friend! Pay attention to your body and do things that are enjoyable at this point in pregnancy. Swimming is glorious because for just a little while, your body gets to feel weightless while you easily move through the water. If your hips and pelvis are okay with it, go for a nice long morning or evening walk with your partner or family. Walking not feeling so great? Cycling on a recumbant bike at the gym can be a great option. You’re sitting back farther so your belly is not in the way, but your heart rate can still get pumping and get that blood flowing. Weight lifting is a great option (don’t do more than you’re comfortable with!), and so is prenatal yoga. Stretching and strengthening those muscles will help prepare your body for birth, as well as just keep everything moving smoothly.
  3. Chiropractic care. Visiting a chiropractor weekly or bi-weekly in 3rd trimester can be the difference between getting out of bed in the morning and, well, not. With your joints loosening in response to relaxin, everything can get a little out of whack. Visiting a licensed chiropractor (and preferably someone who practices the Webster Technique) will help keep your spine, hips, knees, pelvis, and neck aligned and in good working order. It can drastically decrease sciatic pain, and help with round ligament discomfort as well. Not to mention aligning your pelvis (which in turn aligns your uterus), ensuring that your body and your baby are in an optimal position for birth.
  4. Make sure to keep taking your prenatal vitamins, magnesium, and any other herbs or supplements that your care provider has recommended. Keep up on the high protein diet, and cut back on extra sugar and carbs. Now is the time to be making sure that your body is in prime condition for giving birth. In the last trimester, extra weight gain for you or baby comes from carbs, so try not to over do the ice cream even though it’s 50 billion degrees outside.
  5. Rest. I know this sounds like a given, but you’d be surprised how many exhausted pregnant women are still trying to do allthethings. Give yourself a break, and ask for help. Talk to your partner about hiring a cleaning service to help with the vacuuming and bathroom cleaning (bad for your back!). Consider asking a babysitter to come  for a few hours a week to help with any other kids you have so you can catch up on some much needed sleep. Take care of yourself so that when the time comes to give birth, you have the energy that you need to rock it.

 

Mentally

Obviously there is a lot going on in your head right now. You may be wondering how well you’re going to handle the transition to 1, 2, 3, 4 or more kids in the house. You may be wondering how you are going to make it through labor and delivery. You may be battling some fears from a previous pregnancy or birth. You may feel totally clueless about delivery and postpartum. You may be nervous about caring for a newborn, or breastfeeding, or, or, or, or…

I encourage you to stop, for just a second. Close your eyes wherever you are. Take a big deep breath, and breathe out slowly. Remember that as hard as it seems right now, it will pass. It’s true, your baby will be here before you know it, and you will be a great mom. A few  things you can try before this little one’s arrival to help you relax and de-stress:

  1. Find a trusted friend and get together to just spill your guts. Tell them if you don’t want advice ahead of time, and just download. Tell them everything on your mind and everything you’re worried about. It helps just to speak the fears/concerns/preoccupations out loud; putting them out in the open takes away some of their “power” over you.
  2. If you don’t want to talk to a friend, pick up a pen, find a blank notebook and a few minutes each day and jot down (or write an essay about) what’s on your mind. Journaling can be so freeing, with the added bonus of being able to look back to see how far you have come, and how things were or weren’t like you imagined they were going to be.
  3. Try to take time each day to practice focused relaxation. Sit quietly and try to detach from your thoughts. Notice them, but let them float out of your head without dwelling on them. Practice identifying your feelings without judgement, and let yourself just be in the moment, getting in tune with your growing baby. Taking time to center yourself in a positive place can make a big difference on the rest of your day. During this time, also consider taking a few minutes to really focus on what you envision for your birth. Come up a with a mantra that you can repeat to yourself when you’re feeling extra anxious or stressed about labor and delivery. Post it on your wall if you need to. If you’re nervous about certain aspects of your birth-day, jot down questions to ask to your doula or care provider. Try to work through any anxieties so that when the big day comes, there aren’t any emotional barriers holding you back.
  4. Exercise. I know I already mentioned this under the physical tips, but exercise also drastically improves our mental and emotional health. Take a walk or go for a swim or have a dance party in the living room with your kids. Get your blood pumping and you’ll be surprised to see how your mood is lifted.
  5. Take a break from social media. Let everyone know that you’ll be back when the baby is born, and you’d prefer not to hear from anyone right now that’s offering anything negative or questions about when the baby is coming. (DO take people up on offers of help, though!!) Stay away from as much negativity as you can in these last few weeks.

Keeping your mind and body healthy these last weeks of pregnancy is key to keeping you sane and preparing you for a great labor and delivery. This is not an exhaustive list..if you have been there already, what things help you get through those last weeks until baby come? We’d love to hear from you! Comment below.

 

Surprises in Parenting: Motherhood Edition

We all know that parenting is hard, but do you really know everything about it until you are in it? We have asked a few parents to share what things surprised them about being a parent.This month we are going to hear from a few mothers about the things they weren’t expecting when it came to caring for their kids.

Thanks to Karla Griesbaum, for sharing her story!

  1. That each child is different, and require different parenting. There are so many books, articles, magazines, and products that try to tell us how to raise our children. How to get them to sleep, what they should be eating, when they should eat it, or age-appropriate activities and milestone charts. The most important thing I’ve learned as a parent is to follow my instincts. Before I had kids, I thought that I’d be prepared, and most of my preparations were all for not. I had newborn cloth diapers that ended up digging into my son’s little legs. So that was a bust. I read about independent sleeping and put him down when he fell asleep all the time – something which I regret and vowed to hold my subsequent children as much as possible. I thought a pacifier was an evil devise used to silence a baby in need of attention. If I would have let my first use one, he may not have nursed so much he violently spit up all the time. My second didn’t want it. My third now uses it. I’ve learned that I need to follow their lead. I don’t treat all my children the same. It may not seem fair, and it wasn’t how I thought good parenting should be, but the truth is they are all different people, with different needs. There is no perfect answer for how to get a child to sleep, or to eat their vegetables, or to use manners. Each child learns differently and responds differently, and I have to be three different Moms to each.
  2. That there is nothing you can do to prevent “bad” behavior. Of course, as a parent, I’ve learned to see the behavior that I used to see as ornery as normal child development. Babies, toddlers, and kids are going to test limits. They are going to scream, throw fits, break down at the slightest thing, and break the rules. It’s in their nature and has nothing to do with being a “bad” parent. Of course, I take each episode as a learning opportunity – to teach them how to use their words, to let out their anger in safe ways, to be respectful…and it’s an ongoing process. I’ve gained patience from this (but still need more). I was a preschool teacher before having kids and said all the time “My kids will never do that!”. Well, they did. And they do. Because that’s what kids do; and once again, they are all different. My son is a rule-follower. He listens, wants to please. He is also very sensitive though, and it hurts when something doesn’t go how he planned (he is my clone, basically). My daughter never listens, it seems. She fights me tooth and nail, is dramatic, and screams. It’s not because I let her get away with anything…it’s because it’s in her nature, and while we are working on it, I now know that I didn’t cause her to be that way.
  3. That I have come to love my body more with each baby. As a young woman I would hear mothers blame pregnancy and motherhood for their unhappiness with their aging bodies. That each gained a few pounds with each and never lost it, that their skin never returned to normal, and these were all bad, hated things. However, being pregnant made me love my body for really the first time. Growing up I was never happy – I was too skinny as a kid…I had no curves or breasts. Then I was too heavy. Then too skinny again, then fat. My spine is curved making only my left hip stick out. Every woman around me criticized themselves, and I did the same. However, being pregnant I felt like I finally knew what my body was there for. I cherished the curves. I didn’t care about cellulite or my never ending behind. I felt healthy, like this is how I should always be. After three babies my body has changed a lot. However, I feel good. I feel healthy and accomplished. I may not like what I see when I look in the mirror, but that’s all the more reason to not even look, because it doesn’t matter. What matters is I’m active and healthy, and my children see a positive attitude towards body image that they can carry into adulthood to avoid the perils I went through in my youth. I never thought having three babies would make me love my body.KARLA final.jpg