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?

Summer Safety For Pregnant Folk!

Pregnancy, swimming while pregnant, doula tips, hot summer in Buffalo, NY

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With the hot months upon us, it’s good to go over some tips to stay cool and safe while pregnant.  It’s no joke to be heavily pregnant in the summer.  While you have the awesome benefits of  a having great array of fresh veg and fruits in the summer, the heat can be so oppressive it can distract from the pros of having a summer baby.  So what’s a hot pregnant person to do!?

 

  1. Stay covered:  Despite the urge to strip it all off in the middle of the playground, keeping covered will protect you from the rays of the sun.  Keep the clothing light in color and stick to natural fabrics like cotton or linen.  Channel your inner Audrey Hepburn!  28BDB7B9-B201-4D57-851F-CC5DA3933FCBWear a hat for added protection.  Straw or cotton is great, so again, keep it natural in material and light in color.  Dark colors attract the heat.  If you are at the beach or pool, have an umbrella to stay under so you are not constantly in the sun.
  2. Schedule outside time right:  The peak hours for the sun is 11 am to 3 pm.  So try to get your fun or errands done early in the day or wait for the sun to be setting to enjoy the outdoors.  Save the midday activities for the air-conditioned  places.
  3. Hit the pool:  Swimming is great for cooling you off.  We are also blessed in Buffalo to have splash pads in most parts of the city.  They were opened today so check out if there is one close by.
  4. Guzzle the water:  It’s important to stay hydrated when pregnant to begin with, so when you add heat to the mix you’ve got to really keep track.  Always have a bottle with you.  If you are not a natural water drinker, try adding fruits, veggies, and herbs.  Strawberry  and lemon perhaps or watermelon mint and cucumber.  So many options that you could play with.  You could even add a few drops of red raspberry tincture.
  5. Block the sun:  Get a good sunblock.  The higher the SPF the better.  If you go swimming you should reapply.  Most last a few hours.  If you have a favorite please comment below. I’m in the market for a new one.
  6. Adventurer look:  Wet a bandana with cool water and wrap it around your neck to keep cool.

 

So if we have a hot summer, there is no need to hide indoors.  You can have fun and stay safe while pregnant.  Have more tips please share with the class.  You can come in and get a massage with cold stones as well.  Very chill experience.  Enjoy your summer and stay safe!

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!

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What is this round ligament pain about?

CI8A0405Once you hit your second trimester, perhaps some of the early symptoms of pregnancy have abated.  You’ve got more energy.  You are eating well.  Feeling good.  In your second trimester, some will get a sharp pain in on the sides.

What is happening ?

So there is this hormone called relaxin and this lets connective tissues relax.  Sudden movements or stretching with normal movement can cause this sharp pain on your side or even both sides.  The uterus is growing and is heavy and big enough to stretch the ligaments, but not quite big enough to sit on the pelvis bones to give some relief.

 

What’s a pregnant person to do?

First, be aware of your movements.  Use those abdominal muscles to help support your movements and not put those ligaments under strain.  Try to avoid sudden movement and changes of position.  If you work in an office setting, be careful about going from sitting to standing suddenly.  At bedtime, you are probably are all ready doing this, but laying on your side at bed time can help the round ligaments get some relief from all their hard work.   You can do leg lifts.  Start with the side that is in pain.  Holding on to a chair or table, you use your abdominal muscles to lift the leg up a couple inches off the floor and hold for 10 seconds.  Repeat 10 times.  Now do the same rep on the opposite leg.

This too shall pass!

You can expect some relief once you hit the third trimester usually.  Pregnancy massage to the abdomen and myofascial abdominal stretches with a pregnancy massage specialist can really help as well.  Did you or are you experiencing round ligament pain?  What tricks or tips do you have for other moms?

 

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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!

Anemia + Pregnancy

Anemia

 

By Deidre M. Medina, LMT, CBE

What is anemia?

There are a few kinds of anemia in pregnancy.

Pregnancy-related anemia when your blood has too few red blood cells which in this kind of anemia is due to the increased blood volume during pregnancy.

Iron deficiency is due to mother not having enough red blood cells stores to match the babies use of the mother’s red blood cells for its growth and development.  This is the most common type of anemia in pregnancy.

B-12 deficiency is when there is a low level of B-12 which is important for making red blood cells and protein.  If you are a vegan mom, you may find yourself with this type.  It is found in eggs, milk, poultry, meat.

Folate deficiency can inhibit the production of red blood cells.  It is a B vitamin that is water soluble.  Folic acid is the synthetic version of folate and is not as easily digestible and folate.  You can find folate in dark leafy green vegetables, beets, Brewer’s yeast, liver, etc.  It is a common deficiency because the modern diet of processed foods, though supplemented with folic acid, it is not easily usable as the folate found in fresh unprocessed foods.  Your baby needs this to prevent birth defects of the brain and spinal cord.

Using Food as Medicine

Nutrition is most important in pregnancy.  Food can be used to prevent deficiency and to balance any deficiency in mild cases. If you are in need of iron-rich foods, then you can look to dark leafy greens, beets, legumes, beans, kelp, meats, poultry, liver and more.  For iron to be absorbed well, vitamin C rich food should be paired together or supplementing with vitamin C.   Cooking in an iron skillet helps increase the iron in your meal.  A favorite plant based supplement for iron that I took for all three of my pregnancies was Floradix (I am not affiliated with them) or if you are gluten sensitive their Floravital.  It is an herbal iron supplement that is non-constipating.

There are foods and supplements that can inhibit the absorption of food.  The use of antacids or other alkalis will diminish iron absorption.  These are sometimes commonly used in pregnancy if you are affected by heartburn.  Coffee and black tea can inhibit absorption as well.  Calcium can inhibit iron absorption so it is important to try avoid taking a calcium supplement at the time of iron supplement or with your iron-rich meal.  Iron absorption is a slow process and takes about 2-4 hours for the body to absorb iron so you could take iron supplement at separate meal time than your calcium.

Folate-rich foods that can boost your folate spinach, kale, beet greens, beets, chart, organ meats, brewer’s yeast.  Bean sprouts of mung bean, lentils, and soy are really good sources of folate.  B-12 can be supplemented with a sublingual B-12 or shots every three months during pregnancy.

Eat Well, Be Well

So the pattern as you can seen for a well-nourished pregnancy is eat to well-balanced meals.  Make sure your meals are mostly fresh whole ingredients.  Eat less processed foods.  It really pays to understand nutrition and how it affects your pregnancy and your baby’s health.  Learn, have fun with it, ask for help.  Eat well, be well.

Sources:  https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02428  Staying Healthy with Nutrition by Elson M. Haas, M.D.

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:

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