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Filtering by Category: Doula

Episiotomy and Natural Tear

Rachel O'Reilly

Once a routine part of childbirth, an episiotomy is now recommended in certain cases only.

First and foremost: what is an episiotomy exactly?

  • An episiotomy is an incision made in the perineum - the tissue between the vaginal opening and the anus - during childbirth.

And why would you want anyone to cut your vagina during childbirth??

  • For years an episiotomy was thought to help prevent more extensive vaginal tears during childbirth and heal better than a natural tear. The procedure was also (incorrectly) thought to help preserve the muscular and connective tissue support of the pelvic floor.

Thankfully over the years research suggests that routine episiotomies don’t prevent these problems after all. The recovery is very uncomfortable since it requires a deeper layer of tissue to be stitched. And it’s often said that the incision is more severe than a natural tear would have been. One midwife helped me understand this by explaining trying to tear or rip a piece of fabric with my bare hands. She said it’s very challenging and takes a lot of effort. But, if you just snip a little bit of the fabric with scissors and then pull it’s a breeze. The incision in your pelvic floor tissue reacts very similarly. Once you cut the tissue it gives much more leeway to cause a deeper longer tear from the pressure of your baby making its way out. OUCH. NO THANK YOU.

Just like any medical intervention during birth, I’d prefer something like an episiotomy to be done only when it is really necessary. Often during emergency cases your healthcare provider will need the extra space at the vaginal opening to allow for an easier instrumental birth, i.e. the use of forceps or vacuum extraction. A few other reasons I’ve heard of episiotomies being absolutely necessary are if:

  • Your baby is in an abnormal position and needs more assistance to make it out

  • Your baby is very large (fetal macrosomia)

  • Your baby needs to be delivered quickly

Now that episiotomies are not a routine function in birth (please ask your healthcare provider what their percentage of episiotomies are, some still practice them more frequently than I’d like to see) there are a few things that many healthcare providers suggest doing in preparation for birth and during the birth process to lower the chances of needing an episiotomy.

Once you are 34 weeks it’s common for your healthcare provider to recommend doing perineal massage at home. This can be an uncomfortable exercise for some, but if it can help avoid a longer, harder recovery from birth, it’s worth reaching out of your comfort zone and getting busy. Make sure to have natural lubricant near by and lay in a supported position on your bed so that you are able to reach both of your thumbs to your vaginal opening. Place your thumbs just inside and press downward toward your rectum. Hold for one to two minutes and repeat for a total of ten minutes. If you are enjoying baths in your pregnancy this is a great place to give yourself a daly perineum massage and even more effective when your tissues are relaxed and warm.

During the second stage of labor, your OBGYN, Midwife and sometimes a nurse or doula will often use a hot compress to apply pressure against the perineum and vaginal opening. Sometimes a warm oil will be used along with applied pressure to the lower part of the vagina to encourage stretching (not too warm, don’t worry!). The goal is to soften the tissue with heat to allow it to stretch easier and to avoid tearing.

What are the benefits of a natural tear?

There have been several studies conducted to show the frequency of a natural tear versus an episiotomy during childbirth. Many studies show the occurrence of a natural tear of the perineum over an intentional cut of an episiotomy during childbirth. Part of the reasoning for this is the data suggest that women who have an episiotomy do not have significantly improved labor, delivery, or recovery compared with those who do not have one (ACOG statement). Also, by foregoing a routine episiotomy, the mother has a chance to stretch the perineum during the course of the second stage of labor (the pushing phase) and may avoid any perineal damage altogether. With an episiotomy, the connective tissue, muscles, and skin are cut and therefore their strength will be permanently compromised.

I know I want to give my body the chance to do what it is naturally capable of and to be supported during the second stage of labor in a way that allows my perineum to take its time to stretch and allow my baby to enter this world with as little medical interventions as possible.

Have you ever experienced an episiotomy or severe natural tear? If so, how was the recovery for you? How long do you feel like it took to have your body feel normal again?

This brings me back to thinking about postpartum support and care after delivery. It’s essential after all types of birth, especially when your pelvic floor experiences any trauma due to tearing or cutting, to search for additional support to help heal your body from birth.

My body, my choice, my birth

Rachel O'Reilly

 Tiff Delancy

Tiff Delancy

By Aaryn Leineke

I’ll admit it. I am a bit indecisive about how I want to present this post. Should I state a bunch of facts that support how safe a home birth is? Could I suggest to others that home birth might be the best choice? Do I want to list all the reasons why a hospital birth is not right for me? Although doing all of those things might be helpful, none of those things really speak to the honest reverence I have for wanting a homebirth for my impending first child and any other children my husband and I might have in the future.  

Homebirth is instilled deep in my core, it runs through my veins and fills my body and mind with so much light and a passion I have lived for my entire life. I have photos and newspaper clippings of my mother and auntie fighting for their rights to have their own home birth and for the rights to legalize midwifery and homebirth everywhere. I have had the pleasure of watching my very own homebirth on video and ever since I can remember, I have marveled at photos of my mother working so hard to bring me earthside. She did this in her home, lovingly surrounded by those she trusted most to support her. Now, as a doula, I’ve been fortunate to assist with some incredible births at homes as well as many in hospitals.

Having a homebirth wasn’t a decision I had to think about once I became pregnant. There wasn’t any other way for me to even consider.  And when I say there isn’t any other way for me, it doesn’t mean that I’m not aware of complications that can arise in birth or even early on in pregnancy. I work very hard to stay current with my education on all of the important advances in obstetric care. I acknowledge and commend how far formal practices have come and how many lives have been saved over the years, in the last century particularly. That is precisely why, if and when I need any medical assistance, my baby and I will be taken care of both at home, with my very qualified midwife and/or in the hospital if we need to make a transfer for any reason.

One of the most frequent questions I am asked is how will my midwife know if something's not right? How will I make it to the hospital in time if I need to? What if something goes wrong? It’s actually really simple, my very qualified and licensed midwife is trained for this very thing along with countless other scenarios. She will be monitoring me and my baby continuously while in labor, just like she would at a hospital, and she will know if a transfer out of the home is needed. That decision is made well in advance in order to avoid an emergency situation, so there is time to get to a hospital to have any medical interventions that may be needed.

It is my fervent belief that if I am healthy and my baby is healthy the safest place for me to give birth is at home. And it’s the safest place for me, because home is where I feel most comfortable and relaxed and at peace and that is exactly the type of environment in which I want to bring my baby into this world. I have unshakable confidence with this decision. The real question is how can I convince anyone who is doubting me? It’s tricky because although I know what is best for me and my baby (as do all mothers and fathers), these doubts, whether they mean to or not, call into question my strength, my intelligence and my capability to make responsible decisions for myself and my baby. I know the answer is I can’t change others’ minds, but wouldn’t it be wonderful if everyone respected and celebrated women’s choices, especially when they differ from our own? This is why I will forever fight for a woman’s right to choose. And I am so thankful for my mother and aunties before me who fought, so I can choose and write my baby’s beautiful birth story.

Mama's herbal Tea

Rachel O'Reilly

By Aaryn Leineke

One of the greatest gifts I received in early pregnancy was a big beautiful jar of Mama’s herbal loose tea. It was from my dear friend Grace who I asked to be my doula for the most precious time my husband and I would have together, the birth of our first baby.

This herbal tea is a mixture of amazing and nourishing ingredients that help with nausea. Thus, the reasons it’s one of the essential products on my first trimester survival kit. It provides essential nutrients, while strengthening and toning the womb during and after pregnancy, which helps foster an ideal environment for a growing baby.

Ingredients to the special tea:

  • Organic Red Raspberry Leaf: This is the queen of herbs for women’s health. It’s medically proven to help strengthen the womb of a pregnant women and it is also reported to be effective in restoring the womb (uterus) after delivering. Drinking red raspberry tea is also great while menstruating and suffering from menstrual cramps.

  • Organic Alfalfa: Is said to ease morning sickness. It contains a wide variety of minerals including iron, calcium, magnesium, phosphorus, sulfur, chlorine, sodium, potassium, silicon, and trace elements. It is also a good source of Vitamin E, Vitamin C and Vitamin K, which is necessary for blood clotting. Many midwives advise drinking mild tasting alfalfa tea or taking alfalfa tablets during the last trimester of pregnancy to decrease postpartum bleeding or chance of hemorrhaging.

  • Organic Nettle: A nutrient loaded with magnesium, calcium and iron, which are all excellent and essential minerals to ingest during pregnancy.

  • Organic Oatstraw: Rich in both calcium and magnesium, which work together in the body, with calcium stimulating muscles to contract and magnesium relaxing them. The way these elements work in a yin-yang way is why herbalists and midwives believe that oatstraw can be particularly valuable for pregnant women.

  • Organic German Chamomile: For centuries chamomile has been used as a mild relaxation remedy.

  • Organic Rosehip: Great source of vitamin C for boosting the immune system.

  • Organic Peppermint: Great for flavor It also helps with nausea and aids digestion.

Often, I would make my tea when I got home from work, and if I steeped extra I would store it in a jar in the fridge and have it served over ice the next day. Drinking this daily was such a wonderful way to treat myself to something delicious and nutritious. It was especially enjoyed while getting through my first trimester, particularly on rainy days while snuggling with my gorgeous man and sweet pup.


You can make this at home by finding the loose tea ingredients at your local natural grocery or herb store or even find some similar products on Etsy that can be delivered to your door. I would recommend measuring a quarter cup of each ingredient in a mixing bowl, give a light toss to mix together and store in a big glass mason jar that has a screw top to keep it fresh. For taste you can go a little heavier on the peppermint and lighter on the rosehip. Be sure to keep in a cool area away from moisture and direct heat (including sunlight).

First trimester exhaustion, blues and doubts

Rachel O'Reilly

A daily challenge I faced was finding ways to connect with my baby. Connect in a way that kept me excited while believing all is still well with the growth of this little embryo. Each day I would wonder, are you still in there little June Bug?  Are you growing and will you really be my baby come June 2017?

I found it hard to stay patient and trust all was going well with my body and my baby’s growth. I kept reminding my husband that we have to be cautious and not get too attached because it was still so early, and anything could happen. I would give him the statistics of miscarriages for first pregnancies, and he’d tell me to stop thinking that way. I didn’t intend to be negative, I just wanted to stay careful, and keep a safe distance just in case we’d be confronted by any sort of disappointment. I started to feel guilty about keeping a safe distance and not letting myself get too excited. And, often, I would ask myself “when will I start feeling love and admiration for this little being?”

The signs of my first trimester appeared like clockwork, with minimal challenging symptoms. Did I feel nausea? Yes. Maybe for a week or so. Did I feel exhausted? Yes. To say I slept a lot is an understatement. However, I could get through my day-to-day activities and 9 straight hours at the office with relative ease, but as soon as I got home I would pass out. After sleeping for hours, my husband would ensure I ate dinner and made it into bed with brushed teeth and a washed face. And then we’d do it all over again the next day. I made up for years of lost sleep in just the first 3 months of this pregnancy--it was actually amazing! All of this rest felt mostly guilt free because it happened during our coldest months of fall that lead into the craziest rainy winter we’ve seen in years. So, not going outside for a workout, or not making it to my yoga class because it was dark by 5pm was okay with me. I'd find myself being disappointed here and there with my lack of physical activity. But, rest was what my body needed (there was no choice in the matter really), so I let it do just that.

Finally my 12th week hit and we had our first prenatal meeting with our midwife, which meant we were going to attempt to hear the heartbeat of our growing baby for the first time. For weeks and weeks, I couldn’t help but want that day to just hurry up and arrive already! When our midwife came into the room she prioritized listening to the heart beat before everything else. It took some time but once she found it, and we were able to give my husband some time to distinguish the difference between my heartbeat and the baby’s on the doppler, we both were in tears. It was the best feeling finally knowing it was true. We were really having a baby (le swoon).

How did you stay patient and trust everything was going well with your body and your baby’s growth?  What are/were some of the biggest fears and challenges you faced during your first trimester?

 

First Trimester Survival Kit

Rachel O'Reilly

Cherish_First_trimestest

 

By Aaryn Leineke

I’ve been lucky to have had a very easy pregnancy thus far, but I know this is not the case for every woman. Many suffer from typical and not-so-typical symptoms and my heart goes out to them. I know that when you are suffering from all the symptoms at once it’s hard to imagine how to  go on each day. How do you get up,  put makeup on or do your hair so it doesn’t look like you just rolled out of bed when you show up at work? How do you not suffer from the blues when you are now harder on your ‘type-A self’ than ever when you cannot make it to the gym and only want to eat donuts and ice cream for dinner?

You’re not alone. It is common for many women to feel the blues of pregnancy during the first trimester and what’s most important is to know your body is beginning the very challenging task of growing a baby. During these first essential months of  growth it’s no wonder it takes all the energy out of you. It’s important to listen to your body during this time by getting all the calories you need, and the vital rest your body is begging for. Feel good about heading straight to the couch with a blanket once you get home after a long day at work. You have a whole other full time job happening inside of you now.

To help you through your first trimester, here are a few must haves to keep you comfortable, happy and healthy:

Bellybelt - When I was 6 weeks pregnant I wasn’t showing but that was a week that I could not comfortably wear my normal pants. I think bloating and gas was a real thing for me, and I just needed that extra space in my pants to help me get through my day at the office in comfort. I used a rubber band, but will absolutely purchase this bellybelt for my next pregnancy to get through the first few months when the true maternity pants are not quite necessary yet.

Ginger chews - Not everyone loves these, but I’d say they’re worth a try. Only caveat is that you may never be able to eat them again if you eat them daily for the first trimester of your pregnancy.

Sea Bands - These are nausea wrist bands that I personally haven’t needed to use, but when you’re not able to cope with your day to day life due to debilitating nausea, try these out. Try anything.

Essential Oils - A couple suggested combinations I've recently heard of are ginger and geranium behind the ears or grapefruit and peppermint as well. Both combinations or use of one or the other could be tried to help with nausea.

Rest - Sleep. Just do it. Have your husband get takeout for dinner or be the meal planner during those first few months. Throw that dreaded movie or show on for your toddler so you can sneak in a nap until your partner comes home. You have to sleep. I’m a firm believer that lack of sleep will increase  all of the first trimester blues and symptoms.

Mamas tea - There are many teas that are recommended during the first trimester; mint, ginger, nettle to name the top few. But when a great friend and the women my husband and I chose as our doula made me her special mama’s tea, let's just say it was a life changer. Her sisters both made this tea for each of their pregnancies and she gave it to me as a gift as soon as I shared the news that we were expecting. The delicious and nutritious ingredients are below, (look for upcoming post all about this mama’s tea coming soon!):

  • Peppermint

  • Alfalfa

  • Red Raspberry leaf

  • Nettle

  • Oatstraw

  • German chamomile

  • Rosehip

B12 happy hour shots - Weekly B12 shots the first trimester saved me! I got mine with extra boost of folate, vitamin D (for nausea) and sometimes the extra immune boost mixer. These B12 shots help balance your moods, allow for a deeper sleep, boost energy and completely cured my nausea. I did not suffer from nausea for long, but as soon as I got my B12 shot my nausea subsided, my sleeping balanced out after jet lag from my honeymoon, and my energy increased for a few days after each shot which helped inspire me to go on that walk after work with my pup.

Dr. Shannon Wood Gallegos helped me choose the best prenatals and additional vitamins to take during my pregnancy all of which my body has received very well! See below:

Tylenol - Headaches were what I had to overcome often during my first trimester, and one day when I was ridden by a migraine my husband did some research and saw that tylenol was safe for me to take. I have taken only a few tylenol’s in the first 6 months and I’m so grateful I had them in my emergency kit.

What has brought you comfort in your first trimester? We’d love to know!

Pregnancy Myths: Not all waters break

Rachel O'Reilly

 Kimberly Gordon

Kimberly Gordon

There are many signs you can be aware of to give some inclination that early labor/labor could be starting. One very obvious sign is the infamous “water break.” Does that mean it’s the only sign you should look out for when your due date comes, (and sometimes goes)? No.

Does that mean if you are experiencing very strong signs of labor and your water hasn’t broken then you’re having “false labor?” No.

There’s the possibility to birth a baby in their fully intact amniotic sac. Its called born en caul, an incredibly rare and beautiful occurrence.

Other signs of the onset of labor:

  • Contractions, (also known as surges) - You won’t question a contraction once you finally have one. Many women experience Braxton Hicks towards the end of their pregnancy. These are great toning surges that your uterus will do without being painful, but they aren’t necessarily signs of labor. Early labor contractions can feel like gastrointestinal upset, heavy menstrual cramps or lower abdominal pressure. Pain may be just in the lower abdomen or in the lower back and abdomen. It may also radiate down the legs, particularly in the upper thighs. It’s difficult to prepare a woman, or give them an exact explanation, as to what to expect for contractions. Rest assured that once a true contraction is experience, a mother will no longer ask if it was one or not.

  • Loss of mucus plug - At the very beginning of pregnancy, mucus generated during ovulation is accumulated in the uterine cervix. As the mucus thickens it seals the cervix tightly, blocking the way for any infection from the vagina to the cervix and thereby protecting the fetus. When your cervix begins to dilate and thin out, it is possible you will lose your mucus plug; a clear sign that your body is getting ready for labor.

  • Cramping - You may feel cramping in your uterus towards the end of pregnancy which is a good sign that your body is getting ready to birth your baby.

  • Lower Back Pain - Lower back aches and pains are often felt in early labor.

  • Loose stool - Your body may create more room for your baby to enter through the birth canal.

  • Bloody show (stretching of the cervix) - You will often see this when you are in more active labor, but it is a very good sign that your cervix is stretching and thinning, therefore showing light blood within the mucus discharge.

  • Pressure in lower abdomen.

  • Membrane rupture (also known as water breaks) - When your “water breaks” that is a sure sign labor will be coming. It may not activate contractions and labor immediately, but you should let your primary care giver know. Usually they would like to see labor start on its own within 12 - 48 hours (dependent on your healthcare provider).

All of these are really good signs that things are happening! Does it mean baby will be born tomorrow or even that evening? No. Therefore, if these signs are manageable, go on with your day or evening as best as you can. Draw yourself a bath or take a warm shower. Go on a walk around the neighborhood. Lay in bed with support from all your pillows and possibly a heating pad for the achy places in your body. Speak to your baby and let them know you’re ready for them, and for the journey that you both will soon undertake. Find pleasure, comfort and joy in each sign that your body sends you, because it is what you’ve been waiting so patiently for these past nine months.

What are the signs you remember the most when experiencing the onset of Labor?

 

 

Nurturing your woman during pregnancy

Rachel O'Reilly

 Dearest Daughters

Dearest Daughters

Pregnancy is very hard work. I have always been sensitive to that and now know firsthand that growing a baby is tough! It takes a toll, physically and emotionally, and it’s really really important to be aware of that.

In my household I’ve always been the meal planner and executer. That’s not to say I don’t have a LOT of help, but I usually like to take control in the kitchen. Now that I’m pregnant, and just made it through our first trimester, I’m feeling so grateful to my loving husband as I write this post for stepping up to help.

Since I’m the one that has the food aversions and/or cravings, I still feel like I’m doing the menu “planning” (which are usually last minute “I want beef stew for dinner” statements and very real requests). What’s amazing about this is my husband who is not as comfortable in the kitchen takes on the tasks to figure it out. Most of the time I’ll still be in there helping, but what a joy to hear him say, “Great, I’ll go to the store now.” As soon as he’s home he starts the prep. In addition to taking over cooking and meal prep duties, below are a few other thoughtful ways to nurture your partner during her pregnancy.

  • House chores (e.g. taking the trash out, without being asked :))

  • Make sure bed is ready for your exhausted (read: passed out) partner on the couch, when she’s ready for it

  • Have water at her bedside

  • Warm up the room on cold winter nights

  • Make sure she’s taken her vitamins

  • Warm up some water and make her some mama’s tea (link to mama’s tea post)

  • Meal prep and execute as best as you can :)

  • Draw her a bath with epsom salt and essential oils

  • Book her a massage at her favorite local spa (prenatal of course)

  • READ the books that are given to you, and be proactive about preparing for birth

    • Prepare questions for your midwife or doctor

    • Prepare dialogue with your wife that will be communicated to family

I believe that there are many ways to comfort a woman in pregnancy. Each trimester has very specific common “growing pains” but not every woman feels each one or feels them the same. And keep in mind that just because she doesn’t get morning sickness (lucky woman) during her first trimester, it doesn’t mean she’s not feeling extremely exhausted and/or emotional. Be sensitive and cater to your woman’s needs. If you’re not sure how to help, the best thing you can do is ask. She will be grateful, and hopefully will be honest when she’s feeling like she needs help.

Birth by Cesarean

Rachel O'Reilly

By Aaryn Leineke

As a doula, I believe when both mother and baby are healthy, the safest form of delivery is a natural vaginal birth without medical intervention. That said, I also believe that all types of birth are beautiful, and the ability to perform safe cesarean deliveries has without question been one of the most important advances in obstetrics during this century. The bottom line is, women are strong and powerful, and every way of giving birth is a miraculous process -- hiccups included.

Natural birth, vaginal birth with medical interventions, or a cesarean birth (C-Section) are three different ways to bring your baby(ies) earthside. A C-Section is the delivery of a baby via a surgical incision through the mother's abdomen and uterus. Cesareans can be scheduled in advance due to high-risk pregnancy (for mother and/or child), multiple babies (however, many twin pregnancies can be born vaginally), breech position or Transverse lie, Placenta previa or Placenta abruption, and other conditions or circumstances. A cesarean can also be required or suggested unexpectedly, due to unforeseen complications during labor.

Below is the general process you can expect from a C-Section birth.

I. Delivery: The mother is rolled into an operating room and placed on an operating table. If there is time to perform an epidural or spinal anesthesia for the surgery, this is usually done at this time (if it was not already applied during an earlier stage of her labor). If the surgery is a “true” emergency where there is no time to perform a spinal anesthesia, the mother will receive general anesthesia (being put to sleep) just before the surgeon is ready to begin. It’s important to know that these drugs can make the baby somewhat slow to adapt to life, and can increase the risk for respiratory distress requiring resuscitation.

The mother’s arms are placed with straps on boards extending directly out from her body. This allows easy access to the mother’s veins to administer medicine. It also prevents the mother from unconsciously reaching down to her baby during the surgery, which could contaminate the operation and increase risk of infection.

The mother’s abdomen is carefully washed and disinfected in order to prep for surgery. A cloth is hung from two poles at the mother’s shoulder to prevent her from seeing the surgery and allows the anesthesiologist to pay close attention to the mother’s nose and mouth to administer medications when needed.

The operation begins with an incision in the skin of the abdomen (the outer layers of the skin only), usually at the top of your pubic line. After cutting the skin, the doctor will cut through layers of fat tissues (which all women will have, but all vary in amounts) and then through thick fibrous layer called the fascia. The doctor then makes an incision through a thin, filmy layer called the peritoneum (the sac lining the abdominal cavity and containing the organs). The uterus and bladder, among other organs, are not visible. The bladder usually sits on top of the uterus and must be carefully moved before the doctor can make the incision on the uterus and deliver the baby. Once the uterus is opened, the delivery can proceed.

After the uterus has been opened, the amniotic sac would be considered ruptured. At this time, the doctor will act fast with great care to get the baby safely from the mother’s womb. Many hands work to suction the amniotic fluids, from the operations and baby’s mouth, while gently delivering the baby without twisting the neck, body or limbs in the process. The baby stays connected to the mother via his or her umbilical cord. As with vaginal birth, the doctor will clamp the umbilical cord until ready to cut the connection from the mother to baby. This will prevent bleeding from either side of the cut umbilical cord.

Once the umbilical cord has been cut, the nurses will take the baby to a warmer table to clean and swaddle him/her. If the mom is available, she can hold her newborn baby.

II. Post-Delivery: The doctor still has important work to do, with the act of repairing the incision in the mother’s uterus high on the list. First, however, the placenta must  be removed. In most cases, the doctor can reach into the uterus and peel the placenta off the uterine wall. On the other hand, if the bleeding is not too heavy, some doctors prefer to to gently pull the umbilical cord, which will cause the uterus to contract, and the placenta will fall away from the uterine wall on its own. After removing the placenta, the doctor will wipe the inside of the uterus with a cloth to remove any remaining pieces of placenta or membrane, and will then close the incision on the uterus using dissolvable sutures.

The bladder does not need to be reattached to the the uterus, as this will happen naturally within a few weeks. The peritoneum (the lining of the abdominal cavity) also heals spontaneously. The human body is magic, isn’t it?!

Closing the fascia (the thick fibrous layer of tissue that envelops the body beneath the skin) is usually done with dissolvable sutures as well. The fascia heals more slowly than the uterus, so in some cases a doctor will decide to use permanent sutures (which would remain in place for the rest of the patient’s life).

Finally, the doctor will make sure there is no bleeding in any of the layers beneath the skin. Once each layer is carefully closed, most surgeons will use titanium staples to close the outer wound without much effort, generally yielding a thin scar. The staples need to be removed 3-5 days after the operation. After a light bandage is applied to the mother’s wound, she will be transferred from the operating table to a bed and taken to the recovery room where, she can hold her newborn baby, practicing skin to skin contact and letting the baby attempt breastfeeding.

III. Recovery: A cesarean is a major surgery. Most women will experience a lot of pain as the anesthesia wears off. Many hospital staff will be available to monitor the mother and make sure she is comfortable after the surgery. She should be able to walk, eat and drink normally after 24 hours.

There is no question that the cesarean section rate has skyrocketed in the past 30 years. In 1970’s the national cesarean section rate was 4%. By the end of the twentieth century, the rate was about 22%. While cesareans are an incredible medical intervention that have saved many women’s lives, there are many people who still feel that some unnecessary surgical births are being done. The number of cesarean sections performed by any single obstetrician is related not only to how well s/he practices medicine, but also to the doctor’s type of practice. I recommend asking your doctor their cesarean rate for their personal practice, and decide if they are the right doctor for you based on your birth plan.

 

Interview with a Father

Rachel O'Reilly

By Aaryn Leineke

The practice of having a doula present during childbirth is becoming more and more common in the U.S. in recent years. That said, there are still many misconceptions about the role of a doula, and the benefits they can provide. As a doula, one of the most common hesitations I hear from moms-to-be is that they fear a doula might make the father feel like the doula is taking over his support role. Since I’m obviously biased, we at Cherish thought it would be interesting to get the perspective from some fathers who have experienced the benefits of a doula firsthand.

We asked the same five questions of three fathers who had a doula present during the birth of their child (Tyler, Kyle, and Robby). Below are some of the highlights from their interviews.

  1. Name some benefits of having a doula present at the birth of your child.

    • All three fathers mentioned that the doula was a calming presence during stressful parts of the labor, and gave them someone to lean on themselves when they felt exhausted. They knew this person was a professional and felt safe in her hands. Tyler said, “My wife was in labor for a couple of days so it was critical to have someone to help with grabbing meals and calm my wife down, as well as myself if I got nervous or wasn’t sure about what we should be doing.”

    • In one case, a medical intervention was suggested which strayed from the couple’s original birth plan, and being able to talk with the doula as a team was good for the husband and mother in labor to re-group and make a calm decision about what they wanted to do next. Kyle said, “She has different knowledge about the medical procedures than we did. A doctor will tell you it's time for a certain medical procedure, and the doula will be able to give you questions or options for a possible alternative that you can discuss with your doctor to feel more informed and confident that you’re making the right decision.”

    • Robby especially loved having a doula at the birth of his first child because it made the environment feel more intimate and comfortable. For Robby and his wife, knowing they had their doula with them every step of the way made it feel almost like a home birth.

  2. I’ve been told by some mothers that they are afraid having a doula because they assume the doula may steal the show from the father. Did you feel that way?

    • We heard the same resounding sentiment from each father: “No way.” “Not at all,” said Kyle. “Our doula was our angel on our shoulder. She calmed me down, which then helped me calm Susan down.”

  3. What were some of your favorite experiences with your doula?

    • Robby mentioned that all the days leading up to the birth (with the prenatal visits, calls and meetings to prepare the birth plans) were really special, and helped to create a great bond and comfortable relationship with their doula. “The companionship kept everything lighter and more fun in a potentially stressful time.”

    • Tyler enjoyed being able to trade off support duties with the doula, from having another set of hands at the house to prep meals in the days leading up to the birth to massaging/comforting his wife at the hospital during her labor.

    • For Kyle, it was the first meeting (and then his awesome experience continued from there). “She came to our home and worked with our schedule, which was very special since I wasn’t able to go to all the doctor appointments. And she set all of our expectations and made me feel at ease and excited for the birth. Her 24 hour availability closer to the birth was amazing too.”

  4. Would you recommend a friend hire a doula for their birth?

    • Again, the same unanimous sentiment from all three fathers. “Absolutely.” “No brainer.” “Yes, especially for the first.”

  5. Do you feel the additional cost of having a doula was worth it?

    • Tyler said, “Definitely. The peace of mind for the amount of money is easily worthwhile.”

    • Robby said, “Yes, wholeheartedly. Especially for your first, 100%.”

    • Kyle said, “No brainer. You can't put a dollar sign on something so valuable as calming your nerves (and your wife's) during such an intense precious valuable time. That said, my health savings account also paid for it. Check in with your insurance or ask your doula - maybe you can use your HSA credit card to pay for this service.”

We’d love to hear from any fathers out there. Have you had an experience with a doula you’d like to share? Let us know in the comments!

 

Hypnobirthing and the Beauty of Natural Childbirth

Rachel O'Reilly

 

GUEST POST by Jessica Bary

I am not from Northern California. In fact, I’m not even from the U.S. I fell in love with a wonderful man from Occidental, Sonoma County, about 11 years ago. And as we were learning from each other I came across one small, intriguing fact; he was born at home, as were his 10 other cousins. That revelation BLEW. MY. MIND!!!! All I could say was: "Do you know there are hospitals for that kind of stuff?!"

And there I was, an ignorant 20 year-old girl who had never even asked the story of her own birth, while falling in love with a wonderful human who knew almost every detail of how he came into the world. When you think about it, it seems pretty crucial to know the history of our journey on this planet, which starts with our arrival earth-side, right?

So for the next eight years, I informed myself about home births, natural births, hospital procedures, and so on. I watched documentaries like. "The Business of Being Born", read blogs, talked to my husband's family.. Nothing drastic, but the more I learned, I was slowly changing my perspective on birthing a baby. I was finally seeing natural birth as my own power as a strong woman, and it moved away from those crazy movie scenes; A woman in a wheelchair screaming her way up the elevator and then cursing at whoever is in the room while pushing with a purple breathless face.... You know those scenes. Horrific. Why would ANY woman want to put themselves through that?! If those movie scenes are all you know of childbirth, it’s no wonder our natural reaction is, No, thanks, shoot me up with all the medicine you have, so I don't feel a thing. Please.

You might still be at that point yourself, and will never change your mind, and that's totally okay. Take the drugs if you want to. I just want to tell you what I experienced as a woman whose perspective shifted from one side of the spectrum to the other: that it’s also wonderful to feel it all.

Is natural childbirth painful? Yes, of course! Have you seen the size of a baby's head in comparison of the size of the entry to your wonderful vagina!? 10 centimeters indeed. But, it's not like it's all happening at once. Labor is the process of your body preparing itself to push your baby out. So with every contraction, surge, or wave, you are getting closer to bringing the newest member of your family into the world. Without painkillers, you are able to feel your baby working with your body to come meet you. That's why labor is magical and fundamental.

And this is where my hypnobirthing tool worked so well for me.

Hypnobirthing, a coin termed by Marie Mongan, is a childbirth education course that emphasizes special breathing, visualization, meditation and other hypnosis-like techniques to promote relaxation and combat fear and pain during natural childbirth. After meeting with my midwife a few times, I asked her what she thought about hypnobirthing classes. She responded that hypnobirthing is a wonderful tool, along with many other things you will use during labor, but she didn't want me to get stuck on the idea of a painless birth - because she didn’t want me to be surprised or disappointed if I ended up feeling pain. Well, thank you for the genius advice. Pain was there, but the language I learned through hypnobirthing helped me see that pain as a wonderful progress to meet my baby, instead of seeing it as something I had to endure or survive.

Here are some of the phrases that stuck with me throughout my births:

-  Slip into tranquil state.

- The body fills with its own natural relaxant during labor, a wonderful effect that permits easy birth.

- Go DEEPER within, to your baby and your birthing body.

- Leave ALL distractions behind.

- CONNECT with your baby and GIVE birth.

- To view birth as a POSITIVE, NATURAL and JOYOUS experience.

- It's a UNIQUE experience to welcome your baby Earth-side. It only happens ONCE for each child.

- Opening yourself to the JOY of experiencing BIRTH. Being PRESENT. Calmly and serenely.

- The art of LETTING GO.

- Birthing with JOY & LOVE.

- SMILE, LAUGH, SURRENDER.

- Your body knows what to do.

- You are not helpless, you are the main ACTOR, take charge, be CONFIDENT.

- Be HAPPY, celebrate life coming to you!

- You are not a victim. You are the DOER, the ACTIVE participant.

- I AM knowledgeable, powerful, fulfilled, directing, decisive, self-sufficient, confident, satisfied.

- I AM VERY MUCH IN CHARGE.

I had two beautiful all natural home births. The first one was 12 hours from start to finish. The second one was just under five hours. My small birthing team was formed by my husband, my doula, my midwife and the assistant midwife. For the first birth, I had my sister as well. It was extremely quiet around me. My eyes remained closed for the majority of the time. But yes, it was loud inside my head. Focusing inward, having a few go-to calming visuals (like a rose opening in my case), breathing, and cursing a little indeed. ;-) For my second child, the song, "you are my sunshine" was stuck in my head and I was so focused on that song, getting emotional to meet this amazing second son of mine. It was the first song my oldest son learned to sing. All intertwined and meaningful only to me, I was birthing a baby while singing in my head.

During those two births and even during the aftermaths of those births, I never even thought of asking for drugs or medicines. I don't know how that was possible. IT DID NOT cross my mind, not even once. I was blown away by my own mind. I think for me, it was partly because I was away from a hospital or a doctor and partly because my mindset, which I learned from the hypnobirthing classes and book, was that I WAS in control and my birthing body knew what to do.

After birth, STAY IN BED. Let people serve you. Ask for help. Try to sleep. The Wonder Woman part of yourself did her job, and after labor and childbirth, it’s time for her to rest.

If any of this sounds interesting to you, you have options. There are hypnobirthing classes, a book, and even hypnobirthing relaxations on iTunes (Relaxation, Hypnobirthing: The Mongan Method, by Marie Mongan, and Birth Rehearsal Imagery, Hypnobirthing: The Mongan Method, by Marie Mongan). I listened to these before bed, and it worked wonders. It even had my husband falling asleep more easily. :)

I was vaginally born in a hospital in the 80's. With a lot of interventions. I wasn’t breastfed because my mother's milk didn't come right away (which is normal), but then the nurses gave her medicine that stopped any milk from coming altogether, thus I was bottle-fed. I am thankful to have been more in charge and informed than my mother. For me, homebirth was a gift. What's better than my own bed, shower, people, and comforting smells? That said, if you know you would feel more comfortable in a hospital or birthing center (or if you have a high risk pregnancy), you should choose the surroundings you would feel most comfortable in.

Remember, I once thought natural birth and especially homebirth were archaic processes. Nowadays we have hospitals, doctors and drugs for that! But what that actually means is that we have more choices. Whether hypnobirthing and natural birth are for you or not, the most important pre-childbirth thing I can tell you is, learn to LET GO. A lot of events in life don't go the way we expect, and birthing will likely be at the top of this list. You may plan for a homebirth and end up having a C-section. You might end up somewhere between those two situations. But whatever happens, you will do your best. That's it. Your baby will come into the world the way they are meant to, and once they’ve arrived, and everyone is healthy, that's all that matters. You are MARVELOUS, ALWAYS.

 

Hospital Visitor Etiquite: Newborn

Rachel O'Reilly

By: Aaryn Leineke

I recently wrote a post about hospital etiquette for labor and delivery (for those that are not on the delivering mother’s immediate support team). It could pretty much be summed up in two words: “don’t go.”

Once baby has arrived, after mom and others on the birth team have caught up on rest, is when it’s generally okay to make a visit. But, the only way to know of when the right time has come is when you’ve received the invite. I know, it’s hard to keep your excitement under control, but if you don’t receive the invite to come by the hospital, don’t be offended or take it personally. It just means mom, dad, and baby are soaking in this very precious bonding time, and trying to still get the rest they need after delivery.

If you do receive the invite to come by the hospital, be mindful of a few things:

  • Keep your visit short, no more than 1 hour.

  • Come with your loved one’s favorite snack or meal.

    1. Hot burrito from your local taqueria

    2. Fresh pressed juice or smoothie

    3. Handcrafted sandwich from the favorite corner deli.

  • Bring their favorite six pack of beer or bottle of bubbly and make a toast to the newest member of the family! Don’t forget the glassware (or paper cups), as well as a bottle opener.

  • Flowers to brighten their stay while in the hospital.

  • Don’t forget you’re bringing them to a hospital, not a home. Make sure flowers are already in a vase with little wrapping and trash to dispose of in their room.

  • Most important: Unless they specifically request it, DON’T bring your child. Keep your own infant, toddler or young child at home with your significant other, or babysitter. This is most important for a couple reasons:

    1. Keeping a quiet calm space.

    2. Keeping germs from the newborn baby.

    3. Keeping your attention on the new mother, father and baby.

If you do not receive the invite to come by the hospital after birth, there are still a few thoughtful ways to show your love and support:

  • Order a meal to be delivered to the hospital if you know they are craving something outside of hospital food.

  • Have flowers delivered to their room (make sure they come with a vase).

  • Offer your time to get the house ready for their arrival.

  • Group up with other friends and family members, and send a house cleaner to make sure the house is in order for your loved ones’ first days back from the hospital.

  • Bring a group of family and friends together to create a meal train for the new parents first few weeks of parenthood at home.

  • Maybe stock up their fridge with fresh goodies so they don’t have to worry about anything when they first step in their front door.


Remember that every new family needs lots of support in their first weeks with a new baby. Even if you don’t see them at the hospital, you’ll have plenty of opportunities to make their lives a little easier in the days that follow. Check out these Newborn Visitor Guidelines for you when do receive that invite.

Hospital Visitor Etiquette: Labor & Delivery

Rachel O'Reilly

By Aaryn Leineke

One thing I never fail to tell my clients, is to do their absolute best to keep their labor and delivery room their sacred space.

And that often means that when you are going into labor, you have to keep it to yourself, and only inform your birth team. Why is this so important? It’s very hard for your friends, loved ones, and family members to resist their excitement. And it’s not that you don’t want them to be excited for you... But excitement, even when it comes from love, can spark many other emotions. Fear, impatience and anxiety, which can bring questions, phone calls, etc.

Many loved ones feel like they are being supportive by coming to the hospital to wait in the waiting room for hours. But, what they don’t understand is that a waiting room full of people can potentially add to the anxiety of a laboring mother, and the father (or partner) since they will now feel the need to split their time between the laboring mother and the family members wanting frequent updates in the hospital waiting room.

So, all in all, my list of hospital visitor etiquette for labor and delivery is - STAY HOME.

The best way to support a laboring mother and her birth team is by waiting at home, near your phone (or not ;)), and continue with your regular activities until you receive an update. Be mindful to not request an update, and trust that you will get one as soon as the family is ready. It’s very possible that even 12 hours in, mama is still working hard, and there is just no new news to share with you. Maybe the only update they can give is that mama has taken another shit, and daddy too.

Remember that for 48 hours or so, these new parents will already be experiencing the many interruptions in the hospital. There will be hospital staff shift changes, hourly check ups, noises from the different monitors and so on. With all that in mind, the extra stimulation of visiting during this time could just be too much for all involved.

I have been at a birth where a friend of the laboring mother was texting the parents and me, and at one point even called the hospital. “Is everything okay? I’ve been worried sick!!” Everything was okay, but the friend’s stress was immediately felt by the laboring mother and her support team.

Like I said before, of course these feelings are stemming from love, but as a friend of a laboring mother, it’s important to remember, this is not about you. When the mother and father are ready to give you an update, or even a call with an invite to come on over and meet the new bundle of joy, they will. Until then, the best thing you can do is wait patiently.

Yoga Poses & Stretches for Pregnancy

Rachel O'Reilly

By Aaryn Leineke

Prenatal Yoga is one of the best things you can do for yourself and your baby. Not only will yoga help strengthen, it will help stretch and open your body for childbirth. Practicing yoga can increase stamina and energy, yet at the same time calm the nervous system. It provides a wonderful balance for you not only physically but emotionally as well. 

Yoga is a practice of love and compassion. Your body will be facing a full transformation while growing a fetus. It's a time to truly let go, accept, appreciate and love your body, for it is giving life to your unborn child. When practicing yoga and meditation, it is likely that you will be more in tune with your body during the different stages of pregnancy and labor. It is a practice of breath, and finding comfort at times when you are potentially most uncomfortable. 

Some women that I've worked with who practice yoga have been able to tell me they feel their baby's movements, growth, and can give detailed descriptions about where their baby is in the womb. They can feel when their baby has adjusted to a head down position, or even if they've dropped further, deeper into the pelvis. This is not a guaranteed result from practicing prenatal yoga, but it is a pretty special experience I've witnessed.

Forming community for yourself during this time in your life is really important. If your closest family and friends are not on the same stage of parenthood that you are, joining a prenatal yoga class is a wonderful way to meet other moms!

Camel Pose (Ustrasana variation)

Stretches the spine, back, hips, chest and shoulders. Increase stamina. Invigorates and tones the nervous system and relieves stress. Opens the chakras and the heart.

Extended Side Angle Pose (Utthita Parsvakonasana)

Increases flexibility in hips, spine, shoulders & neck and strengthens lower body. Massages & stimulates abdominal organs. Increases endurance and stamina. 

Extended Fierce Side Angle Pose (Utthita Utkata Parsvakonasana) 

Builds stability in inner thighs and outer hips. Strengthens and lengthens the pelvic floor. Lengthens the side body and stretches side abdominal muscles. Increases grounded energy. 

Goddess Pose (Utkata Konasana)

Increases circulation to the pelvic floor and abdomen. Stretches groin, hips and chest. Strengthens inner thighs, hips and shoulders. Prepares the body for child birth.

Squatting Pose (Malasana)

Stretches the groin, lower back, sacrum and hips as well as stimulates metabolism and digestive organs. Helps to tone the belly and prepares the body for childbirth by opening and softening the hips.

Bound Angle Pose (Baddha Konasana)

Stretches inner thighs, groin and knees. Stimulates the heart and improves circulation, stimulates the digestive system. Soothes sciatic pain. Reduces menstrual cramps. Regular practice is shown to ease childbirth.

Postpartum Care & Awareness

Rachel O'Reilly

By Aaryn Leineke

Now that you’ve had your baby, the hardest part is over, right? Well, maybe. My first word of postpartum advice is, TAKE IT EASY. I cannot stress this enough to all the moms I support during birth and into their first few days postpartum.

You must prioritize yourself, your body and your spirit during the early stages postpartum. It’s unfortunate that our society has lost touch with the importance of taking the time to allow your body to heal from birth, establish good breastfeeding habits and bond with your baby.

Must-have home remedies for postpartum care:

  • Arnica homeopathy: Arnica is used for muscle pains, aches and bruising. You can take arnica tablets during childbirth to minimize pain and bruising, or after childbirth to speed up healing (for both a natural birth or in cases of a c-section).

  • Postpartum herbal sitz bath: Soaking in a warm herbal sitz bath can help speed up your body’s natural healing process. Sitz baths are good for all forms of birth recovery, natural, episiotomy, hemorrhoids and sutras from c-sections.

  • Soothing postpartum pads: DIY with aloe vera, witch hazel and essential oils (one example using lavender, chamomile, rosemary is here).

  • Cold pads/ice packs: For vagina and perineum swelling.

  • Soothing cold nipple pads: To help relieve sore nipples.

  • Nipple balm: To help heal chapped nipples.

  • Mama’s rich milk tea (or an ice cold Guinness beer ;) : To help with milk production.

  • Placenta capsulation pills: Believed to help balance hormones, replenish depleted iron levels, assist uterus to return to its pre-pregnancy state, reduce postnatal bleeding and increase milk production.

  • Wholesome, organic, nourishing meals - Our nutrition expert Erica Favela has wonderful suggestions here

  • Pelvic floor therapy: Read more on this below.

In recent years I’ve seen some health centers pop up that focus on pelvic floor health and the importance of this therapy. This type of therapy is especially good for women recovering from childbirth (especially multiple childbirths, or those who suffer severe tears and episiotomies during birth). Years ago I read an article from the New York Times that called out the lack of support women in the US have for postpartum care. This article states that in France “making mothers good as new is of national interest.” Pelvic floor re-education as well as abdominal re-education is 40-60% paid for by government and the rest is generally covered by insurance. I’ve heard some cases of women whom have issues including pain during sex, the inability to hold their urine or pee when sneezing or laughing, as well as defecating when exercising for long periods of time. These are issues that can occur, but that does not mean they cannot be prevented, and should definitely not be ignored.

It’s very common for your doctor to take a look at your tissue and let you know if you’ve “healed” from birth. Often, if you tell them you are still experiencing pain or mention other issues with your bowel movements, they’ll suggest giving it more time, and perhaps do some more kegels. Yes, kegels are a wonderful exercise that help many women tone up their pelvic floor for prenatal and postpartum care, but sometimes it’s just not enough. If you are still experiencing discomfort or other possible embarrassing issues after birth, check in with your doctor and do some research on pelvic floor therapy centers around you. Many of these centers take insurance, and most insurance providers will cover it as long as your primary care doctor has deemed it necessary.

If you think about it, when you tear a muscle in any other part of your body, you are given physical therapy to recover from these injuries. When your perineum tears during birth, it is a tear in a muscle, and when you get stitches you will endure scar tissue. Just like every other muscle in your body, this requires extra time and attention to heal properly. The same thing applies for the abdominal tissues affected from a c-section. Therefore, give yourself that time, and don’t be afraid to ask for the extra help/therapy. You’re not alone, and you won’t be the first person to demand more support.

In traditional societies it is very common to see mother stay home 4-6 weeks postpartum and have family members and friends come to her to help with cooking, cleaning, and rest. This is especially useful when the mother happens to be a single parent, or when her partner has to go back to work early. At Cherish, we’re working to implement that traditional care for mothers back into our collective awareness as much as possible in the United States, and to inform new mothers, mothers-to-be, and those in their communities to give proper attention during these precious postpartum weeks. Check out a few previous posts that can help inform you on these topics, including our posts about meal trains and postpartum support.

Embracing Your Postpartum Body

Rachel O'Reilly

By Aaryn Leineke

There is so much pressure for women to lose their postpartum baby weight. Many first-time mothers imagine they will (or should) “bounce back” to their pre-baby body just after giving birth. It’s important to recognize that it takes six full weeks for your body to recover from birth, to even be able to start “working out” and regaining your physical strength. So, don’t be so hard on yourself. Give yourself the appropriate time to recover. Most importantly, give yourself praise each day for how strong your body was, is and will be for growing, birthing, and now feeding your precious baby.

In the months leading up to birth, and the days shortly after, your body will go through incredible changes -- and all the emotions that come with those changes. Hormones are an incredible things that help us feel good, but they can also cause us to feel sad, hopeless, helpless and lost. As a new mom, remember that it’s okay to ask for help, to accept your body, to embrace your body, and most of all to love your body during the early months of postpartum.

Know that you may still be wearing your pregnancy clothes the first few months after birth. Know that your hips and joints may feel jiggly and unstable during your first efforts to work out. Once your body has recovered from birth, treat it with care and ease into workouts, as if you were still growing your baby inside your womb. Take a look at a recent post Keeping Fit While Pregnant here for ways to ease back into your workouts. Swimming, walking, yoga and light weight-lifting are all good to start with. If you are breastfeeding, know that your body will need the extra calories to endure feedings throughout the day and night, so don’t diet or fast to get rid of your precious, well-earned weight. Do stay conscientious of what you put in your body and continue to stay away from processed foods, sticky fats and sugars. Keeping a well-balanced healthy diet will help with your emotions and physical recovery from birth through postpartum.

If you’re feeling overwhelmed, sleep deprived, and a little lost on how to get your bearings again, remind yourself that it’s not only okay, but important to ask for help when you need it. Maybe that means hiring a postpartum doula to help with nighttime feedings, while you rest more. Or someone to help with daytime chores, so you can find time to get to a yoga class, or go for a walk with your dearest friend. Use that call for help simply to take a nap. Rest, nutrition, and love for yourself is what will bring the energy to get your body and its strength back.

Your body will become your own again, but it’s important to remember that it will always be different than it was pre-baby. And for good reason! Admire your post-baby body for the new life it created. Be grateful for it, for bringing you a beautiful child.

Do you have any struggles or motivating words to share about embracing your post-baby body? Let us know in the comments!