Tip Tuesday: Get Induced for the Right Reasons

There are several reasons a pregnant woman may need to be induced.  Some of them are factors relating to the baby, some to the mother, and some to the functionality of the placenta. Whatever, the reason, make sure your provider is offering you an induction for the right reason.  About 25% of pregnant women are induced every year, and it is higher in some regional areas.

Some reasons a woman may need to be induced include:

• Placental concerns: like abruption, or insufficiency
• Maternal concerns: A uterine infection, diabetes,
• Concerns about the baby: a very small baby, or low amniotic fluid

If you induction is for a non-medical reason, it's best if the cervix is favorable, ripe (ready for induction). Talk to your provider to understand the in's and out's of your induction.
 

Fertility Friday: Consult with an Eastern Practioner

There is a great field of research and medicine out there that we are fortunate enough to have access to. Eastern medicine looks at the body, mind and soul in a different way than traditional Western medicine. This different perspective can often shed light on issues that we may have been feeling immobilized by in the past. Acupuncture is a great way to start. Many acupuncturists will give you an eastern diagnosis, using the 5 Element method or Traditional Chinese Medicine and you might find that it fits. It can also help to tailor your diet and lifestyle modifications in a way that makes sense to you.

Fertility Friday: Tips for Cooking at Home

 

 When trying to enhance overall health, here are a few tips to try at home:

• Use olive oil, greapesee oil, or rice bran oil instead of canola oil, peanut oil, or butter.
• Never use shortening (Crisco)
• Avoid deep frying or frying foods
• Be careful of how long a food is cooked in oil for, don't over cook foods, especially vegetables. Check the cooking time on vegetables.
• Steam things when you can
• Avoid trans fats at all costs
• Add good carbs, like beans and legumes to change up old recipies
• You don't need rice or pasta, vegetables and legumes are great sides

Tip Tuesday: Fighting the Stress

As the holidays descend upon us, I know how hectic it can get.  It's so important to take time for yourself. This is just a gentle reminder to take time this holiday season to do something for yourself. Invite a friend over to bake cookies, go for a walk, take that exercise class that you've had your eye on, or splurge on that fun drink at Starbucks. Sometimes we just need a little nudge or a little encouragement to splurge on time for ourselves, give yourself a big hug, and tell ourselves you love you. Happy Turkey Day. Thank God for all the Blessings.

Fertility Friday: Cutting out the White

Sometimes we can get overwhelmed with what we can and cannot eat, and so sometimes it's nice to have things simplified.  Cutting out the white is about avoid all processed foods. Unless its a coconut or jicama most foods are not meant to be white. The whiteness of a food often signals the high processing that this particular food has gone through. Most grains, sugars and starches are naturally brown in color. Avoiding white breads, white sugars, and white grains is a helpful reminder when trying to enhance fertility.  Other foods that are naturally white, like potatoes are high in fast burning, high sugar carbohydrates. Exchange the color white in  your food for cream, khaki, amber, burnt, tan, taupe, sepia, seal, and beige.

Tip Tuesday: Aloe Water

The new fad, or something great? Aloe is fantastic and aloe water is a great way to get added vitamins and minerals in your diet. Aloe is also very alkaline, and we all know the more acidic we are the more disease can manifest in our bodies.
Aloe contains vitamins, A, C, E, folic acid, choline, B1, B2, B3 (niacin), B6, even B12. It also has calcium, magnesium, zinc, chromium, selenium, sodium, iron, potassium, and copper.
Aloe also has a potent anti-microbial effect, meaning its great to get at bacterial, virus and fungus.  And finally, it aids in decreasing inflammation and increasing hydration.
Fad or not, sounds like great stuff.

In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the wa - See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpufw

In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the wa - See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf Aloe

In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the wa - See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

The juice from the succulent aloe vera plant is indeed a natural miracle worker that has been used medicinally for several millennia, and is one of the primary compounds used in the cosmetics business. In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the way.

You can easily add aloe vera juice to your morning smoothie or mix it with a favorite drink--from lemonade to punch or iced tea--and get a super hydrating boost to keep your skin soft and glowing. - See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

The juice from the succulent aloe vera plant is indeed a natural miracle worker that has been used medicinally for several millennia, and is one of the primary compounds used in the cosmetics business. In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the way.

You can easily add aloe vera juice to your morning smoothie or mix it with a favorite drink--from lemonade to punch or iced tea--and get a super hydrating boost to keep your skin soft and glowing. - See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

The juice from the succulent aloe vera plant is indeed a natural miracle worker that has been used medicinally for several millennia, and is one of the primary compounds used in the cosmetics business. In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the way.

You can easily add aloe vera juice to your morning smoothie or mix it with a favorite drink--from lemonade to punch or iced tea--and get a super hydrating boost to keep your skin soft and glowing. - See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

The juice from the succulent aloe vera plant is indeed a natural miracle worker that has been used medicinally for several millennia, and is one of the primary compounds used in the cosmetics business. In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the way.

You can easily add aloe vera juice to your morning smoothie or mix it with a favorite drink--from lemonade to punch or iced tea--and get a super hydrating boost to keep your skin soft and glowing. - See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

The juice from the succulent aloe vera plant is indeed a natural miracle worker that has been used medicinally for several millennia, and is one of the primary compounds used in the cosmetics business. In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the way.

You can easily add aloe vera juice to your morning smoothie or mix it with a favorite drink--from lemonade to punch or iced tea--and get a super hydrating boost to keep your skin soft and glowing.
- See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

The juice from the succulent aloe vera plant is indeed a natural miracle worker that has been used medicinally for several millennia, and is one of the primary compounds used in the cosmetics business. In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the way.

You can easily add aloe vera juice to your morning smoothie or mix it with a favorite drink--from lemonade to punch or iced tea--and get a super hydrating boost to keep your skin soft and glowing.
- See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

The juice from the succulent aloe vera plant is indeed a natural miracle worker that has been used medicinally for several millennia, and is one of the primary compounds used in the cosmetics business. In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the way.

You can easily add aloe vera juice to your morning smoothie or mix it with a favorite drink--from lemonade to punch or iced tea--and get a super hydrating boost to keep your skin soft and glowing.
- See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

The juice from the succulent aloe vera plant is indeed a natural miracle worker that has been used medicinally for several millennia, and is one of the primary compounds used in the cosmetics business. In addition to containing vitamins, good fatty acids, and serving as an amazing alkalizing ingredient for bodies, its 99 percent water content makes it an ideal hydrator, increasing the skin’s elasticity and supplying oxygen to the skin cells along the way.

You can easily add aloe vera juice to your morning smoothie or mix it with a favorite drink--from lemonade to punch or iced tea--and get a super hydrating boost to keep your skin soft and glowing.
- See more at: http://www.elizabethstreet.com/living/winter-skin-care-aloe-vera?section=home#sthash.bK2iMcsp.dpuf

Fertility Friday: Unsaturated Fats

Unsaturated fats are monounsaturated and polyunsaturated fats. These are the good fats. These are the fats we all should be eating to be healthier, to have healthier hearts, to lower our cholesterol, improve our sex drive and increase fertility. These types of fats help in maintaining a normal slow burn throughout the day and help to prevent dramatic increases and decreases in blood sugar levels.
Eat these fats:

• Fish, fatty fish
• Walnuts
• Flax
• Olives and olive oils
• Avocados

Cut back on these fats:

• Red meat
• Animal fats
• Dairy products with fat, like ice cream
• Trans fats

Some inspiration for the Day

Tip Tuesday: Talk it Out

Be empowered to talk to your provider about your hopes, fears, and desires. Don't be afraid to talk out your feelings and frustrations with your provider. Many providers are open to hearing from patients, so go for it. Be bold and speak up. Talking things through can help ease fears and anxieties about the birthing experience.

Fertility Friday: Carbohydrates

As we learn more about how our bodies work, we are learning more about how carbohydrates effect our metabolism and hormones. Carbohydrates, once ingested, become glucose (sugar). Some carbohydrates are digested very quickly and turn to sugar quickly. Other carbohydrates have a slow burn and take longer to turn to sugar in the system. These slowing burning carbohydrates are a better choice to keep hormone levels under control. Glucose peaks effect insulin (a hormone) which effects sex hormones. Think of the metabolism like wood burning furnace. We want to keep the fire going all day, without having to stoke it too much and without letting it go out. Carbohydrates that are slow burners are ones that have a low glycemic index. Low glycemic index carbs include:

• Beans: white, black, kidney, lentil
• Soy beans
• Nuts, almonds, walnuts
• Small seeds like anything smaller than a pumpkin seed
• Intact grains like spelt, kamut, wheat, oat, rye, rice, barley
• Large pitted fruits like peaches, mangos, avocados, and strawberries

Tip Tuesday: Write it Down

As you think about your birthing experience, write it down. Visualize how you see the labor and delivery experience progressing and your own reaction to what happens. Keep in mind, while the timing of labor can be unpredictable, a lot of what happens once labor starts can be steady, calm and reassuring.  Write down where you will be, who will be with you and different birthing scenarios as well as a the perfect dream scenario.  While we can't always "plan" for birth, we can "try on" different scenarios.

Fertility Friday: Stop Bad Habits

We all have some bad habits that we need reminding every once in a while to cut out of our life.  It takes 21 days to form and break habits, so encourage yourself to try something for 3 weeks before you completely disregard it. Some major bad habits we need to come clean about relating to fertility are:

• Smoking. No amount of smoking is ok when trying to conceive or have good overall menstrual health.  Nicotine and the preservatives in cigarette smoke can interfere with egg quality and hormone levels.
• Caffeine. Caffeine is moderation is ok. One cup of coffee and one other source from chocolate or tea is ok, but a double extra grande with an extra shot may be pushing it. Be mindful of how much caffeine you consume.
• Sedentary lifestyle. If you have no exercise in your life, think about setting a realist goal and getting something going.
• Drink plenty of water.

Tip Tuesday: Keep a Clear Mind

As you move toward your goal of natural childbirth, many will cloud your mind with negative concepts and ideas. At times, women can harp on their own negative experiences with birth or exaggerate another's experience because it makes a good story. Recognize these thoughts, ideas and stories for what they are, and continue to fill your mind with positive stories of birth and labor. Know that most stories are wonderful ones.

Fertility Friday: Diet Matters

Our diet is our medicine. When trying to conceive or even just trying to maintain overall excellent femninine health, diet is the foundation of good health. Some quick tricks include:

• Eat like a Mediterranean. See Mediterranean Diet
• Eat whole foods, avoid processed junk
• Limit Red Meat
• Eat oils, nuts and olives as opposed to animal fats
• Drink water, avoid sugared drinks
• Eat leafy greens, the darker the better
• Eat beans and legumes, the oft forgotten items. Add them to food you enjoy often like pastas, rice, and other grains

Tip Tuesday: Natural Birth: You can do it!

You can do it. Sometimes just saying these words to yourself can be enough to send you down the wonderful journey to prepare for natural childbirth.  It is something that you are completely capable of and your body is more than able to do. Preparation is the key. Align yourself with a supportive team and plan for preparation and you will do it. Find a great class that you connect with. Read inspiring birth stories. Assemble you birthing team. Get connected with a provider that you trust and will support you and invite others to attend you during the birthing and preparation process. You are amazing, you are wonderful. You can do it.

Doctor or Midwife?

Finding the right obstetrical provider is stressful enough, but having to choose betwen the differnt types of provider just might put us over the edge. Here is a quick guide to the difference between the doctors and midwives.

Training
The fundamental difference between a medical doctor (MD) or a midwife (CNM/CM) is the training. Midwives are trainied specifically in the normal birth process. They are trained in how recognize and manage health birth, pregnancy and newborn care. Typically, they are taught to identify risk factors, and deviations from a healthy birth and pregnancy process and then co-manage a high-risk pregnancy or birth with a physician, or refer a client to a doctor for care.  Some midwives do receive additional training to perform surgeries and manage high-risk patient populations. These midwives may have the additional credentials after their name such as DNP, RNC, or PhD.

Physicians are trained in all medical fields from pediatrics to geriatrics in medical school. After usually 4 years of medical school, they are officially an MD, but may not practice as such until they complete some residency training. After medical school, they specialize by selecting a residency program. In OB/GYN, the residency is typically 4 years.  In these four years, they are trained in gynecology, obstetrics, gynecologic cancers, infertility, and gynecology surgery. Some physicians will go on to receive additional training in each of these specialties, called fellowship. Fellowship is only done by a handful of doctors, and it is a sub-speciality of an already chosen medical career path.  In the medical field of obstetrics, sub-specialized training is called maternal fetal medicine (MFM) or sometimes called a high-risk obstetrics.

Beyond the difference in training, each individual midwife and doctor will be unique. Women tend to choose physicians for their expertise and midwives for the personalized, unhurried care.  The model of care the worked in the US until the mid 1900's and still works in Europe today is to have the midwives care for the majority of clients unless they have a medical history or conditions that necessitates the use of a doctor.  Ideally, women would have access to both a midwife and a doctor and have the best of both worlds.

Which IUD should I choose?

I receive many questions about IUDs (intrauterine devices) and because of older versions of these devices were harmful, their current offsprings have gotten a bad rap. In fact, IUDs are
extremely effecitve and patients who use them are very satisfied.  We only have about 6% of women in the United States who use birth control using IUDs. Part of this is becasue are mothers are remembering IUDs from the 60's and how they decreased fertility and increase the risk of uterine infection. We also still think that they are not for women who have never been pregnant, when in fact, they are a great idea for these women.  Currently, there are three types of IUDs on the market: Click on each for a link to their site.

• Skyla
• Mirena
• Paragard

Hormonal
Skyla are Mirena are progesterone containing IUDs and are made of plastic. The Paragard is a non-hormonal containing IUD made of copper. The Skyla and Mirena work by thickening the cervical mucus and blocking sperm from entering the uterus. They also work to inhibit ovulation and implanation.  

Non-Hormonal
The Paragard IUD works by preventing fertilization.  When there is a foreign body in the uterus, it causes an inflammatory reaction which disruptions fertilization, implanation and is hostle to sperm.

For more information, click of each link to see the prescribers information and talk to your healthcare provider.

Kegels Video

Kegel exercises should be like drinking water for any woman of childbearing age.  Some of us are blessed with exceptionally strong pelvic floor muscles, with or without training.   But most of us are not. If you are not one of these women with an exceptionally strong pelvis, here is a very basic explanatory video about Kegels.

6 Tips to Battle Unwanted Pregnancy Weight Gain

Stepping on the scale at a prenatal visit can bring on as much anxiety as an internal exam. And excess weight gain in pregnancy is a battle that many woman face as the weeks go on. For a woman with a health BMI, gaining 20-32 lbs is recommended.  But some of us are overachievers, and our bodies strive to gain 40-50 lbs.   Here are a few tips to curve excessive weight gain.

• Hydrate. Drink plenty of water. Sometimes we feel pangs of thirst and we eat instead. Also, drinking plenty of fluids, like a tall glass of ice water will help the body with cellular regulation and metabolism, as well as helping with mindless snacking.

• Salt. Pregnant woman actually have an increased sodium requirement than when non pregnant. Having an appropriate intake of salt can actually help swelling. That's why, the only conception that pregnant women crave pickles is true. Pickles are actually a fantastic food for pregnant women, high in salt and low in calories.

• Avoid cereal. High glucose levels in the blood contribute to weight gain and excessive fetal weight gain. Cereal is known for it's ability to drive blood glucose levels through the roof. Pregnant women on-the-go often eat cereal often because it's a quick and easy. Try instead, an apple, a balance bar, some trail mix or even a piece of dark chocolate.

• Exercise.  If there was one thing I would recommend to pregnant women, it would be an adequate amount of exercise. The American College of Obstetricians and Gynecologist recommends 150 minutes a week of moderate exercise in pregnancy, after consultation with your health care provider, of course. Exercise in the evening, even walking 15 minutes after dinner curbs weight gain. 

• Don't eat late.  There may be some reasons why pregnant women eat late, like nausea throughout the day, or hunger in the night, but if you can avoid it, don't eat late.  Your body metabolizes fat while your sleep so avoid those midnight snacks.

• Avoid processed foods. As much as you can, avoid over processed foods like refined flours and sugars.  Foods that are processed are very far removed from their natural form. These unnatural foods are difficult for the liver to metabolize and can interfere with metabolism and contribute to weight gain. 

Aquaponics

This is fantastic. Why aren't we all doing this?

http://aquaponics.com/page/home-production

As most of you know, I am a California gal that moved to New York. I live in Manhattan and then Brooklyn, so you may see what I am beyond excited about this taking off. Not only do I think this system is way cool, but I think that it could also be used all over the world where soil is uncultivatable

"Aquaponics is a method of combined fish and vegetable farming that requires no soil," explains Roman Gaus from The Atlantic Cities about the process. "The farmer cultivates freshwater fish (aquaculture) and plants (hydroponics) in a recirculating water system that exchanges nutrients between the two. Wastewater from the fish serves as organic fertilizer for the plants, while the plants clean the water of fish feces and urine."

Growing organic food in almost anywhere.

Because aquaponics is essentially a closed system, with the exception of fish food having to be cultivated or purchased separately, it can function independently, and without many of the normal inputs required for traditional farming. This means that a well-designed aquaponics system can be installed and operated virtually anywhere, including in dense urban environments -- high-rise rooftops, the tops of parking structures, and even basic parking lots are just a few examples of the many locations where high-output aquaponics systems can work.

5 Tips to Tackle Pregnancy Fatigue

1. Get more sleep. Pregnant women battle fatigue from early on in the pregnancy. It's important to listen to your body and get adequate rest when possible. Even going to bed 10-15 earlier or waking up 10-15 minutes later can make a big difference.

2. Exercise. As impossible as it seems, exercise is an excellent way to fight fatigue.  Even as little as 15 minutes a day of aerobic exercise can help to decrease fatigue.

3. Healthy Foods. Foods can act like medicine. Unprocessed, healthy foods can improve stamina and decrease tiredness.

4. Fluids. Staying hydrated and drinking plenty of fluids can increase energy.

5. Take vitamins. B complex vitamins boost energy if consumed daily. Also continuing to take a prenatal vitamin or other vitamins that are prescribed can help fight fatigue related to anemia or a vitamin deficency.

Hydrate Naturally

Pregnant women go though several physiological changes during pregnancy. As a result of these changes, they can dehydrate quickly, especially in the summer. Dehydration can happen rapidly in women at any gestation. It can even happen to women who are generally well hydrated and have great diets. A lot of pregnant women will drink water to hydrate, which is great, but if a woman feels dizzy, weak, or is having several bouts of braxton hicks contractions, she may need to drink something containing electrotypes. While Gatorade, Poweraid and Vitamin water offer a great sources of electrolytes, they can also have excess sugars or artificial sugars. Here are some great, natural alternatives to helping women stay hydrated in pregnancy.


Coconut Water: The water found in the center of a coconut is rich in electrolytes and low in sugar. Some like to drink it mixed with other fruit juices likes pineapple or orange.

Mangosteen juice: This fruit comes from Southeast Asia and is very high in antioxidants like xanthones.  It is a popular drink as part of alternative cancer therapies and also has been shown to inhibit the growth of bacteria. It's low in calories and sugars.   

Noni Juice: Also low in calories and a bit bitter is high in antioxidants. It comes form the South and North Pacific Islands of Polynesia and Indonesia. It's also been said to boost immunity.

Goji Juice and Acai- Similar to mangosteen, Goji and Acai. They are high in antioxidants and low in sugar. Goji comes from the Himilayas. Since it does not contain carbohydrates, it is low in sugar. It also has chlorophyll that aids the body in cellular production and helps fight anemia.   

Aloe vera - Aloe vera is a long healing ago healing plant that was used for all kinds of treatments. It is great for soothing the digestive tract and aiding in heartburn and indigestion or irritable bowels. It also has cancer fighting and diabetes fighting properties. It is aslo great for the skin, hair, and nails.

 So drink up, gals and hydrate naturally!

The Wide Spectrum of Mothering

 Amy Young wrote this. Thank you

• To those who gave birth this year to their first child—we celebrate with you

• To those who lost a child this year – we mourn with you

• To those who are in the trenches with little ones every day and wear the badge of food stains – we appreciate you

• To those who experienced loss through miscarriage, failed adoptions, or running away—we mourn with you

• To those who walk the hard path of infertility, fraught with pokes, prods, tears, and disappointment – we walk with you. Forgive us when we say foolish things. We don’t mean to make this harder than it is.

• To those who are foster moms, mentor moms, and spiritual moms – we need you

• To those who have warm and close relationships with your children – we celebrate with you

• To those who have disappointment, heart ache, and distance with your children – we sit with you

• To those who lost their mothers this year – we grieve with you

• To those who experienced abuse at the hands of your own mother – we acknowledge your experience

• To those who lived through driving tests, medical tests, and the overall testing of motherhood – we are better for having you in our midst

• To those who have aborted children – we remember them and you on this day

• To those who are single and long to be married and mothering your own children – we mourn that life has not turned out the way you longed for it to be

• To those who step-parent – we walk with you on these complex paths

• To those who envisioned lavishing love on grandchildren -yet that dream is not to be, we grieve with you

• To those who will have emptier nests in the upcoming year – we grieve and rejoice with you

• To those who placed children up for adoption — we commend you for your selflessness and remember how you hold that child in your heart

• And to those who are pregnant with new life, both expected and surprising –we anticipate with you

This Mother’s Day, we walk with you. Mothering is not for the faint of heart and we have real warriors in our midst. We remember you.

Pubic Symphsis Pain

Pubic Symphsis Pain is pain at the center of the pelvis at the symphysis pubis joint.  It is also sometimes called Pubic Symphysis Dysfuction (PSD) or Pelvic Girdle Pain (PGP). It is a result of an influx of the hormone relaxin. The benefit of the influx of the hormone relaxin is that it relaxes the pelvic ligaments aiding in easing the baby out during delivery. The downside is that, at times, it can cause a misalignment of the pubic bones and cause inflammation and discomfort.  It is most commonly felt in the third trimester, but can begin as early as the first. It can also begin in the postpartum period, usually felt most commonly in the days immediately after birth and slowing resolving thereafter. It is often described as:

• A sharp pain right at the pelvic brim
• A shooting sensation associated with movement, like getting up from the car or a chair or turning in bed
• A general pelvic soreness or ache that originates in the center of the pelvis

 It is often felt upon:

• Prolonged periods of standing or sitting
• Turning over in bed or rolling side to side
• Long walks
• Walking up and down stairs

Relief is usually not complete until after delivery and therefore symptomatic or temporary relief is where treatment is focused.  Some ideas for symptomatic relief include.

• Pelvic support girdle. Can be purchased online or in a surgical supply shop
• Brace the pelvic floor muscles before performing any activity which might cause pain
• Rest the pelvis
• Sit down for tasks where possible (e.g. preparing food, ironing, dressing)
• Avoiding heavy lifting
• Avoiding steps over things.
• Avoid straddle movements especially when weight bearing.
• Bend the knees and keep the legs 'glued together' when turning in bed and getting in and out of bed.
• Place a pillow between the legs when in bed or resting.
• Avoid twisting movements of the body

Yoga is another great way to relieve some of the aches with pubic symphsis pain. Always consult your healthcare provider before doing any exercise routines

For further resources see

• Pelvic Girdle Pain in Pregnancy

Mom's "Milk" Shake

When breastfeeding: Water makes Milk. An adequate amount of fluids is important. Another key to making more breast milk is a high caloric intake, especially in the first weeks after birth when establishing a good milk supply. This shake is a great, tasty way to increase caloric intake as well as fluid intake. It's also high in protein and fat, making it a great milk maker. Yum.

 

My Mother's Milkshake

1 Cup whole milk

1-2 tbs peanut, almond, or cashew butter

1 cup plain Greek yogurt

1 tsp honey

1 banana

1 tsp brewer's yeast

4 large ice cubes

1/4 cup whey powder (optional, for extra calories and protein)

1 tsp chocolate syrup or cocoa powder (optional, for taste)

1 tsp vanilla (optional, for taste)

Put all the ingredients in a blender on high or 20-40 seconds. Add more or less milk to achieve desired consistency. Enjoy. If whey powder is added, drink right away to avoid separation of whey from the milk.  

 

 

Nutrition in Pregnancy: Going Green

Long gone is the adage "eating for two" and it has been replaced by a more mindful approach to nutrition in pregnancy. Women are also no longer encouraged to be sedentary during their pregnancy. Instead, they are encouraged to stay active. ACOG recommends 30 minutes a day of exercise for pregnant women who have first consulted with their obstetrical provider.  When it comes to nutrition, pregnant women are going green. They are turning to greens in their diet to satiate them and to give them that extra boost of folic acid, B vitamins, magnesium, calcium, and iron.  This is why power salads, power green juices and power walks becoming essential parts of the pregnancy diet.  

Here is fav list of great green foods for pregnant gals.

Green apples

Kale

Chard

Collards

Celerey

Cucumbers

Salad greens

Watercress

Aruguula

Avocados

Fennel

Basil

Broccoli

Brussel Sprouts

Cabbage 

Kiwi 

Grapes

Pesky Pounds

The second trimester can be a time when there is a significant increase in appetite. This is, at times, often compounded with a decrease in activity due to fatigue and other side effects of pregnancy. To keep the pregnancy pounds from packing on, some simples steps include:

• Continue to eat a diet high in protein
• Drink plenty of water
• Snack on fruits and vegetables
• Avoid cereal, especially for snacks or at night
• Avoid eating late and snacking late in the night
• After consulting your provider, continue to exercise as much as possible, modify if necessary.

Skyla: Newest IUD

Sklya: The newest IUD, released in January 2013. See their press release below:

WAYNE, N.J., Jan. 9, 2013 /PRNewswire/ -- Bayer HealthCare Pharmaceuticals Inc. today announced that the U.S. Food and Drug Administration (FDA) approved Skyla^™ (levonorgestrel-releasing intrauterine system) 13.5 mg, a new hormone-releasing system that is placed in the uterus for the prevention of pregnancy for up to three years.[1]

"Research shows that nearly 50 percent of pregnancies in the U.S. are unintended,² which emphasizes the need for increased education and access to effective birth control options," said Anita L. Nelson , M.D., Professor of Obstetrics and Gynecology at Harbor-UCLA Medical Center, Torrance, CA. "Skyla is more than 99 percent effective at preventing pregnancy and may be appropriate for women who want a birth control method that they do not have to take daily. Further, Skyla may be used by women whether or not they have ever had a child, representing an important new choice for women who don't want to become pregnant for up to three years."

Skyla is a small, flexible plastic T-shaped device containing 13.5 mg of a progestin hormone called levonorgestrel. The size of the Skyla T-body is 28mm x 30mm and the outer diameter of the placement tube is 3.8mm. Because Skyla slowly releases levonorgestrel into the uterus, only small amounts of the hormone enter the blood. During the first three to six months of using Skyla, women may experience irregular periods and an increase in the number of bleeding days. Women may also have frequent spotting or light bleeding. Some women may have heavy bleeding during this time. After using Skyla for a while, the number of bleeding and spotting days is likely to lessen, and there is a small chance that periods may stop altogether.^1,3

Women can have Skyla placed by a healthcare provider during an in-office visit. Skyla is intended for long-term use for up to three years but may be removed by a healthcare provider at any time. Women could become pregnant as soon as Skyla is removed, so they should use another method of birth control if they do not want to become pregnant. About 77% of women who want to become pregnant will become pregnant sometime in the first year after Skyla is removed.³

"The approval of Skyla expands Bayer's IUD portfolio and highlights our continued commitment to empower women with a variety of birth control options at different reproductive stages of their lives," said Pamela A. Cyrus , M.D., Vice President and Head of U.S. Medical Affairs, Bayer HealthCare Pharmaceuticals. "We are pleased to bring the first new IUD to market in the U.S. in 12 years, and to provide women who are seeking contraception with an important new and effective option to consider with their healthcare providers."

Skyla (levonorgestrel-releasing intrauterine system) 13.5 mg will be available by prescription the week of February 11.

About the Clinical Trial for Skyla¹
The approval of Skyla is supported by data from a Phase 3 trial that included 1,432 women aged 18-35 who received Skyla, of which 38.8% (556) had not yet had a child. The trial was a multicenter, multinational, randomized open-label study conducted in 11 countries in Europe, Latin America, the U.S. and Canada. Women less than six weeks postpartum, with a history of ectopic pregnancy, with clinically significant ovarian cysts or with HIV or otherwise at high risk for sexually transmitted infections were excluded from the trial. 

The pregnancy rate calculated as the Pearl Index (PI) in women aged 18-35 years was the primary efficacy endpoint used to assess contraceptive reliability. The PI was calculated based on 28-day equivalent exposure cycles; evaluable cycles excluded those in which back-up contraception was used unless a pregnancy occurred in that cycle. Skyla-treated women provided 15,763 evaluable 28-day cycle equivalents in the first year and 39,368 evaluable cycles over the three-year treatment period. The PI estimate for the first year of use based on the five pregnancies that occurred after the onset of treatment and within seven days after Skyla removal or expulsion was 0.41 with a 95% upper confidence limit of 0.96. The cumulative three-year pregnancy rate, based on 10 pregnancies, estimated by the Kaplan-Meier method was 0.9 per 100 women or 0.9%, with a 95% upper confidence limit of 1.7%.

Of Skyla-treated women, 21.9% discontinued the study treatment due to an adverse event.  Most common adverse reactions (occurring in greater than or equal to 5% users) were, vulvovaginitis (20.2%), abdominal/pelvic pain (18.9%), acne/seborrhea (15.0%), ovarian cyst (13.2%), headache (12.4%), dysmenorrhea (8.6%), breast pain/discomfort (8.6%), increased bleeding (7.8%) and nausea (5.5%). 

Other serious adverse reactions were also observed, including ectopic/intrauterine pregnancy, life-threatening infections, pelvic inflammatory disease (PID), perforation and expulsion. 

Important Safety Information for Skyla (levonorgestrel-releasing intrauterine system) 13.5 mg

If you have a pelvic infection, get infections easily, or have certain cancers, don't use Skyla. Less than 1% of users get a serious infection called pelvic inflammatory disease.

If you have persistent pelvic or stomach pain or if Skyla comes out, tell your doctor. If Skyla comes out, use back-up birth control. Skyla may attach to or go through the uterus and cause other problems.

Pregnancy while using Skyla is uncommon but can be life threatening and may result in loss of pregnancy or fertility. Ovarian cysts may occur but usually disappear.

Bleeding and spotting may increase in the first few months, and remain irregular. Over time, periods are likely to become shorter and lighter, or may stop.

Skyla does not protect against HIV or STDs.

Only you and your healthcare provider can decide if Skyla is right for you.  Skyla is available by prescription only.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

For additional information about Skyla, please see full prescribing information at www.skyla-us.com.

About Bayer HealthCare Pharmaceuticals Inc.
Bayer HealthCare Pharmaceuticals Inc. is the U.S.-based pharmaceuticals business of Bayer HealthCare LLC, a subsidiary of Bayer AG. Bayer HealthCare is one of the world's leading, innovative companies in the healthcare and medical products industry, and combines the activities of the Animal Health, Consumer Care, Diabetes Care, and Pharmaceuticals divisions. As a specialty pharmaceutical company, Bayer HealthCare Pharmaceuticals provides products for Diagnostic Imaging, General Medicine, Hematology, Neurology, Oncology and Women's Healthcare. The company's aim is to discover and manufacture products that will improve human health worldwide by diagnosing, preventing and treating diseases.

BAYER^® and the Bayer Cross^® are registered trademarks of Bayer.  Skyla is a trademark of Bayer.

International Women's Day

Today: March 8th is International Women's Day.

International Women's Day has been observed since in the early 1900's, a time of great expansion and turbulence in the industrialized world that saw booming population growth and the rise of radical ideologies. 

1908
Great unrest and critical debate was occurring amongst women. Women's oppression and inequality was spurring women to become more vocal and active in campaigning for change. Then in 1908, 15,000 women marched through New York City demanding shorter hours, better pay and voting rights.

1909
In accordance with a declaration by the Socialist Party of America, the first National Woman's Day (NWD) was observed across the United States on 28 February. Women continued to celebrate NWD on the last Sunday of February until 1913.

1910

In 1910 a second International Conference of Working Women was held in Copenhagen. A woman named a Clara Zetkin (Leader of the 'Women's Office' for the Social Democratic Party in Germany) tabled the idea of an International Women's Day. She proposed that every year in every country there should be a celebration on the same day - a Women's Day - to press for their demands. The conference of over 100 women from 17 countries, representing unions, socialist parties, working women's clubs, and including the first three women elected to the Finnish parliament, greeted Zetkin's suggestion with unanimous approval and thus International Women's Day was the result.

1911
Following the decision agreed at Copenhagen in 1911, International Women's Day (IWD) was honoured the first time in Austria, Denmark, Germany and Switzerland on 19 March. More than one million women and men attended IWD rallies campaigning for women's rights to work, vote, be trained, to hold public office and end discrimination. However less than a week later on 25 March, the tragic 'Triangle Fire' in New York City took the lives of more than 140 working women, most of them Italian and Jewish immigrants. This disastrous event drew significant attention to working conditions and labour legislation in the United States that became a focus of subsequent International Women's Day events. 1911 also saw women's 'Bread and Roses' campaign.
 

1913-1914
On the eve of World War I campaigning for peace, Russian women observed their first International Women's Day on the last Sunday in February 1913. In 1913 following discussions, International Women's Day was transferred to 8 March and this day has remained the global date for International Wommen's Day ever since. In 1914 further women across Europe held rallies to campaign against the war and to express women's solidarity.

1917
On the last Sunday of February, Russian women began a strike for "bread and peace" in response to the death over 2 million Russian soldiers in war. Opposed by political leaders the women continued to strike until four days later the Czar was forced to abdicate and the provisional Government granted women the right to vote. The date the women's strike commenced was Sunday 23 February on the Julian calendar then in use in Russia. This day on the Gregorian calendar in use elsewhere was 8 March.

1918 - 1999
Since its birth in the socialist movement, International Women's Day has grown to become a global day of recognition and celebration across developed and developing countries alike. For decades, IWD has grown from strength to strength annually. For many years the United Nations has held an annual IWD conference to coordinate international efforts for women's rights and participation in social, political and economic processes. 1975 was designated as 'International Women's Year' by the United Nations. Women's organisations and governments around the world have also observed IWD annually on 8 March by holding large-scale events that honour women's advancement and while diligently reminding of the continued vigilance and action required to ensure that women's equality is gained and maintained in all aspects of life.

2000 and beyond
IWD is now an official holiday in Afghanistan, Armenia, Azerbaijan, Belarus, Burkina Faso, Cambodia, China (for women only), Cuba, Georgia, Guinea-Bissau, Eritrea, Kazakhstan, Kyrgyzstan, Laos, Madagascar (for women only), Moldova, Mongolia, Montenegro, Nepal (for women only), Russia, Tajikistan, Turkmenistan, Uganda, Ukraine, Uzbekistan, Vietnam and Zambia. The tradition sees men honouring their mothers, wives, girlfriends, colleagues, etc with flowers and small gifts. In some countries IWD has the equivalent status of Mother's Day where children give small presents to their mothers and grandmothers.

The new millennium has witnessed a significant change and attitudinal shift in both women's and society's thoughts about women's equality and emancipation. Many from a younger generation feel that 'all the battles have been won for women' while many feminists from the 1970's know only too well the longevity and ingrained complexity of patriarchy. With more women in the boardroom, greater equality in legislative rights, and an increased critical mass of women's visibility as impressive role models in every aspect of life, one could think that women have gained true equality. The unfortunate fact is that women are still not paid equally to that of their male counterparts, women still are not present in equal numbers in business or politics, and globally women's education, health and the violence against them is worse than that of men.

However, great improvements have been made. We do have female astronauts and prime ministers, school girls are welcomed into university, women can work and have a family, women have real choices. And so the tone and nature of IWD has, for the past few years, moved from being a reminder about the negatives to a celebration of the positives.

Annually on 8 March, thousands of events are held throughout the world to inspire women and celebrate achievements. A global web of rich and diverse local activity connects women from all around the world ranging from political rallies, business conferences, government activities and networking events through to local women's craft markets, theatric performances, fashion parades and more.

Many global corporations have also started to more actively support IWD by running their own internal events and through supporting external ones. For example, on 8 March search engine and media giant Google some years even changes its logo on its global search pages. Year on year IWD is certainly increasing in status. The United States even designates the whole month of March as 'Women's History Month'.

So make a difference, think globally and act locally !! Make everyday International Women's Day. Do your bit to ensure that the future for girls is bright, equal, safe and rewarding.

About  internationalwomensday.com website

internationalwomensday.com is a global hub for sharing International Women’s Day information, events, news and resources.

The website was founded in 2001 as a non-profit philanthropic venture dedicated to keeping International Women’s Day (IWD) alive and growing.

Since 2007, IWD has gained considerable momentum due to greater media attention, events, social networking and corporate support. IWD is now celebrated via wide scale activity in almost every country and many world leaders support the day with official statements.

This service is proudly provided by Aurora Ventures as a non-profit venture and kindly supported by a number of companies who make it possible for this International Women's Day website to operate. Without their support, the website could not survive. Each Supporting Partner has a firm track record in supporting women's equality and advancement. We like to celebrate International Women’s Day, but we also want to celebrate our Supporting Partners!

10 Childbirth Facts - From Babble

I love this:
What women should know about giving birth

Click Here to see Babble's 10 Childbirth Facts 

1) It's not like how it is in the movies

2) Labor goes through very distinct phases with different challenges

3) It's not a due date, it's a due month.

4) An epidural is just one of many ways to cope with labor

5) The philosophy of your care-provider matters. A lot.

6) Your doctor will not be with you for most of your labor. You midwife, may.

7) Induced labors are twice as likely to end in C-Section

8) Staying Home in Early Labor Can Reduce the Chances of a C-section

9) Birth is a normal physiological event.

10) A good birth experience is not about how you do it       

Tips to prevent an Unnecessary Cesarean

While labor and birth can be quite extraordinary and even more unpredictable, there are some things a gal can do help prevent an unnecessary cesarean.

• Find an honest provider. Get with a provider who isn't going to unnecessarily induce you or perform any unnecessary medical interventions for their own convenience or because they lack  patience.
• Exercise. Exercise is such an under utilized tool in pregnancy and birth. Good exercise helps to promote circulation during pregnancy. It helps to prevent excessive weight gain in the mother and in the baby. It also helps to ripen the cervix when done consistently throughout pregnancy.
• Avoid excess sugar and white flour. Sugar and white flour have what non-nutritive calories commonly known as "empty calories." These are calories that will satiate an appetite, but they will not contribute to nutrition or health.
• Await spontaneous labor. Whenever possible avoid an induction, especially if the cervix is not favorable for induction. Great ways to promote spontaneous labor include: sexual intercourse, stripping the membranes, exercise, and acupuncture.
• Be confident and stay positive. Trust in your body's ability to birth and in your ability to labor brilliantly.
• Work with a birth companion. Birth companions, doulas, and labor coaches are great support during labor and can a be a great advocate when the time comes to birth. They can also delay use of medication for pain, which may increase the need for medical intervention. 

The Unnecesarean

The Unnecesarean: noun, often capitalized

1. A delivery performed via cesarean section for which there is no medical indication
2. A medically unnecessary cesarean section
3. Excess C/S

Delivery by cesarian is performed at astronomically high rates in the United States (33%).  A medically safe rate of cesarian is around 15%, while some hospitals have rates as high as 40-50%. That means that more than half of the cesareans that are performed are medically unnecessary.

Check out my most recent blog post for Baby-Birth about unnecesarians. Click here

 

Midwifery Model of Care

Often, I am asked about how midiwves care for women differently than other obsterical providers.  And while, it's different midwife to midwife, there is the basic Midwifery Model of Care that I'd like to share as a fundation for why we are different.

Midwives Model of Care™

The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:

·       monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle

·       providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support

 

·       minimizing technological interventions and;

·       identifying and referring women who require obstetrical attention

Patience in the Post Term

You are not alone. More than 1 in 4 pregnancies go past their expected due date in the United States. This is even higher for women who are having their first babe and for women who are having a boy.
Going over due can be discouraging and can weigh on our patience, both as a provider but more often as a mother.  It can seem like the babe's birthday is never going to come. But this period of waiting can be a great time for reflection, preparation, and intimacy.  Sometimes we are in such a rush to get everything done, we need to be reminded to stop and take it all in.
I went one week overdue with my son, my second.  I remember it weighing on my patience but I also remember it being a time of joy and rest with my husband and my little daughter, my first.
In Judaism, there is a Yiddish word B'shert, (Yiddish: באַשערט).  It literally means "destiny" and can even mean a destiny that is divine. A baby's timing is b'shert, meant to be, by their very own diving timing.
So take heart, have patience, have hope, and know that you can and will do this most magnificent thing, give birth.

Tips to prevent the Occiput Posterior Baby

The occiput posterior baby is a that is facing the mother's spine. It's also known as sunny-side up. Otherwise known as OP, or the OP position. There are a few tricks to avoid this position at the end of pregnancy.

• Avoid the semi reclined position. Like that lounger you love.
• Do pelvic rocking 10-15 min three times a day
• Cat and cow yoga poses
• Walk on hands and knees 
• Yogic sun salutations and downward facing dog yoga poses
• Walk

Despite positioning, exercising and yoga, some babies persist in the OP position. The majority of these babies will turn in labor.  Those babies that don't turn, may have a very good reason for maintaining the OP position that is unclear to us. It may be the shape of the mother's pelvis or the position of her spine. It could also be the position of the baby's own cord, shoulder, placenta etc, that makes them favor the OP position and makes this is the optimum position for labor and birth.

Heartburn

Heartburn, while not serious, is painful.  In pregnancy, we are more suceptible to a hearburn attack due to an increase in certain hormones (like progesterone) slowing down the gatroiontetaila tract. Fortunatley, there are several home and pharmactolic remedies to this conundrum. 

Modifications

• Avoid large meals
• Eat smaller portions more frequently
• Eliminate foods that are triggers
• Don't eat 1-3 hours before reclining
• Sleep at a 35-45 degree angle
• Avoids spicy foods, fried foods, rich foods, fatty foods, caffeine and carbonate drinks
• Avoid tight clothing around the waist

Home Remedies

• Apples. Eat an apple (it's true an apple a day . . .)
• Baking soda. 1 teaspoon with a glass of water
• Green tea.  This tea coats the esophageous and can decrease heartburn symptom
• Aloe. Drink Aloe juice before meals

Pharmacologic Remedies
*Before taking any medications during pregnancy always consult your health care provider.

• Tums. Tums can be a pregnant gals best friend. Never leave home without them
• Rolaids. Calcium with added magnesum
• Pepcid
• Prevacid
• Some of these medications may interfere with other medications or vitamins. They may also not be recommended for various pregnancy situations. Always consult your provider. 

 
I had once a pain in the chestal area. Now, I was sure it was heartburn, y'know, cause at that time I was married and my wife cooking with her Nazi recipes, y'know, chicken Himmler. I didn't wanna pay 25 bucks to have it reaffirmed by some medic, that I had heartburn. But I was worried 'cause it was in the chestal area. Then it turns out my friend, Eggs Benedict, has a pain in his chestal area, in the same exact spot. I figured if I could get Eggs to go to the doctor, I could figure out what was wrong with me, at no charge, so I con Eggs. He goes. Turns out he's got heartburn. Cost him 25 dollars, and I feel great, cause I figured I beat the medic out of 25 big ones, y'know. Called up Eggs two days later... He died. I check into a hospital immediately, have a battery of test run... x-rays. Turns out I got heartburn. Cost me a 110 dollars. Now I'm furious. I run to Eggs' mother, and I say "Did he suffer much?" And she said: "No, it was quick. Car hit him and that was it.  

- From Eggs Benedict by Woody Allen (1968)