gold coast doulas

Kristin and Heidi discussed her yoga studio’s expansion, including child care and a co-working space.  They also discussed Heidi’s contribution to the fitness section in our upcoming book release, Supported: Your Guide to Birth and Baby.   

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am thrilled to bring back Heidi McDowell of Mind Body Baby to chat about so many topics today!  But the overarching theme is going to be focusing on creating community and certainly addressing the childcare struggle that moms have, that birth and baby and health and wellness practitioners have in building businesses and making appointments.  Welcome, Heidi!

Hi, Kristin!  I’m happy to be here!

Yes, I’m so excited to chat about your news related to solving some of the challenges with childcare and expanding your own practice!

Yeah, we are really excited to be able to announce that we have purchased with the intentions of expanding into a new 8,000 square foot facility.  We’re calling it a Mega Mom Center.

I love it.

It’s titled the Mind Body Baby Collective.  We are partnering with other women-owned, women-operated businesses to support moms, families, women who are really excited for what we have in store.

It’s so exciting, and Mind Body Baby has always provided childcare, not only for your employees, but for your students, and you are solving this childcare issue by providing it for all of the members of the collective.  So you have massage therapists, doulas, a chiropractic practice – so many different businesses can benefit from the dilemma that those of us doing this work faced when we had young children.

Yeah, absolutely.  It is that two-pronged approach.  Not only is the center operating child care for our services, so Mind Body Baby and everything that we have, like, but we are offering childcare for the entire facility.  So anybody that is within the walls of Mind Body Baby has the opportunity to utilize childcare.  My thought has always been, why do we have to choose between self-care and childcare as a community in a country that is considered to be one of the wealthiest?  I think that we’re really failing women and mothers and families when it comes to the level of support that we offer, and most times, whether it is somebody that’s in the same field of birth work or support, or whether it is that you’re just a mother, you do have to choose.  How are you spending your time?  Do you have access to affordable childcare?  And we’ve noticed that being a barrier for people for being able to, one, provide care to return to the workforce, or to be able to get the self-care that you need and want.  So we’ve opened this space, and we have created a beautiful childcare, and whether it is somebody that is coming in to provide the self-care or somebody that’s coming in to receive the self-care, you have the opportunity now to utilize childcare to allow your child to be cared for by a professional in a space that is safe, that you feel comfortable, and you don’t ever have to wonder or worry if they’re getting what they need because they’re having fun with other kids while you get what you need.

Right, while you get a massage, or take a class that’s not a mommy and me class, not the toddler type of classes.  You can just have that true self care.  And I saw some of your social media promotions about a lounge area where you can just take some time, close your eyes.

That might be my favorite part of the new expansion.  Within the Mind Body Baby space, I was thinking, like, what is something that is considered a luxury for moms, and it’s rest.  So we created two different lounge spaces.  One, we’re aptly calling the Mama Lounge.  That’s more of community; grab a coffee.  We’ll have a tummy time area for little ones.  It’s baby friendly.  Come and meet after class and just enjoy a few moments together.  But the other one we’re calling the Rest Lounge.  We’re going to have seven kind of like rest lounge chairs, pillows, blankets.  They’re going to have divider curtains.  It’s going to have, like, spa music.  And the idea is that it’s childfree, so no kids allowed, but it’s guilt-free rest.  So whether you want to bring a book, grab a coffee, drink a coffee while it’s still hot because we know that that doesn’t happen often.  Listen to a podcast.  Or maybe, just maybe, close your eyes and take a nap.

Exactly.  Even 15 minutes of uninterrupted time can make a big difference.

Oh, my gosh, so much.  And we joke that moms don’t get sleep, moms need rest – but in a true health and wellness sense, we are living in a really heightened nervous system.  Moms are overstimulated.  We’re touched out.  We often are short-tempered and a little bit anxious, and it’s because we are constantly inputting stimulation.  And to have a space that’s very low stimulation to help your nervous system down regulate to help you just feel better in such a way – it’s going to be so beneficial for the family unit, for everybody that’s involved, for your health, for your wellness.  Oh, my goodness.  I’m just so excited for it.  Part of me feels guilty because I’m going to be sending my clients sleeping at work.

No, don’t feel guilty.

I know.  No, I can’t feel guilty, right?  That’s the point, too.  It’s got to be guilt-free.  We’ve got to be able to just know that we get to rest, and there doesn’t have to be a prerequisite to rest.  Rest is productive, too.

Yes, absolutely.  So fill us in about the other practitioners that are part of the Mind Body Collective.

Oh, my gosh, yes!  So excited, we just announced, I think on Saturday, so just a couple days ago, the services that are going to be included.  And when I listed out the menu of choices of things that you have to choose from on a daily basis at the space, my mind was kind of – how did this come together so beautifully?  I’m going to just rattle off some of the things.  I hope I don’t miss anything.  So we’ve got services within services within services.  We’re going to have the on-site childcare and the nursery space.  We’ll have specialty movement classes.  We’re going to have a co-working space.  And then the two lounges, the Mama Lounge and the Rest Lounge.  Within our space, we’re going to have a coffee bar café.  And then we’ve got all of our collective providers.  We’re going to have chiropractic care specializing in prenatal and postpartum.  So everybody’s focus is the same stages of life, so fertility, prenatal, postpartum, and beyond.  We have massage therapy, acupuncture, pelvic floor physical therapy, birth and postpartum support, occupational therapy, lactation and feeding support.  We will have counseling services specializing in perinatal mood and anxiety disorders.

Excellent, and having childcare for that – wow.

Right?  I don’t know if anyone listening or you yourself, Kristin, has ever tried to navigate having a telehealth appointment or a mental health appointment while the reason you have the appointment is like, actively, on your lap or talking to you and you feel like you just can’t get the focus that you need on yourself.

Absolutely, with interruptions, yes, it is challenging to have that telehealth, but also convenient for therapy.  I have experienced that.

Yeah.  I can’t be more elated at the way that this has come together and just the next level of support that we’re going to be bringing in and offering.  It just – it blows my mind at the idea that this has come together the way that I dreamed and hoped that it would.  It really feels like everything that I – I was a pandemic mom.  So going through that – it started with infertility and that feeling isolating, and then becoming a pandemic mom and being – like, hoping that after that fertility journey, I would have my big village of people and support.  Pandemic happened; I had nobody.  And then postpartum, I had my baby.  Everybody met my baby through a window.  And it was just – you know, no village, no support, no community.

So you built what you needed with Mind Body Baby.  And now, this collective even more so!

100% !  I love the idea that as we are growing with the community – like, my baby was just one when I started this, and so a lot of it is just my own personal experience and needs and then feedback from people.  So as we’re growing with our community, if we see a need that’s still not being met, a barrier that’s still not being broken down, we’re able to look at that and say, okay, how can we help?  What can we do?  We have space.  We have a platform.  We have resources.  What can we do to help get the care and the healing, the support, the community into the hands of the people who need it the most?  And those are the life-giving, world-populating mothers.

Yes, and it’s nice that you have so many related practitioners, again, focusing on that pre-conception through early parenting stage, that they can black out their appointments and get a coffee in between, meet a friend, take a nap in between meeting with different practitioners.  I wish that Gold Coast was able to make the move, but we are still a big fan, and we’ll send our clients your way.

I appreciate it, yeah.  I think, too, it’s community support, and part of the community is the practitioners.  I love the idea that our practitioners are moms, too.  We are – right now, it’s seven women-owned and operated businesses, and that’s not even counting the individual, like, businesses that are independent consultants that operate within each business.  But they’re all women and all moms, and so they need the support just as much as everybody else.  And I think that’s part of the reason why they chose to be in the collective because they knew and they understood the level that this is bringing and that they can utilize what we have, too, just as much as the community that they’re serving.

Absolutely.  And I know that there are different types of communities cropping up around the country like these postpartum recovery centers in some of the major cities and multiple collective spaces.  But I do feel like you have a unique slant on yours.  I don’t know if you’ve thought about expanding to other communities or even other states, but it’s a great model.

Thank you.  I appreciate the feedback.  Yeah, it’s definitely a lot of work.

Yes, it’s got to be.

As much as we dream of that – we will see.  We’ll see where we end up and if it’s something that we’re able to scale and share.  We’d love to be able to revolutionize the way that the country receives support and take it further than just West Michigan.

Exactly.  And it is so funny that on social media, I see so many moms talking about how they joined a gym just for the childcare and then they work at the gym instead of working out.  So you’ve got this co-working station.  You have areas that you can have coffee and meet with friends, so more of a social environment.  And then the ability to take any of your fitness-focused classes, which you have – you teach yourself, but you also have a variety of practitioners and offerings, whether it’s infant massage to barre classes to, of course, prenatal yoga.  Do you want to expand a bit about the offerings that you have in your studio?

I would love to.  Yeah, so we – again, growing with the community, it really just started with having prenatal postpartum yoga.  And then realizing that that supports part of the community, but what else?  And we added in barre classes after that.  All of our instructors are cross-trained professionals.  They are experts in pre- and postpartum fitness, and so they know how to keep you safe, first and foremost.  That’s really important to us.  It’s not just about being modified.  It’s about making sure that they can educate and keep safe mom and baby.  And then we just keep adding on.  So from there, we’ve got classes that you can do with your baby.  So we’ve got baby and me yoga, baby wear barre, baby and me dance classes where you baby wear and get to dance with your babe.  Such a great, cute thing that we do!  And then we’ve got things that are more baby-friendly where if you’re not quite ready for the childcare aspect of what we offer, you can bring your baby to your mat and they can watch you grow strong.  We’re expanding that now into being more of like a mama and me where we don’t ever want kiddos to look at their moms or to see the way they lead their life or even hear a story from their mom about all the things they used to do.  We want them to see that their mom can just excel and grow and continue to be strong with their kids, and it’s not a life or a lifestyle they had to leave behind.  So we want them to be able to observe and witness that.  So we created this really cool class.  We joke that we might call it Hot Mess Express where you can bring your kids with you.  And they can watch; they can practice; they can jump on your back.  They can do whatever, but the idea is that they’re just in space with you, and it’s something you can do together and they can see you doing that thing that you love to do to grow stronger.  So we’re really excited about that one coming up.  We’ve got toddler time classes, busy babes.  We’re partnering even with a couple other women-owned businesses that bring in other types of movement classes, things that we don’t necessarily offer.  We’re bringing in different workshops, like baby signs and ASL class.  We’re bringing in bilingual babes, so introductions to early languages.  So beyond movement classes, we’re bringing in experts to help shape and offer you fun things to do with your kiddos.

Excellent.  I know Alyssa teaches your sleep workshop on occasion.  So lovely. 

We tell everybody, you’re going to want to sleep.  You’re going to wonder how you could ever think about sleep so much as the fourth trimester of your life.  So that’s a beautiful offering, too.  We love that one.

So Heidi, as far as your true passion in creating this amazing collective, what is your mantra or what keeps you going with all the chaos from finding the perfect building to assembling the members of the collective?  You’ve got a lot on your plate with your existing studio, being a mom, and so I would love for you to just share maybe a meditation that you use or a mantra with our listeners.

Yeah.  Well, I have two.  One is my motivation mantra that brings in the passion, and that is: we can do better.  We can do better for ourselves; we can do better for this community.  We can do better.  And I say that all the time when things just aren’t adding up, when it feels like there’s those barriers.  But the other one is for my own mental health to keep me sane on the days where it seems like I’m doing everything, but really I’m breaking down on the inside or maybe even the outside.  Having a good cry while I’m overwhelmed because I’m human.  And that one is, I can’t be everything to everyone.  While I’m trying to create something for everyone, while I’m trying to use all these different pieces and parts and have them work together, I’m going to let people down, and so I have to remind myself that while I’m doing this beautiful thing, I’m also going to disappoint people at the same time.  So we can do better, but I also can’t be everything to everyone.

Beautiful.  I love it.  Thank you for sharing.  Alyssa and I recently announced our book that’s coming out on Mother’s Day, and we invited you to be our expert contributor on fitness, whether it’s prenatal or postpartum.  So can’t wait for our listeners and clients to see your section that covers everything from swimming to prenatal yoga to different exercises to walking, ways you can move your body in a healthy way.

Well, first of all, I’m so proud of both you and Alyssa for having the mental capacity to put a book together.  You’re so busy.  It’s a long process.  It’s amazing.  I can’t wait to see it, to read it.  Thank you so much for trusting me to be a contributor to your book.  It’s such an honor, and I hope that it’s just so well received because the intentions behind it are so beautiful.

Well, thank you.  And similar to our Becoming a Mother course, rather than trying to bring the information from our point of view, we wanted to bring in experts, so we do have everything from a pediatrician contributing to a mental health therapist to you of course with the fitness section, and so many beautiful client stories, whether it’s their birth story to their caring for a newborn to their feeding journey.  So it really was a beautiful group effort in creating Supported.

Oh, my gosh, it sounds so lovely.  I really can’t wait.  I’m so excited to be able to share it.

Maybe we can come in to your birth story class and share some of the stories.  We could get some of our clients to share their own experiences.  That would be a fun way to do a reading.

That is such a great idea!  I absolutely love that.  Please do!

Yes, we’ll be in touch!

I love the idea, too, that you took out the opinions and the bias and you made it evidence-based information.  And then shared stories.  I think that’s really what – as doulas, what we try to offer all the time, and you just wrapped it all up and put it in a book.

Yes, we tried!  But we would love to continue to partner with you.  Please share all of your different social channels, your website, so our listeners can learn more.

Yes.  The website is Mind Body Baby.  Our social channel recently got an update because we’re no longer just Mind Body Baby.  We are now Mind Body Baby _ Collective to really encompass all that goodness that we have.  I know, yay!  Yeah, we’re hoping to have our grand opening celebration this summer and would love to see you there and have you as a part of it.

Of course, can’t wait!  And we’ll miss you in East Town, but at least you’re here for a little while longer.

I know, kind of bittersweet.  We love that studio.  It really feels like a space that we grew up in.  It kind of held us all and supported everybody, and we watched a lot of families grow within that space, including my own.  So it is bittersweet, but we know the expansion is necessary in order to grow the level of services that we have to grow in the space that we have.

Exactly.  I’m so excited for you.  Well, thanks for hopping on, and we will chat soon!

Thank you so much, Kristin!  Talk soon!

IMPORTANT LINKS

Mind Body Baby Collective

Birth and postpartum support from Gold Coast Doulas

Becoming a Mother course

 Kristin Revere and Dr. Diane Speier chat about how to best plan and prep for the postnatal phase.  They discuss everything from communication to support options in this informative episode.  Dr. Speier is also the creator of the Digital Doula 2.0 app. 

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am thrilled to chat with Diane Speier today.  Before emigrating to the UK, Diane was the founder and director of the Family Tree Center for Parents in New York, offering classes, groups, and workshops for prospective and new parents for 20 years.  Diane became a certified childbirth educator and started attending births as a doula in 1978.  Diane is the author of the book Life After Birth: A Parent’s Holistic Guide for Thriving in the Fourth Trimester, drawing on her 45-plus years of experience with helping parents make a smooth transition from pregnancy to parenthood.  The book is unique in applying energy medicine to the postpartum period for the enhanced wellbeing of new parents.

Welcome, Diane!

Oh, I’m so glad to be here with you, Kristin!

Yes, I’ve looked forward to our conversation!  I am all about talking about resources and support for that postnatal phase, and I’m also very curious about how you got into doula work because in 1978, doulas were not known the way they are now, and there weren’t the number of training organizations.  It was a very new industry.  So I love that you have been supporting families in so many different ways as an educator, author, and as a doula over these years.

Well, I didn’t know I was being a doula when I was doing it.  It ended up being that some of the people who were my clients in my birth education classes wanted me to be there with them, and I just started attending these births and being in a supportive role.  Also, you know, assisting and supporting the partner to be engaged in a way that was very meaningful and purposeful but that was just something that came from the connection I had with my clients and the trust that they had in me.  So I think what it was, beginning maybe 1990, Penny Simkin came up with DONA International – or it wasn’t even international at that stage.  I was sort of grandfathered in, and I’m not part of a list or anything in that sense, but the fact that I had been doing it for so long –

You were one of their early doulas, unofficially.  I love that.  Wasn’t it the 80s that it officially started?

Well, I don’t actually know.  Maybe I’m wrong, but maybe I became aware of it in about 1990, and then I came to live in the UK in 1998.  But at that point, I was doing birth doula work and I was doing postpartum doula work and appearing on lists and things when there were local and regional kinds of articles about doulas and stuff like that, and it was – you know, I feel that it was a privilege to be able to do doula work with people, whether it was during the birth or afterwards.  I mean, there’s definite connection that’s established between a doula and a mother when she’s giving birth.

Absolutely.

And although it’s different when you’re coming into the home and you’re helping out and you’re assisting with people, it’s not quite the same, but I love the aspect of getting people on their feet and helping them to manage what was going on in the household and creating space, holding space so they could just spend time with their babies, learning what they needed to know in order to be a parent.  And my doing all the other tasks and things to create that space for them.  I really enjoyed it.  It was something that felt very empowering.

The second ten years of my teaching birth education was the methodology that I called birth empowerment, and I really am very dedicated to the idea that birth can be an empowering experience and that the transition to parenthood can also be an empowering experience.  And I think that’s the underlying theme of Life After Birth, the book that I wrote.

Yes.  I love how everything progressed very organically from education to doula support to becoming an author, to be able to reach an even broader audience.

Right.  And I’m even going further than that now because I’m in the process of developing an online course that’s called Eight Keys for Thriving in the Fourth Trimester, and that, I’m hoping, will be an even greater audience for understanding that people are very engaged with planning their birth experience, but they don’t really give much thought to planning what happens afterwards.

Exactly.  I feel the same way.  I feel like we should plan for the postpartum phase as much as we do for – and I don’t even want to say people are overplanning for their birth itself.  Now, let’s put into the time, say, decorating a nursery and registering for items and getting everything put away and washed.  That’s the kind of dedication that I would like to have for the postnatal phase.

You know, there’s a book out there that I’m not very in favor of that actually says that’s what you need to do to plan for your postpartum experience is get those things set up, and it’s like, wait.  That’s just material stuff.  That’s not the reality of – what kind of emotional changes are we going to go through?  What kind of role changes are you going to go through?  What kind of relationship changes are you going to go through?  That – we need to really discuss it because it leads to something called baby shock.

Exactly.

If you’re in the hospital, you go home with the baby – or even if you’re in the birth center – come home with your baby, and it’s almost like, what now?  And if you have that information and you also have resources, then you can feel more in charge of the experience, even though it’s going to be hairy for a while, even though they’re going to be heated exchanges and stuff.  And if you know that, 92% of couples experience increased conflict in the first year after a baby is born.  Then you’re not going to think that there’s something wrong with you or there’s something wrong with your marriage because the two of you are fighting now on any number of things.  It’s that kind of information that I’m dedicated to spreading out there and providing in an online course, and ideally, people would engage while they’re still pregnant so that it’s in advance and they can be prepared.  But it’s also something that somebody who has a newborn baby can dip into from time to time because each lesson takes about five minutes, and they can be gradually gathering up this information that’s going to help them feel stronger and more confident and more competent as they transition to this new experience.  I’m kind of excited about that.  I think it’s going to launch in April, and we’re just getting the recordings done now.  There are eight modules for this.  They cover the whole shebang of what could come up and how you can be prepared and how you can do things that will help you feel better.  It also incorporates a whole energy medicine piece, as well.

When I did the training – I did the first year of the training ten years ago.  I finished eleven years ago.  And I didn’t continue, but there were so many little techniques that would be so useful that right away, I thought, I can definitely add this into the book that I was writing.  And I talked with the people who were the – it’s from Eden Energy Medicine and Donna Eden and her husband David Feinstein and I.  We had a meeting together and I shared with them what I wanted to do because Donna wrote a book called Energy Medicine for Women, and there was virtually nothing in there about birth and what happens after birth.  So they were so excited that I was now going to apply the principles of what I had learned towards new mothers and partners too.  It’s not exclusively for the women.  And then I came to the second year in 2022.  We finished a year ago.  And I haven’t really had anything in yet, but there’s more content to come, and I can include that in the online course.  So I’m just excited that there are opportunities to provide additional resources for our new mothers.

Yeah, it’s so excellent!  I’m curious, since you do live in the UK, how are you adapting to other cultures with that fourth trimester preparation?  It can be so different, say, in Europe compared to the United States.

It is different.  I’ve been here for almost 26 years now in July.  When I first came here, I was working on my Ph.D. actually.  I got my Ph.D. based on the account from my clients, my birth preparation clients, over a course of 20 years.  I initially thought I might do some kind of comparative, but it wasn’t feasible in terms of comparing what had happened for 20 years in New York before I came here versus what I might be encountering here.  So we changed it, and it became a feminist retrospective ethnography of my professional practice.  And so what I did was, particularly when it comes to midwifery care – so midwifery care in the United States only represents somewhere around 8% of births that take place.  But in the UK, for instance, the midwife is the first point of contact.  So maternity care is essentially designed for midwifery care and the person would only encounter and obstetrician if there was some level of complications.  So it’s completely different than the obstetric model of the United States.

So I did a master’s dissertation on midwifery as a case study because I needed to learn how they were different.  But the thing that really struck me as not as good as the American system is that you have midwives that see you in the community before and after the birth, and then you have midwives that are due for the birth.  So the majority of people have babies in the hospital.  I think maybe 2 or 3% of people have home births here.  And you go into the hospital.  You don’t know the midwives.  You’re seeing them for the first time.  They don’t know you.  And so I think the fragmentation of care is not right.  In America, if you decide to have a midwife with you, she’ll be there the whole – or someone from their practice will be there from the beginning right through to the end, and I think that’s better.

And then when it came to doula work – when I left the academic realm – because I was there for about twelve years altogether – I registered with the doula UK organization.  And it’s not that different from what DONA does.  And I spoke.  I presented at conferences in 2017, 2018.  I did that for a while, but I did stop.  My last birth, my last childbirth doula role, was a very complicated one.  It was a woman having her fourth baby, and we certainly expecting things to move quickly.  And we had one false alarm, and I drove out there; about an hour drive away, and I came back home.  And then the next time when she was actually in labor, we went there, and I think the thing that was really not very helpful was that she had her three other kids sort of wandering around demanding attention.

It’s hard to do the work of labor when you’re parenting!

Exactly.  So we were all there trying to facilitate this amidst all of that.  Birth pool was filled, but she didn’t get into it, and she petered out, as will happen, because the children were there.  So we went to sleep, and I went to sleep, but the next day I had another job that I had to be at at 10:00 in the morning.  And I couldn’t really cancel it, so I had to leave.  And sure enough, after I left, her labor started to go, and she gave birth.  So I missed it, and I thought, okay, that’s it, I’m too old for this.

The on call life is hard.  I’ve been on call, and I have a partner most of the time unless it’s a repeat client, so I have a shared call model, but it is challenging.  I’ve been a birth doula for over ten years, and yeah, that part of it.  And you don’t want to miss a birth, but sometimes things happen.

That’s right, and in this case, if I’d just stayed there, it would have been three days total.  You know what, I still need my sleep, and I still need – I slept on the sofa that night, but I thought, okay, I can’t manage different things happening, when they start to sort of overlay each other.  It becomes too complicated to do.  That was in 2018.  That was the end of my actual doula work.  And I have not done postnatal doula work here, come to think of it.

Okay, so it was only the US that you did the postpartum?

It was only in the US that I did the postpartum, yeah, and I did a lot of it.

Now, in the UK, do they utilize postpartum doulas, or is it more relying on family or nannies?

They do, but they do it in a different way.  I’m trying to think; maybe I did do.  But my way of doing it was that I would come in, like, three days a week for a couple of hours each day for a couple of weeks, and they did it in a more open ended way here.  It wasn’t sort of any kind of schedule.  It was just like, over a period of six weeks, we’ll come in, and I never quite understood how that worked.  But they were sort of curious about the fact that I had this sort of scheduled out routine, which I think, if I’m honest, I think that the knowledge that I was going to show up at a certain time was very comforting for my moms.  And they all knew Diana will be here at such and such a time, and I’ll ask those questions then.

But in addition, I ran a mother and baby class for 20 years, as well, and that was a very rich kind of environment for the mothers because they also scheduled their life around those two classes a week that they would come to my classes.  And I really feel so strongly about the need for community for the postnatal period and the fact that there really isn’t that – when I started teaching this class, it was about 1981 in New York.  I went around to the pediatricians, and I said, oh, I’m going to start this class for mothers and babies, and they said – one of the doctors sat with me and said, I think it’s a great idea because when you’re in the suburbs, it can be so isolating.  When you’re in the city, you can walk down to the park and there’s a park bench, and someone else can sit down and you can start talking.  He said, in the suburbs, you don’t have that kind of experience, so this is exactly the kind of thing that we would really encourage.  So I was like, okay, I’ve got the blessing.  And I did it for 20 years.  I actually continued it here after I came for a couple of years, and I found that the mothers of young babies were not that different here than they are in New York.

Makes sense.  We all have the same needs to connect and to share our own experience and stories because I find that after delivery with well-meaning family and friends, it’s all about the baby, but the mother can sometimes get lost in the process and lose her identity, her former self and so on, and no one really wants to, say, validate what she went through, help her process the birth.  It’s all about, oh, this baby’s adorable, you should be so thankful that you have this healthy baby, and people wanting to hold baby.

And that’s completely wrong.  That was one of the motivations for writing the book was the fact that she does – she sort of vanishes into the background, and all eyes turn to the baby.  For nine months, she was being celebrated because she was creating life, and then boom, she has the baby and she’s like chopped liver.

Exactly.  It’s like, what about me?

Yeah.  So my book was really to pay attention to the mother and her experience and then also put it within the frame of the whole family.  It’s not just the baby.  It’s the mother and it’s the partner.  Everybody’s having an experience that we need to really validate and confirm, and this is what I feel we need to really give.  It’s just not fair.  I never thought it was fair, in all my years of doing it.

And nothing’s changed.  It’s still not fair.

It’s just unfortunate.  My daughter-in-law is pregnant at the moment and due in June, and they were about to move.  I think they’re very caught up in getting all the logistics done before we sort of sit down and talk about it.  But when I was talking with her on one of our Facetimes, and she was saying, well, what would you like to do?  Would you like to just come and sort of meet the baby and see the baby after it’s born, or would you like to sort of do your whole doula thing?  And I said, well, I’m quite happy to come and do that for you, and I explained to her what that might include.  I haven’t heard back from them yet as far as that, but I think it’s going to be determined by my son whether or not.  But at this point, I have to buy tickets for my flights and find myself an Airbnb, so I can’t wait too much longer.  But it is a real disservice to childbearing women that their experience after the birth is just not appreciated and not centered in terms of the family experience.  We will all write books and celebrate and get the message out that, yeah, it was a big experience to have a baby and to go through the whole childbirth experience, and we really appreciate how challenging the new mothering experience is for you, and people will want to see your baby, but do yourself a favor, and wait.  Because that’s the thing.

You can’t get that time back.

No, that’s right.  And it’s so exhausting when they come.

Exactly.  You can’t predict when baby will wake or need a diaper change or need a feeding.

And if people come to your house, you feel like you need to play hostess and the rest of it.  So no, I say take that time during the fourth trimester to create your little babymoon, your little bubble of who’s in the family.  Of course, there may be older children, as well.  And save those visits for later when you feel stronger and you’re kind of getting your act together.  The exception to that is, if people bring food.

Exactly, or offer to help.

Right.  They cannot come empty handed.  So if they bring food, that’s okay.  If they say, I’ll do the laundry or I’ll wash the dishes or I’ll do the shopping, that’s okay.  But to just come and say googoo, gaga – no.

Yes, where you feel like you have to have snacks for the guests and entertain them when you’re recovering from a major life occurrence, no matter how you give birth.

That’s right.  Absolutely.  Wait on that.  So if I were to describe the modules of my online course – I took it from one of the chapters of my book where I called this the postpartum wellness plan, and wellness was an acronym.  The W stood for we, which is about dealing with relationship stress that happens after birth.  The first E was for energy medicine, so I’m introducing something that’s not well known and yet so easy to do.  Anybody including a child can do it.  And then the first L is for loving kindness because I think one of the things that I have a podcast – well, actually, it was Instagram Live last night – talking about the fact that a lot of times after women have their baby come, they’re very self-critical, and I’m not doing this right or there’s something wrong with me or whatever.  And understanding the premise of loving kindness is that you’re extending your good wishes out to the world out to a person that you love, out to somebody who is neutral, out to a patron.  But also, to yourself.  Bringing that love back to yourself.  May I have physical happiness, mental happiness.  May I have ease of well being.  And a lot of people find that difficult to do and challenging, but it’s still something we need to foster, that you’re okay.  We’re okay.  And this is hard, but I’m okay.  And I can love myself, even though I’m going through a difficult and challenging time now.

The second L stands for less is more, and that’s what we were talking about with less is more – less visitors.  Less stuff.  Less paraphernalia.  Less social media.  Less all of these things that impact on us in sometimes a very profound way.

The N stands for new normal because normal has changed.

That’s not talked about enough, the fact that you can’t go back.  It won’t be the same.  The new normal – that’s everything.

What happens is, people were sort of very – they’re focused on looking backwards instead of looking forward.  And what we need to do is embrace the fact that it’s changed.  Everything’s changed.  And wonderful things can be ahead of us, even though we’re not having that experience of what we were before children came into our lives.  So I thought that was important.  I think the second E stands for expectations and the need to manage them because we can have realistic expectations or unrealistic ones, and we can have helpful ones or unhelpful ones, but we need to manage them, and we need to – because we end up dealing with internal expectations of our own and then external expectations.  We can have other people’s ideas about how you should be doing things.  So here’s where I have them confront the whole word “should.”  People are talking to you about “shoulds” – stop listening.

Yes, agreed.

It’s their story.  It’s not yours.  So, yeah, expectations are important to monitor.  And then also there are two S’s which stand for self-care and support.  And I’m not talking about self-care in the sense of finding yourself at a spa, but doing day to day things, everyday things, that are taking care of yourself so that you can take care of your baby.  And the support goes to the whole idea of community.  The community of new mothers is what I saw from my exercise classes all those years, how women would create these sort of cohesive groups, and then I would bump into them in elementary schools ten years later, and they’d say, we’re still friends.  It would make me smile.  It really would.

So yeah, these are the modules, and I think that if someone has all of these things addressed, then they can make a real smooth transition into and right through the fourth trimester and really feel ready to take on the world when they emerge.  So that’s my intention, and I’m looking forward to launch.  And I’m actually going to start it as a very reduced course so that people are kind of beta testing it, so that people can give us feedback about each module as it comes up.  What worked, what didn’t work, what would you like to see more of.  We’re going to drip it out every couple of weeks and allow that time for people to review it and send us back some feedback if they feel it’s important, and we’ll really fine tune it into something that really is the best we can possibly do.

That’s what I did with our online course, Becoming a Mother.  We did some live launches, three live launches, and then used feedback from the early students in the course and then adapted it by the time it went evergreen.

Maybe I’ll get it out before my new grandchild arrives.  I’ll get the first few sessions out before then, yeah.  And you know something, I’m getting on in my years now.  And people at some point said to me, aren’t you tired of this?  When I went through menopause and past menopause.  And I don’t get tired of it.  I don’t get tired of it.  It’s just something I feel – it’s almost in my DNA, that I feel so drawn to helping this very vulnerable stage in a person’s life so they can feel more confident about what they’re doing.

You said you’ve been doing this for about ten years; is that right?

Correct.

Do you notice any changes in terms of mothers’ anxiety levels?  Is that enough time to be able to say?  Because if I were to compare what I hear and what I read now in the 21^st century versus when I finished teaching in New York in 1998, I feel like the level of anxiety has jumped.

Yes.  It’s so much higher.  I started teaching classes after my son was born, so that’s 11 years, and I became a doula 10 years ago.  Yes, I have noticed, especially since the pandemic, that anxiety is heightened.  There’s more fears going into childbirth.  We happen to teach HypnoBirthing, so we address some of those fears, and it is very mental and using some of the visualization, positive self-talk that you discussed.  So I feel that method helps, but not all of our doula clients align with that or choose to take a childbirth class.  But there is a lot more fear, a lot more anxiety.  I don’t know if it’s the reliance on social media and being on all of the time with work.

I think that’s a good point.  I think that’s really a good point because I think that you’re getting above the water level, gliding across the water, and paddling like crazy underneath the water, and so you see a very skewed version of what somebody else’s experience is, and then yours – the reality doesn’t seem to match up.  I think that’s a form of pressure; would you agree?

I would absolutely agree.  On a previous podcast, I had discussed a bit about how social media can be good and bad in many ways.  There’s that filtered Pinterest, Instagram perfect life, and then you’re getting into the comparison game.  But I also appreciate social media and some of the vulnerability that moms are sharing and showing that their house is a mess or that they’re struggling to make it easier for some of their audience.  Say they’re a celebrity or an influencer and people are following them, and they’re going through real struggles and sharing those.  Then I feel like that can be helpful.

Yeah, I think it can go both ways.  It’s a double edged sword.  You can find the support that you need, but you can also feel that pressure to perform when you’re just trying to get by day to day.  I think that might be contributing to the state of anxiety that mothers are approaching parenthood with, and how that becomes a barrier to opening up to the possibilities.  Do you think people are having less childbirth preparation these days?

I find that our in-person classes have gotten smaller.  Maybe it’s a lack of time or traveling.  My agency also offers some virtual Zoom classes, some self-paced classes, and then the Becoming A Mother course, so there are a lot of things to choose from, but I do feel like that in-person connection – and I know before I became a doula, I took Lamaze with both of my kids, back to back births, and had a real connection, as you described with some of your postnatal classes, with fellow students, and I’m still friends with many of them.  We organized our own meetups with our babies and later toddlers and found out that a few of us were pregnant at the same time with our second babies.  It was quite lovely.  We intentionally created that community, but I learn better in person, so I always choose in person.  But other people, it doesn’t really work for them, for many reasons.  Maybe it’s childcare if it’s their second baby.

And I find that it’s an interesting thing that now people sort of say, well, I don’t have time.  Yet, 40 years ago, people were saying, oh, I have to get ready for birth, so I’m going to make that time.  And my daughter-in-law said, well, there was this one course that was, like, two hours over the weekend.  Or she can do the HypnoBirthing course.  And I said, well, you’re not going to get anything out of a two-hour class on a weekend, so I would suggest you do a HypnoBirthing.  Do you do the Marie Mongan version?

Yes, we sure do.  I love the original.

I actually did that.  When I was moving back into the birth world after I left academia, I did a course that was taught here of the Marie Mongan version of HypnoBirthing, and because I am also a hypnotherapist.  So I thought, well, this is going to pull together two aspects of my work.  It’s almost a synthesis.  I really appreciated what it had to offer.  So I would – at this stage, I would definitely suggest that.  What do people think they need, two hours to prepare for birth?  But there must be people out there that say yeah.  And then they get to the birth and everything gets completely screwed up, right, because they weren’t prepared for this or they didn’t understand that.

Exactly.  They don’t understand what their body is going through.  They don’t understand the intervention choices or stages of labor.  There’s so many things that can’t be covered in two hours.  I teach a very hands-on Comfort Measures for Labor class, and I tell couples who take it that they’re not going to learn everything that you would in a comprehensive childbirth class, but at least it gets the partners connecting, talking, moving.  Whether they have a doula or not, the partners are learning some hands-on techniques.  But that will not prepare them for what they’re going to encounter in labor.  It might make labor more comfortable, but yeah, there’s so much more.

When I was teaching, I would teach just a class on the first stage of labor, and then a second class on the second stage of labor, and then a class on the interventions, and then another class on what you just described in terms of labor support and what you can be doing together.  And I think that what happens is people come into it – they go into labor and they feel the pain, and that’s all that they focus their attention on.  I have this pain.  They don’t know why that pain is happening, so that whole – I give a whole three hours’ worth of information about what’s actually happening during the first stage of labor.  Your body is contracting and it’s also retracting.  And when you know that, you may be feeling the pain, but you know that there’s a real good reason why you’re feeling the pain, and if you haven’t had that education, you won’t – it’s just pain.

Exactly, and they just want it to go away.  But it’s pain with a purpose, or discomfort is what I like to call it.  I don’t consider it pain because you get a break.

That’s right.  And it’s finite.

Yeah, exactly.  You get to meet your baby.  Again, purpose.

That’s right.  Each contraction gets you closer to that.  I just think that – I still feel that education is really important because having that under your belt when you’re going through labor means that there’s a good reason and there’s a good purpose, pain with a purpose.  And really focusing on the fact that this is a powerful experience, as well, not just a painful experience, but it’s really a powerful experience, getting your baby born.

So powerful, yes.  It was one of my biggest moments.  I felt so accomplished, and I’ve never run a marathon, but it sort of feels like that.  I used to be a runner, and really, that visualization.  I felt with both of my births, although they were completely different from each other, were both very empowering for me.

Yeah, all of my births – I have four children – all of my births were very different.  I had a hospital birth with a doctor the first time around because I didn’t know any better in ’74.  And then I had my second child in a birth center in the New York Maternity Center Association, which went out of business and became Childbirth Connection along the way.  But that was the first birth center to open up in the state, and it was in New York, with a midwife.  The third birth was an attempt to have a homebirth, but I ended up being a hospital transfer for a forceps delivery.  And the fourth birth was at home.

All different.  Very different.

Yeah.  The only thing I haven’t done – I haven’t done a Cesarean section, and I haven’t had an anesthetized birth.  I had a pudendal block for the delivery of the forceps delivery because I didn’t want full anesthesia.  But I’ve really sampled a lot of the possibilities in terms of location, anyway.

That’s helpful with your background as an author, creating this app, and understanding different experiences personally and also professionally.

Diane, I could talk to you forever, but we’re running out of time.  So let’s touch a bit about how to connect with you, how to purchase your book, buy your app, how to find the course when it’s out, and of course, your website.

So my website would be www.dianespeier.com.  And the name of the book is Life After Birth: A Parent’s Holistic Guide to Thriving in the Fourth Trimester.  The app is a companion for that.  The sections of the app match the sections of the book, but increase that information and add more and also the links that were in the book in black and white become live links in the app.  And that’s called Digital Doula 2.0.  And it’s available in the app store, as well as in Google Play.

Do you have a chat feature in the app?

We just added a chat feature in the app this past year, and what I want to do – it’s not being used the way we intended, but I changed the app developer in the last year, and I need to sort of follow up on that so that it becomes more communal and we can have group chats in it, and I haven’t worked that out yet.  I’ve had other things going on at a fast pace.

Right, with this course launch.  There’s a lot going on.

Yeah.  And so let me also give you the other website, which is called thrivinginthe4thtrimester.com.  They can get information about the online course there and put their name on the waiting list, but also, there’s a free download there from energy medicine.  We created a digital download called Energy Matters in Postpartum Resilience.  That’s something that people can purchase, but it’s also a bonus as part of the online course.  But then there’s a free download, which is the first part, called the Daily Energy Routine.  And they can get that.  So if they go to Thriving in the 4^th Trimester, that’s where they can access anything related to the online course, as well as some information about energy medicine for free and some to purchase, because the full digital download is a 60-page document, so it’s a little book, and it’s really good.

You can find me on Facebook at Dr. Diane S. Speier.  On Instagram, it’s @drdianespeier.  Did I leave anything out?

Are you on LinkedIn?

I think it’s Diane Speier on LinkedIn.  And you can also find the Digital Doula page on Facebook, as well.  I’ll never get tired of this, and because of that, we should have another conversation down the road, Kristin, somewhere.

Let’s do.  I would love that, Diane.  Thank you for sharing all of your wisdom.  Would you like to leave our listeners with one final tip?

One final tip.  What would I choose?  Look after each other during this very tumultuous time in your life.  Just look after each other so you can be a team, and I like to use the word duet because you’re sort of singing a different part, but the harmony that comes together with that is really a wonderful song.  So look after each other, because people do not know that having a baby really does change the nature of your partnership a lot, which is why We became the first module of the online course.

Thank you.  Excellent advice, and I appreciate all of your time.

And I appreciate what you’re doing, Kristin.  I think it’s really wonderful to see how you are providing resources for the community, as well.

Thank you, Diane!  Take care!

IMPORTANT RESOURCES

Dr. Diane Speier

Thriving in the 4^th Trimester

Birth and Postpartum support from Gold Coast Doulas

Becoming a Mother course

All of the courses available from Gold Coast Doulas

Kristin Revere and Christine Brown address everything from handling tantrums to managing a child’s big feelings in the latest episode of Ask the Doulas.  You can listen to this episode on your favorite podcast player.  

Hello, this is Kristin Revere with Ask the Doulas, and I am thrilled to chat with my friend Christine Brown today.  Christine is the CEO and lead sleep and behavior consultant of Bella Luna Family.  Welcome back, Christine!

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

Yes!  And our last conversation was all about potty training, and I consider you our expert since you’re part of our Becoming course as our expert in potty training and we always refer to your podcast and blog with our clients.  So thank you for sharing all of your knowledge!  Our topic today is one of your other specialties, behavior.  I would love to dive into that.  We chatted earlier about some of the typical questions that you get from parents that you work with in regards to behavior.  What is your top question that you get asked, Christine?

I think probably the biggest thing is, do you have anything quick that I can do to improve behavior with my child?  Because sometimes too much, we get too much advice and try to implement it all at the same time.  That can feel a little bit overwhelming.  Sometimes it’s easy to just focus on one small thing, especially if you feel like you’re in a cycle with your toddler or your preschooler where you’re just not cooperative very well.  And so that thing that I recommend the most is, focusing on the positive.  I know that sounds so simplistic, but what happens is – I don’t know if you remember this, or you might even go through it now.  But when we’re in a difficult phase of our child’s development or we’ve got a lot of stuff going on in our lives coupled with our child just going through normal developmental things that are age appropriate for them, it’s easy to start focusing on all of the things that we don’t like about our child’s behavior.  And I’m sure you’ve heard the expression, what we focus on, we get more, right?  And so the number one thing, and I joke when I say this, but when I start feeling like I want to run away from home, because I think sometimes moms, we’re just like, oh, my gosh.  This is so much.  I don’t know how to deal with all of this.  When I start to have those types of feelings, I recognize, man, I’m really focused on all of these things that I don’t like, and I really need to change my perspective and start focusing on all of the things that my child does and says on a daily basis that are amazing because sometimes we lose sight of that.  And we don’t give that positive feedback to our little ones.  No one performs or acts better when they’re feeling worse about themselves.

So true, yes.

And one of the ways I like to think about it is, imagine early in your relationship, if you have a partner – and I’m going to be very gender stereotypical right now, so just pardon me on that – but it’s like, oh, my gosh, thank you so much for taking out the trash, right?  So grateful.  And oh, my God, that was the best dinner ever.  It was so great.  And then what happens is we get into marriage or our relationship; maybe we have our kids, and then it’s like, he didn’t even put a bag back in the trash can, right?  This again?  And so what happens is when we start to really focus on those types of things, it makes us less likely to want to serve.  And our children really do want to make us happy, even though sometimes their behaviors are challenging, and so if we just start focusing on all of those positive behaviors on a daily basis, we’re going to start seeing more of that flow out of them, and it really can change the energy in the house very, very quickly.

Makes sense.  Excellent.  So what’s next?

So other things that can also help increase cooperation in toddlers: there’s really two kind of main things that toddlers need developmentally at this point, and the first one is attention and connection.  And sometimes the worst behavior is a call for attention or connection, and this can be hard because sometimes we’re like, I’m with my kids all the time.  But we may be doing a lot of different things while we’re with our kids, and we might be distracted.  Our kiddos really need something short, even can be 10 or 15 minutes a day, but really getting down, focusing, doing child-led play with them, and really filling up that cup of theirs.  That can really help improve behavior because the more connected our children feel to us, the better their behavior is going to be.

That makes sense.

And if you’re having bedtime battles with your little one, I love doing after dinner shutting off all screens, putting all technology and devices away, and just getting down on the floor and pouring in because that can make the disconnect at bedtime much easier because they feel like that cup has been filled.

Excellent.

And the flip side of that, especially with our toddlers and our preschoolers, is lots of choices.  We control so much of our young children’s lives, right?  We control who their friends are, where they go to school, what they eat, their choice of clothes, all of that.  And one of their primary needs is to feel like they’ve got some power.  The way we can do that is offer age-appropriate choices because that way, once they feel like they have some of that power, they don’t have to dig their heels in and push back on us so much because they feel like they’ve gotten control over their own lives.  I always think about it imagining if someone controlled every aspect of our lives and we didn’t feel like we had any choice.  I always think about that from our children’s perspective.  They need to feel powerful so that they have that agency over their own life, but age appropriate choices.  Do you want to wear the red shirt or the blue shirt?  Do you want to use the green cup or the yellow cup?  Do you want to put your shoes on yourself, or do you need my help?  Do you want to climb in your car seat and I’ll buckle you in, or do you want Mommy to put you in there?  Lots of those types of age appropriate choices really gives kids that power that they’re craving.

Excellent.  And as a parent of twins, I’m sure that you’ve had to navigate big emotions and giving them choices probably reduces a lot of those tantrums and so on.

Yeah, it definitely did.  My twins definitely liked to have – my son and I even had an incident last night where – he’s nine.  My twins are now nine.  We had a bit of tussle last night, and I had to take a deep breath and be like, it’s okay.  We can undo anything.  Just give him the opportunity to do that.  And I think one of the other things that’s important with choices, too, is knowing when to use them.  So if our kiddos are overtired, overstimulated, or hungry, that’s probably not a time to offer a lot of choices because their emotional reserves are low at that point.  So offering choices in other times, but sometimes we need to make decisions for our kids when they’re in those.

So you mentioned mealtime or hunger.  What are your tips for managing behavior issues during mealtimes, whether it’s at home or in public?

So from my perspective, I think sometimes we have really big expectations of what our children are capable of doing when it comes to mealtimes.  So the number one thing is having realistic expectations of a parent, like how long our children are actually going to be able to sit in their seat and stay still.  I like to use visual timers for children that get up from the table a lot.  Saying ten minutes is how long we have to stay at the table and actually having the child have a visual timer can be really helpful because then they know when they can get up, and that can be a game changer, especially if you have a child that’s up every one or two minutes.  If we’re setting small increments of time and expecting them to just stay there for that amount of time, that can be really helpful.  I have a lot of parents come to me and they’re like, well, we’re still eating, and our little one wants to get up.  And I’m like, yeah, but they’re two.  They can’t sit there for very long.  That’s just not how our little ones are.  They need to get up and move, so kind of letting them do that.

If children are throwing food, to me that means they’re done eating, and so at that point I pick up and plate and say, if you get hungry, you can come back and finish, but when you throw your food, you’re telling me that you’re done.

What other things do you hear from parents as challenges that they come up against?

Naptime, certainly, and getting up frequently, complaining, just the struggle with, of course, bedtime as well, but certainly naps.

Yes, naps can be challenging.  I’m a firm believer in that there’s three things that children can control: eating, sleeping, and going to the bathroom.  From an eating and a potty perspective, I think that should really be child-led, but from a sleep perspective, I think we do have to help our children make choices in that respect.  They can’t actually make the choices.  We have to make the choices for them.  And when it comes time for nap, I always like to say, especially to toddlers and big kids, you don’t have to sleep, but you do have to rest.  And so they have quiet time, whether that’s an hour or 90 minutes or two minutes depending on the age of the child, where they’re in their room, in their crib or in their bed, where they’re having some down time.  That way, they have the downtime, and how they choose to spend that time is up to them.  They can be upset or they can just relax or they can choose to sleep, but they still have to have that down time.

Yes.  What are your tips when a child does have those big feelings?  What do you recommend parents you work with as far as tools to navigate that?

The number one thing is that sometimes our children’s big feelings are very triggering for us, especially if our own feelings weren’t validated when we were younger.  So when they’re having big feelings, it really can trigger us, and it can make us react to those big feelings.  The first thing I recommend, number one, is staying calm, because if our child is having big feelings and we get really upset, we’re just adding fuel to the fire, and it oftentimes will make the feeling even larger and can prolong any sort of tantrum that could be happening.

Second, this is a mantra that I say to myself over and over again when my children are not acting logically.  I have to remind myself, 25.  Because I remind myself that our children’s brains are not fully developed until they’re 25.  When we’re expecting them to react in a way that is logical for an adult brain, I have to remind myself, okay, well, my child may not be capable of my logical, rational adult thoughts right now because their brain is not going to be fully developed until they’re 25.  So that also helps me to be calm and patient because I realize that I’m dealing with someone who doesn’t have a fully developed brain, and that’s going to take some time.  That allows me to stay more patient and calm with my child.

On top of that, just recognizing the feeling, helping our children name those feelings and then validating the feelings because oftentimes many of us – I was raised by boomers, and so I was kind of the, rub some dirt in it kid generation.  Your feelings just didn’t – our parents didn’t get that, and so they didn’t know how to give it.  And now our generation that are raising children are doing things differently, and we are trying to have more respectful parenting.  One of the ways that you can really be a respectful parent is just validating those big feelings that your little ones has.  It doesn’t mean you need to give in to if they’re having a big t antrum because they want another cookie.  It doesn’t necessarily mean that you have to give in to that big feeling just to kind of keep the peace.  Just recognize it’s okay for your child to have those big feelings, right?  Our job is to stay calm and just validate.  “I know” are some of the most powerful words in the English dictionary when it comes to parenting because it lets our child know, I hear you.  I see you.  I see where you’re coming from.  I recognize what your feelings are.  And it’s important to, especially when they’re really little, help them understand what that feeling is.  I see that you’re really mad.  I see that you’re really sad.  And then validate it.  I know you want a cookie.  Cookies are so delicious.  Saying something like that instead of like, no, you can’t have a cookie; stop crying.  You’re going to get a much better response from your child if you validate their feelings before holding any sort of boundary.

And that transitions well into the tantrum area.  What are your tips related to how to handle the child who’s on the floor and just can’t be consoled?

Yes.  Like I mentioned, the first thing with tantrums – and again, these can be really triggering for us as adults, too, especially if we’re feeling low on reserves, but still staying calm is just so important because it truly is adding gas to a fire if we get really upset.  So stay calm.  And another thing that’s important here is when your child is having a tantrum, recognizing they are not coming from a place where it’s premeditated.  When children are having tantrums, their logical brain has been shut down, and they are more operating on that emotional, more primitive brain, right?  Trying to create logic and talk to them about their feelings and being logical with them and expecting logic from them – they’re just not capable.  Until they’ve calmed down, they can’t really hear a lot of what we’re saying.  So if we stay calm, and also limit our words.  Oftentimes when our children are tantruming, we’re trying to talk it through with them and trying to figure it out in the moment.  Sometimes it’s better to just say, I see that you’re really mad right now, and I understand.  Mommy’s here if you need me.  I’m right here when you’re ready for a hug.  You let me know.  And just kind of leave it at that.  That’s also going to allow your child to regulate better because you’re just there, calm, being there and present, and we’re not talking a ton about it, which can really create that tantrum going on much longer than it needs to.

Excellent.  What other tips do you have for our listeners related to behavior issues?

Kind of on that same vein of handling tantrums, time out is a really highly debated topic, right?  I’m a fan of time out because time out truly means to just rest, take a break.  That’s what it means.  So when our children are in a really heightened state, sometimes they do need a time out.  But it’s not like the traditional time out where you think like, oh, you’re going in your room to think about your behavior because oftentimes when we try to do that, our child feels more isolated, and that can really amp things up even more.  And so I’m a big fan of putting together a peaceful pillow or a cozy corner, someplace where our children can go to calm themselves down that’s not a negative place.  It’s in the main living area.  And they can go there if you see that your child is about to go into a tantrum phase.  You can do that in advance.  Like, I see that we’re starting to get really mad.  Let’s go sit together and read a book or something like that.  Sometimes we can preemptively get in front of it.  And sometimes I – unless a child is really breaking a golden rule, and golden rules are, I will not hurt myself; I will not hurt others; and I will not destroy property.  I’m not a fan of sending them necessarily to time out as a punitive way of doing things, but if they are breaking one of those golden rules, I do think that they need some time in a spot that’s a positive place.  It’s not just a negative place, and they’re not isolated, to tell their body to stop, to stop that behavior because it’s not safe.  And then once they’ve stopped the behavior and they come out of time out, just focusing on what went right.  You told your body to stop hitting.  Great job.  Do you want to come help me do X?  Something like that.  We don’t want to punish because that’s not how our children learn, but once everything is really calm is when we have the opportunity for teachable moments.  Our children are going to make a ton of mistakes.  That’s part of it.  We’ve all gone through the process of making mistakes, right?  I’ve made millions of mistakes throughout my life.  And that’s part of how our children learn so they have to make mistakes and we have to let them make mistakes so that they can learn from it.  If the child has been throwing or hitting or kicking, that’s when you can talk about what could we do instead.  That really hurt my body.  Next time you’re feeling really mad, you can’t hit.  That’s not safe.  I love myself too much for you to let you hit me, and I love you too much to let anyone hit you, right?  So what can we do instead next time when you’re feeling really angry?  For a younger child, you could say I’m really mad; you can stop your feet and say I’m really mad.  Give them approved behaviors and ways of expressing those big feelings.  And then if the child has broken a golden rule, sometimes we have to help them figure out how make it right, whether that’s a logical or natural consequence.  Natural consequences are like cause and effect, right?  You threw something and it broke, and now I need you to help me fix it.  Another thing is if a child hit another child, I always say to my son, how can we make this right?  And at first, I had to help them figure out ways that they could make it right.  Like, if that person wants a hug, do you want to give them a hug?  Do you want to say I’m sorry?  Do you want to color a picture?  Those are different ways I’ve helped them, and now I ask them that same question.  I’m like, how do you want to make this right with that person, and they’ve come to the place where they can actually make those decisions and figure that out for themselves.

I love that so much, Christine.

And it’s important because that’s how we truly change behavior is if the child has natural or logical consequences; that’s where they learn.  They’re like, oh, I don’t want to have to keep doing that.  I don’t want to do that again.  And when you’ve given them other tools and other ways of doing things, it might take a little while for them to get there, but you’re going to be so proud when instead of hitting, they’ve said, like, I don’t like that; I’m really angry.  That’s when as parents we’re like, oh, this hard work is working!

Yes!  So how do you navigate technology?  You mentioned screens off near bedtime and on the floor play.  I feel like this is a common issue for parents of younger children like toddlers, as well as older kids, because there’s so much even in school related to working on computers and technology.  It’s a part of our lives now.

Yeah.  So I am not the technology police at home.  I have read all of the studies.  I know the benefits and the downfalls.  We do live in such a technology focused society, and I do understand, it’s addicting for not just children, but it can be the same for adults.  For younger kids, I think following the American Academy of Pediatrics recommendations overall is good, positive, helpful guidance.  As they get a little bit older, they’re allowed to have a little bit more, but also ensuring that lots of breaks are happening in between.  We’ve been through phases – one of my sons has ADHD, which means that his brain is wired for what he’s interested in, and he’s interested in technology.  So we’ve gone through phases where we’ve had to go on more of a technology diet than others because of the behavior that was resulting from having too much screen time.  But I think as parents, we’re just trying to strike the balance.  And reevaluating as time goes on.  My husband and I for a long time had a no technology during the week policy, and that didn’t mean TV; it was more like games and screens.  But my children have gotten to a place where they’re nine and a half now, and they’re better at turning it off and going and doing other things instead of just staying on it all the time.  And when they’re asked to get off of it, it’s not a big struggle.  And so we’ve actually recently loosened up a little bit more so they get a little bit of screen time at home during the week.  At this age, it’s so important for them to connect with their friends, and that’s one way that they’re able to do it.  I think it’s just reevaluating as our kids get older, what makes sense for your family, how your child reacts to technology, and making your rules based on your own specific child and your family’s philosophies.

Very helpful.  So what other questions are you seeing from your clients related to behavior that we didn’t cover?

I think another one is not listening.  Lots of, like, how do I get my child to listen better?  This is a big one, and let’s be honest, as moms, nothing is more frustrating than repeating yourself a thousand times; am I right?

Yes!  Even with teenagers, I feel like I’m still repeating myself to my 13-year-old.

Oh, for sure.  I mean, usually they’re distracted with technology, right?  This is what I feel like I look like when my kids aren’t listening and I’m repeating myself over and over again is like the cartoons where the steam used to come out of the ears and the head started popping off the body.  That’s how I feel inside.

But there are things that we can do to really get our children to listen better that they just play into looking at things from a respectful standpoint, right?  If we’re constantly ordering and directing and we’re just focused on almost that authoritarian, like, do as I say, don’t question me – oftentimes, you will find that when you take that approach, that children don’t listen as much.  They tend to shut down a lot.  So number one is ensuring you’ve got that strong connection because if our kids don’t feel connected to us, they’re not going to listen to us.  It’s kind of like thinking about, like, do you have a friend who isn’t respectful to you?  Are you going to take their advice when they try to talk to you about something?  Probably not.  You’re going to tune them out a little bit more, right?  So I think about that.  Just making sure that you have that connection, making sure that you’re giving lots of love and affection and attention and spending time together and being interested in what they’re interested in, having that legitimate, true relationship and connection.  That really opens up the ears because even think about it in your own relationships with your spouse or your partner.  If you guys aren’t connected, oftentimes the communication just isn’t there.  We’re less likely to hear what the other person is saying in the way that they meant to say it.  Does that make sense?

Exactly.  It does.  Very helpful.

And the other thing – I have many things about this, but oftentimes the most popular, especially when we have toddlers and young preschoolers, I felt like I was trying to keep my twin boys alive all the time when they were younger.  So my most popular words coming out of my mouth felt like, “No,” “stop,” and “don’t.”  But then when I started doing more behavior work and I started thinking about it, when I have someone – even though they’re children and they’re young – when they hear no, stop, and don’t all the time, they’re going to tune us out a little bit more.  So when we actually need it, when we’re in a safety situation where they’re running away from us in the parking lot, if we always say no, stop, and don’t, they might disregard us when it’s a true safety issue.  So we want to kind of reserve those.  And there’s different ways to say no without saying no that can also decrease tantrums, as well.  “Can I have a cookie?”  What’s our natural inclination?  “No, I’m making dinner.”  Temper tantrum down on the floor.  But if you say, “Yes, after dinner you can have a cookie,” you’ve said no without saying no.  You’ve just told them when they can have it.  “I want ice cream.”  “Oh, I know.”  (Validate the feeling.)  “Ice cream is so delicious.  But today has already been an ice cream day, so tomorrow can be another ice cream day.”  You’re saying no without actually saying no.  That works really, really well.

Lots of “Yes, and.”  I always think about this.  I do this with my husband.  I’ll be thinking – obviously, we have different upbringings, different minds, and he’ll have one idea of a way to do things, and I’ll have my idea, right?  And if I say to him, that’s a stupid idea.  We should do it my way.  He’s going to shut down, right?  He’s not going to be listening to me.  Whereas if I say, “Yes, we could do it that way, or we could do it this way,” he’s going to be more open and receptive to thinking about the way that I think that we should do it.

Nice.  Excellent tips.  So what would it be like for our listeners or our doula clients to work with you and your team at Bella Luna Family?

Essentially, what we do is when we start working with a family, we always start by having you fill out an intake form, and that’s where we collect lots of different information because we like to look at every situation holistically.  So we’re looking at everything from sleep, behavior, potty training, nutrition, where the parents are at, and so that’s how we start everything.  From there, we meet with families one on one, and we have conversation about the most challenging aspects that are happening whether it’s potty training or sleep or behavior.  And we kind of have a conversation and share insight and educate on what’s normal.  Parents leave there with action steps on what they can do, and we like to try to keep it really simple.  You’re working on some small things.  Small things can really help improve.  And then we’re continually working with people.  We build on those skills as time goes on.

Excellent.  And you can be found all over social media and your website.   Where would you like to direct our listeners?

I’m thinking I will add a freebie.  If people want to download, I have a Taming Tantrums Checklist.  That tends to be a great way to start.  So if people want more insight about that topic, and also to get on our mailing list.  I send newsletters every other week filled with lots of good insight.

Thank you so much, Christine!  I loved chatting with you again.  What a great resource for all of our listeners!

Thank you, Kristin!  It was so great chatting with you again!

IMPORTANT LINKS

Bella Luna Families

Taming Tantrums freebie

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Kristin Revere and Lynn Schulte discuss postpartum healing including hemorrhoids, fissures, and tears as well as preventative steps to take during pregnancy.

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am thrilled to chat with Lynn Schulte today.  Lynn is the founder of the Institute for Birth Healing, and our topic is all about postpartum healing and recovery after birth.  Welcome, Lynn!

Thanks, Kristin, so much!  I so appreciate any opportunity I get to be able to share what I know and to help moms.

So happy to have all of your wisdom here for our listeners!  Would you start by filling us in on your extensive bio?  I was looking over all of your skill sets, and you have a wealth of experience in not only pelvic floor physical therapy but also just healing in general and body work.

Yeah.  I’ve been a physical therapist for over 30 years and have taken lots of different continuing education courses, but I would say that my specialty really is connecting a person to a deeper part of themselves and really trying to tap into – my gift is being able to understand why the body is doing what it’s doing and getting to the root cause of tension in the body or why a muscle won’t let go.  That is just something that I’ve discovered and developed over the years on my own, not from necessarily taking a particular course.  So I love that deeper healing work, and really working with trauma, because that’s the trauma response in the body that can sometimes cause a freeze response in the body and then the tissues don’t really know that the trauma event is over.  That freeze response is still held in the tissues.  I love that deeper dive.

When we talk about postpartum healing, there’s healing on many different levels.  There’s physical healing, and that’s what we really want to talk about today.  Emotional healing, and there’s energetic healing, too.  I want people to recognize that there is more.  When the physical  healing isn’t really working, there’s a deeper issue that may be at play that’s keeping that physical healing from happening.

Makes sense.  So what are your top tips for our listeners when they are preparing for birth, and then we’ll talk about healing.

So really we need to understand that what we bring to our birth that’s being held in our body is going to impact that birth.  It’s really about getting your body assessed prior to going into labor and making sure that the baby has the space and the balance within your uterus and your abdomen to get into a good position to come on out, making sure that your pelvic bones have the ability to move, open, for baby to pass through, and then releasing your pelvic floor muscles as well and making sure that those are like trampolines: able to bounce and give and lengthen to allow the baby to come on out.  And so I think every pregnant person should not only just be seeing an OB-GYN or a midwife but also a body worker, someone who is trained in what to look for and how to help create balance and space for baby and assess the body so that baby can come on out.  We go into birth just assuming the baby will come on out, and I think that we should be assessing the body more to make sure that it’s ready for birth.

And I feel like there are more and more trained body balancing practitioners, especially in my area, so it is a great referral source, in addition to physical therapy, pelvic floor therapy, not only during pregnancy but also immediately postpartum.

Right.  And it’s really important – I think the most important aspects of the body is the uterine ligaments, making sure that those are nice and released and balanced, but also making sure that your pelvic floor muscles have the ability to lengthen for birth is critical.  And that you know how to push a baby out.  Too many people that I work with in my practice come in and I ask them to push – I’m intravaginal and I ask them to push my fingers out.  They actually tighten their pelvic floor.  That happening at birth can create those stage 3 or stage 4 tears that go into the anal structure.  We really want to try to avoid that, and we do that by making sure the muscles lengthen when you’re pushing.

And tearing is one of the biggest concerns my childbirth students have, as well as my birth doula clients.  That fear of tearing is really overwhelming to them and they want to know how to prevent it.

People talk about doing perineal massage, and the research isn’t confirming one way or another saying that it’s helpful.  But my thought is that we need to be focusing on the pelvic floor muscles themselves, not just that perineal area, like the opening of your vaginal space.  That opening is not where we need to focus.  We need to be getting our fingers in deeper and working with the pelvic floor muscles because I feel like the skin is going to follow the muscles.  So if the muscles can lengthen and relax, the skin is going to follow.

That makes perfect sense.  So after delivery, then, let’s get into concerns.  You mentioned tearing, of course.  Let’s talk about healing and what your tips are, whether it’s a minor tear or you’re dealing with something fourth degree. 

So one of the biggest issues that I find postpartum is that the bones of the pelvis actually need to open up for a baby to come on out.  So the two sit bones that you’re sitting on, your tailbone, all three of those bones need to open up, so your sit bones go wider and your tailbone should lift backwards, which is really hard to do when you’re laying on your back, trying to push a baby out.  So that position that the doctors find so convenient for them is actually not always the best position for a birthing person to be in because the sacrum needs to lift backwards in order for that baby to come on out, and if you’re laying on it, then the entire pelvis has to lift up for the baby to come on out.  The pelvic outlet, from the tip of the tailbone to the ischial tuberosities, that needs to widen for baby to come on out, and I have found, what I want everyone to know, is that that not all the time do those bones go back to their original position.  I find open birthing pattern in the majority of the clients that I work with in the clinic, whether they’re coming to me for back pain, pelvic pain, symphysis pubis dysfunction, pelvic floor tension or tightness or pain, pain with intercourse, prolapse, stress incontinence.  All of those issues that are very common after having a baby can be attributed to the bones of the pelvis not being in their original position.  And when you know what to look for and you know how to close the bones back up to help them get into their proper place, a lot of those problems go away, especially the back pain and the pelvic pain.

Now, some of the signs that your pelvis may be stuck in an open birthing pattern is when you lay on a hard surface, your sacrum doesn’t feel good.  It hurts to lay on a hard surface on your back.   If you’re sitting, sometimes sitting feels off balance or off kilter because one of your sit bones had to move out to the side more than the other one.  One of the key factors that you know if you go see a pelvic floor PT and you’re working in the postpartum period and they don’t ask you what position you were in when your baby came out, they’re not going to be looking at the bones of the pelvic.  And a lot of the pelvic floor PTs do not get this concept, unless they’ve trained with me.  I’m the only one out there talking about this idea of an open birthing pattern.  And so I do have a directory on my website of practitioners that I’ve trained so that you can go and see if there’s someone in your area.  But this idea that the bones don’t always go back to their original position is not something that every practitioner out there is looking for.

Very interesting.  I do have clients – we have postpartum doulas at Gold Coast as well as birth doulas who are working with our clients up to the first year, and they have that lower back discomfort, especially with breastfeeding in those healing first six weeks.  So that sounds like obviously an issue that could be prevented and addressed early on.

Absolutely.  And there is an exercise that people can do resisting their knees together and resisting their knees going apart.  I have a video on my YouTube channel, which is Institute for Birth Healing.  That’s the channel on YouTube.  If you go on there and just search for closing the bones after birth and exercise to close the bones after birth – I think it’s titled that.  But it shows you how to do it.  And I believe in the video I show someone doing it to you, but if you just bend your knees up, you can use your own fists and your own hands to resist those movements, so you don’t need someone externally to help you.  You can do this to yourself; just bend your knees up toward your chest and do the exercises.  But we’re using the adductors of your hip muscles and the abductors to help bring the bones of the pelvis back together again.  So sometimes that can be really helpful for some people.  The sooner we do that, the better.  I really wish every doula knew how to instruct their clients in doing that because that can be done right after birth.  We don’t need to wait, as long as it doesn’t create pain.

If it creates pain, then try the opposite direction, and then if that’s still painful, that person needs help.  They need to find a practitioner who knows how to work with the bones of their pelvis to help bring them back into place.  And if you are a mom and you’re working with a pelvic floor PT or chiropractor, let them know.  I have online courses.  Treating the Postpartum Pelvis is an online course that I have that a practitioner can take.  My courses are only for practitioners because you need to have a license to touch, to do these techniques that you’ll learn in these courses.  Let your practitioner know, go take that course, and then come help me.  That’s the best way for you to get help because in the Treating the Postpartum Pelvis course, there’s four different patterns I find in the pelvis after birth, and it teaches practitioners how to close up the bones, how to get rid of those patterns in the pelvis after birth.  And I tell you, every day in my clinic, moms get off of the table and they feel so much better.  So different in their body after birth, because I’ve adjusted their pelvic bones and gotten them back into a better position.  The pelvic floor muscles attach to those bones, so if the bones are splayed open from a baby coming out, your pelvic floor muscles are now lengthened.  They’re on stretch.  And sometimes the tension or the heaviness that you’re feeling in your pelvic floor or in your perineal area could be because those muscles are trying to keep your bones together.  They’re trying to help you out.  And so if you go and you see a pelvic floor therapist and they try to release the tension without adjusting the bones, then it could make your pain worse.  They’re taking the job away from the muscles.  The muscles are trying to stabilize you, and if they try to release those muscles and they haven’t stabilized your bones, your pain can get worse.  So please know that, and if your physical therapist or your chiropractor – I know chiropractors are adjusting the bones, but they’re not looking at the bones of the pelvis in the way that I teach.  There’s different motions that the pelvis goes through that everybody agrees on, but nobody is really agreeing to this idea that the bones of the pelvis can stay stuck in an open birthing pattern.  And it’s funny, Kristin, because so many laypeople and doulas, as well, are like, oh, that makes so much sense.

It does, absolutely.  And I remember in my early years as a doula, I attended a Zulu workshop, and there was a closing of the bones ritual.  Now, that was more symbolic and healing after birth.  It wasn’t necessarily dealing with your topic, but that term was very familiar to me.

Right, and that’s a beautiful ceremony.  It’s a beautiful idea.  I love it.  But it may not address everything because the hip bones are in the way to really moving the ischial bones back into place, and that sacrum being backwards might need some external mobilization.

I do have a free course on my website.  It’s the Sacral Flexion Pattern.  Again, this is for practitioners.  The common postpartum patterns, anyone can sign up and take a look at.  I go into more detail of all the different things that can happen in the postpartum body, but the sacral flexion pattern is really for practitioners.  And I teach practitioners how to treat the sacral flexion pattern, and that is a game changer.  Again, like I said, the pelvic floor muscles are on stretch.  When we bring those bones back together, then the pelvic floor muscles are in a much better position to be stronger.  And there’s a couple other things that can limit pelvic floor muscles’ strength, and tearing is one of those things that we talked about.  When we have scar tissue in there, scar tissue is not as flexible as normal, healthy muscle tissue.  And so the scar tissue can inhibit that muscle from being able to function well.  But you yourself can get in there and massage that scar tissue.  Just offer compression to it and squeeze it and see if you can’t get it to, like, melt between your fingers, because that can help minimize the amount of scar tissue in there.

The other thing I want to make people aware of is when we’re stuck in this open birthing pattern and these pelvic floor muscles are on stretch, trying to have intercourse can be really, really painful because the muscles – the vaginal opening is on stretch.  It can’t open up more to allow the penis to come in.  That insertional pain is the pelvic floor muscles are not happy.  They need help relaxing so that the penis can insert without pain.  We need to release that scar tissue, and we need to relax the pelvic floor muscles to help with insertional pain with intercourse.

There’s also deep thrusting pain with intercourse, which can be from the cervix not being able to move out of the way, and scar tissue from C-section scars can cause that.

Back to another issue for why the pelvic floor muscles can’t be strong after birth is that as that baby comes on out, it smushes the bladder out of the way, and it can smush it off to the side, and then the bladder gets stuck over there.  And I can find the cervix in any position intravaginally after birth.  It can be stuck to your right wall, your left side vaginal wall.  It can be pulled back.  It can be poking into your bladder.  If it’s poking into your bladder, you feel like you have to pee all the time.  So getting that cervix back into its midline position by balancing the uterine ligaments and getting the bladder back into place instantaneously changes the strength of the pelvic floor muscles.

That’s amazing, because that is a common concern is that, yeah, frequent urge to urinate after that postpartum healing phase.

And that stress incontinence.  When the bladder is off to the side, the pressure from your abdomen can’t reach the urethra.  And so that’s why the pressure only hits the bladder and so that’s why we leak.  If we can get the bladder back into place, then some of that abdominal pressure can hit the urethra and the bladder and keep the differentiation of pressure inside so that you don’t leak.   That’s a bigger concept than most people might understand there, and I’ve really simplified it, but there is a reason, with the bladder being off, that can cause stress incontinence.

Another thing that can cause stress incontinence is that your lower body is jutting out when you go to laugh, cough, sneeze, which increases pressure on your bladder.  So your upper abdominal muscles are pushing down, causing your belly to jut outward, and that can increase pressure and every time you do that, you can be leaking urine.  So you need to learn how to get your lower belly muscles activating stronger than your upper ones to keep the pressure away from the bladder when you laugh, cough, sneeze.  So if people just put their hands on their lower belly and they cough, the belly should draw up and in.  If it’s pushing out, that’s something that you need to work with for your belly.

Excellent tip.  Another common postpartum concern is hemorrhoids.  How would some of your tips factor in there?

Yeah, so the hemorrhoids are around the anal sphincter muscle, and the anal sphincter muscle, I find, knots in most every single postpartum person that I work with.  And the anal sphincter muscle gets so stretched out from the way the baby has come on out vaginally.  And those knots can create problems with hemorrhoids and also fissures.  A fissure is a tear inside the rectal anal canal that every time you have a bowel movement, you’re opening up that wound, and it really feels like you’re pooping glass.  It’s so painful.  So any time anyone is dealing with hemorrhoids or fissures, you need to release the knot in your anal sphincter muscle, and it’s super easy to do the top half.  You can just put your thumb in vaginally and your finger in on the anus and just kind of press around and see if you feel any knots or tenderness.  But to do the lower half of the anus, you need to maybe put your thumb in on the anus and kind of push down.  If you think about the anus like a clock, you should be able to push in all different hours of the clock, and they should feel nice and mushy and mobile.  But if it’s harder or thicker, that’s a tension in that muscle, and it needs release work.  Compression of that knot in that muscle can help it to release.  And so if you can check that out yourself and try to release what you can – if not, one of my practitioners who have taken my postpartum course can help you out.  They know how to release it, and then they can show you how to continue to do it yourself because you definitely – if you’re dealing with a fissure, you definitely want to release your anal sphincter muscle before every single bowel movement.

Excellent.  So is there a point where it would be recommended to release some of that tension?  Would it be immediately after birth or waiting for six weeks?

It depends on if you have any tearing.  So you need to let any tearing or episiotomy scar tissue heal well because it’s going to be way too uncomfortable if you still have stitches in there or if you have an open wound.  With a fissure, I find the open wound is opposite of where the tension is.  So if you have a sense of where the pain is in your rectum as you’re having a bowel movement, try assessing the opposite side of that circle and seeing if you can release that tissue.  That can help because it’s a circle muscle.  It all needs to open up evenly to allow the stool to come on out.  When we have those knots, that knot area can’t open up as freely, so the opposite side has to open up more.  Something’s got to give in order for that stool to come out, and that’s why tears open is because too much pressure is happening there because the opposite side can’t open as well.  So releasing that allows that sphincter muscle to open up more evenly, and it takes the strain off that open wound.  And that’s what helps it to heal.

But I’m saying if you tore vaginally and you had an episiotomy, wait for that tissue to heal before you go messing around in it.  But if you have a fissure and an open wound, you want to try to work with the anus outside prior to having bowel movements to help that to heal.

Okay.  Thank you.  Any other tips or healing conditions that we didn’t discuss?

Oh, there’s so much.  There’s diastasis recti, and you need to release the oblique muscles for that.  There’s an oblique release that needs to happen to help speed up the healing of diastasis.  And then understanding how the belly gets messed up from birth – all that is covered in my Confidence in the Core, Floor, and More course.  That course is designed for moms, so you guys can check that one out.  All the other courses on my website are for practitioners.  But that has a ton of information in it that can help you understand why your body is being the way it is and what you’re experiencing.  And that Confidence in the Core, Floor, and More online course is appropriate for anyone to take.  There’s more information there.

And then I really just want postpartum people to know that healing is possible.  Doctors don’t give you that sense.  So they’re just kind of like, oh, well, you had a baby.  What do you expect?  And there is healing that can occur, no matter how old your baby is.  Please know that there is support for you to feel better in your body after birth.  And if you’ve been working with a pelvic floor PT or you’ve been seeing a chiropractor for a while and you’re not getting results, please check out one of my birth healing practitioners on my website.  Check out the link to the directory and see if there’s someone nearby.  And also recognize that if you feel your birth was traumatic, you need to work with the trauma from that birth first.  And that is something that I can assist people with via Zoom.  You do not need to be in person to do that trauma release work.  That can be done over Zoom.  So you can reach out to me at the Center for Birth Healing.  That’s my clinical practice.  Just reach out and fill out a form and we’ll get in touch and we can set something up.  That is how I would like to support moms, knowing that there’s practitioners that I’ve trained that know what I’ve talked about here today, and they can support you.

I also have a Facebook group, Institute for Birth Healing Community, that not all of my practitioners who have studied with me are on my directory yet.  I’m working on it.  But there are lots of others who have taken my courses that just are not in that directory.  So find my Institute for Birth Healing Community group.  It’s another avenue to try to connect with someone in your area.  Ask the join that.  And there’s practitioners and moms in there alike, and you can see if there’s someone in your area that people recommend.

Excellent.  You shared so much wisdom in 30 minutes.  Any other social channels you’d like to promote outside of the Facebook group and your website?

Yeah, @instituteforbirthhealing on Instagram.  Join me there, and you can hear what I have to say on Instagram, too.  And then I talked about the YouTube channel, as well.  Those are the best channels for me.  Thank you.

Thanks so much!  We’ll have to have you on again, Lynn.

Absolutely.  I would love that.

IMPORTANT LINKS

Institute for Birth Healing

Lynn’s directory of practitioners

Birth and postpartum support from Gold Coast Doulas

Becoming a Mother course

Kelly shares the pros and cons of top breastfeeding gadgets with Kristin in the latest episode of Ask the Doulas.  Check out her free gadget videos here and subscribe to her YouTube Channel and her Breast Friends Forever Club for more videos as Kelly comes across more gadgets and the latest lactation research.

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am thrilled to chat with our resident breastfeeding expert, Kelly Emery.  Kelly teaching breastfeeding classes with Gold Coast Doulas, and she owns Baby Beloved.  She is a registered nurse and international board certified lactation consultant.  Hello, Kelly!

Hey, Kristin.  How are you today?

Doing well!  So our topic of the day is breastfeeding gadgets.  I know that you encounter – there are so many new gadgets that I can’t even keep up with everything on the market.  I would love to hear your thoughts on what you and your clients are loving, what you feel neutral, and what is a negative in your book.

Sure.  It is hard to keep up sometimes.  I’ve been doing this since 1994, and these gadgets have exploded.  I think it’s the internet.  There’s a market for all these things.  It spreads like wildfire.  If somebody says, oh, I used this product and it helped me a lot, it’s going to spread like wildfire.

Exactly.  Whether it’s TikTok, a moms’ group, influencers.  There’s just so many more ways to communicate new products on the market than there used to be.

Yeah.  And more moms are breastfeeding, too, and there’s inventive people out there trying to get some solutions for some nursing problems, so I get it.  I understand it.  I try to, with my clients that I see, go over the pros and the cons, and is this really helping or is it making things worse?  Just like with any product, there’s going to be a little bit of detective work to see if this is really working or not.

Definitely.  So what is your first product?

I have ten little gadgets that I gathered together that I think are some of the biggest ones that I see in my practice.  The first one is the Silverette.  They’re these silver cups, and they look like little rounded hats.  You put them on your nipples, in between your bra and your nipples.  It has a cooling effect.  It has silver in there, which has some antibacterial properties.  And it stops your nipples from rubbing against the bra if that’s something that irritates you.  Pros and cons: they can be very soothing.  One of the cons is they’re very expensive.  They’re in the $60-70 range.  There are some that I’ve seen that knockoffs, probably less silver in them these days, so there are some out there in maybe the $30-40 range.  But typically the really good silver ones are $60-70.  They come in two different sizes, so if you have a smaller nipple or a larger nipple, you can get those.  It’s hard to tell when you’re ordering it on the website.  I don’t know what their return policy is, but hopefully they would take it back if you got the wrong size.  Typically, they would both work.

One of the cons that I see and other lactation consultants that I see is when moms are using them too long.  We even have a word for it, called the Silverette sign.  If moms are eight weeks in and still using the Silverettes, something might be going on here.  Do you still really need those?  Why are you still in pain six to eight weeks in?  The Silverette sign is something that we look for if moms are still using them on a daily basis for pain.

The other thing is they kind of collect if moms leak.  Not every mom leaks, of course, but if you do leak and your Silverettes kind of are wet all the time and your nipple skin is bathed in wetness 24/7, that can irritate the skin.  Think of wearing a bathing suit all the time; you’re going to irritate the skin.  So if you’re leaking a lot into them, I would definitely give them some dry time in between, or else it’s always wet.  It’s going to damage the skin.  That’s my two cents on Silverettes; the pros and cons.  If you do use it, I would use it for a short amount of time, and if you’re not getting better with them, I would reach out for help.

Excellent advice.  What’s next?

The next one  is the massagers.  There’s many on the market.  One is called LaVie.  They can heat up; they can vibrate, and it’s a little thing that you can put on if you have some tenderness or some hardness on your breasts; you can put it over that area.  A lot of moms swear by them.  I think you can turn the heat on or off, so you can do just vibration or just heat or both.  That’s kind of nice.  And sometimes it feels really good to maybe unclog some stuff or if you feel like you have some hardness in your breasts, you can pop it into your bra and it just sits in there.  It’s kind of thinnish.  It’s not that big, so you can kind of pop it in there and just go about your day.  But one of the things with the massagers – I would be careful of them not getting too rough because some of the things that we find with mastitis, which is basically inflammation of the breasts, any kind of hardness that you may feel, you don’t want to be too rough with the breast tissue.  You don’t want to push really hard on the breasts.  It’s kind of like petting a cat.  You want to do gentle breast manipulation.

Similar to what you do in the shower when you have some clogged ducts, yes.

Yes, just something kind of gentle.  Just don’t try to bruise yourself.  We’re finding that with too much pressure on our breasts, it just inflames the tissue even more, which makes total sense.  And then all the tissue around that area is even more inflamed, so that’s no good.  With the massagers, I would use cold instead of heat.  There’s a new protocol out this year about breast pain, and it’s a lot caused by inflammation.  And what do we do when we’re inflamed, like when we twist our ankle and it swells up?  We put ice on it.  We don’t put heat on it.  So if you did want to use one of these massagers, I would be hesitant to use too much power, but also, I would focus more on cold if you did like the sound of this massager.  That’s about all I have to say about that one.

Excellent advice.  What’s number three on your list?

Number three is the hydrogel pads.  I actually used these.  They’re for moist wound healing, and in my days when I would work in the hospital, like with elderly patients – I’ve worked in nursing homes with elderly patients and stuff like that a long, long time ago – during nursing school, we would use these pads that would be kind of like loose dressings that would go over the skin, and it kind of helps the skin prevent a scab from forming.  It helps kind of heal from the inside out, sort of.  So sometimes moms who have almost like a rugburn on the face of their nipples – these can be very soothing.  Soothing for moms.  And you just wear them for 24 hours, maybe 48 hours, and it should heal you enough.  Again, if you’re using the hydrogel pads for weeks and weeks and weeks, that’s another reason to reach out to a lactation consultant, too.  These should be temporary things.  They’re cooling, and they feel wonderful.  They’re cheap.  You can get four of them for, like, $5 at Target.  They’re easy to use.  You don’t have to really scrub your nipples or anything; they’re safe for baby.  Sometimes I tell moms to have some before you have a baby.  Put them in the fridge, and then if you do happen to get sore nipples, they’re there, and they’re cold and nice and soothing.  If you’re super cracked and bleeding and stuff like that, you may want to reach out to your lactation consultant or your doctor about another kind of healing method.  But those are nice for a little bit of minor pain on the tips of the nipples.

Right, and since it’s inexpensive, it’s good to have on hand.

Yeah.  If you don’t need them, you can always regift them to a friend.  Or use them on any other cut on your body, actually.  Like if you cut your knee or something like that.  They’re good for moist wound healing for any purpose.

So what’s next, Kelly?

The next one is a very popular one.  Milk collectors, so things like the Ladybug or the Hakka.  There are tons of brands.  It’s just exploded.  They’re sometimes circular or oval, and you can pop them right into your bra.  Sometimes you can have suction on them and sometimes not; they just hold them there.  But if you leak, say you start nursing on one side and you’re leaking on the other side, you can collect some milk.  You can get milk passively, because when you let down on one side, you also let down on the other side.  Sometimes, some women who leak can put that little collector in, and then they have a little bit of milk to put in their freezer or whatever they want to do with it.

I could have used those for sure when I was breastfeeding.

I know.  I would just put a cloth diaper into my bra because otherwise my whole bra would get soaked on the other side.  So there’s good and bad.  It’s nice and convenient, a way to get a little milk, and everything kind of passive.  The downside that I see of this is that, number one, it’s something you have to carry around all the time.  It can become another thing I have to wash, another thing I have to carry around, all that stuff.  The other downside that I see is if you start getting too much milk in this thing.  If you’re using it eight to ten times a day and you’re getting two ounces each time, that’s 20 ounces a day.  That’s another baby.  You’re telling your body that you’ve got twins, basically.  And this perpetuates an oversupply, which can be – sounds like a good thing, but then it’s a job.  It’s a job if you’re having to do both.  Now you have to take the collector with you to take out this milk, otherwise you’re going to be uncomfortable on the other side.  So pros and cons of it, I would say just use it sparingly and judiciously.  And also, I’ve seen this too, Kristin, where a mom nurses – say she starts on the right side.  She puts that collector on the left side, and it takes out two ounces.  Now when she moves baby over to the left side, they’re frustrated because somebody – the Hakka – just took out all my milk.  Like, what are you doing here?  Not that your breasts won’t regenerate more milk, but it’s going to be a little harder for the baby to get the milk out because we just basically pumped out or removed two ounces from the left side.  So I always tell moms to give baby first dibs on both sides.  So if you start on the right and then you go to the left, then you can put the Hakka on the right side that baby is already done with.  Does that make sense?  Let the baby have the first dibs at the milk, and then whatever’s left over – half an ounce, a little quarter ounce, anything like that on the other side, you can squirrel that away for a nice little stash for going back to work or whatever.  But it’s not like removing so much milk that it’s going to make the baby upset.

Good point.  Okay. 

The next one is alcohol strips.  You may see them – well, all over Target and on the internet.  So if moms want to have some alcohol and they’re kind of wondering if it’s going to be safe for me to give my baby this milk –

It’s one of the most common mom Facebook group questions.  I have to go this event, like a wedding, for example.  Can I have a drink?  I’m still breastfeeding.  The whole bit.  It’s still a very common question.

Interesting.  That’s probably why this product has come along and is still on the market because there’s that question about this education.  And I will tell you that just from a physiological standpoint, your blood alcohol level and your milk alcohol level are the same.  So if you start drinking and your blood alcohol level goes up, at that same time, your milk alcohol level is going to go up as well because alcohol crosses over so well.  However, as you sober up – say it’s been a couple hours since your last drink.  As your blood alcohol level goes down, your milk alcohol level is also going to come down.  So you don’t have to pump and dump.  Your liver – your whole system, your body is going to filter it back out, into your liver, out of your body, out of your milk.  So it’s not something that you have to really worry about if you give it some time.  Time is what’s going to make your alcohol level go down in your milk.  I usually tell moms, feed your baby, and right after that, then you can start drinking.  Or say you’re at a wedding and you don’t have your baby.  Pump, and then you can start drinking, and then, say, three hours later, if you didn’t drink a lot, that alcohol should be out of your system, and you can just pump that milk and keep it.  If for some reason you’re drunk when you’re pumping, then that’s a different story, because if you’re drunk and you’re not even safe enough to drive, then I know your alcohol level is high in your bloodstream, so I know it’s high in your milk, as well.  So for those instances where you’re like, okay, overdid it here; I’ve got to pump, though, because my breasts are going to explode – for that milk, I would still keep it, but I would label it high alcohol milk, and then what you can do when you go home, you can dilute it with your other stash.  You can dilute it with 20% of the high alcohol milk and 80% fresh milk without alcohol.  Does that make sense?

It does.

A little bit of alcohol is fine.  If you’re safe enough to hold your baby, you’re safe enough to breastfeed your baby.  We’ll put it that way.  If you don’t feel safe walking around holding your baby or driving or anything like that, yeah, then I would pump and either dump it or label it and save it, like dilute it with other milk if you want to go to that trouble.

The alcohol strips, they will work, but sometimes they’ve gotten some false positives.  I’ve seen this in a lot of literature that we look at; it’s not 100%.  Those alcohol strips are not 100%.  I think moms mainly can just trust their body.  If they have an alcohol problem, this is a different conversation to have with their doctor and lactation, everything like that.  But if they have someone around them, if they have a friend, if they have someone else who – definitely if they’re sober and they can kind of tell, oh, I think you shouldn’t be driving – then hopefully that person would kind of step in and say something, too.  Like, you should probably dump this milk if you’re going to pump it, or we can save it.  We can do a milk bath with it, for heaven’s sakes.  You don’t have to totally throw it away.  The strips are okay, but I just wouldn’t make that the only definitive thing.  I would say, what was my state of mind?  What was my alcohol level at that time when I was actually pumping?  Does that make sense?

It does. 

Typically, we process alcohol about a drink per hour.  So that’s, like, a beer, a glass of wine, all of those.  We process it out of our body about a drink per hour, if that makes sense.  So if you had one drink, definitely by two or three hours, that’s going to be out of your system.

Right.  So meeting a friend for happy hour, going to a wedding, that would be fine with one drink.

That would be completely fine.  If you have four drinks within two hours, then that’s a different story.

Thank you for clarifying.

No problem.  The next one is cooling packs.  Number six is cooling packs, and those are – you can’t not see them on the internet.  You can put them in your freezer; you can put them in your refrigerator.  Sometimes you can put them in your microwave to heat them up.  They’re nice.  Some of them are very – like, there’s booby tubes that are nice and soft and you can just kind of wrap them around and put them inside your bra.  So especially with cooling packs, for anything with inflammation, when we get a hard area in our breast or red on our breast or if we get engorged for day three, four, five when our milk is coming in and we’re engorged, or say we’re ready to wean and getting engorged – cold is the way to go.  It’s going to help inflammation go away.  It’s going to constrict your blood vessels.  Lots of good things about being cool.  So the cold packs – especially the softer ones fit really nicely.  If you don’t have the money for that or if you’re in a pickle, I also have moms take just diapers, like baby diapers, and fill them with water and put them in the freezer.  They have a nice shape around them that they fit around the breast really well.  When they leak, they usually just go into the diaper again.  They’re not going to leak all over your bra.  The other one is just some frozen peas wrapped in a towel, if that’s all you’ve got and you have, like, one little area that’s kind of hard or painful to touch, you can get some frozen peas.  Right next to your skin is probably going to be a little too cold, so wrap it in a thin towel and then just put it on that area.  You can go all the way from those fancy things all the way down to just some frozen corn in your freezer for that.

Excellent. 

And then the next one is pillows.  There are so many pillows on the market.  We don’t have Babies R Us around here anymore, but on the internet, it’s a ton of options nowadays.

Yeah, it’s not just Boppy and My Breast Friend.  There are so many on the market.

So many.  And whenever moms come to my office to help with lactation, I always broach it as this is going to be a personal thing.  When moms are first starting, especially if they have a C-section, and they don’t want baby even potentially bumping into their C-section scar, their incision – they like the thought of a pillow.  So, cool.  You can use pillows.  And a lot of moms do in the beginning when they’re first getting – it’s kind of like training wheels.  You start with all this stuff that helps you focus and helps you feel your confidence when you first start this.  But over time, moms usually will ditch the pillow because it’s in the other room and I’ve just got to feed, or I’m out and I don’t want to have to carry this big pillow with me.

Exactly.  Or with baby two or three, it’s like, all right, I’ve got this.

Yeah.  Sometimes just using your arm and sometimes if you’re out, you can put your diaper bag underneath your elbow for support or find a chair that has an armrest with it.  When they’re in my office, I usually take that opportunity to say, would you like to try without a pillow, just old school?  Like it’s 1624.  It’s not 2024.  And they don’t even have nursing pillows.  Do you want to try it old school mammalian way?  And they usually do, and it’s so cool to be able to show them how they can do this without any devices.  That gives them flexibility for going out, or if I forgot my pillow or I’m in the back of my car and the baby’s screaming and I have to feed in the car.  Then you can just do it old school, and it’s nice to have a pillow, but it’s also nice to know that you can do it without it, too.

So what’s next?

The next one is breast shells.  One is for inverted nipples or nipples that kind of fold in.  So there are shells that you can use that are kind of smaller.  They fit at the base of your nipple and they kind of help draw it out.  There’s no crazy good research saying that using them prenatally will actually make your nipples stick out postnatally, but sometimes it helps to – what I find it helpful with is if moms are engorged.  It’s kind of like reverse pressure softening, which means you’re putting a little pressure at the base of the nipple, pushing fluid back into the areola.  So sometimes if we’ve had a lot of IV fluids in labor and delivery, sometimes we can get some edema around our nipples or areola area, and the nipple kind of flattens out.  You can either use reverse pressure softening with your fingers, or you can wear those little shells inside your bra.  Another one is for – the wider opening of the breast shells is for sore nipples.  You can put those inside your bra, just like the Silverettes, so your nipple is not rubbing against fabric if you’re tender.  I will tell you with both of those things, breast shells too, make sure your bra is not too tight.  Because I’ve had it where moms put it in, but the bra is really tight, and then you take it off and there’s a big ring, like it’s been pushing into your skin.  That’s not good, either.  If you did want to use a tank top or something that’s not so tight against your breast, that’s better.  If you’re using these for too long, past the first week or two, then I would reach out for help to see what’s going on about why you’re still sore and needing those.

Then number nine is nipple everters.  It’s Lansinoh brand.  That’s the only one I know of, Lansinoh brand.  It’s purple.  It looks like a little bicycle horn, like you’d have on your bicycle.  You put it over your nipples, and – well, you squeeze and then put it over your nipples, and then you let go.  It suctions your nipple in there and pulls it out.  That’s something if moms have flatter nipples or their nipples kind of dimple in or they’re inverted, sometimes that helps bring it out long enough for the baby to latch.  Sometimes in the hospital, they even have them in the hospital and the nurses will give it to you right after delivery.

Pros and cons of that – pros is that it can work well to pull out your nipple, for some women, not everybody.  The cons are, I’ve seen some moms use it and it’s too much pressure and it leaves a hickey.  So if you are going to use those, be really careful about your suction level and don’t bruise yourself or leave yourself a hickey around your nipple, because that can make you sore.  That’s no good, either.

Again, going back to old school, if you didn’t have your everter – it fell on the ground, you can’t find it – you can just take your pointer finger and your thumb and just roll the base of your nipple.  Not the areola, but just right at the base.  You can roll it gently between your fingers, and often it pops out enough for baby to find it and to latch, as well.  So that’s another idea.

Excellent tip.  One more?

Yes, we made it.  The last one is going to be about lubrications and ointments.  With lubrications, there’s a lot of things out there.  A ton; again, a ton of ointments on the market out there, and some are very helpful.  There’s some with lanolin, there’s non-lanolin, there’s coconut oil.  Calendula oil.  There’s tons of little things out there.

So many organic ones.  Earth Mama.

Yeah.  So many to choose from.  Earth Mama, Angel Baby, Mother Love.  There’s just a lot on the market, and they’re all going to be probably pretty soothing to you.  Usually hypoallergenic, and they’re not going to cause any problems.  You’re always going to want to look.  If it’s got some weird things in there, you’re going to want to test it on the inside of your wrist a little bit to make sure you’re not allergic to it.  I have had some moms who, even though it’s supposed to be hypoallergenic, lanolin is irritating to them.  If they use it on other parts of their skin, they’re like oh, I had a reaction.  No wonder.  I’ve been using this ointment for four weeks.  No wonder I’m sore.  So just kind of test it just to make sure that you’re not allergic to some component of it.  Again, some babies, you put on ointment and the baby doesn’t like the taste of it, so you’d want to dab it off.  Some are like, oh, what is this?  This does not taste like you, Mom, and it’s too slippery; it’s too oily.  I’m not going to do it.  So you can just gently dab it off before you nurse.  Then there are lubrications, like for pumping.  There are pump sprays out there.  Sometimes it can make a really big difference.  You’re going to want to get the right size of brush shield flanges, and a lactation consultant can help you with that.  But also, especially if you’re a little tender, a dab of that stuff around the base can really help with comfort, too.  You can use coconut oil.  Anything food grade, like coconut oil or olive oil if your skin isn’t sensitive to that, or any of those pumping sprays on the market.  You can go all the way up to buying a pumping spray all the way down to just grabbing some coconut oil from the your kitchen from wherever you keep it.  And just a tiny dab will do you.  With any of these ointments, you don’t have to overdo it because it can get too slippery, and that can make you increase your suction on your pump too much, and then we cause damage.  Just a little dab will do you.  Everything in moderation.  And some moms don’t have time or money for any of that and will just use their own milk.  You can hand express some of your own milk and rub it into your nipple or rub it onto the breast shield while you’re pumping.  That might be the old school way to do it, as well.

Thank you for sharing all of your gear tips!  I appreciate your expertise!

You know, and Kristin, I’m not someone to take away a gadget that’s working for someone.  I know that sometimes you find something – if you’re desperate and you’re looking for hope and you find something and it works, you’re going to say, I don’t care.  This works for me.  I’m not going to give this up.  This one thing really works for me; I’m not giving it up.  So, cool.  If it’s working for you, beautiful.  If it’s something that is going long term –

It’s like a crutch in a way.

Yeah.  Say with the massager, you’ve got a lump, and you get rid of it.  But then it comes back again.  If you’re needing this massager, like if you keep getting lumps and you need the massager, yes, it gets rid of the lump, but then why are we still getting lumps?  I would recommend doing some true detective work about figuring out why we keep getting this issue.  Why are we still sore a month later?  What’s going on?  And that’s where it would be good – if you find you’re using too much of these gadgets all the time, it might be a good point in your lactation journey to reach out to a consultant to figure out why we’re needing these going forward and how we can maybe get rid of some of these training wheels so maybe we don’t need it anymore.

Exactly.  Any final tips for our listeners, Kelly?

No.  I mean, I went through these quickly, but I have a YouTube channel, and on my website, I’ve got videos where I go through all of these ten things and more, just about old school breastfeeding stuff and – there’s lots of stuff on there on my free resources page.  That’s where I have all the videos, and I go more in depth about these ten things that we just talked about.

Excellent.  And I wanted to give you a shout out.  You are an amazing contributor in our upcoming book, Supported: Your Guide to Birth and Baby, in the feeding section of the book.  That will be out on Mother’s Day, actually.  So very soon!  Thank you for sharing your wisdom with our readers and our Ask the Doulas podcast listeners.

Yeah, you’re welcome!  And congratulations on this book!  It’s no easy thing to write a book, so congratulations to you.  I cannot wait to get my hands on a copy!

Can’t wait for you to see it in person!  And I would love for you – you shared your website, Kelly, but for you to share your other social media channels.  You mentioned your YouTube channel.  You’re on Instagram, Facebook, and so on?

Yeah.  All of the things.  You can find me – usually, it’s going to be “inc.”  Somebody else had Baby Beloved, so I had to do Baby Beloved Inc.  So @babybelovedinc.  That would be my handle for Instagram, Facebook, and my website, too.

Thank you so much, and we’ll have to chat about pumps next time.

Absolutely.  There’s a lot on the market for those, too.

Definitely.  Thank you!

 

IMPORTANT LINKS

Baby Beloved

Kelly’s free resources

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother class

Kelly’s lactation class at Gold Coast

 

Kristin chats about the Fear and Now Documentary with Liat Ron, producer and director.  Kristin and Liat discuss how HypnoBirthing impacted her second birth and why she decided to create a documentary about her experience along with the experiences of other families captured in the film. 

Hello, hello!  This is Kristin with Ask the Doulas, and I am so excited to chat with Liat Ron today.  Liat is a filmmaker, among many other things.  She’s also an actor, writer, producer, Middle Eastern dancer, and co-founder of Techealthiest.  Welcome, Liat!

Hi!  I’m very, very excited to be here.  Thank you for having me!

Yes!  Gold Coast is all about HypnoBirthing, and we’ve been teaching the HypnoBirthing childbirth preparation method since we launched the agency in 2015.  So when you approached me about your new film, Fear and Now, I was all about chatting, and not only about the HypnoBirthing method, but also about birth trauma and some of the other topics that your documentary covers.  I’d love to hear a bit more about your background and why you chose this particular topic for your new documentary.

Well, I think the topic chose me.  I did not intend to become a documentary filmmaker.  I mean, I do come from the film, acting world.  I’m a producer.  I produce theater.  I haven’t considered becoming a documentary filmmaker, until my second birth.  I’ll take you back a little bit before my second birth.  Not just a little bit; my whole life I was scared of birth, I would say more than anyone I knew.  And it was, I think, in the level of phobia if somebody had to analyze me.  And then I was pregnant for the first time, and I thought I did all the proper preparation, and that birth wasn’t a good birth, but I expected it not to be good.  But what happened is that the fear intensified after the first birth.  In other words, when I got pregnant again, I was more terrified.  So when I came across HypnoBirthing – actually, the first time I came across HypnoBirthing was in a Barnes & Noble when I saw the book, and I really dismissed it, although I was really drawn to it.  I just basically browsed it in the store, and I was like, okay, this is too good to be true; bye bye, in my second trimester.

And then when I was in my third trimester – actually, week 30-something – somebody mentioned a class opening, and again, I just – it just sounded too good to be true, really.  And I only signed up for the class because it was becoming – I had nothing to lose.  It was my last resort.  Let’s see if something good can happen.

Yeah, what could hurt in trying the class?  You can always take something from any class or book that you read or podcast you listen to.  There’s always a good takeaway.

Yeah.  And I was still resistant.  Actually, the first class, I was like, okay, this won’t work for me.  I’m sorry.  I’m not someone who meditates.  I’m not – I can’t, like, sit and let go.  And the teacher told me, Liat, it’s not about letting go.  It’s about hyperfocusing.  I can do that.  I can hyperfocus.  Actually, I feel like HypnoBirthing is so beneficial for Type A, even more so.  We’ll get into that in the name.  It’s like the crunchy mama, but all the elements of HypnoBirthing are very mainstream, very scientific.  It’s just that it hasn’t been exposed to mainstream world.

Exactly.  I do agree that it gets a different reputation, almost like the crunchy, only want a homebirth or unmedicated.  But HypnoBirthing is for everyone.

Totally.  What I love about HypnoBirthing is it gives you so many tools, and you choose what works for you.  Everything about HypnoBirthing is customizing your experience to what works for you and being in the driver’s seat of your birth.  So I’ve come a long way from someone who lets people make all the decisions, because they really know best, to really learning what makes me, Liat, feel safe.  What makes me feel supported; what makes me feel fear-free.  So that birth was incredible.  I blew myself away.  My son was born – and by the way, my feeling about what’s right for me was birthing in a hospital, but in a birthing room that won’t feel like a hospital, so I feel safe if there’s special circumstances.  There are all the interventions available, but I don’t want the atmosphere of a hospital.  And I got that.  I found that hospital.  I chose the people who would be my providers and my doula.  But I still didn’t expect it.  I applied all the tools, and the tools are actually fun because it made my experience of pregnancy more enjoyable.  You relax.  You take your time.  I loved rainbow relaxation.  I came to the birth.

My son was born in that room, not in the water, which, again, water, I thought – it’s about in the moment.  And HypnoBirthing, it’s about being in the moment.  My body did not want water.  My doula actually was very wise to do let me touch water, to put a little water on me, before we went into the water, and my body just rejected it.  So water would not work, but for other people, it does.  So I really led myself into this birth that was intervention-free.  I would say as pain-free as could be.  My son was 9.6 pounds, and after that birth, I really came to the conclusion that that was just a rare miracle and those things don’t happen, and how lucky and amazing it was.  And then I realized – I learned.  I did a lot of research.  That’s actually a typical HypnoBirth.

And did you stay in touch with any other students?  Did you hear their birth stories, or did your instructor facilitate any communication?  I’m curious about that.

We were in a small class, and I did not stay in touch, but I do know that at least one did not go with a provider that honored HypnoBirthing, and that – you know, the tricky thing with providers is that they can tell you, oh, HypnoBirthing, no problem.  But when you get to the moment of birth, they totally take the agency away from you and they take charge.  So you really need to choose your providers, and they don’t have to be experts on HypnoBirthing.  In fact, we filmed providers who you can see they don’t know exactly what HypnoBirthing is, but if they’re not conducting themselves based on their big ego, then their job is easier.  They love it.  You know, doctors that really don’t operate from ego, they love it.  They’re not the god of the birth.  They’re not the owner of the birth.  And it makes it more enjoyable for them.  So there’s really no reason for providers not to support HypnoBirthing.  But yeah, in my case, it was that I did have the right providers, and I think it says a lot.  We should all have access to these providers, and all providers should consider it.  But I think that a film like my film will show that there’s nothing weird or esoteric about HypnoBirthing.  And we’re also going to make our choices, and then providers that don’t support HypnoBirthing maybe won’t do so well.  I mean, we live in a capitalistic, patriarchal system, so we’re just going to make our choices.  That is really my goal.

But after that birth, when I realized that that is HypnoBirthing and it wasn’t just a rare miracle, I decided that the world should know about it.  It should be in what I call mainstream consciousness so people can make the choice, and also that HypnoBirthing should be accessible to all is another goal of mine.  But how do you do it?  That’s the next step.

I love that your personal experience translated to wanting to create this very important film.  So how many different couples did you interview?  What was your process in creating the film?

My process was very intuitive.  Maybe like HypnoBirthing; my husband keeps saying that the process and the film itself is almost like HypnoBirthing.  Intuition from the gut was very visceral.  I did not – I just – I would meet one person.  They would lead me to another person.  And you know, in the beginning, it was very difficult to find people who were willing to be vulnerable on camera, to share their births, to let us follow them.  It was hard as it was, but somehow our first day of filming after maybe a year of pre-production was scheduled for the end of March of 2020.  So that was a hurdle!

Definitely!

So everything was delayed, and actually, we restarted that summer, social distancing, and being very creating.  Actually, the pandemic made the film more creative than it would have been if it wasn’t for the pandemic, and once we got vaccinated, we started flying and really traveling and we were less limited.  But we traveled across the country.  We just followed different families with different experiences, and somehow everything I wanted to show in the film just happened organically.  I knew that, for instance, HypnoBirthing works for every birth, right?  You could birth free; you could birth in the OR.  And somebody asked me, does that mean that you don’t use anesthesia?  Well, exactly.  You need a film to show you.  It can be HypnoBirthing along with a C-section as it’s done in the hospital.  But we didn’t follow anyone who wanted a C‑section, and I don’t wish a C-section on anyone, so we ended up having what we call in HypnoBirthing special circumstances with a few of our couples, and you can really see the difference.  It’s amazing.  I’m very excited for the world to see it.

Another thing I wanted to show – I remember this nurse friend used to tell me, well, HypnoBirthing works for a second birth.  It worked for you.  But it doesn’t work for first births.  Well, half of our couples were first birthers.  There you go.  So it’s really incredible.  And the providers we met along the way – just, really, everything that I had in my mind that needs to be shown in my film happened and happened on camera, except for the things that we made a lot of discoveries, and some discoveries, we weren’t prepared for, and that happens when you make a documentary, especially a personal documentary.  But those, of course, ended up in the film, and I’m also very excited for the turns that the film took to become what it is right now.

Yes, I cannot wait to watch it!  It’s so needed, and I do feel like you having these organic journeys with couples where it’s not a predictable documentary, does make it even more perfect, and adapting as you do in HypnoBirthing to whatever comes your way and using the tools that you have.  We have students in our HypnoBirthing classes that have a fear of a surgical birth and need to have a planned Cesarean birth due to medical issues, and they used the relaxation and the pregnancy practice to overcome those fears.  So as you mentioned, it really is for everyone.

Totally.  This is the platform I’m comfortable with, film, but we just need to get it to the masses.  We just need to get this knowledge to the masses, and in the form of entertainment, I think, is pretty optimal.

Agreed.  And people do love consuming video, and there’s so many ways to access films.  I’m sure you’ll be having many launch events for the film in different locations, especially involving some of the couples that you filmed.  It’s got to be so fun to have them see their journey on film.

Yes.  All the couples that we filmed and followed were people who are normally private people, people who don’t like to be exposed to the world with their vulnerabilities, with their most intimate moments of giving birth.  But they were so dedicated to the idea that this is really the only way to show the world what HypnoBirthing is.  And the film is not a birth video that you would Google and see on YouTube.  The film is really an entertainment piece.  It follows a journey.  It follows stories.  There are obstacles that we all meet and conquer, and really, it took the people’s comfort level to be as high as can be, to be in this film.  And they were comfortable because they wanted this film to be out.  I’m very honored that they chose to share those moments with us, with the world.

Definitely.  And did you get in touch with HypnoBirthing International, or how did you collaborate with the – because there are similar methods, like Gentle Birth or HypnoBabies.  But you’re specifically talking about HypnoBirthing?

Yes.  I am talking about the original method.  The reason I’m talking about the original method is, A, I create from what I know.  I don’t know anything about the other methods.  I know what I was trained with, and it wouldn’t make sense for me to create from another viewpoint or needing to learn about other methods.  And it was also the first one.

Exactly.  They all were offshoots of the original concept.

I’m just putting it out there; it’s also on homage to Marie Mongan, who started this revolution.

She was amazing.  So birth trauma is a topic that you’re passionate about.  How do you feel this film and awareness can prevent some future trauma or help people in processing past trauma as they’re preparing?  As you had even mentioned, your first birth didn’t go the way you wanted, so you had some fears going into the next one.  I would like to explore that a little bit with you.

I touched on it a little bit before, about the discoveries I wasn’t prepared for.  Okay, so I was not passionate or invested in working through birth trauma or the idea of birth trauma.  My original idea was to bring a film to the world that shows what HypnoBirthing is and is inspiring birth revolution from within the system, which I can explain later what it means, but really, HypnoBirthing accessible to all, and to show what it really is.  I was carrying birth trauma from my first birth.  My assumption was that we all expect births to be terrible, and then they’re terrible, and that’s it.  A trauma is really – like, what happened to me, I was healthy, and my daughter in my first birth was healthy, even though it was very traumatic.  I suppressed that trauma because everything was sort of okay, and it was normal.  But I was holding on to trauma, and I wasn’t aware of it, and I wasn’t aware of what it was doing to me.

Now, throughout the journey of filming Fear and Now, I suppressed my trauma even more.  I actually developed guilt and shame whenever things came up for me because I met with people who almost died at birth.  So really, there was really no place for me to let myself think that I had birth trauma.  So I buried the trauma even more.  But I guess trauma is trauma.

It is.  That’s what I believe.

And every trauma has to be acknowledged, but the thing is that it’s so normalized in our society that we don’t even know that we have trauma.  All I knew is that whenever I started talking about that birth, I would start crying, and then I would just change the subject and do something else, and that was it.  So I had never talked about that birth until nine years later, accidentally, unintentionally, on camera towards the end of filming Fear and Now.  And that became the second theme of the film.  I did some research.  I learned that 30% of women who birth go through birth trauma.  30%.  And I found out that the research is based on self-reporting, but if we don’t know that we have trauma, then how would we self-report that we have trauma?  I believe that closer to 100% have trauma.  So what do we do with that?

First of all, we acknowledge it and we don’t minimize it.  We don’t suppress it.  We find a way to release it.  And I think there are many ways to release it.  It doesn’t have to be a fancy way.

The fear release in HypnoBirthing, for example, is one way.

To me, it was just talking about it and really letting it out and letting myself cry and letting myself really tell the story, and it’s as simple as that.  For deep trauma, you might need to release or process a few times.  But the bottom line is, the first thing is to be aware.  And it’s hard to be aware in a society that normalized birth trauma as really what you’re supposed to experience.  And I know that just as much as HypnoBirthing changed my life, the trauma release changed my life, as well.  So that became the second theme of Fear and Now.

I love how it organically unfolded!  What are your tips for our listeners as they prepare for upcoming births?  Or even pre-conception?

Especially, I come from really profound fear.  As a child, I remember, it was so scary.  And it took one birth, and then the second birth, I educated myself.  And I find HypnoBirthing is the most thorough course that’s offered.  That’s personally how I see it.  It’s really about awareness, right?  This film is about HypnoBirthing, but any type of education that teaches you physiological birth and how to release fears – I can’t tell people that everyone should do HypnoBirthing.  But I can tell people that everyone should know about it.  You should know about it, what it really is, because there’s so many misconceptions about it, including the name.  So I suggest, yes, exploring what this class is.  Actually, one of the reasons I was drawn to taking the class the second time around, that I thought it would be a refresher course.  It is very thorough in teaching you about birth, if anything.  But the tools are so powerful, and what I love about it is that it offers you so many tools that a few, for sure, would work for you, and really, also people who have had previous births or any traumas, to sort of – I mean, when you watch the film, you realize that it can just come up in the worst moments.  And I think that when you give birth – I think that if I didn’t have HypnoBirthing, my second birth would have been more traumatic because I was still holding onto trauma from the first time.  So finding out what trauma is, really.  It’s not – a lot of things that are trauma, we don’t consider as trauma.  I guess, cleanse yourself of your traumas as much as you can before you enter this world of birth.

Great advice.  So how can our listeners support your film, Liat?

Well, we are deep into post-production, which – we are basically in labor.  The film is in labor.  And baby Fear and Now is crowning.  We are, right now, in our last phase of fundraising.  You can go to our website, fearandnowmovie.com, to explore more about the film.  You can follow us on social media.  We’re mainly active on Instagram, @fearandnowmovie.  Also, on Facebook, we are @fearandnow.  You can sign up to our newsletter on the website.  You can reach out through our website or DM us, and we’d love to hear feedback or if anybody is interested in learning more about our plans for the future, we are here.

Love it.  Well, thank you so much for sharing your beautiful journey to creating Fear and Now!  I can’t wait to watch the film!

Yes, I’m very excited to be in this phase of post-production and really to get this film to the masses because that is the goal, really.  It is not – the film is not an esoteric, sort of grungy film, which there’s room for that, too.  It is a very mainstream documentary that is meant for the masses.

Perfect.  Thank you so much, and we will share information with our audience and our Gold Coast clients as we get updates on when the film is coming out!

Thank you so much, Kristin!  Thank you for having me!

IMPORTANT LINKS

Support Fear and Now!

Fear and Now

HypnoBirthing classes from Gold Coast Doulas

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Kristin Revere and Jess Hull discuss the concept of matrescence and the changes that happen to women when they become a mother.

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am thrilled to chat with Jess Hull today.  Jess is a former Facebook and Google executive who founded Mother Me, which is an app and online course and support framework for successful women who want to do more than just survive their postpartum.  The system Jess developed is called the Mother Me Method, and it’s based on the science and data of matrescence as well as incorporating global perspectives on how other countries and cultures support postpartum women.  Welcome, Jess!

Thank you!  Thanks so much for having me!

I am very excited to dive into the major transition that I don’t feel like gets enough acknowledgment in becoming a mother.  I actually have an online course called Becoming A Mother that started during the early stages of the pandemic when we had to move everything to virtual, and it’s all about women supporting women and a mix of preparing for birth but also the transition to motherhood.  So we have a similar concept, but I love that yours is so research based, clinical, academic focused.  So I would love to hear more about what drew you to this rite of passage and major life occurrence.  Was it a mix of personal and professional coming from the tech industry?  It’s a big change.

Yeah, absolutely.  So I had two children very close in age.  They’re 18 months apart.  And with those postpartum experiences, I felt like my world was rocked both times.  The first time, I like to say that I was comically naïve on what to expect.  Then the second time, you’d think, okay, you’ve been through this.  You know, you should know a little bit more, be better prepared.  But the reality was, my mindset going into it was really just about surviving.  And I was like, I got through it before.  I can get through it again.  And after getting through it, I realized I didn’t really want to have more children, not because I didn’t want to grow my family, but because I didn’t want to have the experience of postpartum again.  And that mindset of just struggling through something that’s meant to be such a beautiful time, I realized, was what was holding me back.  So I started just looking at some data and research, and again, that’s where my background in tech came into play.  I saw that 90% of women felt unprepared for the postpartum experience.  So that helped me feel validated, number one.  But number two, that gave me hope that 10% of women were doing something that helped them feel better about it.  So I used that insight to say, well, what are they doing?  I’m really curious.  What works well for people?  And it’s not just a naïve first time mom problem.  As a second-time mom, I experienced it, too.  And the more I talked to other friends, family, and coworkers going through it, it was shockingly universal how many people felt the postpartum stage was truly something they just wanted to survive.  Like, how low the bar was set that we didn’t even want to enjoy it.  We just wanted to get through it.  So that was really the key catalyst in getting me to explore this space.

And then I started to talk to my husband about it, and we said, what would need to be true for us to feel confident in expanding our family, that it wouldn’t rock us again and that we could do more than just survive?  That’s really how I started down this path and used my background in data and research to understand, again, the insights that would help me feel more empowered rather than just survival mode that we sort of default to.

Yes, and it makes perfect sense with your background in tech to transition to an app to be able to merge your personal experience and your background and also just being able to promote a multi-option business, between the online course and the support that you have.

Yeah, and again, sort of in work and in practice, we know that people can have the best information in the world, but if it’s not convenient and it’s not actionable, they’re not going to do it.  So convenience, I think, is a key part to changing an outcome, whether it’s in postpartum or in any aspect of life.  So I really wanted to design a program that would fit somebody like me who was a busy working woman who has a lot going on but wanted to take care of herself and not have it be a massive time commitment or a huge learning curve.  I’m a very visual learner myself, so developing the app with the video modules was something that I felt as a user I would really want.  And as somebody who’s creating content, you know, I didn’t want to blast it all over social media, either, so having a private community that felt like a safe place for moms to learn and grown and connect was really the heart of how I designed the business.

I love it.  So in your research, I’m curious about what you found that 10% of women were doing that helped them to feel confident and prepared in the journey to motherhood and becoming a parent, whether it’s baby one or baby five.

Yes.  So in the study of matrescence, we know that women go through universal changes and transitions in becoming a mother.  So for those who may have not heard the term matrescence before, it’s exactly like adolescence, which is the process of a child becoming an adult, except matrescence refers to a woman becoming a mother.  And just as in puberty you go through hormonal changes, social changes, identity, you have different nutritional needs, your brain evolves and you have neurological changes – the same exact things happen to women when they become a mother.  And I think that when we holistically embrace the process of becoming a mother, we feel not only more prepared but more at ease with the transition.

So much of what makes this process difficult for women is the cultural narrative on getting your pre-baby self back and feeling like your old self, and there’s this sort of obsession with who you were pre-baby.  Matrescence is really focused on embracing and evolving into the new version of you.  It’s almost like surrendering to the process.  If you think about an adult sort of clinging to the naivete of childhood, you’d be like, buddy, you got to grow up.  It’s just part of life.  And yet for women, it’s sort of like almost a source of – an unrealistic, unobtainable goal to say, I want to be my pre-baby self.  And that sort of unintentionally shames this new version of the woman you’re becoming who’s stronger, who’s more compassionate, more empathetic, and maybe knows herself more.  So it’s embracing this new version of you and accepting this idea that you are meant to change and you’re meant to be somebody new.  I think that’s the foundation to having a better experience.

And in my research, I looked at other countries and cultures and the things that they do to help prepare the women in their communities as they become mothers, and they really celebrate this rite of passage, and they have rituals that honor not only what the body goes through, but what the spirit and mind go through, as well.  So I think there’s lot of different aspects that play into overall feeling more prepared, but the first foundational element is understanding that you are meant to be somebody new.  And when we look towards nature, we see that all the time.  A butterfly started as a caterpillar.  They’re not meant to want to be their caterpillar self again.  But it can be scary embracing the new you, so I understand why so many people sort of fight that urge and that change.  Surrendering to that, I think, helps.

And motherhood in our culture can be so isolating.  And again there is that pressure to get back to work, get back to getting your old jeans on, and just back to that former life, that is really hard to embrace when you’re going through so many changes.  And after giving birth, it’s all about the baby, and the mother often feels left alone and behind.  In so many cultures, with your studies, as you said, it’s all about celebrating this new journey and mothering the mother for oftentimes at least a month, if not longer.

Absolutely.  That’s actually the reason I named my company Mother Me, because I wanted it to be a call to action for women and everyone to recognize that women deserve the same love and care that we give our newborn.  And I think in the US, our culture is sort of women priding themselves on being super mom and doing it all and having it all, and that contributes to the isolation that you mentioned.  Where in other countries and cultures, there’s much more community support and the village support that we hear about, and I think women yearn for that connection and support.  We don’t necessarily want to do it alone, and we feel like it’s a sign of weakness to raise our hand and ask for help, but in reality, it’s a sign of strength to recognize, I need help at this moment.  And guess what?  I deserve help.  I’ve gone through a major medical event of nine months, and labor and delivery, of course, is no walk in the park, either.  So there’s no shame in needing help and actually recognizing that the mom deserves the help, I think, is another sort of cultural aspect I’m trying to support women in, in saying it’s a sign of strength to ask for and give yourself the support, just like you’d say that a baby needs help.  You’d never deny a baby love and care, so why would you deny it of yourself?

Right.  And so with this change, what has your research shown you about the shifts in relationships and how do you teach students in your course and in the app how to navigate relationship changes?

Another very compelling data point that I found from the Gottman Institute is that 70% of couples report a decline in relationship satisfaction after becoming parents.  And as somebody who went through that experience of having two under two, I’m quite honestly shocked that number’s not higher.  Having a baby and becoming the mom and dad or partners in parenthood is a wild ride in and of itself, and the dynamic and resentment is one of the biggest factors to that decline in relationship satisfaction.  In my own personal experience and in my research, I’ve focused a lot on the dynamics between the parents and supporting them as they evolve into new roles of individuals, of being a mother and father, and also being parents together and having different parenting styles, different family of origin values, different expectations of what this time will mean to them and sort of the traditions and rituals that they want to create with their family.

So one of the things that I teach in my program are – I call them mad libs for adults, if you remember those games that we played as kids.  Giving people language to ask their partner for help and communicate their experience – that is very unique.  What a mom goes through versus what a dad goes through: completely different, right?  And so much of what the woman goes through is invisible.  So even my husband, who’s very attuned to the female experience – he has three sisters – he still would be like, well, you look the same, or you look okay.  And I’d be like, how I look is not how I feel.  What I’m experiencing is completely invisible.  So let me tell you about it, and let me use language that helps me explain to you the complicated feelings that I’m having so he could have compassion for what was going on beneath the surface.

In my program, I have scripts where I have a list of emotions, a list of experiences, and you can fill in the blank with your partner in a way that’s kind of fun and a little silly.  Like, we want to have fun, and we don’t need to be so serious that it’s overwhelming or uncomfortable for couples, right?  So we have a little fun about it and say, like, here’s how I’m feeling, here’s what I need from you.  And sometimes it’s really just acknowledgement.  There’s no action that the man can do other than listen and acknowledge and say, I hear you.  I see you, and I appreciate you.  And that does wonders for making a relationship healthy, especially through this vulnerable transition of becoming parents.

And that avoids the resentment that you described earlier, if couples aren’t communicating and then the partner goes back to work and the mother is left alone with this baby and could have other kids at home and wants her old life back and is resentful that the partner even gets to go to work and listen to music and go out to lunch with colleagues, whatever it might be, missing that old life.  Even during just a short maternity leave.

Yeah, and I think that’s where your work as a doula and helping women, especially to get more sleep early on in the recovery – the sleep factor is a huge source of resentment for a lot of couples because the mom is traditionally the one waking up in the middle of the night, and if the male partner doesn’t have paternity leave, which is, again, another systemic problem in the US – there’s sort of an expectation that because the mom is staying home, that she should be the one getting up all throughout the night.  That deteriorates the quality of her recovery massively.  What I focus on in my program is, I have a whole module on sleep deprivation and the impact on not only your physical recovery but also your mental and hormonal recalibration.  Sleep is a huge factor, especially in that first four weeks.  It is critical that the mom gets enough sleep and that the partner steps up in those early days and weeks to allow the woman to recover and have constructive rest in that time.

Exactly, and as overnight and daytime postpartum doulas, we find that some partners have to go back two days after the birth, so they’re there in the hospital, but they’re back at work, working long hours, and then that depletion and exhaustion begins.  With some families, even coming in a couple nights a week can get them at least caught up a bit on rest, no matter how they feed their baby.  For exclusively breastfeeding moms, we can bring the baby to them or wake them and have them go into the nursery, so then they’re optimizing the rest they have.  The doula – or we also have newborn care specialists – do the diaper changes, the sleep shaping, burping baby, and you’re able to get support and ask questions about feeding.  The parent is awake at that time.  So it can be helpful.  But I have found that with some of the media attention, overnight doulas, newborn care specialists, night nannies – there have been a lot of negative public comments about getting help or investing in that much-needed support.

Right.  I mean, I am truly shocked that anyone would view that as negative because it is recovery needed for the woman, and I think that we’re recognizing the toll that pregnancy and labor and delivery takes on a woman’s body, obviously, but also mentally.  It’s critical to get that help, whether it’s from a partner or whether from a third party.  And I think that having a doula or a night nurse or somebody to come in and provide that peace of mind so that the mom can rest – again, there’s constructive rest, and that is the type of rest we want our moms to be able to get in this time.  But if it’s something that’s within the family’s means, I would ten out of ten recommend that people get a doula and support to provide them the opportunity to rest because that will not only help their recovery; it will help their relationship.  It will help how the mom is able to show up with her other kids as a mom, and it’s something that, I think when you look back, this time goes back so fast.  And again, the goal is not to survive it, right?  You want to actually enjoy that time.  And how can you enjoy it if you’re sleep deprived and you’re anxious?  You can’t.

Exactly.  Then it’s a blur, and all you have are the photos to look back and be like, all right, I got through it, as you mentioned before.  We should be embracing and celebrating this change and have the support we need and feel confident in asking for support.  But as you said, having those conversations early on with your partner and even with family members is so important to set expectations.  Otherwise, we can feel like we’re overwhelmed and drowning.

Absolutely, and the majority of women are overwhelmed and drowning, and it’s through no fault of their own.  One of the things that I talk a lot about in the program is that I went through this twice, feeling exactly that way, overwhelmed and drowning.  And I thought it was my fault.  I thought it was a reflection of me as a mother, or I just wasn’t the type of person to enjoy the newborn stage.  And through my research, again, I found the validation that a lot of women were set up to fail.  And this is not a reflection of me as a mom.  This is not a reflection of me as a woman.  This is a reflection of the lack of support that our society provides people, and we need to recognize that not only is it okay to get the support, but we deserve the support and we need the support.  So I’m really trying to, of course, address the immediate term of how to take care of yourself in postpartum and have a wonderful experience, but also, I feel like it’s honestly a movement of women feeling empowered to say that we deserve more and we need more, and this is again not a sign of weakness at all.  Really, it’s not.  We should feel truly empowered to get this help, and not to feel shame in telling other moms when we get this help.  I think that’s where social media for me is a slippery slope because you see people’s highlight reels on Instagram and Facebook and you think, oh, that woman has it all together.  She’s thriving in motherhood.  How is she doing it?  And it’s not the reality for the majority of women.  Or if they get help, they don’t want to publicly show that they’re getting help because they feel maybe ashamed that they’re getting help, and they really shouldn’t.

Right.  Not at all.  And I do appreciate – I feel like there are two sides to social media right now.  There’s the vulnerable side of really expressing that.  Some influencers, if you want to call them that, moms, have shared some of their struggles, and it has led to more openness about how the house doesn’t have to be perfect, and women showing their house with kids running around, and it being okay.  Or that you can have a bad day.  And then of course, there is that highlight reel, very filtered, Pinterest perfect, that is hard to live up to.  It can be overwhelming, but if you find the right accounts, then it can also make you feel like you’re not alone in the journey.  You just have to be connecting with the right people, I guess.

Absolutely.  And again, I talk a lot about tech usage in my content, and I recommend doing sort of an audit of who you’re following and just unfollowing anybody that brings you any type of comparison instinct.  I realized that there were certain people, when they would show up in my feed, I’d be like, oh, how do they do it?  And then I was like, wait a minute.  Let me have some awareness around how that’s coming up for me when I see this influencer or this person or this celebrity, and I’m just going to detox.  And I unfollowed probably about 100 or so accounts while I was pregnant because I realized it’s not serving me.  It’s not serving my child.  And those people will be there.  If I want to go back to them at another point in my life, they’ll be there.  So it’s a temporary thing, and I think that’s what pregnancy and postpartum is all about.  It’s recognizing that it’s a temporary thing, so what can you do?  It doesn’t need to be forever, but what can you do in this moment right now that will serve you, serve your child, serve your relationship, and set you up for what should be a happy and peaceful time of your life.

Exactly.  So Jess, what are your top tips for setting yourself up for postpartum success?

I would say starting in pregnancy is key.  A lot of people will take a wait and see approach, and they’ll say, you know, I’ll be fine.  And some people may be fine, and I hope truly that they are.  But again, we know from the data that unfortunately the majority of people are not.  So recognizing this is something to plan for.  I mean, how many women are planning their baby nursery, right?  You know you’re planning that.

Yes, and showers, and all the planning that goes into those.  People aren’t planning for birth and baby the way they are for a wedding, that’s for sure. 

Right.  For sure.  And I think that recognizing that having stuff and being organized – of course, that’s important.  Of course, that helps you feel calm.  But take care of your insides, your brain, your body, your spirit, with the same love and care that you’re preparing your external environment.  Right?  Imagine if we spent as much time thinking about ourself and our spirit as we’re transitioning to motherhood as we did planning the nursery.  It would be incredible.  I’d say that’s number one.

Great tip.

And number two, I would say, is getting help, whether it’s from a doula, whether it’s from somebody like me who’s working with you during pregnancy, whether it’s from the support of family of origin that you can tap into, friends, coworkers, whoever it is that you feel you can rely on, getting help and recognizing that you are not meant to do this alone.  That’s a big step, too, for me.  And I would say step three would be a very practical thing.  One of the things that I encourage all women to do is get paper plates or little things that make your life easier for the short term because we know that bending over, whether you’re pregnant or in your early postpartum days, is a way many women do too much, too fast.  Emptying the dishwasher, switching the laundry.  Little household things like that are adding up and actually creating longer term injuries for people.  So making temporary accommodations to not do so much in those early days.

Right.  It’s not just avoiding vacuuming and stairs.  There’s so much more to it, as you mentioned, with lifting.

Yeah.  And even if you have a toddler and you’re going to say, like, how could I possibly not lift my toddler?  It’s really challenging.  But having your toddler climb on the couch and give you a hug that way.  For me, bending over and picking up my big kids was really detrimental, so I would have them walk up the first few stairs, and I would say, that’s the bus stop.  I’ll meet you at the bus stop.  And they would jump into my arms that way so I wouldn’t have to bend over to pick them up.  I would say practical things like that, and of course, there’s a lot more on that front.

And then I think valuing your partner and using this as an opportunity for connection to talk about how your experience is different than their experience and opening up rather than keeping it all to yourself.  I think that’s the other part we didn’t totally go into when we talked about the partner aspect, but feeling like I’m going to keep it to myself.  I’m just going to struggle through it, or when my partner comes home from work, they had a tough day; I don’t want to burden them with my tough day.  And it’s fighting that urge to stay silent.  You know, really open up, and that’s where having scripts or language to use makes it a little easier for people to open up.  But we don’t want to keep these things to ourselves, especially in the vulnerable postpartum recovery stage.

Beautiful tips.  So how can our listeners and our Gold Coast clients work with you, Jess?

Yes!  I am on Instagram.  My account is @motherme.io.  And that is the same as my website, motherme.io.  And people can find me through Instagram and book a call with me, and I’m happy to discuss their individual circumstances and recommend sort of a pregnancy prep path.  I’d love to work with anyone who feels confident to say, I want more help and I need more help, and guess what?  I deserve it.  I really feel like that journey through recognizing help and feeling empowered – that’s what I love most about what I do.  So if you’re of that mindset, please reach out to me, and I’d be happy to chat with you.

Excellent.  As you mentioned, during pregnancy, it’s ideal to prepare early, similar with hiring a doula.  The earlier, the better; the more they’ll get out of your different programs.  But what if someone just had a baby and is feeling isolated?  What would it be like to work with you immediately postnatal?

Yes.  I have several women who actually DM me when they’re in the hospital.  And they’re like, I just had the baby.  I need help!  And absolutely, it’s never too late to raise your hand and say, I need help.  So definitely still reach out to me if you just had your baby and you want a little bit more support mentally, nutritionally, or guidance in your relationship and supporting this transition to mom and dad or from individuals to partners and parents.  It is absolutely always a good time, if you need help, to get help.

Excellent.  Well, I could talk to you forever.  We’ll have to reconnect again, Jess.  Thank you for sharing all of your tips and wisdom with our listeners.

Well, thank you for having me.  I could talk to you forever, too.  I’m so grateful that there are services like Gold Coast Doulas to really help women get that support they need because that is a huge part of the experience, so you’re doing wonderful work and we’ll continue talking.  Maybe we’ll do another session.  If the listeners have any more questions, we can go deeper on any of it.

That would be great.  I love everything you’re doing with Mother Me.  I will add you to our resource list.  It’s great to have another excellent app to use for preparation.

Thank you.  Thank you so much, Kristin!

Thanks, Jess!  Take care!

IMPORTANT LINKS

Mother Me

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Kristin Revere and Alyssa Veneklase chatted about their upcoming book “Supported: Your Guide to Birth and Baby.” Their book will be released on Mother’s Day.  Look for it on Amazon and ask for it at your favorite bookstore.  The e-book and audiobook will be available in early June.    

Hello!  This is Kristin Revere, and I get to chat with Alyssa Veneklase today, all about our big reveal.  Welcome, Alyssa!

Hey!  It’s been a while.

It has.  So we’ve been working on a project for a couple of years.

Oh, my gosh.  Seems longer than that.

I think because the project started with our Becoming A Mother course during the early pandemic and sort of branched off from there, it does feel like a lot longer, but certainly similar concepts.  I feel like we’re giving birth to something, or about to, anyway.  So do you want to reveal what we’ve been working on?

Sure.  So we turned our course and all the course work and all the topics of the Becoming A Mother course into a book where Kristin has written the first half about pregnancy and planning for birth, and then I wrote the second half on planning postpartum and newborn care and sleep.  It’s really exciting.

It’s exactly the way we have our Becoming A Mother course.  I facilitate the first section, being the birth doula, and then you, being the sleep consultant, and both of us are postpartum doulas, you took on the feeding and newborn care.  So we divided the book up the same way, and the title is Supported: Your Guide to Birth and Baby.  We’ve been working with an amazing publisher, McLaren Press.  We did the – I want to call it exciting, but it was also nerve wracking – experience of recording an audiobook. 

Yeah, that was interesting.  That was a lot of talking in one session!  But we got it done.

We did, yeah, with the amazing Ben Zito of Centennial Sound.  Many different people involved in this project.  The book will be out on Mother’s Day.  We’re just in final layout stages with our publisher.

Yeah, it will be exciting to be able to offer it as a gift or a guide to friends and family, a guide for students or for any new parent.

The perfect baby shower gift.  We created it not just for first time moms and parents but also for seasoned moms, to understand all of their options when it comes to planning for birth and baby.

Right.  And I know in my sections, I talk about, how do you deal with feeding a newborn when you have a toddler who’s also vying for your attention, and then how do you deal with sleep when you have maybe a toddler who’s not sleeping and you have to feed a baby and get a baby to sleep and nap, and then also try to find time to sleep yourself?  It’s definitely – no matter how many kids, if it’s your first or your third, there’s definitely information in there.

Exactly.  So what is your favorite part of the book as far as the process?

Oh, the process of it?  Just getting thoughts down and writing.  I’m not best ad lib, so when I have an idea, I really like to think about it and change it and talk to other people about it.  So I think getting things down on paper is just good for my brain.  And then having you – when you have someone who can read it and edit it and maybe help you make changes.  And then obviously the sleep portion is my favorite.  That’s my favorite thing to talk about.

I figured sleep would be your favorite chapter, and certainly our most talked-about section in the Becoming course.  Whenever we have live calls or questions in our private community, it’s almost always about sleep, whether it’s infant sleep or toddlers.  And you deal with age 3 to 5, even with your online sleep class that you offer.  It is definitely the hot topic, and there’s so much more awareness now about options like sleep consultants and overnight postpartum doulas to help families when they don’t have support nearby.

Yeah, and I think the sleep chapter is interesting because it’s not a one size fits all, like here’s how you do it.  It’s more of an educational chapter on what is sleep and how does it work for your kid at different ages, and how can you fit that into your current schedule and your current parenting style.  It’s really about finding the best fit for you and your family and not just saying, oh, well, my cousin did it this way, or my best friend did it that way, and now I feel like a failure because it’s not working for me.  Really, really hammering down this idea that every family is different and you have to figure out what’s right for you, and if everyone’s happy, then you don’t need to change anything.

Right.  Because some of those online sleep courses and books on sleep are not customized to unique schedules and situations, and they don’t work.  And then people are frustrated.  So yours definitely has more of that customization and tips on how to make it work for your lifestyle.

What about you?  What’s your favorite part?

As far as the process, I think – I had started on a different book concept back in my early days as a doula, so taking some of those original concepts and what we gathered before we launched the course in serving women that were either Gold Coast clients or in different moms groups about what they wished they would have known about pregnancy, birth, and early parenting.  And I really liked getting those concepts and making it work into a book about other people’s thoughts on what they would want to know, thinking that those are the people that would buy this book for friends, or might be having another baby and want to be told the real truth, that maybe your friends are embarrassed to talk about or don’t think that it’s a normal thing to share.  I mean, we talk about leaking.  We talk about pelvic floor therapy and what is normal and cramping after birth and your legs shaking – so many things that aren’t discussed in your provider prenatal visits or in moms’ groups that I think are important to share.

Yeah, and your chapters do a good job of sharing stories from other people, stories from moms, different writeups from other people.  You give a lot of different perspectives.

Yeah, and that is also key.  I love reading different birth stories with different outcomes, and w share postpartum and sleep stories, all from our own clients and their voices, and we even have a pandemic chapter that covered what it was like to go through pregnancy, birth, and early parenting when things were shut down and maybe some of the options you had planned for weren’t available to you.  Those stories are very impactful, as well.

And hopefully we don’t have to go through that again!

Hopefully not!  But even RSV and flu season –

If we do, at least we’ve been through it.  We’ve learned a lot, and things could be different.

Exactly.  I would say as far as takeaways, hopefully, whether it’s the stories that resonate for you or knowing your options in assembling your dream team for birth and baby, there’s so many different options that aren’t commonly known, from car seat safety technicians to different types of mental health therapists to support group options and so on that aren’t something you’re going to even learn in a childbirth class.

So as far as resources, what was your favorite resource to compile in our final section?  For me, it would be – I know you had a lot of feeding and sleep-related websites and trusted resources or books that you would recommend.  And I would say for me, it was gathering some of the resources that our expert contributors had thought were valuable, so everything from Jenni Froment from VBAC Academy and her favorite VBAC resources to Cristina Stauffer, who is our mental health therapist expert.  She talked about different support groups that were available.  So I would say some of those outside sources and trusted resources that they use within their own fields.

Yeah, I mean, again, just with sleep, I’m always intrigued looking up sleep statistics and how important it is and how devastating it is when we don’t have it, for adults and kids.  It’s probably the most rigorous research that’s done for the book is the sleep related topics.

Agreed, yes.  In the citations, I would agree.  There’s a lot of sleep research.

Well, it is exciting, and we will be updating you when we have the exact release date for the e-book and audiobook.  It should be in early June.  The print version will be out on Mother’s Day.  We’ll update about any events coming up, whether virtual or in bookstores, and we can add that to the blog.  We will have the book available in so many different formats because everyone consumes content in a different way.  So it will be Kindle download ebook format to the paperback or the option to do an Audible download and be able to have the book consumed in that way, especially if you have a membership and you don’t even need to pay for the book.  It will just be part of your monthly membership. 

Any final tips for our listeners that you’d like to share on either the book writing process or your favorite nugget from the book?

No, I’m just excited to have it complete and then hopefully it becomes a really great resources for new parents.  I want it to be something that people put on their gift registries and give to anyone they find out is pregnant to read while they’re still pregnant.  I’m just really excited for that.

Yes.  Me, too.  I think it will be a great shower gift and something to pass down.  You can purchase it for relatives or friends.  You don’t have to be pregnant to purchase it.  And I would say my takeaway is, we talk about it not only in your section on postnatal prep and recovery and early parenting, but also in mine – really trusting your own instincts as a mother during pregnancy, during birth, and listen to your own instincts versus relying on the way, say, your mom birthed or your friend chose to sleep train her baby.  Follow your own compass, and obviously, use evidence based research.  But each pregnancy, birth, and parenting journey is unique, and we talk about that throughout the entire book.

Right.  I agree.

Well, thanks for chatting with me, and we will keep spreading the word about the book.  But this was our first reveal, so very exciting to share it with our Ask the Doulas audience.

Yeah.  We will keep everyone posted!

Sounds good!

IMPORTANT LINKS

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Kristin Revere and Kristin Mallon discuss how certified nurse-midwives support women in all stages of life.  They also chat about how Kristin Mallon transitioned to supporting menopause and feminine longevity when she co-created FemGevity.   

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am so excited to chat with Kristin Mallon today.  Kristin is the CEO and co-founder of FemGevity.  She is a CNM, MSRNC OB and is a highly accomplished and passionate board-certified nurse midwife with over 20 years of experience in women’s health.  Her expertise in menopause and feminine longevity has made her a respected and sought after expert in her field.  Kristin is dedicated to providing the highest level of care to her patients. 

Welcome, Kristin!

Thank you so much for having me!

I am so excited to chat with you about your background.  From what I read on your bio, you actually started as a DONA doula in Maryland.  So let’s explore your passion and pivot in so many different ways in women’s health.

Yeah, so I started as a doula.  I knew I wanted to be a midwife, so while I was in school, I worked as a doula, and then once I got my nursing degree and then ultimately my midwifery degree, I transitioned from that type of support because now I was able to work as a midwife.  There’s a lot of blending and lot of understanding both roles really well because I had been a doula before I became a midwife.

Yes, so that emotional support and physical support and just being with women in pregnancy and then transitioning to more of the medical aspect of care.

Right.  Exactly.

So for our listeners who are not familiar with nurse midwifery, would you mind sharing a bit about how you work with women in pregnancy, childbirth, and the postnatal phase?

I think unfortunately “midwife” and “midwifery” is really confusing in the United States.  When you go outside of the United States, I think most of the people of whatever country it is – Central America, South America, Europe, Asia – they understand midwife kind of means midwife, and there’s one word for midwife, which is someone, a medical professional whose sole job is to help women during pregnancy, maybe a little bit of the time getting pregnant, delivery, labor, and the postpartum period.  It’s a very specific medical role, a very specific niche.  In the US, it’s really confusing, and most of the time when I meet people, they’re like, oh, you’re a midwife?  You deliver babies at home.  You have no medical training.  You were trained by a group of women in the Amish country.  That’s a very common misconception that people have about midwives.

Most midwives in the US, over 90% – I think some years it’s even as high as 96% of midwives – work in the hospital setting.  They work in a very acute care setting, and only about 6% or 4% or 5%, depending on the given year and depending on the state, are actually working in the home.  So the majority of us are working in hospitals.  I think even that is confusing for the average American.

And then within midwifery, we have certified nurse midwives, which is what I am.  I’m technically a board-certified nurse midwife.  Midwifery does have a certification board.  We have certified midwives who have the same type of board certification that I have, but they don’t have a nursing degree.  They’re not a nurse.  We have lay midwives, which are midwives that are just trained in the communities, very similar to doulas, but they tend to have a little bit more understanding of the medical aspects of things.  And we have professional midwives.  Not all states recognize all of those.  All 50 states recognize a certified nurse midwife.  Not all states recognize all of those other types of midwifery.  And so it’s very confusing and I think overwhelming for the average consumer.  It’s hard in the US, I think, to understand midwifery fully.

I agree.  And I definitely agree about the assumption that most people think of midwives as a homebirth midwife versus a CNM or working in a hospital.  A birth center could be freestanding or attached to a hospital, for example.

Right.  And now a lot of hospitals – I mean, we’ve evolved so much.  I’ve been working in this field for 20 years.  We’ve evolved so much.  Now we have birthing pavilions.  We have birthing adjuncts.  We have birthing wings.  We have birthing hospitals.  There’s so many different venues for birth to take place.  And I think it’s even people that I know very personally – I don’t think they have a full breadth of understanding of all the options that are really available to women in the US when it comes to birth.

Exactly.  In one of my area hospitals, we have a birthing suite which looks less like a hospital room.  It’s pretty cool, and it’s attending only by a CNM.

Right.  There’s so many different opportunities.  And my experience – I’ve really only worked in the New York City Metro area, so New York City, and I’ve worked in New Jersey, northern New Jersey, which is where the bulk of my practicing has been.  For my schooling, I went to NYU.  I went to John Hopkins, which is in Maryland.  Very limited experience in Maryland during my schooling.  But it’s very regionally based as well.  So my friends that I went to midwifery school with – I know a lot of midwives.  I’m very fortunate to know a lot of them.  When I hear about what it’s like in Chicago versus what it’s like in LA versus Boston and San Francisco, it’s very different than what it’s like in New York, and even it’s incredibly different from New York to New Jersey, and we’re four miles apart.  We’re separated by a river.  So it’s really hard, I think, for women to understand their options.  A lot of women don’t think about their options until they’re already pregnant, and it’s kind of like this rush to get it situated and to get it sorted out.  Some women do think about it ahead of time, but I think the majority are kind of trying to put together the pieces of what childcare looks like in the US during pregnancy.

Yes, good point.  So Kristin, who would be eligible to work with a certified nurse midwife as a patient?

I was a high risk midwife.  I’ve attended over 2000 births.  I did the majority of the births in the hospital setting.  Very few in a birth center and even less at home.  And I never risked – very, very rarely did I risk anyone out.  I had the fortunate opportunity to work with a maternal fetal medicine specialist as my collaborating physician.

That’s amazing.

So we were only sending people out of our practice that had really complicated things.  You know, needed fetal surgery.  Almost zero.  And in a year, sometimes zero people got risked out.  Some midwives can only take low risk women, the absolutely low risk women.  Sometimes anemia will make a woman need to transfer.  Diabetes, high blood pressure, breach – the baby being in a breach position.  So I would say that any woman – and I know a few midwives who work like myself and work with a maternal fetal medicine specialist.  They work with a very high risk doctor.  Anybody is eligible for midwifery care.  Really, any woman.  I mean, very few – less than 0.01% of women would be ineligible for midwifery care.

That is amazing.  And as you mentioned, it depends on the hospital policies, the state, and it can be very different in other areas.

Yeah, and a lot of it really has to do with the collaborating physician.  So what the collaborating physician’s comfort level is with that particular midwife.  This is just kind of a generalization, which I think there isn’t really in birth.  I think it’s almost impossible to make any generalizations.  But most of the time, the longer a midwife works with any given doctor or any physician group, the comfort level between the two of them or the groups of them in terms of what they can handle is going to only increase exponentially as the years go on.

That makes perfect sense, yes.  Thank you for that explanation.  And of course, insurance covers nurse midwives in the hospital.

Yes, so insurance – we were very fortunate to get a bill in legislation passed in 2022 called the No Surprises Act.  This means that pretty much any woman with insurance can go to a midwife in or out of network.  The way that bill works, labor and delivery is considered an emergency.  So it pretty much has opened up the field.  Even if your midwife is out of network, you can still use that midwife.  And I think a lot of midwives and consumers, patients, don’t fully understand this bill and don’t understand the full benefits of this bill.  This is a bipartisan bill that was passed by both sides.  Not many bills are so bipartisan.  Patients were getting surprise bills.  You would go to a hospital.  You would see an anesthesiologist.  You would see a plastic surgeon because you busted your lip open and you needed some stitches.  And then you were getting this huge bill from an out of network provider.  Because that has stopped, that has enabled birth workers to have access the benefits of this bill, which include being out of network and being able to bill an insurance that has in network only.  So I think it’s a really – and I’m happy to talk to anybody so that they can understand it, or they can have it explained to them.  But for midwives and consumers both, your insurance now will cover an out of network midwife.

Wow.  Well, you are definitely educating our listeners and certainly myself, so thank you, Kristin!

My pleasure!

As far as the role of a doula, how do doulas and nurse midwives work together during labor?

I think this is another kind of big, convoluted understanding in the birth community to people who are outside of it.  A lot of people think midwives are doulas, and it’s just – they’re not the same.  Doulas, as you know, being a doula, are really nonmedical professionals that really are about emotional, physical, spiritual, mental support.  And the midwife is really more about the physiological process of labor, the path of labor, the progression of labor, the safety of the labor, and kind of the captain of the labor ship, making sure that it’s on the right course, safe, effective.   I think that these two roles get confused.  I think every woman should have a doula.  So whether they have an OB-GYN or they have a doula, I think every woman should have a doula.  I think that should be standard of care.  I think that should be a no brainer.  I think we would see a huge shift in birth from a cultural perspective if that was the case.  So how doulas work with midwives is they really kind of work as part of the birth team.  The birth team usually consists of a medical professional – either a midwife or an OB-GYN – the family or whatever family members that entails; it could be one, could be friends, could be ten people – and then a doula is there to kind of be the bridge between the world of medicine and family.

Beautiful.  And as far as prenatal visits, how are visits with a nurse midwife different than an OB appointment?

So I don’t know that they necessarily have to be.  The practice that I had was called Integrative OB-GYN.  I was the only midwife in that practice, and there were four doctors.  The visits were no different between myself and the OB-GYNs.  Very comprehensive, 30 minutes to an hour each, really about making sure the woman and her family and support network felt comfortable, educated, understood what was going on, and we gave her tips and tricks to prepare along the way.  So I don’t know that they necessarily have to be.  I do think there’s a difference between the in-network model of birth and childbirth care, which is more of a number.  You show up.  And I think that can happen in midwifery or OB-GYN, where you show up, you come in, you get your heartbeat checked, you get your blood pressure and weight and urine, and then you’re kind of just moved through and you’re kind of like a number in a system.  I think that’s a very in-network model of care that doesn’t support how birth is really meant to be, which I think is much more in the out of network model of care where the clinicians, midwives or OBs, have the luxury, because the reimbursement rates are higher for providers in an out of network model, to take the time with women that they really need.  I am such a big proponent for having birth move to an out of network model, especially because we had this gift given to us from the 2022 No Surprises Act.

Yeah, that makes sense.  I certainly had the latter experience, out of network, and had longer appointments and worked with both nurse midwives and OBs with both of my pregnancies.  I just felt like there was a lot more time for questions and a lot more emotional connection in some of those appointments.

Absolutely.  And I think that’s the number one difference between the two models of care, midwifery or physician based.

That makes sense.  And then as far as the postnatal care, what does that look like?  It sounds like it depends on the model and may not be much different.  In my community, I know that some of my clients are able to see their nurse midwives sooner after delivery rather than waiting for that six week appointment.   But it may be, again, different depending on the practice.

Yeah, I think that the postpartum care in our country is pretty atrocious.  We give women, if you’re in a birthing center or at home – I mean, home is probably a little bit better, but in a birthing center, you’re given 24 hours of support, and then you’re seen once or twice in a six month window after that.  I think pediatricians, to be honest, are picking up a lot of the slack that’s left by the significant dearth in the postpartum care that we have in the US.

Absolutely.

Generally, it’s the same thing like you said in an out of network model.  Physicians and midwives are doing the same thing when it comes to labor, birth, pregnancy, childbirth, postpartum, typically.  So when people ask me what’s the difference, I’m like, there’s really no difference.  The difference between a midwife and an OB-GYN is that I’m not doing advanced gynecology.  I’m not doing fibroid removals, myomectomies, ovarian cyst removals.  I’m not doing any type of high end fertility, IVF, those types of things.  So when it comes to the pregnancy and the care, they really kind of do the same thing.  It’s kind of about what type of provider or what culture within a group of providers do you more resonate with, versus it being midwife or doctor.  And then for postpartum care, like we said, in the out of network model, you’re going to get a little bit more than in network model, but not much.

And nurse midwives can certainly see patients beyond that postnatal visit, with well woman care.  Can you explain a bit more about the role of a nurse midwife beyond the birth?

Yeah, so nurse midwives are very similar, like I said, to your regular OB-GYNs.  They can do anything that has to do with wellness, prevention, and your average gynecological care, like a yeast infection, a UTI, need birth control, need for birth control counseling, and mild primary care work.  A lot of us are very well versed in the management of blood pressure postpartum or hypo- and hyperthyroidism, very similar to our OB-GYN counterparts, just because of the sheer volume of women that we work with and their health challenges that come up with them just naturally being a woman and being 44 when they give birth or 34 when they give birth or 24 and the sequelae of what happens after that.  So it’s really more about – I think for midwifery versus an OB-GYN, it’s really about finding and connecting with a person or a group of people, a group practice, that you like and that you resonate with because a midwife can do pretty much what a lot of internal medicine can do; not all, but a lot, and then also what an OB-GYN can do in a primary care setting, like in a wellness, preventative, annual, yearly check in kind of setting.  I think that providers specifically all kind of sometime have different niches, and this is where I also kind of tell my friends and family, like, if they do have more of the complications that go along with gynecological care or women’s health – breast concerns, fibroids, ovarian cysts, endometriosis – that’s really when you want to seek out a specialist within that type of medicine, anyway.  So if you have endometriosis or suspected endometriosis, you don’t really want to go to an OB-GYN or a midwife.  You want to go to an endometrial specialist, someone who is an OB-GYN and then within their day census of who they’re seeing on any given day, they’re seeing 20 patients in a day, half of them are endometriosis cases that they’re working with, and then that’s really their expertise and their specialty.

The same thing with ovarian cysts or PCOS or menopause, perimenopause.  Those are really niche specialists that I think the general OB-GYN or the general midwife is probably not the best person to go to when those kind of issues arise.

That makes sense.  Speaking of perimenopause and menopause, how did you come to found FemGevity?

I’ll be honest, I don’t think that – again, there’s so many things in our system – and I try to be an optimist in my life.  Maybe I’m not coming across that way right now.  But I think that unfortunately, the US does not support birth workers in the way that it should, and so burnout is very high.  And I’m no exception.  I fell into that kind of category where it’s very difficult for birth workers to kind of continue because there’s no respite.  The system, in terms of making a living out of this job, does not have built in respite where you can rest and rejuvenate and refresh and then come back to the system renewed and able to continue a career that could be 20 years, 30 years, 35 years.  I, like most birth workers that I know, unfortunately, had to kind of hang up my hat of birth and transition.  It worked out well for me because my clientele that I had worked with for 15 years was older, and they were kind of in their post-reproductive years.  It kind of made sense for me, and it worked out.  I always believe everything works out, anyway, so it kind of worked out that my clients who I’d had for years and decades were asking me different questions.  They were asking me questions more about perimenopause, menopause, post-menopause, the longevity medicine.  And so I was able to morph my practice into that type of practice and then become a specialist and niche into that field and that area.  So now I would say, if you’re looking for someone in perimenopause and menopause, I am that type of expert, whether it’s OB-GYN physician or midwife, I am that clinician to come to when you have questions about those issues and concerns because I’ve been doing it as an overlap of my birth practice for about 10 years.  And so that’s kind of where FemGevity was birthed, no pun intended, because of that transition ramping up so much in my own practice and in my own life.

So as far as working with you, how do our listeners connect, and what is the process like?  Is it a mixture of in person and virtual?  Fill us in a bit more.

What we’re doing now – so what FemGevity Health is doing – anyone can go to the website, femgevityhealth.com, and take a look at what we’re doing.  But it is a virtual type of care because we’re not meant to replace OB-GYNs and not meant to replace primary care physicians.  We’re not the go-to for a pap smear or any of those types of situations that need hands-on and need in-office.  We’re very specifically managing hormonal shifts that happen after 40.  And that kind of looks different in lots of different areas.  All of our visits are virtual, and so we’ll have a virtual appointment, an initial consultation, usually advise lab ordering, depending on what’s going on.  Most of the time, we’re recommending labs.  We also have functional medicine or longevity medicine labs that we offer, like gut microbiome tests, micronutrient testing, allergy and food sensitivity testing, genomics.  And those tests help us put together all of the pieces about how to properly balance hormones in different decades of a woman’s life.  It’s all done virtually because we can mail the kits to women’s homes or if they need bloodwork, we can send them to their local LabCorp or Quest Diagnostic or a BioReference lab and get the bloodwork done, and then we’re able to kind of consume all of that information virtually and then come up with treatment plans and recommendations based on what’s going on.  It enables us to keep the cost down for women because we don’t have the overhead of a brick and mortar practice, and we don’t have to have a whole bunch of staff and a lot of overhead that goes with having an in-person office.

That’s fantastic.  And you do offer free consultations?

Yes.  We offer a ten-minute free consultation at FemGevity Health if women aren’t sure if what they’re experiencing is something we can help them with.  And we also do Instagram Lives on most Monday nights around 8:30 or 9:00 p.m. Eastern time where we also answer questions live that people send us, as well.

Perfect.  So you’re on Instagram, as you mentioned, @femgevity.  And you have a website.  Where else can our listeners find you?

We’re on all socials.  We’re on Facebook.  We’re on TikTok.  We’re on LinkedIn.  I’m on LinkedIn personally as Kristin Mallon.  And we also have live chat on our website.  We have a Contact Us form.  We have email.  So it’s really easy for people to reach out.  People can call or text us, as well; call or text FemGevity Health if they want to have a chat conversation via text about what they’re experiencing or going through and they don’t want to get on a free consult or they don’t want to make a phone call.  Lots of ways for people to reach out and get the information they need.

And the website is femgevityhealth.com?

Yes.

Any final tips for our listeners, Kristin?

Yeah, I think we’ve really covered a lot.  What I say about birth specifically, so for the people who are more interested in birth and childbirth, the real experts to kind of consult with are people like yourself, like the doulas of the community or a lot of times there’s – I know it seems kind of strange, but WhatsApp, Facebook, or some sort of communal chats that have a lot of really good information about birth, birth workers, who to go to, what type of places to go, and it’s usually very regional.  So I always kind of encourage women to get involved in their regional group chats, doulas, birth workers, because a doula from Ohio isn’t going to be able to really tell a woman in Oregon a lot about opportunities, resources, support, et cetera.  I think that’s my best tip for birth.  For perimenopause and menopause and hormone balancing specifically, which can happen – some women have unbalanced hormones, unfortunately, in their 20s, even – you really want to seek out an expert like ourselves.  For women that are 40-plus, a lot of what they’re experiencing is probably perimenopause or changes in their hormones or shifts in their hormones because I think a lot of women just sweep it under the rug.  They’re tired; they’re fatigued; they’re not sleeping well; they’re having more anxiety or depression or night sweats or insomnia, and they just think it’s aging or they just think it’s having little kids.  And there’s usually something shifted that we can help them balance.  It’s not always HRT and hormones.  A lot of what we do is with diet, lifestyle, supplements, nutraceuticals, to help them get back on track.

Fantastic.  Well, it was wonderful to have you on, and thank you so much for sharing your wisdom, Kristin!

Thank you so much for having me!  It was great to talk with you.

IMPORTANT LINKS

FemGevity

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Kristin Revere and Dr. Annie Bishop discuss how Webster Certified Chiropractic Care can be beneficial during pregnancy.  They also discuss other options for prenatal and postnatal support.

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am excited to chat with my friend Dr. Annie Bishop of Rise Chiropractic Wellness.  Welcome, Dr. Annie!

Thank you so much, Kristin!  I’m so pumped to be here again.

I’m excited to chat with you!  It’s been a bit.  We’ve had you on over the years, multiple times, as well as Dr. Rachel.  But our topic is all about the importance of overall chiropractic care during pregnancy, but especially focusing on the Webster technique.  So let’s dive into that.

Awesome.  Thanks, Kristin!  So I really wanted to talk about Webster technique: what it is, why people seek us out, and why it’s so important as a preventative measure for your pregnancy.

So the first thing is that Webster technique was started by Dr. Larry Webster, who was a chiropractor, and he developed this technique that was specific to the anatomy of the pelvis to help moms during pregnancy to make sure that everything was in good alignment.  So that’s been taught now over the last couple of decades to a lot of different chiropractors.  So when you’re searching for, like, prenatal chiropractic, Webster technique is really the certification that you want to check for.  So that has been kind of going on with ICPA, which is the International Chiropractic Pediatrics Association, for several decades now.  They’re the ones who do the training.  Both Dr. Rachel and I have taken that training, as well as some other advanced perinatal techniques.  It’s really important at helping support women during their pregnancy and help support their bodies.  I wanted to go in depth a little bit with what Webster technique is, what it’s actually looking for, and why it’s so important from a neurological aspect, from an overall body tone, how your biomechanics are changing, that aspect.  That’s what I wanted to focus on today.

Beautiful.  Before we begin, you did mention some of your certifications, as well as Dr. Rachel’s, but give us a bit about your background.  I know you have many certifications.  Why did you choose to work with women in childbearing years versus all of the different focuses and types of chiropractic care out there?

Oh, thanks for that question, Kristin.  So both Dr. Rachel and I went to Life University.  We actually went at different times.  She’s my best friend’s oldest sister.  After she graduated, she told me where to go, so I followed suit.  But while there, you take some family, like pediatric and pregnancy, courses in the curriculum, and then you can take some optional ones if you’re really into it.  I think it was during those ones when I was learning about neurodevelopment and all of that when I became really interested in this idea of helping babies and helping with that neuro development, making sure babies are on the right track, and the impact that you can have in a kid’s life that way and in a person’s life.  And a lot of that initial help with infants starts in pre-conception through pregnancy, so doing the prenatal and pregnancy support was a really important aspect of that.  It’s helping moms just have their best possibly pregnancy.  I mean, both Rachel and I are women.  We care a lot about women’s health and are very huge proponents of just women’s health in general and having good doctors and not dismissing women and being really supportive of their whole journey.  That became really important to both of us.

And then when Rachel got pregnant with her twins, we realized how absolutely important and vital it is to have good chiropractic care throughout the pregnancy and how supportive that is.

Absolutely, not only with relieving discomfort, especially with twins, but certainly positioning.  It is so important for vaginal deliveries to have both twins head down, as you know.  I know you worked on Dr. Rachel.

Yeah, absolutely.  And she carried those twins to 39 weeks and had two eight-pound babies.

I was her doula.  She was amazing!

Yeah.  It’s so important.  It’s great support for the mom’s body, for the position of the baby, for all of these factors that go into having a good birth.  That also leads the way so much to prevent birth trauma, to prevent interventions so that baby has the best outcomes, too.  That’s why we’re so passionate about what we do.

So if our listeners see a general chiropractor and then they become pregnant, is that something that you temporarily switch over to a Webster certified chiro, or is there any co-care if they have this longstanding relationship?

That’s a really good question.  It’s up to the comfort of the individual.  I would say if your chiropractor doesn’t have any pregnancy training, I would switch during your pregnancy.  There’s just a lot of important things and changes in your body that you want to have someone who is really educated on it and really prepared for it.  We have a lot of moms who will come to us just during their pregnancy and then go back to their old chiropractor afterwards and take their families there and stuff, too.  We have no problem doing that.  It’s kind of like medical doctors.  You have different specialties, and some people are really good at some things.  I think that’s a really important thing when it comes to chiropractic.  We should really focus on each other’s strengths and give people the best care possible, right?  Having somebody who’s really well trained in perinatal care during your pregnancy is going to be so much more supportive, and then switch back to your old chiropractor afterwards.  I think that’s great, especially if you have a great relationship with them.

Or if your chiropractor is not a pediatric chiropractor, the way your practice is Webster as well as pediatric.  Then potentially having a pediatric chiropractor adjust baby, and then transition as the child ages to a general chiropractor.

Absolutely.  Babies are not just littler, smaller spines.  They have a lot of differences, too.  You want someone who, again, knows and is really good at adjusting kids and works well with kids.

So, Dr. Annie, what are some of the top reasons that your patients seek out a Webster certified chiropractor?

A lot of times, people seek out Webster certified chiropractors because they’re pregnant, but also because a lot of times, it goes along with pregnancy discomfort, what they’re feeling, changes in their body, but also because baby is malpositioned.  I feel like that goes along with the Webster technique.  Usually when baby is not in the right position, moms will start seeking out Webster technique certified chiropractors.  I want to talk about all of that, too, how it all works together.

Webster technique is kind of based on ways to prevent dystocia, which is difficulty during labor.  And so if we go into Williams Obstetrics, which is the textbook that OBs use in their education and their schooling, there are three main causes of difficulty during labor.  There’s power, passage, and passenger.  Those are the three things that they talk about.

Power is talking about the uterine contractions and how well neurologically your body is able to communicate.  The uterus is a huge muscle, and it gets its innervation from the upper lumbar and also from the sacral plexus, too.  It gets those nerves from the spine, coming and talking to the muscle of the uterus.  The power component of that is really making sure that there’s good neurological communication there, which ties directly into chiropractic.  We want to make sure everything is in good alignment so that communication can work well, so that when your uterus and all the muscles are contracting, it’s all working together symmetrically and working together really well.

The passage is looking at the pelvic opening and the shape of the pelvis and how all of that moves during pregnancy, too.  During labor, the pelvis kind of opens up.  You know, the sacrum kind of kicks back.  The pelvic floor muscles have to be pliable and movable so that the baby can have the best chance of going through the birth canal.  If there are subluxations in the pelvis – that’s really what Webster technique is looking at is how the pelvis alignment is working, how everything is working together, because if ligaments are tight on one side, if muscles, pelvic floor muscles, are tight on one side, that’s all going to cause more intrauterine constraint, which is also going to lead into the next one, which is the passenger, which is the baby trying to come through the birth canal.

If there is twisting in the pelvis, if there is intrauterine constraint because of those ligaments or muscles, baby is going to have a harder time getting into the right position and getting into that head down, ready to go position.  Those are all the three main components, and Webster technique addresses each one of those in kind of a different way.  Chiropractic is working with those subluxations to make sure there’s good neuromuscular communication.  We’re making sure everything is in good alignment so baby has the best chance of doing the right thing.  And then we also work on ligaments in the belly and stuff, too, to just give baby optimal room.  Innately, they should be able to get into the right position.

Right.  And what is the best time in pregnancy to start seeing a chiropractor?

I would say the earlier the better.

I would agree.

I think we have the best outcomes.  The earlier you start – I mean, there’s so many factors to chiropractic, too.  It’s not just about being uncomfortable or having the correct biomechanics, making sure that things are in alignment.  There’s so much to the stress component of that sympathetic and parasympathetic balance in the body.  Making sure your body is recovering well and that you’re just functioning as well as you can.  I would say that I think everyone should be under chiropractic care, everyone with a nervous system, but especially early in your pregnancy, you are going to feel so much better.  Your body is going to adapt so much better to the stresses and the challenges of pregnancy.  Then we can just support you all the way, too.

Exactly.  And so for our listeners who may be seeing a physical therapist, how does that relationship connect between a Webster certified chiro and maybe getting certain exercises from their physical therapist to relieve discomfort?

Oh, I think that’s awesome.  I love it when people are so invested in their pregnancy and they have all of the tools.  It’s the best.  Pelvic floor therapy is super important, too, both pre- and post.  But also, yeah, working with a PT just to – I think, again, I go to a  PT monthly just to keep my body working the way it should, to make sure I’m doing the right exercises and balancing my muscles and stuff, too, in addition to getting adjusted weekly.  I think both are so super important, and they work so well together.  So if you have a PT and they’re working with you on strengthening, the beauty of strengthening the muscles in a well-aligned position is just like chef’s kiss.  Just perfect.  They work so well together.

Agreed.  I do feel like there’s a misconception that if someone is seeing a chiropractor, they don’t need PT.  I’m glad you cleared that up.  Or if they’re seeing a physical therapist, then – and obviously, some people, if it’s self-pay or limited HSA funds, or insurance only covers so many visits, they might really try to optimize their budget.  But as someone who is nonmedical, it makes sense for me, if a client has the time and funds or insurance, to utilize all of the options for support that they can.

Oh, yeah.  Absolutely.  And realistically, there’s a lot of different things that you can do, and really finding what works for your body and who’s willing to work with you on it.  I think it’s the best option.  We do those scans in our office that are, again, no radiation.  They’re all functional tests.  And we give our recommendations, but we’re always willing to work with people.  If they’re like, well, I’m doing this and this also.  It’s like, great.  This is supportive care.  So let’s see what we really need, and then if you’re doing all these other things at home, we can kind of modify that because you’re already putting yourself a step ahead of someone who’s only doing this one thing.  It’s a little different because, again, things work synergistically.

Right, exactly.  And I would say certainly I’ve sent some of our clients to you if baby is breach or is malpositioned, for those positioning issues, or, again, discomfort.  But there’s also some of those last minute calls that you would get for someone who maybe has a VBAC and wants to optimize their changes for a vaginal birth after Cesarean or someone whose baby is measuring big and they really want a vaginal birth, so they want to get that extra support from a Webster certified chiro.  What else are you seeing?

Those are big ones.  I mean, we do get the 36-week patients who are like, my baby is breach.  We just found out on ultrasound.  What do we do?  And it’s like, okay, we’re going to do probably close together visits and just try to optimize whatever time we have and also send you to someone who does body balancing technique.  We’re going to hit the ground running and just try to optimize whatever time we have.  Obviously, more time is more beneficial, but we’re always willing to work with those situations because we get it.  A lot of times, you don’t get the ultrasound until that point, so you don’t necessarily know.

Exactly, and then you need to make decisions.

Exactly, but yeah, we’re always willing to support any of those kind of game time things.  But I would say those are pretty big ones.  You kind of nailed it on the head with, like, the breach baby positioning.  VBAC support is huge.  We have a really good success rate with VBAC support, which is so exciting.  There’s also great care providers in town, too, willing to do VBACs, and I think that’s awesome.

And even with induction pending, wanting to get your body as ready as possible if that induction conversation comes up with a provider and you aren’t seeing a chiropractor – similar to what you described with a breach baby, trying to get in as many visits as possible before the induction date would be beneficial.

Yeah, that’s a great point.  Inductions are stressful on the body.  And so the better adaptability and the more ready your body is to have a baby, the better outcomes you have with the induction, too.  That’s a really, really good point, too.  Just again supporting moms, getting them as ready as possible so that their body can handle what’s coming.

Right.  And then certainly reducing headaches or balance issues.  I could name off 20 reasons why I send my clients to you.

Or the SPD.  No one knows what to do with the symphysis pubis dysfunction, which is awful, but we can adjust it, which is great, and that helps.  So if it hurts when you go up the stairs or why you try to put on your pants one leg at a time, it helps a ton.  But that’s the benefit of your body working more efficiently is a lot of those symptoms go away, and it’s not just about the headaches or the pain and stuff, but it helps a lot with those things, too.  Let’s not discount pain; it’s a huge motivator, for sure.

Yes.  And then also in a women-owned practice, supporting women.  When I go in for adjustments or to work on the diaper drive with you, I hear – it’s almost like confiding in that close relationship you would have to your hair dresser.  It’s like you are following their journey.  You’re offering emotional support the way a doula would.  It’s truly a sense of community.

I think that’s my favorite part of our practice.  We do the open adjusting.  There’s so many mom conversations.  Kids will be playing in the corner, and moms are just chatting, like, oh, what do you do about this?  Where do you guys go to play?  What parks do you like?  Just little conversations like that.  And I just love to be witness to that.  But that’s going with moms through – we have a lot of second and third time moms right now that we find out so early in their pregnancy because we’re one of the first providers they can tell, one of the first people they can tell.  We’re just so thrilled for them because a lot of them, sometimes it’s taken a little while to get pregnant again and stuff, and so we celebrate that with them.  We work with them through their pregnancy journey.  They can tell – there’s no shame in our office.  You can tell us literally anything, and we’re just here to support.  And then getting to enjoy that birth, getting to go through all the highs and lows of pregnancy, all the highs and lows of motherhood, and just create a community around that – I love it so much.  I love that aspect of our practice.  And that’s what just keeps us motivated and keeps us wanting to do more and more of this work.

Yes, and I think your practice is unique is that you do home visits and you do have that follow the journey from pregnancy to early parenting with the pediatric aspect of your practice.

Yes.  Home visits are so fun.  Getting to meet baby – sometimes it’s before a lot of the other family members get to, too, which is – what an honor for us, with a mom where we’ve helped support her pregnancy, to then be like, here, adjust my baby, too.  It’s such a tremendous honor to be a part of their lives like that.  I love the home visits.  I think it’s so fun to feel like an old-timey doctor, bringing my whole kit over to someone’s house.  That’s a big fun part.  We always offer those during pregnancy.  We love to follow up with moms, too.  We understand that your focus now is on your baby or recovery or any of those things, and so we always want to check in with you, but not push too much.

And then in pregnancy, if someone’s on bed rest at home, of course you can help there, since you do home visits.

Absolutely.  And if there’s a home birth, too, with stalled labor, we can come during the labor process.  There’s a lot of things.  Even after a Cesarean birth, we can still adjust seated.  There’s always ways that we can modify.  If you’re on bedrest, if there’s certain things, like if you have an incision, we can adjust you different ways, and we’re very flexible with that, too.

Exactly.  So what are your final tips for our listeners, Dr. Annie?

Oh, find a chiropractor that loves you like us and wants to just support you and be psyched about your birth outcomes.  I feel like we have such a good community of birth workers in this area that all feel the same way that we do.  If you’re listening in a different area, find a birth team that really cares about you.  In Grand Rapids, we’re so lucky because there’s so many doulas, so many midwives.  At Gold Coast, you guys crush it all the time with your classes, with your support, with your Becoming course, to just support moms as they are and as they show up and just love them and help them through this challenging time.

It’s such a vulnerable time, and I do love that you have the all-inclusive that we do at Gold Coast.  We follow families through the first year with our day and overnight support.  And so we get to know them on a much different, more intimate level, and you have a very similar model. 

Yes.

You did mention resources for our listeners who live elsewhere.  Remind us again on how to find a certified Webster chiropractor in your area.

Anyone who’s taken a Webster certification and keeps up on it will be listed on the ICPA website, which is icpa4kids.com.  But if you Google ICPA, too, it will take you to the website.  And then right on the main page, it says Find a Doc.  You can type in your address, your ZIP code, even just city name, and it will populate who’s closest to you.  It will show who’s Webster certified, who has a CACCP, which is the certification that I have.  It’s the pediatric certification.  And then there’s also a DACCP, which is a diplomate, which I’ll probably work on here in a couple of years, too.  Those are the different levels of pediatric and perinatal certification, but if you’re pregnant, find somebody who’s at least Webster certified.  I think that would be just tremendous support for you.

Excellent.  And how can we find you?  Fill us in on social.  I know you’re everywhere on social.  Your website, all of it.

Oh, we have a lot of fun on social.  We are on Instagram.  We’re @risewellnesschiro.  Facebook, same thing.  Our website is risewellnesschiro.com.   You can find us on any of those.

And you do Facebook lives.  You have in-office events quite frequently for listeners and clients who are local.  As you mentioned, there’s so much going on.

Oh, yeah.  We like to do Yoga Bumps and Bagels in our office.  We’ve got Jessica, who’s a pediatric OT, working out of our office.  She’s doing a bunch of events every third Saturday now.  Tummy time support, breastfeeding support, all sorts of things.  And then we host Fit For Mom classes, too.  So we like to have events in our office, for sure, and just make it a safe space for moms.

Well, thanks so much for chatting with us, and we’ll include all those links on the blog.  We’ll have to chat again soon, Annie!

Yes.  Thank you so much, Kristin!

IMPORTANT LINKS

Rise Chiropractic

Find a Webster chiropractor

Birth and postpartum support from Gold Coast Doulas

Becoming a Mother course

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