I’ve had several ladies reach out this year asking for information to consider as they hope to conceive sometime in the next few months. As I started replying to some of these inquiries, I realized that it might be helpful for others in similar positions to have some of this information at their fingertips. My hope is that some of these suggestions can help you to achieve the healthiest pregnancy possible as you actively prepare your body for the amazing stress and strength that growing a baby places on your entire system-this is certainly worth seriously considering and prepping for, and I can guarantee you won’t regret any time and effort you invest before pregnancy!
Let’s start at the beginning:
Educate Yourself on Your Hormones and Cycle:
Understanding how your body works, and how to read your fertility signs (temperature, cervical mucous, etc.) can make a huge difference in both your ability to conceive and in determining an accurate due date. There are some disorders or challenges that can be identified early on if you have been keeping track of your fertility signs, and this can save you time, money and heartache if you know what to look for and when to get medical intervention. Simple things such as knowing you ovulate “late” compared to traditional due date calculators can save you the challenge of being considered “overdue” when you actually didn’t have an accurate due date to start with!
For better understanding, I highly recommend the book Taking Charge of Your Fertility by Toni Weschler. This guide helps you to really get to know how the women’s body works, how to chart your cycle, and how to understand all the information you are pulling together. The TCOYF app is also a great way to track your cycle, and it’s free! Another helpful book on the subject is The Fifth Vital Sign by Lisa Hendrickson-Jack (as a disclaimer, I JUST ordered this book and have it sitting in my “to read” pile-it looks great, but I haven’t read through it yet!).
For those particularly wanting to use fertility tracking as a guide to Natural Family Planning, the Art of Natural Family Planning Student Guide is a good way to delve into some of the details, which can also be an aid in achieving pregnancy.
Birth Control/Hormonal Contraception:
If you’ve been on hormonal contraceptives, it’s important to remember that it can take up to three months for normal cycles and fertility to return. The sooner you can get off any hormonal BC the better for your overall health! Aviva Romm has a great article on fertility issues after hormonal contraceptives and getting off the pill here: Post Pill Reset and I highly recommend the new documentary The Business of Birth Control for better understanding of how hormonal contraceptives can negatively affect your overall fertility and health while providing an introduction to other non-hormonal options.
Deal with Any Current Health Concerns Now
Do you have weight you need to gain or loose? Start understanding healthful eating, and work on that now BEFORE you add pregnancy to the mix! I’ll add more on diet below, but healthful eating habits should begin now, and will provide a great foundation for the demands of pregnancy on your body.
Are you currently on any medication that could have a negative effect on a developing baby? Many health challenges (such as elevated BP) can be managed by diet, lifestyle and supplement changes, and these are best achieved before pregnancy. If you’re hoping to have a low-risk delivery at home, this is even more important to consider, as any compilation of medications can increase your risk and rule out homebirth. Also, remember that you should be under the care of a physician or medical provider before attempting to wean off any medications, especially for BP, anxiety, depression, etc. You need to do this safely, and sometimes these changes can take time!
Thyroid health: many women these days experience thyroid imbalances, and it can make a huge difference on your ability to carry a healthy pregnancy if you are on top of these imbalances before pregnancy, and have a provider who can work with any sort of needed thyroid medication especially during the early days of pregnancy. Learn more about thyroid and it’s effect on pregnancy by reading Aviva Romm: Thyroid in Pregnancy
Learn more about healthy food choices:
There are so many things to learn about how food and our daily choices affect the way in which our body works! From supporting the organs, optimizing brain function, regulating blood sugar…the food we eat has so much to do with how our entire body operates. Add to this the growth and development of an additional entire human body and placental organ, and you’ll start to get a glimpse of how important solid nutrition is to your body and that of your future baby! The best book on the subject that I have read is Lily Nichol’s Real Food For Pregnancy, and I would encourage any woman who is pregnant or considering pregnancy to read it and really digest her wisdom and suggestions. Lily covers more than just diet, and her overall suggestions when it comes to regulating blood sugar, exercise guideline, and prenatal vitamin recommendations are all amazing and educational.
Did you know that Gestational Diabetes is a real issue for many women during pregnancy? This can also be changed through diet, and Lily has a specific post on this topic here: Gestational Diabetes & Preconception Nutrition
Support your Liver!
This might seem like an odd topic, but did you know that your liver performs under extra stress during pregnancy? There are many pregnancy complications that can arise when the liver is not functioning well, and there are some studies that suggest that a healthy, supported liver can reduce the amount of morning sickness a mom might experience. With all of these factors on the table, I highly recommend either purchasing a liver cleanse and using it a few months before getting pregnant, or at least taking a high-quality Milk Thistle supplement for a month or two before conception, and continuing to take it during the first trimester. Here is an article that addresses this further: Milk Thistle for Morning Sickness
Prenatal Vitamins:
Start your research on prenatal vitamins now, and begin taking them daily. Remember, the critical time for baby’s development are in the early weeks, so your body needs to start getting a good foundation of nutrients so that your body is ready to nourish the developing brain, organ and other nutrient needs of a growing tiny baby. Many moms end up sick enough that they cannot continue taking prenatal vitamins during part of the first trimester, so having this foundation laid ahead of time is key!
Not all supplements are the same: do your research and be willing to pay for quality. Making sure your prenatal vitamin has bio-available nutrients (for instance, folate instead of synthetic folic acid!) can make a huge difference in how much actual benefit you receive from them. Some helpful links: Folate vs. Folic Acid, Prenatal Vitamins by Aviva Romm and some information with recommendation links: Basic Supplements for a Healthy Pregnancy
Further Reading:
If you’re wanting to read more about how to optimize your fertility and prepare well, many providers recommend the book It Starts with The Egg. Rebecca Fett goes into detail about diet, supplements and other foundational principles of helping your body to achieve healthy conception!
In closing, I hope you’ve found these suggestions informative! I’d love to hear what else you would add to this list, and what has helped you as you’ve prepared for pregnancy. Maybe you’re not pregnant yet, but you’ve found a great resource…or maybe you followed some preconception guidelines and are currently in the middle of pregnancy…either way, I’d love to hear what you found most helpful!
If you’ve recently given birth, you’ve probably wondered how to really help your body heal as you navigate the postpartum period and adapt to your post-baby body. Over the years I have developed a greater passion to see women really cared for and their bodies aided in this healing process, realizing that taking the postpartum period seriously can have long-term benefits for mom’s health & well-being in a variety of areas.
One component to long-term women’s health that often lacks attention is that of the physical rehabilitation needed after birth. If you think about all the changes that the body goes through during pregnancy (stretching, repositioning of internal organs, increased blood volume, muscle strain, weight gain, uterine growth, etc.) and then during birth (the physical exertion, movement, muscle & tissue stretching, internal organ placement changes, and more!), we should consider it normal that our body might need some help in recovering and rehabilitating in order to be able to function optimally. But there are SO MANY voices out there telling you what you should & shouldn’t do, and it can feel overwhelming to know where to start and who to listen to! In light of this (and because I wanted some better information to give to my postpartum clients!), I reached out to several local experts who provide support and services to postpartum women in our area. I’m grateful that they were willing to share a little bit about themselves, the services they have to offer (if you’re local, they are great options to consider as you prepare for postpartum recovery!!), and give us a few tips when it comes to understanding the recovery process and how to integrate physical exercises that will actually help our bodies heal without causing further trauma or injury.
By introducing you to these women who are aiding local moms specifically in their pelvic floor and post-birth rehabilitation health, I am hopeful it can give you an idea of some of the options you have right here in Centre County. Any of these providers will be happy to aid you in recovery from the marathon of growing a baby and giving birth! I also know that many moms are hesitant to reach out for this type of support and therapy, sometimes due to having many unanswered questions about what physical therapy or other services might entail. After learning more about these professionals and the specific focus and background each one has in their respective areas of expertise, you will hopefully have some of your questions answered, and perhaps have a more informed idea of what care might be best for your situation, preference, and recovery.
Hi! I’m Dr. Julie Kulig, a chiropractor in Bellefonte at Kulig Chiropractic & Rehabilitation. I have a strong interest in treating pregnant and postpartum women (and their littles). I have 2 children currently of my own and find joy in observing and assessing these littles movement patterns and developmental milestones.
My educational background is Doctor of Chiropractic, Webster Certified (for all you pregnant mommas), Birthfit professional, DNS (dynamic neuromuscular stabilization), and MDT (the mckenzie method of mechanical diagnosis and therapy.) Previously I held BIRTHFIT postpartum classes 2x/ wk for 4 weeks to help women improve core and pelvic floor function postpartum. I still treat pregnant and postpartum women daily and am happy to offer this service alone if you are interested (no adjustment needed).
Dr. Julie gently caring for my own newborn!
The BIRTHFIT exercises are based on DNS: dynamic neuromuscular stabilization. These are a series of exercises based on the study of babies and their motor milestones that occur 0-18 months. We use these movements to help treat moms both pre – and post – baby! The exercises are based off of diaphragmatic breathing and the relationship the diaphragm has with the pelvic floor (much more intricate and we can talk about that more!!)
We treat: pain, pelvic floor pain, urinary stress incontinence, diastasis rectus abdominus and more. Trunk stability is the basis of all of our movements and essential in our recovery postpartum. Wondering if we could help you?? ASK: drjuliekulig@gmail.com. I’m always happy to chat more! www.kuligdc.com
Hello! I’m Becca Beck. Originally from GA, I live in State College with my husband and 3 sons. I am a Functional Movement Teacher who specializes in the Core and Pelvic Floor and a Certified Restore Your Core® Teacher. Restore Your Core® is a movement program, founded by Lauren Ohayon, that takes a whole-body approach to the Core and Pelvic Floor. It uses exercises that are a mixture of corrective exercises, yoga, pilates, and functional movement to help women reboot their core and pelvic floor. I educate my clients on the contributing factors to core and pelvic floor dysfunction, help them to uncover their movement blind spots and repattern their core and pelvic floor to be functional, reflexive, responsive, and supportive to their bodies.
Here are some things I want my clients to consider and try in their Postpartum Recovery
Rest. Even if you are feeling good, you still went through a dramatic physiological experience and you still have a dinner plate sized wound on your uterus. I hear all the time from women who regret getting back into things too soon after birth but I have never heard a woman regret giving her body time and space to rest and heal. You have to think of it as an investment. This time you take to rest now, sets you up for a better recovery and getting back to the things you love sooner.
Reconnect With Your Core. Your first 6 weeks do not have to be without movement but we want to be smart about how we approach it. You wouldn’t sprain an ankle, rest 6 weeks and then jump into the same movements you were doing before without doing some rehab. Your abdominal system just spent 9+ months rearranging itself and being stretched to new limits. Those early postpartum days are a great time to start reconnecting with your core, waking up your brain to this area of your body, and preparing your body to return to the daily movements of life and the activities you love.
Where to start: Dandelion Breath. Sitting, standing, or laying down. Place one hand on your lower abdominals. Imagine you are holding a dandelion right in front of your mouth. Inhale, and then on a long exhale blow all the seeds off your dandelion and keep blowing smooth and steady until you have no air left. Did you feel a natural drawing in of your abdominals away from your hand? It’s okay if you didn’t. Try a set of 5 about 1-2 times a day. You may not feel it right away, but the more times you ask the stronger that brain connection will become and you will get there eventually! When you feel more comfortable with this exhale and feel that natural corseting in use this Dandelion Breathing whenever you are going to lift or exert. Remember, “Blow before you go.”
Show Your Back Some Love. Early post-partum can be a beast on the low back with all the sitting, feeding, bending over for changes and lifting out of the crib.
A few tips to try:
When sitting, try to sit on your sits bones (the bony parts you feel where your legs and butt meet) instead of letting your pelvis tuck under (don’t feel militant about this advice, slouching isn’t evil we just want you to change it up some!). You may find it easier to sit up if you place a pillow under your sits bones.
When you bend over, think about sticking your bottom out vs tucking your tail like a sad puppy dog. Also consider putting a step stool by your baby’s crib so you don’t have to round as much in the upper back to get baby in and out of the crib. This will allow you to use a squat for lifting and lowering baby putting less strain on the low back.
Working with me or a Pelvic Floor PT can be a great way to learn exercises for early postpartum and how you can progress them as you move through the 4th trimester and beyond. It is never too late to get started. www.beccabeck.com or email: beccabeckmovement@gmail.com
Hello! My name is Kyla Dunlavey and I am delighted to be included in this group of women! I have been an orthopedic/sports med physical therapist for almost 25 years and I launched my private practice Core Physio LLC in February 2021 with a special interest in helping active women stay active. I am originally from NW Pennsylvania and spent 14 years of my career at Walter Reed National Military Medical Center in Washington DC before moving back to Pennsylvania in 2018. I started my own practice in order to practice the way I wanted to… Instead of the typical PT clinic ‘mill’, I wanted to see fewer clients for longer sessions, offering the true one-on-one, in-depth, unique, holistic attention to my active clients deserve. I don’t do any internal pelvic floor work, but rather I approach the entire system through exercise, pressure management, breath work, and mindfulness. I refer as necessary to pelvic floor PT. I look at the entire person and empower them with knowledge about their bodies, movement, and the breath, for greater carryover into activities like running, or even just picking up and carrying a child!
I have an endless curiosity and fascination about the human body and I constantly strive to keep up on the latest research and treatment techniques, as what we know about the human body is continually evolving! Case in point, over the past few years, research has started honing in on the pelvic floor and its connection to low back, SI joint, and hip health…and vice versa! Not only this, but also identifying it’s buddy the diaphragm and proper breathing technique, as part of a missing link in establishing true core stability, along with its teammates: the pelvic floor, the abdominals, spinal extensors, and intra-abdominal pressure. The way women stand, move, and breath typically changes during pregnancy, as the baby grows and hormone levels alter. Ligaments become more lax, abdominals are on stretch, the back extensors may become taut, it’s difficult to get a breath down into the abdominal cavity, and postural alignment changes impacting optimal muscle recruitment like the glutes. This often carries over into postpartum life, impacting return to activity or just simply keeping up with the demands of motherhood. Women may experience things like diastasis recti, leaking (with coughing, sneezing, laughing, or jumping), hip pain, SI joint pain, pelvic floor pain, or low back pain. A bonus, in establishing proper breathing technique, is tapping into our parasympathetic nervous system which gets us out of the tense fight, flight or freeze state most of us stay in all day! Try the 10 minute-Time Out: Go to a quiet area. Have hubby watch the kids. If you don’t have 10 minutes, do 2 minutes! Lie down on the floor with your legs up on the wall and a pillow under your head, (or on your bed with legs up on the headboard if it is flat). Without getting into specifics of proper breathing, just breathe through the nose slowly for 4-5 seconds, letting go of any tension in the body. Exhale. How long did you exhale for? It should be at least 4-5 seconds, if not double your inhalation! How do you feel afterwards? Hopefully relaxed and energized!
If you think you might be interested in tackling your issues, call for free 15min consultation: 814.314.8880 www.TheCorePhysio.com
I have 20 years of experience working as a physical therapist. Born and raised in Belgium, I graduated from the Catholic University of Leuven as a Physical Therapist in 2001. Afterwards, I pursued a 2 year program at the University of Ghent to become an Orthopedic Manual Therapist. I have worked as a physical therapist across the world: in Belgium, the Netherlands, Turkey, New York City and State College, PA.
Becoming a mom in 2010, I became more acutely aware of the need for pelvic rehab in the US compared to Europe. I decided to expand my practice and become a Pelvic Health Specialist. I have done extensive continuing education through Herman and Wallace, the APTA Women’s Health Section, Pelvic Guru, and others. I take pride in staying up to date in the emerging field of pelvic rehab, women’s health physical therapy and pre- and postpartum care with extensive continuing education, literature, and books.
I feel extremely passionate about providing the best possible care to all people experiencing challenges with their pelvic health. Being able to help people achieve their goals and highest potential is my biggest reward.
Why Pelvic Shanti?
Pelvic Shanti was founded to provide resources to women during their pregnancy and in the postpartum period (and beyond). A lot of the symptoms that we experience during this time in our lives are quite common but not normal.
We recommend a consultation with a pelvic floor physical therapist if you experience:
● Urinary or fecal incontinence
● Urinary or fecal urgency
● Heaviness, pressure, bulge or dragging in the pelvic area
We are here to answer all your questions and guide you as you return to your physical activities. To best support the new moms we work with, we offer office or in-home visits and remote consultations. www.pelvicshanti.com
I’m a licensed Doctor of Physical Therapy and a researcher at Penn State University. My clinical practice focuses on treating women with pelvic floor problems like incontinence, pelvic pain and prolapse (heaviness in the pelvic organs), and my research aims to better understand pelvic floor muscle function, how it works with the rest of the trunk, and develop innovative new treatments for pelvic floor problems.
Pelvic floor physical therapy aims to restore optimal function in the muscles that support bowel and bladder use, sexual function, and keep the pelvic organs lifted. These muscles get stretched and can even tear during pregnancy or delivery and can contribute to problems of leaking (bowel or bladder), scar tissue or painful areas of the muscles, and poor support of pelvic organs causing dropping or prolapse. Treatment with a physical therapist may involve local pelvic floor interventions to improve the scarring, strength, mobility and tone in the muscles. It may also involve exercises and movements focused on the whole integrated body so people can return to the movement that matters most to them, whether that is playing on the floor with babies or training for a triathlon. In my practice, I treat the pelvis and pelvic floor as a piece of the puzzle and will also address the whole body and the whole individual.
I will be resuming my private practice in the spring/summer of 2022 and will provide updated information on my website: www.centered-physio.com
NOTE: Dr. Rudavsky will also be recruiting participants for her research in pelvic floor functioning in the spring of 2022. For more information on participating in pelvic floor research, please email Dr. Rudavsky at axr5794@psu.edu
In closing, I want to thank each one of these women for taking the time to share their thoughts, suggestions & tips as well as providing us with an introduction to themselves and the services they provide. If you’re local and end up using one of these providers, please let them know you read about them here! And if you’re not local, it’s my hope that you at least learned more about the services pelvic floor therapists, chiropractors and other professionals can provide to postpartum moms, and perhaps you can use this information to aid you in your search for good postpartum care. I know you won’t regret taking care of your body now and avoiding potential long-term challenges!
If you’ve used a pelvic floor therapist, chiropractor or other professional during the 4th trimester and beyond, would you tell us about your experience?
If you’ve followed my blog for long, you’ll know that tongue & lip ties and nursing challenges are a passion of mine, especially after having experienced challenges with all of these factors with several of my own children. I’ve also been in contact with many moms who are struggling with nursing issues or fussy babies, and so many times there is a connection to either a tongue or lip tie (or both!). Recently, a mom shared her story in a Facebook Group for Moms that I’m part of. Her story touches on so many of the factors that I have seen and/or experienced, that I contacted her and asked for her permission to share her post with you all. I am so grateful, as Tanisha covers many factors to consider in her story, and I think it will be beneficial for many moms who might be struggling. If you are struggling with nursing issues, I really want to encourage you that you aren’t alone, and that there are answers out there!! And if you resonate with this story, I would love to hear about your experiences! It can help other moms when they can hear first-hand what worked for others in similar situations.
~Kelsey
Now on to our guest post, written earlier this year by Tanisha Gingerich:
**Shared by the author’s permission**
I thought I’d make a post for whoever it might concern, about our journey sofar with tongue and lip ties. They are becoming increasingly common it seems, and I thought sharing my experience might be a good way to bring awareness so that any other moms going thru something similar can benefit from (or add to) what I’ve been learning.
A week post partum, I was scabbed from nursing, and in a lot of pain every time I fed Micoma. She was gaining well, so we probably could have made it work (a lactation consultant can help you and baby work past a multitude of feeding problems), but I knew from experience that although I could “make it work,” my milk supply was going to tank around 4-6 months. Ties can also cause speech, dental, and sleep issues down the road, along with a host of other problems.
So in the interest of short-term pain for the long-term good, I took Micoma in at a week old for a consultation and ended up getting her lip and tongue ties lasered right away so we could begin the healing and retraining process as soon as possible before bad nursing habits were formed.
I cried and prayed over her before they did the 3 minute procedure, and sobbed compulsively while they swaddled her and used a laser to cut the ties open. The woman doing the procedure was a mom too, and was so compassionate and kind with Micoma. Then they left us alone in a cozy room to nurse, and I heaved more sobs as I comforted my baby. Being able to hold and nurse her was probably just as healing for me as it was for her.
Her latch was instantly better. Over the next few days I had to continually remind myself of the long term good, as I did stretches on her wounds. To my relief, the stretches were done in under 30 seconds, and Micoma always recovered quickly… I soon realized she was screaming louder over getting her diaper changed than she was over the oral invasion, so that made me feel better. I told her all the time how brave she was, and gave her every comfort to guide her through the rough patch.
That first week dragged on for me. I hated having to keep stretches in my mind every 4-6 hours even thru the night—got kind of sick with dread thinking about it. I kept Micoma on Tylenol the first 2 days, and again on day 4 when there was a flare up of discomfort. Other than that though, she continued to eat and sleep very normally (not everyone has it so easy, some babies will hardly eat for a day or two, and cry all the time. Thankfully Micoma nursed for comfort, and seemed to tolerate gracefully any discomfort she was feeling). At one week we had a follow up appointment and they said everything was healing well and there was no reattachment. I was so relieved.
By the second week all was routine, and the scars were nearly healed up. Sometimes she wouldn’t even wake up when I did the stretches so I knew they weren’t painful. Currently we have just passed the 3 week mark, which means I can de-escalate the stretches rapidly and they will disappear in a few days. Hooray! One hurdle over. Now on to the next. I had a lactation consultant come at week 3, to help me teach Micoma new nursing/sucking habits. I learned so much!
First of all, babies begin practicing how to suck from week 12 in utero. This is how they build the oral strength they need for nursing. Unfortunately, when a part of their tongue is tied down, they are unable to fully lift and tone those muscles. When they are born and begin nursing, the restrictions to their lip and or/tongue, make it hard or impossible for them to latch correctly or suck efficiently. As a result, nursing is laborious for them. You may hear a “clicking” noise or notice milk dribbling out the sides of their mouth, these are telltale signs. They frequently fall asleep while nursing, just from the strain it, and are unable to properly empty the breast. This can obviously cause low-weight issues, milk supply issues, and severe frustration to the baby. The baby will often resort to chomping or some other measure in an attempt to get milk, resulting it a lot of discomfort or pain for the mom.
But even after ties are released, there is still some work to do. Baby’s latch will probably be better right away, but you’ll need to help hertone her oral muscles and relearn how to suck correctly with the new range of motion in her mouth. I was given a series of simple tongue exercises to do with Micoma every day… they are more like games, and activate her reflexes to get her tongue moving, especially in the places she’s not used to lifting it.
Now, to back up a bit, there are two kinds of ties—lip ties and tongue ties. I’ve also heard of buchal ties (cheeks) but know very little about them at this point. A lip tie is easiest to spot (example of one in comments) and if a lip tie is present, a tongue tie is almost always present too—they tend to go hand in hand. Keep in mind that some care providers are not trained to look for *posterior* tongue ties (these are in the back of the mouth and not as obvious as anterior ones), so those often get missed. Ties vary in severity (where they are attached and how drastically they are affecting function of the lip/tongue. Sometimes it may be negligible).
Next thing I learned, tongue tied babies are notoriously “tight.” The tongue sits at the very top of the spine, and if there are restrictions in the tongue, you will see restrictions all the way down through the body. Sure enough, Micoma is very tight in her shoulder/neck area, has over compensated for it in her lower back, and has tight hips. Once again, I was given a series of simple rhythmic motions and stretches to loosen those areas up and bring everything into alignment. She has a bit of a “C” shape curve when she lies down, that’s another common sign of tongue-tie related tightness. (Pic in comments) I wish I would have known this with my oldest daughter Verona. She was incredibly C-shaped, and these stretches would have loosened up her uncomfortably tight muscles.
Looking back, both of my children before Micoma had ties of some kind. I always had to use a nipple shield with Verona, and I remember Benny getting so angry when I nursed him. My supply going down around 4 months was another telltale sign. Both children despised tummy time, which was most likely because of how tight they were in their neck and lower back. I suspect “ties” is some of why they slept so poorly and aggravated colic symptoms early on… In-efficient nursing brings more air into the stomach and causes gas discomfort/excessive spitting up. And in a very strange twist of fate, if the tongue cannot reach up to the top of the pallet and rest there while sleeping, the top of the mouth becomes domed, crowding teeth and restricting airway. This can lead to mouth breathing, sleep apnea, and dental issues.
Verona’s lip tie comes all the way down between her teeth, which is why she has a gap between her front teeth. Neither of the children seem to be having difficulty eating, speaking, or maintaining good dental hygiene and structure other than that. So I’ll just keep an eye on them, and only resort to doing anything about theirs at this point if I see it’s going to cause them major problems down the road. But I do grieve the suffering we all went thru with months of screaming colicky baby, and the eventual loss of breastfeeding bond. That pain far surpasses whatever me and Micoma went through the last month in laser-correction and recovery.
So for that reason, I would support moms in pursuing tie-releases if you feel it would be beneficial for your baby. As with everything child-related, there is controversy surrounding the issue—whether ties are really a thing, whether they’re a big deal, clipping or lasering, stretches or no stretches. In my case, I saw enough consequences in my last 2 children that I was willing to believe ties affect quality of life enough to warrant a minor surgery. Lasering has a lower rate of re-attachment and requires no stitches, so I went that route. And the stretches I did because Micoma tolerated them well and I was determined not to let the fibers re-attach while they were healing… and I grilled my caretaker about whether it was necessary, and she says she does see a fairly high rate of reattachment if stretches are not done. Albeit, I did the bare minimum I thought I could be get by with, and with good results. That was my story, you get to write your own. Decide what’s best for your child, whether that’s therapy to work past a tie, or a surgery to correct it, or whatever and don’t let people throw a lot of shame or fear onto you for it.
Currently I am pumping a few times a day and using an SNS (supplemental nursing system) several times a day to stimulate my supply and simultaneously get Micoma the extra food she sometimes can’t get herself. I’ll keep working with Micoma’s body and tongue to get everything loosened up and toned… hopefully within a month we’ll be at a place where she can keep my supply up on her own. In the mean time we’re not goning to go many places this month, just stay home and focus on the task at hand.
Many people take their children to chiropractors pre and/or post tie release for body work. It helps with nursing if your baby is aligned properly. For the time being, since I have bodywork I can do at home with her, I am skipping that… see if I can get by without it. Cranial Sacral therapy is another thing highly recommended… I don’t know, it could possibly be a legitimate thing with babies since their skulls are still un-fused and somewhat mobile, but I have heard of enough occultist ties connected to this practice done in adults that I plan to avoid it all together.
This post was not meant to diagnose or treat any illness. It’s my personal story and some things I learned along the way, left here for people to sift thru and take whatever is for them.
If, btw, you decide lasering is the right option for you (and you are local to central PA), I had a good experience with Dr. Katherman in York. Her office felt like such a warm and caring place to me, and she was on call at all hours if I had questions later. Also, do yourself a favor and hire a lactation consultant. You won’t regret it! Do a bit of research first and find one that people you know have had good experiences with (there are a few bad eggs out there). Again, I had a wonderful experience with the one I found, and I’ll link her website for reference.
The cost to get two ties lasered was $750. I am going to turn it into my insurance sharing plan, but I do not know yet if they will cover it. The lactation consultant fee for an hour and a half session was $175. So it is a good chunk of change. But when compared to the potential costs of not doing it, it is a very reasonable investment.
I hope that’s everything. My mind is still kind of whirling from all the things I’m learning, so this was my way of processing it. Hoping it will be helpful to someone else.
P.S. Out of curiosity, I asked both the doctor and lactation consultant if ties have become more common recently or if they’re just being diagnosed more, so we’re more aware of them. They both said ties are becoming increasingly common. I don’t think even my mom’s generation would have seen very many, so this seems to be a rapidly developing problem. Presumably, Western diet and lifestyle as well as the declining quality of foods (grown from nutrient-depleted soils) plays a role. There seems to be evidence to support that lack of folate and other B vitamins in the early stages of embryonic development contributes to ties forming—or the presence of the synthetic B vitamin folic acid commonly in prenatals and fortified foods. And others say there are indications that genetic mutations (the MTHFR gene) play a role. But no definitive studies have been done, that I know of. Everything is speculation at this point. Someone gave me two articles so I’m linking them below. My midwife gave me some resources to dig into and I’m hoping to do more research to see if this plague is avoidable.
I maintain a decently healthy diet and take quality supplements including methylated B vitamins so it’s hard to believe that was the cause of all 3 children having ties. Except that I was under exponential stress the past few years, and as I understand it B vitamins are created in the gut… if you have bad gut health or are under stress, B vitamins do not form well. So that could be a factor. Like I said, I’m going to keep digging and see what answers I can find.
Are you confused with the myriad of pregnancy supplements out there, and wondering how to make the best choices that are good for you & baby while at the same time not depleting your budget? Have you wondered, too, which supplements are key and which aren’t actually necessary? And which supplements are going to actually provide you with the nutrients you need? And what are the basic supplements you should focus on? You’re certainly not alone in your musings!
As a midwife and a mom, I’ve had the same questions. I also know that it can be overwhelming to sort through brands, AND remember to take multiple vitamins and pills every day, especially if they have to happen at different times. I also want to make sure the moms and babies I’m caring for are getting the nutrients they need, which means NOT relying on the cheapest brands and options. If you’ve spent any amount of time researching options, you know that there lots of things to consider as you think about vitamins and supplements. Ideally, you want to use a brand that focuses on whole foods, organic sources, and includes bio-available nutrients (such as folate instead of synthetic folic acid). Of course, these vitamins aren’t going to be the cheapest ones available, which means that you will want to choose wisely, and consider using fewer supplements and making sure the ones you ARE taking are high-quality!
For those who have wondered, here is a list of the basic supplements that I routinely recommend to clients. Of course, more need to be added in the presence of specific conditions, but for most moms, these are the basics that I would encourage any mom to take during pregnancy (and while you’re nursing!):
For special considerations, these are typically the first recommendations:
B Vitamin (if dealing with low energy especially: your midwife can do blood tests to determine if it’s caused in part by a B vitamin or folate deficiency).
Most moms with low-risk pregnancies who are consuming a high-quality diet don’t need more than these to have a healthy pregnancy and healthy baby! For more information on understanding diet & supplements and their effect on mom and baby’s health (and what ingredients are important to be aware of!), I’d highly encourage you to check out the following sites:
And finally, if you’re looking for a place to purchase vitamins and supplements, I encourage all my clients to check out www.vitacost.com, as I typically find the best prices at that site!
I’d love to hear what prenatal vitamins and other supplements have worked for you! Feel free to share in the comments below so we can all learn together. And be sure to share this post with other moms that might benefit from the links and information!
Are you looking into the possibility of working with a midwife, and trying to decide if it’s the right choice for you? If you’re blessed to live in an area with several options, it can be a great idea to take the time to “interview” each one, and see which one feels like the best fit for you and your family. Most midwives (myself included) offer free consultations that can give you a chance to sit down and ask your questions in person, and this can be a great opportunity to explore whether or not you and this care provider will be a “good fit”.
While I think it’s a good idea to look into your options for ANY medical provider, it can be especially important when thinking about a homebirth. Your midwife will be coming into your space, and you want both yourself and your husband to feel completely comfortable with this person, which facilitates clear & open communication, thus providing you with the best care possible. So besides some specific questions (which we’ll get to below!), also think about the intuitive side of how you connect and communicate throughout the interview. Another important component in this interview is dad’s perspective, so whenever possible please have him attend this initial consult, as this can give him the opportunity to ask questions he might have, and help establish a good working relationship from the beginning.
There are many posts out there that cover long lists of questions, but I want to get you started by giving you a few basic questions, which might bring up more as you go along. It’s a good idea, too, to do your own research before you meet with a perspective midwife. For instance, does she have a Facebook page or website? Are there reviews you can read by previous clients? Is there information listed about the types of services she offers, or things that set her apart from other options in your area? What type of credentialing/training does she have? Do the philosophies expressed on her website correspond with what you are looking for? Do what you can to find out as much as possible before meeting up, as this will enable you to get the most information out of your time together, and may raise specific questions that you might have missed otherwise. It will also keep you from wasting time that you could be spending looking into other options!
So let’s get started:
What kind of training did you go through to become a midwife?
Some midwives have attended midwifery school, others have been trained strictly through apprenticeships. Some midwives have credentials that indicate a certain level of training, and require a stated number of continuing education hours to be maintained. There are midwives who have gone through rigorous school programs and have delivered few babies outside of the hospital, and others who have done minimal studies and have only delivered babies at home. This question is not meant to dictate which type of training and educational experience is best, but rather to help you think through whether the training this midwife has received is adequate for your own comfort and safety concerns and desired birth location.
How would you describe your style during labor & delivery? Hands-on or hands-off?
Depending on your preferences, this may help you determine if you can work together well. If you know you want someone very involved, or you want to be left alone as much as possible, the midwife’s answer may shed some light on how her style could affect your labor. Some midwives are very good at adapting to their client’s wishes, and some have their own set way they want to see things happen.
What do you provide or include in your services, and what will be my responsibility?
Depending upon your state, local regulations and/or your community options, a midwife’s care package may include the ability to obtain lab work and/or ultrasounds or refer you to providers for these items, or you may be responsible to figure these things out for yourself. Some midwives include a “birth kit” as part of their package, while others ask clients to purchase this separately. A birth pool is included in some midwives care bundle, while others provide options for rental. Some midwives are able to give your baby vitamin K or provide mom with RhoGam if needed, while others need you to get these items from your pediatrician if you want them. Most midwives are able to file the needed paperwork to obtain a birth certificate and social security number, while there are a few who need you to do this legwork. Asking clear questions and getting an idea of what is and isn’t included will hopefully eliminate unmet expectations and surprise expenses as you continue through your pregnancy!
4. What tests & procedures do you routinely offer, and am I given the freedom to decline when I prefer?
It’s great when your midwife is willing to discuss the pros and cons of different tests and procedures, and allows you to make a true informed choice on each of these. Depending on the political environment, local standards of care, protocols, etc the midwife may have more or less freedom in these areas, or she may have personal preferences as to certain tests.
What are some of your recommended resources for pregnancy and for birth preparation?
This question may give you some insight into the birth philosophies the midwife has, as well as indicate how in-touch she may be with more up-to-date resources and educational material. Some books and resources are old classics, but there is also a wealth of more recent publications that can help you to be prepared. Are her health suggestions in line with your perspective and preferences? Does she require certain books to be read or DVD’s to be watched? Does she provide some resources for clients, or are you expected to purchase certain materials? Does she encourage a parenting style or lifestyle that you may be uncomfortable with, or that you find helpful?
What is her client load typically, and what happens if two mamas are in labor at the same time?
While this doesn’t happen often, it does occasionally, and it’s a good thing to discuss. This question will reveal what sort of back-up plan the midwife does or doesn’t have, and will give you some indication with how well she works with the midwifery community around her. It also helps you to think about the “what-if’s”, since birth can’t always be controlled like we wish!
What do you see as your role during labor, and would you encourage me to hire a doula?
It’s great if a prospective midwife can be honest about the support she can provide. Some midwives operate with a large team or a small client load that allows them to spend more time coaching and supporting a mom throughout labor. Most midwives are glad to support in whatever way they can once you’re in active labor, but they need to conserve their resources so that they have the energy and alertness they need for the time of birth, which means that if you really want hours of support early on, you’d probably be best served by considering a doula. This question can help you determine what the midwife’s expectations are for when she would come to you, and what sort of support you can expect, and will help you to define the role she would see herself filling at your labor.
What are some of the reasons I would be risked out of care?
This gives you an idea of the midwives range of comfort, and whether she takes a more cautious or more relaxed approach. Each approach has it’s place, but you need an approach that makes you feel most comfortable and safe. It’s also good to remember that each midwife should only operate within a realm that they truly feel is providing safe care, so this is not a “good vs. bad” topic, rather a way to understand and communicate. Is this midwife comfortable with breech delivery? With a mom that goes past 42 weeks? With a baby that decides to come before 37 weeks? Continuing if gestational diabetes develops?
What happens if I need to transfer care for some reason?
Does the midwife typically accompany clients to the hospital, or send them in by themselves? Does she have a doctor she works with, or a preferred hospital? Why or why not?
How do you handle emergencies, and which ones have you encountered the most often?
This question will give you some insight into the midwife’s perspective: does she rely only on herbal remedies? Does she carry medications? Is she trained in NRP? Does she take a proactive approach to prevention? Does she see many emergencies? The answer may vary according to your area, too, as some incidents of complications can depend upon the clientele and area the midwife works in.
I hope this list can help you as you think through what is most important to cover as you interview your potential midwife! If you find it helpful, or if you have other questions you think should be added, I’d love to hear from you. Feel free to comment below, and be sure to share this list with others that might be looking into hiring a midwife for their maternity care!
As 2020 comes to a close, I am reminded of the fact that we really do not know what the next day or year will hold. Last year at this time our family was anticipating the arrival of our fifth child, little knowing how many strange twists and turns the New Year would bring to everyone all over the world. I am grateful to rest in the confidence that nothing takes God by surprise, and that He cares about the details of our lives, which provides strength & courage to press ahead into the future!
After adding baby Tirzah to our family last December, I enjoyed a lengthy maternity leave, and felt so blessed and cared for during those first postpartum weeks. Thanks to many of you for your part in this! It’s true that you learn some things by experience that you couldn’t learn through academic study, and I am more committed than ever to encouraging moms to get adequate rest, adjust expectations, and take the time to really recuperate during those first postpartum weeks. It really is worth it! This baby has been our most contented, too, and while there are many things that probably play into this, one key factor that seemed to make a difference was the addition of infant probiotics into her daily routine from the very beginning. If you have struggled with fussiness in your baby, please take a minute to check out the blog post I wrote where I detailed this information—I really want to see more families benefit from my own challenging experiences!
As you can imagine, the COVID pandemic has affected midwifery in more ways than one. After the initial quarantine I have been doing prenatal and postpartum care visits for local clients in their homes, as it reduces the exposure for those coming in and out of my home office. I’ve also had more inquiries into homebirth this year than ever before, as many families are concerned about hospital restrictions and germ exposure. Between this added level of interest in midwifery care and my added family responsibilities, I have needed to limit the distance I can travel for births, which has meant turning down requests in outlying areas even for a few clients I’ve worked with before.
One fun aspect of care this year has been the large amount of repeat clients I’ve been privileged to serve! It was really special to catch my first “fourth baby” for a family, and have the opportunity to see babies that I have caught in years past welcoming baby siblings. With one more 2020 baby left to go, the current stats for the biggest baby this year was 8#14oz, and the smallest was 5#14oz. The earliest baby came around 2 weeks early, and the latest was almost 2 weeks late, which goes to show that there is much variation in the range of “normal”. Assisting my back-up midwife with the home delivery of twins was another extra-special experience this year! Speaking of my back-up midwife, I am grateful to have the assistance of RoseMarie Spicher to care for clients when I am unavailable, and I’ve been glad to have a working relationship with a community of midwives in the general area who have all needed to pull together to cover for each other at times due to COVID exposure or for other reasons. I’m also excited to be working regularly again with Lynelle, as she plans to attend births as my assistant this next year after taking some time off to welcome her own baby this past summer.
Heading into 2021, I’m anticipating meeting many sweet babies, and I’m enjoying making new connections with many families who are choosing midwifery care and homebirth options for the first time. I continue to feel a sense of gratefulness towards each of you for giving me the privilege of working with your family as you journey through this intimate season of life. It truly is a gift to witness the miracle of birth and the wonder of that first cry, and the wonder of that moment never grows old!
As I close, I also want to thank my family for their support as I do this work, and in particular thank my husband as he quickly and competently cares for our home and children during my random absences. It takes a special family to deal with the unpredictable aspects of having a midwife for a wife and mother, and I’m grateful for all they do behind the scenes to make this option available to the families I serve. It’s a joint effort, and I could not do what I do without Joel’s encouragement and work behind the scenes.
May God bless you and your family throughout this next year!
~Kelsey Martin/Gentle Delivery Midwifery
Be sure to regularly check out this blog and the facebook page to stay updated on current news, helpful information, health suggestions, birth stories, and announcement of special events. I’m really hoping that playdates can resume again sometime in 2021!
This month I’m continuing to answer questions that were submitted by readers for Gentle Delivery’s 10th anniversary “ask the midwife” series (feel free to check out Part One and Part Two if you haven’t read them yet!) There were several questions asking about miscarriage and how that affects future care, and I’ve decided to make that the focus for this month. Sadly, miscarriage is a reality for many moms, and I’ve had more moms than usual experience miscarriage throughout this past year. Hopefully some of these suggestions and this information can be a blessing to those of you walking through this valley, or those of you wondering what happens next…
What is your approach when a client has a miscarriage? What do you say or do to help her through the process, and if she gets pregnant again later, does your prenatal care for her and the baby look different in any way?
This is one of the “flipsides” of midwifery practice…it’s not always dealing with excitement and new babies. Oftentimes miscarriage occurs “out of the blue”, and usually there is no obvious explanation, even though we usually wish we knew why, or what happened.
Typically, a client will have just been in touch to let me know that they are excited to set up a time to talk about homebirth (or resume care if they were a previous client), and then they let me know that they are having some spotting. Spotting in and of itself can indicate an impending miscarriage, or it can be indicative of an irritated cervix, or it can be sign of a “subchorionic hematoma” (which usually results in spotting/bleeding without harming the baby, and resolves on its own). Quite honestly, if a miscarriage is going to occur, there really isn’t much that you can do, as oftentimes if it is indeed going to progress into a miscarriage then the baby has already died by the point you are experiencing spotting. But the unknown is not easy, as you want to KNOW what is going on. Our options at this point include doing labwork to see where the progesterone and Hcg levels are by now and going in to an OBGYN or an ER for an ultrasound (usually this is a vaginal ultrasound in order to get the best look at the uterus in early pregnancy). If the mom is 5 or 6 weeks or more, they should be able to visualize the baby, and be able to tell if the heart is beating, and labwork can reveal whether the pregnancy hormones are continuing to increase as they should. If mom prefers to wait, then there are some herbs that can be taken, and some moms choose to also use progesterone cream to help support the body until we know for sure what is going on.
If the ultrasound or labwork shows that miscarriage is inevitable, then I try to offer support and encouragement while the mom walks through the next several days. In most cases, mom is able to pass the baby on her own, and we stay in touch via phone or email. Spotting usually progresses into bleeding, and cramps accompany the bleeding as the cervix dilates enough to pass everything, which typically happens within a week of the initial spotting. In the event that it takes a longer amount of time, then we can use herbs to help encourage things to move along, we closely monitor for infection, and occasionally we need to transfer to an OBGYN for further care.
Once a miscarriage has taken place, I really encourage moms to take it easy, and make sure that they give their body time to heal both physically and emotionally. Oftentimes a mom can be left feeling very tired and anemic, as the body usually loses a significant amount of blood, and the intensity of labor can leave her worn out. There is also the emotional side of processing the loss, and this combined with the hormonal swings that go along with pregnancy followed by delivery can create quite a roller coaster of emotions to work with, and mom needs to know that this is normal and okay…and that her body is grieving and adjusting, which takes time!
The good news is that a previous miscarriage in and of itself does not negatively affect care for a future pregnancy. As I mentioned before, we usually don’t know what the root cause was, but there are many moms who go on to carry a healthy pregnancy following a miscarriage. Sometimes it can help a mom to relax more if she has more frequent monitoring during the early weeks of pregnancy after a miscarriage, and I am glad to do progesterone and Hcg testing to make sure that these levels are increasing like they should during the initial weeks. Oftentimes these moms also want to get an ultrasound performed earlier, in order to know that everything is looking good and that baby is growing like he should. Other than these factors, there isn’t much different for prenatal care, unless a mom has had several miscarriages in a row.
If a mom has had several repeat miscarriages, I highly recommend consulting with a NaPro Fertility Specialist (these providers concentrate on helping to achieve and maintain correct hormonal balance in order to prepare a mom’s body for and help in maintaining pregnancy). Many moms have inadequate progesterone levels, and having a specialist helping to monitor levels and provide prescription strength progesterone when needed can be a tremendous blessing, and prevent the trauma of further losses.
In closing, here are some suggestions if you are walking through a miscarriage:
Drink red raspberry leaf tea frequently in order to help balance your hormones and increase your iron as you recover (although stop drinking if you become pregnant again, until you reach the second trimester).
Take Evening Primrose Oil to help regulate hormones and support the body.
Consider taking an herbal-based iron supplement for several weeks to help restore your iron levels.
Take time to rest, don’t push yourself too hard, drink a lot of fluid, and take time to reflect on the short life you were given to carry, and allow yourself time to recuperate and heal before trying to resume your normal responsibilities.
And if you are preparing for pregnancy following a miscarriage, here are some ways to support your body:
Take folate (not synthetic folic acid!) and methylated B vitamins regularly.
Start taking a high-quality plant-based (not synthetic!) prenatal vitamin to build your body’s supply of needed vitamins and minerals.
Look into the benefits of using a quality, natural based over-the-counter progesterone cream to help promote healthy progesterone levels.
Consider having some herbal tincture on hand (such as C & B formula from Mountain Meadow Herbs) that you could take at the first sign of any cramping or spotting-this tincture helps to calm the uterus.
In closing, would you have any suggestions you would add? If you have experienced a miscarriage, what was the best information and advice you were given? Any suggestions for moms hoping to get pregnant soon after going through a loss? I’d love to hear your answers if you would be willing to share!
Interview: 10 Year Anniversary of Gentle Delivery ~ Part 2
Thanks again to each of you who contributed questions for this “virtual interview” as Gentle Delivery celebrates 10 years of practice! I’ve enjoyed this opportunity to connect with various readers, and I’ve loved hearing from so many of you. If you missed the first post, you can check it out here. Here is installment two as I continue working my way through the questions entered:
How do you manage being a midwife and a mom?
Sometimes I’m not sure that I do! But seriously, it comes down to having a very supportive and involved husband. I could not do it without his help & support, and without him having a flexible job. He works from home, and generally speaking is able to set his own schedule. Without these key factors, I don’t think it would be possible. We both feel strongly that our children need to be our priority, especially while they are in their young, formative years, and Joel’s job situation allows us to almost always have one parent present. If I need to run off to a birth or client emergency, than Joel changes his schedule for the day and takes care of the children, which greatly simplifies my life! I honestly do not know how midwives serve year after year with a busy client load combined with stress of needing to figure out babysitting, especially at the last minute. A few months ago, I was called to cover for another midwife who had two moms in labor at once, and the second mom was moving fast. Without having the ability to just load up the car with my gear and run, I would have missed the birth! But since Joel was working from home (his office in our basement), I was able to be out the door in ten minutes, and he took over managing the children. His work-from-home arrangement also allows me to sleep in after a birth, and he will sweetly get children up, feed them breakfast, and care for things while I get some rest.
Hot breakfast made by Joel and snuggles with the baby after being gone all night at a birth!
There are also some practical ways we have found that help to maintain balance, as well. As much as I am able to, I schedule appointments during my youngest children’s nap times, and I try to keep appointments confined to one day each week. This way I am limiting the amount of scheduled time I need to spend away from my children, especially since I never know how much unscheduled time I will be away at actual labors/births/emergencies. Another practicality is hiring cleaning help during especially busy months. My husband maintains that if I’m enjoying midwifery work and getting paid for it, then I might as well pay to get some of my other work done, instead of getting exhausted and stressed out! Oftentimes after a birth we will purchase supper (or take the family out) as a way to get some quality family time AND as a way to provide me with some extra time to do paperwork and miscellaneous business projects. I also get help with school, which is HUGE! My school-age children are part of a hybrid model co-op, where the parents help to teach classes, but they also have a classroom teacher who covers the “basics” and stays on top of the school details. If I was homeschooling full-time there would be NO WAY to do midwifery on top of it.
Each of my children have attended births with me as babies…quite the adventures we’ve shared together!
Balancing midwifery and mom life includes another factor when I have a nursing infant myself. Whenever I interview with potential clients who would be due after I have a baby, I make it clear that if you hire me, you’re also getting my baby. I always have an assistant or specific helper along who can care for my baby whenever I need to focus all energies on the laboring mom (and who needs a baby crying in the background when they are ready to push?!?), but otherwise I keep my tiny ones close so they can nurse and be with mama as much as possible. Some families are not okay with this arrangement, and that is their choice. I would much prefer they know what to expect ahead of time, and decide if they are comfortable with my boundaries, are there are always other options out there for them to consider!
One more key factor has been working with a midwife who is willing to trade call at times, which provides me with occasional time off to take trips and spend some focused time with my family. Without this arrangement, I would be tied to my phone and location almost 24/7 all year round! But this has allowed me to still spend some quality time making memories with my children, while knowing that clients are cared for, which is a tremendous blessing. While I still try my best to make it to my clients births, it’s also a relief to know that I can go “off call” occasionally for special events such as a school program.
Twice I’ve caught babies just before delivering my own…one time a week before, and another time two days before!
Is it realistic to consider being trained as a midwife, and starting your own practice as a midwife, with small children? What advice would you give?
This is a good question that deserves considerable thought. I had the opportunity to do my midwifery training when I was single, which was ideal. In my opinion, training to be a midwife was decidedly more of a time and energy commitment than practicing as a midwife. Here’s the reason why: when you are training, you need LOTS of experience. You need to be able to be completely available to your preceptor midwife, and willing to take advantage of every opportunity you can be part of. The only way to get the experience you need to be a good, safe midwife is by spending an incredible amount of time immersing yourself in pregnancy, birth, postpartum and women’s health. There are a number of midwives who did this training while they were balancing a family, but it is HARD, and you need to be prepared that it will take a long time. As a single young woman, I had the flexibility of time & energy which enabled me to finish my studies and obtain my required clinical experience in about two years. But this included spending 18 months at a birth center where we literally immersed ourselves in the world of birth by living, speaking, and breathing everything birth related. Seriously! I don’t remember a day passing that didn’t include a significant discussion about something to do with an ongoing client situation, lab values, birth stories, complications, etc. This type of immersion would have been impossible had I been trying to spend time with family, and it certainly sped up the training process.
Now that I am an independent midwife, I can make my own decisions about how many clients to take on in a month, what risks I am comfortable with, what my parameters of practice will be (for instance, when I do prenatal appointments, or what seasons I may not be available for first time moms), and when I want to take personal time off to give my family some breathing space. In most apprenticeships, a supervising midwife counts on a student midwife to be available whenever needed, and the student cannot set these types of parameters and still get the training she needs along with keeping a good preceptor/student relationship. So these factors all need to be considered, and I think there needs to be some serious conversation with your husband and family about whether your family is at a good place to make the sacrifices that training would require. I don’t think one will ever regret spending quality time with her children while they are young, but you might regret not spending that time later on!
I would encourage any young mom interested in midwifery to read as much as you can, as learning more about your body and about the birth process is going to be beneficial no matter what. There are excellent books out there that can lay a great foundation of knowledge about how the pregnancy and birth process works. Watch videos & documentaries, read birth stories, connect with other moms and learn about their birth experiences. Look for opportunities to get involved on a small scale. Perhaps you’d be able to provide doula services for a friend, which would give you and your family the opportunity to experience what it is like to live an “on call” lifestyle (ready for mom to leave at any time day or night!), seeing how it works to have mom leave and how to figure out babysitting fast. This would give you a chance to see what this aspect of being involved in birth can be like. I don’t think any birth experience is wasted time, especially if you’re hoping to be a midwife, so slowly looking for opportunities and taking advantage of them as doors open can help as you consider further commitment. Always remember that if God wants to be a midwife, He will make a way for you…but in His timing, and in a way that it will be a blessing to your family. Be patient, pursue the small opportunities as they arise, and see how He directs as time goes on…one older midwife told me once that “women will always be having babies, but you won’t always have young children, so make sure you don’t regret not enjoying them while you have them.” Excellent advice!
I’d also recommend that any aspiring midwife read A Midwife in Amish Country, as Kim does an excellent job of detailing her experience training to become a midwife as a homeschooling mom of young children, relating her experiences and lessons along the way.
How many births do you take on, and why that many?
This really ties in with the whole mom/midwife balance topic, as this is another way we try to walk this line. As a general rule, I cap a month with two due clients. Occasionally I will take on a third, if my family is at a stage where this is more possible, and if I have a slower month before or after. As a mom approaches her due date, her prenatal visits need to take place more frequently, resulting in more mamas needing to be seen each week. Then you factor in a home visit (an additional afternoon besides my usual appointment day), the birth (for anywhere from 3-30 hours), birth paperwork, another visit to their home for a postpartum check, and the frequent contact via phone/text/email that takes place over this time, doing this more than twice a month in additional to caring for other moms is about what I can do and still enjoy my work. Here again, if I didn’t have young children, and all the unexpected things that factor into life as you care for little people, it would be much easier to add more clients due in a month. But I want to enjoy both my own children and the opportunity to do births, and this number seems to be working well for this stage in life!
Thanks for taking the time to read this second installment in this interview series! If you’d like to contribute a question for a future post, feel free to add it in the comments below. As always, thanks for sharing, and feel free to check out Part One if you haven’t read it yet. See you next month!
Gentle Delivery Midwifery Services (Centre Co. PA) 