Pre-conception Considerations: Things to Think About Before Getting Pregnant

Pre-conception Considerations: Things to Think About Before Getting Pregnant

I’ve had several ladies reach out this year asking for information to consider as they hope to conceive sometime in the next few months. As I started replying to some of these inquiries, I realized that it might be helpful for others in similar positions to have some of this information at their fingertips. My hope is that some of these suggestions can help you to achieve the healthiest pregnancy possible as you actively prepare your body for the amazing stress and strength that growing a baby places on your entire system-this is certainly worth seriously considering and prepping for, and I can guarantee you won’t regret any time and effort you invest before pregnancy!

Let’s start at the beginning:

  • Educate Yourself on Your Hormones and Cycle:
    • Understanding how your body works, and how to read your fertility signs (temperature, cervical mucous, etc.) can make a huge difference in both your ability to conceive and in determining an accurate due date. There are some disorders or challenges that can be identified early on if you have been keeping track of your fertility signs, and this can save you time, money and heartache if you know what to look for and when to get medical intervention. Simple things such as knowing you ovulate “late” compared to traditional due date calculators can save you the challenge of being considered “overdue” when you actually didn’t have an accurate due date to start with!
    • For better understanding, I highly recommend the book Taking Charge of Your Fertility by Toni Weschler. This guide helps you to really get to know how the women’s body works, how to chart your cycle, and how to understand all the information you are pulling together. The TCOYF app is also a great way to track your cycle, and it’s free! Another helpful book on the subject is The Fifth Vital Sign by Lisa Hendrickson-Jack (as a disclaimer, I JUST ordered this book and have it sitting in my “to read” pile-it looks great, but I haven’t read through it yet!).
    • For those particularly wanting to use fertility tracking as a guide to Natural Family Planning, the Art of Natural Family Planning Student Guide is a good way to delve into some of the details, which can also be an aid in achieving pregnancy.
  • Birth Control/Hormonal Contraception:
    • If you’ve been on hormonal contraceptives, it’s important to remember that it can take up to three months for normal cycles and fertility to return. The sooner you can get off any hormonal BC the better for  your overall health! Aviva Romm has a great article on fertility issues after hormonal contraceptives and getting off the pill here: Post Pill Reset and I highly recommend the new documentary The Business of Birth Control for better understanding of how hormonal contraceptives can negatively affect your overall fertility and health while providing an introduction to other non-hormonal options.
  • Deal with Any Current Health Concerns Now
    • Do you have weight you need to gain or loose? Start understanding healthful eating, and work on that now BEFORE  you add pregnancy to the mix! I’ll add more on diet below, but healthful eating habits should begin now, and will provide a great foundation for the demands of pregnancy on your body.
    • Are you currently on any medication that could have a negative effect on a developing baby? Many health challenges (such as elevated BP) can be managed by diet, lifestyle and supplement changes, and these are best achieved before pregnancy. If you’re hoping to have a low-risk delivery at home, this is even more important to consider, as any compilation of medications can increase your risk and rule out homebirth. Also, remember that you should be under the care of a physician or medical provider before attempting to wean off any medications, especially for BP, anxiety, depression, etc. You need to do this safely, and sometimes these changes can take time!
    • Thyroid health: many women these days experience thyroid imbalances, and it can make a huge difference on your ability to carry a healthy pregnancy if you are on top of these imbalances before pregnancy, and have a provider who can work with any sort of needed thyroid medication especially during the early days of pregnancy. Learn more about thyroid and it’s effect on pregnancy by reading Aviva Romm: Thyroid in Pregnancy
  • Learn more about healthy food choices:
    • There are so many things to learn about how food and our daily choices affect the way in which our body works! From supporting the organs, optimizing brain function, regulating blood sugar…the food we eat has so much to do with how our entire body operates. Add to this the growth and development of an additional entire human body and placental organ, and you’ll start to get a glimpse of how important solid nutrition is to your body and that of your future baby! The best book on the subject that I have read is Lily Nichol’s Real Food For Pregnancy, and I would encourage any woman who is pregnant or considering pregnancy to read it and really digest her wisdom and suggestions. Lily covers more than just diet, and her overall suggestions when it comes to regulating blood sugar, exercise guideline, and prenatal vitamin recommendations are all amazing and educational.
  • Support your Liver!
    • This might seem like an odd topic, but did you know that your liver performs under extra stress during pregnancy? There are many pregnancy complications that can arise when the liver is not functioning well, and there are some studies that suggest that a healthy, supported liver can reduce the amount of morning sickness a mom might experience. With all of these factors on the table, I highly recommend either purchasing a liver cleanse and using it a few months before getting pregnant, or at least taking a high-quality Milk Thistle supplement for a month or two before conception, and continuing to take it during the first trimester. Here is an article that addresses this further: Milk Thistle for Morning Sickness
  • Prenatal Vitamins:
    • Start your research on prenatal vitamins now, and begin taking them daily. Remember, the critical time for baby’s development are in the early weeks, so your body needs to start getting a good foundation of nutrients so that your body is ready to nourish the developing brain, organ and other nutrient needs of a growing tiny baby. Many moms end up sick enough that they cannot continue taking prenatal vitamins during part of the first trimester, so having this foundation laid ahead of time is key!
  • Further Reading:
    • If you’re wanting to read more about how to optimize your fertility and prepare well, many providers recommend the book It Starts with The Egg. Rebecca Fett goes into detail about diet, supplements and other foundational principles of helping your body to achieve healthy conception!

In closing, I hope you’ve found these suggestions informative! I’d love to hear what else you would add to this list, and what has helped you as you’ve prepared for pregnancy. Maybe you’re not pregnant yet, but you’ve found a great resource…or maybe you followed some preconception guidelines and are currently in the middle of pregnancy…either way, I’d love to hear what you found most helpful!

2021 Year-End Update from Gentle Delivery

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!

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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!!
Preventing Group B Strep Colonization in Pregnancy

Preventing Group B Strep Colonization in Pregnancy

For clients of Gentle Delivery, you know that routine Group B Strep testing is offered to every expectant mom in accordance with the ACOG standards of care. While the pros and cons of testing and subsequent treatment plans are discussed in detail elsewhere, the purpose of this post is to help you to minimize your risk of developing Group B Strep colonization during pregnancy, thus promoting better health for you and baby (and increasing your chances of obtaining a negative test result!).

If you are interested in researching Group B Strep info, I’d strongly encourage you to read Aviva Romm’s article: Group B Strep in Pregnancy: What’s a Mom to do? You’ll find clear explanations of GBS, risks and benefits of antibiotic treatment, and tips on promoting health. This post by Wellness Mama also includes further links for study along with Katie’s suggestions for avoiding GBS colonization with natural methods: How I Avoided GBS Naturally  And finally, this article provides a few other options to consider while making decisions on prevention and treatment: Decrease Your Chances of GBS

As a practicing CPM in a state that does not offer licensure, I am currently unable to offer IV antibiotic treatment to GBS+ clients. This increases my desire to do all I can to help support a mom’s immune system and decrease the possibility of a GBS+ test result, as it greatly simplifies the care protocols and necessary decision making for clients and their families!

So here are the primary suggestions for making your vaginal flora inhospitable to Group B Strep:

  • High Quality Probiotics (if not started early on in pregnancy, then beginning at 28-32 weeks orally, adding vaginal support at 32-34 weeks)

“Many species of Lactobacillus have been shown to be beneficial to the vaginal flora; Lactobacillus reuteri and Lactobacillus rhamnosis are species known to be especially helpful for supporting healthy vaginal (and bladder) flora, while these and others, including L crispatus and L. salivarius strains, have been shown to to inhibit the growth of vaginal pathogens including Gardnerella vaginalis and Candida albicans, and also reducing the frequency of bladder infections in addition to vaginal infection.

In one study, 110 pregnant women at 35-37 weeks of gestation who were diagnosed by GBS culture as being GBS positive for both vaginal and rectal GBS colonization were randomly assigned to be orally treated with two placebo capsules or two probiotic capsules (containing L. rhamnosus and L. reuteri ) before bedtime until delivery. All women were tested for vaginal and rectal GBS colonization again by GBS culture on admission for delivery. Of the 99 who completed the study (49 in the probiotic group and 50 in the placebo group), the GBS colonization results changed from positive to negative in 21 women in the probiotic group (42.9%) and in nine women in the placebo group (18.0%) during this period. The researchers concluded that an oral probiotic containing L. rhamnosus and L. reuteri could reduce the vaginal and rectal GBS colonization rate in pregnant women.

In another study involving 57 healthy pregnant women, L. salivarus was taken daily by the 25 GBS positive women in the group from weeks 26 to 38 of pregnancy. At the end of the trial (week 38), 72% and 68% of the women were GBS-negative in the rectal and vaginal samples, respectively. The researchers concluded that this seemed to be an efficient method to reduce the number of GBS-positive women during pregnancy, decreasing the number of women receiving antibiotic treatment during labor and birth.”  (copied from Aviva Romm’s article here)

In light of these studies, and knowing that probiotics are vitally important to the health of both mom and infant for a variety of reasons, supplementing regularly with probiotics during pregnancy can be beneficial in more ways than one. For GBS specific support, it’s recommended that you begin supplementing orally at 28-32 weeks (though earlier is even better!), and then increasing your oral dosage and consider using a probiotic vaginally for at least 2-4 weeks before your Group B Strep test (and then continue the oral support through the rest of your pregnancy).

As you shop for probiotics, pay attention to the different strains it includes, as not all probiotics are created equal, and they will be most effective against GBS strains if it includes L. Rhamnosus, L. Reuteri and L. Salivarus.

Some brand suggestions that other midwives have given me are:

  • Diet Support
    • Eating a diet high in fermented foods/drinks (kefir, sauerkraut, kombucha, yogurt, etc.) help to promote a healthy gut flora.
    • Eliminating sugar and simple carbs are also effective in promoting beneficial gut flora.
    • Add 1-2 tbl of coconut oil into your daily diet for it’s antibiotic properties, specifically in the few weeks prior to testing.
    • Apple Cider Vinegar consumed daily or in capsule form may be helpful.
  • Vitamin C
    • Consuming 1000-2000mg of high quality vitamin C daily (in divided does) can help to increase your body’s immune response, which makes it more difficult for unhealthy microorganisms to grow. You can begin this regimen around 30 weeks.
  • Garlic/Allicin (active component of garlic)
    • Garlic has been used as an antimicrobial agent for generations, and for good reason. However, high doses of garlic can cause blood thinning, so I don’t recommend staying on high doses of garlic or allicin after obtaining your GBS test. But it is a treatment to consider to reduce the possibility of GBS colonization before getting tested. Currently there is a midwife practice conducting a study where participants are instructed to use Allicin Gel 2x daily for 12-14 days along with ingesting 180mg of Allicin capsules 2x daily for 12-14 days prior to testing. The basis for this study is from a preliminary study done in 2009 where Allicin was shown to reduce the possibility of early rupture of membranes and chorioamnionitis, both of which can be complications of GBS infection. Other methods of using garlic include: taking garlic capsules daily, consume raw garlic daily, and/or insert a raw garlic clove vaginally at night before going to bed.

            While we still have a lot to learn about Group B Strep (how exactly it is transmitted, best ways to treat it, and how to prevent it from the beginning), and while there still seem to be a few moms who naturally carry Group B Strep bacteria in their vaginal tract no matter what they try to do about it (antibiotic or otherwise!), one of the benefits of utilizing these suggestions is that they promote health for mom and baby regardless of the GBS presence (or lack thereof). While obtaining a negative Group B Strep test does eliminate a certain amount of worry, risk and decisions, the benefit to your body of increasing the good bacteria and gut flora through healthy foods, probiotic supplementation and other factors may provide long-term benefits that you will see later on. I’d highly encourage every pregnant mom to consider these suggestions, and wish each of you a healthy and safe pregnancy and birth!

            I’d also love to hear: did you try any of these prevention methods? How did it affect you and your GBS status? Did you test positive in one pregnancy and then negative in another? What was most beneficial for you?

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.

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.

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

“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!

Preparing Well for Postpartum Recovery

Preparing Well for Postpartum Recovery

The longer that I am a mom and midwife, the more I have come to realize how important it is to adequately rest and recover after giving birth. But this does not “just happen”…it takes some serious thought and planning!! Why is it that we spend hours and hours preparing for pregnancy and birth, yet no time or focus is given to what happens AFTER the baby arrives? With this in mind, I’m hoping that these questions and comments will help families to come up with a plan on how to cultivate an intentionally restful and healing postpartum period. I’d encourage you as a couple to sit down and talk about these questions, and figure out what you could do to be better prepared emotionally, mentally and physically for the initial 6 weeks after giving birth.

If you want to read more about some of my own favorite items to have nearby during the initial days postpartum, check out the link here

Reading and Preparation:

Let’s start with some book suggestions. We spend lots of time reading books about pregnancy and birth, right?!? So why not read about how to care for oneself postpartum? Here are some titles to get you started. I’ll note that I don’t endorse everything these authors share, but I do appreciate the way they help me to think through our thoughts and expectations surrounding postpartum adjustments and recovery.

Some Facts to Consider:

As you talk about your expectations for postpartum, it’s good to think about some facts, especially for the dads who wonder if it’s really necessary for mom to spend so much time resting! I love to show the new parents the placenta after the birth, which is generally the size of a small dinner plate. Picture a wound of the same size on the inside of mom’s uterus. Seriously! That’s the wound that needs to heal, and even though the uterus continues to contract and get smaller over those first days/weeks, there is a still a significant amount of healing that needs to happen inside. Add to this any amount of blood loss, any stitches/tears, the length of labor, swelling, and the amount of work it takes to push a baby out, and you can quickly see why it’s important for mom to take care of herself! All of a sudden the reasoning behind “not lifting anything heavier than your baby” makes complete sense, doesn’t it? Along the same note, almost anyone recovering from any type of surgery is usually given a two week minimum recovery time…new moms need AT LEAST that long!

As the postpartum days progress, mom’s body is going through a lot of changes, which include a drop in hormones from the expulsion of the placenta and baby, and a surge of more hormones as her body transitions into producing milk. Keep this in mind those first days…mood swings and emotional roller coasters are NORMAL. But it sure helps if you are expecting that as part of those initial days. And it’s good for husbands to know that this is a normal part of adjustment. Mom needs rest, understanding, and sometimes NO MORE VISITORS!

Another thing to remember is that you won’t be getting a lot of sleep those first few weeks. It’s good for baby to eat every 2-3 hours to establish good nursing habits and milk supply, but it does not contribute to a restful mom. Keeping life low key, and expectations to a minimum can really make a difference in allowing this time to be as stress-free as possible. Along the same lines, nourishing foods and lots of liquids are also hugely important in helping to establish a plentiful and healthful milk supply.

Lastly, try to view the postpartum period as a 6 week MINIMUM. I understand you may not be able to take that much “time off” of your normal home duties. But the longer you can rest and care for yourself in the initial weeks, I can promise you the better off your long-term postpartum experience will be. These initial 6 weeks your baby needs you as much as he needed you when he was inside, and this means an unpredictable schedule, lots of nursing, skin-to-skin time, and lots of cuddles. A slow re-entry into normal life will be beneficial to everyone, and lowering your personal expectations of this time can be a life saver!

Initial days postpartum:

  • Consider staying in bed for several days, getting up only to use the restroom, and perhaps joining the family for one meal a day. This can be beneficial for several reasons: visitors don’t stay as long if you’re in bed, you can sleep when baby does, and it reminds everyone that you are recovering!!
  • Prepare your room or a special corner ahead of time to make it a pleasant place for recovery. You’ll relax better if you find your space enjoyable and refreshing. Think about getting some special reading material or audio books together ahead of time to enjoy while you spend hours nursing your new baby. And don’t forget to have some comfortable clothes to wear that promote easy nursing access and yet allow you to rest well!
  • Limit visitors, and the amount of time that they stay. This can be dad’s job: remember that even if your wife loves people, new moms find extra company more draining than they initial expect. Short 10 or 15 min visits are sufficient, and this allows mom to not be separated from baby too long (since many visitors want to hold the new baby the entire time they are present).
  • Have nourishing snacks, foods and drinks gathered ahead of time: a new nursing mom is ALWAYS hungry and thirsty that first week!
  • Remember that your body is going through some major changes and may need some help: have some ibuprofen, nipple cream, icepacks, heat packs, hemorrhoid balm and magnesium available in case you need them.
  • Consider some ways to have meals taken care of: freeze some ahead of time, or ask a friend to organize a meal train or signup list where friends can bring food. It can be nice for the entire family to have meals provided for the first days/weeks as the whole family adjusts to the new baby.
  • If you have older children, it’s a good idea to think about how to implement the “no lifting” rule…sometimes it can be helpful to invest in a step stool that the older sibling can use to climb up beside mom so that she isn’t tempted to lift him or her up.

First Two Weeks:

  • An old midwife’s adage is “5 days in the bed, 5 days on the bed and 5 days around the bed”. While many moms balk at this amount of recovery time, it’s not a bad idea to consider! Mom will continue to bleed for around 2 weeks, and the longer she rests oftentimes the shorter the time she bleeds.
  • Continue to follow the “no lifting anything heavier than baby” rule until at least 2 weeks to maximize the uterine healing that needs to happen.
  • Keep stressful visitors to a minimum-this may mean telling well-intending friends and family that they need to wait to come see mom and baby, especially if that entails a lengthy visit of several days. Sometimes it’s hard for people to remember that mom is recovering and needs to spend time with baby, so this is NOT the time to be socializing and holding a newborn for hours on end.
  • Consider getting some household help these first weeks (longer if possible!). This would preferably be someone who can come and keep up housework, prepare food as needed, entertain older children if present, and take care of household duties so that mom can rest mentally as well as physically. As you consider this possibility, keep in mind that this works best if it is someone that mom feels completely comfortable with-sometimes this is a family member, but sometimes it is someone totally unrelated, and even hired for this express purpose. Talk honestly about what type of person would work best in your family situation. After my fourth child was born, we were blessed to have a girl who was willing to come spend 2 days a week with us during the first three weeks. This was sufficient time to catch up laundry, clean the house, and keep after work that wasn’t getting done, as my husband had a flexible work schedule the other days of the week. I found it much easier to rest when I knew the house wasn’t falling apart while I rested!
  • As you feel your energy increasing, start slow…remember that the sooner you jump in to “normal life”, the sooner everyone else will expect you to stay that way!
  • If people offer to help, take them up on it! An offer to babysit can mean an extra nap for mom, and many friends are more than willing to run get your groceries if they know you need something. Don’t turn any offers of help down!

Weeks 3-6:

  • This is when it can get hard to remember to rest. Even though you feel much better by now, remember that you need to go slow, and say no to anything extra in life, even if you FEEL energetic. Your baby still needs lots of time to nurse, and your body is still going through significant changes. One day you feel on top of the world, and the next you are in the dumps…all of this is part of your body learning to regulate it’s hormones again! There are supplements you can take to help with this-check with your midwife if you experience lots of these swings.
  • Start slow with exercise. It’s best to wait the full 6 weeks before engaging in anything specific to rehab, but I do encourage moms to get out in the fresh air and start taking slow walks if they are having minimal or no bleeding by week 2 or 3. Put baby in a stroller or in a carrier, and stroll. Don’t push yourself, just give yourself the chance to get some sunshine and fresh air.
  • Make sure you are taking your prenatal vitamins and consider adding some extra Vitamin D and Evening Primrose Oil to help with hormonal balance.
  • Try figuring out a way to get just a little bit of time to yourself each day…perhaps your husband can take care of the children while you slip out for a short walk, or perhaps you can meet up with a friend for coffee (and let her hold the baby!), or even get a chance for a short nap by yourself. These things can help with managing the mental load, and can be a big step in preventing postpartum depression.
  • Find a friend you can talk with and share with as you go through the many adjustments during these weeks. It’s always reassuring to be reminded that this stage of life doesn’t last forever, and you will sleep again someday!
  • Continue to get help with basic household duties as you can, and don’t turn down the offer of food!
  • Consider trying to get some intentional time as a couple: the unique stress of this period, combined with mom’s unpredictable hormones, interrupted sleep, and all the other factors can add some significant stress on your marriage. Getting away for an hour (with baby in tow) to concentrate on your relationship can really help you to navigate this time and grow stronger in your relationship.
  • Eat nourishing, healthy foods, and don’t worry about weight loss while your body is establishing milk supply!

 

In closing, I’d love to hear what you would add to this list? What was most helpful to you when you were anticipating the arrival of your little one? What helped you recover? Please share your tips and input!

A Peek into a Local Home Birth!

A Peek into a Local Home Birth!

I’m tickled to share these photos with you this month! While birth photography has gained in popularity in many of the large cities across the US, it’s not a very common thing in our area. So it’s pretty rare for one of my client families to hire a photographer to be present at their birth. Earlier this year, I was privileged to help Maria’s family for a second time as they welcomed their newest addition, and they graciously allowed me to post some of the photos from the birth here. One fun & unusual aspect of this birth is that my assistant for this birth and the photographer are both involved with the local doula agency that Maria administrates. Check out the Doulas of Central PA  if you are looking for local birth & postpartum doula support! And if you’re looking for a birth photographer, check out Denae at Vigilante Photography

The twinkle lights added a festive atmosphere, and I love seeing how moms relax when they get into the water.

 

Kristina has been helping as my birth assistant in between her doula babies, and you can see her here jotting down notes on the labor & delivery chart.

 

First good look at each other!

 

Older siblings watch excitedly, all excited to see baby brother!

 

He’s here!

 

Traditional sling scale to weigh baby…look at big sister’s face of concentration!

 

Newborn exam…always done within sight of mom and any interested family members!

 

Checking out feet reflexes and creases!

Foot prints for the records!

 

Born at Home!

Midwife gets a little chance to snuggle baby before handing him back to mama.

 

Great birth team-thanks, ladies!!