Ask The Doulas Podcast

Kristin and Danika discuss ways parents can prep for baby during pregnancy.  They also touch on the role of social media in parenting.

Hello, hello!  This is Kristin with Ask the Doulas, and I am so excited to chat with Danika Sanchez today.  She is the president and owner of Baby Steps Concierge Nursing.  Welcome, Danika!

Thank you so much!

I would love to have you fill our listeners in a bit about your impressive background in nursing.  I’d love to hear how you transitioned to this role as more of a concierge support in the postnatal phase.

Okay.  Well, I am one of those people that kind of changed careers late in life and decided I really, really, really wanted to work with babies.  So I went back to college at age 40, went through nursing school, and started in the NICU, which is where I wanted to be.  That’s the neonatal intensive care unit, all the little preemies or ones that need a little extra support.  I worked in that department at a couple different hospitals for about four years, and then I decided I wanted to see what it was like upstairs in our hospitals upstairs where the moms are.  So I’m now a postpartum nurse, helping parents after the baby is born from the time that the baby is born until they go home from the hospital.  And, you know, you’re only in the hospital now for 24 to 48 hours after your baby is born, which is very little time, and the first, I would say, at least half of that time, most of the parents I have conversations with have zero recollection of anything we spoke about when they first got there.  And it’s not anyone’s fault.  You are tired.  You’ve been in labor.  You haven’t eaten.  You haven’t slept.  You’re excited; you’re overwhelmed.  There’s a lot of things.  So doing my best to try to get them ready to go home and teaching all the skills and the swaddling and the feeding and the diapering and all those things, and it was one week in particular, I had three different sets of families say, we are not ready to go home.  Can you just come home with us?  And I laughed and said, oh, ha ha, I wish.  That would be great.  But by the third time, I was like, well, maybe.  Maybe there is a way to make that happen.

There’s a need.

Yep.  That’s where this company was born.  And that is what we do.  We just help ease that transition from having the baby to being at home with the baby and figuring out, what does that look like for your family, because every family is different, as well, right?  So what does that look like for your family?  What skills do you want more practice with?  We give the first bath in the hospital, but that means you didn’t give any baths before you got home.  So, yeah, just being there to answer questions, to be hands-on support, to help you figure out what next, or how do I know if my baby is hungry or tired or whatever.  All of my employees are nurses as well.  They all work either in NICU and/or postpartum, so we all have experience with not only babies in a variety of ways that babies are different, but in helping parents to learn to be a little more confident in that role of being a new parent.

That makes sense, and it’s much different than, say, the role of a postpartum doula or a newborn care specialist in that you have that nursing medical background.

Right.  So especially if you have a baby that is going home maybe from the NICU or has a feeding tube or is on oxygen or has a wound, something that needs maybe a little extra care, even though you are fully able to do those things on your own.  I’m sure if your baby has a wound, the nurses and doctors showed you how to change the wound dressing.  But it’s scary.  It’s still scary, and it’s scary to do it on your own for the first time at home.  So we do have that nursing license and background and experience to kind of help you get more comfortable with those situations, as well.

Beautiful.  So what are your tips to help parents prepare for their new role?

That is the big question!  I mean, everyone nowadays is taking childbirth classes or going to a class at the hospital before they give birth, but those classes tend to focus so much on the labor part, which absolutely still needs to be addressed.  That’s scary, of course,  But then I think there’s kind of a drop off in what to expect after that.  And so when we have brand new parents coming up to our floor after giving birth, they’re like, we don’t know anything.  We don’t know how to diaper this baby.  I mean, everyone kind of knows how to put a diaper on, but –

Some dads may not have, though.

Some dads may not have.  Also, I had this family, I walked in, and they were like, we need more sheets.  This poor baby has peed through his diaper every single time the last four times, and I was like, okay, how about we talk about diapering?  There’s probably some things we can do better so that there isn’t a leak next time.  And sure enough, a couple little adjustments and he was like, oh my gosh, I never even thought about that.  And then they never called for more sheets after that.  There’s lots of little tips and tricks, and this is where social media is both wonderful and overwhelming.  There are – I mean, myself included, I have little videos on YouTube of how to diaper, how to swaddle, how to bathe, how to do those things.  But so do a million other people.  There’s a lot of information out there.  And it can be overwhelming.  You don’t know who’s right or who’s wrong.  And to be honest, with most of these things, there’s not necessarily a wrong way.  I mean, there are a couple wrong things.  Like, don’t ever leave your baby alone in the bathtub.  That would be wrong.  But there’s swaddle baths and there’s submersion baths and there’s different types of bathing, different ways of doing it.  One isn’t necessarily better than the other in general, but one might be better than the other for you and your baby.  Some babies have preferences.  It sounds odd to say; I think people don’t realize it.  Those babies have that personality before they even come out.

Right, and twins can even be so different from each other.

Absolutely, 1000%.  And it cracks me up; even the babies in the NICU.  The preemies that are born at 28 weeks, they already have personality.  Where I think it’s helpful to have someone be there with you and be hands on with you is that we can go through all the different options.  Like, okay, let’s try this, this time.  And if the baby didn’t seem to like it, all right, let’s tweak it and try it this way next time.  And really help narrow down what’s going to work best for your family, your baby, your sanity, all that stuff as a new parent.

And some people as you mentioned – you know, you have all of these YouTube demonstration videos, but some people need the hands-on learning.  Every individual has a different learning style, so having someone in home to help can be beneficial.  Others need more written instructions or watching a video is great for them, and they can figure out swaddling or baby wearing or feeding questions and so on.

I agree.  I do think hands-on still is beneficial for everybody at some point.  And also people, I think, don’t take into account that it’s different when it’s your own baby.  I had another couple, and they – this was in the hospital.  They had had their baby, and the wife says, oh, we’re not really going to need you.  I’ve been a caregiver forever, and my husband – whatever, he was a nanny.  And I’m like, oh, well, that’s great!  Those people called me every 15 minutes.  They were like, did we do it right?  Does this look okay?  She doesn’t seem to like it.  So you can have knowledge before you go into the situation, but it’s so, so different having the actual baby there, having to touch, hold, handle.  Some of the videos I have up on my YouTube channel is how to pick up the baby.  I’ve had dads going, I don’t really know how to hold it.  How do I grab it?  How do I pick it up out of the bassinet?  There’s just so many things you don’t really think about and aren’t real until the baby is actually there and you’re trying to maneuver it and you’re so afraid because they just seem so tiny and fragile.

Right.  I’m interested to hear – it sounds like you made videos based on what your clients were asking for help with.  What are the top questions or concerns that you’re hearing from new parents?

It’s definitely the picking up, holding, swaddling.  Those are big ones.  Diapering, of course.  Feeding is a big issue.  I don’t really have a video up yet on feeding, but a big issue that we have is some babies take longer to what we call transition, so to get used to being out of the womb and being out here in the regular world.  Some take longer than others, and the ones that take longer tend to not eat very well, or they’re very sleepy and they don’t latch very well, and parents get very panicked, which I understand.  A lot of it is just kind of reminding parents that there is a transition period.  Every baby is different.  Your baby might just take a little bit longer to transition.  Here’s what we can do in the meanwhile.  And other babies that maybe have to have formula for some reason or their parents can’t breastfeed or don’t want to breastfeed – there are certain ways of feeding, of holding the bottle, that are better than others for certain babies in certain situations.  So we’re going to get some feeding ones up.  I also had a client call me once.  Her baby had been discharged from the NICU two weeks prior, so we thought everything was going great, and she called me one day, and she’s like, oh, my gosh, he was eating great, and now he’s not eating at all.  What do I do?  And I said, I’ll be right there.  And I came over and we fixed it within ten minutes.  It just was the wrong sized nipples.  So there are different sized nipples and different flow rates, and those need to be adjusted for different babies at different times.  And so there’s just a lot of that kind of stuff that it’s hard to know when, and you can read as much as you want about it, but until you experience it, you don’t really fully understand what you’re looking for, what to watch out, kind of some of those signs.

I love it, yeah.  Every baby is so unique.  There is no manual that will be the perfect solution for every question.

Exactly.  If I can mention one other thing, it’s this kind of soap box I jump on all the time with swaddling.  Everybody likes to swaddle.  They put the babies arms down next to their sides, and they swaddle the baby.  Well, some babies hate that.  They break out of that so easily.  So I ask all my mamas, when you had your ultrasounds, did your baby ever have one or both hands up near their face?  And sure enough, they’re like, yes, she always had her right hand up, and I’m like, then let’s swaddle her with her right hand up.  If you think about it, this baby has had access to her right hand her whole entire life, her whole nine months or whatever.  And now we’re taking that away from her.  She’s in a new environment.  She’s cold.  It’s loud.  It’s bright.  And we’re taking away the one thing that soothes her and comforts her, which is being able to have her right hand up near her face, sucking on her thumb or just touching her face or whatever.

It makes perfect sense.

You can swaddle your baby with one or both hands out and still have it be a very tight, efficient swaddle.

And now there are so many different types of swaddles.  Some have the arms up, like Love to Dream, and others are more the traditional with arms down. 

Yeah.  And some babies like the arms down, and that’s okay, too.  But again, it’s all about figuring out what’s best for your baby.  And as new parents, I don’t know if you remember, but our biggest fear is that the baby is going to cry.  We think that crying means we’re doing something wrong.  And it can mean that, but it also – that’s how they communicate.  So sometimes we need for them to cry so that we know what’s going on and what they need.  But parents in the hospital when they first have the babies are just so afraid to hear their baby cry.  They think that they’re failing the baby.  They think that they’re failing parenthood.  A lot of it is just like, hold on a second.  Let’s take a deep breath.  We’re going to be okay.  And let’s take a moment and figure it out.

Perfect.  Yes, because babies can sense if you’re anxious or upset, so then they become more distraught and will cry more.  So if you take that moment and pause and breathe and relax, it can be better for everyone.

I am a huge, huge, huge proponent of energies.  The Dog Whisperer is one of my favorite shows, and what he always says, right: it’s not the dog’s problem, it’s the owner.  The owner is uptight.  The owner is anxious.  It is the exact same with our babies.  If we are anxious and uptight, our baby is going to be on edge.  If we are calm, our baby will be more calm.  It’s easy to say, of course, but as a new parent, it’s hard to find that center, to find that calm place when you don’t know what you’re doing and you’re panicking and you’re trying to hurry and fix something but you don’t really know what you’re doing.  So, yes.  Deep breaths, take a deep breath before you go over to the baby, and then finding the people that can help you.  Finding the resources, finding whether it’s a company like me, a doula, or just a family member or a friend.  But finding someone that can also kind of help center you and remind you to breathe.  That’s a big deal.

It is.  Absolutely.  So let’s transition to social media and how that affects parenthood.

Okay.  So I mentioned earlier, it’s both good and bad.  I think there’s a lot of good information, but there’s also just a lot of extraneous information that just gets overwhelming.  I had a client who bought five different bathtubs for her baby, because she’s like, number one, everything that I saw on social media had some reason why that was the one I needed to buy, and she was like, I’m afraid of getting the wrong one, and I’m going to make sure I have them all.  Well, she also kind of got herself into a panic over a bathtub.  So I’m all for doing your research; that’s fine.  But your baby doesn’t need five bathtubs.  We can probably start with one, and that should be fine for a while.  So there’s kind of this pressure, maybe, on parents before the baby comes to have all the latest gadgets and make sure that they have every single piece of supply or equipment that they might possibly need.  The Snoo; the Snoo is wonderful.  If you don’t know what the Snoo is, it’s a bassinet that kind of vibrates based on the baby – the activity of the baby.  So if the baby cries more, the Snoo will actually vibrate faster.  And we use it in the hospital a lot for babies that are going through withdrawal.  But some parents have it, as well.  It is very, very expensive.  It is thousands of dollars.

It’s even expensive to rent, because they do have rentals.

Yes.  But some parents are like, oh, I’ve got to have a Snoo.  What if my baby is fussy?  I need to have the swing; I have to have the – you don’t have to have everything right off the bat.  It’s okay to start with just the baby, and let’s see how it goes from there.  You might have a really chill baby that doesn’t need any swinging at all whatsoever.  I also show my parents all the time, as soon as you get your baby in the car seat, buckled in the car seat, swing the car seat a couple times, and a lot of times that calms them.  Most babies hate being put into the car seat, but kind of swing the car seat back and forth just a couple times.  That tends to calm them down enough so that you now are not dealing with a screaming baby.  So your baby might just need that.  And you might not even need the swings and the Snoo and all the other gadgets.  I think there’s an overwhelming aspect on social media regarding gadgets and supplies and equipment for babies.

Exactly, and what works for your friend might not work for you.

Exactly.  Exactly.  Or like you said, even your first baby might be different from your second baby.  Or Twin A might be different from Twin B.  You just never know.  The place where – let me talk about the good of social media.  There is a movement – it’s still kind of grassroots, but there is a movement towards postpartum mental health being much more important and talked about than it is currently, and for that, I love, love, love social media.  There are some phenomenal people to follow, pages to follow, and trauma – with birth trauma, as well, Birth Trauma Mama is one of my favorites.  And there’s so much support there for women who have gone through a delivery that didn’t go as expected or are experiencing postpartum depression, baby blues, how to tell the difference between the two.  There’s also more evidence showing that dads are going through postpartum depression at a rate that we didn’t realize before.  It’s not a huge, really high incidence, but the fact that it’s even out there is something a lot of people weren’t aware of at all.  I think social media is fantastic for finding support for whatever your particular situation is.

Yes.  And I do love the vulnerability in the current social media movement.  More authentic, like showing a messy house and kids being happy and the joy of parenting versus having to have the Pinterest and Instagram perfect life.  I definitely agree with everything you said about just people being open about their struggles and that making it easier for others.

Yes.  Absolutely, 1000%.  That’s definitely the good side of social media, for sure.

Yes.  And I would say the negative or confusing side of social media is getting into some of the mom and parenting groups on sites like Facebook where if that’s the only information source, you could be given incorrect information, bad advice from other moms who are not experts like yourself. 

Right.  And that’s a very good point.  Consider the source.  Any time you see anything anywhere, consider the source.  If it’s just, this is my first kid and so I’m writing articles on how to raise your kid the best way ever, that might not be a completely reliable source.  Make sure you’re looking – and it’s okay to read those things, but also fill in with articles from pediatricians.  Fill in with articles from RNs, from doulas, from people who have education, like formal education and experiences and licensing in those areas so that you can, like you said, see what’s real, what’s not real, what’s safe, what’s unsafe.  I haven’t, luckily, seen too much out there that’s completely unsafe, but it only takes one.  It only takes one person to give bad advice to have something really bad happen to your baby.  So definitely something we want to be aware of.

Exactly.  So how can our listeners connect with and find you?

We can be found online at babystepsnursing.com.  We are getting our YouTube channel all up and running there.  We have some article resources on there.  There’s an inquiry tab if you ever have any questions about either our services or just something related to baby.  You know, we’re more than happy to answer any questions that you have.  So those are kind of the best ways.  We are also on Instagram @babystepsnursing.  I’ve been posting some of the YouTube videos up there lately.

I’ve seen those, yes.

Okay.  We try to be very down to earth.  This is not a formal – you don’t have to have a degree to understand these videos.  These are for everyone to hear, for everyone to follow, and if you have any suggestions or if anyone wants videos on more topics, we’re more than happy to do more of those.  So yeah, those are kind of the best ways to get ahold of us.

And your location geographically for listeners who do want that in person support?

We are in the Los Angeles area, but we can travel pretty far.  I would say LA to San Diego for the most part.

That is a far distance, yeah.

It is a far distance, but there’s not a lot of services out there like ours, to be honest, that we have found.  So we want to help as many people as we can, and to be honest, we do work with the LGBTQ community and with surrogates, and I have some dads who are going to be having triplets.  They weren’t expecting triplets, but they’re getting triplets.

So they’re getting help; good!

They’re getting help because they have to transport these babies.  The babies are going to be born in South Dakota, but the dads live here and are like, there’s only two of us.  We need to transport three babies.  Can we get anyone to help travel?  Yes, absolutely, we can do that.  So we can help technically across the country.  We also can do a lot via Zoom.  Obviously, the hands on stuff can’t be done via Zoom, but we can always have conversations if you just have a quick question.  We can talk about some preliminary things before you go to the hospital.   A lot of that can be done via Zoom so therefore can be kind of anywhere in the country, as well.

Beautiful.  What an amazing service.  Any final tips for our listeners?

Oh, my biggest tip is always build your village or find your village.  Make sure that you know who you can reach out to for different things.  We all have friends that have various roles in our lives, and that’s going to continue into parenthood.  So make sure you have the friend that you can call and vent to without feeling like a horrible person, because you’re going to have a day where you’re going to be like, I don’t think I can do this parenting thing.  Find the friend that will make you laugh because laughing will take you so far in parenting.  Find the friend that has the resources that did it before you, that says, oh, you know what, when my baby had trouble eating, we used this bottle, and it worked for me.  Maybe you should try that one.  Just make sure you have people around you that can support you and that you are comfortable reaching out to because that’s the important part.  So many times, we’re just plowing through.  We’re just putting one foot in front of the other, trying to get through the day, maybe just trying to get through the hour.  But we have to be aware enough to ask for help if we need it, and having a list of people at top of mind or written down next to your phone so that you don’t have to think about it.  You can just look down that list and be like, oh, my gosh, yes, I need to call my mother or I need to call my neighbor.  It can really, really be helpful for stressful times.  I would say the biggest tip is find your village, build your village, yeah.  Find your resources.

Excellent advice.  I loved having you on Ask the Doulas, Danika.  Thank you for sharing all of your tips and wisdom with our listeners.

Thank you for having me on!  This was great!

IMPORTANT LINKS

Baby Steps Concierge Nursing

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Kristin Revere chats with Bianca Sprague of Bebo Mia about the rising need for doulas and how their care transforms family experiences.

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with Bianca Sprague today.  Bianca is a passionate educator and advocate in the doula community, focusing her expertise on supporting women and queer individuals in the fields of fertility, birth, and postpartum care.  As a self-identified super lesbian and a dedicated mother, Bianca brings a unique perspective to her work, emphasizing the importance of balancing professional doula responsibilities with personal life, especially for mothers.  She is deeply committed to addressing issues like queer care, combatting fatphobia in medicine, and exploring women’s rage and its implications.

Welcome, Bianca!

Thank you so much for having me.  I’m really happy to be on the show.

Yeah, I can’t wait to dive into this important topic.  We’re going to be chatting about exploring the rising need for doulas and how their care transforms family experience.

I have a lot to say on this topic!

Let’s start with a bit more about your background, and then we’ll get into exploring the topic.

Yeah, so I came into doula – I mean, I would say most people come into doula work because they either had a really incredible birth experience and they want to make sure everybody has that, or they have a terrible or traumatic birth experience and they want to make sure nobody has that.  And I sat – out of all the statistics, I sat somewhere in the middle.  So my plan was actually to be an OB-GYN, and it wasn’t until the birth of my daughter that I realized the relationship I wanted to have to birth was way more the relationship my doula had, versus my doctor.  And I actually could very clearly identify that I was not prepared to perpetuate the harm that comes from a system that is designed to have us not trust our bodies.  I mean, if we look at the stats for birth outcomes in Canada and the US, our medical system is not looking so good.  I remember pacing after my birth – like, I’m bouncing.  You guys can’t see me, but I’ve got that newborn bounce with the hands on the chest.

It never goes away.

It never goes away.  And I remember pacing with my daughter.  She was days old, and I was like, what just happened to me?  I had the birth that I wanted, but I didn’t have it where I wanted it.  I was in a hospital suite, and I really wanted a homebirth.  And I was like, that was way too hard for me to have an uninterrupted experience.  I felt a lot of rage around it.  I felt cheated and robbed.  And I knew that I didn’t want anyone to feel like how I felt.  I also was in an unsafe living situation, so I very quickly – you know, once you become a dependent with a dependent in a cycle of abuse, I was like, I’ve got to get out of here, and I need to change the world, and I need to protect birth.  And so I started my doula organization, and so that was about 16 years ago.  Now, we train birth workers and folks who work in fertility, birth, and the postpartum period.  And then I think as of right now, we’re in 49 countries, which is pretty wild.

That is amazing!  So much growth!  Tell us a bit about your training organization.  I know some of our doulas have gone through your program.

Yeah, so my organization is called Bebo Mia.  You can find us at bebomia.com.  My experiences as a parent have caused me to want to go into doula work, and then the experience I had with my doula training, which at the time, I loved, but it wasn’t until I went to my first birth that I was like, oh, I’m wildly unprepared because you can’t learn everything you need to know in a weekend.  Then I started building a community where we were building a training together of all the things we’d wished we had.  That’s really how Bebo Mia came to be.  We used to teach in Toronto, and then we had so much – you know, there was a lot of requests from people who lived outside of Toronto.  We moved exclusively online in 2012, so we’ve been teaching in the digital space for a while.  We really want people to come out and go into the field of doula work feeling really supported, understanding how to run their business, understanding feminist values, and having them and their family ready for the type of work they’re going to do.  Tying into the question that we’re talking about today about the rising need for doulas, there’s something particularly magical about doula work.  It’s a cycle.  And so doulas protect birthing and new families, and the work of being a doula also is really healing for the doula and their families because you get to be that voice you didn’t have, or you get to reconnect to that feeling of empowerment that you did have if you were supported in your birth.  So I would say being a doula – not only have I protected hundreds and hundreds – no, thousands of families over the almost 20 years, I also became a better parent and a better partner and a better human and had a better relationship with myself.

Beautiful.  And I feel like your program is one of the first in the fertility space.  There are a lot more fertility doula trainings, but you were early on seeing that important need.

Yeah, I mean, anybody here listening – how you got pregnant impacts how you feel about your pregnancy, which impacts how you experience your parenting journey.  I mean, we know – recently, you had somebody coming on talking about their IVF journey and the risks of postpartum depression.  We see this.  We can’t break up, which is why in our training, every person leaves certified as a fertility, birth, and postpartum doula because it is one journey.  It’s not like you can just look at any one part of it in a vacuum.  So that’s something that we’re really proud of to have that.  We also were the first to remove gendered language of the training organizations.  We were the first to adopt an anti-racist, anti-oppression policy.  And we are the first and only to include therapy for all of our students and alumni so that we send healed healers out into the world rather than folks who have their traumas activated or just reliving it in a cycle with their clients.

Changing the system, and not only the work as a doula, but training future doulas to better support families.  I do feel like – I’ve been a doula over 10 years, and certainly, there’s so much more awareness about birth doulas.  Postpartum doula interest is rising, and awareness is becoming more common.  I felt like people knew about postpartum doulas in urban cities like New York and Chicago, but in Grand Rapids, Michigan, I had to do so much education in the past.

Yeah, I bet.

It is exciting that doulas are getting a lot of national publicity and the field is growing with more and more people.  I’m sure you’re seeing through your training program that people want to consider doulas as a profession.

Actually, the market research is very promising.  I look at it as promising because it means lots of folks are interested in becoming doulas, which I love because I want to train really amazing, grounded, healed doulas.  But it also – I get really excited that it’s expected to double over the next ten years, the market.  But more importantly – I mean, I love that I’ll have students, but my main focus is to have the field of reproductive health protected and have it be a place of safety and joy rather than a place of survival and trauma and the goal of just surviving.  I’m very excited to see how many families are reaching out to inquire about doula support, especially postpartum, which is on the rise.  Anybody that loves squishy babies, there’s definitely a need for you to go out and help parents.  It is really exciting to see how many more families are inquiring about doula services, as well as how many more states are really increasing their awareness and insurance programs for doulas.  As a field for both people who want to work as doulas as well as families who want doula care, it’s looking really, really great.  I’m excited.

I am, as well.  And Medicaid has expanded for birth doula support in many states, including Michigan this past year.  That certainly makes a difference.  And then programs like Carrot Fertility covering both birth and postpartum has been a real breakthrough.

Yeah, there are some good things on the horizon.  Check out what’s available locally.  There’s also lots of doulas who have really cool programs that they support under-resourced families.  So if you are a low or no income family, you should check out your local doulas and see what they have, what kind of programs.  We have a program, as well, where we have scholarships, so if anybody’s interested in becoming a doula who’s under-resourced, you can head over to bebomia.com/scholarships, and you can find out all about that.  We don’t want any barriers to folks accessing doula care or becoming doulas.

Love it.  So Bianca, for our listeners who are not familiar with doula support, whether it’s birth doulas, postpartum doulas, share with us a bit about how doulas can transform your pregnancy, birth, and postnatal journey.

What a good question!  So doula care comes down to supporting through the three pillars of physical, informational, and emotional support.  And so if you ask most doulas, they’d say they support birth or parenting or the trying to conceive journey.  But what I think is the best part of doula care is that it really allows parents to have that pause and to feel like they are making informed choices throughout their reproductive health journey.  And so unfortunately, what’s happening in our current system is there’s a real – this goal of risk management.  And so we have all these really wonderful obstetric tools that are there if we need to jump in and save somebody.  So I like to think of the medical system like a lifeguard, if it’s functioning properly.  If you were out swimming, in a crisis, the lifeguard would run into the water and help you.  But otherwise, they let you swim because you’re doing your thing.  And so these tools are available, but just like if every lifeguard jumped in and grabbed your arms and legs and tried to do the motion of swimming with you, we’re going to run into more issues than if they just let people swim and jump in if there’s a crisis.  And so we have these tools – so I don’t want anybody listening to think any one of the tools have any judgment associated to them.  All of the tools we have save birthers and they save babies and they’re wonderful.  What happens, though, is we have this practice-based care rather than evidence-based care, and so when we go into our hospitals or our birth centers, all the tools just come at us.  And typically, without consent because this belief is, if we use all these life-saving tools all the time, this will make it extra good.  It’s like when kids are like, well, if one piece of cake is great, I bet five is really great, and it’s not.  We’re actually seeing a decline in outcomes when we use all the tools, and it’s not recommended by ACOG or the SOGC, and those are the governing bodies for Canada and the US for obstetrics, or the World Health Organization.  Everyone is saying, doctors, stop doing this.  We need somebody in that room with clients saying, doctors, stop doing this, and literally, like, stopping it if the client is not being listened to.  So it’s really about protecting our clients, whether we’re doing an egg retrieval or we’re going in for an induction or we’re at home and trying to decide where baby should eat or where they would sleep or how they would eat.  You really want somebody there that’s going to help you navigate through the actual research around the topic you’re struggling with, as well as giving you the space to use your intuition because you do know what you want and you don’t want, even if you’re not sure why.  You have this leaning towards one of the options.  Your body does know.  We want parents to feel really empowered and to trust that they know how to make the right decision, and if they get to have that protected in birth, they have that reinforced, that they’re ready to be parents.  And they go into parenting feeling really empowered and knowing that they know what is best for their baby and their family, rather than having the complication of noise around them.

Exactly, yes.  And I feel like there’s so much importance in that preparation during pregnancy, whether it’s taking a childbirth class, understanding your options, getting resources from your doula, like a prenatal yoga class or a therapist.  Really feeling like birth isn’t just happening to you, like you have this education and support team behind you.

Oh, that exactly.  We really want birth to be happening through you and not to you.  I love when my clients at the end of the birth, no matter how it went – we’re also open to having that pivot, like, I really hope it’s going to look like this, but I’m prepared if it’s going to look like this or this or this.  And so even if they don’t get their first choice, my clients, like 95% of the time at the end are looking up at me like, this is exactly – like, this was right.  This felt great because they chose it and they felt really present and that they got to say no when something was a no, and they got to say yes when it was a yes.

And certainly a doula’s presence in that postnatal phase.  If they’re not seeing their provider for six weeks and they have questions, we have that follow-up visit, or sometimes depending on the doula, multiple visits and check-ins and just knowing that you have someone that you can reach out to if you’re struggling with feeding and need a lactation consultant.  Or if you need to know if your hormone fluctuations are normal, for example. 

Yeah.  I mean, your doula is really this combination best friend and walking Wikipedia in your pocket at all times.  Whatever your questions are, you have that support.  We’ve lost that experience of the village and those intergenerational relationships within families.  That’s been severed.  That’s been severed.  Thank you, patriarchy, for rearing your ugly head yet again.  We have to pivot and we have to create something that is going to create the best outcomes for families, working with what we’re working with.  And a doula can really fill a lot of those gaps that have been left by the shift of how we’re birthing in this really isolated way, and then we go home into the postpartum in a really isolated way.  And one of my favorite parts of postpartum doulas – I think it’s the particularly magic element of postpartum work is that there’s so much focus on the baby after the baby is born.  It’s all about the pregnant person during the pregnancy, and then it’s like they’re forgotten, and they really should be centered because if they are well and centered and nurtured and taken care of, they can do a really great job with the baby.  Between the combination of kind of being an afterthought or being an extreme afterthought, as well as the fact that everybody feels like they are entitled to comment or recommend once you have your baby, it creates this really interesting place of isolation and suffering for parents because they have to keep explaining that they’re not spoiling their baby or they’ve chosen to – whatever, keep the foreskin intact or they’re having the baby sleep in their bedroom or not in their bedroom.  Like, all the myriad of choices that parents get to make for their children, they’re always questioned and challenged.  And a postpartum doula might be the first person that that parent has been listened to with no judgment and they don’t have to defend their choices.  I know when I do postpartum work – I mean, I haven’t done it in a few years because I’m mostly teaching, but to just watch people stare at me, waiting to defend themselves.  They’ll be like, so I think I’m going to start just pumping, and I just don’t – I just don’t think it’s working, and, you know, I know that, like, if I pump, they’ll still get milk from my body – and they’re just going so fast.  And I stop, and I’m like, if you want to pump, that’s fine.  Do you need help cleaning your pump?  Do you know how to use it?  And to watch their shoulders drop of, like, I don’t have to defend myself, and this isn’t wrong.  I’m like, great.  Do you want to talk about why you’ve chosen pumping?  Tell me about it.  Otherwise, let’s get you set up and get you some more water and we’ll talk about what a pumping schedule can look like.  And to see that they’re like, you’re not going to make me explain myself or tell me why it’s bad.  And I’m like, are there any other changes you’re thinking about for feeding your baby?  Tell me about those.  And just watching, and they’re like, wait, what is happening?  Everybody has something to say about what I’m doing and if it’s the best thing and if I’m a good parent.  And a postpartum doula salt of the earth, like, just going in and letting new parents know that whatever they’ve chosen is perfect, and they don’t have to do that dance of defending why they’re parenting the way they are.

Exactly.  It’s such a good description of the work that we do postpartum.  Even looking at moms’ groups and all of the judgement if somebody is posting a question, let alone family or friends giving advice.

It gets real – I don’t even go in parenting groups.  Sometimes I’m like, oh, I should see what parents are talking about when it comes to sleep because I’m on this nurtured sleep revolution where I’m really trying to talk about sleep in a different way, and I’ll stick my head in, and it is terrible in there.

It is.

It’s terrible.  People start with the most harmless question, and then by the end of it, how did we tie this back to these deep rooted valued and judgments when all they wanted to know is, is this car seat – I don’t know, do you like the color of my new car seat?  At the end, they’ve been told they’re a bad parent in 14 different ways.  Oh, man, it’s pretty wild.  But I mean, we do see really, really magical statistics around parents who have the opportunity to have doula support.  There’s actually pages and pages and pages of studies showing just the improvement in birth outcomes as well as in parenting outcomes around mental health, the ability to feed from their body if that’s what somebody’s choosing to do.  Like, there’s so many really great things.  And we actually, over 2020 – I don’t know if everyone remembers how wacky the world got.  And we actually had a really unique environment where we got to – you know, there was lots of areas of research that came out because when else have we ever had in modern history these really bizarre circumstances where the world was shut down and medical had shifted?  We have really great research from this.  And we had the opportunity to see what happens when care providers have no witnesses.  And yes, I’m using that language very intentionally.  What happens when doulas are not allowed in the birth space?  What happens if for a certain period of time when even partners or family members were not allowed in the birth space?  What happens when people went into those birthing suites with the doors closed and they were left alone with doctors?  And so we have this – I think they did it over 14 months, and the maternal and fetal outcomes were abhorrent.  And when we look at mortality, morbidity, and stillbirth and depression – it was so bad.  And so I found this fascinating.  I mean, I was devastated to see how many birthers for those 14 months had to experience birth in these ways and then go into their parenting journey after these extremely terrible – after the environment was so not conducive to joy and protection and empowerment.  But it was a huge wakeup call for folks that do want to protect birth and for parents.  So we’ve actually seen a huge rise of parents being like, oh, hell, no, when they’re going into their birth again, if they did have a birth or they heard about births over the pandemic.  So from this terrible experience, we are seeing this rise for people wanting doulas, for people demanding more from their hospitals, for the ability for – this was one of the major turning points for insurance being – there’s been a fast track for insurance policies in so many states.  Tricare stood up and listened and they’ve improved their care.  Everybody was like, oh, man, we actually can’t trust the medical system as far as reproductive healthcare.  So really great things came from this, but it was very stark.  The outcomes plummeted over that time, and it was purely because we didn’t have witnesses and protectors in the space.

I’m so thankful that doulas were considered essential in Michigan due to our governor, and most hospitals followed suit.  As long as a doula was certified, they were able to go through the process and support.  So I had very few clients that I wasn’t able to support during the early pandemic.

That’s amazing.  It was not great in Canada, the lockdowns, so I managed because I know the midwives really well.  I was doing homebirths and still allowed, but doulas weren’t even allowed to be present at homebirths.

Devastating.

Oh, it was, like, 18 months.  And there were some hospitals that literally no one could come to the hospital, and no one was allowed in for birth or postpartum.  I think especially in Ottawa, they had it for the longest, but I believe it was almost – don’t quote me on this, anybody, but I believe it was about 60 days where it was no contact, that people birthed alone, alone, and went to the postpartum floor alone, alone.  Like, nobody went into their rooms.

That is just – I mean, devastating overall, for the partner, for the doulas, for the nurses who are obviously overwhelmed when they don’t have doulas supporting in the hospitals.  Wow.

Yeah, it was bad.  There was a time where they actually got pretty dragged, but they weren’t even allowing folks to Facetime or Skype.  Oh, man.  I can’t believe the babies – like, I hope we do some really great community care for these parents, which can still happen even years later, just to really protect and reconnect and do some healing around that because these circumstances were just really not ideal for all these families to be growing and feeling really confident in their ability to parent and to trust themselves and know that they feel safe.  There’s a lot of aftercare that will need to be done for this.

I totally agree, and as you mentioned, the positive aspects of all of that is that we have some good research for the value and benefit to doula support and the need for support in general, partners being there and the importance they make.

Oh, for sure.  You know, birthing, you require the people that make you feel the most safe around you.  We need the environment that really lets that oxytocin flow.  That’s that love hormone.  And you want to just feel safe and relaxed and have that ability to let go and trust your body as much as you can in labor, and the conditions of a cold room with all the lights on and not your people that you love the most around you?  It’s not the best environment for you to feel really safe and relaxed and to let those hormones and those muscle groups do what they need to do.  We always say as doulas that we want people birthing in similar circumstances to how they would probably have sex.  No, I know not everybody likes a dark room, and some people are a little more interested in something zanier, but most people have a certain circumstance that involves privacy and intimacy and security and the ability to feel comfortable and vulnerable, and so we really want to try to recreate that as much as possible, even if you are birthing in the hospital.  We can do that with lighting and music and candles and different scents, if that appeals to you and your hospital says okay.  And then your people: people that keep you safe and they’re cheerleading and protecting you and creating this bubble of safety for you.

Yes.  So any final tips for our listeners, Bianca?

Well, if you are not sure about doula care, I would highly recommend checking out some of the research because some of the things that you might be the most worried about – like, you might be worried about an episiotomy, or you might be worried about if you’re going to be able to feed from your body or not, or worried about a postpartum mood disorder or a C-section or an operative birth or a belly birth, whatever term feels the best for you.  If any of these are your worries, doulas are the fixes for them.  And so you can check out some of the research there.  You can literally just Google “benefit of a doula” and there will be journal after journal after journal.  And if you are curious about becoming a birth worker, we’ve put together a page for you that you can check out at bebomia.com/ask.  And there’s a code there, too, if you want to find out more about our classes and services, and it’s ASK15, and you’ll get 15% off of everything.

Love it!  And you’re also on quite a few social media networks, if you’d like to share those, Bianca.

Yeah, sure.  You can find us at – you know, pick your channel, and it’s /bebomiainc.  And you can check us out.  Our TikTok is just growing, so it’s not the best place, but our Instagram is awesome, and we have lots happening over on Facebook and on YouTube, so you can hang out with us there in all of those places.

Love it.  Well, thank you so much for spending time with us today and sharing all of the great need items for both birth, postpartum, as well as fertility doulas.

Thank you so much for having me, Kristin.  I really love your podcast, and I love everything you guys are doing.

I feel the same way about you!  Thank you so much, Bianca.

IMPORTANT LINKS

Bebo Mia

Birth and postpartum support from Gold Coast Doulas

Becoming a Mother class

Kristin Revere offers tips on ways to plan and prep for childbirth if you don’t have the time or funds to take a childbirth education class.  Some ideas include: YouTube videos, listening to podcasts, reading books or blogs, downloading meditation or pregnancy apps, Pinterest, and more.    

Hello, hello!   This is Kristin Revere with Ask the Doulas, and I am excited to share a solo episode today, all about childbirth prep when you don’t want to take a class or don’t have time to take a class.  So before we dive into that, I would love to give those you who don’t personally know me a bit about my background.

I have been teaching childbirth classes since right after my son was born in 2012 and became a doula shortly after that.  I am a certified elite birth doula as well as a certified elite postpartum doula and infant care specialist.  I am a newborn care specialist trained through Newborn Care Solutions, and I’m also a transformational birth coach through Birth Coach Method.  I love educating my clients and my students.  I teach a virtual as well as in person Comfort Measures for Labor class.  But not all of my doula clients have the time or extra funds or interest in taking a childbirth prep class.   So I wanted to chare some resources that I give my clients with those of you who are in a similar position.

My number one tip is to look into books.  There are so many great books on everything from feeding your baby to newborn care to childbirth preparation.  We offer HypnoBirthing at Gold Coast Doulas, and there is an amazing HypnoBirthing: The Mongan Method by Maria Mongan that you can certainly either check out from the library or get a printed copy from a bookstore, or even get an audio book for many of the books I’ll be recommending, depending on if they’re in that format.

Natural Hospital Birth; Ina May Gaskin has a variety of books.  You can look into spending some time reading and even having your partner read.  The Birth Partner is an example of an excellent book to read with your partner.

We have a book coming out, but it won’t be available until later this year, so stay tuned for more info on that!

Podcasts are excellent.  Of course, I love our own Ask the Doulas Podcast, where we interview experts in the birth and baby space, our own doulas, our own clients, and our own HypnoBirthing students.  You can get birth stories in past episodes and stories from students of our HypnoBirthing course and other classes that we teach.  If that is inspiring to you, The Birth Hour is great with birth stories, and you can look into Evidence-Based Birth.  They have a podcast.  There are just so many great ones.  So choose one that works for your schedule.

YouTube is also amazing.  You can learn everything from a hip squeeze to paced bottle feeding to information about how to use a baby carrier and info about all the baby gear questions you have.  You can pretty much learn anything on YouTube.  Gold Coast has an awesome YouTube channel, so check that out.

You can also look at articles and read anything from blogs to subscribing to a parenting magazine or just read articles in a bookstore related to parenting.

There are so many different ways that you can get information that can be free, from online articles, or certainly paid.  And Gold Coast has a blog on our website that has everything from expert guests who contribute blogs; we have each of our podcasts transcribed into blog posts, to our own blogs that we write.

You can look into documentaries related to childbirth.  One of my favorite streaming sites is Informed Pregnancy+.  They have everything from The Business of Being Born to information about different feeding options and loss and maternal mortality rates.  Definitely check out some documentaries related to issues that you want to become more educated on.

Another option is Pinterest.  Pinterest can be great for planning a baby shower, setting up your nursery, figuring out what to pack in your hospital bag, coming up with a birth plan.  Those are some things that a childbirth class might cover, like birth plans and packing your bag, some of that postnatal preparation, information about breastfeeding and resources.  Gold Coast has an amazing Pinterest page with a lot of awesome resources for you to check out.  I often send my clients some of that information, as well.

Another thing that you can do: it may have a fee with it, or some of these apps are free, but you can download anything from a contraction timer app that you would be able to figure out when it’s time to go to the hospital based on the frequency of your contractions.  I don’t have a favorite, but any contraction timer, I would recommend and use.  Looking at apps like Expectful could be a great one, or even looking into some guided meditation related apps to doing things similar to what you’d learn in Gentle Birth.  I know they have an app, or in HypnoBirthing, with some of that calm breathing and guided meditations.  That can be very helpful because, as I say, and I feel like I can’t say it enough, birth is as mental as it is physical.  It is helpful to prepare in many ways, and also get your partner on board.  You can send your partner articles or have your partner listen to a podcast about how partners can be supportive with newborn care, or the partner role during birth and so on.

Again, so many different options.  Sometimes that childbirth class comes at a time where your due date is too soon and the class is offered weeks before and so it doesn’t work out.  I know at Gold Coast, we offer some self-paced classes, like our Becoming a Mother birth and baby prep course, as well as some different options for just thinking about a private class or something that doesn’t have to be as planned.  It could be an individual class if having a group is intimidating to you.

Depending on where you live and what options you have in your area, you might have more childbirth ed examples and options than you previously thought.

Again, it’s all about knowing your options.  If you don’t know them, then you don’t have any.  So just a few of my top of mind tips, and I hope that can be helpful.  I would love to hear from any of my listeners and doula clients about things that you’ve done that I may not have mentioned as far as prepping for your upcoming birth.

 

IMPORTANT LINKS

Birth and postpartum doula support from Gold Coast Doulas

Becoming a Mother course

Comfort Measures for Labor course

Gold Coast Doulas blog

Our Pinterest

Our YouTube channel

Kristin Revere chats with Endira Davis of Gold Coast Doulas about everything from infant swaddling to feeding in this fun episode on newborn care.  They also discuss caring for twins and NICU babies. 

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with one of our own doulas, Endira Davis, today.  Welcome, Endira!

Hi!  I’m so glad to be here.  Thank you for having me!

I am excited to chat about caring for newborns.  You are one of our amazing elite certified postpartum doulas and infant care specialists, so you work with families through the first year at Gold Coast, but oftentimes we do get hired right after families are bringing their baby home from the hospital – or they’ve delivered at home – while they’re in those first few months, where they especially may have questions for postpartum doulas about caring for baby. 

So, Endira, let’s get into a bit about your background and why you chose to work with newborns.  You, of course, are a postpartum doula.  You’re also a nanny, and you work for a local nonprofit that supports families with volunteers helping out in the home, MomsBloom.  We actually had Carrie from MomsBloom on Ask the Doulas about a year ago.

Awesome!  Yeah, so my background – I have kind of a mix of everything.  I worked in early childhood, and I worked in more of a clinical role with midwives and OB-GYNs, and I couldn’t figure out how to mesh the two together in a way that felt like I was honoring my desires and what my journey was in work, but also offering something that’s really necessary.  And so I found doula work was like, oh, wow, I can start this journey from the beginning and kind of lean into in a way that starts the process with heart and a great foundation.  Newborns are so fun, too, and being able to create that connection with families and a process that can be really difficult and isolating has been such an honor and something I hold really close to my heart.

And newborns can be intimidating for first time parents.

Absolutely.

It is helpful to have an expert in their home to learn everything from swaddling techniques to support with any type of feeding to some basics on creating a safe and comfortable nursery.

Absolutely.  I think people see little babies and they immediately think, oh, they’re so fragile.  They’re so vulnerable.  We have to be very, very careful.  And I think that is true to a certain point.  They are fragile, and they are vulnerable, and we do have to take care of them, but also, they’re humans, and we can handle them with a sense of fragility but also, like, it’s okay.  They’re trying to figure it out, and we’re trying to figure it out, as well.  That can kind of alleviate some of the anxiety in conversation of being like, yeah, we’re just figuring this out together.  We’ve never done this before.  Let’s give ourselves some grace.

Yes, that is what it’s all about.  And certainly even those baby sounds and trying to communicate and understand what your baby needs, having a doula there, even as a reassurance during sleeping – I mean, some parents wake to every single noise the baby makes, but it’s normal for babies to grunt or make noise and self-soothe versus needing that constant touch and pick-up from the bassinet.

Yes.  Active sleep is a huge thing, and many people don’t know about it, so they are keeping themselves awake to kind of soothe a baby that is actually sleeping, but just going through the normal process of a baby who sleeps.  So being able to educate on that and then finding ways to support you so that you can sleep while your baby is doing their normal development sleeping as well.

Exactly.  And feeding is obviously a big topic, as postpartum doulas, so what are your clients asking you for support with?  Is it more breastfeeding, or do they have questions about their pump or bottles to purchase for that transition or storing pumped milk?  What questions do you get with your clients in a typical shift?

So it’s all across the board.  Every client is different, and every parent decides to feed their baby in different ways.  I would say probably the biggest thing is, am I doing this right?  Does the baby seem okay?  But I think that for the most part, it’s just watching me do things and kind of giving that extra push of like, yeah, this is – you’ve got a great thing going on.  That can be like, how do we assemble this pump?  What recommendations do you have for pumps, because this one doesn’t feel like I’m getting enough milk.  Or how can we get you more water so that your milk can increase?  Or what does your diet look like?  Bottles, if baby’s having gas or baby is colicky.  Okay, this is a bottle that I really recommend for that.  Paced feeding.

That’s a big one.

It’s a huge one, and I think there’s a lot of transitions of, like, a lot of different things work, and a lot of thing don’t work.  And so we give it an amount of time to be like, hey, is this the one for us, or is it not?  And it’s okay if it’s not, because there’s so many incredible products that we can trial and find something that works really well for you and your baby.

Exactly.  And baby gear – I’m sure you get questions about assembly, especially some of those new swaddles or even some of the bassinets.

Yes.  There are so many products.  It can actually be really overwhelming.  I have my go-to favorites, and sometimes I’m being educated by the parents.  It’s like, oh, this is a new thing that I found, and then I go home and I do my research on it, and we talk about it.  But there are so many things always coming out, and I always look for a quick YouTube video and we watch it together if I don’t know how to do it properly.  But really just learning together and leaning in with curiosity, finding baby-wearers that work really well for your body and for your baby, and finding a bassinet that can come up to your bed, if that’s what you desire, or finding a car seat that is able for you to lift well.  Things like that can be an overwhelming process, but there’s so many good things, and we’ve done a lot of research, and so we’re able to encourage you to buy things or help you decide what kind of thing you want.

I’ll never forget my first postpartum doula training.  The trainer did mention that if you can’t figure out an appliance for your client, if you need to figure out a gadget, go to YouTube.  There’s a video for everything.  Again, babywearing, as you mentioned.  You can figure it out with your client.  You don’t need to have all the answers because things change constantly, especially with technology.

Absolutely.  I will never forget when I first started nannying.  I was in the parking lot of the zoo, and I couldn’t figure out how to close the stroller.  And so I’ve got a baby that I’m holding, and I’m watching a YouTube video, and I’m trying to figure out how to close this stroller.  And years later, I was at a client last week, and we are setting her up with her baby wearer, and it’s her first time wearing this baby, and it’s such a surreal moment of, hey, I knew how to do this, and I can pass this knowledge on to you now, and you can have this really special, intimate moment with your baby.  And we don’t have to look at YouTube.  So it was a full jump ahead of learning and all the growth that comes with this work as we meet new people.

Exactly.  And we have a big team of postpartum doulas and newborn care specialists, and we’re able to – we have a messaging platform that we work with, so if a doula is not familiar with, say, the Snoo or another product, I’ve seen questions fly when they’re with a client trying to figure out a product, and our team is able to give each other advice, as well.

I think the continuity that Gold Coast has created within the doulas and the team – we’re able to really all stay on the same page and provide a level of service and care where, even if you’re not within that client, you are able to know kind of what’s going on and how we can potentially relate it to someone else and be able to support with things because you never know what’s going to pop up.  So if you’ve heard somebody else’s experience, you’re able to kind of take what you need and bring it to the next.  So that’s really helpful within the communication platform.

Exactly.  As postpartum doulas, we’re a bit different than a newborn care specialist, who’s focused on the needs of the baby and, of course, supports feeding and does a lot of overnight work which postpartum doulas do, as well.  But as postpartum doulas, what would you say the main difference is in the care that you provide?

I would say it’s caring for the parents through caring for the baby.  That would be the biggest highlight, and that can look like a number of different things.  We have clients who we don’t hold their babies at all, and we offer sibling care, and we wash bottles, and we set them up for when we go home.  And then we have other clients who we go in, and we hold the baby and they take a nap and they shower and they reset themselves to be able to feel like the human that can sometimes be lost in the early days of exhaustion and the realities of having a new baby in your family.

And one of the questions that I get asked the most when it comes to postpartum doula support is what happens if I breastfeed my baby, and how is the doula involved?  And how does that overnight work make sense for me?  The biggest part of that is we do support feeding.  We can bring baby to the parents, or we can have the mother come in to the nursery and feed and we can give suggestions.  But it does optimize their sleep, I would say.  You don’t have to do the diaper changes.  Your partner is not having to wake up and take different shifts as they’re returning back to work.  And the sleep shaping that parents do, the burping – all of that does help.  I mean, you’re still waking to feed if you’re breastfeeding or even pumping throughout the night, but it’s a different – you’re sleeping more, and your baby is also getting into some patterns and routines that are very helpful.

Yes.  Bringing in a baby to feed in the night and still being that go-to person, where you are awake and you are conscious and you are fully aware of everything that’s going on for safety – but also, the person who’s feeding is able to really just kind of be in a state of relaxation, and no, they don’t have to get out of bed.  We can bring the baby right to you and then go do the poopy diaper that’s definitely going to follow and the burping and the reswaddling and all those things.  And you’re really able to just stay in that moment of hibernation and relaxation and be taken care of.  And I think that’s so necessary and healing.  Our brains want to be productive and go-go-go.  We see dishes in the sink and diaper changes that need to be done and diapers on the floor that need to be done, and just being able to exist and be cared for is so necessary for healing and bonding and preservation of your family unit.

And you did mention sibling care.  Sometimes clients will want that time for the doula to care for the newborn and then they spend time with the other kids.  As you mentioned before, sometimes the doula is getting snacks for the other kids, and the parent wants that one on one time with baby.  Having some entertainment, some help with the household tasks and the other children can be very helpful.

That’s a huge thing.  I always set up my days when I come in.  I go in and immediately wash my hands, because that’s the number one thing you do.  But then we just have a conversation.  What are your goals for today?  How have the last couple of days been?  And that can kind of set the standard of what the time that we’re together will look like.  If the past couple of days have been difficult and siblings are needing a little extra support, that’s definitely going to be a time where mom or dad is like, hey, I need you to tap in with the baby, and we are going to go spend some one on one time.  And if it’s the opposite, then we get out a craft, and we do crafts and snack and dance parties while mom or dad goes and snuggles with baby.  It really is just a matter of the day, what have been the hours leading up to this, and how can we support you in this moment.

And there’s just so much to that after baby, postnatal time where sometimes in my time as a postpartum doula, clients would just want a friend and someone to talk to and spend time with.  If the partner goes back to work immediately, there were times where I felt like I needed to keep myself busy and do different tasks, but really, when it came down to it, I learned that my client just wanted my presence and to talk through things and to have reassurance about their role as a new parent.  And I didn’t have to do a list of tasks at each visit.  And of course, each family and each day can be very different, as you mentioned before.

Yeah.  This can be really exciting as you get into doula work to know that there’s a lot of variety in the care that we offer.  It can also be really difficult for doulas to go into a shift and have there be no requirement and they just want to hang out because you feel like, wait, I’m here to support you.  How is this supporting you?  And so I think really recognizing and capping on the fact that support is what support feels like.  So if you have a parent who wants to do the bottles and wants you to talk to them about whatever while they do that, then that’s the support and the care that they need.  And if that’s watching a movie together while folding new baby clothes, or even just sitting and watching a movie together and having that companionship and letting them know, you’re not alone.  You’re supported.  If anything happens, we can tag team it together – really just knowing that that is something we can do.  We are there to support you, and support is what support feels like.

And with a lot of our families working from home and having Zooms, I found for a while there that clients hire me so they could get onto work Zooms and focus strictly on the newborn care during a short daytime shift while they needed to concentrate, to get dressed up.  That can also be a difference in our work, and again, the remote working.  A partner may never go to the office now with the changes after the pandemic, so there is a need to have someone in the home, even though two parents may be there the entire time.

Yeah, that one is huge.  And the variety of what we’re able to offer, of like, hey, we can come for three hours, and that may be that you want to hop on the Peloton and you want to take a shower and you want to watch your favorite episode.  Or we’re there for eight-plus hours, and you have a work shift and you need to put away a grocery order.  All these different things; it can vary, based on what the need is.

Exactly.  Endira, what are your favorite tips for caring for newborns?

I would say – oh, that one’s tricky.

Yeah, it can be different for everyone, but generally, in your experience, what are your top tips that you share with families?

I would say just get to know them.  They’re new humans, and it’s such an odd way to think about it, but they’re new, and they’re new to the family and they’re new to earth and they’re new to breathing, and trying to get to know them is really important, and figuring out what they need and how you can better connect.  Sometimes that just means you’re holding them and you’re just looking at them and you’re talking to them.  Just creating that bonding and that connection that will not only release all the hormones that our bodies want and need, but also just create this level of connection and intimacy with your new baby that is so important in the development of both your parenthood journey and them joining your family.

That’s beautiful.  Such a great tip.  And I would say, yeah, just noticing your own emotions would be my tip.  Baby can sense if you’re stressed, and if you’re doing skin to skin with baby, the baby can pick up on that, and the baby gets cranky.  So as you said, get to know your baby, but also take a minute for yourself and breathe and relax because they can sense your stress, and then they feel stressed and start getting a bit cranky and cry.  The more calm a parent is, the calmer the baby can often be, unless there are some medical issues going on.

Yeah, absolutely.  Recognizing, I think, probably in reflection, the biggest tip I would actually have, also, is it takes a village, and we often hear that saying, and it’s quite cliché, but it is necessary.  It does take a village.  It takes a community.  It takes togetherness and connection and being able to build that and see it flow in.  People want to support you.  People want to love on you.  Creating those boundaries in that, but really allowing yourself to be taken care of is the biggest thing in healing and growth.  Having a good experience in something that can be hard.

Exactly.  There is this perception that you have to be wonder woman and do it all and that asking for help in our society is a sign of weakness.  But it’s honestly not, and we need each other.  In many countries and traditional communities, the village takes care of the mother and the newborn, and they don’t lift a finger.  In Malaysian culture, there are so many different traditions that still exist where the mother is mothered for 30 to 40 days. 

Yeah.  Changing the narrative is really the work.  Changing the narrative so that we know, and people who need support know that they can ask for it.  We may not be able to meet the exact need, but we can find and network and create a way to get the needs met.

In between postpartum doulas and organizations like MomsBloom who offer families support, and certainly just asking for help instead of feeling like you need to do it all.  Look into your budget and find options, whether it’s meal delivery service or a housekeeper, someone to help out, paid or unpaid.

Absolutely.

So Endira, you work with twins, and we also work with triplets at Gold Coast.  What are your tips for managing more than one newborn?

I would say finding the things that work for each baby and really leaning into those.  So each baby is – you can think that they’re duplicates of each other, but they’re very much not.  They have different needs, and they may want to feed in different positions, and they may like different bouncers.  Really allowing yourself to get rid of the idea that everything’s got to be matching and the same and really lean into the individuality of the babies, because it will allow you to have an easier transition into the fact that there are two.  And I would say another thing would be trying to keep the schedule, but also not too close that you feel over-capacity when you’re trying to feed.  So if feeding two babies at once is too much, that’s okay, but let’s try to get it to be in a way that they’re both being fed at a close time so that you do have that break in between and you are able to reset before it’s time for another feed.

Excellent advice.  And any tips with NICU babies?  I feel like having a NICU baby myself, they can be so intimidating.

Absolutely.  NICU babies are so intimidating.  You’re filled with anxiety.  You’re trying to recover from the fact that you just had this whole experience in the NICU, and now this baby is at home.  I would say the biggest thing would be, obviously, keeping germs at bay as much as you can, so washing hands.  And finding things that make you feel supported and safe, so finding a swaddle that feels really good, or finding a baby monitor that you feel really secure with, or having the bottles.  Really ensure that you are handling this with fragility but you are also encouraging the baby to figure things out as it develops and gets older.

And sometimes you need to chart things and make sure baby is gaining weight.  There is more organization that’s needed and structure with a NICU baby, oftentimes.

Yeah, keeping track of things.  And I would say that goes back to multiples, as well.  Get a little whiteboard, and track everything, because it can be so easy to forget these things.  When did Baby A eat last?  Baby B is seeming like – just track everything.  Write it down.  Don’t pressure your brain to remember everything because it’s just too much.  A little whiteboard with a little marker will do the trick perfectly.

Yes, and I know some of our clients use different apps to log baby feedings.  We also keep a written log, so doulas coming in are on the same page, as well as our communication platform, to understand how a day or night went with baby and anything that should be noted from a pediatrician appointment and so on.

Yes, yes.  Making sure everyone’s aware of what’s happening and on the same page is really important to make sure that things all flow smoothly.

And I feel like even if families aren’t using a postpartum doula, you may have grandparents caring for baby.  You may have a part time nanny.  Again, just having some way that all caregivers are on the same page and also understand your goals.

Yes, that’s really important.  Understanding the goals and being on the same page – I like to highlight that.  We can’t be there for every moment, which is the reality.  We can’t be there for every moment.  At least insuring that the people who are caring know what our desires are, so those can be followed through on.

Yes.  And grandparents may be used to – I know with having a big family myself, my siblings had different ways to parenting and feeding their kids, so as grandparents trying to help out, it can be completely different from family to family, and certainly when they had kids.  I mean, everything is different, from feeding to sleep to car seat safety.  There’s a lot to learn for new grandparents or even just different family goals or having one child that has twins and another has a baby that has no restrictions and doesn’t need a log and is less complicated to deal with.

I would say also with having other people care for our babies and care for us, that’s when the education for them is really important.  So, like a grandparent class or a video that you’re sending that’s educating them on the ways that, if you’re doing baby led weaning or you are doing paced feeding, having them be able to be educated so that there is no room for pushback.  It’s like, hey, this is what we’re doing.  This is the evidence on our choices, and this is – any more information you want to know, this is how you can find it.  But this is the track that we are choosing for our family, and we invite you to come along, but I’m not going to be the one that has to do all the education.  I’m going to leave it with you to be curious and figure it out.  Because that can be difficult at times.  Everyone has a different philosophy on things.  And when we have a new baby, it can really exhausting to feel like we have to do all the education or set all the boundaries.  Finding ways to do that is really important.  I always encourage people to use the resources available for other people to be educated as opposed to you having to be the primary educator.

Yes.  And as you mentioned a grandparents class – Gold Coast offers an in person and virtual option.  We find that more of our clients gift their parents the class than grandparents actually seeking the class out and registering themselves.  It is a lovely way to get them up to date on overall newborn care and the differences and understanding how to support, with the changing times today and again, all of the different swaddles and safety and feeding changes in caring for a baby.

We are ever changing, and that be really exciting, and it can also be very exhausting.

Yes, for sure.  So how can our listeners learn more about you?

Well, if I’m your postpartum doula, that’s one way.  Another way is on socials or just interacting in the community.  I am always in the community, and I’m always doing things.  Just being able to connect in those ways.  MomsBloom is a great way to connect with me, as well.  Gold Coast; I’m on our website, so you’re able to see me there and we can set up interviews if you need a postpartum doula.  Those are the main things.  And I think the biggest thing for everybody would be community connections because we have a really cool community, and there’s always ways to connect with each other.

Exactly, and for our listeners who are local to West Michigan, you’re certainly out in the community at tables representing Gold Coast Doulas and MomsBloom.  There’s a baby expo coming up in the spring, so excited for the in-person connections that are opening up.  But yes, you have a fantastic bio at Gold Coast Doulas’ website.  Our listeners can certainly work with you if they’re local.  Otherwise, we do have, as I mentioned, the grandparents class on our website.  We have a newborn survival class led by Alyssa Veneklase that is self-paced and comes with a free call to answer questions after the class is completed by parents.  So no matter where you live, you’re able to take that class.  We also have our birth and baby prep course that covers a lot of newborn care, as well.  That is called Becoming A Mother.  So check out some other options if you’re not able to work with Endira directly.

Thanks so much for sharing all of your wisdom, Endira!  It was so lovely to chat with you today.

Absolutely.  Thank you for having me.  It was such a pleasure to be able to have conversation and reach a larger platform than just the people we connect with day to day.

IMPORTANT LINKS

Endira Davis

Birth and postpartum support from Gold Coast Doulas

Grandparent classes from Gold Coast Doulas

Becoming a Mother course

Kristin Revere chats with Alison Prato, Infertile AF Founder and author of “Work of ART,” a children’s book about IVF and ART.

Hello, hello.  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with Alison Prato today.  Alison wears so many hats, but she is the Infertile AF group founder.  She’s a podcaster.  She’s a new author, and she is a reproductive organizer.  Welcome, Alison!

Hi!  Thank you so much for having me.  It’s great to talk to you.

Yeah.  We’re both Hey Mama members, so I tend to see a bit about your rally and some of the work that you’re doing in the fertility space, and I’ve been so impressed.

Oh, my gosh, thank you so much.  Yeah, Hey Mama has been such a great way to connect with so many women doing incredible things.  So I’m happy to be here.

Totally agree.  So let’s get into a bit about your background and what led you to making a career of your personal journey.

It’s so funny because I never would have imagined 20 years ago or more that I would be in this fertility space, but it kind of does make sense.  I have a journalism background.  I got a journalism degree from the University of Illinois in Chicago, and I started right away working in magazines when I graduated from college.  I always wanted to tell people stories.  My favorite thing to do was to write profiles about people.  I ended up, over the course of the two decades that I was in magazines, I did a lot of celebrity cover stories for magazines, a lot of features just about getting with a group of people and kind of talking about what they did all day.  A lot of college stories, a lot of music stories.  I’ve just always been fascinated with people who have big personalities who are doing interesting things, and that was kind of my career path for 20 years.  I started working for Playboy Magazine.  That was my first job out of college.  It was awesome.  I worked there for ten years as an editor, and I was their music editor.  And that was a really great background because the whole cliché that everyone says they read it for the articles, Playboy – they really did have great articles, so I grew up kind of around all these really great journalists and writers, and they kind of taught me how to do my thing and helped shape me into the storyteller that I am now.

Anyway, I did magazines for a while, moved to New York, bounced around a lot, worked for everybody from Rolling Stone to Harper’s Bazaar to Teen Vogue, and while I was doing that, my husband and I are high school sweethearts, and we had gotten married in 2002.  It’s kind of nerdy, but we always say we did go to two different colleges and we dated other people in college, so it’s not that quirky, but when we moved to New York, all of our friends back in Chicago where we had originally been from were starting to build their families and have kids and stuff, and we were like – we were just turning 30 at the time, and we were both like, we can’t have kids right now.  We’re moving to a whole new city.  We have to start from scratch.  We don’t have really a lot of friends.  We don’t even know how to ride the subway, so we’re not ready to have our kids.

And this is all leading to kind of our fertility journey because I did put it off for a while, having kids.  And I say this all the time now: I didn’t know much about my fertility.  I didn’t realize that at the age of 35, things kind of start going downhill in terms of being able to have kids more easily.  I was looking at Hollywood and being like, well, Halle Berry just had a baby at 46.  Janet Jackson, 50.  Not knowing behind the scenes what might have been going on.  I’m not going to speculate.  They never really, either of them, came out and told their stories about how they actually had their kids.  But point being, I just thought that you could have a baby whenever you wanted.  And I honestly thought that.

So we did start to try when we were in our mid-30s.  I did get pregnant, and we had my daughter when I was 34.  Then second kid – we always talked about having one, but we didn’t start to try for the second kid for two or three years, and that’s when I started down the infertility journey, which I never thought I would be in.  At that point, I was having a lot of problems not getting pregnant, but staying pregnant.  I had four miscarriages after I had my daughter, trying to have our second kid.  And that’s when I found myself in this world of infertility and being like, what’s going on?  Tell me if you want me to stop because I feel like I’m just droning on and on.

Oh, no, I am loving all of it.  And I feel that secondary infertility is not discussed enough.

It’s not.

There’s a lot of focus on that first conception, but as you mentioned, you delayed a couple years.  You started later in life.  I also – we have many parallels.  I started later in life, as well.  I had my kids at 36 and 38.  I didn’t have fertility struggles, but I delayed having kids for multiple reasons, career being one of them, and I also have a journalism degree. 

We are living parallel lives.

Totally.

So, yeah, after I had my first miscarriage, I kind of felt like – I have so many friends who’ve had miscarriages, unfortunately, and it’s always very sad and devastating, but to be honest, I was like, okay, this seems pretty common.  It’s maybe kind of like a rite of passage, I guess, if you’re trying to have a baby.  I didn’t think too much about it.  But then once I had the fourth one, I was like, okay, something’s wrong.

So we did end up going to a reproductive endocrinologist who ended up being the doctor that we worked with, this amazing doctor, Joshua Klein, who now works for Extend Fertility in New York.  He’s awesome, and I got very lucky because it was just kind of – a friend had recommended RMA, where he worked at the time, and I ended up with him, and he was just great.  So basically, he did the workup on me and realized that it was age related.  It was that I had a healthy egg reserve, because now I was about 37, 38.  I had a healthy egg reserve, but the reason that I was having miscarriages was because the unhealthy eggs were meeting with the sperm, so they weren’t healthy embryos.  So he basically said to me, in laymen’s terms, your body is doing the right thing.  It’s getting rid of pregnancies that aren’t going to be healthy.  But that doesn’t make it any easier, obviously.  So he said, you’re the perfect candidate for IVF.  If we can find the healthy eggs and then put those with the sperm, then we should be good because we know that you can get pregnant.  It’s just a matter of having a healthy embryo when you do get pregnant.

So that was the way that it was explained to me.  I never even heard the term secondary infertility until later, which is kind of wild, because I feel like it’s so much more out there now.  But it was really, really hard.  Those four losses, and between my daughter and my son, I got so depressed.  I’ve been really open about relationship problems.  My husband and I were kind of not on the same page after a while.  He’s like, why are we doing this to ourselves?  And I totally understand his side of the story in retrospect, but at the time, I was like, you don’t understand.  I’m going to die if I don’t have a second child.  I just felt like our family wasn’t complete, and it was so devastating to me that I just couldn’t have this second baby.

And yeah, you mentioned secondary infertility.  The thing about it that’s so unique and kind of hard to explain is that you kind of get sometimes some pushback from people.  Like, oh, that’s not a thing, or that’s not as hard as not having a baby at all.  You already have one.  You should be happy with what you have.  And they kind of make you feel guilty for wanting another one.  Not everybody, but some people.

Yeah, I get that.  I led some fertility support groups during the pandemic, and some of the participants had expressed exactly that.  Some of that shame, almost.

Yeah, shame or you’re being greedy.  And what I always tried to explain was that I’m not being greedy.  I just love being a mom so much.  My daughter was everything to me, and I just wanted to do it again.  I wanted to be a mom even more, if that makes any sense.  It was coming from a place of love, not a place of greed.  And it’s kind of hard to explain, I guess, if you haven’t been in that position.  We always talk about in Fertility Rally, which is the community that I co-founded four years ago – we always talk about, it’s not the pain olympics.  Everybody’s got a different story, and when women kind of try to compare or say, oh, you haven’t been through as much as me or that’s not as hard as what I’m going through, I feel like we’re really doing ourselves a disservice and doing each other a disservice.  So I try not to compare pain.  I feel like with infertility in particular, a loss is a loss.  The loss of having a retrieval that didn’t go well and you didn’t get what you wanted, or having a failed transfer or an embryo that doesn’t fall correctly and you aren’t able to use it anymore or an early gestational miscarriage, a chemical pregnancy – all these things are losses, and at the end of the day, it’s all the loss of a dream.  It’s all the loss of how you thought your life was going to be, and it’s all hard.

It really is.  I love that you have the rally as a safe space and an education option for just the general public.  You’ve gotten a lot of publicity, and you’re getting the word out so people who aren’t even considering having kids are getting exposed to things that we might not have during our own pregnancies.

Well, thank you for mentioning it.  I’ll tell you a little bit more about it in a second, but I will say, the whole thing for me was when I was going through all the miscarriages and the infertility and then we ended up doing IVF, which again, I didn’t really know anything about, and I say this feeling so embarrassed on my own behalf that I thought IVF was for people that wanted multiple babies.  I didn’t realize – I had no idea what it was.  I was so completely clueless, and I feel like such an idiot even saying that.  But when it was proposed to me, I was like, wait, IVF?  What?  Like octo-mom?  That was a thing at the time.  I don’t know if you remember that.

Right.  Oh, I totally remember that.  Unless you had family or friend that went through the IVF process, how would you know?

Absolutely.  And turns out I did have some friends that went through it, but nobody was really talking about it at the time.  I remember going to the book store and looking for books about IVF and miscarriage, and there was really, like, a handful, and that was it.  And I was like, what?  Where are all the books?  Why is no one talking about this?  And that’s why eventually after I had gone through IVF and had my son, thankfully, we did one round and that was kind of our Hail Mary round because we were like, it had been years.  We were – our marriage was kind of crumbling.  We were like, this is – we didn’t have enough money.  We had to borrow money from my parents and my husband’s parents to do the IVF because it was all out of pocket, and if people don’t know, it’s $20,000 or $30,000 per round, depending.

It’s very costly, and if you’re not a celebrity, how can you afford it?

Yeah.  Some people have insurance, thankfully, that do cover it, but we didn’t.  So we did do the one round.  I got so incredibly lucky.  I only had one healthy embryo to transfer.  We had five that were tested.  Four were chromosomally abnormal.  One was healthy, and that ended up being my son.  So it was absolutely a miracle, if you ask me.  The odds were pretty low that it was going to work out, but it did.  He just turned eight.  My daughter is 14 now.  But point being, when I was going through, I really just didn’t have resources.  I didn’t have a group.  I didn’t have – Facebook was kind of a thing, but I had poked around on there, and I couldn’t really find my people.  There weren’t really any podcasts that were really talking about that.  So that’s why I did start Infertile AF, which is my podcast, where every week, we tell different family building stories.  I started with – episode 1 is me telling my story.  Episode 100, I went to my husband, and we had some drinks, and I interviewed him about his side of the story because even though we were in it together, he had a totally different version of what he was going through, which is kind of interesting.

I love that.  I’ll have to check that one out.

Yeah, it’s good.  So we started that in 2019, and this week, the 254^th episode will come out.  So it’s been every week.  I interview everybody from celebrities to people I’ve met through Fertility Rally to people who email me or I’ve met through Instagram.  It doesn’t matter.  I feel like everybody’s story matters.  You don’t have to be – people sometimes will write and say, I don’t know if my story is interesting enough, and I’m like, that’s BS.  Everybody’s story matters.  It doesn’t – you don’t have to go through X, Y, and Z to make it interesting.  I think these are all human stories and human experiences.  So we talk about same sex family building, single parents by choice, surrogacy, egg donation, adoption, people who don’t end up with babies and are childless not by choice at the end.  I just want to put as many stories out there as I can to let anybody who’s going through something know that they’re not alone because I felt so alone when I was going through it.

It’s so needed.  You didn’t have that community, and you built your own.  I love it.

Yeah.  I started with the podcast, and then in 2020, Blair Nelson, who’s someone I met through Instagram, who’s also a big infertility advocate, she and I formed Fertility Rally.  We started just kind of doing Zoom support groups during the pandemic.  It was literally mid-lockdown.  And it just kind of spiraled and snowballed, and people were like, we need this every week.  So we started doing a weekly group, and we formed this membership community called Fertility Rally.  Today, we have over 400 members.  We have six support groups per week hosted by us and other people that we’ve hired.  We have events.  We have Fertility Rally Live twice a year, which is an all-day virtual conference, if you will, with speakers and giveaways.  The whole thing, the whole overarching theme is just letting people know that they’re not alone and providing support no matter what people are going through when they’re trying to build their families because it can be so hard and so lonesome and so devastating.  To just have a group of people that get it that you can come on and you can cry or you can laugh or you can say something, and people will be like, don’t think I’m an asshole, but when I met my sister’s baby, it didn’t make me happy, and we’re like, we get that!  Stuff like that.

Exactly, and some people don’t have access.  I mean, if they live in a rural area, the option of these remote virtual rallies and this membership group makes them feel less alone.  I mean, obviously, in New York and Chicago and some of the more metropolitan cities, there are more resources as far as support.

Yeah, there are, but yeah, that’s the good thing about being virtual is that we can have somebody who is in New Zealand, for example.  One of our members, Jenny, who comes on, and it’s the next day for her, because we have our calls at night.  And we’re like, Jenny from the future.  It’s Thursday morning for her, and it’s Wednesday night for most of the rest of us.  We’re able to meet people in Hawaii or the Pacific Northwest or here in New York and New Jersey where I am, or Blair’s down in Texas.  We’ve also had these IRL events.  We had one in Chicago last summer where – we had 40 people come in from all over the country to spend a weekend together and just bond and have fun, and they all met through Fertility Rally.  It was just amazing.

That’s beautiful.  Yeah, nothing replaces in person.  But certainly, having virtual options is more accessible.

Agreed.  Absolutely.

So let’s dive into your journey as an author and your Work of ART.  This is a children’s book, correct?

It is, yes.  I wrote a children’s book.  I actually just got the hard copies delivered to me yesterday.  I hadn’t had them in my hands until yesterday, and I opened the box and just started crying because it was so cool.  Such a cool moment.

Like I said, my son is 8, and we’ve always been super open with him about how he was born.  You know, he hears me doing the podcast.  He’s heard me talking about infertility and Fertility Rally and IVF and all this stuff.  And I realized that there weren’t that many books out there that explained to kids about assisted reproductive technology or IVF.  There are some, and the ones that are out there are wonderful, but I wanted to do my take on it.  So I just wrote this manuscript a handful of months ago, and I called it Work of ART, the ART being assistive reproductive technology, and it’s the story of me telling my son how he was born in such a cool way and how wanted he was.  And my daughter is in the book, as well.  It’s kind of just our little family story.  Again, it’s just to demystify assistive reproductive technology, and there are so many kids out there who are born this way.  Just to have parents share with their kids, if they feel comfortable doing so, this is how you were born.  We wanted you so badly.  You were made in the lab.  Isn’t that cool, that science is so cool?  That’s kind of my spin on it is just explaining to him.  He overhears me talking to another mom on the playground that he’s an IVF baby, and in the car on the way home, he says, Mom, did you say – what was that?  Did you say something about ivy?  And then I say, oh, do you want me to tell you tonight what I was talking about?  So I explain it to him.

I found this really incredible illustrator, Fede Bonifacini, who is in Buenos Aires.  He sent me some stuff.  I sent him the manuscript, and it was just exactly the tone and the level of cuteness and coolness that I was looking for.  The illustrations are gorgeous and fun, and he really – there’s a lot of easter eggs in the book, like little things.  There’s a little Infertile AF logo hanging in the car.  Just little things that people can kind of pick up on.  There’s a place where I’m wearing a sweatshirt that says Worst Club, Best Members, which is our Fertility Rally tagline.  Stuff like that.  It’s for young readers.  It’s a hard cover book.  I’d say it’s for ages 4 to 8, maybe a little older, too.  But it’s just something that people can share with their families.  It’s been really embraced, which makes me so happy.  The first 150 copies, I’m personalizing and shipping for free in the US, and those are sold out.  So that’s awesome.

Wow, congrats!  That’s huge!

Thank you!  I’ll do another run, and they’re available on my website, which is infertileafgroup.  And this is the first in what I hope to be a series.  I already have the second and the third and the fourth ones kind of swirling around in my head.  I want to do one about donor conception.  I want to do one about same sex families.  I want to do one about surrogacy.  They’ll all be under the Work of ART umbrella.  I just think it’s such a good thing to have these available to normalize the conversation, you know?

Exactly.  And not all of your readers have the background that you do, so to be able to have a frank conversation through a book is such a wonderful gift because it can be overwhelming to have a discussion with a four year old or an eight year old, as you mentioned.  A book is a great guide, and then being able to share their own personal story after reading the book with their child.

Right, yeah.  And in this story in particular, I say to my son – he’s like, IVF, is that like NBA?  That’s with basketball.  So we kind of tie in some basketball stuff in there, and then there’s a whole thing about secondary infertility, and kind of like I explained to you earlier how I loved being a mom to Ever so much, I wanted to do it all over again.  It’s not super heavy.  I had to try to keep the tone digestible for little kids.  It’s not really scientific.  But we do talk about how he was made in a lab, and he’s like, I don’t think Jack was made in a lab.  And I’m like, maybe he was.  There’s a lot of kids who were.  That’s kind of foreshadowing to one of my future books.  I’m going to have another.  My friend Jack will be in one of the next stories.  So, I don’t know.  It’s exciting.  It’s a good creative outlet for me, and it was really, really fun to work on it.  I hope everybody loves it as much as I loved writing it.

Well, I can’t wait to pick it up.  Any tips for our listeners who are either pre-conception stage or struggling with infertility?  What are your top tips?

My tips would be, if you’re comfortable talking about it, find people that you can share with.  It doesn’t, obviously, have to be Fertility Rally.  There are so many resources out there.  But find your people, whether it’s via Facebook or just friends, whatever.  I feel like talking about it and sharing makes it so much easier, and you realize you’re not alone, and these feelings that you’re having of devastation and jealousy and especially around the holidays, it’s so hard.  Everyone’s being like, when are you going to have a baby?  You know, asking questions like that.  So to just kind of have a place where you can vent and share and cry and laugh I think is really, really important.  People can always reach out to me.  I’m on Instagram @infertileafstories.  They can DM me.  My DMs are totally open.  I’ve been there.  I know how hard it is and how sad it is, and even if you have a partner, sometimes you’re not on the same page as the partner, and that can be really hard, too.  People are welcome to reach out to me at any time.

My other piece of advice would just be, be true to yourself.  One thing that really kind of bothers me, I guess I would say, is when people are like, don’t give up, don’t give up.  And I kind of feel like I don’t like that terminology because I’ve talked to a lot of women who have gone down the infertility path and then pivoted because it wasn’t happening.  They weren’t having babies, and they felt shamed, that they felt like they quit or they gave up, but it was like, their mental health was struggling.  Or they realized that they could have a really happy life without a baby.  So I always try to veer away from that language of don’t give up, and I think that if somebody has been doing this for a while and it’s not happening, it’s okay to walk away.  It’s okay to pivot.  It doesn’t mean that you’re not going to be happy.  And there’s really, really good resources out there.  Childless Collective – my friend Katie started this, and it’s for people that pivoted from infertility.  She did it for her mental health reasons.  She was like, I can’t keep doing this for years and years and years.  A lot of people have to walk away because of financial reasons.

Makes sense, yes.

It’s okay if it doesn’t go the way that you thought it was.  There’s a community waiting for you there, as well.  I just want to give people resources like that, as well, because you don’t know what’s going to happen, and that’s the most frustrating thing about infertility.  It’s so out of your control.  You can only control so much, and some of it really just has to do with luck and science.  Even if everything’s lined up perfectly well, sometimes it doesn’t work out the way that you want it to, and that’s so devastating.  But just know that there’s people there, no matter what the outcome is, to catch you when you’re falling.

I love it.  So how can our listeners find your book?  You have the website, of course, infertileafgroup.com.

That’s right, yes.  They can go there.  There’s a bunch of different things on there.  That also links to Fertility Rally, if anybody wants to check it out, go to a support group.  Just DM me and be like, I want to see if it’s my jam, and if it’s not, no harm, no foul.  You’re welcome to come and check out a group for free.  We just want people to be exposed to stuff.  But people can also find me on Instagram @infertileafstories.  There’s links in that bio, as well, for the Rally and for the book.  And again, if people want to just DM me and connect, or if they have questions, I’m totally available.  I can put you in touch with doctors or experts or things like that.  It can be really overwhelming, but I’m there as a resource, so please, lean on me if you guys need to.

Love it!  Well, thank you so much for sharing your story, and all of the amazing resources.  It’s been a pleasure.  I’ll have to have you on when your next book comes out.

Thank you so much for having me!  This is really, really cool, and I love what you’re doing, as well.  Thank you to you for having this platform.

Well, thank you! 

IMPORTANT LINKS

Infertile AF

Work of ART

Fertility Rally

Pregnancy and postpartum support from Gold Coast Doulas

Becoming A Mother course

Kristin Revere chats with Arielle Martone, founder of Find Your Way Mama, about why you need to prioritize yourself postpartum and how to do that even with little to no time.

Hello, hello!  This is Kristin with Ask the Doulas, and I’m here to chat with Arielle Martone.  Arielle is a doctor of physical therapy, yoga teacher, and postnatal coach turned postpartum wellness coach after having two kids and overcoming postpartum depression and pelvic pain.  Welcome, Arielle!

Hi!  Thank you for having me!  I’m really glad to be here.

So happy to chat with you today, and congrats on all of your achievements in so many related fields to pregnancy, childbirth, and early parenting.

Yeah, they work so well together.  It wasn’t the plan initially, but I’m glad that that’s where I ended up.

So lovely.  So I also saw that you’ve been published recently in a book where you shared your personal IVF journey and how that impacted your postpartum phase.

I feel like I’ve been pretty open about my IVF journey and the struggles with that, kind of throughout the process, but writing the chapter in that book – it was a little bit therapeutic for me to kind of just get it all out there in one go.  But it really – it highlights – the whole book highlights the struggles that happen postpartum after the success of IVF because that whole process of trying to have a baby through IVF and the sometimes years that it can take to have success – that success doesn’t negate all of that struggle and the trauma of all of that trying.  Again, it doesn’t go away, and it lives in our body to a certain extent, and it lives within our heart, as well.  So there’s a lot of processing in postpartum in general.  I feel like it brings up a lot.  Anything that you’ve gone through in the past; all your triggers kind of are heightened.  And so with the success of IVF, there’s sometimes this feeling of guilt or shame for having any type of postpartum struggle because we feel like we should just be so grateful, and I think to a certain extent, that holds true for many mothers regardless of how they got there.  There’s always this overwhelming shame of admitting that we’re having any type of struggle because we are told, and it’s true, that our babies are a blessing, and we think that we should just be overjoyed, and there is a lot of that.  But just because we’re feeling overjoyed and just because we’re feeling grateful, it doesn’t negate any of the struggle.  And with IVF in particular, a lot of that is very much brought up, and if you’ve gone through IVF, you’re at a greater risk of postpartum depression and postpartum anxiety.

Absolutely.  But I agree, you know, working with clients going through IVF or even clients who’ve had prior losses because they put so much energy, emotional energy, time, just stress into conceiving, and then they should be – I mean, they do have that guilty feeling of, oh, I should just be overjoyed, but it is normal to ask for help and struggle and share stories.  But I do feel like there’s so much pressure to be perfect and be grateful and to not seek help in this culture and not talk about our emotions.  I do feel like things are becoming more accepted.  Perinatal mood disorders are certainly publicized a lot more than they were in my early days as a doula ten years ago.

Yeah, and it’s almost like there’s this weird teeter totter.  There’s like these two extremes in motherhood that we are either, again, supposed to be that overjoyed, glowing, happy – yes, a little teary in that first two weeks, but mostly tears of joys.  All those positive emotions.  But then there’s also on the opposite end just the normalization of so many of the difficult moments.  I was just saying that that’s just a part of mom life, that things are just going to be hard, that you’re going to feel depleted, that you’re going to feel exhausted, that you’re going to feel overwhelmed.  And all of those things are so normalized that when people are feeling any of that, they don’t necessarily seek help for that.  They’re waiting for something to be bigger or for it to be worse or “a clinical diagnosis” when really they might have underlying symptoms of depression or symptoms of anxiety that they’re just kind of normalizing and bypassing.  And really, we can have both.  We can be overwhelmed and learn to fix it and to move through it and also have a lot of joy at the same time.  It doesn’t have to be one or the other.

I agree.  And again, needing to prioritize yourself while focusing on your new baby, if you have other children, relationships.  Let’s talk a bit about relationships can be affected in this postnatal phase.

Yeah, absolutely.  Once you have a baby, that’s a brand new relationship.  And it doesn’t matter, to your point, whether it’s your first or your second or your third.  Your roles and your relationships with all of the other relationships in your family unit are going to shift and change.  And the relationship with your partner drastically changes, at least initially, and it’s not something that is so openly talked about.  And it can be affected for several different reasons, and I feel that a big part of the reason that your relationship changes has a lot to do with what you’re internally processing or really not allowing yourself to process in the postpartum phase.  You know, we talked at the very beginning of how, when you’re postpartum, it really opens you up and all of your triggers come at you a little bit quicker.  You notice more.  You’re more in touch with your emotions, whether you want to be or not.  You just can’t help it in that postpartum period.  And so if you’re not dealing with that, that can then ripple out onto your relationship with your partner, especially if you’re not meeting your own needs.  There can build up a lot of resentment around that if you’re not clear on what you need and your partner may not know what you need at that time to kind of fill that gap, because you’re so focused on taking care of your baby.  We kind of just expect that our partner knows to take care of us in that time, and I think for most of us, they do, but they may not know exactly how.

Especially if we don’t ask or tell them how to support.  If they haven’t been through it before, if it’s baby one, then there are unknowns for both of the partners in the relationship.

Yeah, and I feel like as mothers, we’re told that we need to be able to do it all, and asking for help is really hard, even if it’s asking for help from our partner.  Being able to work through that, talking with your partner beforehand about having them be maybe a little bit more proactive.  You know, I think postpartum planning is a huge piece that we often overlook.

Absolutely, 100%.

There are so many other changes that are happening.  Often, our relationship with our body and with our own self-esteem postpartum can change, and that can then ripple out onto our relationship with our partner.  We’re not feeling good in our bodies or about our bodies.  It’s hard to believe that they can feel that way.  And then once that six week mark is cleared and you’re able to open up to more intimate relationships again, if you’re not allowing for your pelvic floor to heal and recover, a lot of women experience pain with intercourse after having a baby.  And it’s not just within the first three or six months.  It’s women into 18 months, 2 years, still complaining of pelvic pain with intercourse.  That can drastically affect your relationship as well.

And it’s often not talked about.  I’m thankful that there are more referrals from physicians to pelvic floor physical therapists and that physical therapy is talked about not only prenatally but also in the postpartum recovery phase.  So a lot, again, has changed in ten years, but there’s still so much change that’s needed and normalization of just talking about not only emotions but recovery and making a plan and spending as much time planning for the postpartum phase as you do in birth preparation.

Yes.  I was looking up recently the average cost of the nursery in the US, and it’s around $2000 for someone to set up their nursery and get all the things that they think that the baby needs and to make it look lovely.  And that’s great, and do that if you want to, but don’t do that and neglect your own personal recovery and your own personal needs postpartum.  I hear so often where new moms just feel guilty for spending any time, attention, money on themselves in those first few months after baby, when really, what your baby needs most is a mom who’s well cared for and who’s feeling well.

Absolutely.  You do some work in person, obviously, as a doctor of physical therapy, a yoga instructor.  It appears that our listeners could work with you virtually in the wellness space.  Do you do any other virtual services?  How can our listeners find you, Arielle?

If they’re local to my area – I’m north of Boston – I do work with people in person.  I do in-home concierge physical therapy because I know that making it out to appointments can be really challenging within that first year postpartum, especially if it’s not your first kid and you have a toddler or even older children at home.  So you can work with me that way.  And then I do offer postpartum wellness coaching in a small group setting virtually online, and you can find all that information at my website, findyourwaymama.com/postpartumsupport.  I have also a six-week survival guide, The Six Week Wait Survival Guide, which is a virtual program that takes you through gentle movement that you can do from day one postpartum, because we are told so often that you can’t do anything until that six week mark, and yes, you don’t want to be doing vigorous exercise.  You don’t want to be running or doing any type of plyometrics, jumping around, heavy lifting.  But you can and you should be moving, and you need to kind of balance that out with the rest.  That program is a really great way to get started.  There’s no coaching there because I feel like within those first six weeks, it’s just so much of an adjustment getting home that there’s not that face to face connection, but it gives you that guided program with a lot of education on what to expect as far as relationship changes and some talk about sleep and really just basic care information, like going to the bathroom, having your first bowel movement after baby; things that aren’t really talked about that we really should be getting in the hospital before we go home with baby, but we don’t.  So this is my way of offering that to new moms, and it’s a great way to get started.

So how do our listeners find your amazing six weeks survival guide?

They can get it a few ways.  They can get it on my website, which I mentioned before as findyourwaymama.com.  It’s underneath the postpartum support tab, so it’s right there.  You can also find it on my Instagram.  It’s in the link in my bio.  Again, another easy way to access it.  And if you’re kind of on the fence about it, which I honestly – I know people say this, but this is something that I think that every soon-to-be-mom or recently became a mother really should have because there’s just so much information in it that we don’t really get and we really do need.  But if you’re on the fence, I get that.  There’s a free guide that’s in my link in bio as well that is nine quick tips on pelvic floor recovery after childbirth.  That’s a good way to kind of ease into it if you’re thinking about it.

That’s so helpful, Arielle.  What are a couple of those tips, if you don’t mind sharing?

Yeah, absolutely.  So one of the tips is really focusing on allowing the pelvic floor to relax initially, so we’re not so focused on strength right away.  It’s not something that we want to ignore completely, and for some people, they’re going to need more strengthening than others.  But generally, after having given birth, whether it was a vaginal birth or a Cesarean birth, our pelvic floor tends to really tense up and tighten up because it was a traumatic event for our pelvic floor to experience.  Whether or not you actually pushed your baby out, if you’re having those contractions, there’s pressure down on the pelvic floor, not to mention the pressure of carrying the baby for the almost ten months of actually carrying the baby.  So it’s gone through a lot, and often, that tends to be an area where we hold tension, as well.  So if we’re trying to process our own birth stories or even just the challenges that come with being a new mother, a lot of that tension can be held in the pelvic floor.  So a tip is to start by relaxing the pelvic floor.  So I go into some breathing tips, breathing exercises in the guide, as well as positioning.

For the positioning, one of the tips I talk about is a yogi squat, that squatting position where your hips are lower than your knees.  And you can do it supported.  You don’t have to hang out there.  You can sit on some pillows, sit on a cushion, prop something underneath your heels if you’re not able to have your feet fully on the ground.  But that position is one that kind of allows the pelvic floor muscles to lengthen, and if you do support yourself in it so that you’re not straining in the position, it can allow for that pelvic floor to really start to relax and soften.  That way, when the time comes, you’ll be able to strengthen it in an effective way.

Very helpful.  So obviously, you know, tip number one would be to work with you directly or purchase your six week survival guide, but what are your other tips for busy moms who are in that postpartum phase to prioritize themselves?

Yeah.  It’s so hard because we are very much conditioned not to prioritize ourselves; I think as women in general, but especially as mothers.  So it’s going to feel really uncomfortable first.  I want people to know that.  If it feels uncomfortable, it’s not necessarily because you’re doing something wrong by prioritizing yourself, but it feels uncomfortable because you’re not used to it, and it’s different and it’s hard to do things that are different from our everyday and that forces you to change a little bit.  That can be tough.  My biggest tip would be to start prioritizing yourself while you’re with your baby.  I feel like for me, and I know for a lot of other women and mothers that I work with, it’s almost that we’re told one of two things: either we have to be completely selfless and we are 100% for our baby, or we’re told that we need to do self-care and that means putting your baby down and doing something on your own.  And I really do think that there can be a happy middle where you’re not forcing yourself to separate yourself from your baby early on because naturally, instinctually, we want to be with our baby.  So forcing ourselves to do that can feel really kind of alarming to our nervous system.  That can feel really uncomfortable and can lead to some anxious thoughts.  But if you’re able to start prioritizing yourself while you’re still with your baby, then in my opinion, it’s a win-win.  It’s while your baby is napping.  And this of course is very much dependent on how far postpartum you are.  What does that look like for you, in terms of are you home with your baby or are you back at work.  But if you’re withing that first six weeks, definitely, you hopefully are home with your baby.  So when your baby is napping, lay down with your baby as well, whether it’s on a firm mattress or you’re supported and you’re resting; you don’t have to be asleep, but if you’re resting with your baby on your chest.  If you are taking a nap with your baby, you do want it to be a firm mattress or even on the floor, making yourself comfortable there, having a little bit of floor time with your baby.  That is a really great way to start to allow yourself to get the rest because early on the sleep is really challenging.  And it’s something that I feel like we hear – at least, I heard often, and initially, I eye rolled at it.  “Sleep when baby sleeps.”  And there are so many great memes out there about it, like, yeah, sure, I’ll just vacuum when baby’s vacuuming and whatnot.  I think it’s important, and I think, again, it goes with that feeling of being a little uncomfortable because we are forcing ourselves to stop and to rest and that’s not something that we want to do because we have that running to-do list in our minds.  So if you need to, jot all of that down.  Do a bit of a brain dump beforehand.  That way you can see what you need to get done, look at it, circle one or two things that you’ll do later on in that day, but then allow yourself and give yourself permission to actually rest when you are able to.

Great advice.  So you mentioned Instagram and other social media sites that you are engaging with.  How do we find you?  Remind us of your website once again, Arielle, and your social media channels.

Yeah.  My website is findyourwaymama.com.  On social media, I am @ariellemartone.  And that is on Instagram and Facebook.

Excellent.  So any final thoughts to share with our listeners, Arielle?

So many things, but I think it’s really important that we start to value our postpartum period of time as opposed to rushing through it.  And again, I know that comes with some discomfort, because it’s hard to pause.  It’s hard to rest and to stop and to actually do it as opposed to saying that we’re doing it.  We’re saying that we’re resting, but we’re scrolling on our phone for three hours, and then all of a sudden, it’s midnight and the baby is up again.  It’s learning to lean into that, learning to lean into the discomfort, acknowledging that it’s hard, but not wallowing in it.  I think, again, with everything, there’s a balance, and with everything, it’s kind of an and-but or an and-or type of situation.  It’s not an all or none, and postpartum very much highlights that.  So it’s leaning into the hard.  It’s acknowledging where you are at.  And it’s looking to move through it as opposed to getting stuck in that.

Beautiful.  Thank you for sharing so much of your wisdom with our listeners!  I love chatting with you, Arielle!

Oh, thanks for having me, Kristin!  It was great!

IMPORTANT LINKS

Find Your Way Mama

Birth and postpartum support from Gold Coast Doulas

Becoming a Mother course

Kristin Revere chats with Natalie Fay of 9in9out and Sound Sleepers by Natalie Fay about the importance of creating a community and how to do so with a baby expo.

Hello, hello.  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with my friend Natalie Fay.  Natalie Fay is a certified sleep consultant through the Center for Pediatric Sleep Management and a member of the International Pediatric Sleep Association.  As founder of Sound Sleepers by Natalie Fay, Natalie works with a diverse array of families to cultivate healthy sleep habits for their children and households as a whole.

Welcome, Natalie!

Hi, Kristin!  It’s so good to be here!

So happy to have you!  Now, we first met through a training, a baby registry training.  So it’s really fantastic to expand our relationship by working on your amazing baby expo, 9in9out.

Yes.  Thanks for the great introduction!  I’m Natalie, and I am a certified pediatric sleep consultant, and I do own my own sleep business where I work with children and families to get sleep where they’d like it in their home.  But also, I have another hat that I wear, and me and my co-founder, Jackie Cook, have launched a new and expecting parent expo called 9in9out that we have birthed by just being in the postpartum space ourselves as professionals and realizing that there are so many gaps in services that our clients are expressing to us.  But there are so many professionals like us that we know of that we can refer to.  So we thought it’d be great to kind of take a new spin on the classic baby expo and make it less about all the stuff and more about helpful resources and kind of helping to shift the narrative about new parenthood anyway in the US.

And that’s what I loved about your model when I learned about your expo that took place in Wisconsin through Be Her Village and saw all the publicity.  With the core focus at Gold Coast being on the newborn care, especially overnights, I do feel like there is so much more focus on, say, birth doulas and pregnancy prep but not as much on the postnatal preparation and postnatal resources.  So I begged both you and Jackie to bring your expo to Grand Rapids.

Yeah, and you know, we were really happy to do so.  It was really encouraging.  We had our first event here in Madison, Wisconsin where we both live, and it was such a well-received, brand new experience for people that kind of came and didn’t quite know exactly what it was about, because we were brand new.  But after being able to walk through and meet face to face with people that are in their community that they could connect with and kind of form a postpartum care team for themselves – it was really encouraging.  And we also had some special sessions throughout the day where people could look forward to learning about a topic that they were interested in, led by local experts.  And that was really cool, too.  Just having that community was a great thing for Madison, and we’re excited to be able to take it to a couple new cities, and we hope to just keep growing.

I love it!  Fill our audience in about your 2024 schedule and the cities that you’ll be in and how they can get connected.

Absolutely.  For 2024, we have locked in four dates, three cities.  So the first one will be taking place on Long Island, and that one is on March 24^th, 2024.  And then we will be in Madison on April 14^th, 2024.  And then Grand Rapids on May 5^th, 2024.  And then in the fall of 2024, we haven’t locked in a date, but we’re going to run a second event here in Madison.

Amazing.  And that’s nice because pregnancy is such a temporary phase, and early parenting, and so you’re able to meet the needs at different times of the year in your own local market.

Yes.  And kind of just to hone in on the name, 9in9out, we kind of hope to encompass the prenatal, pregnancy, and about the first year postpartum.  So any sort of professional or resource that would be helpful for someone in those categories is who you’d find at one of our events.

And I love that, again, you have speakers.  People can visit exhibitors, and there’s also the networking for the professionals in the birth and baby space.

Yeah, so our audience is kind of twofold.  We’re trying to build community in general for everyone involved, but community for the professionals themselves, too.  We offer a networking breakfast before the event.  And then also community for the parents that attend.  So it’s really neat to see that kind of all meld together.

Love it.  And you do have a premiere sponsor for all of the locations.  Do you want to chat a bit about that?

Sure.  For all of our locations, we offer a tiered level of sponsorship.  So putting on this event is lot of effort, and it’s really wonderful to have so many eager professionals that want to join us at the level that feels right for them.  So for each city, we have not only premiere sponsors, but we also are partnering with a local nonprofit for attendees to be able to donate to that nonprofit when they purchase their event ticket.  That’s something that’s important to us is to give back to a cause that it’s the community that we are actually going to.

Excellent.  And Be Her Village is a sponsor for each of your cities.  In fact, Long Island is kind of their home city, at least Kaitlin’s.

Yes.  Be Her Village, for those that don’t know, is a really great resource for both parents and professionals.  We have such a synergistic relationship with them that our event is basically like the in-person expression of their online baby registry.  So we’ve partnered with them as the premiere sponsor in every city.  Each attendee and also each birth professional are able to get registered with them at a nice discount, and you’re actually to able go through the event and scan a QR code of provider’s table that you really seem to connect with, and you can add it to your Be Her Village registry right then and there, which is a really neat aspect of our events that our attendees have really enjoyed.

Exactly.  And each of our businesses are part of the Be Her Village registry, so I’m a big fan.

Yeah, they’re wonderful.

So any other thoughts on why families should consider attending an expo like 9in9out?

Yeah.  You know, this goes back to the mission that Jackie, my co-founder, and I talked about as we were forming the idea for 9in9out, and that is that a lot of times, the clients that we see come to us in a place of pain or great challenge, and they’ve gotten there because they hadn’t had the resources to support them with sleep or with pelvic floor health or anything in that prenatal or pregnancy or postpartum realm.  So instead of waiting for it to get to a point that is so dire, we hope to kind of help people start changing the way they think and kind of be proactive about it and realize that there are so many wonderful small businesses and resources that can help them.  And so coming to the event is a great way to meet with people face to face, not just read about them on a website, and chat with them in real time in your community and then maybe find out that it can be something that would really benefit  your whole overall well-being, mental, physical, and spiritual health.

Yeah, and even for families who are in that pre-conception stage of talking about wanting to build a family, it would be a great way to see what your resources are and learn in advance versus a month before the due date, for example.

Yeah.  So it’s great, and on all of our socials, we will posting kind of what for each event you can expect to see.  So the vendors and the line-up of special sessions so you can kind of keep a pulse on if something sounds really interesting to you, to make sure to attend at that time.  And we’ll be really transparent about that.  I will say, too, it’s kind of meant to be sort of like a self-care day.  So we have coffee and food available at the event, and there’s also really fun swag bags, so you can get a goodie bag, and then you can also enter to win some pretty awesome giveaways that our vendors generously donate.  So that’s kind of a little perk of being there at an in-person event.

I love swag.  It’s one of my favorite things about going to expos and conferences.

Absolutely.

Awesome.  So if you could share not only your social media channels but the website with our audience, that would be great.

We are on Facebook and Instagram, and it’s 9in_9out.  And then our website is www.9inand9out.com.

Excellent.  So Natalie, let’s get into a bit about your Sound Sleepers business.  I’m curious how you decided to pursue being a sleep consultant as a career.

Yeah, so I became certified as a sleep consultant in 2020, and this was after a lot of career soul searching.  I was actually in graduate school to become a child psychologist.  I’ve always liked working with children and families.  I know that’s where my passion lies.  But that actual program and that career that I thought I wanted to do for many reasons turned out to not be what I wanted to do once I was actually in it.  So I had a moment of a little bit of an identity crisis in my career path where I thought I wanted to do something, and it turned out I didn’t.  So after a lot of soul searching – also, I will say that I had a history of being a professional nanny, so working with families in that way.  I realized that what I really like to do is work with very young children, especially babies.  I’m also really good at helping parents have their children sleep, and I didn’t realize that you could actually do that professionally.  And once I found that out, it’s almost like I just felt it in my body, that that’s what I’m supposed to do.  So I became formally certified.  It was really great to learn a lot of information and really good research that has been done on sleep for children.  And then I became certified and launched my business, and now I support families.  I do one on one support.  I’ll also give talks to small groups.  I’ve done it in my community and the local preschool.  I’ve even had the chiropractor have me kind of give them some content, and they provided that to their pediatric families.  So it’s been really great.  I definitely still have that hat on, as well.

Love it.  So how can our listeners find you if they’re interested in having you speak virtually or in person, depending on location, or of course work with you?

Yeah.  My business is called Sound Sleepers by Natalie Fay.  My website is soundsleepersbynataliefay.com.  And then I’m also on Instagram and Facebook, and that is @soundsleepers.  You can reach out to me via DM.  On my website, I also have a contact form.  So whether you’re a client, interested, or interested in business collaboration, you can reach me that way.

And of course, our listeners can find you at 9in9out next year in multiple cities.

Yes.  So if you’re near any of those cities and are interested in attending as a new parent, or if you are interested in maybe being a business involved by giving a talk or being a vendor or a sponsor, just please go ahead and reach out, and we’d be happy to share with you a little bit more about how that would work.

Excellent.  Any final tips for our listeners, Natalie?

Our message that we’re trying to give out into the world is that things are better done in community.  So no one is alone, and there’s a lot of resources out there for new and expecting parents, so just make sure to look to your community.  That’s kind of the message and what we’re trying to put forward with 9in9out.

Great advice.  Well, thank you so much for your time, and I will see you next year.

Sounds great.  Thank you, Kristin!

IMPORTANT LINKS

9in9out

Sound Sleepers by Natalie Fay

Be Her Village

Pregnancy and birth support from Gold Coast Doulas

Becoming a Mother course

Kristin Revere chats with Gina Mundy, attorney and author of “A Parent’s Guide to a Safer Childbirth” about the important things that parents must know to avoid delivery complications.

 

Hello, hello!  This is Kristin with Ask the Doulas, and I am so excited to chat with Gina Mundy today.  Gina is an attorney, author, parent, and partner, and not only is Gina an author, but she’s a best-selling author.  Welcome to Ask the Doulas, Gina!

Thank you, Kristin, for having me!  I’m very excited to talk to you today.

I would love to hear a bit more about your background.  Your specialty is so unique as an attorney, and I also saw in your bio that you’re located in my home state of Michigan.  Fill us in a bit about how you started to work with OB-GYN cases specifically.

Sure!  Yeah, I’m in Clarkston, Michigan, so I was happy to hear you were west side.  I love the west side.  I head out there all the time.  So I’m an attorney specializing in childbirth cases.  This is something that I’ve done now for almost 21 years.  I got my first case in February 2003.  And a lot of people don’t really understand what exactly that is, but basically, these cases involve the birth of a baby, and unfortunately, it’s when something goes wrong, whether it’s a complication or a mistake.  Something happens and baby is not born healthy, and sometimes baby doesn’t make it during childbirth.  In some very sad cases, I’ve had it where Mom hasn’t made it through childbirth.  So my job as the attorney is to come in and say, what happened; what went wrong?  But more importantly, what should have been done so baby would have been born healthy?  What should have been done so Mom would have been around to raise her baby?  Those questions have taken me across the United States many, many times, meeting with doctors in all different hospital systems, meeting not just the doctors, but the entire labor and delivery teams: the midwives, nurses, anesthesiology, you name it.  If they’re part of a delivery team – with the exception of doulas, as we talked about in pre-show.  I have never had a doula in a case in almost 21 years.  So you guys are definitely doing something right for your clients, which I’d like to talk about more later on.

But anyway, I have all of this experience, and we had basically – my niece was pregnant, and this was in March a couple years ago.  And she just had a very scary birth.  We went about 20 minutes not knowing if baby was going to make it, is baby not going to make it.  I get this phone call from my sister, and she’s like – you know, I’m expecting her to say, “Hey, Sam just had the baby.  Everything’s great.”  Instead, she’s hysterically screaming on the phone.  The baby crash, the baby crash.  And I’m 1100 miles away, and I’m listening to her, and almost 20 years of experience is just going through my head.  Legal analysis; what just happened?  But then it was like this human analysis.  Oh, my goodness; this is how the families feel when something goes wrong during childbirth.

I had a kind of ah-ha moment where, like, oh, my gosh.  I may know something because of what I’ve done with these birthing cases.  So we got news baby was going to be okay.  I do have children.  It did scare me for a minute that I wouldn’t be around for the birth of my kids, again, knowing what I know.  My kids’ childbirth will be different than in any traditional family.

So I decided to take some of that knowledge that I’ve gained over these years as a childbirth attorney and write a book to expecting parents, and even grandparents.  Grandparents are just loving my book, which makes sense because I did write this book kind of for my kids to make sure I have healthy grandkids.

Yes, it makes sense that they would want to read it.  Of course!

Right, and we’re probably same generation and all that stuff.  But I wrote this book to make sure that these mistakes and complications that I’ve seen over 21 years don’t happen during the birth of a baby because a lot of these are mistakes that are reoccurring.  It’s stuff that I talk about in the book.  Basically, I show parents how to make sure these mistakes and complications don’t happen during the birth of their baby because obviously, you know, when the baby is born, that is such a powerful moment in life, and it’s a powerful moment that’s a start to a whole new chapter of your life, and you want it to be the best.

Right.  You don’t get a do-over of that particular birth.

Yeah, you don’t get a do-over.  So yeah, I wrote the book, basically how to have a safe childbirth – safer childbirth.  A Parent’s Guide to a Safer Childbirth.  And it was actually just published in June 2023.

So recent!  Congrats!

It is, but I think people are really gravitating to it.  I checked my Amazon reviews, and a lot of dads are reading it.  They want to step in and protect their wives and children, and grandparents are coming in and leaving the reviews.  It’s been really fascinating to see who’s been reading the book.  I did try to aim it towards moms a little bit, and they are reading it, too, but so is everyone else.  It’s been exciting.

Well, I can’t wait to use that as a reference for the Gold Coast Doula team as we’re talking with clients about recommended reading resources.  And our Becoming a Mother students are always looking for good, evidence-based information to prep for childbirth and early parenting.

Thank you.  I appreciate that.

So how can we find your book?  You said Amazon.  Are you in some bookstores?  Can we find your book off your website?

You can go to ginamundy.com, and that will take you to where you can buy my book.  But it is available really just now on Amazon.  It’s so new.  It’s such a process getting your book pushed out, and I’m still a partner in a law firm.  I’m still a practicing attorney.  I’m still a mom of three.  I still make dinner every night.

Juggling so many different roles!

I worked out at 5:00 a.m.  I’m grocery shopping by 6:15 a.m.  So it’s hard because a lot of it falls back on me trying to get it out.  But it’s on Amazon, and I think it has over 250 reviews, too.

That’s awesome!

Yeah, it’s good.

What tips do you have to plan and prepare for a healthy childbirth?  You had talked about witnessing and representing tragic cases.  What is your advice?  And I’m sure it’s in your book, but just to give our listeners a sample of what they can do to better prepare themselves outside of hiring a doula, of course.

Right.  So chapter one of my book is the lessons learned from baby cases.  So these are the lessons that we can take away from the families, the medical teams, the medical experts.  Basically, how to have a safer childbirth.  So I listed all of those lessons, and then each lesson in chapter one is then a subsequent chapter, which kind of then elaborates on each individual lesson.  So I just kind of put it out there: I think chapter one is absolutely so important for expecting parents to read.  It’s all of your lessons.  This is what you can learn, and this is what you need to know.  If you want to read more, you can put another chapter up there or whatnot, but these are your basics that you really need to know.  If you go to my website, you can grab it.  It’s free.  It’s shareable.  But it’s definitely – the big reason I wrote this book is because when I have met these families, it is the hardest part of my job when a preventable mistake takes the life of a precious baby or a mom.  There is no way to come back.  So these lessons are so important.  I cannot emphasize it enough.

For instance, lesson number one from the families: learning about labor and delivery.  Learning about childbirth before you get to the hospital.  In all of my cases, the families just roll up to labor and delivery and they’re like, I’m here.  And that’s it.  They’re not ready.  Now, when I have to talk to them years later, they know so much more in the aftermath of something bad happening.  It’s heartbreaking.  Because if they would have known this ahead of time, then it’s very possible that maybe they would have had a different outcome.  So it’s learning about your options, and unfortunately, it’s a mentality I think we’re all guilty of.  “Bad things only happen to other people.”  So they just hope for the best.  Well, that leaves you in a very vulnerable state of mind, and I would not recommend that on one of the biggest days of your life, particularly with what I’ve seen for over 21 years.

So chapter one is going to talk about what you need to know for labor and delivery, your labor and delivery basics.  But the facts that I rely on, too, as an attorney when I evaluate these cases or I’m talking to a mom who’s in labor – because believe it or not, as a childbirth attorney, I get the calls from labor and delivery.  What about this?  But a huge, huge chapter of this book that you’re not going to find anywhere else that every parent should read before the big day is chapter 11, and it’s the ten most common facts and issues in a legal baby case.

So number one: when I get a case in, almost every case – not all of them, but almost every single case – the first words I read are, “Mom is being induced with Pitocin.”  Pitocin is the number one most common fact in a legal baby case.  So if you’re having a Pitocin induction, you better understand that Pitocin and mistakes can go hand in hand.  So I’ve seen the Pitocin inductions gone wrong since February 2003.  I’ve taken what I’ve learned from those cases, again, and put it in the book.  So if Mom is getting a Pitocin induction, my book is a must-read.  And not only is my book a must-read, I’m going to put that doula is a must also if you’re getting a Pitocin induction because those are very tricky, and listen.  Some hospital systems, nurses and doctors are great.  The problem is, everyone does a Pitocin induction different.  So everybody’s different with their Pitocin inductions.  Some are more aggressive.  Some are more slow.

Exactly.  Some are very gradual, and some of the clients that I have, they just need a whiff of Pitocin, and they can be taken off Pitocin.  And other times, their body doesn’t respond well, and it’s on the highest level, and baby isn’t doing well; mom’s not doing well.  There are very few other options.

Right.  That’s why having a doula is huge during a Pitocin induction.  But another common fact and issue in a legal baby case is a very busy labor and delivery unit because the delivery teams, they’re running hard and they’re running thin.  When I have a case, I’ll sit staff down, and they’ll be like, oh, I remember that day.  It was so busy.  I mean, I hear this all the time.

Of course, and you can’t control that, other than the planned surgical births and induction, whether or not the women’s center is going to be busy or it’s a slow day. 

Absolutely, because unlike a surgical center where surgery is scheduled at 9:00, 10:00, 11:00, 12:00 – babies come when babies want to come.  Especially in Michigan, you probably know this.  They tell me there’s busier months.

There are.

Yeah.  What about late morning?  Late morning is very busy.  When you’re coming in, it’s very important to know, hey, is this a busy labor and delivery unit, because that’s where it comes into play, where it becomes very important to work with your delivery team.

Now, listen.  You’re a mom.  You’re in labor.  Your mind and body is focused on delivering a baby.  That’s why having a doula there to be your advocate and somebody who knows what’s going on is just so important, especially if you walk into something like a busy labor and delivery unit.

Exactly.  The continuous support of a doula during labor can increase satisfaction, reduce interventions.  If the nurse is busy with other patients or focused more on charting and is unable to provide reassurance or physical support, a doula is necessary, and the partner is often fatigued and overwhelmed and wants to be asking questions, but if no one has time for them, then birth just happens to you, and you’re not able to make informed decisions.

100%.  That’s why the idea of having you guys – and we were talking about this in pre-show, but I was writing my book, and everybody was like, well, are you including doulas, and I’m like, I just don’t know that much about doulas.  Now I do, obviously.  This ah-ha moment – wait a minute.  The childbirth attorney who only sees bad outcomes doesn’t know anything about doulas because if doulas are involved, it seems to be like you guys really play a big part in making sure that baby arrives safely and that mom is able to leave with baby.

So anyway, again, very common in legal baby cases: busy labor and delivery unit.  Have a doula there to make sure that everything is streamlined and everybody’s working together.  That’s huge.

Residents are another big, very common factor in legal baby cases because these are just – I mean, they run the show in some of these hospitals.

Yeah.  It depends on the hospital, but the teaching hospitals, yeah.  And if they’re very busy, then the resident is there versus the OB.

Yeah.  These are just doctors in training.  So we meet with residents because these cases, something happens, and it’s always years later.  So by the time I meet with a resident, they’re a practicing doctor.  And they’ll sit down with me and they’ll be like – so we’ll be preparing for a deposition, meaning they have to testify in a case, and they’ll be like, so do I testify as to what I know now as a doctor, or as to what I knew as a resident a few years ago?  And I’m like, great question in a legal proceeding, but very scary if that’s who’s managing your labor.  Again, it’s important to find out if you’re having residents involved.  But I go through that in my book.

Going through those different types of lessons is just absolutely huge, and then elaborating on them.  I mean, like you said, every labor and delivery is different, so it just depends on which direction yours ends up going.  But definitely, knowing this lessons.

I loved knowing about the baby’s heart rate.  Obviously, baby is inside you, so your doctor or your nurse looks at you.  They can assess mom just fine.  Oh, mom is in pain; I see it in her face.  Let’s talk, let’s do a diagnosis, whatever.  Baby is different.  Baby’s inside you.  So it’s hard to – how is baby doing?  I can look at a fetal monitor and be like, this baby’s a rock star, or this baby is struggling.  Fetal monitoring – you don’t need to know everything about it, but just knowing some basics, because it seems like the medical community just wants to keep that knowledge to them, and that just floors me every single time.  The first thing I do when someone contacts me in labor and delivery: send me the strip.  Take a picture or take a video.  Send me the strips.  I want to see that.

It makes sense.

That’s the best way to know if the baby’s doing okay.  I had a doctor testify in a case: the only way the baby can talk to a doctor is through their heart rate.  So in my book, again, I think that’s really important when you’re preparing for childbirth, just having a basic understanding of it.

Sure.  And, of course, there’s internal monitoring, and I’m sure you’re seeing all the differences between the walking monitors, which as doulas, we love to be able to change positions and still keep track of baby.  Internal monitors if there’s more concern on how baby is responding. 

Actually, I have a chapter in my book about the three different types of monitors that you’re talking about.

Like the Doppler and the handheld?

I’m giving everybody the good and the bad.  I’m sure you guys like the Monica.  Now, there’s been a few cases involving the Monica in Michigan that have been very scary.  So, you know, I put a couple – you know, I go through the three monitors, the benefits and the disadvantages.

That is so helpful that you compare them.

Yeah.  And the disadvantages, I give a couple of case examples just kind of going through everything.  And it’s just so parents can make informed choices.

That’s what it’s all about.

Right.  You’re in labor, and somebody may be like, well, we want to place an internal monitor.  What’s that?

If they’ve not taken a childbirth class, they wouldn’t know.

If you don’t know what that is, that can be kind of scary.  I mean, my niece, they had put one on her, and she was like, there’s a wire between my legs, and I’m hooked to a machine.  And I’m like, but, you know, it’s the most accurate way, because I had requested that they – I want one on.  Get the internal monitor on during labor.  And they were great.  They’re amazing.  Amazing staff.  They ended up doing a really good job.  But she was like, what is this?  It wigged her out.

Oh, I’m sure.

And it’s so important that – you know, you know this, but staying calm and being in, like, harmony in labor.

It’s everything.  It affects baby.  If you’re in panic state, labor will take longer.  If you’re in the flight or fight stress mode versus being calm and relaxed and open to it.

Exactly.  So just having an understanding of these basics is just huge.  Absolutely huge.  When good decisions are made, healthy babies are born.  And ultimately, mom is the decision maker.  There is no one starting Pitocin, no one starting an epidural, no one starting an IV, no one doing a C-section – no one’s doing anything without mom’s approval.  Mom has to approve everything.  And then sometimes when you get to the hospital during childbirth – and this happens in quite a few cases, but sometimes Mom is given options.  You know, maybe there’s a concern about baby.  Maybe we need a C-section; maybe not.  So it’s important that ahead of time, you get ready.  I have a chapter on preparing a birthing plan.  And it’s not so much preparing the plan where you’re going to walk in and give it to the nurse and say, this is what I want to happen.  That’s not – no.  My book’s not about that.  My book is more just the exercise of preparing for birth in the comfort of your own home, learning about it, taking one of your courses, getting knowledge on it, Googling it, asking people, phone calls.  Just having this plan or just being more prepared that anything because, obviously, labor is probably one of the most unpredictable things ever.  So trying to have a plan – you must know it’s going to change.  That’s why it’s important to prepare and get ready.

So what are you seeing as far as surgical births versus vaginal and VBACs in your cases?  Vaginal birth after Cesarean, for our listeners who don’t understand what a VBAC is.

Yeah, I’m not a fan of VBACs.  Those are hard for me.  In chapter 7, I actually go through a personal story with my cousin.  But VBACS – I love putting this out there.  Now, listen, a lot of people – everything has changed.  First it was this whole, once a C-section, always a C-section.  2010, they’re like, C-section rates are really high.  Let’s consider VBACs.  And there’s a lot of moms who have successful VBACs.

Right.  I’ve supported many.

So the consequence of not having one is the old incision scar where you’ve had that C-section tears open, and that causes a lot of problems for baby and mom.  But the thing that I’ve always with VBACs is because your uterus – where they make the incision to get the baby out, it’s inside you.  Nobody can assess that to make sure that it healed correctly for a vaginal birth.  So that’s the thing that always scares me, and we went through that with my cousin.  That chapter starts off with her story.  Her doctor really pushed – she’s in Florida, and they really pushed for a VBAC.  And I’m like, okay, well, this is what you need to know, and I go through exactly what I told her, which is much different than what her doctor told her, but her doctor wouldn’t even schedule her for a C-section.  So she goes into labor.  The doctor’s like, come on, come on.  So she calls me, and I’m like, if it was me, I would do – there’s also other factors.  She’s almost 40 years old.  Everything heals different.  There’s special factors for her, too.

So, C-section.  Baby arrives safely.  And then the doctor comes and sees Allie and was like, thank you for not listening to me.  When she entered the abdomen, the uterus was paper thin, and the baby’s hair was sticking out.  So she was like, you would have absolutely ruptured.  Your uterus would have ripped open right there.  So you say VBAC, I just get scared immediately.  But yeah, there’s cases where it’s hard to talk about because there is a lot of confidentiality.  It’s a risk.  As a childbirth attorney, I am not a fan of them, but I do know that there have been many people who have successfully done them, and yes, we do see them in cases and whatnot.  But just because I’m still practicing, there’s confidentiality associated.

Of course.  Just more broadly, are you seeing more cases when it comes to surgical or vaginal births?

So, basically, this is actually in the book because I have a whole chapter on C-sections.  So in the baby cases, they are basically attempted vaginal births –

That turned to surgical?

They went sideways and result in a C-section.  That is my typical baby case.  There’s a delay in performing the C-section.  Something happens during labor.  Again, remember Pitocin?  Pitocin is usually running.  Usually, there’s an epidural.  And everyone’s trying vaginal.  So for instance, I’ve never had a case involving an elective C-section at 39 weeks.  Actually, this is in the book.  Most baby lawyers just have 39 week C-sections because of the problems we’ve seen.

You’re seeing the worst case scenarios.  Of course, so you would try to err on the side of safety.  Yes.

Now, I’m not sure I’d recommend it.  You know, I had three C-sections, and they’re rough.  I don’t know if my kids will – I don’t think they’ll do that route, which again, hence my desire to get this information out there.

Exactly, so they can prep, yeah.

Yeah.  Everything is usually attempted vaginal birth that ends in a C-section.  That’s your typical childbirth case.

Interesting.  So what other tips in your book would be helpful for prepping for birth and baby?

Number one, know your delivery team.  So that’s another huge lesson in the book.  The delivery team is responsible for bringing your baby safely into this world, and in my cases, it is the delivery team’s care that is at issue.  It is the biggest part of the case.  It is the most analyzed part of the case.  But having a good delivery team is so important.  You have to understand that while you may be able to pick your doctor or pick the practice – maybe there’s a couple doctors – the delivery team is who’s scheduled to work that day.

Exactly.  You may have never met them.

Yep.  Most of the time, you’ve never met them.  Again, important to have a doula there, because a doula you’ve met, you’ve built a little relationship with them.  Somebody you’re comfortable with.  Because you can walk into labor and delivery, and it can be luck of the draw.  In my book, I talk about a case, and there were two nurses in the case.  One of the nurses was the primary nurse who did something wrong, but there was two nurses.  One was a nurse who had 20 years of experience, and she was literally born to be a labor and delivery nurse.  She’s amazing.  I loved her.  Nurse number two: she had just finished training.  She had just been on her own in labor and delivery, and had figured out she hates labor and delivery and was looking for a different job.  I’m sure you can figure out who’s care was at issue in that case.  The good nurse, the experienced one, was just trying to help.  But that day at the hospital, when the patients walked in, it was luck of the draw.  One got the experienced nurse who’s a dream, and one got the other nurse.  So you have to – it’s important that if you get that nurse that you’re not a fan of, that you’re like, hi, I would like a new nurse.  You don’t just – your delivery team is so important.  I cannot stress that enough.  So in my book, again, I’m like, these are the players of your delivery team.  This is what you need to know.  Now, again, you’re a mom in labor, so it’s important that you have somebody there that can – I call it the baby advocate.  Whether it’s your husband: you look at your husband and you give him the nod, like, get me a new nurse.  Or you have a doula, and you’re like, hi, I need a new nurse.  And then that’s it, and then you go back to being comfortable and focusing on you and baby.

But here’s the deal with the nurses: that day, all the nurses on that floor knew the labor and delivery nurse sucked, for lack of a better word.  So if mom would have said something to a charge nurse – or I tell you in my book exactly who to approach, but if that mom would have said something, other nurses would have done what they do best, and they would have stepped in and helped.  But the other nurses, they’re not in charge of hiring.  They can’t just open the door and say, “Hi, do you hate your nurse?  Let me know and I’ll get you a new one.”  It doesn’t work like that.  You have to say something.  But literally, just the nod of the head or whatever.  Make sure you like your nurse.  And there are so many great labor and delivery nurses.

I agree.

They’re amazing humans.  It’s a special breed of people.  I love my labor and delivery nurses.  But sometimes in my cases, it’s the ones that don’t have a lot of experience and are not really – you know, they’re just not really into it.

Right.  And we do talk about that as doulas, that our clients are consumers, and they have a choice if it’s not a good fit.  They can request a different nurse, and it’s rare in my career that I’ve seen that personally happen, but just to know that you have options and you don’t have to just tolerate your care team is a huge thing.

Oh, yeah, for sure.  So I have a whole chapter on the delivery team.  And then another big part is I have a whole chapter on doctors; picking the good doctor.  So I have analyzed doctors, OB-GYNs in particular, for almost 21 years.  I mean, it’s semi-creepy.  I’m not going to lie.  But I have.  Listen, I have to stick these people in front of a jury.  Is the jury going to like them?  What’s going on?

So I’ve taken the knowledge that I’ve gained from all my interactions with doctors, questions to ask them, things to think about, and just did a whole chapter on them.  There’s so many different aspects that are so important for moms to consider and think about when they’re picking their doctor.  Because ultimately, the doctor is the head of your delivery team.  They’re captain of the ship.  So they are the ones that are making the recommendations.  But you know this.  Doctors are not just hanging out at the bedside.

No.  They check in.  They’re busy with other patients.

Oh, yeah, if they even check in.  Some just come in for the labor, and sometimes they miss that.  So it’s so important that you have this good doctor that you trust because they have to be able to communicate with you.  Think about how they’re communicating with you during the pregnancy.  I mean, are they good communicators?  Think about it, because once you go into labor, they’re relying on the nurse or the residents to communicate what’s happening.  And if they’re good communicators, awesome.  They’re going to be able to get a good idea of what’s going on with you during labor and delivery.  But if they’re not – so there’s just a lot of things to think about with doctors, and again, a lot of the times, it’s their care, too, that’s at issue in these cases because they head the ship.

They do.  Even if you’re working with a nurse midwife, the OB would oversee if things turn into a surgical birth or if vacuum was used, for example.  It would be the OB.

Yeah.  And then I think probably this could be one of the last ones.  There’s so much in the book.  We are just hitting the surface.  But a huge, huge one is having a baby advocate.  I have a whole chapter on having – because you need to focus on you.  You need to focus on baby, staying calm.  So whether it is husband or grandma or doula – I really like doula because you guys know what’s going on.  You know how to keep everybody calm.  Having that advocate for you, just this second set of eyes, in case you do walk in and it’s busy that day.

Absolutely.  And then there are patient advocates, as you know, and different resources within the hospital system.

Yeah.  You guys know so much.  I would say on my baby advocate list as the top one would be you guys.  You know, but it’s just the second set of eyes because you just really need it as labor progresses to help with, again, talking to the delivery team, just making sure everybody’s on the same page.  And it’s nice with a doula because you speak their language.  So you know a little bit more.  You can ask the right questions.  You can make sure that mom’s being informed with all of her options.  Because maybe mom is surprised with a couple of options, but when it’s like, here are your options, but you have one person explaining it – well, is that person – you know, how are they doing that day?  Are they a good communicator?  I mean, I don’t know about you, but I have off days.

Of course.  We all do.

So it’s nice having a doula that you trust where then you can kind of bounce those – okay, well, I have two decisions, because sometimes – and I talk about this in the book.  Two decisions can really result in a different outcomes.  I compare three different cases where it was the same decisions – or not the same decisions, but the same options but different decisions and different outcomes, and it’s kind of – whoa.  So the importance of decision making – again, you’re making good decisions.  You’re making informed decisions.  I mean, your chances of having a healthy baby is so important.  So having that baby advocate, especially when you’re in labor, is just huge.  That’s a whole chapter.  And if you do choose to have grandma or somebody else – you know, at the end, it’s like, okay, make sure your baby advocate knows this stuff.  There’s five things the baby advocate should know.  Now, it wouldn’t apply to you guys, because it’d be stuff that you already know.  You’re already prepped to be a baby advocate with what you do.

And grandparents and friends, if they’re the support person, they can often attend a childbirth class.  Say there isn’t a partner.  So if you want them to be informed, it’s another option.

It’s a great option.  Grandmas are the best advocates ever.  Expecting grandparents have this wisdom, and they’ve been through it.  The circle of life playing out right in front of them, watching their own child have their first baby or their second baby.  It’s awesome.

Yeah, we teach a grandparents class.  It’s both virtual and in person, and we love it.  So much has changed, and just keeping up with safe sleep and feeding and all of the new gadgets and tech items related to parenting, and apps for pregnancy and so on.

Yeah.  That’s awesome.  I love it.

Well, I could talk to you forever, Gina, but we must wrap up.  So if you would fill us in again about how to reach you, what social channels you’re on, and again, how to find your book.

Oh, great.  So ginamundy.com is the best resource because it’s going to have my book.  But, you know, I also have a childbirth blog that I just recently started.  Actually, my book was so long that it was actually cut in half.  So this is only the first part of the book.  This book is focused on childbirth.  The next book is supposed to be focused on pregnancy.  This childbirth blog is awesome because if I forgot to include something about childbirth, I’m like, blog.

Perfect, yes!

And then I’ve been taking some of my pregnancy content that’s really important because it is hard to get a book out, and posting that.  Just different topics that expecting parents need to know.  It has also some great resources for expecting parents.  So ginamundy.com, and then you can always go to Amazon, and if you just type my name in Amazon, it comes right up.  And I forget to do this because I have never been a social media person, so this is very difficult for me, but I am on Instagram.  I think I have maybe 1400 followers.  A lot of times if I’m on a podcast or something, it’s popping up on Instagram, so it’s definitely a good way to find the different podcasts I’m on.  That’s @ginamundy.  And then Facebook is @ginamundy,author.  And that’s just different stuff that’s popping up.  Sometimes I’ll post my blogs and stuff like that, too.

Well, we will link to all your sites and the book on our blog and social media.  Thank you so much, Gina!

Thank you for having me.  What a great conversation.  I love the work that you guys are doing.  You are definitely helping babies come into this world much safer.  Thank you for doing what you do.

And thank you for creating such a thoughtful book and for fighting for families.  Your work is so important!

Thank you!

IMPORTANT LINKS

Gina’s website

Birth support from Gold Coast Doulas

Childbirth classes from Gold Coast Doulas

Grandparents class from Gold Coast Doulas

Becoming a Mother Course

 

Kristin Revere chats with Josh Dech host of ReversABLE- The Ultimate Gut Health Podcast about the importance of gut health and how to achieve it.

Hello!  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with Josh Dech today.  Josh is a podcaster, as well.  His podcast is named ReversABLE – The Ultimate Gut Health Podcast.  He’s also an ex-paramedic and a holistic nutritionist specializing in gut health. 

Welcome, Josh!

Kristin, it’s a pleasure to be here.  Thank you for having me!

I would love to hear a bit of your backstory and why you’re focus and passion on gut health emerged from all of the different focuses you could have in holistic nutrition and holistic health.

Sure, and I call it more of an obsession than I would anything else at this stage in my career.  I’ll give you the quick Coles Notes here.  I used to be a paramedic, and I realized very quickly it was just sick care.  You’d pick up the same people over and over for a lot of the same issues, and you take them to the hospital.  They get new medications or more of the same medications and send them back home.  And I really became a glorified taxi for the ill.  It’s not what I wanted to do.  I enjoy doing trauma and stuff like that, but it wasn’t what I wanted to do.  People weren’t getting better.  So through a series of accidents and happy accidents, I ended up getting into personal training when I was probably 20, 21.  One of my clients came to see me, one of my first clients in my professional personal training career.  She was 57 years old.  She was on 17 pills and insulin with breakfast, 9 pills and insulin for bedtime.  She had high blood pressure, slept with a CPAP machine.  She was on the disability list at work, so if the fire department got called, she’d have to wait 56 floors up for them to come and get her.  It was just a whole mess of things going on.  And by the time she turned 59 – we were working together on health and nutrition and gut and fitness and training – at age 59, coming from this background, she ended up breaking her first world record in the raw powerlifting division as a weightlifter.

What?

Oh, yeah.  This 59 year old woman kept breaking records until she was 61, 62 when she retired.  5 foot nothing, 160 pounds, and she’s pulling 315-plus pounds off the floor.

Amazing.

It was incredible to see.  That was really my first window there, Kristin, into seeing that the human body has so much more potential and capability to heal itself.  So I got interested in that holistic side, and I started seeing people in my personal training space with skin issues, anxiety, depression, hormonal issues.  I started doing some self-study.  Found some mentorships; started working with and learning from different doctors.  I decided to ultimately go back to school and become a nutritionist.  The holistic nutrition kicked things off.  I started seeing gut disease and gut issues and severe IBS, until my career eventually landed specifically in inflammatory bowel disease, which is Crohn’s and colitis or ulcerative colitis, where I work now.  And through the work we’ve done there, I’ve been recruited since to the Priority Health Academy as a medical lecturer.  That’s sort of where my career is today.

I love it.  So as a paramedic, I have a side question for you.  Did you support any unexpected home births?  What was your experience with women in childbirth as a paramedic?

I had a few OB patients that we had seen.  You know, I got some OBs; more so when I was actually doing my preceptorship before I was a full fledged paramedic and student.  And the odd MVC, or motor vehicle collision, that we would see with obstetrics; thankfully, everybody was fine and healthy, nothing major.  Yeah, I did a little bit of a short stint there in the OB ward, as well.  Through clinical and through hospital placement, we work in the ER; we work in dialysis; we work in OB.  So we get to kind of see everything.  And I really found obstetrics fascinating, and it was through actually my career in the holistic side helping women with fertility or men with fertility issues that really sort of highlighted the importance of the gut to me in every aspect of our being and well-being.  And looking back now at my clinical and the stuff that I could actually see, I could see these gut connections and these chronic disease things that people started to have, so it’s a really cool 360 moment.

It really is.  I love it.  And I also appreciate that you mentioned working with men in fertility issues because it often is connected to the woman as far as any issues with conception.  And focusing on gut health for both would be so beneficial pre-conception or in that fertility stage of starting treatments and so on.

Oh, absolutely.  And there’s so much incredible things that happen with the gut to set things up for both pre, peri, and postnatal.  It’s really amazing when we make that connection, but it’s just like you said.  I think through a lot of history, fertility issues have been connected with women.  “Oh, she is barren.  She’s this.  She’s that.”  But they never look at the men who might have low T or low sperm motility or digestive issues or dietary issues, and we never really look at both sides of that picture, and I think it’s about time.

I agree completely.  So what are your tips for our listeners in each stage, whether it’s pre-conception, early pregnancy to focus on, you know, maximizing gut health, and then also in the postnatal recovery phase?

I would actually love to go through these step by step.  Why don’t we start with pre-conception, and we’ll work our way through early pregnancy, perinatal, postnatal, and just kind of talk about the role of the gut and these gut bacteria.

So let’s start things from the top.  I think first it’s really, really important to understand for the listeners how important our guts really are because oftentimes we hear in the mainstream, oh, gut health this, gut health that.  Yeah, okay, I get it.  But I think it’s really important to understand a reverence for gut health because in my practice, I often tell my clients, our gut bacteria are more important than our very own DNA and our very own genetics, which is a huge claim to make realistically.  We’re talking about the foundation of what makes a human being a human being.  But that’s actually being broken.

So to give you an idea, Kristin, if we take a look at the gut microbes, our microbiome, we have about ten trillion cells in the human body.  Your gut microbiome alone has about a hundred trillion different bacteria.  So they’re outnumbering your bodies own cells ten to one, which is pretty dramatic.  And if we look at the genetic material, there are millions – 10 or 15, 20 million different bacteria in there, multiplied out to 100 trillion.  Your own genes, the entire human genome, is about 23,000 different genes.  But looking at your gut bacteria, you have about 3 million different genes.  There’s 130 times more genetic material in your gut alone.

It’s shocking.  It really is astonishing.  We dig into what it does for the body, and it integrates with everything.  It integrates with hormonal health, which again, obviously, is very important for healthy pregnancy and delivery.  It integrates with your hair, skin, nails, sleep, moods, emotion, how social you feel like being, detoxification, vitamin and nutrient production.  There’s so much that they do.  There’s not a single aspect of your body not influenced in some way by our gut bacteria.

So just to illustrate one quick little story; it’s one of my favorite stories: the importance of small things.  If we look at – I’m sure you’re familiar, obviously, as a doula and with all your OB clients and interviews you take in – you’re probably familiar with toxoplasmosis and the dangers around that?

Yes.

So have you had a chance to talk to your listeners about toxoplasma and what it does and how it works in the body?

Not that I can recall over the years.  Fill us in!

Here’s a fun little story for you.  Toxoplasmosis is an infection of a parasite called toxoplasma gondii.  And this toxoplasma parasite – this is just to illustrate the importance of small things in the body.  Every living thing on earth has a prime directive, right?  Grow and pass on its genes.  And even this parasite, this toxoplasma parasite, knows it has a prime directive.  It has to grow, pass on its genes, and live its best life, which ultimately is actually in the belly of a cat.  And so what we see this toxoplasma doing – it’s why you can’t change kitty litter if you’re pregnant because it could have these parasites in these litter, and you could ingest them and cause problems.  But this parasite wants to get into mice because it knows mice will end up in the belly of a cat.  But interestingly enough, mice are genetically wired – it’s in their DNA to fear cats.  As a prey animal who’s never seen a cat, a baby mouse will still run, and even mice who have never seen a cat who smell cat urine are hardwired to run the other way.  And so this parasite actually hijacks this entire living organism, and what it will do is it will get into the brain and it will burn out the dendrites in the fear center of the brain of the mouse, making it no longer afraid of cats, making this mouse very brave.  So it increases the likelihood to run into a cat.  But it goes one step further.  This will blow you away.  It actually rewires the brain to be sexually attracted to the smell of cat urine.

What??

Oh, yeah.  So this one little parasite completely hijacks and rewires an autonomous living organism to get it more likely to end up in the belly of a cat.  Now it’s not afraid and it seeks cats.  And so then this parasite gets consumed; it can go to the belly of a cat where it’s happy.  But it can also be in any cat, even jungle cats.  So we’ve even seen humans who have this toxoplasma infection.  Now, obviously, over here, we don’t have to worry about cats, but in the eastern countries, the only predator of a human is going to be lions and tigers and large cats.  And so we’ve even found it in people.  Now, talk about bravery – again, we can often think, well, it’s just a mouse.  A parasite; it’s a small mouse; what’s the big deal.  We’ve even seen them hijack humans, kind of like The Last Of Us with the cordyceps.  These little parasites – we’ve found people who are very brave who jump into traffic to save a human being or a child or run into a burning building to save a stranger.  Many of these people have been found to be infested with toxoplasma gondii parasites, making them seem braver than they actually are.  It’s really interesting to me to look at what one little thing can do to hijack a host, a living organism.  And so I’ll often say, if one parasite can do this to a mouse or a human being, one little organism – you have a hundred trillion bacteria inside your gut.  Imagine what they can do for you when they’re aligned.  Or worse yet, imagine what they can do to you if they’re not aligned and they’re out of balance.  And this ultimately is the importance of gut health prenatal.

What an amazing story.

It really is one of my favorites.  So we have to understand that your gut bacteria set up everything for you pre-conception.  They balance your hormones; they keep you healthy.  70 to 90% of your immune system comes from your gut.  If you find yourself getting chronically ill or having digestive issues, you’re going to be depleted on nutrients.  You’re not going to be able to have a full nutritional profile, even as a basic level, to bring a baby to term or to have healthy sex hormones and sexual function.  So we see a lot of people who have digestive issues who either, A, are more prone to having babies with birth defects or development delays, or B, may not get pregnant at all, or C, not carry a baby to term.  This comes down to nutrients because the body needs nutrients in surplus, obviously, when you’re pregnant.  And so in order to have that, you have to have a healthy gut because a healthy gut absorbs and produces nutrients.  But if you’re not eating well or your gut is unhealthy, you’re both going to be in debt because your body is burning through nutrients at an increased rate.  Any time you’re under stress or you’re inflamed or you’re sick, it’s burning through these nutrients in excess, and then you’re not ingesting or absorbing properly.  So now you’re in debt.  So what happens when you’re in debt – I mean, imagine, Kristin, if you went broke; you went bankrupt.  The only way to get money is to work more, work harder, or to borrow it.  The human body does the same.  It will borrow from hair, skin, nails, other organ systems, hormones, and all these other aspects that hold nutrients in the body in order to sustain its most vital parts, which is brain, liver, heart, digestion, the basics.  So if you’re in debt, you’re borrowing from other places, it’s no wonder we’re going to be so sick all the time and unable to carry or to deliver or to have healthy sperm and sperm motility if we’re constantly in debt.  So we have to have healthy guts ahead of time to get ourselves to the end goal of, obviously, conception and development.

Thank you for explaining that.  I feel like it’s often assumed that just taking prenatal vitamins and trying to eat healthy is all you need, both in preparing for conception and also during pregnancy.

We often think exactly that because it’s often what we’re told.  It’s just, take these vitamins; you’ll be fine.  Well, if you have an unhealthy gut, even if you may think it’s unhealthy – if you have skin issues, anxiety, depression – you might actually have an underlying gut issue.  So you end up with really expensive urine because the vitamins come in; your body can’t absorb, utilize, breakdown, and then they get wasted.  Or worse yet, most doctors will tell you to take folic acid, right?  Just folic acid.  Even if we look at genetics, something that’s become very popular and I’m sure you’re very aware of in this space is that 44% of the population has a particular snip in this gene called MTHFR.

Exactly, yes.

You talk about that, I’m sure.  So 44% of women can’t use folic acid, anyway.  So we need these methyl folates in usable forms.  So I think it’s really important to understand all sides of this thing, exactly like you’re saying, to really have a well-balanced idea of how to have a healthy body, healthy baby, healthy nutrients.  Not just coming from what you ingest, but how you digest.

Yes.  So true.  And obviously, I mean, it helps to be in a healthy state before conception, so exercise, water intake, nutrition.  And as you had mentioned, really setting yourself up for conception.  But getting into pregnancy – again, what are your tips once a listener is pregnant and wants to focus on their health?  Would that be to seek a holistic nutritionist?  What are your thoughts there?

Definitely, I am a little biased, because I am a holistic nutritionist.  So definitely seek a nutritionist, because they’re really great at making sure you’re getting what you need.  I know, again, not all practitioners are created equally, as you’re aware in your field, as well.  In any field;  not all doctors are going to be equal; not all engineers will be equal.  Not all janitors are going to be equal.  So we really have to vet to make sure they’re competent.  My specialty being in the gut, I can make those connections, particularly for those who are trying to conceive who have gut issues or gut disease.  But what I won’t actually touch – because I specialize in Crohn’s and ulcerative colitis – I actually will not work with women who are actively pregnant or breastfeeding because – in very rare circumstances, I will – but if there’s a lot of toxins in the body and things built up, flushing those out while you’re pregnant or breastfeeding is actually very dangerous for the baby.

That makes sense with your specialty, absolutely.

Yes.  We want to just make sure to take care of that first.  Now, if you’re looking to conceive or you’re finished breastfeeding, absolutely, we can get in and fix gut disease.  But if you have very basic gut issues – irritable bowel syndrome; if you have some acid reflux and bloat, some cramping, constipation, diarrhea – that can absolutely be managed through very simple processes often.  We just have to figure out what’s causing the problem.  So if the issue really is just gut bacteria, sometimes taking the odd probiotic.  Now, I’m not condoning taking probiotics randomly.  I’ll get into that in just a second.  But sometimes it can be as simple as a probiotic or sitting down to chew your food.  If you’re shoveling five kids in the car to soccer practice and scarfing down dashboard dining, you’re actively in fight or flight, so you’re not going to break down; you’re not going to digest; you’re not going to absorb.  Your digestive system will be compromised.  Especially if you’re pregnant, all your organs are displaced, and so you’re not going to be – your digestion is already going to be a little bit off.  You might be more prone to being burpy or bloaty or gassy.  So we have to take extra special care to sit, to eat, to breathe.  Sometimes digestive enzymes can really help with that.

But in the case of taking probiotics, I often caution.  Now, the good news here is there’s a safety net because most probiotics, oftentimes they’re dead in capsule, so even their postbiotics that they produce can have nice benefits going through.  But it’s hard to find, unless it’s a very high quality maybe refrigerated probiotic.  It may not be an active, live culture.  So you’re kind of okay in that regard.  But if someone’s adding live cultures – say you have an overgrowth of lactobacillus; a very common probiotic we’ll see.  You have an overgrowth in your gut, and that’s contributing to your issues.  You take that probiotic; well, now you’re pouring gasoline on the fire.

So I often recommend in gut issues, severe gut issues, to get GI mapping done, which is a DNA stool analysis of your gut bacteria, which shows us everything in or out of balance.  As much as we can really see; again, we have 20 million different bacteria.  The best GI maps can maybe show you 100.  So it’s a grain of sand on the beach.  But it’s all actionable.  We can actually do a lot with these 50 to 100 we can see and make actionable differences.  So if we’re looking at gut and just how to generally take care of a gut, unless you have some severe conditions, again, like severe IBS or inflammatory bowel disease, I would say digestive enzyme; pausing; chewing; eating whole foods, and just taking your time.  Even – it might sound crazy, but avoid water 30 minutes before, during, and after meals, sipping as necessary, because if you’re low on stomach acid, which is a very common cause for acid reflux, then you’re going to be diluting your digestive enzymes further, which will further prevent or inhibit your digestibility of your foods.

Great tip.  So how does this affect baby and just overall gut health?  Obviously, with breastfeeding moms, there’s a lot of correlation . I’d love to hear your thoughts on the newborn and how gut health affects the child or children if they’re multiples.

Sure.  Something to keep in mind, we often hear gut microbiome.  But microbiome is really just an ecosystem, like a neighborhood of bacteria that happen to live in your gut.  We have microbiomes everywhere.  Women actually have them vaginally, so the entire birth canal is coated in bacteria.  You have them in your mouth.  You have them in your stomach, your hair, your nails, your eyebrows, your scalp.  It’s all different, but these neighborhoods all talk to each other.  So if you have healthy microbes, you have healthy microbiomes in one area, it actually influences beneficially the others.  So if we look at the vaginal microbiome in the birth canal, healthy gut bacteria influences that directly.  So when the baby is born – this is the difference between, obviously, natural and C-section.  As the baby comes through the birth canal, they’re fully inoculated in these bacteria.  And having a healthy gut fully influences that bacterium.  But even in utero, a baby developing in a placenta, we used to think the placenta was sterile, but we now know it’s teeming with microbes that you get from mom who got them from her mom and her mom before that.  So these genetics are passed on, these genetics and these microbe genetics.  So it’s really important to have a healthy gut to provide healthy vaginal bacteria and healthy placenta bacteria.  So as the baby is being born, they’re fully inoculated – eyes, nose, mouth, everything – with these microbes.

Now, for those who might need emergency C-sections, something that’s now being explored I’m sure you’ve heard or talked about yourself is a vaginal swab, and then you cover the baby with that swab and those microbes to try to inoculate as best you can.

Yes.  The seeding is very popular.

I’m so glad.  And a lot of doctors will still say that’s stupid, but we know how important it is.  If we look at the importance of having these natural births, obviously, having a natural birth as best we can, we know babies who are C-section will more commonly develop respiratory or neurological disorders like autism spectrum, schizophrenia, or auto-immune related diseases.  They might have more asthma or skin issues, juvenile arthritis, celiac, diabetes, or even obesity through childhood if you don’t have these bacteria properly.  They’re very important for a healthy childhood.  And we’ve even shown, again, connections to weight loss or the ability to have healthy body weight to gut bacteria on the body in general through mouse studies where they’ve gone through and put mice, for example, and they’ve had them go through and they’ve gleaned out their bacteria through antibiotics and flushing, and they’ve put them on a caloric deficit.  Well, these mice with altered bacteria didn’t get the benefits from calorie deficits, so weight loss or bacterial or hormonal benefits.  But the mice who have healthy bacteria did.  So then they reinoculated these mice with the good bacteria from the healthy mice, and they were able to lose weight again and have healthy thyroid and hormones and other things.  So we’re still exploring.  This is a very new science we’re just bridging into in the last 10, 20 years.  It will take us 50 to 100 more to really map the biome.  It’s amazing what we’re getting into to see.

So let’s take the next step.  Baby’s been born.  They’re covered in bacteria, assuming it’s healthy, or they’ve been seeded with vaginal seeding, which is great.  And now we have to look at breastfeeding.  There are obviously huge risks of not breastfeeding.  Again, medically, some women just cannot, and oftentimes, it’s actually a prenatal issue of gut health and healthy production.  But if we look at women who are already developing or already have a baby in utero and they’ve already given birth and now they want to breastfeed – if you can breastfeed, obviously, that’s ideal.  If you can’t, in these cases it might be recommended to have donor milk because – and this is a really hard stat.  Again, I’ve been under fire for this one because it hurts people’s feelings, and I’m just talking about the science.  There are some medical circumstances, of course, where women cannot give birth vaginally, and it’s emergency, or they cannot breastfeed, and those are the situations we have to do our best.  But the reality is, if you’re able, for your baby’s health, you should.  We know statistically speaking, babies who are strictly formula fed from birth versus strictly breastfed are twice as likely to die from SIDs.  And so it’s detrimental to have these gut bacteria.  We know they’re a huge part of your immune system.  We know they’re a huge part of development and brain development, heart development.  So obviously, having these beneficial microbes the first three days – lots of colostrum.  A thick turf being laid down inside the gut and the gut bacteria.  But infants not breastfeeding, we can see infectious incidents of increased infectious morbidity.  We see elevated risk of childhood obesity, type 1, type 2 diabetes, leukemia, again, SIDs.  And even for mothers, a failure to breastfeed, it’s a bidirectional relationship.  We have a failure to breastfeed associated with premenopausal breast cancer, ovarian cancer, retained gestational weight, type 2 diabetes, myocardial infarction – that’s heart attack.

So we see all these problems associated with not breastfeeding on both sides.  It’s this very natural process, and of course, the oxytocin and the bonding and all those things.  And those gut bacteria – the gut is like a meadow, a newly seeded meadow.  And if you were to take a meadow that’s just growing grass, a brand new patch of dirt, just getting grass and little baby plants starting to come in, and you light it on fire with drugs or medications or antibiotics, it may never grow back the same again.  And so this is the importance of long term breastfeeding, 12 months, or some women are doing 24 months, which, I mean, I obviously don’t have breasts or a baby, so I can’t say if it’s too long or not.  Some people say it’s the best.  And so really, we have to look at the science behind it, and that lays down this nice thick meadow.  And gut bacteria can grow from a meadow to a rainforest if it’s seeded properly, if it’s taken care of properly, if it’s fed properly, if we avoid fire and salt in the soil.  You know, antibiotics and medications where possible.  And this is how we prevent disease and have healthy lives later on.  And even just looking at tribes, a lot of indigenous tribes still living off the land, they don’t know what failure to breastfeed is.  They don’t know what Alzheimer’s is.  They don’t know what diabetes or obesity is because they’re all extremely healthy.  Their bodies are functioning as they should.  That’s sort of the link there between pre, post, peri, and all the things.

Yes.  And you mentioned donations, so milk banks do screenings, and there are different milk sharing groups.  We’re fortunate to have a milk bank in our area.

That’s amazing.  What a gift of technology, and even just human compassion, to understand the importance of these things.  Moms above all else are superheroes.  My mom’s got five boys.  I get it.  It can be a zoo.  Really, moms give up everything.  They sacrifice and will do anything for their babies.  And it’s interesting to see in nature how different species even – I sent my wife a video, and we’re both watching this and tearing up.  This little dog – it’s an old pup who comes out of its dog house and sees a little baby chick wandering by itself.  It scoops it up and takes it in and tucks it into its warmth inside of its little doghouse.  It’s just the sweetest thing, and it’s so beautiful to see nature take care of each other and moms take care of other moms with things like breastmilk and donation when there’s excess.  It’s just really amazing and such a great gift to be able to give another baby.  It’s as powerful as being a bone marrow donor or a blood donor.  It really does make a difference in the rest of that baby’s life as they grow to become adults.

Absolutely.  And I know some moms who’ve experienced loss who chose to pump and donate their milk as a gift and a way to work through their grief.  It’s very beautiful.

That’s amazing.  I love stories like that.  That’s incredible.

For sure.  So you had mentioned that you wouldn’t directly work with breastfeeding moms, but for someone who has finished their breastfeeding journey or was unable or chose not to breastfeed, what can our listeners do to improve gut health postpartum as a final question before we wrap up?

Sure.  That’s as you’re actively breastfeeding?

As you’ve completed breastfeeding or for listeners who are not choosing to breastfeed.

Great question.  And I want to be careful not to deter women who are actively pregnant or breastfeeding.  I don’t want to deter you from seeking help, either.  In rare circumstances in digestive disease, we still can help in get things reduced or at least cover some basics and give your body some basic nutrients to help heal or get ahead of the curve.  Because obviously, there’s breakdown.  We want you trying to recover as much as you can, give your body a tool to try to get ahead of the breakdown.  So I don’t want to discourage you from getting help.  It’s just that to clean toxins from the body and kill off gut bacteria and fungus and overgrowth – that can be very dangerous.

But for those who are done breastfeeding or choosing not to breastfeed in your postnatal, taking care of your gut is obviously very important.  The number one thing we want to do is look at the roots.  And this is really my qualm, my challenge that I have with western medicine.  It’s been a huge blessing to be able to work with doctors in this space who are in functional medicine or their doctor ego doesn’t get ahead of them, because a lot of doctors will just say nope, this is the protocol; this is what we do.  The protocol, what they do, unfortunately, is assess your symptoms.  With those symptoms, if you check all the right boxes, you get a diagnosis.  If you don’t check all the right boxes, you’re kind of left in limbo.  We don’t know what it is, or there’s nothing wrong with you.  We call that medical gaslighting.  And they just send you home and offer you antidepressants.  We see that all the time.

So if you don’t check the boxes, you’re kind of stuck.  If you do check the boxes, great.  They give you a diagnosis.  That diagnosis just attaches you to drugs A, B, or C.  We give you these medications, and it masks those symptoms for this diagnosis.  And a diagnosis – we often attach to it and go, okay, well, I have IBS, or I have Crohn’s or colitis or whatever it is.  Unfortunately, that diagnosis really doesn’t mean anything.  All it is in the medical system is one word that quickly helps a medical professional understand what’s going on in the snap of an instant.  Okay, you have colitis.  Here are your symptoms, and now I know what’s going on with you.  But we attach to these diagnoses and say, well, there’s nothing we can do.  It’s autoimmune.  It’s idiopathic.  It’s whatever.  Which I saw is asinine.  You know, looking at the ulcerative colitis space, for example, or Crohn’s disease, looking at inflammatory bowel, they say idiopathic, no known cause, or it’s genetic or maybe environmental.  But either way, take the drugs and hope for the best.  And this is where western medicine goes so wrong.  Even looking at the data, we’ve grown between 1.5 and 2 million, give or take, cases of inflammatory bowel disease worldwide since 1990 to 7 million today.  So we’ve 5x-ed the amount of bowel disease in the world in the last 30 years.  And 50% of that – the United States of America is 5% of the global population, but they have 50% of those diseases, and we’re still saying it’s idiopathic.  Well, if 5% of the world has 50% of the problems, and you tell me there’s no known cause, you better figure it out.  And if it’s just genetic, that is a statistical improbability.  It can’t happen.  So we have people worsening these gut diseases from what might be 72% of Americans who complain of gut issues, be it constipation, diarrhea, gas pain, bloat, whatever it is, at least once a week.  That is an open door.  That is a gateway disease process to inflammatory bowel disease or whatever else, and we know the gut is connected to 93% of the leading causes of death in the USA.  And that’s everything.  We’re talking heart disease, cancer, Alzheimer’s, liver, diabetes, kidney.   All kinds of issues that we see in the States, gut issues are directly connected.

So the question is what do we do or what can we do.  Well, number one, we have to get ahead of this thing if you’re on that slippery slope.  Because we look at it as a severity spectrum.  Right now, you’re wearing a pair of shoes, and you’re not wearing socks, and you’re a little irritated.  Your foot might be red or raw or blistering.  Great.  We can get ahead of it and put socks on now.  Or you can keep waiting until it’s bleeding and raw and you’ve worn down to the bone, and now there’s a lot more recovery process.  And that’s really how we look at these disease processes worsening over time.

So if you can get ahead of it now, if you just have gas or bloat or something, seek someone out.  I mean, I do work all over the world, but if I’m not a fit – some people hate my personality.  That’s fine.  Go see someone else who can help you, but I just care you get better.  We just want you to get ahead.  Gas and bloat or acid reflux is an early warning sign something else is going on.  If you have acid reflux, I hate antacids.  They make it worse as far as I’m concerned.  If you have bloat, digestive issues, IBS, IBD, get a stool sample done.  Look at your gut bacteria.  Seek an expert who specializes in these gut bacteria to actually help you rewind and reverse and rebalance.  Again, I’m very careful with who I work with on gut bacterial issues because of what we talked about, but there’s always a way to reverse it.  Inflammatory bowel disease – I talk about it because it’s a severity spectrum.  It’s the 12 out of 10.  It’s as bad as it gets.  It’s crippling.  It’s the worst next to bowel cancer.  But on the low end of the spectrum is bloat.  And so you have the potential to get worse, and if you don’t get ahead of it, you’re going to have a lot more cleanup to do down the road.  But even those cases of IBD, they are very reversible.  The western world says it can’t be helped.  Your doctors will give you a diagnosis and give you drugs.  But they’re not looking for the roots as to why.  So your gut issues come out in two ways.  One, it’s a slow wear and tear.  Something happened, like that wear and tear of a heel in a shoe.  Or two, it was an insult like antibiotics or a flu virus or a disease; something happened, food poisoning, and you’ve never been the same since and it got worse.  That’s an insult.  Those are the only two ways we really get these diseases.  Genetics are a very small component.

So my advice is don’t let your doctor just give you medication and send you on your way and chalk it up to genetics or say it’s not known.  Every symptom, every disease in the body, is a symptom of dysfunction.  We can simply correct that dysfunction and your body will heal itself in every instance of almost every single disease.  And that’s where I’d like to leave that one for you.

I love it.  Yeah, finding the root cause versus just treating the symptom.  And you had mentioned even like skin issues.  So I was having breakouts and was trying to change products, get facials, see my dermatologist and so on, but it ended up being, after I spent all of this money on product changes and so on, it was allergy related.  And I had blood work done, and certainly gut health was also a factor.  Once I made changes, I was able to see immediate improvement when I had been struggling for so long.

That’s amazing.  It can be so easy, right?  Something like the skin, we go to a dermatologist who gives you cream for the skin, but your skin is a detox organ.  It’s a direct outside reflection of what’s going on inside, and your food allergies created leaky gut, created inflammation in the system that came out in your skin.  It always has a root.

Exactly.  So how can our listeners find you, Josh?

Well, Kristin, it’s just like you said earlier.  The best way to find me is on ReversABLE – The Ultimate Gut Health Podcast.  And we have the absolute pleasure of dealing with all things gut.  And it’s not just about our guts, but we talk about all the things in our world that affect our gut: our food, nutrition, stress, lifestyles.  We have had gynecologists on and OB-GYNs and all kinds.  We’ve had all kinds of different specialists and doctors, and we talk about how our gut influences our world, how our world influences our gut, in long interviews like this, about an hour, and we also have short, quick, ten-minute tips that you can always write in.  And if you have questions and you’d like more information, head to reversablepod.com.  There’s contact information.  There’s free stuff.  We actually have free gut health programs for acid reflux and fatty liver, irritable bowel, SIBO, the works.  You can find it there for zero charge.

My goal is just to make this information free to the world, and I believe it should be.

That’s amazing.  Well, you are a wealth of information.  I see you’re also on social media between Facebook and Instagram?

That’s right.  That’s @joshdech.health.

Excellent.  Well, I’ll have to have you on again, Josh.  It was so wonderful to chat with you today.

It was a pleasure, Kristin.  Thanks so much for having me.

IMPORTANT LINKS

ReversABLE

Birth and postpartum support from Gold Coast Doulas

Becoming a Mother class

 

Kristin Revere chats with Anna Downs of Move Well with Anna about cesarean recovery tips and guidelines. 

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with Anna Downs today.  Anna is the founder and director of Move Well with Anna.  Welcome!

Hi!  It’s very nice to be here.  Thanks for having me.

Great to chat with you today!  I would love to hear not only a bit about your professional background, but also your story of deciding to work with women in pregnancy as well as the postnatal phase.

Yes.  I mean, I think like anybody who finds their vocation and the thing that gets them up in the morning and makes them keep on going to work, I very much came to doing this work through my own experience of trying to find what I was searching for to help me in my pregnancy and postpartum recovery and really struggling to find anything that kind of fit the brief.  And it kind of led me down a rabbit hole of doing more and more qualifications, getting more and more information and experience, and then kind of really thinking, oh my goodness, there needs to be more of this in the world.  I kind of found myself falling into it by happy accident.  I suddenly had people who wanted to work with me, and it’s just grown and grown over the past 12 years.  It’s been a real journey of self-discovery, which has turned into a very vocationally driven practice.

I love it.  And you’re a mom of two?

I am.  My youngest is now 15 and adorable, communicating with a series of grunts.  We are entering a new phase, which I’m not quite ready for, but yeah, that’s my 15-year-old, and I have a 12-year-old daughter, as well.  So we’re just navigating the teens and the tweens at the moment.

Love it.  I have a 12-year-old as well, a 10-year-old and a 21-year-old.

Wow, okay.  So you’ve got the full spectrum!

Exactly.  Love it.  So obviously, there’s a lot of personal passion as well as just focusing on continuing your education.  You have a very impressive background.

Yes, I just find the courses are so addictive.  Once you’ve done well, it’s like, well, it’s just not quite enough information.  I need to know more about that.  And I’m sure you’ll find from being in this field, as well, that things are just changing and evolving so quickly and I feel like we’ve got this massive wave of evidence based information coming in, and it’s just so exciting to be doing this at this moment because it’s changing so fast and so needed.

100% agree.  I’m 10 years into the field, and I feel the same way.  It’s changing, and I learn with every client or student.

Yeah, it’s powerful stuff.

So our topic today is Cesarean recovery.  I would love to start there and talk a bit about preparation in advance for a planned Cesarean, and then recovery, whether it’s a planned Cesarean or unplanned.

Yes, again a topic that we so need to keep having this conversation because I don’t know about you, but one thing I’m finding is that if you’re comparing things, like the guidelines for preparation and recovery for something like a C-section or, on the other hand, open abdominal surgery, the guidelines just don’t match on.  On one hand – I mean, I’m talking from kind of UK guidelines, but the Royal College of Surgeons in the UK advocates for a four to six week break from lifting pretty much anything heavier than two to three kilos, followed by no substantial lifting for definitely 12 weeks.  Yet our C-section mamas, the day after they give birth, they’re handed a three to four kilo baby who only gets heavier.  So there is this massive disparity between what we’re expecting optimum healing to look like for somebody who’s having open abdominal surgery, which is what a C-section is, and somebody who’s having a C-section.  And the narrative is very unhelpful, and it really does feed into so many issues with expectation and perinatal anxiety and depression.  And I think we just need to keep on having this conversation with our healthcare providers and find more allies and find more support because it’s really just not good enough at the moment.

Exactly.  And not everyone can afford to hire a postpartum doula or newborn care specialist or a nanny right away to help with that lifting, accompanying the parent to the pediatrician appointments, where you need to carry that car seat as well as baby, and avoiding vacuuming and stairs and other lifting.  It’s just – it’s a lot.

It really is.  And I was just speaking this weekend, actually, at a public health conference here in Bangkok where I’m working and practicing, and we were talking about how C-sections, how they’ve changed, how they’re being performed now in terms of – from the 1970s, we’ve had a 500% increase in C-sections being performed annually.  Yet the guidelines about prehab is nonexistent, and rehab has hardly changed since the 1970s.  But we’ve now got one in three births globally happening which are C-sections.  So there’s this – nothing’s caught up yet.  And I think as women, we’re relying very much on the knowledge of the village, of that woman to woman chat, you know, friends telling us things over a cup of coffee.  Or if you are going to, say, a feeding support group or an infant massage class, just having people talking and sharing their experiences in that very informal setting.  I’d really love there to be a much more directive set of advice coming down from our OB-GYNs so that their responsibility isn’t just stopping at the door, you know, at D-day when you’ve safely delivered a baby.  When you’re thrown into that postpartum hormonal depression, it is equivalent of being dumped into perimenopause overnight.  That makes it additionally really challenging to heal and to get the appropriate rest that you need.  The odds are stacked against us, so we need to find some way of changing the narrative, starting the conversations, supporting people more.

Exactly.  And so many of my clients want to get back to their passions pre-baby, whether it’s fitness, running, being active.  And they want that time to be released to exercise and lift and be more active.  That can be a struggle for a lot of personalities, that healing phase and lying-in.

Absolutely.  And especially – again, I refer to the UK – once you’ve had your postpartum check with your OB-GYN, which is usually four to six weeks for a vaginal delivery and then six to ten weeks, depending on how your scar is healing, for you C-section delivery – once you’ve been given the all clear, then the guidelines are that you can return back to exercise.  But there aren’t really many written-out clear guidelines about what that looks like and how you should address that and where you start.  The whole toxic body bounce back character narrative is so unhelpful with this because people just think, oh, I’ll just start again and then I’ll be fine.  The doctor said it’s fine.  Actually, a much more carefully considered approach needs to be taken in order to avoid injury and to repair nine months of your musculoskeletal system completely changing and shifting and your center of balance being in a different place.  So it’s very unhelpful to just be given that green light and then expect everything to work how you remember it working before.

Yes.  And I feel like recovery from other surgeries has stricter guidelines.  There’s more information, PT, and so on.  Say it’s a shoulder or a knee surgery.  But there are so many unknowns, and sometimes mothers are getting information from online communities, Facebook groups, and the information they’re given is not always accurate.

Yes, absolutely.  And the really challenging thing is that there isn’t actually a catch or solution for everybody.  It is an individualized process because our bodies have all responded differently to pregnancy, that have responded differently to our births, and we’ll have all had different births.  All of those little factors that come into play have an impact on your body is healing and how it’s responding.  It is giving out a blanket guideline of four weeks, you can start to do abdominal breathing and gentle Pilates-style exercises.  For one person, that means lying on their back with their hands on their belly and just breathing in and out, and for somebody else, that’s doing half-planks and bear walks.  So it’s very difficult to give a clear answer of sort of what is safe and what isn’t without there being some kind of personal contact with someone, whether that’s in a group setting or privately or just having somebody assess you in a bit more detail.  Again, that’s challenging because it can be completely out of someone’s budget, especially also if they don’t have a lot of time and they’re chronically sleep deprived.  That is a big challenge as well.

Exactly.  So as far as working with you, what does that look like?  I know you’ve got some videos and books, as well as different programs, both prenatally and in the postnatal phase.

Yeah.  I mean, at the moment, I’ve just started to create a few support items, digital products online, but I’ve been mainly working face to face with people.  I quickly realized that people wanted a little bit more support outside of our face to face sessions.  But working with me, we always start with a very detailed assessment because me personally, my own personal journey when I had my kids, I was trying to get back into fitness.  I was just thrown back into a group program, which wasn’t postpartum specific.  And it did me some terrible damage because I was trying to apply the knowledge I had about being fit and active pre-pregnancy to my postpartum body.  And I really valued somebody taking time, about three or four years after I had my second child, to just sit with me and explain how my body had changed and how I could nourish it with movement instead of punishing it for not behaving in the way that I wanted it to.  And so I apply that principle with everyone I work with.  We have a really detailed assessment; we’ll look at your posture, your pelvic floor.  I’m not a physiotherapist, so this is screening verbally and then looking for certain movements in the hips and the posture to see where you might be tight or carrying tension.  But it’s out of my scope of practice to deliver an internal assessment.  And so I would defer on for that.

We look at your day to day movements and your daily lifestyle and your preferences and your habits, and we really build a bespoke program around what you’re going to be able to fit into your day and into your world.  Also is solving the problems that you’re encountering with your healing and your body.

But I do have lots of free tips and free videos on my Instagram and Facebook feed.  I have a weekly newsletter where I send out juicy tips, and a few additional products on my website.  But it’s an ever-evolving feast, and there will be more things – small things coming in the new year, but I just need a little bit more downtime to make the magic happen.

I love it.  And you do have a virtual book that is focused on the postpartum back, neck, and shoulder pain, and I know especially for breastfeeding moms, I mean, the posture that you have can cause so much discomfort in the shoulders and neck with nursing one baby or two.

Yes, and it’s very similar in the way that it shows up in your body as something called office syndrome, which has become very trendy for everybody to talk about and a physiotherapist to be selling programs to try and help support.  I feel like no one’s really talking about this kind of nursing back and shoulders that so many new moms have, and yet it’s equally as crippling and painful and debilitating.  And it’s the same thing; it’s a real tightness in the muscles in the front of the chest and shoulders.  And when that’s really tight, it pulls the shoulders forward, which makes the upper trapezius, the muscle going from the shoulder up into the neck, super tight.  And that’s teemed together with a bit of weakness, a bit of muscular imbalance in the back of the shoulders and the midback.  So you’ve got this tightness pulling the shoulder forward, teemed with weakness around the upper back, which just exacerbates that forward curve.  A lot of people also find they end up thrusting their chin forward, which creates an enormous amount of tension up from around the back of the head and scalp and into the jaw.  All of these things can be massively – the intensity of the discomfort can be decreased massively by strengthening the upper back area and really stretching the front of the chest and just also paying attention to our postures.  I mean, I know as a doula, you’ll have spent a lot of time coaching moms when they’re feeding their babes to have the pillows supporting them, to be thinking about stacking their posture, not craning their neck.  It’s all the same principles, but just with a slightly more kind of movement focus.

That’s great.  And of course with surgical recovery on top of breastfeeding or pumping, you know, again, it’s just a lot to manage.

Yes.  And I think – I mean, over the past twelve years, I’ve worked with over 1300 women.  And the demographic of people I’ve worked with ties into the one in three births being C-sections before I moved to Thailand.  And now here in Thailand, about 80% of the women that I’m working with had C-sections.  So it’s really a big demographic of people.  Sorry, I digress, but the reason why I mention that is that every single one of them, regardless of whether they planned their C-section birth or not, is absolutely floored by that complete incapacitation for the first 24 to 48 hours.  It’s a real shock to the system.  And anything that we can do to prepare for that without – you know, while treading that fine balance between information and scaring somebody, it helps people to feel prepared so it’s not so much of a shock.

Yeah.  That makes sense.  I mean, preparation is everything.  As doulas, we talk about the importance of preparing your body physically for birth, no matter how you end up giving birth.  But also the mental aspects of it, and I love that you touch on the mental aspects in your pregnancy journal.  Tell us a bit about that.

So again, I created this book of pregnancy journaling prompts because I was really finding that lots of my mommas to be were struggling with a lot of anxiety about the unknowns, about knowing which conversations they should be having with their birth providers or with their support network.  And this book is just loads of different prompts.  I think there are about 120 pages, and there’s a different prompt on each, where you can either work through methodically or you can just pick the one that speaks to you.  The process of journaling has been well-documented in helping to allow us to make sense of something and to frame the narrative in a way that feels empowering and calming so we’ll just feel a little bit more prepared.  And so, yeah, I put all these prompts together, and it’s very much designed for the mama to be preparing for pregnancy and birth and those early few weeks in the postpartum period, just to help her frame a few conversations and make sense of something that feels overwhelming.

Love it.  And that journal, as well as your other virtual and in-person services, can be found on your website, Move Well with Anna.  I know you’re also, as you mentioned, on Instagram and Facebook.  What are the different ways that our audience can find you?

The best way to find me is probably on Instagram, and that’s just @movewellwithanna.  Or through my website, which is the same.  Those are the places where I’m showing up the most at the moment.

And then you mentioned that our listeners can sign up for your newsletter, and that has a lot of free information and tips?

Yes, absolutely.  There are loads of freebies on my website.  There’s a download about how to manage pelvic floor pain and dysfunction, another one about how to manage constipation during pregnancy and postpartum, and a list of gorgeous, lovely ideas and tips about how you can feel fit and strong and empowered after you’ve given birth.  So loads of freebies on my website, as well.

Beautiful.  So what are your final tips for our listeners who are in that recovery phase for their surgical birth and want to do some gentle movement and make a difference in the recovery without pushing themselves too hard?

So the first thing I would advise would be investing in a medical grade compression garment.  I say medical grade because you want something that’s been designed with this specific purpose in mind that’s comfortable, that’s breathable, that you can wear 24 hours a day initially, if you wanted to.  That just helps to support your scar area a little bit and take some of that pressure off.  I think the guidelines are recommending at the moment that after a C-section, the compression garment should be worn for multiple hours during your waking day for about six to eight weeks, just to give you a little bit of support and a helping hand during that initial healing phase.

So you mentioned the medical grade.  How do you feel about, like, the Bangkok belly binding and other binding methods?

I think they have their place.  They can be wonderful if they’re done by a skilled practitioner.  I mean, again, I can only really talk anecdotally here from my experience of working with people, but in some cases, if it’s done too tightly, then that can have an adverse effect on the pelvic floor by creating more intra-abdominal pressure than we want.  It has to be the right tightness to support but not restrict, and I love the cultural practices here and some ancient Chinese practices where women have a much more restful first 30 days after they deliver.  But that binding just – it needs to be done skillfully and with an understanding of the body and what it’s managing at the time.

Very helpful.  What’s your next tip?

My next tip would be to start gentle movement from your second and third day, and I’m not talking about doing like formal exercises, but this can be as simple as belly breathing.  So just being in a comfortable seated position, preferably stacking the ribs and pelvic bowl, and just allowing the belly to expand and contract gently with each breath and really focusing in on that.  And then also seeing what’s happening with the rib cage because quite often, by the end of the pregnancy with our ribs flaring to make space for the baby to grow in our abdomen, our ribs kind of get locks and stuck and flared, and that’s really not conducive to getting that lovely floor of coordination between your diaphragm and your pelvic floor back.  So focusing and just seeing, are my ribs moving when I’m breathing?  If they’re not, if I place my hands on them, can I expand against the pressure of just pushing them together a little bit?  And just really focusing on that breathing to start off with.

Then progress a little bit further on to doing gentle things like arm raises, so you’re stretching the skin and the fascia just a teeny bit because you want to be able to stimulate that blood flow to that healing area.  So gentle seated side bends or raising the arms one at a time or both together and teeming that with some breathing exercises is such a delicious way to start without it feeling scary and without putting too much pressure through that area of your body.

Love it.  So anything else to add?

Yes.  Scar tissue massage is unbelievably important, and I’ve found that most of the doctors who are advising massage for the scar, it’s purely on aesthetical reasons, just to make the outside look a bit better.  So having a silicon gel and just rubbing it on a few times.  We now know that there’s so much benefit to, after the scar is healed, so at least two weeks after the last part of the wound is healed, starting to do gentle nerve training exercises.  So rubbing the fingers gently above and below the scar, checking what the sensation is like, switching the object that you’re using to run across the scar to see if you can recognize the change in sensation.  Because we need to reconnect with that part of our body if we’re then going to strengthen our core and reconnect with our body.  And so often, I find that with my C-section mamas, there’s a real disconnect or reluctance to connect with that part of their body, with that scar, with how it feels, with how it looks.

And it could be traumatic for them, reminding them, if the birth was traumatic.

Absolutely, and that’s another thing to really know.  If the thought of touching your scar or touching your belly in that area is bringing back traumatic emotions or feelings or flashbacks, then to recognize that and be kind to yourself, but also to seek some form of counsel, whether that is a birth debrief with your doula or your OB-GYN or professional help.  And I know that there are lots of wonderful peer support groups for birth trauma, but also, it’s a real growing of practice in mental health and support as well.  Unfortunately, I don’t really have anyone I can recommend here in Bangkok.  It’s a struggle.  It’s something that the doulas here are working really hard to try and find good practitioners.  At the moment, we are referring out to the UK and the US.

It is helpful to have virtual therapy options, certainly.

Yeah.  But yes, the scar tissue massage, and a staged progression from just gentle touch to, after 12 weeks, doing much more targeted fascia release.  And again, I’ve got some videos on my YouTube which show you how to do that.  There are also many great practitioners out there if you just Google it.

Love it.  Well, thank you for sharing all of your wisdom with us, Anna, and we’ll have to have you back on when you get some of your future programs ready to go.

That would be fabulous.  It’s been really wonderful to talk with you.  Thank you.

Thank you!  Have a great day.

IMPORTANT LINKS

Move Well with Anna

Birth support from Gold Coast Doulas

Postpartum support from Gold Coast Doulas

Becoming a Mother course

Kristin Revere chats about the importance of creative movement with Regina Lum of Little Feet Movement. 

Hello!  This is Kristin with Ask the Doulas, and I am so excited to chat with Regina Lum today.  Regina is a creative movement instructor, infant massage educator, and a self-proclaimed lay advocate.  She owns Little Feet Movement for developing minds, a parent child movement program that was voted as the top two toddler time in the 2023 GR Kids Best of Grandtastic Awards.

Welcome, Regina!  So happy to have you here!

Thank you!  I’m so excited to be here as well!  It means a lot to me, especially being a small business owner, to be given this opportunity and to be recognized by such an influential organization like yours who’s doing great work for the community.  So thank you!

Thanks!  We love partnering with you.  I’d love to have you tell a bit of your why story of why you started Little Feet and a bit more about what you do in the community of West Michigan.

Yeah, sure!  I’m happy to share that.  I was born and raised in Malaysia, and growing up, I danced ballet and played the piano for 15 years of my life and did cheerleading.  And I really believe that these opportunities positively impacted my life.  I’ve always dreamed of running a children’s music and movement program.  I moved to Michigan for college, which is where I met my husband, and then we moved to Seattle and lived there for over ten years.  We had two kids there, and then we moved back to Grand Rapids to be closer to family.  We now have three beautiful children, and they’re 9, 5, and 2.

Certainly some of your own personal experience and bringing play and movement to your children’s lives.  I love it!

Although I ended up getting a business degree, my dream of running a children’s program never wavered.  After I graduated college, I worked in different youth development organizations.  I coordinated trainings for adults who work in youth programs.  And I did marketing for various youth programs, as well.  But where that switch happens is when I became a mom myself.  I had my first daughter, and I didn’t know what to do with her.  I wanted to play and connect with her, but I didn’t know what to do.  And the experts tell you, oh, you need to put her in tummy time; this is important to them.  But I never was taught how to do it effectively and why it’s important.  And every time I put her in tummy time, she would cry.  So I just never did it.  That’s when I found the program in Seattle called Nurturing Pathways that not only showed me what to do with my daughter and how to connect with her, but it also taught me how and why movement and music supports the physical, social, emotional, and cognitive development of the child.  It made me become a more confident parent.

I was really excited to share all that information with as many parents as possible, and I thought, this is it.  This is what’s going to be my path to my dream of running a movement program.  So I got certified to be a Nurturing Pathways instructor, and I’d been teaching with that program in Seattle since 2017.  And then when we moved to Grand Rapids, that was finally my chance of bringing my dream to life, and I brought that program to Grand Rapids and started Little Feet Movement.

Love it!  And then you’ve expanded, so not only are you a play advocate, but you are an infant massage educator.  Tell us a bit about that expansion to your business.

They all kind of work together because what’s the most important ingredient of a child’s development?  It’s really the relationship between the parent and child.  It’s that strong relationship that fuels development, especially that parent-child relationship.  That’s because our brain’s first job is to keep us safe.  So when our kiddos feel safe and secure in that relationship with their primary caregiver, their brains can then get out of that fight or freeze mode, and then they can be freed up for learning and attending, right?  They know that they have that secure base to always come back to so that they’ll feel more confident and willing to go out and explore the world.  It’s really the glue that holds everything together, effecting how kiddos relate to themselves, to others, and how they perceive the world around them.

For example, I think I have a pretty positive outlook in life, and I really have my parents to thank for that.  My relationship with them has really set a good foundation for how I relate to my friends and how I was able to develop friendships and how I have a positive outlook in life.

I love it.  I’ve taken a group infant massage class with my daughter years back and found it to be so beneficial.  I mean, touch, communication.  I just learned so much about my first baby and how to communicate and even asking before touching, that consent being a big part of it.

Yes, and it’s really giving you the opportunity to tune in to a kiddo’s needs and then be able to respond to their needs, and it’s that constant attuning, responding that kind of builds that trust and relationship with our kiddos.  Infant massage is really a good start.  And then we kind of go into the play part and the movement part, you know?

Yeah.  It definitely is a great extension, and with Little Feet, it is parent-child based, and you cover not only the babies, but also into the preschool years.  So tell us a bit more about what that looks like, to work with you.

Yeah.  We talked about the infant massage part, and then for the movement classes, we have our baby, our waddler, and toddler classes.  With the baby classes, we do a lot of dancing with kiddos in arms.  We’re really working on that bond and that playful connection with our kiddos.  Actually, that applies to all of our classes, you know, really working on that playful connection, because play is really like a little window to our kiddos’ world.  If we’re able to enter their world through play, we’re able to forge that relationship with them.

I love that.  So not only are you a big play advocate and focused on creative movement, but how does that help physical development for babies and/or toddlers?

A little brain fun fact here is that our brain is built from the bottom up, starting with our low brain, which consists of our brain stem and cerebellum, and I want to talk a little bit more about the cerebellum here in our low brain.  Then it goes up to our midbrain, which is our social and emotional brain, which we’ll talk more later, and then our high brain, which is our cortex and our thinking brain, which is responsible for cognitive functions and executive functions, language development, and things like that.

So how it supports our physical development is that our cerebellum is responsible for automated movements.  So things like riding a bike or driving or walking.  As adults, if you think about it, we don’t even think about how we move our bodies anymore.  We just do it, because thanks to our cerebellum, it’s automated now, right?  But for our kiddos, especially babies, they don’t even realize that they’re a separate entity from their caregiver until about 6 to 8 months.  That’s where the separation anxiety begins.  So let alone learning how to use their bodies, right?  That’s why through movement we are teaching them about their bodies and how to use their individual body parts and then how to coordinate all these different body parts together to do what we want our bodies to do.  That’s like motor planning.

And then we also teach our kiddos how to relate to the space that we’re in and the things and the people around us and how to navigate through the space.  For example, do we need small movements when we’re in a crowded room that’s pretty small?  Do we make big movements when we’re in a bigger space?  Moving in different directions and different tempos.  Just so many different things we can do with our bodies to explore the world.  And the more we move our bodies, the more automated movement becomes.  And once movement is automated, it will free up our brain for higher level learning and thinking.

An analogy I like to use to illustrate this point is that when we first learn to drive, we had to think about our every move.  We probably can’t even talk to the person next to us or listen to music.  We’re just focused on where our foot is, where our hands are, am I looking.  And the more we drive, the more automated it becomes.  So now we’re able to talk to the person next to us.  We can navigate directions on the GPS.  It’s because that movement and that process has already been automated.  That’s what we want for our kiddos.

Of course.  Love it.  And I’m also a big fan of the self-regulation that you work through, especially with toddlers when they start to get into tantrums.  Tell us a bit more about that work.

Sure.  That’s where our midbrain gets lit up, right?  Our midbrain is responsible for emotions, our memories and stimulation, and that’s where that body-mind connection comes into play.  When we know our bodies and we’re aware of those emotions and we’re able to connect those emotions and our feelings in our bodies, the sensations that we’re feeling in our bodies, we’ll be able to tell – for example, if our skin is starting to get prickly from maybe feeling overstimulated or like our shoulders are starting to tense up because we’re getting angry.  When we’re able to be aware of our body and the emotions, we’re possibly able to find the reason why we’re feeling that way.  And then learning skills to manage those feelings, whether it’s to remove ourselves from the situation or find a healthy outlet for those feelings or simply talking about naming those emotions.  That can help control them.  And that’s what self-regulation is, really.  It’s that ability to notice when we’re reaching the threshold and then figuring out steps to keep us in homeostasis before we explode.

That’s great, and very practical if they’re out in public and having some emotions that need to be managed or in a preschool classroom and so on.

Yes.  So, for example, in class, we do different activities that support self-regulation.  For example, we do heavy work and deep pressure activities, which can help regulate our nervous system.  We practice stop and go movements so that we can practice our self-control skills.  We do freezing and melting movements to learn to control our muscle tension.  And then we can use all of these tools, like you’re mentioning, as a way to manage our emotions, right?  If our kiddos are running wild and they’re feeling dysregulated, then we as adults can say, okay, let’s get down on the ground and do some heavy work.  We’ll roll around.  We’ll push the wall.  Different heavy activities that can help regulate our nervous system.  Or when we’re mad, muscles are tensed, right?  We can then take deep breaths and intentionally relax our muscles, our shoulders, and maybe we can even shake our bodies to relax those muscles.  How we feel physically can affect us psychologically.

Oh, absolutely.  And so you’re helping them to be very social and also with the cognitive development functions – take us through a bit about that as far as how your classes can help with sensory processing and language development.

For cognitive functions – I think we briefly mentioned memory, learning, attention, executive functions, language abilities.  In class, we do different things like play with speed to help develop attention span.  We problem solve using our bodies.  For example, okay, let’s go through this hoop, so they’ve got to figure out, oh, first I’ve got to duck my head and then take a step through and do that movement through the hoop.  That’s really problem solving with our bodies.  We do things like obstacle courses to develop motor sequencing.  All of these things that we do in class will translate into mental capacities because the same neurons for doing are the same neurons for thinking.  So if we can do with our bodies, we can also do with our minds.  And the more we do these functions, the stronger the neural connections are, allowing us to be able to perform these functions more quickly and automatically in the future.  Like a path in the grass, right?  It forms through walking that same path over and over again.  That’s what we want to do for our kiddos.  That’s for the attention and different functions that we can do in class.

The other part that supports our cognitive development is memory and learning.  Through dance, whether it’s dancing in our caregiver’s arms, playing with different sensory props and a variety of music, we’re giving our kiddos a rich visual, auditory, tactile, and kinesthetic experience, which are the four learning sensory pathways.  When all four of these pathways are activated, the child is more engaged, and it provides more memory pathways to recall information.

For example, trying to recall somebody’s name, because I’m so bad at remembering people’s names.  When people just tell me their names, it just flies out of my brain.  But if you kind of hear it and then you write it down and reactivate the kinesthetic and tactile sense, and then we see it visually, we have more chances of remembering that person’s names, right?  Because we’re just giving more pathways to recall that information.  That’s what learning really is: the ability to recall information.

So a Chinese proverb that I’ve heard of is: I hear, and I forget.  I see, and I remember.  I do, and I understand.  So that’s why some people learn better through doing.

Yes.  Everyone’s got their way.  I learn best by writing things down.  Like you said, some people really need to experience it to remember.  It is great that you can focus on all of the different learning styles and communication styles.  And movement is so central, as you said.

For our listeners who live outside of West Michigan, what is the best way to find a similar program in their own community?

Oh, yeah.  Well, the program that I’m certified through is called Nurturing Pathways, and it’s based out of Seattle.  The founder of that program also trained different Creative Movement instructors, as well, and they’re all over the country.  I know that there’s a program out in Colorado and, I believe, in Kentucky and different states.  Good question, because I’m not really sure where we can find a whole list of all these programs.  I know there’s one in Idaho, too, I think.  Our founder retired last year and she used to have a whole list of all the providers on her website, but once she retired, she kind of removed the website, so now we are kind of figuring ways to house all the information that she had.

 That’s a challenge.  And if it’s not that specific program, I’m sure even doing a search or Googling “creative movement” or different terms could be helpful.  And you are located in Grand Rapids, Michigan and serve the West Michigan area.  What would be some of the different channels that our listeners can find you at, besides littlefeetmovement.com?  You’re also on social media, correct?

Yes, I’m on Facebook and Instagram, as well.  Right now, I don’t post as often as I should, but that’s where people can find me.

And before we wrap things up, Regina, how can parents support their child’s sensory and motor development at home?  Again, if our listeners are in a very rural area that doesn’t have these options, I would love to hear some tips from you.

Yeah, for sure.  You mentioned earlier sensory processing, right?  So 80% of our brain is dedicated to sensory processing, and that’s what really parents can do for kiddos at home: activating those different sensory pathways, like the visual, auditory, tactile, and kinesthetic, which is through movement.  They can do that at home with any sensory toys, ribbons, scarves and instruments.  Dance and sing with them at home.  But I think going back to the main ingredient of what supports development is that strong relationship.  I would say get on the floor and play with your kiddos.  Follow their gaze and their interest and really engage in the world of play.  That’s kind of what I would recommend that parents can do at home.

And you mentioned your own personal struggles with tummy time.  Any advice on that?  Because as you stressed, floor time is important.

Yes, exactly.  For those who know me, they know that I’m a huge advocate of floor time and less propping our kiddos up to sit or stand or putting them in seats.  There are so many development milestones that our kiddos go through as intended, and letting them get their themselves is so important.  When we think of tummy time, we always think, oh, putting them on the floor, right, on their tummies.  But there’s actually a variety of ways that we can do tummy time, like whether it’s on the parent’s chest or even if you’re sitting, they’re still on your chest and they’re still holding their head and their back up, right?  We can put them on yoga balls and roll them around.  That’s what we do for rhyme time in our baby class, as well.  So just different ways we can offer tummy time, and doing floor time with our kiddos.  It can also be instead of just being on their tummy, we can do sidelying positions with our kiddos, as well.  All of this is because getting them on the floor really helps them to learn about their bodies through that feedback from the ground when they kick the floor or push with their arms.  They can feel, oh, that’s my arm; that’s my legs.  It helps develop a sense of agency because they know when they see a toy, they’ve figured out how to move their body to get to that toy.  And then when they get the toy, can you imagine how they feel?  Woo-hoo, I did it myself!  Right?

And then we help them develop the strength to get to the next milestone.  For example, with sitting, when we prop our kiddos up when they’re not ready for it because they haven’t developed the back and core strength, they end up flopping forward, or even worse, they fall backwards.  And then when they fall, they won’t be able to catch themselves because they didn’t get to that sitting position on their own.  So that’s why we want to let them just develop that strength that’s required to get to that next milestone.

And then lastly, when we go through those different milestones, we develop different motor patterns that help stimulate the neural pathways in our brains, and the more we stimulate those neural pathways, the more organized they will be.  Then information can flow more quickly and automatically to all different parts of our brains.  That’s what an integrated brain means.

One final question, Regina.  How do you manage, say, parents who have multi-age children at home, so they’re not yet in school, with your classes?  Are they able to bring along, say, a three-year-old with a newborn, or how does that work with multiple ages?

That’s a really good question.  Right now, I do allow for – of course, if a parent is able to have another caregiver watch the other kid so that then you can have one on one time with that one kiddo coming to class, that’s wonderful.

That’s ideal, yeah.

Right, ideal, of course.  That’s what we want with our kiddos is that one on one time.  But I know, like you said, myself includes, we have multiple children.  So I do encourage parents to also bring the kiddos.  For example, if you have a three-year-old and a baby, you can bring the baby in the car seat or put them in the carrier, and you can move and dance together.  So you sign up for the toddler class, and then you bring the baby.  Everybody can dance and benefit from the music and the movement because if you strap on the carrier, the baby is also feeling all this kinesthetic sensory input.  Some of the things that the baby can involved in is with the instrument time and the rhymes.  We’re also really developing for the baby, even though they’re not actively signed up for class.

That’s ideal because often childcare is expensive.  If you’re paying for a program, then it’s like, okay, what do you do budget-wise?  So it’s wonderful that your program and likely many others offer that option.

And if the kiddo is older, like two siblings, I might offer a sibling discount when you sign both of them up for class, and then they get a 50% sibling discount.  It’s a pretty steep discount that I’m offering because I want people to come and benefit from the program.

Wonderful!  Well, thank you for sharing all of your wisdom.  It was a blast, Regina, and I look forward to chatting with you again soon.

Yes!  Likewise.  Thank you so much, Kristin!

IMPORTANT LINKS

Little Feet

Brain Fun Facts from Regina

Pregnancy and postpartum support from Gold Coast Doulas

Becoming a Mother course

Kristin Revere talks to Jennifer White of Bright Futures Families about different options related to surrogacy.   

Hello!  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with Jennifer White today.  Jennifer owns Bright Futures Families.  She is the owner and director, and she wears many hats in the fertility sphere: survivor, advocate, and professional.  Jennifer loves helping people realize their dream of becoming parents and is honored to play a role in their intimate and life-enhancing journeys, as well as advocating for access to care for all.  Welcome, Jennifer!

Thank you so much for having me!  I’m excited to be here.

I’m so happy to have met you at DoulaCon in Colorado and to learn more about the important work that you’re doing in the surrogacy and fertility fields.

Absolutely.  I will say, start me off from your end on the doula perspective.  What are the burning questions that you want to know about surrogacy?

I have so many questions, since surrogacy is not an option for families in Michigan.  As a doula, I have yet to support a family working with a surrogate.  I have doula friends –

I will caveat, parents can have surrogates, but they just have to be outside of your state is what it comes down to.

Exactly, yes.  I was going to say, some of my doula friends have supported families with surrogates in other states and then flew out to those states for the birth and so on. 

There’s an amazing advocacy group that’s trying to get that law changed for you all, though.  They’re working on it.

Fingers crossed!  I remember you saying that at conference and that would be amazing to have as an option for families in Michigan.  As far as surrogacy, from a parent perspective, what is that process like?  Can you walk me through how you support families who are looking to get matched with a surrogate?

Sure.  Some of it really depends on what perspective people are coming from because everybody comes to the need for a surrogate from a slightly different place.  There’s many people who come to it from infertility.  Some people come from needing it for an LGBTQ family who just simply does not have a uterus, we’ll simply say, for lack of a better way to say that.  Sometimes it is because there may be a mental health need that they can’t possibly go off medications or things like that.  Sometimes people have had cancer, so they no longer have the ability.  Everyone has to come from it at a different place.  So that’s one of the things that we do.  We meet people where they are, to start.  From the parents perspective, they need to create embryos to transfer because we only do gestational surrogacy.  There are two kinds of surrogacy, and one is more common than the other.  Gestational surrogacy is where the person carrying the embryo is not genetically related to the child that they are carrying, which means that the parents created the embryo either with their own gametes, so their own egg and sperm, or they utilized a donor.

The other less commonly used is something called traditional or genetic surrogacy where the actual surrogate is actually donating her own egg.  So she is biologically related to the child she’s carrying.  It’s far less common now.  You rarely see it, but it does exist, and it is legal.  Legal in some case; not legal or recognized in other states is what it comes down to.  So as parents, they need to have created those embryos to transfer to their gestational surrogate.  When they come to us, we spend a lot of time talking through what it is that they desire and want in a surrogacy match because this is hard, right?  People are giving up control of carrying their own child, which can be emotionally very difficult.  We really want to make sure that we meet them where they are, and if there are things that are really important to them, that we are honoring those requests.  Obviously, in your state, for example, we can’t honor the request to find a local surrogate just because that’s not possible by the law.

But we also then can have conversations about reasonableness about their requests.  We’ve definitely had parents – I had a parent once who said, I want the surrogate to text me or call me every single time she leaves the house, arrives at her destination, et cetera.  And I understand their fear, right?  So I can come to them and I can see where their fear is coming from.  Their child is being carried, and so they’re very nervous about what’s happening.  But it’s also not a reasonable burden to put on the person who’s carrying your child.  And so we had to have a conversation in that situation about reasonableness of expectations.  And so we can help as an agency to guide people through, what is a completely normal request.  And a lot of times people get very fearful that things that actually are normal, they’re like, is it too much?  And like, no, it’s completely normal.  But then also we want to make sure that if they’re scared, let’s talk through, where is this coming from?  Why do you want this?  What else can we do to mitigate that instead?

There are three things that, when we’re matching, I consider completely, and I call them nonnegotiable.  What I mean by that is that everyone has the right to their own opinion, but we want to make sure that opinions match because, of course, by the time you’re pregnant, it’s too late to be having that conversation and be at a mismatch.

The first is the number of embryos to transfer per transfer attempt.  Most clinics will only transfer one, but sometimes parents ask to transfer two.  And gestational carriers, of course, have the right to say, hey, I don’t want to put two embryos in my body because that increases the chance of carrying twins, which increases my risk, right?  So we always want to make sure that everybody is on the meeting of the minds there.

The second is the stance on vaccines.  And I know COVID vaccine, of course, is something that is still at the top of people’s minds, even though we’re now at kind of endemic stage.  But some people chose not to be vaccinated, and that’s perfectly valid.  Or some people may have been vaccinated with one, and then chose not to vaccinate further.  Also completely valid.  Some people have all the vaccines.  Great.  But what we want to do is we want to make sure that both sides, the parents and the gestational carrier, are at agreement with each other on that.

And it goes further than just the COVID vaccine because routinely, OBs and midwives ask for the flu vaccine during pregnancy.  They also ask for the TDAP vaccine, as well as recently now asking people if they will get the RSV vaccine.  So we want to make sure before she’s pregnant, right, before a gestational carrier is pregnant – it would be catastrophic, right, if the parents were like, hey, I believe fully in TDAP, and the gestational carrier is like, no, I refuse to get it.  Well, she’s already pregnant, right?  It’s too late to have that meeting of the minds.  So we want to have that conversation beforehand.

Makes perfect sense, yes.

It’s one of those things that you’re like, oh, yeah, now that you think about.  And there’s not a right or wrong to it.  Everybody’s choices are valid.  We just want to make sure that we find people who match each other in their belief.

The third one, and this one can be a hard conversation and a very emotional conversation, is to talk about everybody’s stance on termination of a pregnancy.  Obviously, in surrogacy, these are very, very wanted pregnancies.  Surrogacy – I mean, the unfortunate thing is that surrogacy is very, very expensive.  So it’s not like people undertake this as, hey, I just decided to do it, and I’m going to change my mind.  That doesn’t happen.  The question, what it really comes down to, is what happens if a major medical decision needs to be made.  And same as with vaccines; all stances are valid.  Everybody has the right to their own personal belief.  We just want to make sure that people match each other so that if a major medical decision needs to be made, I wouldn’t want to have matched a gestational carrier who says, I would never terminate a pregnancy under any circumstances except in favor of my own life, with a parent who’s like, hey, I really need to be able to make that medical decision, and I don’t want any harm or any suffering or things like that.  We want to make sure everybody matches up with each other.  No right or wrong; no judgment in that question.

Also, of course, as we’re having to now in this day and age, we have to also have a conversation about is the gestational carrier willing to travel is a termination is necessary and requested and agreed upon to.  In some states, there is no access to that care, and so we really want to make sure that we’ve thought through – and I will say, I think that people get very overwhelmed and terrified by that conversation.  It’s very important to have it, but it is very, very rare to actually have to act upon the conversation.  It’s just that as an agency, it’s our due diligence to make sure that, hey, if you are that one in a million who’s in this worst case scenario, did we talk about it in advance, and everybody feels good about this conversation.

The first part of matching – I was going to say, I can keep going about it, but those are the big criteria for matching.

Yeah, and then obviously, you know, there are personal preferences and contracts that could be negotiated; say, if the family wanted the surrogate to have a doula, or if the surrogate wanted to have doula support.

Absolutely.  I can only speak to my agency and our policies.  We actually have a line item in our benefit package when a gestational carrier comes on board that actually says – she checkmarks, I would like a doula.  And so then that means that from the point of matching, the parents have agreed that, hey, yes, we understand you want a doula.  We are willing to pay for you to have a doula in this process.

There’s so many, many reasons to need a doula besides birth, as well, and so we’re oftentimes talking as things go further along about other things.  When you’re a doula, you support your specific client, right?  In that situation, where they check the box that I want a doula, they’re supporting the gestational carrier.  The parents are still there, too.  And it could be that the parents need a doula during the process, as well; somebody to take care of them and help them in their anxiety and their worries through the birth process.  Sibling doulas could be a possibility for that gestational carrier to take care of their children who are home because all gestational carriers already have children.  So they have to think through, who’s taking care of those children?

I love when there’s sibling doulas because instead of being like, hey, I’m just going to call my neighbor down the street – it gives me a lot of peace in that situation because then I know that there’s somebody who’s 100% dedicated to being on call for them no matter what.

Newborn doulas, of course, afterwards.  I think doulas are so valuable, especially in the LGBTQ sphere, because a lot of the newborn classes and birthing classes at hospital are geared to use very gendered language and to talk to the pregnant person.  So hey, mama.  Mama, this is what you’re going to do.  And you have a lot of same sex males couples who are very uncomfortable going to those classes because they’re not geared towards them and what their situation is going to look like.  So there’s so many opportunities and need for education for doulas to do pre-birth education.  Quite honestly, it’s limitless.  We need doulas out there!

With the newborn care specialists or postpartum doulas, then, the family would be hiring the doula versus the surrogate?

That’s correct generally.  I mean, every once in a while, I have seen a surrogate say, hey, I want somebody to come in and just be with me for the week afterwards while I’m recovering, but you’re absolutely correct.  Generally, it is the family of the new newborn who is asking for somebody to come in and say, hey, you know, especially sometimes they need overnight care to figure out how to get through that new rhythm of having a new child at home.  Or of course, like, hey, we’ve never had children.  Can you please help us through this in that first starting off point?  We see that quite a bit.

We also see it quite a bit, actually, with international families because surrogacy is not just limited, of course, to parents who are in the United States.  There are oftentimes families that come in from overseas, and so then they are lacking that family support around them that a lot of us can take for granted.  Like, when I had my child, my parents flew out, right?  Great; they were there; they helped me.  But when you’re international and you’re in the United States – one, you have a language barrier, and two, you don’t have that family safety net surrounding you.  So there is a huge opportunity and need for help there because that gives them that help and safety net, especially while they’re trying to deal with passports and paperwork and things like that with a brand new baby so they can get themselves home.

Right.  That makes so much sense.  And there could be delays. 

Especially during COVID, there were delays.  There were significant delays.

Right.  And certainly for the surrogate, having a postpartum doula in the hospital or, as you mentioned, with recovery and sibling care could be very beneficial for the first week or so.

Absolutely.

I love it.  So for our listeners who are interested in becoming a surrogate, what is that process like?

I think the biggest thing is a genuine love of being pregnant yourself.  I can absolutely admit with full heart that I really did not love being pregnant.

Same.

Some people do, and some people don’t.  And again, no judgment, right?  I just – that’s why I will admit it.  I did not love it.  But there are people out there who think that the greatest moments of their lives are always when they are pregnant.  It’s just that they’re done growing their own family.  So from my perspective, I feel like you really should be done growing your own family because as we all know, any pregnancy can lead to complications and could end your childbearing ability.  So we never want somebody to say, hey, I’m going to give this most selfless gift to somebody else, but I’ll just wait and have my own children later.  No, no.  You can’t do that.  We want you to have finished your own family so that there’s no hard feelings or guilt over this as things go forward.

So finish growing your own family.  Love being pregnant.  Have complication-free pregnancies.  Not be on any mental health related medications.  So I know in this day and age, we’re all cumbered with anxiety, but unfortunately, we can’t be on those medications to move forward in the surrogacy journey.  Can’t be on any government related aid.  Needs to have a reasonable current health history.  So, like, reasonable BMI, and I hate to – it’s not that there is – I don’t personally discriminate against people based on their size, but there is something with the medications that you are given during the IVF process that the body metabolizes better at lower BMIs, usually 32 or under.  That’s why we ask for that, and that’s why the clinic asks for that.

That’s the general, big overarching.  Can’t have more than three C-sections.  Can’t have had more than five pregnancies.   That kind of thing.

So as far as finding the surrogate and matching with a family, you talked about some of your criteria, and they can obviously be in different states, but what would be the – I mean, do you ever have family members go through the formal process, or people that a client has identified versus getting matched with a stranger?

Yeah, absolutely.  And I will say, I know that’s scary when you say the word stranger because that kind of makes it a little harder feeling, but we’re very methodical about matching.  People meet each other, and they make a conscious decision to match with each other.  So we actually introduce and walk through introductions; have full, long, detailed conversations about everybody’s expectations, about getting to know each other.  It’s not that you are – if you’re going through an agency, and I’m going to put in my little air quotes that nobody can see, a “stranger” – that you are a full stranger.  It’s that you actually have full free will on both sides.  You meet each other, and you make a decision as to whether you want to move forward together in this journey.  It’s not that scary, is what it really comes down to.

That makes sense.

It can seem really overwhelming, and I will say, there are some agencies out there that just say, yeah, no, you’re matched, and you just go.  And you go, oh, okay.  But most agencies actually are going to introduce the parents and the gestational surrogate together.  You’re going to make a conscious decision about matching with this person about whether you want them, whether you like them, whether you have the same aligned beliefs with them and things like that.  And that’s the way it should be.

Right.  And as you mentioned, the communication and everything would have to be agreed upon by both parties on the involvement or lack of involvement, depending on choices.

Correct.  Absolutely.

I love it.  So how did you get into this work?  I know you’re very involved in the fertility space and advocacy.  You have traveled and lived all over the country, so you do work in multiple states currently.

Yes.  I personally went through my own infertility journey.  We went through seven years of infertility.  My husband was active duty military until two months ago.  He just retired with 24 years of military service.  We went through our infertility journey while he was in the military.  And we now have an 18-year-old.  It’s amazing, and we’ve gotten this far, but the thing is, the military hasn’t changed in how they help people and use their healthcare system for infertility.  And access to care is extraordinarily difficult for military families because we move so much, because we don’t have the insurance that covers anything related to fertility or family building.  And so that’s part of what brought me into this, of course, is my own personal journey.  Then I actually started working in a law firm that does assistive reproductive technology law.  I was, of course, dealing with legal contracts and looking through things there.  Full disclosure, the law firm was owned by my sister, so I feel very strongly about family in all of these things, too.

And then after a number of years of us helping people who were independent matched – which is exactly what you alluded to, right?  A family member or a friend that you already knew.  They tend to independently match outside of an agency.  Well, as a law firm, we were helping a lot of those.  And what we found was that we couldn’t serve people very well there or very fully on the law firm side and give them what they all needed.  And honestly, I love logistics.  I feel like a party planner every day, and the most amazing party is having a baby.  So we actually broke out the agency separately from the law firm.  So my sister still has the law firm, and I now run the agency.

Beautiful.  And as far as you being involved heavily in the Colorado advocacy, as well as having the agency, how did that – was that just based on where your husband was stationed at the time, or how did that come about?

Yeah, so actually, my sister lives in Colorado.  So I was stationed in Colorado at one point, and at the same time we were stationed there, my sister moved there, and then we ended up moving away because we got stationed somewhere else.

You’re on the East Coast now?

I am now, but in the middle, I’ve been in a couple other places.  Since I was in Colorado, I went to London, then Alabama and California, and now I’m back out on the East Coast.  We’ve lived all over, but we were in Colorado originally, and so that’s where that started.  Since my sister is there and our original agency – well, we are Bright Futures Families.  We have DBAs in a lot of locations.  And Colorado Surrogacy was actually our original location.

What we saw there was a lack of access to insurance coverage, right?  This goes back to the access to care conversation.  And while it didn’t affect Tricare on a federal level, we wanted to see what we could do to help on a state by state basis.  So we founded Colorado Fertility Advocates, and in conjunction with Resolve, who is incredibly helpful to us, we actually had legislation introduced, and we had a big, huge advocacy day in Colorado.  We actually got the bill passed.  Ironically, on April 1^st, which was not an April Fools’ Day, of 2020, right as the world shut down, the governor signed the bill giving fertility benefits.  It’s only to the large cap market.  It has a few issues, as all bills do, right?

Sure, but it’s a huge step!

It was absolutely amazing.

So going into working state by state and also dealing with benefits – as you mentioned, Tricare does not cover surrogacy.  Are you seeing changes in employer funded benefits to expand to cover surrogacy?  I know many are adding adoption.  Some are even adding birth and/or postpartum doulas to their coverage plans.  I have so many questions related to that.

I’m not seeing it on a health insurance basis.  The health insurance is more about fertility benefits like IVF and gamete freezing and things like that.  I will say, though, I am seeing a lot of trends towards employers having other benefits programs.  So, like, Carrot Fertility and Progeny where they either have discount programs or they have a pool of money and they’ll say, hey, you know what, you get $25,000 worth of benefits towards any of these fertility-related things.  I am seeing that as a big improvement that is happening out there.

The only state I know of that has made a really big difference – and insurance is such a – I love talking about insurance, and I can and will talk about it all day if you will let me.  The thing is that as an intended parent, you can never cover a surrogate on your own policy because she’s not your beneficiary.  So what they have to look at is the actual surrogate’s health insurance, and not all health insurance will cover a pregnancy when acting as a surrogate.   So that also then becomes a very important thing.  So then you have to talk about open enrollment exchange if it doesn’t cover and again, I could talk about it all day.  But there are a couple states that have moved and said that it is illegal to discriminate on that basis.  Nevada is notably one of them.  So all policies in Nevada must cover pregnancy when acting as a surrogate, which is amazing.  That’s kind of a goal.  All of us are trying to use that gold standard and see if we can get things moved towards that.  I know especially in New England, like Resolve New England is working very hard to try to get some policies in some states changed up here, as well.

Okay.  So you’d mentioned Carrot, and I’ve worked with Carrot for clients with both birth doula support as well as postpartum.  As you mentioned, they have a set amount of money, so they’re able to utilize that for surrogacy if that is their choice?  Is that correct?

So that would be actually a question for an expert from Carrot, quite honestly, because I imagine they have different employer policies for different places.  I know sometimes they negotiate discounts or sometimes they say, hey, you have this pot of money.  What Carrot is, it’s a benefits administrator.  So they administer out whatever it is that the company has agreed to provide to their employees and their beneficiaries.  So I couldn’t give a blanket as to what Carrot does.

That makes sense, and I’ve noticed it does depend on the employer.  It varies.   That’s so fascinating.  And hopefully things keep moving similar to the fashion that Nevada has, state by state, to be more encompassing.  Do families pay for insurance?  I know you mentioned that a surrogate cannot be on state aid, but do they add on to insurance policies for the carrier?

If her insurance will cover a pregnancy while acting as a surrogate, then she can use her existing health insurance at that point.  And then the parents would be paying for up to her maximum out of pocket amount.  If her insurance does not cover, then in that situation, then they would be taking out an additional policy on her, one that would cover a surrogacy.  And in 49 out of 50 states, there is a policy through the open enrollment exchange that covers pregnancy when acting as a surrogate.  I just always want to caveat the one.  There’s always one exception to every rule, right?  And because I’m licensed in New York, I would be very careful about this.  Under New York law, if you’re matched with a surrogate in New York, the parents still must pay the premiums for her policy, even if it is an existing surrogacy-friendly policy.

Oh, interesting.  How many states do you work with families out of, then?  You mentioned being licensed in New York.  You’re obviously working in Colorado.

We generally have about 17 to 18 states that we work in.  We will actually work with a surrogate in any state where surrogacy is legal.  We just don’t tend to have as many from certain states, not because we’re against those states.  We just have them in places that are much more.  My six d/b/a’s are Colorado Surrogacy, Montana Surrogacy, Texas Surrogacy.  Then we get a little more regionalized with Southwest Surrogacy, Pacific Cascade Surrogacy, and New England Surrogacy.  So obviously, that leaves out kind of the Midwest and the Southeast, not because we are against those places.  We absolutely would have surrogates from there.  It’s just that those are more where we’re concentrated and looking is those other locations.

That makes sense.  So how do our listeners connect with you, Jennifer?

Sure.  So they can head to my website, which is www.brightff.com.   Or they can send me an email at jwhite@coloradosurro.com.  Either way would be absolutely great.

Also, if I can throw a little plug in there – we have a great referral program if there are people who are listening who say, hey, I can’t be a surrogate myself, but I know somebody who might be a fantastic one.  Our referral program – if you just have the conversation and encourage them to fill out the intake form and put your name on it, you each get a $5 coffee gift card.  I know that seems silly and little, but just have a cup of coffee on us for having the conversation.  If they are qualified enough to fill out the application, each person gets $100 for the referral, and if they end up being matched, each person gets $500 for that referral.  So it’s worth having the conversation with people that you know who might be interested in surrogacy.

Are there any national resources that you would recommend in starting this process and doing more research on either becoming a surrogate or the process for families who are looking into it?

Yeah, that one’s a little harder.  I definitely think we try really hard to be open and transparent on our webpage.  If people head to our webpage – I know a lot of people go to Facebook.  There’s a lot of Facebook surrogacy groups out there.  You have to take some of that with a grain of salt.  They absolutely have some level of valuable information, but they also have some not always accurate information.  So you have to be a little bit of a cautious consumer in those groups, but they are really good sources of information, too.

Excellent.  Any final tips for our listeners?

The honest answer is, it’s not even a tip.  It’s a shoutout that I love doulas and everything you all do to support our families.  It makes me happy every day.  So I just want to say I appreciate you all.

Oh, thank you!  Well, I appreciate the work that you’re doing, especially in the advocacy space, and hopefully things change in Michigan in the future.

I hope so, too.

Maybe we’ll work together!  Thanks so much for sharing your wisdom and educating our listeners and our doula clients on this option.

Thank you for having me!

IMPORTANT LINKS

Bright Futures Families

Birth support from Gold Coast Doulas

Postpartum support from Gold Coast Doulas

Becoming a Mother course

Kristin Revere chats with Marya Eddaifi of Marya Eddaifi Coaching on the latest episode of Ask the Doulas.  The discussion is centered around dysfunctional labor maneuvers and her work as a coach.    

Hello, this is Kristin with Ask the Doulas, and I am excited to chat with Marya Eddaifi today.  Welcome, Marya!

Hi!  How are you?

Doing great!  So you and I have connected a couple of different times, and we saw each other recently at DoulaCon, where you were presenting, and I was, as well.  I’d love to have you start with a bit of your background.  I know you have a nursing background, as well as military.  So to get to this point of working in the pregnancy and postnatal space, I’d love to hear how you journeyed and chose labor and delivery as your specialty.

Oh, yes.  It was a long journey.  I started in the Air Force as a medic, and then halfway through, I was commissioned because I went to nursing school.  So that’s how that happened, and you have a choice.  You could do med surge, or OB.  And I originally was going to do med surge because I have an emergency room background, actually.  But it had been over a decade of me doing that, so I decided for something different, and I opted for OB.  And I had my very first labor and delivery assignment in England.  That, I think, was one of the pivotal things about the way I turned out to be because I didn’t start labor and delivery because I had this passion for it.  I started it because I just wanted to change from emergency medicine.

And they train us, and during that training, I’m a pretty big perfectionist, I guess you could say.  And I felt like they weren’t giving me enough training to help women with their pain, whether or not it was a natural unmedicated or just somebody dealing with an induction . If it wasn’t IV medication or pills, I wasn’t really getting any training.  So I actually – within the first of me being a nurse – I was also older, too.  I had a 15-year-old, and I was almost 40, I think.  Around 37, 38 years old.  So I started researching how to help women, and I came across doulas and what they are and do.  And I’d never really heard of them.  And I just saw all this comfort measures.  So I was like, well, they’re not teaching me how to do these comfort measures, and I remembered in my birth, nobody helped me.  I had a pretty – like, it wasn’t a good birth experience.  Let’s just say that.  So I remembered nobody helping me, and when I saw that that could have been an option, I said, well, I’m going to know how to do this.  I remembered just being left alone and not even a suggestion, like not even here’s a birth ball; nothing.  Stay in the bed.  It was in ’95.  I had my son in ’95.

And so when I looked up doulas, I was in Virginia because that’s where the training was.  So I was stationed in England, but doing my training in Virginia.  And I happened to find a lady named Kathy Stewart who is a DONA doula trainer in Richmond, which was about 60 miles from me.  So I called her up, and I said, hey, can I come to one of your workshops?  And she said, yeah, sure.  I really didn’t know what I was getting into.  But what she was teaching, they don’t teach nurses, and I thought, wow.  This is important.  They need to teach nurses this.  And so I kind of thought, oh, this is the answer to everything.

I went back to England, and of course, they threw every natural labor they could at me.

Because you had the training.  It’s like, okay, Marya’s got it.

She loves it.

Yeah, that’s how it goes with nurses in my area who are Spinning Babies trained.  They end up working with me more often than not.

Yeah.  So what happened, thought, it wasn’t always working, all these natural comfort measures, right?  We were still getting stuck at 8 centimeters.  We were still sometimes – she would opt for the epidural out of exhaustion, or it would end up in a C-section.  And I was still kind of frustrated.  And that’s how I found Spinning Babies.  That was back in, I don’t know, 2011 or something like that.  Long time.  And I took my first workshop, and I said, oh, this is a big missing piece of the puzzle.  That was the first time I’d ever heard the term myofascia.  I didn’t know what myofascia was.  And there wasn’t a lot of information.  There was Facebook, but it wasn’t the social media platform it is today.  There was no TikTok.  There was barely YouTube.  YouTube had a few things on there.  So I was very intrigued with myofascia.  And what I found for myself – like I said, I’m a perfectionist.  So when I really am connecting with something, I just got to know how to do it.  I’ve got to be the best at it, basically.  But I was also a new labor and delivery nurse.  I was also a new nurse.  I was also, with the doula background, that’s not common for nurses, especially in 2010, 2011.  And then I go to a Spinning Babies workshop.  So then it was like, what is that?  And I’m like, I don’t know how to explain it.

So in order to try to get it taken seriously, I studied myofascia because I felt like there was something in that, and I could maybe explain that to these doctors and nurses to make sense of it.

In a more medical way than just positions for labor?  Yes.

Yeah, because it was like, how do I get them to understand that this is not a comfort measure?  How do I get them to understand that it’s more scientific than they think?  They’d never heard of it.  The people I worked with in England had never heard of it.  And I was still trying to figure it out.

So a few years went by, and I had a couple of bases.  What happened would be, finally, they would start to kind of listen to me.  I mean, I even brought my own peanut ball.  That’s how long ago this was.  We didn’t have peanut balls.

So nice to have all those tools in the hospital.

Yeah.  So I went from England, then I actually went and got stationed at Langley.  And I ended up – because Carol Phillips is so close to Langley, I started taking her workshops for her Dynamic Body Balancing.  So I just really dove into the world of body work and fascia.  I mean, around 2015, I was with Gail and the Spinning Babies trainers when she first started that, and so for a couple of years, I was able to teach Spinning Babies.  But then I got stationed in Italy.  When I got to Italy, everything changed.  Everything was different.  My access to communities was cut off, so to speak, because of being in Italy.

Time zone changes.  There’s so much.  I mean, even virtually, your work would be limited.

Well, there was no virtual then.  There was no virtual, and then I’m in a country where they don’t speak English.

Right, so coaching is more established now than back then.

Oh, yeah.  What I ended up doing was, instead of staying with Spinning Babies, I started to study Anatomy Trains by Tom Myers.  And so while I was in Italy – so in 2016, I was in Italy.  And I was studying Anatomy Trains and blowing my mind.  Tom Myers just is so smart.  And his book, Anatomy Trains, opened me up to this new understanding of fascia.  Like, such a profound understanding of fascia.

Now, can you explain fascia for our listeners who don’t fully understand?  I’ve had fascia work so I get it, but yeah, if you can explain that.

Yeah.  So originally, like I said, when I was on that journey of myofascia – myofascia this and myofascia that – when I first started with Spinning Babies, I started to learn it was a connective tissue.  That’s all I could really get.  So I was – like, it’s a connective tissue.  It weaves through the other fibers of your body, like your muscles and your tendons and your ligaments.  And it kind of holds them.  It’s the scaffolding.  And it’s what keeps them together.  And so that was the limited knowledge I had, and if the fascia was dry or dehydrated or unhealthy, maybe from overuse, underuse, injury – it sort of traps your muscles from functioning the way they were meant to function, which was lengthen and shorten.  So during that time, I actually became a certified personal trainer, certified corrective exercise specialist, and started learning more about fascia and how it would create limited range of motion, or if you’re an athlete, you might not be able to – say you’re a marathon runner.  You won’t be able to run as well if your fascia starts to get overworked because then the body starts to lose the integration of being structurally aligned.  It starts getting pulled, and the bones start to follow that, and then you start getting pain in your hip, pain in your foot, pain in your shoulder.  And what I found while learning with fascia is when you do fascia work, the fascia is from head to toe.  It is weaved through every centimeter of your body.  So when you have a fascia restriction – say in your ankle – you may feel that in your shoulder.

That’s wild.

That’s what blew me away.  Listening to people complain about their pain and how we always kept focusing – it’s in my back, so that’s where we focus, in the back, and now I’m just not getting better – then I started to learn through Anatomy Trains that it’s the whole system.  So moving a bit, fast forward through 2016 through 2018, I started to take training classes with Tom Myers and going to Anatomy Trains workshops.  And I became a body worker.  And I originally thought I would use it for athletes because of me taking the certified personal training and stuff.  But as I was practicing – well, I’m a labor and delivery nurse, right?  So I’m practicing on my patients.

Right?  Might as well!

And I was just like – I was blown away by the difference that it was making.  There’s – like, I had so much better releases, just with labor, taking those – you know, the prodromal labor patterns or the dysfunctional labor pattern.

Yes, and for our listeners who don’t understand prodromal, can you define that?

Yeah.  Well, prodromal is this appearance of labor.  They’re very strong, and it’s confusing because when the cervix is examined, it’s maybe one or two centimeters.  So by definition, an active labor cervix is five or more centimeters.  So you have this mismatch going on.  You only have a two centimeter cervix, but a woman really pounding out painful, strong contractions, sometimes back to back.  They don’t get relief.  Sometimes you get one, two, three in a row and then a pause.  But they’re so strong that you’re just like, this has got to be labor.  And a dysfunctional labor pattern is just when the contractions are either too far spaced apart that there’s no momentum, or they’re what we call coupling, where you’ve got two in a row back to back and then it’s a pause.  And then maybe two or three, and then there’s a pause.  So the body is just struggling to just kind of chug away.  Like, a contraction, two or three minutes later another contraction; two or three minutes later, another contraction.  That is the most optimal contraction pattern to keep it relatively equal between contractions because then the body is just driving smoothly, having that labor pattern that will create the dilation and the descent.  And that’s what we’re looking for in the labor pattern.

Exactly, because it can be exhausting.  I mean, it can be days of that at home before getting admitted.

I think it can be also heartbreaking or even traumatizing for some when they don’t understand what’s happening, and they show up at the hospital because that’s where they’re planning to birth, and they’re sent home with nothing.

And what do you do?  And if you don’t have a doula, they’re home by themselves.

That was for me where – in my experience, we had all military, because I was a military nurse, and I was overseas for most of it.  And they didn’t have doulas.  There wasn’t a big doula community.  You know, there’s language barriers and things, and information is not out there.  They don’t have – I think doulas are a lot more popular now than they were ten years ago, and so these families were sent home to just be told, take Tylenol, Benadryl, or a bath.  And honestly, you would see one of two things happening.  They would come back frequently, and there would be some animosity building because they were told again, no, you’re not in labor, you’ve got to go back home.

They just want to stay, yeah.

Yeah.  And then even some women who were like, I planned a natural birth, but I’ve been like this for a week.  I can’t do this.  I’m so tired.  And I was like, this is so sad.  And what I ended up doing was taking my training, the things I learned from Spinning Babies, the things I learned from Carol Phillips, my bodywork, and I started to do things in triage.  And what I noticed was, I tell when it’s real labor.  Like, you just see it enough.  And I’m like, you know, this is probably kind of early labor for her, but I’m going to show them this – I call it my triage protocol or prodromal labor protocol.  It’s a protocol for me.  That might be my military stuff, but I have a certain – I do, like, five or six things, and they’ll either feel better, so they say, okay, I feel better.  I’m not in so much pain.  I’m going to go home, and we’ll come back later.  I also am teaching their partner, you can do this at home, too.  And then if they really were in labor, they would dilate.  Sometimes we even had a baby in triage because prodromal labor, to me, is real labor.

It is.  It’s effective.  It’s taking longer, but it’s still doing work.

The reason it’s taking longer – and this is my opinion.  Now, I’m going to talk to you as the body worker.  As soft tissue mobilization is – they are physically stuck.  When the fascia is not allowing the rest of the body to function, then everything gets stuck.  So when I’m doing my – like, you can release fascia through positioning, like those – like, a sidelying release is a fascia release.  That’s why you hold it for so long.  Fascia can be released through stretches if you give it at least three to five minutes.  It’s a very long type of stretch.  And yoga actually even tackles this through yin yoga.  If you’ve ever done a yin yoga session, you will sit in those positions to stretch for at least three minutes.  And so as it unwinds – so you’ve got some muscle unwinding; the fascia is letting it go, and now the body can open.  And this is a body work thing.  So you’re taking these nurses and these doctors and these midwives who do not understand this because it’s not what they were trained for.  And I feel like there’s a lack of communication between the body working world and the birth world because this – I am learning things outside.  I take fascia webinars.  I go to fascia workshops.  I do dissection labs.  I learn everything about the body and different ways to release it.  Positional releasing, muscle energy technique, craniosacral therapy.  All of that plays into how well the body functions during labor.  And so this is so important.  Now, you don’t have to become this body worker, but I’ve taken enough that in my training, I actually have like a 90-minute training of advance fascia work for those who feel ready for that because some people are just getting into birth, so you’ve got to learn these basic things.  I realized, like, I’m very advanced.  So I also took over a decade to get to this point, so I remember being very new.   Obviously, I remember not even knowing what myofascia was.  So I try to bring it down to a very digestible way to intake this very, very important information so nobody feels as though they have to become a body worker as well as a birth worker.  However, if you have the knowledge, then maybe you can refer people.  It’s so important to know who’s in your community, know the type of work they do so you send your client or patient to the right person.  We don’t have to do this alone.  I do this across the country.  I have looked for different types of soft tissue mobilization workers.  So you’ve got structural integrators, rolfers, osteopaths, and there’s another one.  I can’t think of the name of it.  There’s different names for these similar modalities, but it really is fascia work, and I’m going to have to say – it’s not massage.  Massages are nice.  They’re relaxing, but they’re not fascia work.  You really have to find fascia work.  And since it’s not so mainstream, so many people do not understand how to do this.  So, I know how to do it.  I will Google.  I’ve asked people I don’t even know.  Maybe they’ve reached out to me on social media.  I’m like, well, what city and state, or what city – I do my best because if you’re from a totally different country, I may not be able to find that person for you, but I can go onto Rolfing Institute or Structural Integration and find, like, they have find a therapist.  And I’ll find the country you’re in, and I’ll see if there’s something around where you live.  I’ve done this in Spain, and I’ve done this in the US.  I’ve done this in Canda.  It’s because I want people to get this work done so they have such an easier birth.  I know people don’t really agree with the word “easier” and “birth” at the same time, not everybody, but I do.

Yeah, I mean, who doesn’t want a smoother or easier birth?  Not necessarily faster, but yeah.

Just let the body do what it was designed to do.  But the way you as an individual live your life, that makes the difference.  If you are somebody who is too sedentary, the fascia network that is weaving through all your muscles and soft tissues, like your ligaments and stuff, actually gets very disorganized.  And I don’t have, obviously, a visual aid right now, but the disorganization of fascia creates restriction and then the muscles cannot lengthen and shorten.  And then think about how the muscles have to lengthen to allow the bones to move for the baby’s passage through the birth canal.

Of course, yes.

So if you’re not getting that, then it’s going to be tougher and longer.

Right.  Yeah, that is beautiful.  So you offer coaching.  You offer training for birth workers.  You have an app for birthing parents.  So let’s start with the app and then cover a little bit of the other ways that our listeners can touch base with you.

The things that I do – I’m very multifaceted because what I’ve learned along the way as a labor nurse, as a body worker, and I also studied with Bob Proctor for mindset work.  I believe there’s a holistic approach to pregnancy, birth, and postpartum.  And that’s something that found me, so it’s such a calling and feels like this is my purpose.  This is why I’m here.  So as I was learning, and now I get on social media and I’m talking; I’m trying to raise awareness about soft tissue body work.  That’s what I’m calling it, because I don’t want to box in, the only work you can get is this, because say for example if I say the only work is rolfing – if it’s not available in your area, then you’re going to be stuck.  So you’ve got to know, what is rolfing?  Rolfing is soft tissue mobilization.  So that’s how you would start opening the idea of like, okay, maybe we’ll start here.  If we can’t start there, I’m going to look for a certain type of therapist for my body.  And so I’m on social media, and TikTok is one of my bigger platforms, and I would get messages.  Like, I’m in prodromal labor.  I just started thinking, like, I’ve got to figure out a way to help these people faster, right?

And then one day I kind of just woke up and I was like, an app.  I’ve got to make an app.  Everything’s on an app.  Like, that’s the first question we start to ask now.  Is there an app for that?  Is there an app for that?  I saw this make-your-own-app, but the reviews were like, oh, when it glitches, nobody’s there to help me.  And I said, okay, we cannot have laboring mothers on a glitchy app.  So I found a wonderful developer, and we started creating the DLM app, which stands for Dysfunctional Labor Maneuvers.  And I also was thinking about the app because there’s limited access to getting some of the training, and I said, you know, sometimes you don’t need the training.  You’ve just to do exactly as I say, and it will work, right?  So I said, but I can do that on an app with videos.  That’s how I learn all the time.  If I have to learn how to do something, I get on YouTube, and I learn how to change a lightbulb in my car.  I get on YouTube.  So I was like, I’m going to make an app.

So originally, the app is meant to have a parent option and a professional option.  Right now, the professional option is still in the mix.  It’s almost done, though.  But I wanted to get the parents side done.  The parent side was a lot easier.  But it’s specifically for these moments of uncertainty.  If you’re feeling a prodromal labor pattern, or if you’re – early labor can be very confusing, too, because it’s irregular but you feel contractions.  If you’ve just never felt this before, you don’t know what to do.  So you go on the app and you basically are asked a few questions.  It’s like what you would do when you go to triage.  They would ask how long are your contractions; are they regular.  And so it’s a systematic questionnaire that brings you to the solution.  And very easy for parents; they don’t have to know anything except, I would say, maybe how to read.  I don’t have a voiceover for the questionnaires.  And it’s in English because as this app – it will grow, and I figure as the need starts, maybe there will be some translated versions of it.  I don’t know.  But it’s in English, and so you will have to know how to read English.

Beautiful.  I mean, as doulas, we’re always referring different apps to our clients, whether it’s a contraction timer or a registry app or to count the kicks; whatever it might be.

This is for just women who are more than 38 weeks because this work is so effective.  I do not want any woman who is not full term, at least 38 weeks, to be doing this.  If you feel contractions and you’re not term yet, you really should be going to the doctor, not hopping on an app to see if you can make the contractions feel better.

Good point.  Yes.

This app is for labor.  It isn’t for prenatal anything.  And it’s because there’s nothing to help these families who are in difficult, challenging labor, maybe turned away from the hospital because their cervix isn’t dilating, and they don’t have a doula, and they don’t have anybody who’s savvy with labor or birth.  Then this app – it’s like having me in your pocket.  And I tried to think of every scenario that I could, and it’s done by algorithm.  So as you plug in your answers, the videos that will help you should pop up.  That’s all you need to do.  Once you finish watching the videos, it gives you what to expect next so that you know, okay, well, now that I did that, what do I do?  And so that was my way of trying to be there for every family because that’s one of the things.  We can’t be there for every family.

No.  I mean, even if they could afford to hire you as a coach, you can only coach so many families at the same time.  And you can’t really turn people away if they’re at 38 weeks and they need you now.  So this is a great alternative. 

And the professional side is much more complex.  It is going to include triage scenarios.  It’s going to include epidurals, and even once you do the – we’re calling them exercises, so we’re not being complicated, because sometimes I’ll say body work and people are like, what is that?  So I’m just calling them exercises.  And then after, then there’s how to – a good way to use the peanut ball very strategically.  That’s in the professional side.  And I made the professional side, even though I have – Dysfunctional Labor Maneuvers is the course that I teach to professionals on the work that I have done over the last decade, in combining my body work and all the other things that I’ve learned about positioning and movement.  And I have that option online.  So you can take an online Dysfunctional Labor Maneuvers workshop, and I do have some in person, but these in person workshops, not everybody can get to.  Some people have to work or they have families, or they live too far.  And I said, like, we’ve got to make this accessible to every birth professional.  So I put mine online for anybody who can’t make an in-person workshop.  I love in person workshops.  There’s so many things that pop up that maybe wouldn’t have popped up in any other time.

Sure.  Especially with hands-on work, it’s so beneficial.  I couldn’t imagine doing Spinning Babies, the two day training I took, virtually. 

This is something – but learning it online, I think a lot of things changed during COVID.  A lot of online training came, and out of necessity.  So I was like, you know what?  Like, this might be second best to in person, but what if you didn’t get any of it?

Exactly.  I mean, I taught my comfort measures for labor class virtually for two years.  It still helped couples.  It’s just different.

Yes, exactly.  And then especially, I remember taking workshops, leaving, and going, I don’t remember anything.  So having it online, it’s online; it’s self-paced.  So if you can’t remember something, you can go back to your video lessons because you have access to the lessons.  But I realized how complimentary the app now is for the professionals because if you took the online course and you do have the videos, you’re not going to have time to pull them up in a labor.

Not at all.  An app is easy to look at quickly.

Yes.  And so what I realized, and I remember this with the doula training.  I said, being a nurse, taking doula training, I said there’s nothing for these doulas after they take their training.  They have no preceptor.  They’re going in by themselves.  And I was like, this is – that must be so hard for a doula to go through, her first client, right?  And so what I really felt like was like, it’s going to be a preceptor.  The app for professionals.  If you took any kind of training, even if it was a Spinning Babies training or even if it was my training, it doesn’t matter, right?  You’ve got the idea, but you can’t remember when to use what, and you’re trying to quickly think on your feet because some hospitals, they’ve got a little time clock ticking for some people.

Right, and you’ve tried everything, and you’re exhausted, and it’s like, what do I do now?  The nurse and I have strategized.  We’ve tried everything.  What’s next?

Yeah, and I’ve got these chat groups where people come in and say, I’ve got this, but, you know, not everybody’s on their phone or responsive to it.  So I was like, you know what, if you’ve never done this before and you’ve just maybe took an in-person class or you just took my online class, and now you’re at your first birth, download the app.  Use the app.  Everything that I teach, it’s in the app.  It’s just going to be – I don’t explain it.  There’s no, like, let’s talk about it.  It is like, what is your signs and symptoms?  Here’s the videos.  What do you got?  Here’s what you do.  This isn’t a place to learn theory.  This is a place to do the action.  And so that was what I felt like.  I said, this is like a preceptor for them.  That way when they finish up any kind of training, and they go in with their first client or even with nurses, you may be juggling two patients.  You don’t have time to jump on your computer or jump on your phone to go look something up and dig through all these videos of training when you can just go into the app and be like, I have this, this, this, and this.  What videos do I do?  What do I do?

Why don’t you give me your different social handles, your website, all of the different contact info that our listeners, whether they are a birth professional or a pregnant couple, so they can find you?

Yes.  My website is simple.  On Facebook, I do have a group called Dysfunctional Labor Maneuvers.  That is private for birth professionals.  You’re welcome to join.  And I do have a community chat, and that’s where some people get on to say, hey, I have this going on.  I’ve done this.  I’ve done this.  Can somebody help me?  So we come on, and we help each other out on that.  I’m on TikTok a lot as @empoweredbirthpregnancy.  Instagram, @empowered_birth_pregnancy.   Empowered Birth and Pregnancy is my company name.  And then my email is coachingintoresults@maryaeddaifi.com.

And Marya, if they’re searching to download your app, how do they find it in the app store?

In the app store, Android and iOS, DLM App.  It’s rose gold with DLM written on it.  It’s easy to see because of the icon being rose gold.  My team did a very beautiful job.  I said, make it beautiful.  That’s what I told them.

Love it!  Well, I can’t wait to check it out!  Any last minute tips for our listeners?

My biggest tip, I’m going to say, to birth professionals is learn your community.  Find your soft tissue body workers.  Raise awareness to these families that this is – it is an investment in yourself, in your pregnancy, in your birth outcome to really take the soft tissue work as part of your prenatal care.  And families, look for somebody in your area.  You only have to go once or twice a month.  It’s not a consistent thing where you’ve got to go every two or three days.  But you know chiropractic is good work, too, but imagine how well your chiropractic can work if your soft tissues are beautifully aligned and allowing that adjustment that a chiropractor would make.  I think that is such a synergistic way to take care of your body in pregnancy.

Love it.  Thank you so much, Marya.  We’ll have to have you on again.  You have so much valuable information.

Thank you for having me on!  I appreciate it.

IMPORTANT LINKS

Marya Eddaifi’s website

DLM App

Birth support from Gold Coast Doulas

Comfort Measure for Labor class from Gold Coast Doulas

Becoming a Mother class from Gold Coast Doulas

Spinning Babies

Kristin Revere chats with Kay Vorce, postpartum and sleep consultant at Gold Coast Doulas about the benefits of overnight postpartum doula support!  They also discuss the difference between the terms night nurse, newborn care specialist, night nanny and postpartum doula.  

Hello!  This is Kristin Revere with Ask the Doulas, and I am chatting with Kay Vorce, who is another Kristin.  We actually have three Kristins on the Gold Coast team, and Kay decided to give herself a nickname.  She’s actually Kristin!  Welcome!

Hey, thanks so much for having me on!

Happy to have you hear, Kay!  I would love to start by having you give our listeners a bit of insight into your professional background before you became a sleep consultant with Gold Coast Doulas and an overnight postpartum doula with us.

Yeah, absolutely.  Happy to share.  My journey with this field of mom and baby and with baby care started when I had my son who’s now almost five.  He was just a really difficult sleeper.  I was very sleep deprived.  I was basically miserable.  It was starting to affect my relationships and my family.  And I come from a rehab background.  I was trained in traumatic brain injury rehab.  So I’m really used to looking at goals and what it’s going to take to achieve those goals.  When someone told me about a sleep consultant, I was like, oh, my gosh, I need one of those ASAP!  And I hired one, and I worked with her.  I started to kind of see some parallels between what I would do in rehab and then when I was working with the sleep consultant, what she was doing with me.

And I thought, you know what?  I think that I could become a sleep consultant, and I think I would be good at it.  So I was certified, and the rest is basically history.  I started working with clients right off the bat.  I have a knack for it, I can humbly tell you.  And from there, I started to notice that by the time a client got to me, they were pretty much already at their wits’ end.  When I was asking them to start this sleep plan, and they basically had no reserves, I started to think, wow.  I see this need for someone to be in the home.  I see this need for someone to be there, helping parents build up some reserves in order to even get over the hump of what it will take to get their baby sleeping in healthier patterns.

With Gold Coast, you guys being so awesome and having this kind of full menu of services, I am now able to do both.  So I work with tired families doing consultations for sleep, and then I’m also helping out as a postpartum doula in the home, which honestly is just something that I really love to do, and it’s such a necessary field.

It is, and that’s our topic for today’s conversation: overnight postpartum doula support.  One thing to mention with our four sleep consultants that we have, including yourself: there is a pause period before you start consulting, and certainly the postpartum doulas can do some sleep shaping and the newborn care specialists on our team, but you don’t do sleep consulting with a newborn, where our postpartum doulas can start in the hospital or day one getting home. 

Yeah, exactly.  No, that’s a really good point.  Thanks for bringing that up.  There’s sleep shaping, and then there’s the “sleep training,” or what I would call sleep teaching, because that’s really what we’re doing is we’re teaching your baby a new way to sleep.  But the sleep teaching or the sleep training doesn’t really get the green light until about 16 weeks or after in terms of any kind of formal sleep training.  Prior to that, it is all sleep shaping: building healthy routines, healthy sleep habits.  And that is something that a postpartum doula is trained on to do.  It’s a really nice kind of seamless transition that we can make by helping parents in the home with sleep shaping, sleep routines.  And then if needed, moving into a little bit more of a formal sleep training when they’re old enough to actually learn the skills to sleep more independently.

Love it.  So walk us through a typical night as an overnight postpartum doula and infant care specialist.

Great question.  It really looks different for every single client because every single client has different needs.  A typical night might be – and I’ll just maybe think of a recent client that I’ve had in the last year.  A typical night might look like, night one, I come in.  Parents are overwhelmed.  Brand new baby at home.  Whether it’s their first baby or they have toddler or preschool siblings – either way, it’s just overwhelming.  And so when I show up at their home, it’s basically just give me the download on what’s been happening since you’ve been home.  Maybe they’ve had baby a couple nights on their own, and maybe it’s their first night home.  So there’s so many nuances to how it all starts, but basically what I do is I go in and I just say, what do you need from me?  Like, what do you need?  Do you need a couple of hours of sleep?  And maybe you’re working on breastfeeding, and I can bring baby to you in a couple of hours.  We can feed baby; you can feed baby, I can help with latching, basic latching.  Those kinds of things, and then you give baby back to me and I burp and resettle and get baby back to sleep.

Or maybe mom is formula feeding, and I can do all of the infant care overnight, and mom and dad can just sleep or tend to their other child, something like that.  It looks a little bit different for overnight care for every family.  Sometimes I have a lot of interaction with Mom and Dad overnight, and sometimes I have very little interaction.  It really does depend on the client need.

Yeah.  At Gold Coast, our minimum overnight shift is eight hours, but we certainly have clients who want ten or twelve hours of sleep, so we’re pretty flexible.  And you work sometimes with a family as the only doula in their home, and then because we have a large team, some of our clients want help seven days and seven nights a week.  We have a good portion of our team working seamlessly with a family.  So explain what that might look like.

Yeah, I really feel like this is what sets Gold Coast Doulas apart is that we are really good at continuity of care.  If you are a tired mom and you want support five, six, seven nights a week, like Kristin said, we have the capability to provide that with multiple doulas.  One, two, sometimes three overnight doulas, as well as different day doulas.  But we’re really good at communicating behind the scenes with each other, and we also have systems in place that allow us to share information.  In a client’s home, we keep a journal that we can keep notes in that is fully accessible to the client, as well as the doula coming in, to read what happened exactly the night before.  Maybe the feeds went up from 35 to 45 mLs overnight.  These are just really important things to know.  Let’s say that one doula has this great burping technique that’s specific for this particular baby that works really well.  That’s all being shared with each other.  So we’re able to really come in night by night, day by day, and pick up the ball seamlessly.  And that just provides a level of peace for these moms and dads and families who really just want trusted care, and that we are going to continually move your baby forward as they grow and change so much in those first couple of months.

Yeah.  And you love working with twins.  At Gold Coast, we work with twins and triplets.  What does it look like to support twins overnight?

Yeah, love twins.  Twins are just a whole other ballgame.  Obviously, you have two babies, but you really do need to have some tools in your toolbelt to just make sure that you have really good systems in place for how you’re going to provide care overnight.  So it might look like tandem feeding when babies are able to have a tandem feed.  Can we start working on getting babies eating overnight at the same time so that way when Mom and Dad have their first night alone, we can show them some tips to work on cutting these feeds down from 90 minutes to feed both babies back to back.  Here’s how we can start doing a tandem feed.  From there, we can kind of help guide parents.  You’ve got Baby A who can probably do six hours, and Baby B can only do three, so when is the right time to let Baby A keep sleeping, to only feed Baby B?  There’s just a lot of different nuances to twins.  It comes with experience of systems, how to care for them, how to quickly soothe them, how to burp one while the other one is still eating.  We’re great at that at Gold Coast, and we have a couple of twin experts on our team, too, which really sets us apart.

It does, for sure.  And some doulas prefer to work with one doula, and that’s totally okay.  I’m glad that we have quite a few twin experts and triplet experts on our team.

Absolutely.

Let’s talk about the average amount of nights per week a client would work with you for and how long of a stretch, and then we can get into some variations of that.

Absolutely.  Probably three to four times a week is a good amount, and it doesn’t have to be that many, but I find that three times a week is just a really nice rhythm starting out.  As we have just talked about, it can be up to seven nights a week.  These are clients who just might need that additional level of support for various reasons.  Maybe they have a demanding job they need to get back to sooner than later.  Maybe their husband is traveling, and they have no help overnight.  But by and large, three to four nights is a great starting point.  It gives some respite for additional sleep but it also allows mom and dad to just experience baby a little bit overnight, too.  It’s just a really nice balance.

And then in terms of duration of support, we do provide postpartum doula support up through the first year.  So we can help out with – and sometimes in the beginning, I’m there a lot, and then as time goes by, I can help with mom or dad’s back to work transition.  And then maybe after that, it is coming in and just providing some respite or some overnight support for a parent who’s traveling out of town.  It can really look like lots of different things, but I personally love to work with clients for the first three months, through typically if there’s a working mom, helping mom get back to work.  I find that’s a really good rhythm for what I do.

Yes, I would agree.  And it does vary based on need.  Again, your typical client, they either are planning for postpartum support in pregnancy and then want that help right away, or they’re so sleep deprived, and a friend tells them about newborn care specialists, overnight doulas, and then they call us, saying I wish I knew about you before, and I need you tonight.  We can fill that need because we have a big team.

Absolutely.  And yeah, you’re so right.  We do have – I mean, if I had a dollar for every time I’ve heard, “Oh, my gosh, I wish I would have known about you sooner!”  Because it’s true.  Sometimes it’s that moms are networking with each other, and someone has heard of a postpartum doula and overnight doula and tells their friend, hey, listen, I don’t know if you know that Gold Coast Doulas provides overnight support.  And then, yes, we come in and we’re right there, ready.  We can be there the day that you call.  We can have a qualified doula at your home, ready to provide much needed overnight care.

Yeah.  And certainly awareness is spreading about postpartum doulas in general.  I feel like birth doulas are finally becoming quite well known and popular, but there’s still a lot of education about what we do that would be different from, say, a night nanny or the former term “baby nurse” that is now newborn care specialist.  So let’s get into a bit about the differences in training and education and our specialty.

Yes, definitely.  Yeah, I am a certified postpartum and infant care doula.  So what that means is that I’m specifically trained outside of what your nanny can do.  I’m specifically trained in, first of all, like we already said, baby sleep shaping, baby routines, all things infant care.  We don’t dive in terms of infant care as much as a newborn care specialist.  They are aptly named.  They truly are a newborn care specialist, and I am an infant care doula.

Also, with the postpartum part of my title, basically, that means that I’m trained on how to mother the mother.  I am trained on how to give our clients the most satisfying postpartum period possible.  Whereas a newborn care specialist is going to have most of their focus on the baby, and a postpartum infant care doula, which is why I love what I do, is I do both.  I’m able to come in and mother the mother, and then I’m also able to provide that vital infant care support.

Yes, exactly.  And I happen to be both a postpartum doula and a newborn care specialist, a graduate from Newborn Care Solutions.  In our training, it’s not medical, but it covers a lot of conditions that babies have to be able to give referrals, and it is that training focused on caring for baby, and a lot of overnight work, a lot of travel work, a lot of live-in contracts.  So it’s nice that we have a mix of overnight postpartum doulas, as well as newborn care specialists who can give customized support based on what each client wants.  But as you mentioned, feeding support; recovery support; the emotional support and recognizing any sort of mood disorders and postpartum depression signs and being able to talk through that and give resources, as well.

Absolutely.  Most of our culture now is very aware of things like postpartum anxiety, postpartum depression.  And those are all things that I, when I come into your home, I am looking, and I want to make sure that mamas are okay and that mamas know that they have me, and I am not judgmental.  You know, you cannot shock me with everything that you’re going through and during your postpartum period.  And I think that’s a big relief for moms who, even their best friends, they sometimes don’t feel comfortable talking about the things that I get into with mamas, and especially that maybe they don’t feel comfortable talking with their mom or their mother-in-law because they might feel like they’re going to get judged.  Well, a postpartum doula, we are not going to judge you.  We are trained in screening.  We’re going to give you resources and referrals.  And again, we want you to have a satisfying postpartum period.  It does not need to be a sleep deprived, miserable stupor.  It really doesn’t.  I think that is our biggest challenge in this field, just continuing to get the word out on how vital this is.

Exactly.  There’s so much education that is needed, and the support is so important.  I know with inflation and prices increasing, you really have to be intentional with your budget, but many of our clients are being gifted postpartum support by friends and family members, or they’re using their health savings or flex spending.  I’m thrilled to see so many employers adding doulas to their benefits and programs like Carrot Fertility to make it easier to pay for the support that is so necessary.

Yeah, it’s about time, you know?  I mean, here in America, we don’t have the greatest maternity leave benefits for our moms, and then couples with sometimes just budgeting constraints, there can be some barriers to overcome in getting this care.  So yeah, I definitely agree.  And as we’ve said, it doesn’t need to be four times a week for three months.  There’s definitely – even coming in for a week or two right at the beginning and just helping some of the physical healing, to get by and get past that physical healing, and then maybe they have a little bit more reserves to tackle some of the more sleepless nights.  Really, any kind of care that you can get in those vital early days, it’s just not going to be wasted money.  It’s just not.  I’ve never, ever heard from a client that they felt like it was wasted money.  I totally agree with you; I’m so glad that we’re seeing insurance benefits taking this, and that more people are understanding what we do.

Yeah.  Unfortunately, general insurance does not cover it, but some of these add-on maternity benefits are, so I’m very thankful for that.  As you said with starting whenever that support is needed, or pausing and then calling us – I do find, and I’m thankful for this, as well, that paternity leaves have been extended for many of our clients, which is great.  For some of our clients who are on a budget, they will wait until the partner goes back to work and may have us for daytime support initially versus those longer stretches, and then once the partner goes back and needs to be at the top of the game to get back efficiency-wise at work, then we will come in for multiple overnights during weekdays, or some families, again, want us seven nights a week.  And then there are those clients where the mom is the one who wants to be refreshed and has a very demanding career.  We work with medical professionals and CEOs and management level executives who need to get back to peak performance, as well, so it’s not just their partner.

Yeah, absolutely, and it is really nice in the early days when mom and dad are both there and they’re tag teaming and they can help with keeping each other rested.  But as we know, that doesn’t go on forever, so yes, that’s a good strategy, and a strategy that a lot of parents do is like, okay, we’re feeling like we can tackle the first eight weeks with maybe my mom coming and then my husband is going to be here and we’re going to do this.  But then when that changes and we need to be a little bit more on, like you said, and we really just can’t be sleep deprived, or frankly, the emotional impact of sleep deprivation.  So sometimes we do come in later and we are able to provide that overnight support when both parents are already back to work.  There’s nothing that says that we need to be there right from the beginning after birth.  It really does look unique for everyone.  You know, that’s how we started this conversation.  I think it being unique for everyone – just give us a call.  We’ll talk through what’s going to be the best.  I mean, this is what we do.  We can help guide what’s going to be the most beneficial support.

Exactly.  And I have found since I’ve talked to all of our potential clients who call in or email to Gold Coast – I find very few grandparents willing to take those overnight shifts, and I honestly don’t blame them.  So they’re often able to help during the day, whether they’re traveling in for a week or two or live nearby, but it’s really hard on them to do overnights.  And also, so much has changed with feeding and safe sleep.  We keep up to date on all recalls and are able to do some education for grandparents who are caregiving during the day with our grandparents class.

Absolutely, and there’s really just no price on your peace of mind.  I know that sometimes if you have someone in your home, I think back to the early days.  I have a 15-year-old now, and I think back to my mom helping out overnight; bless her heart.  I couldn’t even sleep because I was nervous that my mom wasn’t going to be able to do it.  Even though she was there, like you said, just the peace of mind of knowing that you have a professional in your home and knowing that they know about babies and they know what baby is going to need and they know about safe sleep and they know about all those things – it is different, and our clients have that peace of mind where they can actually rest and know that their baby is in good hands.

And similar with daytime nannies, we’re able to communicate and talk about the napping schedule and try to get the whole family aligned if there are other caregivers in the house during the day that we’re not actually seeing.  We’re able to show them the logs, keep in touch, find out how napping is going, and have as seamless a transition as possible.

Absolutely.  That is the goal.

Any other tips or topics that we didn’t mention related to overnight postpartum and newborn care?

Yeah, I think the biggest takeaway to overnight care is that a lot of us moms, we’re pull up our bootstraps kind of gals.  We’re so used to kind of getting it done.  We’re going to do it, and we’re going to be okay.  It’s not going to last, and we’re going to do it, and we’re going to tough it out.  But I would just encourage all of us moms in solidarity to say that we really can’t do everything on our own, and it’s okay to not be okay, and it’s okay to ask for help.  And sleep deprivation does not make anything better.  It only makes things harder.  And so by preventing that from the get go, or by asking for help when it gets really bad, you just won’t regret it.  I think the key takeaway is that you’re worth it.  And it is a good thing to get help where you need it.

Absolutely.  My final takeaway is that, again, that term, postpartum doula, isn’t my favorite because so many people think that you only need a postpartum or infant care doula if you’re suffering from postpartum depression or perinatal mood disorders because that term, “I had postpartum,” instead of the range of time after having your baby, it’s used to refer to postpartum depression.  So I often have casual conversations in public about postpartum doulas, and I hear, “Oh, I had postpartum,” or, “I didn’t need one because I wasn’t struggling mentally,” so there’s some of that to overcome in our industry.

Yeah.  That term postpartum is now synonymous with, like you said, the different postpartum ailments that can happen with your emotions and hormones crashing after the postpartum period.  But yes, the term postpartum just simply means that period after you had a baby.  So there is a bit of terms and terminology and education to overcome with the term postpartum doula, but yes, the terms overnight doula, like you already said; baby nurse, things like that – those are all terms that people are already familiar with, and so whatever kind of helps people to understand the spectrum of what we do, I think, is helpful.

Exactly.  And I’ll often use postnatal support to clarify the difference.  Well, thank you for all of your information and insight.  We are so thankful to have you on Team Gold Coast, Kay.

Well, thanks, Kristin.  I appreciate being able to talk about what I do.  I love it, and yeah, if anybody would like to get in touch with me personally, I would love to chat.

Yes, and we are on so many social media channels.  You can find us at Gold Coast Doulas.  We’re on Instagram and Facebook.  We have a Pinterest page, and we’re on YouTube and trying to be more active on YouTube.  You’ve got some videos on there that are big hits.  Of course, people can hire you if they live in West Michigan.  We also have overnight support in northern Michigan and southwest Michigan, but you focus more on clients in Grand Rapids, as well as some of those lakeshore communities.

Yes.  We have a large team of doulas.  I think every single one of them is amazing.  Yes, get in touch with us if you live along the gold coast.  Visit us on our social channel or our website, and give us a call.

IMPORTANT LINKS

Overnight support from Gold Coast Doulas

Sleep consultations from Gold Coast Doulas

Becoming a Mother course

Register for our services

Modern Grandparent class from Gold Coast Doulas

Kristin Revere chats with Marnie Madras, founder of Rumbly, about the identity shift in motherhood and how to incorporate self-care into motherhood.

Hello, this is Kristin Revere with Ask the Doulas, and I am so excited to chat with Marnie Madras today.  Marnie is the founder and CEO of Rumbly.  Welcome, Marnie!  So happy to have you here!

Thank you!  I’ve been looking so forward to this.  It’s great to be here.

I would love for you to give us a bit of your background.  I know you worked in the corporate sector and also in the startup landscape, and then I’d love to hear how your journey took you into working with women in pregnancy and early postpartum and also starting a subscription box.

I’ll try to go through it a little quicker because my background is really diverse.  I’ve kind of dipped in and out of corporate and entrepreneurship, I would say, throughout most of my working career.  I was working for large, multinational organizations and for my entrepreneurial side, I had a tea shop at one point; very different from what I’m doing today with Rumbly.  I had a jewelry business.  Otherwise, in corporate, I was in food and beverage and toy.  So I’ve kind of been all over.

My journey to Rumbly really started with – I’m a mom of four right now.  I have four littles.  My oldest is almost eight, and my youngest is eight months.  My journey really started after I was pregnant with my second daughter.  With my first, I wanted nothing more than to be pregnant.  I had a bit of a struggle to get there, and then I got there.  It was in my eyes the most magical thing.  It really struck me that I was kind of alone in that thinking.  Most of the women I knew around me that I spoke to really disliked being pregnant.  And I get it.  Pregnancy is hard.  There’s a lot of challenge and physically, emotionally, spiritually, everywhere.  And that’s there, but personally for me at the end of the day, I still was so excited to be pregnant, and it really saddened me that other women around me didn’t feel the same.

So fast forward to my second pregnancy.  After I had my baby, I felt really off.  I loved my pregnancy.  I loved being a mom.  And something just didn’t feel right.  It wasn’t postpartum depression, and I really couldn’t understand what it was.  And after really spending a lot of time working through that, what I learned was that I lost Marnie in the process of becoming a mother, and that loss of identity was very, very hard on me.  Before going into pregnancy, I was confident, multipassionate, very career-driven.  And when I came out as a mom, I became just a mom, and Marnie was second.  And my whole universe around me identified me as mom first and Marnie second.  So going on a long story, that feeling of transformation and loss of identity and new identity, mixed with the fact that women didn’t love their pregnancies, and my background in entrepreneurship, I knew this is the place I have to be.  I have to do something.  I have to do something for these women, and we have to change the narrative, and we have to make pregnancy more focused on women and their experience and improving that experience.

Yes, 100% agree.  I feel like especially after the first baby, women do get lost in motherhood and our identity as moms.  With the baby shower the first time, it is more celebrating baby than the mother, so I love that your subscription box is focused on the mother, that unique journey, and quite a bit of self-care items and just ways to celebrate.  Whether it’s baby number one or baby five, you’re still going through that transition to motherhood every time.

Absolutely.  Absolutely.  I’ve personally been through it four times over, and you continue to evolve, but I believe so strongly that the way you start off this journey will impact your journey through motherhood, and that’s really why for Rumbly, I want to start connecting with women the moment they find out they’re pregnant and really being there for them.  And being there, it means supporting through the hard times, but also celebrating the good and the milestones.  Every time you hit a new month, a new week, that’s a milestone, and we should be celebrating it because the journey is so hard.  If we can work on improving that part of the motherhood experience, then I really think that in postpartum and those early years of motherhood, we’re really going to set ourselves up for a better experience.

Exactly.  And it certainly seems like the perfect gift from family members or friends to just have a lovely reminder to take some time for yourself and focus and just have the anticipation of the next box arriving.  Are you doing a lot with gifting or showers?

Yes.  Rumbly has really two main purposes, and one is to show up monthly for women on their pregnancy journey, and that’s gift them basically a box of stuff that’s really timed to where they are in their pregnancy journey with items that are for the woman they are and the mom they’re becoming.  And that’s consistent.  In every single Rumbly box, you will find half the items for where you are today, and half the items to remind you of who you are and where you came from.  So the subscription journey is a monthly experience, and it does end at the end of your pregnancy.  And then we also offer a line of themed gift boxes that are encouraged for women to purchase on their own.  If they want just one specific box and they don’t want to commit to an entire subscription with Rumbly, but it is also the best gifting solution.  And I mean that from the bottom of my heart because so often, everything is about the baby, and again, mom is going through a tremendous amount of transition and change, and she needs stuff, too.  Rumbly is really – we love babies, but we’re not here for baby.  We’re here totally for the woman.  And when you get a gift from Rumbly, you will find items in there that are all catered to her.  And yes, you’re right, it’s a combination of self-care items.  There’s apparel.  There’s tech.  There’s books.  Beauty, wellness.  We really cross every single product category that you will find sprinkled throughout every Rumbly box.

I noticed that from your website and love it.  It’s not solely focused on the typical subscription box that might have tea and very self-care focused items, like cozy socks.  There’s much more to it.

Yeah, it’s very, very thoughtfully curated.  I spent two years before I actually launched Rumbly, just on the curation.  And it was really interesting because first when I was working on it, I sat down – what am I going to put in these boxes?  And really thinking back to my own experience and speaking to women, whoever I could speak to and what they wished they had or what they did have and they loved, and then right before launching Rumbly, I found out I was pregnant with my fourth.  So as I launched Rumbly, I really got to live through the experience myself.  That was the best kind of way I could really test out, are these products that we’re putting in these boxes the best thing that we can give for women that are really going to support, uplift, celebrate, and really make the whole experience better?

Yes.  I love it.  Obviously, it’s ideal to subscribe very early in pregnancy, but there are options if our listeners or doula clients find you later in pregnancy.  As you said, there’s the one time box, or you can join later.

Yes.  Even with the monthly subscription, you select which month you want to start at, and we’ll start shipping you boxes then.  If you don’t find out about Rumbly until you’re in your fifth month, then you start on your month five box.  There’s a lot of flexibility, and I’m working on getting it on the website, too, but if there’s any items from past boxes that you wanted to add to a box if you were starting later, you’d be able to do that.  Our first box in the subscription, our first trimester box, there’s a lot of items in there that you’ll use throughout your entire pregnancy and even after.  Some of those items, if you start on month five, one of my favorite items that we created, and this was created in-house, is a countdown flip milestone calendar.  It’s in a wooden frame.  It’s really beautiful.  It can just sit on your desk, your bedside.  I’ve seen women put it in their bathrooms.  It’s a weekly tracker of milestones, but the prompts are all about the woman.  So it’s a little bit of a twist on your classic fruits and how big is baby because this is about the woman, and it’s about her experience and what’s happening.  Things like, this week, later in pregnancy, you might be experiencing lightning crotch.  Or they may be a tip of, hey, time to consider if you want to do any maternity photos.  So it’s all about her, but it’s a weekly calendar, and that’s one of the items that is in our first trimester box, but women would use that throughout their entire pregnancy.  So if you start later, it’s a product that’s also nice to add in to a later box.

Beautiful.  Let’s chat about identity and that shift in the transition to motherhood.  What are some of your tips in trying to reclaim your pre-pregnancy self and have a bit of time where it’s not as much of the focus on baby and more about your journey and celebrating motherhood?

Yeah, there’s a lot in there.  I mean, the first thing is acknowledging that it’s happening, and there’s not enough awareness in conversation that you are going to go in as one person and you’re going to come out another.  And that’s okay, but what’s important is keeping who you are in that process.  What I mean by that is for me, I went in Marnie, and I came out Mom, but I lost Marnie in a way.  And what I hope women do is they go in as one and they gain motherhood, but they don’t lose themselves in the process.  So in terms of identity, it’s that motherhood becomes one of your multi-identities, but it’s not your only identity.  The first step is really knowing and understanding that this will happen, and other things that I think women can really do is know that you can hold space for the “and” too.  It’s that I’m Marnie and I’m a mom.  I’m Marnie, and I love to do yoga.  I’m Marnie, and I love to cook.  So holding that space for the and, I think, is also something that women can practice doing as soon as they’re pregnant because there’s a lot in pregnancy that you can’t do, but then there’s a lot that you still can do.  And it’s really important where we kind of shift our focus.  I think, too, it’s finding within those cans and can’ts and making those modifications.  You know, with my first, I heard from everyone that I can’t lift things; I can’t work out; I can’t eat certain foods.  I can’t drink coffee.  And it’s navigating what feels right for you, but also understanding, there is a lot that you can do.  If you’re passing over that cocktail, reach for the mocktail.  In terms of exercise, absolutely, women should still be doing exercise.  You may just need to modify what your routines are.  And we actually put wrist and ankle weights in one of our subscription boxes, as well, to motivate women, to inspire them to still keep moving.  It helps not just from the physical point of view with blood flow, but mentally, it’s so important.  Get fresh air; go for a walk.  That’s really a point of inspiration.  It’s about making these modifications.

A lot of change happens in our relationships, as well.  Rumbly tries to support that a bit in our subscription boxes with games and other products that really help you reconnect with your friends and partners.  We have letters in every box, as well, that kind of provide little tips, as well, to really support your relationships.  And something, too, I found I really struggled with, and I’m still struggling with, to be honest, is kind of rebonding with a lot of loved ones in my life.  There are a lot of shifts and changes in pregnancy, and I think that being really cognizant of that, too, is really, really important.

Then carving out time for yourself.  Think about what did you love to do pre-pregnancy?  Still do that.  Still do that.  Don’t lose those things.  Especially when you become a mom – I really dislike when women are like, I’m a mom and I can’t do that anymore.  You can.  You can do everything.  You can do everything.  You just have to be creative and find the ways, but you can still do it.

Such good advice.  And spanning everything from relationships to friendships to just finding that self-care time.  I agree about the exercise component.  If you’re medically able, it can make your labor much quicker and smoother, as well, having that consistent, simple exercise, as you mentioned.  Walking; I love swimming during pregnancy.

And you may discover new passions.  That’s something to embrace and look forward to, as well.  Again, we’re continuing to evolve; be open to that, too.  But make sure there are things just for you.

Exactly.  So what are your top self-care tips for our listeners?  As a busy mom and entrepreneur, how are you taking time?

The number one thing is do one thing for yourself every single day.  Something totally, totally selfish, if that’s a word you’re comfortable using.  Whether it’s going to get a coffee, whether it’s taking a moment to scroll Instagram or TikTok.  It doesn’t matter what it is.  It’s whatever, as long as it’s something that’s just for you and feels that way, even in a rebellious way.  If that’s the response to that, if it feels that way, it’s magical and amazing.  And someone gave me that advice, and I’ve really stuck to that every day.  A lot of times for me, it may just be that I have a small dinner with my kids, and afterwards, I sit alone and eat alone, and that brings me so much happiness.  I can’t tell you.

Avoiding the criticism of what self-care means is also important.  I hear a lot of women trying to tell you what self-care is and isn’t, and that’s kind of why I mentioned that if self-care to you is that you just happen to have a moment to go on your phone and scroll or whatever, that’s okay.  No one is here to tell you what is right or wrong.  It’s really whatever feels good for you, and find that one moment in a day.

The other thing that I would really recommend for all women is setting boundaries, and that’s something that I’m really working hard on now personally.  I think, again, as early as your pregnancy, start setting those boundaries to really help set you up for postpartum and the early years of motherhood.  Spend time understanding what your boundaries are, and then verbalize them so those around you know what those are.  It really helps to hold yourself accountable to it.

Great advice!  So how can our listeners find Rumbly and subscribe?  I know you’re on quite a few social media channels.  Feel free to share away!

The best way to find Rumbly is on Instagram.  We’re @rumbly_co.  It’s the same on TikTok, and you can follow us on either of those channels.  Otherwise, our website is rumbly.co.  You can also send an email.  My personal email – I’ll drop it, too, because I’m always happy to have a conversation with anyone, anything to do with pregnancy, motherhood, identity; I’m here.  It’s marnie@rumbly.co.

Love it.  I know you shared a bit about the calendar in the box.  Any other favorite items in the box for our listeners to get excited about?

I would have to say two things for that.  Our Rumbly exclusive items are probably my favorites, and I created those because they don’t exist.  They didn’t exist, and they still don’t exist, and they were things that I really felt would be really useful in my pregnancy.  One is that countdown milestone calendar.  The second would be that I have a pregnancy felt folder organizer.  It has two ultrasound photo slots in it, as well, and this is your personal PA.  It’s to hold all your papers, your pamphlets, your documents, your appointment reminders, ultrasound photos, everything, in this one chic folder, your go-to, and I absolutely love that because I found when I was pregnant and even after birth, I just was inundated with tons of papers and things to read up or even ultrasound requisitions, and they were scattered around my house.  So I absolutely love that item.  I used it in my fourth pregnancy.  Those would be my top two favorites.  The rest of the box – we hold a very limited inventory of everything in the boxes.  Currently, we’re only partners with female-founded brands across four continents, and those are typically independent brands.  So we’re not always working with big brand names because part of, I think, the delight is to discover new brands that we absolutely fell in love with and that we want to share with you.  And so we’re constantly rotating products to keep it fresh but also keep, as we discover new products on the market and new other businesses that we want to support, those are always rotating through.

What a wonderful way to support other female entrepreneurs.  My business is a certified B-Corp, so I always try to support local and support women.  So I love everything you’re doing, Marnie.

Amazing.  Thank you so much.

And thank you for your time.  I can’t wait to share Rumbly with our doula clients and our online course, Becoming A Mother, students.

Amazing.  Thank you.  It was so great to talk to you.  I really enjoyed everything.

Same.  Take care!

IMPORTANT LINKS:

Rumbly boxes

Becoming A Mother online course

Kristin Revere chats with Melissa Llarena, author of Fertile Imagination: A Guide to Stretching Every Mom’s Superpower for Maximum Impact about how to reawaken your imagination!

This is Kristin with Ask the Doulas, and I am so excited to chat with Melissa Llarena today.  Melissa is an imagination coach, consultant, seeker, contributor to Forbes Women articles, having garnered four million plus views, and the host of Unimaginable Wellness, the podcast for entrepreneurs, founders, and creators who happen to be moms.  Melissa holds a psychology degree from NYU, an MBA from Tuck School of Business at Dartmouth, a Transformational Coaching Academy certificate, and is on the road to becoming a meditation practitioner.  Melissa lives in Austin, Texas, with her husband and three sons.

Welcome, Melissa!

Thak you so much, Kristin!  What a mouthful, but thank you!  I think I’m an expert in tongue twisters, it seems, but thank you so much for this opportunity.

Yes, I am so happy to chat with you!  We are both fellow Hey Mama members, so it’s great to connect.  You have such an impressive background, and it seems like so many different interests.

Yes, Kristin, I would say I love a slough of things.  For me, I think being someone who has a lot of knowledge around a variety of topics has actually helped me as a fellow podcaster, to be honest, Kristin.  So it really helps with conversations and just having that rapport with anyone, including clients who come to us and share some intimate details and seek our honest opinions.  I think having that variety of experiences is so helpful for anyone that’s even curious about this space, including a mom who’s listening right now.

It is interesting that oftentimes as mothers, our career paths tend to take a few little detours and changes.  Did you want to work with and interview moms because of your own journey as a mother, or what led you to your focus on working with women, especially mothers?

It’s such an amazing question because you would think that this is like my coming out party.  Like, oh, I’m a mom.  I’ve been a mom for 12 years and in parallel, a coach and business owner.  I launched my business, actually, with my firstborn in my Ergobaby, so on my chest in midtown Manhattan, and it all began with his diaper blowout on my prospective client’s wife.

Oh, no!

Oh, no – oh, yes.  I still got the sale.

You made it work.

Oh, yeah.  Just like a mom, right?  Whatever it takes.  I think that’s such a phrase that resonates with any mom.  For me, I would say that was the beginning of a pivot because I had worked prior to that in corporate.  I was on the agency side, working at a design agency in Brooklyn, and before that, having pursued my MBA, the anticipation would have been that I would have been working for a Fortune 500 organization, which I had worked for prior.  But there was this incongruence when I was at the design agency in Brooklyn and I had just had my first son.  The incongruence was this: I was working on the car seat account, like the Graco baby car seat account, as an agency professional.  And I was not – that was the choice I had to make, and I was not being a mom to my firstborn.  So when I came back from maternity leave, the very first day, it just felt so out of sync with my heart.  It was like, this is really weird.  I’m here working on these advertising briefs and such for a brand that is supporting moms; meanwhile, I felt unsupported.  So that was a cue for me to send in my resignation letter.  This was totally pre-pandemic, pre-hybrid work opportunities.  Yeah, Zoom existed, but it was just not common in an agency sort of setting.  That was the moment that I just had to figure out what else would be more flexible.

Entrepreneurship, for me, has been more flexible, but there’s been some hiccups along the way.

So you moved across the country?  When did that happen, the move to Austin from New York?

Well, I moved even across the world.  This is the interesting bit, and I definitely share this story in the book that’s coming out, Fertile Imagination.  I remember there’s been moments, and maybe other people can relate, where you look at it like a restaurant menu, and you’re anticipating what you’re going to order when you get there.  And you spend some time making that decision.  So I remember when we were living in Connecticut, actually, and my husband then says, what if we move to Australia?  And I literally didn’t even have to think about it as long and hard as I would have for a menu item at a restaurant.  I was like, heck yeah.  And we had three little boys already.  I have identical twins in my mix.

So fun!

Yeah, fun and frazzled, I guess, is the best word to say.

We work with a lot of twins and triplets, so I don’t personally get it, but professionally, I do.

Yeah.  It’s a blast.  Every single day, you just don’t know what you’re going to get, to be honest.  I remember we had three little boys at the time, and my husband says, oh, Australia, and I was like, heck yeah.  We had just bought a home.  We had a car for maybe three years.  And it was like, okay, let’s make this move because we wanted to experience life in a different sort of way.  And so this was pre-pandemic.  We went to Australia, made it happen.  It was not because of a job.  Again, this was pure interest, and we had to work through the visa process and figure that out.  When we landed, that was when they had the wildfires, which maybe listeners are aware of, right?  You probably saw it in the US on the TV.  Australia, right?

And then after that, for another global milestone, that was the pandemic.  And that was when I wrote the book, and that was a choice I had to make because Kristin, for me, entrepreneurship was supposed to be flexibility.  And during the pandemic, I’m sure a lot of folks can attest to this.  I felt really inflexible.  It was wild.  And it was at that point, to kind of go to your earlier message, which was why did I choose moms as someone to support.  I would say during that moment, as I felt even less supported than when I had my corporate career, I just decided.  I said, what, I do have a book inside of me.  And if you’re listening and you’re wondering to yourself if you do, maybe you do.  But that was all I needed in order to say, this is the time to actually work on this book, and who do I want to support?  Like, who needs the most support?  For me, it’s moms.  It’s us.  Like, we need so much support.  We have this village for our kids, but I would argue that we need it for ourselves, as well.

Absolutely.  100%.  That’s why I pivoted my career, as well.  I was a political fundraiser before opening the doula agency and getting into birth and baby work.

I mean, yeah, what an opportunity.  As I think about that support – and I love the idea that we have doulas.  And I know that it’s not necessarily a new invention, right?  Since the beginning of time, there have been individuals helping other individuals get through this extremely tender and sensitive moment.  And I use tender in a thousand ways.  But I think it’s so beautiful to have that new sort of support, especially coming from a position of empowerment, you know?

Exactly.  There’s no perfect way to birth or parent or feed your baby, and everyone is unique.  And so our focus is judgment-free support, and I feel like moms have so much judgment, whether they go back to work, start their own business, freelance.  And certainly in their choices in schools and parenting and feeding; there’s just a lot on our shoulders.  I love the work that you’re doing, and it definitely seems to be both focused career-wise but also on the mental and emotional stability and support for women.

Absolutely, Kristin.  My background, and part of the reason why an imagination is critical, is because I was raised by a single mom with manic depression.  So for me, mental health is not like the month of May.  It’s not something that is all of a sudden has this bright light after the crisis we came out of in terms of the pandemic.  I know my mom as someone with this mental illness since birth, so for me, it’s like my podcast, right, Unimaginable Wellness.  And when I think about entrepreneurs, it really is about bubble wrapping your sanity.  This is not an option, if moms are at the front of what’s happening the next generation and the next generation.  We need so much support that it’s like – it would be horrible, immoral, not to have the sort of back up plans and back up solutions and all the resources to make sure that we can raise this next generation with a level head and clear mind and a clear conscience.  And in terms of how I think about this by way of the book, I would say that it’s really about reclaiming our power and that one super power that I firmly believe is one that every mom has is a fertile imagination.

Yes.  I love it.

Yeah.  And the reason why I’m imaginative, to go back to my mom’s mental health, is because during her manic highs, for anyone that’s familiar with manic depression, you get very – how can I describe it?  Very active, for lack of a better word, when you have mania, and you have these grandiose ideas.  So when I would see my mom have grandiose ideas about her and what she can do, that just told me, oh, there is no roof.  There is no ceiling on what I can do.  And this is me interpreting it, right, as a little girl.  But then when she would have her lows, so those depressive states, that was when I had to pick up the slack and use my imagination to do a myriad of things.  Find her at a movie theater.  Get her the help that she needed.  Negotiate with her so that we didn’t cause a scene in the street.  These are the things that really, really fine-tuned my ability to cast this huge vision of what was possible in my life.

And that’s a skill that, in my book, I would love to teach a mom because right now, I’m thinking about last year, for example.  I dropped off my kids in a school here in Austin, Texas, and there was this kind of false lockdown moment.  And for me, I thought to myself, this is the stuff that moms have to be ready for, right?

Absolutely, Melissa.  We are at all times, prepared for whatever may happen.

Ready for anything.  We’re like the Navy Seals on crack.  You know what I mean?  Yeah.  And for us, this is at the DNA level.  This is not at the surface; oh, there’s a community we have to support.  Oh, no, it’s like our heart, like our inner organs, our outside of our bodies, and we have to protect them.  And so who – what mom can’t use all the resources available to her?  And that’s again why I really point to this idea of a fertile imagination and why my book walks a mom through the process of how to wake it up, because for me and part of why I wrote the book, it was in a coma because I wasn’t sleeping very much as a newer mom.  And then you have to also play with your imagination.

So here’s the thing.  With our children, I hear this all the time.  “Your child is never going to be five years old again.”  “Your child is never going to be ten years old again.”  Well, guess what?  At those ages, our kids are ripe for imagining, for wonder, for awe.  And guess what?  As a mom, I’m never going to be 40 again, even if I lie about that age, right?

So true.

Right?  Or AI, at least the way it is being discussed right now, is never going to be as exciting in this moment, either.  So what if I have an idea?  What if I, as an entrepreneurial mom, have an idea, and it has a timestamp on it?  And what if my child is five and their imagination is ripe at the age of five?  Could you imagine if I, alongside my child, decided to play, and maybe I would stumble on a new, innovative solution for a creative problem that I’ve been trying to solve?  I mean, it’s like – it’s this missed opportunity that I feel that moms have because we might feel overwhelmed or just in the stuck of all these kid things, like kiddie toys and kid talk and all I do is talk to a child, and it’s hard because I don’t talk to an adult.  Well, why not use that opportunity to incorporate a level of playfulness that can, A, maybe lighten up your load emotionally and bring joy into your life, or B, help you come up with a new business idea.

How many ideas are brought up in a play room?  Like, you’re looking at toys all around you, and you’re saying, I think there should be a toy that looks like A or B.  Or you know what, why haven’t they thought of a way to just close up a stroller with one hand – for real?  Not pretend that you can.  Right?  So that’s the second part of the book.  So you’re waking up the imagination, and a lot of that has to do with the way that we feel about ourselves, and a little bit of it is imposter syndrome, and I share with readers my own journey around that.

The second part is playing with your imagination, so using the moment in time with your kids to come up with these ideas or just introduce joy into your life.  And then it’s about stretching your imagination.  That’s the third part.  And that’s really about almost duplicating yourself.  What mom does not want to duplicate herself?  That’d be amazing, right?

It would, yes.  All of us do.

Yes.  All of us.  All of us.  And so for stretching your imagination, what that means is that you’re enlisting the help of other people.  You’re mobilizing your network, right?  And so it might sound like a businessy, jargony phrase, but even from the perspective of a stay at home mom who’s not in the corporate world or an entrepreneur yet – and I love using that word because I feel like a lot of us should really explore that as an option –

Agreed, Melissa, for sure.

Right?  I think that it’s the way to go as far as making sure that whatever skills we have, whatever talents we have, whatever dreams we had, actually make their greatest and maximum impact.  And that’s where I stand.  I see so much beauty on a playground when I see moms look at their children.  I actually see wonder in the eyes of moms on the playground with their kids, and my mind, what I can imagine, is a situation where you’re there with your child – maybe holding their hand, maybe skipping along a path, and you’re both dreaming bigger, but at the same time, you’re respecting and honoring the fact that everybody needs support, needs love, has their moment.  Moms do not have to wait until their kids graduate high school to get started on their ambitions.  Sometimes those ambitions, as I said, do have a timestamp, and that’s part of the book.  I want to make it happen for moms.  It’s a guide.  Lots of reflection questions.  I have examples of people that I’ve interviewed on my podcast who are imaginative, and some of whom are not moms.  And I feel like there’s a place for that because it gives you a sense of what’s possible as humans.

And we all as women still have the mothering instinct, whether we’re a mother or not.  Some of my doulas are child-free, and they have the instinct within them, the same way that our doulas who are mothers do.

Absolutely.  I mean, I have an example of a client in my book who doesn’t have children, and she did the most beautiful thing for a little girl at a school where she was working.  She saw that this little girl who has different abilities couldn’t participate in a ride to school on your bike day, and then she launched a fundraiser for this little girl.  Like, are you telling me that this person is any less nurturing than someone that has a child?  No way.  I can learn from her.

Exactly, yes.  It’s still in us, whether you’re an aunt or a teacher, whatever it may be.  We all carry that instinct to nurture and grow and mother and care for others.  I love it. 

Your book basically is for anyone, as you mentioned; stay at home moms, working professionals, mothers, women in general. 

Absolutely.  And I would say this, Kristin: I’m not sure if you’re familiar with the book The Artist’s Way.  Are you?

I have not read it, but I’m quite familiar.

So I basically compare fertile imagination like The Artist’s Way by Julia Cameron, but for moms who feel like they’ve lost their ability to dream big.  So it’s all about rediscovering your imagination, and the reason why I compare it to this book, for anyone that hasn’t read it, is because it’s very much so like a course in a way.  In every chapter, you’re invited to reflect on questions, do exercises, consider different perspectives.  And it’s really about handholding you throughout your life.  It’s not a book that’s meant to be just consumed immediately.  It’s really meant to be enjoyed, depending on what you need.

So I basically compare it to going into one of those woo-woo stores with crystals.  Like, when I was living in Sydney, Australia, I went into one of those stores.  It was this beautiful, rainy day.  And the person working said, hey, is there a crystal that you’re drawn to, and that’s how you choose the crystal that you purchase.  That’s exactly like the book.  The different chapters, they really share different adventures in a way, but in the beginning, it’s more like limiting beliefs and things that might stop you from dreaming very big.  So if you feel, for example, that you’ve been very indecisive and you want a solution for that, there’s a chapter for you.  If you feel like you have been like the boring parent, which I’ve been there –

Yeah, someone’s got to be the fun parent, and then you feel like, okay, I have to be the boring one, then, and keep the structure and routine.

I know, and then you’re like the bad person, right?  So if you feel like you’ve been the boring parent, well, there’s a chapter for you there, as well.  And what’s amazing is that every chapter features a podcast guest that I have had who’s exceptional in terms of their use of imagination.

For example, Beth Comstock.  She is the former CMO of General Electric.  This is a powerful, powerful woman who is inviting us to be and do weird things as a competitive edge.

And also, I would add – again, to lighten up the mood and just see what other interest might lie for you or might be right for you.  So that’s a chapter that a working mom in a corporate setting – you could take that, and you could really come up with a really amazing business idea, right?  Or if you are someone who has a child who reads books that are, like, picture books – I invited David Roberts, the New York Times bestselling illustrator of The Questioneers series that’s written by Andrea Beaty.  I invited him to share how he uses his observational skills to really imagine bigger and better.  So there’s a chapter with him inviting a mom who’s read books – I’m sure the same ones a billion times, as all of us – to see beyond what’s on the page through the lens of an illustrator.

It’s very, very much so conversational in the sense that I am vulnerable and I share my mom and entrepreneurial stories, but it’s also practical because for anyone that is curious about writing a book, there’s so much research that goes on behind the scenes.  This was a two-year journey for me during a global relocation/pandemic historical moment.  And I would say that part of the research that I notice as far as other books for moms on the market is that, okay, there’s a lot of theory out there, but what about practicality?  What about – okay, I have a unique situation.  I have two children, for example, that have different abilities, and I’m constantly schlepping between doctor appointments, et cetera.  And I have children that maybe don’t need that sort of support.  Like, how can I bring this idea, this big idea of a fertile imagination, to my life?  And so that was important to me.  I wanted flexibility in terms of how these concepts could be adjusted to a mom, and I completely know and am confident that any mom reading the book can make the adjustments based on her reality.

Beautiful.  We need actionable steps versus feeling overwhelmed by some of the books, the self-help, business-focused options where you walk away and say, well, that’s not me.  I can’t really make this happen in my life. 

Absolutely, and I think what’s important, too, and as I was sharing the book with other moms who actually write books, as well – what’s important too is that some of this does read like my own personal diary.  And I was like, oh, wow, people really want to read my diary?  How weird is that.  But apparently, there’s an interest for what we’re actually thinking versus the way we present ourselves to the world.  So if I’m having a conversation with, like, someone who is powerful – like, Suzy Batiz is in the book.  She’s the inventor of Poo-Pourri.

Big brand, right?

Huge brand.  During that conversation, I could have just given the world this idea that, oh, I’m just hanging out with multimillionaires and I’m fancy-schmancy.  But I actually reveal in the book that it was a 2:00 a.m. conversation for me because I was in Australia.  I had to write questions that were so clear that I just could not go off script because I didn’t trust myself at that hour of the day without sleep, and I was so intimidated, you know what I mean?  Like, these are the things that a lot of moms, especially anyone that suffers with imposter syndrome, for example, might be struggling with and you’ll never know.  Like, you’ll never hear this, but I wanted to really share the reality of what I’ve experienced.  And I also wanted to show moms that, although some of these things may have not been “originally intended” for moms, so some of these adventures that I’ve gone on, for example, getting Gary Vaynerchuk on my podcast was not a walk in the park.  It took 100 days, and I wrote 67,000 words in total in order to get his attention.  But I wanted to show moms that if it’s something that’s on your heart – like, if there’s something that you really, really want, that there’s a way for you to explore the opportunity while, again, being mindful of your sanity and what you’re family needs and not having the guilt of, like, oh, I’m ignoring my kids, or I’m not a doting mom.  No, how about your kids are watching you fall down and stand back up?  Your kids are watching you do things that other people have not asked you to do, so take the initiative, and in that way, they’re learning from us, and not just because we’re telling them things, which I think we know that they learn more from what they see as opposed to what they hear.

Absolutely.  So your book is coming out this fall, and tell us about how to get on the preorder list or where it will be as far as online and in store options.

Absolutely, Kristin.  At fertileideas.com, you have the opportunity to do a myriad of things.  I actually created a five-day challenge on my website that gives anyone the opportunity, whether you’ve read the book or not.  It’s totally free.  You can actually go through a real-life implementation of the concepts that I talk about in the book.  So this concept of leveraging your child’s imagination, coming up with a business idea, playing with your child – you can go to the website and actually go through a five-day challenge alongside your kid.

At the end of the challenge, which is so much fun, and I know I’m super nerdy – you can actually print out a certificate of completion because your kids are imagination experts in residence.  And I think that we need to really celebrate.

There’s also for free for anyone that’s an entrepreneur mom – you’re able to actually take a quiz, and on that quiz, you’re going to have a very clear area of focus on why you might be stagnant in your business and income.  It’s really designed for moms that want a surge of energy in terms of both of their roles, as a mom and entrepreneur.  So there’s two options, totally free.  Take the quiz; do the five day challenge.  You can buy the book on the same website.  It’s going to be available October 31^st.  Oh, my goodness.  I’m so excited!

So soon!  Yay, that’s amazing.  And of course, our listeners and doula clients can find you on your podcast, the Unimaginable Wellness podcast.  You’re on all podcast players, and I know you have quite an active social media presence.  Where else can our listeners find you?

I would love to hear from anyone who’s listening right now on Instagram: @melissallarena.  Send me a DM with the word “doula.”  I would love to know that you caught this conversation.  Kristin has been so amazing.  I am so grateful for this.

Well, I’m grateful for you, Melissa!  You also are a coach, so if our listeners are interested in working with you personally, do you prefer that they reach out on your website or Instagram?

Either way, I’m available because hey, why not be creative about it, right?  We’re using our imaginations.  Smoke signals; that works, too.

I love it.  Message in a bottle; whatever works.

Absolutely.  I think right now the idea is that anyone that’s listening to the conversation – I mean, you have resources available to you.  I can be a resource.  If you do the quiz, you’ll be invited for a breakthrough session with me that’s complimentary.  So there’s all these ways of us engaging and me helping you really strengthen and super power your fertile imagination, too.

Beautiful.  Any final tips for our listeners, Melissa?

I would say here’s two tips.  One is the following.  I know as a new mom, the need for reassurance is such a big part of it, and there’s been so many moms who have been powerful in other realms of their life, but for some reason, when you become a mom, there’s this, like, am I doing it right, you know?  For every step of the way.  And what I want to say to anyone that’s listening is, your heart – follow what’s on your heart.  Like, really, really.  For me, as with the book journey, too, like, it was a very intuitive process.  I was just really keying into what I wanted and what I felt when I saw what I wanted.  So same with anyone that’s listening.  If you are unsure what your baby might need or what you might need, at least give yourself the opportunity to be still and just really feel into your body and see what it’s trying to tell you, and I think that’s part of the medication practitioner coming out in me.  But that’s the biggest tip.

I love it.  Excellent advice.  Well, thank you so much for all of your time and sharing your talents.  I am so excited to read your book!  Hopefully we can talk again soon, Melissa.

Thank you so much, Kristin.  Absolutely.  This has been such a pleasure.

IMPORTANT LINKS

Fertile Ideas – buy the book!

Melissa Llarena’s website

Becoming a Mother course

 

Kristin Revere of Gold Coast Doulas chats about how to get the funds to pay for your birth or postpartum doula.  This includes insurance, gifting support, payment plans, packages, and more.

This is Kristin Revere with Ask the Doulas, and this is part two of our solo chat with me.  Our topic today is based on an old blog post I wrote when I was a solo doula, titled How To Get the Moolah To Pay For Your Doula.  So it’s all about affording your birth and/or postpartum doula.  So let’s chat!

Flex savings, HSA, & Medicaid

Doulas have been part of most health savings and flex spending plans for a bit now, and that is super exciting.  We’re even approved to take HSA cards.  Now, those plans, depending on each unique one, may need to be itemized; may sometimes need doctor approval, especially if it’s a flex spending, and often covers not only birth doula support, but often day or overnight postpartum care.  Now, as of this recording in 2023, standard insurance does not cover doulas.  But certain states do have Medicaid coverage, Michigan being one of those as of January 2023.  Now, at Gold Coast, we don’t personally accept Medicaid at this time.  We did a whole podcast on that in the past, and we’ll link to that episode if you scroll down to the bottom under Links.  If you want to learn more about Medicaid coverage in Michigan or Oregon or New York or other states that do cover it, listen to that podcast.

Gifting

We’re finding more and more gifting of services, especially after the pandemic.  You can add doula support to your baby registry and have links to the doula groups or individual doulas or agencies like Gold Coast that you would like to work with.  You can also work with sites like Be Her Village that has their own registry service, not only for doulas, but other professionals that do support families after baby is born and during pregnancy.  We are partnered with Be Her Village, and you can find all of our services on their website.  I also happen to be set up in an in-store baby registry through our local baby store in Holland, Michigan, called EcoBuns Babies.  They’ve added us to their virtual and in-store registry.  It makes it so much easier.  Instead of getting all the stuff and baby items, why not get the support you need, especially with a postpartum doula?

Payment Plans

Many doulas also offer payment plans.  You can look into making a deposit and then see what their terms are for final payment for postpartum support.  If a client wants to reserve a particular doula or a team of our overnight doulas, for example, then they would put a deposit down and then pay another final payment before the first shift begins, and then after their block of hours that they choose, then they’re able to add on week to week and get invoiced weekly as needed.  That’s certainly another option.

We certainly also encounter clients who want to use their credit card to get points, so that’s an option.  We take checks and other payment methods besides an HSA or a credit card.  And we do believe in supporting other businesses and shopping local, so we hope that you find a lot of local resources when you’re making your baby registry and choose local stores.  Choose local service-based businesses like Gold Coast and other doula groups and lactation consultants, so as you’re planning for birth and baby, think local.

Packaged Rates

Many doulas and other birth and baby professionals offer packaged rates.  So, for example, at Gold Coast, if you purchase our HypnoBirthing class and hire a birth doula within Gold Coast, then you get a discount.  We give $30 off as of this recording, and we also have packages where the more hours of day or overnight postpartum support that you purchase, you get a lower hourly rate.  There may be discounts for other particular categories.  For us, we have a military discount for birth and postpartum support.  We also offer a discount for repeats clients.  As our rates raise, we want it to be as affordable for them and we value that long-term connection.

Special Discounts

I think this is pretty unique to Gold Coast, but we also offer a postpartum and mood disorder discount for any clients who are suffering and really need that postpartum doula support, or for clients who are in therapy in general, we give $2 off per hour.  So there may be discount plans or packages, or you might be able to make multiple payments to afford your doula.

So just thinking about planning for birth and baby, again in that way that you would for a wedding or building a home or moving into a new home and redecorating, what is important to you?  What’s your budget?  How are you going to pay for it?  When are payments due as you’re breaking down your household budget?  Certainly, there is so much evidence that doula support ensures your satisfaction, even if there are interventions.  It can reduce interventions, reduce the rate of Cesareans, which then could reduce your medical bills if you’re having fewer interventions, based on the insurance you carry.  And then another thing to think of is getting more sleep and how that can affect your mental health with a postpartum doula or a newborn care specialist.  It’s definitely worth the investment to have support versus all the things.

Doulas added to benefit plans

Other ways to pay for your birth or postpartum doula: a lot of companies are now adding doulas to their benefits, which I love.  We had worked with some individual companies in our areas that have self-funded insurance plans over the years, and we can link to an article about CVS Health that Gold Coast Doulas was fortunate to be part of through the publication The Lily, and it will give you more insight into that.  Many companies have added doulas to their benefits, along with Pioneer Construction here in West Michigan who we partnered with.

Some examples of companies are Target, Walmart, PNC Bank most recently.  A lot of tech companies have added doulas to their benefits.  Sales Force, LinkedIn.  There’s also a new fertility benefit called Carrot Fertility, and they offer different incentives for birth and postpartum doulas and include that in company benefit packages.  It would be helpful to check with your employer and see if doulas are part of your benefits, and if not, talk to human resources and see if they would be willing to add to the plan or consider Carrot Fertility.  Depending again on the benefit package, some benefits are only for birth doulas.  Other are for birth and/or postpartum support.  I’ve had clients work with Gold Coast and choose to utilize their funds for one service or the other or a mix of both and then self-pay for any funds that aren’t covered.

There are a lot of options compared to when I had my own babies.  We’ll see if general insurance down the road does decide to cover doulas.  There are some nonprofits and community based programs that also would cover doula benefits, and if they’re grant funded, then maybe a certain portion.  Some doulas work in sliding scale plans, so based on income, they may have a reduced rate for birth or postpartum support.  You can certainly look into all of those options as you’re trying to budget for birth and baby.  But let me tell you, having hired doulas myself before becoming a doula, the investment is worth it, and my husband would certainly agree.

Doulas are worth the investment!

I’d love to hear ideas for you if there was any other way outside of baby shower or gifting or payment plants or packages, how you afforded your birth or postpartum doula.  Or if you’re a doula yourself and have a different plan than we do at Gold Coast, reach out to us and let us know what you’re doing.  I’m always interested to hear about other options because we know that it is a big investment and that money is tight, but it’s very valuable, especially in my opinion, that newborn care and that postpartum support and getting sleep.  Even one good night of sleep can change your life.  So reach out to us!  You can find us on Facebook and Instagram.  We have an amazing Pinterest channel.  Find us on YouTube.  We’re pretty much everywhere, so reach out and we’d love to hear from you soon about how you plan to budget and pay for your doula.

Take good care!

IMPORTANT LINKS

Medicaid for Doulas

Be Her Village

EcoBuns Baby + Co

Becoming a Mother course

CVS Covers Doulas

Carrot Fertility

Gold Coast is on Facebook, Instagram, Pinterest, and YouTube.

Kristin Revere chats with Emma Bromley of the Bromley Method about how to tell the difference between a tight and weak pelvic floor.  Emma is also the author of The Pelvic Floor: Everything You Needed To Know Sooner.

I’m so excited to chat with Emma Bromley.  She is the owner and creator of the Bromley Method.  Emma is a single mom, Pilates studio owner, diastasis expert, and co-author of The Pelvic Floor.  She helps busy moms heal from things like diastasis and leaking with simple but highly effective, strategic, core-healing workouts, both in person and with her online courses.  Welcome, Emma!  I’m so happy to have you here!

Thank you, and thank you for that great introduction!

I am very excited to chat about the pelvic floor.

It’s one of my favorite subjects!

Doula clients and listeners are often confused about the difference between Kegels and preparing in pregnancy and recovery in the postnatal time about what they can and cannot do with the pelvic floor, and what is normal and what is something to chat with your provider about and seek a pelvic floor therapist or physical therapist.  Let’s get into it!

So the first thing to note is that I’m not a huge fan of traditional Kegels in the traditional sense of the word, and the reason for that is – well, I don’t know if it’s a case of broken telephone that’s happened over time.  I don’t know how they were initially intended to be taught.  But what’s happened over time is that many women thinks it’s squeezing of their pelvic floor.  And what happens when you, over time, squeeze and squeeze with the pelvic floor is it can become very tight.  Tightness and weakness, first of all, go hand in hand.  They’re like best buds.  But secondly, tightness brings on a whole other set of symptoms and issue than a weak pelvic floor.  So what you’ve essentially done is you’ve got your weak pelvic floor, and you’ve done your Kegels and you’ve done squeeze squeeze, and now you’ve got a tight pelvic floor and you’ve got a whole other set of issues on top of that.

A common misconception is that a tight pelvic floor is a strong one, that tightness equals strength, and it doesn’t.  It’s actually completely the opposite.  A tight pelvic floor is actually a weak pelvic floor.  It’s not tightness we’re looking for with the pelvic floor; it’s strength.  So basically, in a nutshell, a tight muscle equals a weak muscle, and a weak muscle can’t do its job properly.  What we’re actually looking for is a strong muscle that can both fully contract and fully release, and that is essentially what many people’s idea of Kegels are.  We aren’t getting that full release as well as the full contraction.

That makes perfect sense.  As a birth doula, it’s all about relaxing.  If my client is tight and tense in any way – and sometimes athletes tend to have a hard time relaxing and releasing, so they might have a really tight pelvic floor.  To get them to open up in labor can be challenging.

I feel like I should say that I’m not a physical therapist.  I’m not a licensed physical therapist.  I never claim to be.  This kind of conversation is well known in the physical therapy community.  It’s not well known in the fitness community or the general public.  And my passion is to help to change that in the fitness community for that understanding that squeezing and tightening actually isn’t what we’re looking for.  There are telltale signs.  When I work with somebody in a private capacity, I usually ask them a bunch of questions in the beginning.  There are certain symptoms that go along with a weak pelvic floor and there are other symptoms that go along with a tight pelvic floor.  It’s very difficult to strengthen a muscle that is in a constant state of tension.  So it’s important for me to know if somebody’s got a tight pelvic floor before I start helping them try to strengthen their pelvic floor because if they’re very tight, we need to work on releasing before we can start to strengthen.  Probably the most common telltale sign is urge incontinence, and I’ll talk about the difference between urge incontinence and stress incontinence.  But urge incontinence is when you’re absolutely all of a sudden desperate for a pee and you’re kind of hopping up and down and you don’t know if you’re going to make it on time.  That is a very, very common sign of a tight pelvic floor.  If somebody is experiencing that, then I know we need to start working on release techniques first before we can strengthen.

The other really common one is painful penetration.  Penetration is not supposed to be painful, and sometimes people think, oh, well, I’ve had a baby, so that’s why it’s painful.  No.  It’s usually painful because the pelvic floor is too tight.  So I’ll use various different techniques to help them try to release their pelvic floor, and if I’m working with someone in a private capacity, I usually do that at the beginning of our first session.  I’ll do it at the beginning of maybe our first few sessions to try to help them get that release first before we can start to strengthen.

A weak pelvic floor often goes hand in hand with stress incontinence, which is more like if you’re jumping on a trampoline or you sneeze and you leak a little bit.  They’re two very different types of incontinence, both very related to the pelvic floor, but for slightly different reasons.

That makes sense.  Typically, the second is what women assume they’re going to have to live with after having a child or children.  It’s the idea that you can’t dance without leaking or sneeze, whatever it might be.

The crazy thing about that is that a weak pelvic floor actually has a very easy fix, and so many of us have just been led to believe, because it happens to all of our friends, we just think, oh, well, I’m a mom now.  It’s normal.  And it’s not.  It’s common, but it’s not normal, and it’s not supposed to be that way.

Exactly.  There’s so much education that’s needed.  But I feel like a lot has changed in the ten years that I’ve been a doula.  Providers are now talking in that postnatal visit, the six week appointment, about pelvic floor physical therapy and what is normal and what isn’t.  I feel like we’ve come a long way.  But there are still a lot of misconceptions out there related to, as you said, intimacy in the postpartum phase.  It’s not supposed to hurt.  You don’t have to leak.  You don’t have to be uncomfortable.  That urge is also not normal.

Right.  I think typically in the fitness industry, we’re told to go to our six week postpartum check, and the doctor says, right, you’re cleared for working out.  And what happens is, not knowing any better, we all go back to our regular routine of whatever workouts we were doing pre-birth, not realizing that actually the pelvic floor needs a bit of a rehab period before we can start doing those things again.  I’m a Pilates instructor, so particularly in the Pilates world, what happens is people are desperate to get back to their Pilates Reformers classes, and they go into their Pilates Reformer class.  They’re cleared at six weeks.  They go straight back into all of the things they were doing before.  They’re doing the 100s and the crunches and the sit-ups and their series of five, and they’re like, yes.  But what happens is those exercises – a lot of people don’t realize this, but those exercises are actually quite advanced core exercises.  And when you go straight back into doing advanced core exercises with a weak pelvic floor – I usually use the analogy of building a house on sand.  You’re basically asking for trouble.

That makes perfect sense.  I know that you work with women not only throughout pregnancy, but in the recovery time and have specific programs and exercises just for them during the recovery so they’re not going straight back to their old workouts, whether it’s Pilates or any sort of workout; whether they want to get back to running or swimming, whatever their sport is.

Right.  Here’s the other thing that happens with running.  When you go right back into running with a weak pelvic floor, it bounces.  It really bounces up and down.  And when there’s not much stability in the pelvic floor and it’s really bouncing, what can happen is – a lot of people will say, oh, I went back to running, but it feels like my vagina might fall out.  That’s actually a sign of a prolapse.  A prolapse can happen when the pelvic floor is not strong enough to hold up the internal organs and it all starts to kind of collapse a little bit inside.  And that’s another thing that – then people get disheartened and they say, oh, do you know what, I’m just not going to run anymore.  It just doesn’t feel good.  Not realizing that actually, if you strengthen your pelvic floor, it doesn’t feel like that anymore.

Right.  So starting out with a program to ready your body for physical activity is the first step versus going right back into your exercise program from pre-pregnancy.

Exactly.  And to be honest with you, I work with women who maybe they’re 20 years postpartum.  Maybe we’ve been working together for several years.  And I still don’t teach them the 100s.  I still don’t teach them the series of five.  I’ve got all the Pilates equipment, but I essentially now – because I believe that these low pressure essentially physical therapy ab exercises are so much more effective for anyone who’s ever had any kind of pelvic floor dysfunction, I continue teaching those exercises.  So I’m basically the Pilates instructor who teaches anti-Pilates because I’ve tossed out all of the traditional Pilates core exercises from my repertoire and essentially replaced it with variations of physical therapy core exercises because I find it to be so much more effective.  You can have great abs with those ab exercises.  Here’s the other misconception: a lot of people think, oh, if it’s not burning, if it doesn’t feel really hard, then it’s not doing anything, which actually isn’t true.

That makes sense.  And so you don’t feel like you’re getting a good workout unless you’re really hurting.

Right.  I was explaining this to someone the other day, and here’s the difference.  Any time you lift your head up from the ground – let’s say you’re doing the 100.  You’re doing the series of five.  You’re doing crunches or you’re doing sit-ups.  You’re using your rectus abdominals, your six pack abs.  What I teach with what I call low pressure abdominal exercises is we use more of the transverse abdominals.  And the transverse abdominals, those are the ones that wrap around your waist like a corset.  And I always use this analogy of tying your shoelaces tight.  If you want to tighten your waist, get rid of your bulging tummy, all of those things, the best way to do it is to work your transverse abdominals because it pulls your shoelaces tight.  It tightens your waist.  Whereas your six pack abs, your rectus abdominals, they don’t tighten your waist.

That makes sense.  So tell us about the Bromley method specifically.

Specifically, the Bromley method is essentially Pilates but with all of the core exercises taken out.  That’s essentially what the method is.  And I’m super passionate about it because when you take out all of those super advanced core exercises – those are the ones that tend to give people low back issues.  You’ll hear people say, oh, my doctor told me to go and do Pilates, so I’ve been doing Pilates classes, but then they keep throwing their back out.  And they keep throwing their back out because the core exercise are too advanced for their core in particular.  And what’s more effective is strengthening the pelvic floor, learning how to activate the transverse abdominals, strengthening the obliques.  So essentially I toss out all of those exercises and really, like, I could have been working with somebody for seven years, and I’m still not doing the 100s with them because – why?  What’s the purpose of it if you can get results elsewhere without them throwing their back out?

And you work with your clients in studio.  You of course have an online program.

I have a studio, as you can see in the back here.  I teach one to one only in the studio.  I don’t teach any group classes, and the reason for that is because people call me nitpicky, which I’m actually very proud of.  When somebody says, wow, you’re so nitpicky, I take it as a compliment.   To pull the exercises apart and pull it back together – we slow it down.  We’re not using momentum.  We’re not doing things really quickly.  Partly, it’s mind body connection as well.  A lot of people are so disconnected, their mind from their body, and a lot of times, what we feel like we’re doing in our body is not how it looks like to an onlooker.  And that’s what I look to change when I teach somebody privately.  Let’s reconnect those mind-body connections, and let’s actually really connect with your body because it translates into life.  It translates into – let’s say you’re on a plane, and you’re lifting a suitcase down.  Being aware of how you’re moving your body so that you’re not throwing your back out all the time.  So yeah, I teach privately in here, but I also teach privates on Zoom and on Facetime.  I have a six-week program, essentially, where they can go through and learn all of my techniques.  Some of those people have been doing it for several years.  They just keep going around the six-week program.  Some of them will occasionally check in with me and do a one-off private with me.  Maybe they’ve got a bunch of questions.  Maybe they want to do a trouble shooting session or whatever.  I also have a live program where I teach twice a week, and I just basically open up my Zoom room, and if they’re enrolled in the live program, they can come and join my own workout in the studio.

So many options.  And you can have clients all over the world that way, so it’s lovely.

Yeah, it’s great.  I love it.

You’re a co-author, as well, so tell us about your book.

Yes, I co-authored.  There were ten of us.  It was released in May of 2022.  It’s called The Pelvic Floor, and we basically are a bunch of pelvic floor experts from different fields.  So we’ve got a birthing coach.  We’ve got a doula.  We’ve got a physical therapist.  We’ve got myself, a Pilates instructor.  So we’ve got people from all different walks of life who consider it their specialty to be in the pelvic floor.  It’s super, super interesting because everybody’s written essentially a main chapter, and then we’ve all kind of chimed in on different topics.  It’s essentially a pelvic floor 101.  It’s a pelvic floor Bible, essentially.

I love it.  Where can our listeners find the book, outside of Amazon?

Yeah, they can find it on Amazon by searching for The Pelvic Floor Emma Bromley.

And you do have an excellent, comprehensive website with all of your different programs.  I know you’re also very active on social media.

Instagram is my happy place.  That’s where I like to essentially disrupt the Pilates community.  I like to think of myself as a disruptor.

We need more disruptors, for sure.  What other tips do you have for our listeners, Emma?

I think honestly my main tip is listen to your body.  Listen to your body because I think so many of us have become disconnected.  Listen to your body.  Listen to the symptoms.  Those symptoms are essentially warning signs from your body.  Your body is telling you something.  None of these are things that we just have to tolerate as moms.  Whether it’s diastasis, whether it’s prolapse, whether it’s leaking, whether it’s urge incontinence – whatever it is, those things are warning signs.  And it’s super important to address those warning signs.  I said this the other day on Instagram: if you want different for yourself, you have to move different.  And I think so many of us just follow along with what all our friends are doing or what we were doing pre-pregnancy.  And if it’s not working for you, do something different.

Yes.  Any advice for listeners who have had tearing and they’re trying to heal from that as far as wanting to work out and how to really deal with some issues with painful tearing and trying to even prep their body for baby number two or three after experiencing some tearing?

Yeah.  I think with tearing, I’m not a huge expert on tearing, but I think go easy on your body.  I think so many of us want to rush back into the workouts.  I was messaging with somebody the other day who was feeling frustrated with her body because she was four months postpartum and she wasn’t happy with the way her belly looked.  And I was like, four months postpartum is really early.

It is.

It’s really early to be feeling frustrated with your body.

There’s so much pressure.

Yeah.  Obviously, there’s tons of things that you could be doing, but don’t rush it.  There’s no rush.

And for prepping your body for future babies?

A question I get asked a lot is: I’m planning on having another baby.  Shouldn’t I just wait until after I’m done having babies to begin working on my pelvic floor?  And my answer is always definitely not because a stitch in time saves nine.  It’s wild to me that people would think, oh, I’ll just wait until afterwards because these issues get worse with each pregnancy, right?  And we can do so much work on fixing these symptoms before we go into another pregnancy, and then you’re essentially starting with a fresh slate again.  It’s a no brainer.  Definitely work on your pelvic floor; rehab your core.  That’s not to say put off having another baby.  I’m just saying, don’t put off your pelvic floor rehab until after you’re done having kids.  Do it now.

Exactly, and that can impact your length of labor, your labor experience. 

The other great thing is that a strong pelvic floor actually typically makes for a smoother and less complicated delivery.  It’s very often particularly a tight pelvic floor that can make delivery more complicated.  Again, I’m not an expert in delivery.  That’s a conversation for somebody else.  But like I said at the beginning, a strong pelvic floor, a strong muscle, is one that can both fully contract and fully release.  Right?  So a strong pelvic floor has that ability to get a really good release.

That’s very helpful.  As far as pregnancy, any tips in preparation during pregnancy that would be helpful?

Strengthen your pelvic floor.  Strengthen your pelvic floor during pregnancy.

Obviously, join your program.

Strengthen your pelvic floor.  So my program is a specific postpartum program.  It’s not tailored towards specifically people who are pregnant.  However, I’ve had so many women go through the program and then get pregnant with another child and say which of these sequences can I do during pregnancy that I ended up pulling out all of the sequences that can be safely done during pregnancy and that are also super helpful to do during pregnancy, and I’ve put a prenatal workout library together.  Basically, if you go through the program and get pregnant again, here are all the workouts that you can do during pregnancy and are super helpful.  So yeah, I’ve had this conversation a lot with people who are pregnant who literally think that because we don’t do crunches during pregnancy, they take that to mean don’t train your core during pregnancy.  Your rectus abdominals are just one part of your core, and so that’s the important thing to note during pregnancy.  We don’t train the rectus abdominals during pregnancy because the rectus abdominals are the abdominals that get affected when we have diastasis because they move apart during pregnancy.  It’s a natural part of pregnancy that they should move apart to make space for baby.  What we do want to be doing during pregnancy, however, number one, strengthening the pelvic floor.  Number two, strengthening the transverse abdominals, which are your corset abs and give a huge amount of support for baby.  And number three, strengthening the obliques, your side abs.  So four different parts of your core, but a lot of people have this misconception that if they’re not doing crunches, that they shouldn’t be doing any core work at all, which is not true.

Excellent advice.  Well, thank you for sharing all of your wisdom and resources!  I will definitely chat with you in the future.  We have so many topics we could discuss.

Definitely, yeah.  I could talk all day about the pelvic floor.  I eat, sleep, and dream it.

We definitely need more education, so thanks for the important work you’re doing, Emma!

IMPORTANT LINKS:

Emma Bromley and the Bromley Method

The Pelvic Floor book

Becoming A Mother – a course from Gold Coast Doulas for all things pregnancy

Freebies from Emma: Pelvic Floor 101 , Too Tight

Katie Bertsch and Kristin Revere chat about the tools we use as birth doulas during labor and delivery.  Some of these include hands-on support, birthing balls, birth stools, and more.

This is Kristin Revere with Ask the Doulas.  I’m here today with our own advanced doula, Katie Bertsch.  Welcome, Katie!

Hi.  Thank you!

So happy to have you here!  Our topic of the day is comfort measures and how we use them as birth doulas.  Katie, what are some of your favorite tools with clients, whether they’re looking for an unmedicated birth, a home birth, a hospital birth, or the support of an epidural?

I realized quickly that my list was not tools so much as how to support a physiological birth by using positions and movement within the body to help the baby rotate and descend and help labor progress.  I love physiology, anatomy, and how the body works.  I love knowing that their bodies were created to do this, to birth babies.  It was really fun to make this list, thinking about all the ways we can help that mama and baby get to meet each other.

As you speak about your passion for birth, can you share about why you became a birth doula and some of your related trainings over the years that have led you to that elite or advanced status that we have within Gold Coast.

Absolutely.  I became a doula about six years ago.  It was after I had my first son.  My husband and I took all the classes.  We both love to learn.  He has an engineering brain and he wanted all the research.  We took a lot of classes and practiced a lot of things, but it still felt like birth just took us by storm.  His birth was pretty hard; we had to be induced, and nothing went by the birth plan.  We quickly learned that it’s more of birth preferences and how to achieve the birth that you want, even when things need to change.  But I didn’t know any of those things yet, so I just held so tightly to my plan.  Nothing was going the way I wanted, and it was so hard.

Thankfully, we had an amazing nurse, and she helped bring us back down to our center.  She gave us some options, and the birth was great after that.  I got this bug in me – I want to know more.  I want to be able to help.  A lot of my friends were having babies at the same time, and I just kept hearing this theme that it felt like birth happened to them.  It was like they didn’t have a voice.  Things just kept happening really fast.  There weren’t choices.  They and their partners were just overwhelmed.  And I’m just thinking: I love babies.  I love birth.  And that’s not the feeling that you should walk away with.

I got my training through DONA International, thankfully pre-COVID.  I got to have this awesome four-day in-person training, hands on, really intensive.  Since then, I’ve done a Spinning Babies training, which I will talk a lot about because it has just changed the way that I see birth.

Yes, we took it together, and it’s life changing!

Yes!  So that I’ve loved and I definitely use it for every single birth.  It almost changes the philosophy of how I walk into it.  After having a few clients who needed Cesareans for medical reasons and then wanted a VBAC afterwards, I wanted to know how that was different for them and how to support them best.  So I did a VBAC training to give them the specific care that they needed.  I love to learn, so I’m still trying to build my toolbox to give clients what they need.  After seeing a lot of different types of birth, I’ve seen the beauty in all the different ways, whether it’s a fully natural homebirth, whether it’s a planned Cesarean, and absolutely everything in between.  There is beauty in all of it, and there are ways to get what you want and use your voice and feel empowered and calm and comfortable as you get to meet your kiddo.  I’m very passionate about it.  I just love talking about it.  I’m excited to talk about comfort measures.

I can tell you are!  I love it.  What’s the first tool that you utilize as a doula?

I feel like I can’t not talk about the birth ball and the peanut ball.  Those are definitely easy go-tos, especially because hospitals stock them, so it will be in every room that you birth in.  I do think it’s helpful to buy a birth ball for your home.  It’s important to get the right one for your height so that your hips and knees are at a 90-degree angle.  It’s just so versatile; you can sit on it and do hip circles, figure 8s, side to side, back and forth – all great ways to open and loosen the pelvis, help baby rotate and descend.  You can do these leading up to birth; you can do it while you’re still working, and swap it out for your office chair.  You can do it as early labor begins to relax and find comfort.  It’s great for during surges.  It’s great for in between them.  Really, it can be used whenever, and that’s just sitting on it.  You can also be on all fours and lean over it to give your upper body a rest when you want to relax and melt over the ball, but you still want to be in a really positive position.  And you can sit on it and have that open pelvis while you’re leaning back or leaning forward on your partner for a great moment of connection.  The birthing ball is just so great.

I think the peanut ball can be more versatile just because of its size.  You can do a little bit more movement with your lower half.  You can put it between your knees and feet and extend it behind you for a flying cowgirl, which is a Spinning Babies move.  It’s just really great for helping baby through the inlet if they’re kind of stuck up high.  You can put it under one knee that’s drawn up high if you’re doing exaggerated sidelying release.  That can help them through the mid pelvis.  You can kind of rest in the butterfly position with your feet together and your knees out, and you can put a peanut ball under each leg.  You can put it under your left leg; you can drape it over.  So many things.

It is great for rest.  If you have a hospital bed, you can move it up and down and change into so many different positions.  But if you’re at home in early labor or birthing at home and don’t have a peanut ball, you can just take your pillows and fold them and stick two of them in between your legs to give you that open outlet.

Yes.  It creates some space in your pelvis by moving your knees apart.

Exactly.  Great tips!  What are your other favorite tools?

I also love the forward leaning inversion as a position that’s just really helpful.  Babies get into the best position available with the space available, but that’s not always the most optimal position with the head down, facing the back, chin tucked.  That’s ideal, but that’s not always what happens.  Maybe that’s just based on where we hold tension on one side or what’s going on with the umbilical cord inside.  We don’t always know.  But we know that babies get in the best position they can.  But we can help them to get into that more optimal position, and that forward leaning inversion is great for that because you lean forward and put your head down, and that gives you a reset to the uterine, sacral, and round ligaments.  They stretch while you’re down in the inversion, and then as you come up, they reset.  That gives baby room to float off the pelvis and then hopefully rotate, tuck their chin, and reengage into that best optimal position.  And if baby is head down, you can do this daily at home after 24 weeks.  You can do it during early labor or if there’s a stall in labor progression, if malposition is indicated.  If any intervention is suggested, you can do this to give baby a chance to reset before you talk about doing the next thing.

For our listeners who are not familiar with the forward leaning inversion, you can check out the Spinning Babies website for those videos and tutorials.  I know there are plenty of doulas who are Spinning Babies trained who have also created YouTube videos that you can search.

Yes.  I am not super into the social media world, but I’ve already seen TikTok videos of it and all those good things.  So it’s out there, and I love that.

For sure.  What’s next?

The sidelying release is also great.  This addresses 30-plus muscles that go to the pelvis, which is just incredible that one move that is very relaxing is also so productive and so great for your pelvis.  This one is great to use if mom has been at it for a long time and she’s exhausted and wants to be laying down in the bed.  She’s got her bottom leg straight, her hips kind of rotated so that she’s more on her belly, and her top leg is just thrown way over to the side.  That’s why it’s called exaggerated.  That is making amazing opening and movement to the pelvis, which gives baby a chance to rotate if they are in that nonoptimal position.  And then mom can just breathe and rest while we’re supporting.  It does feel a little tippy, like you might be falling off, but you’re supported.  And it stretches the pelvis and the spine muscles.  It opens that sacroiliac joint, frees up the sacrum, and softens the pelvic floor to help that open cervix for the uterus and baby to turn.

And if you have a doula, your doula will likely know how to do the sidelying release.  But I’ve been impressed over the years at how many nurses not only were in our Spinning Babies training, but just hearing more and more from the hospitals that we work with about how their nurses are getting trained in some of these techniques.  It’s very exciting.

It is.  I was at the hospital this weekend, and as we were doing laps, walking around, I saw the nurses’ board.  They had posters of different positions on there.  They’re doing a position of the week.  It’s just so encouraging that they are committed to learning these things, to help their clients.  Not everyone does have a support person.  If they’ve got a nurse in the room who understands this, then it’s just great for their team.

Exactly.  What’s next, Katie?

Another great one is a posterior pelvic tilt, or an abdominal lift and tuck.  If I can kind of describe this one, it would be flattening your back, tucking your hips and tailbone in, and then with your hands, lifting your belly during a surge.  This gives baby more room and can help them reposition, especially if they’re posterior.  It’s most helpful if baby is still up high, and sometimes it’s a good one to do when the nurse is in the room because then they can be doing heart tones on baby.  Sometimes if there is an umbilical cord issue, this can kind of change baby’s heart rate.  For the nurse to already be in there and to know, okay, it’s just the position.  Baby’s doing fine.  And then hopefully as they reengage, they’re going to be more optimal, and so there’s not going to be any heart issues after that.

Next is massage.  Just kind of doing a light touch on their jaws, shoulders, forehead.  This can really relaxing, and it can also be a good, quiet reminder.  Sometimes if you’re feeling that tension of a surge, you’re lifting your shoulders up to your ears and your face is tensing and you’ve got a furrowed brow.  And if you’re tensing up there, you’re probably tensing down low, too.  What you want is to open and relax and allow baby to move.  So a light touch on the forehead, jaw, cheeks, shoulders to help relax and bring that down can be really helpful.  It can be a great way for the partner to engage with soft touch to bump up oxytocin.  Lower back massage can relieve tension after surges.  There’s also the light touch and jiggle.  Jiggle is such a funny word, but it’s exactly what you’re doing.  With soft hands, you’re just shaking the back, hips, thighs, hamstrings, bottom.  And this helps release the fascia in that area, which in turn releases the tendons and ligaments and just provides more room for baby to shift and descend.  And it’s incredibly relaxing.  It can help mama move more into that parasympathetic nervous system.  We want her to feel slow, steady, restful; not in the sympathetic where she’s in fight or flight.  So it’s very relaxing.

Excellent.  One of my favorite tools is coming up – Rebozo.

The Rebozo is long and kind of like a scarf.  You can even use a hospital sheet, and that’s usually what I do.  With the mama on hands and knees, you can wrap it around their tummy.  You’re standing behind them and just lifting and holding their belly during a surge.  You’re acting as the broad ligament, instead of their broad ligament pulling in their tummy and working really hard.  You’re doing it for them, and that adds comfort and relieves pressure.  It takes the load off for them, literally.  And then in between the surge, you can slowly let belly back down and then sift it, which is just small movements, bringing your hands back and forth, which is kind of jiggling that tummy.  Shake the apple tree is my favorite one, and I love that this one is becoming more common in the hospitals.  The nurses talk about it, midwives, OBs, everyone, because it’s magical.

Yes!  I learned it from Gina Kirby herself.  When I had my Sacred Pregnancy instructor training, she was there.  I learned about so many different techniques, including relaxation and partner bonding.  Shake the apple tree is one of my favorites.

It’s a funny name, but as mom is on hands and knees or on knees with her hands up on the top of the bed, it is taking the Rebozo or sheet and fully covering from lower back to midthigh and then creating almost handles on the side.  With those handles in a firm grip, you’re going to shimmy back and forth, making the whole low back, bottom, legs, jiggle.  And this again is just great for helping baby out of mid-pelvis.  It is that myofascial release.  It’s good for repositioning baby, for relaxing mom.  It feels amazing.  It usually brings on some laughter for both mom and partner, which is a great sensation to have during labor.  It’s a fun one.

And the doula or partner can do it alone.  In some births, I’ve done it with a nurse, or with the partner on one side.  So two people can be involved.  It just depends on how many resources you have and how often you’re doing it, because it can be tiring if you’re doing it for every contraction for a baby who needs to turn. 

Yes, we definitely get our upper body workout during these births!

For sure!

With that Rebozo or sheet, you can also just tie a knot in one end, toss it over the door, and shut the door and that gives you some support to do a deep squat.  You’re holding onto that while you’re squatting really low.  It’s great for pelvic positioning.  And I don’t think we’d be doulas without the hip squeeze or the counterpressure, so I’ll talk about those ones next.  Again, that upper body – really good workout.

It is a great workout!

I was at a birth this weekend, and the husband and I kept taking turns because it was 17 hours of hip squeezes.  So the two of us did some together; he’d take a few, I’d take a few.  And it was great.  She was supported.  He was connected.  We were sore, but it was good.  That double hip squeeze is really effective when they’re sitting, they’re kneeling, they’re standing, they’re dancing.  You can do it at any time, so it doesn’t matter what position she feels the most comfortable in; you can still get access if you can reach the hips.  And it brings relief as you squeeze in and rotate up during the entire duration of the surge, and that opens the pelvis to give the baby more room.  It takes the pressure off a ton.

It does.  I even utilize the hip squeeze with an epidural, so it can be effective if they’re still in any discomfort in the hips.

Especially if they’re still feeling it on one hip.  And then the counterpressure – and sometimes mamas want the hip squeeze, and then as baby gets lower, they want the counterpressure.  Sometimes they want them intermittently.  But that counterpressure is just that steady, firm press on the lower back with your palm for the entire duration of the surge.  And that brings relief, especially if they’re having back labor.

That’s the main time that I use that.  In my Comfort Measures for Labor class, when I do some of those demonstrations, I explain to partners that they’re most likely going to be using the hip squeeze, unless there’s an issue with back labor and position and nothing feels good but that solid, firm counterpressure.

Yeah, and I like to show them that one during their prenatal, too, because that can be really helpful at home if right away when the onset of surges start, they feel like they need support, but they’re not ready to go in and they’re not ready for me to come.  Then their partner can do all of those hip squeezes or counterpressure.  It’s a good teamwork between the two of them.

One other simple one is just walking or dancing.  Think about how you can use your body, how you can use gravity to help baby descend and progress labor, whether that’s because it hasn’t started yet and you’re past your due date and you’re just really hoping to bring it on.  Going for a nice, long walk keeps everything loose, and it can help bring on labor if your body is ready.  It’s great for early labor, during labor if there’s a stall to just help things move along.  And it keeps your body really fluid.  You want to avoid freezing into one position because that can just build up tension.  So it’s a great way to keep moving.  Dancing together can bring the oxytocin, which you just want to keep flowing through the whole labor.

Yes, and as you mentioned, walking the halls.  There’s railings you can hold on to during contractions or surges.  Movement is so helpful.  

Another thing to work on is the breath.  Hopefully, they’ve done a lot of work to control their breath and hone in to their breath during pregnancy, but sometimes in the heat of labor, they kind of forget, and you’ll hear their breath change.  Maybe they get a little panicky.  As the doula, I can emphasize my breath to help her refocus.  You don’t even need to say or do anything; just loudly next to her – and then you see her like, oh, right, and then she starts breathing and she gets that control back.  You can even do that same thing during transition or during the pushing stage.  If the breath or vocalization has started to become really high and screamy – and it is perfectly okay and really positive to make a lot of noise during labor, but that high noise usually means that you are tensing.  And if you are tensing up top, you are probably tensing your pelvic floor, as well, and that is not what you want.  Just kind of moaning or groaning or even mooing next to her to remind her to bring it down and low.  You don’t have to break her rhythm or say anything; you can just do it and watch her follow suit, or have the partner do it.

Also, practicing that destressor breath – in for four, out for six.  That’s a great one to be doing while warming up for labor at home just to practice.  It can be great to recenter yourself during your labor.  Your breath is so, so important.

It is; it’s everything.  It’s the number one tool.  We don’t want our clients or students to hyperventilate.  Talking about that with a partner is key.

What’s next, Katie?

The birth stool – not all places have this, but it is helpful for physiological upright birth.  Your position during labor helps provide balance and support.  Similarly, you can using the toilet, instead, just because your body knows exactly what to do on the toilet.  It knows to open, relax, release.  And then with the birth stool position or the toilet position, you can be sitting on it and then putting one foot up on a stool for a few surges and then switch.  This is just shifting your pelvis and helping baby rotate and turn.

Exactly.  I’ve seen the traditional birth stool used more at home births, but now hospitals have a new tool, which is very exciting.

They do; the CUB, which stands for Comfortable Upright Birth.  I know that Gold Coast was instrumental in getting one of those in a hospital nearby.

We actually donated three to Trinity Health.

That’s awesome.  It looks like an inflated C, and it’s quite large.  You can sit on it with one leg on each of the arms, basically, or you can kneel and lean over it, resting your body.  It can help with posterior pelvic pain or coccyx pain.  Their website has some amazing stats I want to share.  They’re truly amazing.  It says that it increases the available space in the pelvis by 30%.  It can make surges more effective.  You’re 23% less likely to need medical assistance.  Baby is 54% less likely to become distressed.  It can decrease the length of labor, so shorter labors.  There’s also a 29% reduced rate in emergency Cesareans and a 21% reduced rate in episiotomies and reduced rate for epidural.  So you’re thinking that you’re just sitting on this; you’re leaning over it; you’re using it.  But it’s doing so much for your pelvis and your positioning; it can do all of those amazing things to progress your labor.

And it’s not just for sitting.  As you mentioned, you can do the kneeling and the leaning into it.  You can rotate your hips and do hands and knees supported on the CUB.  There’s so many ways you can use it.  I’m a huge fan of the CUB.

Yes, it’s definitely one to look up and look at pictures for it because it’s a really cool tool.

And I’m happy to see even some of the smaller hospitals have recently gotten them.  It’s very exciting.

It is.  We’re seeing a lot of movement towards that more physiological birth and letting her body do what it’s supposed to do.

What’s next?

A few simple things, but using stairs or doing lunges or curb walking.  These are great things to shift the pelvis, to assist with an asymmetric or an OP baby.   We’re just trying to really move the pelvis and shift it and jiggle it up so that baby can get out of maybe a stuck position or just get into a more optimal position.

Another one is the bath.  The bath is amazing.  That water – it does give you some buoyancy.  It can relieve pressure and feel great.  A lot of my clients say that it feels like a natural epidural.  We see a huge shift in their presence, their calmness, their control, their ability to handle the next surge.  It’s so great.  You go in there, and it’s warm.  You keep the lights down or off.  Maybe it’s just you and your partner.  It’s calming; it resets; it allows connection.  And you can go in as much as you want.  You can stay in as long as you want, as long as you’re not overheating.  In the last birth, she used it four times.  That was her tool; it’s what she wanted, to breathe and float.  And just watching her move her body and use her own instincts for what felt right – it was amazing.  The water is awesome.

It is.  A lot of hospitals have jets, and I like to take the showerhead and use that.  Clients can get in different positions in the tub.  Of course, not all hospitals have tubs.  Some have waterfall showers or a standard shower as an option.  Water in general can be calming, as you said, and just a great reset and can keep any discomfort off your back by having the flow of water.

Yes, and the sensation and the noise, if you just have the bath running the whole time, that white noise.  Like you said, bringing the showerhead down and having that hot water either hitting one spot or kind of a fluid motion up the entire length of the back can sometimes feel really nice.

For those of you who plan to have a home birth or who have given birth at home before, there are the inflatable tubs.  I’ve also attended home births where my clients had a bigger tub of their own, and they just delivered in their own tub versus an inflatable.  There are lots of options.

Yeah, and it can be great in early labor just to relax when you don’t want to be focusing on the labor too much.  It can be great for during transition.  It has many uses throughout the entire duration.  If you’re doing a homebirth, maybe being able to push baby and catch baby while you’re in the water.

Yes.  The water births are an option for many individuals, depending on the state requirements for midwives, but certainly in Michigan, you can.  In our hospitals, you can labor in water, and you can even have a walking monitor and be monitored while you’re in the water.  But you are not able to deliver your baby in water, so then you move to land to have your baby.  But again, movement is helpful.

Yeah, and that is a point you talked about, wireless monitoring.  Just asking for that, to be able to keep moving.  You can use wireless, and they can put the bands on.  Or they’ve got intermittent Doppler monitoring, if you and baby are doing well.  It gives you that freedom to move and get in the water and to not feel stuck.

What other tools do you have?

The last one on my list is just using the squat bar.  This is a metal bar that attaches to the hospital bed.  Most hospitals have them in every room.  It allows for a supported squat so that if you’re feeling a little shaky and your legs don’t feel like they can hold you, then just being able to be in bed and pull yourself up on this, to have that supported squat, which increases the pelvic opening and helps with the descent of baby.  You can do that during the pushing stage.  You can tie a towel or sheet to the squat bar and kind of do this tug of war motion, which can really help with pushing, because you’re giving this push-pull motivation in your brain.  You can have your partner or a nurse or a doula hold it and go back and forth; as you’re pushing down low, you’re also pulling, and it’s just a great counteraction in your body.  You can also rest your feet on it.  If you don’t want to rest your feet in the stirrups, you can rest your feet on it.  I’ve had a few clients who’ve had trigger things with the stirrups, but they loved the squat bar, so they were very happy to put their feet on the squat bar, but they wanted nothing to do with the stirrups.  Just having lots of options to move the bed, use different things, just creating space and creating movement.

Depending on the strength of the epidural, I’ve had clients use the squat bar even with the support of an epidural, if they have some movement in their legs.  It’s a great tool.

Well, thank you for sharing all of our amazing tips with our listeners.  Any final suggestions or comments?

I think just believing in your body’s capability to do this.  I’ve been fascinated to learn just what the body does on its own, the physiological aspect of it and how your anatomy works with you to help birth this baby.  So just believe in the power that you have, the support that you have, and just trusting in that and reminding yourself of that.  I am safe; I can do this.  I am supported.  Our bodies are amazing.  As a doula, it’s a privilege to get to be in that room and help you know that, help you feel that so deeply.  You’re doing this, girl.

It is a privilege.  It never gets old.  Every birth and every person is so unique, so it’s not like anything is routine for us as doulas, which I love.

I do, too.  No births are the same.  It helps us to hone our skills because we’re on our toes the whole time.  It shows the beauty of it.

It’s so beautiful!  Well, I appreciate you so much, Katie.  We’re very lucky to have you on the Gold Coast team.   

If you aren’t planning to hire a doula, then check out our Comfort Measures for Labor class.  That’s part of our Saturday series.  We also offer HypnoBirthing, which is a five-week comprehensive childbirth class.  It is very partner-involved, and it involves a lot of visualization and focuses on breathwork and understanding the physiology of what your body is doing at each stage in labor. 

Thanks so much, Katie!

Thanks for having me!

IMPORTANT LINKS:

Katie’s bio

Comfort Measures for Labor class from Gold Coast Doulas

Birth doula support from Gold Coast Doulas

HypnoBirthing class from Gold Coast Doulas

Spinning Babies

CUB Stool

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Kristin Revere chats with Jenni Froment of VBAC Academy on the latest episode of Ask the Doulas.  Jenni offers VBAC tips and information.  VBAC is defined as Vaginal Birth After Cesarean Section.  You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you find your podcasts.

Welcome.  You’re listening to Ask the Doulas, a podcast where we talk to experts from all over the country about topics related to pregnancy, birth, postpartum, and early parenting.  Let’s chat!

Kristin:  Hello, this is Kristin with Ask the Doulas, and I am so excited to chat with my friend Jenni Froment.  Jenni is the founder of VBAC Academy, a labor and delivery doula, and a VBAC pro.  Welcome, Jenni!

Jenni:  Thank you!  Thank you for having me!  I’m so excited to be here.

Kristin:  Yeah, I’m so excited to chat with you today.  Now, you have had two VBACs after two Cesarean births, so known as VBA2C.

Jenni:  It’s funny that there’s kind of slang for it.  They usually say VBAC after 2 is, like, the shorthand for it.  VBAC after 2.

Kristin:  Love it.  So your personal journey led you to advocacy, and I know you trained me through VBAC Academy and many of the doulas at Gold Coast Doulas.  I’m so thankful for you and the information that you provide doulas in order to better support our clients.  But many of our listeners may not even know what a VBAC is, especially if they’re a first-time mom.  So let’s start by defining what a VBAC is and then getting into a bit about your stories, if you don’t mind, Jenni.

Jenni:  Yeah, absolutely.  So VBAC is an acronym, and it stands for vaginal birth after Cesarean.  And as you were mentioning earlier, there’s some other variations of that, like VBAC after 2 indicates someone that had two C-sections and then wanted to have a vaginal birth after that.  There’s also a term called HVAC, which is homebirth after C-section, and then there’s actually a term for having a C-section after a C-section, which they call CBAC, and that’s typically reserved for people that were planning a vaginal birth but for whatever reason ended up with a C-section.  They usually refer to those as CBAC.  So yes, that’s a VBAC, and then a little bit about why I got started – you nailed it.  I had two C-section births up front, and for very real reasons for the first time.  I had preeclampsia and had to be induced at 37 weeks and truly very amateur level birther at that point; very first time birther.  Didn’t really take any birthing classes.  So it’s hard to say if it could have gone differently, but I definitely had preeclampsia, and the induction resulted in her heartrate going down.  So necessary C-section.  My second baby was kind of the catalyst before I knew it would be the catalyst.  So I like to share that when I first got pregnant with him and I went to have my first OB appointment, I remember asking – so how does this work?  Do I push this baby out?  Do I have to schedule a C-section?  I truly didn’t know what the next steps were.  And the provider at the time said something along the lines of, it’s safer for you to have a vaginal birth, and it’s safer for baby to have a C-section, and, “Most moms do what’s best for their baby.”  Which is not true.  That’s actually a really weird twisting of the facts, and I wouldn’t even call it a factual statement, anyway.  So I didn’t know better to push back, but it was a really crappy informed consent at that time.  So I actually scheduled that C-section thinking I was doing the right thing for my baby, and the entire pregnancy, they said that my baby was big.  They ended up moving up my due date by almost three weeks.  And when he was scheduled for a C-section, they gave me the option to have him at 38 and 5 days.  So long story short, when he was born via C-section, he presented similar to, like, a 35 or 36 weeks fetus, and he was having trouble oxygenating and had to be in NICU.  And it was really the first moment I was like, wait a minute.  How did we get here?  I was trying to do what was best, and now the NICU pediatrician is saying he was born too early.  It was just really the first time that I understood that doctors didn’t know everything and that I needed to have a little bit more of a front row or driver’s seat, even in what the decisions were about my care and about my pregnancies going forward.  It just kind of lit that flame in me.

Kristin:  Makes sense.

Jenni:  So that was a little bit long, but important.  Then I moved into – I stopped having babies for a little bit, and about five years later, I got pregnant again.  And first I didn’t know the word VBAC.  I was still very much that person that had gotten talked into a C-section.  I just knew I wasn’t ever going to schedule a C-section again.  So I was Googling things like “unscheduled C-section,” “show up at the hospital in labor,” and things that – I thought those were my only choices.  And then that word VBAC started popping up.  So once I learned the word VBAC, I got – it was just one of those things where as soon as I heard it, I knew I wanted it.  And I became very driven and ambitious to get it.  I see that in a lot of VBAC moms, actually.  I don’t know if we’re naturally type A, like go-getters, but a lot of times, very focused, just eyes on the prize.  So I really wanted that VBAC.  And there’s a lot – I feel like this was the first time that I learned what it was; it was the first time I realized how shrouded in challenges it was and how there was a lot of misinformation out there.  When I first started to talk about it with my doctor, the one that I had had before, it was very pooh-poohed, and like, this is not what we talked about, especially as a VBAC after 2.  So I would say just that first – those first moments of knowing what it was and then seeing how hard it was to achieve only made me want it more.  So I guess I’m just that personality type.  So once I really got my teeth in it, I pursued it.  I ended up going through about four or five providers to let me try.  I landed on someone that I would describe as compliant.  Like, just would let me do whatever I wanted, kind of hands off.  So long stories here, so I won’t go into all of it, but I’ll just say I ended up having my VBAC after 2 successfully for my third birth.  In that, I learned a lot about all the rules.  I would use to joke that I could teach classes back then just as a pregnant person learning everything she could about VBAC.  But what was difficult about it was I had put all of my time and energy into fighting for my rights to VBAC and learning everything I needed to know about VBAC because I felt like I couldn’t get it in one space.  And when it came to the emotional bigness of labor, which we all know as doulas or birth professionals or anyone that’s had a baby, it’s a really big transformative person thing that happens to us.  And I felt really unprepared for that for my first VBAC.  So – and this is bringing us home here.  I know I’ve got four babies, so my intro takes a minute.  But with the fourth baby, I had had my VBAC after 2.  I’d had two C-sections, one scheduled, one emergency.  With my VBAC after two, I ended up getting an epidural at one point, so I’d had a medicated vaginal birth.  And with this fourth birth, I really wanted an unmedicated vaginal birth after two C-sections.  I knew all the rules from the last birth.  I felt like I’d had a lot more experience at that time.  I was starting to do birth work with what could happen.  So I really put all of those planning pieces aside and just focused on how to enjoy my birth and how I wanted to feel before, during, and after my birth, knowing what kind of birth baggage I was coming in with.  And I did a lot of inner work and a lot of practice emotionally and mentally and spiritually to kind of get to that.  But when I had that last birth – I call her my opus birth, which is, like, a musical term for the best event ever of your life.  But she – it was about six hours.  I would say there was no suffering, barely anything that I would call pain, just kind of a big feeling.  A really easy pushing; she started coming on her own.  I went to the hospital at, like, 7:20, and she was born by 8:08.  And that really cemented for me that VBACs are important and they’re difficult to plan, and I have a big passion for not just only giving people the information they need to feel safe planning a VBAC but helping them get to the point where they’re not feeling like they just survived their VBAC but that they actually enjoyed their birth.  So that is how my birth story ties into what I’m trying to get done here.

Kristin:  I love it.  And so when did you then take the leap to becoming a doula to support VBAC and other birthing clients?  And then take us to starting VBAC Academy.

Jenni:  All right.  It does get very busy during that time of VBAC after 2-ing that I was doing.  So I got pregnant.  I had my first VBAC after 2.  I was really on fire for the cause after the first one, even though I had some conflicted feelings about my own birth and it felt scary and big and like I wasn’t prepared.  I was still absolutely proud of myself and feeling on fire for helping other people.  So I actually joined and led an organization called ICAN, International Cesarean Awareness Network.  It’s an organization that’s international, and they open up chapters locally in many places.  I encourage everyone to look it up.  And they offer women support on how to avoid unnecessary C-sections and how to get resources for planning VBACs.  So that’s kind of their core.  Once I started leading that, I was hosting meetings monthly for anywhere from 5 women to 50 women.  And there was, like, a 1000-person Facebook group.  And it was just all the questions suddenly about VBAC and then really getting to know the different kinds of experiences that people can have.  I was lucky that I didn’t have a traumatizing C-section experience.  It was more scary after his birth.  But there are some really sad, scary, traumatizing C-sections out there, and learning how to sit with those women and hear how they feel and try to figure out how I can help other people not feel that way after was a really big piece.  And so I led the nonprofit for a while.  And then naturally the kind of – that led to birth work.  I wanted to get out of the group space and start helping people on an individual level.  So I was a labor doula that really specialized in VBAC in Phoenix here for a few years.  Maybe from 2014 to 2018, but it all blurs together.  Lots of VBAC births during that time.  And again, it just kind of broadened my scope and broadened my horizon because I knew what it was like to plan for a VBAC myself.  I knew what it was like to have a C-section for myself.  Then I got to learn from all these great women in the nonprofit all the different ways they could feel and experience.  And also people that were going for VBACs, sometimes they were going for VBACs and it was going great.  Sometimes they were going for VBACs and they had a C-section.  Sometimes when they had a C-section, they still felt okay about it.  Sometimes when they had a C-section, they would still feel bad about it.  So just really observing what helps people feel good, no matter what way the baby ends up coming out, because that’s sometimes out of our control.  I really tried to pay attention to, how can I help people process whatever happens and go into birth with an attitude of, whatever happens, I’m going to be okay and I’m going to try to enjoy this process as the once in a lifetime event that it is.  Then I was doula-ing, enjoying that.  There’s just about nothing that I can think of that’s more humbling and more of an honor than being with people in that space, so I really liked that.  But I will say that it was really emotionally uniquely difficult to be a VBAC doula because every client has so much at stake in it, so much expectations for it to go well.  So did that for a few years, learned a lot.  And then just like when I went from the nonprofit to the doula space, I wanted to go bigger.  So I had been in this space where I was helping one on one.  Now I wanted to help professionals.  I wanted to be able to train other birth providers and parents that weren’t just my clients how to have – I call it joyful VBACs.  How to enjoy it, but educated, too.  So there’s a lot of words I used.  Educated, empowered, joyful, ready.  All of that.  So that’s when VBAC Academy started.  That was around 2020, so it was my pandemic project.  At that time, I had already been teaching parents outside of my client scope and teaching professionals, holding classes at chiropractic offices and OB-GYN offices.  And in 2020, I pulled it all together to make it an online format so that I could not just only reach my local network of professionals but start to reach out to great agencies and movers and shakers like Gold Coast out there and get more people in my tribe and out there hopefully moving and shaking and pushing the VBAC movement forward.  There’s definitely a strong layer of what I do that’s still trying to make VBAC more accessible and less shrouded in all that conflict and should you, should you not, like all the rumors.  Trying to clear up what VBAC is and that it’s safe and hopefully create an army of people out there that also know how to support this unique group of women and parents having babies in this condition.  So that was a lot.

Kristin:  That was a lot!  You are amazing.

Jenni:  Thank you!  It really fuels me.  I call it my labor of love, but it means a lot to me to help women and even when I have someone call me or reach out to me through Instagram or Facebook or my website and just have a question, I never talk to them – it’s satisfying to me to know that I can be there for them in that moment to give them that piece of information that will hopefully help them go on to even bigger, better things.  But yeah, it’s definitely a soft space for me.  I love it.

Kristin:  Yeah, and I find as an agency owner and practicing doula myself that I had considered myself a VBAC doula having had experience over so many years with VBAC clients and finding that clients were requesting doulas with experience and having a large agency and some brand new doulas, it is just as helpful for the seasoned doulas like myself to go through your certification program as it is for a brand new doula.  And certainly the newer doulas on our team, taking that fresh out of training and never have attended a VBAC birth – it gives them more selling ability for clients to know that they have the education.  They’ve gone through the program versus just having gone through a general doula training certification program.

Jenni:  Yes, I totally agree.  And not just as – obviously, it’s mine, and so I like to think so, but also as a woman that has had a VBAC and a woman that has tried to support VBACs after gathering all of her own information – like, I felt like I’ve really had to trailblaze what I’ve built here because there was similar stuff but nothing quite like it.  And by the way, shout out to some of the early foundational stuff like VBAC Link and VBAC Facts because those spaces really helped to get me access to information to start that process for me.  What I do a little bit differently is I have a big push on not only the safety and the facts of it and a pursuit to make sure that I am having the most up to date information year over year that people can come and access without having to go and do their own research to catch up on what’s been the latest studies.  That is so important to me that when I train people, there’s a lifetime open door policy and a lifetime uptraining process where anytime I have new information that comes out, doulas or birth professionals that were trained before are able to come and join these new trainings so that they can stay up to date because it does change, and there are so many different places to get the information.  It’s hard to stay an “expert” unless you’re focused on gathering all that information all the time.  And by the way, you all are one of two agencies that are trained in the US, which I think is really cool.

Kristin:  That is cool!

Jenni:  Yeah, having an agency that can say that we prioritize this – I know as a parent would have been a standout thing for me as a vaginal birth after C-section.  It shows a level of commitment to a society problem that we have right now where we really need to be educating people on how to VBAC, but it also shows that you have the emotional awareness of how this VBAC birth hits different.  We plan it different.  During childbirth, it’s different.  Postpartum, it’s different.  It really is a different track for support, and I think it shows good emotional awareness to have all of your people ready for that space.  So kudos to you for prioritizing that.

Kristin:  Well, thank you.  And as you mentioned with the lifetime access, I have found even taking it early pandemic, with your updated handouts and resources, I’m able to add more value to my clients and my students who are again wanting to work through their self-education along with having an experienced VBAC doula by their side.  So those worksheets are so helpful in getting discussions going with clients during prenatals.  So thank you for again always doing the research so we don’t have to on our end.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Jenni:  Absolutely.  And I know we love – pregnant mamas love those handouts.  It’s good to just sometimes get it in your hands and be able to look at it.  There is so much information that it can be hard to kind of sift through and know where to start.  Understanding the safety of VBAC is always number one in all of my classes for both parents and professionals because if you don’t have that bottom foundation of truly understanding that it is the “safe and appropriate reasonable choice,” per ACOG and many worldwide health organizations, knowing that it is safe and reasonable helps you to put that piece aside and just focus on enjoying the birth and planning for a joyful birth that you can experience with joy instead of feeling like you’re trying to fight through something.  So it’s a balance for me, and preparing people and making them feel like, yeah, of course VBAC is safe, because it is, and then focusing on – so with all of the kind of birth baggage that you have and these expectations and things that have happened to you that have shaped these beliefs about birth and your body and how things work, how can we work on those things so that you not only know that VBAC is safe, but you can really come at this in a fresh space with all of the good tips and tricks of someone that’s been through birth personally and with hundreds of people giving them everything that they wished they would have had the first time, which is what all doulas do.

Kristin:  Exactly.  So Jenni, I know we’re talking about safety and the benefits of VBAC.  When would a VBAC not be safe?

Jenni:  Great question.  So there’s only a few things that contraindicate going for a VBAC, and I’m going to start with the very easy – I would like to start with what makes VBAC different than a regular birth, and then we can kind of segue to your answer.  The only thing that makes VBAC, a vaginal birth after C-section, unique in planning or risks is that there is a higher risk of what we call uterine rupture with a VBAC.  So that aside, everything else is the same.  A regular first time birth and a VBAC birth – all the other planning and risks are the same except for this one thing, which is a uterine rupture.  Now, uterine rupture is when the previous scar or incision site on your uterus where your previous C-section was opens either partially or completely due to the power of the contractions during labor, usually.  So uterine ruptures can happen outside of labor, but it’s, like, astronomically rare.  Like, .000000 stuff.  But it is true that women that have had a previous C-section are at a higher risk for having this uterine rupture than what we call non-scarred or non-previous C-section birthers.  So with this risk, though, even though it’s definitely more statistically likely to happen if you’ve had that previous incision, it doesn’t mean that it’s statistically likely to happen.  So the risk is really relatively low compared to other risks that we make all the time.  So the risk of uterine rupture ranges from 0.4 to around 1%.  It wobbles a little.  There’s a range there because of how we study rates has a bunch of different variables.  Did they use Pitocin?  Did they not use Pitocin?  Did labor start on its own?  Did it not start on its own?  Did they have an epidural?  So we’re pretty confident that spontaneous labor without any use of anything to make contractions stronger, like Pitocin and things like that, that’s closer to the 0.4% range.  So really relatively low.  When it starts to raise or go up higher getting closer to the 1% range, that’s when you do things to artificially increase the intensity of contractions.  Again, if the uterine rupture is the one risk and what makes it happen is the intensity of contractions, it’s clear to say that if you do things to increase contractions, you’re going to do things to increase your risk of uterine rupture.  But even with induction and Pitocin and things like that, it’s still a relatively low risk, which is why the American College of Gynecology and like I said, the World Health Organization, the French College, the UK College of OB and GYN – everyone says that VBAC is the safe and reasonable choice for women that have had up to two previous C-sections.  So the reason they say it like that is because there hasn’t been a lot of studies on more than three C-sections yet.  But the studies that they have had do suggest that it’s similar risk.  So it goes up slightly, but nothing significant after the second.  So in all of these different organizations that recommend VBAC as the safe and appropriate choice, there are a couple areas – back to your first question – that they say, these things increase the risk to a place where you might want to consider what’s the option that’s best for you, scheduling a C-section or proceeding with a vaginal birth after C-section with this increased risk.  I do want to say that ACOG is very clear that no one should ever be forced into C-section and that all of these “rules” should be discussion points to say, like, do you understand that this increased risk could do this.  But some of those things that can risk someone out is a previous T incision or a classical scar.  So anything other than that low bikini cut on our uterus.  So sometimes they have to open us up in a T on the outside, but it’s still a bikini on the inside.  What matters is that low transverse bikini incision on the uterus.  Anything besides that can increase risks.  If you have multiples, sometimes that can increase the risk of uterine rupture just because that uterus is stretched more.  Again, not contraindicating, but just something to be discussed.  There is a slight increase in uterine rupture in pregnancies that happen less than six months.  So if the rate between the delivery and getting pregnant again is less than six months – there’s been a correlated increase in uterine rupture that gets into, like, the 1 to 2% range.  After the six months range, nothing – no changes.  So as long as you wait six months, you should be safe there.  And then – this is all from the top of my head, so I want to make sure I don’t forget anything big – I think those are the big ones that are popping out.  Those are the ones where you might get serious pushback from a provider if you don’t – if you want a VBAC.  Now, there’s always – one of the things that I do in the consultation that I do – I do offer a free consultation for people who just want to talk about their options – is I talk about what their past birth history was like.  I’ll say the ones that make my eyebrow go up just a little bit, and I wonder what else is going on, is when people get to pushing and they say things like, I pushed for four hours and I couldn’t make any progress.  Even then, there’s some things that I would have asked, like, did you do this?  Did you do that?  But most of the time, the former reason for birth, it’s very related to the mom and the baby during that pregnancy and doesn’t impact the future deliveries.  So those are a few that I just, like, threw out at you.  Are there any others that you’ve heard of, Kristin, that I can clear up?

Kristin:  Those were the ones that were on my mind, as well.  And my other question is circling back to home birth after Cesarean and risk there.  Now, whether you choose to birth at home or in the hospital, and a lot of that varies on other risk factors.  So do you want to get into what would make someone a good candidate for a home birth versus a hospital birth as a VBAC?

Jenni:  Yeah.  I’ll start by saying if you’re a candidate for vaginal birth, you really are a candidate typically for home birth or hospital birth or birth center birth, depending on where you’re most comfortable.  So it really has to do with where you feel safe and where you feel like your body will be most comfortable getting into that really primal labor land.  So obviously, the first one is where do they feel safe.  And if you can vaginally birth, then typically you can do it either in a home birth, birth center, or hospital.  The risks that you have to consider when planning a home birth – we know from studies that home births have less interventions and have higher vaginal birth rates by far.  So we know that just by choosing home birth, vaginal birth after C-section parents are not going to be faced with as many things – as many interventions that could cause a C-section as they would if they were in a hospital space.  What we have to evaluate and know is that if there were signs or signals that there was a uterine rupture happening – which, again, only risk of VBAC that’s different from a normal home birth – you would want to understand how close is the local hospital, and what would that process look like to get there.  That said, most of the time these things are not, like, a sudden emergency.  Most of the time for transverse for midwives, it’s things like, oh, this doesn’t look or feel quite right, or we’re starting to have this little thing that doesn’t feel safe anymore for this situation.  So most of the time, it’s not, like, an emergency transfer.  But there is the opportunity for that, so just making sure that people understand, there is this added layer of uterine rupture risk, and what is your plan if that happens, and how quickly can you get to the hospital, or is it a better situation to call 911.  Like, you just have to be able to think through that plan and have it put aside so you don’t have to worry about it.  But in general, I highly recommend home births, HVACs.  They’re delightful to have.  It’s really just beautiful to see people go from a situation where they didn’t get the birth they wanted in a hospital and then watch them push a baby out at home is just really beautiful.  I chose to have a hospital birth, so there’s also not a right or wrong way to do it.  It really matters on what the situation is.  But they should feel free to explore those options because home births, birth centers are options and available for VBACs in most states.

Kristin:  Yes, like you said, it’s dependent on the state and what their policies are, if midwives are licensed in a particular state and what the licensing rules are.  So I know in Michigan, we have licensure, and so part of it would be dependent, at least what I’m seeing in Michigan, on other medical areas that might put them in a high risk category, not necessarily that they are attempting a VBAC.  But it might be some other medical conditions that would make them a better candidate for a hospital birth than to birth at home, which most midwives tend to be in the low risk as far as medically.

Jenni:  Good call, exactly.  So if a VBAC is a low risk, they should have basically all the same options as a regular non-scarred, we call them, birther.  But anyone that goes into that high risk category usually does have some decisions to make and some extra care that they have to be under.

Kristin:  Exactly, yeah.  But certainly calling midwives in your state would be a way to find that information out or doing some research yourself.

Jenni:  One of the things that’s hard in the VBAC space is finding supportive providers.  So that is one of the reasons I like to have VBAC pros in as many places as I can.  So a VBAC pro is the term I coined for birth professionals that have gone through my VBAC training.  Right now, I think I have – I’ve got them in most states at this point, but not all.  So there’s a good list.  I have one person in Canada.  They’re having to hold down all of Canada right now.  But the goal is that there would be VBAC pros in each state, as well.  For the listeners, if they’re like, dang, how do I find my closest VBAC pro, or how do I find people who are supportive in my area, and I’m hoping that they can go and find someone – like in Arizona.  Phoenix is our big metro area, but if they were to reach out to someone, a VBAC pro in Phoenix, and say, hey, I live in Tucson or Sierra Vista or Yuma, some of these smaller areas outside of Phoenix – my hope is that even a VBAC pro in Phoenix would be able to say, I know some people that I can get you in connection with.  So I really encourage people to check out the VBAC pros on the site, and if you don’t have anyone in your area, you can always reach out to me, and I am a great sleuth for finding VBAC pros in areas.  And unfortunately, there’s also a conversation of what to do if you don’t have a VBAC expert in your area; there’s not a provider that provides VBAC or there’s not a midwife.  Things like that can happen and do happen, unfortunately, more than they should.  So I can help people do that, as well, and get them connected to resources or just give them options.

Kristin:   It’s all about having options.

Jenni:  Yeah, just being able to choose for yourself.  Absolutely.

Kristin:  Exactly.  And I do love your directory, so if I am getting a friend who’s reaching out, asking me for support – it happens so often where it’s like, I need to find a doula or can you do some research on a VBAC friendly provider in my area.  Like, I can look at your directory and also some other resources, but certainly in those Facebook mom groups in my area, the question of VBAC friendly providers comes up quite frequently.

Jenni:  All the time.  And it’s ever changing.  I notice that especially having been out of the live birth space and not being on call with births – I still take usually two to three clients a year just to stay fresh locally.  Yeah, and it’s honestly because I miss it.  I love it.  But even my – I notice in our landscape here – and there was a time when I knew everybody here and could tell you exactly who was and wasn’t, but it changes so much.  So it’s good to have access to the people who are still out there taking births, especially doulas.  They’re experts on knowing who are the VBAC friendly ones.

Kristin:  We’re all about knowing the resources.  That’s one of our primary roles, and giving evidence-based information.  So you certainly help us with both of those.

Jenni:  Great.  I love to hear that.

Kristin:  So any final tips for our listeners who are curious about exploring a VBAC for themselves?

Jenni:  Yeah, I would say if you feel like VBAC is still unsafe or you’re unsure if it’s safe, please come to my page.  I’m a self-described research scientist.  It really mattered to me to get to a place where I really understood VBAC to be safe, or I wouldn’t be able to tell everyone else to do it.  So if my page on its own – you know, either the website, vbacacademy.com, or I have a whole library of content just on my Instagram available for free and you can just peruse through it.  But if you’re still feeling like VBAC is scary or you’re not sure if it’s safe, please talk to me.  I’m happy to talk to people over DMs or phone calls for the free consult.  It really is a safe choice and we really do have a problem, at least in America and many other countries, with too many unnecessary C-sections happening, and there is a cost to that.  It’s scarier for moms.  We have a higher morbidity rate with C-sections.  We’re at more risk for morbidity afterward with these major surgeries.  It’s not just another way to birth.  So if people are having questions, they should definitely check out my website and my Insta just for some really good core foundational info.  Also, I offer classes.  I have a VBAC 101 class for parents who are looking to plan a VBAC.  Then I have a VBAC 201 class, which is my VBAC Pro Certification.  That’s for any birth professionals that are looking to specialize in VBAC.  I also have a VBAC 301, which is coming soon.  It’s a VBAC advocate class.  Sometimes people aren’t pregnant and they’re not doulas, but they want to be out there making a difference for VBAC.  So I have a space for them and getting them connected to how they can help in their community.  And then there’s the VBAC 401 for people who are interested in doing what I do with me and potentially becoming a trainer and working in their own communities to train VBAC Academy stuff.  So lots of options to get connected and mobilized in your local area, and I’m really grateful for you, Kristin, and agencies like yours that help to carry this message forward.  It’s such an important cause to me.  Thank you for what you do.

Kristin:  Well, thank you.  I wouldn’t be in this space to support so many VBAC clients without your continued research and support and mentoring, so I appreciate you very much, Jenni.

Jenni:  You’re welcome.

Kristin:   And thank you for taking the time.  We’ll have to chat again soon.

Jenni:  Yes, definitely.  Thank you for the time.  It was fun to talk VBAC with you.

Kristin:  For sure.  Take care!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

Kristin Revere chats with Dr. Annie Bishop of Rise Wellness Chiropractic about the importance of giving back.  You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you find your podcasts.

Welcome.  You’re listening to Ask the Doulas, a podcast where we talk to experts from all over the country about topics related to pregnancy, birth, postpartum, and early parenting.  Let’s chat!

Kristin:  Hello, hello.  This is Kristin with Ask the Doulas, and I am so excited to chat today with Dr. Annie Bishop of Rise Wellness Chiropractic.  Welcome, Annie!

Dr. Annie:  Hey, Kristin.  Thanks for having me on here.  Super excited to be here again.

Kristin:  Yeah, it’s been a while!

Dr. Annie:  It has.

Kristin:  So for our listeners, if you’d tell us a bit about your chiropractic practice and how they can connect with you if they are local to the greater Grand Rapids area.

Dr. Annie:  Sure.  So Rise Wellness Chiropractic is myself and then Dr. Rachel Babbitt.  And we have a pediatric and perinatal focused chiropractic practice right here in GR, and we’re located on the corner of Diamond and Lake.  We always say we’re where Marie Catrib’s used to be.

Kristin:  Yes, the center of the universe, as it was always called.

Dr. Annie:  Center of the universe was such a highlight in our community.  And so we’re happy to, like, create more community in that area and be just like in the heart of Grand Rapids, which is so fun and so – like, we love our space and we love being a part of that community.  So like I said, we’re pediatric.  I’m fully pediatric certified through the International Chiropractic Pediatrics Association.  Both Dr. Rachel and I have Webster certification, and we’ve done advanced perinatal training.  So we pretty much see women through their entire pregnancy journey and then beyond that, too, with their kiddos and their whole families.

Kristin:  So for our listeners who haven’t heard you on past episodes, could you define what a Webster certified chiro is and how that is a bit different from other chiropractors?

Dr. Annie:  I would love to.  So Webster certification was started by Larry Webster, who was a chiropractor who focused on pregnancy and really saw all the benefits, and it’s really expanded.  So that was, like, in the 70s, and it’s expanded from there.  So now all over the world there’s Webster certified chiropractors, and it’s really in the analysis and adjustment technique that focuses on the mom’s pelvis and getting that in good alignment or neurological coordination, like most chiropractors do, but also to create optimal positioning so that baby can get into the right position so mom’s labor is super easy so recovery is easier.  Just all of those great things that we want with a birth.

Kristin:  Love it.  So now that we’ve learned a bit about your practice, let’s jump to our topic today which is all about giving back.  So you have participated in Gold Coast’s annual diaper drive even before you started Rise and when you were in a different practice.

Dr. Annie:  Yes, a whole lifetime ago!

Kristin:  Totally, a whole lifetime ago.  You have really focused your business, when you and Dr. Rachel started Rise, all about giving back to the community and making a difference which, again, like with Gold Coast being a certified B Corp, it is everything we live and breathe is giving back and making a difference and being a for profit versus a nonprofit company and also creating change and I’ve always been impressed not only by how you have been all in on our diaper drive since day one but also in all of the other give backs that you do throughout the year.  So let’s chat a bit about that.

Dr. Annie:  Sure, yeah.   I would love to.  So this is what – is this your sixth that we’ve done diaper drive with you?

Kristin:  Yeah, you’ve done six of the eight with us, yes.

Dr. Annie:  That’s wild.  How time flies.  Yeah, so diaper drive is one of our favorite give backs.  You guys really started us on this path with the diaper drive and stuff, and we just jumped all in because it’s such a great organization and it’s such a fun drive to do, and it’s something that’s so easy for our community, too, because we have parents who are transitioning out of different diaper sizes.

Kristin:  Exactly, and we take open packages, and so if you have a handful left and don’t have anyone with that right size, they’re getting put to good use.

Dr. Annie:  Yeah.  We end up just collecting them year round, honestly.

Kristin:  So do we.  We keep them, yeah.  I just brought them into my office.

Dr. Annie:  Yep, we do the same thing.  We just, like, as kids are growing out of their diapers, we just, like, hold on to them and then we have, like, a diaper change station in our office, too, so it always – like, it benefits us and our patients that come in on a day to day basis, like if they don’t have a diaper bag with them, we have supplies for them.  But then we donate all the rest of them to the diaper drive in September, which is one of our favorite ones that we do.  But I guess to kind of backtrack a little bit, this whole idea of being – I don’t know, just being a good business.  You know, giving back to the community that nourishes us, like, one of our – I mean, one of our major, like, our moral tenets, I guess, like, we – both Rachel and I have always wanted to give back and wanted to serve the community.  That’s why we became chiropractors because we wanted to do good.  And our whole structure of our practice is based around a really pivotal transition point in people’s lives.  And so we do home visits for those moms at no extra cost.  We want to be a part of their lives and their family’s growing, but we also want to be a part of the bigger community, too.  So we try to focus on give backs that are focused on kids, so we try to do a back to school drive every year.  We used to do with DA Blodgett and we transitioned it to GRPS.  And then this year we actually instead of the back to school drive, we did a food fundraiser in the middle of summer because what was happening was we were just doing two drives back to back with the diaper drive, and this has been such a solid one for us over the years, so we decided to do a food pantry drive this summer, and that was super successful because we know food pantries are always – they got a lot of donations, like around the holidays, but they’re usually running pretty empty in the summer, so we tried to get a bunch of food together and donate this summer to feeding America, West Michigan.  Other ones: we sponsor a kiddo in Honduras, too, through Children’s Home Project.  One of our friends, Abby, is a photographer with them and raises money with Children’s Home Project, so we sponsor a kiddo through our office.  And we just try to do things that are – we talked about how hard it is because so many organizations are asking for money, and we try to really focus on ones that are going to make the biggest impact in our community, especially in the lives of kids as they’re growing and developing.  So that’s kind of our focus there.

Kristin:  Yeah, and it’s one thing to obviously volunteer yourselves as business owners or give money directly to charity, but I love the fact that you are very similar to Gold Coast in that we involve our clients.  You involve your patients and give back and how life changing that can be because they’re also invested and feel like when they see the numbers and the social media posts, like, that they made a difference, as well as your practice, versus you just saying, I gave $1000 to this charity, you know?

Dr. Annie:  It’s fun being able to talk about it, but like, we don’t – I mean, we’re just the hub.  We organize it, I guess.  And we end up doing the donation, but it’s all of our – it’s our community.  It’s our patients that are the ones who are doing the donations and stuff, too.  We have families that year over year, you know, are like, when is the diaper drive?  We’re already collecting diapers or we’re going to go out and buy some huge packs to donate every year, and they’re the ones who are really – like, we do – we also buy some diapers to throw in.

Kristin:  Same, yeah.

Dr. Annie:  We have such awesome patients.  It’s been such an awesome community that also cares about this.

Kristin:  Exactly, and I will never forget the social posts that I’ve reshared so many times where you’ve got the mountain of diapers and you’re pointing at it.  Your clients – your patients can just be like, hey, you know, that stack right there, that was me.  And yeah, even the little, the smallest donation makes a huge difference and as a way to recycle cloth diapers and cloth supplies and be good for the environment and help families in need.  Diaper drives in the area, like Nestlings Diaper Bank works with some schools and churches in Ottawa County, and they partner with Great Start in Kent County for our drives since many of the businesses, like your own, participate and are located in Kent County.  So we’re able to make an impact, and then they directly distribute the diapers to families in need.  So, yeah, it’s such a wonderful program that has so much impact because social service organizations do not give diapers.  It’s not part of the program with WIC and related organizations.

Dr. Annie:  Blows my mind every time we talk about that.

Kristin:  Yeah, and the fact that the need is, like, one in two families now this year.

Dr. Annie:  Diapers are expensive, yeah.

Kristin:  Exactly.  They’re so expensive and with inflation and prices raising on everything from diapers to food, with your food drive being so relevant, people just can’t afford the basics and if social service programs aren’t covering it, then what do you do?  Then your baby is unhappy, crying, will get diaper rash and not sleep.  You’re not sleeping.  And so it’s this cascading effect, and so the fact that both of our businesses are able to give back to the community and involve our clients and patients and they can see that impact and then the social service organizations distribute to the people who need it most versus us just guessing and trying to find families in need.  But yes, I mean, food prices really targeting your giving based on what’s important in the area.  Again, back to school drives when that’s needed, and pivoting, I think, is so essential.  We’ve focused some of our foundation giving to some rural hospitals through Trinity Health St. Mary’s Foundation and everything from blood pressure cuffs to giving to Clinica Santa Maria and to the Hispanic population and directing dollars to the programs even with the foundation giving.  Like Spectrum Foundation; we focused on breastfeeding moms and educating nursing staff.

Dr. Annie:  That’s so cool.  I didn’t realize you guys did all that, too.

Kristin:  Yeah.  So a lot of our Pine Rest Mother Baby program.  Again, that’s giving dollars but really directing – Pine Rest is such a big organization – to programs that serve low income women and children in our target demographic as a B Corp.

Dr. Annie:  So cool, yeah.

Kristin:  As far as making impact and being passionate about your work, what other tips do you have for listeners who want to make a difference?  They might not live in West Michigan and be able to directly contribute to our diaper drive or other drives like you do, like the food drive, for example.  But how can our listeners make an impact in their own community, or if they happen to own a business, what are your tips for really making that important choice to not only give dollars but time and take, as you know, the time to set up a drive and promote the drive?

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Dr. Annie:  Yeah, I mean, it’s a lot of work, but not really.  I think you just need to get into your community.  Like, just be passionate and just be embedded in your community because that’s – you will find need, and need will find you.  And I think the biggest thing is just like, we as business owners get too concerned about, like – I don’t know, we get concerned about numbers and stuff.  That’s part of business.  But it’s not just about you.  Our businesses especially, Kristin, we’re of service.  And so it just kind of expands from there.  So I think if you come at it from an aspect of, like, I am doing this business to, like, serve my greater community, to serve these families, to serve these people, you see where there’s pockets of non-service, basically.  So we see where there’s pockets of families who can’t afford food or families who can’t afford diapers, who can’t afford back to school supplies, and so we see those things, and it just becomes more clear of like, oh, this is a great way for us to better serve our community again.  The initial drive comes from there, from just being of good fellowship, good humanitarian, and that’s kind of – you will find that in any community that you look at.  Anyone who’s not in West Michigan, just look at your own community.  There’s always pockets of need there.  And then find ways that you can best fill those.  I mean, out of abundance of love and service and caring, you will find room to give, and then that will also come back to you.  There’s no – for me, there is no ask that’s not going to also come back into our community, so it’s really – it sounds like a little karma, but it’s like you give and you receive, and that’s just kind of the way that the world works.  So why not give as much as you can?

Kristin:  Exactly.  And some businesses choose to give a certain portion of their proceeds to a cause.  There’s so many ways to engage.  At Gold Coast, we focus directly giving to the areas in need versus just attending a gala or a fundraiser, which I do and I pay for those on my own and don’t include that in our annual giving for the sense of community and the networking possibilities, but again, just really –

Dr. Annie:  Yeah, that stuff’s all super important because networking is – you need to know people in the community and that’s how you – that’s a lot of the ways that you meet people.

Kristin:  You do.  But rather than give $500 to attend an event, I would rather give it directly to families in need.  So if I attend a ticketed event, it’s like a different focus.  But my biggest tip for our listeners that want to give back is don’t create a nonprofit arm or start something that is so time intensive and would take away from your work.  Partner with someone.  I have so many partners in this annual diaper drive, including Rise.  Mindful Counseling, Mind Body Baby Yoga.  So many different businesses.

Dr. Annie:  Those are good people, yeah.

Kristin:  Yeah, and they are working to promote the event and be involved because I couldn’t do it on my own.  So creating community and something larger than yourself and not having to, again, do all the work that takes you away from your clients and patients.

Dr. Annie:  And it’s so easy to get people amped up on giving back.  Like, it’s really easy.

Kristin:  Yes, and you’ve been involved in your community as well.  So you and I served on the East Town Board together, and then once you moved, you are very involved in Uptown and your neighborhood business district.  So for me, it’s not only getting involved in the passion areas for Gold Coast but also in our neighborhood, in our community, and getting to know other business owners.  We’ve got four of our business partners who reside in Uptown business district and different areas.  So how cool is that?

Dr. Annie:  It’s so cool.  I love it.  We have such a cool community.

Kristin:  Exactly.  Yeah.  Again, just focusing on what is important and making a difference in the world.  For our diaper drive – again, this is the eight year.  It’s September 1st to October 1st-ish.  Some years, depending on national diaper needs awareness, it might be off a couple days.  But we’re able to again make that impact for a whole month versus just doing a drive for a week or a couple of days to really get the energy up, get people who may not have access to drop off diapers.  I always offer to pick them up from people if they’re not able to drive to the locations, and we have strategically partnered with businesses that have locations all over the community in West Michigan so you don’t need to drive an hour to drop off diapers.

Dr. Annie:  So smart.  Love it.  We do a special benefit, too, for donations.  I think that’s why we collect so many every year.  I mean, also because we have great patients, too, but we offer a no charge initial exam at our office if you donate diapers.  So basically, any size pack – I mean, we definitely like you to bring as many as you can for a diaper mountain.  But that’s usually what it is; family members want to get in and get scanned, but anyone who’s been kind of eyeing our office and wondering – like, wanting to check it out and stuff, our initial exam process is a couple of scans.  No radiation.  And you get all of that for no charge with the donation of diapers during this month, during the month of September.

Kristin:  That is huge.  Well, thank you for all the good you’re doing in the world and for your patients.  We just appreciate partnering with you so much.

Dr. Annie:  We love it.  We look forward to this every year.

Kristin:  Yeah, and we will be sharing updates.  Once this episode comes out, we’ll have show notes with links on all of the locations, all of the information if you happen to be tuning in during the time of the diaper drive.  But no worries if you catch this later; there’s always next year.

Dr. Annie:  Yeah, we hold on to them every year.  Like we said.

Kristin:  Exactly.  Well, thanks so much, Dr. Annie, and we’ll be chatting soon!

Dr. Annie:  I’ll see you soon, Kristin.

Kristin:  Before we end this, why don’t you give your social media handles and website.  I know we talked about your physical location, but share your social and contact info with our listeners.

Dr. Annie:  Sure.  We’re on Facebook and Instagram.  Both of them are @risewellnesschiro.  We’re way more active on Instagram, but I think we share it all to Facebook, too.  We’re available on pretty much – if you message us on either of them, we will get it.  And then our email address is rise@risewellnesschiro.com.  And our website is Risewellnesschiro.com, so pretty consistent across the board.

Kristin:  Awesome.  Love it.  Thanks again, Annie!  Talk to you soon!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

Kristin Revere chats with Victoria Facelli IBCLC, author of Feed the Baby: An Inclusive Guide to Nursing, Bottle-Feeding and Everything in Between about the best ways to prep for infant feeding.  Victoria has so many resources to help you!  You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you find your podcasts.

 

Welcome.  You’re listening to Ask the Doulas, a podcast where we talk to experts from all over the country about topics related to pregnancy, birth, postpartum, and early parenting.  Let’s chat!

Kristin:  Hello, hello.  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with Victoria Facelli today.  Victoria is an international board certified lactation consultant and a postpartum doula and a new author of the book called Feed the Baby: An Inclusive Guide to Nursing, Bottle Feeding, and Everything in Between.  Welcome, Victoria!

Victoria:  Hi!  Thank you so much for having me.  I’m so happy to be here.

Kristin:  I am so excited to chat with you, and I love your book.  It is so needed.  So let’s get into a bit about your personal story that, of course, you share in your book, leading you to the journey of becoming a postpartum doula and IBCLC and then of course now an author.

Victoria:  Yeah, it’s been quite a journey, let me tell.  So I had been a nanny forever, and I did a lot of theater, so that sort of complimented what I was doing.  And I just found that I loved that space right after a baby was born.  There was just something so magical about that time in the early postpartum.  And so I decided to become a postpartum doula and started that work and loved it.  And then we happened to have a fabulous IBCLC program at the university up the road from me up at UNC, and so I decided, okay, let’s go for it.  That was really the piece of my work that was fascinating to me and really driving me because it’s such a puzzle, and I like complex puzzles.  So I found myself really drawn to that work and ended up getting my IBCLC and really diving into all of that and found that I was a little bit of a black sheep at times because I asked a lot of uncomfortable questions and was always looking to push the envelope.  But in general, even though when I started my practice, I started a practice that was formula positive, when I had my own kid, I found that I was still carrying a lot of that kind of, like, best health misinformation with me.

Kristin:  Yes.

Victoria:  And so I had a really uncomplicated pregnancy.  I was literally working at a doula agency, surrounded by birth doulas and postpartum doulas all day every day.  I had two incredible birth doulas at my birth, this amazing midwifery team.  And those outcomes happen, and we had one of those bad outcomes.  And so my daughter was born not breathing and spent three weeks in the NICU.  And as a result of that, has cerebral palsy.  And so learning the motor planning of how to eat was our biggest barrier in leaving the NICU.  So we left the NICU with me pumping and her bottle feeding, and then I pursued nursing directly for a good while, and we had her tongue tie revised and I was working with really phenomenal lactation consultants and finally came to a place where I was like, this is actually not helping.  Like, I – we had so many appointments.  We had so much going on.  I really needed sleep due to the PTSD that I was navigating at the time.  I was really physically ill.  And so I just – so I took that off the table, and I’m really proud of that.  And one of the things I talk about in the book is that it is good parenting to change your mind with the circumstance in front of you.

Kristin:  Absolutely.

Victoria:  And so I was so proud of that and then continued to pump for nine months which, to some degree, I regret.  It was really negative for my health.  And – but it was the one place where I had control, and it was so symbolic of who I was as a professional.  So walking away from all that and with this much broader understanding of ableism and bodies and the way – like, the sheer – I think I say in the book, the sheer breadth of human experience that was just blown wide open for me in having my daughter, and so when the pandemic started and we locked down, my therapist told me that I needed something that was just about me.  I had spent coming up on three years with total focus on my kid’s therapies and her needs and solving the complex problem that was having a disabled kid, and she really encouraged me to walk away from motherhood as a problem to solve and find something that was just for me.  And so I started writing.  And so the book came out a little bit memoir, both mine and that of other families.  I really wanted to tell the stories of the complexity of our families and not sort of these – you often see in parenting books these little snippets of, like, Janet’s baby slept through the night at three months, and it was wonderful.

Kristin:  Right, but the real story is the hardships are not shared as often.

Victoria:  Yeah, you don’t hear about the fight she was having with her mother-in-law and, like, the depth of the pain of the miscarriage that she was still carrying with her and all of those pieces.  And so it was really important to me to share really diverse stories with a lot of depth throughout the book.  And then also I was writing a book that we need, that I had always had in my head, that I was forging a new path where I think the part of it that is most important to me is the everything in between, that for so many people, the journey into exclusive breastfeeding actually involves a lot of bottles and formula and pumping, or the road through weaning involves those things, or the transition back to work revolves around those tools.  And so one of the things that was a beautiful gain of having a disabled child and being welcomed into this world of understanding disability was understanding that all tools are neutral, that a wheelchair isn’t bad.  It’s a tool.  And a communication device is a tool, and medication can be a tool.  And tools are all neutral.  A flathead screwdriver and a Phillips head screwdriver are morally neutral.  And so can we move into a place where we can say, like, okay, all things being equal, like, human milk that a parent makes for their baby is species-specific, and that’s pretty groovy.  And we have made this other incredible biomedical tool that we can use, and we can use those tools in a way that really honors those individual experiences.

Kristin:  Exactly.  I mean, you are speaking to me 100%.  My doula agency is focused on unbiased, judgment-free support, so no matter how you birth, parent, feed your baby, we just want to support families, so this book is so needed.  I feel like there are people in the camp of formula is more convenient and better, or pumping is the way to go, and then there’s of course breast is best as long as you can, and there’s so much judgment in feeding and also how we parent.

Victoria:  And then the other part of it with feeding in particular is even if we step outside of that judgment piece, we’re the tools.  You know, like people – we actually, in my opinion, are number of ways of feeding babies, the number of variables we’re managing, be that, like, brand new pumps hitting the market every 45 minutes, the one true upside of the formula shortage being an influx of different kinds of formula.  We’re starting to see a little more diversity in our formulas across the board, as well as, like, a really wide range of how we navigate work, right?

Kristin:  Yeah, and I love that you cover those different types of formula in the book.  The goat’s milk and European formula versus – yeah.

Victoria:  Because unless you really know where to find those people on the internet, you’re not going to find that info, and the Facebook groups are so overwhelming that I wanted people to be able to get – like, I just really wanted to get all the way out of the why you should feed your baby one way or another and get way into the how.  And I sort of – for me, I likened it back to birth where I had the incredible experience of my best friend is a trained midwife, an infant massage therapist, a tattoo artist, and an illustrator, so she actually illustrated the book.

Kristin:  I love the illustrations!  That is so wonderful.

Victoria:  Aren’t they stunning?  Yeah, in love.  So talented.  And she also taught my childbirth ed class.

Kristin:  Love it!  So talented.

Victoria:  So unbelievably talented.  And taught the class from this perspective of, instead of not learning about birth tools because you’re scared that someone will foist them upon you, learn about them so that if you need them, you can make those tools.  And I happened to have a birth – I was in active labor for around 72 hours.  Quite active.  And so I needed all the tools.  There was not a tool – I guess we didn’t use a vacuum.

Kristin:  Yeah, that’s a long labor.

Victoria:  It was a long labor!  I used every tool that that hospital had to offer, and knowing what they were and what they did was enormously helpful in making those decisions because it’s not that those tools are good or bad.  It’s that they have different impacts depending on when and how we use them.

Kristin:  Exactly.  100%.

Victoria:  And that’s also the case with formula, right?  If we indiscriminately use formula on day two after having a baby because we have a perception of low milk supply, even though low volumes are physiologically normal at that point, it’s going to disturb production in a really different way than at six or eight months, which is not to say it’s wrong to do that at day two, but we need to understand the how of that tool.  And so I really wanted to get into, like, really concrete stuff for folks at two in the morning, and that’s such a funny thing in 2023 to, like, not be an Instagram star, not be all over my Facebook group, but rather to make a book, which is so old school, but it’s so concrete.  It’s just like this is one thing.  It is, like, one voice that covers all of the things.  And so it just cuts through a little bit of the chaos.  And then the other piece of it that I love, my favorite part of the book, is that there are QR codes to videos because I can tell you that nursing a baby is like eating a taco, not drinking a Slurpee, and I can show you an illustration, but to see a video of a real newborn actually latching is just a different thing.

Kristin:  Totally, and the paced bottle feeding video – all of it is so needed.  Like, the different holds that you illustrate.  It’s excellent.  It’s a way to modernize a book.

Victoria:  Exactly.  And it allows me to show different bodies and it – if you’re like, I’m confused.  I’m overwhelmed.  It’s just right there.  You don’t have to search for anything.  You’re already holding your phone, and it’s just right there.

Kristin:  Instead of scrolling the moms’ groups, you have actionable videos at 2:00 in the morning.  I love it.

Victoria:  Yeah, and there’s so much – because of the privacy stuff and, like, the nature of bodies, a lot of that stuff will get filtered and so you end up with things like dolls or not really showing people’s chests.  And so it also gives me a way to not have to worry about any of those filters and instead just, like, actually really show what people need.

Kristin:  So excellent.  I can’t wait to share this with the students in my Becoming a Mother course and our clients.  So thank you for taking the time to make such an impactful book!

Victoria:  I really hope it is impactful.  I hope it brings in a new generation.  Some of the formula companies are starting to catch on to this messaging of neutrality, but there’s still an ulterior motive there.

Kristin:  Of course, to make money.  Their brand.

Victoria:  Yes, and it’s still not neutral to lots of pads and everybody in, and I just really – like, I wanted a book that dads could read.  I wanted a book that grandparents could read that was really going to open that up for everybody.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Kristin:  Exactly, and I love that it’s so inclusive.  Adoptive families, LGBTQ+, and also even getting into the plus size category that is not often covered, and we – my doula team recently had a training on supporting plus size families both in birth and postpartum, and it was eye opening to really learn some of the biases that are faced, not only in birth, but also with feeding.

Victoria:  Absolutely.  I mean, the medical bias around large and fat bodies is really something you need to take a hard look at, and bodies are different.  Like, that is one of my things is that the different shapes and sizes of our bodies actually impacts the ergonomics of how we feed babies.  And so we have to be direct about that.  You actually need different holds.  They’re going to be different depending on the size of your body.  And the function and recovery, depending on the kind of birth you’ve had.  There’s all of these pieces to it, and I will say that is one regret in the book.  While I do have beautiful illustrations of holds of larger bodies, I was not able to find the right dyad for the videos, and I really wanted to do that well and not just sort of grab whomever to do that.  And so one of the things that is great about QRs, though, is that the QRs are basically just an address to a door, so I can change what’s behind that door.  So once I find the perfect team to include in there, to include those larger bodies and those other positions, I will update the video and change that on the back end because that is so important to me, and I was really grateful to the folks who were gracious in allowing my illustrator to illustrate those different holds and those larger bodies in feeding and really honor fat pregnancy and fat postpartum, and I feel really grateful for that and I look forward to continuing to push that envelope because it’s not my experience.  I am straight sized.  But it’s something that I think about a lot.  And on the other end, we don’t see a lot of images of how to nurse with a really small chest, and people with pretty flat chests, as well, so that is another thing that I want to find just the right person and include more of that.  But I do, in the topography of chests, have those smaller chests represented because I think it’s important for people to be able to see the difference between small chests that make enough milk and chest shapes that tend to indicate physiological low production, because it’s a really subtle difference that I find that many practitioners don’t know, let alone parents.

Kristin:  Right, so true.

Victoria:  So one of the things that I really want to get across in this book and in this work is how are we preparing for feeding?  We do so much preparation for birth, and then we sort of assume that feeding will fall into place.  And so how are we preparing?  And the classes are phenomenal.  What is missing from a class is you don’t, generally speaking, take your shirt off in breastfeeding class.  So having that information of, like, how do you take stock of your own anatomy before you have a baby, as well as really taking a medical history of your chest and having a conversation about that medical history with your provider if it’s relevant.  So if you have had surgery on your chest or armpits, if you have had augmentation or reduction, if you have flat nipples, if you have very wide spaced chest tissue, all of those things are things that it would be helpful to talk through with your practitioner before you have a baby.

Kristin:  Absolutely.  And you’re right, that’s not discussed oftentimes.

Victoria:  No, and it’s really hard to process that information when you have a tiny baby in front of you.

Kristin:  Yes, and you’re exhausted.  Again, even talking about your own labor being multiple days and just learning as a new parent, or if you have other kids at home, every baby and every birth is different.  And so I found that with my own kids and their feeding journeys.  I had different struggles and still had to seek lactation consultant help.  My son had a tongue tie, and my daughter was in the NICU.  I had preeclampsia and had an induction, and she needed about four days for glucose issues.  So I was pumping and she had formula and an IV, and then had to get help to transition to breastfeeding.

Victoria:  Well, and the postpartum care for preeclampsia is also often very intense, which we don’t talk about very much.

Kristin:  No.

Victoria:  We don’t talk about the impact of hemorrhage, both psychologically and physiologically, and we don’t talk about the impact of preeclampsia physiologically and emotionally because it’s really something for those of you who have never had the experience of being on magnesium, which I have not personally, but having worked with clients who are on a magnesium IV, it’s like watching someone try to swim through concrete.  And so being in a state where, as a human, as a mammal, you just want to get to your baby and your instincts are all to care and feed, and your body feels like you’re swimming through concrete.  That really is traumatizing.

Kristin:  Absolutely.

Victoria:  Not to mention, either someone is going to have to help you express milk in that state, or it’s going to impact production, and that’s also really challenging.

Kristin:  Yes.  And then getting all of the judgment on how you should feed your baby from family and friends.  Oh, just stick with formula, or I breastfed, so you need to.  I was hearing so many different opinions as a new mom.

Victoria:  Yeah, and it’s actually just more complicated, right?  Maybe your family is very well meaning and saying, oh, just take care of yourself.  You need to recover.  But maybe your instinct is that part of your recovery is that reconnection through nursing.  So it just actually is always more complicated than that, and how do we honor both?  How do we sit in that in our discomfort with that middle, and that’s what attracted me to that phase of life anyway is that it’s messy and it’s problematic, and there’s not simple answers.

Kristin:  Yeah.  And like you said, Victoria, I mean, preparation with a breastfeeding class, having conversations with your provider, reading a book like Feed The Baby and getting as prepared as possible, and again, I felt like I needed to prepare both times and still even with being someone who plans, there were so many unexpected twists.  Like, again, the tongue tie with my second child that was causing pain that I hadn’t experienced before, and I was tandem nursing, and so I had the supply, but you just never know.

Victoria:  Yep.  The tongue tie piece is so complex for people.  I work in a tongue tie clinic that I started with a dentist because I was looking for a dentist with really strong ethics, and she was like, oh, that’s interesting.  I did a PhD in infant suck physiology.  I was like, okay.  Great.  You want to come take this tongue tie course together?  She’s amazing.  And then my illustrator and body worker also was in collaboration of starting that clinic, so our patients get to see a body worker, a dentist, and an IBCLC all in one visit, which is really helpful to people because one of the things that is so difficult with tongue ties is that you really need a functional assessment.  It’s not just about how it looks.  It’s really much more about how a baby is able to move their mouth, and the appearance really changes a good bit in those early weeks.  And so depending on when a provider looks at it and who looks at it and their level of training, you’re going to get really different answers.  And that is really confusing for folks.

Kristin:  Absolutely.  It is, because you don’t know which individual to listen to.  I have that with my birth doula clients.  They get different advice from the lactation consultant at the pediatrician’s office than they got in the hospital.  So it’s like, who do I listen to?  And then of course if they have a postpartum doula in their home who’s trying to support feeding and give referrals, you just – it’s overwhelming.

Victoria:  It’s very overwhelming.

Kristin:  The information doesn’t align.

Victoria:  Yeah.  Once your son’s tongue tie was resolved, did nursing get better?

Kristin:  Absolutely.  It was a breeze after that.  It was just identifying, and it got a misdiagnosis at first, and my pediatrician caught it, but it wasn’t caught in the hospital.  Yes, so it – I had no issues after that.

Victoria:  That’s great.  And that’s another thing I remind parents, that pain is your body communicating with you.  So while pain is common, it is always a sign that you need more help.  So any time you’re in pain, even if one provider brushes you off and says that looks normal, if you’re still in pain, to continue to pursue the people who are trying to find the answer for why you’re in pain.

Kristin:   Absolutely, Victoria.

Victoria:  Parents are tough.  Like, I have seen parents tough out all manner of things.  And as long as their baby’s gaining weight, they’re fine.

Kristin:  Right, because that’s the goal is to gain.

Victoria:  But you can do real damage.  You can do real nerve damage to yourself, pushing through that.  And so I always want people to listen to their own pain.

Kristin:  Great advice.  So what are your tips for partners and family members in supporting feeding?

Victoria:  Well, unfortunately, it’s the advice that’s hardest for me to listen to myself, which is to try not to fix and to listen and respond and to really ask people, like, are you wanting to vent right now?  Do you want help solving this?  Do you want help finding someone to help solve this problem?  Because sometimes you’re just in it, and you just need to be upset about it.  And our inclination to problem solve sometimes from the outside can feel undermining.  And so to just sit in that question with somebody and be like, okay, let’s go find a provider to give us advice to lead to where you want to be going instead of, like, you’re in pain, this is too hard, you should switch to formula.  Really sitting in that with your partner, I think, is really important, or as a grandparent or a support person, to really try to get out of our own desire to solve the problem and instead sit in it, which is probably the hardest thing for me, which is why I’ve positioned myself to be the person people go to for the solving.

Kristin:  I love it, yes.  That makes sense.

Victoria:  And then the other thing I want folks to learn about is protected sleep.  This is my big soap box is that difficulty with feeding causes or exacerbates postpartum mood disorders.

Kristin:  It does, yes.

Victoria:  And we have a tendency to focus only on postpartum depression.  Like, we actually use the word postpartum often too stand in for depression.  And that is a tiny slice of what is a much bigger picture of often anxiety, postpartum PTSD, intrusive thoughts, which is sometimes part of obsessive compulsive disorder, which we think about as, like, cleanliness or light switches going on and off, but is actually intrusive thoughts, and those intrusive thoughts are often because of the nature of that mood disorder, the scariest thing we could possibly say out loud.  And so then we don’t tell anyone that it’s happening because often those thoughts are something like, what if I leave my baby in the car?  What if I roll over my baby, and it makes it sound like you want to harm your baby, and you don’t.  You’re having intrusive thoughts that you might.  Right?  And those are really hard to spot.  And so if you notice that your partner or your child, if you’re a grandparent, or your bestie is off, is just, like, generally pretty off, the first line of defense is to say, hey, if they’re nursing, like, nurse and pump, and then I want you to go to bed.  One bottle of formula today is not going to rock the world, or if there’s some feeding stash, and put that person to bed for ideally six hours but at least four.  White noise, no phone, you are not getting that person.  Like, you can take care of that baby for six hours.  Nothing catastrophic is going to happen in six hours.  And if they wake up from that nap and feel better, then we can make a plan involving that person getting more rest or if they’re not able to sleep or wake up and are still feeling badly, it’s time to seek help.  So your first easiest place to get help is the 24 hour line that you use for your birth practitioner.  It’s the same line we’re going to use if you have mastitis.  And you’re going to go ahead and call them and say that you need a referral for postpartum mental health for that individual.  And then start working on a plan from there.  But that protected sleep can be both therapeutic and diagnostic, and I feel like people don’t know enough about that tool.

Kristin:  I’m so glad you brought up sleep, Victoria.  It’s essential.

Victoria:  It’s so essential.  I mean, as postpartum doulas, we are the facilitators of that sleep, and so we know a lot about protected sleep, but you really don’t hear about it much in the common consciousness.

Kristin:  Right, exactly.  And with feedings, the rest is interrupted, and so to get a solid block can make a huge difference.

Victoria:  Exactly, and if it doesn’t, then we know there’s something happening chemically that we really do need to take a hard look at.  And I myself was pretty aggressively, I would say, medicated for my postpartum mood disorder and needed to be.  I had very severe postpartum anxiety and depression and suicidality, and my word to folks in that experience is that there is treatment.  It’s safe and well-tested, and you deserve to feel better.

Kristin:  Exactly.  Thank you so much for sharing!  I feel like we could have ten different podcasts on all of your knowledge.  But I would love to have you share more info on Feed the Baby, how our listeners can purchase your book, and all of the sites that you’re on as far as purchasing options and bookstores that you’re in and so on.

Victoria:  Yeah, so I’m probably at your local bookstore.  Feed The Baby is on Bookshop and Amazon and your Target app and all of those things.  You can have the book right now digitally or overnight it from Amazon if you’re in that situation right now, or you can go ahead and get it from your local bookstore if you’re anticipating a baby.  And you can find me – I’m mostly on Instagram, @victoria.facelli.ibclc.  I’m attempting to be on TikTok, but it’s a stretch for me.

Kristin:  I have an issue with TikTok as well.  I feel like I’m just too old for it.

Victoria:  I know, yeah, exactly.  I’m trying to get into it, but it’s not my comfort zone.  My comfort zone is definitely Instagram, like the millennial I am.  But yeah, that’s where you can find me.  My website, victoriafacelli.com, where you can find some of my videos, as well as on YouTube.  Paced bottle feeding bodies, SNS, some info about poop transitions and kind of what to look for in baby poop, all that stuff, is up on YouTube.  So those are all the spots where you can find me.

Kristin:  Excellent!  And any final thoughts to share or tips for our listeners?

Victoria:  My big final statement in the book and in my heart is that I hope you feel like enough, because you are enough just as you are, and you are enough as a parent beyond how you feed your baby.

Kristin:  Love it.  So true.  Thank you, Victoria!  It was so amazing to chat with you today.

Victoria:  So great to talk to you!  Take care.

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

It’s the 200th episode!  Alyssa Veneklase and Kristin Revere answer questions from listeners and share fun stories about how Ask the Doulas came to be.  You won’t want to miss this one!  You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you find your podcasts.

Welcome.  You’re listening to Ask the Doulas, a podcast where we talk to experts from all over the country about topics related to pregnancy, birth, postpartum, and early parenting.  Let’s chat!

Kristin:  Hello!  This is Kristin Revere, and I am joined today by Alyssa Veneklase.  We are chatting about our 200th episode.  Hey, Alyssa!

Alyssa:  Hey!  That’s wild.  200.

Kristin:  I know.  I can’t even believe it.  So just thinking back, you know, we launched the podcast in November of 2017, and Ask the Doulas originally started on a radio show, Radio for Divas, and then we shifted to the podcasting platform.  So, yeah, a lot has changed, and it feels like just yesterday that we had our 100th episode and celebrated that.

Alyssa:  Yeah, it’s so weird.  It seems like a lifetime ago that we were – I’m having flashbacks of sitting in that radio booth, and I don’t remember what made us change our minds and say hey, we can just do this ourselves.  I wonder if podcasts were kind of, like, really becoming – I don’t know, more well known at that time.  What was it, like six years ago?

Kristin:  Yeah, so podcasting was coming up, and Monica Sparks, who runs Radio for Divas, actually suggested in when we just couldn’t schedule the live shows due to my full time job at GROW.  And so we were trying to work around all of that and decided with her advice to start the podcast.  And I remember ordering our microphone and speakers, and you did all of the editing back then.  We now have an editor, but it was a lot.  And we started by wanting to, again, like, show our clients and listeners some experts.  So we chatted with each other in many of the original episodes but also brought in local experts, everything having to do with pregnancy, birth, and early parenting.  So I know you had some awesome interviews related to mental health and pediatric dentistry, and I had some of our students come on and talk about HypnoBirthing and some of our birthing postpartum clients came on and shared their birth and postpartum stories.  And then again we brought in different experts.

Alyssa:  I think it’s great to have them as a resource.  I just used a podcast the other day – I had a call with a student in my newborn survival class, and they asked me specifically about how to get their dog prepared for this new baby, and I am by no means a dog expert, so I just referred them to the podcast and said that’s all the information you need.  It’s so much great info.  It took me two seconds to search it on Google and give them the episode number.  So it’s just really nice to have all this backlog of so much information and so many resources to share with people.

Kristin:  Right, and now 200 episodes of information and expert interviews.  We transcribe our podcast into a blog, so we’re able to share it, and I often share what to pack in your hospital bag and quite a few specific to my birth doula clients.  And then with our Becoming A Mother course, we share episodes that are specific to what our students are looking for resource-wise, everything from safe sleep to having now the opportunity to interview national experts.  With the pandemic, we weren’t able to have our local experts come in to our office for interviews, so we started reaching out to experts across the country.  So it’s really opened things up for us.  Many authors have been on and national, well-known experts in the birth and parenting space.  Like Dr. Berlin was one of my favorites, and getting into a lot of the maternal health crisis and interviewing experts in that space.

Alyssa:  Yeah.  Well, I know we’ve got several questions that we can go over, but do you have any quick stats you want to share from where we started to where we are now?

Kristin:   Yeah.  So one thing that really stood out to me is when we started, we basically just set up interviews whenever we were able to bring in experts.  So some months, we would have two episodes in a month, and now we’re on a weekly basis.  So we release our episodes every Wednesday and have interviews with each other or experts in the birth and baby space every week.  But as far as interesting stats, we recently ranked on Goodpods as Number 12 in the top 100 in the indie kids and family chart, and then 52 in the top 100 overall kids and family.   That’s pretty amazing.  And then Feedspot has consistently ranked Ask The Doulas over the years, but we are currently, for their 2023 stats, at Number 6 in the Top 15 best doula podcasts, and we are ranked from thousands of doula-based podcasts based on traffic, social media follows, freshness, content, and more.  So pretty exciting!

Alyssa:  Yeah, way to go!

Kristin:   I know, go us, and cheers virtually as we’re recording this.  Many podcasts don’t make it to – this is a huge milestone.  And many record a few episodes and then pause and get back into it, so –

Alyssa:  Well, as we know, it’s a lot of work.  I think just because you have some good stuff to say, you may not understand on the back end how much work it takes, so I think that’s why a lot of people might try it and just give up.  It’s really hard.

Kristin:  Yeah.  I mean, you know because you did all the editing.  So it’s one thing to set up the interviews and record and get fresh content and get excited about podcasting in general, but then there’s promoting the podcast and getting ours up onto a blog, and like you said, there’s so much work, and I think especially because podcasting is trending right now, that everyone sort of glamorizes it.  But that’s very similar to our profession as doulas.  People get into it and think that it’s easy and exciting and want to change the world, and then you get into it, and you’re on call, and you miss birthdays and holidays, and you really have to commit to it.  So we asked our listeners some questions about what they wanted to ask the doulas because it’s rare that we get on a podcast together anymore.

Alyssa:  Right.

Kristin:  So why don’t you pick out a question to answer, and then I’ll do the same.

Alyssa:  I’m going to combine two sleep ones.  So, as usual, there’s a ton of sleep questions because people love sleep.  So I’m going to combine this one that says: What are some signs that indicate my baby may have a sleep problem, and when should I seek professional help?  I’m going to combine that with: What are some common misconceptions about baby sleep?  So in this question, you know, my – how do I know if my baby has a sleep problem, I think that in and of itself is a misconception because a problem to one parent might not be a problem to another.  So one family could choose to co-sleep or have their baby in their room for a really long time and feed throughout the night and feed their baby to sleep, and that same scenario to another family might be a problem because family A chooses to do it – maybe one of the parents stays at home, but family B, let’s say both parents work, and they need to have a little bit more structure and they need to sleep at night.  So for family A, what is their choice and is not a problem could be a problem for family B.  So it’s really hard to – it almost gets to that point where we feel like we’re judging other people, and I don’t like that because there is no right or wrong way.  It’s whatever works for you.  So I always tell parents, if it’s not a problem for you, don’t fix it.  Just because someone else says, oh, my gosh, your baby doesn’t sleep through the night yet – well, if you’re getting enough sleep and you’re happy and your mental health is okay and your baby is getting enough sleep and they’re thriving, then I don’t see a problem.  Where I see problems is usually mother’s mental health is suffering.  She’s exhausted.  If mom does have to go back to work, her work is suffering.  Oftentimes I see a partner who is sleeping in another room.  Maybe they’re three children in and they haven’t shared the same bed in years, and mom hasn’t slept a full night of sleep in years.  So when you really start to feel that exhaustion, that mental exhaustion, the physical exhaustion, I think that’s a problem because sleep is critical to our mental health and for our little babies who are growing exponentially, sleep does wonders for them to grow, to build their immune system, to help regulate their emotions.  It’s like the number one wonder drug that’s free.  So I think sleep is just the most important thing.  So, you know, if you do think that you’re – as a parent, you’re struggling, you don’t think your baby’s getting enough sleep – let’s just say they’re fussy all the time.  Maybe they’re so fussy that they won’t even eat.  Then you try to put them down to sleep, and you know they’re tired, and they just won’t fall asleep, either.  Those are typical signs of an overtired baby.  The more overtired they get, the harder it is for them to fall asleep.  Seems really counterintuitive, but that’s just the way it goes.  So calling a sleep consultant right away – the longer you wait, the harder it is.  So typically, three to four months, depending on your baby, is a really good age to start.  If you’re seeing those signs and also feeling the fatigue yourself as a new parent, three to four months is a really, really good place to start.

Kristin:  Exactly.  And you have an amazing class based on different age groups called Tired As A Mother.  Love the title.  And you do some sleep consulting in that recorded class content with live Q&A calls.  And then we also cover a lot of sleep in our Becoming A Mother course.

Alyssa:  Yeah, we’ve got a whole module on that, which – I think it’s the last module, Number 6.

Kristin:   Yeah, it is.

Alyssa:  And then my Tired As A Mother class, I’ve got broken down into three different age groups because like I said, every baby is different, but based on their age, they’re going to have different sleep needs.  And I know that some families just aren’t ready for a sleep consult yet, or maybe they don’t have the resources, so this is a $50 class with a ton of good information, and then a quick phone call with me to ask specific questions.  So it’s a really good place to start, and I think if you took all three classes from pregnancy – while you’re pregnant, take the first one, up through toddler – that’s only three classes, and if those things I tell you, those tips, those tricks, you actually follow them and figure out how to use those for your baby, I think you’d be in pretty good shape without actually having a full sleep consult.  Some parents need both.

Kristin:  Exactly.  It just depends.  If you want your hand held, then reach out to one of our sleep consultants at Gold Coast Doulas.  Or if you feel like you’ve tried some of the books or listening to other podcasts on sleep and really want something a bit more customized for ages and stages, and knowing that they can have a call to get their individual questions answered, just like our Becoming students get monthly calls with us and have the ability in our private group to ask questions if they’re struggling with sleep issues, newborn concerns, feeding, birth prep, whatever it might be.

Alyssa:  Well, that’s the thing about sleep deprivation is even if you think you have the wherewithal, I’ve done sleep consultations for pediatricians who are like, I know all this stuff.  I am just so exhausted, I cannot put this into practice.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Kristin:  All right, well, thank you for covering those sleep questions from our listeners.  I feel like, again, whether it’s a course, for our clients sleep is really the most mystifying aspect of the work that we do.  Yeah, you can’t just follow a manual.  Every baby is so unique in their needs, and a lot of it has to be customized.

Alyssa:  And parents put so much pressure on themselves and other people around sleep when it’s really not that hard when you know the basic rules, and that’s what I try to teach, just the basics, so that parents can just get on with their lives and be rested and not worry so much about the minute little details.  I definitely try not to make it harder than it needs to be.

Kristin:  Exactly.  So on to some birth-related questions.  I’ll tie two of our listener questions in together.  The first one is, what are some common misconceptions about childbirth that new parents should be aware of?  And the second part of that is what are the benefits of having a birth plan and how flexible should it be?  So great questions!  First of all, misconceptions – I’d say the biggest thing is that you can just wing it for your birth.  And some of our clients do, as far as not taking childbirth prep or breastfeeding classes or the newborn survival class that you teach, Alyssa, but it is something that requires conversation between a couple and some discussion with your provider to make sure everyone’s on the same page and just some basic understanding of what your body is going through during labor, regardless of how you choose to give birth, whether it’s an unmedicated home birth or unmedicated hospital birth or wanting an epidural as soon as you arrive at the hospital, or even a planned surgical birth.  I tell my clients so often that birth is as mental as it is physical.  It’s like a marathon in that you train for it, so focusing on nourishing your body, hydration.  You need to drink water during labor.  Focus on your breath.  Stay calm.  And at times, where you get tired if the labor is lengthy, or even those quick births that can be very intense and tiring, really focusing on your goal of meeting your baby or in the case of twins and triplets, babies.  And so yeah, just understanding that there is a correlation between the mental preparation and the understanding of what your body is physically doing during labor.  And so on to the second part of the birth plan.  And so again, you don’t need a birth plan, but I do tell my clients that it’s helpful in many cases at those prenatal appointments with your midwife or your doctor to have that discussion of what your wishes are.  Everything from your actual birth preferences, any interventions that you may want discussion on, if it’s not an emergency, newborn procedures, feeding preferences.  All of it is very helpful.  I’m not a fan of a four-page birth plan, and I do agree that they should be flexible because birth is unpredictable.  Even if you took every childbirth class, watched every documentary on birth, and read every book, you still can’t guarantee that you’re going to have your birth plan 100% go the way you want it to.  And so understanding that some flexibility is needed, but also just having that discussion point between your provider, helping your partner, or anyone else who’s in the room, like whether it’s a doula or a family member, on what your wishes are.  Some of our HypnoBirthing students don’t want a lot of chatter in their room, for example, so really wanting the space to be peaceful and quiet.  So those side conversations that sometimes happen during labor may be something that you want to avoid.  A lot of hospitals, at least in our area in West Michigan, have these really easy checklist templates.  Again, having that conversation with your provider, making two copies, giving them to nurses, and having your partner be on board with your wishes, as well.

Alyssa:  Yeah, I think with birth plans, it’s kind of the same as sleep.  Like, we put a lot of pressure on ourselves and say, oh, my gosh, this is my plan, and it didn’t go as planned.  Well, welcome to parenthood.  I love structure and I love knowing what’s happening.  I love planning.  I’m a spreadsheet girl.  But parenting is one of those things that made me realize, I have very little control over this, and you just kind of have to roll with it.  Like you said, plans are great.  Keep it simple, and know that you didn’t fail if it doesn’t go 100% as planned.

Kristin:  Yeah.  And then as far as other misconceptions around childbirth, focusing on those conversations, if you have a partner, with your partner, that they’re just going to know what to do magically.  Well, partners don’t, so having – in my Comfort Measures class, there’s a lot of couple conversations, and we talk about fears related to birth or what their individual goals are, and couples are often surprised at the others’ feedback, whether birth is gross or it’s a natural event or it’s a religious experience, like I have them just check of boxes and go around the room, and there’s often some surprises.  And it really starts that conversation between the couple going, so they’re on the same page and the partner understands how to support their loved one because if you don’t talk about it and just expect them to know what to do, especially if it’s the first baby, it’s not really going to happen.  So doulas love to do those whispers in the ear and give partners ideas of, like, hey, suggest some different positions or have her drink some water and different things, so they end up being the rock star in the birth.  And otherwise, partners – men want to be helpful, and if they don’t know what to do, they end up just standing around, and then there can be some resentment from that, like, oh, he’s not helping me.

Alyssa:  Right.

Kristin:  So yeah, so I would say those are the biggest things is really having those relationship discussions, getting on the same page, and then having some sort of plan, even if it’s just checking a few boxes, and nurses love to understand how to better support their patients, as well, because they never met you in many cases, and there’s a relationship with your doula or team of doulas, and many conversations throughout pregnancy.  But, you know, from my labor and delivery nurse friends, I’ve found that they appreciate some basic information on how to best connect with and support their patient.

Alyssa:  Yeah, totally.  You don’t know it.  That’s what our whole everything is about.  We want families to feel like they know what they want and what to expect, feel empowered.

Kristin:  Yeah, that’s what it’s all about.

Alyssa:  Like the experiences we both had – I mean, that’s the whole point of it.  We want families to know they have resources.  There’s so many resources available, and not all of them cost money.

Kristin:  Yeah, not all of them cost money, and if you don’t know your options, then you don’t have any.  So that’s why we do so much education.  I think we can expand – there are some relationship based questions.  We could take, you know, the birth question and just get into overall maintaining that strong relationship with a partner while navigating a new baby and the change in the family dynamic, whether it’s baby number one or adding baby number four.  What are your thoughts on that, Alyssa?

Alyssa:  I mean, we kind of already touched on the communication piece.  You know, in my newborn survival class, I talk about communicating from the beginning, because it gets really hard to do once you have a newborn, and then if you have a newborn and a toddler, your relationship can suffer because it seems like last on the list.  So communication is always key.  And I know some people aren’t communicators, so that may take some extra work.  It may take seeing a therapist to figure out how do I talk to my partner.  Whatever you need to do to make that happen because if you’re expecting something of your partner but you haven’t told them that – we as women especially can be really good at that – well, why didn’t he read my mind?

Kristin:  Exactly.

Alyssa:  Well, they can’t, as much as we want them to.  They can’t.  So communication is really key, and some – I feel like some – again, women especially, we are afraid to ask for help.  We want to ask for help.  I’m not personally afraid to ask for help.  I just never do.  I have this mindset of I can do it myself.  Then after a baby, I just got so tired and so worn down, and I remember saying something to my husband, and he was just like, well, why didn’t you ask me?  Like, all you have to do is ask.  And part of us just expects that they notice and fill in, but he’s like, all you had to do was ask.

Kristin:  Right.  Again, they’re not mind readers, and having some helpful things that family members can do when they visit are also – especially with things opening up more, and there aren’t visitor restrictions currently in hospitals, so setting some boundaries and having the partner be involved with their family members about how many visitors you want in your labor space or to come visit you in the hospital or how frequently – again, as you mentioned, Alyssa, the focus on sleep and bonding with baby and healing and feeding, like all those things.  So it can be helpful to have that discussion early on about what you want as far as visitors and if you are accepting visitors on a regular basis, like how they can be helpful.  Unloading the dishwasher, for example, or running some laundry or picking up some things from the drugstore can be helpful versus just feeling like you need to entertain and have your house be spotless and be dressed for company.  All of the things that we worry about as mothers when having people in the home, especially certain personality types that want to entertain and please other people.  It can be really hard for them.

Alyssa:  Yeah, I think for families who – say they don’t have the resources to hire a doula, because this is the type of stuff we go over with them, right?  Birth and postpartum.  Gold Coast offers so many classes that if that’s a better option – you know, we still educate you on all this stuff, like how to best communicate with your partner and your family and your friends and with hospital staff.  We go through all this at a pace that you can just go through on your own, and it’s a cheaper option with still a ton of great information and a ton of great resources.

Kristin:  Exactly.

Alyssa:  So maybe – you want to just give the website information and tell people where to find us?  Because between our website and all of our classes and all of these podcasts, if people could just find those alone, there’s so much information there in the Gold Coast Doulas website.

Kristin:  Yeah, and we have a YouTube page.  You have some awesome swaddling techniques and paced feeding.  Our website is www.goldcoastdoulas.com, and you can find a link to our Becoming A Mother course there or your Tired As A Mother sleep class, our virtual sleep consultants, and all of our services and classes, whether it’s virtual or in person.  So yes, and then our podcast can be found on our blog page at the Gold Coast website, but we’re on every podcast player, and we certainly appreciate all of our listeners for sticking with us.  200 episodes is huge, and it’s all thanks to you.

Alyssa:  Yeah, thanks everyone for listening.  Subscribe; forward this to all your friends and family who are pregnant or thinking of getting pregnant.  We would love to have them listen, as well.

Kristin:  Thanks for your support!  Take care!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.