New Holistic Postpartum Care Offering!

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I am so thrilled to introduce you to the newest Ebb & Flow offering. Let’s get together and see if this plan is right for you. I know it is worth it. It’s  known in many societies the new mother is not valued. We do not teach new mothers to accept that they are valuable and though countless women before us have birthed, every single one is special and is your own experience. What does postpartum support look like for you? What do you wish it was for you? In the post before I talked about the support I provide mom’s immediately after the birth and in the 5 weeks to follow.  Massage in the home using hot stones to warm and pull back the pelvis area and lessons on self-massage that you can practice daily. IMG_2524.PNG

Nourishing meal preparation in the home to encourage your body’s healing.  IMG_2519

When your body is ready, rejuvenating makko ho stretching. This is about mom and helping her replenish, nourish her baby, and be nourished. Let’s talk about how I can help you feel nurtured in the #4thtrimester.

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Water Birth – Is it for you?

 

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Preparing For Your Water Birth

It can’t be denied that when in labor water can become your best friend.  It is common to be in and out of the shower or tub and sometimes, not even wanting to get out of the water.  This speaks volumes about the benefits of water in the birthing tool kit.   This is especially true in the instance of water birth.  Birth in the water?  Why would I want to birth in the water?  Is that safe?  How does one go about having a water birth?

 

What’s So Great About Water Birth?

 

According to Water Birth International the benefits of a water birth are:

 

  • Water facilitates mobility and enables the mother to assume any position that is comfortable for labor and birth

  • Speeds up labor

  • Reduces blood pressure

  • Gives mother feelings of control

  • Provides significant pain relief

  • Promotes relaxation

  • Conserves mother’s energy

  • Reduces the need for drugs and interventions

  • Gives mother a private protected space

  • Reduces perineal trauma and eliminates episiotomies

  • Reduces cesarean section rates

  • Is highly rated by mothers – typically stating they would consider giving birth in water again; some even stating they would never give birth any other way!

  • Is highly rated by experienced providers

  • Encourages an easier birth for mother and a gentler welcome for baby

 

Movement is so important in labor and laboring in water can help you to move freely into any position you feel is comfortable.  That gives us another benefit.  You move into what position is comfortable for you, not what is convenient for the care provider.  Water birth can give you a sense of control. With regards to speeding up labor, Michele Odent a pioneer of water birth in the 1980’s in France, found that women whose labors were not progressing beyond 5 cm, quickly dilated once immersed.  He attributes this to the reduction in catecholamines, which have been associated to slowed or stalled labor, due to pain relief from water immersion.  Michele Odent felt that when these levels go down it allows a release of oxytocin and cervical dilation.  The reason for reduced pain in labor with water immersion may be because the warm water causes peripheral vasodilation and improved blood flow which provides pain relief. Penny Simkin (1989) attributed the pain relief to “ cutaneous nerve endings causing vasodilation in the skin, relaxation of tiny muscles in the hair follicles and generally a reversal of the sympathetic nervous system response flight or fight response.”  As a massage therapist, I’ve seen this to be true in my work with nurturing massage.  

 

So many benefits to water birth.  There needs to be more research to give water birth more credit.  Many of these are observed findings by countless physicians and midwives.  Though there is no formal bodies of scientific research there is a plethora of observational evidence in the safety and benefits of water birth.  According to Evidence Based Birth’s website over 20,000 water births have been documented in some manner.  So if you are having or have had a water birth consider sending your experience into Water Birth International’s Registry.  They have been building a database since 2004.  Well now that we’ve talked about benefits let’s look at safety.

 

Is Water Birth Really Safe?

 

One of the first concern you  may have about water birth is, what if the baby breathes in.  Well, let’s get a little technical on how amazing our bodies are.  When the baby is in utero, the baby makes a breathing movement intermittently, about 40% of the time.  The baby does not breath as such in utero.  It’s more of practicing since baby’s lungs are filled with fluid that keeps the lungs protected and open to get ready for the real breathing work.  This fluid’s presence will keep any other fluids from entering due to its viscosity.  Also, there is low blood supply to the lungs and this causes high pressure in the lungs making it difficult for any other fluid to enter.  When the time nears for labor to begin, prostaglandin E2 levels released from the placenta increase which slows or ceases fetal breathing movements.  As the baby is being born, the levels of prostaglandin E2 remain high and this keeps the lungs from functioning which is the first inhibitory response.  Another mechanism in place to help the baby is baby’s are born with low oxygen levels, which causes an absence of breathing, and thus the baby’s first reflex is to first swallow not breath.  There are other physiologic mechanisms in place that would keep the baby safe during a water birth.  There is a more thorough paper on this that I highly recommend parents to read regarding the safety of water birth at Evidence Based Birth.

 

When Is It Not Advisable?

 

The following are a few contraindications to birthing in the water:

 

  • Amnionitis

  • Maternal fever greater than 100° F or suspected maternal infection

  • Active genital herpes

  • Fetal distress

  • Rupture of membranes greater than 24 hours

  • Thick meconium-stained amniotic fluid

  • Excessive vaginal bleeding

 

 

Setting Up For Your Water Birth

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So you have decided a water birth is definitely for you.  So how do you do this?  Well the first thing is look at your space that your birthing in.  If you are in a birthing center, the setup is already designed just right.  If you are birthing in home, you want to have a birth pool set up within a hose distant of a faucet.  Be sure that your faucet is compatible with the adapters for the hose.  You want to make sure there is enough space all around the pool for the support team to access you or your partner.  Once you’ve found the right space, you’ll need to choose the right birth pool.  Considerations are the size of your space or if your partner is going to be getting in the water with you will you both fit.  Most pools are spacious enough for two.  There are many sources to buy or rent a pool.  Yourwaterbirth.com has many supplies for water birth and homebirth and you may find that your midwife or doula has an account and recommended supply list.  Ask them and if they do they will be able to give you a 10% discount.  If you would rather not purchase a pool many midwives or doulas offer birth pools for rent along with the needed supplies to go along with the pool.

 

It takes about 20 minutes to inflate your pool and it is a good idea to inflate it before the big day to make sure there are no tears causing leak in the pool.  Something you don’t want to find out while you’re laboring.  It’s also good to practice different positions in the pool ahead of time before it is filled with water to see all the possibilities.  The next important thing is to make sure that the pool’s temperature stays between 92-100 ° F (32-38° C) but not exceed 101° F (38° C).  We don’t want your core temperature to increase because that can adversely affect the baby.  You can find a thermometer that floats in the pool to keep track of  your pool’s temperature.  It’s important to keep the water comfortable and keep it warm.  With that said, being in the warm water, make sure you stay hydrated and use a cool cloth on your forehead or neck.  

 

How deep should you fill your tub? You should fill the tub at least 20 “ of water depth to give benefits of buoyancy and to insure the baby is born into the water and not exposed to the air too early so as not to stimulate inhalation.  You don’t want it so deep so that the care provider is not able to see what is going on either.  It takes about an hour to fill the pool up and when things start moving along you can fill it about half way, so that if it cools a bit you have more space to fill it up with more warm water.  Keep it covered in between when you get in and out to lengthen your pools warmth.  Someone should stay with you at all times.  You can get in and out whenever you feel you need it.  It has been observed that it may be best to wait for immersion once your 4-5 cm dilated and have a well-established pattern.  Really though whatever helps you be comfortable and helps you manage the contractions do it.  You want to alternate between water and land to maintain the effects of the water.  Dr. Michele Odent’s research found that when entering the water early in labor (before 5cm dilated),  a surge of oxytocin happens and this increases uterine contractions and helps cervical dilation and effacement move along.  This effect, however, decrease if immersed 90-120 minutes.  So if you do get into the pool in early labor, take breaks so that labor can consistently progress.

 

Birthing In The Water

Finally you’re ready to push and as baby is born, your care provider will make sure to gently but quickly bring baby to the surface.  You finally feel the warm and slippery little person that has been a part of you for the last 9 months.  Eyes so bright looking right at you.  What an unforgettable moment.  If you are comfortable in the water and all is well, you can birth the placenta in the water.  Just have a lightweight bowl on standby to place the placenta in.  You’ve done it!  With any birth choices, do your research.  Watch water birth experiences.  There are plenty on YouTube.  Or ask your childbirth educator or doula their suggestions for water birth videos and resources as well.   I hope this article has been helpful.  Happy birthing!

 

My favorite resources:

Books

Websites

 

 

 

Tend Your Garden Well

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I love this quote from Ina May Gaskin. It is a subject that can be missed in the prenatal care. But as the quote says you need a nutrient rich soil to grow healthy plants. Why should this be less important when it comes to nutrition and babies.  What do you know about nutrition?  What are your nutritional needs in pregnancy?

Nutritional Needs of Pregnant Woman

With the growth of baby your stomach has been pushed up further and not much room for a big meal. This means that every bite counts. Eating small meals throughout the day instead of three larger meals.

Non-pregnant vs. Pregnant

Calories
1500-2000 to 2300-3200

Fiber
8-15 g to 10-15 g

Protein
45-65 g to 75-90 g.

Calcium

Your needs are greater in the second half. Insufficient calcium will lead to your body pulling it from your bones to nourish the growing fetus. Baby’s teeth, bones are forming and calcium helps with muscle and heart function, blood clotting and nerve transmission. Sources of calcium include milk, yogurts, cheese, if vegan then make sure you take in extra soy products and nuts and dark leafy greens.

850-1200 mg. to 1200-1600 mg.

Iron

You need 30 mg to 60 mg of iron when pregnant. Iron builds blood cells in mother and fetus. Anemia is when your blood has a lower than normal number of red blood cells. Anemia also can occur if your red blood cells don’t contain enough hemoglobin. Hemoglobin is an iron-rich protein that gives blood its red color. This protein helps red blood cells carry oxygen from the lungs to the rest of the body. If you have anemia, your body doesn’t get enough oxygen-rich blood. As a result, you may feel tired or weak. You also may have other symptoms, such as shortness of breath, dizziness, or headaches.

Because iron is not absorbed efficiently, more is needed to make it more available. So most women are usually prescribed an iron supplement. Not all can tolerate this. The supplement I recommend that is non-constipating and won’t make you nauseous is Floradix (a plant-based iron supplement) (I am not affiliated with).  It can actually help with constipation.

Nutrient-rich foods to prevent deficiencies:
Eggs
Fish
Poultry
Organ meats (organically raised; these foods are really more like medicines)
Milk products
Red meats
Nuts and seeds
Whole grains
Wheat germ
Yeast
Molasses
Seaweeds
Leafy green vegetables
Other nourishing choices to consider is the use of herbs. The #1 choice for nourishing women’s health in general and especially in pregnancy is red raspberry leaf tea. This has been shown to tonify the uterus and it is said if drunk daily in pregnancy will assure a healthy labor. Stinging nettles is another great choice. You can make a tea with this or use it as a green in soups. This is high in vitamins A, C, K, calcium, potassium and iron. Stinging nettle is used in many pregnancy teas (and women’s health teas in general) because it is a great all-around pregnancy tonic. Rosehips are another great choice because it is high in vitamin C which is key for absorbing iron well

Fiber

Fiber is important because the digestive system slows down. So to avoid or relieve constipation drink plenty of water besides milk and herbal teas and eat high-fiber foods like whole grains(Ezekiel 4:9 bread) (not affiliated with this brand), fruits, and vegetables.

Morning Sickness 
Another challenge to staying nourished in your pregnancy is morning sickness.  Though it’s name implies it only occurs in the morning, this can last throughout the days. If you find you can’t keep down water or food then speak with your care provider immediately because you could be dealing with hyperemesis gravidarum (HG)       Hyperemesis gravidarum is a more serious condition that will require the care of a physician.  Morning sickness is actually helped with good nutrition choices.  Vitamin B6, C, E and extra magnesium and potassium can lessen or relieve morning sickness.  Red raspberry, peach leaf, tea, peppermint, and ginger root teas can help with nausea.  Avoid fatty foods, junk food, and obviously  alcohol. Upon awakening eating dry toast and crackers has been shown to stave off nausea. Snacking on carbs or protein throughout the day.

Nourishing yourself with the goal of giving  baby the best start is possible. It’s a delicious and fun adventure when you explore your choices armed with nutritional knowledge. If your still unsure seek out the assistance of a nutritionist  knowledgeable in the needs of pregnant women. Speak to your care provider or midwife. Your friendly neighborhood doula (hi there) will have some insights as well. If unsure ASK!  We are all to eager to help you have the best pregnancy you can.  I hope you have a happy and nourished pregnancy.  Have suggestions for eating well in pregnancy?  Please share in the comments.

Birth Song

The birthing process is intense. It’s no secret that it takes every ounce of a woman’s power in your life into the world. And one of those powers is the voice. Most Birth workers are comfortable with the range of sounds birthing women make but you still run into those who are not. When woman is silenced in the birthing room and told to not scream, don’t make noise, or calm down, they’re taking one of those powers away from her. Sound can be a pain reliever, a rhythm for the mother to cope, a distraction. It also can let others know she’s not coping well. The voice in the birthing process is important. We know how healing it is to express ourselves through our voice whether in singing or spoken word.

When a woman sings her birth song, she is opening her vocal chords and is releasing tension. When tension is released in the upper body, this leads to opening and release in the pelvis area. Why would you take this power away from her? Everything  we do in the birthing room is to assist opening in releasing. So mothers, partners, birth workers, let her voice be heard!

Moan, grunt, sing, breath as loud as you want. Roar!  Roar your baby out!

How to Give a Fantastic Massage

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Everyone wants a massage, but sometimes making it in to see your favorite massage therapist (hi there!) just isn’t feasible. It’s in those unexpected and inconvenient moments that knowing how to give your partner a pretty great massage yourself can make the difference between a rotten day and a better one. But of course, this hinges on one thing: do you know how to give a good massage? Giving an at-home massage is not that hard. Here are my favorite tips:
Use firm pressure, but not hard.
People get confused about pressure in two opposite ways. If your partner is smaller than you, you may have a tendency to use very light pressure. This is okay to a point (you probably won’t hurt anyone), but can be a little frustrating if your partner is tense or sore or, even worse, ticklish. On the other side are the people who come from the “no pain, no gain” school of massage. Don’t buy into this myth! Massage should be pleasant. If your partner has to tense their muscles and clench their jaw in order to get through your ministrations, it’s not helping.
Slooooooow doooooown.
There are absolutely occasions where someone might want a fast-paced, vigorous massage. But unless your partner is getting warmed up for a race or ballroom dancing competition, this is probably not one of them. You’re not going to miss some key muscle if you take your time. If you seem relaxed, your partner is going to relax too. So take a deep breath, put your hands out, and make each stroke last.
If you meet a bone, leave it alone.
There is one exception to the firm pressure rule, and that is bones. You don’t need to be an anatomist to recognize the ones that stick out, like knees, elbows, ribs, and spines. With little padding between them and the skin, these areas can be quick to bruise or feel painful. If you find your hands arriving at one of these bony landmarks (yes, that’s actually what massage therapists call them, it’s like reading a topographical map), you have two options: turn around and go back the way you came, or skim over them using gentle pressure and keep going with your massage on the other side.
Practice good body mechanics.
If massage shouldn’t be painful for your partner, it also shouldn’t be painful for you. If you are hunched over, if your wrists are bent at an awkward angle, if you are using your thumbs or fingers in ways they weren’t designed to work, you will end up regretting the day you ever offered to give a massage. Use bigger muscles in place of small ones whenever you can: use your back to provide pressure instead of your arms, and your arms instead of your fingers. Whenever possible, push instead of pulling. When you move to a new part of your partner’s body, adjust your entire position, not just your hand placement. It may feel strange at first, but imagine if you tried to shovel snow by standing in one place and using just your arms to move the shovel from one side of you to the other. If that image seems ridiculous, you already understand why proper body mechanics are so important.
Communicate, communicate, communicate.
Really, you probably don’t need to talk to a massage therapist to learn that open communication between you and your partner is key to anything you undertake together. But it’s especially true in a situation like a massage, where one of you is more vulnerable than the other. As the massage giver, it’s important that you check in regularly: How does this feel? Would you like more or less pressure? Do you remember whether I turned the oven off? (Okay, maybe not that one.) The same goes for communicating your own needs. If you are getting tired, or thirsty, or really need to leave for work, say something. Don’t leave your partner feeling guilty about enjoying a massage because you made a unilateral decision to sacrifice your needs for theirs.
Learn from the pros.
As with any skill, one of the best ways to learn to give a massage is by watching the people who are already great at it. Getting regular professional massage (hello again!) and taking a couples massage class are both helpful. Barring that, YouTube is a fantastic source of tutorials for beginners. You can search for a style you like—Swedish massage is a great place to start—or an area you’d like to focus on, like the neck and shoulders.
If you follow these guidelines, you’re going to be fine.
You may not be winning any championships, but massage isn’t a competition. If you can give a caring, relaxing massage without hurting your partner or yourself, you’re way ahead of the curve on this one. And if you feel like you need more than that … well, give me a call.

Deidre M. Medina, LMT 140 Elmwood Ave Buffalo, NY 14201 (716)292-6113

Body Image Risk and Reward in Massage

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Body image. Almost everybody has something about their body that they don’t like. For many people it’s a minor issue, no big deal. But some people have a major issue with their body image. It affects how they live and their happiness.
When I tell some people that I’m a massage therapist it can cause a strong reaction. They tell me, whether verbally or through their reaction and body language, that massage is not for them. Their body image is such an issue that they don’t think anybody else can accept them.

The paradox here is that massage can really help with body image issues. In massage school we were all nervous about taking off our clothes and letting somebody else touch us. It didn’t take long for us to discover that bodies are just bodies and become much more comfortable with our own. We also experienced how good receiving a massage made us feel. Something unexpected happened – when our bodies felt better we felt better about our bodies.

I think there are three options to consider. Let’s look at the risk versus reward for them.

1. Don’t get a massage.

This is the easiest because it involves doing nothing. The risk is low since you are not letting another person see or touch you at all.

The reward is zero. You didn’t get a massage so your body doesn’t feel any better, and you still have the stress you had before.

2. You get a massage, but the massage therapist either makes note of how you look, as if it matters.

If this has happened to you, I’m sorry. You got a crappy massage therapist. That’s a bummer, and I’m really sorry. You took a risk, and even if the rest of the massage was decent, got very little reward.

This is not going to happen if you come to me. Never. No way. I can’t say this strongly enough. It goes against the very nature of who I am, how I treat people, and what I believe.

3. You get a massage. A great massage. And the therapist does nothing to make you feel uncomfortable about your body. In fact, you feel pretty good about your body after the massage.

In this option your risk is low. I don’t care how your body looks. That’s none of my business. I just want to help it feel better. Your reward is high. Again your body will feel better from the massage and you can start feeling better about it.

I have no idea how your body got to be in the condition that it’s in. You may be dealing with something that you can’t control, such as a medical condition or an injury or accident. You may be in a lot of pain or are limited in what you can do physically. Since I don’t know what caused your body to be like it is now I can’t make any judgments about you.

I’ve worked on hundreds – maybe thousands – of people. Each body is interesting and I’ve yet to come across one that I could not help.
If you have been avoiding massage because you feel uncomfortable about your body, let’s find an option that works for you. You don’t even have to explain anything to me. Leave your clothes on. Stay sitting up or face down or lying on your side or however you want. It’s up to you.

It’s my job to help you feel better. That’s it. Together let’s find a way to help you relieve your pain and stress. Don’t let your body image keep you from feeling good.