Viewing entries tagged
birth
On September 11, 2016, we welcomed our third child, second son, into this great, big world. After what seemed like forever we finally named him on his fourth day of life. Nico Elliot.
He is perfection. Delicious.
Nico Elliot
Although I didn't blog throughout the pregnancy-- there was much to blog about. This pregnancy and birth was so different from my other two, that I have a whole list.
For starters SPD, physical therapy, diabetes and plugged milk ducts. Stay tuned...
If you are reading this I assume, like many, you want to know what a postpartum doula does and better yet, why can't you just have your mom or family member help you out once the baby arrives?
These are valid questions and hopefully I can shed some light.
Let's start with what postpartum doulas actually do. Postpartum doulas support families anytime within the first year of having a baby. Starting, most often, during the first few weeks -4 months after the baby is born. This support is tailored to each individual family's needs, and the support changes as the needs change-- sometimes with each visit! Some examples of what a day with a doula looks like can be found here , here and here.
A postpartum doula is hired and contracted for a certain amount of hours. These hours can be spent during the day or some doulas even come to your house overnight to give you and your partner a peaceful and deep night's sleep. Depending on how the baby is fed, in the early days an overnight doula would feed the baby or bring the baby to you and then take the baby back to his room to sleep. The doula would make sure the baby stays safe and content, all while you sleep! In the early weeks, when feedings happen often, a couple of hours of restorative sleep can do wonders for the next day.
Daytime hours are spent doing things like:
A postpartum doula could essentially be hired to manage the house while you rest and bond with your baby, all while keeping you fed and hydrated.
But wait, why can't your mom do all of this? Or an experienced friend or family member?
Maybe they can! And that is absolutely wonderful if you have that type of support. But just for kicks, let's consider a few reasons why one might hire a doula:
Sometimes I wonder about how mothers back in the day lived without letting their kids watch a TV show once and while. Now, I definitely ere on the more conservative side when it comes to screen time, but sometimes, I feel like I NEED to stick a 2 hour movie on so that I can do some work or clean the house in peace! I also used to wonder how many women can have 4, 5, 6, 12 (!!) kids, until one day I looked around at my filthy walls (I know, I know, do people really take note of their walls and feel like they need to be cleaned? I do, apparently) and I just had to clean them. I got out a sponge and a bucket of soapy water. Suddenly I had attracted my troops! The kids were here to play and that's when it hit me. THIS is why people have a lot of children.
A lot of children = a lot of helpers. ;)
I realized two things. First, things have changed. Our society has changed. Most women have to work and when they are home, they are living in houses where they are isolated to just their immediate family. This can either make one mind numbingly bored or extremely stressed to work, care for the children and the house on their own. Second, I began to think about my own travels to countries like Haiti and Greece, where village life is still very much alive and the village kids and families are at each other's disposal. There's no need for TV: when kids can roam freely, parents don't have to entertain them.
Better yet, there's always someone around to lend a hand.
So what does this have to do with postpartum care? It has everything to go with postpartum care!
You are coming home from the hospital and you need to rest. You need to be able to nurse, sleep, snuggle and enjoy these moments. Maybe you have older children who can't wait to see you and spend time with you, your partner and the new baby. You don't need to be doing dishes, you don't need to be making food (but you do need to be eating food!) and you don't need to be worrying about laundry. You could benefit from some sleep, a nutritious meal, maybe a shower or a bath and your body needs to recover.
Maybe your partner can help with this for a little while and maybe your friends and family can come over and help too. But we don't live in a village. Much of our support doesn't live close by. If they do, they have to work and care for families of their own. This type of help makes a lovely and refreshing visit, of course, but is it sustainable? Does it feel helpful and secure?
A postpartum doula is trained in this type of support and is with you ONLY for that very reason: to support you and your family well and they stay with you for as long as you need to feel safe and confident.
We have an overwhelming amount of information coming at us. We want what's best for our families and we are part of a generation of people who will not just do what the generations before us did if it doesn't seem best. We research, we observe, we learn and we try to do better. A postpartum doula can help you navigate information found on google by providing current and evidence based research specific to each of your concerns. A doula can also remind you to tap into your own intuition regardless of outside information; encouraging you, that YOU and YOUR PARTNER know what is best for you baby. A doula doesn't judge. A doula supports, listens and provides the space for you to make the decisions you know are best. This can be especially valuable when it feels as if you are swimming upstream.
I almost didn't list this as a reason why a postpartum doula is beneficial, but then I thought to myself. NO. With one in seven women dealing with some kind of mood or anxiety disorder, it needs to be said. PPD is a very real issue that mothers face every day. It can be scary. It can be overwhelming. It can feel like it will never end. But it can and it will. There is so much support and help available. It does not have to be something to fear.
A postpartum doula is trained in helping mothers to decompress and process their pregnancy and birth. Postpartum doulas welcome all emotions and provide a safe place to be real and raw. A doula can tell the difference between (and help the partner tell) what are normal hormonal changes and what seems as if mom could use a bit more support. She can give referrals to specialists who can help navigate the sometimes, very dark, places of postpartum depression and help find a way out.
Hopefully I have provided a bit more information as to what a postpartum doula does and how you can benefit from hiring one. If you are here in Rhode Island, I would love to chat with you more about this wonderful service. Feel free to reach out with any questions or just to say hi!
Elimination diets aren't easy. For anyone. I know this. What I didn't realize was how hard it was going to be for me to even begin.
About 3 years ago, we started realizing that our oldest child was having some issues with her skin. At first, it seemed like her skin was "sensitive"-- whatever that means. She would react poorly to different types of soap and she had some really gnarly patches of eczema. As time went on, it seemed we couldn't figure out what her triggers were and it was rather frustrating. Have you been there? Could it be this? Oh it's definitely that! Wow, look! She seems to be clearing up!
Not.
I had about had it, and then poop really hit the fan. (Side note: What? Hit the fan?) She had been having this red burn-like rash on her bottom (different than the patches), it would come and go but when it came, it was painful! Our pediatrician assured us it was because she wasn't keeping herself clean and dry and for us to consider helping her wipe after she went to the bathroom. Could this really be the issue? Such an easy fix-- although my heart did sink a bit, as I would have to take back the happy dance I did when I realized I had finally broken free of wiping her butt!
Time went by and I just wasn't convinced.
What we were convinced of was that sugar and highly processed foods made it worse. So we avoided them. Even fruit.
Things would be good. And then the rash would come back. F.
Spring of 2014 rolled around and she got a strange bite on her neck accompanied by a very high fever about two days later. Unsure if it was Lyme or not, our new and very conservative pediatrician apologized to me profusely but said that he would like to put her on 2-3 weeks of antibiotics. I partially knew about the negative effects of antibiotics on our gut, but not to the extent I know now.
And I hate Lyme. So we went for it.
A few days into the prescription, her red rash turned purple. A few more days go by and we let her have a BITE of birthday cake and she turned into a maniac. Screaming in pain that her bottom hurt. Crying. Waking in the night... the whole thing.
What does a mother do when her baby is in pain and there is nothing she can do to help? Google. Ha. No, really. We all do it, don't we? I read and I read and I read. And I ended up...
Confused.
I started to think back on her life a bit. In her 3 years of living she had antibiotics at birth, she had prophylactic meds for Malaria (for our trip to Haiti) and now another round of antibiotics right around her 3rd birthday. Was this considered a lot? Could the antibiotics be contributing to the problem?
After much prayer and thought and research and frustration, we decided to (randomly, this had not been on our radar) cut out dairy from her diet. To our surprise in 3 months her eczema was completely gone and her rash on her bottom was gone and it didn't come back! CUE THE CLAPPING!!!!
I was finally able to REST. And she was finally able to eat a damn apple again.
She kept on me though, kept asking when we would try to figure out what was going on. The girl is persistent. So I finally did it. I set a date and I didn't budge on it.
Let me tell you. Prepping for this sucked. Meal planning for this first week had me in tears.
The 4R's stand for Remove, Replace, Reinoculate and Repair. So we planned to remove anything that could trigger inflammation, to replace with healthier choices and a digestive enzyme, to reinoculate with probiotics but then...
DANG, this was EXPENSIVE; so we decided to hold off on the repair for now.
Let's chat a minute about making a shopping list for myself, a husband, a four year old and a two year old when all of our go- to snacks were on the naughty list. And I'm not talking about candy or fruit snacks either, I'm talking about mango and bell peppers! (The top photo isn't accurate, we can't even have freaking bell peppers). Yogurt, cottage cheese... EGGS! Wh
Life was sweet. For awhile. Until she really wanted some yogurt and I really wanted to let her have some.
I wanted to get to the root of the food sensitivity.
Which is what led me to Dr. Aviva Romm's Healthiest Kids University and the Allergy Epidemic. In this course she discusses the root causes of some allergies and even auto-immune diseases and guess what one of them was? Antibiotics, yes, but more specifically, treatment using antibiotics for Group B Strep during birth.
BINGO.
So began our journey with Dr. Aviva's 4R program. Well, in theory anyway. Anything sounds good in theory right? I would set dates to start, and then cancel them. I would think about how to prepare and then not prepare. She and I would talk about it at length and she would get excited at the idea to eat cheese again, possibly-- but then a family party would come up or she would get invited to a friend's birthday or we could go away for the weekend and I would put it off.
Because who the heck can fit an elimination diet like this into their life? Don't get me wrong, we cook the majority of food at home anyway-- we eat well, mostly vegetarian, I pay attention to the dirty dozen, we brew our own Kombucha for goodness sakes! But what if I wanted to quickly grab Chipotle one night? Or go to a friend's home for a meal? What happens then?
It seemed impossible.
Dairy-free. Gluten-free. Sugar-free. Red-meat free. Limited fruit. No nightshades.
AND THE LIST GOES ON.
What the heck would we eat for breakfast, I want to know??? I can only seem to scrounge up recipes for dinner, but am at a complete loss for breakfast, lunch and snacks.
I plan on having smoothies (which take up all of our fruit choices) for breakfast almost every single morning. For 3 months. Everybody laugh along with me!! Only a crazy person would attempt this with whole family.
Hello, nice to meet you. I'm CRAZY.
When we aren't having smoothies-- well, I guess we can have bananas and almond butter.
Lunch: Rice and carrot sticks? Will my two year old eat a salad?
Snacks: Green beans.
Is that enough? Ha. I'm tired already. That's it folks. That's all I've got.
Wish me luck!
Late pregnancy belly
Hello there.
You're getting close to your due month. How exciting! You're feeling pretty good. Maybe you are ready to have this baby, maybe you need a bit more time. Overall you are happy to have had such a healthy pregnancy. Then your care provider tells you, you've tested positive for Group B Strep.
Group B what?
Group B Streptococcus.
You may have some questions. Here are some answers.
Bacteria
Group B Streptococcus (Group B Strep) is a bacteria that lives in the intestines of many people. It can travel down to the vagina, urinary tract and rectum. Often, it is the culprit of urinary tract infections (UTI). But for the most part it lives in the intestine and doesn't seem to be much of a problem. Some women find out that they have a GBS infection which would show up during routine urine testing, but most women would only know they were Group B positive because of a swab test around 37 weeks pregnant.
So what's the deal with pregnancy, then?
Well, here's the deal. If the GBS moves its way into the vagina and/or rectum during the last weeks of pregnancy it can get passed on to the baby (in other words, baby can become colonized with GBS) during a vaginal birth. It is not alarming when a baby becomes colonized but developing an infection is. The chances they would develop an infection are small but if they do, they can develop meningitis, pneumonia and sepsis. This is why, in the US, we screen for GBS and the standard is to treat with antibiotics during labor and birth.
Pretty straight forward, right? Sort of.
When I was pregnant with my first baby I tested positive for Group B Strep. I didn't know much about gut health and the negative effects of antibiotics on our bodies.
In fact, I didn't know anything.
I was concerned about mobility. I wanted to move while I labored and I wanted to make sure that this Group B business wouldn't take that away from me. I was told that I would have to be hooked up to an IV periodically to administer antibiotics but it shouldn't restrict my movement. That's all I wanted to know.
But there's so much more.
How many babies actually develop a GBS infection? What are the short term and long term effects of antibiotic use for the mom and baby? Do the benefits outweigh the risks? and is there any way to avoid testing positive for GBS?
There is a wonderful resource on this grand Wide World Web called Evidence Based Birth. Here, they lay out the research and what it has to say regarding pregnancy and birth issues, including Group B Strep. If you want answers to the above questions, this should be your first stop.
Second stop, right here: Dr. Aviva Romm has some truly wonderful information on Group B Strep for the thoughtful mom, including how to protect against an infection. She also has interesting research, over at Healthiest Kids University that connects antibiotic use in newborns with allergies, eczema, asthma in childhood, obesity and diabetes.
So begins our journey. My baby is four now. She has a dairy sensitivity, eczema and another recurring rash that we have yet to explain. It doesn't sound too complicated, but when I began to realize that eczema, skin issues, even allergies are our body's way of telling us there's something wrong, I needed to get to the root of the problem!
Hoyles at a PVD playground.
Our family is embarking on a 3- month (at least!) hunt for healthier guts :) We will be following Dr. Aviva Romm's 4R program and although I am excited to begin trying to help our daughter kick some of her symptoms (and maybe some of mine too!) I can't imagine it will be easy with a 4 year old, a 2 year old and a husband who loves ice cream and coffee milk.
Join us week by week for highs, lows, recipes and more!
There are women giving birth every day of the year. At home, in the hospital– even in the car! It seems as if labor progressing is not problem. It seems as if a positive birth atmosphere would not matter much given the different circumstances in which women have their babies.
But it does. So much.
Here’s why: there’s this stuff, this hormone, called Oxytocin; also known as the “love molecule” or “trust molecule.” This delightful hormone is front and center in labor and delivery. In fact, if labor slows, the #1 intervention is to give the laboring woman intravenous Pitocin, which is the synthetic version of our body’s chemical, Oxytocin. It is responsible for labor starting and for contractions to continue and increase in strength and frequency.
I was at a birth once with a client who loved the TV on for background noise. When I first met the expecting couple at the hospital, the TV was on in triage. My gut reaction was to let them know that they could shut it off and to offer to do that for them. I was surprised when the birth partner said to me “No, actually, she likes it on.” As a doula, it’s not my job to do what I think is best, or to organize the birth in a way that I would birth my baby, but to quietly support and trust my client’s wishes. After all, even if the TV on would stress ME out, if it was bringing my client comfort, then having the TV on was exactly what we needed.
Or not.
As time went on it became clear (particularly during an episode of Dateline) that the TV was pushing its way from a background role right up to lead and kicking out our good friend Oxytocin. What the doctor was telling us was that my client’s contractions had become ineffective and her cervix was not continuing to dilate. What I was noticing, was that the human connection in the room was almost non-existent. After 12 hours of staying at 5 cm dilated and closing in on a caesarean birth, I suggested that my client and her partner get close.
We shut the TV off, we said a prayer- as this was part of their support system, I put on some soft music and the two expecting parents shared conversation, massage and giggles.
One hour later, Mom was dilated almost fully and the baby was born shortly after.*
This is when I learned that babies don’t like Dateline.
They want to be born in an atmosphere of comfort, safety, trust and love. This is when the body can pump out oxytocin to it’s fullest.
As important as it is to learn how to promote oxytocin, it’s also important to understand what can inhibit it’s production. Aside from Dateline, here are 3 other ways to stop labor in it’s tracks.
You are sitting in a dimly lit restaurant enjoying a delicious meal, some fantastic live music and great company. You feel relaxed and are having a fantastic time. Suddenly, the light switch gets turned on. What do you do? What does everyone in the restaurant do? You squint your eyes, sit up straight (tense up) for a minute and maybe the musicians even stop playing for a second. People are probably feeling a bit exposed.
Ina May Gaskin, midwife, birth activist and author of many books including “Ina May’s Guide to Childbirth” famously speaks about the Sphincter Law and it’s importance in childbirth. She says that sphincters (ahem, the cervix, too!) are shy.
We seek privacy to allow our sphincters to do their jobs, jobs that at the most basic level, have to do with hormone levels in the body. -Ina May Gaskin
Bottom line: It seems as if bright lights equal exposure. The cervix would prefer a safe, intimate and private environment where Oxytocin can thrive.
Adrenaline is our good friend in stressful situations. It is a hormone which prepares our muscles to move it or lose it! Although many popular Blockbuster hits would lead us to believe that this is precisely what we need for labor and birth– actually, the exact opposite is shown to be true. Adrenaline can actually shut down the production of oxytocin.
So, when exactly can adrenaline creep in and wreak havoc? According to Elizabeth Davis, co-author of Orgasmic Birth, ” when women become frightened or over-analytical or anxious about their progress.”
Let’s discuss fear for a moment. A woman may never feel fearful during her labor and birth, but her body may be reacting to the environment around her with fearful responses. The question isn’t “am I feeling afraid?” rather, it is “what might my body perceive as frightening?”
Some answers: commotion, bright lights, negative thoughts/words from herself, partner and especially caregivers, transferring location, loud noise, vaginal exams and spectators.
Bottom line: Birth is supposed to be an act of love. Treat it as such and adrenaline will have to hit the road.
Let me be clear, I am not saying lack of people in the room, I am saying lack of SUPPORT. When a laboring woman is with a person/people whom she loves and trusts, oxytocin is free to flow and the process should progress rather smoothly. If she is surrounded by people who are not in support of her birth wishes the exact opposite may ensue.
This is why a partner’s support is SO incredibly important. They can literally change the course of labor, at times, with a touch of their hand!
It’s also why a doula’s support has shown to decrease the length of labor, decrease the need for epidural, decrease the unplanned caesarean birth rate and increase positive feelings surrounding the birth experience.
Bottom line: Partners, don’t underestimate yourself! You have such an important role– your closeness is priceless! Hire a doula to free you up to be as present as you need to be for the laboring woman.
*Birth story shared with permission.
“So… how did you decide to become a doula?”
That’s a question I often get asked when interviewing with a potential client.
I usually smile, remembering my very own journey through pregnancy and birth and then proceed to tell them that it was a gradual happening starting with my daughter’s birth and ending some time after she was a year old; when I realized how much I loved all things birth and had naturally fallen into a support role as my peers began to have children right alongside me.
But that’s a lie. I’ve been lying.
I didn’t realize it until two days ago when Randy Patterson from Prodoula asked me: “Who is your business’ hero?”
Umm…. what? My business’ hero? I’m not very good on my feet– plus this was an intense question!
I sat and thought. I thought back to the story I always tell. I thought back to Judah’s birth– is she my business’ hero? I thought back to my friends’ births and their postpartum periods, were they my business’ heros?
I thought back to the very first birth I ever witnessed. Suddenly my face became hot and tears welled up in my eyes.
I was 17 years old. I remember the day like it was yesterday. I was taking a nap not expecting any company, when I felt a tap on my shoulder. Kneeling by my bed, was my cousin, 17 years old, just like me.
She looked at me with tears in her eyes and said: “I never got my period. I’m pregnant.”
I sat up– still fuzzy– not knowing what to say.
She continued on… and the story wasn’t a pretty one.
She eventually looked at me and said “I don’t know what to do. Everyone says I should have an abortion. What do I do?”
Suddenly, me, a 17 year old high schooler without a care in the world, who was obsessed with her boyfriend and auditioning for school plays, was assuming the position of authority in things BIRTH related. <GULP>
Lord knows if I even knew HOW a baby was birthed, never mind if my partnerless, jobless, senior in high school teenage cousin should go through with her pregnancy!?
Did I mention I’m not quick on my feet?
I took a breath and muttered “I’ll help you. Whatever you need. I’ll help you”
For the next nine months, I quietly watched. I watched as her body changed and grew. I watched as she was congratulated, was given loads of advice and I watched as she was stared at and probably talked about behind her back. I watched as she navigated school as, quite possibly, the only other kid growing another human being.
I watched her strength.
Springtime came, and I was playing Peter Pan in my high school’s yearly musical. I got word that I would be needed bright and early the next morning for my cousin’s induction. My director gave me the day off and headed to her house.
The night before, we packed her bag. I remember the little diapers… I was so excited. A baby was about to be born!
When I think back on it now, I wonder how she must have been feeling.
Nervous? Embarrassment? Dread? Resentment? Guilt? Shame?
The details that I remember from the birth are unlike the details that I remember when I attend births now. I remember taking videos, I remember writing down different things that she was saying during the labor. I remember playing card games and I remember falling asleep outside in the hallway while she got her epidural.
I remember how she pushed. I remember how hard it was physically but how incredibly intense and beautiful it all was.
I remember that I wasn’t afraid.
I remember his black, fuzzy hair and his red skin and squishy nose.
I remember holding him. I remember that she didn’t want to hold him.
But I remember how she did, anyway.
SHE is my business’ hero. SHE is the reason I love birth and I support families.
Because the journey is long sometimes, and the journey is unexpected sometimes. The journey is bittersweet sometimes. It can be joyful, it can be easy, it can be enjoyable, but not always.
This is not a position on abortion. This is not a position on epidural or induction…on purple pushing or passive descent.
This is about supporting a mother in making the decisions that SHE thinks are best for her and her family. This is about the STRENGTH within a woman that defies circumstance, feeling and plans.
SHE is how it all started for me. Thirteen years ago on a sunny day in April, when if someone would have mentioned the word “doula” to me I would have tilted my head and said:
“What? What’s that?”
