What’s the Deal with Amniotic Fluid

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Amni-what now?

Amniotic fluid is the liquid that is within the amnion or the membrane that holds the baby.  Also known as waters.  So when you hear the term her water broke, that is amniotic fluids.  It serves as a cushioning to protect baby from external movements for shock absorbtion.  This fluid also does a lot more.  It also a source of nutrients, water, and biochemicals from mom to baby.  As the baby grows, the fluid allows free movement allowing baby to do those acrobatic acts they like to do in utero.  This helps their muscles and bones to develop.  Also, when baby swallows this assists in the baby’s gastrointestinal development.  It also helps keep baby’s body temperature just right.

 

What’s it made of?

It’s made mostly of water and electrolytes early in pregnancy.  Later on it also contains, proteins, carbs, lipids, phospholipids, and urea.  These “ingredients” help your baby in its development.  So your body is making baby Gatorade of sorts.  Plus it that’s where the baby’s urine comes from along with meconium (black sticky first poo after birth).  Yes there is pee in there.  It’s totally fine.  How much is in there? Well, it increases with the growth of baby.  It peaks at about 800 ml and decreases to 400 ml by week 42.

Where does it all come from?

It comes from moms plasma and later in the pregnancy baby contributes by urinating.  This is why staying hydrated is key in pregnancy.  You should drink at least 8 cups a day.  You have an increase blood volume and are producing amniotic fluid.  By the time of the birth you will have about 1 liter of water gushing out.  Little known fact, the majority of births don’t see the waters break until baby is actually emerging.  It is not as common to have a giant gush of waters and then baby.  It happens, just not as often as people (the media) thinks it does.

Did you know that amniotic fluid can tell us a story.  It is used to test for diseases and genetic anomalies.  The amount excess or shortage can signal problems with baby or signal maternal issues.  In labor, the color will signal whether baby has had a bowel movement which may or may not signal fetal distress.

To Break or Not to Break

Breaking of the water as mentioned before can be spontaneous in active labor or at the birth of baby.  Sometimes a labor has gone on for a while with no “progress” and the provider may suggest rupturing your membranes.  They may use a amnihook or amnicot.  The amniohook kind of looks like a crochet hook.  It is inserted and used to break the waters.  The finger cot is the same except its a little finger cot with a bit of a hook on it.  It does not hurt and mom may feel relief at the breaking of the waters.  Some providers feel that this potentially will speed up progress.  There is no real proof it actually does.  It can potentially make it harder to cope with the labor pains since now instead of a cushion of water on the cervix, the baby’s head is not directly on the cervix, leading to the need for pain medication.  It can be helpful if labor has been long and the provider wants to make sure there is no meconium is in the fluids.  All in all though, it seems like it’s best to leave things alone if possible.

So that is it.  That is a brief run down on amniotic fluids.  Have a fun fact you’d like to share please comment.  Did your water break before the baby came, leak during labor, or gush right at baby’s arrival?

June Treaments

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Try out this cool dream of an add-on for the hot months ahead.  If this week is anything to go by, we are in for some hot days.  Enjoy this fresh aloe vera and cucumber mask for the back to help you have a cool experience.  Cold marble massage stones deepen the cooling experience.  Perfect to soothe a sun-kissed back.  If you are experiencing hot-flashes from menopause this is a nice break.  Enjoy a green tea and fruit infused water to take with you on the go.  Schedule your 60/90/120 minute massage session and add-on this treatment to give yourself a cool treat!

BOOK

Postpartum Massage – A Returning to Self

New Awareness

You look in the mirror and see a new person.  Welcome mother.  Welcome to motherhood.  Do you recognize her?  Can you believe how much a little person has changed life?  What now?

Enjoy the ever changing and evolving life of motherhood.  It can feel like standing at a precipice.  Whether you have waited a long time to get here or happened upon this path of mothering, you may feel overwhelm at the responsibility and uncertainty before you.  Who am I now?  How can I remain me and embrace this  new sense of self?

Reconnection

Massage is a beautiful way to increase self awareness.  As your body is massaged, you become aware of how each part of the body feels.  Done regularly, massage can help you get to know your body well.  This is so important because our body talks to us.  It tells us the real story of what is going on in our lives.  Tension in the shoulders, is it anxiety, am I slouching because of feeling sadness, am I aware of my posture when nursing my baby?  Making a plan for massage as a part of your life is worth it.  It has been found in research to decrease anxiety and depression in new mothers.  Done regularly during the immediate postpartum phase and into that first year of postpartum can make a world of difference to a mother.  It is not just six weeks to recovery.  Postpartum affects our bodies and minds for years to come. Physically, the body is jumbled up so to speak from our growing baby being inside and postpartum abdominal massage can help to reorganize things.  You have just run a marathon of birth and need to address areas of tension that have built up during labor.  You carried a growing baby for 9 months and you will have postural changes.  If you have had a Cesarean birth, this still applies to you momma.  You will have scar tissue to be addressed and you need no less self-care than a woman who gave vaginal birth.  With a plan of massage mother to baby interaction is more positive and helps baby grow well, have better social interactions, and just generally happier.  Self-massage routine can be taught to mom so that in between her massage appointments she can still reap benefits.  Plus she will know her body well, having a better awareness, and positive body view.CI8A0367

Committing to Yourself

Planning for postpartum massage should be a necessity for new moms.  It is a normal part of cultures worldwide.  Mothers are given massage daily in some cultures as well as baby.  It is not stressed enough to take care of mother in our culture.  This conversation needs to be heard more.  That is my goal.  The better cared for the mother is the better cared for the baby.  We really all benefit when mom’s are cared for.   Make it your commitment to be well, be cared for and thrive in your 4th trimester.   Mom’s make the world go round!

Book an Appointment

Deidre’s massage studio is at Buffalo Midwifery Services 289 Summer St. Buffalo, NY 14222 (716)292-6113.

 

 

Postpartum Depression – My Story

My postpartum story with FarrahI love my children!  I loved my births and the birthing. Each was different and beautiful in it’s own way.  My second birth was a beautiful home birth with a midwife who made me feel supported.  However, after the birth, I felt different.  At first I just thought I’m tired.  Yet the feeling persisted.  I looked down at my new baby and felt, nothingness.  I cared for her and fed her.  I found my joy was muted.  Like the picture above felt like I was under water and heard sounds but they were muted and unclear.   I feared what feelings welled up when she screamed relentlessly night after night.  I had to sleep in a chair with her in my arms.  I could not put her down.  She would not be satisfied.  I felt like I was running out of air.  I could see the surface above but could not quite reach it.  Just helplessly watching the bubbles of my decreasing oxygen escape.  I cried, I was angry, I was back to work 3 weeks earlier than I wanted to be.  Mind you I worked from home which would seem like a God send, but no.  I was here with my attention constantly drawn from work to my screaming little person.  I had also a 2 year old who was waiting in the wings.  I was, drowning.  My husband did not understand what was wrong.  Women had done this years before me (to be fair to my husband this is not an uncommon thought).  I sank a bit more.  People came, cuddled, and went.  I sank deeper into the depths.  My mind raced about options out.  This was not how it is supposed to be.  I followed up with my midwife and lied.  I said I was fine.  Everything was wonderful.  I could not bring myself to say I was so incredibly sad.

I happened to have a follow-up with my primary doctor.  He  went through basic questions.  I was tired and that was why I was there.  He gave me a list of questions to tick off.  I stared at it and tears welled up.  I can’t remember the exact questions today, but they were in effect, are you sad, are you depressed, do you feel suicidal?  I was scared but tired of being under water and took a chance.  I answered honestly.  He went over the questions with me and said, I would like you to see a therapist.  A what now?

Now I was not okay with this idea, but thought, what the heck.  I called a couple therapists met with both and stuck with the one that had more experience in postpartum depression.  She was a breath of fresh air.  I talked.  I said what was on my mind without fear of judgment and I was given homework.  Things to work on?  Say no more!  I have a baby to care for others can wait!  I felt freer to acknowledge my feelings.  I felt okay saying no and letting people work out there own feelings on how they feel when being told no.  I could focus on myself and not be selfish.  I started exercising regularly getting outside to walk in fresh air (I love being outdoors).  I ate better.   I took a shower daily.  I got better.  I am grateful for that doctors perceptiveness.  I know my story is not always the norm when a mom tells her true story postpartum.  Armed with this knowledge and experience, I knew what to look out for the next pregnancy and was able to be proactive.  I had more support.  My hubby made sure I had healthy snacks on hand.  I said no when I needed and yes when I wanted.  I took off the time from work.  I rested and when I could started getting outdoors.  I had a doula for my birth.  I practiced self massage.  I had planned out a better postpartum experience through support, forethought, self-care plan and being honest with myself and others.  My feelings are my feelings and I acknowledge them, honor them, and will not be shamed by them.  I will ask for help before the calamity arises and if it arises.

This was my experience.  This is the catalyst for my work.  I love postpartum moms so much.  I have walked in the same path and want to support you so that you do not find yourself lost in the depths of dark waters.  I want to be there to guide you to the resources you need to get help.  I want to provide nourishing touch through massage therapy that is so missing in our culture here in the States.  I want to prepare a meal for you so that you have the energy to heal.  I want to teach you self-care not because you have no one else to do it, but because you love yourself and want to care for you.  If this resonated with you in any way please feel free to leave your experience in the comments for others.  The more women who tell their story, the more chance another mom struggling will feel less inhibited to tell her true story and get support.

Much love to you momma!  You can and will thrive and I am willing and ready to support you!

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!

Meet the Doula Event October 16, 2016

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The Meet The Doula Event in Buffalo, NY was a beautiful event organized by Shannon Johns of Calming Nature Doula Services.  Thank you Shannon.  So many great services for pregnant women in Buffalo. Moms were pampered with samples of massage, and facials. There were presentations all day regarding pregnancy-related subjects such as placenta encapsulation, what a Doula does, rebozo,  midwifery, chiropractic, and of course a presentation on pregnancy massage benefits and myths by yours truly.  The Postpartum Resource Center of New York’s Western New York Perinatal Mood and Anxiety Disorders Task Force was there to educate our community to really ask moms how they are doing and to be aware of signs mom is having a hard time and how to get her help. https://postpartumny.org/wny/

It was fun and informative.  We really are fortunate in Buffalo New York to have so many supportive services for families and mothers.  If you ever have any questions about pregnancy massage or how I do look and help you in your birth, please shoot me an email and we can chat.