Posts Tagged: Women’s Health

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What Nobody Talks About During Pregnancy: Your Postpartum Health

Prenatally, we tend to focus on mom and how she can optimize her health for her benefit and the benefit of the baby. However in the postpartum period, our culture seems to completely focus on baby and mom’s well-being is forgotten. This attitude is also reflected in postpartum medical care in the USA. Generally, the baby goes for their first pediatrician visit just a few days after birth, but mom’s first visit with her OB isn’t until a whopping 6 weeks after the delivery!

Thankfully, recently there has been more media attention to this problem (see this great guide in the New York Times). The American Academy of Pediatrics has even recommended that new moms be screened by their child’s pediatrician for postpartum anxiety and depression. In my and many others’ opinion, this is a positive step, but more support for new moms is needed. Until healthcare systems in the USA begin providing appropriate levels of support to new parents, you must develop a plan for your postpartum health during pregnancy. After the baby is born it will likely feel much too overwhelming.

Postpartum Changes

Many physical and emotional changes can bring uncertainty to the post-delivery recovery process. Physically, constipation, urinary incontinence, breastfeeding difficulties, incision pain and pelvic floor pain can be present. Emotionally, mood fluctuations can be quite normal, but often women need support in determining if their emotions are normal or are a cause for concern. The earlier postpartum mood issues are identified, the more effectively they can be treated. The bottom line is this: if you aren’t sure if the symptoms you are experiencing are normal, seek help from a therapist, midwife or your OB and they can tell you. Ask for as much help as you need.

Below are some categories of experts I recommend familiarizing yourself with. Find a local practitioner, reach out to them in the third trimester (or earlier!), and keep their contact information handy in case it’s needed. You shouldn’t be expected to do it all on your own and many times even with lots of support from friends and family, an expert’s experience and care can make a huge difference.

Resources:

Mental/Emotional Health:

I recommend finding a therapist who specializes in treating postpartum mood disorders. It’s best to establish a relationship with a therapist before giving birth so that you are not overwhelmed with the task of finding someone while you are taking care of your new baby. Have one session with them during your pregnancy so they are familiar with your history, and you can make sure you feel comfortable with their approach.  Keep in mind, new dads/partners often experience anxiety and mood issues after the birth as well- it may be helpful for them to follow the same approach.

See The Seleni Institute, The Motherhood Center and Postpartum International for articles and information.

Pelvic Floor Experts:

In Europe and many other places, pelvic floor muscle rehabilitation is standard care for new moms, whether they delivered vaginally or via c-section. It can help with urinary and bowel problems as well as abdominal muscle separation called diastasis recti.

In NYC, I like Beyond Basics PT, Shift Integrative Health and The Functional Pelvis. Even if you aren’t in NYC, check out their websites for lots of informative articles. I also recommend reading Heal Pelvic Pain by Amy Stein, MPT.

Lactation:

If you choose to breastfeed, know that most moms do have issues at some point! It’s a very good idea to have a lactation counselor available for questions- both for initiating breastfeeding and how to stop once it’s time.

See La Leche League to find a local support group, and here in NYC I recommend Boober, Leigh Ann O’Connor and The New York Doula services.

Newborn Care Specialists:

Commonly known as baby nurses, these are experts who provide in-home care focused on the baby, so you are able to get more rest.

The New York Doula and British American Household Staffing both are highly recommended.

Postpartum Doulas:

As compared to a Newborn Care Specialist, who focuses on taking care of the baby, a postpartum doula focuses on taking care of you. Many are also lactation consultants so can help you with breastfeeding, but also will help with preparing healthy meals and whatever else will make you feel nourished and taken care of.

I recommend The New York Doula, Baby Caravan Doulas, Kin Doulas, and Amber Star Merkens.

Books:

The First Forty Days– an excellent collection of recipes and tips for preparing for the period immediately after childbirth, this is also a guide on good self-care practices throughout pregnancy.

 

 

 

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Listen Up: Your Cervical Mucus Is Trying To Tell You Something

Vaginal discharge, cervical mucus, leukorrhea- it all refers to the same thing. Hereafter I’ll refer to it as “CM” (cervical mucus). It seems that generally speaking, women I see in my practice either are quite unaware of what changes in their CM mean or are worried that any CM is a sign of infection.  I hope this article will help to de-mystify your discharge and, just maybe, make you feel a little amazed by it. Possibly even happy to see it? By knowing what to look for and what it all means, you can feel more empowered and make better decisions. Read more

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Recommended Reading: Ina May’s Guide To Childbirth

I was completely blown away by this book and have been enthusiastically recommending it to every last one of my pregnant patients since reading it early this summer. As far as I’m concerned, it should be required reading for all pregnant women, whether you’re planning on a home birth with a midwife or a hospital birth with an OB.

A little background: The author, Ina May Gaskin, is a Certified Professional Midwife who co-founded a community in rural Tennessee in 1970 called The Farm. Sounds pretty hippy-dippy, right? Yeah, it is! But keep reading. These hippies know things that you need to know. Ina May as well and her team of midwives have handled over 3,000 births at The Farm, with astonishingly low rates of c-sections and other intervention (vacuum, forceps, Pitocin, etc). For more information and their complete statistics, here is the link to their website.

I loved this book because the tone is non-judgmental and the facts are laid out clearly to help you do everything within your control to get the best outcome in a situation where ultimately, you must surrender control. This includes surrounding yourself with the birth team that makes you feel the most supported.  Ina May gives you the lowdown on possible birth interventions that may be necessary so that you are already familiar should your doctor recommend them. Having the knowledge before you’re in the situation can greatly alleviate anxiety when faced with needing to make a quick decision.

This book begins with about 125 pages of the birth stories of women who gave birth at The Farm, written by the women themselves. These stories let you see how varied a normal, healthy birth can be. They eliminate the worry that “if my birth doesn’t go this way, something must be wrong”.

Ina May then delves into topics including:

  • Prenatal care and what all those tests really tell your doctor (and which ones you might be able to skip if you desire)
  • Choosing a caregiver- whether it’s an OB or midwife, plus tips on deciding who else will be present at your birth (doula, partner, other family members)
  • Facts on VBAC’s (vaginal birth after cesarean)
  • My favorite chapter: “The Sphincter Law”- it explains how anxiety and fear can actually reverse the labor progress that has been made already, and how to guard yourself against this happening! This is really amazing, useful stuff.
  • Techniques you can easily use to make your labor progress more smoothly and efficiently
  • What actually happens in labor, and what to do once you are in labor (call the doctor? Wait it out?)
  • What Pitocin and epidurals do

To summarize, this book has the ability to make women feel more empowered about giving birth. You’ll also feel less afraid of the unknown and what could go wrong (Ina May has a great way of explaining what could happen without creating unnecessary fear). In my work with pregnant women, I’ve found that everyone has some degree of fear around the process and wants to do everything they can to ensure things go smoothly (for herself and baby).

After reading this book, I truly got the feeling that birth is a normal process that a woman’s body is designed for, and felt inspired to confidently relay this information to my patients!

Can Acupuncture Really Induce Labor?

Over the years I’ve gotten many calls from frantic women (and sometimes their husbands) who are 40 or 41 weeks pregnant, some who are even scheduled for medical induction in a matter of hours. They all want to know- can Acupuncture help you go into labor in order to avoid induction? The answer is yes… and no. Read on, I’ll explain.

The ideal situation is when a woman comes for regular acupuncture (1-2 times a week) beginning at week 36. I call this “Labor Preparation Acupuncture”. I have a few goals with these sessions:

  1. To help with any pregnancy related discomforts such as low back or hip pain, insomnia or swelling.
  2. To use acupuncture points which get the woman mentally and emotionally relaxed and in a place where she feels ready and optimistic about giving birth.
  3. To stimulate acupoints which aid in relaxing and opening the pelvic region as well as influence cervical ripening (dilation and effacement).

In my experience, women who follow this schedule tend to go into labor more or less on time (and avoid needing a medical induction) and have shorter labors with fewer complications. Acupuncture treatments gently and gradually send your body a message to get ready for labor. Your body is doing this all on its own, but acupuncture helps it happen more seamlessly and helps you to feel more relaxed and ready when the time comes. And YES being mentally relaxed has a HUGE and very real effect on the progress of labor (see this book for more information).

But what about those women who were mere hours away from being induced- can acupuncture help them? I’ve certainly had many cases where I’ve been able to use acupuncture at the last minute to help women go into labor- it’s powerful stuff! However I’ve seen much greater success, by far, with 3-4 weeks of regular sessions leading up to the due date. Rome wasn’t built in a day my friends, and acupuncture is not the same thing as Pitocin. Thankfully!

I’d also like to take this opportunity to encourage all women to get a birth doula as well as a postpartum doula. Read more about doulas and what they do here and here. And, the best way to avoid unnecessary interventions in labor (such as c-sections and episiotomies) or to achieve a VBAC is to choose your hospital based on its maternity procedure statistics. In New York State, they are found on the Department of Health’s website here.

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Breath, Mantra & Music: 3 Holistic Ways to Help Improve Your Sleep

The following is a special guest blog post by Maya Benattar, a music therapist and psychotherapist here in New York City. Her website is www.mayabenattar.com. Thanks, Maya!

 

There are a lot of reasons why people may have trouble sleeping- anxiety, stress, too much caffeine, hormonal shifts. We live in a fast-paced society where lack of sleep is often seen as a badge of honor.

If you’ve ever had a sleepless night (or many!), you probably know all too well the feelings that arise when you can’t get back to sleep and you really want to! Sometimes we can do everything “right”- no caffeine after 2pm, less screen time in the evenings, warm milk, lavender- and sleep can still be elusive. Read more