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10/10/2020 0 Comments

"What do you do to monitor me and baby?"

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Safety is often a question that comes up in regards to home birth. How do we know if there is a problem? How do we decide when to transfer? What do we do during prenatal care and labor to monitor? These are important questions! Let’s break it down into what home birth midwives do to monitor during each prenatal care, labor, and postpartum.

Monitoring During Prenatal Care:
We see you on the frequency as an OB/Gyn during pregnancy, and we take vitals as a part of every visit to make sure you and your baby are safe and well. 
Here are the things we are tracking:
  • Blood Pressure
  • Pulse 
  • Weight
  • Baby’s growth by measuring your fundal height (the distance from the top of your uterus to your pubic bone)
  • Baby’s heart rate
  • Baby’s position
One of the most beneficial things we look at in midwifery care that is often not monitored in other settings is the position of your baby. Every visit we palpate your belly to feel for the position of baby. If your baby is not in an optimal position as we get closer to the end of pregnancy, we can recommend lots of exercises and techniques to encourage your baby to be in a great position during labor. Positioning plays a huge role in how labor can go, so we pay a lot of attention to it!

We can run standard prenatal blood work, do urinalysis in office, order ultrasounds, and consult with a doctor or perinatalogist if there are any concerning signs in your pregnancy.

Monitoring During Labor:

We check your vitals every 2-4 hours during labor, more often if there is anything concerning. We check blood pressure, pulse, and temperature to make sure you are handling labor well. For your baby, we use handheld dopplers to listen to their heart rate about every 15-30 minutes unless we hear anything concerning. We listen more often if needed and see if we can resolve any minor issues easily at home before recommending a transfer.

Did you know “continuous EFM (electronic fetal monitoring) is associated with many known medical risks to women, without providing any benefit to the fetus in low-risk pregnancies (Alfirevic, Devane, & Gyte, 2006; ACOG, 2009)”? Continuous monitoring requires you to be strapped to a monitor and your movement is quite restricted. We use intermittent monitoring, which allows for freedom of movement, utilizing water, and is adequate in low risk, unmedicated settings to monitor your baby. We are able to follow you around and listen as needed, in water, or out of water during labor.

Monitoring During Postpartum:
Immediately postpartum we are monitoring your blood loss and vital signs and we are also watching baby’s vitals as well. We count baby’s respirations and heart rate, and we assign APGAR scores based on how your baby is transitioning. For the average smooth, low risk births, vitals remain steady and normal for both you and baby, and we monitor for 2-4 hours after birth. If all is well, we go over things to watch for that could be signs of distress for you and baby and we tuck you into bed to get some rest. You have our phone numbers to call at anytime if you have a concern. 

We return in 24-48 hours to check vitals again on you and your new baby. We track your baby’s weight, feedings, diaper output, respiration rate, heart rate, and temperature. We can do the newborn metabolic screen where we take a blood sample to make sure your baby doesn’t have any rare metabolic disorders that need to be addressed early on. We use a pulse oximeter to screen for congenital heart defects and make sure your baby is oxygenating well.

During the first six weeks, we see you and your baby 4-5 times to make sure breastfeeding is well established, your baby is gaining weight normally, and to monitor both of your vitals. We spend a lot of time talking about how you’re coping with postpartum and run labs if needed for you. Each time we see you in those first six weeks, we monitor for any signs of postpartum depression or anxiety, we check in about your bleeding, any pain you’re having, and refer you to any support that may be needed to relieve any problems you may be facing. 

Our monitoring is thorough through all phases of our care, and we are trained to recognize whether you are having a low risk, normal pregnancy, or if there are circumstances that would make it safer for you to birth in a hospital setting.


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9/20/2020 0 Comments

"Is there anything you can do to help with the pain?"

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The short answer is yes. Whether you are birthing at home or elsewhere, I’m going to offer you some thoughts on minimizing pain during labor and birth. 

So home birth is really appealing for a lot of people these days, but one of the things that prevents people from jumping in is the fear of not being able to handle the pain. I’m not going to lie, labor and birth are really hard work. There is an intensity to it that is quite unique to giving birth. And also, not sugar coating, it is manageable. It’s really hard for awhile, and then it’s over and gone. I have seen people roar, shout, hum, growl, rock, dance, laugh, and breathe their way through, but I have never once had anyone tap out of home birth during labor because of the pain. Not that there would be anything wrong with that at all, but in those moments at home, people seem to just handle it. 

I’m going to give you some reasons why I believe that labor pain is more manageable at home:

  • You’re at Home!: Where do you want to be when you feel completely awful? At work? Someone else’s house? A hospital? No! We want to be at home, because home is our comfort and our calm, and in our homes we are free to be completely ourselves. Crawling into your own bed is some sort of magic when things are hard. Being in your own four walls is familiar and safe. Do you know what happens when you feel comfortable and safe during labor? Endorphins flow which are our bodies’ natural pain killers. Oxytocin flows in a setting of trust which helps facilitate steady labor contractions. Based on my own experiences and observations, home, in and of itself, minimizes the pain.
  • Freedom of Action & Movement: When you’re in your own home, you instinctually move where you want to be. You don’t feel the need to ask if you can go down the hall or to get a drink or to get out of bed. You don’t feel like you have to be quiet or civilized. It’s your domain, and you will move in it how and when you want to. Free movement facilitates a more comfortable labor. Being stuck in bed or in a small area does not easily and freely facilitate the sort of movement you need to better handle labor. During labor there are some positions that will feel excruciatingly wrong and some that will feel way more right. At home, you can be however you want to be and wherever you want to be, and that goes a long way in minimizing pain.
  • Waterbirth: Laboring in the water at the most difficult and intense parts of labor is an amazing relief for a lot of people. Most home birth midwives are supportive and comfortable with both laboring and birthing in the water. I have heard many say the water was way more effective at providing relief than they had imagined.

Being at home in general lends itself to a more comfortable birth. There are also plenty of things you can do to help you cope during labor at home or in any setting:

  • Childbirth Classes: As a midwife, I see the preparation of childbirth classes make a huge difference in how someone moves into and through labor. Knowing what to expect and being able to release some fear about labor through the learning you do in childbirth classes helps make a big difference. Classes give both you and your partner or support person tools for how to help you cope when labor becomes more intense. When your support people have tools, they are confident and can help keep you calm during labor. Childbirth classes help relieve stress about the labor. While calm helps endorphins and oxytocin flow, stress does the opposite and it can make labor more difficult! So get yourself a good childbirth class that teaches labor coping methods.
  • Hire a Doula: Doulas are amazing at supporting and helping keep you comfortable and calm. They know how to provide counterpressure that can make contractions feel better, they know the words to keep you calm, they know when to put a cold cloth on your neck to cool you down, and they know what positions might better facilitate the process. They are worth their weight in gold. 
  • Breathe & Relax: Easier said than done, right? But breathing deeply during every contraction and mentally making an effort to soften and release every part of your body will help your labor be easier and more comfortable. The deep breathing keeps you from going into fight or flight mode and the relaxing of your body allows your uterine muscles to do their job without resistance. Tension in the body is literally working against the labor process making it lengthier and more painful. 

So is there really anything that can be done to minimize the pain in labor? There is no magic bullet in unmedicated birth. No one can take the intensity away, but you can be supported through it by preparing yourself well. The choices you make leading up to labor and the team and location you choose are what can help you have a labor that is more comfortable and manageable.


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9/6/2020 0 Comments

"But what about the mess?..."

“How messy is it? Is it going to look like a horror scene afterwards?”

This question pops up all the time during my home birth consultations. And ok, it’s a fair question right?

So here is the answer. Birth can get a little messy, yes. But by the time we tuck you in your bed and leave your home, no one would ever know a baby was just born in your room.

Home birth teams are total pros at cleaning up after births, and that is not your job in any way. You will be enjoying your baby in your bed and sipping some tea while we put the towels in the wash with peroxide to get out any stains. We will change your sheets while you shower and clean up any little spots that might have escaped the absorbent chux pads we throw down around you while you give birth.

If you used a birth pool, it will catch the majority of the mess, and then we just pump out the water into your toilet for you while you rest. We will get that tub taken down and put away so it’s not taking up your space.

During labor, when you are nearing the time to birth your baby, we will be throwing down chux pads under and around you to catch the mess. We put plastic backed sheets on the floor around your bed to keep your carpet clean. We do our very best to protect your space and make for easy clean up.

So can it get a little messy? Sure, but not horror scene messy, and we are ready for it. It’s not as messy as you may think, and we won’t leave any mess for you to clean up while you’re trying to settle in with your new baby.
​
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2/28/2020 0 Comments

When We Gather In Support of the Mother

Most pregnancies are spent planning for the baby and the birth, but not the mother. Most often the baby is showered with gifts, but not the mother. And in the postpartum, the baby is held, but not the mother. 
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This country forgets about mothers. It forgets to celebrate them, thank them, honor and support them. But not in my circle of birth workers. The mother comes first.  We care for her and support her because we know that if she is healthy and well that the baby will be too.

Have you ever been to a baby shower? What about a postpartum shower? Or a Mother’s Blessing? Most of us have been to plenty of baby showers, but what about the other two? I recently had the honor of helping throw a postpartum shower and Mother’s Blessing for a friend and here is how it looked:
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Women in a circle, sharing positive stories about their birth in support of the mother.
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Women bringing food to the group to nourish the mother, including bringing extras for her to put in her freezer for when baby comes.
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A bead ceremony was completed where we chose beads that symbolized our wishes for her birth and we shared our wishes and added our bead to a bracelet for her to wear during labor.
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Making affirmation cards for her to hang in her room to remind her to trust her body and herself as a mother.
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Speaking our intentions for her journey as a mother into a bottle of water for her to drink during labor.
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Instead of gifts, people brought cash donations so the mother can hire the postpartum support she needed after baby is born.
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The mother sat and received our love and the beauty of henna on her skin by a loving artist.
It was beautiful and loving and supportive for this woman. She knows she can call on any one of us during her postpartum days for support, a meal, or encouragement. With this event, she sealed her circle of support. None of us were there about the baby. We were all there about the mother and THAT is where our attention needs to be in order to truly support those around us. And I’m sure if you tend to the mother first, she might even let you have a chance to hold that cute new baby. ​
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8/3/2019 0 Comments

when breastfeeding feels like an uphill battle

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By Alyssa Johns, LM, CPM

I’m a midwife. I thought I knew things. Pregnant with my second baby, I was sure breastfeeding was going to be easier than with my first, because I have learned things as a midwife that I didn’t know when my son was born. Breastfeeding him felt like breastfeeding an angry piranha. He chomped, screamed, but would not suck. After two weeks of my six week maternity leave had passed, I was marked with cracked and bleeding nipples and the feeling of defeat. I decided I was done spending my short leave crying and stressing over breastfeeding and I decided to just pump for as long as I could before switching to formula. That was 7 years ago. Since then, I have become a doula, a HypnoBirthing instructor, and a midwife. I have seen so much in the breastfeeding world. This time, I was sure I would be able to bypass the difficulties I faced with my son because of the experience I had.


Right after my baby girl was born, she latched on and ate and I felt elated at the thought that this time it was going to be smooth sailing. But 36 hours later, my nipples were damaged and flattened after every feeding. No problem, I thought, I have resources and support. So I called them in. I took her to see a consultant at three days old to have her tongue tie revised. It turned out she also had a lip tie and a cheek tie which I had never even heard of. So much for me knowing things! She was tiny, at 6lbs 4oz and those restrictions were making it so hard for her to open her already small mouth wide enough to eat. I had all three ties lasered and she latched on beautifully immediately after the procedure. I felt that relief and elation again. It lasted until the next day, when suddenly she wouldn’t latch at all, instead just screaming at me. Turns out some babies really take a long time to recover from those revisions. All of her muscles were now working differently and she was too sore and weak to breastfeed.

That was the beginning of a five-week journey involving chiropractic appointments, lactation consultant appointments, pumping, bottles, and tears. Why was breastfeeding so hard?! Every feeding involved my latching her and nursing her for as long as she could handle, then bottle feeding her and pumping. I felt like I was on a rollercoaster, with some days taking two steps forward and the next day one step back. It was practically impossible to go anywhere, it was hard to handle visitors with all of that feeding business, and I was quickly beginning to struggle mentally and emotionally with this challenge. The first consultant I saw who revised the tongue tie gave me a very interesting thought to ponder when I asked her why so many babies struggle to breastfeed and have tongue ties. She said she had read some research that suggested that formula, bottles, and pumps have kept alive many babies that would not have survived in the past due to their struggles to eat. As a result, these poor little eaters have survived and passed on their genetics. For the first time I stopped cursing my breast pump and gave thanks for it and for the formula that had kept my babies alive.

I had many days where I felt ready to give up. I grew so frustrated at the idea that I was a midwife that couldn’t get breastfeeding to work. My husband reassured me time and time again and reminded me not to put that extra pressure on myself to breastfeed just because of my job. Either way, I just couldn’t give up when I was always telling women not to give up! Working in the field that I do, I had many  knowledgeable women checking on me, supporting me, and encouraging me. I had a wonderful, compassionate lactation consultant friend reminding me that it wasn’t me doing anything wrong and that it would eventually come together. One particularly low day, where I was really struggling and trying to decide how long to keep trying, I posted on my facebook page that I was struggling and asked for success stories. So many women posted about the similar struggles they had of having to pump, spoon feed, syringe feed, or supplement while facing issues like bad latches, tongue ties, and supply issues.

I realized that breastfeeding struggles are so incredibly common. These women had stuck it out and they said to give it six weeks. If they could do it, I knew I could too. So that day I decided that as long as I was seeing forward progress, no matter how slow, I would stick with it for at least six weeks. People encouraged me, but also reminded me the importance of my sanity. They reminded me that fed is best and that whatever happened, it wouldn’t make me any less of a mom if I decided to stop and switch to formula. Breastfeeding problems can feel so big when you are already exhausted, overwhelmed, and unsure. My friends wanted to make sure I knew that my mental and physical health mattered too.

At the end of week four, I noticed that my baby was starting to take more gulps and breastfeed for longer periods. I slowly started letting her just nurse and started weaning off the bottles. By the middle of the fifth week, she was eating exclusively by breastfeeding and my heart was soaring.

​The ease of breastfeeding without having to worry about pumping, bottles, and carting around so much gear was astounding to me. I had never had the experience of being able to just pack myself and my baby and a couple of diapers and know that we were set not matter what rolled our way. The struggle we had to go through to get there was rought and I do not ever fault a single mom for giving up during that struggle. Our sanity is important and thanks to our modern times, our babies can be fed in many ways. But support is out there. Every mom I talked to that had successfully breastfed had words of wisdom and support for me. They had empathy for my struggle. There is so much lost breastfeeding wisdom that we are slowly regaining. I don’t know how many times I tearfully said I wanted to give up. It would have been ok if I had, but I am so glad I didn’t.


For the mothers out there struggling, if you want to breastfeed, reach out. If I hadn’t, I am confident I would have quit. There are caring consultants, support groups, and mothers that have been there and can help. I still don’t know why breastfeeding can be so complex and difficult, but I also know that leaning on the support from others made all the difference for me and my little one.

Update: This blog led to an opportunity to be interviewed for the podcast All About Breastfeeding. Check it out here!  

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8/3/2019 0 Comments

when breastfeeding feels like an uphill battle

PicturePhoto Credit: Alyssa Leon
By Alyssa Johns, LM, CPM

I’m a midwife. I thought I knew things. Pregnant with my second baby, I was sure breastfeeding was going to be easier than with my first, because I have learned things as a midwife that I didn’t know when my son was born. Breastfeeding him felt like breastfeeding an angry piranha. He chomped, screamed, but would not suck. After two weeks of my six week maternity leave had passed, I was marked with cracked and bleeding nipples and the feeling of defeat. I decided I was done spending my short leave crying and stressing over breastfeeding and I decided to just pump for as long as I could before switching to formula. That was 7 years ago. Since then, I have become a doula, a HypnoBirthing instructor, and a midwife. I have seen so much in the breastfeeding world. This time, I was sure I would be able to bypass the difficulties I faced with my son because of the experience I had.


Right after my baby girl was born, she latched on and ate and I felt elated at the thought that this time it was going to be smooth sailing. But 36 hours later, my nipples were damaged and flattened after every feeding. No problem, I thought, I have resources and support. So I called them in. I took her to see a consultant at three days old to have her tongue tie revised. It turned out she also had a lip tie and a cheek tie which I had never even heard of. So much for me knowing things! She was tiny, at 6lbs 4oz and those restrictions were making it so hard for her to open her already small mouth wide enough to eat. I had all three ties lasered and she latched on beautifully immediately after the procedure. I felt that relief and elation again. It lasted until the next day, when suddenly she wouldn’t latch at all, instead just screaming at me. Turns out some babies really take a long time to recover from those revisions. All of her muscles were now working differently and she was too sore and weak to breastfeed.

That was the beginning of a five-week journey involving chiropractic appointments, lactation consultant appointments, pumping, bottles, and tears. Why was breastfeeding so hard?! Every feeding involved my latching her and nursing her for as long as she could handle, then bottle feeding her and pumping. I felt like I was on a rollercoaster, with some days taking two steps forward and the next day one step back. It was practically impossible to go anywhere, it was hard to handle visitors with all of that feeding business, and I was quickly beginning to struggle mentally and emotionally with this challenge. The first consultant I saw who revised the tongue tie gave me a very interesting thought to ponder when I asked her why so many babies struggle to breastfeed and have tongue ties. She said she had read some research that suggested that formula, bottles, and pumps have kept alive many babies that would not have survived in the past due to their struggles to eat. As a result, these poor little eaters have survived and passed on their genetics. For the first time I stopped cursing my breast pump and gave thanks for it and for the formula that had kept my babies alive.

I had many days where I felt ready to give up. I grew so frustrated at the idea that I was a midwife that couldn’t get breastfeeding to work. My husband reassured me time and time again and reminded me not to put that extra pressure on myself to breastfeed just because of my job. Either way, I just couldn’t give up when I was always telling women not to give up! Working in the field that I do, I had many  knowledgeable women checking on me, supporting me, and encouraging me. I had a wonderful, compassionate lactation consultant friend reminding me that it wasn’t me doing anything wrong and that it would eventually come together. One particularly low day, where I was really struggling and trying to decide how long to keep trying, I posted on my facebook page that I was struggling and asked for success stories. So many women posted about the similar struggles they had of having to pump, spoon feed, syringe feed, or supplement while facing issues like bad latches, tongue ties, and supply issues.

I realized that breastfeeding struggles are so incredibly common. These women had stuck it out and they said to give it six weeks. If they could do it, I knew I could too. So that day I decided that as long as I was seeing forward progress, no matter how slow, I would stick with it for at least six weeks. People encouraged me, but also reminded me the importance of my sanity. They reminded me that fed is best and that whatever happened, it wouldn’t make me any less of a mom if I decided to stop and switch to formula. Breastfeeding problems can feel so big when you are already exhausted, overwhelmed, and unsure. My friends wanted to make sure I knew that my mental and physical health mattered too.

At the end of week four, I noticed that my baby was starting to take more gulps and breastfeed for longer periods. I slowly started letting her just nurse and started weaning off the bottles. By the middle of the fifth week, she was eating exclusively by breastfeeding and my heart was soaring.

​The ease of breastfeeding without having to worry about pumping, bottles, and carting around so much gear was astounding to me. I had never had the experience of being able to just pack myself and my baby and a couple of diapers and know that we were set not matter what rolled our way. The struggle we had to go through to get there was rought and I do not ever fault a single mom for giving up during that struggle. Our sanity is important and thanks to our modern times, our babies can be fed in many ways. But support is out there. Every mom I talked to that had successfully breastfed had words of wisdom and support for me. They had empathy for my struggle. There is so much lost breastfeeding wisdom that we are slowly regaining. I don’t know how many times I tearfully said I wanted to give up. It would have been ok if I had, but I am so glad I didn’t.


For the mothers out there struggling, if you want to breastfeed, reach out. If I hadn’t, I am confident I would have quit. There are caring consultants, support groups, and mothers that have been there and can help. I still don’t know why breastfeeding can be so complex and difficult, but I also know that leaning on the support from others made all the difference for me and my little one.


​

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7/3/2019 0 Comments

A HypnoBirthing Birth Story

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A HypnoBirthing Birth Story
by a beautiful mother I was honored to have in class

Wednesday morning I woke to some strong surges around 1:30am. I was still just waking up so I wasn't sure if it was a practice surge or the real thing. I knew I would be going into labor soon as the day before I started to have my birth show. So I laid awake for awhile to see what was going on. About 10 minutes later another came, really strong in my lower belly, would travel to my back and the tightening pressure in the belly usually felt with practice surges. So I practiced allowing myself to just drift away and let my body do what it was made for. The discomfort went away after my first breath but the tightening pressure remained, so I wasn't sure if it was still practice or actual labor surges. I practiced with a couple more still about 10 minutes apart. Then I made myself go to sleep so I could conserve my energy. 

Later, I woke around 6:00am for the day, but laid around to see what was going on, this time I used those contraction timers, just to see if things had progressed. So from 6-6:40 I was having surges roughly every 5 min for just under a minute each. But I also went 10 minutes between one and 3 minutes between another, so not consistent. I got up to start my day and continued to practice during each surge and I was good, so using my experience with my previous labor I thought I was still really early. 

My daughter had a doctor appointment at 8:45am and after that we went to Wal-Mart for a few last minute things before baby was to come. We were thinking that night or early Thursday. So between 7-11:30a I tried to have a normal day and planned to even come home and clean (haha).

When we got home I realized how tired those couple of activities made me so I decided to try and sleep again. I don't know if it was sleep or just deep relaxation, but I got through a few hours that only seemed to get interrupted 1-2 times an hour with a particularly strong surge, which after a few breaths I was relieved from discomfort but the tightening pressure remained. This made it difficult to decided if I was actually having real labor surges, because, well, I remember them to be painful with no relief until they ended. These were only a brief moment of discomfort relieved after a good breath, but tightening lingered.
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Around 1:30-2:00pm I got up and decided to time them again. I called my midwives office before 3:00p to get in and see how far I have come, if at all, to make the judgment on whether to go to the hospital or not. When I told them I had only been timing them for about an hour and the were pretty consistent at 5 min apart, they wanted me to just go to the hospital. But with my stubbornness and past history lingering in my mind, I insisted on being checked first. They made me an appointment for 4:00pm. We started loading up the truck with our bags just in case the hospital was in our near future and planned to take my daughter to my parents. She just got her shots that morning and a dental visit the day before. With her share of doctors, I knew she wouldn't like the hospital, so there's one thing that changed in my plan. My husband dropped me off at my appointment at 3:40 because we weren't going to make the appointment time of 4:00pm if we dropped my daughter off first so he took her and was to come back. I patiently waited to be taken back to be checked out and had about 5 surges during that time where I continued to practice my breathing, at this point though my exhales were loud and just trying to release as much discomfort at the peak of those surges. Still nothing terrible, but I could feel the end of those breaths using that little push we've talked about. Uh- Oh! They finally call me back, during a surge no less, so I take my time standing and what do you know, my water breaks! My husband returns and I got checked. I was at 7 cm! 7 cm, can you believe it?! I couldn't, except I felt my body wanting to bear down with those breaths! 

The midwife said ok let's go to the hospital, I said I'm not going to make it. Luckily they are just across the parking lot so she pushed me in a wheel chair surpassed the ER, they were asking if we registered, she responded we don't have time for that and I'm feeling like I have to take a poop now! We get to a room, nurses are asking what I want, if they need to give me an IV? So after a surge I told them I'm going natural and directed them to my birth plan in my purse. The attending midwife, after learning I was practicing HypnoBirthing and knowing how far I was, just stood off to the side and directed me to continue to listen to my body and ignore everything going on around me. (Putting the sensirs on my belly etc.) A few, not very graceful, surges later my son was born! I tried in those last moments to use the breathing we practiced but my body wanted more and there was some grunting and feeling like I had a really big bowel movement to pass, luckily it was only my little boy! 

My husband announced the sex with such excitement and we all shared a tear of happiness and relief on my end! 
Oh and my mom had made it in just as I could feel my baby's head about to crown! 
I knew this was possible and just as the author of the book knew that the birth of a baby was meant to be a beautiful thing, I have always wanted that and long before kids I knew I wanted a natural birth with no meds. I was very unprepared for the birth of my daughter but still knew it was possible. I am so thankful I found you and your class because it allowed me to have the birth I wanted and to trust and allow my body to do what it was perfectly made for.
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6/25/2019 0 Comments

Dear Soon to Be Dads...

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Dear soon to be dads: 

Here’s what you need to know. The mother of your baby is about to need you more than ever. When this baby arrives, your relationship will shift. Her attention will be drawn over and over to this baby and sometimes you won’t be sure what your role is. You may not be sure how to help, especially if she’s breastfeeding, because baby will depend on her for both food and comfort. But you have a seriously important role to play and how you play it could either make or break this new relationship of yours. She will likely be exhausted and unsure of herself in this new role. She needs you to show up. Take care of her. There will be plenty of ways you can step in and take care of your baby, but she also needs you to be her biggest cheerleader and supporter.

Here are some concrete things you can do in those first months postpartum to create an unbreakable bond with your new baby and the mother of your child:

*Wear the baby- That’s right, those slings and carriers aren’t just for moms. Strap that baby on and go for a walk, cook a meal, go to the store, clean the house, whatever you want. Babies tend to love the closeness so they are content and your partner can get a much needed nap, shower, or moment to herself. Women feel a constant demand on their presence in the postpartum period, this is a way to share the load. 
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*Bring her breakfast in bed- After long nights of being woken up to feed this new human, mornings need to be slow. She is also recovering from all her body went through and she needs to take it easy. Breastfeeding moms tend to bear the brunt of night wakings, so make sure mom sleeps in and wear that baby while you make some breakfast. My husband did this for me for the first several weeks after our baby was born and I will never forget it. I was exhausted, so being able to sleep in and sit in bed, sip coffee, and eat while the baby laid between us was priceless for me. 

*Change the Diapers- Literally the only time I have seen men boast about being weak is when it comes to diapers... You all talk about doing the most disgusting stuff, but a diaper is just too much for you? Come on. That poop is 50% your responsibility and we all know you love poop in every other situation. Jump up and change the diaper. I believe in you! 

*Bring in some help- This time will be exhausting for both of you as you navigate how to parent a newborn. Set up a meal train, ask for GrubHub gift cards, hire out whatever you can. People want to help, line up friends and family to clean, cook, do laundry. Don’t try to do it all while mom recovers, you both deserve the help of your families and communities. 

*Encourage her to contact other moms- You will be an amazing support to her, but you can’t carry it all. She needs other women who are moms to encourage her, support her, answer her questions and remind her she is normal. Women need each other during the postpartum period and she will likely feel more supported and content if she spends time with other moms. 

*Lift her up- There is no job that leaves you feeling quite so inadequate as motherhood. Tell her she’s amazing. Tell her you’re proud of her. Tell her you’re so thankful she’s the mother of your baby. Tell her you’re both lucky to have her. You are, and she needs to hear it. And she’s lucky to have someone like you who is doing his best to support her. 

*Get her outdoors- Nature is the best postpartum medicine. It’s rhythm reminds us that it’s ok to slow down and hold a baby all day. The sunshine lifts our moods. Being inside all day with a baby will likely bring on some level of depression or low mood. Have a picnic, go for gentle morning walks, sit outside with your coffee, just get that fresh air for both of you.

Now, gear up for this new little one. You’ve got this. 

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5/27/2019 0 Comments

It takes a village to Raise a mother

PicturePhoto by Cherry Blossom Doula Services
Everywhere I look, including my own home, I see mothers struggling. Exhausted, depressed, anxious, at their wit’s end. I hear the words “How you feel right now is normal. Most moms feel this way.” And while I agree that these feelings are the norm, I’m not sure I agree that they’re normal. The more I read about postpartum practices in other cultures, I see quotes from different studies about how postpartum mood disorders, including the expected baby blues, are practically non-existent in cultures that have strong postpartum traditions that care for the mother. These cultures recognize and honor that it is the mother that needs to be nurtured by the community during the postpartum period. She is expected to rest and bond with her baby while everyone else takes care of everything else. Not only do they take care of the household needs and other children, they nurture this new mother, bringing her healthy nourishing foods, teas, providing daily body massage, herbal baths, the works. The extreme life change and physical changes that motherhood brings are recognized and cared for. They do not look at this type of care as a luxury, but as a necessity to bring healing and vitality to the mother after all her body has been through. They recognize that a thriving mother equals a thriving family. 

Now what do we do here in the United States? Families often receive support in many ways. Meals are brought or sent over, visitors come by to help with the baby, families show up and often help with other children and housekeeping. However, nurturing the mother is rarely the primary focus from the stories I hear. Often I hear new mothers say they have been overwhelmed with visitors, or that they didn’t know how to get visitors to leave sooner so they could get the rest they needed. They watched visitors hold their crying baby wishing they could have some time alone to work on establishing breastfeeding. They watched visitors hold their sleeping baby, wishing they could be sleeping too instead of entertaining visitors. The meals brought, while helpful, are often fast foods or foods not often eaten by the mother so they could actually cause some gastrointestinal discomfort which is more likely immediately postpartum. This was highlighted for me when I received a phone call from a postpartum mom with shooting pains in her belly. After running through her symptoms and ruling out anything serious, we came to conclude that the problem was just gas and constipation, likely due to all the fried and unhealthy foods well-meaning friends had been dropping off for her. All of these families want to help, the problem is that our culture has lost the wisdom of how to truly care for mothers in the postpartum period.

We live in a world of efficiency and productivity. Postpartum mothers struggle to slow down, rest, and be ok with not being productive. They may have only a short window of six weeks or sometimes less before they are expected to be back to work. Many countries have paid maternity leave, sometimes for as long as up to a year. Imagine how much more our mothers could rest and take care of themselves and their babies if they weren’t up against a clock.

With my first baby I had six weeks of unpaid maternity leave. I quit breastfeeding after 2 weeks of  struggling to get through the rough patches because I knew I was going to have to pump when I returned to work anyway. I didn’t want to spend my whole maternity leave struggling to bond with my baby while we stressed over eating, so I skipped the breast and went straight for the pump for the next several months. With my second baby, I had eight weeks of unpaid maternity leave, but would be taking her to work with me for several months. We spent six hard weeks getting breastfeeding to work and at the six week mark, I marveled at the thought that most moms were returning to work at this point because breastfeeding was just finally smoothing out. It makes perfect sense why so many moms give up on breastfeeding. We just don’t have time to give it a fair chance before returning to work. And with both babies, my return to work also signaled the beginning of a period of depression and anxiety. It’s no wonder as it is so difficult learning to balance the demands of a newborn with work and pumping, all while being sleep deprived.

So yes, these feelings of loneliness, overwhelm, exhaustion, inadequacy, depression, anxiety, fear, hopelessness are all common, but I don’t buy into the idea that they are normal. I think we are feeling these things because our culture is missing the mark in a big way when it comes to caring for mothers. We are missing a village and we have lost the wisdom of how to nurture new mothers. I often day dream about living in a little village where all the kids are just running around and all the moms are hanging out together caring for the babies and supporting the new mothers. I think we struggle so hard partially because we are so isolated. Living in a big city, my closest friends and family are at least a fifteen to thirty minute drive away. I don’t know any of my neighbors, because I have moved so many times. I imagine how different life would be if I could just walk out my front door to talk to another mom friend when I need to not be alone with my baby all day. Our society is not set up in a way that supports families.

The best shot at a solution I have found was when reading the book Seven Sisters for Seven Days: The Mothers’ Manual for Community-Based Postpartum Care. In it, the author Michelle Peterson talks about preparing for postpartum by setting up seven people to help care for the mother in the six weeks after the baby arrives. These people are set up in advance with the intention of nurturing the mother. Each person volunteers to take one day a week for six weeks to bring a meal, do a chore for the mother, or serve the mother in some way. They are not there to hold the baby or chat with the mom. They expect that some days they might not even see the mother or the baby as they are intended to be in bed resting often.  This set up makes it effortless for the mother as she is not having to ask for anything. People are readily checking in with her and have a plan for how to support her before she is in the depths of postpartum struggles.

One thing people keep telling me during my postpartum period is to ask for help, but if you have ever been in the throes of depression, you know that reaching out for anything feels nearly impossible. And while I might ask someone to help watch my kids, I would find it extremely difficult to ask someone to come over and make me a specific meal, clean my house, or make me some tea while I’m resting in bed with my baby even though at times those were the very things that would have helped me the most. In countries where postpartum rituals are a part of the culture, these mothers aren’t having to reach out and ask for things, those things are being readily brought to them by neighbors, family and friends, because part of the cultural belief is that mothers need to be nurtured so that they can nurture the baby. That is not our current cultural belief, so it has to be set up intentionally in order for it to become a regular part of our postpartum lives. The mothers I have talked to that set up the Seven Sisters in advance had a postpartum period that they described as healing and nurturing. Those aren’t words I usually hear used to describe this difficult period of time. These mothers had learned something very important: just because they could do some of these tasks themselves doesn’t mean that they should.
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I am a midwife that has grown weary of seeing so many mothers struggle quietly, thinking that is just the way it has to be. It’s not the way it has to be and I am working in my practice to promote a change in how my clients experience postpartum.  My hope is that we can help mothers thrive during their postpartum days instead of just surviving them. 

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2/27/2018 0 Comments

Mia's Birth story

All photo credits: Alyssa Leon at Cherry Blossom Doula Services
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I’m not sure when my birth story starts, I had been having surges for three weeks, some of them so strong that I couldn’t catch my breath. I had thought I was headed towards labor so many times I wasn’t sure if I would recognize the real thing. On February 2nd I told Sean I needed to have some fun so we went out to our favorite burger joint and then played arcade games at Fat Cats. I beat him bad at Space Invaders and we laughed so hard. I joked I would probably go into labor overnight since I had finally relaxed and had some fun. We went to bed and my phone rang at 11:30pm. My boss was calling, there were two moms in labor at the birth center and one was a breech baby that I had said I wanted to be at with her. So I sighed, said “I guess tonight is not my night” and headed to work. The breech birth went quickly and I hung around to be at the second birth as well. At 4:00am, both babies were out and I told my boss I was going to go home and get some rest if she had it all under control. She was more than happy to send me home. I had been contracting all night, but it felt like all the other nights so I didn’t think anything of it. I went home, crawled in bed and fell fast asleep... and then at 5:15am, I woke up to a gush of fluid coming out of me.  My first thought was, "Ok, so I guess we are doing this now... Fluid kept coming out and it had vernix in it, so I knew it was amniotic fluid. I still checked it with pH paper because... midwife. And I quickly grabbed my Doppler and listened to Mia’s heart, because I was still in midwife mode! Sean sprang into action setting things up and surges started coming on stronger pretty quickly. He called my midwife friend, Sarah, and asked her if she could come. The surges picked up fast and hard and I thought everything was going to go fast. I tried to turn off my midwife brain. I knelt on the floor with my head in Sean’s lap and focused on breathing through each surge and softening and relaxing my body completely. We talked and laughed in between, we kissed, hugged, danced, we were enjoying labor. He was by my side through every surge, holding me, pressing on my back or hips, reminding me to relax and breathe.

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I heard a song come on and heard the words “the storm is coming, but I don’t mind.” I cried hearing that because I was so happy to be in labor and so excited to bring this baby into our family. Hudson arrived at our house and came in to rub my back and say he loved me. 
Sarah, Hailey (her student), and my doula/photographer friend Alyssa arrived and my surges were coming frequently. I checked my own cervix, it felt really far back and not very open and her head was not low. By how my surges felt, that didn’t seem right. I worried something was wrong. I asked Sarah to check my cervix and it was only 3cm. I tried to relax into things, but the surges suddenly got very hard. These surges were slamming me one after another and there was a pressure at my pubic bone that I hadn’t felt in my labor with Hudson. It was extremely hard to relax into the surges with that kind of intensity, but I refused to fight against them. It felt like my body wanted to shoot her out quickly, but couldn’t. I stood and rocked, I tried the tub, nothing was relieving the intense pressure at my pubic bone and it felt like nothing was working. My doula friend Alyssa reminded me that there were no expectations from my support people for this labor to be fast or easy. It was helpful to me to hear that, because I felt like I was inconveniencing everyone!
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I could tell by checking myself that not much was happening. I finally just crawled in bed and laid on my side. It felt awful, but I tried to rest there. When I couldn’t get comfortable there any longer, I got on my knees and sank deep down into a kneeling position, trying to sink deeply into each surge, trying to let the energy of each surge push me lower. I got loud. I moaned and howled and roared at this point, trying to let each surge work and releasing every bit of resistance out of my mouth as the rest of me stayed soft. If I howled, I could still surrender and my body didn’t resist. I knew I was scaring the crap out of Hudson. He came in with wide eyes and I tried to reassure him that everything was ok and this is just how mommies sound sometimes to get babies out. I had to be loud, my body wasn’t letting me do otherwise. This labor was so much different than the peaceful, relaxed, birth of Hudson. He came easily and without much intensity or discomfort. This whole labor felt like the hardest part of his labor. My doula friend Alyssa was encouraging me quietly and calmly through each surge, reminding me I was strong and to let my body melt. Sean was a strong presence by my side always. 
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I asked Sarah to check me again. She did and said she felt some cervix left in the front and on the side. Luckily my midwife brain was blocked enough that I didn’t think about her being asynclitic at that point (tilted head) or it probably would have shaken my confidence even more. I continued to ride these intense surges, encouraged that she was lower and that I was opening. Sarah reminded me that this was my story, not anyone else’s. She wanted me to shut out the labors I had been at that reminded me of this one. It helped me a ton to hear that. 
Soon I started feeling a lot more pressure and I asked Sarah to see where the baby was at. She told me to see if I could feel her head myself. I was afraid to check because I was afraid she wasn’t any lower, but I reached in and felt her head easily. “I feel her head!” What a crazy feeling to feel her head inside me. I was discouraged though because my body wanted to bear down but I could still feel a lip of cervix left. I could barely resist bearing down and the surges were so incredibly intense. I asked Sarah to do something and she said she didn’t want to hold the lip back because it might swell. I said I needed to push, she said “well, there is no research that says it is harmful to push when there is a lip present.” That was all I needed to hear. I took two fingers from each hand and put them inside and held back that lip while I bore down to see if I could move her. I felt her nudge down closer so I gave a couple more pushes and was able to slip that lip right behind her head. I gave another push and could feel her head was starting to crown. “Sean, she’s right here, do you want to feel her?” He reached down and touched the top of his baby’s head. I was so glad he was right by my side. I’m pretty sure that at this point I was yelling for this baby to get the hell out of me. I was protecting my own tissues as I gave another couple of nudges and felt her head emerge as I exclaimed that her head was out. 
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I remember yelling and swearing that I couldn’t push anymore and for Sarah to pull her out of me. I truly thought she did, but later Sarah told me that my body did the work for me. Mia  had a tight cord around her neck and it was a short cord, so Sarah juggled her as she flew out of me and passed her under my legs. She told me to unwrap the cord and then my baby was in my hands. I sat down and saw that she was tiny, completely covered in vernix. I had done it. I couldn’t believe I got her out. It turns out she was asynclitic which was what made me open more slowly and made the surges so intense at the pubic bone. Her little head was perfectly round, so she didn’t help me out by molding the shape of her head to my body. She arrived at 11:55am in all her 6lb 4oz glory, and gave immediate healthy cries to announce her arrival.
I am so grateful for the people that were there to encourage and support me, as my confidence was shaken many times. And I am so grateful I had this baby at home where we could snug up in bed after and enjoy our family.

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