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Postpartum Depression or Baby Blues?

Most people get pregnant for the first time with very little idea about what life with a new baby will be like. We have a vague idea that the first few weeks and months will be a bit chaotic, but not much more than that. This often leaves us feeling totally unprepared, even wondering if we are cut out to be parents. Thankfully, in recent years, there has been more media attention on postpartum life, including mood disorders like postpartum depression. This awareness helps reminds us that we are not alone in our experiences.

What is normal?

Almost all everyone who has given birth experiences some version of the postpartum blues or baby blues. Postpartum blues has been attributed to the sudden shift in hormones that happens during and immediately after birth. For most of your pregnancy, the placenta makes estrogen and progesterone, after birth that source of hormones is suddenly gone. In up to 80% of birthing persons, this results in low mood, feeling down, tearfulness or anxiety starting 2-3 days after delivery. However, this should only last a few weeks at most.

As your hormones stabilize and you get used to life with a new baby, you should notice your mood levelling out. However, remember that in the first few months of your baby’s life and any time they go through a developmental shift, their sleep will be erratic. This usually means that your sleep will also be erratic. Even the most capable of human beings won’t operate well on only a few broken hours of sleep a night. So, if you are starting to feel more irritable and moody during these times, don’t worry too much about it. See if you can rally some support, like a friend or new grandparent who’s willing to stay the night. Notice if you feel better after a full night’s sleep.

It’s also totally normal to have periods where you feel a bit overwhelmed. The first day you’re alone with your baby will probably be very daunting. You’ll also probably wonder if you’re a good parent. For example, you’ll question whether you really want to sleep train that first night you’re hearing your baby cry. That’s ok! Parenting is an adventure that will be filled with the highest highs and the lowest lows, and that’s just a normal part of it.

What’s not normal?

Postpartum depression: PPD can start any time in the first year postpartum. It affects 15-20% of birthing persons, but it can also affect their partners. Symptoms can include:

  • Intense feelings of overwhelm and/or guilt
  • Numbness or like you haven’t bonded with your baby
  • Sadness, you may notice yourself crying for no reason
  • You can’t find the joy or humour in anything
  • Thinking about hurting yourself or your baby

The biggest thing to notice here is that you aren’t able to feel positive emotions. Either you feel down all the time or you feel numbed out. If you are noticing any of these things, the most important thing to remember is that you are not alone and there is help. The best thing that you can do is reach out to someone you trust and to share how you are feeling.

While anyone can get PPD, certain people may be more at risk. This includes people who have experienced depression in the past, people who are socially isolated or who have little support and those who did not receive prenatal care or who had a particularly stressful pregnancy.

Postpartum Anxiety: While not as common or as well known as PPD, postpartum anxiety is very common and rates are on the rise. It can also come on any time in the first year postpartum, and can coexist with PPD. Symptoms include:

  • Episodes of racing heart, difficulty breathing, sweating that are not brought on by anything in particular
  • Racing thoughts that you don’t feel like you can control
  • Inability to fall asleep or stay asleep, even when baby is sleeping
  • Increased irritability
  • Increased tension in your body, you may notice that you are clenching your jaw constantly, for example.

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Just like with PPD, if you are experiencing any of these symptoms, there is help. Speak to your care provider, and reach out to someone you trust.

The most important thing to remember is that none of these experiences makes you a bad parent. You are suffering from a very real illness, but that doesn’t mean that you care for your child any less.

Ways to help prevent postpartum mood disorders

If you think you may be at higher risk of developing a postpartum mood disorder, you may want to speak to your care provider about ways to reduce your risks. Thankfully, there are many services available in Toronto and most hospitals in the downtown core have support groups. For example, Mt Sinai runs a perinatal mental health group. Starting these types of groups early, or pre-emptively can decrease your risk substantially [1].

Making sure you have good nutrition during and after your pregnancy can also help. Things like adequate protein, and healthy fats like oily fish ensure that your brain has everything it needs to create hormones and neurotransmitters.

Taking the time to take care of yourself can go a long way. Even if it’s just one minute of quiet breathing or a 5 minute shower. Doing things for yourself regularly will help you feel grounded and more like a person, as opposed to a 24/7 milk diner. Call on your partner or a friend to take care of baby for half an hour while you go for a solo walk, trust me, you’ll be surprised at how much better you feel when you get back.

One of the best things that you can do is to make sure you’re not isolated. Whether that means joining a parent group or meeting up with friends for coffee, knowing that you have support is so important. The nice thing about groups is that chances are, other people in the group have had or are having similar experiences to yours. You’re not alone.

Bottom line, if you think that something isn’t quite right, let someone know. Your care provider can give you good advice and good support, and you will get through this!

[1] “Pregnancy And Birth: Depression After Childbirth – What Can Help?”. PubMed Health. 2017. Web. 5 June 2017.

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

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Orgasmic birth?! Tell me more!

Wait did you say orgasm during birth?

This is a very taboo topic, while writing this article anyone I spoke about it with was totally shocked and confused. Isn’t birth supposed to be painful? That is what you would think from the way that birth is portrayed in the media, but that isn’t always the case. In fact, according to Ina May Gaskin, up 20% of people experience orgasm during birth [1]. While that seems to be a staggering number, it’s important to remember that she was surveying parents who gave birth on The Farm, a birth centre run by midwives that highly valued privacy and intimacy during birth. I can imagine that it’s much more difficult in hospitals surrounded by doctors (many of whom you’ve never met) to feel relaxed enough to experience orgasm.

So, some people may orgasm during birth, what does that mean? Why should you care?

Let’s start with the definition of an orgasm, so that we’re all on the same page. Researchers on this topic have defined orgasm as:

A temporary peak in sensation that creates an altered state of consciousness which is accompanied by contractions of some of the muscles of the pelvic floor [2].

be honest, that definition sounds a lot like childbirth already…

Okay, let’s move to a bit of physiology:

During labour, contractions are stimulated by oxytocin. This causes an increase in intensity of contractions, which results in an adrenaline surge. The stress hormone adrenaline causes a decrease in oxytocin so the contractions don’t get too intense. Meanwhile, your body is also releasing endorphins which increase your pain threshold and promote a sense of euphoria and sexual pleasure [2]. This is sometimes referred to as the oxytocin-adrenaline-endorphin cycle. From this you might draw the conclusion that orgasm (or sexual pleasure at least) is part of physiologically normal birth- and you’d be right.

 

 

Let’s look at some of the science!

First of all, the hormones that are involved in orgasm are the exact same as the ones involved in childbirth. This includes the well known “love-hormone” oxytocin. It is released from the brain in response to sexual stimulation. This is the hormone that causes the contractions in the pelvic floor muscles during orgasm and the contractions of the uterus during labour [2]. This is why you’ve probably heard of nipple stimulation as a way to get labour going- it stimulates the release of oxytocin. So, orgasm can help labour progress!

Ok, next let’s take a look at pain. What if I told you that there is an easy, drug-free way to increase your pain tolerance? You’d be all over that, right? Well here it is: orgasm. In a study measuring pain threshold in women who were performing vaginal self-stimulating, pain threshold increased 106% during orgasm [3].

Yeah, you read that right, orgasm caused a 106% increase in ability to tolerate pain.

This study was testing pain tolerance to finger crushing, not labour. But, I would argue that there are other hormonal pathways in place that help you tolerate pain even more (more on that later). In addition, there is some other good news from this study, even women who didn’t achieve orgasm had an increased pain threshold. Pleasurable genital stimulation resulted in a nearly 75% increase in pain threshold.

It appears that the nerves that transmit the pain signals up to the brain are the same ones that transmit the pleasure signal [4]. There is also evidence to suggest that there is an overlap in the areas of the brain that experience pleasure and pain [2].  This all means that science is suggesting that your body can only experience one of theses sensations at a time. If you are experiencing pleasure, your brain is distracted from feeling pain!

Orgasm not only helps to stimulate labour; it also helps with pain management! Why aren’t more people using this amazing tool? It is difficult for birthing persons, their partners and maternity staff to view birthing persons as sexual beings. So it’s hard to create an environment that is supportive of sexuality and sensuality during birth.

 

Want our Top 5 Tips for Loving Your Birth? Grab them here!

So how can you take advantage of your amazing physiology?

  • Give yourself time! That whole oxytocin-adrenaline-endorphin thing relies on time. Trust that your body is designed to give birth and it will birth in it’s own time without help. A continuous Pitocin drip doesn’t respond to adrenaline at all and won’t give your body time to adapt in the same way
  • Get your partner on board. Get the rest of your birth team on board as well. Speak openly about your desire to take advantage of your innate physiology. Put it in your birth plan that you would like to try self stimulation as part of pain management.
  • Cultivate intimacy early. Deep kissing is one of the best ways to move through labour. Ina May Gaskin suggests that if your mouth is open, so is your cervix [1]. Kissing also gives a sense of intimacy and security which helps to decrease adrenaline and stimulate endorphins.
  • Demand privacy. This is easier at home, but not impossible at a hospital. If you’re labour isn’t progressing or you’re feeling overwhelmed request some private time with your partner, or just on your own. Use this time to introduce some passion into your birth process: deep kissing, nipple stimulation and pleasurable vaginal stimulation works wonders.

 

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

[1] Gaskin, Ina May. Ina May’s Guide To Childbirth. 1st ed. New York: Bantam Books, 2003. Print.[2] Mayberry, L. and J. Daniel. “‘Birthgasm: A Literary Review Of Orgasm As An Alternative Mode Of Pain Relief In Childbirth”. Journal of Holistic Nursing 34.4 (2015): 331-342.[3] Whipple, Beverly and Barry R. Komisaruk. “Elevation Of Pain Threshold By Vaginal Stimulation In Women”. Pain 21.4 (1985): 357-367.[4] Komisaruk, Barry R. and Giorgio Sansone. “Neural Pathways Mediating Vaginal Function: The Vagus Nerves And Spinal Cord Oxytocin”. Scandinavian Journal of Psychology 44.3 (2003): 241-250.

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Birth without fear

Think about the last movie you saw that featured someone giving birth. I’m guessing there was a woman screaming, a man freaking out, and a doctor yelling “Push, push push!”

Now tell me how many of your friends are terrified by the thought of giving birth? Maybe you’re included in that group!

Popular culture does a really good job propagating the culture of fear around birth.

And that translates into our everyday lives.

You hear negativity about birth all the time. Even friends who haven’t had kids say things like “oh, you’ll be screaming for the meds” or “are you ready for your body to be destroyed”. Seriously, Sarah heard both of those things while she was pregnant.

I remember in my first maternal and newborn care class, so many of my friends whispered to each other during lecture about how scared they were.

I was scared too – how could I block out all that negativity?

But those lectures taught us about physiology. About how pregnancy is not a medical condition, it’s normal.

This drove me to look further, to learn more.

So, I dove head first into the birth world. Reading books, articles, watching videos. This lead me to a doula training. Everything confirmed what I learned in those first lectures.  

Birth doesn’t have to be scary. It doesn’t even have to be painful!

My education and understanding of physiology took away my fear.

It also got me incredibly excited! I NEEDED to learn how to help parents achieve empowering birth experiences.

Get our Top 5 Tips for LOVING Your Birth!

This lead me to HypnoBirthing. This training taught me techniques that help parents remain calm and relaxed. Techniques that work WITH our physiology, to facilitate empowering birth regardless of circumstances.

How we view things matters.

So, that crazy pop culture birth scenario doesn’t have to be my experience. It doesn’t have to be anyone’s experience.

The more I go to births, the more I see how beautiful these moments could be. Labour can be a sacred space. Parents can connect with each other and welcome their babies into warm, nurturing environments.

All of these experiences have completely change my outlook about birth. Now, I look forward to becoming a mother and naturally birthing my baby. There is no more fear.

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Let’s get realistic about postpartum bodies

What’s the biggest mistake to make after giving birth?

Rushing to lose weight. 

It is my biggest pet peeve, as a women, that so many of us feel such intense pressure to look model ready 24/7

If you don’t like the way you look after spending 9 months growing your baby, I get it. Your body has been completely taken over by the process. It’s not just yours anymore. And if you believe what you see in the media, you’d think that you should have your old body back immediately after your baby is born. That plus the lack of sleep of new motherhood can leave anyone feeling like they aren’t adequate.

But what you see in the media is not reality.

Let me break it down:

Your weight gain during pregnancy consists of this:

  • Baby ~7lbs
  • Uterus 2 1/2 lb gain
  • Placenta 1 lb
  • Mother’s breasts 3 lb gain
  • Mother’s blood 4 lb increase
  • Mother’s fat 5 + lb increase

So, most of this weight isn’t even fat! It will come away on its own. You just need to give it time.

Remember too that your core has undergone significant changes. Even if you don’t have a vaginal birth, your pelvic floor and abdominal muscles have a lot of stress just from carrying baby for so long. These muscles and ligaments need time to heal.

Basically, your body needs rest and rehab. I truly believe that every pregnant person should see a pelvic floor physiotherapist.

Rushing into exercise can lead to injury, including pelvic floor complications like incontinence. No physique is worth peeing yourself.

Coming from a kinesiology background and a competitive athlete background I always tell people there is no such thing as over-training its actually under resting.  

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Cutting back on calories or “dieting” can be a big problem too. Breast milk production may also be affected, but more often we see exhausted women exhausting themselves even more. Your baby needs you as nourished as possible, that means eating nourishing foods. In nourishing amounts.

Growing your baby took you 9 months, assume it will take at least that long for your body to adjust afterwards.

So, give your body the rest and nourishment it truly needs.

Your body, mind and soul will thank you in the long run. 

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Formula is Medicine

My mom formula fed me.

She did this because she was told it was the best decision for me. This was really common, if you breastfed 30 years ago you were consider a tree hugger!

I turned out just fine. I hardly ever got sick as a kid, I was put in the “enhanced class” growing up and have always maintained a healthy weight.

But, when I have a baby I will be breastfeeding them.

Why?

Because I have learned through years of education that breastfeeding is the healthiest choice for both mom and baby.

I’m not alone in this goal. In fact, in Canada most families go into a birth planning to breastfeed. Unfortunately, a lot aren’t able to fulfill that goal.

Don’t get me wrong, FED is best. But, it drives me nuts that families are presented with breastfeeding and formula like they are equivalent.

They are not.

Breastfeeding is the physiologically normal way to feed a baby. 

Breastfeeding has so many benefits for babies; from decreased risk of obesity and diabetes, to orofacial development, to better immune function.

There are also benefits to mom! Decreased risk of cancers and heart attack, for starters.

Not to mention that there is no waste, and it is FREE!

Breastfeeding has everything a baby needs. Formula is a medicine.

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Like all medicines, it is necessary for some people, but it is not meant to replace physiology.

A huge part of the problem is that a lot of families assume that breastfeeding will be easy. It’s the most natural thing in the world isn’t it?

Maybe breastfeeding would come naturally, if we all grew up seeing our mothers and aunts and sisters and friends breastfeeding their children. Talking openly about their struggles.

But we don’t.

Instead, I’ve seen so many new mothers struggle trying to latch and feed their newborn. Often feeling like a failure because they can’t figure it out.

Then a doctor makes them feel worse because baby isn’t gaining well and they feel pressured into giving their baby formula. I’ve seen many new mamas completely devastated by this!

The first line of treatment should be to ensure that baby is breastfeeding well! Quality, informed help help exists. Parents should get access to help early, before they run into problems.

Our healthcare system is failing families by not providing this care. 

Our society has medicalized pregnancy and birth, and it has medicalized how we feed our babies, too. But, breastfeeding and formula are not equal.

It is not a one or the other choice.

I’m not saying this to shame people for formula feeding. Formula is life-saving.

I’m saying it because families need to make INFORMED choices about the health of their babies.

So, when I decide to have a baby, I plan on breastfeeding. I don’t think it will come naturally, but I’m committed to making it work.

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The best tool I had without realizing it.

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If I could recommend one purchase to every pregnant person, it wouldn’t be baby gear or maternity clothes.

It would be a yoga ball. Like these ones.

Dirt cheap and SO useful!

My son was a very long baby. Like “kicked me in the ribs while I was in labour” long. People kept telling me don’t worry, he’ll drop.

Sure he dropped, on his way out! 

My ribs were bruised for about a month after he was born.

I had a yoga ball from years back and I busted it out because I knew I would want to use it while I was labouring. Turns out it was about the only place I would sit in late pregnancy. It forces an upright posture so my babe had a bit more space to move around. 

Which meant less of the kicking me in the ribs.

So, that’s where you would have found me in my last few months of pregnancy. Basically all the time.

I spent my early labour at home. The yoga ball was amazing.

Being able to sit but also move and sway felt really good. I also leaned over it which is a great alternative to being on all fours. It gave my upper body a rest and also let me stretch my chest and belly. It’s a worthwhile purchase just for that.

I assumed that would be the last I used of it. 

I assumed wrong.

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Fast forward a few months, welcome to the 4-month sleep regression. It’s a thing, google it. 

All of a sudden my fall-asleep-anywhere-newborn is no longer. Overtired becomes a thing. So overtired that he refused to eat, or do anything but cry.

I tried rocking, I tried singing, I tried shh-ing. 

Nope, nope, nope. 

Out comes the yoga ball. Big, deep bounces plus some shh-ing and a giant hug are about the only thing that settled him. Even better, I can slide him down to my breast without him really noticing because he’s distracted by the bouncing.

It was way more sustainable than trying to bounce while standing or walking. 

While it may not have solved the sleep regression, it has certainly made things way easier to manage. 

So, there you have it. Looking for a SUPER useful prenatal purchase? Check out a yoga ball! 

here…

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I felt guilty about loving my birth

While my birth didn’t go 100% according to plan (read about that here). I had an amazing experience. 

I laboured at home and at the Toronto Birth Centre. My husband caught my son and after he was born the 3 of us curled up on a king sized bed for a nap. I was back home within 3 hours of giving birth. Most of all, I didn’t feel pain.

Let me explain.

Labour was hard, it was the hardest thing I have ever done. But through my whole pregnancy I thought of labour as a physiologic process. Something that I was designed to do. This was the language that I used when I spoke about birth to myself and to others. I went in assuming that it wouldn’t be painful.

During labour, I remember thinking that I would love a break, and that it was really hard work. I am not a runner but I assume this is how marathon runners feel. But, the word “pain” never came into my head. 

I will add that I did experience the burning that is affectionately called the ring of fire. But even then, I remember thinking “it burns”, not “it hurts”. I think the mindset and months of self-talk paid off.

I had an amazing birth experience.

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You don’t hear that a lot.

In fact, I actually felt awkward sharing it with my mom friends. People trade birth stories like war stories. The crazy experiences that happen, how awful it was.

When I first started meeting up with other moms I felt like I didn’t have anything to add. That if I shared my story it would sound like gloating, or worse, like lying.

But then a friend told me she was pregnant. She told me that she was scared about giving birth because of all the crazy stories that she had heard.

I NEEDED to share!

I LOVED my birth experience! It had not been painful! It wasn’t a horror story!

Amazing birth is possible!

I think the biggest thing for me was the mindset. The words that I used to speak to myself about how my birth experience would be.

I never assumed that it would be painful. But I did assume it would be hard work.

And that’s exactly what happened.

I also had an amazing support team around me who knew my goals and helped me accomplish them.

Lastly, I knew what to expect. I knew that during transition I would think that I couldn’t do it.

I even told my partner that I would say that I couldn’t do it and that he should tell me that I was already doing it.

I knew that as my sons head was moving through my birth canal it would burn. I expected the ring of fire, even if it wasn’t pleasant I knew it would happen.

And I knew that I had to move through it.

Knowing what to expect made all the difference.

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My Birth Didn’t Go As Planned

I had a very easy pregnancy.

Other than the usual first trimester fatigue and nausea and a long baby who kicked me in the ribs a lot, things went very smoothly. Because my pregnancy was so smooth I was lucky enough to be able to have midwives as care providers and to be able to choose my birth location.

I loved my midwives. They knew I wanted a natural birth, wanted as few interventions as possible. They were extremely supportive

My husband and I decided to give birth at the Toronto Birth Centre; it’s like a spa. The biggest draw was the bathtub. We don’t have one in our apartment and the ones there are huge. I had been to births at the birth centre, and they had all been lovely.

I went into labour very early in the morning on December 26.

I woke up around 2am starting to feel contractions. They weren’t very intense, but they were regular. I timed them for a bit, then dozed off. Around 5am I let my husband know that this was labour… not a rush, but just so he knew. We both dozed off again.

I spent the morning doing as much of my regular activities as I could. We had breakfast, we walked our dog, we had lunch. All the while, contractions were steadily increasing in intensity and getting closer together.

By around 4pm I knew it was time to call the midwife.

We were at the 4-1-1 mark (contractions coming every 4 minutes, lasting 1 minute and that had been going on for at least 1 hour). I remember hoping that I was in active labour, because I’ve been to so many births, I thought about how embarrassing it would be if I couldn’t even tell if I was in active labour.

Well, I was. When she checked me I was about 4-5 cm dilated!

So, around 6pm we decided to move to the Toronto Birth Centre.

I got into the tub immediately, and it was glorious, all the pressure just lifted. Goodbye, gravity.

Really quickly after we got settled there, my contractions really picked up, and I mean really picked up. 2 minutes apart and lasting 90 seconds, as in only 30 seconds break in between each one.

This MUST be transition, I thought, it’s not going to last long.

At 10:30pm my midwife asked if I wanted another cervical check. Sure, let’s see the progress of all this work.

I was only 6 cm dilated. 

Uh, what?

I was totally discouraged. I was so sure that I was in transition and would start feeling the urge to push any second.

My midwife offered me nitrous oxide – laughing gas. It wasn’t in my birth plan, but I needed a break. I had been working so hard. So, I accepted.

It was unbelievably helpful.

It gave my mind a break from all of the work that my body was doing. I used it for almost 4 hours, 2 tanks worth.

I had another cervical check at around 2:30am. Only 7 cm. But then my water broke during the check, afterwards I was 8 cm.

Things are moving. 

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At this point I was beyond discouraged. I was moving back and forth from the bed to the tub, totally unable to cope. I remember thinking that I wanted an epidural. Not because of pain; because I wanted a break. I wanted a nap. Can I come back to this in like 3 hours and try again?

THIS is transition.

Less than an hour later I am pushing.

I didn’t even realize I was doing it. I have told many a pregnant mama that you don’t need to push, that your body has a reflex that gets the baby out. It’s true.

My midwife told me that she was calling her back up, I asked if it was because she had been on call for too long and needed a break. “No, it’s because you’re about to have your baby”. Oh!

The back up midwife arrives at about 5am. I pushed in a lot of different positions. A few contractions in one position, but baby doesn’t like this and their heart rate is dipping. Move to another position, same thing. Move to another, same thing.

Finally, at 6:30am I settle onto my back. This isn’t the position I wanted to birth in, but this is where baby seems to be happiest.

It burns.

 I knew that it would, but that didn’t make it any easier.

This was the hardest work I have ever done in my life, sending all of my energy down as intense waves move my baby out. But, the only way out is through. I remember saying out loud “I will not break”.

20 minutes later, my husband caught my son and placed him on my chest.

He wasn’t breathing right away. My midwife started to cut the cord to get him to the crash cart. I asked her to wait. She did. 2 full minutes. Babe still isn’t breathing. I told her to cut the cord. This is what it is to have a team who respects your role in the birthing process.

He was brought to the warmer and needed suctioning and oxygen, but within 4 minutes he is breathing just fine. Minutes later he is back on my chest.

My husband, my son and I take a very well deserved nap.

We wake up around 8am, and my son latches on and breastfeeds amazingly well.

By 10am, I carried our bags to the entrance of the birth centre.

 The staff told me I needed to be wheeled out. Ok fine, I sit in the wheel chair and get wheeled to the car.

We are home and snuggling on the couch by 10:30am.

In the first few days after giving birth, I felt like I hadn’t accomplished my goal. I had needed an intervention, nitrous oxide- a minor one, but still. Why had I not been able to handle it? I had been so confident in my ability to give birth. It’s a physiological process, right? 

The thing that helped the most was looking at the chart that the midwives had filled out during labour. I knew I had wanted a break, but at the time I didn’t realize just how close together and long my contractions had been. 90 seconds, every 2 minutes, for about 12 hours. For most births I’ve attended, there were 1 or 2 minute breaks in between contractions. What I would have given for a 2-minute break!

I realized that there is no way that I could have coped with 12 hours of intense work without some sort of help. If I had tried without the nitrous oxide, I would have needed something stronger.

Ultimately, the nitrous oxide is what facilitated me having the birth I wanted. It didn’t take away from it.

Things don’t always go according to plan, and being fluid is important. Especially with something as unpredictable as birth.

I knew that my team respected my goal of a natural birth and that the suggestions they made were in line with that.

We had clear discussions prior to my birth regarding these goals.

The key to a great birth?

Have a plan, but don’t be afraid to change it.

Have a team that you trust and who know your goals. They can help you achieve them regardless of how your birth plays out.

The best way to start is to make a birth plan. Fill it out and bring it to your team. Make sure you discuss it with them. You can have an amazing birth, even if things don’t go as planned.

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Informed Consent

Informed consent: What is it and why is it important

Informed Consent

Informed consent: Informed consent is a process in the medical system that helps you make decisions. Your care provider provides you with information and answers questions for you. Ultimately, this is so you can decide what is done to you and your body and in this case, your baby. Informed consent applies for everything from prenatal ultrasounds to induction to whether your baby is weighed right after birth.

Why is informed consent important?

It respects your right to self-determination, empowers you with the authority to decide what options are in the best interest of you and your baby. Informed consent honors your right to autonomy and your right to the truth (as best as it can be known at the time). It also honors your right to keep yourself and your children safe and free of harm.

Care Providers Responsibilities:

You have the legal right to “informed consent” whenever a medical procedure, drug, test, or other treatment is offered. This means your doctor, midwife, or nurse is responsible for explaining:

  • Why this type of care is being offered
  • What it would involve
  • The risks and benefits associated with this type of care
  • Alternatives to this care, and their respective risks and benefits
  • You have the right to refuse any care.
    You have the right to change your mind.
    You have the right to ask for privacy to make decisions.

How to make sure you get the information you need

A great tool to help you remember the important aspects of informed consent is the acronym BRAIN.

B stands for benefits. What are the benefits of having the procedure or intervention? This is important to ask about tests as well as treatments. In the case of a test, what are the benefits of knowing the results? How will that affect future treatments? Sometimes the results of a test won’t actually change your plans. If that’s the case there’s not much point in having the test.

R stands for risks. Almost every procedure, test, or intervention comes with risks. You have the right to ask what these risks are and how likely they are. You also have the right to ask what the best and worst possible outcomes are.

A stands for alternatives. There is almost always more than one course of action available to you. You have the right to know what they are, and if your care provider doesn’t have an alternative for you then you have the right to ask for a second opinion.

I stand for intuition. Also known as your instincts. You know your body and your baby better than anyone else does, so trust your gut. Asking for some time and privacy to make decisions can help you to tune into your intuition and to get a better idea of what’s right for you.

N stands for no or not right now. What happens if you decide to wait or do nothing? You will probably need to re-do the risks, benefits, and alternatives for this option. Watchful waiting is an option and sometimes it is medically indicated.

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

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Finding Comfort During Labour

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.

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 someones 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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Sample Visualization script:

Close your eyes and take a few deep breaths, allow your body to relax. Imagine that on each breath you inhale a beautiful white light. Follow this light as it fills your entire body and surrounds your baby. It feels safe, comforting and full of love. As you breath allow this light to move down, through your cervix and birth canal. This light allows your cervix to relax and open with ease and creates a clear path for you baby’s journey into the world. Take a few more deep breaths sending love to your baby while you both enjoy this beautiful light, when you feel ready, open your eyes.

Massage:

Massage is a great way for your birth partner to support you both before and during labour. Light touch massage serves as a tactile reminder for you to relax whereas deeper massage can help to ground and ease muscle tension.

Light touch massage: Use the whole hands or finger tips, run them gently up and down the length of your partners arms, back or thighs.

Deep massage: Can be performed on feet, shoulders or the lower back, ask your partner how much pressure feels good and where they prefer to be touched.

Acupressure:

Acupressure can be used by your birth partner or doula during your labour, many people find it extremely helpful in reducing pain sensations. It works best if you apply medium to firm pressure. It should be mildly uncomfortable but not painful.

1) In between the thumb and the first finger, in the fleshy portion, called large intestine 4, this point is well studied for relieving pain

2) 4 fingers width above the bone of the inner ankle, called spleen 6, this point helps to dilate the cervix

3) On the top of the foot in between the big toe and the second toe, approximately one inch from the web, this point is very grounding and also helps with pain relief

A really amazing acupressure resources can be downloaded here.

Positions that may be helpful:

  • Hands and Knees
  • Assisted squat
  • Cross legged
  • Leaning forward
  • Leaning backward
  • Slow dancing

Really, what it all comes down to is finding what works for you. You may have to try all of these things and more before you find it. What’s working may also change as labour progresses, walking through High Park when the cherry blossoms are out may be great for early labour, but it’s not the best as things become more intense. Surrounding yourself with people who can help remind you to try something new is probably the best thing you can do for yourself.

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

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