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Top 3 Pregnancy Reads

by Dr. Sarah Winward, ND IBCLC

Given the MILLIONS of books out there on pregnancy and childbirth, it can be hard to decide where to invest your time as you prepare for this new adventure!

Here is a list of my top 3 favourite pregnancy reads that I recommend to my clients.

The list is short & sweet but packed with great information to help you feel prepared!


1) MAGICAL BEGINNINGS, ENCHANTED LIVES: A HOLISTIC GUIDE TO PREGNANCY AND CHILDBIRTH

By: Deepak Chopra M.D.

Available on Amazon for about $21

Why I love it: This book combines the latest in evidence based medicine and the ancient wisdom of Ayurvedic medicine in a way that only Deepak Chopra can. Providing a holistic and spiritual approach to pregnancy and childbirth, including simple exercises you can do in your home to help you feel more connected and aware during all stages of your pregnancy and 4th trimester.

2) INA MAY’S GUIDE TO CHILDBIRTH

By: Ina May Gaskin

Available on Amazon for about $20

Why I love it: Ina May Gaskin is single-handedly responsible for reviving the midwifery movement in North America, with more than 30 years of experience she is a veritable guru. This book starts with a fantastic collection of birth stories written by women from every walk of life that really help to normalize the whole process of birth and inspire incredible confidence in what a woman’s body can do. The second half of the book is full of information from Ina May on everything from inducing labour to pain management to orgasmic birth, all with an emphasis on restoring woman’s faith in their ability to navigate natural childbirth

3) THE NATURAL PREGNANCY BOOK:YOUR COMPLETE GUIDE TO A SAFE, ORGANIC PREGNANCYAND CHILDBIRTH WITH HERBS, NUTRITION AND OTHERHOLISITIC CHOICES 

By: Aviva Romm M.D.

Available on Amazon for about $20

Why I love it: As an MD with many years of experience in alternative medicine, Aviva Romm is staple in the field of holistic women’s health. This book provides a knowledgeable introduction to the world of natural remedies during pregnancy.


BONUS: MY FAVOURITE BOOK FOR BIRTH PARTNERS

THE BIRTH PARTNER: A COMPLETE GUIDE TO CHILDBIRTHFOR DADS, DOULAS, AND ALL OTHER LABOR COMPANIONS

By: Penny Simkin

Available on Amazon for about $25

Why I love it: I consider this book to be an essential read for anyone who is attending your birth. It covers every topic from how to prepare for labour right up to newborn care, in a wonderfully inclusive way. It provides invaluable information on every possible birth path including medical interventions so that you and your partner are in the know before you need to make decisions. The also has pages marked for quick reference, so it’s great to have on hand during that birth itself.

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How Can My Partner Prepare for My Birth?

by Dr. Sarah Winward, ND IBCLC


Is my partner truly prepared to help me in childbirth?

Do a quick google or amazon search on “childbirth preparation” you will get a list of results that are overwhelmingly geared towards you, the pregnant person. You might notice that there are very few books written that would help prepare your partner for childbirth.

Why is this a problem for me?

How you are cared for and supported during childbirth affects how you give birth and how you feel about it. How you feel about your birth experience can also influence how you feel about your own ability in being a mother as well as affect your chance of developing postpartum depression and anxiety. Knowing this, it’s pretty clear that ongoing emotional and physical support during the very transformative experience of birth is of the utmost importance.

What about a doula?

A doula is a person who provides continuous and on-going emotional, physical and informational support for the labouring person. It has been shown that doulas help to reduce the rates of interventions, including epidural use and c-sections and help to increase reported satisfaction in birth experience. In other words, having a doula increases the chance of having HEALTHY AND HAPPY parent and baby.

But what if I can’t have a doula?

Not everyone can access a doula. Even though having doulas would actually reduce health costs, increase positive outcomes and would be a good basic addition to any healthcare system, hiring a doula is not possible for everyone.

At the time of this writing, COVID-19 virus (simply referred to as coronavirus) is emerging as a global and local public health concern that is resulting in changes in hospital policies. Hospitals are restricting the number of people who can attend births, in some cases reducing it to only one person, usually just your partner. As a doula, when I attend births, the more support the birther can receive, the better their experience. Sometimes, in addition to their partner and me (their doula), their own mother and/ or a friend will be there too. So this change in policy can greatly impact your birth experience and well-being.

How should my partner best prepare to support me? 

Here are some tips to help your partner be your “doula”:

Communication! Be honest about your fears around childbirth and be honest about your partner’s strengths and weaknesses in handling high stress situations. Play up those strengths and how they can be best used to help you during labour and childbirth

Take a high quality prenatal class that focuses on teaching techniques and skills that your partner can use to help you during labour and childbirth. We at Your Downtown Doula offer the Confident Birth Prenatal Class for a comprehensive approach to help you feel relaxed and confident during childbirth and labour.

Labour at home for as long as possible. If the concerns around infection still exist at the time of your childbirth, then reducing your hospital stay is a good idea. Your partner can help you with relaxation, help distract you, do massage and attend to your basic needs. Doing most of your labouring at home can also reduce unnecessary interventions.

A great book for partners is Penny Simkin’s The Birth Partner. It is specific to doulas and partners and contains very comprehensive information.


Want to learn more about our Confident Birth Prenatal Program?

Click here to sign up for a complimentary virtual Meet & Greet with one of our instructors (by the way, did we mention that they’re all Naturopathic Doctors!)

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Finding Comfort During Labour

by Dr. Sarah Winward, ND IBCLC

Labour is intense, to say the least. But does it have to be painful? It can be helpful to reframe the sensations you are feeling. In the words of Ina May Gaskin “labour is an interesting sensation that requires all of your attention”. Many people prefer to refer to surges or rushes as opposed to contraction, HypnoBirthing follows this tenant as well.

Labour is an interesting sensation that requires all of your attention.

Ina May Gaskin

The Pain-Tension-Fear Cycle

It’s very common to have fears surrounding birth. When we experience fear it releases adrenaline which in turn can cause ineffective muscle contractions around the uterus. As a result the production of oxytocin and endorphins decrease and the muscles in the uterus start working against each other. All of this restricts blood flow to your uterus and is a trigger for pain. It also lowers your pain threshold. In dangerous situations, this fear-pain-tension cycle allows for response and survival, in birth it can become a complication. Often, as the pain increases the fear increases and then the tension increases resulting in a repeating, and counter-productive, cycle. So, reducing pain really comes down to reducing tension in your body.

Breaking the Cycle

In her book “The Birth Partner” Patty Simkin discusses the 3 R’s of labour. These are Relaxation, Rhythm and Ritual. Engaging in all 3 of these brings you into the present moment and allows you to move through each contraction without being overwhelmed by them. Often rituals will arise spontaneously during the course or your labour and they can change as your labour progresses. The best rituals involve rhythm and repetition, which lead to relaxation. Things to incorporate in your rituals include: focusing on the breath, staring into someone’s eyes, “slow dancing” with your birth partner, dancing to music, or anything else that feels good to you in the moment.

Helpful hints for your birth partner

Penny Simkin’s book The Birth Partner also outlines a great tool for partners. It is called the Take-Charge routine and is outlined in detail in her book. It is great to use when the birthing person is having difficulty maintaining their ritual or is appearing to be overwhelmed or distressed.

1) Remain calm, others pick up on your energy

2) Stay close, bring your face close to theirs

3) Anchor them by calmly holding their shoulders or hands

4) Get them to look at you, eye contact itself can help to bring them back to the moment

5) Talk to them in between contractions, make suggestions of rituals to try, such as concentrating on the breath

6) Help them regain their rhythm, move your body with theirs

It may also help to remind birthing persons that they are about to meet their baby!

Tips to use in the moment

Any of the following can be helpful during labour, but remember that the right thing for you to do is whatever makes you fell calm, safe and relaxed:

  • Discuss any fears that you are experiencing with your doula, partner or care provider
  • Progressive relaxation, guided meditation or visualizations
  • Make noise and breath with sound
  • Change positions: hands and knees, on a birth ball, walking around, slow dancing
  • Acupressure
  • Use water such as a shower or birthing pool
  • Ask for assistance and allow your partner and doula to support you with hip squeezes, low back pressure, massage, etc
  • Hot or cold applications to your face, back or neck
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Herbal Medicines during Pregnancy

by Dr. Sarah Winward, ND IBCLC

There is a lot of wisdom in traditional herbal medicine, but with health food store selling more products than most people know what to do with, it’s hard to know what to take. This is why, if you are using herbal products, it’s important to have a practitioner, like a Naturopathic Doctor, who is knowledgeable and who is familiar with what is safe during pregnancy. Here, we’ve provided you with some good information and a place to start!

(This doesn’t replace individualized medical advice!)


Herbs that you may want to keep on hand during your pregnancy

Red Raspberry leaf

Why? Nutritive- nutrient dense, high in vitamins and minerals, including iron, calcium and magnesium; uterine tonic- helps prepare the uterus for labour

How? Drink as a tea, 2-3 cups/day

When? Last trimester of pregnancy to help get your body ready for labour

Research: Shortens labour and leads to fewer interventions

Traditional wisdom: Speeds childbirth


Stinging Nettle Leaf

Why? Nutritive tonic, also high in vitamins and minerals, including chlorophyll, vitamin A, C, D and K, and iron; contains protein, helps to bring in mother’s milk, anti-inflammatory

How? Combine with red raspberry leaf to drink as a tea

When? Can be consumed safely throughout pregnancy and breastfeeding

Research: No clinical trials, but experiential and observational evidence show benefit in anemia, preventing postpartum hemorrhage and preeclampsia

Traditional wisdom: Pregnancy tonic, improves kidney function, prevents postpartum hemorrhage, reduces hemorrhoids, increases milk supply


Cranberry

Why? Urinary antiseptic, anti-inflammatory, preventing and treating urinary tract infections by blocking the ability of E. coli to stick to the lining of the bladder

How? As an extract in capsules form or as juice (not cranberry cocktail), 1-2 cups/day for preventing UTI, consider capsules for an active UTI

When? Good to have on hand for the first signs of a UTI/bladder infection, combine with increased fluid intake to help flush the urinary tract. **If symptoms don’t resolve in 1-2 days, or if you develop severe symptoms (fever, low back ache, visible blood in urine) contact your health care provider immediately.

Research: Preventing and treating UTI, safe for use in pregnancy

Traditional wisdom: Preventing and treating UTI


Ginger

Why? Antiemetic, helps with morning sickness, anti-inflammatory, carminative- soothes pain from gas/bloating

How? Fresh or dried root steeped in hot water, drink as a tea 1-2 cups/day

When? If you are experiencing nausea or vomiting in pregnancy. Caution with doses higher than 2 g/day as this is traditionally considered an emmenagogue (brings on your period).**If you are having very severe or frequent vomiting, contact your health care provider

Research: very strong evidence in favor of use in nausea and vomiting in pregnancy

Traditional wisdom: warming tonic, useful in nausea and vomiting in pregnancy


Chamomile

Why? Promotes relaxation, relaxes the nervous system, relaxes the smooth muscles of the digestive system, soothes pain from gas/bloating, anti-inflammator

How? Drink 1-2 cups as a tea, especially soothing in the evening

When? Can be consumed throughout pregnancy, at any time but especially if you are feeling nervous or anxious**Caution with this herb if you have a ragweed allergy, they belong to the same family of plants

Research: Sedating, sleep inducing, some evidence in treating mild anxiety, decreases gas and soothes digestive spasms

Traditional wisdom: nervousness, muscle spasms, gas and colic


What to Take & what to Avoid

Safe Herbs

  • Garlic (Allium sativum)
  • Senna (Cassia senna)
  • Turmeric (Curcuma longa)
  • Echinacea (Echinacea spp.)
  • Licorice (Glycyrrhiza glabra)
  • Chamomile (Matricaria recutita)
  • Ginseng (Korean) (Panax ginseng)
  • Raspberry Leaf (Rubus ideaus)
  • Cranberry (Vaccinium macrocarpon)
  • Bilberry Fruit (Vaccinium myrtillus)
  • Ginger (Zingiber officinale)

*Despite these herbs being listed as safe, it is important that you advise your medical practitioners regarding any supplements that you are taking. These herbs can have other adverse effects such as raising blood pressure that may be important in your individual case. This list may change based on ongoing research and safety studies.


Unsafe Herbs

  • Dong quai (Angelica sinesis)
  • Bearberry (Arctostaphylos uva-ursi)
  • Arnica (Arnica montana)
  • Wormwood (Artemisia absinthium)
  • Barberry (Berberis vulgaris)
  • Blue cohosh (Caulophyllum thalictroides)
  • Greater Celandine (Chelidonium majus)
  • Guggul (Commiphora mukul)
  • Goldenseal (Hydrastis Canadensis)
  • Chaparral (Larrea tridentate)
  • Gypsywort (Lycopus europaeus)
  • Bugleweed (Lycopus virginicus)
  • Oregon grape (Mahonia aquifolium)
  • Pennyroyal (Mentha pulegium)
  • Boldo (Penmus boldus)
  • Poke root (phytolacca Americana or Phytolacca decandra)
  • Jamaica dogwood (Piscidia erythrina)
  • Pasque flower (Pulsatilla spp)
  • Sage (Salvia officinalis)
  • Pau d’arco (Tebebuia avellanedae)
  • Tansy (Tanacetum vulgare)
  • Thuja (Thuja accidentalis)
  • Tylophora (Tylophora indica or Tylophora asthmatica)
  • Cat’s claw (Uncaria tomentosa)

*Please do not take any of these herbs unless prescribed by a licensed practitioner that will carefully monitor your health and the health of your baby. This list may change based on ongoing research and safety studies.

This article is meant to provide information only, it does not substitute for personalized medical advice.

Are you preparing for your best possible birth? 

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Top 5 Tips for Self Care During Pregnancy

by Dr. Sarah Winward, ND IBCLC

Real talk, the pregnant body is a weird place to live. Your skin stretches in ways you have no control over. You leak, if you’re lucky it’s just increased vaginal discharge and colostrum. If you’re unlucky it’s peeing a bit when you sneeze. Sometimes you sleep, sometimes you don’t, and sometimes you wake up so stiff that you wonder if you’ve been in a brawl and just don’t remember. To say the least, it’s a lot to get used to. At 32 weeks pregnant, I’m right in the middle of the third trimester, and the pregnancy weirdness is in full swing.

It’s become obvious to me that self care is extremely important, now more than ever. The more I take care of myself, the more comfortable I am with my ever changing body, the more I feel connected to my baby, and the more excited I get about giving birth. So, I wanted to share with you my top 5 favourite self care practices for pregnancy.


1. Positive Self Talk

I’m putting this one first and foremost, because you can’t do any of these other practices without speaking to yourself in a loving voice. Remember that you’re growing a human being! I’ve found it helpful to reframe the changes I’m noticing. For example, instead of thinking that the veins I’ve noticed in my legs are ugly, I remind myself that I have about one and a half times more blood than I used to and my body is working to accommodate it.  Plus, how cool is it that my body was able to make all that extra blood to nourish my baby.


2. Dry Brushing

Dry brushing is a simple technique used to increase circulation to your skin and promote lymphatic drainage. Using a coarse bristle brush, and light strokes, you brush from your extremities towards your heart. You can find a tutorial here. I love doing this right before hopping into the shower because my skin feels super soft afterwards and it gives me an opportunity to pay attention to every part of my body and notice how it’s changing. It’s also possible that it may help decrease your chances of getting stretch marks, so that’s a bonus.


Just remember, you’re body is doing a lot right now. You should be impressed!

Dr. Sarah Winward

3. Self Massage

I’ve added this as part of my shower routine as well, and it doesn’t have to be super complicated. I just take some extra time applying moisturizer, I use coconut oil, after I shower. I usually give my belly, thighs and hips a bit of extra love using a circular motion and light touch. Again, I love this because it gives me time to see how my body is changing. But it also means that I am touching myself with my own hands, getting comfortable with what feels different. This is another opportunity to be really loving to your body, and appreciate everything that it’s able to do to sustain a new life.


4. Spending Time Naked

I’ve done this 2 ways. The first is that my shower routine has gotten longer, so I am spending more time naked with myself then. I also take some time to do yoga in the mornings. The mornings work for me because I’m not sleeping well (surprise, surprise) so I’m usually up much earlier than the rest of my house. I can get in a 20 minute prenatal flow without being interrupted. And I have been choosing to do this naked. Yoga is amazing because it connects you with your breath. It brings you into the present moment and it reminds you to be in your body without judgement. I’ve been enjoying this one, but there are tons out there that are free to access. I love this practice because it is super gentle, it reminds you to put your hands on your belly and to connect with your baby. Being comfortable at least partially naked will become important, because after your baby is born the best place they can be is skin to skin with you, you can find out more about that here. The more comfortable you are, the more you’ll want to hang out skin to skin, and the better for both you and your baby. 


5. Exercise

I have been lifting weights for years. So, it was natural for me to want to continue into my pregnancy. Although, I did take a bit of a break during the most exhausting parts of the first trimester. As long as you’ve been given the ok by your care provider it is safe to continue most exercises through pregnancy. But, it is important to check in. How do you feel while your doing it? How do you feel after? I love lifting because it really shows you what your body is capable of, you can see your own strength. But, you can also see how things shift. I stopped doing pushups  at around 25 weeks and started doing wall pushups because I didn’t feel like I could maintain good form. I’ve recently started feeling the same about deadlifts. And that’s ok, because my core is shifting to accommodate a tiny person.

In my second trimester, I also started attending prenatal exercise classes. I highly recommend this because it gives you a chance to connect with other pregnant people. And you get solid guidance from fitness professionals who specialize in pregnancy and postpartum, so they can help you modify appropriately when you need to.

Just remember, you’re body is doing a lot right now. You should be impressed! Take the time to thank your body and take care of it. 


This article is meant to provide information only, it does not substitute for personalized medical care.

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Nursing Positions

by Dr. Sarah Winward, ND IBCLC

If you’re exclusively breastfeeding, you’re doing it a lot. Like a lot, a lot. But so often I notice that parents are getting into weird and uncomfortable positions while latching, and then they have to stay there and hold that for the whole of the feeding. You’ve probably heard me say that breastfeeding should never hurt. That also means that it should never hurt in your neck or your shoulders either. So, I wanted to share with you my top two most comfortable positions for nursing. The best part about both of these positions is that they require no equipment – no nursing pillows, no blanket rolls, nothing. Just you and your baby.

The Cradle Hold

Dr. Sarah Winward and Dr. Olivia Chubey, ND

This position involves holding your baby with the same arm as the breast you’re feeding on. I love this position because it leaves your other arm free and because you’re supporting your baby’s weight with your biceps instead of with your wrist (as you would be in football or cross cradle). You can also lean back to put some of their weight on your belly and this is often even more comfortable. 

I’ve recently seen floating around the internet that this position is meant for older babies with more head control. I disagree. I frequently recommend this position to parents with newborns and have them report that they are much more comfortable. Babies are born with good instincts, it’s often easier to latch them in this position because they are able to guide themselves. 

Check out our video for exactly how to get baby latched in the cradle hold.

Side Lying

Dr. Sarah Winward and Dr. Olivia Chubey

Exclusive bodyfeeding means that you’re also feeding your baby overnight. It is exhausting enough doing night feedings, but add in the extra steps of having to get up and move to the couch or arrange all your pillows ‘just so every 2 hours’ and it’s too much. It’s normal for babies to continue to nurse overnight in the first year (plus) of life, having to do this for that long would be literally impossible. 

Enter side lying nursing. I love this position because all you have to do is put baby beside you, nurse, and then pop them back in the bassinet. You don’t even have to sit up. Even better, you can have a partner bring baby to you and put them back down so all you have to do is roll over and nurse and you can stay half asleep for the whole process. 

This position is what makes exclusive bodyfeeding possible. 

Plus, it’s super relaxing for both parent and baby. If baby is clusterfeeding or if you’re having trouble with milk flow, this position is a game changer.

Check out the video on how to latch in this position.

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Nitrous Oxide – the “other” pain relief option

by Dr. EeVon Ling, ND

** At the time of this writing, COVID-19 policies have restricted the use of nitrous oxide in some birth settings. Inquire with your birth location if this option is available to you. 

What is it? 

Laughing Gas for pain relief?

Nitrous oxide (N2O). Aka “Laughing Gas”, “Gas”, “Nitrous”, “Entonox” (Brand name). 

It is a colourless and nearly odourless gas that is a chemical compound and mixture of nitrogen and oxygen. It has both analgesic and anesthetic properties – meaning it can reduce or alter pain sensation and pain perception.  You may know about nitrous oxide because of its wide use in dentistry. It is the same gas, but the concentration used during labour is much less. 

I haven’t heard much about Nitrous Oxide. Is it common in labour? 

You may be surprised to learn that N2O is the most commonly used form of analgesia in childbirth around the world. 

Historically, N2O has been in use for more than a hundred years! It was widely used in US hospitals for childbirth in the 1930’s – 1950’s. By the 1960’s, epidural use sharply overtook as the primary choice for pain relief and N20 use would pretty much disappear from labour and delivery in the US. But more recently in Canada, its popularity has increased as a pain relief option.  A survey in 2006 found that about 1 in 5, or 20%, of women who gave birth in Ontario used N2O for pain relief. In comparison, the rate of epidural use is about 50-60%. 

Is it as good as using an epidural for pain relief?  

The short answer is “no”. 

It does not replace getting an epidural in terms of pain relief. An epidural is meant to completely take away pain to the point where you usually don’t even know when you are having a contraction or not. Because N2O doesn’t take away pain like an epidural, I have noticed that OB’s and nurses don’t mention it as an option to clients, even to clients that express that they want to labour without an epidural. They don’t consider the value it may offer and in fact, I’ve heard OB’s tell my clients that nitrous oxide “does nothing”. This thinking is a result of comparing N2O with an epidural, but it is a great disservice to completely dismiss it as a useful coping tool.

The more thoughtful answer is that nitrous oxide is a “good enough pain relief”. The following are quotes from my own clients who used nitrous oxide as their main pain relief: 

“It helped take the edge off”

“It helped take the edge off” 

“It made me care less about the pain”

“Breathing through the tube helped distract me” 

“It helped me relax more and focus” 

“It helped me birth without an epidural”

“Without it, I would not have been able to have my homebirth”

“I think it made me a little giddy”**

In some cases, clients have used N2O while waiting to get an epidural or when they are receiving stitches on their perineum post birth. 

What can I expect if I use N2O? 

Begin use at the beginning of a contraction

Where available, it is used in a hospital or birth centre setting, and occasionally some midwife groups have it available for home births (check with your midwife or birth location for availability). It is administered through a tube with a face mask attached. When you are in labour, you hold the mask to your face and deeply breathe in the N2O at the very beginning of or in anticipation of a contraction. The maximum concentration is reached within 60 seconds so you continue to breathe the N2O gas until the contraction ends. Once the contraction is over you take the mask off of your face. Repeat this for each contraction if you continue to use it. If you’ve learned breathing exercises for labour (which I highly recommend that you do, either through a comprehensive prenatal program, HypnoBirthing or through our own Confident Birth Prenatal program), the deep breathing that you’ve been practicing is perfect for using with N2O. 

It is quick acting with the effects felt almost immediately. As described above, N2O does have the ability to alter the way you perceive and feel pain. It doesn’t take away pain like an epidural, but it can help increase your ability to cope with it. 

At the biochemical level, N2O alters levels of certain brain chemicals. It reduces those neurochemicals that activate pain (N-methyl-D-aspartate, NMDA for short) and increases neurochemicals that increase endorphins and make us feel good (dopamine, norepinephrine, endogenous opioids). It has the ability to produce a sense of euphoria and occasionally psychedelic effects. (**Yes, I’ve observed a couple clients get a little “high” while using N2O, all to their benefit)

You are able to remain alert and have full control of your body (no numbing effects). You don’t need an IV or continuous fetal monitoring, you can move freely and use the washroom, and you can eat and drink as normal. 

If you don’t think the N2O is helpful, or if you start to feel drowsy or dizzy, you simply stop using it and it leaves the body within 30 seconds.  Being able to fully control how and when you use N2O is seen as a big benefit to using this option. 

Studies of thousands of people who used N2O during labour (compared to placebo) report 

N2O helps by increasing endorphins
  • Decrease in pain perception
  • Decreased anxiety
  • Increased sense of control
  • Increased satisfaction

That said, when compared to epidural use, women were much less likely to rate N2O as effective pain management compared to those who used an epidural. But when compared with no pain relief or placebo, there was better pain relief reported with N2O use. Reported levels of satisfaction were about the same among epidural users and N2O users. And most N2O users said they would have used it again. Again, highlighting that N2O doesn’t replace using an epidural, but it may still be a very useful measure for those who want to birth without an epidural. 

Is it safe for my baby? What are the side effects? 

Some nitrous oxide does cross the placenta, however, it is safe for both you and baby when used in labour in a full-term pregnancy. It is not recommended in preterm labour as there is increased risk of brain hemorrhage for the preemie baby. Care providers may recommend using N2O only when you are in active labour (cervix is dilated 6cm or more) to reduce excess exposure to the gas. 

N2O is safe for baby when used in active labour

Otherwise, the use of N2O has not been found to affect APGAR scores in babies (the initial assessment of well-being for the newborn) and does not slow down labour or increase risks (such as interventions or c-sections) for the pregnant parent. That said, no long term studies of nitrous oxide on both the parent or baby have been conducted (in fact, no long term studies of many interventions in birth exist). From a biochemical point of view, N2O exposure can decrease levels of vitamin B12. Vitamin B12 is an essential nutrient for blood, nervous system and metabolic functions. It is found in animal-based foods such as meat, eggs and usually included in prenatal vitamins. If levels of vitamin B12 is a concern, this is something that can be addressed post birth with your naturopathic doctor. 

Potential side effects (from most common): 

  • Nausea 
  • Vomiting
  • Dizziness
  • Drowsy
  • Reduced sense of awareness
  • Reduce feelings of being present; Increases feeling detached from situation 
  • “Mask phobia” from using the mask on their face

Bottom-line: 

Nitrous oxide, if available, can be helpful during labour. It can be used as your main coping strategy (along with massage, relaxation exercises and breathing techniques) or be a helpful tool as you wait for an epidural or even be used immediately post birth if you need to receive stitches for your perineum. 

We at Your Downtown Doula are fully supportive of your choices in birth. We act as your source of information so that you are fully aware of the options so that you can make good decisions for yourself and your baby in labour. We have attended births where parents chose N2O, epidurals or other means to cope and in the end, positive births can happen no matter how you decide to journey towards parenthood. 

Want to learn more about how a doula can be a valuable support to you during pregnancy, labour, childbirth and beyond? Book a free 15 min meet and greet with one of our Naturopathic doctors and doulas today! 

Dr. EeVon Ling, ND

Resources: 

https://www.contemporaryobgyn.net/view/nitrous-oxides-revival-childbirth

https://evidencebasedbirth.com/nitrous-oxide-during-labor/

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Two Tips to Avoid Nipple Pain when Breastfeeding!

Dr. Sarah Winward, ND IBCLC

Concerned about nipple pain?

Pain with breastfeeding is one of the most common concerns for new parents, and with good reason! How can we be expected to do something for 20-40 minutes, 8-10 times per day if it hurts every time!?

I hate seeing parents in pain, it’s especially hard because to make a full assessment as I have to see baby latching, which means I’m asking them to be in more pain so we can make things better.


Pain in breastfeeding is never normal.

Let me repeat that. 

Pain in breastfeeding is never normal.

Not in the first few weeks, not when your baby is teething, never.

Especially not when there’s damage to your nipples or you’re curling your toes every time you latch your baby. Pain is a sign that something is wrong. 

Pain in chestfeeding is not normal.

If you’re experiencing pain I highly recommend reaching out to a lactation consultant for hands on support. The most important thing is to figure out why you’re having pain so you can fix it.

Here are some of the two most common reasons for having pain with nursing:

A good latch can help you avoid pain.
  1. Latch mechanics– basically this is how you’re holding your baby. We have an article here on how to get a good latch, I recommend taking a look and reviewing it. One of the things I see commonly is that if you’ve had pain, you’re expecting pain and so you hesitate when you go to latch your baby. The hesitation means that baby’s latch ends up being more shallow – which will hurt. So, when you do go to latch them, make sure you’re latching with intention by putting pressure through their shoulder blades. 
What’s going on with baby?
  1. Oral mechanics- this is something that’s going on with baby. This could be a tongue or lip tie, it could be tension in their body or it could be something else getting in the way of their having proper oral function. This is where an assessment from a lactation consultant really makes a difference, especially if the latching tips aren’t resolving the pain. 

A note for those having pain sometimes during the feed but not all the time. This is very common, and usually can be fixed with just a few tweeks:

If you’re having pain at the beginning or end of a feed

Hangry babies can hurt!

Sometimes it takes a few seconds for the flow of milk to get going, if your baby is ravenous they can tense up before the milk gets going and this can hurt. Then, once the milk comes they relax. Catching baby on early feeding cues can help a lot so they aren’t “hangry” when you latch them. The other thing that can help is breast compressions, adding a bit of pressure at the chest wall to pick up the flow. If the pain picks up again once they’ve been on there awhile take this as an indication to switch sides. 

If you’re able to get things pain free but only if you hold your breast ‘just so’

Don’t force a latch.

You’re bringing your breast to your baby. A lot of times parents kind of pick up their breast and put it in their baby’s mouth. What happens is that if you move or change the latch they tense up their mouth because they’re trying to hold on to your nipple. Leaning back and bringing your baby to where your breast naturally lies will help a lot with this. 

If you’ve tried all the tips in this article and you’re still having pain, I highly recommend reaching out to a lactation consultant for a full assessment. For parents in Ontario, you can book a free 15 minute call with me here.

Sarah Winward
Dr. Sarah Winward, ND IBCLC
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Do I *Really* Need a Birth Doula?

Dr. Olivia Chubey, ND

Yes!

And no. And Maybe.

It depends. On a lot of factors. Let’s break this down in an easy way. Take a few minutes and ask yourself the following questions:


  1. What is important to you in your birth experience?
  2. Do you have a birth companion?
  3. What kind of support do you expect from your birth companion?
  4. Are they capable of giving your that support?
  5. Do they have the tools and knowledge to support you?

If you answered YES to #2 but NO to #4 and #5.  

You *might* be able to get away without a doula if you take a prenatal class that focuses on educating you and your birth companion on coping techniques, how to use them in labour, and common interventions – for example our Confident Birth Program.  You may find that your birth companion may be enough, armed with the information they have learned to help you with your answer in #1. 

If you answered YES to #2, #4, #5 you may decide to still work with a doula for one of the following reasons: 

  • I understand that my labour may be longer, and I value the idea of my partner being able to rest so that they may help me more after baby is born. 
  • My partner feels anxiety regarding whether they can be whatever I need them to be/remember it all etc, so it would be good to have knowledgeable and comforting help in addition. 

(*Research has shown that the most positive birth experiences for fathers were ones where they had continuous support by a doula or a midwife.)

  • I know that statistics show that moms have better birth experiences and less medical interventions when a doula is present

(*Although continuous support can also be offered by birth partners, midwives, nurses, or even some physicians, research has shown that with some outcomes, doulas have a stronger effect than other types of support persons.)

  • I desire a low-intervention and/or no-intervention labour and understand the skill set and assistance a birth doula provides can support those goals even further then I can alone, or solely with my birth companion. 
  • I experience anxiety with hospitals, medical equipment, etc.
  • I understand a birth doula may have other areas of help and support that they can share with me to smooth my transition into parenthood. (For example, Lactation Support)
  • I feel birth is more than just a biological event, and would like to work with someone who treats it more holistically. 

If you answered NO to #2, I would highly recommend a doula. 

If this has piqued your interest or you’d like some more questions answered, you can book a complimentary Meet & Greet with a doula from our collective today! We’ll spend about 15 minutes with you in a video chat to answer you personal questions and help you decide if we’re the right match to support you in your birth!

Dr. Olivia Chubey, ND

*Evidence Based Birth, “Evidence on: Doulas”, May 4, 2010, Rebecca Dekker, PhD, RN.

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Alternative Options to Pain Medications

To epidural or not to epidural… is that even the important question? 

Dr. Olivia Chubey, ND

Do you want an epidural?

Great!

Do you want to labour and birth without an epidural?

Great!

Do you want to wait as long as possible before getting one?  Or, get it as soon as possible?  

Regardless of your personal preferences or medical necessities, in every circumstance – the real question is ‘can I cope with this’? 

Cope with discomfort, with pain, with the pressure of being a parent, doing the right thing for me – for baby…and the list of things goes on and on….   

The birth of your baby and the labour process, is a complex, enigmatic, beautiful collision of science, faith, luck, love and transformation.  But when discussed in modern science – it is usually reduced to pain. (If I were to extrapolate further, the entire birth experience often is reduced to: whether you will tear, what gender you are having/do you have a name, and whether you will breastfeed)

And I get that.  Pain is scary.  We are also wired to want to avoid pain, just like birth – it’s human nature, so it’s no wonder it’s become such a focus of our energy.

So whether or not you want, or need, the epidural, there are so many techniques/ways of being that can help get you more comfortable and able to cope – so that birth can be more than just about the pain.

Here is a quick breakdown of some of them

  1. Breathing Techniques
  2. Visualization techniques 
  3. Relaxation techniques
  4. Using hand on manual therapies
  5. Positions
  6. Water
  7. Music 
  8. Affirmations 
  9. Education – understanding your body and also the hospital interventions
  10. An active birth companion [partner doula or otherwise] and supportive healthcare team

I want you to know these and how to use them. 

I am deeply passionate about sharing the education, training and experience that I have with you. I want to support you through one of your most vulnerable experiences. 

My hope, by doing so, is to further reduce the statistic of you calling your birth a ‘traumatic experience.’ 

Connect with me, or anyone on our team – we are all just as passionate about this!

We can talk about what your needs are and suggest what course of action we recommend based on your unique needs. 

Or, if you just want to learn these techniques – click here to learn more about our Confident Birth Program or email info@yourdowntowndoula.com!

Dr. Olivia Chubey, ND