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

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 MovementRestore 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?

Birth Story of our Christmas-time Baby

Birth Story of our Christmas-time Baby

As we enter into the Christmas season again, I have to think about the year we were anticipating our own Christmas baby, and what a delightful time of year it was to cozy up inside with a newborn! Our little Tirzah had quite the dramatic entrance into the world, and it almost makes me laugh every time I recount it…

By the time I was expecting my fifth baby, I knew to expect lots of contractions and discomfort, and this pregnancy was no exception. Thankfully my blood pressure was staying within normal limits, and everything else was proceeding smoothly. But after several nights with contractions and signs that labor could be imminent, I was getting TIRED. Once you loose that much sleep and feel heavy and uncomfortable all the time, you start to wonder how on earth you are going to make it through labor yet! One night I was pretty sure it was the “real deal”, after being up for hours with regular contractions, only to find everything stopped once the birth team was here and the pool was filled! Funny that it took the fifth child to experience that “false run”, but after not calling the midwife soon enough last time, we were trying to not repeat that scenario—only to send everyone home after a couple of hours!

My previous baby had come after an extremely intense labor, and I was trying hard to not allow fear to overcome my anticipation of this birth. Lynelle, my good friend and birth assistant, had told me that I really should try the birth pool this time around, and even offered to take care of all the set up and prep to make that happen. So we had set up the pool in the office, and had everything ready to go, and I was really hopeful that it would make a difference in the intensity, especially at the end.

Everything set up and ready go for round #1!

Fast forward a couple of days: after getting a good night’s sleep, I woke up on Saturday feeling like this baby needed to be encouraged to come. I’ve taken Castor Oil before, but every time I thought about that option it made me want to puke. So I figured there had to be an alternative: enter the Midwives Brew! I had read about this recipe (used often by European Midwives), but had always figured that the small amount of castor oil combined with the other strange ingredients wouldn’t actually be effective. But by this point I was willing to at least TRY it and see! My husband was on board (he was ready to see me up at night nursing a baby instead of up at night with contractions!), but I warned him that I really didn’t think it would work.

Mid-morning, I took my youngest for a little “mommy date”, and we headed to Wegman’s for a few groceries and the ingredients for the brew (see this post to find out what those are!). I had fun picking out a few things that I thought would sound good to eat or drink IF I was in labor later on, and we had a pleasant little outing. Once I returned home it was about lunch time, so while Joel fixed lunch, I blended up the brew, and sipped it down before eating a little lunch. While not the best flavor I’ve ever tasted, it wasn’t nearly as bad as downing large amounts of castor oil in juice!! My stomach felt a little funny, but eating some food and then chewing some gum seemed to settle things.

strange blend of ingredients!

This was the weekend that one of our little local Victorian towns always holds an event called “A Victorian Christmas”. That event combined with the opening of an exhibit of an Underground Railroad station in one of the museums there had made me want to take the children out for awhile if we were still waiting on a baby over that time. Since Joel had a Bible Study planned at our house for the afternoon, it felt like a great opportunity to take out the older children for some educational distraction and let me get a chance to think about something other than baby waiting! Since all I had been experiencing for two hours was some minor stomach discomfort, I decided to head out around 2:30pm, despite my husband’s slight misgivings. Laughingly I joked with him that if I called him he’d better answer the phone, as it might mean I needed him to come pick me up!

Bellefonte is about 10 min from our house, and we parked and went through the historical museum, only to find out that it did not contain the Underground Railroad Exhibit like I had thought. The curator pointed us up the road about half a block to the right museum, and the children and I headed that direction. Right as we hit the steps (around 3:30pm), I felt a slight “pop” and had a thought that perhaps my water had broken. But I wasn’t sure, and decided since we were RIGHT THERE we might as well go in. I felt a bit of dismay when the museum volunteer cheerily told us that the exhibit was on the top floor…UP THREE FLIGHTS OF STAIRS!! We started up the stairs when I felt my first real contraction, and I immediately thought that we’d better not stay long. The children were oblivious, of course, and thoroughly enjoyed exploring, while I tried to act like nothing was amiss as the contractions quickly started getting stronger and harder. I hurried them through the exhibit and back down the stairs, stopping briefly in the bathroom where I confirmed that indeed my water had broken. As we headed outside, my children excitedly discussed the next place we would go…and  I seriously informed them that we needed to get home NOW. They looked at me puzzled, and I told them I thought baby sister was going to be coming, to which my 6 year old son replied “how do you know? Your water hasn’t broken yet, has it?”. That made me laugh in spite of the situation, and when I told him it HAD, they all got really serious!

The half-block walk back to the car seemed to take forever, as the contractions were definitely picking up in speed and intensity. Once we pulled out and started on the road, I called Joel. The first time he didn’t answer, but then when the phone rang the second time he figured he’d better pick up! I told him that labor had begun, and to please have all the Bible study men out of the house by the time I got home and figure out where the boys were supposed to go…and to pray I could drive home safely! Next I called my friend Lynelle, as I knew that she would need to get a babysitter for her children, and I really wanted her free to get the pool started if things continued. Once I was finished with this phone call I knew I couldn’t make any more calls and drive, as things were just too intense. It was all I could do to stay focused on driving! I kept praying a policeman wouldn’t pull me over, as I had no bandwidth to explain why I was headed home instead of to the hospital!

I reached home, and our friend Daniel had his van running so he could pull out with the boys as soon as I arrived with Matthias. I pulled in the garage around 4:20, and had a massive contraction that made me unable to even get out of the vehicle. I heard Joel on the phone—he had called our midwife to see if I had called her yet (I hadn’t!! She was next, but I couldn’t make another call after I talked with Lynelle!), and she said she’d be on her way. I still remember running inside to the bathroom, trying to focus on relaxing, and coming to grips with the fact that at this rate I would not be having a water birth, then Joel calling through the door “the pool is warm and half way filled if you want to get in!!”  He had so sweetly started filling the pool, turning on the music, and getting things ready the minute I called home! I told him he’d better call Lynelle and Priscilla (our friend who was going to come help with our girls and take pictures), and they’d better hurry, and I still remember the relief of settling into the warm pool.

Just a minute or so old! Pink all over except for her slightly bruised face which was caused by her speedy birth!

Once I got in the water, the intensity and closeness of the contractions subsided, and I had a chance in between to catch up Joel on all that had transpired. Lynelle and Priscilla don’t live far, and arrived within a few minutes, and I still remember us all laughing in between contractions as the craziness of how fast things were happening! It wasn’t long before I felt the pressure of Tirzah’s head descending, and Lynelle was ready to help in anyway she could. Priscilla called our girls in, and they all clustered around the pool, quiet with excitement and anticipation. This time around I didn’t want anyone to touch me (other than squeezing Joel’s hand!), and I have never experienced the awareness during pushing as I did with this birth. It was an incredible experience to actually breathe her out and catch her myself—something I don’t think I could have done without the help of the water! I pulled her up to my chest, she cried right away, and we settled back in the warm water, both amazed at all that had happened. It was 4:42pm, only 20 minutes after I had arrived home!!

Sisters!

My girls were so delighted to help welcome their little sister, and their eyes shown as they stroked her head, and I thoroughly enjoyed the chance to sit back and relax and catch my breath. Being in the warm water seemed to decrease my usual after-birth shakes, and we had a long chance to connect and rest. Rose Marie arrived about 20 min later, and since I hadn’t delivered the placenta yet, daddy and the girls took baby sister to the other room while I transitioned to the birth stool where the placenta came easily. I was feeling good enough (and minimal blood loss!) that I showered quickly, and then cozied up on the couch while our midwife and friends did all the baby checks, and Joel popped a pizza into the oven. Eventually Priscilla went to bring the boys home to meet their sister, and we had a lovely evening rejoicing in our new gift. I had never had a daytime baby, and I couldn’t believe how good I felt and how I was hardly even tired! After everyone had some supper and everything was cleaned up and taken care of, I took our new baby upstairs, and we cuddled up together for the night-so thankful for the amazing experience, and still in a bit of unbelief!

Our Fantastic Birth Team!!
Immune Support For Pregnancy

Immune Support For Pregnancy

Supporting your Immune System during Pregnancy

As we head into flu season and continue to navigate the Covid-19 pandemic, I wanted to share some suggestions for pregnant moms wanting to boost their immune systems. There are so many ways we can proactively support our bodies in order to provide better resistance to germs and illness, and possibly prevent severe sickness. Many women find their immune systems face greater stress during pregnancy, so it’s extra important to try to support your body as it grows a baby while exposed to germs!

Before mentioning specific supplements, it’s important to remember that there are some key factors that also play into your overall health. These factors include:

  • Sufficient, regular sleep: you need ENOUGH sleep to support your body’s needs, and these needs are often increased during pregnancy. Make a habit of going to bed early enough to get the hours of sleep you need! If you’re having trouble sleeping, let your midwife know (I have some suggestions for pregnancy-induced insomnia, so don’t hesitate to reach out!).
  • Reduce Stress Levels: stress wears your body down, and makes it harder for your immune system work properly.
  • Eat a healthful, whole-foods diet with lots of variety. If you need information on what a good pregnancy diet looks like, I highly recommend Lily Nichols’ book Real Food For Pregnancy (check out her blog for helpful info, as well: Lily Nichols, RDN)
  • Stay hydrated: this helps to keep your body flushed and supported.
  • Add fermented foods to your diet, such as raw sauerkraut, kefir, etc.
  • Get 15-20 min of direct sunshine daily whenever possible!
  • Exercise regularly, especially in the fresh air: a 30 min walk outdoors daily is excellent for ALL pregnant moms!

Consider the following supplements daily (check with your prenatal vitamin to determine your needed dosage to reach the recommended levels below):

  • High Quality Probiotic: it’s no secret that our culture’s frequent antibiotic usage and lack of cultured and fermented foods are contributing to inadequate and/or imbalanced intestinal flora and correlating issues. A good probiotic with multiple different strains can help your body to work the way it should! One that specifically targets Candida overgrowth can be especially helpful in supporting the immune system. Klair Labs and Jarrow are two brands I recommend, but there are many options out there!
  • Vitamin C (preferably with bioflavonoids) 2000mg daily: this can be split up throughout the day.
  • Vitamin D3  4,000IU daily: for best absorption take with a meal containing fat.
  • Zinc lozenges  5-10mg daily: preferably in the form of acetate.
  • Elderberry  1-2TBL daily

When needing extra support (feeling run down, extra or direct exposure to illness, etc.) you may want to add the following to your regimen for 7-10 days:

  • Gargle with Salt Water 2-3x/day for 15-30 seconds.
  • Echinacea: 300-500mg dried herb (capsule or tablet) 3x/day or 2.5-5mL of tincture up to 3x/day
  • Astralagus, Garlic, Ginger & Green Tea
  • Bone Broth (find instructions for making high-quality bone broth at Broth is Beautiful: Weston A. Price Foundation)

The following are some combination immune boosting blends that are wonderful to have on hand for extra immune support (they contain combinations of the above suggestions):

A few years ago I posted some additional tips and suggestions on preparing for cold season, and you can find that post here: Preparing for Cold Season: Pregnancy-safe Suggestions

For those wanting to learn more and get further tips, check out the following links:

Lily Nichols on Vitamin D

Mama Natural: Boosting Your Immune System

Aviva Romm: Natural Prevention for Covid 19 in Pregnancy

American Pregnancy: Boost Immunity During Pregnancy

A Mother’s Journey with Tongue Ties

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.

Anemia During Pregnancy & Postpartum: what it is & what to do about it

Anemia During Pregnancy & Postpartum: what it is & what to do about it

If you are like many moms, struggling with low energy can be a challenge during pregnancy. Understanding how to support your body as it faces the increased demands of growing a baby can help you to have a better experience, and improve your recovery during the postpartum weeks. For many moms, the lack of energy is due to low hemoglobin levels, which can be linked to low iron. There are many ways to boost these levels naturally, thus providing your body & baby with the nutrients they both need in order to thrive!

What is Hemoglobin?

In a nutshell, hemoglobin is component of your blood that carries oxygen to your cells. If your hemoglobin count is low, you can experience some or all of the following symptoms:

  • Low energy
  • General Fatigue
  • Shortness of breath (especially after climbing stairs or exerting yourself)
  • Heart palpitations
  • Dizziness or lightheadedness

How do I find out if I have low hemoglobin?

Having routine labwork performed during pregnancy can tell you where your hemoglobin levels are. In my practice, we often check these levels towards the beginning of pregnancy, and then again after you reach 28 weeks of pregnancy. As you progress in pregnancy, your blood volume expands, preparing you to be able to handle the blood loss that occurs with delivery. For many women, their total volume increases over 25%, and tends to peak by the time you hit the beginning of the third trimester. Testing your hemoglobin soon after 28 weeks tells us how your body has handled this blood volume expansion, and gives us time to really hit support should your levels be low at this point in pregnancy.

What if my hemoglobin levels are low?

If your results are low, my first step is to look at all of your lab results to see if we can get a clue as to WHY they are low. There are a few different types of anemia, and the two most common in my practice are:

  • Iron Deficiency: caused by a lack of iron, which can show up as low hemoglobin combined with a low hematocrit ratio on your lab results.
  • B12/Folate Deficiency Anemia: caused by a lack of adequate B12 vitamins and folate, and can be indicated by an elevated “mean corpuscular volume” (abnormally large red blood cells) on your lab results in combination with a low hemoglobin level.

In occasional instances, low hemoglobin levels can also happen if a mom bleeds excessively after delivery. This is one of the reasons that it is so important to get your hemoglobin in an optimal place before birth, as it increases the body’s ability to handle blood loss. But if your hemoglobin is low and you need iron support after having your baby, the following suggestions will also pertain to you!

What can I do to bring up my hemoglobin?

Some key factors to consider as you weigh your options for iron and vitamin support:

  • Typically natural-based supplements take consistency and time to really be effective. This is why to start helping your body early, as the body will then have time to respond. Many iron and vitamin supports will take one to two weeks to really start working to bring levels up.
  • Look for products and options that are whole-food or plant based when possible, as these will cause less constipation and be able to be more easily utilized by your body.
  • Pay attention to labels, and stay away from supplements that contain synthetic ingredients. This is particularly key when it comes to “folate”, as you do NOT want the synthetic form called “folic acid”. Due to genetic issues, many women are unable to adequately absorb synthetic folic acid and synthetic forms of B vitamins, which increases the specific problem of B12/folate deficiency anemia. To understand more about folate and the importance of methylated vitamins, check out this article here by Wellness Mama.

Now onto options for increasing iron levels!

Borderline anemia: if your levels are borderline, and you are looking for some general ways to boost your levels and provide more support to your body, these are some great ways to start:

  • Use cast iron cookware for cooking.
  • Eat foods high in iron (beans, lentils, red meat, liver, spinach, turkey, pumpkin seeds, broccoli, black strap molasses, etc.)
  • Increase your vitamin C intake with a high-quality Vitamin C supplement once or twice daily.
  • Make sure you aren’t mixing calcium supplements with your iron-rich foods or supplements (they will block the absorption of the other, negating the benefits of either one!)
  • Alfalfa Tablets, Moringa capsules & Yellow Dock tincture.
  • Drink several cups Red Raspberry Leaf tea daily during the 2nd and 3rd trimesters (and during postpartum as well), or drink several cups of NORA tea daily (a combination of Nettles, Oatstraw, Red Raspberry Leaf and Alfalfa). To learn my favorite recipe for Red Raspberry Leaf, click here or for NORA tea, check out this link.

True Anemia Support: for those who need to seriously boost their hemoglobin levels, here are some additional supplements to consider, in addition to the list above:

Many moms have found this combination very effective at bringing up their iron quickly (combined with some of the above suggestions):

  • Liquid Chlorophyll (drink 2-3 tablespoons daily, and 1/4c. daily during the first week postpartum)
  • Hemaplex Tablets (make sure it’s these tablets, as they do not contained the synthetic forms of folate)
  • Desiccated Liver capsules (grass-fed organic is best)

Others have found the combination of Chlorophyll with one or two of the following to work for them:

For additional information on anemia during pregnancy, I’d encourage you to check out the following links:

And for more suggestions on anemia in general, Aviva Romm has some great suggestions here: Aviva Romm on Anemia

I’d love to hear from you: what has helped to bring your hemoglobin up, and help you have adequate iron levels during pregnancy and postpartum?

Preparing for Postpartum Recovery

Preparing for Postpartum Recovery

The first few hours, days and weeks after having a baby are special times to treasure as you recover from birth, transition to mothering baby from the outside, and spend time bonding and adjusting. Being adequately prepared ahead of time can make a key difference in helping postpartum to flow smoothly and successfully. Here are a few tips to consider as you prepare and plan for AFTER baby arrives. Remember that adequate rest, low stress, nourishing food, good support and planning ahead will help you to heal and promote a better overall experience for baby’s first few weeks. It’s important for your physical & mental health to take recovery seriously, and provide your body with the things it needs to continue nourishing a baby while recovering from the demands of pregnancy & birth. You won’t regret being adequately prepared!

Before the Birth:

  • Consider your support system. Do you have a close friend or family member that would be willing to be a resource to answer questions, let you talk with when you’re feeling low emotionally, or just need a listening ear? Is there someone you can trust and feel comfortable with who could come into your home to help care for the household (especially if there are other children) for a few days or weeks so that you can adequately rest and recover? Is Daddy able to take some extended time off of work? How does support look to you? Do you have some babysitting options?
  • Meal Planning: consider having some wholesome family favorites stocked in the freezer so you don’t need to think about cooking. Does your church or support group have a plan for after-baby meals? Do you need to reach out to someone to coordinate this? Would you have a friend willing to start a “meal train” after your birth? And just a note to Gentle Delivery clients: if an online “meal train” is something that would bless you, your midwife is very glad to start this after your baby arrives!
  • Consider stocking up on disposable plates, cups, silverware, etc. in order to simplify clean up and household chores.
  • Shopping (consider the below suggestions, and try to have these things together before your baby is due):

Immediate Postpartum (first hours after birth)have these things handy in a basket or box for immediately after delivery.

  • Newborn Diapers & Baby Wipes
  • Preferred first outfit for baby, along with a swaddle blanket, socks and hat.
  • “Adult Diapers” or Depends (or whatever type of pad you prefer for heavier postpartum bleeding).
  • Comfortable Nightgown or Pajamas that are nursing accessible and easily work for skin-to-skin contact with baby.
  • Ibuprofen and/or tincture (such as AfterEase or After-Pain Relief) to help with after-pains.
  • Pre-made “padsicles” or perineal ice-packs and/or an herbal healing spray such as this one from MotherLove.
  • Heating pad or rice sock to help with sore muscles and after-pains.
  • Rhoid Balm, Tucks or other soothing support for hemorrhoids.
  • Large Water bottle that is easy to use, to remind & encourage you to drink lots of fluids!
  • Nourishing foods, drinks and snacks (think bone broth, energy bites, juice, etc.).

First Few Days since you’ll be resting and nursing and taking it easy the first few days, you’ll want to consider having some of these items purchased ahead of time, and ready to be used during the initial few days after baby arrives, in addition to the items above (which you’ll continue using throughout the first few days/weeks).

  • Comfortable nursing-accessible clothes and nursing bras (remember that you may go through multiple changes of clothes due to leaking milk, bleeding and/or baby messes!). Comfort is key, since you will be resting and sleeping whenever possible.
  • Belly Support Binder (can use a Rebozo or scarf, or you can purchase something like Belly Bandit or MamaStrut).
  • Breastfeeding helps:
    • Disposable or reusable Nursing Pads for your bra.
    • Small flexible ice packs or Breast Soothies to relieve engorgement the first week.
    • If you have experienced challenges with milk supply, have supplements such as MaxiMilk or Legendairy products available to start once your milk begins to come in.
  • Stool Softener or Magnesium to help the first stools pass easier.
  • Pads/period underwear for a lighter flow (be sure to check out non-toxic options such as these JewelPads).
  • A journal or baby book to jot down thoughts and memories.
  • Something to read or do as you spend hours nursing your baby!

And finally, feel free to print/download and post this list of visitor guidelines to aid you in navigating the stress and joy of baby visits during those first days!

Questions to Ask When Interviewing a Potential Midwife

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!

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!

Probiotics: A Key for Fussy Babies?

Probiotics: A Key for Fussy Babies?

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Note: I am sharing this post from my own personal experience, in hopes that it might encourage another mom and perhaps give you some ideas as you research options and solutions for colic and fussiness. This is not to be taken as medical advice, but rather an introduction to provide you with a foundation for further investigation and research.  I also want you to keep in mind that this post deals with just ONE aspect of what can cause extra fussiness in an infant…there are often a multitude of factors that can be part of any situation, so I’m just tackling this particular aspect in this post! The products that I mention are ones that I have used myself, and I am not receiving any incentive or gain by recommending these!

As I was preparing to welcome our fifth child at the end of last year, I was resuming my usual research into how to help prevent excessive fussiness in infants. If you’ve followed my blog for long, you know that all of my babies have tended to be fussy and “high maintenance”. Nursing challenges have been part of that, and so have issues with sensitive tummies (I’ve ended up needing to go dairy free at some point in my breastfeeding journey with each of them!), but there’s always been this underlying fussiness that has not tended to improve until they reached 6 months or older. This has presented a number of challenges, as it really takes away from the joy of adding a new baby, if the baby needs constant juggling, bouncing and soothing!

While reading anything I could find on how to help soothe fussy babies, I came across this article that talks about a study that showed b.infantis linked to reducing inflammation in infants.

Shortly after reading the article, I saw a post on a Mommy group that I am part of, where a friend of mine recommended an infant probiotic, noting that it had made a world of difference in the temperament of her baby.  Earlier in the year, I had a client who told me how her  youngest baby has been her happiest ever, and credited a nightly bottle of goats milk kefir as part of what made a difference.

I also kept running into articles such as this one on babies needing L. reuteri, and others that talked about how different probiotic strains can help with colic such as this one: Can Probiotics Soothe Colicky Babies?  Then there is this article that, while encouraging people to purchase their company’s products, has some good information on why fermented foods and probiotics are essential components of health, and in particular infant health:  Introduce Babies to Probiotics.

I found it interesting to think about how years ago our typical diets contained more fermented foods (think about the sauerkraut and other fermented products that were a necessity in the days before refrigeration), and how antibiotic usage is so much more common these days. We are still figuring out what all the possible long-term effects are caused by frequent antibiotic usage over the course of our lives, and how these effects may come into play on our children. Here’s some interesting data looking at long-term effects of antibiotics on our micro-biome: Long-term impacts of antibiotic exposure on the human intestinal microbiota.

After reading and researching these articles and more, I decided that it was worth trying for my baby, as it obviously couldn’t hurt! There are many different products available on the market, and it can be hard to determine which one is best. I was searching for one that specifically had the strains B. infantis and L. reuteri, and would also be easy to give (with five children I knew that I wouldn’t make it happen faithfully if I had to be mixing and syringe feeding anything!). I ended up trying Humarian Probonix that my friend had recommended, and I started giving baby Tirzah a few drops beginning on the third day after birth. I gradually increased it to the 6 drops recommended, and she’s been getting that daily ever since. Occasionally I will give her another brand/type, but the Probionix drops are by far the most convenient. While there may be many other factors at play, this baby has been my happiest by FAR, has had regular diapers, hardly any skin issues, and has not had nearly as sensitive of a tummy as my other babies. I have to think that regular probiotics have been one element in helping her, so I wanted to share this in case it can help another mom out!

There are plenty of other brands out there, such as Envivo, Love Bug for Tiny Tummies, and Mama Natural has a whole blog post devoted to discussing the pros and cons of these and other probiotics specifically for infants here. By reading about them, comparing ingredients and determining your own needs, you should be able to find something that can work for your baby. And if you’re looking for more info on the benefits of cultured foods for baby, there’s a great article here.

Have you given your baby probiotics? Do you feel like it’s helped? What else have you found beneficial for fussy babies? I’d love to hear about your journey! And if you end up using probiotics for your infant, I’d also be interested to hear what brand you used, and whether you saw it make a difference.

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

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

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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!