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​Optimize Your Prenatal and Postpartum Support

2/3/2022

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Postpartum can be such a special yet vulnerable and sometimes challenging time. Especially as a new parent, you may wonder if each noise and movement is normal (most of the time it is), if baby is “getting enough” (vast majority of the time it is), and if you’ll ever sleep through the night again (yes you will!). Hybrid midwifery care can offer peace of mind as you navigate the transitions of early postpartum. In at least four appointments throughout the first six weeks after birth, we assess both birthing parent and baby—things like taking vitals, checking baby’s weight, and doing lab work, but also emotional check-ins, networking support, and navigating feeding baby. Newborn testing, like bilirubin and newborn screening, can be done in-home as well. These appointments are very individualized, focused on your specific needs.
 
While hospitals generally schedule 1 postpartum appointment at six weeks and often you see a pediatrician every few weeks, a lot can come up in between these. Sometimes it seems like there’s so much support prenatally and for the birth but then you are left to your own devices with a newborn. That compounded with sleep deprivation and family transitions can be overwhelming at times. Having a licensed healthcare professional available to answer your questions and come to your home for all appointments can offer extra reassurance.
 
In-home midwifery care can complement your scheduled postpartum visits with your primary provider. Hour-long appointments are also available prenatally, in which childbirth and chest/breastfeeding education is reviewed, labs can be performed, and preparation can be discussed in more detail for your upcoming labor and birth. These appointments can help integrate what’s reviewed with your primary provider and provide supplemental information.
 
Here in Santa Fe, both Lucy French (www.wildwoodmidwifery.com) and Rebecca Palak (www.rebeccapmidwifery.com) are New Mexico Licensed Midwives offering hybrid care in the comfort of your home, as well as home birth services.
They offer a free consultation to review care and answer any questions you may have; contact either or both to find out if hybrid care is a good fit for you and your family. Pregnancy, labor, and postpartum is such a transformative time in our lives; having support is crucial.  
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Choosing a Maternity Care Provider During Covid-19

6/3/2020

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Choosing a maternity care provider is a more significant decision than you might think! In fact, who you choose can greatly influence the course of your pregnancy, birth, and postpartum experience. For so many reasons, a provider's philosophy directs the options that they give you, right down to how they handle variations of normal during pregnancy to what position they want you in to have your baby. Doctors and midwives carry their own expectations for birth. A provider’s idea of what an “ideal birth experience” looks like may not match yours.

Choosing the right maternity care provider is especially important these days, given the limitations, changes, and unknowns that pregnant people are facing due to the COVID-19 pandemic. Across the nation, pregnant people are adjusting to Telemedicine prenatal visits, online childbirth education courses, and virtual doula support on FaceTime. For those giving birth in the hospital, the COVID-19 related restrictions in place that limit the number of support people allowed in a birthing room can cause a lot of anxiety & disappointment. It’s a tough time to be pregnant, but you’ve still got options! Continue reading to find out more….

What are my choices? What kinds of maternity care providers are there?

Many pregnant people feel their only choice in a maternity care provider is a hospital-based OB/GYN (Obstetrician/Gynecologist). However, this is not the case for those with low risk pregnancies! OB/GYNs do offer services for low risk pregnancies, but they actually are trained surgeons who specialize in more complicated, or higher risk cases (they are the specialists who perform Cesarean section births and other complex surgeries). The services provided by an OB/GYN are not necessarily the best option for someone with a low risk, healthy pregnancy.

If you’re someone with a low risk, healthy pregnancy, you may want to consider working with a midwife. Midwives are trained in normal, physiologic birth and they tend to view health care as a collaborative process. In the United States, we have two primary “types” of midwives: Licensed Midwives (LMs) and Certified Nurse Midwives (CNMs). Licensed Midwives provide home birth and birth center services. Certified Nurse Midwives typically work in hospitals, but they can also serve those desiring to birth at home or in a birth center. Working with a midwife lessens your chance of having an episiotomy, vacuum/forceps delivery, and Cesarean section birth while increasing your likelihood of successfully breastfeeding and being satisfied with your birth experience.

One option for out-of-hospital birth is the Santa Fe Birth Center. During an interview with SFBC’s Clinical Director Rebecca Palak, she explained that the midwives at Santa Fe Birth Center value support people and doulas throughout the birthing process and encourage their clients to have both. They follow the midwifery model of care, which includes hour-long prenatal and postpartum visits, in order to foster a relationship and for clients to feel comfortable in the birthing space. Once your baby is born, they offer the one-day postpartum visit at home. They also promise inclusive, individualized care from pre-conception through birth, postpartum, and well-person visits. They offer regular tours and welcome questions.

Another option for low risk pregnancies is home birth. Wildwood Midwifery is one of several home birth midwifery practices in Santa Fe. Wildwood Midwifery offers comprehensive prenatal, labor, birth, and postpartum care. Appointments are hour-long, and take place in the comfort of your home. Lucy French, owner & primary midwife at Wildwood Midwifery, finds that families tend to birth and parent with more confidence when they understand their choice and make informed decisions. Her goal is to facilitate this process by providing thoughtful, un-rushed prenatal and postpartum care. Lucy offers free consultations for anyone interested in home birth and midwifery care. Like the Santa Fe Birth Center, she values and encourages families to have support people and/or doulas during the birthing process.
Sometimes we don't have the luxury to choose our providers, whether for financial, medical, or other reasons. If you find yourself in a scenario where you desire a home birth, but your health insurance doesn’t cover that option, then your choices may become more limited. If your pregnancy is complicated and requires medical intervention, you may need to be seen by a specialist who you didn’t originally choose to work with. However, if your pregnancy is healthy and low risk, you certainly have options to choose from.



How do I choose my provider? How do I make the best choice for myself? 


The process of choosing your maternity care provider can begin with figuring out your desired place of birth. Do you want to have your baby in the hospital? At home? In a birth center? Once you’ve selected your preferred birth setting, your provider options are automatically narrowed down to choosing someone within that scope. Ask trusted members of your community for recommendations, and be sure and come up with a list of questions to ask during a consultation or initial visit. Set up interviews with midwives and schedule a tour of your local birth center! Be thoughtful about who you choose, and pick someone who resonates with your preferences and philosophy. 


What about the COVID-19 pandemic? How does that impact my choices or decision making?


As you consider who you want your provider to be and where you want to give birth, you may be wondering how the COVID-19 pandemic will alter the course of your pregnancy, birth, and postpartum experience. Many pregnant people across the country are choosing to give birth at home or in birth centers because of hospital restrictions and the potential increase in exposure to the virus in a hospital setting. Others are continuing with hospital care because that is where they feel safest. All reasons are valid - just remember that most of the time, you have options. Many home birth and birth center midwifery practices are open to working with families who decide to switch from hospital care quite close to their expected due date, for example. The best course of action is to ask questions and do your research.


Here’s a preliminary list of questions to ask a provider at an initial visit or consultation. Keep in mind that this information may change throughout your pregnancy.


  1. What kind of protocols does your practice have in place to help minimize the spread of coronavirus?
  2. What can I expect for prenatal visits? Do you offer in-person visits, or will they primarily be virtual through a Telemedicine app?
  3. How many support people will I be allowed to have in labor?
  4. Do you offer rapid coronavirus testing when I go into labor? What happens if I test positive? What happens if I test negative?
  5. What kinds of requirements do you have regarding mask-wearing in labor? Will I have to wear a mask when I’m in labor? Will my partner have to wear a mask?
  6. What kinds of protocols or requirements do you have in place once my baby is born? Will I be restricted from holding him/her for any reason?
  7. What is your policy on skin-to-skin contact and breastfeeding given the COVID-19 pandemic?


We know there is a LOT to think about right now and a LOT of information out there. Always remember that it's your body, your baby, and your birth experience. Where and with whom you give birth matters. Take time to consider who will offer you the best choices for you and your growing family. 


Please let us know if we can support you in anyway during your pregnancy.
info@thebirthingtree.com 

505.552.2454


*This post is co-written by Licensed Midwife Lucy French and Nurse-Midwife Shabd Simran Adeniji. Thank you for understanding that this guidance is based on professional experience and should not be considered fact. 

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Reclaiming Postpartum Rites of Passage

3/10/2019

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The time after childbirth is marked in many different ways around the world. Given our modern lives we may not have the opportunity to witness or experience any of these postpartum rites within our community. More so, we may only hear bits and pieces of traditions practiced generations ago within our own families. Even with the resurgence of attention on the importance of caring for the postpartum person, the layers of social, physical and emotional support can seem like a far away ideal that perhaps only the privileged in western society may have access to. As an indigenous midwife, it is more important than ever to provide culturally responsive care that includes such postpartum rites. Within my tradition specifically, I am speaking of the cuarentena or forty days laying in period after birth and the cerrada de cadera or  “closing of bones” ceremony.

I have found that the laying in period after a birth and the ceremonial closing or binding of the womb is common among many cultures. The specific design of each tradition is unique and intelligent to the environment, social/spiritual traditions and materials available. It is well understood that the time immediately after the birth of a baby will help define the well being of the birthing parent for years to come. Were valuable nutrients and warmth reintroduced into the body? Was the body that birthed honored in a compassionate way to energetically release or integrate the birth experience? Was the transition into “parenthood” treated as a rite of passage to assist the new parent with the integration of a new identity? It can be challenging if not impossible to answer these questions when we aren’t sure what options exist or more so if the context for them to exist at all has never been introduced.  

As an indigenous midwife, I have taken the path to reclaiming and remembering the ancestral rites that accompany my work. Yet, even with the tools in hand, the biggest challenge is helping others to also reclaim their memory. Not to mention, the social and economic barriers that keep most postpartum parents from practicing a forty day laying in period.  Most if not all home birth midwives work to promote as much of a laying in period as possible and we are able to be part of the care team with multiple postpartum visits. In addition to this, I also provide my clients with a ceremonial closing. The cerrada de cadera or “closing of bones” involves the ancestral practice of re-introducing warmth to the womb with a bajo or vaginal steam bath, a womb message, the apapache or loving embrace created with the use of traditional rebozos and sometimes the binding of the womb as needed.

Although these practices fall well outside of “clinical” practices in the West or even in many places in the world, more and more modern medicine is catching up with what our ancestors already knew. It was not that long ago that I did a search on the subject of the forty day laying in period and found lots of articles and research studies quantifying the benefits. It may be some time yet before the same will be true for the ceremonial closing done at the end of the forty days but until then, I will continue to do what I can to steward the ceremonial rites of my ancestors and to support others to do the same.

To all my relations,
Monica Larrea de Arellano, LM, CPM
daughter of Josefina M. Larrea and Ruperto Larrea
(written with the permission of my elders, teachers and spirit guides)

Note from The Birthing Tree: Monica is one of our trusted community partners, if you would like to know more about her midwifery services or the cerrada de cadera ceremony be sure to visit her website and mention The Birthing Tree for a 10% discount!
web: parteriacolibri.com
email: parteriacolibri@gmail.com

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Your Baby's Sleep: Busting Myths & Helpful Tips

2/2/2019

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After years of working with new parents a primary request is always for evidence-based, reliable information about sleep. While this is a good goal, achieving it can be a challenge in the midst of information overload.
 
This is true whether we want to know when to introduce solids and in what order, how to best support a child’s social-emotional development, or how and when to make sleep changes. 
 
When looking for information about sleep there are many books that are opinion-based rather than evidence-based. This can be confusing and frustrating when you want to make an informed choice based on advice you can trust.

The traditional field of infant sleep research is limited. The research that exists is primarily focused on one area: behavioral changes. Newer sleep research looks at the emotional impact of sleep training, temperamental and other influences in sleep challenges and disorders, as well as linking sleep disorders in childhood to attention and learning challenges later on. This research debunks much of what experts have “known” about infant sleep.
 
As you gather evidenced-based information to make decisions about sleep for your family here is some useful sleep information to get you started:

Myth: A baby's sleep patterns are fully developed at birth.
 
Fact: Babies' sleep patterns are not fully developed at birth. In fact, one of the most common reasons babies aren't able to "sleep well" is that the part of the brain that organizes sleep is just beginning to form in the first three- to six-months. The development of circadian rhythms, the biological temporal rhythms that help our bodies "know" a 24-hour day, and the difference between day and night, begins to develop after birth. You baby develops a circadian rhythm based on cues in the environment like your support and care, exposure to sunlight and consistent routines. You can help your baby develop his or her circadian rhythm through consistent routines, exposure to natural light during the day and darkened rooms at night, even during feedings and diaper changes.
 
Myth: There is only one method to teach a baby to sleep.
 
Fact: Research (and my five years of experience as a sleep coach) shows you can effectively use one of many different methods to help a baby or young child learn to sleep. It is the consistent implementation of the strategy that determines success. Whether or not a sleep method is successful is mainly dependent upon parent readiness, consistent implementation of a strategy to improve sleep, infant temperament and how your baby responds to a specific approach.
 
Myth: All babies need the same amount of sleep.
 
Fact: Just like adults, babies vary in their need for sleep. Some guidelines you can use to check if your baby’s sleep falls within a typical range are:
​
 Newborn
 16 – 20 hours per day

 3 weeks
 16 – 18 hours per day

 6 weeks
 15 – 16 hours per day

 4 months 
 9 – 12 hours, plus 2 naps (2-3 hours each)

 6 months
 11 hours, plus 2 naps (1.5-2.5 hours each)

 9 month
 11-12 hours, plus 2 naps (1-2 hours each)

 12 months
 10-11 hours, plus 2 naps (1-2 hours each)

 18 months
 13 hours, plus 1-2 naps (1-2 hours each)

 2 years
 11-12 hours plus one nap (2 hours)

 3 years
 10-11 hours plus one nap (2 hours)

 4-5 years
 10-12 hours with no nap, or one nap (1-1.5 hours)

 6-7 years
 9-11 hours with no nap

Tip: If your baby is getting enough sleep he or she will wake up sunny, cheerful and in a good mood. If your baby is not getting enough sleep he or she will wake up cranky, sullen or grouchy. Your baby’s mood upon waking is the best gauge of “enough sleep.”
 
Myth: If my baby doesn’t sleep well by a certain age, he or she will never be a good sleeper
 
Fact: There is no “magic age” to become a great sleeper. Like other important life-long habits, like eating healthy foods, it is best to learn good sleep skills before kindergarten. Within those first five years the “right” time to help your child become a skillful sleeper is when you are ready.
My son woke every hour or two for sixteen months. When I finally figured out, and committed to, a strategy to help him learn to sleep he became an amazing sleeper in three nights. And he’s slept 11-12 hours a night ever since.

Babies have the basic developmental capacities to self-soothe as early as 3-5 months-old. It is up to you when you are ready to help your baby learn to use these capacities to fall asleep at bedtime and stay asleep for most or all of the night.

For more information about sleep join me for a free sleep class at The Birthing Tree March 2nd, 2-3pm
Please register with Tekla Johnson, LLC, LCSW www.teklajohnson.com (505) 920-7818  
You can also, sign up for a free monthly newsletter, read my blog about sleep topics like naps, bedtime, travel and more, or to schedule a free, initial conversation with me to talk about next steps to improve your family’s sleep.


Article by guest blogger Tekla Johnson 
 
 

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Finding your Manners when you’re Mad

6/27/2017

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 As an etiquette consultant I’m often asked what age I start teaching students. I offer classes starting at age four but teaching good manners starts at home right out of the womb.
 
While I wasn't focusing on forks and thank you notes with my then toddler son and my baby girl, now 9 months, I was keenly aware of my behavior towards them and my peers. Children are much more likely to do as you do than as you say. So as parents we have to lead my example. Since these foundations of life skills start in the home this means that children will learn their social skills by watching how you behave with fellow family members.
 
My husband and I say “please” and “thank you” to one another. We make eye contact regularly. Well, at least we try and therein lies the challenge.
 
Parenting is a full time taxing job full of highs and lows. There are moments and, sometimes days, where I’m impolite and snappy to my partner. There are evenings where I raise my voice and rude things come flying out of my mouth. And in front of the children. I’ve slammed doors, teared up and used “bad words”, as my son would point out.
 
Seconds later inevitable regret washes over me. Why could I have not handled that better? Why wasn't I more articulate?
 
Why not? Because this is real life. Not every moment in front of your children can be sanitized, polite and rated G. Arguing in front of a child isn't always wrong. It shows that even parents are human, make mistakes and get upset the same way a child does. Coping mechanisms as adults can be akin to a toddler break-down in the grocery store.
 
However, instead of protecting your children by pretending a disagreement hasn't occurred or changing topics right away you should acknowledge these challenges with a display of problem solving with your partner and an age appropriate conversation with your child. Make it a teachable moment.
 
Children need to learn problem solving and conversation skills. If we, as parents, run from confrontation, then our children will be done a disservice thinking that they can’t voice their concerns and stand up for what they believe in. Alternatively, if we just yell and push our views to exhaustion, we don’t teach children valuable listening skills and that there are two sides to every story. A future bully might be born out of these environs.
 
When words get the better of you and your partner try these tips to work towards resolution and show your children how to manage conflict.

  • When you’re headed for an argument, count to five or 10 to prevent an outburst. You may still be angry but your tone of voice and words might be tempered thus received better.

  • Speak with your child. Try: “Mommy and Daddy sometimes don’t agree about ___ but we still love each other” or “I’m sorry we used loud voices in front of you. Mommy got mad and I’ll talk with Daddy about it to make it better.” Depending on how serious the argument and the nature of it, reassure your child that they are not at fault and they are loved and safe.

  • Ask your partner if you can find a time to speak about your disagreement when you are both calm and collected (and potentially away from the children). Scheduling a conversation has worked wonders in my relationship.

  • Apologize to your partner and in front of the children even if it’s not your fault and no resolution has been found. Try: “I’m sorry we’ve argued. Let’s continue this later” or “I apologize for raising my voice.”
 
There’s no perfect relationship and certainly no perfect way to handle an argument but there are rules of etiquette to help guide you once you find yourself in a quagmire. Practicing them in front of your children sets an example of conflict resolution, tools your child will benefit from for years to come. It also exhibits respect towards your partner and that you are equals.
 
Every parent wants their child to have good manners. By circling back to etiquette in a variety of scenarios they will grow up to be not only polite but empowered and engaged citizens.
 
Bizia Greene owns the Etiquette School of Santa Fe. Send your comments and conundrums to hello@etiquettesantafe.com or 988-2070.
 
 
 
 
 

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A Tale of Two Births

11/1/2016

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Number one: Trial by Ordeal (or The Initiation)
My muccus plug came out on shabbat, probably during the prayer for wine. I was 38+6 weeks. I had read somewhere not very reputable that the first child arrives on average 8 days past its due date (41 +1) so I figured I would just be muccus plug-less for a few weeks. I continued ritually welcoming the holy day of rest without much expectation. I had bronchitis that was maybe pneumonia. I hadn’t slept in over a week (ha! I thought that was bad!). I kept doing neti pot because I was pregnant and couldn’t do anything else. It kept not working. I kept bending down lower trying to coax the salt water through my sinuses in a way that would be cleansing and not drowny and useless. I kind of hung upside down over the sink.So when my lower back started to hurt, that’s what I attributed it to – irresponsibly over-aggressive neti pot posture.
I went to sleep. I woke up. I was having contractions. Except they were in my back. And they didn’t hurt very much. A and I excitedly got out a notebook and timed them. They were 3 minutes apart! I was even better than 5-1-1! And it didn’t even hurt that much. I smugly thought about all the bicycle commuting I did throughout my pregnancy against the advice of my coworkers. Also I hiked like every day. That’s why my labor is so easy, I’m just so fit. Or maybe I’m just tougher than everyone else. I had never thought of myself as particularly pain tolerant, quite the opposite, but when it comes to this most primal of all experiences, my body just knows what to do. I called my mom and told her I was having contractions three minutes apart. I had some while on the phone but they didn’t hurt much, I could still talk. I called my doctor. She was skeptical. When she heard I was bleeding, she said to go to the hospital to get checked. We giddily grabbed our hospital bag, which contained two neti pots, some organic cheeto/pretzel snack mix, a ginger drink, and clothes for me and the baby to wear home-and headed over. The triage nurse checked me. 2.5 centimeters. We and our neti pots were sent home.
On the way home we stopped at Albertsons for some matzo ball soup ingredients. My contractions and I waited in the car. I ate matzo ball soup, then eventually it was dinner time. We went to some Italian place and I ate pasta like I was not going to be allowed to eat for two more days. We came home. The contractions got more painful. They stayed in my back. I never felt anything in my uterus. We decided to watch a funny movie for distraction like you’re supposed to but we didn’t really know anything about funny movies so we just picked Bridesmaids which is weird and heteronormative and not so funny. By 11pm I was in real pain. I realized my cycling and hiking weren’t shit. I was sure this was active labor. 3cm according to the triage nurse, but they admitted me I think out of pity and because there was a lot of blood. “This looks like an OP labor” she remarked. She was weirdly gruff for a New Mexican lady. “What’s an OP labor?” “Sunny-side up. The baby is facing the wrong way. Her back is facing your back. That’s why your labor is in your back. These labors are really painful and really slow.”
Our friend who was studying massage therapy was with us as a support. I needed her to push as hard as possible on my back for every contraction. I thought each one was going to take my life. I had two minutes to neti pot and then I would feel one ramping up again and I would scream PUSH and she would position herself and lean as hard as she could.
There was a nurse on duty that used to be a doula. Or still was a doula but right now was a nurse. She super kindly volunteered to help me flip the baby. There were all kinds of props, scarves and birthing balls. So many positions. I only wanted to be lying in the bed on my right side. Words kept coming out of her mouth at me and making me have to comprehend them and then move and it all hurt so badly it was almost unbearable. I finally said I felt the baby flip to make it stop. I did not understand doulas. I hated them.
I had kind of avoided any mention or image of birth on the internet so I wouldn’t have any expectations but I did somehow internalize that at some point one needs to be in a tub. I was holding on to this idea through each contraction like a piece of a rope in some kind of scuba diving disaster rescue situation. I felt like each contraction was going to break me. I asked to get in the tub. The nurse gently suggested that I wait until things were a little further along. I demanded to get in the tub. (I also felt like at some point I was supposed to be demanding things). It really felt like it was about survival. I just had to get in that tub, and we would survive.
I got in the tub. It was unfathomable to me, but the contractions actually hurt just as much in the tub as out. I got out of the tub and left the useless scuba diving rope behind. I don’t know how but I stayed alive the rest of the night.
Around 11am the nurse checked me again. “I’d say 4cm?” she said in a way that was clear that she was being generous. I used the absolute last vestiges of my energy to break down into hopeless, desperate sobs. I felt the beginning of the next contraction pull me under. The doctor was called.
She suggested two interventions, break my water and give an epidural. I agreed to the water breaking. She stuck a wooden hook into the water bag and all the amniotic fluid gushed out and immediately things became even more intense. I descended into a world of shadows and archetypes. The nice nurse was like a guide across the river styx. I stopped seeing. At one point I was on the birthing ball in the shower. The ball was over the drain. The room flooded. Water dripped into radiology below. There were many people, men, in my room, wondering about the deluge, and I took absolutely no notice of  any of it.I stopped worrying about whether I would die. The only thing I was capable of knowing was the forming, cresting, and ebbing of each contraction.
An hour later i was checked again. 5cm. “I think an epidural would help you” said my very very natural-y, non-interventionist doctor. A: “I really think you should get an epidural” Me,”No.” I don’t understand words. I’m remembering from some distant, unrecognizable past that I wasn’t going to get an epidural. That sounds right. A: “I really think it’s a good idea” Me – “Ok”  Just stop. The nurse anesthetist came. When she forced herself into my consciousness I could only vaguely perceive her as an evil witch with terrible potions. They prepped me to shove an extremely large needle down my spine. I did not give a fuck. The only thing I cared about was that I wouldn’t be able to have my friend push on my back during the contraction when they were preparing my back.
And then they stopped. I slept for an hour. I woke up. I was shaking violently. I couldn’t drink enough water. I had to drink all of the water. I vomited. I drank 10 gallons more water. The vitals machine sounded an alarm. The evil witch came back and injected something into my IV. “What’s that? ” “Epinephrine. Your blood pressure is too low” More violent shaking. I said I felt pressure. The nurse checked me – 10cm and ready to push. The nurse put her hand on my uterus and watched the machine, informed me of when I was having a contraction, and told me to push. I pushed like I was trying to split myself in half. Nothing happened. I had been in labor for so long that my contractions were petering out, not strong enough to help the baby out. I was given pitocin. Eventually the Dr remarked that she could see the baby’s head and could put a bow in her hair. At one point the nurse took my temp, looked alarmed, showed it to the Dr. The dr remained impassive and just said “It’s ok. She’s drinking plenty of water” I even tried to drink water while pushing. Eventually, after three hours, I asked if maybe this called for the vacuum. The Dr agreed that that was a good idea. I didn’t look at it but I imagined a dust buster with my baby’s head in it. She got it in position and told me to push as hard as I could. I summoned all of my remaining strength and everyone else’s and the epinephrine’s and PUSHED. Y was here.  She was perfect. Strong and beautiful and mysterious and so familiar. I had never seen such a creature. It was like the universe cracked open and god fell out. I loved her.
And I was in such shock.
Y’s temp was 102.5 and the doctor, amazing as she was, told the nurses that she should stay with me rather than being brought to pediatrics because she knew she had a fever only from cooking in my crazy feverish body, not because she had an infection. Her temp dropped quickly. She stayed with us the whole time, got a perfect APGAR score and latched well. I was given antibiotics for pneumonia and a nebulizer.
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​Number two: He Basically Just Crawled Out in My Sleep
We hired a doula for this birth, even though I was doubtful of their usefulness. We only had two questions for the potential doulas: Are you homophobic? Are you ok with epidurals? Because we’re gay and I’m getting an epidural. Much sooner this time.
I weathered another end of pregnancy bronchitis adventure this time with a different doctor who strongly encouraged me to take drugs and sleep – better for baby if I sleep than if I stay sick and cough myself into early labor because I didn’t want to expose him topharmaceuticals.She tried to give me Ambien. I took the cough syrup with codeine. I slept 5 hours one night and  finally got better after five weeks of refusing drugs and staying sick.
I started to have some back pain and so I went to acupuncture at 38+6 days. The Acupuncturist asked if I wanted her to get labor going. I declined.It was dark when I walked home, but it was snowing and bright so I didn’t trip over anything for once. Around 10pm I started to feel twinges. In my fucking back again. By 11pm they were regular and not so painful. Nothing to see here, I know what this looks like, let’s all go to bed. Our doula told us that in early labor I should sleep as much as I possibly could which was damn good advice. She had also shown me different positions to hang out in to encourage the baby to be facing the right way. I kind of dozed in those positions. My three year old who never sleeps jumped on my back and asked me to be a horse. The contractions got a little bit stronger around 5am (and they were also in my uterus!) but still nothing to write home about. I didn’t write home,  I did write to the doula just to warn her that in the next few days I might have a baby. I hesitantly woke A and had her push on my back for some of them, but most I could just breathe through. My daughter petted my face as I breathed. Then she went to dance class with Grandma, who was visiting to take care of her when I went into labor.
Around 9am I realized I was hungry. I ate fried eggs and a peanut butter banana chocolate smoothie. All of it. The contractions were 5 or 6 minutes apart but I still didn’t make much of them. I asked A if she thought we should write the doula. “I just don’t think you’re there yet, compared to last time.” I agreed. The doula suggested getting checked at my Dr’s office since then I’d skip triage at the hospital if I were admittable. I thought we should wait, but then I became curious.
I got dressed and we left. Anne threw the hospital bag in the car cause why not?. This one also contained organic cheetos-so good for pushing babies out. When I was standing, the contractions were coming much faster but still not so painful. I had to manage a contraction outside before I could make it to the receptionist. She asked how quickly they were coming. I looked at my watch. Actually, about every minute. I learned against the wall to deal with another one.
I told the doctor to lie to me if I were any less than 3cm because it would be too discouraging. She agreed. She checked me for ten years. I waited to hear “3cm” But instead: “There is no cervix there. You are like 9.5cm. And the baby’s head is RIGHT THERE. Why are you not at the hospital??? Ok.. I just got an emergency kit so I can deliver you here. Do you have to push?” I did not have to push. We all rushed to the hospital.
The 0.3 miles between the clinic and the hospital is primarily composed of speed bumps. A flew over them like there was not a baby evidently about to fall out of my vagina. We waked into our room and somehow the dr. had already teleported herself there. I got hooked up to the monitors and cracked some jokes between contractions. I was convinced that the Dr had somehow missed my cervix and that I was actually like 3cm. No blood, no mucus plug, I’m having a coherent conversation, I pointed out to the nurse. She kind of agreed. But I didn’t want to be checked again.
Then I  was in transition. I descended down to the pain place. It was incredible, magnificent pain. The hot shower maybe helped  and then it didn’t. An hour went by.I still didn’t feel the need to push. I was stuck. I panicked. I can’t stay in this place. I want an epidural.
The doula calmly said that sometimes when people feel stuck there’s something they’re afraid of. She asked if that was maybe happening. She expected me to worry about tearing or pushing,but I burst into tears and said “we never did the genetic testing and I’m scared that he has a chromosomal abnormality.”The doula calmly encouraged me to maybe just worry about getting him here.
But voicing my Down’s Syndrome concerns didn’t lead to eviction. She recommended that I pee. I stayed on the toilet for several awful contractions and then finally felt like I maybe needed to push. I asked the Dr to break my water, which still was intact. Then I was really ready to push.
The feeling of pushing not numbed, I will never forget it. It is crazy. It was like 7 pounds of jello in my vagina. Bone-in jello. I pushed for three contractions. Each time I was told to rest between contractions, gear up as the contraction gears up, and then give it my all when the contraction peaks. I could feel the jello go out and back in. I didn’t think we were getting anywhere. At the fourth contraction the Dr said, “The head and shoulders are out, let’s get the rest.” She yelled at me to push. Some crazy strength came over me and I did as I was told. With enormous force. I think a noise even came from me from somewhere. Then I lay back down to get ready for the next contraction.”Look down, your baby’s here!”
And so he was. I couldn’t believe it. He was already shining, light, so happy to have landed here. He was totally embodied. He was love. I loved him. I was so scared I wouldn’t be able to love someone as much as I loved my daughter but here he was and I did.
Delivering the placenta HURT.
Several nurses called me rock star. I wanted to let it get to my head but I knew better.
Here’s what I learned:
The way your birth goes is all about chance, mostly the position of the baby. You can’t control it. You can’t prepare for it. You can’t be doing things right or not right. And especially this: If your birth did not go the way you anticipated, it has nothing to do with you having unresolved something or other that stopped you from truly accessing your whatever. I had much more unresolved something or other with N’s pregnancy but my whatever was evidently engaged. How it goes is how it was going to go, how it was supposed to go and you just brought a new life into the world, and people profiting from preaching ecstatic births or results from hypo whatever or spiritual techniques etc should really take a look at what they’re doing because in my opinion it is fucked up to try to make people think they can control this and are supposed to have a particular experience and failed if they didn’t.And the obvious corollary, if you were lucky enough to have a relatively easy birth, it was just luck and other people who weren’t so lucky are in no way less good at it than you are.
Contrary to what I might have initially feared, hospitals don’t send anesthesiologists to suddenly pounce on you and shove a needle in your spine the second you walk in the door. In fact having the option of an epidural was super helpful for me and saved me from a c-section. I have all respect for all types and places of birth, seriously, but I don’t think the hospital is a terrible option.


People who give birth without medication are not amazing heroes of strength and power and endurance any more than anyone who gives birth in any scenario. It’s all completely unfathomably amazing. But people who have back labor kind of are the toughest.
Basically, just not judging, ourselves and others. There’s no control over any of it and the sooner we get ok with that first and hugely important lesson of parenting, the better this continual ripping apart of ourselves (in order to make room for life and growth and amazingness) that is parenting will go for us.
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Encapsulating Your Placenta

10/1/2016

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I have had two pregnancies, two successful births, and two postpartum periods. My first postpartum period resulted in one of the darkest depressions I have ever experienced. The second was completely the opposite, so much so that it is staggering. What did I do differently the second time that caused me to be in awe of my new child versus feeling like I was spiraling into the deepest, darkest hole imaginable and that danger could be around every corner? I ingested my placenta in a pill form. You read that right, I ate my placenta.
 
 
Guess what? I'm not the only one. The popularity of the practice of placentophagy is increasing exponentially. Women are finding the benefits of ingesting their placenta to be invaluable, and are ignoring conventional thinking that it has no benefits and is only medical waste. Although few studies have been done on the effects of placentophagy, in one study, interviews were done with women who had recently ingested their placentas after giving birth. "When asked to rate how positive the placentophagy experience was on a Likert scale, the majority of women reported that placentophagy was a very positive experience (75%) or positive experience (20%). Four percent of participants described it as slightly positive and 1% of participants selected not positive. Nearly all participants (98%) indicated that they would participate in placentophagy again." (1) 98% is a statistical number that is rarely seen. Having the knowledge of this percentage along with my own experience and the experience of my clients, I would say that there probably something to this placentophagy thing, despite the opposition.
 
 
During pregnancy, we hear so much about how to take care of ourselves and our unborn babies. We get advice from our practitioners, family, friends and even, on occasion, strangers on a range of topics such as what to eat and not to eat, how to exercise and what pre-natal supplements to take. Rarely do we or others question how we plan to be supported during the postpartum period.  As natural as pregnancy and birth are, these events take a tremendous toll on a woman's physical body, hormonal balance and emotional wellbeing. This can result in a very turbulent experience for the mother, baby and the rest of the family after the baby is born. After birth, there is always a ripple effect that usually originates with the mother and tends to permeate everyone in the family. Making this ripple as positive as possible results in a much less stressful situation and a happier family. And really, what is more important than the happiness of the family? We need all the help and resources we can obtain during this time. I personally feel that taking the placenta pills is one of the best things a new mother can do for herself.
 
I was devastated that I was unable to take the pills after my firstborn. Somewhere deep inside me, I knew I had missed an opportunity to heal faster, balance myself and have a profound source of support. Not only was I greatly affected by this depression, but naturally my husband and my new son were as well. Three and half years later when I had my daughter and was able to take all my placenta pills, I did not experience any depression at all! The difference in my two postpartum experiences was like night and day. I was so inspired by this difference that I decided to provide this service for other women, and a year after my daughter was born, I began to encapsulate placentas myself.
 
The positive effects of ingesting your placenta go beyond prevention of postpartum depression. The pills will give you energy, boost your immune system, balance and stabilize your hormones and your moods, replenish your iron, provide key minerals and vitamins, and enhance lactation and milk production. The hormones will also remind your uterus that it knows how to heal and will stimulate your endocrine system, especially the hypothalamus gland to bring your body back to homeostasis and regulation. This is done by maintaining cortisol levels.
 
Specifically, placenta pills have been known to:
 
  • Increase general energy
  • Allow a quicker return to health after birth
  • Increase production of breast milk
  • Decrease likelihood of baby blues and postnatal depression
  • Decrease likelihood of iron deficiency
  • Decrease likelihood of insomnia or sleep disorders
  • Decrease the length of time and amount of bleeding after birth
 
 
The placenta contains vitamins and minerals such as vitamin B6 and is rich in iron and protein, which is useful to women recovering from childbirth. A more complete list of the nutritional properties of the placenta can be found in (2). The placenta’s hormonal and nutritional make-up is completely unique to the mother. No prescription, vitamin, or herbal supplement can do what one placenta pill can. Encapsulation gives women an option who may feel uncomfortable with other methods of ingesting this powerful organ or want to reap the benefits of the placenta over a longer period of time. Powdered placenta has been used in Traditional Chinese Medicine for centuries, and has also been used to help women through the process of menopause as well as postpartum. Doctors of oriental medicine today feel that placenta ingestion is not only good for the mother postpartum, but that it also places her on a more healthy trajectory that can last the rest of her life.
 
 
Now over five years later (and four years after providing placenta encapsulation services), I'm still learning of more of its benefits to women. I've never felt better about any other work that I have done and LOVE to hear how much this has helped my clients. The placenta is not only a gift to the child during the pregnancy, but a gift to the mother as well after birth. As the current paradigm shifts to trusting our bodies, we will be able to realize the full potential of practices that come to us naturally during the childbearing years. I strongly believe that ingesting the placenta and its benefits will be a significant transformation for mothers, families and society in whole.
 
 
 
  1. Jodi Selander , Allison Cantor , Sharon M. Young & Daniel C. Benyshek (2013): Human Maternal Placentophagy: A Survey of Self-Reported Motivations and Experiences Associated with Placenta Consumption, Ecology of Food and Nutrition, 52:2, 93-115
  2.  http://www.placentawise.com/research-studies-supporting-placenta-encapsulation/
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Staying present in Pregnancy: getting control of my monkey mind

9/7/2016

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by Shabd Simran Adeniji

Being in the moment is a constant battle of mine.  Like many, I struggle with my ‘monkey mind’. Thinking and then more thinking! As a kid, I grew up around yoga and meditation. I have used these tools all my life as a way to control my mind and turn inward to find a more peaceful balance. But even all that meditation didn’t prepare me for the anxiety of pregnancy.
 
When I had first became a midwife one of my mentors used to say ‘worry of the work of pregnancy’. I didn’t really get what she meant and I actually felt like she was being a little cynical when she said it but then I was pregnant for myself and it all made sense.
 
My first pregnancy ended in a miscarriage at 10 weeks -- heartbreaking for my husband and I both. So by the time I was pregnant the second time I was full of angst about it going well.  I felt like all I did for the first many months was worry; worry whether everything was ok with the baby; worry that I might do something to ‘cause’ another miscarriage; worry that something was wrong with me or that I might never have a baby.  My hands were basically clenched in fists for the first four months of pregnancy. It was rough. No matter what people said I couldn’t shake the fear that things might end at any moment.

​I couldn’t trust anything about the process because it was so fallible, so fragile and so out of my control.
I couldn’t understand the depth of fear one can feel even though I had walked with many women on the journey of pregnancy loss.  To add to it, having seen so much as a midwife, I kept thinking of wore case scenarios.  Unlikely situations that were still ‘possible’.
 
I was a mess.
 
Once I passed the golden twelve-week mark I thought things would get better. They didn’t.   I continued to feel scared.  I started to realize this wasn’t going away by the mere fact that the pregnancy was progressing smoothly.  I needed to take charge of my mind because it was taking over my pregnancy and my whole inner world. 
 
I went back to what I knew worked for me so many times before.  When my mind would begin to spin with fears and worries I would stop, sit up straight, close my eyes, take a deep breath and get myself back in to my body.  It was the only thing that brought any sense of peace in my mind. Getting out of my head and into my body where I could get a real sense of whether things were ok or not. Sometimes the breathing was enough but other times I would need to add a mantra to the mix, something to occupy my spiral thinking.
 
I use mantras from the Sikh tradition for the most part but I also would use affirmations like ‘ I am ok, my baby is ok’ or ‘ we are taken care of… I don’t need to worry’.  I would simply repeat those ‘mantras’ over and over engaging my brain in different thinking. I was able to almost ‘talk back’ to the anxiety with my positive affirmations, prayers or mantras.
 
Even in to the second and third trimesters when things were stable and I could feel baby moving regularly I still found myself feeling fearful.  If it wasn’t about the pregnancy itself then I found other things to worry about; could I handle the birth, would I be a good mother, will there be enough money if I stop working, will my marriage change. The list kept going.  I only started relaxing toward the end of my pregnancy, surrendering in the process and realizing no matter what the outcome- I cannot control it.  

​I used my meditation practice and called on friends for reassurance regularly.  I mostly needed reminding that I needed to trust in a higher power and that my main role in this pregnancy is to keep a relaxed, calm environment for baby to grow in  (within reason of course, it’s never all roses and unicorns).
 
What I now know as a mom and midwife that I didn’t know before is that worry is indeed the work of pregnancy BUT it doesn’t need to consume us.  It is biological for a parents to become hyper aware of their circumstances and surroundings in order to prepare for the arrival of a new baby. And despite the fact that this might begin as a hormonal response, our mind can take it to another level- a non-beneficial level.  
Here is a list of tools I used and that I regularly recommend to parents who experience worry or anxiety in pregnancy and early parenting.

  • Learn a simple breathing practice
  • Regular prenatal yoga and meditation
  • Outdoor activities- nature works wonders on our minds
  • Acupuncture (there are some great points to quiet the mind)
  • Essential oils (diffused over night helped me with sleep)
 
And remember, for many parents this is a passing phase, for some it lasts through the early months after birth (others are able to move through it faster) and some continue to struggle further in to parenting.  If you or your partner struggle with anxiety on a deeper level please be sure to reach out for additional support/guidance and feel free to contact me for referrals to local providers who may be able to help. 
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More Than Just A Luxury

8/4/2016

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Prenatal massage may sound like a luxury, but research shows it’s a valuable tool in promoting optimal health for you and your baby. In fact, it is the most common alternative therapy recommended by doctors and midwives during pregnancy.
 
During pregnancy your body goes through many changes as your baby grows. In the first trimester, massage can relieve morning sickness, headaches and reduce fatigue. In the second and third trimester, massage helps to alleviate back, neck, hip and joint pain, and relieve leg cramps. Prenatal massage reduces swelling, edema, nerve pain, and lowers blood pressure. It enhances the quality of sleep and helps keep the pelvic muscles relaxed as the hips widen, relieving discomfort and helping you have an easier labor.
 
Prenatal massage increases circulation of blood and lymph, and increases oxygenation to the blood, brain and body of the mother and baby. This increase in blood circulation and oxygenation helps alleviate stiffness, swelling, cramping, numbness and nerve pain (like sciatica and pregnancy induced carpal tunnel). It increases deep breathing and lowers breathlessness and dizziness for the mother and positively affects the baby’s ability to receive blood circulation and nutrients for optimal development.
 
Arguably the biggest long-term benefit of prenatal massage for mother and baby is that it reduces stress hormones. High levels of stress and stress hormones like cortisol and epinephrine can affect the mother and baby negatively during pregnancy. Bi-weekly prenatal massage has been shown to reduce stress hormones and increases feel-good hormones like endorphins and serotonin. Keeping these hormones balanced has been shown to reduce stress, anxiety and depression during pregnancy.  It also improves cardiovascular health, lowers blood pressure and boosts immunity, which allows the mother’s brain and body to perform optimally.
 
According to a study published in The National Library of Medicine, “depressed women given massage therapy had fewer prenatal complications, including a 75% lower prematurity rate and an 80% lower incidence of low birth weight” (Field, 2010). The study also reported, decreased depression, anxiety and back pain. The women in the study who had regular prenatal massage had lower levels of stress hormones (cortisol and epinephrine) and lower levels of postpartum depression. Their newborns also had lower cortisol levels and performed better on Neonatal Behavioral Assessment tests­. “With mothers less depressed during the neonatal period along with more mature and interactive newborns, the bonding process between them is enhanced.”
 
Including massage as part of your prenatal care is not just a matter of indulging yourself, so take the opportunity to enjoy a massage for its health benefits for you and your baby! Feel free to call me or

Field, T. (2010). Pregnancy and labor massage. Expert Review of Obstetrics & Gynecology, 5(2), 177–181. http://doi.org/10.1586/eog.10.12
 
Field, T., Hernandez-Reif, M., Hart, S., Theakston, H., Schanberg, S., & Kuhn, C. (1999). Pregnant women benefit from massage therapy. Journal of Psychosomatic Obstetrics and Gynaecology, 20(1), 31-38.
 
Howell, J. NMT, PMT, Prenatal Health Through Massage Therapy: For women and Their Babies. The Free Library 01 December 2002. 04 August 2016 <http://www.thefreelibrary.com/Prenatal health through massage therapy: for women and their babies:...-a098250301>.


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Ashlee is a Licensed Massage Therapist, Doula and Ayurvedic Women’s Wellness Practitioner in Santa Fe, NM. She specializes in prenatal massage, postpartum massage and ayurvedic bodywork. Ashlee is a certified birth doula with The Birthing Tree and a certified prenatal massage therapist. Her office is located at The Birthing Tree. She offers discounts on packages and discounts to her doula clients. To learn more about Ashlee please visit: www.birthbodyworkandbalance.com or email her at birthbodyworkandbalance@gmail.com
 
 
 

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It’s Not About The Double Stroller. (Well actually it is)

6/4/2016

31 Comments

 
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Walking uphill and facing the wind, I quickly do the math. Nadia (proud 5.5 year old) is just over forty pounds, Mateen (the toddler) is plus twenty, and the double stroller must be at least twenty more.  More often than not, they play with each other. Eighty additional pounds, I push, and I climb.  I remind myself to straighten my back and look down at my legs to see my quadriceps work. I feel strong and alive, even if strained. I hold on to the handlebar tightly – thankful for its support and balance, as I transition to the downward slope.  Suddenly I wonder to myself, how did I ever walk this path without the stroller?
 
I was always a walker. Growing up in Sub-Saharan Africa, something I did well was walk everywhere. In the hottest of hot days, and with the dry wind blowing dust into my face. I love to walk. It is my time to feel and process the many things.  It is my time to determine what my opinion on something is. Walking is my tool.  I organize thoughts, make plans, and find motivation for action.  It is my means of being a creative thinker.
 
Oh, to be a creative thinker again!  My mind now begins to wander. What does that look like in my now family-focused life? Do I still take time to think creatively about the world, and my role in it? Do I still try to keep an honest awareness of self and the collective to which I belong? I haven’t walked like this in a long time. Walked mindfully.  My mind and daily routine are so very consumed with the children I push in this stroller.  Currently they are trying to determine who truly has possession of the bag of apples I handed one of them at the beginning of the walk.
 
“Mama, isn’t this mine?” yells the older one.  I break away from my wandering mind. I pull out another Ziploc bag of sliced apples from the handlebar accessory (that nifty pouch can hold more than just your water bottle and phone), and pass it over to a reaching hand.  I am still walking. I say nothing. My son acknowledges the gesture with a smile and they continue on their interaction.
 
The thought of creativity returns to me. It’s a funny thought - to consider that as a mother to these unique children I should feel the loss of creativity.  Perhaps its more than making babies for nearly ten months and getting them out into the world that I’m questioning.  Perhaps that creative self is yearning for more than making the milk nourishing them for 1 to 2 years of their life. Perhaps it’s about more than shaping their character in the formative years of their life. The loss I am feeling is a result of a particular need to let my mind do just this – to think.
 
I turn off the path and onto the sidewalk down our street. The kids are ready to get out of their seats and walk the last few hundred feet themselves. Now they are running because they see their father, just home from his very own long day, parked on the driveway. He is standing out looking in our direction. Arms open.
 
“You went for a walk!” he calls out with a knowing smile.
 
In this moment I realize it has been far too long since I’ve gone for a walk. It’s been far too long since I have given myself the time to think about the many things.
 
So, as often as I can, I lace up, buckle them in and walk; and I thank God for my active mind, my legs, my cargo, and my double stroller. 
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