Childbirth Class Options

General Childbirth Classes
Many general classes are taught by a hospital, birthing facility or employee of a specific birthing facility.  These classes can be great general overviews on how to prepare for the birthing process without a specific concept in mind for the birth experience.  Many times the classes are basic and review specific facility policies and procedures.  Often, these classes don't have a set philosophy or model of instruction and are often advertised on the facilities website.  

International Childbirth Education Association

This is an organization that also offers general childbirth classes. It was founded in the early 60's and is not aligned with a particular philosophy or method.  Their main goal is to educate mothers and decrease the fear surrounding childbirth. This organization was one of the original supporters of father involvement and midwifery.  They not only certify childbirth educators but doulas, prenatal fitness educators, postnatal educators, and postnatal doulas.

Lamaze
Ferdinand Lamaze, a French obstetrician, developed the Lamaze Method of childbirth.  Traditionally known from their breathing method or techniques, their core values are about building confidence in the mother, providing support, and using evidence-based practices and techniques in their instruction. Each certified lamaze instructor works a bit differently; but, the classes are usually limited to 10-12 couples and are broken up into 4 or 6 sessions. 

The Bradley Method
Dr. Bradley & his Bradley method was one of the first obstetricians to bring father's into the delivery room and strongly believes in partner-coached childbirth.  He wrote the book Husband-Coached Childbirth.  Bradley classes are usually some of the most comprehensive classes and are taught in 12 installments over 12 weeks. Partners are strongly encouraged to attend. Some certified teachers break up the classes into 8 longer sessions.

Hypnobirthing
Hypnobirthing, also known as the Mongan Method is a childbirth educational series that utilizes relaxation techniques and self-hypnosis.  It was founded by Marie Mongan, a hypnotherapist, and has beliefs that pain does not have to accompany labor.  It is traditionally taught in 5 sessions lasting 2.5 hours each. Marie wrote the book Hypnobirthing: The Mongan Method.

Calm Birth
The method focuses on meditation and progressive relaxation techniques.  The method blends psychosomatic medicinal practices and mental awareness focusing exercises.  Influences into the method come from Buddishm, Tao, & Hinduism.  Special techniques include womb breathing and giving and receiving mediation. The founder wrote the book Calm Birth and published a CD with sounds for relaxation and meditation.

Birthing from Within
This is more of a philosophy of birth than a method of preparation yet their are certified birthing from within teachers.  The philosophy focuses on inspiring and teaching expectant parents that birth is a rite of passage.  The goals include co-creating holistic prenatal care and minimizing emotionally difficult birth through preparation.  Pam England, the founder, wrote Birthing from Within.

Other Childbirth Preparation Programs
Dancing for Birth Link
Purebirth Link

Preparing for the Postpartum Period

The postpartum period can sneak up on us and catch us off guard. We spend countless hours preparing for the labor and the delivery but not as much for the postpartum period.  Those inital days and weeks can be very challenging even for the experienced mom, so I recommend a little preparation and planning to ease the transition. Here are a few suggestions.

BREASTFEEDING SUPPORT
1) If you plan on breastfeeding, set up a postpartum doula or lactation consultation ahead of time to meet with you in your home after the delivery

• Ask your provider for a recommendation during a prenatal visit
• There are plenty of doula organizations D.O.N.A and ICEA (to name a few) that have lists on their website for postpartum doulas.
•  The international lactation consultant association also has a listing by area

HOUSEHOLD HELP
2) Get cleaning and laundry help set up ahead of time.

• Due to the needs of a newborn and sleep deprivation, it's very difficult to keep a home organized and clean.  
• Sometimes it can be very distracting to have the dishes and the laundry pile up. 
• The postpartum period isn't a time to be stubborn. Take as much help as you can get (even daily) from hired help or from family for the first 6-14 weeks to do household chores and cleaning. 

MEALS
3) Get meals set up ahead of time.

• Mealtrain.com is a website that will allow your friends and family to organize meals. Most people are happy to help out in this way and it let's them feel involved and part of the birthing experience.
• Make meals in your last few weeks of pregnancy that can be easily heated up and freeze them like lasagna, sauces, baked goods and soups
• Don't be afraid to buy frozen meals. Trader Joe's and Whole Foods sell great frozen (even organic) meals.

FINANCES
4) Put some money aside. Sometimes, it's not possible, but if you start putting even just a little away week by week of your pregnancy, it can help.

• Financial stress can contribute to postpartum depression. 
• Keeping a little money aside can be a stress relief even it it's not needed.

SOCIAL SUPPORT
5) Find a community

• Connecting with other new moms can lead to a better sense of self-efficacy as well as decrease the baby blues and postpartum depression.
• The National Mother's Center Association has a list by area of Mother's Centers, groups and actives by area.
• Holistic Mom's Network is another national group that has local chapters
• La Leche League also has local chapters, groups and actives to be a part of 
• Ask your birthing facility or provider about support groups

Headaches in Pregnancy

Headaches in pregnancy are common and can happen at any stage. They do tend to be more common in the first trimester, up to 20 weeks. Here is a great overview of headaches in pregnancy.

HEADACHES 

What causes them?

Hormonal changes

Nasal congestion

Allergies

Hunger (low blood sugar)

Fatigue

Lack of sleep

Food triggers

Eyestrain

Tension

Stress & anxiety

Caffeine withdrawal

TMJ or Jaw tension

What to do about them?

Avoid triggers such as MSG and artificial sweeteners

Teas, coffee, wine and nuts have tannic acid which trigger headaches

Aged cheeses and added nitrites to meats can be triggers

Stay hydrated with lemon water

Talk a warm shower

Place a hot compress on the temples or over the eyes

Take a warm bath

Exercise to increase circulation

Drink a caffeinated beverage 

For congestion try inhaling steam or a warm compress over the sinuses

For tension, anxiety or stress get a massage

Wear a mouth guard at night

Consider acupuncture or acupressure

  The vitamin supplement magnesium has been associated with lower headaches in pregnancy*

Tylenol, as recommended on the bottle, is safe for most pregnancies*

Links

American Pregnancy Association

Mayo Clinic

*You should always discuss your pregnancy symptoms with your provider at each visit, including headaches.  Any severe headache, blurry vision, or floaters should be reported to your provider right away. Always consult your provider before taking any medications, supplements, or herbs in pregnancy.

Midwives as a Status Symbol

New York Times Article Click Here

Midwives as a Status Symbol

Are we really the next pooch in a prada or a Buggaboo stroller?

The NewYork consumer has changed, but so have we; and, so has New York herself.  Nowadays, most of us have higher education degrees and are delivering in the hospital as well as the home. It wasn't until 1992 that we were legally prescribing medication in New York and 2010 that we were able to legally practice independently.  New York trusts us, while we have the outcomes and education to support why she should.  In addition, we happily provide care for the "hippy-dippy spiritual birth," but we also provide what many women want: simple and supported, natural hospital birth.

The Importance of Postpartum Support

Women are doing excellent jobs of preparing for childbirth. They begin labor with many weeks or months of studying, preparing, exercising, and practicing.  Even these women, though, can be side swiped when it comes to the postpartum period.  It's overwhelming, but something that women can also prepare for.
Postpartum support in American is dramatically undervalued.  Women are discharged from the hospital in 48 hours (sometimes less) and expected to go back to work in 6 weeks.  There are no routine/standard home visits or groups for women from their hospital or providers like in many other countries and women are expected to figure it out on their own and basically cope as opposed to thrive.
The rise of postpartum depression has escalated. Up to 80% of women experience postpartum blues or a milder, generally shorter lived and non-medicated form of postpartum depression. While it is often fleeting, it's disconcerting and emotionally taxing. While hormonal changes are often the culprit for postpartum blues, women report that feel they have ample postpartum support from family, friends or professional support (doulas, nurses, midwives, lactation specialists) seldom report postpartum blues and depression.
Postpartum depression occurs about 10% of the time while major depression occurs in 6% of women.  The difference between postpartum depression and postpartum blues is that in order to be diagnosed as depressed, the woman must have the symptoms of depression most of the day, every day for two weeks or longer.
Women who are at risk for postpartum depression include women who have: marital stress, childcare stress, a lack of perceived social support from family and friends, lack of emotional and financial support from the partner, living without a partner, and complications with their own relationship with their mother.  There are other factors that place a women as risk, but each of these aforementioned risk factors involve a perceived sense of lack of support.  It is proven that in cultures where support from extended family is available and where spousal support is encouraged the rates of postpartum depression are lower.  So, as part of a labor team, family, or circle of friends . . . support those mommas!

Natural Hospital Birth

At the risk of being a groupie, I just have to mention how excited I am by Cynthia Gabriel's book Natural Hospital Birth, The Best of Both Worlds.
In America, we are so unindated with compromise and moderation.  We have business class, crossover SUVs, and 2% milk, but when it comes to birth we have been black and white for a long time,  Cynthia's book, however,  is an anthem to the 50 Shades of Grey natural hospital birth allows us.

I'm elated that this middle of the road option is also being applied to the birthing room.  I mean, where would America be without the middle class? Women no longer have to choose between the two extremes of home birth or overly defensive hospital birth, armed only with a birth plan and a semi-supportive, annoyed practioner.  We are seeing all types of women, providers, and births in the hosptial setting. It's darn well about time!

Amazon link to the book

The Importance of Kegels

Kegels - Never to be Underestimated

I feel I can never stress enough the importance of doing Kegels.   After a recent gal pal date, over coffee, I realized "do your kegels" is the "monthly self-breast exam" and "practice safe sex" women's health motto for this new decade. 

We, as women, do Kegels to prevent complications that arise with the pelvic floor from age, regardless of whether or not we had children.  These complications can include urinary incontinence, urinary urgency, pain during intercourse, pelvic organ prolapse, and uterine or cervical prolapse.

Ok, but what are Kegels?  The Kegel muscles are the group of muscles that make up the pelvic floor. Kegel exercise are the subsequent exercise that strengthen these muscles.

How do I do Kegels? The best way for women to do Kegel exercises is to imagine they are trying to pick up a marble with their vagina.   Another way to know a woman is doing them correctly is to try to stop the flow of urine. They can be done in any position (sitting, standing, lying).  They should be done in 3-5 times a day for 10 reps each set.  Pilates exercises are known for consistently engaging the Kegel muscles.  Most women need 3-4 weeks before they will begin to see improvement.

Benefits in Pregnancy. Kegels can also be beneficial in pregnancy and labor and delivery, as a strong pelvic floor offers the pregnant woman more support during pregnancy and more strength in delivery. 

Some resources:

 The Mayo Clinic Guide to Kegels a step-by-step guide to exercising the pelvic floor.

Kegelmasters - Like lifting weights for the pelvic floor. Products that provide resistance and increased strength training.

Light Bladder Leakage - information about light bladder leakage and it's link to menopause.