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?

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!

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

Follow gentlemidwife on Instagram!

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!!
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!

Proactive Preparation Tips: Helping You Achieve a Successful Vaginal Birth

Proactive Preparation Tips: Helping You Achieve a Successful Vaginal Birth

Proactive Preparation

Proactive Preparation Tips: Helping You Achieve a Successful Vaginal Birth

If you’ve read much about preparing for birth, you probably have realized that there tends to be two different “extremes” when it comes to how much or how little you do to prepare your body for the marathon of birth. On the one hand, there are those who feel strongly that you need to “trust your body” to do what it was made to do, and that the addition of herbs and other proactive methods give moms a sense that their body is broken and unable to work on it’s own. The other hand tends to view the whole process of labor and birth as an “accident waiting to happen”, and rushes to medicalize every situation (for example, routinely inducing labor at 41 weeks just because it’s a week past your due date).

My personal opinion (and take this as my opinion-as with anything, you must do your own research and make your own decisions about these suggestions!), is that there should be a balance between these two extremes. I feel strongly that a women’s body was designed to grow, nourish, carry and deliver a baby, and that you can have confidence that this a totally normal and natural process (and not a medical emergency!). But just like any other capabilities your body may have, these abilities can be supported, enhanced and enabled to do their job more efficiently, smoothly and successfully. With that mindset, I’m going to share with you some suggestions on how to support and prepare your body in order to provide you with a greater possibility of achieving a low-risk, normal, natural vaginal birth.

Some of the biggest factors that arise that prevent moms from their desired birth outcome include: pain in pregnancy that prevent them from moving well at the end of pregnancy, going so far past your due date that your care provider feels like an induction is necessary, a long early phase of labor that prevents mom from getting adequate rest and results in exhaustion (which often ends in transport from home and/or an epidural to provide needed relaxation), and a long pushing period that sometimes ends in surgical or assisted delivery. While there are varying factors in all of these situations that can all be prevented, there are MANY things you can do to reduce your risk of these situations occurring, if you just know what to be aware of and how to help your body to prepare!

  • Movement, Alignment and Positioning:

One key factor that makes a difference in your pregnancy comfort level, baby’s ability to descend efficiently, and your overall length of pregnancy/labor is the position of your baby in relation to your pelvis. I highly recommend you find a good chiropractor in your area (for those who are local you can find some recommendations when you click on the “Local Resources” tab) who is certified in Webster technique and works with pregnant moms, and get regular adjustments specifically throughout the last 6 weeks of pregnancy. If your pelvis and muscles are out of alignment, they can keep baby from being able to descend into a position that is optimal for triggering the start of labor, and the ability of the baby to navigate the birth canal, which can then cause labor to stall and/or make it more challenging for you during the pushing phase.

For the best explanation of position and how this can affect labor (and what you can do about it!), I highly recommend that you take the time to watch the Parent Class taught by Gail Tully at Spinning Babies. Once you’ve watched it, check out the Spinning Babies website for more tips and suggestions on optimizing your baby’s position. And finally, if you are getting near your due date (or are past your due date and are waiting for baby!), taking time to complete a few rounds of the Miles Circuit exercises has been shown to improve baby’s position and encourage labor to happen.

  • Exercise:

As they say, you don’t decide to run a marathon and then complete it tomorrow! I think it’s wise to go into labor with a similar mindset as one would in preparing for a long-distance athletic event. Regular exercises that help to strengthen your legs, open your pelvis (think deep squats and lunges) and build your stamina can play a role in encouraging baby to come in good time, helping to improve your ability to handle the rigors of labor and provide you with a much better recovery. Even if you’re only able to include ten minutes of purposeful exercise a day, it will give you great benefits. Here’s one to get you started: 10 Minute Pregnancy Workout. Long, brisk walks and swimming are also great exercises to consider including in yoaur routine.

  • Herbal Supplements:
    • Red Raspberry Leaf Tea has amazing health benefits, besides helping to prepare and tone your uterus making contractions more efficient. I have more information on this great tea in my post over here, and you can begin drinking one cup a day during the 2nd trimester, increasing to 3+ cups per day as you near your due date.
    • Birth Preparation Formula: I have personally had great success taking an herbal supplement during the last 5-6 weeks of my pregnancies that is specifically geared towards preparing your uterus and cervix for labor. Yes, I take it in addition to Red Raspberry Leaf tea. If you have a history of preterm birth, you would want to wait to start this until 36 weeks, and on the flip side, if you tend to go way past your due date, you could begin taking it at 34 weeks up until delivery. The moms that I have had take this tend to have shorter labors, earlier deliveries, and minimal postpartum bleeding (myself included!). There are several different brands available, though I tend to think the tincture forms work the best. My all-time favorite is the  Gentle Birth Formula. You will need 4 to 6oz in order to take it daily for 5-6 weeks, and it’s best to not consume the tincture in the late afternoon/evening, as it can cause contractions that may prevent you from sleeping!
    • Evening Primrose Oil or Borage Oil: The high GLA content in either of these oils can help to soften and prepare your cervix for labor, which can assist the body in working more efficiently once labor actually begins. You want a “mega” gel-cap with 1000mg or more per capsule, and this can be taken orally every day for the last trimester, and then also inserted vaginally at bedtime during the last few weeks of pregnancy.
  • Abdominal Support:

Some moms just need some extra support for their abdominal muscles, especially if they have had a few babies, or if their babies tend to be large. The muscles that support the uterus and help it to contract efficiently can become stretched (think of a rubberband that has been completely stretched out, and doesn’t quite return to “normal”), and are unable to “hug” baby enough to get a consistent labor pattern started, or even get baby low enough to obtain a good position to begin with! One way to work with this is to consider regularly providing your uterus with support, in particularly during the last 6-8 weeks of pregnancy. You can purchase a maternity support belt (Belly Bandit has some great, albeit expensive options), but many women find that using a rebozo or long scarf/piece of scarf works great, such as is illustrated in this post here  and another option here. The goal is to pull the uterus slightly up and towards you, mimicking the way your muscles naturally pull, with provides a firm, consistent support (which also relieves pressure from your back!).

  • Eating Dates!

The benefit of consuming dates during the last weeks of pregnancy has only recently been discovered. The suggested protocol is to eat 4-6 dates daily beginning around 36 weeks until you deliver. To find out more, you can check out the details of a recent study at Evidence Based Birth and see what Mama Natural has to say here.

With the exception of eating dates (this is newer option I’ve discovered!), I have personally tried all of the above suggestions for my own five pregnancies and births, and have seen many women successfully use these recommendations throughout my midwifery practice over the past 11+ years. I wish I would have known about many of these earlier in my practice, as I think it would have prevented more transfers and unnecessarily lengthy labors. Another side benefit to following these suggestions is that your body is that much more prepared and ready should an induction actually be medically indicated. While I rarely have reason to need to get labor started, when there is this need and the body is ready for labor, then there are many more options available that have a high likelihood of actually working (in case you’re wondering, one method many midwives use is the Midwife’s Brew, but you should never attempt this without discussing the details, risk vs. benefit, etc. with your care provider!). And if you end up needing a hospitalized induction, the above suggestions will also increase the chances that you end up with a successful induction and normal vaginal birth.

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!

Miscarriage Questions: 10 Year Anniversary Interview Part 3

Miscarriage Questions: 10 Year Anniversary Interview Part 3

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Interview Pt 3: Miscarriage

This month I’m continuing to answer questions that were submitted by readers for Gentle Delivery’s 10th anniversary “ask the midwife” series (feel free to check out Part One and Part Two if you haven’t read them yet!) There were several questions asking about miscarriage and how that affects future care, and I’ve decided to make that the focus for this month. Sadly, miscarriage is a reality for many moms, and I’ve had more moms than usual experience miscarriage throughout this past year. Hopefully some of these suggestions and this information can be a blessing to those of you walking through this valley, or those of you wondering what happens next…

What is your approach when a client has a miscarriage? What do you say or do to help her through the process, and if she gets pregnant again later, does your prenatal care for her and the baby look different in any way?

This is one of the “flipsides” of midwifery practice…it’s not always dealing with excitement and new babies. Oftentimes miscarriage occurs “out of the blue”, and usually there is no obvious explanation, even though we usually wish we knew why, or what happened.

Typically, a client will have just been in touch to let me know that they are excited to set up a time to talk about homebirth (or resume care if they were a previous client), and then they let me know that they are having some spotting. Spotting in and of itself can indicate an impending miscarriage, or it can be indicative of an irritated cervix, or it can be sign of a “subchorionic hematoma” (which usually results in spotting/bleeding without harming the baby, and resolves on its own). Quite honestly, if a miscarriage is going to occur, there really isn’t much that you can do, as oftentimes if it is indeed going to progress into a miscarriage then the baby has already died by the point you are experiencing spotting. But the unknown is not easy, as you want to KNOW what is going on. Our options at this point include doing labwork to see where the progesterone and Hcg levels are by now and going in to an OBGYN or an ER for an ultrasound (usually this is a vaginal ultrasound in order to get the best look at the uterus in early pregnancy). If the mom is 5 or 6 weeks or more, they should be able to visualize the baby, and be able to tell if the heart is beating, and labwork can reveal whether the pregnancy hormones are continuing to increase as they should. If mom prefers to wait, then there are some herbs that can be taken, and some moms choose to also use progesterone cream to help support the body until we know for sure what is going on.

If the ultrasound or labwork shows that miscarriage is inevitable, then I try to offer support and encouragement while the mom walks through the next several days. In most cases, mom is able to pass the baby on her own, and we stay in touch via phone or email. Spotting usually progresses into bleeding, and cramps accompany the bleeding as the cervix dilates enough to pass everything, which typically happens within a week of the initial spotting. In the event that it takes a longer amount of time, then we can use herbs to help encourage things to move along, we closely monitor for infection, and occasionally we need to transfer to an OBGYN for further care.

Once a miscarriage has taken place, I really encourage moms to take it easy, and make sure that they give their body time to heal both physically and emotionally. Oftentimes a mom can be left feeling very tired and anemic, as the body usually loses a significant amount of blood, and the intensity of labor can leave her worn out. There is also the emotional side of processing the loss, and this combined with the hormonal swings that go along with pregnancy followed by delivery can create quite a roller coaster of emotions to work with, and mom needs to know that this is normal and okay…and that her body is grieving and adjusting, which takes time!

The good news is that a previous miscarriage in and of itself does not negatively affect care for a future pregnancy. As I mentioned before, we usually don’t know what the root cause was, but there are many moms who go on to carry a healthy pregnancy following a miscarriage. Sometimes it can help a mom to relax more if she has more frequent monitoring during the early weeks of pregnancy after a miscarriage, and I am glad to do progesterone and Hcg testing to make sure that these levels are increasing like they should during the initial weeks. Oftentimes these moms also want to get an ultrasound performed earlier, in order to know that everything is looking good and that baby is growing like he should. Other than these factors, there isn’t much different for prenatal care, unless a mom has had several miscarriages in a row.

If a mom has had several repeat miscarriages, I highly recommend consulting with a NaPro Fertility Specialist (these providers concentrate on helping to achieve and maintain correct hormonal balance in order to prepare a mom’s body for and help in maintaining pregnancy). Many moms have inadequate progesterone levels, and having a specialist helping to monitor levels and provide prescription strength progesterone when needed can be a tremendous blessing, and prevent the trauma of further losses.

In closing, here are some suggestions if you are walking through a miscarriage:

  • Drink red raspberry leaf tea frequently in order to help balance your hormones and increase your iron as you recover (although stop drinking if you become pregnant again, until you reach the second trimester).
  • Take Evening Primrose Oil to help regulate hormones and support the body.
  • Consider taking an herbal-based iron supplement for several weeks to help restore your iron levels.
  • Take time to rest, don’t push yourself too hard, drink a lot of fluid, and take time to reflect on the short life you were given to carry, and allow yourself time to recuperate and heal before trying to resume your normal responsibilities.
  • Check out these sites that have further tips: Healing After Miscarriage and Healing Naturally.

And if you are preparing for pregnancy following a miscarriage, here are some ways to support your body:

  • Take folate (not synthetic folic acid!) and methylated B vitamins regularly.
  • Start taking a high-quality plant-based (not synthetic!) prenatal vitamin to build your body’s supply of needed vitamins and minerals.
  • Look into the benefits of using a quality, natural based over-the-counter progesterone cream to help promote healthy progesterone levels.
  • Consider having some herbal tincture on hand (such as C & B formula from Mountain Meadow Herbs) that you could take at the first sign of any cramping or spotting-this tincture helps to calm the uterus.
  • Check out this blog post for more practical tips: Preventing Miscarriage

In closing, would you have any suggestions you would add? If you have experienced a miscarriage, what was the best information and advice you were given? Any suggestions for moms hoping to get pregnant soon after going through a loss? I’d love to hear your answers if you would be willing to share!

 

The Birth Story of Baby Darius

The Birth Story of Baby Darius

It’s hard to know where to start with Darius’ birth story, as there were several starts-and-stops along the way during the last week or so of my pregnancy. Joel will shake his head and say something along the lines of “shouldn’t a midwife know when she is in labor?”, but once again I had trouble figuring it out.

To give some background (especially if you’ve read my previous birth stories), we had used our dear friend Rose as our midwife with our girls, and she ended up being the first one on the scene after Matthias was born (she was home on a school break THAT weekend, and our midwife was on her way from Lancaster, but Matthias came in a hurry-read his birth story here). We love her, but due to a variety of reasons (especially the fact that Joel has no desire to ever catch one of his own babies again) we decided that this time we needed to use a midwife who lives closer to us. In the past two years I have been blessed to meet and work with Rose Marie Spicher, a midwife who lives half an hour away, and who worked for years in TX (where I did my midwifery training). She provided the “mothering” care I needed throughout my pregnancy, and it gave Joel a sense of relief to know she wasn’t too far away. With me being on maternity leave the month of May, and the fact that everyone else was expecting in May as well (I have NEVER received so many inquiries for one particular month!), I was just hoping that she wouldn’t be tied up whenever our baby decided to come!

So fast-forward through all the months of sickness, fatigue, finding out that we were expecting a baby brother (the children are still certain this was a direct result of their prayers, as I was convinced it had to be a girl given how sick I was!), and everything else until the beginning of May. By early May I was reaching that totally-done-being-pregnant stage where I wasn’t sleeping at night, having lots of cramps  & contractions, felt extremely emotional all the time, and we were wondering just when this little fellow would decide to make his appearance. Between 34-36 weeks I was experiencing enough cramps and contractions to know I needed to take it easy, and once we hit 36 weeks I had a couple of times where I thought perhaps we were getting started-I distinctly remember one night when I couldn’t sleep because of contractions, so Joel & I slipped outside to take a walk in the moonlight. It would have been so romantic if I hadn’t been so uncomfortable! But everything always fizzled away, and left me feeling tired and discouraged.

At this point we were preparing for a visit from my parents, who live in Kansas. My sister had her first baby the month before, and my mom wanted to come out to help her over the time my brother-in-law was graduating and they were preparing to move. So she flew into northern PA, spent a few days with my sister, and was then joined by my dad. The plan was that they would drive down to see us before they headed back to Kansas, and of course we hoped that baby would arrive before they left, though we knew it was entirely possible that he would wait until they were home again. However, with all the early labor signs I had been experiencing, I’ll admit that I was getting my hopes up! Mom & Dad planned to arrive on Mother’s Day, and the night before I was trying to encourage things along, and ended up with a night of contractions with no baby to show for it. Everything was regular enough that I actually called my midwife to give her a heads up, but then it all petered out.

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Mother’s Day 2017

I really had to work through the disappointment of knowing that perhaps my folks wouldn’t get to meet their grandson on this trip. We didn’t know when we would be seeing them next, and I hadn’t realized just how much I had my heart set on them getting to be here to see MY baby while he was new and tiny. It took some talking, praying, crying and processing with Joel to get to the point of being okay with the fact that perhaps this time with mom & dad was to be spent enjoying their company and not stressing over whether baby was here or not. So for the next few days, my parents helped to take my mind off of waiting for baby, and we enjoyed some lovely family time at the park, taking walks, picnics, a backyard barbeque, and some time for Joel & I to be together while our children were cared for.

The last night of their visit, they took our two oldest children back to stay the night with them in their cabin. In the interest of full disclosure, I had taken some castor oil in the afternoon, knowing full well that there was a good possibility nothing would come of it, and yet hoping that perhaps it would give my body the nudge it seemed to be waiting for. I was NOT going to get my hopes up, though, and I tried to just go to bed to get some sleep. I think it was around midnight or 1am when I woke up with a contraction, and yet I tried to sleep, as it sure wasn’t the first time that random contractions had woken me up at night! After an hour or so of not really sleeping, I figured I might as well get up to see if moving around made them go away or get stronger.

Joel sweetly got up with me, and fixed me sourdough toast with strawberry jam-his mom had given me jam and sourdough bread the week before, and it was becoming a regular midnight tradition to eat a piece when I couldn’t sleep! After another hour or so, Joel commented that these contractions seemed to be pretty regular and close together. I did NOT want to give another false alarm to anyone, and didn’t feel sure that this was anything more than what had happened on previous nights. Looking back, they were coming close together (every 2-4 minutes!), but they weren’t very intense, and they didn’t last long, so I wasn’t convinced they were doing anything. With my previous babies, my water had always broken either before labor began or at the start of active labor, so I kept waiting for that to be the clue that this was the “real thing”.

At 4:00am, Joel really felt like we should call Rose Marie, as he said he thought this seemed more serious, and he did NOT want to wait until it was too late! So I  called Rose Marie, and I told her I still wasn’t sure this was “it”, yet Joel would feel better if she came, but she didn’t need to rush. The contractions were starting to get a bit more of an “edge” to them that took my breath away, but I still felt like I could make myself talk through them, though I preferred not to. Another sign I should have paid attention to!

Within 15 min of calling Rose Marie, all of a sudden things kicked in with a vengeance. Up till now I had still been puttering around, but hadn’t gotten birth stuff out yet, as I had gotten it all out and then had to put it all away a few nights before. I wanted to make sure I was in REAL labor before getting everything set up again, and figured I could do it in between contractions as a distraction. Well, that’s not how things happened. Labor went from being “not sure this is it” to “we’re in seriously active labor” in a few minutes! Joel called Rose Marie back and told her to step on it, and then he promptly called Lynelle (my birth assistant who was planning to assist Rose Marie with our birth-she lives less than five minutes away) and told her to come. I think it was around 4:30am when Joel called Lynelle, and boy did she know how to get over to our place in a hurry! Joel said he has never in his life been so happy to see Lynelle walk into a room, and it was just in time.

By this point my contractions were one on top of another, and I felt like I didn’t have any time to collect myself, catch my breath or get a break in between. Joel kept encouraging me to breathe through them (he didn’t want me pushing!), and I was leaning over the birth ball squeezing his hands for all I was worth, just praying that God would make it stop so I could catch my breath. Lynelle quickly realized things were serious, and started pulling all the birth supplies together. All of a sudden I told them there was no way I could keep from pushing any longer. It had been taking everything I had to blow through contractions, and I was done. I distinctly remember saying “you all are just going to have to catch this baby ‘cause I can’t keep him in any longer!” Lynelle calmly replied that everything was okay, and with the next contraction my water broke. Now I can laugh about it-that was the clue I had been waiting for all along to tell me if I was actually in labor! With the next contraction Lynelle could see his head, and she did an awesome job of coaching me through as I tried to breathe him out. Right at the point his head was delivering, Rose Marie walked in the room! Lynelle started to move out of the way, but Rose Marie just smiled and said it looked like she was doing a great job, so she might as well continue. Rose Marie guided Lynelle through the rest of her “first catch”, and the official birth time was 4:56am.

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Those first moments after birth…

I can still remember the absolute relief that comes from being finished, and laying down with my baby on my chest. He cried just enough for us to know he was great, and then he snuggled on my chest, and we all exclaimed over his head full of strawberry blonde hair-that was a surprise! We had a really special next hour or so as we reflected over the crazy labor, the special-ness of the unplanned “first catch” for Lynelle, Rose Marie’s perfect timing, and Joel’s relief that he didn’t have to do this birth alone. We had invited another family friend to be present at the birth, and sadly she didn’t make it time, but her sweet & joyous spirit added to the atmosphere in the room as Joel fixed breakfast and baby Darius had his first meal. Thanks for coming, Mary!

And then it was SO amazing to call my parents and tell them that their grandson had arrived! Having them able to bring our oldest two over first thing that morning was so special. They were able to watch the newborn exam, meet our midwives, and see the children as they delighted in meeting their new sibling. It was the “icing on the cake” to have them around, and able to snuggle their newest grandbaby that morning, before they had to leave that afternoon to catch their flight home.

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Yoanna & Matthias and Grandma & Grandpa meeting baby Darius. Yoanna was delighted to help Lynelle give him his first bath!

We had struggled with finding the right name for our little guy, and settled on Darius Rafael just a few weeks before his birth. Darius means “Upholder of Good” and Rafael means “God is Healer”.  It is our prayer that our little son will grow into a man who does good, and is used to provide God’s healing to others. He checked out at 8# 10 oz, and measured 20 in long. Matthias was absolutely delighted to have a baby brother, and they continue to have a special relationship as brothers.

Here’s a few more snapshots of Darius’ “birth” day…enjoy this glimpse into our little family’s life, and feel free to check out the birth stories of our girls, Talitha & Yoanna.

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Big sister Talitha was pretty excited to wake up and find that baby brother had “come out!”

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Rose Marie checking baby out

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Our amazing birth team-thanks so much for everything!!