Month: April 2017

One of the most important parts of every pregnancy is its birth team. This group of people and professionals is a support system to provide education, answer questions, and  remove some of the stress from the time before conception, pregnancy, and the postpartum period. It is incredibly impactful to feel empowered and safe as you prepare to bring a child into the world.

A birth team looks different from family to family and depends greatly upon their individual needs, wants, and circumstances.

There are many possible components of a birth team- and they all play a vital and valuable role for families. To learn more about these professions, check out the sections below! Most of these headings are direct quotes from providers in the Puget Sound region. Their contact information is available at the end of each segment should you have additional questions about how they contribute to beautiful births.

Midwife versus OB/GYN

If you have landed here, you probably have already chosen your main birth provider. However, in case you are trying to decide whether to choose an OB/GYN, Nurse Midwife, or a Lay Midwife, check out this article (and this other one) to learn more about what the differences are between providers.

Chiropractor

“While many (in fact most) Chiropractors treat pregnant women, there are additional certifications in Webster Technique that allow Chiropractors to specialize and gain a deeper understanding of the unique changes the body undergoes while pregnant. As a Webster Prenatal Chiropractor, I work to create balance within the body as it adapts and changes in the stages of pregnancy and the months following birth.

Chiropractic techniques are adapted to gently and effectively work with the ligaments, bones, and muscles of the spine and pelvis. This helps to prevent or treat the aches and pains that are commonly associated with pregnancy from sciatica and low back pain to headaches as well as round ligament pain. Outside of this, when the body moves better throughout pregnancy, delivery is often shorter and less complicated.

The muscles and ligaments of the spine and pelvis are impacted by the changes in pregnancy. As the uterus grows, the muscles and ligaments that attach it to the pelvis and lumbar spine are likely to be directly impacted by the alignment of the pelvis. Unequal stresses through the ligaments and muscles of the pelvis can cause the uterus to undergo torque. This can contribute to malposition of the baby (Breech, Transverse, Occiput Posterior presentations, etc).

Remember: structure determines function. By balancing the pelvis, we enhance its function. According to the International Chiropractic Pediatric Association, “when a mother’s spine is realigned to proper position, a symphony of physiological responses happens immediately in response to the uninterrupted communication between the central nervous system and the rest of the body.”

It’s no wonder that many women who are under chiropractic care throughout their pregnancies have shorter, easier labor and experience fewer complications as a result. According to one study, women under chiropractic care experienced 25% shorter labor in their first pregnancy and 31% shorter labor for multiple pregnancies[1]. Many birth providers now recommend Webster certified chiropractors as part of a birth team.

I encourage all pregnant women to see a Doctor of Chiropractic who is certified in Webster Technique throughout the perinatal period to ensure that her body is functioning optimally and providing the best home for baby, possible. You can find a Webster Certified Chiropractor via the International Chiropractic Pediatric Association. “- Sharonrose Samelak, DC, Prenatal Chiropractor

Dr. Samelak has been Webster Certified with the ICPA since 2012 and has worked extensively with pregnant women, their families, and children. She currently practices in the Fremont neighborhood of Seattle, WA at Seed of Life Chiropractic and Wellness, LLC.

Sources:

[1]. Borggren, Cara L. “Pregnancy and Chiropractic: A Narrative Review of the Literature.” Journal of Chiropractic Medicine 6.2 (2007): 70-74. Web.

Doula

“To hire a doula or not? This is such a wonderful question that we’re so glad you’re thinking about. The word “doula” is greek for “women’s servant”. And when you’re facing the unknown of how your birth will go, it’s comforting to have someone there specifically for you as a woman as you are birthing your child.

While pregnant women are dealing with surging hormones and swollen feet, their partners are going through this journey as well. A doula can help a hands-on partner by providing them guidance and suggestions as they help with the pregnancy and birth. For those who wish to be more on the sidelines, a doula can step in. This allows not only the expecting mother to, hopefully, have the birth she envisions, but the partner as well.

A doula can help facilitate communication among all those involved, including between mother and medical caretakers or other family members. As the mother’s advocate, doulas work to ensure that her voice is heard during a vulnerable time — whether that’s clarifying a clinical procedure or articulating your wishes to surrounding family. Births with doulas resulted in lowering the cesarean rate by 50% and the length of labor by 25%, according to the Cochrane Review, Continuous Support for Women During Childbirth (reported by the American Pregnancy Association). While the causes could be a number of reasons (more relaxed, better techniques to progress the process) the end result: a shorter labor — who doesn’t like the sound of that?

Doulas range in prices, all the way from $500 – $2,000. It is important to find someone that meshes well with the birth story a family is planning. Ask good questions that help you get to know the doula. Calm and Confident Doula wrote a wonderful blog about 10 questions to ask a doula, this is a great tool to use to help you get to know your potential doula.” -Courtney Yorks, Doula

Courtney Yorks is a doula in the Seattle area. She attended her training at Bastyr in January of 2016 and since has attended every kind of birth you can imagine. She has pursued her passion for educating, advocating for, and empowering women in the perinatal time. She uses her passion for birth and extensive trainings to make your birth experience beautiful, unique, and safe. To learn more about Courtney, check out her website.

Fitness Expert

“Physiologically and holistically, the benefits of exercise during pregnancy are numerous for both mom and baby.  A sampling of these includes increased placental growth and function, less pregnancy related aches and pains, enhanced perception of quality of life for mom, increased ability to tolerate the physiological stresses of labor for both mom and baby as well as a decreased likelihood of pregnancy induced hypertension and gestational diabetes to name a few!

At Bodies for Birth, we help individuals to prepare their bodies both mentally and physically for the endurance event of pregnancy, childbirth and motherhood!

Interval and strength training mimic the work of contractions as we prepare the mind to stay calm while the body is working physically hard.  Through this practice, individuals learn and practice coping skills that translate beautifully during labor and delivery.

Physical strength, endurance and flexibility develop with consistency.  Individuals learn to work with and trust their ever evolving bodies.  Taken together, these components help to promote empowering birth experiences!”- Maura Shirley, RN, Owner of Bodies for Birth

Maura Shirey is the Owner & Creator of Bodies for Birth. During pregnancy and motherhood, it became clear that I needed to fuse my varied professional experiences with my passion for wellness to do something wonderful for pregnant and postpartum individuals. Bodies for Birth was created from this passion. Ever since, I have been on a mission to change the conversation about exercise during the perinatal time…and truly, I like to think I’m creating and leading a birth and fitness revolution! I watch individuals gain physical and mental strength, I watch them tackle the unexpected with resilience and grace. My work allows me the gift to bear witness throughout this evolution and I am forever grateful.

Women’s Health PT

“Women’s Health Physical Therapy is a sub-specialty of PT focused on treating women’s specific health concerns. These include pelvic health complaints such as pelvic pain and urinary incontinence, and pregnancy and post-partum conditions.

A Women’s Health PT can help with a number of things during pregnancy. These include: designing a safe exercise routine, addressing pelvic pain including pubic symphysis dysfunction, and SI joint pain, helping minimize risk for diastasis recti, and addressing pelvic floor conditions like urinary incontinence and tight pelvic floor muscle concerns.

A Women’s Health PT will often see women early in their pregnancies to help them figure out safe exercise routines and deal with chronic back and knee or hip conditions that might impede labor. Later in pregnancy they will usually treat low back, hip, and SI joint pain, and urinary incontinence concerns. Women’s Health PTs also help women get their baby into an ideal position for labor and use biofeedback to determine positions of most relaxation that might be helpful for the pushing phase of labor.

Women’s Health PTs provide education regarding pelvic floor care post partum to assist with healing and will often see women post partum to help with abdominal and pelvic floor muscle healing and strengthening as well.

Insurance will cover all of Women’s Health PT services.”

Aimee Lake, DPT is a Women’s Health PT at Greenwood Physical Therapy. Her original PT background is in general orthopedics and she takes that holistic approach in her work as a Women’s Health PT. Because of that her treatment philosophy is to treat the pelvic region as an integrated part of a women’s whole body. Aimee says, “As an active woman and a mom I know the physical challenges of pregnancy and the post partum period. I work hard to make my treatments efficient and not overwhelming. I keep my home exercises to a minimum and work to provide a hopeful atmosphere for women to feel successful in.”

Massage Therapist

The pregnant person can expect to be situated on a massage table in a manner that is safe for the pregnant body.  For first babies, the first trimester still allows lying face down on the table and on the back.  As the pregnancy progresses, it is no longer safe – so adjusting the body safely is key.  It is recommended that the practitioner perform the massage in a side-lying position, and then have either a table to allow a reclining position on the back or appropriate bolsters.

Lactation Consultant

Breastfeeding support is essential for new moms and it often helps to know your resources ahead of time. Many hospitals provide nursing support and many communities have a La Leche League which can be great support systems for parents. However, there is also an alphabet soup of other types of lactation professionals.

“IBCLCs (International Board Certified Lactation Consultant) are by far the most advanced lactation professionals, and the only certification that requires hundreds of hands-on clinical hours. IBCLCs must pass an internally standardized exam,  take health science courses, lactation education, and clinical hours. This education generally takes 2-5 years.

Non-IBCLC lactation professionals can provide amazing, vital lactation support, but in  cases where there are moderate to severe health concerns or issues that do not resolve quickly, should be attended by an IBCLC. Other lactation credentials include CLC (Certified Lactation Counselor), CLS (Certified Lactation Specialist), CBS (Certified Breastfeeding Specialist), CLE (Certified Lactation Educator), and LS (Lactation Specialist).”- Adeline Hill, CBS

Adeline Hill is a Certified Breastfeeding Specialist and Doula with Black Rose Doula. She serves the Greater Seattle Community.

Childbirth Educator

“In this age of information overload, it seems like anything that anyone might ever want to know about everything is as close as a few taps on your smartphone or tablet. Despite this plethora of instant information, there is still something special about taking an in-person childbirth education class. It seems like life has never been busier, more hectic and fast-paced.  Being a new parent is all about slowing down and living in the moment, at least for the first days and weeks of welcoming a new baby as the family transitions and recovers. Quality childbirth classes can help start that process of being in the moment, taking things in and learning about making choices that feel good to the expectant family, as well as preparing them for the labor and birth experience, the postpartum time and care of the newborn.

Adding a childbirth class to your “birth team”

Preparing to give birth requires a lot of flexibility, as does parenting. Learning about the process, creating community with others who are going through similar experiences and increasing the confidence in both your ability to give birth and in your partner’s ability to support you with comfort and coping measures can all add to a positive experience for you and start you off on the right foot for this new adventure called parenting.

Having some familiarity with the process and learning about the choices you can make during your labor and birth can help you to decrease your fear and nervousness and increase your sense of excitement and ability to cope. When you take a childbirth class, you should be given lots of opportunities to practice comfort and coping techniques to use in labor.  You also can learn about the options available to you for pain relief, variations in labor and birth and planning for the unexpected.  Many friends and family are happy to share their own experiences, but your journey is your own, and it is nice to haven a safe, nonjudgmental space to absorb information with your partner or support person, where no one is telling you what they did or what you should do.  While your birth class instructor will not be with you on the big day, what you learned and discovered during classes will be accessible to you as you move through your birth experience, so adding a good childbirth class to your birth team can help create a very positive experience.

What should you look for in a quality childbirth class program

There are lots of options for childbirth classes in our community.  It can be overwhelming to select what might be a good fit.  As someone who has been teaching childbirth classes for almost 14 years, I would like to offer up a few suggestions:

Look for an independent class offering versus one that is offered through the hospital and taught by hospital employees.  An independent class will consist of people birthing in many locations and it will benefit you to hear about other class participants’ experiences and options.  Independent instructors often have more flexibility to share information about best practice, beyond what is strictly specific hospital protocol.

Try and take a series class versus a one day option.  I am often told from families who opt into the ‘one day and done’ model that the entire class is pretty brain dead come 2 PM, even though class went on for another few hours.  It is hard to stay focused and take in information when you are asked to do it for eight hours straight. Enrolling in a class that is spaced out weekly can really help you and your partner to absorb information, discuss things in between classes and build community with the other class members.  The pace feels so much more comfortable and builds confidence in your skills.  You are also provided so much more information – as there is so much more time.  My 17.5 hour seven week series class offers lots of engaging activities and information compared to an eight hour class, which is really about 6 hours when you subtract lunch and breaks.

Look for a childbirth class that is taught by a certified childbirth educator – Lamaze and ICEA are two of the major national certifying organizations.  In order to maintain their credentials, certified educators are required to demonstrate continuing education hours in topics related to maternal-infant health.  It is a nice to know that your educator is current on best practice and evidenced based care.

A quality childbirth class will also –

• • Limit the number of families to ten or less so the class is not too crowded, and you have lots of chances to ask questions and have manageable class discussions
  • Offer variety of teaching activities that are engaging and hands on, with lots of opportunity for actual practice
  • Limit or restrict the use of Powerpoint presentations – to quote a friend of mine, Teri Shilling, “the person who is doing the most talking is doing the most learning.”
  • Be welcoming to all family structures and value diversity in the class members
  • Present impartial information that helps you to decide what are the right decisions for you, versus informing the class about the “right” way to birth and not leaving room for you to choose what feels best for you.
  • Include adequate information on breastfeeding, newborns and the postpartum period

Health insurance plans do not often cover childbirth classes, but if your family has access to a Flexible Spending Account (FSA) or Health Savings Account (HSA), most people are able to use those funds to pay for their childbirth classes.  If you are receiving Applecare from the state of Washington, childbirth classes are covered and their class coupons are accepted by some class programs.  Many programs are committed to offering classes to all, so do inquire about your options for financial assistance.

Choosing just the right program for you

Some people view childbirth as a spiritual journey, others are more of the “squat and get it done” type.  Some expecting families like lots of information on all topics and find comfort in lots of research and evidence, others prefer to learn about select items.  Some people know already exactly the type of birth they hope for and others want to learn more before narrowing down their options.  Everyone wants a healthy baby, a healthy parent and a healthy birth.

Choose a childbirth program that seems to resonate with how you view birth and early parenting.  Select a class that will meet the needs of your particular interests and style.  Ask others who have taken classes locally about their experiences and places to seek out or avoid.  Call the organization or instructor to get a sense of what you are in for.  Ask how much time is spent practicing skills and doing hands on activities versus sitting and listening.  This information should be readily available.  In the end, just like with labor, birth and parenting, go with your instincts and what feels right for you.  Allow yourself to be present with your partner or support team taking in information and building community with others in the class.  It is a chance to slow life down for a few hours and really connect with your baby as you prepare for birth.”- Sharon Muza, CD(DONA), BDT(DONA), LCCE, FACCE

Sharon Muza, BS, CD(DONA) BDT(DONA), LCCE, FACCE has been an active childbirth professional since 2004, teaching Lamaze classes and providing doula services to over a thousand families through her private practice in Seattle, Washington. Sharon is a Birth Doula Trainer at the Simkin Center, Bastyr University. She is also a trainer with Passion for Birth, a Lamaze-Accredited Childbirth Educator Program. Sharon is a consulting instructor at Great Starts, Parent Trust for Washington Children. She also teaches classes at the Seattle Indian Health Board. To learn more about Sharon, you are invited to visit her website, SharonMuza.com.

Acupuncturist

Chinese herbal medicine is also extremely helpful in postpartum recovery, and an acupuncturist trained in the use of these herbs can prescribe Chinese herbs to be used postpartum to help nourish and replenish the woman’s body. There is a well-known Chinese herbal formula that is often prescribe in the first week postpartum. There are also Chinese herbal formulas that can be used postpartum for things such as low milk supply, postpartum depression, and for overall nourishing of the body. In addition to acupuncture and Chinese herbal medicine being useful for the new mother as she recovers from childbirth, it can also be a wonderful resource for babies and children. I will often use simple acupressure for babies for issues such as gas and constipation, and use pediatric Chinese herbal formulas for issues such as pain from teething, or chronic ear pain in young children.

Prenatal Yoga

“Prenatal Yoga is one of the best activities that pregnant women can do for the well-being of mother and baby. What differentiates yoga from other forms of exercise is the connection to the breath. Yoga breathing is different from other breathing practices.

Birth is very physical as well as mental, emotional and spiritual. Yoga helps us to connect to all aspects of our humanness. In western medical science, we are beginning to realize how the mind affects the body. Knowing your state of mind and learning not to attach yourself to it allows the body to do what it needs to do.

Practicing yoga postures can help a pregnant woman alleviate many of the common discomforts of pregnancy like sciatica, restless legs, heartburn, nausea, low back pain, pelvic pain, sacro-iliac joint dysfunction, neck and shoulder pain, carpal tunnel syndrome and more. Yoga poses also strengthen the body, while developing endurance without strain.

One type of breathing is Ujjayi, or “victory breathing.” It is simple to learn and easy to do. The sound of the breath helps the mind to focus on one point (one-pointed mindfulness), which helps you to be in the present. It also balances energy and can help you to access and move your energy. Ujjayi, along with yoga postures can help to free this energy.

How is prenatal yoga different from other yoga classes? The focus is completely on mother and baby. There are women in all stages of pregnancy, from 6 weeks gestation to 42 weeks. Women learn about pregnancy, labor and birth in the classes. And prenatal yoga classes are SAFE. Her body is changing. Prenatal yoga addresses these changes.

What are the benefits of prenatal yoga? Whether preparing for pregnancy, or in your first to third trimester, our classes are safe and gentle for everyone.  No previous yoga experience needed.  Prenatal yoga helps you manage the discomforts of pregnancy, while maintaining wellness, and preparing you for birth.  You will build strength and flexibility as your body and baby grow, but more importantly, our classes will help you connect your body and mind, and create space in your consciousness for your pregnancy and journey into motherhood.

Pregnancy  is a short time in our lives when looking at the big picture. I believe that taking this time to embrace your changing body and growing baby can better help to prepare you for birth and motherhood. It’s a time to really nourish yourself on all levels, physically, emotionally and spiritually, and this will help you be healthy and vibrant in your later years.”-Colette Crawford, RN, BSN, E-RYT

Colette Crawford is an experienced registered nurse specializing in maternal/child health, labor and delivery and childbirth education at Seattle Holistic Center.  She says, “The inspiration for the prenatal yoga program came from my public health nursing days when I wove yoga poses in with childbirth education for women who were hospitalized. I have assisted hundreds of women in labor and early postpartum care, including being a lactation specialist. Since 1989 I have taught prenatal yoga to thousands of women, their families and yoga teachers from all over the world.”

Perinatal Emotional Health/Mental Health Services

Therapy focuses on managing stress, increasing self-care, and alleviating any symptoms of anxiety or depression. Psychotherapy can also include partners to expand your network of support people.“- Shanna Donhauser, BA, LAICSW, MHP, CMHP

Shanna is the owner of Happy Nest. Happy Nest provides emotional/developmental support and counseling to small children and their families. Happy Nest also provides pre- and postnatal psychotherapy to expecting parents. For more information please visit www.happynesttherapy.com or call 360-813-8587.

[1] Watson, S. (2013). Can Your Stress Affect Your Fetus? Retrieved from http://www.webmd.com/baby/features/stress-marks#1.

Postpartum Emotional Support

The postpartum period can also be a pivotal time to speak with a mental health provider.

-Feeling overwhelmed and worried all the time

 

Who’s On Your Birth Team?

Thank you to all of our contributors on this blog!

We hope that this compilation helped you to learn more about different birth providers. As a community, we are dedicated to helping women achieve healthy childbirth. We would love to hear about the members of your birth team and your experiences! If you would like to share, please feel free to use the comment section, below.

Babies are adorable.

They come into this world and hypnotize us with their steady, wide eyed gazes, their little sighs of satisfaction, and that new baby smell. We love to hold them. We love to snuggle them close. And we watch them as they sleep in our arms. It is utterly peaceful… until we try and turn our heads later in the day.

Enter: New Baby Neck.

Many parents, grandparents, aunts, and uncles suffer from this condition as soon as a new addition is made to the family. The anterior head carriage involved in gazing adoringly at babies causes an intense strain in the cervical spine (neck).

This is especially prominent in nursing mothers. While breastfeeding in a seated position, many women find their head pulled forward as they watch their child nurse. There are many positions for nursing and any certified lactation specialist can help you to determine which is best for you!

The facts behind forward head posture (FHP) have been very well documented in research over the past few decades. The following facts were taken from an article in Dynamic Chiropractic:

• For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds.” (Kapandji, Physiology of the Joints, Volume 3)
• According to Rene Cailliet MD, director of the Department of Physical Medicine and Rehabilitation at the University of Southern California, forward head posture can add up to 30 pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. FHP results in loss of vital capacity of the lungs by as much as 30 percent. This shortness of breath can lead to heart and blood vascular disease. The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation is a common effect of FHP. It causes an increase in discomfort and pain because proprioceptive signals from the first four cervical vertebrae are a major source of the stimuli which create the body’s pain controlling chemicals (endorphins). With inadequate endorphin production, many otherwise non-painful sensations are experienced as pain. FHP dramatically reduces endorphin production.
• FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage and early arthritis. (Roentgenographic findings of the cervical spine in asymptomatic people. (Spine, 1986;6:591-694)

The good news is this: There are tools that can be used to combat New Baby Neck.

Chiropractors have been working with the biomechanics in the cervical spine for over one hundred years. Maintaining healthy motion in the upper mid back as well as the neck can help to relieve the symptoms of New Baby Neck. This works best, however, when coupled with restorative exercises.

Cervical Extension exercises utilize an appliance to allow gravity to restore the curvature in the neck and improve biomechanics.

Head-Neck Retraction exercises help to bring the ear back into line with the tip of the shoulder which removes a lot of stress from the muscles of the posterior cervical spine.

Scapular Retraction and Shoulder Stabilizing exercises can be used to open up the shoulder girdle and improve respiration.

There are many more!

It is always important, though, to have a movement specialist such as a Doctor of Chiropractic or Physical Therapist evaluate your individual circumstances before applying home care exercises. Through careful examination, Chiropractors assess the biomechanics of the spine before choosing appropriate exercises to enhance function. We may even teach  you to modify other behaviors such as lifting and carrying children to further protect your spine!

Whether you are suffering from New Baby Neck, work at a computer all day, or spend a lot of time on a tablet or cell phone, it is important to take care of your cervical spine. To schedule a consultation to talk with Dr. Samelak about your neck or shoulder pain, please use the contact form below!