Introductions

Morning Sickness: Remedies, Suggestions & Research
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Morning Sickness: Remedies, Suggestions & Research

Please note: I am NOT affiliated with any of the mentioned companies, and I do not receive any sort of reimbursement from sharing their products other than occasional free samples that are sent to my office (which is how I was introduced to several of them!). Some of these companies have offered discount codes for my readers, and I’m passing those on when available, at no benefit to myself!

As a mom who has struggled with severe morning sickness with most of my pregnancies, I know from experience how incredibly difficult and challenging those first months can be when you feel so miserable! In fact, the mere thought of going through those early weeks and months of sickness makes me desperate to find some type of relief to try. Because of this, I’ve spent quite a bit of time reading any new research, thoughts and suggestions that I can get my hands on regarding combating morning sickness over the past couple of years. My hope with this post is to help you understand what might be going on under the surface, and to provide you with a number of suggestions and resources so that you can hopefully find something that works for you! I know each mom (and each pregnancy!) can respond differently, and that there is NO cure-all that works for everyone. But sometimes you find out about something that can make a difference, so my hope is that you might discover something new that can bring some relief to you as you nourish and carry that tiny baby that is already requiring so much from mama!

For the foundation, it’s important to be caring for your body BEFORE pregnancy whenever possible. If you haven’t done so, I would highly recommend that you take the time to read Real Food For Pregnancy by Lily Nichols. Having a high quality diet in place that is low in simple carbs and refined sugar and high in quality protein has made a big difference for many moms, but this provides the most help for morning sickness if this has been a way of life long before pregnancy. Along these same lines, taking the time to do a liver cleanse and possibly a candida cleanse have made a big difference in pregnancy health for moms.

Talking about the liver brings me to the first important suggestion for morning sickness relief, and that is LIVER HEALTH. As you know, a mom’s body works hard to support the massive amount of growth that is happening for baby during the first weeks after conception, and one of the organs under a lot of stress is the liver. It is fascinating to study into this more, and realize how gentle support of the liver can help alleviate the severity of morning sickness (you can read more about this here). A great way to provide liver support is through taking Milk Thistle twice a day (and if you are planning a pregnancy, start taking this a couple of months before pregnancy for even better success!). Some good Milk Thistle options are: Jarrow Milk Thistle  & Natural Hope Herbals Milk Thistle Tincture.  If you want more support (and possibly more success), consider taking a liver support complex such as the pregnancy-safe tincture from  Mountain Meadow Herbs Liver Glow II. This product from Earthly Wellness includes dandelion which is another herb that provides liver support, along with some additional herbs to aid in reducing nausea: Mama’s Tummy Relief (use code “gentlemidwife” for 10% off your first order from them!). Another form of liver support comes through the addition of lemons to your diet, which is most easily done by squeezing fresh lemon juice into your water that you sip on throughout the day (add some honey for a bit of a natural sugar boost!).

Another factor that can make morning sickness worse, and be especially problematic when a mama is vomiting often, is maintaining good hydration and electrolyte balance. Staying on top of this before it gets to the point of needing IV treatment is key, and one of the ways to help with this is having some high-quality electrolyte drinks available (that are not full of artificial flavors & dyes like Gatorade!). A few good choices that I’ve personally tasted an tested are: GoodOnYa Organic (this one tastes like delicious lemonade, yet it has only healthy ingredients: use the code “gentlemidwife” for 10% off + free shipping on your order!), Nectar (another organic, sugar-free option with multiple flavors), LMNT (available in several different flavors-you can purchase a sample mix on Amazon to get you started), and DripDrop. You can even make popsicles out of these electrolyte drinks in order to sip on them…just make it a priority to stay hydrated and prevent your electrolytes from orbiting out of order…we want to prevent the need for an IV or other intervention whenever possible!

A “newer” remedy that I am finding quite fascinating is that of additional magnesium supplementation for morning sickness relief. Here’s a couple of articles that go into more detail: Magnesium for Morning Sickness Relief, & Magnesium for Morning Sickness: My Story. If I have another baby, I’m definitely planning to try this idea! Besides swallowing pills or drinking magnesium-containing drinks (which many sick moms can’t handle), a few ways to supplement with magnesium that might be easier on your stomach are creams and sprays. Pink Stork carries this  Magnesium Spray for Morning Sickness, and a local company that I highly recommend carries this cream: Shade Mt. Naturals Magnesium Cream . Another magnesium cream I have used personally is this one: 8 Sheep Organics Magnesium Cream

If you’ve read other posts on my blog or talked with me long, you probably have heard how strongly I feel about incorporating high quality probiotics into your life for pregnancy, nursing and newborn health…and now I’m finding proof that probiotics can also help with morning sickness! These two articles show how: Study: Probiotics Reduce Nausea & Vomiting  and Study Finds Probiotics Significantly Improve Nausea and Vomiting in Pregnancy. Based on this research, as well as knowing how beneficial probiotics are to your overall health, it seems like it can’t hurt anything to increase or start your probiotic intake during the early weeks/months of pregnancy. If you’re looking for some good quality options, here are a few that have been recommended by other midwives and clients that I trust: Klaire Labs Therbiotic Complete, This Is Needed: Prenatal Probiotic, and Entegro:Flourish. Another way to increase your probiotic consumption is through fermented foods, such as raw sauerkraut and drinks like Kefir. Some moms have found the “sparkling” aspect of water kefir to be especially appealing while feeling sick, and many stores carry options such as Kevita in the cold drink section. You can also learn How to Make Water Kefir at Home or purchase something like this: Coco-Biotic Coconut Water Kefir

Some moms can obtain relief by supplementing with some specific vitamins & nutrients. Adding a few drops of this Liquid PhosFood by Standard Process to your drinking water (it tastes similar to lemon) has been beneficial to a few clients. Other times your body really needs some additional B vitamins, both for the B6 that specifically helps with nausea, and for the energy that is so lacking during the first trimester! My favorite B complex for those early weeks is the Max BnD Fermented B complex that helped me SO much with my last pregnancy. Whatever type of B vitamin you find, make sure that is contains bio-available forms, such as folate and methylated Bs, in order to obtain the most benefit. Jarrow and Seeking Health are two good brands to purchase.

Now we’ll move on to some random suggestions and options that have helped other moms (thanks to so many who shared in response to my question on what has helped!):

  • Hard Candies Specific for Morning Sickness: Morning Sickness Sweets by Pink Stork,  UpSpring Stomach Settle Drops , PreggiePop Drops & Tummy Drops are several good options to choose from.
  • Ginger: many people find ginger helps to settle the stomach, and you can try it in the form of Ginger Ale, Ginger supplements, or even through chews & candies such as these: Gin-Gins Ginger People Candy & Chews
  • Pink Stork offers a product called Total Morning Sickness Relief that contains needed vitamins & minerals for nausea.  
  • Herbal tinctures formulated specifically for morning sickness: Wishgarden Calm-A-Tum, BrighterMornings from Natural Hope, StomachAid from MMH, & Nausea Relief Tincture from HerbLore.
  • Acupressure in the form of Sea-Bands is helpful for some moms: Research on relief of nausea from Sea-Bands
  • Frequent snacking (don’t let your stomach get empty!), and eating something light before you get out of bed in the morning. Make sure you’re getting protein in whenever possible, even adding it to smoothies if needed!
  • Daily mineral supplement, such as this Fulvic-Humic Acid Mineral Blend available through VitaCost.
  • 1 gel cap of Heather’s Tummy Care Peppermint Oil Caps before each meal for 3-5 days, adjust as needed.
  • Fruit Juice popsicles
  • Some moms find that they need to quit taking daily prenatal vitamins during this time, as they can be too hard on the already sensitive stomach. Don’t stress if you need to do this-you & baby will both do better overall if you can keep food down, and this is more important than the vitamins during these weeks! Remember, baby needed the vitamins the most during the first few weeks, so by the time morning sickness hits with a vengeance this key foundation is over, so the goal is keeping mom hydrated and healthy! An alternative is to find a different vitamin and see if it might be gentler on your stomach. There are gummies, powders and pills, so another form may work during these initial weeks, especially if it does not contain iron which can be particularly hard on a queasy stomach.

IF you really are struggling to keep anything down, and need to move past the natural supplement stage, don’t hesitate to reach out to your care provider for additional support. Some moms MUST have prescription meds to survive these months, and that is totally warranted depending on the situation. Other moms need to have an occasional IV in order to restore hydration, and we are thankful for these interventions when they are desperately needed. Some over-the-counter yet more medically-based solutions are:

In closing, here are a few other blogs that contain more suggestions on how to find relief from the challenges of morning sickness: Wellness Mama: How to Avoid Morning Sickness & Natural Morning Sickness Remedies

I would love to hear from you readers: what did you find helpful?? Any suggestions that aren’t on this list? Did anything listed here benefit you? What did you find helped from one pregnancy to another? Thanks so much for sharing so that we can all learn and hopefully be better able to handle these early weeks and months of pregnancy!

Postpartum Rehab: Local Options, Tips, Introductions & Info!
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Postpartum Rehab: Local Options, Tips, Introductions & Info!

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.

Dr. Julie Kulig, Chiropractor@ Kulig Chiropractic & Rehabilitation:

Dr. Julie & family

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

Becca Beck

Becca Beck Movement – Restore Your Core® Certified Teacher:

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

Kyla Dunlavey

Kyla Dunlavey, PT at CorePhysio:

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

Mieke Haeck & family

Mieke Haeck, PT at Pelvic Shanti:

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 

● Pain with sexual intercourse 

● Constipation 

● Rounded abdomen, separated abdominal muscles or decreased abdominal muscle strength 

● Hip, pelvic and low back pain 

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

Dr. Rudavsky

Aliza Rudavsky, DPT, PhD

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?

2021 Year-End Update from Gentle Delivery
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2021 Year-End Update from Gentle Delivery

As I think back over this past year, it is with a sense of gratefulness for the ways that God has led, protected and provided. 2021 has included more complications, challenges and adrenaline rushes than I’ve ever had in one year’s time since I began practicing as a midwife 12 years ago! The additional gray hairs accumulated over the months prove this, and I am ending the year feeling like I’ve gained a level of experience that I honestly wouldn’t have minded doing without. However, I’ve also been reminded that this is WHY a midwife takes training seriously, and I’m more committed than ever to doing my best to assist families in safe births, even when at times this requires a different birth location than what we had hoped for, or more invasive assistance than what I prefer to provide.

            Besides being the most intense year complication-wise and the most stressful year when it comes to constant changes & research due to the ever-changing Covid landscape, it was also my busiest year baby-wise! I had the honor of helping to welcome 6 girls and 11 boys by the time the last December babies arrived. Weight ranges were fairly average: smallest was 6#8oz and the biggest was 9#9oz. While a couple of little ones came a week or two early, most typically went on the later side with two babies waiting until 13 days past their due date. Three babies made child #6 for their families, and two boys were the first ones for their families. While there were several long labors and many hours spent with a family before the birth, one little guy was in a big enough hurry that he made his appearance in his home before I did! As usual, birth always has an element of surprise that keeps us all on our toes.

Lynelle, Myself & Lanna

            I was blessed to work with several great assistants this year! These ladies really help to lift my load, and add a lot to our team. After assisting with births throughout the past 6 years, Lynelle is sensing a need to step back for a time, so she won’t be seen as frequently in the next year. Lanna began helping this spring at the height of our busy season, and has been such a blessing! She will continue to assist as her schedule allows, and there’s the potential of another assistant joining the team in the near future. I’ve also been grateful for the continued help of the midwifery community here in central PA: other assistants and midwives have been willing to fill in as needed, and I’m thankful to have had help available whenever I’ve needed an extra set of hands or someone to cover for a trip or emergency. I was especially thankful for RoseMarie’s willingness to cover for me this fall when our family had COVID, and I was thankful for the baby who so beautifully cooperated in waiting to arrive until I was recovered and my family was past quarantine!

Guerrero, Mexico Summer 2021

            On the home front, my little family is growing and doing well! In spite of lots of babies and the craziness this adds to our calendar, we were thankful to get to spend some time camping over the summer, as well as taking a family trip to Mexico to visit missionaries serving with the organization my husband works for. I couldn’t serve as a midwife without the amazing support of my husband Joel, who graciously steps in to care for everyone when mama disappears at a moment’s notice. With children ranging in age from almost 2 to 10, life at home is always exciting and active, and my girls can’t wait until THEY are old enough to “help mama at births”.

            A big thank you to each one of you who have trusted me to support you as you navigated your pregnancies and deliveries—it is something I count a privilege and honor! I love to hear from families, so please feel free to send an update and picture when you have a chance!

Many blessings as you head into the New Year,

Kelsey Martin & Gentle Delivery Midwifery Services

Be sure to check out the blog and Facebook page to stay updated on current news, helpful information, health suggestions, birth stories, and announcement of special events such as playdates!

www.gentlemidwife.wordpress.com       facebook.com/gentledelivery

Follow gentlemidwife on Instagram!

A Mother’s Journey with Tongue Ties
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A Mother’s Journey with Tongue Ties

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 so far 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.

Dr Katherman: https://www.cdepa.com

Jessica, Lactation Consultant: https://bornandfed.com

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.

Connection to MTHFR gene: https://www.checkupnewsroom.com/a-pediatricians-goes-in…/

Connection to regular folic acid intake: https://pubmed.ncbi.nlm.nih.gov/31835174/

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.

Questions to Ask When Interviewing a Potential Midwife
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Questions to Ask When Interviewing a Potential Midwife

Baby Tirzah helping Mommy do office work!

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:

  1. 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.

  1. 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.

  1. 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.

  1. 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?

  1. 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!

  1. 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.

  1. 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?

  1. 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?

  1. 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!

answering questions after a birth…
End of Year Update for 2020!
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End of Year Update for 2020!

Some highlights of the year!

Dear friends and clients of Gentle Delivery,                                                

      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!

Resources and Info on COVID-19: Links, Practice Changes, Recommendations & More
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Resources and Info on COVID-19: Links, Practice Changes, Recommendations & More

IMG_3380-001

With the COVID-19 crisis in full swing, it can be hard to know where to go for good information. As a midwife wanting to give my clients the best, up-to-date, evidenced based care as possible, I have found it extremely challenging to navigate all the information being thrown around as everyone scrambles to learn what they can about this new virus. Even information from reputable sources can contradict each other, leaving one’s head spinning, and making you unsure of what measures should be taken to protect your clients and your loved ones from any unnecessary exposure, while also caring for the emotional and physical needs of expectant moms! I’m sure you’re probably in a similar boat, so I’m wanting to make available some information sources for you as you try to understand how the current crisis may or may not affect you, your baby, your care, and your birth.

Here are some links that I have found helpful:

Aviva Romm Series on Covid-19 Info

WHO info for Pregnant and Nursing Mothers

National Association of Certified Professional Midwives: Covid-19

WHO Info-graphs

While information is changing on a day-to-day basis, I am currently implementing the following changes to my practice in order to minimize risk for my current clients, and enable safe midwifery care to continue in my community:

  • I am available to answer any questions clients might have via email or phone/text at any time.
  • Pushing prenatal visits further apart to minimize person-to-person contact.
  • Practicing social distancing and limited exposure for myself and my family, and not seeing any clients if myself or one of my family members are sick.
  • I will be performing April prenatal visits in client’s homes to reduce the risk of transmission or exposure. My current client load is light as I am just coming off of maternity leave, so this feels like the best option as I look into ways to make my home office space more practical for office visits due to the stringent recommended disinfectant protocols.
  • I am not taking on new (non-repeat) and/or long distance clients during April. I hope to resume new client consults and prenatals in May, but will base this on information as it becomes available, as well as on how able I am to handle the extra time needed to maintain the possible new protocols, etc. Having to unexpectedly homeschool two children this month, as well as juggling the demands of a nursing infant (and trying to understand what risk there could be to her health) all combine to make my days extra full right now, without adding in the hours of research needed to stay on top of current medical news!
  • If you are just beginning to look into the option of homebirth due to concerns with exposure at the hospital, I would suggest you begin by reading these two links:

I am also asking clients to follow these guidelines:

  • Please reschedule your visit if you or one of your family members are experiencing any of the typical Corona symptoms, including:
    • Fever
    • Coughing
    • Shortness of breath
    • And remember that Covid-19 care is outside of the scope of practice for your midwife to advise you on, so please contact the proper medical authorities if you suspect you may have contracted it!
  • Try to limit your exposure to illness by practicing safe social distancing from ill persons, and practicing good hygiene and hand washing.
  • Due to the unknown severity of respiratory complications for both mom and infant, a home birth will be out of the question if you test positive for COVID-19 over the time you are in labor.
  • Realize that there may be some changes in birth practices as more information and studies become available, so feel free to reach out with any questions, and stay tuned as I continue to research and keep you up to date on current research and practice guidelines/changes. Some of these changes may include restrictions on children attending prenatal appointments, amount of people in attendance at your birth, etc. As time goes by, I hope to have more concrete information to guide our practice protocols for the safety of everyone.

I would also strongly encourage all expectant moms to do what you can to boost your body’s (and your family’s!) natural ability to fight any virus (there are other illnesses out there you don’t want to catch, as well!). I don’t think we need to just sit back and hope we don’t get sick-you can be proactive in assisting your body in being able to resist and fight illness right now. There are some great resources available that help you to consider how healthy eating (low sugar, lots of whole foods) combined with adding some immune-boosting supplements (such as high-quality vitamin C, regular vitamin D, probiotics and others) and regular exercise can help you and your family to stay healthy and strong. Here are some resources to get you started in thinking about the possibilities:

Advice from a Pediatrician

Aviva Romm on Natural Remedies

If you’re interested on hearing additional perspective on the crisis from a well-known, more “naturally minded” pediatrician, then you may appreciate Dr. Sear’s podcast series: Coronavirus Update: Are We Doing it Right? Pt. 1

And finally, some practical ways to help you handle the extra challenges from social distancing right now, tips on reducing anxiety, and helps in understanding more about the virus: COPE Updates on Covid-19

If you have found a source to be especially helpful as you navigate the news surrounding Covid-19, I’d love to hear about it. And if you are in a different area, I’d love to hear how your midwife/care provider is implementing changes to their practices. Blessings to all of you expectant mamas navigating this new territory during this time in your life-I know it’s a challenge, and I am committed to continuing to provide you with personal, safe, gentle midwifery care!

 

“The First Birth”: A Story from 18 Years Ago
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“The First Birth”: A Story from 18 Years Ago

Not the baby featured in this story, but another baby born early on in my training!

From the time I was young (8 years old or so!), I had an interest in midwifery. I’m sure it stemmed from the fact that my mother used midwives for her pregnancies and the births of my five younger siblings, which gave me exposure to this “alternative” type of care. This was back in the day when having babies at home was NOT the popular, photographed and blogged about way to have your baby as it has become today! The midwives that cared for my mother seemed like an extension of our family, and as a young girl growing up, they were certainly some of my heroes that I wanted to become like when I “grew up”.

I think I was about 14 when I seriously felt like midwifery was something I wanted to pursue. Still very young and extremely inexperienced…with no idea what all this profession entails! I had read lots of missionary biographies, and a common experience in most of them included helping in some way (either unexpectedly or because they were prepared!) in childbirth in various countries.  So it seemed to my 14-yr-old mind that this was certainly a skill that would be good to know, and I pictured myself helping women in some far-off jungle or desert clinic someday. As I got older, I continued to feel a major pull towards midwifery that wouldn’t go away.

By the time I was 16, I was convinced this is what I needed to start pursuing. My parents wisely recommend that I begin by doing some reading, and they told me that they thought I should probably try to attend a few births before diving in head-first in a midwifery study program. Their reasoning was that perhaps this was just a passing whim, and why sink all sorts of time, energy and money into something only to find out that I would faint at the sight of blood, or have some other sort of aversion to what all comes with the birth territory. This is no joke. I personally know people who were SURE midwifery was what they wanted to do, but when they faced the nitty gritty, it didn’t take long to realize that it wasn’t their calling after all!

So, the next question was how on earth was I going to get any birth experience in, seeing as I was so young and inexperienced?!? I figured I would have to wait years for the opportunity, though I was reminded that if God wanted it to happen, He could figure out a way. That’s what makes my first birth experience so special-it was completely unexpected!

The summer that I was to turn 17 found me helping several families out on a weekly basis, going in to care for children, clean, cook, or do whatever was needed as a mother’s helper. One family was expecting their fourth child that summer, and they were excitedly planning their first homebirth in our state. Seeing as they had several young children, and that I had been spending a lot of time with them over a number of months, they asked if I would be on call to come and help babysit when the mom went into labor. This was the plan, with a backup plan being set where the children could go to a neighbor family’s home if the mom decided she could relax better without children in the house.

So one hot (Kansas is REALLY hot in July!) day, I got a call that the mom was in early labor, and that they would be glad if I could come care for the children so she could concentrate on resting and relaxing. I went over and made supper, took care of some household things, and entertained the children so mom and dad could focus together. An hour or so after supper, the mom decided that she would prefer the children leave the house, which left me thinking that I should probably go since my job was done. But the mom looked at me and said “I want the children to go, but you are to stay. I don’t want you going anywhere.” I sure wasn’t going to argue with that! She then went on to tell me that she wanted me to rub her back “just so” while her husband finished setting up the birth supplies and called the midwives, which I was more than happy to do. All of a sudden things kicked right in, and I vividly remember both parents bemoaning the fact that they hadn’t studied better on how to catch a baby if the midwife didn’t make it! I was blissfully ignorant, as I was only aware of my own mother’s very long labors, and figured we still had a very long night ahead of us. Little did I know!

I continued my “job” applying back counter-pressure as dad set up birth supplies, sweated nervously as he watched the signs of his wife progressing rapidly, read his childbirth class manual, and gave his wife emotional support. Thankfully, the midwives arrived just as mom started feeling more pressure, and all the last details were quickly set up and ready to go. About half an hour after the midwives arrived, a beautiful, howling, red little boy made his safe and smooth appearance, and I was in awe. I had no idea birth could be this beautiful, and I was so very, very grateful for the amazing opportunity. I was flying pretty high for days after this experience, and as you can imagine, I was totally convinced that this was what I wanted to do.

What is really hard to believe is that this baby will turn 18 this summer…I cannot believe that time has flown, and this many years have passed. After this first birth, I attended random births that I was invited to (word started getting around that I was interested, and some very sweet, very brave women invited me to share in their experiences, for which I will always be grateful!), and eventually began midwifery school when God opened the doors. It’s now been over 10 years since I graduated and started my own practice, and I continue to be thankful for those who initially helped me to start down this path by allowing me to be present at such personal, private life events.  As I continue to reflect back on memories and celebrate 10 years of practice, I want to especially thank each of you moms and midwives who took this very young girl under their wing and gave her experiences that will last a lifetime!

I’m so privileged to be involved in this work of ushering life into the world!

Miscarriage Questions: 10 Year Anniversary Interview Part 3
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Miscarriage Questions: 10 Year Anniversary Interview Part 3

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Interview Pt 3: Miscarriage

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.
  • Check out these sites that have further tips: Healing After Miscarriage and Healing Naturally.

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.
  • Check out this blog post for more practical tips: Preventing Miscarriage

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 1
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Interview: 10 Year Anniversary of Gentle Delivery, Part 1

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The year 2019 marks ten years since I started my practice as a midwife, after having spent several years studying, training and preparing to serve families in this way. I still remember the excitement of catching my first baby as a graduate midwife in January of 2009, after having moved home from TX (where I completed my academic training & clinical experiences here in Dec. 2008), and I cannot believe how quickly ten years have passed! Since that birth, I have been privileged to catch babies and care for moms & families in four different states, I’ve moved crossed country, married, and have had four babies of my own. All of this has certainly helped to mold, shape and broaden my experiences and skills, and I am so very grateful to each of the families I have been privileged to work with.

In honor of reaching 10 years, I thought it would be fun to see what questions some of you might have, and I was delighted by the questions that were thrown out on the Gentle Delivery Facebook Page. Here is Part One of a series in which I’ll start answering these questions…and I would love to hear yours, so if you haven’t left a question yet, feel free to do so below in the comments!

  • How and why did you get started in the field?

The “how” is the fault of my mother, who pursued homebirth after two negative hospital experiences, back when birthing at home was not such a popular idea. After her first birth at home with midwives, she went on to use them for care with the rest of my siblings (there are 7 of us!), and I grew up with the idea that having babies at home is a normal experience, and much preferred over the standard hospital setting! The midwives became close family friends, and were certainly heroes one would aspire to be like, in the eyes of a 7 to 14 year old girl growing up watching these women serve, care for and love on our family.

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My 11# 8 oz cousin!

The “why” part is two-fold: one, I had a dream of serving God on the mission field somewhere, and thought that having a skill to offer would be an amazing way to connect with and become friends with women, while hoping to make a difference in an area where women were at high risk during pregnancy & birth. I was interested in pursuing midwifery with this dream/idea in mind, and several friends and relatives knew of this interest. My dear aunt then invited me to be present at the birth of her son, and I still treasure the memories of the time I spent with her and my uncle while we waited on my cousin to make his appearance. This not-so-little cousin of mine still tops the record as the largest baby I’ve ever witnessed being born, and it required a great amount of skill on the part of the attending midwife to not only deliver him, but also to help him breathe and recover from his rocky transition. While this was not your typical smooth, low-complication normal birth, I learned a tremendous lesson through this experience: a skilled midwife can make a difference between life & death, and that this is a serious responsibility to consider. After this birth, the thought that kept playing in my head was that I never wanted to be in a situation surrounding birth and wish I had learned what to do to help. It also helped to solidify that this was something I wanted to pursue, but it also gave me the reality check I needed as I began.

In light of the fact that my original dream was to work with women in another country without access to good maternity care, I do find it a bit humorous how God has taken me down a completely different path as I serve women in a very prosperous, beautiful little university town in Central Pennsylvania!

  • What changed in your approach / practice as a midwife from before you had children to after you experienced birth first-hand?

This is a good question! I find that I have a totally different perspective on the intensity of labor…there were times I seriously wondered if I could actually do it when I was in labor myself, and experiencing that has certainly helped me to understand what moms are going through. I also don’t look down on anyone for getting an epidural after experiencing labor myself! Before I had children, it was like “why would you do that?!? Don’t you know the side effects??” but once I was in labor I totally understood why that option would be considered! I’ve also found myself trying to be more sensitive to each mom’s individual preferences, spoken or unspoken, as I found out in my own labor that just because someone thinks they are helping, it’s not always the case. I think it’s helped to soften my opinions, too, as I’ve realized on a different level how many things are actually outside of our control. For instance, while not specifically about birth, I always thought that any mom could nurse if she tried hard enough. Well, I learned the hard way that trying hard isn’t always enough, and nursing has been a complete battle for me, which has taught me that each mom must figure out what actually is right for her and her baby, and that might look different than what you anticipated. So maybe the simplest answer to this question is that it’s helped me to grow in empathy!

  • What is one “bucket list” experience you haven’t had yet but hope to in your midwife career (e.g. delivering triplets, delivering a breech birth, an en cual birth, etc.)?

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Newborn exam on a baby that I caught during my first year of practice.

To be honest, I don’t mind the un-eventful and un-exciting ones these days!  All midwives know that at some point they will attend a breech birth (usually a surprise baby that turns between that last appointment and birth, or when the head is mistaken for a butt), and I experienced my first surprise breech two years ago (I was called to cover for another midwife, so it was a REAL surprise!), so that one is off the “bucket list” with plenty of  gray hairs to prove it. I’ve missed several babies that didn’t want to wait for me to arrive (even if I was driving fast…my brother used to say he thought it would be fun to drive for midwives, so he’d have an excuse to drive FAST!), and I had the special privilege of catching twins & assisting with several sets. Two things I would love to witness yet would be an en-caul birth (I still haven’t had a baby born before the membranes have ruptured…though I’ve had plenty that ruptured JUST before birth, providing me with a shower of fluid!), and I’d like to top my current highest repeat client number of three babies for the same mama. One downside to moving across country (and then moving across several counties a few years later!) is that you don’t get to continue care with the mamas you might have started with. Up until recently, two had been the record I had been able to deliver for the same family, and I finally caught my third baby for the same family in 2018. If we can stay put long enough (and I can convince my clients to keep having babies-ha!), maybe that record will be higher eventually…though I’m guessing that not of all my clients want to help accommodate my wishes on that one!

So, after reading these, what are your questions?? Feel free to let me know, and stay tuned for Part Two of this 10 Year Anniversary Interview. Thanks for sharing & adding your comments!