postpartum depression

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The Power of Distraction

We often think of distractions as negative. We may get distracted by all the to-dos on our list, and it’s hard to stay focused on work or give our full attention to someone. Our kids may get distracted while getting dressed, or for older kids maybe it’s while doing homework.

But let’s reframe distractions. They can be extremely helpful when used in a healthy manner. For instance, if you are a person who worries a lot, or gets fixated on one idea, sometimes a distraction can help. Let’s say you’re worried about an upcoming work presentation or you child’s teacher conference; give yourself a mental break. Think of something you like to do that you can become completely absorbed in. For me, it’s working out or watching a good show. I can shut off my brain and completely focus on something else. This helps your mind relax and hopefully will tell your body to stop producing stress hormones for a while. For you, maybe it’s going for a run, or mindlessly looking at beautiful vacation homes online. Give yourself that break. Get distracted. But….don’t allow yourself to be distracted for too long. If you find yourself binge watching a show for 3 hours while you get behind on other things, this is not helpful. Set a timer if needed, and once it goes off, you get back to your work. Think of this distraction as hitting a reset button. It doesn’t fix whatever problem you were worried about initially, but you gave yourself a mental break. And sometimes, when you come back from that break, the problem doesn’t seem so bad.

This works for kids too. If they are struggling to figure out a problem in their homework, let them take 15 minutes to watch a show or play a game. Let them reset. Let them give their little brains a break and hopefully they are able to focus when they come back to the table. You know your child, so maybe watching a show isn’t the answer for them. Maybe they need to go play some football, listen to music, or dance – whatever your child can becoming fully engrossed in to give their mind a quick break.

Sometimes we can feel overwhelmed by all the things we have to do; the never-ending lists that just seem to get longer. Parents and kids both can have several tabs open at once in our brains. Kids are thinking about school, a test, play practice, sports, friends, etc. As parents, we know all too well how many balls we are constantly juggling. Our kids classroom party, a big work meeting, piles of laundry, picking up groceries, planning dinner, the house is a mess, the guests coming tonight, the dog needs grooming, the dentist appointment tomorrow, that email you still need to respond to, etc. The best way to shut down some of those tabs could be to distract yourself. It seems counter-intuitive. Shouldn’t you stay focused and get working on all this stuff?

If you can step away from all of it for a little while and let your brain be silent, sometimes you might find you come up with answers. Have you heard the saying, ” We come up with our best ideas in the shower.”? That’s because typically we are doing a mundane task that we don’t have to think about, and we don’t have distractions. So leaving technology behind is key here. Go for a walk, drive your car, or take a shower without distraction. Let your mind go. You’ll probably notice you come up with great ideas, solve problems, and figure out how you want to respond to that email while you let your mind work in silence.

For parents who have trouble falling asleep, distraction can be helpful too. If your mind is racing at night when you’re trying to fall asleep, use a distraction that will shut your mind down. For me, I have to write down ideas or problems that are keeping me awake so I can revisit them tomorrow, otherwise I cannot fall asleep. Once they are written down, only then can I turn off my brain and relax. If I wake in the night thinking about the problem again or I have an idea, I have that notebook by my bed to write it down, get it out of my brain, and fall back asleep.

It’s important for parents and kids to try and stay off technology right before bed. Parents, alcohol and caffeine intake can negatively affect sleep too. Sugar is a culprit as well, so watch how much sugar you and your kids eat after dinner. I have other blogs detailing out the ideal sleep environment, but a dark, cool room is important no matter your age.

If you find you’re prone to anxiety or depression, and you also aren’t sleeping well, make sleep your #1 priority. Sleep deprivation has all the same symptoms as anxiety and depression, as well as lowering your immune system, so get your sleep on track, talk to a therapist, and work on ways to find healthy distractions.

Alyssa Veneklase is a Certified Infant & Child Sleep Consultant, Newborn Care Specialist, and Certified Elite Postpartum & Infant Care Doula. She is currently a real estate agent working with her husband, but continues to teach three classes at Gold Coast Doulas – Newborn Survival, Becoming a Mother, and Tired as a Mother.

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2022 Reflections

2022 Reflections:
Whew! Our word of the year for 2022 was changed. Gold Coast announced an expansion for day and overnight postpartum support to Northern and Southwest Michigan in April.
Alyssa Veneklase transitioned from co-owner to subcontractor at Gold Coast in August. She still leads the Becoming A Mother course with Kristin and teaches at Gold Coast.
Kristin and Alyssa have signed with a publisher for a book deal!
Our small business has been operating on EOS with our implementor Laurel Romanella for a full year now and we have seen tremendous growth as a result.

Here are the Gold Coast stats for 2022:  

  • Number of group and private classes taught: 28
  • Number of students: 82
  • Number of birth clients that delivered in 2022: 95
  • Number of birth clients supported in 2022 with 2023 due dates: 26
  • Average Continuing Education training per doula: 5
  • Lactation: 22 clients
  • Alyssa created a new sleep class for infants and toddlers at different stages
  • Sleep Consultations: 18 clients served
  • Day and Overnight Postpartum Doula support hours: 7,776 (our best year yet for postpartum)
  • Multiples: 6 families served.
  • DEI our entire team had a 2-hour virtual DEI training with Sabia Wade, The Black Doula in February
  • Our entire team participated in a 2-hour pregnancy and newborn loss training through PAILAdvocates.
  • New Subcontractors Added to our Team: 8 doulas, 1 sleep consultant
  • Advanced Certifications Achieved: 12
  • Julie Skripka and Gina Kraft celebrated five years with Gold Coast.
  • We had our seven-year anniversary in October.
  • Ask the Doulas Podcast- We ended the year with 167 episodes total. Feedspot ranked Ask the
  • Doulas as 6 of the Best 15 Doula Podcasts on the Planet in 2022.   Listen Notes ranked Ask the Doulas as one of the top 5% most popular shows out of 3,005,585 globally. We launched our podcast in 2017 and are still growing strong thanks to our fantastic guests and listener support.
  • Becoming A Mother Course- We added new expert videos and enhanced our email communication to further grow our self-paced online course.
  • We offered two pro-bono spots in the course to low-income women.
  • 2022 Awards: West Michigan BBB Torch Award for Ethics Finalist, Best of Michbusiness small business award winner and Kristin Revere was named one of the 50 Most Influential Women in West Michigan by the Grand Rapids Business Journal.
  • Media: First Time Parent Magazine: Kristin Revere wrote an article on making your hospital room feel like home.
  • Gold Coast continued as a Climate Leader with Aclymate. We purchased 13,855 lbs of carbon offsets.
  • Gold Coast applied for B Corp recertification in July.

Volunteer Hours: 129 

  • Charitable Donations:  $2,703 to charities supporting low-income women and children.
  • Organizations donated to include: Nestlings Diaper Bank. Spectrum Foundation for a breastfeeding training for the Butterworth Women’s Center nursing staff, St. Mary’s Foundation with funds dedicated to clinics, Pine Rest Mother-Baby Program, MomsBloom, Preeclampsia Foundation and the Hello Seven Foundation.
  • We also donated a birth stool to St. Mary’s Foundation.
  • Diapers Collected for our 7th Annual Diaper Drive for Nestlings Diaper Bank: 11,133 disposable diapers, 97 packs of wipes and 100 cloth supplies. Many thanks to our partners: Rise Wellness Chiropractic, Fit4Mom Grand Rapids, Mind Body Baby, Mindful Counseling, Advent Physical Therapy, Hopscotch Children’s Store, EcoBuns Baby + Co, Brann’s, The Insurance Group, R. Lucas Scott. Co, and Howard Miller Library.

We are so thankful for our clients, partners, podcast listeners and students. Thank you for
trusting us to support your families!

 

Transformed by Postpartum Depression: Podcast Episode #110

 

 

Alyssa:  Hi.  Welcome to the Ask the Doulas Podcast.  My  name is Alyssa Veneklase.  I am co‑owner of Gold Coast Doulas, and today, I have Jessica Kupres, one of our postpartum doulas, with us, and we are both so excited to talk to Dr. Ladd.  She is the author of a book called Transformed by Postpartum Depression.  Hi, Dr. Ladd.

Dr. Ladd  Hi, guys!

Alyssa:  Hi, Jessica!

Jessica:  Hi!

Alyssa:  So, it’s still COVID.  We’re still in a pandemic.  We’re recording via Zoom, so if we hear any — you know, I have a dog and who knows what else.  Bear with us, right?  So, Dr. Ladd, I have to start — so Gold Coast Doulas is a doula agency, and I read that you were a birth doula.

Dr. Ladd  That’s correct!

Alyssa:  Are you still actively working or not?

Dr. Ladd  No.  I miss it.  I miss parts of it.  I decided to become a doula — I had a doula for my first birth, and she was wonderful.  And after I had my experience with a traumatic birth and then postpartum depression, I decided that I wanted to be a birth doula and did the DONA training.  And when I did the DONA training — this is all related, I swear – I saw in the syllabus, and Jessica, you can probably relate to this.  This was back in 2000ish – 2001, 2002.  So I was doing the training for birth doula certification, and I saw on the syllabus that there was nothing about perinatal mood and anxiety disorders.  Nothing.  And at the time, it wouldn’t have been even called that, but we didn’t – there was no training about depression or anxiety or any sort of mental health other than this kind of vague emotional support.  So I asked the trainer if I could bring in my own materials and do a presentation at the doula training.  I was so obnoxious.  And I took the PSI information with me and some basic statistics and basic, you know, what I had been through and shared my story.  And so my doula practice ended up being – I got breast cancer shortly after I was certified, so I took a hit in terms of how many I was able to do, but I did specialize in working with moms and partners who had had some sort of a trauma.  Either previous birth trauma or other; military.  I worked with some military couples.  And I absolutely loved being a doula.  It was hard physically.  I don’t think people realize how hard it is in terms of sleep deprivation and physical stuff.  But yes, I was a birth doula.

Alyssa:  Yeah.  I thought that was amazing.  Well, and it’s really amazing that you – they let you do your own presentation on mood disorders at that time, and I almost wonder if maybe you were a catalyst to adding some of that stuff to the DONA training, I wonder.

Dr. Ladd  Well, I’ve since been lucky enough to know Penny and Phyllis and work with them.  I was the founding president of PATTCh, which is dedicated to preventing traumatic childbirth.  And I’ve had many conversations over the years with Penny regarding whether or not doulas, birth doulas, should have what she would consider, I think, a scope of practice issue, because her amazing vision and belief was that anyone should be able to get the training to be a doula.  And along those lines, she felt that anything that kind of went into mental health needed to be handled by a professional.  So she and I have had those conversations throughout the years, and I’m hoping that the more the doulas nudge, that we can handle the statistics.  We can wrap our head around how to help somebody get to the Edinburgh Postnatal Depression Scale.  It’s fairly straightforward.

Alyssa:  Yeah.  I think we’ve come a long way in 20 years, right?  It’s been almost 20 years since that training.  At least we’re talking about it more.  I mean, that’s a step; a huge step in the right direction, that mothers are talking about this.

Jessica:  Yeah, getting the word out there so they don’t feel alone.

Alyssa:  Right.  So one question I had about even just the title of your book, Transformed by Postpartum Depression,  I was wondering – you know, that word “transformed” is so powerful.  And then I read in one of the chapters that you had – you were reading a book yourself about – I forget who the author was, but it had something to do with mental illness and mental health for mothers, and you read that word and it just, like, hit you.  So I’m guessing that’s why that word is so powerful to you and why you used that for the title of your book?

Dr. Ladd  Partially, yeah.  I mean, the title – that word did jump out, and it was Jeanine Driscoll, and this was a book that I had been given in my clinical training as a therapist.  And her story of postpartum – at the time, this was, for her, in the ’80s – she used the word transformed, and it’s the first time, I think, I had aligned the idea of transformation with perinatal mood disorders because I felt so different.  And when I, years later, went forward to do research in this area, the original title of this study was Changing instead of Transformation.  It was Changing Depression.  And my thought there was that what I was finding from the women’s own lived experience was that there’s a certain nature to postpartum depression.  Like, it has its own entity, and it is a changing kind of depression.  It’s so forceful.  It’s so sudden and comes on so strong, like a trauma, that it has its own sense of power.  It can change you.  And then I came back to the word transformation, and I think now, to be honest, I still grapple with that word a little because I think it has – I don’t want it to only be seen as a good thing or a bad thing.  It’s just that, gone untreated, these disorders change women.  They change women.  And for some, that change can be powerfully positive, and that’s where I got more – you know, I got involved with posttraumatic growth, but not everyone.  Not everyone.  So, yes, it’s a transformation, but I’m also kind of hinting at – which I don’t think I’m quite there yet.  I want to keep working on it.  I want to transform postpartum depression itself.  I mean, in the very back, I put together that graphic at the back page, which shows what we’ve called postpartum depression since the beginning of time, and we haven’t really gone very far.  It’s around birth.  It’s always related to some sort of reproductive event.  So I want, like you guys, to transform not only the experience that women have, but what we say about it, what we know about it, and the language that we use.

Alyssa:  Yeah.  You had mentioned that your husband at the time just kept telling you, this is all in your mind.  You’re making this choice.  Right?  And I think, you’re not the only one who hears that.  And maybe even if we as mothers aren’t hearing it from someone else, we’re hearing it from ourselves.  Why don’t you just do this?  Why can’t I just be that?  So I think you’re right in transforming not only what we call it but what we think about it and what we know about it, and I still think we don’t know enough about it, even though we’re talking about it.  It’s very surface level.

Dr. Ladd  Why do you think that is?

Alyssa:  You know, I didn’t know about it when I had my daughter.  I didn’t really know what it was.  And I would say, oh, no, of course I didn’t.  But then I think back, the more I learn, I’m like, oh, my gosh.  I remember sitting in the nursery just in tears in the rocking chair, and breastfeeding was so much harder than I imagined, and your hormones and your emotions are all over, and, you know, granted, for me, it slowly got better, but I don’t know.  I guess, was I in a depression?  Did I just have some anxiety?  Was this all just normal?  It’s hard to put a name on something.  And then the stigma of that is also what hinders a lot of mothers.  And, Jessica, I think you had a question specifically about postpartum depression, too.

Jessica:  Yeah.  But to go along with what you guys were just talking about, I think that part of it is, a big piece is that stigma, and going with my question in just a second, is that moms are afraid.  If they speak up and say something, their baby will be taken from them.  I did have postpartum depression pretty severely, and I didn’t seek help for eight months because I was, like, these horrible thoughts, which I now know were intrusive thoughts: they’re going to take my baby.  I don’t want to lose my baby.  And I think that that’s a big message that has to get out there, is that seeking help doesn’t meant that you’re a bad mom, and it doesn’t mean they’re going to take your baby.  It just can help.  And so I think that is a big piece of it.  But talking about this and this language, I wonder – you’re predominantly saying postpartum depression and focusing on the depression.  Why don’t you include more of the other things that go with it?

Dr. Ladd  Good question.  And I do, but it’s all because of language.  What we’ve known in common society – I think postpartum depression is the most identifiable.  So anybody who’s a possible reader or a clinician who hasn’t full training in the full spectrum of perinatal mood and anxiety disorders might identify postpartum depression.  And I also use it as an umbrella for all of the disorders because the language hasn’t filtered out to – I mean, we’re talking, all three of us this morning, about not knowing what to call our own issues when we have them.  So somebody with intrusive thoughts is not necessarily going to know that they might have postpartum OCD or postpartum panic disorder.  So I use the language that we’re most familiar with.  And I want to tag team on something you said about stigma.  You know, stigma – I did a study about how women who are diagnosed with bipolar disorder in the first year of postpartum, how they experience stigma.  And, basically, for all of us, any sort of the way we make decisions about the world is we observe how people are behaving, and if we perceive something to be outside of the norm – this is based on Goffman’s stigma theory – we kind of mentally categorize them as different.  Right?  And that different space is over, away, from what we’ve come to recognize as everybody else being normal.  Right?  So that different space lingers, and if we perceive them as either physically different or behaviorally different or emotionally different, we’re going to put them – our habit is to put them over in the “different” space.  And gone unchecked from just basic knowledge, that “different” group of people, we will build assumptions and beliefs about what they are capable of or how they fit in society, and it’s usually negative.  That creates the prejudice.  A prejudice; a preknowledge belief that, okay, that person who is behaving or looking different is going to potentially do things that are unpredictable.  And then if that goes unchecked, we can actually unconsciously build this implicit bias where we will discriminate.  We will discriminate in micro ways against or away from people that we perceive to be different.  So let’s take a mom who is crying a lot, and in the book, one of my participants referred to it as leaking.  You know, it’s like this kind of leak.  It’s like an involuntary crying.  Like the stomach flu, but you’re crying.  There’s no control over it; it’s just coming out.  So let’s say this mom is crying.  She feels that those symptoms are out of – they are out of the range of normal for her, and all of the baby stuff that she’s seen, from the minute she peed on the stick, didn’t show anybody crying inconsolably.  So when she goes out into the world, if it’s to Walmart, if it’s to the care provider, if it’s to the postpartum doula, there are no representations of that as normal.  So she moves herself into that “different” space and can start to believe that maybe there’s something seriously wrong with her.  And if that goes unchecked and she is at a family event crying, it gets validated because everyone’s like, why are you upset?  You have a new baby.  Everybody’s great.  So that process of stigma happens for women constantly.  And we unfortunately do it to each other.  When I was a doula, I once had a mom ask me to go to the supermarket for her to get formula because she was so afraid that some of her neighbors would see her buying formula instead of breastfeeding.  So that’s just one example.  So that stigma piece is – and the media certainly doesn’t help.

Alyssa:  Right.  And I had a question about one excerpt from your preface, and maybe I’ll just read it, because it stuck out to me.  Again, it’s the whole stigma, and it’s the idea of what do we call this.  So it says: “I reject the notion that objective truth is inherently real or measurable but rather constructed by multiple entities, including society, culture, history, and individuals, all coexisting.  So from this perspective, the reality of postpartum depression can’t be known, defined, or quantified.  By definition, it is constructed in real time, every time, in multiple ways, by multiple people.”  So it’s dynamic and changing, and to me, this pinpoints exactly why this is so hard to define, because postpartum depression, for one, doesn’t look – you know, for you doesn’t look like it does for me, and a lot of how we feel about, you know, if I had it, maybe it’s the way my family’s talking to me about it.  Maybe it’s, you know, not going to the grocery store for fear of my friends finding out I’m buying formula.  Or maybe I don’t care about that, but I have to post all the beautiful Instagram photos.  There’s just so many different layers and levels that I think you just hit the nail on the head with why this is so hard to define and then so hard for others to understand.

Dr. Ladd  Exactly.

Alyssa:  So when a mom has it, I feel like she’s – you know, maybe her partner doesn’t understand.  So like you, getting the whole thing about well, just change your frame of mind.  Just do something different.  Get your head out of the hole and, you know, you have a baby who’s beautiful, so what are you so sad about?  If people don’t understand, then we just dig ourselves into a deeper hole.  Well, I know I feel this way.  I shouldn’t feel this way.  I don’t want to feel this way.  But now they’re making me feel worse, so now I’m probably digging a deeper hole, and it’s just getting harder and harder to get out.

Dr. Ladd  Yes.  And part of what you’re saying, really, it speaks to how do we fix this, and I think the more we can normalize that – we have no trouble talking about a clogged milk duct.  No trouble.  We’ve made that okay.  And women have said, I need help.  So there’s been this agreement between science and society to allow women to talk about things like sore, cracked nipples, for God’s sake.  We can do that.  We can talk about how to care for an episiotomy repair.  I think maybe if we could talk about the range of that for every birth, there is a range of physical and emotional recovery and experience, and within that, I mean, we do know that 80 to 85% of all birthing women will experience postpartum blues, that kind of – you know, shortly after birth, two or three weeks.  It lasts for a few days and then moves out.  But we’re not even comfortable talking about that, and when I say we, I mean all of us.  But predominantly care providers.  So when you’re discharged after having a baby and you have all those pamphlets about how to lactate and breastfeed but there’s nothing in there about how you can identify if you’ve got some things going on with your brain, there’s a miscommunication.

Jessica:  So what would you suggest?  And this – I just really am interested.  What would you suggest as care providers that we do to get the word out?  How do you think we could improve that so more moms would know about it ahead of time and can be better prepared for it so it doesn’t just hit them like a ton of bricks?

Dr. Ladd  I think there are a couple of things, one of which is public health.  And on the public health level, we need more support for mandated screening.  And ACOG is close, but not there with the mandate to screen.  And even asking a woman about her family history, we’re not – if it’s not on the checklist for an intake for the OB nurse, for any sort of prenatal or perinatal care provider to say, so, tell me about your family history with any sort of mood or anxiety disorder.  If that’s not on the list, that’s something we could add quickly.  We’re not shy, and ACOG is not shy, about saying that we need to test your urine.  We need to test your blood.  We need to test your blood pressure many times to screen.  But yet even though we’ve got these validated screening tools, it’s not mandated, and that sends a message.  I’m not even sure that would fix it.  But on the public health level, organizations like National Perinatal Association, NPA, PSI, who are saying, we have to change it by asking women.  That’s one way.  And then I personally believe, and that is my personal belief, that the more women can talk about how they’re feeling, regardless of what they think might be happening in response to that, the better.  So in my research, all 25 women ended up having to get themselves treated because providers failed, even when women were saying flat out, I’m not sure I want to be here, or I think I shouldn’t be my child’s mom, or I can’t sleep.  And providers miss it.  And I don’t want to bash providers; I really don’t.  I want them to get the support from their certifying bodies that it’s important; important enough to take 5 minutes out of the 15 minutes that they’re given with a patient and ask.  So that’s part of it.  And I think as the birth community, the mom community, that’s so huge now online.  Maybe we just need to lighten the load on the language.  I mean, the women in my book speak very frankly, and I think all women speak very frankly when they’re not under the – you know, when they’re not being analyzed.  We all have those private Facebook groups where women are throwing down.  So when a participant will say to me, I don’t know why we don’t just tell each other.  It sucks, man.  That resonates on a level to any mom, regardless of their perinatal mood or anxiety disorder.  Why don’t we tell each other it sucks?  And that’s the last piece.  And it seems to be that we have a lot of trouble allowing – I’m going to use the word allowing – women to be ambivalent about motherhood.  You’ve got to love it all, or you’re horrible.  Every moment of it, every diaper change, every ear infection, all of it.  And that’s – who loves all of anything?

Alyssa:  Right.  That’s not fair for anything, let alone a screaming toddler or a sassy teenager, right?  With each new stage, I feel like – you know, I always tell my postpartum clients that every developmental stage, you lose something that’s so hard, and then you go onto something that’s easier, but then this new hard thing is going to come.  Like, there’s always going to be this new hard thing, and you won’t be prepared for it, and it’s okay.  It will suck for a while.  But yeah, I think it’s hard to – you know, I have whole days that I’m just like, oh, my God.  This is awful.  What in the world?  Why?  I read something the other day where this mom said she had one kid, and it was – you know, the pain of it and just the exhaustion.  It was, like, a two-day induction or something.  She goes, my only thought was, why in this developed world where contraception is available do we have so many humans?  Like, why are people doing this again and again?  And she was so real.  I loved it.

Dr. Ladd  Yes!  And the last piece of this, and not everyone – you know, I will just share that I think Bowlby and attachment theory has done a number on us for six decades because, on some internalized level, guys, we are buying the notion that maternal deprivation will harm the thing that we love more than anything.  That if we sneeze in the wrong direction or have a thought about, God, I’d really like to not be doing this right now, we will harm our child.  Not only once; for their lifetime.  And while we do have, you know, years of science about maternal attachment and development, we have yet to really clear the debris of what attachment theory can also do, which is to shame women out of their reality.

Jessica:  Yeah.  I feel like that’s a lot of mommy wars type of stuff.  There’s so much information on how to be a good mom, and whichever way you choose, every other way is going to say you’re wrong, and I think that’s just really hard, that we just don’t – I mean, it’s all this pressure to be this perfect mom.  Yeah.  I think that’s a big piece of it.  And then we have, on that, that if you have depression, if you’re not happy, if you don’t enjoy every minute of every day, now you are destroying your child for the rest of their life.  Now you’ve not only given them depression because you have depression genetically, but now you’ve given them depression because you’re depressed and you didn’t bond with them appropriately.  And so let’s just add a little more stress and anxiety to someone who’s already stressed and anxious.  And I just think that’s – I mean, it’s good to know.  Like you said, it’s research.  We know that there’s not that – it’s not going to be as much bonding and that it can cause more depression, but I feel like sometimes it just adds more.  It’s another way to feel like you failed.

Alyssa:  Well, and I think – I have the same thoughts about the attachment.  You can always go too far.  You know, and of course the oxytocin that you can get from the skin to skin, but sometimes even now, and my daughter’s 8, I just feel touched out.  Everyone just needs me all the time, and if I were a depressed mom with a newborn baby, and everyone’s saying, oh, you’re feeling depressed.  Just hold your baby all the time.  Wear your baby all the time.  Breastfeed more.  That’s just more touch when I need my own space.  And then sometimes babies – I see this a lot because I do sleep consultations, and I get those depressed moms who haven’t slept for months.  They are so sleep-deprived, and then they think, I’ve been holding my baby to sleep for three months straight or all these things.  They don’t know that their little babies are developing these personalities, and they might not want to be touched all the time.  Just because you’ve been told that they need to be picked up every time they cry – your baby doesn’t always need that.  So really listening and being in tune with what you want as a mother and what your baby is actually asking for – I think we’re just getting – like you said, the attachment thing.  We’re just getting too touched out.  We don’t necessarily need that all the time.

Dr. Ladd  This is such a great conversation, and it makes me think about how it loops into the stigma.  It loops into what we said about needing to let women speak to their own experiences.  And I think there’s something about redefining attachment as – or this idea of motherhood as, you can communicate to your baby and to your child: Mommy’s struggling, and I’m right here.  I had a conversation with a mom this week, a colleague of mine, who’s got a boy who had to have a tooth extraction.  And as anybody listening can imagine, a child having a tooth extraction is incredibly anxious, and it was long and very difficult.  And I said, you know, it’s okay to tell him that you – it was hard for you, too.  And that you went through it together, and that you’re okay.  Yeah.  I was there, and because it validates to your child, yeah, that was pretty crazy, wasn’t it?  That was pretty hard.  It was hard for me, too.  And I’m okay.  And maybe we can allow each other to say, you know what?  I see that you’re an amazing mom, even though you have these experiences that tell you that you’re not.  And we can start to say to our children, you know, I went through this, and I rock.  It didn’t screw me up in terms of my connection to my child.  It actually made it stronger.  And I’ve had women, lots of women, tell me that, that the connection with that child with whom they went through a mood disorder is unique and tight.  In other words, I think women – we love our kids, no matter what.  It just doesn’t have to always be positive.

Jessica:  I love that you said it doesn’t always have to be positive, and I think that’s really important for moms to know, that it doesn’t always have to be positive.  That there will be ups and downs, and it’s the hardest job in the world.

Dr. Ladd  And we’re able, in other areas of society, to really honor struggle in a way that’s noble.  Veterans: we’ve gotten our heads around honoring the nobility of somebody who’s sacrificed and paid a price emotionally, physically, et cetera.  And yet we’re not able to do that for moms in terms of honoring their suffering nobly.

Alyssa:  I love this conversation.  Two more things.  We’re going to end with how people can find you and your book and tell us anything else about your book, but let’s say not everyone is going to be able to read your book.  What’s one thing you think every mother, parent, would need to know going forward, either about motherhood or mental health or…

Dr. Ladd  I would say about any woman who is of childbearing years should be talking, should be telling, their provider about their sleep, their appetite, whether or not there’s a history in their family of mood or anxiety disorders, and for women of color, it is so much harder to get the message across, so I would say we all need to support our women of color to have an ally, to possibly go with them to the provider.  Without a doubt, we need to be telling – because they’re not asking right now.  They’re not saying.  They’re just not asking.  For a number of reasons; put COVID on top of everything else.  So we need to be encouraging.  I would love to see – there’s this concept called a reproductive life plan where doctors could be asking young girls and young men about their emotional and mental health very early on.  So a pediatrician who’s doing a well‑check for a kid who’s 11 could be planting the seeds that that’s a safe space to say, I am not sleeping.  I’m having intrusive thoughts.  Or I can’t stop thinking about this, or I’m any of the symptoms that would come forward.  So to wrap that one up, I would say – and for anyone who’s pregnant and/or just had a baby, I would say, know the language of mood disorders to be able to say it to your provider to get help, and that would be how your sleep is affected, how your appetite has been affected, and how your sense of hope or interest in life, anhedonia, has been affected.  Just being able to say, I’m not sleeping.  I’m not eating.  And I feel like I don’t want to do this.

Alyssa:  Yeah.  I think that’s beautiful.  Well, thank you so much for doing this.  It’s such a pleasure, and I look forward to finishing the book.  We got quite a ways into it.  But tell people about your book; maybe say your name and the title again and where they can find your book.

Dr. Ladd  Sure.  So my name is Walker Ladd, and you can go to my website.  And the book is Transformed by Postpartum Depression: Women’s Stories of Trauma and Growth.  And that’s on Amazon or at my publisher, Praeclarus Press.  And I also wanted to give a shout-out to anybody interested in the book to think about – I was able to get interviews with amazing experts, so a part of the book is dedicated to – I ask, you know, Karen Kleiman and Jane Honikman.  I had such a great experience interviewing these leaders to see what they think about the idea that untreated postpartum depression or any disorder could be experienced as a traumatic life event, and it was a very interesting response.

Alyssa:  Great.  Well, thank you so much!  We’ll talk to you soon.

 

Audra Geyer Doula

Audra’s Birth Story: Podcast Episode #105

 

Audra Geyer, Gold Coast’s newest birth doula, tells us her birth story and how birth support from her doula was a game changer.  She also took HypnoBirthing classes and went from being afraid of labor to looking forward to it!  Her experience with Gold Coast let her to become a doula herself! You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with Audra to talk about her birth and HypnoBirthing experience.  Welcome, Audra!

Audra:  Hi.  Thank you!

Kristin:  So tell us a bit about yourself.  I know we met at the Baby Expo in your early pregnancy stages.

Audra:  Yeah.  I live in Alger Heights with my husband and our two dogs, and we have a seven-month old daughter, Charlie.

Kristin:  This was your first pregnancy.  So tell us about how you planned for your birth.

Audra:  So initially, I had no plans for my birth.  I just envisioned that it would not be an enjoyable experience, and I just had to get through it, and it was just part of what the process was for having a baby.

Kristin:  And how did you get that information?  Was it from movies or friends, or what made you sort of fear birth?

Audra:  I think just society’s view on birth.  You know, everyone I had talked to, I had just heard horror stories about their own personal experience.  And, yeah, watching movies, TV shows, everything just shows that this is a terrifying, awful experience, and so that’s just — I was just preparing myself for that.

Kristin:  And I think people tend to share negative stories more than they do their positive birth stories with friends and family.  That just feeds into it.  So you took some classes with us in early pregnancy, and also used both birth doula support as well as postpartum. So tell us a bit about that preparation and maybe how it changed your mindset.

Audra:  Yeah.  So I went with a friend to the Baby Expo, and I had heard about doulas before but just assumed they were for natural home births.  So we just started talking, and I heard about HypnoBirthing.  I remember the first question I asked you guys at the Baby Expo was, can I still get an epidural?  And they were like, oh, of course.  Whatever birth you want, we’re just there to support you.  So I went home and just did a ton of research, and I was like, holy cow.  There’s this whole world of doulas and support for women that I never knew about.

Kristin:  Yeah.  There is a misconception that doulas are only for home birthing, unmedicated birthers, and, you know, especially at Gold Coast, we pride ourselves on judgement-free support, and we have clients who want an epidural the second they get to the hospital, clients who are planning a surgical birth and they want support emotionally and with resources for that birth.  So, yeah, doulas are definitely for all birthing persons, not just unmedicated birthers.

Audra:  And my whole life I’ve struggled with anxiety and depression, and my husband and I knew that would be something we’d have to keep a close eye on while I was pregnant but also postpartum, and to be like, oh, I could have this support right away, and just knowing that I will have someone in my corner and someone to support my husband, too.  It just provided us both with a lot of comfort.

Kristin:  Yes!  So tell us about HypnoBirthing and what you learned in that class.

Audra: HypnoBirthing was amazing!  First off, we just learned so much about the birthing process and what happens to our bodies in labor.  Stuff we’ve learned, but I’ve never really taken a deep dive into it and thought about it.  And just a big focus on labor and delivery and pregnancy — our bodies were meant to do this.  We learned a lot of medication, breathing techniques, but it was also a big focus on bonding with your baby, bonding with your partner.  Every class we left, I just felt so connected to my baby, to my husband.  A lot of positive affirmations and just really starting to envision my pregnancy, my labor, delivery, as such a beautiful experience no matter what happens.  And what a gift I’d been given to be able to go through this.

Kristin:  Right.  Exactly.  And what I love about HypnoBirthing is it’s, as you said, it’s more like that mind-body connection versus just positions and some physical techniques you can do to reduce the perception of pain.  So it’s just — there’s such an emotional connection to birth and your partner and your support team, and of course breath and using positive language in birth and taking the fear out of it.  It’s a huge aspect of HypnoBirthing.

Audra:  I remember my husband was like, sure, I’ll do this with you.  And when we left our first class, he was like, that was nothing like I imagined.  He thought we were going to be in a gymnasium with pool noodles on the floor in different positions, and I think he just felt really empowered, too, that look at what I can do to help support my partner and be just as involved in the birth.

Kristin:  Right.  Beyond HypnoBirthing, I know you took some other courses through Gold Coast.  What else did you do preparation-wise?

Audra:  I took the Saturday Series course.  So Comfort Measures, Breastfeeding, and then Newborn Survival.

Kristin:  And what were your takeaways from that one day series?

Audra:  It was just so nice to have information, and I just felt so much more calm and educated and kind of knowing what to expect and knowing that there’s no right or wrong way.

Kristin:  Right.  It’s what right for you.  I think all of us, you know, emphasize that in our classes, whether it’s Alyssa’s Newborn Survival or the Comfort Measures that I teach, and certainly Kelly’s breastfeeding class is eye-opening in so many ways and shows how a partner can be involved in feeding, as well.

Audra:  Yeah, and I think with the breastfeeding, it really just prepared me, that if that’s the route I choose to go, it’s going to be hard, and it’s okay that it’s going to be hard.  I think I had an idea that, oh, no, breastfeeding is going to be so easy.  She’ll latch right away.  We’ll have no issues.  But to know that, yep, you’re not alone.  This can be a struggle, and again, you have to figure out what’s best for you and your family.

Kristin:  Exactly.  Now we’re getting to your birth phase and working with birth doulas and so on.  I know Katie was your doula.  Tell us about that experience.

Audra:  Oh, it was amazing.  I went from initially, “Of course I’ll have an epidural,” to, nope, I’m going to do this all naturally, thanks to HypnoBirthing, to at 37 weeks finding out I needed to be medically induced.

Kristin:  Lots of changes with that.  Tell us how Katie supported you in pregnancy and then leading up to the induction.  A lot of people don’t really understand the role of a birth doula through pregnancy and labor.

Audra:  Yeah.  I had — the minute I signed the contract with Gold Coast, I had Katie’s support.  Through the phone; I could text her with any questions, anything I was worried about, anxious about.  She would respond, provide me with resources.  A lot of what I needed was just reassurance that things were going how they were supposed to go, that I was okay, baby was okay.  And especially as a first-time mom and first time being pregnant, your body does a lot of things that you don’t know would happen.

Kristin:  Right.  There’s a lot of, “Is this normal, or do I need to call my provider?”

Audra:  Exactly.  And so just knowing I had someone there, nonjudgmental, you know, just supporting me — because, you know, calling your provider, you don’t always get to talk to them, or they’ll just yep, yes or no, give you a short little information, and then they have to move on with their day.  So having someone who can sit down and really just talk through your options, talk about how you’re feeling, checking in with you emotionally.

Kristin:  So when you found out you needed to be induced, how did your doula support you through that process before she supported you in the hospital?

Audra:  So I left my appointment with the doctor sobbing in the car, just absolutely terrified about getting induced.   So the first thing I did when I got home was text Katie.  I just expressed all my fears to her and what I was feeling, and first and foremost, she reassured me that the medical team I had chosen were going to take the best care of me.  My baby was going to be safe and healthy.  I had blood pressure issues, and so I was just terrified of what could happen if my blood pressure gets really high.  She encouraged me to write out a list of questions to ask my doctor.  Like, if this happens, then what do we do, or what would this step be?  What would this look like?  So I could have more of an understanding of what potentially could happen at the hospital.  And then also she really encouraged me to write out some affirmations, because I love writing affirmations and I use them all the time, and so I was able to write a list of affirmations that I would use while I would meditate to just help calm me down and center me, focus me, and let me still enjoy these last few moments of being pregnant.

Kristin:  That’s fantastic.  So you were able to have conversations before the induction started, and you got the answers you needed to feel empowered.  So tell us about some of the induction process and when your body started to kick in and when you felt like you needed in-person support and how that went.

Audra:  We knew it was going to be a long induction process, just because I was 37 weeks and my body was not near ready for labor.  So between Katie, myself, and my husband, we were basically in constant communication through text message, just how I was doing, how I was feeling, what the next step was.  And Katie actually came the first night we were at the hospital just to check in, see how we were doing, letting us know whatever we needed, she was there and ready for us.  And things were going pretty stable at that point; nothing that we needed a lot of support.  We were just resting.  So she went home, and said, I have my phone with me.  Anything you need, call, text, reach out.  And things were slowly progressing.  It got to the point where I did end up getting an epidural, but I was just pretty relaxed.  And then the next day around noon, my water broke, and things started to pick up pretty quick.

Kristin:  Yes.  It intensifies everything, for sure.

Audra:  We reached out and said, hey, you know, I think we’re ready for you to come.  Labor has officially started after 24 hours of being at the hospital.  And so by the time Katie got there, my epidural had kind of worn off a little bit.  So I was in a lot of discomfort.  I was not feeling well, and I just remember her coming in and with her and my husband, they were both just supporting me as I would breathe through my surges.  And I actually — Katie has two sons, and I remember at one point looking up at her, and saying, I just need you to tell me what you love about being a mom, in between, so that I was able to focus on the things I had to look forward to as I was in some of these deep pains and discomfort.  And it was just so amazing to hear.  You know, I had my husband on one side telling me the birth affirmations we’ve written, and then I had Katie on the other just sharing these amazing things that I knew I would soon be experience.

Kristin:  Yes.  I love it!

Audra:  With that, I was able to just relax, surrender, and just — I felt so calm despite being in one of the most uncomfortable situations I’ve ever been in.

Kristin:  That’s great.  So things intensified.  Did Katie help you move into different positions?

Audra:  Since I had the epidural — because I finally got some relief — she would help with the nurses, with moving me, and I think the biggest thing for me was just the reassurance she was giving me, that I was doing great, my body was moving along, this was where I was supposed to be, helping me feel excited.  And I think for Rob, too, she just was an extra support for him because he was supporting me so much, and it helped me to know he was taken care of as well.

Kristin:  Yes.  That is a huge part, because we do support a couple as a whole and make sure that the partner has gotten rest if needed with inductions or had a chance to get food or to step out and take a break because it can be intense when they’re pouring everything into you and are trying to be that supportive partner.  We don’t want them to be depleted at the time of pushing and meeting their baby.  So I’m glad that he felt taken care of, as well.

Audra:  Yeah.  And once I finally felt relaxed and got a lot of relief, Katie encouraged us both to take a little rest.  And there’s actually a picture of us, with me in the bed sleeping, Rob on the couch sleeping, about an hour before I gave birth, and it’s just one of my favorites.  The last few moments of us resting, just the two of us, and that moment was able to be captured.

Kristin:  And then did Katie offer support after the birth?  Like, how did she help after your daughter was born?

Audra:  When Charlie was born, she came very quickly and ended up needing to be on CPAP pretty quick after she was born.  So as a new mom and just already very anxious, I was terrified.  Like, what is this looking like?  Is she okay?  Is this normal?  What are they doing?  And I had just given birth and my body — you know, I was just in this tremendous amount of emotions in general, and she was able to support both my husband and I.  She encouraged Rob to go stand by Charlie and then was able to be there with me while the doctor was finishing up with me and just kind of keeping us informed, educating us about what was going on and that things were okay because the nurses and doctors, they’re all talking to each other and saying terms we didn’t understand, and just encouraging me to ask questions if I had any and validating that, you’re doing a good job advocating for yourself, Audra, and just — yeah, it was nice knowing my husband could be with Charlie for that brief time, and I had someone right there with me, as well.  And so then after Charlie was able to be off of CPAP, we were able to do our skin to skin.  She helped us with latching and, again, I was just very anxious.  Is this supposed to be happening?  Does she look okay?  Is she breathing okay?  And just, like, bringing me back to focus of, look, you just gave birth, and you have this newborn baby in your arms.

Kristin:  I love it.  Did she follow up after she left to see how you were doing when you were still in the hospital?

Audra:  Yes.  She would follow up to see how feeding was going, and then we did — I would say about a week after Charlie was born, she came to our house to just follow up and see how things were going, and she got to see Charlie and hold her.  And it was just so nice to have her support and to have — like, that she was such a part of this experience to us, where I was so vulnerable, but yet it was such a beautiful, emotional experience that I feel just so connected to her now.

Kristin:  Yes.  I feel that way with my doulas.  It is vulnerable, and a time of reverence.  So, yeah, you end up feeling like your doula is part of your family for that journey, whether it’s a birth doula or a postpartum doula.  And, of course, you delivered pre-COVID, but your postpartum phase was during COVID.  So that’s changed your initial plans as far as postpartum doula support went.

Audra:  Yeah.  So we had — I’m trying to think.  Maybe a couple weeks before COVID hit, being at home and being able to use our postpartum doula.  And I remember initially being like, okay, what do I do?  How can I entertain the doula?  Like, I need to clean the house.  I need…

Kristin:  You’re a helper, obviously!

Audra:  I need to look presentable!  And Jen was our doula, and she came over and was just like, oh, my gosh, Audra, like, you can relax.  I have Charlie.  Don’t you worry.  And I would go take a nap.  I would rest.  I would come downstairs, and the house would be tidied.  She’d have a snack waiting for me.  My pump parts would be clean.  The diapers bag was packed and ready to go.

Kristin:  Perfect!

Audra:  Yeah.  Less things I had to worry about or to focus on later that day.  And I like to talk and talk through experiences, so a lot of times, too, we would just sit and talk, which is what I needed at that time.

Kristin:  And we are there to process the birth with our clients as far as postpartum doula support and then help you heal and talk to you emotionally.  I feel like friends and family ask more about the baby and don’t check in enough with the birthing person and how they’re doing and how they’re feeling.  Everyone wants to hold the baby and give gifts for the baby, and there’s not enough attention to the birthing person.

Audra:  Yeah.  The amount of times I got asked, how’s the baby sleeping?  You know, it was never, how are you sleeping?  How are you doing?  It was, oh, how is she sleeping?  And I also got a lot of, oh, I’m glad that’s going great now, and you just wait until you see what happens.  And I’m like, my body is still healing from this crazy experience.  I’m keeping another human alive.  What about me?  I need help, too.

Kristin:  Exactly.  And in traditional cultures, women are supported for 30 to 40 days from friends and family, and they aren’t expected to do anything.  And in our culture, it’s like, okay, get back to work.  Get back in shape.  You should be feeling great and don’t complain.

Audra:  Keep the house clean!

Kristin:  Right.  Be perfect!  And that’s not how it should be.  So we’re trying to bring back some more of that focus on the birthing person.  So you are now a doula with us!  So tell us how you became interested in becoming a doula after your experience and a bit about why you are drawn to this work, because you obviously have another career.

Audra:  Yes.  So like I said earlier, I went from not knowing a lot about birth, just expecting, you know, this to kind of be a terrible experience, and through my education and through the help of having doulas, I was able to make my birth one of the most beautiful experiences I’ve gone through, and I found myself, after giving birth, wanting to talk about birth a lot, and I was doing a lot of research, reading a lot of books, reading about postpartum, and right now, I’m a speech language pathologist.  I work with people who’ve either had a stroke or a brain injury.  So I’ve always worked with people, helping people.  That’s been a passion of mine.  And just realizing the lack of knowledge, especially in the United States, of the postpartum experience, the birth experience, and what a doula is.  And I just thought, wow, if I could help give other women the support I had and help them through this journey, help them have the experience and support that I had, that would just be so fulfilling and just — it makes me sad when I think about all the people I know who look back on their birth and their postpartum and it was — they felt like they had no support and they felt so alone.  And that shouldn’t be the norm.

Kristin:  Right.  Yeah, they feel isolated, especially now during COVID, and we’ve been working all through COVID.  Some of our postpartum work had halted, and some hospitals weren’t allowing doulas in, so we offered virtual support only, but I feel like now more than ever, because of the isolation with COVID, doula support and that connection is so essential and providing information, as you said, so couples can make informed decisions about their birth and their postpartum phase and planning out what they want to do after baby or babies are born and how they can accept help from others or hire help, like postpartum doulas or a housekeeper or a meal delivery service, whatever it may be.

Audra:  Yeah.  And even the comfort of knowing you guys have a sleep consultant, and if I ran into issues, you know, I had 12 weeks off for maternity leave, and a big area of anxiety was, what is it going to look like when I go back, with sleep?  And so I always knew I had Alyssa if I needed her.  Thankfully, Charlie got on a good sleep routine on her own, but just knowing the amount and the diverse support that Gold Coast had, I knew I was going to be taken care of, and I knew I was in good hands.

Kristin:  So what did you learn — obviously, you worked with doulas, but then you recently took your birth doula training.  What opened your eyes that you didn’t know before about the doula role?  Tell us a bit about your training.

Audra:  It was so amazing.  Just learning about nonjudgmental support.  No matter what someone is thinking, feeling, we are just really there to support them.  And, obviously, as we go through our own births and raising our own kids, we can develop our own feelings, but putting those aside and saying, we are there to support you, and no matter what you choose.  So it was nice to just learn about all those different strategies and how I could go in and help a woman in any situation, no matter what.  I would feel confident doing that.

Kristin:  Right.  And your particular training through ProDoula — and I’m also trained through ProDoula — you realize you don’t need all the things as a doula, and you have that instinctual knowledge, and you’re able to just serve; again, without judgment, and an open heart, and a brand new doula can be just as effective as someone who’s seasoned like myself.

Audra:  Yeah.  And, again, before I knew much about doulas, I always thought, oh, they have the birthing balls and they’re in the tub and, you know, all these other knick-knacks that you have to have.  And it’s really just yourself being there.  That’s all you need.

Kristin:  I mean, I have a birth backpack that is filled with things, but outside of, you know, my bosu and a couple other things — like, I like the LED candles to put in the bathroom if a client’s in the tub or shower, but I don’t use everything I bring.  Other than snacks for myself, and that’s key.  Got to keep going!  But, yeah.  So we’re excited to have you on the team!

Audra:  Yes.  I’m so excited!

Kristin:  And I know you have plans eventually to become a postpartum doula, but you are available for hire for labor doula support.

Audra:  Yes!

Kristin:  So we’re excited to begin that process with you.  Thanks for sharing your story, Audra!

Audra:  Yes.  Thank you for having me!  I love sharing it and talking about my experience.

Kristin:  You’ll impact so many families, not only from listening to the podcast, but when they begin working with you.  And we will include a link to your bio in our podcast notes and the blog.  Thanks for listening to Ask the Doulas with Gold Coast Doulas.  These moments are golden!

 

Acupuncture for Anxiety: Podcast Episode #105

 

Kristin Revere, Co-Owner of Gold Coast Doulas talks with Vikki Nestico of Grand Wellness about acupuncture to help relieve stress, tension, and anxiety.  You can listen to this complete podcast episode on iTunes or SoundCloud.

 

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with Vikki from Grand Wellness to talk about how acupuncture can help with anxiety, both in pregnancy and after delivery.  Welcome, Vikki!

Vikki:  Thank you for having me!  It’s awesome to be here again.

Kristin:  Yeah, it’s great to have you back!  We spoke about acupuncture and fertility last time.  So I’m excited to delve into anxiety.  A lot of our clients struggle with anxiety, both in pregnancy and after giving birth.  So I’d love to hear a bit about you personally and also your practice before we begin.

Vikki:  Well, I moved here from New York City about six years ago and was so happy, because I do love it here — it’s such a great city — but really exciting to bring — I wouldn’t say I brought this medicine here, but, you know, I’m one of handful of people that do acupuncture in West Michigan.  And in New York, every corner has an acupuncturist.  So it’s wonderful to be a part of the crew that can — that really gets to share this medicine for the first time to so many people.

Kristin:  Right.  Yeah, it is definitely all about education, and we feel the same way about birth support and certainly postpartum doulas.  Everyone has a doula in New York or Chicago or in other markets, and so both of us in our practices have the challenge of educating the community on the benefits of our services.  So it’s great to partner with like-minded professionals like yourself and refer clients and know that you’re a trusted referral source.  You know, we tend to refer a lot of our clients who are either struggling with pain in pregnancy or are trying to induce labor or have a baby who’s breech, for example, and they’re trying to do everything they can to flip baby.  So we appreciate how much you’ve helped our clients.

Vikki:  Oh, thank you.  I love working with women and with women in the process of getting pregnant and working through pregnancy, giving birth.  There is nothing more exciting than to get that note from a client with a beautiful picture of their baby on it.

Kristin:  Yes!  That is the best.  And then if you continue the relationship, that’s also quite lovely, to follow up and see how they’re doing.

Vikki:  Absolutely, and usually when you get in — you know, obviously, with doulas, you then work on next pregnancies and sometimes around that.  For us, it really opens our clients’ eyes to what acupuncture can help with.  So if we’ve helped somebody through fertility and through pregnancy, we’ll often see them down the road for the beginning of other conditions.  You know, they’ll pop in and say, you know, you helped me with this.  Before I have to go in and, you know, take maybe a certain medication, you know, can acupuncture help?  And so it’s really wonderful to, exactly, continue on and help them throughout other struggles they may have in the future.

Kristin:  So, Vikki, tell us how acupuncture can help a birthing person with anxiety during their pregnancy.

Vikki:  Well, first of all, we are all aware when we’re pregnant that the body is making these huge changes.  And with that, we are increasing our blood supply.  We are just making this little human.  And that amount of added blood in our body can really affect how smoothly our circulation flows and how smoothly our energy flows.  So when we look at things like anxiety, in particular, you know, we want to make sure that we are helping somebody have everything circulating through their body with ease.  But why things may struggle: there can be a whole host of different reasons why, and so with Chinese medicine, we — for those that have never had it, there’s not just one answer to a condition.  So there’s not just — you know, say somebody is having struggles sleeping.  There’s not one pill or one herb or one item for the whole idea of insomnia.  And the same way with anxiety.  If we’re having a client who’s struggling with anxiety, we need to ask a lot of questions and go through a lot of our diagnoses to find the pattern and to help unravel that pattern.  So we do — we ask a lot of questions.  We want to know things like, have you had anxiety before?  Or is this something new due to the hormonal changes in pregnancy?  Are you eating differently?  You know, we change our eating habits when we’re pregnant, and sometimes we’re craving things, maybe more items that are hot and spicy, or dairy, or fried foods.  That can affect anxiety.  Being depleted because we’re working at home or at the office a lot can, you know, cause some fatigue in the body.  That can add to anxiety.  But then also we want to know the physical symptoms of what they’re feeling.

Kristin:  Sure.  And if someone’s had back to back pregnancies, there can be a lot of depletion with that.

Vikki:  Absolutely.  Absolutely.  So we just take all this information that we get during our conversations with our clients and through our own diagnoses or tongue and pulse diagnosis that we do.  You’ve had your tongue looked at before, so you know.

Kristin:  Yeah.

Vikki:  It gives us a lot of really objective information.

Kristin:  I felt like your intake session was very thorough and, you know, even getting into the supplements that I take and how that affects my mood and energy level and so on.  Yeah, it was very thorough.

Vikki:  Yeah, and then that gives us, you know, how are we going to release this anxiety; how are we able to cool the body if it’s more of a racing anxiety; how are we going to be able to bring that down and allow our clients to take this big, healing, deep breaths.  And acupuncture’s really helpful for that.

Kristin:  Yes!  And so as far as this session — and you describe sort of the intake process, but for clients who say they have a fear of needles or are uncertain on, you know, what a session would look like, and you mentioned that it’s relaxing, and I would definitely agree with that — can you take — walk our listeners through what a session would be like during pregnancy?

Vikki:  Yeah.  I totally understand that it seems really odd that it could be relaxing, until you’ve had it done.  And I see a lot of clients that come in who are very hesitant because they’re very — they may be fearful of needles.  And so I work within their capacity.  Here, we’re very gentle, and as I always say to my clients, you’re in control when we’re in the room.  The importance for me is to help the patient find comfort so when they are resting with the needles in, then they’re able to really relax.  So treatments usually start by a lot of talking.  You know, our first treatments are about 90 minutes, and that’s because we do a good chunk of talking to unravel where this pattern starts so I know how I’m going to approach the treatment.  It also helps our clients get comfortable with me or Corey, who’s the other acupuncturist here.  And know that this isn’t a rushed treatment.  What we do here, we take our time, and we always make sure that our client is comfortable.  And then after we chat for a while, we do that tongue and pulse, that diagnosis, which is, you know, just how we can objectively see what’s going on in the body.  And then we choose the points that we’re going to use to right the imbalance, and the client gets to lay for about 25 minutes or 30 minutes with the needles, which, again, sounds like it wouldn’t be relaxing, but you don’t even know they’re there.

Kristin:  Right.  I would agree.

Vikki:  And it’s a very deep rest.  A lot of times, people are surprised how deeply they nap when they come in for acupuncture.  Very relaxing.

Kristin:  Now, after baby’s born, walk us through how that can be helpful if a listener is struggling with postpartum depression or anxiety or OCD after giving birth and how you can level hormones and so on.

Vikki:  Acupuncture’s a really wonderful and natural way for women to build their strength and to heal after birth.  First and foremost, it’s a great therapy for restoring energy and boosting that immune system, and that is not just, you know, after — for women after they’ve given birth.  That’s for clients going through cancer treatments.  That’s for people struggling with chronic fatigue syndrome.  Acupuncture is just a really great therapy to bolster our energy of our body and really direct it to helping us heal and be stronger.  But specifically to helping after a baby is born, acupuncture helps to rebuild blood that was lost during childbirth, which can bring on other conditions.  It helps you increase circulation that will speed up wound healing and helps stop pain.  It helps with women with breastfeeding issues, increasing milk production or healing mastitis.

Kristin:  That’s amazing.  I didn’t realize.  I knew that the milk supply would be affected, but mastitis healing — fantastic.

Vikki:  I know I see people that, you know, come in and we have certain points that really help to increase that milk supply but also helping our body just to use our body fluids correctly and to create that breastmilk.  It’s wonderful to see women be able to get some support, not with the aspect of how are you positioned and how is the baby breastfeeding, but internally, how your body is actually dealing with the milk supply.  We also, after the baby’s born, we help a lot with emotional issues.  And, you know, like you said, it’s not just anxiety and depression.  It’s worry.  It’s grief.  I see women that aren’t breastfeeding and maybe they couldn’t for some reason, or they chose not to, and after they made that decision, they’ve been feeling grief about it.  We are here to help; we help them process that.

Kristin:  Right.  Or grieving the birth that they wanted that didn’t happen.  There’s so much.

Vikki:  Absolutely.  You know, I always — I often say that in China, women have a whole month where their job is to rest after giving birth, and, you know, they take — the baby is brought to them.  They feed the baby; they cuddle the baby.  But for the most part, their family is there to take care of that baby and to take care of that mom and feed her great food and get her energy and her blood back to normal so she’s at full capacity when she’s back, when she’s clicked into really taking care of that baby.  And we don’t do that here in America.

Kristin:  We don’t, unfortunately.

Vikki:  Yeah.  And so it can take longer for us to heal physically, for us to heal emotionally, because, you know, we don’t — we haven’t nourished ourselves and been able to rest as much and to have as much self-care time.

Kristin: And you describe what we do as postpartum doulas, like in that role of what a family member would do in other cultures, making sure that they’re nourished and they’re taking care of their house and bringing baby to them and encouraging them to rest or take a shower or have a cup of tea.  And so, yeah, so we love that role.  It is such a depleting time, and I feel like our culture is so rushed.  I do love the first 40-day concept of healing and rest and care.

Vikki:  Absolutely.  As I say to my clients when we talk about working with doulas, during that time — in a lot of these traditional countries, villages, our families were so close that we didn’t need all this, you know, this other — we had somebody that was coming.  There was somebody in the village coming.  But now, we don’t have people in the village coming.  We don’t have our families right there.  We need our doulas.  We need our acupuncturists.  We need our advocates or people that listen to us.  Therapy, I often will say, is a wonderful thing, because we don’t always have the support here.

Kristin:  Right.  Exactly.  And a lot of people move here for work and don’t have any family to help care for them and, you know, it’s so needed to take that time.  And like you said, that 30-minute session is a time away from family and responsibilities as a mother, and you can just rest and relax and have someone take care of you.

Vikki:  And in that 30 minutes, that 30 minutes isn’t even just the whole treatment.  That is just the 30 minutes that you’re laying and resting with the needles in.  You’ve already been able to share your truths, to share what’s going on, and we can begin treatment, but then you get that time in just a safe, healing environment, with gentle music, to just relax and let the body just take full control of healing and making some really great, balancing changes.

Kristin:  I love that.  So, Vikki, tell us how our listeners can get in touch and payment methods.  I know you take health savings and flex spending and some insurances and so on.

Vikki:  Yeah.  So we are happy to work with our clients when it comes to billing, in many ways.  First off, if their health savings or FSA does cover acupuncture, we definitely take it, and we definitely supply people with superbills that needs them for insurance reimbursements if they’re unsure about reimbursement.  We do bill insurance directly for those that do have benefits for acupuncture.  And we also have loyalty programs where we, for our clients, we offer the tenth treatment complimentary, and that is a mix of many of our treatments here from acupuncture to reiki to massage.  We understand that, you know, the Western world hasn’t really gotten on board to the preventative medicine, and so insurance doesn’t cover everything.  And we love to be able to help in ways that we can.  So, you know, that’s how with insurance and that.  But they can get in touch with us from our website, and on there is a whole bunch of information.  You can also book online there.  Otherwise, clients can call the office directly and make appointments with our front desk, and the number there is 616-466-4175.  I often encourage people that are unsure to schedule a complimentary consultation with myself or Corey, the other acupuncturist who works here, who’s awesome.  And, you know, we’re happy to really answer questions and for people to hear our voices and to be able to have some conversation about them directly to help with their comfort level as to whether or not they feel like this is the right therapy for them.

Kristin:  That’s fantastic.  Do you have any parting words for our listeners?

Vikki:  You know, when it comes to dealing with changes in our mood, especially around the times of pregnancy and giving birth, these times are just really a struggle for us.  It’s what makes us as women so powerful is the ability to be able to roll with these changes and to experience what is amazing about our bodies.  But it doesn’t mean that everything goes smoothly, and I often see people get caught up in — you know, women seeing other mothers who just effortlessly fall into being a mother and gave birth and just the ease of raising children.  And I can usually guarantee most women that that is — that we all struggle.  We all struggle.  And there are many options for help, and acupuncture is a great one.  It’s not the only one, but it is a great therapy for supporting women during these times and just unraveling the stressors and emotions that we struggle with during that time.

Kristin:  I love that.  Thanks for sharing!

 

acupuncture

Acupuncture during Pregnancy and Postpartum: Podcast Episode #103

 

Dr. Carrie Dennie, ND speaks with Alyssa about the benefits of acupuncture during pregnancy and postpartum.  You can listen to this complete podcast episode on iTunes or SoundCloud.

 

Alyssa:  Welcome to the Ask the Doulas Podcast.  You are listening to Alyssa Veneklase.  I am the co-owner of Gold Coast Doulas, and today, I am so excited to be talking to Dr. Carrie Dennie, a naturopathic doctor at what was Grand Rapids Natural Health but is now the Michigan Center for Holistic Medicine.  Hello!

Dr. Dennie:  Hi, Alyssa!  Thank you for having me!

Alyssa:  I want to know, do you prefer Dr. Carrie or Dr. Dennie?

Dr. Carrie:  Dr. Carrie is fine.

Alyssa:  Okay.  Dr. Carrie.  So I have some questions for you.  You started out this path, and you became a naturopathic doctor, but then I was reading your bio.  You had one acupuncture treatment and just fell in love with it and then went on to acupuncture school and graduated the valedictorian of your class?

Dr. Carrie:  I did.

Alyssa:  That’s amazing!

Dr. Carrie:  Thank you.

Alyssa:  That makes me wonder what happened in that treatment of acupuncture that just made you fall in love with it so much.

Dr. Carrie:  So it was interesting because my school has both programs, and we get free access as students to go and have free appointments.  And so I had never had it, you know.  Heard about it, and so I went and tried it.  And it was just — I think the — my favorite part about acupuncture is that it’s so relaxing.  I don’t care what you’re coming for, if it was pain, if it’s some sort of an organ dysfunction.  Nope — well, yes.  That is important, and you can get relief, but also, the relaxation.  It just — it’s so amazing.  It’s just so invigorating.  A lot of my patients will say that they feel gentle sensations when they’re in the treatment.  And, again, everybody leaves feeling just relaxed and they end up sleeping better that night or even several days afterwards.  Like, there’s just so many different ramifications that can occur as a result of one acupuncture treatment.  So that’s why I loved it.

Alyssa:  So I’ve only had one, so I’m not very experienced in acupuncture, but what exactly — what is it doing?  You know, I know I have these little needles poked in.  I would imagine that it’s doing something to my nerves, which then send signals to my brain to do something else?

Dr. Carrie:  That is correct.  So that’s how we understand it from a conventional medical perspective, is that you have nerve stimulation.  The nerves release chemical messengers that can go to the brain, the spinal cord, the muscles, the organs, and then affect change from that point on.  Also in general, acupuncture can reduce inflammation.  It is a stimulator of endorphins, which are natural pain relievers, so obviously can help relieve pain.  It can improve blood flow and circulation.  And, again, like I said, it is just relaxing and has an overall mood-boosting affect.  One other thing that I will say is that I had a patient recently who was undergoing chemotherapy currently, and they were unable to get their treatment because their white blood cell count was too low.  So they came for an acupuncture treatment, and after one, the numbers went up enough that this person was able to get his treatment the next time.  Again, it’s so amazing how these little needles can affect great change in the body.

Alyssa:  Yeah.  So this is kind of a strange question that just popped into my head right now, but what’s the most amount of needles you’ve ever had in someone?  Or is it typically, like, only a dozen or so?

Dr. Carrie:  So I try to keep it around let’s say 15 or 16, and again, it just all depends what they’re coming for.  But the most, I think, that I’ve ever personally put into someone was around 30, and the reason why is that their concern involved their fingers and toes.  And so I had needles in between fingers and toes, which is about 18 needles in total, let’s say.  And so the rest of the other body points add on top of that.  Like I said, normally, I try to keep it less than that, but again, it just all depends.  This person who I did all these needles in, they felt benefits afterwards.  I love it.

Alyssa:  And that’s the point, right?

Dr. Carrie:  Exactly.

Alyssa:  So how do you integrate the two, then?  As a naturopathic doctor, how do you integrate that medicine with acupuncture?  Is that a silly question because you’re like, well, they just go hand in hand?  The benefits of both?

Dr. Carrie:  It’s not silly, but you’re 100% correct.  They definitely go hand in hand, and it all depends on the patient.  So as a naturopathic doctor, for your listeners who may not know, I am trained as a primary healthcare professional, and I am trained to emphasize prevention, treatment, and optimization of health using natural therapies that are safe.  And most of the time, research has proven them to be effective.  And so primarily my goals are always to identify the root cause of disease, to reestablish the foundations for health, which basically is diet and lifestyle changes, and then again to support the body’s natural ability to heal itself.  And that’s the piece right there where acupuncture just fits in perfectly.  Again, tiny needles being applied in random places, if you don’t understand the theory behind it, but it, again, it just has so many different effects on different systems.  And so like I said, I was in school for naturopathic medicine, but once I had that treatment, I had to add on my acupuncture degree because it just didn’t make sense to leave without this awesome therapy.

Alyssa:  For you, it was just a no-brainer.  It was like that missing piece of the pie to what you were already doing?

Dr. Carrie:  Yes.  And it was interesting, what I was learning, because it just makes so much sense when you really start to dive into the theory and why they are — you know, why this person or these people decided to do these things.  It’s just so interesting.  And it’s natural.  Again, the Chinese developed this over 4,000 years ago.  They didn’t have MRIs or X-rays but they were able to ascertain functions of the organs in an — you know, almost in the exact same way that we do in western medicine, but there’s some tweaks.  But again, it was just amazing, so I had to do it.

Alyssa:  I love it.  So, you know, for our listeners, most of them are either pregnant or in this postpartum period.  If someone were to come to you pregnant or newly postpartum, would you have to treat them differently, or what would treatment look like for them?

Dr. Carrie:  So treatment for anyone is initially a two-hour long appointment, and we talk about everything, especially if they’re coming to me for naturopathic medicine.  If they’re coming to me for acupuncture, the initial appointment is an hour and a half, and again, we’re still talking for at least an hour in both sessions.  But I’m not just focusing on their chief concern, whether it’s, you know, having lactation issues, or I’ve just got this nausea all of a sudden.  You know, it’s more than that.  I want to know everything because your health is influenced by so many different factors beyond just the physical.  You know, what is your mental emotional state?  Do you have any religious or spiritual beliefs?  Are you walking in those beliefs?  Are you using — are you living those principles?  All of that affects your health.  But then also, too, we talk about the things that you do and the things that you eat and what comes out of your body every day, and hopefully people are looking at the things that come out because, again, these are all…

Alyssa:  It’s important!

Dr. Carrie:  Yes!  These are clues towards your health.  And so we talk about all of those things, and then, you know, the thing that I love about naturopathic medicine and that I incorporate with acupuncture is that I want to heal your whole body.  I want to care for your whole body so that you can have the best life that you have because your whole is as well as can be.  And so that’s usually how it starts is a two-hour treatment.  If it’s acupuncture-based, after we talk, then I start the acupuncture, and I have a whole process, especially for people who don’t or who have never had acupuncture before, and I kind of walk them through it.  But then they just get to relax afterwards.  And if they like heat, there’s heat therapy that can be provided.  Music, you know.   Essential oils.  It’s just relaxing while you lay there.  And you can either focus on your breathing, or if you’re a person that prays, you can pray while you’re laying there or you can meditate.  Or you can just, again, invite in relaxation and good vibes and sent out the bad ones while you’re resting and not thinking about all the things you have to do afterwards and the nuances of life that tax our systems.

Alyssa:  I think that maybe the relaxation part that people who have not had an acupuncture treatment before might not realize is that you put the needles in, and then — is this the case for you?  Do you leave the room and then they have time to relax?

Dr. Carrie:  Yes.

Alyssa:  And that’s what I didn’t know when I had mine is, oh, I just get to sit here in this beautiful room with the noise machine going.  But yeah, that sounds lovely.  Heat therapy and essential oils.  It’s kind of like you get a massage and then you still get to lay there for a little while.

Dr. Carrie:  Yes.  You get to bask in stillness, you know, and hopefully, you can let go of all the things that are plaguing you for those moments while you’re laying there and just let your body heal itself.  You know what I mean?  Let your body do what it can do for you when you’re not under stress all the time.

Alyssa:  So are there certain areas of the body, then, that you probably couldn’t work on for a pregnant person?  Like, you know, certain spots that might activate labor?

Dr. Carrie:  Correct.  So with pregnant women, we do not — we’re trained very strictly on this.  There are several points we do not do during the pregnancy, and even with my patients that are trying to conceive, depending on what’s going on, I may or may not do them, either.  But, yes, we’re trained very much not to do those, unless the woman is in the third trimester.  Maybe she’s trending towards her due date or she’s past her due date.  She wants to try to avoid an induction process in the hospital.  Then we would do those points because we are trying to promote labor.

Alyssa:  Yeah.  That’s a great point because early in pregnancy, you want to avoid them, but you’ve got this mom who’s 38, 39, 41 weeks, and she is in there for the complete opposite reason.  Help me get this baby out!

Dr. Carrie:  Exactly.

Alyssa:  That makes sense.  And then what about postpartum?  You know, a newly — you know, there’s all sorts of things with healing and then mental and emotional wellness.  Is there anything specific in the postpartum time that you would do for a parent?

Dr. Carrie:  Totally.  So moms, being a new mom or a new parent in general, is overwhelming.  Now there’s a whole other human or humans that you have to care for, and it can definitely be an around-the-clock experience.  So the first thing that I would suggest for anyone looking to acupuncture to help is for that relaxation piece, to alleviate anxiety; to relieve stress.  For the parent to have, again, that moment, time where they don’t have to worry about the baby or babies or their spouse.  They can focus on zenning out, relaxing.  So that’s number one.  Specifically for new mothers, you know, postpartum depression can be a huge obstacle to battle during this time, and so acupuncture, again, would promote serotonin and dopamine production, and these are the happy hormones.  So, again, boosting mood.  It can improve sleep and boost energy, which are very much important things to have when you have new babies.  But beyond that, again, like you said, there’s healing and rejuvenation that needs to happen after a birth, and acupuncture can definitely assist with that.  Another thing that people don’t think about is milk production.  Acupuncture can definitely help boost lactation so that, you know, that’s one less thing that mom has to worry about.

Alyssa:  So where in the body — I’m picturing nipples or needles in the boobs.  Where do you — is there another spot on the body for anyone who might say, oh, that sounds interesting, but I don’t think I could handle a needle in my boob.  Where does it go?

Dr. Carrie:  Totally!  Again, all depends on how they present.  But you’re 100% correct.  There are points in the chest area where I could put needles.  I would not, though, and that’s the beautiful thing about acupuncture, like you said, is there are other places that you can put needles, and the answer is yes.  So some are — one is on the shoulder area or in the — yeah, on the shoulder area, and then there’s other that are kind of, again, on the limbs that I could use to boost milk production.

Alyssa:  That’s really cool.  We have two lactation consultants, and I wonder if they’ve ever recommended acupuncture to anyone who’s struggling with milk production.  That’s an interesting idea.

Dr. Carrie:  Something else, though, that I want to mention, too, as a naturopathic doctor, is I don’t just think in one lens.  I have both on, hopefully, if my brain is working correctly.  But I would also be thinking about naturopathic therapy.  So as we know, labor is a trauma to the body, and depending on — even if it goes smoothly, or even if there are some complications, like you said, healing reformation needs to be done.  But you also need to know the state of your body, and a lot of times, bloodwork is necessary or recommended after labor.  And so think of things like just the general CBC in case the person is anemic; looking at the thyroid, because there is a connection between delivery or pregnancy and thyroid dysfunction afterwards.  And then simple things like vitamin D.  Depending on the time of year, you may have been inside for the majority of your pregnancy because it’s cold.  What’s your vitamin D status?  And so a lot of these, if there are dysfunctions in these areas, it can mimic depression.  And so those are things that you want to look at, also, or consider looking at, but then also other lifestyle things.  I know that having new babies is overwhelming, like I said, and so are you taking care of you?  Are you going outside if it is nice enough to go outside?  If you can go outside, you know, I always recommend people go out for 30 minutes.  Take the baby for a walk.  Hopefully, the rhythm of the walk will put the little one to sleep, and then you can tuck them in the bed when you get back and hopefully have more time.  And especially if you live around nature, if you can go into nature, it’s been proven that being in nature is calming.  And so those are other things that I suggest.  And then the walk is exercise, and that we know is beneficial to the body, as well.  You know, it’s just so many different aspects of being that I look at when people come to see me.  And so you likely will hear me say things that are naturopathic tips in my acupuncture appointments, and I definitely recommend acupuncture to the majority of my naturopathic patients, unless I know they don’t like needles.

Alyssa:  Right.  Well, I think even someone who doesn’t like needles, you could put, like, a sleepy blindfold on them or something, because you can’t even feel them.  I was so surprised because I was watching, and I was, like, I didn’t even feel that.  That’s wild.

Dr. Carrie:  It’s so true.  A lot of the times, I do hear from people that they don’t necessarily feel certain points.  But I won’t lie and say that there aren’t times where you definitely feel the needle go in.  But it’s instantaneous, you know what I mean?  It’s not like a lingering pain.  You’re not going to lay there in pain for 30 minutes.  No.  You’re going to be relaxed.  But you’re right, and they’re very thin.  The needles are almost as thin as a strand of hair.  It’s totally different from what people think when they’re normally thinking about getting their blood drawn.  That’s a huge needle.

Alyssa:  I agree.  Totally different.  Totally different.  You know, that makes me wonder, how young — can you take children?  Can you do acupuncture on children or even babies?

Dr. Carrie:  Yes.  Technically — I wouldn’t say babies, but in China, they do acupuncture as young as one year old.  But with children that young, the needles are not in for an extended period of time.  It’s more of a stimulation of the point and remove the needle and move on to the next point sort of a thing.  With children, I think the youngest person that I’ve done acupuncture on was 14.  And so for kids, especially us in America where this is not our culture — it’s the norm to have acupuncture as a therapy that they can readily go to.  I would say if you’re children can’t be still for, I don’t know, 10 minutes, let’s say, then they probably shouldn’t come for acupuncture.  Again, you have to have the mental capacity to be still and be able to relax and not move.

Alyssa:  Right.  And that’s why it doesn’t work on babies because they’re flailing their arms all around, and if anything, they’re going to hurt themselves more than heal.

Dr. Carrie:  Exactly.  Right.

Alyssa:  This has been enlightening!  Is there anything that you wanted to cover that we didn’t cover?

Dr. Carrie:  So I just want to mention, for women who are pregnant, definitely, acupuncture is safe and an awesome way to relieve any of the common symptoms that they have at any stage or that they may have at any stage of pregnancy.  During the first trimester, if you are having nausea, vomiting, or you’re just extremely fatigued or you may be constipated or have diarrhea, this is an important way to kind of support those systems and just, again, rejuvenate the body.  During the second trimester, a lot of times aches and pains occur or start occurring.  That is another great reason for acupuncture.  Again, if sleep is starting to become uncomfortable, acupuncture is awesome for insomnia.  And then even like hemorrhoids or complications from GI dysfunction can be addressed through acupuncture.  And then like we were talking, in the third trimester, if they are close to or beyond their due date, labor induction or labor promotion, I should say.  And then one thing that’s really interesting that women may not be aware of is that if your baby is in a breech position and the doctor is talking about a C-section, you can come to an acupuncturist and we can do a sort of heat therapy, and it’s really interesting.  It’s over your toe, your pinky toe, and it’s amazing.  Again, the woman — it’s ideal if she comes at 36 weeks if she finds this out, but we do this heat therapy, and I send them home with the heat therapy so they can do it at home, but a lot of times, the baby will move into the correct position.

Alyssa:  That’s incredible.  Is there a statistic on how often that actually works?

Dr. Carrie:  I don’t know any off the top of my head, but I know that it’s definitely been studied.

Alyssa:  Yeah.  I’ve heard of it before.

Dr. Carrie:  Yeah.  The therapy is called moxibustion.

Alyssa:  Say that again?

Dr. Carrie:  The therapy is called moxibustion.

Alyssa:  Moxibustion.  Huh.

Dr. Carrie:  It’s basically burning a dry cone of Chinese mug wort over the toe, and it sends this, like, smooth, warming sensation deep into the body.  We use it for other reasons as well, but that’s — again, you just get it over the toe, and baby flips over the majority of the time, in my experience.

Alyssa: That little baby pinky toe sends some signal all the way into the womb, and tickles that baby right around?

Dr. Carrie:  That’s right.

Alyssa:  Wow.  Well, thank you so much.  If somebody wants to find you specifically, I mean, we’ll link to your website and stuff, but why don’t you tell us how people can find you?

Dr. Carrie:  So you can definitely find me on Facebook.  I’m Dr. Carrie ND on Facebook, and you can also find me on Instagram.  But all of this is available on our website.

Alyssa:  Perfect.  Well, thank you so much for all of that information.  I’m sure everyone will love this, and I have learned so much more about acupuncture!

Dr. Carrie:  Well, thank you again for having me.  I really appreciate it.

 

Kristin Alyssa Gold Coast Doulas Owners

Podcast Episode 100!

 

It’s the 100th episode!  Alyssa and Kristin, co-Owners of Gold Coast Doulas, talk about what the past two and a half years of podcasting has looked like, how the podcast has changed, how the business has changed, how services have pivoted in the midst of the COVID-19 pandemic, and how they are playing their part in supporting other local businesses.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Alyssa:  Welcome to the 100th episode of Ask the Doulas Podcast!  I am Alyssa, and Kristin’s here via phone because it’s COVID-19.  We can’t even see each.

Kristin:  Right.  It changes everything!

Alyssa:  I know!  We haven’t seen each other in forever, and I actually came into the office for the first time in weeks, and it feels so good to be not working in my house.

Kristin:  Yeah, it certainly changed so much about the way we do business.  But 100 episodes — I can’t even believe it, Alyssa!

Alyssa:  I know.  It seems wild that in two and a half years, we’ve done 100 episodes.  What is that even — I should do the math on that.  Let me do it real quick while you talk.

Kristin:  Yeah.  I mean, we started this podcast as a member of the Radio for Divas team.  It’s a radio show with women experts in the community.  And then we transitioned to the podcast format, wanting to really keep our clients as the central focus and information that they would want to hear, and then also thinking about what other listeners, whether it’s regionally or across the US, might be interested in.  Capturing more information from experts on anything related to pregnancy and newborns to even toddlers and parenting in general.

Alyssa:  So the math, by the way: two and a half years is 130 weeks, so in two and a half years, there have only been 30 weeks that we did not put a podcast out.

Kristin:  Wow!  Yeah, I know when we started out, we had more frequent podcasts and then have slowed it down a bit.  And Alyssa is the editor and producer.  How has that changed for you?

Alyssa:  It’s a role that I don’t particularly love, but I think, actually, COVID has increased because — you know, I think for the first year and a half of it, I was cranking these out once a week, and then it slowed, just because it is so time-consuming and so much work.  We covered a lot of topics already, and we had a lot of changes in the business happening and I wanted to focus on other things, other than the podcast.  But now that we’re home, the last few weeks I’ve actually been putting one out every week.  And the fact that I can’t meet with someone in person — it’s kind of easier to do it over the phone.  The sound quality obviously isn’t as good, but it’s allowed me to — you know, I’ve got three podcasts recorded now with Laine Lipsky, who’s in California and is a parenting coach, and we’ve had just a ton of stuff to talk about.  But the virtual, like able to do that virtually, it doesn’t matter that she’s in California.  She can coach a parent in Michigan, and same with my sleep.  I can do sleep consults for families anywhere.

Kristin:  Yeah, it’s been amazing to see the locations that some of your sleep consults have been from.

Alyssa:  Yes, my last ones from Colorada and New Orleans, I think, and then somewhere in Florida were my last three.  So they haven’t even been local.

Kristin:  That is one thing with COVID.  We’ve taken things more globally as far as now offering classes online and being able to expand our base outside of the 50-mile radius that we serve.  And your work hasn’t changed much because a lot of what you do is virtual anyway, so you haven’t had to pivot all that much as a sleep consultant.

Alyssa:  Right.  I just don’t do it in person, obviously, but everything else is exactly the same.  And then we can’t offer postpartum doula support.  Well, I mean, I suppose we could for a newborn, but I’m not doing sleep consults for a newborn, so that doesn’t come into play, either.

Kristin:  So, Alyssa, let’s talk about some of the episodes and highlights of what we have gone over in the last two and a half years that we have been producing the podcast.

Alyssa: The topics have been all over the place.  You mentioned a few, but I know you in particular, you like to reference a few of them for your birth clients, like the episode, #54, What to Pack in your Birth Bag that you did with Dr. Rachel from Rise Wellness.  You know, a lot of our topics, we choose because they’re questions that we get asked often, so why not do a podcast on it, give them all the information, and then just allow them to reference that all the time.  So it’s a lot of the reason why we choose certain topics.

Kristin:  I also love the dad perspective.  We’ve done a couple podcasts of what it’s like to work with a doula and how a partner feels about their role in the birth with having another support person in the room, and even some of our students in the classes we’ve talked, talking about their person experiences, have been really fantastic because it’s a better testimonial to hear it from someone outside of our agency than us telling, you know, our audience all of the features and benefits of everything we offer.

Alyssa:  Right, and I think for somebody who doesn’t quite understand the role of a doula, even after researching, sometimes just hearing the personal story from one of our clients makes something click.  We love hearing personal stories of clients.  Like you said, either birth support, postpartum support, any of our classes.  We’ve done a lot on nutrition and diet, babywearing, pelvic floor stuff.  You know, that’s a big question for parents after a baby is born.

Kristin:  Especially because we happen to work with a lot of athletes, especially in the birth doula role, and they want to be able to get back to running marathons or whatever their particular sport is.  So, yeah, pelvic floor therapy and physical therapy in general has been very helpful for our clients.

Alyssa:  Right.  And then our friends at Rise have given us lots of information on different chiropractic topics.  Obviously, I’ve got quite a few on sleep.  I love talking about sleep.

Kristin:  And tongue ties and lip ties and working with breastfeeding.

Alyssa:  Yeah, breastfeeding.

Kristin:  Yeah, a lot of breastfeeding-related questions and feeding in general.  And certainly anything related to mood disorders and postpartum depression with different experts.

Alyssa:  Pediatric Dental Specialists of West Michigan is one of our partners, and Dr. Katie has been on a few times to talk about, you know, her special laser beam for tongue ties and lip ties.  And she just had a baby of her own!  We should probably check in with her and see how they’re doing.

Kristin:  Yeah.

Alyssa:  Cesarean births; we’ve talked a lot about Cesareans and what is a doula’s role within that, and we’ve got some actual birth stories about what that looked like for the birthing person and the family.

Kristin:  It’s been a lot of fun to have different guests in and try to find new and fresh content.  I mean, after 100 episodes, there are only so many topics you can cover, so…

Alyssa:  I know.  You kind of have to redo topics with different people.  But I’d love for our listeners to email us, too, and just let us know, like, what haven’t we talked about, or what did we talk about but you would like more coverage on?  Or do you know somebody who would be a great person for us to speak to?

Kristin:  And recently we’ve done some COVID-related podcasts, but that is ever-changing with policies in the hospital and specific states, of course.  We have had personal client experiences, birthing during COVID, as well as how our agency has adapted to this time and what precautions we cake.

Alyssa:  Maybe we can talk — do you want to talk a little bit about, just in case people aren’t up to date?  So as of May 21 when we’re recording this, 2020 — what the role of a doula is right now, like how we can work in hospital settings, and our postpartum doulas.

Kristin:  Yes.  So for those of you listening in other states, in the state of Michigan, we are following the governor’s stay at home orders.  So as Alyssa mentioned earlier, we’re not in our office working together, and we are seeing our clients and students virtually.  So all of our classes are done virtually via Zoom, so still very interactive.  We recently had our Saturday Series class, which is interesting, because for me, the comfort measures class that I teach is so hands-on and interactive.  To do that virtually without even a helper or model to demonstrate positions, I’m trying to describe things and show diagrams and videos and how to do a hip squeeze and counterpressure, for example.  So that’s been really interesting, and I know you taught your newborn class several times virtually.  And our lactation consultant had the breastfeeding class.

Alyssa:  Yeah, I think it’s hard for her, too, the breastfeeding, because to show different positions and — I mean, same with me.  Mine’s not as interactive as yours, but even moving the computer into the right spot so I can show my different swaddling methods or, you know, paced bottle feedings, things like that.  It works, and I always ask, did everyone see that okay?  Is everyone getting it?  Do you need me to do it again?  It’s just different.  I miss being able to meet the students in person.  But it’s just where we’re at right now.

Kristin:  But at the same time, it’s more convenient for them because they can be at home and, you know, not have to travel.  It gives everyone more time in their day, but as far as how we’ve adapted, other than classes, right now with the stay at home order, our lactation visits are all done virtually.  So, again, for our two registered nurses and IBCLCs, that has been different than hands-on or more engaging support.  But our clients have found it — I’ve had personal birth clients that I’ve worked with who have told me that Kelly was very helpful virtually, so that’s been going better than we had hoped.  And with birth support, things are, you know, ever-changing for us, but we’re doing all of our prenatal visits and even the initial consultations before hiring and certainly the postpartum visits after the birth — all of that is done virtually.  And different hospitals have different policies related to whether or not a doula can be in the hospital.  We’re fortunate that our governor has an executive order that includes a doula and a partner in the hospitals.  The doulas are not considered visitors, and we have access.  But every hospital, again, has the ability to make their own policies surrounding doulas, and we are right now working in Spectrum Butterworth and all of the regional Spectrum hospitals like Zeeland and Gerber and Pennock and Hastings and Greenville, and so that has been really fantastic.  St. Mary’s Mercy Health is currently not allowing doulas but encouraging virtual support, and Metro is allowing doulas.  Holland Hospital is not.  I was just informed that Mercy Muskegon, who was not allowing doulas up until very recently, and as of — I want to say it was this week — doulas are now being admitted to the hospital and able to support birthing persons.  So that has been fantastic since we do serve a 50-mile radius of Grand Rapids.  So as doulas, we are monitoring our symptoms, and if we have any symptoms of Coronavirus, then we send in a doula who is symptom-free.  Right now, all of the hospitals in our area are requiring doulas to be certified, so if a doula took a two-day or four-day training and chose to never certify, they are not able to work during this time.  And if a newer doula is working toward that, then that would be an option in the hospitals.  They could certainly attend homebirths.  So that has been interesting.  We worked with our lawyer and consultant to work on a COVID questionnaire and have included COVID language in our contracts that our clients sign so that our doulas are able to feel comfortable and confident, as well as our clients, in potential exposure during stay at home and what each household is doing as far as going to the grocery store versus having groceries delivered, or is a partner working outside of the home as an essential employee.  And then our clients and doulas are able to choose each other.  Some of our doulas are not working during COVID or only working with completely isolated clients.  So we’ve done a lot of focus internally on what our team wants to do and how we’re able to pivot during this time.  So we’ve been able to, you know, have conversations with the governor’s office and make sure there are no gray areas in the doulas role during stay at home and got some confirmations about what a postpartum doula can do, because a lot of that language was focused on our work in the hospital.  During the stay at home order that is set to expire at the end of the month — it may or may not be extended — we are only offering essential postpartum support.  So since we are working with clients normally through the first year, and they don’t need to have an urgent reason to have us there — they don’t need to be struggling with postpartum depression or a mood disorder — and they don’t need to be healing from a birth.  We can work with them until their child is one year old or until their multiples are.  So we have stopped working with some of our existing clients during the stay at home and plan to resume work with them.  We’re focused only on those first six to nine weeks of healing, depending on the type of birth that our client had, or those struggling at any point in their postpartum time with mood disorders or depression.

Alyssa:  So, to clarify, before this, we worked with people up to — we worked with families up to a year old, but now we can only do essential work which is, like you said, the six to nine weeks after someone just had a baby or with someone suffering from a perinatal mood disorder.

Kristin:  Yes, or if they don’t have a partner, that is essential, if they need support, since obviously grandparents cannot be involved during this time.  Families that have other kids are not able to take them to daycare if they’re not essential workers, so that has been interesting.  Obviously, we can work with triplets and multiples because they need more of a hand around the house especially during healing.

Alyssa:  So the moral of the story for postpartum is, we can’t just work with anyone right now until the stay at home order lifts, but we can work with you if you have a newborn, if you are suffering from a mood disorder, and/or have had multiples; twins or triplets.

Kristin:  Exactly.  Yes.

Alyssa:  And we can do day or overnight, and that would involve you, again, virtually meeting the doula.  You would both fill out this COVID-19 form that we created so that you and the doula both know what your risk, your exposure risk, is.  Who’s leaving for the grocery store?  Is someone in the home leaving for work?  And as long as you’re both comfortable with it, you can work together.

Kristin:  Exactly.  Yeah, and our doulas are taking every precaution and following what the family wants as far as, you know, sanitation and wearing gloves.  We’re all wearing our own cloth masks in the home, but if a client wanted surgical masks and has those or needs us to get them, then we work around their needs, and our doulas are bringing in a fresh set of clothes and taking their shoes and any coats that they may be wearing off immediately.  So that has been a pretty seamless process transitioning over for the doulas who are comfortable working with our clients.  And we’re so busy in postpartum pre-COVID.  You know, that has been some growth that we’ve seen since we started the podcast and very intentionally focused on educating our community and what a postpartum doula is and the benefits of it.  But now that is obviously slowed during COVID.  But we’ve seen an increase as far as, you know, our students, and being that many hospital classes have closed or not all educators are offering virtual classes, and certainly our birth clients have increased more recently.  It slowed for a bit initially because, you know, some doulas in our area are not offering in-person support, and we are.  So that has also been a change in our business.  Focusing on supporting local businesses is so key.  So for any of our listeners, support the local shops in your community.  I know, Alyssa, you order from Rebel, and I’ve been getting juice from different local businesses, whether it’s delivered to me or pick up, and just trying to keep our local businesses afloat, because as Local First members and a B-corporation business, we know the importance now and don’t want to see more businesses close down due to COVID.

Alyssa:  I know.  It’s so sad.  What’s the statistic; like, 50% of small businesses aren’t going to make it through this?  And luckily, Gold Coast will.  We’re doing what we can.  We’ve changed our business model a bit.  We’ll be good; we’ll make it through this.  It’s going to be a tough couple of years, I think, for everybody, but we’re going to do what we can in the midst of this to continue to help other small businesses and to keep all of our subcontractors.  They’re their own small businesses.  We want to keep them working and support them as much as possible, too.

Kristin:  Yeah.  And it’s been really sad even seeing other doula agencies that started at the same time as Gold Coast, which we’re nearing our five year anniversary.  You know, they’re closing their doors in bigger markets than we live in, and it’s due to COVID.  And that’s been very sad for me because they were peers of ours.  And so, yeah.  If you can support your local service and retail businesses and restaurants, do your part and think local.  And just thinking of our stores like EcoBuns with online ordering and Hopscotch, that we often partner with.  Supporting them, and the nonprofits.  We’ve actually given more during COVID since a lot of the fundraisers we would normally attend and support for some of the hospital foundations have been canceled.  We’ve given money to Mercy Foundation and we’re looking at what we can do within Metro and the Spectrum Foundation.  And we are analyzing what we can best do to help Nestlings Diaper Bank because let’s not forget that diapers are needed now more than ever, and it is not covered by your basic government assistance programs.  So that is something to keep in mind if you’re looking to help; if you have extra diapers or you’re looking at giving somewhere.  Nestlings Diaper Bank is in need, and they are running low in diapers.

Alyssa:  Yeah, the need is probably greater than ever right now, I would imagine.

Kristin:  Yes.  So, yeah.  Thanks to everyone for listening all of these years and supporting our podcast.  We would love to know what topics would be of interest to you and where we can go from here.

Alyssa:  Yeah.  Please let us know.  You can find the podcast on iTunes and SoundCloud.  We also have on our website a blog section.  If you hover over that, we actually have a listing of all the different podcasts.  There in order by date.  I don’t think you can search by topic, but you can probably Google it and find a certain topic.  But we appreciate you listening, and obviously, if you can subscribe, if you can like it, if you can rate us.  We’ve never really asked people to do that.  It kind of started out as just like — I don’t want to call it a hobby, but, you know, something fun to do to give our clients something; a resource for our clients.  But the more people we can educate, the better.

Kristin:  We’ve gotten some recognition in Grand Rapids Magazine about being a local podcast, and also through a national organization that rated us in the top ten podcasts that are birth-related.  So that was pretty exciting!

Alyssa:  Thanks for listening, again!

 

Hyperemesis Gravidarum

Hyperemesis Gravidarum

This post was written by Lauren Utter, a ProDoula trained Birth and Postpartum Doula with Gold Coast Doulas.

Finding out you are pregnant can bring an array of emotions – planned pregnancy or not. Maybe you’re excited because you have been waiting for this day. Maybe you are surprised because a baby wasn’t on your radar. Maybe you’re fearful – of what your pregnancy will be like, how you will look, if the baby is going to be okay, or how you’ll feel.

All of these feelings are normal. Being pregnant causes your body to change. Not just a growing belly, but new hormones, cravings, thoughts, and illnesses. 70-80% of women suffer from morning sickness. At least 60,000 cases of extreme morning sickness, also known as Hyperemesis Gravidarum (HG), are reported (the number of cases is actually higher as many are treated at home). Perhaps you wonder if this is how all pregnant women feel or is it just you? Or maybe you question your ability to handle nausea and pain. Do you feel as though others minimize how you are actually feeling- giving you tips that you have relentlessly tried?

Morning sickness is difficult to deal with; it’s exhausting and frustrating, but there are many differences between HG and morning sickness. Women with HG lose 5% or more of pre-pregnancy weight. Morning sickness doesn’t typically interfere with your ability to eat or drink, whereas HG often causes dehydration from the inability to consume food or drinks. Morning sickness is most common during the first trimester, while HG lasts longer – sometimes through the whole pregnancy. A woman with HG is more likely to need medical care to combat symptoms.

HG is often described as debilitating, making everyday activities like working, walking, cooking, eating, or caring for older children hard to do. Not only are women having difficulties eating and drinking, but taking their prenatal vitamins is often difficult, too, which results in a lack of proper nutrition. Because of severe dehydration and insufficient nutrients, headaches, dizziness, some fainting, and decreased urination can present as greater symptoms of HG.

On top of all the physical signs of HG, secondary depression and anxiety may also be present. There are potential complications that arise when HG is present. We talked about malnutrition and dehydration, but some others include neurological disorders, gastrointestinal damage, hypoglycemia, acute renal failure, and coagulopathy (excessive bleeding and bruising). Fortunately, with effective treatment these complications can be managed or even avoided completely.

While there is no cure for Hyperemesis Gravidarum, there is a variety of treatments including medications and vitamins, therapies (nutritional, physical, infusion), bed rest, alternative medicine, chiropractic care, massages, and more. Not all women and cases respond to treatments in the same way. Caregivers typically believe early intervention, even prevention, is most effective.

Medical providers work with each woman to discuss which treatments work best for them. Common medications offered to women suffering from HG are antihistamines, antireflux, and metoclopramide. Because HG can be traumatic and highly stressful, 20% of mothers experience Post Traumatic Stress Disorder (PTSD) and Perinatal Mood and Anxiety Disorders (PMADs). Early intervention proves to be effective, and your OB/GYN, primary care doctor, or a mental health specialist are fantastic resources for mothers experiencing symptoms of any mood disorder. Along with medical professionals there are many forms of support and resources. There are several Facebook groups of women who are suffering or have suffered from HG. This is a great way to feel supported by knowing you are not alone.

The website Hyperemesis.org is equipped with resources, facts, and blogs from other sufferers and their organization, HelpHer, are leaders in research for HG. The HER Foundation puts on events throughout each year for women and their families to come together.

Another great support system is hiring a doula. Doulas offer support through pregnancy, birth, and postpartum. Through pregnancy we can be there for bed rest support, informational, and emotional support. We provide you with evidence-based resources, and factual information. With this information, women suffering from HG can self-advocate for proper testing and treatment that best suits their pregnancy journey. During the postpartum time, not only do doulas help with infant and family care, but doulas are trained to notice signs of PMADs and will provide you resources that can assist you through recovery.

Doulas want to see you be successful, confident, comfortable, and healthy. I know I can’t be the only one who pushes aside her feelings, physical and emotional, and says “Oh, I’m fine” or “It’s nothing.” Our bodies are designed to “tell” us when something is wrong. Here is a tip: start logging your symptoms, from a single headache to daily nausea and vomiting. This will help your medical provider reach answers. Trust your body and trust your intuition, strive for testing that you believe is necessary, and find your people.

Photo by Andrea Piacquadio from Pexels

 

Parenting and Sleep: Podcast Episode #98

 

Laine Lipsky, Parenting Coach, talks with Alyssa today about the negative effects of sleep deprivation on children and parents.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Alyssa:  Hello and welcome to the Ask the Doulas Podcast.  I am Alyssa Veneklase.  I’m excited to be back with Laine Lipsky, parenting coach.  How are you?

Laine:  Hi!  I’m good.  How are you doing?

Alyssa:  Great!  So when we talked on the phone last week, we talked a lot about sleep, and we didn’t intend to talk about sleep, but I told you that I was an infant and child sleep consultant, and then you were like, oh, gosh.  The way sleep deprivation affects some of the families that you’re working with — it kind of created some interesting thoughts.  I’d love to hear some examples of how some families you’ve worked with and how sleep deprivation has affected that whole family, because I see that when I work with — I’m hired to help children sleep, but obviously, these parents aren’t sleeping, either.  That’s why they’re calling me.  And then sometimes even when I get the children sleeping, these parents are, like, I still can’t sleep.  It’s like if they’ve been two years without a good night’s sleep, they have to retrain themselves.  So even though I’m not an adult sleep coach, there’s still a lot of rules from children that apply to us as adults that I kind of have to remind them of and tell them to be patient with themselves, just like they had to be patient with their child to get them into this new rhythm.

Laine:  Yeah.  It is such a big issue, and I can speak from personal experience.  I have, hands down, the champion worst sleeper ever.  He is now a teenager, so for anybody out there who thinks that they could take me on, like, my kid on, when he was a baby, I challenge you to a duel, a sleep duel.  A sleep-off.  Whatever you want to call it.  My son — so I’ll just start by saying my son — he would go to sleep.  We did all the “right things” for sleeping, and when we would put him down at night, he would go through the night and wake up every 45 minutes.  And I was a nursing mom and I was not intending to cosleep, but because of his wake cycle, and nobody — nothing could get him back to sleep.  He had something called silent reflux.  It was really hard to diagnose.  It was really concerning.  We ended up cosleeping, and I — we had to out of absolute necessity.  So every 45 minutes — so literally, when I would put him down — and that’s in heavy quotes; “put him down” for the night, I would start weeping because I knew that there was just this huge thing ahead of me called “night” which was going to be really, really painful and difficult.  And you and I said we both know that, you know, sleep deprivation is a form of torture in prisons and there’s — I firsthand have been through it, and I work with people who have been through it.  So I just want to start off by saying, like, I feel anyone’s pain who’s walking around feeling like their body hurts, their eyes burn, they’re short-tempered; they’re not making clear decisions, and especially on top of it, we’re recording this podcast during this COVID lockdown time.  All of that stuff is just on, you know, steroids right now because we’re also stressed out about the uncertainty that surrounds us.  So my heart goes out to anybody who’s struggling with sleep right now, and it’s so widespread.  The impact of a parent being sleep deprived and maybe both parents being sleep deprived is just such a trickle-down effect.  And so, yeah, I can tell you a lot about clients who I’ve  had, but I just wanted to start off by saying that I have total empathy for somebody who is going through that.  It’s a really important issue.

Alyssa:  Yeah.  You almost forget how bad it is, and then you have one night of bad sleep, and you remember.  Oh, my goodness; how did I do this for weeks, if not months?  And some of my clients, for years.  You know, for two years.  It’s devastating to relationships to where I –you know, they’ll say — or even six months.  Six months old; I had a long maternity leave.  I need to go back to work, but I haven’t slept in six months.  Or I went back to work after three months, and I have not been productive at work for the last three months.  It affects everything.

Laine:  Right, or people driving to work totally sleep deprived.  That’s dangerous.

Alyssa:  It’s worse than drunk driving.  I mean, statistically, I think there are more driving deaths related to sleep deprivation than drugs and alcohol combined.  Combined!

Laine:  Wow.

Alyssa:  Yeah.

Laine:  I didn’t know that.  So I say a lot, joking not joking, in my practice, if parents were able to get on top of sleep early on in their families that I’d be out of a job because a lot of what I see are behavioral issues that are stemming from a lack of sleep.  And you just think about how you feel when you are tired, when you’re cranky, when you — you know, when you feel that way as an adult, you’re able to sit down.  You’re really able to say, I’m feeling really — at best, you’re able to say, I’m feeling really cranky.  I’m just really tired.  You’re able to maybe take a nap somehow, magically.  You’re able to have a cup of coffee.  When we think about our kids — or, you know, maybe people have a glass of wine to take the edge off.  There’s no taking the edge off for the kids.  They don’t have that.  Maybe it’s nursing.  I guess that would be the closest thing.  But there’s no edge — they’re just edgy all the time.  And so in a family system, what I see is that when kids are not rested and parents are not rested, we’re not dealing with the actual people.  We’re dealing with the tired versions of those people.  And so one of my very first questions when I speak to people about their parenting is, how is your sleep.

Alyssa:  That’s great.

Laine:  It’s that essential.  And because I shared a few minutes ago about my own son and my own sleep struggles: we defied the parenting books at the time to schedule our day or create a schedule around feeding.  I was, like, forget feeding.  Who’s going to eat when they’re tired and cranky?  Like, does eating feel good when you’re tired?  That’s not a solution.  The solution is sleep.  And so we quickly learned — and I don’t know if this is what you teach, but you’re so flexible.  You teach a lot of different things to people.  But had you been my sleep coach at the time, or sleep consultant, I would tell you that we were scheduling our day around our son’s wake-up time.  Like, that’s what we — we’re scheduling our day around his sleep needs.  His feeding seemed to be fine, but his sleep was just crazy off the charts.  And I think part of that is temperament.  I think a lot of it is.  And to this day, he doesn’t — well, to this day, he is a teenager, so he sleeps crazy amounts, but up until he started that whole sleep routine as a teen, he still needed less sleep than everybody.  He still needs less sleep than me.  And that’s where I see in families the real — when it’s upside down, when a parent has high sleep needs and a child has lower sleep needs, that’s a red zone for me as a parenting coach.

Alyssa:  Yeah, it’s really hard because in the podcast we previously recorded where you said there’s no one parenting style; there’s no practice style — but the same with sleep.  There’s no one — or there are some best practices, but there’s no best parenting style.  Same with there’s a lot of sleep methods, but there’s no one right sleep method for everybody.  So when I give someone a sleep plan which says, you know, based on your child’s age, this is what a child typically — what a nap schedule typically looks like or a feeding schedule typically looks like.  Most parents want to go by the — just down — and I have to remind them, we’re not watching the clock.  We’re watching your baby.  Your baby’s cues tell us, how long is their wake cycle?  Can they stay awake for an hour and a half before they get tired, or can they stay awake for two and a half hours before they get tired?  That will determine feeding and sleep schedules, not this list, not the clock.  So they just want me to hand them this guide that miraculously works, and it’s just not that easy.  We really have to watch Baby’s cues to understand what your baby needs, because if a typical baby needs 15 hours and yours only needs 14 hours, what does that mean?  Let’s try some things.  What is this going to look like?  A later bedtime?  An earlier wakeup?  A shorter nap?  Troubleshooting together is why I think finding a good sleep coach is the only way to be successful because you can’t just read a book because then you are looking at this sleep guide in a book saying, okay, oh, my gosh, it’s 2:03.  I’m three minutes late.  You should have been down for a nap.  But your baby’s not tired.  So then what?  Who answers that for you?

Laine:  Yep, and to have somebody help you watch that, because just like with parenting advice, you know, the old adage is that — the old whatever you want to call common wisdom or whatever that you might get from your own parents often doesn’t apply.  Sometimes they do.  Like, if you’re lucky, you know, like a baby will sleep when they’re tired.  Well, not if you have a baby who’s really high-strung, temperamentally speaking, or who’s overtired.  Their form of being really tired is wired, which is the case in my kids.  Right?  He didn’t get that dreamy, dazed-off look when he was tired.

Alyssa:  He didn’t give you the sleep cues of yawning and rubbing his eyes?  Mommy, I’m tired.

Laine:  There was no book that fit my child, and so to your point, I had to learn to read him and I had to stop reading the books.  And I didn’t do it perfectly.  You know, I still don’t do it perfectly, but just even that shift in my mindset of, like, oh, I need to read my child, not the books.  It’s the same thing that I say to parents about parenting, which is, learn to read your child and take in the information but, you know, information overload is overwhelming and we’re just being inundated with it now, and it’s conflicting information.  It’s like, you know, I’m a sports coach by training.  Then I apply all of that to parenting.  If there are too many voices in your huddle, right, the team gets off track and doesn’t know what they’re doing.  You need to have one clear voice in the huddle and for each parent, it’s going to be them.  Their family is their huddle, and the more clear that the leader can be, right, the captain — you’re the captain of your team — the better everybody is going to respond to that, or at least you’re going to know whether it’s working or not.  So what I find is happening with parents is they get in their, you know, best-meaning selves, they want to be informed.  They’re getting, like, flooded by information and they don’t know how to parse that out and to make it work for their child.  So is that something that you — how do you talk to parents about that?  Like, how would you help — that’s what I hear a lot from parents is, like, I don’t know what to do.  How do you handle that?

Alyssa:  A lot of the times, parents will come to me and say, we’ve tried it all.  We’ve done all of the methods.  All of them, even ones that I don’t agree with, right, like just crying for two hours.  But they’re so desperate.  They’re, like, this is what my pediatrician told me or this is what the book says.  I’m just going to try it.  Well, there’s so many methods, but they can be done incorrectly, and maybe that method’s not the right one for your child.  So if they’ve come to me and said, I’ve tried Method X but then I read through their intake form and I’m like, well, no wonder that didn’t work.  Here’s what we’re going to try.  Or we get into something and they’re like, hmm, but my sister has a baby who sleeps really good, and this is what they did, and you’re not telling me to do that.  I’m like, well, that’s their baby.  So you do.  You have to tell them — like, I love the coach analogy.  I am your coach.  We’re a team.  We’re doing this together.  I’m not coming in and just telling you what to do.  I’m doing this based on your family’s needs.  And then I educate you so that you can go and do it yourself because I’m not with you everyday for the next several months or years.  So I educate them so they have the tools moving forward to do exactly what they need to do.  And I also love the coaching analogy, the sports analogy, because for older children, I explain to them sometimes that it’s even with the emotional aspect.  You know, we talked in the last podcast about how we can’t just make our kids happy all the time.  Experiencing a wide range of emotions is normal, and we need to help them learn how to cope with those.  This comes into play a lot with sleep because you hear your child cry when they’re tired, and it’s this automatic — we just feel this distress.  But sometimes those same cries during the day — you take a toy away or you have an overly tired child who just wants to cry about everything — you can ignore them during the day a lot easier than you can at night.  But we need to help them cope with these emotions.  So it’s — what do I say to them?  You’re not in this to play the game for them.  You have to help teach them how to play the game themselves.  Right?  Like, we can’t hop in and do it for them all the time.  With sleep, we’re coaching them.  That’s my basic — I forget where I was going with that, but…

Laine:  You were talking about how coaching as an analogy was working for — yeah, for helping them learn how to do it and being — I think you said it; like, not doing it for them but coaching them to do it, and that the older they get, I think you were talking about, that maybe that was a piece of it, too.

Alyssa:  Yeah.  I mean, a baby needs a lot more help and it takes a lot longer.  When you have a two-year-old, it’s a lot different than a six- or nine-month old.

Laine:  Right.

Alyssa:  You know, they’re talking, walking, moving.  They’re a little bit more — they’re smart.  They can be tricky.  They know how to get you to stay in that room a little bit longer.  There’s no thirstier child than one you’re trying to get to bed.  Mommy, I’m thirsty.  Mommy, I’m hungry.  Mommy, I need this.

Laine:  Yeah, so does that — does your advice for parents change depending on all the things?  You know, the child and the parent, whatever — because that’s a classic one that comes up for people.  Like, my child has all the excuses and can crawl out of their crib and can crawl out of their bed or whatever.  Do you have some wisdom to share with people who are really —

Alyssa:  Bedtime routines.  Bedtime routines are so important.

Laine: For the kids who don’t — for the parents who are like, we have a bedtime routine, and it involves bath time and books and me putting my child in bed, and then my child’s coming out of bed, like, a zillion times before they stay in bed.  That’s the bedtime routine, and they’re sick of it and they don’t have any recourse.  And I’ll tell you something, Alyssa: some of my clients have gotten some of the worse advice from pediatricians, including people to, like, lock their child in their rooms.  That’s come straight out of the mouth of a pediatrician, and just, like — I want parents to know that if advice that you’re getting from a source doesn’t feel good, then it’s not good.  It has to feel good to be good, and it should be something that is aligned with your values, something that’s aligned with your personality and also that will work for your child’s temperament because it just breaks my heart to hear people on the phone, and I hear it all the time, people crying; well, I did this and it felt terrible, but my pediatrician told me to do it, so I — you know, thinking that they were doing the right thing.

Alyssa:  So when they work with me, I have them fill out an intake form for that reason.  I want to know, what is your parenting style?  What’s your child’s temperament?  What have you tried in the past?  What’s worked; what hasn’t worked?  And what is your end goal?  So I will make a plan based on that.  Not what I think you and your child need to be doing, but what is your goal as parents?  Maybe you have a one-year-old still breastfeeding exclusively, and you just to cut that down.  You don’t want to eliminate all night feeds.  Twelve months probably could sleep all night without a feed, but if you’re okay; you just want to have two feeds instead of five — okay.  Let’s work our way back.  Let’s eliminate a few of them and see how it goes.  And typically, you know, at that age, we would probably end up eliminating all of them, but then it’s also the opposite.  I might have a four-month-old client whose parents are, like, I need my baby to sleep all night.  Well, okay.  At four months, your baby probably still needs to eat at night, so let’s talk about what a realistic overnight looks like for this age.  So sometimes the expectations aren’t quite — you know, they might be a little bit unrealistic.

Laine:  Right.  Same thing with parenting.  We want our five-year-old, three-year-old, to set the table and then go up to bed by themselves.  And I’m like, yeah, no.  That’s not — that’s not a thing.  Or it could be, but it’s very rare.  So maybe you get this question a lot or this issue a lot that comes up; maybe this is a good place to overlap a little bit.  I hear from parents a lot that they have some shame, like, a lot of shame that they don’t know how to parent, that they should know how to parent.  Some people are more forthcoming and say, you know, well, I was raised by parents who I’m not looking to emulate.  I want to be parenting differently than how my own parents parented me, and I don’t know how.  There’s not so much shame there, but when people are, like, trying to do it differently and they can’t; they think that they should know how to do it naturally, and it’s not coming out the way — it’s like when you have a picture in your head and you start drawing, and it’s, like, nope, that’s not what’s in my head.  Not at all.  Right?  I get that a lot.  I hear that a lot from parents who are really struggling with this internal sense of, I should be able to do this.  Do you get that with people who are — especially around sleep and in this culture of, well, just let them cry it out, or they’ll sleep when they’re tired.  Do you find that parents struggle with that?

Alyssa:  Yeah.  It’s kind of like breastfeeding, right?  We think it’s going to be this natural thing, and then when we really struggle with it, we think that there’s something wrong with us when nobody tells us as new moms that breastfeeding is really hard.  Same with sleep.  It’s just something that our bodies want to do naturally, and people tell you that newborns sleep all the time.  Well, they do for a little while, and then they don’t.  So when it hits the fan and you don’t know what to do, they start reading books.  It’s this downward spiral of, well, I read this book and it didn’t work, so I gave up and now, like you, you just end up cosleeping if you don’t want to, and I have clients who have been cosleeping for three years, and the parents haven’t slept in the same bed for three years.  Some families, that works.  They do that by choice and it’s fine, but the ones who are calling me, it’s not because they love this situation.  They’ve gotten there by desperation, and somebody’s not happy.  So every family is so different, and I always warn people: if any sleep consultant comes in and says they have a plan and just one plan, or if it includes cry it out, you just say, thanks but no thanks.  There is no one plan.  If there was one way to do this, I could write a book and tell everyone what to do and be done.  Right?  And same with you.  Every family is so different.

Laine:  Well, what I see is that when people are willing to take a plan, kind of no matter what, it means that they’re actually going to start — they’re going to start walking down a path of, I’m going to do whatever works to get the behavior I want, no matter what.  And that’s a path, from a parenting perspective, that’s a path of very authoritarian, very old-school parenting style.  Right?  Where it’s going to be harder if you’re not really showing flexibility; you’re not going into it with empathy.  It’s going to be harder to develop those skills and that mindset toward your child and toward your parenting style as your child gets older.  Right?  So something that I think gets lost when parents are willing to pick up a solution — and I get why they do.  Right?  Like, I get why they pick up the, “I’m just going to let them cry and figure it out,” because they are at their wit’s end, and it’s overwhelming to think about it being a process.  They want it to just be a simple solution.  I get the temptation there.  However, my cautionary tale to parents is, if that’s the way that you approach sleep, it’s likely going to inform how you’re approaching parenting in general, and that is — I rely on the science for this and I don’t come to this with judgment.  The science absolutely tells us, and the research tells us again and again, that when you’re parenting with an authoritarian style of parenting of, we’re going to do this no matter what, and you’re lacking empathy in that, you’re going to get certain outcomes for your kids in the long term, and they’re never the outcomes that parents want.  You know?  Like, if I were to ask you, what are the outcomes you want for your daughter?  What are your outcomes that you want for your daughter when she’s — push it out 20 years.  She’ll be 27?  What kind of woman do you want her to be?

Alyssa:  I want her to be kind and successful and learning from me, right?  Maybe running her own business.  Yeah.  I want great things for her.  Right.  Right.

Laine: Independent, right?  You want her to be emotionally healthy?

Alyssa:  Right.

Laine:  Attract emotionally healthy partners?

Alyssa:  Right.

Laine:  Right?  All that stuff; resilient, gritty.  Right?  All that stuff; self-assured.  All that stuff are the outcomes that we know — we know that a certain type of parenting, a certain parenting path, gets.  There’s not one right way to walk the path, but there is as path, and that’s what I call best parenting practices.  Right?  We know.  The research is telling us again and again, and if you’re not walking that path, you are walking another path, which is to get insecure kids who are, you know, not as successful as they could be in the three big categories, which is work, school, and relationships.  That’s just research.  So I feel so passionate about having people start as early as possible making parenting choices that feel right to them to get the outcomes that they want.  Never had somebody raise a hand in my course or my class or workshops that I run saying, I want my child to be insecure.  I want my child to attract dysfunctional partners.  Never, right?  I would love to talk to that person.  I think; maybe I wouldn’t want to talk to that person.  But we don’t want that.  That’s not our natural instinct, and it’s so — I like to think of the really early years of being a parent as training for the parents of how you want to be a parent.  And then it sort of morphs into, how are we training our kids?  How are we guiding and shaping them?  But the early decisions, how we respond to them as infants, how we respond to them when they’re really little, when they’re preverbal, especially — that’s training ground for us.  It’s essential training ground for parents for how we’re going to be.  How are we going to listen?  Are we going to ignore?  Are we going to jump every single time?  What is the sweet spot?  What is the sweet spot for each particular parent?  There is a sweet spot.

Alyssa:  We talk a lot about that, and I like the term “sweet spot” because there are some parents who are fine ignoring, and then there are some who are jumping every time.  And when you really talk about listening — they’re like, well, my baby’s just crying.  What do you mean, listen?  I’m, like, crying is communication.  And they are — they can’t verbalize it, but there are different cries.  Especially as a baby develops, those cries actually do sound different, and even before they sound different, take a look at what happened when your baby started crying.  Was there something that you can actually take note of?  A loud noise; maybe a dog barked and it disrupted something, or the sun moved just enough, and it’s shining right in their eyes.  Taking note of what maybe happened to cause the crying instead of saying, oh, my baby must need food, or my baby needs to be held.  Because some babies, as much as we want to hold them all the time, are a little bit — they just don’t need it.  They need their own space a little bit more.  And those are the ones who will cry.  You know, grandma comes over and gets in their face and wants to pick them up right away, and then grandma feels bad, and I’m like, no.  I call them space invaders.  You just invaded the baby’s space.  Move in a little bit slower.  Give them time to adjust.  My daughter was like that.  She needs to assess everything that’s going on in that room before she decides where she wants to go and what she wants to do.  If someone comes at her, game over.  Babies are the same way.  They have little personalities.  I mean, it takes a while to figure them out, but —

Laine:  But in those early stages, they’re little mammals, and they’re responding from that part of their brain and their being that’s the most developed, which is that limbic part of them, which is able to convey — like, my dog right now is conveying a message, right?  She’s not using words, but I know what she wants.  She’s sitting by the door.  She’s having that little howl-cry, plaintive cry.  I know she wants to go out.  I also know that she’s already been out.  She doesn’t need to go out, and when she does go out, she’s been super destructive lately.  And it’s going to get louder, and she’s going to get upset.  And if she were to — to be clear, because I never want to be at all misquoted or confused as saying kids are or should be treated the way that animals are treated — if she were a child, I do not believe in ignoring kids.  I would be going over there.  I would be getting down on her eye level, and I would say, oh, I know that you want to go outside and you’re so upset, and I see you’re so frustrated.  And while leading her away, because if she’s not — while setting a boundary.  We’re still not going outside.  Let’s do something else.  So it’s not just bait and switch, which I know that there’s a lot of parenting programs out there that are all about just redirecting a child’s behavior.  But we’re not looking at just behavioral creatures.  We’re looking at emotional, one day fully formed, human beings.  Right?  So the behavior is one piece of it, and to your point a moment ago about what parents are doing, it’s not just the what; it’s also the how.  Like, how are you walking into your child’s room?  Are you flinging the door open while they’re crying and being, like, oh, my gosh — because your babies are going to pick up on that energy, too.  Right?  So being responsible for our own energy before we engage with our kids, whether they’re crying or frustrated or being pissy or whatever it is, being responsible for our own energy is an essential piece to how they’re going to then react to us.  How we respond to them informs how they react to us.  It is a cycle, for sure.

Alyssa:  Yeah.  We talk about that.  And, you know, they can pick up on our anxiety, especially around sleep.  Like you said, you can go this whole day; you can drink your cup of coffee, have a glass of wine at night, but then all of a sudden you knew: it’s night.  And you just feel this anxiety around sleep that you almost can’t help, but then your child senses that, which makes going to sleep even harder.  But then you’re also sleep deprived, so of course you’re more anxious because you’re sleep deprived, and it’s just this vicious cycle.  Probably 30 percent, maybe up to 50 percent of the parents I work with probably have some form of postpartum depression and/or anxiety, because I’m working with a lot of new moms.  And that just escalates.  That’s another vicious cycle.  If you have it, sleep deprivation makes it worse.  But even if you don’t have it diagnosed, maybe you have sleep deprivation, which is causing depression-like symptoms without being actually depressed.  It’s just really hard.

Laine:  But it doesn’t matter.  If the symptoms are the same, it doesn’t matter what it is.  You have to treat the symptoms, right?  I was talking to a sports psychologist the other day, because I’m always curious about how sports training and sports psychology overlaps with parenting.  It’s just this intersection that I find really fascinating, and it’s where I lean in with parenting.  Let’s treat it like sports training, in the sense that you’ve got to be prepared for it.  You’ve got to do some real training for it.  There’s a pre-game.  There’s a game time situation.  There’s a post-game.  You know, it makes sense to me because I grew up around athletics.  But — oh, what were you just saying about —

Alyssa:  Oh, depression and anxiety.

Laine:  Oh, yeah, yeah, yeah.  Thank you.  So this sports psychologist, who also now works with women who are postpartum and have postpartum depression and/or anxiety, she was, like, oh, sleep deprivation — it’s not only, like, tied to it; it can be the cause of it.  You know, back to this thing about sleep deprivation being a form of torture: it can absolutely trigger anxiety and depression.  And I just was, like — I mean, I knew that, so when she said it, it wasn’t earth-shattering news to me, because I’d seen it — but to hear her say that with such, like, authority — I was just, like, wow, yeah.  That’s a real thing.

Alyssa: The hormone shift that’s happening anyway after you have a baby — like, it’s the largest hormone drop of any mammal, I think, when you have a baby.  And then add sleep deprivation on top of that, which as a human species, we can handle a little bit of it.  Our bodies are made to handle a little bit of that after having a baby, but not months.  We just can’t handle it.

Laine:  And certainly not years.  So what would you say to somebody — like, what would be advice that you would have for somebody who is struggling with sleep during this particular moment in time; the COVID situation; the unique time that we’re all going through around sleep, because, you know, people wonder, you know — they worry.  They worry and they wonder, and I remember that feeling of, like, I know sleep is the most important thing.  My baby’s brain is growing, and I have all this information about it, and I was definitely one of the more anxious people around sleep.  I was like the sleep police.  And I was also facing people who were saying, oh, it’s no big deal.  It’s no big deal.  So I felt like I was fighting the other side of it, which made me more vigilant.  So it was hard to find that balance for myself.  But I’m wondering, like, what would you tell somebody who is feeling like, I know sleep is super important, and I’m in this, like, bizarre situation at home where I’m working from home and there’s, like — there are noises around.  There’s not quiet.  It’s not ideal.  So I’m struggling with sleep, and we’re in this bizarre time.  Like, can you put anybody’s mind at ease?  Like, beyond saying, like, well, your child’s not going to die.  You know, they’ll survive.  For people I work with, that bar is too low.  You know?  They want to be raising thriving, really healthy — like, optimizing their child’s childhood experience.  Right?  So do you have any just blanket wisdom or anything that could help them have their minds put a little bit at ease?

Alyssa:  Yeah.  I mean, you said it.  Sleep is so important, and I think especially right now with a worldwide pandemic with this virus, proper sleep helps build our immune systems, so let’s try to get proper sleep.  And even though we’re working from home — you know, like we said in the last podcast, let’s change your perspective.  Instead of saying, maybe my kid won’t sleep enough because I’m here and I’m working and there’s all these noises.  Let’s shift that and say, well, I’m home.  I have a lot more opportunity.  I don’t have anywhere I have to be at a certain time.  Let’s focus on sleep.  Instead of letting my kid say, oh, you don’t have a schedule and you can stay up until 10:00 now, let’s continue a pretty consistent bedtime routine, especially for kids — you know, you have teenagers; different story.  For babies and toddlers — even my daughter; she’s 7.  We walk back there at 7:30 at night.  We brush teeth, put PJs on, we read a book, and I walk out at 8:00.  So a 30-minute routine is pretty good.  It gives you plenty of time to do kisses and cuddles and, you know, that’s plenty.  But it’s so important because someday school will start again and work will start again, and it’s going be really, really hard on these parents who have to get back into a rhythm.  So if you’ve gotten out of that rhythm, maybe you can slowly work your way back to getting them.  And it’s hard.  Like, here it’s summertime, which means at 8:00 when I leave her room, it’s still light out.  But she’s still tired, so I just make it as dark as possible.  But try to keep a consistent routine, and that’s a wake up time and a bedtime.  And then if you have a younger kid who’s still napping, sound machines; make it dark in that room; crank the sound machine, and do what you can to keep the house as quiet as possible.  And then you had mentioned some of your clients have kids who are crawling out of cribs.  If you can wait until a kid is 3 to take them out of the crib, that’s better, because developmentally, they’re — before 3, they don’t really understand that this is a bed and I shouldn’t crawl out of it, and then you’re kind of having to shut the door and lock them in the room, which nobody wants to do.  You’re essentially making — I tell parents who have to do that, consider the room now a crib.  So you have to look at everything in that room and make sure nothing can fall on them; they can’t — there’s no — nothing that can hurt them, and you’re essentially turning the room into a crib.  But before 3, it’s really hard.  But there are some tricks.  If you have a 2-year-old who’s crawling out of a crib and you’re afraid they’re going to hurt themselves, and if they wear a sleep sack and they can unzip it and crawl out of it, flip it around so that the zipper is in back.  Maybe they can’t reach that zipper.  If they’re really smart and can get at that zipper, put it on backwards and then put a little T-shirt over it.  They would have to really work.  They have to pull the T-shirt off.  Just try to make it as hard, but it’s hard to climb out of a crib with a sleep sack over your feet.  I have had some Houdini babies who even that doesn’t work, but for most, even just having the zipper in back, they — even if they can touch it with their hand, they can’t get it all the way down.  So that’s one trick.

Laine:  Houdini babies.  That’s hilarious.

Alyssa:  But make sleep a priority.  Instead of saying, oh, I can’t — I just can’t — there’s no way I can get on a sleep schedule or get my kids back on a schedule.  If you make sleep a priority and have some sort of routine — we need routines as adults, and kids especially need some sort of normalcy and routine.

Laine:  Does it have to be to the minute?  Bedtime is 7:30?

Alyssa:  No.

Laine:  What’s your take on that?

Alyssa:  No.  Give yourself some flexibility, especially for younger babies.  Thirty minutes on either side.  So let’s say a working parent; they need to be up — they need their baby up at 7:00 in the morning because they have to get baby fed and out the door.  Now, on the weekends, let them sleep in until 7:30.  If you go past that, you’re really messing with the natural rhythm of the baby’s sleep cycle that we’ve worked so hard to put in place, that they can sleep, you know, 7:00 to 7:00.  You don’t want them to some days be able to sleep until 9:00 or stay up until 9:00.  Even as adults, every hour of sleep that we lose, it takes us about a day to recoup.  So time differences; if I fly to Seattle and visit my friend, three hours different, it takes me about three days to adjust.  And I can deal pretty well with that, but for a baby, it’s really hard; really hard to deal with.

Laine:  Yeah, yeah, yeah.  And parents get really nervous about traveling with babies, and how do I do this?  And, again, this comes back to being aligned with what your values are.  It’s okay to not travel with a baby.  Even though you see people on planes with babies all the time, it doesn’t have to be you.  Just getting really clear about where you stand and what’s important to you and why you’re doing what you’re doing.  What’s your why?  Is it because you feel guilty or is it because you feel jealous, or is it because you feel like you really, really need to go visit your mom?  Those are all really different answers to the same question.

Alyssa:  Yeah, I get asked a lot about travel.  People want to travel with their kids a lot, and sometimes it’s just not conducive to have a three-hour time difference with a baby because you’ll probably have to go to bed really early or get them in bed really early, and that means you can’t go anywhere, unless you have the resources to hire a nanny or you’re visiting parents and they’ll stay.  You know, you can put them to bed at home while you leave.  You know, my client right now, they like to go camping.  Before we part ways, how do we camping with this baby?  And we talk through that.  What does that look like?  Go hiking after the nap; come back at lunch; put the baby down again.

Laine:  Again, I think kids are so different.  They come just so different.  You don’t get to — it’s like getting a dog, right?  If you want to, you can thumb through a book and find your ideal breed, and you can pick the type of dog that’s going to have, likely, like, 99 percent sure, you’re going to have the kind of behavior that you want from that dog, right?  If you go to the pound and you’re going to get some sort of mix so you don’t know exactly what you’re getting, then you have to work with what you have.  And that’s what parenting is.  Parenting is, you work with what you have, and you don’t get to pick.  And so I really — one of my favorite things to caution parents against is comparing other people’s outsides to their insides.  Right?  Like, what is your reality versus what you’re seeing somebody else in that moment having?  If you’re somebody who wants to go camping with your baby, if you have the type of baby that can hack that, there’s nothing inherently wrong or bad about taking a baby camping, unless you’re going to artic.  You know, perhaps that is not a good idea, right?  But if you’ve got an “easy” baby and sleep is not an issue, or you’re happy snuggling together, great.  That’s awesome.  But if you don’t have an easy baby or sleep has been a huge issue in your house, then you’re not the family who’s going to — if you want to have the shit show afterward, you know, and you’re willing to go and take that risk and then it’s a calculated risk — it’s just not fair to then be upset with the baby or be upset with your child for being cranky afterward.  You just to be informed, know what you’re doing, know what you’re getting yourself into when you take those risks.  And I think it’s one of the most empowering things that parents can do, to be really clear about what they are and what they’re not willing to tolerate.  Just like in life, right?  What are you willing to tolerate, and what is your happiness equation?  What are the elements of your happiness equation?  It’s really important for people to know that and to get right with themselves so that they can live their best family life.  And it’s not going to be a blueprint from somebody else’s family.

Alyssa:  Yeah.  Realistic expectations, again.  You know, it’s just maybe sometimes telling them, sorry; I have to let you know that your baby’s not going to — based on working together, this activity you want to do won’t suit your baby — but now.  Maybe later.  Don’t give up on this dream to go camping.  It might just have to wait a couple of years until your child is down to one nap a day instead of three.  And again, like you said, you talked about being fluid instead of, like, having this solid — it needs to ebb and flow.  Be flexible.  Realize that your baby is a human who has separate needs from you, and just because you want to do this, your baby might not want to.

Laine:  Part of the deal of becoming a parent.  There’s sacrifices, you know?  And it’s funny; like, I think that we talk about that a lot, right?  Like, there’s a lot of sacrifices in parenting, or there’s a lot of sacrifices in marriage, or there’s a lot of sacrifices in whatever.  But when it really comes down to it, when that happens, when you’re confronted with the sacrifice, it’s a very hard thing.  It’s a tough pill to swallow.  And I just — maybe a good sort of point for us here is to talk about or to ask the question of, like, what is it that is important, you know, and where are you willing to sacrifice?  What is the sacrifice that you face when you’re a parent, and what are you — how do you respond to that?  How do you respond to the fact that you’re being asked to sacrifice stuff?  You know, it’s a tough one.  I don’t think people have a high tolerance for that, especially in this day and age.

Alyssa:  Yeah.  We want things to go our way all the time.

Laine:  All the time.  All the time.  Well, it was definitely a good conversation.

Alyssa:  Yeah!  We covered a lot!  Well, why don’t you tell people again where they can find you if they have questions about the parenting end, before we sign off?

Laine:  Sure.  I have my website.  You can also find me on Facebook, and I have a very slim social presence right now because most of the stuff I’ve been doing in my life and my career has been live and in person, but I’m slowly building a social presence.  So definitely go to my website.  And feel free to check out my online course.  It doesn’t talk directly about sleep, but it does talk about discipline and the issues that follow, you know, if you’re having trouble with getting kids to cooperate and you’re facing a lot of meltdowns.  It will definitely, definitely help you.  And some of that is probably because they’re underslept, but it will help you anyway.

Alyssa:  But the two go hand in hand.  You know, a lot of times, to help them get to sleep better, they need a little bit of discipline, and then once that — you know, with consistency and the right discipline for that family, the child will understand, this is the new routine.  I can sleep better, and then you no longer need to discipline because then it just becomes part of their routine.

Laine:  Absolutely.  Absolutely.  So, yeah, the course will be — the free class will definitely be of help, and then people can also book a free call with me.  And those are the main ways to find me.  And I want my listeners to listen in to what you’re about to say, too, because I want them to be able to find you.

Alyssa:  Yes, you can find us at our website.  We’re on Instagram and Facebook, and this podcast is called Ask the Doulas.

Laine:  So good.  Thank you so much for having this conversation today!

Alyssa:  Thanks for joining me!

Laine:  My pleasure.  We’ll do it again soon.

 

Mental Health Awareness Month: Podcast Episode #97

 

Dr. Nave now works with queens through her virtual practice Hormonal Balance.  Today she talks to us about hormones and how they affect our mental health, including the baby blues and postpartum depression.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Alyssa:  Hi.  Welcome to Ask the Doulas Podcast.  I am Alyssa Veneklase, co-owner of Gold Coast Doulas, and today, I’m excited to talk to Dr. Gaynel Nave, MD, and she works at Hormonal Balance.  Hi, Dr. Nave.

Dr. Nave:  Hi, Alyssa.  Thanks for having me.

Alyssa:  Yeah.  It’s been a while since we’ve talked, but we were emailing a while ago, and we realized that it’s Mental Health Awareness Month in May, and then this week is Women’s Health Week.  So you wanted to talk about baby blues and postpartum depression.  So before we get into that, why don’t you tell us a little bit more about Hormonal Balance because last time you talked with us, you worked for — you were at a different place.  So tell us what you’re doing now.

Dr. Nave:  Okay.  Awesome.  So as of this year, I’m in my own practice, as you said.  The name of it is Hormonal Balance.  And so I am an Arizona licensed naturopathic physician, and here in Grand Rapids, I operate as a naturopathic educator and consultant to women, with all gender identities, to basically reconnect to their — who they are and directing their own health, hormonal health concerns.  And that’s the reason why I went with Hormonal Balance, because our hormones affect almost every single aspect of our health, including when we wake up, our mood, our sexual health, all of it.  And for us who are women or female-identifying, the medical community sometimes doesn’t listen to our concerns or minimizes our experience, and so I want to be a part of changing that and, you know, helping women be advocates for themselves and learn more about their bodies, basically.

Alyssa:  Yes.  Awesome.  I love it.  And then you can do — so even though you’re here in Grand Rapids, Michigan, you can do virtual visits, so technically, you can work with anybody anywhere?

Dr. Nave:  Yep, yep, yep.

Alyssa:  Cool.  Well, we’ll tell people how to find you at the end, but let’s talk a little bit about the mental health aspect of, you know, bringing some awareness to it this month.  And then, obviously, you know, baby blues and postpartum depression is something that we deal with on a regular with our clients.  So how do you help your patients?

Dr. Nave:  I call them clients.

Alyssa:  Clients?  Oh, you do?

Dr. Nave:  Yeah, because here in Michigan, because my — there is no regulation for naturopathic physicians, even though I have my license.  I function more as a consultant, so I call the people that I work with “clients.”  And so the way in which I assist them is basically gathering information about their concerns as in-depth as possible because I’m not just going to look at you from the perspective of, oh, I’m experiencing this particular symptom, because nothing occurs in a vacuum.  And so looking at you as a whole, how does what you’re experiencing affect you mentally, emotionally, and physically.  And so we do the full assessment, and then a part of that is talking about and educating you on labs that are pertinent to you.  So there are different types of hormonal labs that are available.  There’s salivary.  There’s urine.  There’s blood.  And so, like, making sure that the one that’s best and indicated specifically for you is what we talk about.  It’s very individualized because each person has a different experience, even if we have the same diagnosis.  Does that make sense?

Alyssa:  Right.  So you’re saying if somebody comes in, you do a pretty thorough — kind of like with my sleep clients, I do an intake form.  Right?  There’s no, like — you’re saying there’s no one blood lab for — oh, there goes my dog.  I should have mentioned that we’re recording at home on speakerphone, and — okay.  So what I was saying is with my sleep consults, I do an intake form because there’s no right answer for every family, so if somebody comes in and needs blood work done or — well, like you said, labs.  Blood work might not be the right lab for them?

Dr. Nave:  Yeah, because there’s — let’s talk about female hormones, for example.  So the female sex hormones — and when I say female, I’m using the medical terminology for it, not like — so, like birth sex.  You have ovaries — versus the gender identify.  I’m still working through how to talk about these medical things and still be cognizant and respectful of the different gender identifies, so please forgive me if I say anything that’s offensive.  So the female sex hormones — estrogen and progesterone — but these hormones don’t just occur in women.  They also occur in men.  So all gender identifies have these hormones involved, but specifically for those who can give birth, estrogen is involved in the building up of the uterine lining of the uterus so that implantation of a fertilized egg can happen.  Progesterone is important for maintaining that uterine lining as well as maintaining healthy pregnancy so that you don’t lose the baby.  Obviously, there are a lot more factors involved.  These hormones, based on how the body breaks down balance specifically as it pertains to estrogen — we have three different types of estrogen, so it’s not just one form that’s in the body, and depending on what lab is done, you’re able to verify all three at the same time.  The one that I’m thinking of right now is the urine test called DUTCH test.  I really enjoy that one.  I’m not promoting it right now, but I’m just explaining why I like it.  So that particular type of analysis looks at all three of those types of estrogen in the body as well as how the body breaks them down.  Is it able to get rid of it effectively, which gives information on the metabolic pathways.  So there’s a lot more information that can be gleaned from — depending on what type of lab is utilized and depending on your specific concern and the way in which your symptoms are presenting; a more investigative or information-bent lab analysis might be indicated, and so being able to speak with someone like myself who is well-versed on the different approaches and all the different options can be really beneficial because then you don’t end up having to do multiple tests, you know, all that kind of fun stuff, or having to get blood drawn if you don’t have to.

Alyssa:  Right.  So what hormones are you looking for when somebody comes in and says, gosh, I think I have postpartum depression?  Is it just hormonal, or do I really have — I guess, where do you as a naturopathic doctor, say, “I think I can help you with hormones,” versus, “I think you need to see a therapist”?  Or do you do both?

Dr. Nave:  So I will probably tell them to do both because postpartum depression, as with any mental health condition, is on a spectrum.  So you have mild, moderate, and severe.  Before we go into that, I think it would be important for us to define a couple things.  Baby blues is feeling down or feeling a shift in your mood, like feeling more weepy, more exhausted, after giving birth, and this can last anywhere from a couple days up to two weeks.  If it extends beyond that time or it’s interfering with your ability to function, then it would be classified as postpartum depression, and postpartum depression can occur in that same time frame as the baby blues, like soon after childbirth, within three to five days, up to a year after giving birth.  And I’m going to read a couple of stats, so bear with me.

Alyssa:  Go for it.

Dr. Nave:  Just for a frame of reference.  So postpartum depression affects up to 15% of mothers, and shifting to 85% of moms is that they get the postpartum blues, so that — these statistics may provide some form of comfort that you’re not alone.  Please don’t suffer alone.  If you’re feeling more down and you need more assistance from your family and friends, please reach out.  If you’re a single mom, I’m sure that there are different groups, like single moms groups, or talking to your doctor or your friends who can be there to provide some emotional support for you during that time.  Please, reach out to people.  It’s not anything to be ashamed of.  A lot of women go through it because our hormones, as I said previously, affect a lot of things, including our mood.

Alyssa:  Right.  I feel like mothers are getting a little bit more comfortable talking about how hard it can be and how maybe bad they feel or these thoughts that they’re having.  You know, you talk to the older generations, like our mothers and grandmothers, who said, well, we didn’t talk about those things or we didn’t need help.  And we’re slowly getting to the point where we’re seeing more and more families look for and seek out postpartum support, which is one of my favorite services we offer because they can work day and night.  When a mom is suffering from any sort of perinatal mood disorder, having that in-home support that’s judgment-free can just be crucial to healing.

Dr. Nave:  I totally agree with you.  I’ve seen it in practice and the research back it up.  Just being pregnant, much less giving birth, is hugely taxing on our body and increased your risk for feeling down.  Some of it has to do with the hormonal changes.  I’m going to go really science-heavy because I’m a nerd and I think it’s fun and interesting…

Alyssa:  Do it!  Teach us!

Dr. Nave:  As I said, estrogen is responsible for the building up of the uterine lining, but it also affects things like our serotonin production, which you might know as the neurotransmitter involved in depression.  Like, if you have low serotonin, then you might get depression.  So the thing with estrogen is that it increases the production of serotonin by affecting a particular enzyme called tryptophan hydroxylase that is responsible for processing an amino acid that we get from our food called tryptophan into serotonin.

Alyssa:  Isn’t tryptophan the one that makes us sleepy?

Dr. Nave:  No.

Alyssa:  Tryptophan isn’t the thing that we eat that makes us sleepy?  What am I thinking?  It’s in turkey and stuff?

Dr. Nave:  Tryptophan is in turkey.  Serotonin and melatonin have the same precursor in terms of amino acid but the thing about their bodies is they use similar substrates or building blocks to make stuff, and just because we have the same building blocks doesn’t mean that we’ll get that particular product.  Does that make sense?

Alyssa:  Kind of, I guess.  In my sleep work, I talk about serotonin and melatonin a lot just for, you know, sleep cycles and feeling alert and then feeling sleepy, but I didn’t realize that a lack of serotonin can cause depression.  I’m trying to, in my brain, you know, the science of sleep, then — it makes sense, then, that people who are depressed sleep a lot, right?  Am I going down the right path here?  Because if you don’t have enough serotonin to make those hormones makes you feel awake and alert — sorry, I’m getting you totally off track by asking these questions.  Sorry!

Dr. Nave:  No, no, no.  I don’t think you’re going off track because sleep is very much an important part of the postpartum depression process.  If Mom isn’t sleeping, she’s at a greater risk for experiencing postpartum depression, and we know that the hormonal changes affect our sleep.  Also having a baby, a newborn baby — if the baby’s up crying, and they’re getting their sleep regulated; you’re adjusting to waking up and feeding the baby, feeling exhausted during the day, and your sleep is thrown off in terms of it not going or being matched up to when the sun rises and the sun goes down.  You’re more trying to sync to the baby, and that can lead to fatigue, which then exacerbates your mood, which makes you then more susceptible to feeling more down.  And then it’s like — one of the things that they mentioned is that babies who have a hard time sleeping — there seems to be a relationship between moms who have postpartum depression — so the baby isn’t sleeping; Mom tends to have a higher likelihood of having postpartum depression, but then the opposite is also true.  So if Mom has postpartum depression, it seems that the baby also as a result has a hard time regulating their moods and being more colicky and all these other things.  So taking care of yourself also helps the baby; it’s important to support Mom, which is why I’m so grateful that you guys have the postpartum doulas, and you guys do a lot of work with supporting moms post-baby.  Sometimes people focus so much on the baby that they forget the mother.

Alyssa:  Oh, absolutely.  It’s all about the baby.

Dr. Nave:  Yeah.  Yeah, yeah, yeah.  So the hormonal mood connection is very complex, and it’s not just A + B = C, you know, because, yes, estrogen influences serotonin production, but there are other factors that then influence, you know, the mood.  Does that make sense?  Specifically, when it comes to the mood changes or the hormonal changes in early pregnancy and postpartum – early pregnancy, we see the estrogen or progesterone levels are shifting because you’re now pregnant, so the body doesn’t have to produce as much of those hormones.  And when we have lower estrogen, which is what happens when you get pregnant, and since estrogen is responsible — or, rather, plays an important role in serotonin, which helps you feel calm when it’s at the normal level — if it’s particularly high, it can lead to anxiety-type symptoms.  If it’s really low, depression-type symptoms.  During those times when the estrogen is lower, there’s this lower mood that can also be accompanied by it.  Are you tracking?

Alyssa:  Yeah.

Dr. Nave:  Yeah.  So that’s the estrogen portion.  So estrogen affects serotonin production and also directly affects the neural networks in your brain.  Now, we have progesterone.  So progesterone: I like to think of it as our calm, happy hormone.  And so when you’re just about to have your period, usually it helps you sleep.  It helps you remain calm.  But if it’s really low, that can lead to insomnia, feeling really agitated and grumpy, and those kind of symptoms can also happen postpartum and early pregnancy.  And so that’s how the hormonal fluctuations can then manifest with the depression.  For the reason, at least in the postpartum stage, that these hormones might drop is that you give birth.  There’s a huge change because the body doesn’t have to maintain the hormones to keep the baby inside.  The baby is now outside of you.  And it really drops off really quickly, and that huge shift can then lead to the baby blues.  Then if it prolongs, your body having a hard time regulating, then that’s when we shift from the blues to the depression.  In terms of what I would do, I would assess what exactly is going on for you.  Do you have physical and emotional support?  Do you have a history of depression or any mental health condition prior to being pregnant?  Have you had postpartum depression before?  How is your sleep?  You know, sleep is really important.  If we can get you sleeping, I think that goes a long way.  Good quality sleep.

Alyssa:  You’re preaching to the choir here.  I think it’s one of the most important things!

Dr. Nave:  The other thing that they mention, the American College of Obstetricians and Gynecologists, is that if Mom has any feelings of doubt about pregnancy, that can also influence her feeling depressed because it can get, like, amplified during that time.

Alyssa:  So you’re saying, like, maybe doubting if they wanted to become pregnant?

Dr. Nave:  Maybe, or doubt that she’s capable of being a good mom, because there’s a lot of pressures on moms, you know?  Like, oh, someone will mention, like, oh, my baby’s sleeping through the night, or my baby — you know, they started eating at this time.  So there’s a lot of pressure to meet certain milestones that are from society, and that can amplify feelings of inadequacy that Mom might have had prior to becoming pregnant.  And so addressing that piece with a therapist or someone like myself will be a very important part of supporting her with the postpartum depression and getting her out of the state.  For some women, medication might be what they need to do, and their healthcare provider will be able to assess that.  But it’s not the only thing that’s available.  There’s therapists; there’s hormonal intervention, because if it’s a hormonal issue, if you address imbalance, then women get relief pretty quickly.  There’s having a doula, if that’s something that’s accessible to you, or if you have family members who are close by, asking them to help out some more.  Having people provide meals for you so then you don’t have to cook; having your partner be a part of taking care of the baby and asking them to step up some more to give you additional support.  Basically, asking for what you need is — I know it can be really vulnerable and scary if you’re not used to asking for help, but that can really be important in terms of getting what it is that you need because no one is in your exact position and knows exactly how you need to be supported.  Does that make sense?  Because I can talk about, like, a doula and a therapist and a naturopathic doctor, but you know what you need, and I want you to trust yourself in that knowledge.  You know what you need!  And here are all these different options to provide that.

Alyssa:  So you mentioned something a bit ago, and I don’t know what made me think of this, but how — let’s say a mother came to you pregnant and had postpartum depression before and knew that she — you know, her hormones are all over the place.  How much can you actually do in regard to hormones while pregnant?  Is there any risk to Baby?  You know, risk of miscarriage?  What does that look like for a mom who’s pregnant but knows she needs some help from you?

Dr. Nave:  So in terms of working with me specifically, I wouldn’t want to mess with her hormones during that time.  I would employ other tools, one of which is homeopathy, which basically supports the body’s own ability to heal and regulate itself.  As well as putting a plan in place — basically, working alongside her other healthcare providers to create a plan to support her and make sure that the transition is as smooth as possible.  What does she do if she notices that she’s trending from green and happy, healthy, thriving, into, I’m not doing so hot — what are the resources available to me when I’m at that place?  Who do I reach out to?  Who do I talk to?  What supplemental intervention needs to happen?  Do I need to talk to my doctor about starting me on medication?  There are so many different options, and prevention is always better than cure.  We would talk about what her issues — so she’s coming and she’s had it before — we would talk about what was her previous pregnancy like; when did the symptoms start to occur; what did they look like; what sort of things — what sort of red flags occurred during that time; what was the intervention utilized at that time; what were her hormone levels like?  What else; what were any medications that she was on; what medications is she on presently?  And, basically, maybe even talk about how that pregnancy is different than this pregnancy.  Like, does she feel more supported now?  What were the things that weren’t present in the previous one that she does have presently?  You know?  And basically coming up with a plan.

Alyssa:  Yeah, I like that.  So it’s kind of like what we do, you know, throughout birth.  It’s talking about all those what-if scenarios and what plans do you have in place for if any of these happen.  And then, like you said, once Baby comes home, nobody plans for that.  They’re so worried about the pregnancy and the labor and delivery part that they come home and go, oh, shoot.  What do I do now?  So it sounds like that’s a really healthy way to plan during pregnancy, if you do have any sort of mood disorder, to find a professional like yourself to sit down and say, hey, let’s go over all these things and put a plan in place, and then I’ll be here for you postpartum.  And then we’ll talk about what we can do then.  I like that.

Dr. Nave:  Right, because, as I said, there’s so many different options.  For one woman, maybe hormones, just giving her the hormones, is what she needs, and then I would, you know, work with her other — because I can’t prescribe hormones at the level that would be therapeutic, but I would be able to recommend, okay, that’s what you need.  Let’s talk to your doc.  Hey, Doc.  This is the plan.  If this happens, this is what we’re going to do so that she doesn’t have to suffer.  You know?  Or maybe it’s something else.  Just being able to work with someone who — again, like myself — who is savvy on that in terms of knowing — yeah, it definitely needs a collaborative approach, which is what I’m about.  In my head, in my dream, everyone would have a health team, you know?  People, health professionals, who are all in communication with each other who are just there to support you and help you thrive.  But I think to wrap up, it would be sleep, health, get your hormones evaluated.  If you’re thinking of getting pregnant and you have any mood disorders or any mental emotional concerns, as part of your pregnancy plan, you should be working — ideally, you would be working with a mental health professional as well, just to insure that you have the support that you need and you’re processing stuff effectively, because those concerns, those mental health concerns, can be substantially amplified once you become pregnant, as well as after giving birth.  If you have a mental health condition or if you’ve had postpartum depression before, you are at significant risk for developing it again.  And this applies to — postpartum depression can also occur if you have a loss of a baby, so it’s not just if you’ve given birth, but any form of baby loss can also result in postpartum depression.

Alyssa:  Yeah, I can imagine it would probably be even amplified with that because you still have the hormonal shift, that drastic hormonal shift, and then grief on top of it.  So it probably takes it to a whole new level.  Well, thank you for all of your expertise.  I always love talking to you.  I would love for people to know how to find you at Hormonal Balance, if they want to reach out.

Dr. Nave:  Yeah.  I am on Instagram and on Facebook as @drgaynelnave.  I’m in the process of getting my website up, so I’ll update you on that afterwards, or you can call my clinic at 616-275-0049.  If you have any hormonal or mental health concerns and you want to optimize your health team, you want a second opinion, or you just want some additional support — that’s what I do!

Alyssa:  Thank you!  During this Covid pandemic, can you see people in person, or are you choosing to do virtual only right now?

Dr. Nave:  I’m choosing to do only virtual at this point.  I see clients virtually most of the time Wednesdays through Fridays, actually, from 8:00 to 5:00 p.m., and in person at 1324 Lake Drive Southeast, Suite 7, Grand Rapids, Michigan 49506.

Alyssa:  So once the stay at home order lifts and things get a little bit more back to normal, you’ll be seeing people in person again?

Dr. Nave:  In person, yes.  But for now, we will see each other virtually!

Alyssa:  Thanks for your time!  Hopefully we’ll talk to you again soon!

 

fertility center

A Journey Unlike Any Other

To all of the couples who have had retrievals, transfers, and IVF schedules postponed or affected by the Corona virus outbreak my heart breaks for you. IVF is no small or easy journey; it takes a toll on your mental, emotional, and physical state. It’s beautiful and terrifying all at the same time. It’s expensive and stressful. It’s all the feels at once every single day.

My journey with the Fertility Center of West Michigan began after my son was born. I suffer from secondary infertility. My son was conceived naturally and born in May of 2012. I began doing hormone therapy to conceive again a year after he was born. Unfortunately every pregnancy I had resulted in a miscarriage. We did several months of hormone therapy and endured four miscarriages. Unfortunately we never made it to IVF, instead my then husband and I divorced in 2016. I remarried in 2018 and in January of 2019 my Husband, Matt, and I began working with the Fertility Center again doing the hormone therapy for 6-months, which again resulted in another miscarriage. It was time to step up our game.

After taking a break in April of 2019, Matt and I decided to travel and take some time away from the constant thought of trying to get pregnant. It had become a chore and that can be so hard on a marriage. When December rolled around we decided to get on the IVF list and signed up for March of 2020. During this wait I began doing something for myself, I started taking a close look at my own health and began to prepare my body for pregnancy. Starting IVF at 35 years old made me a senior citizen in this setting. My body had changed immensely since my first pregnancy. So I began working with my coworkers at Grand Rapids Natural Health to address my thyroid and hormone issues as well as my food sensitivities and stress. I began weekly acupuncture sessions that I planned to do all the way through IVF and into pregnancy. I was working out to build my body’s strength to carry a baby and to create healthy habits I could continue into my pregnancy. I also began sharing my journey with the world via Instagram.

Sharing my journey was very important to me. Working in the health industry I notice too often that these sensitive topics are not spoken about enough and I wanted to share my story in hopes that my own vulnerability might help others along their journey. I wanted to empower women to talk about their pain, their loss, and their sadness instead of hiding it from the world. I found once I started to share my journey that there were so many others like me out there. I didn’t feel that I was carrying that burden alone anymore which was incredibly comforting.

When February arrived they started me on birth control. During this time we did our mock transfer and Endosee. I was thankful for the mock transfer because it calmed my nerves and answered a lot of my questions in regards to how the procedure worked. Since I have undiagnosed infertility an Endosee was performed to make sure that my uterus looked healthy and had no underlying problems that may prevent me from getting pregnant. We then met with Dr. Young and our nurse who walked us through every detail of our care during this process. Since my problems weren’t about getting pregnant, but more about keeping a pregnancy, our plan was a little different than what they were use to seeing. They decided, because of my age and history of miscarriages, that they would transfer two embryos. Our chances of twins are now much higher since twins are on both sides of our family, my age, this being my second pregnancy, and because we are transferring two embryos. As scary as that sounded we took our chances and agreed to the two embryo transfer. From there we waited for my period.

During our wait I began getting myself organized, ordering medications, supplements, syringes and needles for injections, and sharps containers, all of which were provided by our pharmacy. I found so many wonderful resources along the way to help me organize and reduce the stress of injections. My favorite was My Vitro. My Vitro is a small business that have created organizational items that help make the process of IVF a bit smoother. I was so thankful for their Caddy and mat. It helped me organize everything I needed everyday in one place. They also offered the gel hot cold pads to use before and after injections to ease the pain of the needle pokes. They were a great resource for support since they were a couple who had also been through the IVF journey and created products they wish they had had when they were going through it.

When February 28th arrived I began my injections. I started with two evening injections. The Follistem and Menopur injections were used to increase the number of follicles and to help with the quality of the eggs. I did these every night between the hours of 6pm and 8pm in the belly, until I was instructed to stop using them on day 10. Alongside these injections I had blood work and Ultrasounds every other day to measure my progress and determine exactly when I would be ready for my trigger shot and retrieval. On day six of my cycle we introduced an injection of Cetrotide, which was also administered in the belly daily in the morning hours between 6am and 10am. Cetrotide inhibits the premature LH surge to prevent ovulation from occurring while the follicles are maturing. By March 6th my ultrasounds and blood work had become a daily routine instead of every other day. By March 7th I was done with my Follistem & Menopur injections, and by March 8th I took my last injection of Cetrotide and was instructed to take my trigger shot. The trigger shots consisted of two injections, hCG (Human Chorionic Gonadatropin) and Lupron, one in the belly and one in the muscle of the upper thigh. These two injections were used to trigger ovulation, help the eggs to mature, and make it easier to retrieve the eggs from the ovaries.

Monday, March 9th I had my last ultrasound and no injections that day which I was so thrilled about because I had a really hard time with the injections making me physically ill, causing migraines and vomiting. Everyone reacts differently to the medications and they all have different side effects. Some women don’t have any trouble with the medication, others do and that was just how my body reacted to them. Our retrieval was scheduled for the morning of March 10th and we were ready to rock. The procedure went beautifully with the successful extraction of nine eggs. Three of the nine were immature; six were mature and ready for fertilization. We did a two-day fertilization process and ICSI (Intracytoplasmic Sperm Injection), a technique for in vitro fertilization in which an individual sperm cell is introduced into an egg cell. We were thrilled to hear they all fertilized beautifully.

Thursday, March 12th was our transfer date and our two little embabies transferred smoothly. After our transfer we would continue injections of Progesterone up to the day of our pregnancy test. If we were not pregnant we would stop taking the progesterone. If we were pregnant we would continue injections for 11-weeks in the muscle of the upper booty. Progesterone is the hormone that is needed to maintain the lining of the uterus and to help support a pregnancy. Now it was time to go home, rest and wait.

After our transfer was complete, our 2-week wait had begun but I had never anticipated what would happen next. That Friday morning, I woke up to the school closings due to the Corona Virus. Our State was gearing up to take action against the spread of this deadly virus that seemed to be doubling in cases overnight. By Monday morning I read with tears in my eyes a message from the Fertility Center of West Michigan that they were suspending initiation of new treatment cycles and strongly recommended patients consider canceling upcoming embryo transfers due to lack of data on the risk if pregnancy complications when COVID-19 is acquired during first or early second trimester of pregnancy. My heart sank. I was terrified for my embabies who just days earlier were tucked into my uterus, and devastated for all the mamas out there that I had met and connected with along my journey. They had supported me every step of the way, they had become sisters and friends throughout this time and now in an instant their worlds, hopes, and dreams came crashing down.

The same day that we were informed that the Fertility Center would be postponing future cycles and transfers, we found out we were pregnant. It was a bittersweet experience at first but I have decided to make it the light that has come out of these dark times. People are dying, losing jobs, and unable to hug loved ones but through it all I was able to finally create life amongst all the turmoil and that is the most beautiful thing in the world. I am taking this time at home and resting, accepting this time as an opportunity to bond with my son before he has to share me with another baby and that is such a gift. I am taking care of my mental, emotional, and physical health and working hard to create a healthy environment to grow a baby in. April 7th is our first ultrasound and my husband will not be allowed to attend it with me to keep down the amount of exposure at the clinic. As disappointing as that is, I am thankful that they are taking these precautions and count my blessings everyday that we have even made it this far because I know so many would love to be in our shoes.

So I ask you to be gentle with yourself, be forgiving, and be kind. Allow yourself to break down and cry, you have earned it. But also be strong, be safe, and be vigilant because your time will come. Take this time if you are able to show yourself some self-care. Eat healthy, exercise, and brain dump into a journal so you can sleep soundly at night. Reach out to me, or a friend along the way, when the days get hard because you are not alone and your story needs to be heard so that others do not feel alone in this time of isolation.

Jen Smits is the Office Manager at Grand Rapids Natural Health.

 

postpartum physical therapy

Postpartum Recovery

Have you ever heard of an athlete getting back on the field after a major injury WITHOUT a period of rest followed by intense rehab? Of course not! But somehow the expectation for women after their pregnancy is to mysteriously “bounce back” to normal activity, appearance, and function without any guidance. Most mamas even attempt to do this while caring for one or more very adorable, yet extremely needy human beings.

Wow!!  Just writing that paragraph made me feel anxious!  Thankfully our society is beginning to recognize the fact that child-rearing is hard work and calling in reinforcements is acceptable and often necessary.  Thank you doulas, lactation consultants, counselors, chiropractors and more for all that you do!  I would like to propose that a Women’s Health Physical Therapist should ALSO be part of your postpartum team.

Women’s Health Physical Therapists specialize in the changes that occur within your musculoskeletal system (muscles and bones) during and after pregnancy.  They often have additional training in pelvic health which means they have specialized skills in how to assess the pelvic floor’s function from an external as well as an internal perspective.

Let me tell you a story about how one woman’s body changed after having her first baby; let’s call this woman Susie. In the delivery room, Susie’s baby made its way through the birth canal so quickly that Susie’s perineum had very little time to stretch to make a clear path for her baby to exit.  Susie ended up with significant perineal trauma that required stitches to repair.  After the delivery, it was painful for Susie to walk around her hospital room and sitting proved to be very uncomfortable as well.  She faithfully rested and used her ice packs for pain relief in hopes that with time she would feel better.  As time went on and she saw other new moms grocery shopping, going for walks, and starting to exercise again, Susie started to become worried that she was falling behind in her postpartum recovery!  Not only was she still having pelvic pain that got worse with activity, she was now having rectal pain that filled her with dread each time she felt the urge to have a bowel movement.  Susie was given the go ahead to return to sexual intercourse and begin exercising again at her 6 week follow-up appointment with her OBGYN, but she knew there was no way she could tolerate these activities without experiencing a lot of pain.  Susie had proactively participated in Physical Therapy before delivering her baby, so she bravely asked for another referral.

Although a woman’s body is going to be forever changed after participating in the miracle of creating life, mamas shouldn’t feel like they’re left with a body that is broken.  Physical Therapists want to give you tools and strategies that keep you strong so you can participate in activities that make you healthy and happy inside and out!  We want you to lift and chase after your little ones, return to intimacy in an enjoyable way with your partner, and be able to participate in activities like barre classes, 5ks, and nature hikes. Sometimes it is a common misconception that women “pee when they sneeze” BECAUSE they had a baby, it’s “normal for sex to hurt” BECAUSE they had a baby, or “vaginal heaviness” occurs BECAUSE they had a baby.  While it’s true that these things commonly HAPPEN after we’ve had babies, they aren’t normal or inevitable after having children, and it will likely require more than just lots and lots of kegels to solve these problems.

Let’s check in with Susie again to see how things turned out after going to several Physical Therapy appointments. Susie learned that her pelvic floor and surrounding muscles were very tight (kegels were NOT recommended) and that she needed to learn how to combine breathing, stretching, and relaxing positions to maintain a relaxed and healthy pelvic floor.  Her Physical Therapist performed manual techniques to break up scar tissue from her episiotomy which improved the elasticity of her perineum. They even taught her how to work on these things at home on her own between sessions.  With hard work and guidance from her Physical Therapist, she was able to enjoy sex with her husband again, have bowel movements with less pain, and exercise with confidence because she had learned safe ways to move her body.

Physical Therapy for mamas can be done during your hospitalization, at an outpatient clinic, or even in your own home! And while there are lots of therapists just waiting for mamas to walk through their doors, it isn’t standard for Physical Therapists to be included in postpartum care in the United States.  Good news though, they are accessible and sometimes even covered by insurance when you seek them out. You’ll know you’ve found an exceptional Physical Therapist when they ask about your specific goals, give you tasks to complete at home between sessions, and you notice progress after each session.

Knowledge is power, and I hope that this information empowers you to feel comfortable talking to your providers about Physical Therapy or seeking it out on your own.  Mamas do incredible things and they deserve to have the resources they need to live their best life.

Newly postpartum and ready to get started? Download this FREE handout to start your postpartum recovery journey today (even useful for mamas still in the hospital!)

If you’re ever looking for free information from the perspective of a mama and Physical Therapist, I put out videos weekly on my YouTube channel. I also offer 1 on 1 Physical Therapy Evaluation and Treatment sessions for moms living in West Michigan and offer an Online Postpartum Recovery Course for moms that don’t have the time or resources to get out to appointments.

Investing in your health is one of the best investments you can make. Become a STRONG mama so you can grow a STRONG family!

Dr. Nicole Bringer, DPT
Owner of Mamas & Misses, LLC
Email: nicole@mamasandmisses.com
Phone: (616) 466-4889

 

Perinatal Mood Disorders: Podcast Episode #91

Today we talk with Elsa, a therapist at Mindful Counseling in Grand Rapids, Michigan who specializes in perinatal mood disorders.  Learn what postpartum anxiety and depression look like, how they are different, and signs to look out for.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with Elsa Lockman from Mindful Counseling.  She’s here to talk to us a bit about postpartum anxiety.  Elsa specializes in the following areas: perinatal mood disorders, which includes postpartum depression, anxiety, OCD, grief and loss, eating disorders, and body image issues.  She also works with clients dealing with relationship problems, coping with medical illness, trauma and abuse, women’s issues and self-esteem, and mood disorders and anxiety.  So obviously, you’re a natural fit working with clients who struggle with everything from eating disorders to anxiety and depression, transitions in their relationships, and expanding their family or having their first child.  So today, Elsa, let’s focus a bit on the difference between postpartum depression and anxiety and what women can do if they’re interested in seeking treatment and getting help.

Elsa:  Yes, postpartum depression and anxiety can go together.  Sometimes women will struggle with anxiety with depression.  Sometimes it is separate.  Postpartum anxiety and depression can look very different.  People classically think of postpartum depression as mothers who don’t connect with their babies, moms who are checked out and can’t get out of bed all day.  That’s actually not always the case.  Often, women with depression are exhausted and often can’t stop crying.  They can’t look, maybe, on the positive side or think rationally.  As far as the anxiety, it can come out more in not feeling necessarily down but feeling like you can’t relax; feeling that something bad is going to happen at any time.  Having thoughts of something happening to your baby; scary thoughts.  Sometimes even flashes of images of very violent things happening or the baby falling, and moms often feel guilty for those, actually, and don’t tell anybody, but they’re actually really important to talk about.

Kristin:  I had a friend who was afraid of driving in her car or anyone driving her baby.  There can be a lot of, like you said, those intrusive thoughts.

Elsa:  Yes, and it’s obsessive sometimes and you can’t get it out of your head.  So rationally, you can say, I’m not going to drop the baby going down the stairs.  I have the baby in my hands.  But it keeps going; it gets hooked, the idea or the image, and then they’ll struggle with almost a loop where it just can’t get out of your head.  Or anxiety can present sometimes in something around sickness.  No germs.  Thinking that my baby is going to get sick; I can’t take her out to the store, and I can’t take her to this house.  And how far that goes; I mean, some of these are common sense, and you want to take care of your child, but then how far does it goes?  Does it prevent you from doing things that you want to do, or do others notice that maybe this is being a little unreasonable?  It seems to be causing you even more anxiety to be thinking some of these things.  Another part is that sometimes anxiety can come out as anger.  Feeling just angry and irritable; feeling tense.  That can come out, obviously, with partners, and they can notice it.  Being different, a marked change from before for women.  Those are some of the symptoms that come that people can notice with anxiety.  Another one would be sleeping; when moms can’t sleep when the baby is actually sleeping.  That’s another sign of postpartum anxiety for people to watch out for.

Kristin:  Sure.  That makes sense.  I know even with postpartum doulas in the house, some women still struggle with fully sleeping even though their child is being care for by someone else. And sleep is so essential.  There are so many studies on how, if you’re not getting enough sleep, it can lead to mood disorders and anxiety and so on.

Elsa:  Yeah, it just leaves women very vulnerable, and now it’s become so normalized that part of the postpartum world is just not getting sleep.  And I think it’s also expected that women are also just supposed to go on with their lives and do all the normal things that they’re supposed to do even when they’re running on little to no sleep, and this goes on for weeks or months.

Kristin:  Yes!  So what resources would you suggest if they’re looking for help?  Obviously, we can talk about how to reach out to you!

Elsa:  For sure!  You can definitely contact Mindful Counseling GR.  You can contact Pine Rest.  They actually have a mother baby unit, so they actually have therapists that have specialized training, like I do, to work with women postpartum.

Kristin:  And now Pine Rest even has the ER when you can —

Elsa:  Oh, the urgent care center?

Kristin:  Yes, the urgent care center.  They can go in at night and not have to go the hospital.

Elsa:  yeah, they can go to the urgent care center and get assessed and get attention or treatment a lot quicker.  OB offices have a list of therapists who are trained and specialize with postpartum or perinatal mood disorders, which includes anxiety and depression in pregnancy and postpartum.  So there’s a list that you can ask for from your OB, as well.

Kristin:  Great!  How do they directly reach out to you?  Are you accepting new patients, Elsa?

Elsa:  Yes, I am!  You can reach out to me by contacting me through our website.

Kristin:  Perfect!  Thank you for coming on today!

 

Deb Timmerman Stress Mastery

Stress Mastery: Podcast Episode #85

Deb Timmerman, RN, DAIS, CSME speaks with us today about her new certification in Stress Mastery.  What does that mean, you ask?  It’s all about learning positive ways to handle stress and actually master it, instead of letting stress take over.  Listen to see how this can help parents throughout pregnancy and postpartum.  You can listen to this complete podcast episode on Itunes or SoundCloud.

Alyssa:  Hello, welcome to Ask the Doulas Podcast.  I am Alyssa Veneklase, and I’m so excited to be talking to Deb Timmerman today.  I haven’t seen you in so long!

Deb: Hi, Alyssa, it’s great to see you, too!

Alyssa:  For a little while, we had you teaching a prenatal stress class here, and then life    and business just got kind of in the way, and we haven’t scheduled any more, but I loved that class.  You have so much good information about stress and how stress affects the body, but now you have some new certifications where you’re actually talking about how our bodies need stress to a certain extent; is that correct?

Deb:  I am.  So I think maybe the first place to start is, why the prenatal stress education?  I’m a member of the Michigan ACEs Initiative Education team, and that’s not a formal name, but a couple years ago, Michigan got some grant money to bring the ACEs study — ACEs stands for Adverse Childhood Experiences study — and the consultants who were involved in that study, they actually set up a agreement for them in Michigan to use the ACEs science to see how we could change the way we’re delivering healthcare in Michigan.  So the ACEs study is all about things that happen in childhood, like dysfunctional household, abuse, neglect, and you basically get a score for the ten questions that are on this little survey, and what they found was that the higher your score, so if these things happened to you from 0 to 18, the more likely you are to have emotional, physical, mental health issues as you age, and it even cuts time off your lifespan.  As they began to do further studies after that, they found out that some how we deal with stress actually affects our genes and is passed on when you have a baby.  That’s a long answer to that, but I think it’s really important because it’s where kids get their start, and if you don’t know about that, you can unknowingly pass on certain things to your kids.

Alyssa:  You are in this high-stress environment while pregnant.  It’s affecting your baby?

Deb:  Yes, it is.

Alyssa:  And I remember the movie.  It was called Resilience?

Deb:  It’s called Resilience, the science of stress, biology of hope. Or maybe that’s backwards; biology of stress; science of hope.  Anyway, you can find it, Resilience, and there’s a trailer out.  Yes, really interesting movie.

Alyssa:  It is.  Tell me about your new certifications and this new idea about stress.

Deb:  Okay.  I was an ACEs kid.  Out of ten, my score was six, and when I learned about that particular piece of data in my life, it clarified everything for me.

Alyssa:  And six is high?

Deb:  Six is high, yes.  Anything over four, it really increases your chances and your risk level.  So I had a lot of health issues when I was in my 40s.  I fell down a flight of stairs on my summer vacation, had a bad injury from that.  But also was extremely heavy.  I weighed 321 pounds, and I was on diabetes medication and high blood pressure pills, and I had a really high-stress job.  And my family life was nuts.  So I happened to go to a conference, a nursing conference, and heard about this, and it was like I had discovered something really critical.  It was like the missing puzzle piece for me to figure out why I reacted or had the habits that I had, and as I started to travel down that road, I became really interested in sharing that information with people because I think it’s key.  We spend a lot of money on the back side of health, taking care of chronic illness.  My thought was, wow.  This made a huge difference for me.  What if I could share that information with folks?

Alyssa:  And it’s probably worth noting that you are an RN?

Deb:  I am an RN.

Alyssa:  And that’s what you were doing in your previous life?

Deb:  I did, and I didn’t know about that particular study at that time, and I wasn’t — I mean, they cover the stress response in nursing school, but not to the point with all the brain science and all of that.  So in the last 20 years, they’ve made huge discoveries, and it’s super interesting.

Alyssa:  When did you leave the nurse world?

Deb:  Four years ago, I left the nurse world and started my own practice, but I had trained as a healing touch practitioner.  In 2009, I started that, and I don’t remember when I finished, but I was never able to use that in a private practice, but I did in my buildings.  I was a nurse manager in both of my previous jobs, and I found that when you teach people those self-care skills, it really changes your culture, and it made us care about each other.  When we care about each other, we do better with our patients and the folks that we’re charged with caring for.

Alyssa:  So you taught the other nurses or the patients?

Deb:  Eventually, we did teach nurses healing touch at the hospice, which was my last job, but there are all kinds of other really cool interventions that you can do to build capacity for stress management, and those are the things that we worked on.  You mentioned the stress certification.  I’ve been a diplomate of the American Institute of Stress for a couple years, and you get that designation based on the amount of training that you’ve had regarding stress and how you’ve used that to help other people, and at the end of last year, this little thing came in my email box, that they were doing a beta for this stress mastery educator certification, and I got invited to submit an application.  I was one of 40 people throughout the world that was chosen for beta one, and we worked with Heidi Hannah.  She’s a Ph.D. researcher and stress mastery educator and teaches at Harvard, and she has all these other amazing professors and Ph.Ds. who share this information, so I was super interested and hoped I would get selected just because I thought it would be really neat to learn from these people.  And it has been beyond my wildest expectations.

Alyssa:  What is stress mastery?

Deb:  We talk about stress management like we have to manage stress, but we actually need some stress in our life to help us grow, learn, and adapt.  And when we master something, it means that we learn to dance with it in a positive way, and we use it to fuel positive change versus working on controlling what’s going on in our life.  So I actually now help people build their capacity versus teaching them how to manage it.

Alyssa:  Build my capacity to deal with stress instead of trying to reduce it or eliminate it?

Deb:  Yeah.  The way we do that is through evidence-based practices like the healing touch that I did.  That was one thing I had under my belt, but since then, I’ve become a Tai Chi Easy Practice leader.  That’s all about Qigong breathing and moving meditation.  I’ve also gotten a certification in mindfulness and meditation.  Breathing and some of those other key interventions that we can do on a daily basis throughout our day are really what helps stop that stress reaction and helps us build that capacity.

Alyssa:  What if somebody is like you before with a really stressful job and a stressful home life?  All these stressors: you don’t want people to try to eliminate some of that?  You just want them to learn effective ways to cope?

Deb:  Well, I don’t think that you really — coping means that we have to continue to deal with it, and yes, you do have to decide what you’re going to work on first, and there are certain areas of life that you’re going to have to make some decisions about and maybe pare down, or maybe that job is really horrible for your health and it’s time for you to move on.  So we do validated stress assessments to figure out what areas of your life and out of sync and where your stress issues come from so that you can make good decisions.  Oftentimes, when you’re in the midst of it, you just know that the world is falling down around you, and you don’t have any clarity about where that stress is coming from.

Alyssa:  So how do you differ from a therapist or a counselor?  Or do you also kind of work that in?

Deb:  I would say I work in tandem with a therapist or a counselor.  I’m not going to talk to you about all the things that happened to you in your childhood.  I don’t get into all of that.  We use the ACEs screen as a way to help you recognize how your stress patterns developed and then look at the different areas that are out of balance in your life, and then I’m going to teach you how to do a daily practice to help yourself not be so triggered.  Triggers and tamers, I would look at; what are you stress triggers; how can we work with that; what kind of language are you using with yourself.  That negative stuff breeds more negativity.  How can we switch that around to help you have a more positive outlook?  I do a lot with breathwork.  It is one of the easiest ways to get that stress reaction to moderate and to get you into that rest and digest state so that you can think clearly.  The way the brain is organized, the brain’s number one job, priority one, is safety.  It’s always scanning, looking at the environment, trying to figure out how to keep you safe.  The stress reaction is what keeps you safe.  It gives you that juice, that bolt, of adrenaline to get to safety.  But when you’re stuck in that feedback loop and that’s your whole life, you really can’t think and use the part of your brain for higher executive functioning because that feedback loop kind of gets in this little track.  Do you know those people in your life, where they’re kind of stuck in that?  Things are always falling down around them.  Some of the exercises for building capacity are to be able to get that to shut off so that your brain can actually rewire and build new circuitry for that.  That’s capacity-building.

Alyssa:  Do you think everyone in general could benefit from some sort of practice?

Deb:  Absolutely.

Alyssa:  It’s not just the high anxiety, panic mode — I mean, I think we all feel it at some point, right?  So even if you don’t have it on a daily basis, you’re noticing it — like you said, what are your triggers?  So how do you — we talked a little bit about prenatal.  What about a postpartum mom who has sleep deprivation working against her, as well, and then maybe new triggers that she didn’t even know existed before, who says I don’t have time to do Tai Chi with you.  Are you crazy?  I can’t do Tai Chi and meditate.  How would you help a mom who came to you and said, what can you do for me?

Deb:  I would tell a mom like that, what did you do to take care of yourself before, and what are you doing now?  Typically, when a new baby comes in or there’s a child, they take first priority, and oftentimes, moms are trying to work and take care of this, and the demands are huge.  So first we would walk through, what are you doing now?  What did you love?  What do you have time to do?  How can we structure something so that you give yourself some attention every day?  We’ve all heard that adage, you can’t give from an empty cup.  That’s super important.  Your child, from zero to three, learns from serve and return, and you need to have the energy to show up for your child every day so that that child learns to feel safe with you, cared for, and loved.  If you don’t have that ability for your child, then you’re going to be suffering with problems further on down because your child develops anxiety, sleep issues, all those things.

Alyssa:  And what do you mean, develops from serve and return?

Deb:  Babies mimic what we do to them, the cooing, the eye movement, hugs, kisses.  That’s serve and return.  When you’re munching on your baby and nuzzling, that actually builds their neural circuitry and helps them feel safe.  It’s a normal part of development.  We used to think that babies got all their neurons and they were never going to get another one after they were born, and what you had, if you didn’t use, you would lose.  There’s a little bit of truth to that.  What gets paid attention to develops, and what doesn’t eventually kind of gets pruned away.  There’s a process actually called pruning in the brain.  But we know that neural circuitry actually develops now from our experiences and the things that happen in our world around us, so you want to create that loving, safe environment for your baby, and if you come home stressed out and you have nothing else left to give, are you doing the right thing for that child?

Alyssa:  So zero to three is really, really important?

Deb:  Very important!

Alyssa:  Into my brain is popping this video I saw where a mom gives a sad face or a mad face and the baby mimics that.  There’s an actual study, and I’m forgetting the name of it.

Deb:  I don’t know that particular study, but the Center for Child Development at Harvard does a lot with that serve and return, and they actually have a campaign going right now.  I’ll post that link on my website, and you can look at that if you’re interested.  Lots of wonderful videos about how the brain develops and why that’s so important.  Back to the mom: trying to figure out what she can do within her day to recharge her batteries is super important.  Actually, I just met with a mom this morning.  I think her little guy is four, and then she’s got one that’s maybe two.  And she said that they just went through a period of stress where their family dog was sick, and they had some financial issues, and their older one started acting out.  My question to her was, and what was going on in your household?  She said it was chaos, and then she looked at me and goes, oh, crap, he saw that, didn’t he?  So yes, that is exactly what happens.  And their job is to build a relationship with you, so if you can’t be present, they’re going to act out because they’re trying to get their needs met.

Alyssa:  They notice everything.  My daughter is six, and nothing gets by her.

Deb:  I think I saw a picture with her meditating someplace when you were off, and I thought, wow, Alyssa, that’s awesome.  What a great skill to teach your child!

Alyssa:  Well, it’s amazing even in schools now; I think they know the importance of this.  They’re teaching yoga.  They’re teaching mindfulness.  They’re teaching meditation.  And even if it’s only once a week — I never had that as a kid.

Deb:  Well, and when it becomes part of what we do as our daily practice, it becomes easy.  It becomes habit.  So then it’s not like you have to spend all this time on self-care.  You have it integrated into your day.  That’s really my job; to teach you how to discover all these different practices that might speak to you because what you love isn’t necessarily going to be what someone else loves.  Figuring that out, and then how do you work that into your day, and how do you sustain that for long term?

Alyssa:  That’s the hard part, especially as a mother.  My days are never the same, so I would love to be able to say, from 9:00 to 10:00 AM every day, I’m going to do this.  Doesn’t happen.  I mean, on top of that, I’m a business owner, too, right, so the day just gets more hairy.  But having someone say, okay, well, let’s figure out something that can work for you.  If you can’t do it at 9:00 today, let’s do it at 8:00.

Deb:  The newest research that’s out there is that you should start your day with that practice before you even hop out of bed, and my favorite go-to is a guided meditation.  It’s the thing that always made me feel really good, and it’s the thing that I teach because I love it.  There’s lots of them on YouTube, and the cool thing about YouTube is you can pick the amount of time that you have.  Maybe today you have five minutes, and tomorrow you have ten, but building that and scheduling that into your week.  And then because there’s so many different ones, you could pick the rate of speech, the kind of voice.  Like, I have one that I love at night.  It’s an Aussie guy who does a sleep thing that’s maybe 26 minutes.  I’m never awake by the end of that.  I usually wake up the next day and it’s still frozen on my iPad.  It’s wonderful.

Alyssa:  For someone who has never experienced a guided meditation, you could choose some with or without talking?  Or do they all have talking?

Deb:  A guided meditation typically is something that helps cue you by voice to pay attention to your body in the here and now, and there’s all different kinds of scripts out there, but for someone who’s just beginning, I think a breathing thing, a couple minutes of breathing, is really good, and then after you get comfortable with that, you can explore.  We know that the brain needs 10 to 20 minutes of that prime-timing in the morning, but truly, any time you can do 30 seconds or more with focused attention on that effort, it’s still beneficial to your body.

Alyssa:  My Apple watch actually does that for me.  It will tell me when to breathe.

Deb:  Yeah, it has a breathing app.  Perfect.

Alyssa:  So that alone, if I do it — most of the time, I’m somewhere that I can’t do it and I just dismiss it.

Deb:  If I was working with you to coach, I would talk about what you already have in place, and we would work on building that.  How could you work that into your day, and really, even if you’re in a meeting, you could excuse yourself, go to the restroom or whatever, if you were that committed, or reset your watch or program it so that it works around your meetings.  Those are all things that you can integrate into your day.

Alyssa:  I love it.

Deb:  It’s easy.

Alyssa:  I mean, it is.  We just find excuses of why we can’t or shouldn’t.  I just feel like we’re always full of excuses.

Deb:  Well, I think that’s what I’ve appreciated being part of this stress mastery educator process.  Heidi is wonderful at being able to package things in a way that are easy and doable.  Three steps to getting your stress mastered: assess, appreciate, adjust.  Figure out where you’re out; appreciate what you can learn; and then those tools to adjust.  And then the BFF model, so yeah, being your own best friend, but it really stands for breathe, feel, and focus.  It’s really that simple.  We make it difficult because we think it’s this thing that has to take a lot of time.  What takes time is changing the habit, but once it gets integrated, then it’s easy.

Alyssa:  And then coming full circle here, working that in to your daily practice and having your children see that as part of your practice, right?

Deb:    Yes.

Alyssa:  Because then they are like, oh, this is just something we do.

Deb:  Yes.  Last week, I actually taught teachers how to look at their own stress, a group of 20, to look at what was happening, and they got to choose the track that they wanted to be in, so at the start of the two days that we were together, why are you here?  My mother in law is driving me crazy; I need to figure out how to get hold of my stressor.  At the end of my day, I have nothing left for my family.  Starting with the ACEs piece that we talked about and recognizing how they developed the way they look at stress.  What were the patterns?  What are their triggers?  It was really beneficial for them.  Many of them have ACE training otherwise in their classrooms, but they don’t know how to apply it to their own lives.  I mentioned that puzzle piece for me.  That was it.  Okay, now that I understand how I developed it, now I can shift because I can appreciate how I got where I am and make those adjustments.  It makes it a whole lot easier than someone saying, oh, I have to do these ten things today because I have to manage my stress.  At the end of the two days, it was so fun to go around in the circle and to hear them say what they learned about their own issue and what their one takeaway was going to be and how they were going to integrate it.  You can throw out everything you’ve done and say that you have to start with ten things, but the reality is, we don’t have time for that, and it needs to be graduated.  You start with one thing, two things, three things, and pretty soon, you start to feel the shift, and then you’re motivated to do the rest of the work.  So yes, they’ll go back and model that, hopefully, for their students.

Alyssa:  For their classroom, yeah.

Deb:  I taught some interventions, some Tai Chi interventions, moving meditation, breathwork, short meditations.  You don’t have to come up with all the stuff on your own.  There are tons of resources out there.  My job is to just share those resources with you and have you pick what you want.

Alyssa:  Tell us how people find you.  I know you have a website.

Deb: Yes, and you can follow me on Facebook.  Deb Timmerman is my name.  I’m on LinkedIn.  Same thing, Deb Timmerman, RN.  And then on my website.

Alyssa:  And people can find you there?

Deb:  They can find me there.

Alyssa:  Ask questions?

Deb:  Ask questions!

Alyssa:  And set up a consult?

Deb:  Yep, sure can!

Alyssa:  Is it just kind of like booking an appointment?  And what do appointments look like — 30 minutes, 60 minutes, 20 minutes?

Deb:  I typically offer an assessment or at least a meet and greet first to find out if we’re even compatible in working together.  That’s usually a 30- or 45-minute, either online; we can do a Zoom call, or we can meet in person if you’re local over coffee, and finding out what your goals are.  What is it you hope to learn?  Why did you call me?  What’s your reason?  What’s your motivation?  And then I would recommend, based on that appointment, what I thought was a good strategy for us and how long that might take and what that would cost, and then we would work together.

Alyssa:  Excellent.  Are you covered by insurance or not?

Deb:  We are not at this point covered by insurance, but I think that’s going to change because there is a big shift with all this ACEs movement, and they’re all getting on board.  Yeah, but in terms of investment, I think — my job isn’t to stick around forever.  It’s to give you those tools so that you can go on your own, and if you need a little check-up now and again, that’s easy to do.  We offer all kinds of online resources for people, and a podcast.  There are medications on there that you can do.

Alyssa:  What’s your podcast called?

Deb:  It’s called Mindful Moments.

Alyssa:  How fitting!

Deb:  Those podcasts, there’s always a little nugget of information.  Usually, they’re short, 7 to 8 minutes, but there’s a couple that are 20, like if you need a longer relaxation and have time.

Alyssa:  I will have to look it up myself!  Thanks for sharing!

 

Health for Life Grand Rapids

Preparing Your Body For Pregnancy: Podcast Episode #84

Dr. Nave now works with queens through her virtual practice Hormonal Balance.
We talk this time about how a woman can prepare her body for pregnancy.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Alyssa:  Hello!  Welcome to another episode of Ask the Doulas Podcast.  You have Kristin and Alyssa here today, and we are excited to be back with Dr. Nave, the naturopathic doctor at Health for Life GR.

Dr. Nave:  Thanks for having me again!

Alyssa:  Thanks for coming again!  Last time, we had an amazing conversation about a woman’s cycle, and today, we want to talk about actually preparing your body for pregnancy.  What do you want to say?

Dr. Nave:  Well, that ideally, we would start a year ahead.

Alyssa:  One year ahead?

Dr. Nave:  One year ahead.

Kristin:  Does that mean they should be off birth control one year ahead, or would you advice getting off of an IUD or birth control pills in advance of that year?  That’s my question because that’s something that is commonly asked.

Dr. Nave:  That’s a great question.  Even though ideally I say a year, if a woman wanted to, say, get pregnant in less than a year, then I would suggest, if she’s coming off of an IUD that has hormones in it or an oral contraceptive, to stop taking it at least three months before starting to try to conceive.  That’s because the oral contraceptive and the IUD with hormones is basically producing the hormones that your body should be responsible for making, and what women often find is that once they stop using those — because, basically, it’s suppressing the body’s own production of hormones.  She’ll find that she doesn’t have a period for an extended period of time, and I would also want her to detox her body and make sure that she’s pooping regularly, that her hormones are being made at an optimal level, and basically establishing what the normal and optimal cycle should look like.

Alyssa:  So if you’re preparing your body for a year, then that means you can stop at three months?  So the three months is just a part of the year?  Twelve months ahead of time of when you would ideally like to be pregnant, you’re going to talk about what to do; but then three months before, minimum, is when you should get off a hormonal birth control pill or IUD?

Dr. Nave: Yes, because it gives your body time to normalize your cycle and it prepares your body to actually hold a baby so that it can grow.

Alyssa:  So then what do we start doing at twelve months out

Dr. Nave:  It’s basically a multifactorial approach.  It’s stopping the things that interfere with your hormones, like oral contraceptives or getting the IUD removed.  Also cleaning up her environment, so skin care products, household items, household cleaning supplies, being more environmentally aware of the things that she’s using, the foods that she’s placing into her body.

Kristin:  If she’s coloring her hair and things like that?

Dr. Nave:  Right, if she’s coloring her hair, nail polish, things like that.  And then we would also want to address nutrition.  A lot of the foods that are really accessible, like going to fast food or going to a restaurant, are foods that promote inflammation.  They tend to be higher in trans fats and refined sugars, which are all shown to increase inflammatory products in the body.  We want to reduce that by making sure that the woman is eating more whole foods.  When I say whole foods, I mean from the earth; no one processed it.  If you’re getting it frozen, that’s fine too, as long as someone didn’t already make it into a meal, so that you have more control and autonomy over what is being placed into your body.

Alyssa:  What does inflammation do to affect fertility?

Dr. Nave:  With inflammation, we have more cortisol.  We have dysregulation of blood sugar.  We have greater likelihood of mental and emotional disorders.  It wreaks havoc on us.

Alyssa:  It’s a lot of what we talked about last time with the cycles; if you’re not having a regular period, your cortisol levels could be too high, and that disrupts everything else?

Dr. Nave:  Right.

Alyssa: And inflammation kind of does the same thing to your body?

Dr. Nave:  Right, and things that can influence inflammation is not just the food that you eat, but being in a constant high stress environment and not managing that effectively or not having tools to really take care of yourself and having self-care.  Self-care is not selfish the way that people typically think of it as being, but more so, it’s nurturing.  Nurturing of yourself.  Think of the year leading up to pregnancy as rediscovering yourself, as reconnecting to who you are, and getting in the mode of, “I am ready to carry a baby to full term.  I am ready to add a new life to my life.”  It’s getting connected to that.  Also processing your past traumas.  Mental and emotional health is absolutely important with regards to getting ready to conceive.  Ideally, I wouldn’t want someone to be seeing conception as a solution to a relational issue because it probably won’t be, and it will probably exacerbate a lot of those things.  So during that year leading up, it’s dealing with your past traumas, whether they be related to a miscarriage previously; processing what happened and how it affected you, not just trucking along to get pregnant again, but really fully processing it.  Not necessarily living in it, but not pushing your emotions aside because they are valid.  Whatever you haven’t dealt with — and this is not guilt any woman by any means — but whatever we haven’t dealt with, that influences the baby.  That influences the baby’s risk for depression and anxiety.  It influences the genes and their susceptibility to different types of conditions.  In that year, by you taking care of yourself, you’re taking care of that baby in advance, as well.

Alyssa:  The baby you haven’t even had yet?

Dr. Nave:  The baby you haven’t even had yet; you haven’t even conceived yet.

Kristin:  So what if a woman is a constant dieter?  How do you handle women who are, say, on a fad diet, if they are wanting to conceive?

Dr. Nave:  I really like the book Intuitive Eating.  It’s written by two dieticians, and before mindfulness eating was a thing, these two dieticians came together, and they were like, diets don’t work.  Diets are a lie, and I completely agree with that.  If you think that, oh, I don’t have enough will power — you’re not the one failing.  The diet is failing you, because they weren’t built to work.  They’re not sustainable, at least the diets that people often purport.  Now, I would like to reclaim the term diet, because diet just means eating.

Alyssa:  What you’re eating, right?

Dr. Nave:  Right, right.  And so if you view your diet, if you view your food, as nourishing yourself, as honoring yourself, you fully immerse yourself in the experience of eating, like smelling the food.  You eat with your eyes first, so viewing it; it’s appetizing.  You smell it; you taste it.  You savor the textures that are in your mouth and the flavors that are bursting on your tongue and really immerse yourself in that and sit in that and be mindful.  Then you have a greater connection to yourself.  You are then more apt to tell when something isn’t going well.  If a woman is a fad dieter or is using food as a coping mechanism, we would then assess what is food giving you that you are not at this time receiving.  And so talking about that, having her read the Intuitive Eating book, because it goes through what type of eater are you, and reconnecting yourself to that intuitive eater, because as children — have you ever watched children eat?  They do not sit.  They get up, they eat what they want, and then they go back around and play.  At some point, we lose that ability to tell when we’re hungry or when we’re craving something and really honoring that, and intuitive eating is all about getting back to that.  SO I would definitely work with her and address, when did this first start?  What is it giving you?  What is it not giving you?  What is your motivation for doing things in this way?   Because what is encouraged by the media as what a healthy weight looks like is very cookie cutter, and I’m all about individualized care.  If you look at someone’s bone frame and they’re really thin and they have big bones and they look sick or they don’t feel well, that’s not good.

Kristin:  And then fitness is obviously a big question many of my birth doulas clients have.  What should they do in preparation?  If I was with them for the first delivery and then they want to conceive again, what would be an acceptable form of fitness as you’re trying to conceive?  What should you do to get your body ready for birth and postpartum time?

Dr. Nave:  If you’re already exercising, just maintain it.  Don’t go overboard.  Don’t become sedentary.  Moving your body at least ten minutes per day — ideally, thirty minutes, but that thirty minutes doesn’t have to be in one chunk.  Being consistent is more important than doing things really hard and really intense in a short period of time, so if she’s already exercising, just keep doing it.  You’re doing great, Mom.  Now, if she’s excessively exercising, that could be another thing that’s causing amenorrhea.

Alyssa:  Yeah, I’ve had friends who have been extreme athletes who just don’t get their period.

Dr. Nave:  Right, because all the hormones are being turned into something else as opposed to getting turned into progesterone and having adequate levels of estrogen so that you can bleed.  And I know some women are, like, oh, I didn’t bleed for a really long time and I’m so happy, but…

Alyssa:  Our bodies do this for a reason, right?  It needs to happen.

Dr. Nave:  Right, it needs to happen.  When you shed the old — think of it as shedding the old.  It’s a new month; I’m shedding the old from last month.

Alyssa:  It’s like a natural cleaning, almost.  It’s like a detoxifying — yeah, just — it seems like anything else that stores up in your body that needs to be shed can create toxic levels of something.

Dr. Nave:  Right, absolutely.  It can create adverse symptoms.  Having too much estrogen is not the best thing in the world.  Last time, we talked about estrogen dominance and how that can influence having more PMS symptoms like bloating, for instance, and being more weepy on your period.  If you’re not having your period, then you’re basically reabsorbing the estrogen and that could by your PMS looks that way.  But I digress.

Alyssa:  I have one question before we move on to whatever you want to talk about next.  Even with, like, what we’re putting on our body and our environment — so there are things that are called hormone disruptors, things that will disrupt your hormones, right, like in the products that we’re putting in and on our body?

Dr. Nave:  Yes.

Alyssa:  What do you know about that?

Dr. Nave:  Those are parabens or phthalates.  They’re actually made from crude oil, which is refined and you can get parabens and phthalates.  You get mineral oil from it; you get the gas that you put in your car from it.  All of these things come from this product.  Why parabens and phthalates are an issue is that, basically, they act like estrogens.  Then that can be part of the estrogen dominance.  It can also affect increased risk for breast cancer.  It can affect mental and emotional health because remember I said that estrogen can increase weepiness or having a lower mood on your period.  Ovarian cancer; you have an increased risk for that because it’s an exogenous estrogen.  It acts like estrogen; technically it’s not estrogen, but our bodies respond to it in that way, which can also lead to extra weight.  On the topic of weight, if you want to lose weight before getting pregnant, you would want to do that in a year before trying to conceive because with exposures to things like parabens or phthalates, which — technically, they’re solvents, so you would usually pee them out; however, if you have higher levels of them or if you’re being continuously exposed to it, our bodies store it as fat.  Then, when you’re trying to lose the weight, you’re releasing it back into your bloodstream, which can create symptoms like headaches or feeling really lethargic when trying to work out.  It’s not necessarily because you’re working too hard, but it could because your body is working on detoxifying or biotransforming these things so that they’re no longer toxic to you so you can pee it out and poop it out.

Alyssa:  So if you need to lose weight, that needs to happen before this twelve-month timeframe of detoxing before you get pregnant?

Dr. Nave:  It can happen in that twelve months.  You can start it before that because then you don’t have as much to do during the twelve months.

Alyssa:  But it should be one of the things that you’re thinking about a year ahead of time?

Dr. Nave:  Yes, because there are so many things that we use on a daily basis that, if we really thought about them, I think most of us would be scared to leave our homes, but we have to live, you know.  We need things in order to live efficiently and not work as slow, I guess.

Alyssa:  Well, if you think about the chairs we’re sitting on.  These are as eco-friendly as we could find, but the majority of them — there’s sprays on everything.  I looked at the new pajamas I got my daughter, and it said the flame retardant — it said that I can’t wash it in soap because the flame retardant will come off.  I was like, no.  I’m washing it.  I’m washing all the flame retardant off, actually.  But you don’t think about that.  My daughter needs a new nightgown.  You buy her a nightgown, and it’s covered in a chemical so that it doesn’t go into flames.

Dr. Nave:  Yeah.  Another of the things that the woman can do to help get herself ready before even consulting with a physician is that, with regards to environment medicine, opting to eat the dirty dozen — you can look at www.ewg.com, so that’s the Environmental Working Group.  The release the dirty dozen each year, and these are the fruits and vegetables that are the most heavily sprayed.  Opting to eat those things in season and organic, as opposed to nonorganic, and what that will do for you is — pesticides have solvents, which parabens and phthalates are a type of solvent, so they have some of those components to them.  By opting for organic fruits and vegetables that are on that dirty dozen, you don’t have to do all your fruits and vegetables organic.  Preferably, if they’re thin-skinned, like if you eat the skin of it, like tomatoes and strawberries and berries, you would want to opt for organic, but if not, at least the dirty dozen.  Make sure those fruits and vegetables are organic because those pesticides have the endocrine disruptors.  They’re things that affect your estrogen and your progesterone, and it’s not just those things it affects but your overall well-being.

Alyssa:  So because it’s disrupting hormones, it can affect your ability to get pregnant, but let’s say even while doing all this, you get pregnant.  It’s essentially affecting, again, your growing baby?

Dr. Nave:  Yes.

Alyssa:  Because you’re disrupting the hormones that the baby is using to grow?

Dr. Nave:  Yes.  So if you’re already pregnant, don’t freak out.  Don’t try to lose weight.  That’s one, because you’re pregnant, so your body is trying to use all the energy to make baby, as well as the fact that we don’t want to release any of the stored toxins in your fat to the baby.  What you can do is, if you’re going to eat fish, make sure it’s not one that’s high in mercury.  Avoiding things like swordfish, and if you’re going to eat tuna, make sure that — I think it’s albacore tuna, but don’t quote me on that — you can look at the Environmental Working Group, and there are other resources as well that list out the fish that are lowest in mercury.  Looking at your skin care products and, as much as you can and as much as is possible, avoiding shampoos and skin care products that have parabens or phthalates or sulfates in them.  It’s also because sulfates rub down your skin and it’s not as moisturizing.  We want you to look glowing and magnificent!  You can avoid those things in your skin care products and your household items and the food that you eat.

Kristin:  So cleaning products, obviously, as well?

Dr. Nave:  Yes, cleaning products.  And if anything has any fumes and you have to spray it, make sure that you have all the windows and doors open so it can air out.  If you get your clothes dry-cleaned and you have a garage, leaving them in the garage to off-gas before taking them into your house.  If you don’t have a garage, if you have them in a room where you can remove the plastic and open the door and let them air out so that you’re not exposing yourself to those fumes.  Just do that.  And then after the fact, then we can address those things then.

Kristin:  And then they would meet with you for a consultation preconception to try to get their body as healthy as possible?

Dr. Nave:  Yeah, and even if she is already pregnant, what can we do to maintain the pregnancy while also minimizing her exposure to these environmental toxins.  And her addressing her mental health during that time, if she hasn’t already started that process.  Is she eating adequate amount of calories?  Since we’re on the topic of nutrition, prenatal vitamins — you would start that at a year out.  A year ahead of time.

Kristin:  And, obviously, food-based versus the generic that you get at the normal doctor’s office?

Alyssa:  Yeah, you know, you get free prenatals at the pharmacy but they’re basically junk.

Dr. Nave:  We have very good-quality ones as naturopathic doctors, and I think DOs also have really high-quality ones, as well.

Alyssa:  So for somebody who can’t afford it, what are those over-the-counter free prenatals doing?  Are they doing any good?

Dr. Nave:  Yes, because they have folate and they have an adequate number of B vitamins.  It’s like a multi that’s specifically geared towards not only the mother’s health but also making sure that the baby can develop well.  Folate is the one that I’m most thinking about at this present time because folate is important for neural development, like the spinal cord.  What happens if there is insufficient or no folate is that the neural tube doesn’t close, and then that can cause spina bifida, which is a preventable condition if the mom is getting adequate vitamins.  Folate is B9.

Alyssa:  Oh, folate is a B vitamin?

Dr. Nave:  Yeah, it’s a B vitamin, so it’s a water-soluble vitamin that’s very important for the neural tube development.

Alyssa:  So my best friend found out she has this, and what’s the name — your body can’t absorb folate.

Dr. Nave:  Oh, right.  I know what you’re talking about.

Alyssa:  So she actually had a really hard time getting pregnant because she was taking too much folic acid.  But if you don’t know you have this, then…

Dr. Nave:  If you don’t know you have it, if possible, choosing a supplement that has methylated B vitamins, so methyl folate as opposed to hydroxylated folate is better.  What Alyssa was talking about is call MTHFR.  It’s methylenetetrahydrofolate reductase, so that’s an enzyme that basically, when you take in folate, for most people, they can then attach a methyl group to it, which makes it bioactive. There’s this cycle that you need methylation to occur in order to make the B vitamins active, which is important for making your red bloods cells, which is important for energy production, which is important for getting energy from your food.  B vitamins — I think of them as, like, the power house side kick.  Almost every enzyme in the body requires B vitamins.  I have this lovely chart right here that shows the citric acid pathway, basically the utilizing our food to make energy pathway, and almost every single step in here requires two or three different types of B vitamins.  There are even B vitamins that are enzymes themselves and carry things along.

Alyssa:  You love B vitamins!

Kristin:  So the free prenatals are helpful, just not…

Alyssa:  It’s better than nothing?

Dr. Nave:  Yes, it’s better than nothing, but if possible, there are different brands that we use as naturopathic doctors that you can probably try to get on Amazon, like Ortho Molecular or Integrative Therapeutic Initiative, I think is the name of it, ITI.  SO I know those are pharmaceutical-grade, and when I say that, I mean that they have enough of the vitamin.  It’s beyond the recommended dose, like what the government says this is minimally what you need, and it’s of good therapeutic value, so we know that it will do what it says it’s going to do.  They tend to have more of the methylated form, so whether the mother has a different time methylating her B vitamins, or if she doesn’t, it takes out more work for the body to do so then it can go right to where it needs to go.

Alyssa:  That’s fascinating!  Is there anything we didn’t touch on?

Dr. Nave:  I don’t think so.  We talked about environment medicine and reducing your exposure.  We talked about nutrition and making sure you’re getting enough calories.  Oh — fish oil, vitamin D3, specifically, vitamin D3, because that’s the active form, and prenatal vitamins with regard to eating whole foods.

Kristin:  We don’t get enough vitamin D in Michigan anyway, and I know that — and, again, I don’t have a medical background, but I know a lot of research on preeclampsia shows a lack of vitamin D3.

Dr. Nave:  Yes.  Another thing about preeclampsia is calcium and magnesium.  If a woman starts to experience preeclampsia, making sure that — sometimes, it’s due to an electrolyte imbalance and not getting enough protein, so we would want to look at how much protein is she getting.  The ratio that we usually look for is at least 0.8 to 1 gram of protein per kilogram of weight, so however many pounds you weight, divide your weight by 2.2, and that tells you how many kilograms, and then it’s 0.8 to 1 gram per that number that she should be getting.  If she’s getting adequate protein and has enough calcium and magnesium, then she shouldn’t get preeclampsia.  If she has a history of hypertension, making sure we’re managing that, whether naturally or if she’s taking medication, as long as it’s not one that would interfere with conception, would help to prevent it from happening.  But even if a woman experiences preeclampsia, it doesn’t automatically mean that she will get eclampsia because we can still, at that point in time, address what’s going on.

Alyssa:  Right.  Well, thank you so much.  I just feel like we could keep going and going.  You probably have 80 other topics we could talk about.  We’ll just have you back once a week!

Dr. Nave:  Oh, I’d be down for that!

Alyssa:  We’ll set up a couple more!  Well, tell our listeners where to find you if they want to reach out.

Dr. Nave:  You can find me at our website, and you can find me on Instagram, @drgaynelnavend, and I’m also on Facebook at the same handle.

Alyssa:  Great!  Thanks again!

 

Sleep Deprivation

How Sleep Deprivation Impacts New Parents

Becoming a parent is one of the most exciting and scary milestones of a person’s life. It’s likely your emotions will run the gamut from excited anticipation and joy, to fear of the unknown and uncertainty about what’s ahead and how you’re coping with parenthood. Managing night time feeds, tending to your baby throughout the day, and trying to keep up with your other responsibilities as you acclimatize to parenthood can make sleep difficult. While this is somewhat expected, sleep deprivation can have a serious impact on the health of new mothers and their babies, so it is important to get as much rest as possible.

The importance of sleep for new parents
The diminished quality and quantity of sleep that new parents often experience can result in physical and mental fatigue and an increased risk of postpartum depression. Prolonged lack of sleep or poor sleep quality can also increase the risk of diabetes, weaken your immune system, reduce attention and focus, and impair hormone production, causing weight gain, loss of libido, and moodiness.

Because our bodies require sleep to function correctly – and a specific amount of sleep that allows us to cycle through the various sleep stages several times throughout the night – a dip in the standard or quantity of hours we accumulate asleep in bed can have a far-reaching impact on our health and quality of life. One recent study found an association between poor sleep quality and postpartum depression.

There are two main phases of sleep – NREM (non-rapid eye movement) and REM (rapid eye movement, when dreams occur). Throughout these stages, specific changes and functions are carried out in our bodies and brains. NREM phases are when most of the physically restorative processes of sleep are performed. Our muscles and cells are repaired, our immune system is boosted, and the deep sleep of stage three NREM is what’s needed to wake feeling refreshed in the morning.

REM sleep occurs around 90 minutes after we first fall asleep and NREM phases are complete. This is the dreaming phase and the time that our brains process the salient and emotional experiences from waking life. When our body doesn’t get the required amount of sleep, it is unable to consolidate all the emotional and experiential data we have collected while awake, neither is it able to complete the physically restorative processes we need to feel refreshed and energized. That’s why we feel fatigued, forget things easily, and may find it difficult to manage our emotions.

Tips for getting the right amount of sleep
While some disruption to your sleep is to be expected as you adjust to the new normal; the good news is that there are a range of tactics and strategies you can employ to still get the amount of sleep your body needs.

Create the right environment for sleep:
When you do head to bed, it is important that you are able to drift off to sleep as quickly as possible so you can maximize your sleep time. To create the right environment for good sleep, keep your bedroom cool and dark. Light affects our melatonin production and signals to our brain that it’s time to get up. Turn the baby monitor down too so their snuffles and murmurs don’t disturb you, but you’ll still wake if they cry out for comfort. If you do have trouble falling asleep, try a wind-down relaxation or mindfulness meditation that will help calm your mind and body.

Share the responsibility:
Taking care of a baby is a 24/7 job that requires constant activity and emotional resilience. No one should expect that they can do this on their own.

Negotiate a schedule with your partner that lets you share nighttime feeds, diaper changes, and those evenings when baby just doesn’t want to go to bed. It’s necessary to ensure you have the right support so the sleep and health of you, your partner, and baby don’t suffer.

Accept help:
Have you ever heard the African proverb “It takes a village to raise a child”? This isn’t just about the direct interactions; it’s all the support functions that are needed to raise a happy healthy child too. Don’t be afraid to ask for help with the cooking, cleaning, endless laundry, groceries, or just holding your baby for a while so you can have a shower and dress! The everyday, mundane tasks that were so simple pre-baby can take monumental effort to complete once there’s a baby in the house. Most people know this and will be happy to lend a hand.

Embrace the nap:
Babies rarely sleep for more than four hours at a time. While this is a major contributing factor to those interrupted nights, the multiple two to three-hour naps your baby takes through the day provides ample opportunity for you to rest too – if you let yourself. Resist the urge to catch up on chores and instead take a half hour nap that will help manage your fatigue. Avoid sleeping longer than 45 minutes though as this will adversely impact your night’s sleep.

Christine Huegel is on the Editorial Team of Mattress Advisor, covering a variety of topics pertaining to sleep health in order to help people get their best night’s sleep.

Image via www.pexels.com.

 

Postpartum Depression

Supporting a Postpartum Mother: Podcast Episode #79

Elsa Lockman, LMSW of Mindful Counseling talks to us today about how partners, family members, and other caregivers can support a mother during those critical postpartum weeks to ensure she seeks help if needed.  How do you approach a new mother and what are her best options for care?  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin, and I’m here today with Elsa Lockman.  She’s with Mindful Counseling, and we are talking about how partners and other caregivers and family members can support a woman who has potential signs of postpartum depression or mood disorders.

Elsa:  Yes.  So postpartum is going to be an emotional time, so tears, some anger, sadness, are all part of the experience.  After about two to three weeks out, if spouse or a friend or a mother is noticing maybe a mom is crying more than usual, isn’t really looking forward to things, has these unusual fears that they can’t seem to let go of.  Another sign would be not seeming to eat very much or either sleeping a lot or not being able to sleep when the baby is sleeping.  If they’re noticing those signs, it would maybe be a sign that they could go talk to somebody as far as a therapist or go see their doctor.  Approaching Mom would be in a way to not criticize mom as if she’s doing anything wrong.  She’s not doing anything wrong, so start off with validating, actually.  She’s doing a great job with how hard it is; validate how hard she’s working, and try to tell her that it doesn’t have to be this way.  She doesn’t have to do it alone.

Kristin:  How does the caregiver know if it is baby blues or if it’s something that she needs help for?  Because, of course, there can be that hormonal fluctuation.  They may be teary.

Elsa:  Baby blues usually stops after three weeks postpartum.  So after that would be maybe a sign that there’s more going on.  But I would say, is it getting it the way of functioning?  Is it getting in the way of relationships?  Is it getting in the way of their working in the home or outside of the home, getting those things done?  To a degree, that is expected postpartum; not everything running smoothly, but are relationships being affected?  Those would be signs that it’s more than just baby blues.

Kristin:  How can a spouse, partner, or caregiver be supportive in order to empower her to get help?  Is it best for them to directly reach out for help for her if they’re seeing signs, or what do you recommend?

Elsa:  I recommend the mom reaching out, so that would be encouraging Mom to reach out herself.  And maybe she needs to talk to a friend and have more time with friends or more time to herself; maybe that would help.  See how that works.  If that seems to help and is enough to alleviate whatever stress is going on, then that works, but maybe if it’s not working, then take it to another level, which would be contacting a therapist or your doctor.

Kristin:  And since, obviously, women have multiple doctors — they’re seeing their OB or midwife and family doctor and their pediatrician — does it matter who they’re speaking with about getting help?

Elsa:  No, it wouldn’t matter who you see.  Usually the OB would be the person that they’ve seen most recently, but they can even bring it up to the pediatrician, since moms see the pediatrician very often.

Kristin:  And as far as getting help for our local listeners and clients, they can reach out to you directly?  How do they access you at Mindful Counseling, Elsa?

Elsa:  They can go to the website, and they can contact me through there.  Another resource would be Pine Rest, and through your OB’s office, there also is a list of therapists who specialize in perinatal mood disorders, which includes postpartum depression and anxiety.

Kristin:  That’s so helpful.  And in past conversations, you had mentioned that women can bring their babies to therapy; that you allow that with clients you’re working with, and I know Pine Rest encourages that with their mother-baby program?

Elsa:  Yes, for sure.  Bring your baby to the session; you can feed the baby, breastfeed, anything.  Coming with your baby is welcomed and encouraged, for sure.

Kristin:  Do you have any final thoughts or tips to share?

Elsa:  Just that it doesn’t have to be going through this alone.  It’s very normalized for women to feel that anxiety is just part of the postpartum experience or feeling depressed and stressed is part of it, and while it might be a new phase and there’s a lot going on, it doesn’t have to be that women are just suffering through it.

Kristin:  Great point.  Thanks so much, Elsa, for being on!

 

postpartum doula

Benefits of A Postpartum Doula and Why Should You Hire One?

Author Bio: Roselin Raj is a journalist and a writer. She has been writing extensively on health and wellness related topics for over a decade. Besides her professional interests, she loves a game of basketball or a good hike in her free time to fuel her spirits. “Health is wealth” is one motto of life which she lives by as well as advocates to every reader who comes across her blogs.

In the months leading up to my first delivery, I had many emotions ranging from excitement to fear. The idea of delivering a baby was daunting and had occupied my headspace completely. Though I had a consulting doctor and limitless information on the internet, getting the personal assistance and care from a doula did the trick. 

According to What To Expect, “Doulas, who offer non-medical emotional support, are growing in popularity in the delivery room (or birthing center), but many also do postpartum work, helping new moms navigate the stressful, bleary-eyed early days of parenthood. Here’s why you may want to consider hiring a postpartum doula to help you through the fourth trimester.” With the rising popularity of doulas, let us understand what a postpartum doula is and how they help expectant mothers through and post pregnancy. 

What is a Postpartum Doula?

As mentioned earlier, a doula is a trained professional who guides mothers with information, emotional and physical assistance before, during, and a short while post birth. The guidance and assistance are given to expectant mothers to make the process a healthy and less stressful experience. However, a postpartum doula extends their assistance until the baby has adjusted with the family. 

A postpartum doula is skilled to assist with a variety of needs and requirements according to each family. For instance, once the baby is born, all the attention is directed towards the new bundle of joy. But the physical and mental health recovery of a mother is very important. A postpartum doula can help the mother ease into motherhood, provide necessary information on caring for the baby or help with breastfeeding issues, and much more. But a postpartum doula is not a nanny and helps the mother emotionally to recover after the birth of the baby, bond, offer newborn care, sibling care, and lighten the load of household tasks.

Benefits of a Postpartum Doula

The work of a postpartum doula extends post birth, unlike a birth doula. The postpartum doula’s main purpose is to make the mother comfortable with the baby and support her in doing so. The tasks may vary from mother to mother, and she is equipped to do the best in any situation. Here are a few of the tasks a postpartum doula can provide:

Postpartum Care for the Mother

Once the baby has been delivered, the mother requires a lot of caring and help. The basics involve eating healthy food, drinking water at regular intervals, and most importantly, rest. A postpartum doula will help in cooking, running errands, etc. to allow the new mother to recover. In the case of c-section delivery, she can assist the mother with the newborn, household tasks, offer support and resources, rest and healing, and aid in hassle-free recovery. 

Women are usually emotionally weak post-birth with chances of depression and anxiety. Postpartum doulas can help create a stress-free environment, take care of the baby, and be emotionally available for the new mothers. 

Breastfeeding and Newborn Support

Postpartum doulas are equipped with complete knowledge of handling newborn babies, and they help mothers to ease the process of parenting. The next big challenge after giving birth to a child is often breastfeeding. And as you are probably aware, it can be a challenging experience for both the mother and the baby. 

In such cases, the doula helps with information on newborn behavior, soothes the process of breastfeeding or transitioning to bottle feeding. If further breastfeeding support is needed, she can offer local resources to an IBCLC (Board Certified Lactation Consultant).

Finding the Perfect Doula for You

Doulas can be found through word-of-mouth or going through service providers to find certified doulas as per your needs. The idea is to get a suitable doula who is certified, experienced, and well-synced to you and your family requirements. Before hiring a doula, talk to the agency regarding their qualifications, certifications, insurance, etc. to get a clear idea of who you are hiring. 

Doulas or the agencies usually charge for services by the hour, location, services required, and the experience of the doula. There may be provisions to use your Health Savings Account (HSA) to hire a doula. Clarify with your insurance provider or the doula agency before going ahead with the plan.

Photo credit: The People Picture Company

 

EMDR Therapy

EMDR Therapy: An Overview

We are so excited to share this guest blog by Joshua Nave LLMSW and Paul Krauss MA LPC of Health for Life GR. We get asked frequently about EMDR Therapy, so read below to find out what it is and how it works!

This blog is a discussion of the basics of what Eye Movement Desensitization and Reprocessing Therapy (EMDR) is, its origins, and how it can help people.  Many people have heard about EMDR in one fashion or another, and with over 2 million people reporting healing from its use (Trauma Center, 2007), it’s no wonder that more and more people are asking “Just what is EMDR?”  So let’s begin with trying to answer just that: what is EMDR therapy?

EMDR therapy is a physiological psychotherapy technique that aims at unlocking the body’s natural ability to process information and heal from past trauma and current distress (EMDRIA, 2019).  EMDR therapy seeks to access the process that the human brain uses during the REM (Rapid Eye Movement) cycle of sleep to reduce the disturbance caused by memories, events, and thoughts that have become stuck or intrusively repeated in a person’s mind and/or behavior and personality.  EMDR therapy is an advanced type of empirically-validated therapy that can be utilized by Masters-Level Counselors with specific advanced training (post-graduate school). Hundreds of studies have confirmed that when human beings are enduring great duress or stress, the brain becomes incapable of processing information as it normally does.  While the brain may change its normal processing abilities to protect the person during a stressful situation–there are often negative side effects.  Information that is not processed in a normal manner, due to a stressful or traumatic event can then become “locked” within the mind, and as the brain attempts to process that event, an individual may experience a repetition of the very stress, pain, thoughts, and other body sensations that they experienced during the original event(s).

EMDR therapy works on multiple levels of the brain, both incorporating talk therapy and elements of the rational brain, along with the deeper memory systems as well as the physical memory to allow an individual to access those “locked” stressful/traumatic events in a therapeutic environment– so that the effect on the brain is essentially “reprocessing” the stressful or traumatic event in an adaptive way that allows resolution of suffering. As the brain processes the event, individuals become able to embody with healthy and adaptive beliefs about themselves both from the past and during the current time, which can build long-term resiliency in an individual. In addition, EMDR therapy works to clear the body of disturbing physical sensations associated with the event, or what is sometimes called “the felt sense.”   To this day, scientists and medical professionals have been unable to ascertain the exact mechanism of action that helps to change brain and body’s response to triggers and associated negative stimuli (all of the elements that make EMDR therapy effective), nevertheless study after study demonstrates its tremendous positive effect on people, and often shows improved outcomes over such therapies as CBT and traditional talk therapy. Counselors who utilize EMDR therapy often theorize that it is the use of rapid eye movement or other forms of bilateral stimulation (BLS) during the treatment, combined with the cognitive elements of counseling, which ultimately causes the stress reduction and adaptive processing to occur.

Francine Shapiro originally theorized the foundations of EMDR therapy in 1987 when she discovered that rapid eye movement could have a beneficial effect on reducing the effects of stress and the effects of traumatic memories (EMDR Institutive, 2019).  Dr. Shapiro later went on to perform clinical trials to test her theories, and today, EMDR Therapy is a certified evidence-based approach to recovering from traumatic experiences.  In addition, EMDR Therapy has been reported to be effective with anxiety, depression, panic disorders, addictions, body dysmorphic conditions, phobias, pain disorders, and more (Legg, 2017).  Many people have sought EMDR Therapy as a method of treatment for these conditions instead of the traditional route of medication first.  

Is EMDR Therapy right for you?  If you suffer from repeating intrusive memories, feelings, body sensations, or thoughts of past disturbing events, or in fact, any of the symptoms previously discussed, then EMDR Therapy could assist you in your healing.  If you are interested in receiving a different method of healing where you are in control of having the healthier life you’ve always wanted, then I encourage you to contact a licensed therapist who’s undergone EMDRIA approved training in providing EMDR Therapy services.  

EMDR Therapy is an effective psychotherapy method when its methodology is followed by a licensed counselor. It is important to have the right fit for you, so when investigating, make sure you feel aligned with your therapist and that they are experienced and knowledgeable and have valid EMDR therapy training.  If you’re interested in a free 15-minute consultation to either learn more about EMDR or to set up an appointment, please visit our website at healthforlifegr.com. At Health for Life Grand Rapids, we are now proud to have a counseling wing called The Trauma Informed Counseling Center of Grand Rapids. You can also give us a call at 616-200-4433.

References:

EMDR Institute. (2019). History of EMDR.

EMDRIA. (2019). How does EMDR work?

Legg, T. (2017). EMDR therapy: What you need to know.

Krauss, P. (2019). The trauma informed counseling center of grand rapids.

Trauma Center. (2007). Eye movement desensitization and reprocessing (EMDR).

About the Authors:

Paul Krauss MA LPC is the Clinical Director of Health for Life Grand Rapids, home of The Trauma-Informed Counseling Center of Grand Rapids. Paul is also a Private Practice Psychotherapist, host of the Intentional Clinician podcast, Behavioral Health Consultant, Clinical Trainer, and Counseling Supervisor. Paul is the creator of the National Violence Prevention Hotline (in progress) as well as the Intentional Clinician Training Program for Counselors.

Joshua Nave MA LLMSW 
“I became a social worker and ultimately a therapist to assist in God’s mission to bring healing to the hurt. Through my years of work in the field of trauma, behavioral health, and the broader social work field, I discovered that many of us are held back from reaching true healing by the traumas and lessons imparted on us in our early childhood. It has thus been my passion over the past several years to provide early childhood intervention to families struggling when their young children, as well as assisting adults in overcoming the barriers to healthy living through trauma-informed therapies. I have used my training in Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Play Therapy, and Eye Movement Desensitization and Reprocessing Therapy (EMDR) to assist my clients in achieving a more complete and healthy life. It is my belief that all individuals have not only intrinsic value, but also the natural capacity for healing and change.

As a therapist, I provide my clients with a truly “client-driven experience.” I am skilled at partnering with you to identify the changes that you wish to make in your family’s life, or even your individual life, and developing a plan to achieve success. I look forward to partnering with you on reaching your potential through natural healing!”

EMDR Therapy

 

Postpartum Fitness

Podcast Episode #69: Postpartum Fitness

Today we talk with Dr. Theresa, Chiropractor and BIRTHFIT Instructor in Grand Rapids, Michigan.  We ask her about what’s safe for a pregnant and postpartum mom to be doing and why having a supportive tribe around is so important.  You can listen to this complete podcast episode on iTunes or SoundCloud. Be sure to listen in or keep reading to get a special discount code for your BIRTHFIT registration!

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas!  I’m Kristin.

Alyssa:  And I’m Alyssa.

Kristin:  And we’re here with Dr. Theresa today from BIRTHFIT.  She is also a chiropractor and does many things, which she’ll explain later.  So, Dr. Theresa, tell us about BIRTHFIT and why you decided to bring this to Grand Rapids.

Dr. Theresa:  Yeah, so I have been in practice for about seven years, focused on the perinatal population, and I found this big disconnect in the postpartum time where women are preparing for birth, and it’s kind of like this mindset of, okay, I just need to get through birth.  And we’re kind of forgetting about that postpartum time where the real work begins, because now you’re not only taking care of a new family member, but you need to heal and take care of yourself, too.  So I really wanted to help with that time specifically and give women more information on what they can do.

Kristin:  So when does a woman typically take your class after they’ve had their baby?

Dr. Theresa:  We recommend the first two weeks postpartum as the coregulation period, so that would be way too early to take my class.  That’s when you are bonding with Baby, hopefully not really leaving the house at all, and usually after that time, women are like, okay, I’m ready.  So probably the earliest somebody has taken my class was after two weeks postpartum, and that was almost an exception to my rule because of her fitness level during her pregnancy and before.  But for the most part, I recommend four to six weeks as a perfect time.  But also with that being said, postpartum is forever, and I’ve had moms that are a year or two years postpartum take the class.

Kristin:  That’s what I’ve seen on your social media posts, and tell us about how babies are involved.

Dr. Theresa:  Yeah!  I kind of time my classes so that, even though women are on their maternity leave, they may have other kiddos at home that they want their husband to come home and take care of.  But Baby needs to come with Mom, and we totally encourage that because they need to nurse or they need to be tended to during our class.  So we encourage moms to bring their babies; bring your favorite carrier, and we can implement them during the workout in a safe way.

Kristin:  That is amazing.  Do you find, since you also have a prenatal series, that women take that during pregnancy, and then you’re able to extend the relationship into the postpartum time?

Dr. Theresa:  Yes, that is the goal, and my last session for the prenatal series is all about postpartum.  So I talk to them about things they can during pregnancy to stay active and hopefully lead to better birth outcomes, but then what can you start doing postpartum at what time.  So for those first two weeks, right away, women can start working on their belly breath, whether they’ve had a C-section or a vaginal birth.  They can start doing that to mobilize their pelvic floor in a really gentle way, and then also reteach their abdominal wall how to come back together.

Kristin:  You mentioned Cesarean.  If she had a Cesarean, does the provider need to give approval at some point for her to start taking your series, or how does that work?

Dr. Theresa:  Good question.  So, typically they’re released for exercise, depending on the person, between 8 to 12 weeks or whenever the scab falls off is usually another really good time to start doing some exercise.  And with those women, we teach the slow-is-fast mindset anyway, for everybody, but especially for those women, because now there’s a different pull happening when they move.  So that can be a little bit scary, so we talk through those things; we talk through signs that, okay, we need to slow down a little bit.  So it’s totally customizable to the woman and the birth that she had, which is also why I keep the class sizes small.  They’re limited to about ten people per class, so I make sure everybody’s being tended to.

Kristin:  Now, of course, you mentioned some of your students are very fit and they exercise throughout pregnancy.  So say they’re a CrossFitter or they took prenatal yoga.  What about women who were not in shape before they got pregnant and who are trying this and worried about their fitness level?

Dr. Theresa:  Yes!  Those are my favorite clients that I have in these classes because most of the women have never picked up a barbell before; women like that who have really never exercised.  And when I first did this, you think BIRTHFIT; CrossFit — is it the same thing?  And it is not the same thing at all, so I don’t want that to intimidate people.  When I say barbell, that could be an empty 15-pound barbell that’s just there to give you a little bit of load, and it can even help you with your form on some of the movements.  So we go really slow, and we really focus on form and breathing through each and every movement.  And I love to see how confident these women get when they have a barbell in their hand.  Or when we’re coaching pull-ups and we use a band to help assist them with the pull-up, and they have so much fun!  They’re like, I never thought I could do a pull-up before!  And it’s just the coolest thing to see.

Kristin:  So what, of all the focuses you could have, why are you so passionate about the postpartum phase in women’s life?  You’re focused, obviously, on prenatal, as well.

Dr. Theresa:  So I think we’re really luck in Grand Rapids.  There are so many resources for prenatal.  There are some awesome childbirth education classes, and I see a lot of people preparing and taking multiple childbirth education classes and taking, like, car safety and CPR and all the things to get ready for a baby, and then postpartum kind of looks like this, where they go to their six-week checkup, and they’re released for exercise and maybe they’re given a sheet with exercises to do on it, like strengthen your abs and do Kegels.  And it’s such a blanket recommendation that is not doing service to women the way that we need them to be feeling really connected back to their body through the four pillars of BIRTHFIT, which are fitness, nutrition, mindset, and connection.  So I think those four things are so important in the postpartum time that women aren’t having the opportunity to do or they’re not understanding how they can do it postpartum.  So I want to take each person and individualize to them: what can you do postpartum to really help fill your cup so you can take care of everybody else?

Kristin:  And it sounds like a wonderful community.  Women are often isolated after giving birth and they struggle with childcare or even wanting to leave their child.  So they can bring Baby with them and find a circle that women are going through the same thing around the same time; some may have toddlers and be the “wise ones” to give the newer moms some advice.  So I think that part of it sounds great because everyone needs a tribe.  I know that word is overused, but it’s true.

Dr. Theresa:  Yeah, and that is so fun, to see them exchanging phone numbers.  This summer is the first year — because I just finished up my first year of BIRTHFIT.  I started in 2018, so now I’m on my second cycle of it, and we’re going to do a meet-up this summer where, whether it’s going out for coffee or meeting in a park or whatever, because women are asking for that.  They want to see the people that they took class with; they want to talk to other people.  So I really loved that.  We also have a private Facebook group, so they’re able to still keep in touch that way, too.

Kristin:  And then you’re able to give them resources in the community if they need to see a pelvic floor therapist.  I know you said you work on the pelvic floor, but they need recommendations, and as an expert, you’re able to give them.

Dr. Theresa:  Absolutely.

Kristin:  And postpartum doula recommendations and sleep and lactation and whatever they might be looking for?

Dr. Theresa:  Yes, exactly, and I really keep that door open.  We always have, during each class — so we meet twice a week for four weeks during the series.  At each class, there’s a workout, but then there’s always an education component, whether I’m having my good friend Emily VanHOeven from Spectrum Health, who’s a pelvic floor PT; she comes in and gives a really awesome presentation and answers questions for these women.  I have a nutritionist come in, Jenna Hibler, who you guys had interviewed.  She comes in and talks about nutrition.  So I have these different resources and topics, depending on — and sometimes it changes, depending on the needs of the group.  I kind of ask them in the beginning what they’re looking for and what they need, so that way I make sure, at some point, they’re getting that.

Kristin:  That’s great!

Dr. Theresa:  Yeah, it’s really fun!

Kristin:  Alyssa, is anything coming to mind for you?

Alyssa:  Where were you six years ago?!  Because, yeah, it was really hard to find things to bring my daughter to with me postpartum.  And I know some moms are like, no, I don’t want to bring my kid with me; I’m coming alone.  This is my time.  But when that’s not an option, it’s good to have a place that you can bring your baby, even if it’s just in a car seat right next to you.  I mean, I’ve done that before, too.

Dr. Theresa:  Absolutely, yeah.  And the postpartum series takes place at the CrossFit gym I go to, CrossFit 616, and they have a childcare room there, which you never see.  Especially in a CrossFit gym, it’s unheard of.  And we’ve had a baby boom in the last couple of years within our gym, so it is not uncommon to see women breastfeeding just at the gym, out in the open, and it’s not uncommon to see somebody else holding somebody else’s baby and just kind of helping out.  So it’s a great community.

Kristin:  Yeah, I would not picture a childcare room in CrossFit at all!

Dr. Theresa:  There’s a TV; they have PBS Kids.  It’s pretty nice.

Kristin:  I’ve supported some birth doula clients who were CrossFit, and they were incredibly strong and determined.  So, yeah, I’m inspired that they’re so healthy that they could exercise in that way through the entire pregnancy.

Dr. Theresa:  Exactly, and those are sometimes the hardest ones to teach that slow-is-fast mindset, and there have been several high-level CrossFitter women coming out now, like athletes coming out and saying, I really wish that after my first baby, I had done this differently because I did some serious damage just starting too soon.  And then after they have their second baby, they’re like, I’m doing this differently and slowing down.

Alyssa:  I like that you talk about breathing, even just having that breath, like that yoga breath, of when you breathe in, your stomach should expand, and that actually helps your pelvic floor.  You don’t know that — I didn’t know that until I saw a pelvic floor therapist.  I’m, like, breathing helps make my pelvic floor stronger?  And it does!  And how slow and gentle that is for somebody who just gave birth, no matter whether you had a Cesarean or a vaginal birth; that slow movement makes you stronger.  Your breath makes you stronger.

Dr. Theresa:  Absolutely.  Those are our top pelvic floor tips: belly breathing and LuLuLemon high-waisted pants because they give just enough compression without too much downward pressure.

Kristin:  And the focus on nutrition is key.  Woman are so depleted, especially if they’re breastfeeding, so making sure that that’s part of the class and having someone who specializes in nutrition speaking — I love that you bring in experts.

Alyssa:  If you want to ever talk about sleep, I would love to come in and talk about sleep.

Dr. Theresa:  Yes!  I am always looking for people who want to come in and talk to these women because it takes some of the pressure off of me, too, and they don’t have to listen to me talk the whole time.  It’s nice to hear from an expert!  That would be great!  And a postpartum doula — I think a lot of women don’t know that’s a thing.  That’s big.

Kristin:  And I think of it as more of the tasks that we do as postpartum doulas, like someone to clean up or do meal preparation, and caring for the baby, but we are caring the whole baby and setting up strong systems and supporting sleep.  So it could be anything from three hours in a week to 24/7, and so we’d love to come in and talk about our role and how we can support a family.

Alyssa:  That would almost be better for a prenatal series, to get them thinking about it before.  I think the biggest thing is that we plan for this birth, and then it’s like, what now?  What do I do?  I’m home alone with this baby.  So talking to them about the resources that they have postpartum before the baby actually comes.  Not that it’s too late; if you have a six-week old or a six-month old, you can still hire a doula, but it’s certainly more critical in those first few weeks.

Dr. Theresa:  Right.  And I find in my classes, it’s the women who are third- or fourth-time moms, even fifth-time moms, that are like, I understand why I need all of this stuff now to help support me.  Even though you would look at them and think, oh, they must know it all; they’ve been through this — but those are the women who are seeking more information, I find, and they’re the ones hiring doulas and really trying to prepare because they know what they’re in for.

Alyssa:  Exactly!  They know how hard it is.  These first-time moms are in this state of bliss, which you should be, thinking about all the wonderful things that will happen, but no matter what kind of birth you have, you’re going to be waking up every two to three hours while you’re healing.  So you’re not getting the rest you need to heal.  You can’t really exercise yet.  You’re sleep deprived, and you are in pain.  It’s hard!

Dr. Theresa:  It is!  It’s really hard!  It’s so good to have support, from having somebody coming into your home to having that tribe, again, using that word, but having that tribe to talk about those things together.  One of my favorite topics that we talk about during the postpartum series — and it’s totally one of those things I was nervous to even bring up because I don’t want to offend anybody, but talking about having sex for the first time.  We’re talking about all of these things that other women are like, oh, my gosh — you, too?  So having those resources to be able to talk — I think that’s a perfect thing, that you could have a conversation about that one-on-one with your doula, because I don’t know how many OBs are talking about that.

Alyssa:  It’s a lot of what our doulas do postpartum is just tell them, this is normal; this is okay.  Let’s normalize this.  You know, as a first-time mom, breastfeeding is really hard and I’m failing.  No, no, no.  This is normal.  Let’s talk to a lactation consultant, or let’s just change your latch a little.  Some very simple things a doula can help with, but this mom might not even know she has a problem with latch.  She might not know that it’s a problem that her nipples are cracked and bleeding.  The doula can say, no, this isn’t normal; you do need to seek out additional help.

Dr. Theresa:  Totally.  Something that I’ve seen crop up a couple times lately are vasospasms, that they just have no idea what that is, so they don’t do anything about it, and it’s like, oh, this is a perfect opportunity to work with a doula or work with somebody who can be, like, oh, yeah, I’ve seen this before; this is what you do.

Alyssa:  What’s a vasospasm?

Dr. Theresa:  From nursing; it’s like Raynaud’s in your fingers where you lose blood supply, so the nipples turn white and it’s super painful.  It’s like frostbite on your fingers, you know, that searing pain.

Alyssa:  I get that on my fingers all the time.  I can’t imagine that on my nipples!

Dr. Theresa:  I know, yeah!  And it’s things like warm compresses, checking latch; you can use some magnesium to help dilate the blood vessels.  So some things like that can really save that mom some excruciating pain.  Yeah, just talking about those things that people think are normal, and you’re like, no; that’s not normal.  We can do stuff about that.

Alyssa:  Well, and that’s the beauty of a doula, too.  It’s different than a babysitter.  It’s different than a nanny.  Doulas have this vast knowledge and experience and resource base to share, and sometimes, it’s crying and talking together.  Sometimes it’s just like, okay, go take a nap and I’ll clean up your house, and that mom feels like a million bucks after a two-hour nap and a clean living room when she makes up.  It’s much, much more than that.

Kristin:  And a doula, just like you, as an instructor, would have resources to say, hey, you should really check out this BIRTHFIT postpartum series, or you need to go see a chiropractor, or there are some things that you can do in the community.  You can do to La Leche League meetings and bring your baby with you.

Alyssa:  And I think that’s what you’re doing, too.  It’s so much more than just going to work out.  You mentioned those four pillars; they’re getting that, and that’s why they want to keep coming back and why it feels so good.

Dr. Theresa:  Absolutely!  And changing that mindset, because women want to come for the workout.  They’re, like, yes, I want to get back in shape, and that’s kind of their focus is that physical piece.  But we sneak in all this other educational stuff that they didn’t know that they needed, and they are able to leave with so much more than they thought they were going to get.  I love that.  I love seeing that.

Kristin:  So, Dr. Theresa, tell us when your next series is, how people can find you and register, and any other info that is relevant.

Dr. Theresa:  Yes!  So this year, with the postpartum series, I also developed a workshop to do before the actual series starts.  So the postpartum workshop is a two-hour event where we just focus on body weight exercises, more like floor exercises, which are great for that early postpartum time for Mom to get reconnected to her body.  And it’s great, too, if Mom can’t commit to four weeks, but my goal is that women are taking the workshop and then they take the series, which builds on the workshop.  So the next workshop starts April 23rd, and that’s from 6:00 to 8:00 PM at Renew Mama Studio, and then the series starts a week or two later; I believe it’s May 4th, something like that.  It starts in May, and that will go for four weeks twice a week.  And you can find more information on our website on how to register.

Kristin:  And you said you had a special coupon code for Gold Coast clients and our podcast listeners?

Dr. Theresa:  Yes, absolutely.  So I’m offering $20 off registration using code BFLOVESGCD.   That promo code can just be applied at checkout.

Kristin:  Fantastic!  Well, thanks for joining us today.  It’s so good to see you, Dr. Theresa!

Dr. Theresa:  Thank you!  It’s so good to be here!  Thank you for inviting me!

 

Ask the doulas podcast

Podcast Episode #68: Overnight Doula Support

Many of our clients and listeners don’t fully understand what overnight doula support looks like.  Kristin and Alyssa, both Certified Postpartum Doulas, discuss the kinds of support their clients look for and how their team of doulas support families in their homes.  You can listen to this complete podcast on iTunes or SoundCloud. You can also learn more here about overnight postpartum doula support.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  I’m Kristin.

Alyssa:  And I’m Alyssa.

Kristin:  And we’re here to chat about what an overnight postpartum doula does, as that is a question that we get asked often by our clients and our podcast listeners.  So, Alyssa, my first question to you is, as a postpartum doula and sleep specialist, what do you see as the key benefits to a family in hiring overnight postpartum doula support?

Alyssa:  Whether they hire for sleep or not, it helps the parents get sleep.  So let’s say they’re not even hiring me for a sleep consult.  Parents don’t understand what sleep deprivation means until their in the midst of it, probably at least three weeks in.  Like, our bodies are designed to survive a couple weeks of this, sometimes even three or four, but after that, our systems start to shut down.  So if you think about overnight support being this trusted person who sleeps in your home to take over all those overnight responsibilities so that you can get a good night’s rest.  Even a six-hour stretch or sometimes even a four-hour stretch makes you feel like a whole new person the next day when you’re used to only sleeping maybe one- or two-hour chunks.  A four-hour stretch seems amazing in that moment, whereas right now if you told me I could only have four hours of sleep tonight, I would cry.  I would be miserable the next day.  And you, Kristin, as a birth doula, you know that feeling.  If you’ve had one night of no sleep, you’re just wrecked.  So you’re running on adrenaline.  You’re sleep deprived.  So having a doula come in and take over all that responsibility at night — obviously, she can’t breastfeed your baby, but you have a couple different choices if you’re a breastfeeding mom.  If you’re a bottle-feeding with formula mom, you can literally go to sleep at 10:00 PM and wake up whenever you want because the doula can just feed that baby every three hours.

Kristin:  Exactly, and clean the bottles and change the diapers and burp the baby, all of it.

Alyssa:  Yeah.  So if your partner is feeding in the middle of the night, you’re certainly not going to wake up to clean bottles and parts in the morning.  The doula does do that.  But for a breastfeeding mom, you can choose to pump instead of breastfeeding because it’s usually a lot quicker.  So you pump and you set those bottles out for the doula.  The doula wakes up when the baby wakes up; feeds the baby; burps the baby; changes the baby; gets the baby back to sleep — and Mom’s sleeping this whole time.  Or, if Mom chooses to breastfeed, the doula can bring Baby to Mom so Mom doesn’t even have to get out of bed.  I was just talking to Kelly Emory, our lactation consultant friend, and she was saying that when she was nursing, she would just side lie and her husband would bring the baby to her.  She would lie on her side, so she didn’t have to get up.  She didn’t even have to open her eyes if she didn’t want to.  She was still kind of in this half-sleep state, and then when Baby was done on that side, her husband would take the baby and she’d roll over and she would feed on the other side, and then the husband would take the baby away, change the baby, burp the baby, and do all that stuff.  So she said it was amazing.  She took over one shift of the night, and he took over the next, so she would get a six-hour chunk of sleep and would feel amazing in the morning.  So you’re able to tackle all those everyday tasks during the day because you didn’t have to also worry about those at night.

Kristin:  Yes!  And I’ve also had overnight clients who prefer to come into the nursery and sit in a rocker and feed their baby rather than have me come in and disrupt their husband’s sleep.

Alyssa:  Sometimes they’re sleeping in separate rooms, too, because they’ve become used to that.  So oftentimes, my goal as an overnight doula is to have both parents sleeping in bed together again, or wherever you were before this baby arrived.

Kristin:  Right, no more partner on the couch or in the guest bedroom.

Alyssa:  Right.

Kristin:  So as far as other tasks of an overnight postpartum doula, sleep is one.  So we can get Baby back to sleep and if they’re working with a certified sleep consultant, like you, then they can implement that.

Alyssa:  Yeah, I guess I didn’t answer that initial question.  So if they do work with me as a sleep consultant, you can hire an overnight doula in conjunction with.  So I offer this customized sleep plan for your family, and then our doula knows that plan, understands that plan, and implements that plan overnight.

Kristin:  That’s amazing.

Alyssa:  So you wake up again refreshed because you’ve slept, and then you have the energy to implement the sleep plan during the day.  And then the doula comes in at night and implements that plan overnight.  So it’s consistency because that’s always the key with any sort of sleep consult is that you have to be consistent.  You can’t just do it during the day and then give up at night because you’re tired.  Your plan will fail.

Kristin:  And so who hires a postpartum overnight doula, and how often do they use the doula support?

Alyssa:  Who hires them?  Tired families hire them!  You get to the point of exhaustion.  I don’t think when you’re pregnant you’re thinking about an overnight doula because you truly don’t understand what you’re in for.  But newborn babies sleep all the time, so they could sleep up to 22 out of 24 hours a day, so you’re thinking, well, of course, like, newborn babies sleep all the time.  I’m going to sleep when the baby sleeps.  They’re going to be feeding every two to three hours!

Kristin:  They get up a lot!

Alyssa:  Which means all day and all night, you will be up feeding every two to three hours, at least.  So your sleep becomes these little tiny chunks.  Because if you think if you have a newborn baby that’s eating every two hours, and it takes you an hour to breastfeed, and then after the breastfeeding session, you have to burp; you have to change the diaper; you have to get the baby back to sleep.  You’ve maybe got 30 to 45 minutes, if you’re lucky, to sleep before the baby needs to feed again.

Kristin:  And some clients hire us for one overnight to get a good night of sleep and catch up; other clients hire us every night, and we bring in a team, in and out, or have one doula consistently.  And some of our clientele have a partner who travels a lot, or I’ve even supported a family where the mother was going back to work from maternity leave and was traveling for her job, so as an overnight doula, I supported the husband as he cared for the toddler that was waking; I was caring for the baby.  And so there are a lot of unique situations, but a lot of our moms who have partners who travel a lot want that extra support, whether they have a new baby or other kids in the household that need support, as well.

Alyssa:  I think it depends on resources.   So if someone is sleep deprived and they’re like, I just need one night of reprieve, and that’s all we can afford and that’s what we’re going to do, then that’s what they do.

Kristin:  Exactly.

Alyssa:  Even if they don’t have the resources, oftentimes during pregnancy, if parents have the foresight to ask for postpartum support as a baby shower gift, they can have several overnights gifted to them by friends and family.

Kristin:  Which is better than all the toys and clothes they’ll outgrow.

Alyssa:  I always tell them, you’re going to get mounds of plastic junk that you’ll literally look at and say that’s hundreds of dollars’ worth of stuff I’m never going to use, and you could have had an overnight doula in your home so you could sleep.

Kristin:  Easily!

Alyssa:  So I think it’s just based on resources because, like you said, we’ve had people hire us for, you know, two overnights and we’ve had two months straight.  So I think it just depends.  I mean, I don’t know that it’s a type of client.  I think that’s just kind of based on resources available.

Kristin:  And we certainly support families who are struggling with postpartum mood disorders and anxiety, but that is not all that we serve as far as clientele.  But for moms who are being treated in therapy, then we certainly are able to give them much-needed support and rest as we care for their baby, and we do have a package where we are able to lower our hourly rate for clients who are in the Pine Rest mother-baby program or are seeking therapy.

Alyssa:  Yeah, sleep deprivation is considered to be the number one cause of perinatal mood disorders, so all these moms with anxiety, depression, up to postpartum psychosis — when you’re sleep deprived, you’re literally torturing your brain and your body, and it’s really hard to function.  So sleep is such an imperative thing, and for your baby, too.  If you’re not sleeping and your baby’s not sleeping, physiologically, that baby needs sleep in order to grow, for their brain to develop, for their immune system to function properly.  It’s so critical for both parents and children.

Kristin:  Agreed.  So, really, anyone can benefit from it.  Our shortest shift would be coming in at 10:00 PM and leaving at 6:00 AM, but a lot of clients extend that time.

Alyssa:  I’ve found that a lot of people like you to come a little bit earlier, especially if they have older children.  So if there’s older siblings, let’s say 6:00 comes around and you’re trying to get dinner on the table.  You have a two-year-old, a five-year-old, and a newborn.

Kristin:  That’s a lot!

Alyssa:  That overnight shift tends to, when parents say, yeah, yeah, come at 8:00 or 9:00 when I’m going to go to bed — that very quickly changes to 5:00 or 6:00.  So either that shift moves up, or it just lengthens.  So the doula can come from, a lot of times, 6:00 PM to 6:00 AM, and they do a lot of 12-hour shifts because they’re there for the hustle and bustle of getting dinner, wrangling toddlers, helping with the newborn, and then helping with bedtime routines for two or three children and then taking that infant newborn and helping them get to sleep.  Usually, it’s in that order.  Like, the doula will take the baby and put them to sleep, and then the parents get to spend some quality time with this toddler who is usually lashing out because they are used to being the only child, if there’s only one, and are really, really seeking that one-on-one attention that they’re not getting anymore.

Kristin:  Yeah, that’s the perfect time to bond, and they can read them a bedtime story and sing songs; whatever their nighttime routines were before Baby arrived.

Alyssa:  Yeah, and that’s one thing I stress, too, with my sleep consults is just having a really good bedtime routine, and even if I’m doing a consult for one child and there’s others in the household, I usually ask about them, too, because if you’ve got three kids who all have a different bedtime, and each bedtime routine is taking an hour, certainly whoever’s last on that list is going to bed at 9:00 or something, which is way too late for these little kids.  So trying to consolidate and have a system in place and just get a schedule that works for the family, for everyone in the family, is a really big goal.

Kristin:  Awesome advice.

Alyssa:  So you mentioned earlier that a doula sleeps when the baby sleeps, and sometimes parents wonder, well, what do you mean?  What does that look like?  Depending on the house, we’ve had doulas sleeping on sofas in the living room.

Kristin:  Yes, that’s what I’ve done.

Alyssa:  We’ve had doulas sleeping in a spare room.  We’ve had doulas sleeping in a spare room on the same floor, in a spare room on a different floor, and you can make anything work.

Kristin:  With monitors and technology now, you know the second a baby stirs.

Alyssa:  So parents are always like, oh, shoot, I don’t know how this is going to work.  How am I going to do that?  We’ve had blow-up mattresses in the nursery.  Ideally, you want the doula to be as close to the nursey as possible, so they’re the one, when they hear that baby, they’re up; they’re there.

Kristin:  No one else gets woken up in the household.

Alyssa:  Yeah, you want the parents to be as far away.  So sometimes I even tell them if you have a spare bedroom in the basement, go sleep there, because even with one of my most recent sleep clients, the first night we did the sleep consult, the doula was there overnight, and I contacted them the next day: how did you sleep?  And they were like, oh, I wanted to so bad, but I kept hearing this phantom crying.  Even when the babies weren’t crying, they hear it, anyway.  So it does take, as parents, who are used to not sleeping for week after week after week — it takes time for your body and brain to adjust back to, oh, I’m able to sleep again.  So it’s not instant.  It usually takes at least a couple nights to get your brain to say, I can sleep.  It’s okay to sleep through the night.  I don’t have any responsibilities tonight.  This doula is taking care of it.  And it’s just a matter of them getting sleep in two-hour chunks instead of the parents getting sleep in two-hour chunks.  So a doula can usually do two or three in a row before they’re too exhausted.

Kristin:  Just like a birth doula.  We can do a couple nights with a client in the hospital without sleep, and then we’re done.

Alyssa:  Yeah.  So for those clients of ours who we’ve had for two weeks straight or two months straight, it’s several doulas taking turns.  Otherwise, they’re just too exhausted.

Kristin:  Right, and that’s where we sometimes will bring in a team if it is continuous care.

Alyssa:  But I think ideally, with sleep training, I would love to see every parent have a sleep plan and then a doula for five nights.  That would just be — I don’t know; I think the mental well-being of these parents would increase drastically if they were able to do both.

Kristin:  I would have loved an overnight doula with my kids being 21 months apart; having a toddler and a newborn.  It would have been amazing.

Alyssa:  Well, and some people, too, think it’s weird to have somebody sleeping in your home.  I mean, always, when they meet the doula, they’re totally fine with it, but it is a weird thought to have this stranger come into your home who’s going to care for your babies.  That’s why I think we’re so adamant about talking about our training and our certification process, and we’ve done background checks for people who want us to.

Kristin:  Yeah, and we’ve shown immunization records and CPR certifications and so on and liability insurance.  We have all of that.

Alyssa:  Yeah, because especially with a mom with anxiety who needs to sleep and knows she needs this help, but now she has anxiety because a stranger is going to be sleeping in her home — we need to do whatever you have to, to make that mom feel comfortable to be able to sleep.

Kristin:  Yes, and we’re there to do just that.  So feel free to reach out to us if you have any questions about overnight doulas.  We’d love to work with your family! Remember, these moments are golden.

 

Technology and mindfulness

Technology and Mindfulness for New Parents

Technology is an amazing tool that we use daily for our work and personal lives, but it can also be the thing that drags us down. We need it, we love it, but we hate it.

It’s time we take a good look at our data usage and figure out what’s draining us. Why not find some parts of technology that are being used for good instead? They do exist. I’m going to give you several options for positive ways to use technology that can actually help you improve your mental health, whether you’re pregnant or not.

Mind the Bump

This is a free app that helps individuals and couples support their mental and emotional wellbeing while preparing for having a baby or becoming a new parent. It teaches brain education (the importance of mindfulness and meditation), the difference between mindfulness and mindlessness, and gives an overview of a child’s brain development.

Expectful

This is a guided meditation app for your fertility, pregnancy, and motherhood journey. Their team of licensed hypnotherapists, meditation experts, a psychologist, and a sound engineer have created 10-20 minute meditations customized just for you. This app offers a free trial then requires a paid monthly subscription.

Insight Timer

This free app claims to have the largest library of guided meditations in the world. Although it’s not specifically made for pregnancy, it seems to be a great app for meditations and sleep, and it is offered in 30 different languages.

Babies Help Mommies

This free app was created by a cardiologist. After having three children she couldn’t find an app for new moms that focused on health and wellness. This app is meant to improve overall health by focusing on fitness, activities that decrease heart disease, ways to be active with your baby and how to create new memories. It provides motivational feedback and highlights positive choices you can make throughout the day.

Enjo – Wellness for Parents

This app was created to offer new parents a positive way to interact with technology. The goal is to take a few minutes out of your day to reflect on something positive or that you are grateful for. The app leads parents through a positive and affirming conversation, but it will also notice when they are down and offer some reflections to support during struggles. Comments are not monitored by an actual person, so if someone is struggling with severe depression or anxiety this app is not meant to be a replacement for therapy or treatment for mental illness. It’s unclear if this app is free or paid.

Shine

This is a free self-care app that they call “a daily pep talk in your pocket”. You will set a self-care goal and get personalized audio challenges and self-improvement audio tracks to help you grow. You will receive texts with researched- backed affirmations to feel more confident.

Head Space

This app has hundreds of themed meditations on everything from stress and sleep to focus and anxiety. They are “bite-sized” to easily fit into your busy schedule. They also offer what they call “SOS Exercises” for sudden meltdowns. This app offers a free trial and then requires a paid subscription.

Using apps like these can be a great start to boosting your mood, lowering anxiety, or helping you sleep. Please do not substitute professional support for a phone app. If you are struggling with a mental health disorder, please seek the help of a professional therapist. We are able to give some trusted recommendations if needed. If you are struggling as a new parent and need in-home support, contact us about postpartum doula support. If you aren’t sleeping, contact us about our sleep consultations. We offer a discounted rate for postpartum support to anyone seeking treatment for a perinatal mood disorder.

Alyssa is Co-Owner of Gold Coast Doulas. As a Certified Postpartum Doula, Newborn Care Specialist, and Certified Infant & Child Sleep Consultant, she is passionate about the mental health of families during the fragile postpartum period. She is a member of the Healthy Kent Perinatal Mood & Anxiety Disorders Coalition and was recently honored as Health Care Professional of the year by MomsBloom.

 

Newborn

Podcast Episode #62: Newborn Traumas

What is birth trauma and do all babies experience it?  How can you remedy it?  Dr. Annie and Dr. Rachel of Rise Wellness Chiropractic give us several examples of common birth traumas, what they mean, and how chiropractic care can help.  You can listen to this complete podcast episode on iTunes or SoundCloud.

Kristin:  Welcome to Ask the Doulas with Gold Coast Doulas.  This is Kristin, and I’m here with my business partner, Alyssa.

Alyssa:  Hello!

Kristin:  And we have Dr. Annie from Rise Wellness, as well as Dr. Rachel.  Today we are talking about birth trauma with babies and how a chiropractor can help them, especially since you have a focus on newborns.  So, Annie, tell us some different ways that you can help parents.

Dr. Annie:  Sure.  Well, first, I want to talk about what birth trauma means.  It’s not necessarily that all births are categorized as traumatic births, but let’s say there is a lot of pressure on the mom and the baby while the natural birth process is happening.  So even with a natural birth, there can still be some things that show up in little kiddos after.  But if there is any sort of birth trauma, if Mom has to get an epidural, that can affect the baby.  If there are risks of C-section, stuff like that, any of those red flags that are happening during labor, that can all lead to birth trauma, too.

Dr. Rachel:  You’re probably wondering why an epidural would even effect the baby and create more of a birth trauma.  What happens is when Mom gets an epidural, you can’t feel from the waist down, so we can’t feel when we’re supposed to push.  So what happens is that the baby’s head puts more pressure on the cervix that you can’t feel, and it can cause some birth injury in the cervical spine.  Minor, but it can still have effects later on.

Dr. Annie:  Yes.  And then they’re also more likely to need intervention at birth, too, so whether that’s help pulling the baby out by the head and neck or if that’s use of forceps or vacuum-assisted.  And all of those put a lot of pressure on the upper cervical spine of the baby, where the neck is, and your spinal cord goes through that area.  So that’s what we find in kiddos, even after a natural birth process, but especially in those instances where there’s been a lot of intervention.  We see a lot of upper cervical misalignment that affects the nervous system.  And so what we want is to take care of is correcting that misalignment so that they can develop the way that they’re supposed so that their bodies work.  A lot of people think of brachial plexus injuries in kids, when the shoulder gets stuck and there’s traction on the brachial plexus, but if there’s enough traction there to injure those nerves in the arm, there’s enough pressure just in a natural birth that can affect the whole nervous system through the neck.

Kristin:  We find with breastfeeding there can be some issues with the latch or a baby preferring one side to the other, and that could be, obviously, remedied by chiropractor care.  Maybe something happened during birth where they’re just having some issues with their neck and alignment and so on.

Dr. Rachel:  Yeah, that’s super common.  We see that.  That’s one of the first signs that there could have been upper cervical misalignment is if a baby prefers one side or one breast when they’re breastfeeding or if they have latching difficulty because that all has to do with how they can turn their head, how the muscles in their face are working, what position their jaw is in.  So we see that a lot, and when we do home visits, that’s often for a baby who’s head is turned to one side, and then we can correct that with a simple gentle adjustment, and then it’s amazing.  They breastfeed like a champ after that.

Dr. Annie:  I would say a big one, too, right now is the torticollis and the flat head.  I would say that’s later; you see that later, but it probably started with favoring nursing or with latching difficulty that didn’t get corrected.  They’re favoring, so they always want to turn to one side.  And then they hyper-develop those muscles on that side, and then just further down the road, it becomes harder and harder to correct.

Dr. Rachel:  That’s why we always say it’s good to get your babies checked.

Alyssa:  Maybe that’s why I’m so lumpy on this side!

Dr. Rachel:  It’s probably your parents’ fault!  I blame everything on my parents!

Alyssa:  I had no idea!

Dr. Rachel:  It all started with the birth!

Kristin:  And then, certainly, babies that are colicky or have other issues at birth can be helped by chiropractor care.  That’s an easy fix?

Dr. Annie:  Yeah.  And we’ll say this, just so people don’t think we’re crazy.  There was a study done by an MD, Gutman, and he found spinal injury present in 80% of infants examined shortly after birth.

Dr. Rachel:  Out of a thousand births.

Dr. Annie:  Yeah.  Causing interference to neurological and immune function.  So like I said, even just the natural birth process.  I mean, think about it.  If they’re pulling — what is it, 60 to 90 pounds of axial pressure, they say?  So even a natural delivery.  And just the whole process of babies going through.  The uterus contracting; that’s going to cause some sort of distress on that spine.

Dr. Rachel:  And we see that.  I mean, we see other things, too, in kiddos who ended up C-section.  Because they don’t go through the vaginal canal, they don’t get that compression, and so when they’re pulled out of the abdomen, they have a lot of those issues, too, but then their lungs aren’t cleared of fluid and stuff, so then they’re more likely to have allergies and asthma and stuff like that, too, because of those things never getting corrected.

Kristin:  So can you explain to our listeners what an adjustment for a newborn is like so they can rest assured that it’s very gentle?

Dr. Rachel:  Yes.  So the ICPA says you’re going to use the same amount of pressure that you would use to check the ripeness of a tomato.  So it is so gentle.  If you push your finger on your eyelid, the amount of pressure that you can just feel — that’s how much pressure we’re using to adjust a newborn, especially.

Dr. Annie:  We’re using our pinkies.  There’s no instrument; there’s no twisting, cracking, popping.

Kristin:  And I think that’s what people imagine is the cracking.  So it’s not like that?  And the fact that you do home visits is amazing, so people can come to your office here in East Town, and for certain cases with newborns, you’ll go to their homes.  That’s so wonderful!

Dr. Annie:  We do that with most of the moms that we’ve seen throughout their pregnancy.  As soon as their baby is born, they call us up and ask us to come over to their house and check the baby, please.

Kristin:  And do you also adjust the mom when you do these home visits?

Dr. Rachel:  We usually do.  I think almost every time.  And sometimes Dad, if Dad’s home.

Dr. Annie:  Yeah, exactly.  I mean, it’s important for the whole family.  Birth is stressful!  It’s stressful on everybody.  It’s stressful on the mom’s spinal mechanics and on her body, but emotionally stressful on both parents, too.

Dr. Rachel:  And on your body.  We see doulas after the birth!

Kristin:  You are so helpful to me after a birth because we have some recovery, as well, especially if it’s a physical birth, or even if it’s not as physical and my client’s sleeping with an epidural and I’m trying to get rest in a waiting room and kind of shoving myself into these strange positions on a chair to sleep.  I definitely recover faster and my immune system is much stronger as a result of chiropractic care, so I appreciate you both!  Thank you for explaining some of the remedies for different newborn traumas they experience.  How can we find you?

Dr. Annie:  You can find us on our website.  Or you can find us on Facebook and Instagram.  Both are @risewellnesschiro.  It’s probably the best way to find us and get in contact with us.

Kristin:  You’re still accepting new patients, correct?

Dr. Annie:  Yep!

Kristin:  Awesome.

Dr. Annie:  Oh, yeah, we’ll take all the babies!

Kristin:  Thank you so much for chatting with us, Dr. Annie and Dr. Rachel, and we will see you next time!

Dr. Annie:  Thanks for having us!

 

Pregnancy and Depression

Podcast Episode #60: A Naturopath’s Perspective on Pregnancy and Depression

Doctor Janna Hibler, ND talks to Alyssa and Kristin about how a naturopathic doctor treats pregnant and postpartum women, body and mind.  You can listen to this complete podcast episode on iTunes and SoundCloud.

Alyssa:  Hello, welcome to Ask the Doulas podcast.  I am Alyssa Veneklase, co-owner of Gold Coast Doulas, and I am here with Kristin, my business partner today, and Janna Hibler.  She’s a naturopathic doctor and clinical nutritionist.  Hello, Janna!

Janna:  Hi, how’s it going, guys?

Alyssa:  So Kristin and I met you at a little gathering of the minds at Grand Rapids Natural Health Recently.  We kind of hit it off, and then you and I got coffee, and we hit it off even further.  We got to chatting forever, so we were like, let’s just pause this and record our conversation!  And today, first, I want to know a little bit more about what you do, but when the two of us were talking, we spoke quite a bit about postpartum depression, and I want to talk about what happens leading up to that, even before you get pregnant, but then during pregnancy, too.  What does that look like?  What do depression and anxiety look like?  How do we nip that in the bud?

Janna:  Yeah, definitely!  So it’s really important for all of us mamas and future mamas to know that how we are before we get pregnant and give birth is a good indicator of how our health might look like after we give birth.  Things you mentioned such as anxiety or depression tend to get more severe after we give birth just because of the extreme stress and sleep deprivation that we are under, having a newborn.  I like to emphasize to my patients that this is nothing to feel bad about.  It’s just when you don’t sleep, you don’t release the same neurotransmitters and have the same brain chemistry with certain levels of uppers and feel-good hormones.  So it’s kind of…

Alyssa:  I’m obviously a big proponent of sleep for babies and parents.  So what would you tell a parent who says I’m not even pregnant yet; I’m thinking about getting pregnant.  How does a person even know if they have depression or anxiety?  And what do you do about it?  Let’s say that I’m kind of a depressed person or I get anxious about things at work or with my friends or my family.  What do you recommend?  And then let’s say I came to see you as a naturopathic doctor.

Janna:  So again, I like to really emphasize that you are normal and this is a normal part of being a female.  If we’re talking evolutionarily speaking, we were made to be out in nature, and so when we’re put in the city, even if we’re out half an hour from Grand Rapids downtown, there’s a lot of lights.  There’s a lot of noises.  There’s a lot of things going on that cause an overresponse, and that can lead to anxiety and depression.  So some symptoms might be feeling nervous in certain situations or some OCD tendencies, or a lower mood display and laughing less or getting less excited about certain things in life.  These can be very mild, but if you look at them over the course of the day, if you have a lot of little things, they do add up.  So when you walk into a naturopathic doctor’s office, something I really love and take to heart is that we have our medical concentration, but we also have a lot of education with psychology and knowing how the brain works.  So I would ask you a bunch of questions; the normal medical questions you get, but in addition, we’re going to ask about your sleep cycles, your exercise, your diet regimen.  All these play a part in our mental health, and my end goal is for everybody to feel their best all the time.  In order to find out how people are feeling, I like to run a series of either urinary or blood tests.  This can give us an indication of brain chemistry, hormone levels, cortisol, in addition to the normal things like checking sugar and red blood cells.  I really like to hone in on these specialty tests because by checking our brain chemistry, I can find exactly what neurotransmitters might be high or low, and we can treat appropriately.

Alyssa:  So when you talk about neurotransmitters, what does that mean?  What are you looking at and what does that mean to you?

Janna:  So our neurotransmitters; there’s the common ones we’ve all heard of like dopamine, serotonin, norepinephrine, epinephrine, even histamine.  There is a whole slew of uppers and downers, and basically, we take the brain chemistry analysis tests so we can see if some of them are off.  Some people that have allergies have high histamine levels.  That’s an upper, so when we have allergies, those people actually tend to have anxiety, as well.  And so we can actually nip the anxiety in the bud by treating the allergies and reducing histamine levels.  So it’s really a cool science.

Alyssa:  And the cortisol and serotonin and melatonin, all those things you can actually check with blood and urine?

Janna:  Exactly, yeah.

Kristin:  And a lot of women have issues with their thyroid; is that part of the testing, that you can check thyroid levels?

Janna:  Absolutely.  I like to refer to it as our hormone triangle where we have our thyroid as the king, our sex hormones like estrogen, progesterone, and then we have our cortisol.  All three of those categories play a huge role in our hormone development and picture that we have, so we do a lot of intensive testing to find out where those levels are at.

Alyssa:  And what would you do if I came in and my cortisol levels were sky-high and you noticed something with my thyroid?  What would you tell me to do?

Janna:  So depending on your lab results, the thyroid could be treated in two ways.  One, sometimes we do give conventional medications, and then another way to treat, depending on your levels, is with herbs.  We can give a series of botanical herbs to actually bring your levels back to normal, as well as certain nutrients.  There’s a number of co-factors that actually feed our thyroid hormone to turn from its inactive to active form, and without them, we will not function.  So that’s things like vitamin D and iron and vitamin C; very common nutrients that we take for granted, but they play a vital role in our thyroid health.

Alyssa:  So how long do you test that out before you put them on a drug?

Janna:  Typically, I like to give a patient three to six months to see if we can fix it with nutrients and herbs.  Again, it comes back to what the patient wants.  If a patient wants results this month, then we might take a more aggressive treatment plan.  But if they’re willing to do it completely naturally, then three to six months.

Alyssa:  So let’s say I get it under control; I’m pregnant, and I still notice now that I still have some anxiety or depression.  What do you do during pregnancy?

Janna:  I really like to encourage diet and exercise and sleep.  Those are our biggest best friends to really help out.  Different lifestyle factors can have a huge effect on our mood and behavior.  So let’s start with maybe some foods.  We could eat a diet rich in dopamine, so we could do things like chocolate.  I mean, who doesn’t love chocolate?  We all love it, but do we know it’s high in magnesium and it’s high in zinc?  Those are vital co-factors to run our brain chemistry.  We can also have blueberries or nuts and seeds, which are high in vitamin B6 and 9 and all these B vitamins to help also with our mood.  We could do some grass-fed or fermented foods, which help with our gastrointestinal health, which again, I’m sure you guys have all heard of the gut being the second brain.  And then sulfur; sulfur-rich foods like onions and garlic that actually help with detox, so if we are having some things get backed up, we can help get them out.  So we really try to approach it from a multifactorial view hitting all points.  How’s our diet?  How’s our exercise?  How’s our sleep?  How’s our stress?  And a lot of what I get into with patients, too, is how is your relationship at home?  Do you feel supported?  Do you feel loved?  Do you feel heard by your partner?  By your business partners, your coworkers?  These are all part of our needs that play a role in our mental health when we’re pregnant and when we’re not pregnant.

Alyssa:  I was going to say those are things that should be carried over throughout, right?

Janna:  Yeah, yeah!

Alyssa:  Meanwhile, exercising and getting enough sleep.

Janna:  Totally, and pregnancy just kind of is that opportunity where we find our weaknesses in our body, and it’s actually a great opportunity to increase our health for the rest of our life and find out things we wouldn’t know about it unless we were pregnant.

Alyssa:  Oftentimes, I feel like that is the point in a woman’s brain and body where we finally start to understand and care about what’s happening to our body, and because we’re growing another human, then we’re like, oh, I better start taking care of myself so that I can take care of this baby.

Janna: Yeah, and I think that has a lot to do with what happens after we give birth and why a lot of moms struggle.  I mean, I want to say that loud on this podcast right now that mom life is hard.  It is a struggle, and I know we all try to put on a face that we’re doing well and everything’s perfect at home, but mom life is hard, and that’s maybe another podcast sometime, but that’s a conversation I’d love to get started because it is hard, and to that extent, why we have a hard time after birth is a lot of the time – and I’m sure you guys see this all the time, being in the house with moms – that the moms forget about themselves.  They put all of their energy, all of their love, into their baby, and I was guilty of it, too.  I mean, I have a two-year-old, and I definitely did it.  I’m still guilty of it some days because we love that human so, so much.  But I think it’s really important for our mental health and as mothers to put the energy back into ourselves and remember that we really can’t pour from an empty cup, and we have to be healthy and strong ourselves in order to make strong and healthy babies.

Alyssa:  So what do you recommend to a mom who’s suffering from depression?  You know, maybe they had a beautiful pregnancy, easy labor and delivery, and then they’re like, oh, my God; this is way harder than I thought, and then sink into a depression that they’ve never experienced before.  How do you get them out that?

Janna:  And so many moms do!  There are so, so many out there that come in, and they’re like, not even my husband knows how sad I am; not even my best friend knows how sad I am, and that’s where I really encourage everyone to just start reaching out.  I don’t want you to be ashamed; I don’t want you to feel guilty, because it doesn’t mean you’re a bad mom.  You’re an excellent mom because you care so, so much, and asking for that help and taking that first step, making people aware that this is something I do need help with, and receiving that love.  From a medical standpoint, too, we’ll go in and I’ll help adjust hormones and your brain chemistry with either herbs or conventional treatments or nutrient levels to help your body, but I think so much of it also comes from a mental and emotional spot of feeling supported and loved by your people around you.

Alyssa:  So is naturopathic medicine, in general, more of a functional approach versus the medical approach or kind of a combination?

Janna:  Exactly, yeah, and functional medicine is so great.  That is the bridge between conventional medicine and natural medicine because we all agree on it, you know.  We see a lab level, and it’s important to attend to it when it’s on its lower level.  Traditionally-minded thinking, we only would treat something like vitamin D if it was set low because that’s the level that can cause rickets and true mobility issues, but what about everybody that has low-normal, that they’re in that functional, funky range?  That’s at a stage that can cause depression, that you can get autoimmune diseases.  So as a naturopathic doctor, I really work on treating it then and now so we can prevent getting those diseases because they may not pop up in five or even ten years, but they will happen if they’re not treated.

Kristin:  Even in pregnancy, there’s evidence that preeclampsia with the lack of vitamin D, that can be a factor in developing preeclampsia.

Janna:  Exactly, and that’s how it can be that simple sometimes where moms come in and, hey, they just want to run a nutrient panel just to find out what are their baseline nutrients, and then that way when breastfeeding comes into play, especially for extended breastfeeding – I’ve been breastfeeding for two and a half years, so that’s something I’ve been keeping a constant eye on, what are my nutrient levels, because we don’t want to cause other problems from just being depleted.  So yeah, that’s a great point.

Alyssa:  Depleted is a good word to describe mothers postpartum, I think.  Most of us at some point just feel depleted, whether it’s mentally, physically, whether it’s just breastfeeding.  That alone can make you feel depleted; this baby is literally sucking the life out of me!

Janna:  Because you’re giving everything!

Kristin:  I tandem nursed, so I really felt depleted when I was nursing two!

Alyssa:  It’s like this weird tug of war between “I love doing this” and “I hate doing this so much.”  I remember getting so over it when I was done, and then a month later I missed it.  I was like, oh, my God; I’m not breastfeeding anymore!  But I was so ready to throw those pump accessories in the trash and celebrate, but it’s just a weird…

Janna:  It is!  And every mom is different, so we like to celebrate moms at each level, whether they want to breastfeed for three months or six months or a year.  We all have our breaking point, and we want to prevent us from getting to that point.  Mama matters, too!

Kristin:  For sure!

Alyssa:  Well, thank you so much for joining us, and if people want to find you to come visit you or just ask you questions or follow you on Instagram, where do they find you?

Janna:  Absolutely!  So I’m currently accepting patients at Grand Rapids Natural Health, and I’m also on social media as holisticmommyandmedoc, and you can reach out there anytime.  My name is Janna Hibler on Facebook, and feel free to message me anytime.  I like to get to know my mamas.  Since I just moved from Vermont, I’m looking to build up my network of mamas because we are a tribe and we all need to stick with each other, so whether it’s personally or professionally, I do want to link up with you!

Alyssa:  Thank you so much!

Kristin:  Thanks, Janna!  We appreciate it!