The pelvic floor is the layer of muscles that stretch under the pelvis and support the inner organs (bowels, uterus, and bladder). I had never heard of the pelvic floor until I started learning about pregnancy and birth. Even though I was already suffering from and getting treated for a pelvic floor dysfunction long before I became pregnant, no one, not my OB or physical therapist, explained what the pelvic floor muscles did and how they could impact my well-being.
Turns out, as I would later learn, my pelvic floor could wreak a lot of havoc on my body during pregnancy and labor. My pelvic instability lead to symphysis pubis disorder that caused excruciating pelvic girdle pain that still lingers today, one year after I gave birth. The pulling on my pelvic muscles also lead to a lot of back pain.
To learn more about pelvic health, I reached out to Rachel Parrotta, DPT, a pelvic health physical therapist.
“I believe that all people would benefit from learning about their pelvic floor muscles prior to giving birth,” Dr. Parrotta said. “Since we are often unfamiliar with these muscles, it can be difficult for people to use their pelvic floor muscles in ways that help facilitate both birthing and post-partum recovery.”
Imagine, you are in labor and your care provider says, “Okay, it’s time to push.” Many birthing people may feel that bearing down feeling, that urgent need and desire to push. However, receiving an epidural can prevent people from experiencing bearing down and even from pushing effectively because the abdominal and pelvic floor muscles feel numb. Care providers do something called “coached” or “directed pushing” until the laboring person gets the hang of how to push. Your care provider will tell you when and how to push in accordance with your contractions.
This happened to me. I got an epidural during back labor and didn’t have the bear down feeling until my water broke. My midwife coached my pushing because I wasn’t using my pelvic floor muscles correctly. She told me I wasn’t doing right. She got frustrated and impatient with me. She actually shoved her finger up my bum WITHOUT INFORMED CONSENT to pinpoint the muscles I should be using – an action that still makes me shudder and feel small to this day. I don’t want this to happen to you.
Ideally, we want our pelvic floor muscles to be relaxed during the second stage of labor (pushing), as tensing those muscles can actually delay birth. You can go to a professional like Dr. Parrotta to identify your pelvic floor muscles and learn how to use them for pushing BEFORE labor.
“Learning about your pelvic floor muscles prior to birth can help prepare for a more effective pushing phase of birth, especially if a person is planning on birthing with an obstetrician and/or with an epidural,” said Dr. Parrotta.
Pushing your baby into the world is a powerful action that we are all capable of doing. Exploring your pelvic floor to ensure its health and learn about its abilities can make an impact on your birth and postpartum experiences.
I’m a postpartum doula on Long Island. The first response I get when I tell someone this is, “What is a postpartum doula? What do you do?” The answer is quite simple and the service is a life-saver for many.
Mothering The Mother
My job is to help Long Island postpartum moms who have recently birthed or adopted a baby. I help them cope, adjust, heal, and feel confident in their parenting. How do I do this? Well, I provide a myriad of services that combine into a practice of care and support.
The first tenant of being a postpartum doula is to “Mother the Mother.” Us doulas believe that every mama deserves to be nurtured with compassion; so, our role is to give motherly love and support. We don’t replace any client’s mom or other family member. In fact, we often work hand-in-hand with our clients’ family members to give as much help as possible.
What Services Postpartum Doulas Provide
The types of services a postpartum doula does will depend on the doula. I provide full spectrum care to moms, which includes the following:
1. Emotional and physical support for mom
2. Postpartum care – help with healing and perineum care, c-section support, rest, and sleep
3. Infant care – educate the whole family on baby care best practices, help with bathing, sleep, feeding, and more
4. Feeding education – breast and formula
5. Nutrition – guidance for healing and lactation, meal and snack preparation
6. Household chores – light tasks such as washing dishes, doing laundry for the whole family, kitchen cleanup, and organizing the baby’s room
7. Family support – help partners and older children adjust to new family dynamic
8. Mental health – I’m trained to educate and identify perinatal mood and anxiety disorders such as postpartum depression and anxiety
9. Overnight care – I’ll take care of your baby’s needs throughout the night including diaper changes, bringing baby to you for breastfeeding, bottle feeding, and comforting baby so you can get a good night’s sleep
I do all this and even more!
What Postpartum Doulas Don’t Do
Postpartum doulas are not medical health providers. While we can provide evidence-based information on care, we aren’t doctors and cannot answer medical questions. When appropriate, we will refer clients to their pediatricians.
Sometimes people assume we are just like babysitters. However, our job is to put the mom first, not baby. Postpartum doulas will often watch over the baby so that mom can get some rest. But, we don’t completely take over care for extended periods of time unless we are providing overnight care. More importantly we are highly trained professionals that receive certification credentials.
We also typically do not do heavy cleaning like vacuuming, washing the floors, cleaning the bathroom, etc.
Are you a Long Island mom looking for support? Contact me or learn more about postpartum care here.
Coping During Natural Birth Pain. How Do I Do It?
Is coping through natural birth pain possible? This is the most frequent question I get from moms, whether they’re approaching their first or fifth birth. Labor pain appears to be the number one concern about birthing. Many believe an epidural is their only option. But I’m here to tell you, that there are more natural alternatives than you may think.
If having a natural, meaning no medical interventions, birth is important to you, then you’re going to want all the information you can get on coping with labor pain. And yes, I’m saying pain. Some educators don’t like to use the “p” word, mostly because as soon as we hear that word we tense up and think of it negatively. But I want to be realistic here. Yes, it is pain, but it’s not negative. It has a beautiful purpose and it is possible to naturally reduce labor pain through coping techniques.
Become The Ruler Of Your Mind
Staying relaxed and as calm as possible during natural birth contractions is very important. When we feel pain, our body’s stress response is called to action. We get a rush of adrenaline and cortisol, leading to a faster heart rate and increased breathing. This isn’t a bad thing. Our body is trying to help us prepare for fight or flight and the chemicals that flood our body actually helps reduce pain. I know, cool, right?
But the downside of the stress response is that it can quickly turn us to panic and fear if we don’t know how to control it. The trick to coping in labor is to become the ruler of your mind.
You’re already a queen. Now you need to be the queen of your thoughts by thinking positively and learning physical and mental skills to harness your power and focus.
How Do I Learn These Skills?
You can read as many free articles and resources about labor pain coping skills as possible. However, this will not compare to learning these methods from an actual childbirth educator. Reducing pain naturally during labor requires practice throughout pregnancy and you need someone who can go in depth about these techniques and give you alternatives that you can’t get elsewhere.
This is why I’ve partnered with The Nesting Place LI to offer a new online class that deals solely with natural birth coping skills and why all of my online birth education courses cover comfort measures and coping techniques.
Isolation can be a real trigger for depression, especially since so many of us are now practicing social distancing and self quarantine because of COVID-19 (coronavirus). Pregnant and new moms, in particular, can be at-risk of prenatal and postpartum mood and anxiety disorders (PMADs). Just because we’re stuck home, doesn’t mean we have to do it all alone!
While things will return to normal eventually, here are five things you can do today to help prevent isolation depression and anxiety.
1. Virtual Support
Many birth workers and care providers are adapting to the current situation by providing virtual support via web chat. There are apps that provide chat and over-the-phone access to therapists. You can look for a pregnancy or postpartum support group online, like this one from The Nesting Place.
Birth and postpartum doulas are also offering online care. I’m still able to chat with clients, show them newborn care basics, help with lactation, and provide emotional support and encouragement. If you’re interested in getting a postpartum doula virtually, contact me.
You can also talk to friends and family members via Skype, Facetime, Facebook chat, or on the phone to avoid feeling alone.
2. Get Some Fresh Air
If you’re able, sit outside in your backyard or balcony for a while. Get some fresh air and Vitamin D. Just getting outside, without running into other people, can be so refreshing and uplifting. If you live in an apartment and can’t leave, but the weather isn’t too chilly, try opening the windows for a little while. Let in the sunshine. Take in its warmth for a moment. Nature can offer some relief.
Get those endorphins pumping! If you’re pregnant or in postpartum and cleared for gentle exercise, stream some prenatal workouts on YouTube. Prenatal yoga and meditation can be calming. You don’t have to exercise all day, but even twenty minutes can make a big difference in how we feel. If you’re new to yoga, check out this YouTube workout for beginners.
Reading is a total immersive experience that’s good for your brain! Stories can transport you out of your current environment. According to a study by Emory University, reading activates neurons in the brain that create a sensation of not just reading about the action of the book, but experiencing the sensations it is describing. You are figuratively and biologically put in the shoes of another. This is called grounded cognition.
Reading can also help to calm the mind and help it focus if you’re feeling anxious.
5. Find and List Resources
Sometimes just being prepared helps us feel more calm and in control. Do some research on local and other online resources you may want to use during this time like restaurants that are still doing delivery, your care providers’ emergency numbers and assistance programs in your area. You don’t have to use any of these if you don’t need to, but having a list of people to call may help you feel more connected. Many of us are isolated at this moment. It’s important to remember that there are networks of people in every community that are still out there to help you.
Sending you love through this difficult time!
Tensions about COVID-19, a type of coronavirus, are rising in the United States as the illness has been spreading. Travel is becoming restricted, people are working from home, schools are closing, and apparently toilet paper is now a hot commodity. Many are starting to panic. The symptoms of COVID-19 have mainly proven to be more serious in older patients and those with serious complications such as heart and lung disease, and diabetes. But what about pregnant women and new moms?
Are Pregnant Women More Susceptible to Getting COVID-19 or at Higher Risk of Serious Illness?
At this time, the CDC does not have conclusive information. However, the physiological changes women experience during pregnancy do tend to make them more susceptible to viral respiratory infections. The CDC advises pregnant women to take standard precautions like washing their hands and avoiding other people who are sick.
Can COVID-19 be Transmitted to Babies During Pregnancy or Vaginal Birth?
The virus is currently thought to only be spread through respiratory droplets, meaning through fluids expelled by the mouth and nose during coughs, sneezes or intimate contact. It is unknown if the virus can be transmitted through the womb. However, the CDC said, “In limited recent case series of infants born to mothers with COVID-19 published in the peer-reviewed literature, none of the infants have tested positive for the virus that causes COVID-19. Additionally, virus was not detected in samples of amniotic fluid or breastmilk.”
Can I Continue Breastfeeding?
So far, no evidence of the virus has been found in breast milk. La Leche League International (LLLI) advises women to continue breastfeeding unless a care provider deems it medically necessary to stop. Human milk provides important immunological antibodies produced in the mothers body to the baby.
LLLI says, “Those who become infected shortly before giving birth and then begin breastfeeding, and those who become infected while breastfeeding, will produce specific secretory IgA antibodies and many other critical immune factors in their milk to protect their nursing infants and enhance their infants’ own immune responses. At this time, these immunologic factors will aid their infants’ bodies to respond more effectively to exposure and infection. Following good hygiene practices will also help reduce transfer of the virus.”
For more information on pregnancy and birth in relation to COVID-19 (coronavirus), please visit the CDC here.
The nursery is ready, you’ve gotten everything on your baby registry, and your pregnancy is nearing full term. But do you know how to labor effectively and push baby out?
We tend to over prepare for our babies’ arrival in ways that help us when we’re past the finish line, in postpartum. That’s all well and good, but we need to get ready for those last few miles of pregnancy, too. I’m likening pregnancy and labor to a marathon because it is! Actually, it’s even harder. Don’t worry, though. You’re tougher than all of it.
If runners have to train, be knowledgeable about their bodies and have the right tools to finish their marathon, then so do you! It’s important to be educated about labor and birth so you can be more prepared. Just picture it – you’ve been in labor for quite a while. Then your care provider tells you it’s time to push. You’re mentally, emotionally and physically tired. You can see the finish line but it’s one mile uphill. You may be tempted to tell your care provider to go do something unsavory. But you won’t – because you will know exactly what you’ll need to do next.
Have you heard this phrase? You probably have A LOT lately. You’ll be ready to push when you reach 10 cm dilation and feel a lot of pressure on your vagina and rectum, almost like you really need to poop (I know, gross, but it’s true). It’s at this point that you’ll want to bear down (exert pressure) and push.
We’ve all seen “hee, hoo, hee, hoo” breathing in TV and movies during birth scenes. This type of restricted breathing was popularized by Lamaze. However, Lamaze stopped teaching it in the 1980s, so popular culture needs to quit it with this one.
Evidence shows us that the most effective way to breathe during labor and pushing is whatever is most comfortable for the mom. Diaphragmatic, or belly, breathing is usually a very pleasant breathing technique for women during labor. When you feel a contraction coming on during pushing, try to take in a breath and then try to slowly release it while you bear down. Do whatever works best for you!
Don’t run your marathon without getting ready. There’s so much more to learn about labor and birth. Get all the tools and knowledge you’ll need by taking a childbirth education course. You’re almost there! You’ll be in labor soon enough.
You’ve done it! Congrats on your baby, mama! Be proud of what you’ve accomplished. Now it’s time for postpartum care.
Your care provider or childbirth educator may warn you about how you could feel after delivery. If you had a vaginal delivery, you’ll experience swelling around your vagina and perineum. Tearing is pretty common during birth, but there are varying degrees of severity. Third and fourth degree tears (the most severe) are less common, thankfully! And, I’m sorry to say, many of us will experience hemorrhoids from pushing. Every mama needs to take it easy to heal up.
I know this sounds scary. These discomforts, especially after being pregnant and uncomfortable, can be difficult. But you can get prepared for postpartum and what you’ll need to get through those first few weeks of healing.
Here are my top four postpartum care products for vaginal delivery.
1. Ice Diapers
Hear me out – many maternity wards make these for new moms. Take a Pampers diaper and pull apart the top of the diaper. Fill it with ice chips. Then fold the open top and use the sticky tabs of the diaper to close. Watch directions here. This goes right in your underwear and IT WILL FEEL AMAZING.
I had a second degree tear that was very close to being a third degree. Ice diapers were the only things that could completely numb my perineum and vagina. These were the most helpful in my postpartum care. The ice greatly helps reduce swelling after delivery. Another option if you don’t like the ice diaper is to make a padsicle – soak a maxi pad in witch hazel and stick it in the freezer for some nice cold pain relief.
You may find a can of Dermoplast in your hospital room after delivery. It’s used to spray your perineum to cool and help numb any pain from swelling and hemorrhoids. The spray’s cooling effect provides some temporary relief. This was one of my go-tos after vaginal delivery.
Another important product in my postpartum care kit for new moms is Tucks Pads. They are medicated with witch hazel to help relieve, you guessed it, hemorrhoids. But I found its cool temperature great for the perineum, as well. You can put them on your pad or panty liners.
4. Disposable Underwear
While I never saw myself wearing Depends until I reached ripe old age, using disposable underwear was the best advice I got from another mom. Women often bleed for several weeks after birth and may have trouble controlling pelvic muscles and actions, including peeing. A cough or sneeze, and like in pregnancy, a wee bit of wee may come out. I was so glad that I didn’t have to worry about my good underwear during postpartum. If I moved around too much one day and my bleeding got worse or I all of a sudden felt the urgent need to pee and wasn’t sure I’d make it to the bathroom, my disposable underwear had me covered.
Postpartum’s not glamorous for sure, but these items will definitely help get you recover from birth. If you want to learn more about what to expect from birth and postpartum, check out my Informed and Mindful Birthing online class.
Guest post by Melissa J.
I’m a new mom and all I want this holiday season is a break. When I had my son 5 weeks ago, I didn’t get a postpartum doula because I thought between my husband and my mom I would have almost too much help. I was wrong. Recovering from childbirth has been rougher than I thought it would be and now I’m asking my friends and family to skip giving me gifts that will, I’ll admit, sit in my house for months before I find a place for them, and contribute toward postpartum care. It’s the best gift new parents can receive. Here’s why.
We’re Exhausted and Need Help
If there’s one thing we’ve learned in the past 5 weeks, it’s that there’s nothing wrong to ask for help. My husband and I take shifts taking care of our son through the night. We each get around 4-5 hours sleep if we’re lucky. He’s had to go back to work so I take care of our baby the rest of the day. This means I’m the primary caregiver for at least 18 hours straight most days. I love my son, but I’m so damn tired.
When I try to sleep while he naps, my mind just races with anxious thoughts. I can’t sleep without knowing someone else is watching him. It will be such a relief to know that my postpartum doula, a trained professional in mama and baby care, can take care of him and I can take a nap for once.
Postpartum doulas also help with the chores I don’t have the energy to do, like laundry and grocery shopping. Also, they don’t just come during the day. Many do overnights, as well! My husband and I are seriously considering this. I’m breastfeeding, so I will still have to wake up to feed him, but the doula will take care of everything else. I’ll be free to dream of a time not long ago when I didn’t need hemorrhoid cream and Dermoplast to sit down comfortably.
The doula will even make us a simple, healthy breakfast in the morning and watch my son so I can actually sit and enjoy a cup of coffee! New moms – when was the last time you got to do that?!
Our family is giving us money toward a postpartum doula this holiday season and it’s the best gift for new parents like us. We’re so thankful.
Modern Moms is now offering e-gift cards toward postpartum doula care and Informed & Mindful childbirth education! Ask your friends and family to give you something you really need this holiday season – support, empowerment and knowledge.
It’s no secret the TV and movie industry likes to take liberties when it comes to accurately portraying events. But, its representation of birth is perhaps the most dramatic and is negatively affecting our perception of labor and delivery. The differences between a Hollywood and real life birth may surprise you. Below is my list of the worst birth myths that Hollywood perpetuates.
Laboring on Your Back
This is perhaps the most egregious birth myth out there. Known as the supine position in the birth world, lying on your back is the least effective position in which to labor. It is horribly uncomfortable, putting unnecessary pressure on your back during contractions, and doesn’t help move the birth process along. The only reason this portrayal has become commonplace is the popularity of the epidural, which requires people in labor to stay in bed because it causes numbness in the waist down (if it works correctly). Best evidence research proves that birth outcomes improve by laboring while walking and in standing and squatting positions. You are also more likely to tear when delivering baby on your back.
I’m not discouraging or encouraging an epidural. Lots of people get them, including myself after hours of excruciating back labor. All I’m saying is lying on your back before possibly receiving an epidural or while laboring naturally should not be commonplace as shown in the media we consume.
*If you’re thinking of getting an epidural, but don’t want to deliver on your back, ask your care provider about the possibility of giving birth on all fours in the hospital bed. Often the epidural will be turned down so you can feel the need to push after reaching 10cm. If your care provider says it’s hospital policy that you can only deliver on your back when receiving an epidural, talk to your childbirth educator and/or doula about it. They can provide you with research and evidence to speak about with your doctor.
**If you’re ever not happy with your care provider, you can switch to someone else!
Screaming Bloody Murder
Contractions are intense, don’t get me wrong, but you’re not going to hear screams coming from every room in the maternity ward. Most people try to breathe through them and give out a low, guttural moan, which is actually a very positive and helpful action during labor. Deep tone moans help to release tension, keeping the jaw loose and the perineum.
Surprise, surprise that the things women have been doing naturally during birth throughout history have an important purpose! Our bodies are amazing. We need to trust our instincts rather than what our media tries to sell us about childbirth.
My Water Just Broke!
Hollywood loves this one – the pregnant woman who has been experiencing little to no contractions all of a sudden has a gush of water spray from between her legs. Cut to a look of shock on the characters’ faces as the woman yells, “My water just broke!” Then they rush to the hospital. Life seldom imitates this art.
While, yes, some women do experience a gush of water when their amniotic sac breaks, it’s more common for women to feel a trickle of water down their legs. This all depends on where the amniotic sac breaks. If the protective barrier separates in the back or sides, then it takes longer for the fluid to get out, hence the trickle. Your bag of waters may not break at all until you start the pushing stage.
There’s also no reason to rush to the hospital if your water breaks beforehand, unless it smells funky and has a green tint. This could mean baby has passed meconium in the amniotic sac and your care provider will most likely want you to come in. Call your midwife or doctor if this happens.
*Remember, if you’re labor is low risk and you’re having a vaginal delivery there’s rarely a good medical reason for your care provider to break your bag of waters. It increases the risk of infection and there’s no harm in letting it break naturally on its own.
Hope you enjoyed reading about these birth myths! Learn more about childbirth with my Informed & Mindful Birthing online class.
Healing During Postpartum? It’s Not Always That Easy
The moment you’ve been waiting for has come and gone. Baby is here! You did it! Whether you went natural, had medical interventions or surgical birth (c-section), you delivered your sweet little one. Now it’s time to go home. Your care provider gives you “The Postpartum Speech” before you leave the hospital. Do this, not that. Don’t push yourself to do too much. If you do, your bleeding will come back or get worse. Take it easy. But here’s the catch – you have a new, tiny human being that depends on you or you and your partner 24/7.
Diapers need to be changed. Dishes washed. Laundry cleaned. When I brought my daughter home, I felt like the medical advice I was given was impossible to follow. Something constantly needed to be done. Take it easy? How? Please someone tell me.
I came home with a third degree tear (Yup. You read that right). Moving was so painful. Sitting was unbearable. Getting up, walking and standing were the worst. Whether you tore like me, didn’t tear at all, or had a c-section, birth is exhausting and recovery can be rough. All I wanted to do was lie perfectly still in bed with an ice diaper and a heating pad on my back and sleep for seven days straight. Alas, this wasn’t an option.
My Privilege & My Mistake
The most eye-opening part of this experience was that I had help. So many other moms don’t have others to rely on after bringing baby home. I had my husband and my mom even stayed with us for the first two weeks. With all this support, I didn’t think I would need a postpartum doula. I thought, “Of course I’ll be able to get rest. There will be three of us to take care of the baby. Why would I need anymore help?” The three of us took turns sleeping, bottle feeding, rocking baby and washing dishes. And yet I was on my feet way more than I should have been.
My body had been through something extreme. Researchers liken birth to completing a marathon or climbing Mount Everest. We were all taking care of the baby. There wasn’t much time to take care of me, too, though my family tried their best.
Learning to Balance
While getting rest to the extent I needed to heal more quickly was not going to happen, I realized not getting a postpartum doula was a mistake and that this process was going to take a lot more time. My bleeding would come back, I’d stay in bed for day. Bleed, rest, repeat. Bleed, rest, repeat. I had to learn my new limits for those first six weeks.
I needed to heal and take care of myself; I needed to take care of my baby. Those two things were in constant conflict of each other. I suppose this is one of the earliest lessons in motherhood – the need for balance. I’m still learning.
Sending love to all you mamas!