Meet Mya, Our Newest Postpartum Doula!
Meet Mya, Our Newest Postpartum Doula!
As you know, when we bring a new person onto the Gold Coast team, we love to find out more about them and
share that with you!
Let’s find out more about Mya.
1) What did you do before you became a postpartum doula?
Before becoming a doula, I worked as a swim instructor, and as a head swim coach for young children in
Naperville, Illinois. After that, I went to Central Michigan University to earn a bachelor’s degree in science.
2) What inspired you to become a postpartum doula?
I’ve always been fascinated with pregnancy as a whole, after watching my family members, experience,
pregnancy, childbirth, and postpartum. I knew I would be the perfect helping hand for those who look like me,
which is what inspired me the most. I want other minorities to feel comfortable while giving birth, which is why I
pride myself on creating such a warm and open environment.
3) Tell us about your family.
My family has a very tight bond, we are quite a small family, because of this we spend lots of our free time
together whether it’s hanging out and enjoying each other’s company or traveling and going on new
adventures. Overall, my family is very loving and supportive, and most of all we love to have a good laugh.
4) What is your favorite vacation spot and why?
My favorite vacation spot is probably Barcelona Spain, the reason for this is because I’m a total foodie, and the
food there was beyond fresh and different from anything I’ve ever had before. Also, the architecture of all the
buildings were incredibly breathtaking.
5) Name your top five bands/musicians and tell us what you love about them.
This is a hard question, considering I enjoy listening to almost all genres of music.
6) What is the best advice you have given to new families?
The best advice I have for families is to stick with their goals and values, just because they don’t align with
others in your community does not mean they are wrong, and also to give yourself grace and patience. Some
things take time to heal, and we must be mindful of that.
7) What do you consider your doula/consultant superpower to be?
I believe my doula superpower is making people feel comfortable and empowered, no matter what the situation
is. Growing up looking different from most of my peers I know how it feels to be in uncomfortable situations.
This is why I pride myself on being able to make others feel both comfortable and confident in all environments.
8) What is your favorite food?
My favorite food is tacos, I could probably eat tacos every day for the rest of my life.
9) What is your favorite place on West Michigan’s Gold Coast?
Since I’m not a Michigan native, I absolutely love going to the dunes, we don’t have anything similar to that in
Chicago so it’s always a fun treat.
10) What are you reading now?
Self-care for new moms
11) Who are your role models?
I would say, my mom is one of my biggest role models, she’s taught me how to be kind, empathetic,
independent, and resilient.
Mya serves day and overnight postpartum and infant care clients in West Michigan, SW Michigan and Northern
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!
Why You Should Take a Breastfeeding Class: Podcast Episode #166
Kristin chats with Kelly Emery of Baby Beloved about why moms should take a breastfeeding class during pregnancy. You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you find your podcasts.
Welcome. You’re listening to Ask the Doulas, a podcast where we talk to experts from all over the country about topics related to pregnancy, birth, postpartum, and early parenting. Let’s chat!
Kristin: Hello, hello! This is Kristin with Ask the Doulas, and I am so excited to chat with Kelly Emery. Kelly teaches our breastfeeding classes at Gold Coast and our Back to Work pumping class, and she’s an RN IBCLC and has so many certifications and degrees including the fact that Kelly was a former doula before doulas were even really a thing. So welcome, Kelly!
Kelly: Thank you, Kristin. It’s great to be here. I’m happy to be on your podcast.
Kristin: I would love for you to give our listeners a bit of a glimpse of your background. As I mentioned, you have so many different degrees and trainings and you have so much experience. You were helpful with my own children. I’d love to learn more about you.
Kelly: Yeah, sure. It all happened way back – well, I went to college, actually, to be a teacher, and then a psychologist. I wasn’t quite sure, so I got both certifications. But during my graduate school when I was wanting to learn to be a therapist, I got pregnant, and that was way back in 1990. And then all of life changed. My focus changed, and I can’t even explain it to anybody, but I just fell in love with the whole birth and breastfeeding world. It just took my world in a different direction. And then I became – I did some certification for being a – it’s called a lactation educator, a certified lactation educator back then was the certification in 1994. And then to become a doula around that same time, like you said. So got some really good experience helping moms just in my role as a doula, and that grew and grew and grew. It just keep snowballing, and I’m like, okay, I’m not going to be a psychologist. I’m not going to be a teacher. This is what I want to do. Fast forward a bit, and I decided I needed to go to nursing school. I wanted to learn more about how the body works and how the breasts work and how everything just kind of fits together and just how amazing our bodies are, actually, just really pulled me forward into that. So I got a nursing degree, and then I started working – well, I’ve always been doing home visits, but then I started doing hospital work, which was an eye opener, and it was really great to see babies just right after they’re born and what happens in the hospital, and it just progressed. I started a little boutique where I sold breastfeeding – I saw patients in my office, but I also sold, like, pumps and bras and all the breastfeeding gear.
Kristin: Yeah, and I taught my first class in your space.
Kelly: That was such a lovely time.
Kristin: Yes, it was!
Kelly: While it lasted, it was so great because we had so many classes and just people coming in and just lonely moms wandering in just wanting to get out of the house, you know. We had a support group in there, and it was the best. But unfortunately, 2008, and I just financially couldn’t keep it going. It was a bad recession time. So the boutique ended, but I still have – still kept doing Baby Beloved, which is my business, where I do home visits and office visits. I do telehealth, and then I also go to six different pediatric offices and I subcontract with them. So I’m all over the city, usually at least five, sometimes six days a week.
Kristin: Yeah, you are busy, that is for sure. And you’ve been an educator both in hospital and classroom for quite some time, as you mentioned?
Kelly: Yeah, back from in the ’90s on, I’ve been teaching breastfeeding classes and just ventured out, you know, doing more of that via Zoom because of COVID and getting my online class going, too. But I actually also a few years back got my master’s degree in nursing education. So it was a really good adjunct to that to help me understand better how people learn and just different techniques for educating people about their bodies and their health and all of that. So yeah, I have lots of little initials behind my name.
Kristin: Yes, you sure do!
Kelly: But long story short, I love teaching, and it’s a great – I mean, I teach even when I’m one on one with a person, but in a group, it’s a different dynamic, and it’s super fun.
Kristin: Agreed. And yes, with the pandemic, we had to shift all of our Saturday Series to virtual for a bit, and luckily we’ve been back to in person since the spring, and that has been so much better as far as being able to really, yeah, interact and attune to each couple’s needs. But tell us a bit about your breastfeeding class and why it is important for couples who want to breastfeed to get educated before they have their baby or babies.
Kelly: It’s something that a lot of people just bypass. They don’t – not a lot of people take a breastfeeding class, and they wish they had later, you know, when I’m in their living room helping them breastfeed, they’re like, oh, nobody told me this, and oh, I wish all of those things. But they focus a lot of childbirth education, which is very important, as well, but labor’s going to be over, you know, hopefully within 24 hours. You know, labor is going to be over, and it’s a wild ride getting there, but in the end, you have your baby, and there you go. But breastfeeding goes on and on for as long – however many weeks, months, years you want to do it. It’s a daily thing, sometimes 8 to 12 times a day. So it’s something that’s going to take up a major part of your day and lots of things to know. Lots of expectations to set, and just learning how your body works but also how your baby eats, like how human mammals actually eat. And then once you know that – like, once you know how your body works and how your baby works, then you can blend it together to make, like, a unique breastfeeding relationship for yourself within your family unit. Everybody has competing things. Like, I’ve got to go back to work in this many weeks or months, or I have my mother-in-law living with me and she had dementia, or I have six other kids. There’s so many things that weigh into the decision of even whether you want to breastfeed. But the more you know, the more you can tweak it to personalize it however you want it to be.
Kristin: Exactly. And your class is definitely recommended for partners, as well as the birthing person.
Kelly: Yes. That’s the first slide in my PowerPoint is a picture of the dad holding baby or a partner. You know, whoever is going to be your person who’s going to be with you at 2:00 a.m. and who’s going to hold your hand through all of this, that person would ideally be in the class, as well. And I know sometimes, especially guys if they’re there, they feel a little awkward being there, but I will tell you, I will not make it awkward for you, and a lot of what I have to say is directed at the support people because research has shown over and over again when we look at research about what makes breastfeeding successful and what helps a person meet their breastfeeding goals, it’s always the support person, the partner that’s there. It’s not the lactation consultant. I mean, I play a small part, as does your pediatrician and all the other people in your life, but far and away, it always rises to the top that that one person who is so influential in the breastfeeding rates and how they turn out is the partner. So they play no small part in this, and I totally encourage everybody to come and bring your cheerleader. Like, bring whoever’s going to be with you there at 2:00 a.m.
Kristin: Yes. And I know you touch on other feeding methods in the course, but you also have a specific class on back to work pumping for those clients who wish to pump later or, you know, some students have the plan to start out pumping for multiple reasons.
Kelly: Sure. Yeah, there are some people who don’t want the baby at the breast. They want to lactate and they want to pump it and then feed it by bottle. So I go over all of those in my class. The last section of my class is dedicated a lot to going back to work or pumping and how can the partner introduce a bottle without it interfering with breastfeeding. How do we manage both, if mom wants to do both? A little bit of breast, a little bit of bottle; how can we set that up for success? So yes, definitely, we do some of that in the last part of the class, but if you wanted a deeper dive into it, like it’s a three-hour class on back to work that goes through a lot more stuff. Plus during the back to work, it’s a lot about pumping. How to choose a pump, how to maintain your milk supply, are there any foods or what’s up with that, is there anything that helps it. And then how do you talk to your employer? There’s so much rich content in there. If you did the breastfeeding and back to work class, you’d be there for six hours with me, so that’s a little long to sit for a class, so the back to work, that working and pumping class, is separate. You have access to it for two years so you can always go back to it nine months later and say, what did she say about freezing this or blah, blah, blah, whatever. So that’s kind of a nice option.
Hey, Alyssa here. I’m just popping in to tell you about our course called Becoming. Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between. You’ll gain the confidence and skills you need for a smooth transition to motherhood. You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more. You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most. And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls. If you’d like to learn more about the course, you can email us at firstname.lastname@example.org, or check it out at www.thebecomingcourse.com. We’d love to see you there.
Kristin: That’s amazing. And then your breastfeeding class is part of our Saturday Series. We offer that in our office in Eastown every two months. And then for those students who can’t make that date on a Saturday afternoon, then you do have recorded self-paced options for the breastfeeding class that you can register for off of the Gold Coast Doulas website, as well as the back to work pumping, also, is a recorded version, correct?
Kelly: Yes, that’s right.
Kristin: And then with Saturday Series, the beauty is you can register for all three, the comfort measures, the breastfeeding, the newborn, or just pick ala carte what you want. So if you’re only interesting in the breastfeeding class, then you can select that option. And then as far as just getting into the differences, you did describe your class beautifully, but having attended it and gotten so much wisdom from your series, I’d love for you to talk about the difference between your class and a hospital breastfeeding class.
Kelly: Yeah, sure. I used to, a few years back, I used to teach a hospital class, and when I did it, I was representing the hospital, so I had to use their – it was like a prepackaged PowerPoint, basically, that they bought from a company. So it was pretty basic, and it was good information, but it was pretty basic. And because I have so much experience as a lactation consultant, I also peppered it, you know, with my own real life experiences and case studies and stuff like that, which kind of made it more fun and interesting. But my PowerPoint, which is, for my own business, I have total control over creating that. So mine is not so cookie cutter. It’s very individually curated to what I see the most things that cause hiccups in breastfeeding in just all the patients that I’ve seen since 1994. So I know what are the biggest hurdles that moms need to know about. What are some ways – just basically boiling it down to, what does she really need to know? What’s going to be important? And I can tell her this and this, but she’s not going to remember it, so how do I bring a story to it so if this does happen, she can remember that story and then remember the concept better. And I have lots of pictures. Tons of pictures, which I think the more modes of learning, the better. You know, when you can see it in motion. So I have lots of videos, too, of moms breastfeeding. And then the other thing, especially for the pump part, I bring in my pump, and we get to play with all these pumps and all these things like nipple shields, all these stuff. I pass them around, so tactilely, they get to touch it and play with breast shields and see how they’re different sizes. There are different sizes when you pump, so we can kind of look at all of it. So that’s different, I think from the hospital one, and it’s fun, too. I like to make it interactive, especially in a group class. There’s just some cool dynamics when you get people together who are in the same stage of life, and it’s not like in a big auditorium where there’s 100 people in there and you don’t really feel like you can raise your hand. These are smaller group classes where you can have a conversation, and I think where conversations happen, that’s where the richness is, and that’s how we understand concepts better, like when we talk it through. Plus the camaraderie. The other people all in the room, they’re in the same boat, and they’re just starting out, too. So it’s really good to know that you’re not alone and you’re not dumb for not knowing this stuff. It’s just you’ve never done it before. You’re a rookie. So it’s very normalized to be able to take in all this information.
Kristin: And I recall from registering students that it’s not always first time parents who take your classes. Some people didn’t have success breastfeeding with other babies and then really want to get that education and set themselves up for success this time around.
Kelly: Yeah, and those are so good to have in class because they – when they talk, the others really perk up and listen because they want to hear it. I mean, you can always hear it from a lactation consultant, but hearing it from another person who’s already been in the trenches and coming back with real talk about it, it’s very powerful to hear a real person’s story.
Kristin: Agreed. And again, just accommodating to different learning styles. I loved the interaction and the way you demonstrated different breastfeeding positions and talked a lot about latch and supply. That’s always a big concern for doula clients is, am I going to produce enough milk.
Kelly: I know, it’s a big – I mean, most people do, but I’ll be honest, there are some people who struggle, and it’s through nothing wrong that they’ve done, but sometimes that happens. So we also go over – you know, I’m honest about that, as well, to say there is a small amount of people who – with certain medical issues, usually, and I talk about those in my class, that if you have any of these medical issues, it’s great to get support right away to set yourself up for success, especially during those first two weeks of breastfeeding when supply is established. The more you know, the better prepared you’ll be, and you can get support lined up ASAP.
Kristin: Exactly. And I love also the option with the recorded class that people can take your class from anywhere in the country or world. With our Becoming students, they’re able to register for your virtual options, and they could live in New York or Seattle. That is also amazing. And you do – even though these are some recorded versions, you do offer Q&A calls, correct?
Kelly: I do, yeah. Like, once a month. It’s the first Wednesday of the month in the evening. There’s a free Q&A for anyone who’s pregnant, so they can come and ask me anything, and it’s free, and the last one that I did, I had someone who just wanted to jump on to see if she jived with me, you know. Is this someone I want to be taking a class with? So that was cool. You don’t want to spend your time and money with someone who’s values you don’t – you know, you want to be able to know that you can talk to them and you’re going to gel with them. So that was really good. So anyone who just wants to get to know me better or has a burning question. Maybe there’s something on your mind. Maybe you did take a class already, but you still have questions. Anyone can register for that on my website.
Kristin: That’s great. So any final tips for the listeners or our students?
Kelly: No, I just really encourage you to think about taking a class because once your baby comes, it’s go time, and there’s not going to be a lot of time to sit down and read books and take three-hour classes after the baby’s born. Now is the time to soak up as much as you can, and having four ears there is better than two because sometimes you may hear something and then your partner hears it a little differently, or it just hits differently, and then they can remind you later. I’ve had that happen a lot where someone who’s taken my class and then later has hired me to be their lactation consultant, the dad comes in and says, yeah, remember, she said to do this, blah, blah, blah.
Kristin: Right, they remember. I know my husband did.
Kelly: They do. They really do. They’re listening with a different set of ears. So it’s good.
Kristin: Totally. So Kelly, you mentioned price before, so our course, the breastfeeding as part of Saturday Series, is $85. Each class in our series is $85, so whether it’s an in person or virtual, that is $85, and we do accept health savings and flex spending. And Kelly, your back to work pumping class is how much?
Kelly: It’s $49, and that’s access for two years.
Kristin: Awesome. Well, thank you so much, and feel free to share your personal contact info with our listeners, and of course, you can find any of the class information on the Gold Coast Doulas website.
Kelly: You can find me on my website, and that’s the best way to contact me, through the contact page.
Kristin: And I know you’re on Instagram and Facebook and other areas.
Kelly: Oh, yes. Absolutely. Thank you for that.
Kristin: Well, it was lovely to chat with you. Thank you so much for sharing all of your wisdom with our listeners, and I hope they’ll all be seeing you soon in either the in person or recorded class.
Kelly: Me, too! Thank you so much, Kristin.
Thanks for listening to Gold Coast Doulas. Follow us on Instagram, Facebook, and YouTube. If you like this podcast, please subscribe and give us a five-star review. Thank you! Remember, these moments are golden.
Meet our new Postpartum Doula, Jene’e!
1) What did you do before you became a doula/consultant?
For many years, I primarily have been a “domestic engineer”, a stay-at-home mom. Although in some of those years, my family has owned a few restaurants, and I helped there when I was needed.
2) What inspired you to become a doula/consultant?
Becoming a mama at a very young age, to two boys, and the birthing experience I had with them started my journey to want to make others mamas experiences more empowering and filled with better memories and support. Because of my birthing experience with them, for a long time I wanted to be a labor and delivery nurse, or an OB nurse practitioner, but that was not my life path.
I now have 7 beautiful children, and each one of those birthing experiences was different. It was not until my 6th child that I became more aware that I have a choice to a have different birthing experience. Now I want to empower mamas to know that they can too.
3) Tell us about your family.
We moved here to the Traverse City area at the end of 2020, from Henderson, Nevada. We would visit family here every summer, and loved the area.
We are a very outdoor family. Love the beach, paddle boarding, fishing, soccer, snowboarding, sledding, all fun activities
4) What is your favorite vacation spot and why?
I absolutely love Hawaii. The beaches, the warm water, the smell, the culture. It is my Happy place.
Traverse City use to be one of our favorite vacation spots every summer also, until we moved from Las Vegas.
Now Las Vegas is one of my favorite vacation spots, so I can see my son, my amazing friends, and my previous village.
5) Name your top five bands/musicians and tell us what you love about them.
This is really hard to answer. I really think it depends on intention, mood, and the time of day.
6) What is the best advice you have given to new families?
There is so much “best” advice to give! Give yourself Grace, time to heal and rest, do what is best for you and your family even if that means setting boundaries, and do not feel the need to follow the western culture to “bounce back”.
7) What do you consider your doula/consultant superpower to be?
From what I have been told, is that I bring great, empowering, safe energy when I walk into the room
8) What is your favorite food?
I love raw sushi and Mexican food
9) What is your favorite place on West Michigan’s Gold Coast?
I love Empire, Sleeping Bear Dunes, Glen Arbor, & Traverse City
10) What are you reading now?
The First 40 Days
11) Who are your role models?
I love to listen and surround myself with empowering woman and friends.
Top 5 Tips for Encouraging Baby to Sleep Through the Night
Kay Vorce, CED-PIC
Gold Coast Sleep Consultant
If there is one question I get all the time, it’s this one: How can I encourage my baby to sleep through
the night while still responding to their needs?
First, let’s define what that means. If your baby is sleeping 6-8 hour stretches, that’s considered sleeping
through the night. Although babies need 10-12 hours of sleep overnight (along with naps), your baby
may technically “sleep through the night” by sleeping 8:00 p.m. to 2:00 a.m. I don’t know about you, but
that’s hard to celebrate unless you also want to go to bed for the night at 8:00 p.m.!
The good news is that there are things parents can do to encourage a healthy chunk of sleep at the right
time, but there are some factors to consider: Age, weight, and habits.
Here are my top 5 tips for getting your baby to sleep through the night, with parents getting the most
sleep out of it too!
1. Keep your expectations realistic.
A newborn (8 weeks or less) needs to eat frequently. Expect your baby to wake every 2-3 hours
for feeds. If they don’t wake that often on their own, check with your pediatrician about setting
an alarm overnight for feeds. It’s very important that your growing baby gets the calories they
need in these vital early weeks.
These are the exhausting days. The trifecta of physical recovery, sleep deprivation, and hormone
adjustments in the post-birth period can bring on a myriad of complex emotions. Consider hiring
a postpartum doula. A postpartum doula can provide overnight newborn care while a mother
gets the vital rest she needs to stay physically and emotionally healthy. Don’t try to just survive
this period, reach out for help and support, you won’t regret it.
Once your baby has regained their birth weight and is closer to 2 or 3 months old, 4-6 hour
stretches become more realistic.
2. Don’t neglect the daytime calories.
Sometimes a baby will sleep A LOT during the day. Your baby is a perfect calorie regulating
machine. While this may be great for getting things done, keep in mind that the calories a baby
does not consume during the day, they will wake for overnight. Don’t be afraid to wake your
baby for a feed if they’re still napping and they’re due a feed.
3. Place a feed before parent’s bedtime.
If your baby is 12 weeks or under, consider a “wake and feed.” This technique combines a feed
with a short awake window to build sleep pressure, with the goal of a long sleep placed at a better time for parents. Wake your baby an hour before you’d like to go to bed and combine the
feed with some kick and play time in lower light, then put baby to bed for the night.
If your baby is 16 weeks or older, do a standard “dream feed” with no awake window. Just rouse
baby enough to take feed, then back to bed again.
The goal here is to help maximize sleep for the parents. If that doesn’t happen, ditch the
technique, and just aim for a filling feed at bedtime.
4. Start working on laying your baby down awake.
When your baby is under 12 weeks, and especially in the first 8 weeks, they’ll need total
assistance to sleep. But that doesn’t mean you can’t help them off to sleep while they’re laying
down in their own safe sleep space! Get your baby nice and drowsy in your arms, then try to pat
their bottom and “shush” (white noise is great here) them off to sleep once they’re laying down.
You can gradually pull back on how drowsy you’re getting your baby as they get older. A baby is
far more likely to sleep through the night when they recognize the environment is the same one
where they first went off to sleep.
5. Don’t rush straight to a feed overnight.
Your baby will make all sorts of sounds overnight, so try not to rush straight to a feed at every
sound or wake. If your baby is under 12 weeks, wait a minute or two before responding—your
baby may fall back asleep. If your baby is 12 weeks or more, a healthy weight and tracking well
along a growth curve, it’s worth a try to see if you can resettle your baby without a feed. The
amount of time is whatever you’re comfortable with, but I’d suggest trying to resettle with
motion, white noise and/or a pacifier for no more than 30 minutes before going to the feed. If
you’re exhausted, aim for just trying this one time a night.
2022 Diaper Drive Numbers Are In!
Special shoutouts go to the following partners:
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.
Fertility and Acupuncture: Podcast Episode #101
Today Kristin talks to Vikki Nestico, R.Ac of Grand Wellness Acupuncture. We learn a lot about fertility and how acupuncture supports the nervous system, reduces stress, and increases blood flow to the reproductive organs. You can listen to this complete podcast episode on iTunes or SoundCloud.
Kristin: Hi, Vikki!
Vikki: Hi, how are you?
Kristin: I’m good. Good morning!
Vikki: Good morning.
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 fertility and acupuncture. So welcome, Vikki!
Vikki: Thanks, Kristin! It’s good to be here.
Kristin: So tell us about yourself before we begin.
Vikki: Well, I am an acupuncturist, and I own a holistic care clinic here in Grand Rapids called Grand Wellness. And we’ve been here for about six years. So it’s been wonderful being here. Previously, I had moved here from New York City where acupuncture is used very often, and so moving here, it’s been wonderful to see it growing and holistic health in general just growing every year by leaps and bounds. So it’s been really wonderful.
Kristin: And I think we met when you first moved to Michigan through a mutual friend.
Vikki: Yes. Absolutely, yes. That was quite a while ago.
Kristin: Yes. It sure was! We’re glad to have you here, and I love seeing how well your practice is doing.
Vikki: Thank you! Yeah, so we work with a lot of different conditions here at the office, but, you know, a group that I really enjoy working with are couples who are trying to conceive. It’s very rewarding to work with these women and men who are trying to conceive naturally or maybe they’re using IVF or anywhere in between.
Kristin: Sure. Take us through the process of how a couple would work with you as they’re trying to conceive, whether they’re using natural methods only or if they are going through a fertility center, for example, and want a mix of holistic and medicine.
Vikki: Yeah. So we really meet each couple or mother at whatever place they’re at. So, you know, optimally, you know, as soon as they have a little glimmer in their heart that they would like to start a family, that’s when we love to start seeing them. But that doesn’t always work out. A lot of times, we — and we see people after they’ve been trying for a while. We see probably our greatest group of couples when they’re working with a fertility clinic. So we do a lot of work with the local fertility clinic here. I think they know our smiling faces over there. But we really meet them where they’re at, and we’re able to help in all aspects of preparing both the women as well as the men, and I think that working with men is an aspect of fertility that people don’t think about.
Kristin: I’d love to hear more about that! Do you work with the man surrounding his emotions or just basically to repair him biologically?
Vikki: I guess the easiest way to explain is to really explain how acupuncture works in the body. There’s a couple different ways to look at it. There’s through the eyes of Chinese medicine, and then there’s through the eyes of our scientific knowledge, right, of how the body works. So I’ll sort of walk you through, maybe, the scientific knowledge, since that’s what most people think of when they’re trying to figure out what’s going on with their fertility. So acupuncture really is great at calming the nervous system, balancing hormones, and increasing blood flow. Blood flow, blood flow, blood flow. I can’t say it enough when people come in for treatment. And the reason that acupuncture can help and is so helpful is because, first off, if we look at just increasing the blood flow, we’re focused on having that blood flow reach the reproductive organs. And so in that way, we’re looking at it to improve the function of the ovaries, to nourish and help grow these healthy, ready eggs, to send more blood to the uterus to create this thick and healthy lining. And those aspects are, you know, obviously extremely important when we’re looking at ease of getting pregnant. Another way that acupuncture helps is by reducing stress, and I’m sure you’ve heard it a million times, right? Stress can really cause a lot of problems for us across the board, but when we’re looking specifically at fertility, it’s easy to see how it can cause a problem. I always explain stress by using my little prehistoric story of a woman. She’s sort of walking down the street, and this saber tooth tiger jumps in her path. And at that moment, her body clicks, the sympathetic nervous system. And all the blood and all the energy in her body is getting out to the muscles so she can run fast, so she can be strong. To her eyes, so she can see. Opening the ability to bring in more oxygen, to breathe more, to be fast. And that’s great in that situation, but at that time, the blood is not in your reproductive organs because it’s not necessary there. And so nowadays, we’re in this time where we’re overloaded by work. We’re overloaded with family obligations. And so we have this ongoing chronic stress that can be overreacted to by our bodies. So our reproductive organs just aren’t thriving in that environment. So having acupuncture be able to click us back into that parasympathetic nervous system, where we breathe, where we get more blood to our organs and can really focus on healing our body and nourishing eggs and all of those things – it’s extremely important. And especially when people are trying to get pregnant, they add that much stress because they’re always stressed about whether they’re pregnant.
Kristin: Yeah, and for our clients who started out their journey with The Fertility Center, there’s a lot of stress with that, or clients who had loss in the past and their worry about experiencing loss again. I can see how emotionally it would be great in preparation. Our clients who had an easy time getting pregnant the first time and then struggle with secondary, and they come to me wanting resources and help, and I do bring up acupuncture, but I’m learning so much with you today about the whole process and the benefits. It seems like even if it’s years away that preparing their bodies well in advance would be beneficial for couples.
Vikki: Absolutely. And even when we look at males in this way, they’re doing research, and there’s research out there showing, that stress can reduce the amount of sperm, healthy sperm, that a male has. It can alter the shape and reduce its ability to be a great swimmer and all the things we need to make sure we’re making some good quality and in some cases quantity, depending on what we’re working with, embryos. So really important for males to be in on that. And I say this to all of my women that come in: a third of fertility difficulties lie with the man. And I don’t think we as women always understand how high that number is.
Kristin: A lot higher than what many women think. It’s surprising.
Vikki: In fact, I think that what the research states is about a third of difficulties are on the female side, a third are on the male side, and then a third are somewhere in between.
Vikki: Very interesting. And I think we take on the burden as women that it must be ours. And many men just assume it’s a problem, you know, with the female side. So it’s great to know that men can really help out and be a part of increasing success. A couple other things that acupuncture is great for, especially when we’re working with IVF, is it can prevent uterine contractions. So the way that we work with the nervous system, we can calm that nervous system, which connects to that smooth muscle tissue, and — yeah, so when we do embryo transfers — or when we work before and after embryo transfers — the after treatments really are focused on eliminating uterine contractions as much as possible, and that really helps to have successful implantation.
Kristin: So if any of our listeners or clients have yet to experience acupuncture, can you describe what a fertility session would be like and how many visits a male and female client would have? I don’t know if you work with the partner in a certain number of sessions ideally and then the expecting person? Is it different as far as the number of sessions or what that would look like?
Vikki: Ultimately, we like to work with them on a course of 12 treatments, and it’s not an arbitrary number. Three months of acupuncture helps to create good healthy eggs and is about the time of how long it takes to regenerate sperm. So it takes about 90 days for this egg to mature to be ovulated. And so we can get to working with the woman right away. We can get more blood flow. Inside that blood is all these nutrients to really impact the health of that egg and, equally, the health of the sperm. And so that’s why optimally we’re looking at three months, though I will always say to my clients, three to six months because we want to make sure we’re working over, you know, a couple of cycles in that capacity with healthy eggs.
Kristin: That makes sense. And would that be a session a week? An hour long session? What would that look like?
Vikki: So all the sessions are an hour long. The first one is usually longer, so probably about 90 minutes, because we do a pretty lengthy intake, lengthier than if you went to the doctor. We ask a lot of questions, and a lot of the questions, people can’t possibly understand how they would connect with their reproductive strength, but we look at the whole body. And so we’re using a tongue diagnosis, pulse diagnosis. If somebody brings in their BBT charting because they’ve been charting their basal body temperature, we use that information. And we put together this story. You know, where does the imbalance lie? And we work to change that as well as helping to just move that blood to where it needs to go. And so they’re about an hour after the first one, and we like to do them once a week.
Kristin: And I know you have a male acupuncturist, as well, for those who prefer.
Kristin: So that’s a great option. And do you treat — do you ever do dual sessions, since you have multiple acupuncturists?
Vikki: We’ll do them at the same time. We can book people at the same time. We don’t do them in the same room. For the session itself, you know, people come in and we talk. We assess. And I put together my point prescription, choosing the acupuncture points that I’m going to use. And it seems like it wouldn’t be extremely gentle, but it actually is. I mean, ultimately, my goal is for people just to feel very relaxed. I treat a lot of people that are very afraid of needles, and they’re always happy when they’re done that they came to treatment because it’s very relaxing. Many have gotten over their fear of needles. It’s nothing like going and having a blood draw.
Kristin: Right. I would agree. I just had a session a couple weeks ago, and I wasn’t sure what to expect. It was very relaxing! I enjoyed it.
Vikki: It’s a great way to be treated, right? To walk out and be like, ah, the relief, the relaxation. It leaves us feeing very balanced.
Kristin: Agreed, yeah. And I can see how some people would, with a fear of needles, would have a challenge, but if they’re going through traditional fertility methods, they’re dealing with needles in a different way.
Kristin: So maybe that could help their fear.
Vikki: You know, it does. And it’s funny because I’ve had clients who don’t have the support, maybe, to do some of those needling, and so while I can’t do any of that, the needling from the fertility clinic for them, sometimes I’ll sit and I’ll just support them and just be, like, you’re doing good. You’re doing good. So we’ll do a treatment before, and then they get that support. You know, we really help our clients wherever they are with whatever tools we have.
Kristin: I love it. So how do our listeners find you?
Vikki: We have a great website. It has a lot of information on it, and they can make an appointment on there. They can also call. I always do — so does Corey. We do complimentary consultations, you know, just so people can really talk, because everyone is approaching this from a different place. And sometimes the need to just check it out and say, you know, is this right for me, is important. And so we always love people to have the option to really talk to us, so see how they connect with us, and to ask their questions before treatment starts.
Kristin: Thanks for being on! Do you have any parting words for our listeners who are struggling with fertility?
Vikki: You know, I think it’s important to remember — and I say this to all of my clients — that when you’re told or see that infertility is your condition, that it’s not a word we use here because my clients aren’t necessarily unable to conceive. They just haven’t conceived yet. And I think it’s really important for us to keep that in mind because our nervous system, our brain, our heart, really can make change in many different ways in our body. So coming at it knowing that we can do this, you know, and your body can do this, is a great way to approach your future.
Kristin: I love it. Words matter. We believe that with HypnoBirthing. Just changing the language and the imagery can make a big difference in getting the fear out.
Vikki: Absolutely, and to know you’re supported.
Kristin: Exactly. You’re talking some doula language there, about just telling them that they’re doing great and being there emotionally as a support person. So it’s great to have a big team supporting you, especially during this time of uncertainty with coronavirus. I love that you’re a great resource for our families and listeners.
Vikki: And we also offer — we have a couple of conditions that we know are big struggles, and we like to treat people for a certain amount of time. Because of that, we have some programs that we do offer, and fertility is one of those programs. So on our website under programs, you can see the different programs we put together to give a little financial help to those going through this struggle to make it a little bit easier.
Kristin: That’s wonderful. And I know you do take most health savings and flex spending; is that correct?
Vikki: We can give receipts, and it really depends on if your health savings and flex spending covers acupuncture. But if it does, yes. And more insurance companies are starting to cover acupuncture, but it really depends on if they cover it and what they cover it for. But we’re happy to give super bills to everyone and anyone so they can, you know, get reimbursement if that’s applicable with their insurance.
Kristin: Thank you! It was great to chat with you today, Vikki, and we’ll have you on in the future to talk more about pregnancy and acupuncture.
Vikki: Fabulous! That would be wonderful. Thank you for having me!
Signs of Early Pregnancy
This blog is written by Jessica Kupres, BSN, RN, CLC, CBE a Postpartum Doula with Gold Coast.
As you lie in bed thinking about your day and putting your brain to rest, you might think about the great presentation you gave today. Did you put the clothes in the dryer? When was your last period?…. When was my last period? Was it over a month ago? Am I pregnant?!
The best indicator of pregnancy is taking a pregnancy test. Today’s home pregnancy tests can be over 99% accurate, and many can be taken even before you miss your period. You can even get them at the dollar store. But what are the symptoms you might experience that mean you could be pregnant?
Remember that everyone is different, so you might have one, none, all, or a handful of symptoms. Probably the most common first indicator of pregnancy is a missed period. Every month your body prepares for pregnancy by thickening the lining of the uterus, and when no fertilized egg implants into the uterus, the additional lining sheds, and you have your period. This can be a little tricky, though, because 15-25 % of women will have implantation bleeding. Implantation bleeding is when you have a small amount of bleeding or spotting as the fertilized egg (zygote) implants or anchors itself into the uterine lining. For all three of my pregnancies, I took and had a positive at-home pregnancy test at the start of my “period” which was actually implantation bleeding, and not a period at all.
But let’s say you’re lying in bed, don’t have a pregnancy test at home, and may or may not be spotting. What other symptoms might imply you are pregnant? As soon as your body recognizes you are pregnant, it starts going into overdrive and your hormones quickly shift to prepare for the pregnancy. You might be surprised how quickly your breasts change. They might feel tender or swollen, and you might notice your nipple and areola, which is the area around the nipple, become darker. Surprisingly, this is already in preparation for childbirth, when the darkened nipple and areola become a “bullseye” for baby to easily see and help him or her latch on for breastfeeding!
You might also noticed an increased need to urinate. You might think this is something that comes with a large uterus pushing on your bladder, which it does later in pregnancy, but at this point, your new pregnancy hormones and increased blood supply cause your kidneys to filter more fluid and increase the need to urinate.
You might also notice an increased sense of smell, or changes in food preferences. All of the sudden you may crave a lot of potato chips, and the smell and taste of chicken may send you running to the bathroom, even though chicken was a favorite food before. For me, I have always been a chocoholic, but for the first 14 weeks of my first pregnancy, the thought of chocolate was repulsive to me. And along with food and smell aversions, you may have nausea and/or vomiting. This may or may not be directly linked to food or smells, though. Many women find they get nauseated, or have morning sickness, if they get too hungry in the first trimester. That’s why it was originally associated with the morning… you are probably hungry from not eating all night, so might have morning sickness. A helpful trick might be to have some crackers by the bed, and eat a cracker or two before you move or get out of bed. This may help ease this hunger related morning sickness. Unfortunately for many, though, morning sickness doesn’t just stick to the morning. Some may experience it all day.
In early pregnancy your body is working really hard to get everything set for a healthy pregnancy, and as such, you may feel an overwhelming fatigue. You may also experience increased irrationality, mood changes, headaches, dizziness, or faintness. When this happens, it’s best to sit or even better, lie down, if you are not feeling well. Your body temperature may also increase slightly in early pregnancy, though not high enough to be considered a fever. Some of the less talked about symptoms of early pregnancy may be increased gas, constipation, and a change in vaginal discharge.
Finally, you might notice some insomnia in early pregnancy. Your mind may be racing with all of the questions and excitement pregnancy brings, making it hard to fall asleep. So as you lie there trying to fall asleep, you now have a good list of symptoms you may experience in early pregnancy. And if you are still wondering if you are pregnant, it is probably a good idea to take a home pregnancy test and call your health care provider if it is positive!
Photo: First Response Pregnancy Test
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
Planning a Nursery During the COVID-19 Pandemic
Today’s guest blog is written by Isabella Caprario, Content Marketing Specialist at Porch.
During the COVID-19 pandemic, we all feel uncertainty. We don’t know what will happen or what steps to take next. We only know that the best way to end this madness is to sit at home and take all the necessary precautions to be able to take care of ourselves and our family. Stay home and stay safe.
Being quarantined can feel a bit overwhelming. We may feel stressed or anxious about being locked up in our homes, but it definitely doesn’t have to be that way! We must focus on the positive. I firmly believe that we will become better humans, more responsible with our environment, and above all think more about others than ourselves.
For future parents that still have to continue planning a nursery for their baby during this pandemic, there is no need to panic or worry! In this post, I will give some tips, recommendations, and activities to create the perfect nursery for your needs and those of your baby.
Where to start:
At this point, surely you already have defined the place, space, and distribution of what the nursery room will be like; and if not, the first thing that we should consider is, what is the space/place that would be most suitable for the baby?
To answer this question, the most important things to take into account are the following:
- A place/room that is close to yours and is easily accessible.
- The room has enough light during the day, can be darkened for naps and bedtime, and is isolated from any type of noise that may scare or awaken the baby.
- It must have the right temperature for the baby to feel comfortable and safe in his/her new space.
- It has to be a pleasant and comfortable space for parents as well.
- The room must have the necessary space to have everything that the baby requires, such as a crib, a diaper station/changing station, chair for feeding, and a space to accommodate clothing.
Once we have defined the most appropriate place for your baby, we go to the next step which would be to choose a theme, if you wish. This allows you to purchase accessories and decorate the nursery based on that theme.
The best place to get creative ideas is Pinterest. Here you can find color designs and everything you need for your nursery. If you do not already have an account, I recommend you get one so you are able to create a board and save all the ideas that you like the most.
Tip1: “Less is more”. Go for a minimalist look since it helps to make a room seem wider, cleaner, and more organized. It will help you save money and look more luxurious at the same time.
Taking into account how we want to distribute the nursery, colors, furniture, and accessories, we can start planning online purchases.
Choosing the right furniture:
Since we currently can’t leave our homes during the pandemic, luckily, we can still shop for the furniture and accessories that we need. Online stores are still open and many are offering sales!
First of all, we must create a list of our favorite online stores. Creating this list will help us to make a comparison of prices and items between stores. Once this comparison is made, we can remove from the list those stores that have very high prices, those that do not offer a wide variety of products, or those that are lower quality. It is up to you how you prefer to discard possible online stores.
Tip 2: Use an excel spreadsheet to organize your options. Write down the description of the product, where you found it (online store link), delivery time, delivery cost, how many units are available (enough stock), and price. This planning will help you with budget reduction and delivery time frame.
Also, keep in mind that some online stores will guide you when choosing furniture and accessories and can create a package with discounts and other extra benefits that will help you save money if you place your order in advance.
Get ready for some DIY Projects:
There is no more perfect time than now for some DIY projects at home. A DIY project can be quite therapeutic and will also keep you occupied throughout the day. Your mental health will thank you. You can exploit your creativity and forget for a moment about what’s happening outside. It can also help you relax and feel productive.
Some DIY ideas to try:
- Baby blanket arm knitting tutorial. This so much fun and easy to do at home. You will find tutorials on Youtube and Pinterest.
- Nursery name sign. You can show how creative you are with this activity.
- Make a nursery mobile. Here you can find different materials you would like to use, like paper, or glitter, etc.
Tip 3: Keep in mind that you should look for DIY projects that you can make at home with the things that you already have. Do not do very large projects that might make you feel overwhelmed because you lack the necessary materials or it’s simply not coming out as you would like.
Planning your nursery is a very fun and relaxing activity, despite being in a difficult situation. It’s better to smile and spread that happiness and positivity to your family and your baby on the way.
Isabella Caprario is a SEO Marketing Specialist and does Content Marketing at Porch. She has an International MBA, and her hobbies are reading, writing, and music.
COVID-19 Reduce Your Risk!
Reduce Your Risk by Megan Mouser, NP.
March 31, 2020
With statistics regarding the novel coronavirus changing daily (and even hourly), the most up-to-date information can come from Michigan Department of Health and Human Services as well as the Centers for Disease Control. To date, at the time of this publication, there have been over 163,000 cases in the U.S. alone with over 2,860 deaths. Michigan appears to be an emerging epicenter for COVID-19, making our efforts to reduce the spread of this virus even more emergent.
WHAT ARE WE SEEING? WHY SHOULD WE BE CONCERNED?
Locally we are beginning to see an increase in cases. Today there are 108 presumed positive tests with 119 tests pending. You can find local updates for Kent County on the Access Kent website.
With coronavirus being a new (novel) virus, very little is known about best practices. This is why you are seeing information and decisions varying day to day. The clinical picture for those suffering from this virus can range dramatically from very mild symptoms (including some with no reported symptoms) to severe illness resulting in death. Current treatment options are fairly limited, however new therapies and studies are emerging. Even with recovery from the illness, long-term consequences are possible. Coronavirus is also very easily transmitted, even without an individual ever presenting with symptoms. This is why socially distancing and practicing preventative measures is so important! In regards to healthcare resources here in West Michigan, we are preparing for a large influx of possible patients from this virus which will put a strain on our healthcare resources if we do not slow the spread. We are already beginning to see this in the metro Detroit area.
We cannot stress enough the importance of washing your hands often with soap and water for at least 20 seconds (if not available, use hand sanitizer with at least a 60% ethanol or 70% isopropanol alcohol content), covering your mouth and nose with your elbow when coughing or sneezing, avoid touching your face, cleaning “high touch” surfaces daily, limiting your contact to only people in your household, and practicing social distancing by remaining at least 6 feet apart from anyone else if you absolutely must go out.
I also think it is important to recognize that this is a very stressful time for many of us and it is important for our overall health to make sure that we are taking care of ourselves including getting adequate sleep, regular exercise, eating a nutritious and healthy diet, getting out for some fresh air (while maintaining social distance), reaching out to our support systems, and allowing yourself some “slack” regarding loss of control and frustrations.
In regards to specific populations, this virus does pose a higher risk to people who are older or have other serious chronic medical conditions such as heart disease, diabetes, or lung disease. Women who are pregnant are also considered at increased risk, however to date limited data is available regarding this illness during pregnancy. Coronavirus has not been shown to cross into amniotic fluid or into breastmilk at this time. However, if a pregnant woman became ill with the virus, additional precautions would certainly need to be taken at the guidance of your healthcare team. While on the topic of pregnancy, we can rest assured that healthcare providers and hospital staff are working diligently to reduce the risk and spread of COVID-19. While locally there has been visitor restrictions in place at the hospitals, your support person (as long as healthy) will be able to support you through delivery and hospitalization at this time.
Infants are also considered to be more at risk for not only COVID-19, but illness in general due to underdeveloped immune systems at birth. I would encourage all new parents to continue to practice not only standard precautions (including hand washing, cleaning surfaces, avoiding sick contacts, etc.) but also to continue to restrict visitors to the home after delivery to only members of the household. While this is certainly a time to celebrate your new addition, our primary goal is a healthy baby and family!
As for older children and teenagers, we know that this is very challenging time with the cancellation of schools or daycares and changes to routines and schedules. The risks for these age groups from coronavirus continues to be present, therefore as difficult as it can be to enforce and practice social distancing, it is imperative for parents to not only model this behavior but to also help our children understand why this is necessary. In a time of uncertainty, parents can continue to lessen anxiety in children by discussing together as a family, remaining calm, and continuing to offer love and support.
As a community we all share responsibility to continue efforts to reduce the significant risk from COVID-19!
Centers for Disease Control and Prevention
Michigan Department of Health and Human Services
World Health Organization
Megan Mouser is a board certified Family Nurse Practitioner serving the Grand Rapids area since 2014. Born and raised in the Upper Peninsula of Michigan, she completed her Bachelor’s of Science in Nursing through Northern Michigan University and went on to obtain her Masters of Science in Nursing through Michigan State University. She has over a decade of experience working with infants and children in the Neonatal Intensive Care Unit, and most recently seeing both adults and children in her outpatient family practice office. She also volunteers her time teaching graduate students as an adjunct clinical faculty member with Michigan State University School of Nursing’s graduate program. Megan is passionate about preventative medicine and creating strong relationships with her patients and families in order to provide personalized, high-quality healthcare. Megan resides in Grand Rapids with her husband Matt and two golden doodle rescues “Max” and “Marty”. In her free time she enjoys spending time with her family and friends, traveling, being in nature, cooking, and gardening.
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.
Staying Fit and Healthy During Your Pregnancy
My name is Kaysie, and I am currently 20 weeks pregnant. This is my 4th pregnancy and the first one where I have maintained a very healthy and fit lifestyle. I am a mom of three – 16, 13, and 7. After my last child was born I was the heaviest I had ever been and I knew I wanted better for myself. I wanted to set a good example for my children as they grew up. It took a year to lose the weight but almost 6 years to be in the best shape of my life, and I continue to maintain it!!
After I had lost the weight I competed in the NPC bikini competition in 2017 just to say I got up on stage and did it!! Even though the stage was not my favorite, the road it took to get there was what made me who I am today. I surrounded myself with women that empowered me and supported me. After a lot of hard work and dedication, I decided I wanted to be the light for someone else in a tough spot. I wanted to be the woman that supported and empowered other women to be the best versions of themselves. In 2018, I received a certification as a group trainer. Along with that, my knowledge of nutrition has put me in a place to teach others how important their food choices are along with exercise.
I think most of us know how important it is to stay healthy and fit throughout our lifetime. Whether we choose to execute this or not is the hard part. To some it comes easy and natural. To others it may be a very difficult task to complete daily. Now that you’re pregnant, it’s even more important to maintain a healthy lifestyle and some type of daily exercise.
Personally, I am in the gym 4-6 days a week and my workouts last 1.5 hours-2 hours consisting of cardio warmup/HIIT, strength training, and stretching. I eat 1700-2000 calories a day and I carb cycle two days of the week and I drink 90-120 ounces of water daily. I choose to eat organically 98% of the time.
If you’re new to exercise, I don’t recommend starting out as heavily as I do. Even though my body has been used to doing hard exercise for a long time, I keep an eye on my heart rate and don’t go over 150 per my OB’s recommendation.
Here are some tips you can try daily to ensure you continue to have a healthy and fit pregnancy.
Exercise at least 30 minutes daily
(please talk to your doctor/midwife/OB before starting a new exercise routine)
Drink at least half your body weight in ounces of water daily. If you weigh 140 you should be drinking at least 70 ounces if not more.
Eat lots of veggies, some fruit, organic grains, and limit your fat content. Stick to healthy fats like avocados and nuts. (I personally chose to buy all my foods organic.)
Stay away from sugars. Try to only consume sugars from fruits and veggies
Get a good night’s rest.
Stay positive. Surround yourself with people that support you, uplift you, and motivate you to make positive choices for you and your family.
For more health and fitness tips. follow Kaysie on Instagram.
Physical Therapy During Pregnancy
Maternity clothes✓ Registry✓ Hospital tour✓ Doula✓ Photographer✓
What could you possibly be forgetting? What about getting YOURSELF prepared?
Likely from the moment you found out you were pregnant you have been focused on the tiny human growing inside of you. While prenatal vitamins, nursery preparations, and choosing the perfect name are all very important parts of preparing for the birth of your baby, so is preparing YOUR body to birth this baby!
Hopefully in the midst of your nesting you have decided to create a birth plan. As you consider what positions you want to labor and deliver in and what interventions you feel comfortable with during your birth experience, I would challenge you to consider what you are doing to achieve those goals. Hiring a doula and recruiting a rockstar support person is a great place to start, BUT there is more!
Research has shown that the percentage of first time moms that experience perineal tearing during delivery is somewhere between 80-90%. Research also shows that 66% of women that deliver their babies in sidelying have NO perineal trauma and 61% of women that deliver on hands and knees have the same TRAUMA-FREE experience. (Simarro 2017, Walker 2012, Soong 2005, Shorten 2002) Instead of crossing your fingers and hoping for the best when it comes to your perineum, what would it look like to practice different delivery positions with your partner BEFORE you go into labor? What about the evidence that says perineal massage 1-2x per week starting at week 35 can DECREASE your risk for tearing and episiotomies? Have you been taught how to perform this technique and are you taking the time to do it? (Seehusen & Raleigh, 2014) With my first son, I totally missed the boat on perineal massage. I ended up with a nasty episiotomy. You better believe I’ll be making perineal massage a priority this time around!
Our bodies become a temporary home for our babies during pregnancy. Our mama bear instincts have already kicked in, and we want to make sure we are creating a healthy and happy environment for our babies to grow within. Exercise and intentional movement is a great way to foster this type of environment for our little ones. Did you know that exercise helps prevent or manage gestational diabetes, high blood pressure and preeclampsia? Exercise also helps us sleep better, reduce our stress levels, and minimize back pain. If your pregnancy is non-complicated and you do not have activity restrictions, you should be exercising! The American College of Obstetricians and Gynecologists recommend exercising at a moderate intensity 3-5x per week. Sometimes we become paralyzed when we’re not sure where to start and what’s safe. Trainers, instructors, and Physical Therapists with certifications and experience working with women during pregnancy are great resources for mamas hoping to create safe exercise habits.
Let’s not forget about investing in our pregnant bodies to make life easier for ourselves in the postpartum. During your pregnancy your belly is doubling or even tripling in size. As we gain 25+ pounds, we expect our pelvic floor to step up to the challenge and make sure we don’t pee our pants when we sneeze at the grocery store. There are two studies that give us good reason to keep our pelvic floors strong during pregnancy. The research found that women experienced less urinary incontinence at 35 weeks gestation, 6 weeks postpartum and 6 months postpartum when they did pelvic floor exercises DURING their pregnancy compared to women that DID NOT do pelvic floor exercises. (Boyle et al., 2012, Price et al., 2010) Sidenote: sometimes the phrase “pelvic floor exercises” is confusing. Does that mean kegels? Yes and no. Clear as mud I know! Kegels are pelvic floor exercise where we lift and squeeze our pelvic floor muscles, but it’s also important for our pelvic floors to have the ability to relax and lengthen. Sometimes women experience pelvic pain and incontinence because of overactive pelvic floors (need help relaxing) and sometimes it’s because they have underactive pelvic floors (need more strengthening). Even if you have excellent pelvic floor strength and no concerns about incontinence, it’s still helpful to create a mind-body connection with your pelvic floor. During labor and delivery the goal is to relax and open your pelvic floor while pushing so that your pelvic floor remains healthy even after childbirth. Bonus points if you practice your breathing and pelvic floor relaxation while pregnant in the positions you hope to deliver your baby in.
I’ve been a mom in your shoes, running around with my To-Do list trying to check off all the boxes before my baby arrived. As you prioritize your list and consider your baby budget, remember that your body IS this baby’s home. The way that you prepare your body WILL make a difference on the day that your baby decides to make its grand entrance. Exercise, pelvic floor awareness, perineal massage, and labor positions are all important pieces of the pregnancy puzzle. It’s tempting to become intimidated or overwhelmed at this point because you’re just not sure where to start. Start by consulting a Women’s Health Physical Therapist. Now that you know what your goals are, you have some great questions to ask them! Physical Therapists should be another member of your prenatal team, and we want to help you make your planned Birth Story a reality.
My practice is Mamas & Misses, LLC and we offer In-Home Physical Therapy sessions for women local to West Michigan as well as phone or video consults for those who live further away. One of our missions is to provide knowledge to mamas that will empower you during your pregnancy and postpartum experience; therefore, we have lots of FREE info on our YouTube channel as well as our Instagram account @mamasandmisses_pt.
Dr. Nicole Bringer, DPT
Owner of Mamas & Misses LLC
Phone: (616) 466-4889
Boyle, R., Hay‐Smith, E. J., Cody, J. D., & Mørkved, S. (2012). Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 10, CD007471. doi: 10.1002/14651858.CD007471.pub2
Price, N., Dawood, R., & Jackson, S. R. (2010). Pelvic floor exercise for urinary incontinence: A systematic literature review. Maturitas, 67(4), 309-315. doi: 10.1016/j.maturitas.2010.08.004
Seehusen, D. A., & Raleigh, M. (2014). Antenatal perineal massage to prevent birth trauma. American Family Physician, 89(5), 335-336.
Shorten A, Donsante J, Shorten B. Birth Position, Accoucher, and Perineal Outcomes: Informing Women about Choices for Vaginal Birth. Birth. 2002;29(1):18-27.
Simarro M, Espinosa JA, Salinas C, Ricardo O, Salavadores P, Walker C, Schneider J. A prospective randomized trial of postural changes vs passive supine lying during the second stage of labor under epidural anesthesia. Med. Sci. 2017, 5, 5. doi:10.3390/medsci5010005
Soong B, Barnes M. Maternal position at midwife-attended birth and perineal trauma: is there an association? Birth. 2005;32(3):164-169.
Walker, C., Rodríguez, T., Herranz, A. et al. Int Urogynecol J (2012) 23: 1249. https://doi.org/10.1007/s00192-012-1675-5
Symphysis Pubis Dysfunction with Rise Wellness Chiropractic: Podcast Episode #90
Dr. Annie and Dr. Rachel talk to Alyssa about Symphysis Pubis Dysfunction (SPD), how to prevent it, how to treat it, and things every pregnant and postpartum woman should be doing! You can listen to this complete podcast episode on iTunes or SoundCloud.
Hello. Welcome to another episode of Ask the Doulas. I am Alyssa, and I’m talking with Dr. Rachel and Dr. Annie again of Rise Wellness Chiropractic. How are you?
So I got asked by a client about symphysis pubis dysfunction, and I’m not even exactly sure what that is, but you knew. Right when I told you, you knew. So can you tell me?
So SPD — sometimes people think of sensory processing disorder, which is with older kids, but in relation to pregnancy, it’s symphysis pubis dysfunction.
And what the heck does that mean?
It’s a mouthful! So basically, where your two pelvic bones meet in the front is called your symphysis pubis, so that’s where the two bones meet together. There’s cartilage in between there, and that area widens for birth. So usually late second to third trimester, we’ll see some women will start having pain. That can be related to the relaxin that’s in their system that’s helping the ligaments loosen and helping that area separate, but what we usually find is it’s more due to pelvic imbalances. Usually one side of the pelvis is higher than the other or something like that or it’s rubbing in a weird way. That’s usually what causes that symphysis pubis dysfunction.
So it’s strictly for pregnancy?
And are there any ways to not get it? Avoid it? Treat it?
Yeah, just because if it’s caused from a misalignment —
Exactly. Yeah, if it’s caused from pelvis imbalances, then that is directly a chiropractic issue. It’s biomechanical. That’s something that we can address through adjustments. And then we also have stretches that you can do, and there’s also a Serola belt which is like an SI belt. It goes around your sacroiliac joints, and it’s just a low belt. It doesn’t really do anything in terms of — it’s not like a belly band or something that you would wear to support the baby, but it does help to support the SI joints and keep everything together. Really, it’s hypermobility in that joint that’s causing that pain.
It’s too mobile?
It’s too mobile. Yeah, so we usually see it with not first-time pregnant moms but usually second or third, especially if they’ve had some kind of fall or something like that while pregnant. They can injure their pelvis, and that’s usually what brings those things up. I actually had a patient a couple weeks who came to us for SPD, and under care, she was doing great. All her pain went away. But she had fallen during her first pregnancy, and then during her second pregnancy, she started having all this pain and stuff come on.
So falling during pregnancy; it’s not just like a random fall at any time in your life that could affect this?
It could be. Pregnancy is really good at exacerbating existing issues or past issues. Like if you’ve had any pelvic imbalances in your past and then you’re pregnant, just that relaxin is going to kind of flare things up. Typically, what we see is pain with putting weight on one leg. Climbing stairs is when your pelvis is moving the most, so that’s usually when a lot of the pain is flared up.
Walking; something that you don’t have to do very often.
But sitting is not good for it either. It’s one of those things that nothing is good for it.
Laying hurts; turning while you’re laying. Like that’s not already hard when you’re in the third trimester!
Does it actually cause any more pain or discomfort during labor and delivery?
It can. It depends on really, like, what the pelvis — because if you think of the pelvic bowl, if there’s imbalances in the pelvis, it’s not just affecting the bones. It’s also affecting your pelvic floor muscles. It’s affecting all of your stabilizer muscles. So it can potentially affect how things go during labor. I don’t know if it creates more pain, necessarily, or if it would be, but any pelvic imbalance is going to effect, probably, the efficiency of your labor.
Plus, it doesn’t necessarily clear up after.
That was my next question.
Yeah, it’s not like you deliver the baby and then it’s gone.
Because you still have that imbalance?
So then what do you do for that? Just keep getting adjusted?
Well, it should clear. If you’re getting adjusted, it should help clear it up while pregnant. So I guess what we’re saying is, you should get checked if it’s happening.
I mean, it’s definitely like you have to retrain that pelvic imbalance somehow, and you do that through chiropractic adjustments or through exercises, through physical therapy, sutff like that.
Yeah. PT floor rehab, yeah.
Probably a combination of both, right?
Right. If you do it all, then you probably have best outcomes.
Yeah, I don’t think we understand how important the pelvic floor is, and all we’ve learned is Kegels. That’s not necessarily even a good thing to think. When I saw a physical therapist for pelvic floor issues specifically, I was, like, that makes so much sense! Even just the way we breathe; I didn’t know that my diaphragm was part of — what would that be? The top? The diaphragm is the top of your pelvic floor?
Yeah. It’s the top of your —
Like the space? I guess I can’t say top of the floor. Your pelvic floor is the floor.
Your intrabdominal space. So it’s like the lid, and then your pelvic floor is the bottom. But it’s a big airtight balloon, pretty much, so when you breathe, it affects everything. But pelvic floor is an issue that we don’t talk about, really, with women in birth, but it’s a huge thing. Every woman who pushes out a baby has pelvic floor issues. Every woman who has a C-section has pelvic floor issues because those are attached to your abdominals, too. So, really, every woman should be getting some kind of rehab on pelvic floor after birth. That’s my soapbox!
I’m in these group exercise classes, and every woman is, like, oh, jumping jacks. I’m going to pee my pants! I had one friend who was, like, I was working out and I didn’t know if it was sweat or I had peed my pants! Yeah. I get it!
Well, pelvic floor and core strength, too, are both things that get overlooked with women after pregnancy, and then we see women with back pain later, and it’s because their core is so weak. So, really, we’re just promoting physical therapy pelvic floor rehab. It’s what needs to be done.
And chiropractic care. Retraining all that neurology is important.
I think even just learning about it! I’ve done yoga classes forever, and they will say, like, during this pose, tighten your pelvic floor. I’m, like, what the hell are they talking about? What? How do I do that? But now after learning that even breathing is different and the feeling of — I hate saying Kegel because it’s not even what it is, but I guess that is the feeling of what you would do to stop your pee, but doing that during certain exercises is a whole different feeling, but I think now that I’m conscious of it, I’m, like, oh, that makes sense. Oh, I can do that here. Okay. It’s gotten a lot better, but I still can’t do jumping jacks.
See? The jumping jacks! I don’t do them either. They’re like, do jumping jacks to warm up, and I’m like… No.
I do the ones where I just put my hands up. I just kick my leg out. I’m fine with it!
It’s what everyone’s doing! They call those jumping jills.
Is there anything else pregnant or postpartum women need to know about symphysis pubis dysfunction?
It’s not something that you need to suffer through. There’s a lot of chiropractic studies where it helps in a lot of case studies, but also, biomechanically, it makes sense. You don’t have to feel like you can’t walk up the stairs or sit or that you have to be in a lot of pain when you’re trying to sleep. Find out you’re pregnant and get under care. That’s really what we tell people.
Tell people where to find you!
We are in East Town in the Kingsley Building right next to Gold Coast Doulas, or you can find us at our website or on Facebook and Instagram. You can message us on those platforms.
Well, as always, thanks! We’ll have you on again soon!
Baby-Friendly Hospital Initiative: Podcast Episode #89
Today we speak with Katie and Becky from Spectrum Health in Grand Rapids about what it means to be a designated Baby-Friendly hospital. 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, co-owner, and I’ve got Alyssa here. And we’ve got special guests joining us today from Spectrum talking about the Baby-Friendly initiative. So welcome, ladies! Introduce yourselves and tell us about your background!
Becky: My name is Becky Crawford, and I’m a nurse manager at Spectrum. My background is in postpartum and labor and delivery nursing.
Katie: And I’m Katie. I’m the project specialist for women and infants at Spectrum Health. My background: I am an RN, and my background is high risk OB and postpartum nursing.
Kristin: Fantastic! Thanks for joining us! Tell us about what baby friendly means and why it’s such an intense process to go through certification. Fill us in!
Katie: The Baby-Friendly hospital initiative was actually created back in the early 90s, and it’s an international organization to promote, protect, and support breastfeeding practices. Spectrum Health Butterworth was designated Baby-Friendly initially in October of 2014, and we just went through the redesignation process and were redesignated at the end of May of this year. There are ten steps for Baby-Friendly that each support breastfeeding practices, and we can talk through some of those steps, as well. You have to be proficient in all of those ten steps to receive the designation, so you really have to show breastfeeding excellence, and it’s a really strict and rigorous process to go through.
Becky: I think overall, the way I describe it to patients is that we’ve created a culture that’s supportive of breastfeeding and of moms that want to breastfeed. So it’s not that we force anyone to breastfeed. Our goal is just to educate moms, support them, and help them be successful if that’s the option they choose.
Katie: Absolutely. As nursing professionals, part of our responsibility it to make sure that best practice and current research reaches our patients and that they’re educated on all of those best practices. Breastfeeding is best practice, but it’s also about informed choice and supporting our patients with whatever choice they make. While Baby-Friendly is primarily about breastfeeding and supporting breastfeeding, there is a formula feeding option there, and we support patients in that option, as well. It should never be about pressure. It should just be about education and informed choice.
Kristin: That is a question that I get from doula clients. If they choose, whether for medical necessity or personal choice, to formula-feed, how they can navigate the system with Baby-Friendly hospitals.
Alyssa: That’s what I was going to ask, too. Do you think that designation scares a mom who knows she doesn’t want to breastfeed? Does she think shes going to come into this hospital and you’re going to try to force it? What does that look like for a mom who doesn’t want to?
Becky: We do hear that feedback from moms that haven’t delivered with us, that they’re just nervous. Having to talk about breastfeeding, even, can be an uncomfortable conversation if they know that’s not the choice they want to make. So our approach with our staff is to educate the patient on all the options, let them choose, and then support. So it should be a one-time conversation. We’re going to talk through all your feeding options. These are the great benefits of breastfeeding. If you choose not to do it, okay. Then let’s talk about formula feeding, and we’ll focus our education there. So making sure they know their options, they understand the benefits, and then support.
Katie: And, you know, nurses educate on a lot of topics, right? It’s not just about breastfeeding. But the other topics we educate on, it’s the same sort of informed choice, right? Breastfeeding is such a personal decision. It’s such an emotionally charged topic. I think that while we need to educate our patients on breastfeeding and why it’s great, we also need to acknowledge the fact that it is a really personal choice, and it’s okay if you choose not to, as long as we’ve given you all of the information.
Kristin: And so your labor and delivery nurses, your postpartum nurses — everyone is specially trained to support the initial latch and continued breastfeeding through their stay?
Kristin: And that’s something that we always stress as doulas is that you have support from your nurses as well as the board-certified lactation consultants who do rounds in the postpartum time.
Katie: Actually, one of the ten steps is staff education. All of our nurses receive 20 hours of dedicated breastfeeding education. Of that, 15 hours are classroom education and then 5 of those is clinical, practical breastfeeding education hours. Every one of our nurses; it’s built into orientation for any women’s nurse, so everyone from labor and delivery to postpartum gets this education. There’s also a requirement for providers, so nurse midwives as well as physicians, to receive additional breastfeeding education, as well. Per Baby-Friendly, they’re required to receive three hours of breastfeeding education.
Becky: We also have a team of lactation consultants that offer further help for any mom that’s struggling, but I’m also bringing in more peer counselors, too, just to round on every patient and offer every mom some support, ever with those first few times they’re latching, just so they can hear that they’re doing a great job. It’s really just to address the breastfeeding concerns of all moms, not just the moms that are struggling, just to really walk them through it.
Katie: And we do have quite a few nurses that are certified breastfeeding counselors, so they have received additional education as well as the education that they received for Baby-Friendly.
Kristin: How are you able to support moms with babies that go to the NICU initially with their breastfeeding goals?
Becky: Well, actually, we get them pumping right away. If your goal is to breastfeed, we like to have them pump within two hours of delivery to start establishing that supply. Our nurses will come in and do education, and the lactation consultants will see them, also, and just talk about the importance of pumping to build up that supply. They’re also going to skin to skin. There are some lactation consultants that are dedicated just to the NICU and these moms, so there’s a lot of support there, too.
Katie: The providers in the NICU are very, very supportive of breastfeeding, and they encourage and educate moms on the importance of breastfeeding, as well, so there’s good collaboration between our OB teams and our NICU teams regarding supporting those moms in breastfeeding and being successful.
Kristin: That’s what my clients tell me, that they get a lot of support, even over at Helen DeVoss, as well as in their rooms with lactation. As far as other elements of the Baby-Friendly designation, what else encompasses those ten standards?
Becky: There’s a lot. We start right at delivery, with the golden hour after delivery. We place baby skin to skin immediately after delivery, and we avoid all unnecessary care for that first hour. Any exams or assessments would all be done while the baby is skin to skin on mom. We try to give them that time to bond and establish that first feeding.
Kristin: And if the mom can’t do skin to skin, I have dads ask me all the time about the benefits of them doing skin to skin with baby. So that’s something that’s encouraged, as well?
Becky: Absolutely. We’ve had lots of dads do skin to skin. We like to bring them in on the process whenever possible.
Kristin: That’s fantastic. And then delayed cord clamping is now a standard policy?
Becky: Yes. And we also room-in, so babies stay with their moms 24 hours a day unless mom requests otherwise. But that’s what we try to encourage and do all procedures at the bedside to keep the family together 24 hours a day.
Katie: I think that rooming in is another hot topic when you’re talking about Baby-Friendly and breastfeeding, and the literature does tell us that rooming in does help moms to be more successful breastfeeding. I think that it’s important that patients understand that we’re going to allow you to keep your baby with you. We’re going to be able to take care of mom and baby together. You’re going to learn your baby’s feeding cues. You’re going to learn all those little nuances. We’re going to help you learn that in the couple of days that you have with us. There is space where if you wanted your baby to go to a nursery, we could do that. We’re supportive of that, as well, but again, we are going to educate, and then we’re going to honor choice.
Kristin: And then there’s delayed bathing and other procedures beyond that?
Alyssa: What’s the thought behind all the delayed cord clamping, delayed bathing? Why? What are the benefits?
Katie: The delayed bath is sort of about the transition from being inside mom and then outside and regulating temperature. So we wait at least twelve hours. We like to wait closer to 24 hours to do that first bath. We’re, of course, not going to hand you an ooey gooey baby. We do a little wiping off, but it really does help that baby transition to life outside of mom and regulate. It also allows you to go immediately into skin to skin so the baby can help regulate not just the temperature, but the heart rate and the breathing. And, again, that’s evidence based. In fact, there’s a pediatrician out in Massachusetts who really pioneered the Baby-Friendly initiative in the hospitals out in Massachusetts, and she did a study on delaying the baby bath, as well. That’s the literature we have for it; it’s all about maintaining stability for the baby.
Kristin: That’s awesome, Katie.
Becky: For the delayed cord clamping, that just gives the newborn a little more blood volume, and, actually, it’s better for baby. There’s no reason to cut the cord any sooner, unless the baby is having a respiratory issue and would need resuscitation, so that would be out of the norm. But otherwise, we do wait and delay so the baby can have more blood volume from the placenta.
Alyssa: How long?
Becky: Our standard is a minimum of one minute. I know a lot of moms request —
Alyssa: So this isn’t like it’s for an hour —
Becky: We’re not saying 10 minutes or 20 minutes. Generally, the cord stops pumping within five minutes. So some moms request to please wait until it stops pulsating, and we can do that, too. Generally, we wait about a minute, and that’s probably close to when it stops pulsating. But we’re not talking about an hour or anything like that.
Kristin: Yeah, some of my clients want to see it actually turn gray and stop pulsating before it’s cut.
Alyssa: And I didn’t want to see mine at all.
Becky: I didn’t either, personally!
Alyssa: My husband did accidentally and was like, oh, my God, an organ just fell out of you!
Katie: I love all of that stuff. It’s so fascinating!
Kristin: As far as additional steps that you take to get recertified, tell us about that process and why it’s important.
Katie: You will see in our women’s and infant services department that OB triage is on A level, and then all the way up to the 8th floor in that tower, you’ll see the 10 Steps for Baby-Friendly posted. It’s just showing our support of those ten steps. We have to show that patients receive prenatal education in our clinics regarding breastfeeding. We have to show that all of our staff receive the education. The people that come out to do our survey — the interview staff.
Becky: And patients.
Katie: And patients and providers, so they will go in patient rooms to see that they receive the education about breastfeeding and that they’re being appropriately supported for breastfeeding. So they look at our exclusive breastfeeding rate.
Kristin: And then you have support groups, as well, when mothers go home and need additional support. They can go to free support groups and seek help through their OB or midwives or pediatricians?
Katie: Absolutely. I think a lot of our pediatricians have at least one pediatrician who is an IBCLC, so a lactation consultant, as well. I know that our DeVoss clinic has two pediatricians that are lactation consultants.
Becky: And our pediatrician who is an IBCLC actually oversees the residents, and so she’s the one working with them and training them. It’s kind of keeping that mindset forefront for all of them, too, and helping them learn the Baby-Friendly system.
Katie: So while nursing took this on and rolled it out, there is a lot of support from providers, as well. Of course, our nurse midwives receive, as part of their education, breastfeeding, but our pediatric providers are all very supportive of breastfeeding, as well.
Alyssa: Is there anything that you think is a misconception for this Baby-Friendly Initiative? Is there anything that it isn’t? You told it what it is, but what isn’t it?
Becky: Yes. I think the thing we hear most is that, I’m going to be pressured to breastfeed if I deliver there. And there is nothing further from the truth. Our goal is a culture supportive of breastfeeding, not a culture of pressure. So our goal is to educate, let moms make decisions, and support them. So there’s no pressure. I think the other big misconception is about rooming in. Sometimes you have a mom who, let’s say, has had a C-section and she’s exhausted, and she just needs support for a couple of hours. We will accommodate that. We’re all about supporting moms. So although we do encourage rooming in, and there are a lot of benefits to it, in certain circumstances when it’s not best for the family, we support what is.
Katie: I think that it’s the 80/20 rule. There’s going to be exceptions to every rule, and it’s just important that we support our patients through that. I think that Becky and I have probably both taken care of those moms that have had long labors or C-sections, and they come up to the floor, and they just need rest. You have to take care of yourself.
Becky: They’re crying. The baby’s crying. Everyone’s hit a wall. And it’s like, why don’t I just cuddle your baby for an hour. You take a nap, and then let’s try again. Sometimes just 45 minutes of sleep can change the entire situation.
Katie: I remember after my second one, I got two hours of sleep. Like, two consecutive hours. And it was the best two hours ever!
Alyssa: I’m thinking about my situation. It was fairly quick. Yeah, sure, I was tired, but I did choose one time in the middle of the night to have them take my daughter to the nursery so I could get — it was about two hours. But I felt so amazing. But I wasn’t in this dire circumstance. So today with — this was before the Baby-Friendly. So today, would I have to prove to you that I need the sleep?
Alyssa: It’s just, would you take her for a couple of hours? You’re not going to say, well, you don’t check these boxes, so she won’t go.
Becky: No. I think the goal is when moms come up to the postpartum unit to talk to them about, well, babies room in 24-7, and we keep you together and care for you together. However, if you have a need to send your baby to the nursery, we’ll accommodate that. So our goal is to not educate the mom at 2:00 a.m. who’s exhausted and crying about how she should room in with her baby. That’s not really the time to have that conversation, and it probably wouldn’t be well-received. So we want to educate them when they first come up so that at that point, at 2:00 a.m., if you decide to make that decision, it will be more like, okay. I’ll bring her back for her next feeling.
Alyssa: I didn’t think I wanted to, but now I do.
Becky: And that is common. Okay, I just need a little bit of a nap, and then I can keep going.
Kristin: Yeah, we’ve had clients hire us to help out in their postpartum room when their partner had to go home to tend to another child or had a job to get back to. We’ve loved that role of being in the hospital, as well as later on in the home, to support them and help them get sleep and also learn baby cues and feedings and help support breastfeeding.
Alyssa: Basically, be their postpartum doula in the hospital as well as at home.
Becky: We would welcome that support, definitely! I’m sure our nurses would love to partner with you on that!
Alyssa: For those moms who don’t want to send — maybe they desperately want the sleep, but they don’t feel comfortable sending their baby to the nursery. Your doula sits in the rocking chair and holds your baby.
Becky: What a great option!
Alyssa: Yeah, it’s been really kind of life-altering for a few of our clients who are a little bit more on the — you know, a lot of moms just have anxiety, especially first-time moms.
Katie: I think that so much of the focus goes to the baby, but we’re taking care of mom, too, and that needs to be in the forefront, as well. There’s two patients there.
Becky: And be aware of her self-care and her needs in the moment, too, because what I always try to tell my patients is, you need to take care of yourself so you can take care of this baby. And if that means a short nap, then I think we need to do that because it’s going to make you a better mom in the morning when you’ve had a little bit of sleep.
Kristin: Exactly. What other hospitals in the area within the Spectrum brand are Baby-Friendly? We have clients in a 50-mile radius of Grand Rapids, so we work with a lot of your smaller hospitals, as well.
Katie: So Spectrum Health Butterworth just received redesignation, like we talked about. Spectrum Health Zeeland.
Becky: They’re newly designation last September.
Katie: And then Spectrum Health United Memorial up in Greenville. They were designated five years ago, and they’re going through the redesignation process right now.
Alyssa: So is it every five years?
Katie: Yes. And then Spectrum Health Big Rapids is going after designation, as well. We have, as a system, Baby-Friendly requires us to have an infant feeding policy, and we have standardized that infant feeding policy across the system for all of our regional hospitals, as well. So you’re going to see a piece of Baby-Friendly in all Spectrum hospitals. And the reason for that is that it’s evidence based and it’s best practice, so even if they’re not designated Baby-Friendly, these are practices that we should all be doing.
Becky: Right. They’re probably practicing very similar to Baby-Friendly, even if they don’t officially have that designation.
Alyssa: That’s great. Anything else you want to share before we sign off?
Kristin: What resources, if any of our listeners want to learn more about Baby-Friendly or some of the work Spectrum has done — where can they go online to get more information?
Becky: I think just going to the Baby-Friendly website will give you a lot of information about the 10 Steps and about what we’re focused on as a Baby-Friendly hospital. So you can really start just researching Baby-Friendly, and we are following that to a T, so that will tell you how we’re practicing.
Katie: Our provider offices also have education and information about Baby-Friendly, and then —
Becky: Our childbirth education classes.
Katie: Yes, at Spectrum Health Healthier Communities. They have information, as well.
Kristin: So the educators can fill their students in with any questions they have?
Katie: Correct, yes.
Kristin: And then is there anything special with the hospital tours that our clients go on before delivery? Do you incorporate Baby-Friendly or answer questions based on that? I haven’t been on a tour in a while.
Katie: I don’t think that they specifically talk about Baby-Friendly, except that —
Becky: The practices, probably.
Katie: Yeah. They likely don’t highlight the nursery like they used to. Our nursery — we don’t have babies lined up in the nursery like we used to. They’re with their moms, so you can’t go to the maternity floor and look through the window of the nursery. There’s no babies there.
Becky: I do think they talk about some of our practices, about how you room in and we keep babies together. And I think the other thing is maybe some of the practices, like the skin to skin after delivery. Things that might be different than other hospitals, just so they know what to expect; that we would never supplement a baby unless it was medically necessary, and we’re not handing out pacifiers unless somebody requests it. So it might be slightly different than other hospitals that are doing deliveries in the area.
Katie: Our childbirth educators are pretty passionate about breastfeeding and supporting breastfeeding practices, as well as supporting natural birth. They give the whole gamut of the birth experience.
Kristin: Well, thank you for joining us and sharing so much!
For tips on how to make your hospital room feel cozy for birth read Creating A Cozy Hospital Birth Space in First Time Parent Magazine by Kirstin Revere.
Saving for Baby: Podcast Episode #88
Kristin talks to Paige, The Millennial Guru, again today about how to financially prepare for growing your family! 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, co-owner of Gold Coast, and I’ve got Paige Cornetet, the Millennial Guru, here with me for our second episode on financial tips. This one is focused on, once you’ve had your baby, how to really stock savings and plan ahead and make important financial decisions. So welcome, Paige!
Paige: Thank you! Thanks for having me on!
Kristin: Yes, it’s our pleasure! Fill us in, for those who missed the previous episode, a bit about what you do, and then we’ll get into your ideas for how our clients and audience can save.
Paige: Perfect, thank you. I started the business Millennial Guru, and basically, I do workshops and trainings focused on women as well as millennials. I’ve written a couple of children books focused on financial education.
Kristin: Fantastic. Yeah, I love your books, and you’ve got another one coming out?
Paige: Yes. This one’s called The Hen in the Pen, and it’s all about investments and understanding the difference when you eat your chickens, when you eat your eggs, and if you eat all your chickens, you don’t have anymore eggs left, so focusing on eating your chickens because they provide for your lifestyle and growing your flock of chickens.
Kristin: I love it! I can’t wait for it to come out. So tips — okay, so baby is here, and children are expensive?
Paige: What?! Yes, very!
Kristin: So let us know what you would recommend for our audience.
Paige: Oh, my gosh. I mean, that’s a good question; that’s a big question. I would say tips for moms: I think it’s really important to definitely have, like we talked about before on the previous episode — margin. So understanding that cushion of what it is, how much that you need for a rainy day fund, whether it’s an emergency or something that the baby needs that you didn’t know that you were going to need and they didn’t get it at your baby shower, whatever it is. Understanding what are the necessities, and then taking it even further, around the wants and needs. So understanding what is it that you need; what is it that your baby needs; what is it that your family needs, and then what is it that you want? What is it that your baby wants? And what is it that your family wants? Kind of differentiating those two, I think, makes a big difference.
Kristin: Sure. And they’re all the decisions of, do you leave your job and stay home with the baby, or do you look at in-home or a childcare center for daycare, and how do you maximize your income if you do return to work when all this money is going out for childcare, and what is the best situation for your family?
Kristin: Short-term and then long-term.
Paige: Well, and I think you have to be honest with yourself, as well. I have a lot of friends who are having babies, and they’re either going back to work or leaving work and figuring out what that is, what that means to them. And I think that, as well as, yeah, your personal desires on top of, you know, what is it that you can afford, whether it’s daycare, whether it’s staying home, and how does that look for you? But I think being honest is the first step with yourself. And then on top of that is, what is it that you want, and what is it that you need? How do you need to provide for that desire?
Kristin: Yes. And then planning for college and other expenses and even — I mean, my kids are in sports and other activities, like theater, and all of the activities get pricey. My daughter started dance at age two, for example, and so you think of those expenses, and are you going to limit activities for children? What are you willing to budget for activities, sports, and so on?
Paige: Absolutely. Well, it’s interesting you say that about activities. My family had a saying. It was called GUTS, and it stood for Golf, U Pick, Tennis, and Swimming. So those were the four activities that we were allowed to do, so golf, tennis, and swimming are things you can do until you’re 80, so they’re life-long sports. Even if you don’t play it, you still have to learn it and do it. And then the u-pick was just, whatever it is that you wanted. So I loved dance. I loved ballet; I loved jazz. And I had to do it. So even though it was u-pick, since there was four of us, my dad was, like, well, your sister has to do it with you, too, in terms of coordination and carpool and schedules. It’s time and money.
Kristin: That’s what it’s all about, yes.
Paige: My sister, Brooke, she didn’t love dance as much as I did, but she did love the vending machine that gave candy at the bottom of it, so I was able to convince her to do one more year because there was skittles and candy that we could get right after. Her want was candy; mine was dance.
Kristin: It’s all about compromise.
Kristin: And then looking at other things outside of kids’ activities and just — you had talked in the previous podcast about maximizing your time, talents, energy, and so on. So outsourcing your household things, whether it’s getting your groceries delivered by Shipt or having a housecleaner come in, or a postpartum doula, which I highly recommend! Get some sleep! What are your priorities? So tell us about some of your theories in maximizing and how to figure out what might be more beneficial to outsource.
Paige: Yeah. I think just the things that you mentioned are really great, but understanding what is it that takes you a lot of time and what are the things that you don’t like to do that you can outsource? So I would say, yeah, I love the grocery delivery. If you want to work out, too, who is going to take the baby so that you can be physically active, or is there a place like the gym that you can bring your baby to so that you can work out while the baby’s there? So I think figuring out what are your lists of goals; what are the things you need? Definitely sleep! Number one is sleep, and then we can talk about food and physical activity. It’s understanding that, what that is that you need, and then going, okay, so if I need sleep, let’s hire a doula so that mom can get some rest. Okay, now that I have the sleep — food. I need healthy food. Using outsourcing; people bringing food, meals. Communities, whatnot; Shipt.
Kristin: Yeah, special food delivery services that are local, as well as national, that you can get food delivered to your door, which is also a time saver, and if you can get specialty diet needs because a lot of people may need to cut out dairy or have certain allergies if they’re breastfeeding their baby and need to make some adjustments to their regular diet.
Kristin: So other than that, what are your other tips when you’re looking at — you’ve got this baby. I mean, there’s college, obviously. That’s a big one.
Paige: Yes. Well, I would say education, just in general, is an important one to be thinking about because, okay, they’re going to preschool. Now they’re in middle school. All those different levels of schooling, and what does that look like? Where do you live? For example, Michigan has a really great public school system. Where I grew up, Florida, does not. So what does that look like where you live, the state? What works for you? Would you want to send your kid to, like, a Montessori — I grew up there, so I’m a big fan of Montessori — and if you do, what does that look like? So I think education is definitely a priority and planning for that, as well as just, not only education for paying for that, but education for your child from you because you are a teacher, as well, to your children. And so are there things that you want to teach your child? For example, I just have coffee this morning with a good friend. She has a two-year-old, and she’s, like, what is education? I want my daughter to go to a great college and — but she’s like, but I want her to have access to a lot of experiences like they’re going to spend a month and a half in Hawaii with her brother to really understand — and she’s like, I’m bringing my daughter with me. I’m so excited because it’s important for her to see the world is bigger than just West Michigan where she lives. So education, I think, in the whole sense of the word, is definitely very important on many levels for your children.
Kristin: It’s not just planning for college. You’re looking at, will it be a private or parochial school that you need to reserve funds for, or is music education? You would lump that into the education category? Same as sporting activities, for example?
Paige: Yes, as well as experiences, too, right? So let’s say travel is very important to you and you want that to be important to your children. Are you going to be providing for those experiences that are very educational but maybe aren’t necessarily around schooling?
Kristin: So when you’re planning your family budget, how does all of that fit in?
Paige: Well, I think it depends on each family, of course. So each family has, you know, from different jobs, different means, different lifestyles, different priorities. But the one thing that we all have in common is time. So we all have that equally, and I think that understanding where is the time going and what is it that your children are going to be doing? For example, like you said, different sports; activities. What’s important to you? What’s important to the child? What’s important to give them exposure to? And then I think if you can do that and set that overarching as a bigger picture, it kind of will fall into place and you can start planning for that more strategically.
Kristin: So how can people connect with you individually if they want to set up a planning session or hear you speak? You have many appearances with your book releases coming out and so on.
Paige: They can email me at email@example.com. Or you can call me and contact me at 616-443-1000. Or they can go to my website or any social media, Millennial Guru.
Kristin: Thank you so much for being on!
Paige: Thank you! Thanks for having me!
The Millennial Guru: Podcast Episode #87
Paige, The Millennial Guru, shares some savvy saving tips to help you think about priorities, wants, and needs and how to budget for them. 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, co-owner, and I’m here today with Paige Cornetet, and she is known as the Millennial Guru. Welcome, Paige!
Paige: Thank you! So excited to be on the show today!
Kristin: Yes! Tell us about why you started Millennial Guru. You’re also an author. Fill us in, since you’re a local Grand Rapids resident and business owner.
Paige: Absolutely! So I started the business with the intent in mind of how to help my generation. I’m a Millennial, too, so full disclosure, I’m a Millennial helping the Millennials. It was about how to help my generation understand themselves and dive in a little bit further, as well as teams. Obviously, when you get out of college, you get a job and you go to work, and you work with a different type of generation of people, so yourself, as well as different generations, and kind of how to bridge that gap with the different generations. What does that look like with different technology, with different concepts, with different philosophies. I think the most important thing with who I work with is starting with yourself. Who are you? What are your talents? What are you good at? Then, once you understand that fully, how can you express that to your team and understand your team members and their talents.
Kristin: I love that!
Paige: You, yourself, is kind of the thought and the basis of the philosophy for my business. Then it kind of led into not only understanding yourself but also understanding your wealth. Those kind of go hand in hand. I wrote a bunch of different children’s books, and it was really fun. It was with the intent of, okay, so I’m helping my generation understand about themselves and also about their wealth and that the themes are and the concepts and the understanding. Then I was thinking, how can I help the even younger generation, the kids, the little guy, understand at even an earlier age. They’re not going to necessarily understand themselves yet, but they can understand themes and concepts of their wealth or their future wealth.
Kristin: My kids have one of your books, and they love it!
Kristin: So as far as focus, how can people who are local to you connect and figure out, even if they’re not ready to have kids, maybe how to plan for their future of wanting a family, wanting a house/
Paige: Yes! First of all they can connect on the website or my email, firstname.lastname@example.org.
Kristin: And you’re very active on social media. They can find you on Instagram, Facebook, everywhere.
Paige: Exactly, all of the above. I think that, first of all, they can connect with me, and then we can have a bunch of different conversations. I do workshops, on top of that. It’s understanding first what you’re good at and what that looks like for you. So, for example, one of my talents is Maximizer. I love doing many things at once, meaning killing many birds with one stone. That’s the high pressure life, and how I do things is make sure that I’m covering a lot of things. It’s kind of for the greater good, the excellent. So I bring that to my business and also my personal life, as well. So when I’m investing, I want to maximize my return. I always want to maximize; what is the best way that I can do it to get the most out of it? That’s how I do things, including my goalsetting. As an example of a big goal, I have three siblings, and I wanted to go on a trip with them each individually this year, which is a lot of trips. My 30th birthday is coming up, and so I thought what if I can just do a whole sibling trip and we can all go together and I can check all those boxes off at once? We’re about ready to do that. We’re going on a safari in Africa, the four of us together, soon. That’s an example of how understanding yourself and how you approach things can apply to you professionally, to your goals, your personal goals, your business goals, and to your future financial planning goals.
Kristin: What are your priorities? If travel is a priority before having children, how do you save for that and craft out the time in a busy work schedule? Life in general is busy.
Paige: What? It is?
Kristin: Right? And then saving for a family if that’s something they desire, as well as checking off those boxes of travel and things that they want to get accomplished.
Paige: Absolutely, and I think you said that really great. Priorities means establishing what are your wants and what are your needs. Once you have the needs covered for you, you also have to think about the needs when you have a family. What are the needs for the kids? What do they need? What are their wants? First, if you can do it with yourself: what do I want? What do I need? Planning financially for that will help make it easier going forward when you do have a family and you have kids. It’s like, okay. Do I want those really cute little baby shoes for them, or do they actually need them? They’re really cute and they’re Instagrammable, so…
Kristin: So much of life right now is the Instagram filters and photos!
Paige: And they do grow, so eventually, they probably won’t need those shoes. It’s things like that.
Kristin: And you also travel quite a bit. We have listeners from all around the country, and you do workshops and speaking engagements?
Paige: Yeah. It depends on who and what and how and also where, but I’m mostly in Eastern standard time. That’s kind of where I stick myself a lot. It’s a little bit easier for myself. Again, my Maximizer can’t help it. Let’s just stay in the same time zone so that I don’t have to catch up on sleep! But yes, I’m all over. I do a lot of speaking engagements and workshops, mostly focused around yourself and your wealth.
Kristin: And we had talked ab bit when we met up for coffee recently. You do some strategy session for entrepreneurs like myself and helping small businesses maximize their wealth, personally and for the business itself.
Paige: Absolutely. It’s interesting that you say that because I’ve been thinking about that a lot as myself being an entrepreneur. Where is my margin? Where is that space where I can have creative development for that, and where is the space that I can have financially, as well? So the margin has been kind of at the forefront of helping entrepreneurs. Where is that cushion — and margin is the word that I use for it, but you could use a lot of different words — of financially, and so feeling that way or distributing or redistributing things, as well as your time and energy as an entrepreneur. Are you doing it all?
Kristin: Yes, or can you outsource?
Paige: And that goes back to families, too, right? If there are certain things when you’re having kids or having a family, what can you outsource? Who can you use to rely on, if it’s a community or if it’s grandparents. Extra set of hands!
Kristin: Yes, we’ll have to talk about some of that outsourcing for families in our next episode. We’ll have you on to talk a bit more about savings when you have a newborn. And again, if people are interested, they can find you at your website.
Paige: Thank you so much!
Kristin: Yeah! Thanks for being on!
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!
Maddie’s Birth Story: Podcast Episode #83
Our listeners love hearing a positive birth story. Today Maddie, a previous HypnoBirthing and Birth client, tells us all about her labor and delivery as well as her experience in the hospital right after having her baby. 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 my former birth client, Maddie, and we’re here to talk about her personal birth story. Welcome, Maddie!
Maddie: Thank you. I’m glad to be here!
Kristin: So we talked a little bit about why you chose HypnoBirthing in a previous podcast, so tell us about your birth story. How did you know you were in labor? Give us all the details. I was lucky to be there!
Maddie: Yes, it was wonderful to have you there! I went into work on a Wednesday, and I was due July 18th, and it was July 13th. For some reason, I just kind of thought, oh, I’ll know. It’s not going to happen yet. I went to work; I had a normally-scheduled weekly appointment with my midwife. I went at 10:30, and I had been kind of grouchy all day and just felt a little off but did not think about it at all. I’d been having practice labor for a few weeks, so I really wasn’t noticing anything different. I went to my appointment and sat down, and she said, how are you feeling? And then I started bawling. I said, “I just feel so confused by my body!” And she was like, well, let’s just take a look. How about we just take a look, and so she did an exam, and she said, girl, you’re six to seven centimeters! And I was like, what?! And I started crying again, and then I said, but what does that mean? Even though I’d been through HypnoBirthing; I knew what it meant, but it was just so unexpected. I was so far along already. She was fantastic; she was so wonderful, and she said, well, it means you’re going to have a baby today. Go have some lunch. So I called my husband. He was working, and I told him I was six to seven centimeters, and he said, well, what does that mean? And I called my mom who was coming, and she said, but wait; what does that mean? So we were all pretty taken off guard because it wasn’t like I had woken up and said, oh, you know, I think something’s happening. No one was really prepared. Hey, I’m six to seven centimeters.
Kristin: Right, I couldn’t believe it when I got the call. I was like, what?!
Maddie: Yeah! I went and got some lunch and drove myself to the hospital and parked on the fifth floor of the parking structure and waddled in. You showed up; you were the first one, and we went up to the room. Fortunately, since I’d already had the exam, I didn’t have to go through and wait for 20 minutes for them to monitor me or anything.
Kristin: That’s so nice to skip triage and go right up.
Maddie: We went up the room, and it was not bad for a really long time. You know, my body was doing a lot of the work as far as maybe turning the baby or getting more effaced. Having done HypnoBirthing, I knew that dilation is not the only factor that you need to pay attention to, so I was able to just kind of relax and say all right, it’s going to happen when it happens. You were there; you did a lot of hip squeezes for me, which was really fantastic for that counter pressure, because I was having back labor. My husband is not able to do those with his wrists, so that made a huge, huge difference. And we just kind of hung out, and I listened to my HypnoBirthing, and I listened to some relaxing music. My appointment was at 10:30, and he wasn’t born until 10:45, so it was a while, but…
Kristin: But for a first-time mom, it was pretty quick, and it’s one of the few calls I get in the daytime hours. Most of the time, I get a call at 2:00 AM or 11:00 PM.
Maddie: Right! Things started to get ramped up some, and then I started noticing it more, but none of it was overwhelming. One thing that we talked about in HypnoBirthing was breaking the amniotic sac. That’s protection for baby, so I didn’t want to do that; didn’t really feel like there was any reason to. The contractions really weren’t bad. The surges weren’t overly painful or overwhelming, and so my midwife worked her full day at the office and then came in. She checked me again quite a bit later, and then she did accidentally break the amniotic sac, and then after that, things got pretty intense.
Kristin: Yeah, that can intensify a lot!
Maddie: Yeah! I think from the time my water broke until the baby was born was about 2 hours and 45 minutes, so doable. I spent a lot of the time in the tub, and that felt really great. My husband was able to just use the hand shower, and having that, the different points of pressure, I think kind of helps take your mind off of it to some extent. The water makes it a little less intense. I really liked to be in there. Then we got out, she said she wanted to check me, and I was Group B Strep positive, so they wanted to do another round of antibiotics. That had been one thing that, when I found out, I was super devastated, because I wanted to labor at home for as long as possible. I didn’t want to have to come in before six centimeters, and we had me the plan that if I came in and I wasn’t six centimeters, I didn’t want to know what I was at. But I would just not go home. You could know; my husband could know, and then we could make the decision. Let’s walk around a little bit or just not be admitted. But because I was already six to seven centimeters, when I was checked, we went right in after I got lunch. We went right in and got admitted, so I was able to get those antibiotics in. Once she checked me again and broke my water, it got intense. It was really just — I felt very internal. You know, it was not a lot of talking, and it was — I think right after it broke, I kind of got to that point where I was like, oh, no. I can’t do this!
Kristin: Which most women go through with unmedicated births. Transition!
Maddie: Right. However, as soon as I had that thought — I have a distinct recollection of, oh, no, I can’t do this. No, wait – that means I’m really close. That means I can do this. And so then I really tried to just focus on my breathing, because we’d talked about that and learned and practiced about getting those breaths in. And I did end up struggling with that, but having you, having my husband, having my midwife all saying, all right, this is the birth you prepared for. You can do this. Just take those big breaths. Breathing and focusing on those voices helped me to kind of get back on track, get it under control. We tried a lot of positions for delivery, which that was one big thing. I had changed providers pretty early on from an OB who said you’re only allowed to birth on your back, and I said, I want the freedom to do whatever position feels comfortable for me and for my baby and my body. And so I ended up doing a lot of my laboring and pushing leaning over the back of the bed on my knees, and that definitely felt like the best position for me. We tried on the side with the peanut ball.
Kristin: I remember trying a lot of different positions, and it’s all about listening to your body.
Maddie: Right, and my body was saying, this does not feel good! Don’t do that! So I spent a lot of time there, and then I got to a point where I just remember feeling so hot and just, you know, put as many ice-cold washcloths on me as possible. I was so hot, but I was just kind of getting right there to the end. It was right at the end, and then my midwife had said, okay, I want to check you after this next surge, and so I want you to roll over. And I already knew I was crowning, but I couldn’t really explain it at that point. I’m like, no, no. He’s there.
Kristin: Right. I feel him!
Maddie: He’s right there! So I did end up flipping over, and that was okay on my back, and that was fine. What was helpful was the nurse that was there; she had said, do you want a mirror? And I had said no, no, I don’t want a mirror. And then she said to reach down and feel your baby. When I could feel — he’s right there. More than just oh, I feel it with my body, but actually touching it with your hand — he’s almost here! That kind of gives you a little reinvigoration. I’m right there at the end! So I was able to catch my baby and put him right on me and do optimal cord clamping. It was fantastic, just beautiful. He was born on July 13th at 10:45 PM, so about 12 hours from when I figured out that I was in labor until he was born. And it was being just relaxed about the whole process and recognizing it’s going to happen when it happens, and your body is going to do it, and trusting your body.
Kristin: Exactly, trusting your baby and your connection with your own body and your baby, because it’s the two of you working together along with, of course, your partner and support team.
Maddie: The very first thing I ended up saying after Charlie came out was, good job, buddy! He was a part of it, too.
Kristin: Exactly, babies work so hard! They have to turn in the canal and — yeah, they’re exhausted. You’re exhausted.
Maddie: Exactly, there’s a lot happening. It was beautiful!
Kristin: It really was. It was an honor to support you. How did it go with the skin-to-skin time and breastfeeding as a first time mom? Let’s talk about some of that and how you felt bonding in that first golden hour.
Maddie: That was fantastic that I could do skin-to-skin right away. I didn’t feel pressured to stop. That was super important. I did have some postpartum bleeding, and so while all of that was being taken care, not being separated from my baby was so big so I could just focus on him. That part was wonderful. We got all cleaned up. The breastfeeding definitely was more difficult. I have one side that’s inverted normally, and so baby really struggled to latch on that side, but he also struggled on the other side. I was fortunate that Spectrum has IBCLCs on staff 24 hours a day, and so they were able to come in at 3:00 AM and focus on what’s going on, why is baby not latching. We did end up using a nipple shield, and that was pretty demoralizing for a while. We used it until six weeks, and I went to some Le Leche League meetings and things like that. It really was important to have those contacts ahead of time and know where the meetings are; know when the meetings are; know an IBCLC that’s recommended in case you are having those issues so you’re not having to try to figure that out when you’re exhausted and you’re feeling downtrodden and things aren’t working. It’s really hard to try to find that when you’re already struggling. So having figured that out ahead of time, I was able to go to a meeting, go meet with a lactation consultant again. We did stick with it, and then at six weeks, which is pretty common, he just kind of got it. We got in the tub where it was warm and kind of womb-like and got rid of the nipple shield, and it worked.
Kristin: That’s amazing that you were so persistent and it paid off!
Maddie: Yes! We just weaned at 2 years and 11 months.
Kristin: Oh, congrats!
Maddie: Yes, that was exciting. We had a fantastic nursing journey. If you really stick with it and arm yourself with that support system, you can do it. I feel like so many women don’t have that support system. My mom nursed; my sisters nursed all of their children. Having that support system makes a huge, huge, huge difference.
Kristin: Yeah, and like you said, just taking advantage of lactation while you’re in the hospital, even for moms who have a great first latch, to just have someone see your holds and answer any questions you might have — it’s a resource that I highly recommend anyone take advantage of, if they’re birthing in the hospital, of course.
Maddie: Right. That was important that they did come in. They came multiple times to check on us and did work on holds and really understanding, you know, here’s another technique. Here’s another hold to try if this one isn’t working, so you have those skills in your toolbox to pull out. Okay, this isn’t working; let’s try this. That definitely was helpful for me, as well.
Kristin: Great! Well, thanks for sharing your story! Do you have any parting words?
Maddie: I would just say to do your research. It’s easy to just say that my doctor is going to do what’s best for me. This is what happens. This is how it goes. But it doesn’t have to be. You can be such an advocate for yourself, and you can surround yourself with other people to advocate for you so that you can get the type of birth that you want so that you have the support that you need. Even if you have a partner that’s not able to be there in the way that you need, you can get a doula. You can have a midwife who births in the hospital. It’s really not different. I know people that really think, oh, they’re not a doctor. That’s totally different. Just really doing your research and asking other moms who have been through it. Moms are very willing, good or bad, to give you their advice, so get as much information as you can so that you can make your own informed decisions.
Kristin: Yes! Thank you for sharing your story because other women want to hear personal, especially positive, stories. I feel like when it comes to birth, you here the dramatic or tragic. Everyone likes to tell negative stories, and there aren’t enough positive, and a lot of women in pregnancy want to surround themselves with light and positivity. We really appreciate you coming in! Thanks so much, Maddie. Thank you, everyone, for tuning into our podcast. Remember, these moments are golden.
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.
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.
Understanding Your Cycle: Podcast Episode #82
Alyssa: Hello, welcome to Ask the Doulas. I am Alyssa, and I’m here with Kristin. Our guest today is Dr. Nave, who is a naturopathic doctor at Health for Life Grand Rapids.
Dr. Nave: Hi!
Alyssa: We were excited to meet you – what was it, a few weeks ago? We presented to your team, and you – I was really intrigued. Tell everyone what you specialize in as an ND, and then they’ll know why I wanted to talk to you so bad.
Dr. Nave: I am especially excited about assisting women to reconnect to their identities, and the way in which I do that is by really looking at their hormones, their mental health, their physical health, and other aspects of their life.
Alyssa: Do you only work with women?
Dr. Nave: No, I do not, but my passion is women.
Alyssa: So today you’re going to talk about cycles, and I know you have a couple specific thing about a woman’s cycle that you want to talk about, so explain what those are, and then let’s just dive in.
Dr. Nave: Okay. I want to talk about what a typical cycle should look like, so this is how your cycle should look if nothing is going wrong. And then we’ll transition to talking about PCOS and what is going on with that.
Alyssa: And what does PCOS stand for?
Dr. Nave: PCOS is polycystic ovarian syndrome. In medical terminology, a syndrome just means a cluster of symptoms that fit this particular diagnosis, and so with PCOS, what’s happening is that the woman isn’t bleeding or she has skipped periods, and that is due to low progesterone, which is an important hormone that allows the endometrial lining, basically, in the uterus so that implantation of the fertilized egg can happen.
Alyssa: Okay. So let’s talk first about what it should look like.
Dr. Nave: Sure. With our cycle, there are five main hormones that influence a woman’s hormonal cycle. We have LH and FSH, which are the hormones that are produced by the brain to tell an egg to mature and to allow the endometrial lining, which is basically the build-up of tissue in the uterus that allows the implanted fertilized egg to become a baby. So we have those two hormones that are produced by the brain, and then we have estrogen, testosterone, and progesterone that are produced in the ovary.
Alyssa: All the time, or only if an egg is implanted?
Dr. Nave: At specific times. A typical cycle, in terms of what we would call the normal cycle or the optimal cycle, would be a 28-day cycle. We have some leeway in terms of, in the medical community, how we diagnose whether it’s too long or too short, whether it be above 35 days or less than 21. For me, I think it’s best if it’s 28 days because it’s kind of like cycle with the moon, so the lunar cycle, because it also helps with the math. So we’ll just use 28 for the typical just for explaining what happens. In the first 14 days, that’s what we call the ovulatory – like, the building up of estrogen. The brain tells the ovary, by way of follicular stimulated hormone, FHS, to make one of the eggs mature. So it’s like, hey, ovary, let one of these eggs become the mother, so to speak. The brain does that, and then the ovary responds by allowing one of the eggs to become mature. We have multiple eggs that are responding during this time in different life stages, but the one that is the oldest usually gets picked, in terms of its life phase. It becomes mature; the estrogen is being made by the egg itself, which allows for that ovulation to occur. FHS tells the egg to become mature, and then the egg itself makes estrogen so the egg can further mature. It’s a fascinating, interesting thing that’s happening.
Alyssa: That’s during ovulation?
Dr. Nave: Yes, so during the first 14 days of your cycle, the estrogen is building up so that the egg can fully mature. Then what happens is that there are two types of cells that are a part of the egg. One produces estrogen, and the other aspect makes testosterone, so those are the other two hormones that we’re talking about. Once the egg matures and it’s released, the thing that’s left behind is called the corpus luteum, also known as the yellow body. That then makes progesterone. All of this is sort of happening at the same time, so we say 14 days for the ovulatory phase, but really, it’s like the brain is telling the body to make progesterone at the same time it’s telling the body to make estrogen. It’s just that it’s at a lower level. Until the egg is released. You don’t really have that progesterone being made.
Alyssa: It’s ebbing and flowing based on the day of your cycle?
Dr. Nave: Yes, yes. Around day 14 is when the egg is released. It’s the highest level of estrogen at that point in time, and then the yellow body that’s left behind – the brain told the egg, by way of the luteinizing hormone, LH, to start making progesterone. Are you following?
Alyssa: Kind of, yeah. In my head, that little egg is moving along, following a timeline.
Dr. Nave: Right! At day 14, we have the highest estrogen, and progesterone starts to climb up.
Alyssa: And estrogen is decreasing and progesterone is increasing?
Dr. Nave: Yeah, estrogen is at its peak; progesterone starts to spike up a lot more. I’m grossly simplifying it, sorry! As the progesterone is being built up – so the corpus luteum is making the progesterone because the brain told it, hey, make progesterone by way of the LH, the luteinizing hormone. That causes, then, the endometrial lining in the uterus to build up so that implantation of the egg can happen. Towards day 28, which is when you expect bleeding to occur – basically, the reason why bleeding occurs is that the progesterone starts declining at that point because progesterone is necessary for the build-up of the uterine wall so that implantation can happen, but if there’s no fertilization off the egg, then it basically is a withdrawal of the progesterone, and then it just sloughs off.
Alyssa: So day number one is not the – is that the day your period starts?
Dr. Nave: Yes.
Alyssa: So day 28, then, is the day before you period starts? Okay, I’m seeing the timeline in my head.
Dr. Nave: Yeah. Day one, when a doctor asks a woman, okay, what’s day one of your period, he or she is technically asking, when’s the first day of your bleeding. Technically, we’re always cycling, but we consider day one the last time you bled. That’s what the cycle should look like. Now, when we experience our periods, even though people consider it the status quo that we experience PMS, we don’t have to experience it. Does that make sense?
Alyssa: The hormonal changes don’t necessarily mean that we’re going to have the mental and – becoming angry or disorganized or frustrated?
Dr. Nave: Yeah. Seeing those symptoms for a woman, that would indicate to me that maybe the ratio is a little bit off. Some examples are acne or being really bloated. Being bloated, puffy, having water retention and having really heavy bleeding – that could be a sign that the woman is experiencing what we call estrogen dominance. Now, estrogen dominance doesn’t necessarily mean that she has high estrogen. It could just mean that her progesterone is low and therefore throwing off the ratio so that when she’s experiencing premenstrual syndrome, PMS, she’s experiencing these symptoms, even though if it were normal, she wouldn’t have to.
Alyssa: So you’re not saying that PMS is made up. It’s a real thing; it just means there’s an imbalance somewhere? It can be fixed, that you don’t have to deal with this stuff?
Dr. Nave: Absolutely. And the weepiness: estrogen. Estrogen is important for our bone health, our cardiovascular health. It’s the reason why we as women don’t get heart attacks until much later in life because it protects our hearts; it’s important for our bone health, which is why when you experience menopause or perimenopause, it’s very important to get your bone density checked. That’s the importance of estrogen. And then testosterone, which is produced by the egg, is important for sex drive and being able to be aroused.
Alyssa: What happens in a woman’s body when they’re aroused that helps with implantation?
Dr. Nave: When the woman is aroused, that allows the cervix to sort of pulsate so that when climax is achieved, the sperm can travel up into the uterus and, hey, let’s get to the egg wherever it is. It also allows for the vaginal canal, which typically is around three inches, which sounds crazy, but it actually lengthens and stretches. It’s a muscle that moves to accommodate the penis, if you’re having that kind of intercourse, or allow for artificial insemination in that way. So it increases the likelihood of implantation successfully occurring. It’s so cool!
Alyssa: We’ll pause so everyone can visualize!
Dr. Nave: Our bodies are amazing! In order for conception to occur, not only do the hormones have to cycle how they should, but you have to address your mental health; are you in the space that you can have intercourse or whatever it is? The ovary itself isn’t even attached to the uterus. There’s a gap between the two of them, and we have chemotaxis – basically a chemical, like how your body produces the hormones, that attracts the egg to go down the fallopian tube as opposed to staying in your abdominal area.
Alyssa: So every time you see a picture, it looks like…
Dr. Nave: They’re attached? Yes. But they’re not.
Alyssa: So they have to let go and then actually be drawn up by the fallopian tube and then into the uterus? They’re not attached?
Dr. Nave: No. We have connective tissue or fascia that’s in that area –
Alyssa: Which helps kind of push it in the right direction, probably?
Dr. Nave: Not exactly. It’s more like it creates this compartment so that your uterus isn’t just floating around in your abdominal cavity. We have this connective tissue that anchors it in that area so there’s less likelihood that a fertilized egg will end up outside of the uterus, which is why ectopic pregnancies are so low in terms of their incidence. But we also have these finger-like projections in the fallopian tube that brushes the egg along. So it’s not just the hormone that’s attracting the egg to where it needs to go and we have all these other signaling processing that are working.
Alyssa: I’m picturing a crowd surfer pushing it along.
Dr. Nave: We’re all supporting you! So that’s what a normal cycle should look like.
Alyssa: Ideally, that’s what it should look like?
Dr. Nave: Yes, ideally, that’s what it should look like.
Alyssa: And when a woman doesn’t have her cycle?
Dr. Nave: When she doesn’t have her cycle, then we have to consider two different things. Is it that she’s not bleeding at all, which we call amenorrhea, or are there greater than 35 days between each cycle, in which case we call that oligomenorrhea, or many menses, technically.
Alyssa: It seems like it would be the opposite because there’s a big space between. But either way, it’s a problem, and that will help determine how you treat it?
Dr. Nave: Yes. And so if it is that a woman isn’t bleeding, as in amenorrhea, then we have to consider why is that the case. Is it that she’s pregnant? That would be the first thing to assess. Is she pregnant? Okay, she’s not. What exactly is going on? One particular condition that I’ve been hearing or rather seeing more women experience is called PCOS. We mentioned it earlier, that PCOS stands for polycystic ovarian syndrome or Stein-Leventhal syndrome. Basically, what’s happening is that instead of the progesterone going up around day 14 to day 28, instead of it increasing, the body is changing it into another type of hormone. Just to give you some context, our bodies use cholesterol to make all our steroid hormones, which are all our sex hormones as well as cortisol. Our bodies use the cholesterol and then turn it into pregnenolone which is like the mother of all of those hormones. Pregnenolone can then become progesterone. It can become testosterone. It can become estrogen, which we have three different types of estrogens, or it can become cortisol. In PCOS, what’s happening is that instead of the pregnenolone going down to becoming progesterone, it’s getting turned into either testosterone, estrogen, or cortisol. A woman who potentially has PCOS or has been confirmed with that diagnosis – in addition to having amenorrhea, for her to be diagnosed with it, she also has to have two out of three symptom criteria. We have what’s called hyperandrogenism, which is high testosterone, and some of the symptoms she could experience would be cystic acne or hirsutism, which is just a fancy term for hair in unwanted places, like coarse, thick hair along your hairline or along your breast or in places that aren’t typical areas that you have hair distribution. That’s one, and then the amenorrhea that we talked about, and the last one is seeing cysts. The only way that we can really assess if there are cysts in the ovary is if we do a transvaginal ultrasound. I say we, but not me, but the actual tech would do that for you, and basically, they place a probe inside the vaginal canal, and they use an ultrasound on top of the abdomen to visualize if there are any cysts in the ovary. The reason why we get the cysts – to back up again to looking at the cycle, instead of the egg being released, the egg just stays there, because you need the progesterone to tell the egg, hey, release.
Alyssa: It stays where?
Dr. Nave: It stays in the ovary. And then in the ovary itself, you have all these eggs that look like they’re just about to release, but they end up forming what’s called a cyst. It can be fluid filled. Cyst is just a fancy term for a ball, kind of.
Alyssa: I didn’t know a cyst could be an egg that didn’t move.
Dr. Nave: That didn’t move, yeah.
Alyssa: So when people say they’ve had ovarian cysts burst, it could be an egg that didn’t move? Could be, doesn’t have to be?
Dr. Nave: Could be, doesn’t have to be. It could just be fluid. But in the case of PCOS, it’s like the ovary doesn’t release the egg, so it becomes mature, kind of, but not to the point where it actually releases because we don’t have any progesterone, or there’s minimal levels of progesterone so that if and when a woman experiences bleeding, if she has PCOS – so long cycle or no bleeding at all – in the long cycle aspect of things, there’s no egg. It’s just blood or tissue that got to build up a little bit.
Alyssa: So the egg still is stuck in the ovary?
Dr. Nave: Yes. I mean, you could have some release at some point if her progesterone can get high enough that that can occur, but it’s kind of scattered. You can’t really track it per se because it’s insufficient.
Alyssa: So she’s having them, just not – I guess 35 days instead of 28 – wouldn’t most women just go, oh, that’s no big deal; I just have a long cycle? What are the other symptoms? What else would they see?
Dr. Nave: She could have the symptoms of PMS but never actually bleed. So she’s still cycling, because remember you’re still cycling, always, whether you bleed or don’t bleed; the hormones are still doing their thing. She can experience the PMS symptoms but not bleed, which means that she’s not able to get pregnant. And even if you don’t ever want to get pregnant, our uterus is what I like to call an emunctory. An emunctory is basically an organ that our bodies use to detox or remove toxins. If we are not bleeding, that means those hormones are getting reabsorbed into our bodies, which for a woman, if she’s estrogen-dominant, it basically reinforces the estrogen dominance because she’s reabsorbing it in her intestines, which makes the symptoms to get worse. Because to get rid of our hormones, once they’ve done their thing and we’ve shed our lining and we bleed, the other way in which we get rid of our steroid hormones is by poop. So if you’re not pooping, then…
Alyssa: Is that another symptom or side effect? Is that a cycle issue, or not?
Dr. Nave: It could be a cycle issue. One of the symptoms that women sometimes experience is when they’re on their periods, either they’re constipated or they have really loose stool, and that’s because of hormones.
Alyssa: They call it period poop, and I never knew why.
Dr. Nave: Yeah, it’s because of the hormones.
Alyssa: So it’s normal? If you’re having a regular cycle and you have a day of poop that’s not normal, it’s just your hormones? That’s normal?
Dr. Nave: Normal in the sense of it’s to be expected with what you’re experiencing, yes. Other things that can happen with PCOS, and this is not with every woman, is that some women gain weight. Some don’t. For a woman that does gain weight if she has PCOS, what’s happening is that the body is converting the progesterone into cortisol. And cortisol is the hormone that affects our sleep-wake cycle. So when you first wake up in the morning, the reason why you’re fully awake is cortisol. It spikes at that point. What happens when we’re under a lot of stress, or if you have PCOS, our bodies are making a lot more cortisol, and that cortisol allows for the breakdown of stored glucose and the conversion of other proteins and fats into glucose. This issue with that happening for prolonged periods is that the woman can experience what’s called insulin insensitivity, so her body is no longer able to respond to insulin, which means that when she eats, then she can’t stabilize her blood sugar, which means that the sugar stays longer in the bloodstream, which causes damage to small blood vessels and nerves, which is what happens in diabetes. That’s why for a woman with PCOS, having metformin might work, which is why some doctors place a woman with PCOS on metformin to increase her chances of conceiving. It’s not just the hormones that affect your cycle; hormones influence every aspect of our lives, from the moment we wake up and take our first breath to the moment that we pass on into the next life. It’s this orchestra that each hormone has a part to play and influence each other in term of how effectively each part is able to do their part.
Alyssa: So let’s say I came in and I had questions about my cycle. What’s the first thing that a woman could expect? Bloodwork?
Dr. Nave: The first thing I would want to know is what labs she’s already gotten done. Has she gotten her thyroid checked? And when I say thyroid, I don’t just mean THS because THS is just your brain telling your thyroid, hey, make the thing. It’s also looking at the levels of the thyroid hormones because you have two types of those. You have free T3 and free T4. Their ratio is also important. So thyroid function; CBC, which just stands for a complete blood count. It’s checking for anemia, because that could be another reason for amenorrhea. You may not be bleeding because you’re iron deficient. And then I would also want CMP. That’s a complete metabolic panel, and that looks at the kidney and liver function, which are affected if blood sugar isn’t being regulated effectively. On the CMP, there’s also a fasting blood glucose on there, so that would be something to look at. I would also want to review her symptoms. What symptoms are you experiencing? Are you experiencing acne? Are you experiencing bloating and irritability on your menses? Do you experience depression on your period? There’s also the consideration that we have PMS, and then we have PMDD, which is premenstrual dysphoric disorder, which is basically PMS on steroids. It’s like the cycle overall is so horrendous that the woman can’t go to work. It’s affecting her daily life, affecting her mental health. She’s more depressed on her period, more irritable, or really angry, or in so much pain that she can’t leave her home. Looking at her as a whole person is what I’m about. And she’s the expert in her experience, right? She knows what it’s like to walk in her body, to experience these symptoms, how they affect her life, and then both of us taking our expertise to work together to get to the root of why this is happening and give the body the tool that it needs so it can rectify it.
Alyssa: You just reminded me that I need to make an appointment with you. I remember when I met you the first time, I was like, yeah, I need to see her, because not only have I turned 40, but I know my hormones are changing. My periods are changing. Just weird things happening. So how do people find you? What’s the best way to get ahold of you?
Dr. Nave: I am at Health For Life Grand Rapids, and you can check the website and look for my page. There’s a 15-minute free meet and greet and consult, so we can see if we’re a good fit. I can hear about your concerns, and you can get the cure that you need.
Alyssa: I love it. Thank you so much for joining us. We’re going to have you on again, and we’ll talk about some other intriguing topics. Again, thanks for tuning in. This is Ask the Doulas Podcast; you can always find us on our website and on Facebook and Instagram. Remember, these moments are golden.