Cara Mehlon writes about the effectiveness of regular postpartum massage.
Cara Mehlon writes about the benefits of prenatal massage.
Jennie Rader shares a personal piece concerning the importance of planning for postpartum.
Julie Ann Pichon writes about VBAC success and what to be aware of when going into a VBAC scenario.
Mimi Sosa shares the benefits of partner yoga during pregnancy to prepare more fully for birth.
Cara Mehlon writes about all of the in's & out's of creating a plan for the birth of your baby.
Postpartum massage can be as important and beneficial as massage during pregnancy. Postpartum bodywork is an effective and holistic approach for the many adjustments to motherhood. Massage is well known for relaxation, stress reduction, pain relief and other health benefits. Unique postpartum benefits include hormone regulation, reduced swelling, better sleep and improved breastfeeding. More advanced therapy helps restore your body to its pre-pregnancy condition, speeds healing and assists with C-section recovery.
The Benefits Of Postpartum Massage Postpartum massage has been shown to be effective for a smooth recovery and better health. Here are a few of the many benefits:
Relaxation and Stress Reduction Pain Relief
When Can A New Mother Start Postpartum Massage? You may start receiving postpartum massages as soon as you feel comfortable. Your therapists will position you comfortably if your abdomen or breasts are sore. If you have maternal complications, first consult with your trusted medical provider.
What Positions Are Safe In Postpartum Massage? Any position is safe after delivery, but may be adjusted for your comfort or specific treatment. Some moms crave being able to lie face-down again after lying on their sides for almost nine months. Others may be uncomfortable face-down because of breast discomfort or the distraction of leaking milk. (don’t worry we have clean, dry towels for leaking) The side-lying position can be comfortable and very effective to treat specific issues of the shoulders, pelvis or legs. Massage can improve post-delivery recovery and health for many women.
A trained therapist will assist you with physical, emotional and educational support as you find the joy of motherhood. Consult with your physician if you have had any complications or have concerns before beginning any new therapeutic practice.
For more information or to schedule an appointment in the Carmel/Indianapolis area please visit: www.CaraMehlon.com or call 812-212-9512
Prenatal massage and bodywork focuses on the special needs of the pregnant Mom as her body goes through the dramatic changes of pregnancy. There are many different modalities to consider, I will cover some of them here in this post. The benefits for all of these treatments are all across the board.
Massage Therapy enhances the function of muscles and joints, improves circulation and general body tone, improves appearance from healthier skin and relieves mental and physical fatigue. The very relaxing approach of prenatal massage can ease discomfort associated with pregnancy, help Mama prepare for labor and give her nurturing emotional support. All sounds good so far right?
Whether your appointment will be your FIRST or one of MANY, each massage should be a different experience. Your therapist will tailor your massage to fit your needs THAT DAY. If your needs change between visits, this means that the massage will be adapted to the changes happening in your body. Let your therapist know if you need more or less pressure, or if you want to focus on specific trouble spots or do a general full body massage. This part is very important. We wish we could read minds but let’s face it, we can’t. Often times we can “read” your posture or your muscle tension which is very telling but please let us know what’s bothering you so that YOU can get the most out of the time you will be on the massage table.
Benefits for the Body and Mind
The benefits of prenatal massage include a wide range of physiological, emotional and psychological benefits.
You will always be positioned for comfort.
At the conclusion of the session, I suggest that you practice self-massage and stretching sequences in between regular prenatal appointments. I also encourage you to stay well hydrated throughout pregnancy as even more so after a massage to flush the body of any toxins released from the muscles during the treatment.
Liz Escoffery, Founder of Indy Fertility Care (www.indyfertilitycare.com) shares her experience with massage therapy:“Prenatal massage has been critical for my comfort and health in pregnancy. In both of my pregnancies, I have had to receive intramuscular injections in my first two trimesters. These oil-based injections are extremely painful, but very important for the health of my developing baby to give him or her the progesterone I am lacking. While a heating pad, warm showers, Tylenol, and movement from exercise lend some temporary relief, professional massage has been a long-lasting measure which has helped minimize and work out the knots and welts from frequent injections in the same site. I love that it is an all-natural solution that truly works. It has also helped the rest of my body, especially my legs which get stiff and sore during movement. In the days and weeks after a massage, I sleep better and I can be a better mother to my toddler, wife to my husband, and I can be fully present in my work. Receiving a massage is also an opportunity for me to relax and take some time for myself, which does not happen too often, but is critical to stress management and an overall lowering of my anxiety levels. I am so grateful to have found Cara and received massages from her during pregnancy"
You may or may not know, you can request massage therapy during labor and it can be helpful to encourage labor to begin naturally as well. Many Doulas know some massage or acupressure techniques to support you during this time.
For more information or to schedule an appointment in the Carmel/Indianapolis area please visit: www.CaraMehlon.com or call 812-212-9512
(Photo Credit: Birth Boot Camp)
I still remember the significance of her question and the sting I felt as I lied in response.
“How are you doing with that new baby?”
Oh fine! I told her, a forced smile of my face that I knew she could see through. She was a brand new friend and I feared I would lose her if I let it all out. If she knew how often I cried, resented my baby, and doubted every bit of parenting intuition I had.
We had just moved to Indy with our 4 week old baby, our first, and I was a mess. I had a horrible breast infection, my baby spent most of the day crying, we had no family or friends in town, I was still sore from the birth, and I spent 19 out of every 24 hours desperately trying to feed my baby, who also didn’t like sleeping. I really needed a friend but didn’t want anyone to get to know me in this state. I just wasn’t myself and wasn’t sure I ever would be again.
In my work as a birth doula, I’ve sat beside countless women who are overwhelmed in their new role as mamas. The birth comes and goes and many of them are surprised at how unprepared they are for life with baby and all that it brings. When I visit a week or two after the birth I always ask if they’ve had a good cry. I find it opens up a door for sharing. I hear about struggles and fears. Maybe they are having trouble figuring out how to get the baby to sleep, or maybe they are worried that their body may never be the same. Husbands and partners are often just as overwhelmed. That sweet baby brings so many changes- physical, social, emotional, spiritual. It’s easy to wonder if the ground will ever be steady to walk on. And it also seems everyone else has it together. Facebook and Instagram make it all look easy. But for many women, it’s anything but. There is sweetness in life with a fresh bundle, but learning how to care for your sweet baby and yourself can be daunting, and isolating.
Many cultures have beautiful systems in place for families after a baby is born. I remember one postpartum visit in particular when I was able to witness an Indian family caring for a new mama. It was a joy to see her mother cooking traditional foods in the kitchen, her father and brother playing with the older sibling, while the new parents rested and enjoyed tea. This new mom was expected to rest, she was given guidance on nutrition and baby care from her mother and mother-in-law, and no one expected her to carry out her normal tasks. She was at ease because she had help, and resources available to her. I left her home wishing such a lovely scenario existed for every woman.
I think it’s interesting that as a culture, we don’t put a lot of time into planning for our postpartum season. We plan the nursery, we collect supplies for the baby, we even make birth plans. But so often we navigate the uncharted waters of postpartum without a map.
In her book, Natural Health After Birth: The Complete Guide to Postpartum Wellness, Aviva Romm writes,
“…realistic preparation for the postpartum is essential for coping with the challenges that inevitably arise. In fact, studies demonstrate that women who have realistic expectations about the postpartum fare better as mothers than those who don’t (Bing and Colman). Therefore pregnant couples should keep an open mind about what their postpartum experience might be like, and plan for challenges that might arise. If everything is smooth sailing, you won’t need to rely on contingencies; but if you do face challenges, you will be able to meet your needs and respond well to the circumstances.”
One support option for those who have limited help from extended family is postpartum doulas. These doulas (or specially trained helpers) carry out a variety of tasks depending on the family needs. From holding the baby while mom sleeps to helping with feedings or light housework, they serve to help lighten the load of a new mother. Postpartum doulas can also help families make strategies for a new rhythm of life, giving parents guidance and encouragement. They are often knowledgeable about community resources available and can offer suggestions to families as needs arise.
As with many things in life, preparation can mean the difference between surviving and thriving. I love to see families thriving, even when facing challenges during postpartum. Discussing the realities of life after baby’s arrival and how to prepare is key. When couples have spent time before the baby’s arrival discussing and making plans for the coming transition, I see them enjoy it more. When a woman knows the resources of the community and professionals who can assist her should challenges arise, her level of anxiety is decreased.
So what does it look like to make a postpartum plan? It doesn’t take much time, but the investment is invaluable. A postpartum plan is a way to plan for wellness and helps give a framework for realistic expectations. Here are examples of questions answered in a post-partum plan:
Working through questions such as these gives couples confidence as they walk into a tiring season. The plan doesn’t make everything suddenly easy, but it does EASE the transition. When you are tired and hormonal, coming up with a plan is crazy hard. Decisions tend to be reactionary instead of intentional. Creating this guide for yourself helps you be intentional!
Those long hard weeks and months after giving birth are still very vivid in my memories. I’ve had four more kids since then, each transition unique, and some harder than others. Thankfully, that friend stuck around, and she has walked with me through the many ups and downs of my postpartum seasons. I’ve learned to be honest and ask for help. And I’ve learned that putting effort into planning for this season makes a world of difference.
Jennie Rader is a DONA certified birth doula and is a member of the Indy Birth Alliance. She resides on the near east side of Indy with her handsome scientist husband and five sweet kiddos. You can connect with her at : www.citymama-birthservices.com
In the birthing field, similar to pop culture, there are trends.
The topic that seemed the most important five or ten years ago may be totally different today. New information is discovered during research, and things slowly, slowly change. Since the beginning of time the birthing process has always been the same, but the way in which it has been treated by the medical community over the years has changed dramatically. The C-section rate in the US has climbed from 4.5% in 1965 to about 32.2% in 2014. In some countries it is over 50%, and in certain hospitals in South America, it is around 90%. Why is this?
It is a very complicated tangled web of reasons.
At least in the US, much attention is given to physical care, but little attention is paid to the psychological health of the mother during pregnancy. Midwifery care and doula birth support can make a huge difference in the birth environment. Since in the US, surgery is often viewed as lifesaving during childbirth, the mom often times does not fully understand the risks of a c-section for her and her baby, because they are rarely discussed. We do hear stories of fear, “My baby would have died if I hadn’t had an emergency c-section!” While this certainly can be true, the vast majority of c-sections done are not for emergency reasons.
Another reason for so many surgical births is the wide use of interventions in labor that raise the potential need for c-section. Labor induction without medical need, especially in first time moms, is an intervention that can comes with many risks. Continuous fetal monitoring, for low risk moms and babies, does not result in better outcomes. The widespread use of epidural anesthesia and pitocin to augment labor can lead to fetal distress and mal-positioned babies, which results in women having very few options for optimal positioning that can lead to a vaginal birth.
Currently, the primary c-section rate for women in the US is approximately 21.5%. One factor that raises the overall c-section rate, is the fact that many women with a prior c-section are not told that they could have the choice of a vaginal birth after cesarean (VBAC) for subsequent births. About 9 out of 10 pregnant women who have had a surgical birth choose to plan another one. But is this a truly informed choice, or is it just by default? In many cases they are not offered options, and the possibility of a VBAC is denied by their provider or the hospital.
VBAC was more popular in the 90’s with around 30% of women choosing a trial of labor, but in the 2000’s it began to decline drastically. VBAC fell out of fashion in medical circles. ACOG suggested that doctors needed to be in the hospital, along with anesthesiologists, to provide the option of immediate surgery for any VBAC woman in labor. That meant that a doctor had to be present for the entire labor, which is not the normal practice in labor and delivery. Insurance providers were less willing to cover doctors who practiced VBAC. As a result, by 2006 the rate of VBAC was less than 10%.
Over the last ten years things have changed.
Labor induction is at the lowest rate in many years. Many hospitals are requiring doctors to justify any non-medical induction before 39 weeks. In some places that is changing to 40 weeks. ACOG released new standards in 2010 and 2014 that opened the door for many more women to have a try a vaginal birth. In 2010 they suggested than many more categories of pregnant women should be offered a “Trial of Labor.” By 2014 they redefined labor progress that allowed for a longer latent or early phase of labor, and called for induction to be limited to medical necessity before 41 weeks of gestation. They also mentioned the use of labor support for proven improvement of outcome. (Go Doulas!)
So what is a mother to do?
Any woman with a healthy pregnancy, one or two low transverse incisions, with more than 18 months since her last birth, and with one or two babies should consider requesting a trial of labor. Of course there are some women who would prefer a repeat c-section, even if they understand the risks. However, most women are not counseled of the true risk of repeat c-section (RCS) vs. VBAC. Each one has some risk, but they often even out. Statistically VBAC is a little riskier for babies and RCS is a little riskier for mothers. The benefits of a VBAC are great. Mothers have faster recovery and less infection and hemorrhage, babies have less respiratory problems and better APGAR scores. Vaginally birthed babies often get a better start at breastfeeding as well.
What is the chance of success?
Current statistics state that US women who attempt a VBAC are 70-75% successful. What if you are that mom, currently expecting a baby after a previous c-section? How can you increase your odds of success? There are several factors that ACOG outlined that can increase the success rate: avoiding induction of labor, having continuous labor support, waiting until 6 cm of dilation to consider it active labor, and being able to use upright positioning for labor and pushing stages. However, the most important factor for success is finding a caregiver and birth location that will be supportive of a true trial of labor. Look at that 70-75% and think about our national c-section average of 32.2%. That gives you odds of vaginal birth better than every other birthing woman out there!
“The evidence shows that over 95% of women with a prior cesarean can labor safely for a VBAC without any uterine scar problems.” Henci Goer & Amy Romano, Optimal Care in Childbirth, 2012.
What if you are a childbirth professional, like a doula, labor assistant, childbirth educator or even a midwife? What can you do to make a difference in the VBAC statistics?
First of all, we can offer our clients the full range of birthing options and educate them so they can make the best choice for their birth. We can offer support and encouragement, and help them become good advocates for their choice. We can also offer good childbirth education, so first time moms are more likely to have a vaginal birth in the first place. We can promote the idea of VBAC in our community and sphere of influence. It is also very important to know what resources are available in your area, so that we can help women to connect with them. Do you know who the VBAC providers are in your area?
Even more importantly, we can educate ourselves. One fantastic opportunity is coming up in Indianapolis on April 21st. The 27th annual Indiana Perinatal Educators Conference this year will be at Methodist Hospital and the topic is, “Plan of Attack for Successful VBAC.” www.indianaperinatal.org Speakers will include Dr. Chris Stroud, a VBAC supportive OB from Ft. Wayne, and Connie Livingston, the president of ICEA (International Childbirth Educators Association). ICEA has produced a FREE VBAC education module for parents and educators alike. www.icea.org The Indy Birth Alliance is a group of birth professionals empowering a healthy birth community through support, service, education and advocacy. Since our goal is to empower positive birth choices, we will continue to promote such great educational opportunities for our clients and for one another. We would love to hear your VBAC experiences!
Julie Pichon has been DONA certified doula for 12 years and has attended almost 400 births. She is one of the founding members of the Indy Birth Alliance. In her spare time she enjoys spending time with her grandchildren. You can connect with her at www.birth-by-design.com
Statistics found at Childbirth Connection.
Prenatal Yoga is one of the most effective, safe, and enjoyable ways to increase comfort during pregnancy and prepare for an empowered birth. Partner Yoga offers a uniquely nurturing way to experience deeper awareness, strength, stability, and release. These two practices combine gracefully and can help to ease discomfort during pregnancy and prepare both mom and partner for birth.
Some Benefits of Partner Yoga as Birth Preparation:
Indy Birth Alliance member Mimi Sosa offers fun, 2-hour classes in various locations around Indianapolis. If you are interested in learning more, you can contact her at: firstname.lastname@example.org
Mimi specializes in prenatal as well as mommy and baby yoga and has been instructing classes for the last 12 years.
I know, I know, ONE page for one of the BIGGEST most amazing days of your life? That does seem difficult. Can you imagine if you were planning a wedding… (I’m doing that right now by the way, for my incredible younger sister and her loving fiance – it’s been a lot of fun)…and the wedding plan was only ONE page!? LOL.
With this wedding the plan is a binder….it’s going to be outstanding!I’m so happy for them both!
The difference is, the (female) human body knows how to give birth. We have all of the right equipment on board! When we plan a wedding, we need many different vendors, decorations, venues, people…so many people…you get the idea.Being in tune with your body and TRUSTING your body will help you feel more comfortable throughout all stages of labor. A plan, while it may not guarantee everything goes exactly as it is laid out, let’s be real, it probably won’t – helps us figure out exactly what we want, we can make choices accordingly, and clearly communicate those desires with those that are important to the plan. It’s a great tool in preparation. Ultimately, when your baby is born, no matter how the plan ends up, it’s going to be an incredible moment and you all will be glad that you took the time to prepare for it.
Your baby’s birth day will only happen once. Carefully and thoughtfully consider your desires. A good care provider will respect your wishes and honor the sacredness of your special day when you meet your baby for the very first time.
After you have cleared things with your provider I like to get it all written down so that you can share your plan with your carefully chosen birth team.I like to begin with general information.
If you are prepared to have an unmedicated birth write a short paragraph stating this and thank them for helping you achieve this goal. Explain that IF any interventions are necessary to please discuss the options with us first.Some choose to have bullet points here, others like to have a “preferred” list and an “avoid” list. Both are very acceptable.
Some examples of this may include:What type of lighting you would like
The avoid list for example may include unnecessary interventions.Understanding that when you have chosen this provider you trust they will avoid unnecessary interventions unless it is best for you and baby. You may even want to list a few postpartum requests such as:
Again, you and your partner will have more specific requests and it’s important to make your birth plan your own. Remember these are all only examples. Discuss all of this with your childbirth educator, your doula and of course your care provider.
So what’s the idea behind the birth plan? We want to facilitate communication between partners, care providers, and truthfully figuring things out for yourself too! Whether it’s your first baby or your 7th baby, it’s always a new birth. It’s going to be different every time. Another thing I wanted to mention is that some don’t want to make a birth plan and guess what, it’s your birth – you get to decide. But, I assume since you are reading this you may be thinking about it.
One thing I noticed while teaching my class last week was: A student asked me,“What will the nurses do if my wife asks for pain meds but we had decided to do our best to avoid them. Will they jump into action, will we have any time to try something new for a while instead of getting the meds right away?” It was a great question!
This is a great example of why to have a birth plan. Your nurses would know that you wanted to avoid meds and if you are asking for them, they may help distract you, change positions and use other comfort measures in hopes that you can get past this for a bit longer without the meds since that was what you had planned. Having this laid out for your birth team is going to get that communication across respectfully which is very helpful for everyone involved.
Congratulations and I wish you a beautiful birthing experience.