Empowering Yourself for the Journey: A Guide to Prepare for Your Birth

Preparing for the birth of your child is an exciting and empowering experience, but it can also be overwhelming. There are so many things to think about and prepare for, and it's normal to feel a little unsure about what to expect.

I know how important it is to feel confident and prepared for birth. That's why I've put together this guide to help you prepare for this incredible journey in an intimate and respectful way

• Educate yourself: Take the time to read books, attend childbirth classes, and talk to other moms about their experiences. The more you know, the more empowered and confident you'll feel.

• Create a birth plan: A birth plan is a document that outlines your preferences for labor and delivery. It can include things like pain management options, who you want in the room with you, and how you want to handle unexpected situations. Creating a birth plan can help you feel more in control and prepared for the big day.

• Find a supportive care provider: Your care provider can make a big difference in your birth experience. Look for someone who listens to your concerns, supports your preferences, and encourages you throughout the process.

• Practice self-care: Taking care of yourself during pregnancy is essential for a healthy birth. This can include things like getting enough sleep, eating a healthy diet, and practicing relaxation techniques like yoga or meditation.

• Consider hiring a doula: A doula is a trained birth professional who provides emotional and physical support throughout labor and delivery. Having a doula can help you feel more supported and confident during this incredible journey.

• Pack a hospital bag: Make sure you have everything you need for your hospital stay, including comfortable clothes, toiletries, and any items for your baby.

• Prepare your support team: Talk to your partner and any other support people about their role during labor and delivery. Make sure they know what you want and how they can best support you.

Preparing for birth is an intimate and respectful process that requires time, attention, and self-care. By finding and knowing what works for you, you can feel confident and empowered as you embark on this incredible journey. Remember, you've got this!

In health,

Dr. Shirley

Reflections from a C-Section Mama During International Cesarean Awareness Month

April is International Cesarean Awareness Month and as a c-section mama and member of International Cesarean Awareness Network (ICAN) myself, this month holds a lot of significance for me. 

Why is cesarean awareness important?

In the United States, 1 in 3 women will have a cesarean birth.  While a cesarean can be a life-saving surgery for both moms and babies, cesareans do also come with real risks that are rarely talked about.  International Cesarean Awareness Month is organized by ICAN and focuses on raising information around cesareans including reducing preventable cesareans, supporting cesarean recovery, and advocating for vaginal birth after cesarean (VBAC). 

The World Health Organization (WHO) consideres the “ideal cesarean rate” to be 10-15%.  In the US, in 2021, our cesarean rate was 32.1%.  The rate of primary cesareans* in the US in 2021, was 22.3%.   According to the WHO, cesarean rates have risen worldwide from 7% in 1990 to 21% today.  These rates are predicted to increase throughout the decade. 

Some facts from ICAN’s website:

·      It is estimated that almost half of cesareans performed could be prevented safely.

·      Preventable cesareans may be responsible for up to 20,000 major surgical complications each year.  These complications include sepsis, organ injury, and hemorrhage. 

·      Cesareans can be “family friendly” depending on the providers and hospital protocols.

o   A “family friendly” or gentle cesarean can include two support people in the OR (partner and doula, family member, birth photographer, etc.), immediate skin-to-skin contact in the OR, unrestrained arms, music of choice, immediate breastfeeding, partner involvement in the OR, clear drape, etc. This cesarean gives the family as close to a vaginal birth experience as possible. 

·      Many families do not know options exist regarding VBAC, family friendly cesarean, and more and therefore cannot advocate for themselves.

2023 Theme for Cesarean Awareness Month: “You Have Options”

To me, this theme is such an important topic of discussion.  Many people still assume that “once a cesarean, always a cesarean”, when in fact, 60-80% of women who have a trial of labor after cesarean (TOLAC) will have a vaginal birth!  For many, a vaginal birth after cesarean carries less risks than a repeat cesarean does.   When planning a VBAC, it is important to find a provider that is not “tolerant” of a VBAC, but “supportive”. 

Uterine rupture is a real risk of a VBAC; however, uterine rupture occurs in less than 1% of those laboring after a cesarean with a low transverse incision.  Evidence shows that risk of uterine rupture decreases with each VBAC.

A vaginal birth after multiple cesareans is possible- and for many, low risk! 

Ultimately, you decide what is best for you and your baby.

You have the RIGHT to informed consent and informed refusal.  Informed consent is being given an unbiased discussion on all of the benefits, risks, and alternatives of the proposed treatment or procedure and you are able to choose to consent freely.  Informed refusal is being given the unbiased discussion on all of the benefits, risks, and alternatives of the proposed treatment or procedure and you choose to refuse.  Unfortunately, it is VERY common in the medical community to feel bullied or coerced into a decision.  This behavior is unethical and often leads to trauma.  Consent forms in a doctor’s office or hospital DO NOT replace a discussion on the benefits, risks, and alternatives. 

My Story

I planned a homebirth with my oldest son, Otto.  I hired two midwives and a doula to be at his birth.  Soon after my midwives arrived, we learned that he was experiencing heart rate decelerations with contractions.  This can be normal- his heart rate was not dropping too low and was coming up quickly after the contraction ended.  I made the informed decision to continue to monitor it at home and try some different positions.  A few hours later, his heart rate dropped lower than it had been and didn’t come up as quickly, although it did come up. I asked my midwives to be checked and decided to drive to the hospital for additional monitoring and support, if our baby needed it.  I was 4cm dilated.  I knew that my body had quite a ways to go and a first time mom pushing could be longer and harder on the baby.  I do have his full birth story on my podcast (Delivering Strength) and will spare the details for now, but ultimately, he was born via unplanned cesarean.  I hate to call his birth an emergency cesarean as we were able to calmly go into the OR and I was not put under general anesthesia. 

Just about 2 years later, I found myself 33 weeks pregnant with our second baby.  I was planning a homebirth and was still working with hospital-based midwives.  At this appointment, I had planned to tell my hospital-based midwife that I was planning to have a homebirth, but the appointment went sideways.  While she meant well, she ended up saying to me “you will need to start to think about the possibility of getting to 41 weeks and deciding if you want to be induced with Pitocin or have a repeat cesarean.”.  WHAT?!  Ultimately, I did not tell her that I planned to have a homebirth and did not return for future appointments.  My son, Rhys, was born at 42 weeks + 1 day gestation in the comfort of our home after a 3.5 hour labor. 

I had a second HBAC (homebirth after cesarean) in July 2022 with my daughter, Adeline. 

While I am truly honored to work with every patient that walks into my office, I have a special passion for working with women recovering from cesarean and preparing for a vaginal birth after cesarean as I have walked these journeys myself. 

Xoxo,

Dr. Candace

*primary cesarean= cesarean that is performed for the first time on a pregnant woman. 

Preparing Your Pelvis for Birth

When it comes to pregnancy, there’s a lot of information and focus on mother’s health (for herself and baby), what to buy for the nursery/baby, and planning for baby…but what about how to prepare for birth itself? Did you know there are things you can do to help feel more comfortable during the 3rd trimester and help prep your body for labor? One of the best things you can do to prepare for labor is to help your pelvis get ready for birth. But you might be thinking: doesn’t this happen naturally? Yes and no. Birth and labor are natural, however, our modern lifestyles can interfere with normal movement and function of our body, especially the pelvis. Prolonged sitting, repetitive movements, muscle tension, joint restrictions, previous injuries, and even stress can interfere with how the pelvis moves and functions and may cause issues during pregnancy and labor. So what can you do? Here are a few tips to help you prepare your pelvis for birth:

1.      Stay active! Movement is essential for healthy pelvic function. Avoid sitting for prolonged periods. Incorporate more movement including walking, swimming, prenatal yoga, and exercising.

2.      Practice better sitting posture and habits: Most of us sit more than our pelvis was designed to sit. While jobs and driving may affect how much we sit, we can modify our sitting posture, making sure to sit up over our sit bones and keep good, aligned posture (think not rounding your back, slouching, or getting “text neck”. Be sure to get up at least once an hour to move and stretch. Try sitting on a balance ball or stability pad or kneeling chair.

3.      Stretch! Yoga and pelvic specific stretches are great ways to keep your pelvic joints and ligaments mobile. Try gentle hip and pelvic movements sitting on a balance ball. Deep squat stretches are very important, too (supported with a ball or small stool are great modifications especially later in pregnancy). Pigeon or modified pigeon stretches help to loosen the pelvic joints and stretch the pelvic floor.

4.      Strengthen! Strength of the muscles supporting the pelvis (including glutes) is important. Squats not only stretch tight tissue but also can strengthen stabilizing muscles for the pelvis. Shin box get-ups and glute hip hikes are great, too.

5.      Get adjusted! Prenatal chiropractic care helps to keep your pelvis moving and identify possible issues or imbalances that may affect pregnancy or labor. Restrictions of the pelvic region not only can cause pain and discomfort but can also affect optimal nerve flow to reproductive organs and lower extremities. Pelvic restrictions can pull on soft tissue and may affect baby’s position. Tension in the body along with nerve interferences may

6.      Get a massage! Massages help to loosen tight soft tissue and can reduce stress and tension in your body.  Not only does this provide relief to sore, tight, achy muscles, but also can loosen the pelvic area and help the body prepare for labor. Plus, it can help relieve stress which may help balance pregnancy hormones.

7.      Try perineal massage: Starting about 4-6 weeks before birth and performing perineal massage at least several times per week may help. This technique may help the soft tissue in that region to prepare for the stretching that occurs during labor which may reduce pain and prevent tearin or the need for an episiotomy. Check out https://hermanwallace.com/blog/perineal-massage-for-childbirth for more information.

8.      Check out Spinning Babies and The Miles Circuit: These resources have wonderful information and stretches to help reduce pelvic tension. They also have information that may help if baby is not in an optimal position for birth. Check out https://www.spinningbabies.com/ and http://www.milescircuit.com/the-circuit.html for more information.

Note: these are suggestions and do not replace specific professional advice. If you are experiencing any pain, issues, or complications during pregnancy, consult your healthcare provider.

Want more information? Be sure to check our Prepare Your Pelvis for Birth class next month on Friday December 2nd! It’s free and open to anyone preparing for birth (you don’t have to be a patient to attend). Contact the office to register.

We’re here to support you at any stage of pregnancy and postpartum. Wishing you all the best as you prepare to meet your new baby!

In health and blessings,

Dr. Abbey

Preparing Your Body for Labor and Birth

Your body is not only preparing for childbirth, but your mind is too! The third trimester might feel the longest and busiest. The idea of labor comes more to mind and it can be overwhelming, especially if it is your first baby. Thoughts about being tired, in pain, finding help or just simply being ready can wear you down. 

Mama, we got you! These ideas will help you to physically and mentally prepare for birth. Even if you check a few of the list, it will help to make you feel empowered and as ready as you can be. You got this! 

Take a Class

Childbirth Class: This is one of the most important things that you can do to prepare for the delivery of your baby. There are a variety of classes available,however  they mostly cover breathing, relaxation techniques, labor positions, pain relief options and more. You will also get knowledge about your body's anatomy and understand the process of body changes, Braxton Hicks, contractions and cervix dilation. During this time you can also connect with your partner and with other mamas out there. Ask questions, connect and learn. 

Breastfeeding Classes: If you are looking to breastfeed, taking breastfeeding classes during your prenatal period is extremely important. It will provide all the information about the basics of how lactation works, what's normal, and how to know your baby is getting enough. You will hear about the most common challenges so you know what to look out for. 

Hypnobirthing Classes: During labor, your body produces a hormone called oxytocin which is the hormone in charge to stimulate contractions and dilation of cervix. When stress hormones are present, such as adrenaline, it can slow labor. Hypnobirthing can help you manage stress hormones and reduce anxiety, which can lead to smoother and calmer birth. 

Self Care

Women’s bodies know what to do at the time of birth - the shape of pelvis, the strong muscles, the hormones and more work together to help bring the baby Earth side. However, during the physiological changes, your body can experience some discomfort and even pain at times. Regular chiropractic care, prenatal massages and pelvic floor PT can help restore movement in your body, making your prenatal period and even birth an easier and smoother one. 

Eat Properly

During pregnancy major cravings increase. Some of those cravings might not be as healthy as we would like them to be. Filling your body with healthy meals is another way to prepare for childbirth. 

Stay Active

Labor can be stressful to your body. Getting regular exercise during pregnancy can help your body to be strong and working properly. It can help decrease pains and aches as well. By creating a routine with your favorite activity such as swimming, walking, prenatal yoga, prenatal fitness classes or going for a run, improves your body strength and stamina. Try to at least do 30 minutes of exercise a day for 4-5 days a week. 

Write a Birth Plan

Labor and delivery can be very overwhelming for you. Your mind is focusing on giving birth to your child. For this reason, you should talk to your birth team and let them know what you would like to do during this time. Whether it is an unmedicated birth, holding the baby right after birth, delaying cord clamping, birthing positions and more. Let them hear your voice! 

Hire a Doula

Creating a support system is essential. Talk to family and friends to help you with house chores, such as cooking, walking the dog, doing the laundry and more. Extra help will never harm you!  If you don't have the help that you are looking for, consider hiring a doula for extra support during labor and postpartum. 

Rest

The months ahead of you will be busy, but wonderful! It is not selfish to make sure you are getting enough sleep during your second and third trimester. It can help with your mood, stress, anxiety and overall health.  Don’t feel guilty for taking naps here and there. Afterall, you are growing another human being!

Ask Questions! 

It is normal to worry and have too many questions. Don;t be afraid to speak up and ask your birth team, healthcare providers, the person who leads your birthing/breastfeeding classes and even your friends! NO question is a silly question. 

If you need support, know our team has a list of resources that can help you to be as ready as you can be for birth. Let us know how we can help!

Xoxo,

Dr. Shirley

5 Tips to Prepare for Postpartum

There is so much emphasis on nurseries and “must haves” for baby, but what about for you, mama?  Giving birth is an incredible event and postpartum is no joke.  I am currently 39 weeks pregnant with my third baby, preparing for another postpartum experience.  With each baby, I have learned more about my needs and the needs of my family during this sacred time.  For this baby, we have bought very few things and while we have everything we need, we didn’t even bring out everything from storage.  We have spent much more time preparing for postpartum.  Here are 5 things I am preparing for this postpartum period:

Prepare to Rest

Are you familiar with the term “lying-in” period?  The lying-in period is a time for you to rest and bond with your baby after birth.  I have seen a few different suggestions for this:

·      5-5-5 Plan: 5 days in the bed, 5 days on the bed, 5 days around the bed.

This means: 5 days totally in the bed, meaning you should only be doing activities that can be done from your bed (feeding your baby, reading, napping, sleeping, watching tv, LOTS of skin to skin, etc.).  5 days on the bed, meaning majority of your time should be in the bed, but you can start moving around more.  The suggestions I have seen are 30 minutes up for every 2 hours in bed.  5 days around the bed, meaning no big outings!  Try to stay close to home, close to your bed, resting!

Sadly, our culture in America does not set us up for this and I did not honor the lying in period as I wish I would have after the birth of my older two children.  With this baby, I do plan to give the 5-5-5 Plan a try.  It is going to take lots of help and preparation, which is where the rest of my list stems from J  

·      1 Month or 40 Days (6 Weeks) of lying-in:

1 month (or 40 days/6 weeks) of staying in or close to the home resting as much as you can while feeding your baby, napping, sleeping, and lots of skin to skin!

Prepare to Heal

Whether you had a vaginal birth or a cesarean birth, please give yourself time and space to heal. 

·      After birth, the space between your anus and vagina (the perineum) will be sore and can typically take 3-6 weeks to heal.  Some people experience tearing of various degrees and will also be healing from tears.  Try using a perineal bottle (plastic bottle) with warm water and patting the area dry instead of wiping.  There are special ice packs (either purchased on your own, from the hospital, or in your homebirth kit) for the perineum or you can make your own “padsicle” using witch hazel, aloe vera, and herbs.  (Google “padsicle” and a ton of recipes will come up!).  Herbal sitz baths can also be lovely and those can also be used to create your own padsicle as well!  Earth Mama has an organic clean sitz bath that can be found online and in many stores!  I was gifted Earth Mama sitz bath and I have some homemade padsicles in my freezer ready to use in the coming weeks!

·      If you had a cesarean, your cesarean scar will be most sore the first few days after birth, but the soreness can last for a few weeks.  Be sure to follow your providers recommendations on caring for the incision and signs of infection to look out for.  Tips that no one told me after my cesarean birth are to hold the incision gently with my hand when going from sitting to standing, rolling in bed, coughing, sneezing, etc.  This helped tremendously with pain once I found it!   Once the scar is healed (typically around 6 weeks postpartum).   You can begin doing some cesarean scar mobilization.  Check out my cesarean scar mobilization video here. 

·      General aches and pains postpartum are common and can last anywhere from a few days to a few weeks.  Contact your care provider if you have any concerns about aches and pains you are feeling! 

o   Aches and pains in neck, back, or other joints:  if you can’t get to your chiropractor or they can’t get to you, you can try the following things:

§  Heating pad (or ice) on the affected area- whichever feels best!

§  Improve your posture when holding baby, breastfeeding/chestfeeding, and sleeping

o   Uterine pains aka “afterpains”: the uterus grows so much during pregnancy and contracts and relaxes postpartum in order to go back to its normal size.  Afterpains may feel like period cramps or may be stronger like labor contractions.  If you have given birth before, it is likely that your afterpains will be stronger.  Nipple stimulation (breastfeeding/chestfeeding and pumping) causes uterine contractions so you may notice an increase in afterpains when feeding your baby or pumping.  A heating pad may help relieve the discomfort from afterpains. 

·      There are a lot of changes that can happen to the breasts postpartum.  If you are breastfeeding, you should not be experiencing any pain with breastfeeding.  If you are, please please please reach out to a lactation consultant!  Engorged breasts can be common during the early postpartum period and be quite painful!  Engorged breasts tend to feel hard and the skin may also be warm.  Try feeding your baby or hand expressing some breastmilk.  You may find comfort in using a warm compress along your shoulder/above your breasts or below your breasts before expressing milk.  Breastfeeding is all about supply and demand so it can be a little dance between relieving engorgement and stimulating more milk production.  The more milk you express, the more milk your body will make.  Avoid wearing a tight bra if you are experiencing engorgement.  If you do not plan to breastfeed or discontinue breastfeeding, you may also experience engorgement.  It will resolve in a few days, however you still would want to avoid clogged ducts (that could potentially turn into mastitis) so I also would suggest reaching out to a lactation consultant.  Overtime, your body will stop making milk if you don’t breastfeed or pump. 

·      Constipation is common postpartum.  There are various factors that play a role in this: weak abdominal muscles, pain medications that you may be on, dehydration, and nerves (it is common to be afraid to poop postpartum!).  Try eating nutrient high-fiber dense foods and drinking lots of water.  It’s not a bad idea to keep a stool softener around, too.  If you are breastfeeding, be sure that what you are taking is safe for breastfeeding!

Prepare to Nourish Yourself

This is one thing that my husband and I really did right before the births of our first two babies.

·      Meal trains are a great way to organize home-cooked meals delivered to your door by loved ones.  They can be created on Facebook pages, emails, or even by the Meal Train website!  You can set one up for yourself or have a friend take the lead.  Be sure to tell your loved ones if you have any food sensitivities or allergies. 

o   Note:  this option may not be the best if you or your family members have food sensitivities, unless your loved ones are versed in cooking to accommodate those.

·      Crock pot meals.  Have you seen New Leaf Wellness?  This takes meal prepping to a whole other level.   This blogger has a meal plans that provide a grocery list, recipes, and labels for freezer Crock Pot meals.  All of the ingredients go into a labeled freezer zip-lock bag and frozen until used.  Pick out a meal the night before, let it thaw, and put it into your Crock Pot to have a nice hot meal in 6-8 hours.  For me personally, this was the best thing I did to plan for postpartum.

o   Note:  this will save you time and money in the long run, but requires a lot of time to prepare.

·      Freeze meals, soups, and stews ahead of time.  During the last couple of months leading up to your guess date, make a little extra of what you are cooking every once and a while and freeze half.  Chili’s, soups, stews, and bone broth are great to have on hand.  You can also do this with homemade breads (banana bread), egg casseroles, pot roasts, etc.  Look into proper preparation to freeze each of these and be sure to label everything with the freeze date.   

o   Note:  this option is great for those who meal plan!

·      Stock up on favorites.  If there are household favorites (think almond butter, Rx bars, coconut oil), grab some extra at the store leading up to your guess date so that you don’t run out in the first month or two postpartum.  Think about what quick snacks you would like to have on hand, especially if you are planning to breastfeed. 

Preparing for this postpartum period, we did a mix of our favorite Crock Pot meals from New Leaf Wellness and freezing meals ahead of time!  My goal was to have 30 meals + muffins and pancakes for quick breakfasts in the freezer before baby came.  I haven’t done a count lately, but we will see what we have before he or she does arrive :)

Prepare to Say “Yes” to Help

Things I am planning to say “no” to during my lying-in period?  Laundry, housework, and cooking meals.  We will have anywhere between 15-30 meals in our freezer that my husband can pop into the crock pot or into the oven to ensure our family has nutritious meals to enjoy. 

I am planning on letting friends and family come over and play with my “big kids” and help out with household chores. 

Prepare Your Postpartum Team

Remember how I said America does not set us up for a lying in period postpartum?  Depending on how your labor and birth went, how your baby is doing, and how breastfeeding/chestfeeding is going, you may need to leave the house for appointments or finding yourself looking for referrals.  I suggest building your referral list during pregnancy.  Some people to consider having on your postpartum team (outside of your midwife/OB and pediatrician):

·      Chiropractor

·      Pelvic Health Physical Therapist

·      Lactation Consultant

·      Pediatric Dentist (in case of tongue/lip tie)

·      Craniosacral Therapist

·      Postpartum Doula

·      Mental Health Therapist

Wouldn’t it be amazing if there were providers that came to your home?  Fortunately, in Cleveland, there are a few pediatricians, chiropractors, and lactation consultants that will come to your home during the immediate postpartum period. 

Here are a few:

·      Primrose Newborn Care:  Dr. Madden is a neonatologist that does newborn well-baby medical home visits

·      MamaBird Hendry: Madison is a breastfeeding educator offering in home breastfeeding support! 

·      Cleveland Chiropractic and Integrative Health Center: yepp!  Our office provides in-home care for mamas and babies after birth! 

How are you preparing for postpartum? 

Xoxo,

Dr. Candace

Questions on preparing for postpartum?  When Dr. Candace returns from leave, she will be offering custom consults on prenatal support, labor support, and postpartum preparation.  Send her an email to get on her waitlist.

Preparing For Labor + Birth as a Third Time Mom

I get asked all the time how patients can prepare their body for birth and what things I am doing to prepare my body for my third birth.  This post should not be considered medical advice, but simply things I am doing to prepare for birth that are backed by research.  Please consult your care provider if you are interested in incorporating any of these into your own birth preparation.  

Chiropractic Care

Coming from a chiropractor, this one may be obvious.  Chiropractic care throughout pregnancy is an effective way to prepare your body for labor and birth.  It helps align the joints of the pelvis which allows the uterus to align, helping the baby get into the ideal position for labor and birth.  Webster Technique is a specific series of adjustments that the providers at our office utilize.  When the baby is in an ideal position, it can decrease labor and birth times.

Find a chiropractor that will also give you stretches and exercises that you can do at home to prepare your pelvis for labor and birth!

Acupuncture

Research shows benefits of acupuncture to help stimulate labor and shorten labor times.  It does this by ripening the cervix (softening and opening the cervix).  Acupuncture and acupressure can also help manage pain during labor!  As a provider that also practices acupuncture, my general recommendation for acupuncture near the end of pregnancy is 1-2x/week beginning around 36-37 weeks. 

Dates (the fruit!)

Dates are commonly eaten near the end of pregnancy around the world as part of preparation for labor and birth!  The general recommendation is around 75g of dates (3-4 medjool dates, 6 petite noor dates) per day for 4 weeks before your estimated due date.

Research compared women who ate dates the last 4 weeks of pregnancy and a group that did not. The women who ate dates the last 4 weeks of pregnancy were more likely to go into spontaneous labor, were less likely to have labor augmented, experienced more cervical dilation when admitted to the hospital, and had shorter first stage of labor than those who did not consume dates.

For most people, dates are safe to eat during pregnancy. Take caution if your care provider has advised you to limit your carbohydrate intake and/or if you have been diagnosed with gestational diabetes.

I am not the biggest fan of dates (and the majority of my patients are not either!). I think they are way too sweet and I am not a fan of their texture. During this pregnancy (and my last), I made big batches of bacon wrapped dates and have been eating 1-2 at a time throughout the day.

Perineal Massage

The goal to perineal massage is to reduce perineal trauma during birth.

Benefits of perineal massage during labor and birth:

·      Slightly longer (but normal) 2nd stage of labor- this allows the perineal tissues time to stretch (this is a good thing)

·      Greater sense of control during childbirth- people report feeling more prepared physically and psychologically

Benefits of perineal massage in the postpartum period:

·      Less pelvic floor muscle and anal sphincter damage

·      Less perineal suturing (stitches) needed

·      Less acute and chronic pain

·      Greater sexual satisfaction and sensation

·      Greater likelihood of orgasm

There are no reported risks or adverse outcomes with perineal massage.  This means that it does not “overstretch” the perineal and vaginal opening, there is no increase in postpartum urinary or fecal incontinence, and there is no decrease in sexual satisfaction postpartum

You can begin doing perineal massage around 34-35 weeks gestation.  It is recommended to do daily, however at least 4x/week is the minimum recommendation.  You may want to use a water- based lubricant.

How it’s done:

·      First- wash your hands and trim fingernails!

·      Find a comfortable position to reach the perineum

·      Insert both thumbs or index or middle fingers into the vaginal opening.

·      Inhale and as you exhale:

o   Press toward the back wall of the vagina (toward the rectum) and hold the stretch until feeling a slight numb or tingling sensation.  Continue to breathe through this. 

o   Glide your thumbs or fingers out to the side of the wall of the vagina (remember to breathe!)

o   Repeat this massage in this slow “U” shaped path for up to 5 minutes

Tips for perineal massage:

·      Use a warm or cold pack on the perineum afterward to reduce soreness

·      Increase the pressure you are using as you feel comfortable doing so over the course of a session or over the course of a few weeks. 

Red Raspberry Leaf Tea

Red raspberry leaf tea comes from the leaves of raspberry plants!  It has been used for centuries to support healthy pregnancy and tonify the uterus to prepare for birth.  It is high in vitamins A, B, C, and E and contains many minerals that nourish the uterus and help it contract and relax. 

Research has found that consuming red raspberry leaf tea during the end of pregnancy has been associated with “easier” labors. 

Many midwives and herbalists recommend drinking RRL tea daily (1 cup) around the second half of the second trimester, increasing to 2 cups/day during the mid-late third trimester. 

Xoxo,

Dr. Candace

Our office is now offering a *FREE* Quarterly Preparing Your Pelvis (+ Pelvic Floor) For Birth Workshop!  Dr. Abbey will be leading the next one in September (Friday September 9th at 6pm!).  Registration is available online.

Top 5 Pregnancy Myths Busted

#1. C- section is EASIER than Vaginal Birth: There is often a misconception that because your birth was surgical that it was easier- especially if you scheduled your C-Section. Surgical birth has become very safe and common, so many people assume that the recovery is easy, However, Caesarean birth is still major abdominal surgery and will generally have a longer recovery time. If you experience a C-section, remember to be gentle with yourself and give yourself plenty of time to rest and recover. Not only are you healing from the demands of pregnancy but you are now healing from major surgery as well

#2 C -sections will prevent urinary incontinence: While the statistics show that there is a greater incidence of stress urinary incontinence associated with vaginal birth than with a planned C-section, women who undergo a planned C-section can still experience urinary incontinence. According to a recent study published in the May 2021 issue of the medical Journal Medicine, more than mode of delivery was associated with risk of Stress Urinary Incontinence. For first time mothers, pre-pregnancy BMI, Diabetes, Abortion, Newborn Weight, Use of Epidural Anesthesia and Duration of Second Stage of Labor all were significant factors in development of Stress Urinary Incontinence. An honest conversation with your healthcare provider will allow you to make the best decision for your birth.

Reference:

Gao J, Liu X, Zuo Y, Li X. Risk factors of postpartum stress urinary incontinence in primiparas: What should we care. Medicine (Baltimore). 2021;100(20):e25796. doi:10.1097/MD.0000000000025796

#3 Sex will hurt the first time after birth- While this can be the experience of some women, it is definitely not the norm. Just as before baby, intimacy is more than just intercourse and your biggest organ of intimacy is your brain. Communicate any fears to your partner and make sure that you take physical intimacy slowly. Give yourself enough time to heal and find new ways to be physically intimate along the way. Massages, warm baths, have a good laugh and/or an enjoyable dinner, plenty of time to relax can help. Remember that each woman heals differently after birth and give yourself plenty of time to work your way into a physical relationship. If the above suggestions are not working or you feel something is really off, this would be a great time to schedule an evaluation with Pelvic Floor Physical Therapy.

#4 Labor has to be a painful and awful experience- Watch any shows on television and you will see birth as a painful and tortuous experience. Unfortunately, we are not shown how many labors are a lot of work but can be peaceful and rewarding. There are many childbirth preparations classes available that show that by physically and mentally preparing for a birth, you can have a wonderful experience. Chrissy’s personal favorite resource is Ina May’s Guide to Childbirth by Ina May Gaskin because more than half the book is dedicated to affirming and uplifting birth stories that help combat the negative images of birth that we are surrounded with by society.

#5. Just because your Healthcare Provider clears you for activity at your 6 week check up does not mean everything has to be back to “normal”- Post-partum recovery takes much longer than 6 weeks! Your body is amazing when it grows (and delivers) a human, Post-Partum recovery can take up to a year especially if you are breast feeding. It is never too late to help with post-partum issues. As a physical Therapist, I have helped women more than 10+ years post-partum deal with issues that happened

during or after their pregnancy. If you are struggling with back pain, incontinence, pelvic pain or heaviness, difficulty getting back into an exercise routine or difficulty exercising, schedule an appointment to see Chrissy, our Pelvic Health PT, to help you speed up your healing process

Chrissy Frey, Pelvic Health PT

Laugh without Leaking

Having a great time with friends laughing about the latest crazy adventures of motherhood? Have you ever laughed so hard that you “peed your pants’? While that is a common expression and experience for many women, it is not “normal.” Many women think that just because they have been pregnant or that they are getting older that urinary incontinence is a normal fact of life that they just have to live with. After all, it happens to everyone, right?

Urinary Incontinence (which is the leaking of urine that you cannot control) is not a normal part of aging or a normal lasting side effect of pregnancy or childbirth. Two of the most common types of urinary incontinence include Stress Urinary Incontinence and Urge Urinary Incontinence. Stress Incontinence is leaking when you are walking, bending, lifting, sneezing, coughing, or laughing. Urge Urinary Incontinence which is the sudden “urge” to urinate even if your bladder is not completely full. Having both of these types of symptoms? That is called Mixed Urinary Incontinence -yes, the “best” of both worlds- leaking with activity and /or feeling of a strong urge to urinate frequently.

Despite these symptoms being common, (nearly 1 out of 3 women have some type of incontinence symptoms during their lifetime) there are many things that can be done to decrease or eliminate incontinence, especially if treated early.

*Lifestyle changes can be extremely effective- looking at behavioral factor and nutrition can decrease symptoms.

*Bladder Retraining strategies- no “just in case” going to the bathroom, keeping a bladder diary for a few days.

*Looking at exercise, movements and lifting patterns- increased intraabdominal pressure can put pressure on pelvic floor muscle causing increased leakage

*Pelvic Health Physical Therapy to address any muscle weakness or tightness in Pelvic floor causing urinary leakage.

If you have these symptoms and are ready to address them, come see our physical therapist, Chrissy, for a physical therapy evaluation. Chrissy partners with each client to develop an individualized holistic approach to help you mange and eliminate your incontinence issues so you have the freedom to laugh as hard as you want- without fear!

Appointments with Chrissy can be scheduled online via our website or by calling 216-952-3830.