gold coast doulas

Kristin chats with Gold Coast client Amber Shaw about her VBAC birth story and the preparation she had for her birth.   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:  Welcome to today’s episode of Ask the Doulas.  I’m Kristin, and I’m joined by my former client, Amber Shaw.  Welcome, Amber!

Amber:  Thank you.  I’m so excited to be here.

Kristin:  So you have shared your birth story with Parker with us in the past.  So if you could give our listeners a bit of a recap of your first birth journey, and then we’ll get into your most recent birth with Miles.

Amber:  Sounds great.  So my son Parker is about four and a half years old now.  His birth seems like so long ago.  But it was kind of a crazy experience.  I’ve always been pretty obsessed with birth, all things birth.  I love hearing birth stories.  I think it’s just fascinating, the human body, what the woman’s body can do and accomplish, and I always knew that I wanted to see what I was capable of.  So when I got pregnant with my son, I knew that I wanted to attempt a natural birth.  So I brought Gold Coast on right away, started working with doulas; I did HypnoBirthing.  I read all the books.  I really prepared myself for this physical feat that I was about to embark on.  And he was breech, so got that news around maybe 32 weeks, and I became obsessed with flipping him, because that’s just my personality.  I did everything I could have to flip him.  I did acupuncture.  I did chiropractic care.  I was doing Spinning Babies.  I was doing everything.  And he wasn’t budging, and at about 39 weeks, I went in for an ECV, and that wasn’t successful, either.  So I still remember this call I had with you.  I was having a really hard time processing just the fact that I was going to have a C-section.  It’s not what I wanted at all.  I had never had a surgery in my life, and then just to imagine, like, having my first child born C-section, I just wasn’t grasping it well, and I wasn’t coping well with it.  And you just had such great advice on just allowing what was, and it was still going to be my birth story regardless, and I really just had a breakthrough that night, and I wrote him a letter that I still haven’t opened.  It’s actually still sealed in his baby box, but I trusted the process, and I knew that he was like that for a reason, and whatever way he came out was going to be just perfect.  And that was really cathartic for me, very emotional for me, and it really helped me process what was going to be my birth.  And then that was it.  He was born on his due date at 10:13.  Like, ten minutes after I went in, he was there, and it was kind of crazy how fast.  It’s an interesting experience.  I can definitely say it wasn’t as bad as I thought it would be.  It was still beautiful.  I still had birth preferences.  You know, we had a playlist going, and we did the passthrough drape, and I watched it all.  Kind of bizarre.  But, you know, I kind of took back my power in it and realized that I still do have a say in how it happens, no matter how it happens, and I really embraced that, and I have just a beautiful memory of his birth, and it was definitely very impactful no matter how he came.  And so that was Parker’s birth, in a nutshell.

Kristin:  And tell us about your healing after Parker’s birth and how that went.

Amber:  It was pretty straightforward.  I mean, obviously, healing from a C-section is hard because your abdominal muscles are cut through, so any time you’re sitting up, any time you’re really doing anything that uses your midsection, there’s a lot of adjustments that needed to be made for me, getting around, sitting up, being mobile.  With him, I had the luxury of not having another child, so I seriously was on the couch for, like, two weeks straight and breastfed and I binged watched all the shows, and I really just allowed myself to heal and really took it easy, and it was a pretty straightforward healing process.  You know, my scar looks incredible.  He did a great job with that.  I didn’t really have any points where I felt like I went backwards at all, and it was a pretty good process, really.

Kristin:  Good.  So now with your preparation for your birth with Miles, tell us a bit about what you did to prepare for a VBAC, vaginal birth after Cesarean, for those listeners who don’t know what a VBAC is.  And then a bit about what you did as far as other learning this time around.

Amber:  It was different.  You know, I already had the HypnoBirthing under my belt.  Of course, I brushed up on it.  But I kind of wanted to get some different aspects into my knowledge about this one.  So I brushed up on the HypnoBirthing, reviewed a lot of my stuff from the course that I took from Ashley four years prior.  Probably one of the most impactful things, I think, was reading Ina Mae’s book, The Guide to Natural Childbirth.  That was really mind blowing for me, I think because it just really educated me so much on truly what my body goes through during birth.  It tells so many successful VBAC stories and just so many stories about women just persevering, the strength of it all.  It educated me so much about interventions and the downsides to them.  I just felt so empowered after reading her book.  I highly recommend it to anybody that is attempting this.  Yeah, she’s incredible.  So that definitely helped prepare me really mentally.  And then honestly, I did The Becoming Course as well.  That was also super helpful because there’s so much that you kind of forget the second time.  Obviously, you’re in survival mode a lot with a newborn, and I had a very different birth experience with my first than I was hoping to have with this one, so in a lot of ways, I felt like this was my first time, you know, so I was really just trying to absorb all the stuff.  And I think what prepared me physically was doing barre classes.  So I’m a member at The Barre Code, and that – I can’t speak highly enough about staying active, and especially staying active in a way that really prepares your body for birth.  And I truly feel like the barre classes really do that because of just the micromovements and just really strengthening all parts of me, mentally, physically.  That really helped me a lot to prepare, as well.  One hurdle that I did come across, which was very unexpected and pretty debilitating for a little bit, was I was diagnosed with SPD, symphysis pubic dysfunction, at about 20 weeks, and I had no idea what it was.  I just knew one day I woke up and was having a hard time walking.  Unbelievable amount of pain in my pubic bone; literally came out of nowhere.  And so once I found out what it was, I started doing a lot of research about it and went and saw Dr. Annie at Rise, and I was a disaster in her office.  I was, like, bawling.  I didn’t know how I was going to get through the next 20 weeks.  I couldn’t even do stairs or, like, walk very well.  With wanting to do this natural birth, I wanted to stay as active as possible, so I imagined, you know, doing barre classes, you know.

Kristin:  Right, until the very end, yeah.  Now, for those of our listeners who don’t know Rise, tell us a bit about how Rise is different from other chiropractic offices.

Amber:  Truly, a feel a women-centered office.  I know they have male clients, as well, but I just feel like their approach is very female-centered and very, like, pregnancy- and birth-centered.  They just have a lot of support in general for pregnant women, but they do a really gentle form of alignment that’s very specific to pregnancy.  And I am not kidding you; I thought that there was, like, no way that I was going to have any type of comfort going through the rest of my pregnancy with the way that I felt when I went in there, and she had me working out again within two weeks, which is unbelievable.  I could not be a bigger proponent for chiropractic adjustments, and specifically at this office.  Annie has been such a huge part of my pregnancy, my birth, and my postpartum story, and I’m just so grateful for the fact that she gave me my comfort back.  It’s just unbelievable.  So, yeah, I’m in love.

Kristin:  And for our listeners who live elsewhere, there are directories of Webster-certified chiropractors across the country so you can find one who specialized in pregnancy and positioning and helping you get movement back.  And this practice also happens to do postnatal in-home visits, which is amazing, because they’re pediatric-certified as well.  We’ll get into that part later, but I did want to mention how our listeners can find a similar practitioner.

Amber:  Yeah.  I think chiropractic care is vital through pregnancy.  I mean, your body is undergoing so much, and just to care for yourself in that way, keep yourself as aligned as possible, is so important, and you feel such a huge difference once you start doing it.

Kristin:  So let’s get into your birth.

Amber:  Well, first, I want to remind you, which is so crazy, that this kiddo was breech, as well.  That was kind of crazy.  So obviously, their positioning really doesn’t matter for a bit.  I did find out he was head up at about 27 weeks, and I was kind of nearing, you know, the time when it gets kind of important to be aware of where they’re at.  And I’m petite.  I’m very petite.  I have a very short torso.  I don’t feel like a lot of room for my babies to move in there, and so my midwife – you know, we were kind of just chatting, and she’s like, maybe this is just how you carry babies.  You know, maybe they have a hard time going head-down for whatever reason, and I already started to feel a little deflated and just – I had time, but I was really starting to feel like just my body was not going to cooperate with me and that I was going to have to have another C-section.  And so I really, like, went through this mental back and forth of, do I have faith, you know?  Should I just keeping doing what I’m doing, doing all the things to prepare for this natural childbirth while still knowing that a C-section may be imminent, or do I just accept the fact that I am probably going to be having another C-section and just kind of not do all of this work to prepare my body?  So I was so torn.  Every day was different, I felt like, and I was really talking – you know, I had hired you guys at that point again, and I was talking to Ashley and Audra quite a bit about just where I should put my mental space because I didn’t want to be obsessed with him flipping again if that just wasn’t in the cards.  But I did decided that I would be at peace with having another C-section because I knew what to expect.  But I also wanted to do as much as I possibly could to try to get him to flip, just knowing at the end of the day if he didn’t, that I tried.  I started doing the Miles Circuit stuff, Spinning Babies.  I actually purchased their e-book on flipping a breech baby, and it’s a pretty structured program on things that you do every day, kind of leading up until the grand finale of really trying to flip them.  And so I stuck to that for a little bit, but he ended up flipping, and it was pretty unbelievable.  It was about 35 weeks, and the night before my appointment – they were pretty much doing scans on me, quick scans in the office, every time I was in there just to check his positioning.  Right before my appointment with my midwife, I had this insane abdominal pain.  It was super uncomfortable; it was really stabby.  I was having a hard time even standing and so I went over to the couch and was sitting there for a while and just could not get comfortable, and I felt like he was legit, like, swimming inside of me.  Limbs were going wild.  What is going on in there?  And I was almost thinking about going into triage just to see if he was okay, because at that point, you don’t feel a lot of movement anymore.  You do, but not like that.  And so it kind of ended up going away.  I went to bed early that night, didn’t have any more pain.  And I woke up the next day and went into my appointment, and I was not – I was just expecting him to still be head down, and we were talking about scheduling out my C-section, what OB I wanted it with.  We were very much talking about the fact that I was going to have another C-section.  And she scanned me, and he was head down.  He flipped the night before, and we both just started bawling.  It was an unbelievable feeling because I just felt like I had been given everything back.  Like, I had been given the chance to have the vaginal birth that I wanted.  And I just had, like, so much gratitude, and I was just in shock and I didn’t know where to start because I kind of, like, stopped preparing a little bit.  So everything got flipped upside down again, and here we were, five weeks out from his due date, like, once again preparing for this vaginal birth.  So that was pretty wild.

Kristin:  Yes!  So you were open to possibilities, but also did a lot of work.  That’s a great example of just realizing that you’re only in control of so much and releasing and sometimes when you release, things happen.

Amber:  Yes.  That is the truth.  I definitely have a tendency with my personality to just want to know how things are going to go, and if it’s one lesson that I’m learning from pregnancy, birth, and parenthood, you really got to flow.  You have to be open to what’s going to happen because holding on to an expectation of something is just dangerous.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Kristin:  As you’re leading up to – again, you had a scheduled birth the first time.  What was it like for you to have sensations of labor and feel the surges or contractions, as some people call them, and so on?

Amber:  It was such a different experience.  You know, I never experienced any of that with Parker because he wasn’t head down.  He wasn’t engaged.  So I never had any Braxton Hicks.  I never had any, like, sensation down there.  Like, it was just very – like, he kind of just came out.  So it was really exciting, like, starting to feel my body getting ready for this, you know, really paying attention to every single sensation and wondering what that was and what that meant.  I just very much remember, like, being in the excitement of that.  Probably around, like, 37 weeks, I started just to feel my body gearing up.  You know, I started to feel the Braxton Hicks, kind of some tightening and then loosening.  And from reading and doing so much preparation, I did understand that those were not surges.  They were not, like, labor.  So I was really feeling into all of these little practices that your body gives you to kind of give you a little idea of what it’s going to be like.

Kristin:  So you practiced your breathing?  And it’s wonderful; those warm-ups are a great way to get into it.

Amber:  They are.  And just – they immediately make you in tune with your body and present.  That’s one of my favorite things, honestly, about, like, the end of birth and birth in general is, like, there’s nothing else in our lives that makes us so attuned to our body.  It’s just an unbelievable thing to be that connected to yourself, and I don’t think anything else gives that to us.  So yeah, I was feeling some stuff, and then at about 39 weeks, I started to experience some early labor.  And, you know, at first, you don’t know what’s what.  You’re like, is this just more intense Braxton Hicks?  You know, what is this?  But I was to a point at 39 weeks where I was waking up every single night and laboring by myself out in the living room.  You know, I was bouncing on my ball; I was doing, like, cats and cows.  And it was really an interesting thing because I was getting excited, because that’s of course what you do once you start feeling like something is actually different than Braxton Hicks, because they were different.  And so, you know, I’d wake my husband up after, like, a couple hours, and he’d be like, I don’t know, this might be it.  And then we’d feel it out for a little bit, and then it would eventually just taper off.  That happened for a while, and it was exciting at first, and then it started to get exhausting and frustrating, and I was starting to just feel depleted.  You know, I wasn’t sleeping.  I literally was up in the middle of the night for a week for all hours, and I was just miserable.

Kristin:  And then you’re also caring for Parker, so again, this is a different experience.

Amber:  Yeah.  Be up entertaining my very energetic four-year-old the next day, and I was just like a zombie.  And I started to get nervous because I’m like, how am I going to go into birth feeling so exhausted?  I’m like, I can’t do this.  So on my due date, I had an appointment, and I wanted – first of all, I wanted to know if I was dilated at all, because I’m like, I know something is happening.  Need to know something is happening and it’s not in my mind.  And so I was at a 2, which really doesn’t mean anything.  You can walk around at a 2 for, like, ever.  And I do know not to get attached to the numbers because, you know, it’s just your body getting ready.  The numbers don’t mean much.  But something was happening.  But, you know, I’m pretty natural, but at that point, I was miserable, and I wasn’t sleeping.  So I did decide to start taking a medication to help me sleep a little bit at night because it was either that or I was going to be just up all night long doing this over and over again, waiting for birth.  And so that was really helpful – very helpful, honestly.  So for the next couple nights – so this was on my due date, so this was July 2nd.  So I started taking that medication and got a couple nights of decent sleep.  They were still waking me up, but I was able to kind of go back to sleep without getting out of bed.  So that was awesome.  But it was still very much going on.

Kristin:  Yeah, that therapeutic rest is important for prodromal labor that just starts and stops and doesn’t give you time to, you know, get in any sort of rhythm.

Amber:  Yeah.  It was always in the middle of the night.  Like, it never really came during the day.  I would have sensations during the day, more Braxton Hicks stuff, but the second everybody went to bed in the house is when they started.  But retrospect, right?  So at the time, it was hard, but having retrospect of it now, it was such a blessing for a lot of reasons.  It made me so much more in tune with my body than I already was because I knew what those felt like, and once they started feeling different, that could be labor.  But I understand now why women go into triage at the start of that kind of stuff because it did feel like labor.  It was labor.  It just wasn’t timeable, and it wasn’t consistent, and it just ended up going away.

Kristin:  And so then they get sent home, and they’re frustrated and exhausted.  Yes.

Amber:  I get it.  I was uncomfortable through some of those nights where I felt like I was laboring.  But I was paying such close attention that it just wasn’t – there wasn’t consistency to it yet, and that’s how I knew that it wasn’t real.  So, you know, at this point, I think with the prodromal labor, and then also just, like, being that close to my due date, that is such a weird time because I feel like you’re, like, just in this weird dream state of, like, you don’t know when it’s going to happen, so you don’t want to do too much, but you want to keep your mind busy, and you’re kind of just, like, waking up and waiting for it.  And that was interesting for me because I didn’t experience that with my first one because I knew when he was going to be born.  But with all of this back and forth, I just – every day, I was like, is this going to be the day?  Is this going to be the day?  Is this going to be the day?  So it really felt like I needed to start distracting myself.  So Ashton, my husband, took the week off before my due date just to kind of, you know, enjoy the last little bit of our family of three time.  And I wasn’t sleeping, so he was helping out with Parker during the day so I could get some rest, which was really nice.  So we did the zoo one day.  We were trying to just do some stuff as a family just to stay busy, stay active.  You know, the 4th of July, you know, I woke up, and I was like, you know, I’m two days overdue, but let’s go out to the cabin.  So we went out to my cabin that day, which is, like, 45 minutes away, and enjoyed some time in the water, which that’s the only place you want to be when you’re over 40 weeks is in the water.  So really enjoyed that and got some really great pictures of me just massive in a bikini, and you can barely see the bikini over my belly, and I just treasure those pictures so much because we were just waiting for him, and he was so close.

Kristin:  It’s that in-between time.  It is such a special time if you look at it that way.

Amber:  It really is.  It’s hard when you’re in it because you’re so anxious, but that is such a special time.  So, yeah, we really enjoyed – or, no, this was the 3rd of July.  We were out there the 3rd of July.  I’m sorry.  But there was, like, obviously, you know how people celebrate 4th of July.  It’s like a week and a half long.

Kristin:  Of course.  Yes.

Amber:  So the 4th of July, I woke up.  We came home that night.  I woke up, and I just felt different, and it’s a hard thing to put your finger on, but I just felt like that was the day that he was going to be born.  I felt like I had more pressure down there, and I also was feeling sensations a little bit earlier, but I decided not to say anything to anybody.  I was so sick of, like, telling Ashton every time I had a surge.  I was just, like, sick of it, you know what I mean?

Kristin:  Or telling your doulas, like, I’m not sure if this is it… Yeah.

Amber:  I’m going internal.  I’m going internal on this one.  I am just going to, like, really just be so in tune with myself today and not talk about it.  And so, you know, I woke up, and I went to Target because, you know, what other way to waste a couple hours and be on your feet?  So I’m at Target for a while walking around, buying a bunch of stuff I don’t need, because that’s what you do there, and I got a cayenne kombucha, because that was, like, spicy, good.  So got my kombucha, and I was kind of, you know, walking around.  I was feeling some stuff.  I was feeling different, but I still was just being quiet about it.  And then I went over to my sister’s house, because I was borrowing a Bluetooth speaker from her for labor, so I went over there and I was hanging out on her porch for a while, and I started to leak a little bit, and I felt like it was water because it’s just different, you know?  You have all kinds of fluids and sensations, but I just felt like this was, once again, different.  So I called my midwife, and I was like, I think I’m leaking a little bit.  Nothing substantial.  It’s not like it broke, but, you know – and she’s like, well, put a pantiliner in.  Pay attention to it because if it’s water, it’s not going to stop.  So I did that, and I continued to hang at my sister’s house for a while.  And I was, like, telling her a little bit about how I was feeling but still being kind of, you know, mum about it.  And I decided to call my friend Sarah on my way home because that’s who we were going to be leaving Parker with when we went to the hospital, and she was having a little get-together that night for the 4th of July that we’d planned on going to, and I was kind of talking to her, and I was like, girlfriend, I feel like today is the day.  She was, like, the first one that I was like, I think this is it.  And she’s like, well, why don’t you just bring Parker’s stuff over tonight, and you can leave him here just in case, and you know, if you don’t go into labor tonight, then worst case scenario, it’s just a sleepover.  So, you know, I got home, and I was like – that’s the first Ashton had heard that I was just, like, feeling something.  I was like, hey, you know, I’ve been experiencing some stuff today.  I think we should leave Parker at Sarah’s tonight.  And he was, like, apprehensive about it because he just didn’t want to, like, take advantage of her before we were actually going into labor.  He kind of wanted to save that card, but I was like, let’s play that card.  So we packed his stuff up.  We went over to her house for a little bit, and I got right into her pool, and I did not leave there for a couple hours.  And it was the best thing ever.  Like, gravity didn’t exist; my surges didn’t exist.  Nothing existed besides just kind of me hanging out, acting like everything was normal.  I almost kind of like forgot what was going on until I got out of the pool and literally, like, all the weight plus some came back.  And I was like, we should probably leave soon, and this was at about, like, 7:00, 7:30.  So we kind of packed some stuff up, said goodbye to Parker, and left.  And on the way home, you know, Ashton was really doubting me and doubting that it was going to be that night, and he was like, you know, I really feel like we shouldn’t have left Parker over there.  This has happened so many times.  And I just got upset because I knew how I felt.  I have a really good intuition, and I feel very in tune with my body, and I just, like, knew it was going to be that night, and I couldn’t explain that to him because he didn’t see me struggling that day, and I didn’t talk a lot about it.  So from his perspective, yeah, he probably didn’t think much was going to happen that night, but in my mind, I’m like, I’m going into labor tonight, and I’m upset with my birth partner, my husband, and I am scared now.  So, you know, we get home, and I went back into my bedroom, and I was just like, I’ve got to get in a good frame of mind right now.  Like, that’s the only thing I kept thinking about is, like, my frame of mind and that I just needed to be in a good place.  So, you know, I drew a card that was really applicable, and, you know, really started to do some deep breathing, and I kind of saged myself, and I was just trying to kind of, like, ground myself, calm myself.

Kristin:  Clear the air, yes.

Amber:  Yes.  And he was like, I’m sorry.  Like, I don’t know how you’re feeling.  I’m sorry that – if I’m doubting you.  You know, let’s try to enjoy tonight.  So we talked about, like, putting a movie on and stuff.  So literally, like, ten minutes after walking in the door, you know, I go back to the bedroom.  I come back out here.  I sit on the couch, and my water, like, breaks.  And there’s blood in it.

Kristin:  And was it the big, like, gush?  The popping, or describe this for our listeners.

Amber:  It wasn’t a gush, but it was my water.  Like, I just knew that – I didn’t soak the couch, but I definitely left a spot there.  There was blood in it.  So, like, my bloody show was, like, there as well.  And pretty much after that initial break, it was leaking a lot more.  Like, I definitely had to have a towel between my legs.  But it wasn’t, like, a gush-gush.  So – but I knew that was it, and I’m like, this is insane.  Like, I knew this was going to happen.  Ten minutes after walking in the door, my water breaks, and this is happening.  And so I called Audra, and I called my midwife, and I was like, this is it.  I know this is it.  And I imagined laboring at home for, you know, as long as possible, and so, you know, I kind of was preparing to just, like, be there for a little bit.  And literally, like, a couple minutes after getting off the phone with Audra, I was like, we have to go.  Like, I was already on all fours and coping, which is really crazy to me because that’s just not how I’ve read it goes down, you know what I mean?

Kristin:  No.  Not typical.

Amber:  Not typical.  But I knew that I had to go, and we had a half hour drive into the hospital, anyway, so I was just like, we have to go.  So I feel – I prepared so much for this moment.  You know, I packed all the bags.  I did all the stuff.  And then when it came down to it, it was mass chaos.  Like, it was –

Kristin:  Right.  Intensity.  But your body did all of that prep work before, so I find that with prodromal labor.  It can be really quick once it gets going.

Amber:  That was absolutely my experience.  Like, I had so many more things I wanted to throw in my bag, and at the end of the day, we grabbed our shit and we were like, we are out.  So the ride into the hospital was wild.  There were fireworks everywhere because it was –

Kristin:  Of course.

Amber:  So it was pretty epic.  I wish I would have been able to watch them more as I was, like, definitely laboring in the car.  And Ashton kept being like, look at over here, look at over there.  And I’m like, open my eyes, pedal to the metal, drive.  So we get into triage.  My midwife met me there.  Audra met me there.  And they checked me.  You know, it was definitely my water that broke.  They checked that.  And then she checked me for dilation, and I was still at a 2, which I was discouraged for a hot minute, but I was 100% effaced.  Crazy.  So all of that early labor was my effacement happening.  You know, she’s like, this could go really quick.  Like, the effacement is a lot of it.  She’s like, you’ve done a lot of the work already.  So I was just in shock over that.  So, yeah, we were hanging in triage for a little bit, and I was pretty surprised at how I was experiencing my surges.  You think that it’s going to be in your belly and your stomach because, you know, if you do research and learn about this, you know, it’s your cervix moving up with every surge.  And so you expect to have more sensation in your belly, but I was having a lot of discomfort in my hips and back.  So I had a lot of, like, back and hip labor, which is not what I expected at all.  And it was really painful.  I felt like I was having a hard time getting through a surge without counterpressure.  I couldn’t without counterpressure.  And, you know, Audra quickly realized, like, that’s what I was experiencing, and she taught Ashton, you know, how to do the counterpressure on that specific part that I needed it and because when you’re in labor, it’s a specific part.

Kristin:  It is very specific.  And everyone’s got a different point.  You have to feel around until you find it, and then –

Amber:  I know, it’s like – it’s so crazy.  The amount of pressure can make a difference, and Ashton thought he was, like, hurting me, but I was like, that’s better.  So they got a workout that night, as well.  So essentially every surge that I had, I had to have counterpressure on my hips during, which was difficult when I was in different positions because they had to be directly behind me, essentially.  So it made a lot of it difficult.  But shortly after being in triage, we got up to the room.  They saw that I needed to be in a room immediately.  So we went up there, and we had a nice view.  We could still see the fireworks, which was kind of cool.  And we got kind of settled a little bit, and then we decided to get right into the water because I just felt like that’s what I needed in that moment, and I also felt like I was coping okay, and I knew that if I wanted to have that experience of, like, being in the tub with my husband, it was going to be at that point.  So we got in the water.  It was beautiful.  There were some LED candles around the tub.  And he got in behind me, and we just worked through it for about an hour.  And I really liked that time.  It’s probably one of most memorable moments of the birth because I was with him, and it was relaxing for me, and it was just a beautiful thing.  I definitely suggest people do that, and they do that early, before you’re really kind of struggling, so you can just really be present with your partner.  Yeah, that was just a beautiful, beautiful experience for us.  I made this playlist for labor, and it had just all of the best songs on it, so we had our music going.

Kristin:  And water is like a natural epidural, so again, if you’re having that discomfort in your back, it’s a great relief, as long as, like you said, your pattern is consistent, so that’s a good time for you to go in.

Amber:  Yeah.  It was everything, until it wasn’t.  Like –

Kristin:  Yeah.  And then you know you need to try something else.  It’s like labor Olympics.  Okay, what position’s going to work?

Amber:  It really is.  I definitely got to that point where I was like, I don’t want to be in here anymore, and it was abrupt.  Like, I was happy one minute, and then I wasn’t the next.  So we drained the tub, and then I decided to be on the toilet for a little bit, so I was on that, but that was a hard position because I felt like they couldn’t get the right pressure or position on my hips, and that is what was so necessary to me was just having them be able to put the counterpressure where I needed it.  So I didn’t spend much time on the toilet.  And after that, I spent quite a bit of time on all fours on the bed over a peanut ball.  That’s probably the position that I remember spending the most time in.  I think that time kind of ceased to exist after I got out of the water.  But then everything is quite a blur because, like, nothing matter.  Like, nothing matters besides –

Kristin:  Yeah, time doesn’t exist when you’re in labor.  It is a beautiful blur.  But yeah, hands and knees is a great position.

Amber:  It felt like I could move myself.  I could move my hips.  I could do cat cows, and they could also get to me easily.  So that was probably my most successful position that I was in or the one that I had the most just comfort in.  The way I imagined laboring is not at all how I labored.  I imagined being in all of these really just, like, you know, animalistic positions –

Kristin:  Right, or slow dancing, yeah.

Amber:  Yeah.  None of that happened.  And looking back on it now, I think because my SPD was so well controlled, it was an out of mind thing that really reared its ugly head during labor.  I realized why I couldn’t get in a lot of the squatting positions at the time, but now I do realize it, and it’s because of my pubic bone.  Like, it just was not – when he was there and engaged, it was not allowing me to really open my legs as much as I wanted to and needed to.  And so that was really a little bit of a blockage during labor was, like, being able to open up enough.  And so, you know, was on the peanut ball for a while, and I tried a couple different positions that just did not work for me.  I tried the squatting bar on the side of the bed; didn’t work.  I just felt like my pubic bone was going to break in half.  Like, it was impossible to get in wide positions.  And so I ended up being on the bed, and that’s not what I envisioned.  It’s just what happened.  And once you get to a point where you’re really uncomfortable, moving is really scary because if you can find any sense of comfort, and you just grasp onto that, and then, like, getting up and moving can just create almost more, like, unrest, if you will.

Kristin:  And sometimes it’s necessary, but listening to your body is so important.

Amber:  So, you know, I feel like pretty soon on, after moving around a little bit, I was starting to really have a hard time coping and questioning whether I could do this.  And looking back on it, like, I know this was transition.  I knew it in my mind, but at that point, I didn’t know it because it was early to be in transition.  I haven’t been up here that long, but I’m having a really hard time coping.  And so I was, you know, questioning what my options were.  None of them sounded good.  It was just – I almost just needed to hear it, maybe just hear that, you know, I had options, and then, you know, we decided with my midwife and all of us were like, let’s get through a couple more surges, and then we’ll reevaluate, and so I did that, and then she checked me, and I was at a 9.

Kristin:  Woo-hoo!

Amber:  Crazy, because that happened in literally, like, four hours.

Kristin:  So quick to go from 2 to a 9.  But, again, your body was doing so much work and preparation before, and it is baby number two, so even though you didn’t go through a vaginal birth the first time, your body still has muscle memory.

Amber:  Yeah.  I didn’t expect that.  I expected to be the norm.  You know, have a 24- to 48-hour labor.  And all of these things; that’s what I was expecting.  And so it was pretty shocking.  I think the whole thing was kind of shocking just how quickly it happened when it actually started.  You know, being at a 9, I almost didn’t even, like, react to it, because I was just like, oh, my God.  I essentially just did a lot of it, you know?  And then I just got this, like, inner power.  Like, Ashton said he saw it in me.  Like, I was just like, let’s do this.  And so I really, like – I just got this new sense of just, like, dedication to doing this the way that I wanted to do it, knowing that I was, like, so close to the end, and you know, pretty much right after she told me I was at a 9, I started getting kind of pushy.  You know, I would go through a surge, and then at the very end of the surge, I would feel this just need to push a little bit.  And she didn’t tell me to stop that.  This is what I love about midwives and about my midwives is they were like, whatever you feel like doing, do it.  We trust your body.  You need to trust your body.  And that’s exactly how it went down and how it happened.

Kristin:  They’re so great.  I love them.

Amber:  Started getting a little pushy, and then one of the midwives at Advanced is – I’ve always just had a really close connection to her.  I love all of the midwives, but we’re just, like, energetically really similar, really connected, and I always imaging her being at my birth; you know, birthing with her.  And she ended up coming in on her day off at 11:00 p.m., leaving a 4th of July party, to deliver, which was unbelievable because I had started to push and I was on the bed, and she just walked in like a little angel off the streets and was just everything that I needed.  It was pretty amazing.  Like, I remember that moment really vividly.  And pretty much after that, it was just kind of crazy.  You know, I started pushing, and I tried a couple different things on the bed, a couple different positions on the bed, and what I ultimately ended up doing, which is just crazy to think about the fact that, like, this is physically possible for as long as it was, I was flat on my back, and every surge that I had, I essentially came up into a C-curve and grabbed the bars and pushed.  It was so much work.

Kristin:  It is a lot of work.

Amber:  And I just kept thinking about barre, actually, during that time because you do so many C-curves in barre, and I was like, gosh, this is really paying off right now, so that kind of made me – but it took a while to actually feel how to push.  And what I mean by that, like, you know you need to push, so you do it, but there is, like, a specific way to push, and I didn’t quite understand it in the beginning, so I feel like I pushed for a bit without much progress happening.  And I remember Breck kept telling me to open my legs wider and open my legs wider, and every time I tried to do it, I was, like, shaking uncontrollably.  Like, they just wouldn’t do it.  And neither of us knew why, and once again, it was my pubic bone was kind of getting in the way of really opening up as wide as I needed to, so I feel like I pushed harder and longer than I needed to because I just couldn’t open up wide enough.   And so, you know, this part’s a blur, too, but I pushed for a while.  I pushed for a little over two hours.  It was really intense.  It was really intense, and, you know, I was pushing and he wasn’t quite coming down, and then Breck started to kind of get her hands up there, started kind of, like, working on my perineum area, and she discovered that I had a forebag of water in the way of him coming down.

Kristin:  No wonder.

Amber:  It’s crazy.  I guess it’s, like, not that common, but I had one, so he was bumping against that for the first little bit that I was pushing.  So she was like, so I’m going to rupture this, and then it’s going to get really intense really quick, and it did.  I remember she ruptured it, and it felt like just this sea of fluid in between my legs, and it was crazy.  I was having a hard time even getting traction on the bed with my feet because I was just so wet under there.  But that’s when stuff really started to happen.  It’s when he started to kind of come down more into the birth canal.  You know, my pushes were getting more substantial, and they were doing more work.  And yeah, that’s kind of when it really started to happen.  So I definitely – this was at about 4:30 in the morning.  I was just losing a lot of steam.  It was such a fast and furious labor, and I was losing energy, and I was pushing, but I was having a hard time really putting as much into it as I knew that I needed to.  I was just kind of in this lull of, like, I’m doing it because I know I need to, but I am really struggling right now physically to get through this.  And I remember thinking, I’m like, God, I just looked around, then I, like, realized, nobody can do this but you.  Like, you are the only one that can push this baby out.  You have total control over how hard you push right now.  And I just realized I didn’t want to be doing this that much longer.  And so there’s just this thing in me that, like, it was like a second wind.  I just got this, like, deep desire for it to be over as quickly as possible, and I really started to bear down, and I really started to put, like, everything into it.  And Breck and Julie, the midwives really realized that, and they were giving me so much encouragement.  And he was born about 15 minutes later.  So it was insane.  I mean –

Kristin:  What a birth story.  You are amazing.  What a rock star.  You had an unmedicated VBAC, defied odds with a breech baby the second time around.  You flipped him.

Amber:  Yeah, I think the moment that he was born was, like, very different than I expected it to be because instead of, like, pulling him on me and just – of course, I did that, but my arms were so tired from pulling myself up for two hours that, like –

Kristin:  Oh, yeah, all the hands and knees.  They had to be tired.

Amber:  I was shaking uncontrollably.  I felt like I was going to drop him.  I was in shock.  I was, like, bawling because I was so proud of myself, and also, like, what the hell just happened.  It was not this, like, you know – it was, of course, a beautiful and insane experience, but I was – I feel like I experienced shock more than anything, and I didn’t expect that.  You know, but I think after a couple minutes of just realizing he’s here, you’re okay, you’re alive, he’s alive, everybody’s okay.  I kind of started to settle in a little bit.  Obviously, birthed the placenta, which I got encapsulated again this time.  But it was interesting birthing it.  I remember, like, the thud that it made on the wet blankets, and Ashton was like, oh, my God.  Just this organ comes out.

Kristin:  It’s shocking to partners, for sure.

Amber:  But it’s such an afterthought.  Like, obviously.  It’s, like, afterbirth.  It’s an afterthought.  You don’t even realize you’re doing it.  It’s funny.  And then –

Kristin:  Did you see your placenta after?  Sorry to interrupt.

Amber:  And I wanted to.  I didn’t see it because I – you know, I was getting stitched.  I had quite a bit of tearing.  It was just a whirlwind, obviously.  So, you know, I was getting stitched.  I was trying to have him latch.  I was still shaking.  It was just, like, a very strange time.

Kristin:  I bet.  They’re so beautiful.  It is like a tree of life.  They’re gorgeous.

Amber:  I saw a picture of it the first time.  The woman took a picture, and it was just unbelievable how beautiful they are, and actually this time, I had Ginger Blossom do it, and I was so surprised, first of all, the turnaround.  She did a great job, and I got them, like, the next morning.  But she made me a little keepsake with his umbilical cord, and she dehydrated it into a heart, which is just adorable and amazing.  So that was great.  But yeah, he was born, and then, you know, all of the preparing I did was for birth because I was like, you know, I already have a kid.  I’ve got everything under control from here on out, like, I know that, you know, vaginal births, from what I’ve read and heard from people, you can heal a lot faster from them than a C-section.  So I kind of just expected to, like, get up and go to the bathroom and – you know, obviously, I knew –

Kristin:  Let’s actually cut this off here, and we’ll do a second episode with your postpartum experience so this doesn’t get too lengthy.

Amber:  I have to go get my son anyway, so, yeah.

Kristin:  So why don’t you give us one final tip for any other women who are seeking a VBAC of any type, and then we will resume our conversation in another podcast episode.

Amber:  That sounds great.  So my advice is to just envision your birth and what you want it to be and, you know, really embody that because, you know, no matter what position they’re in, what is happening, like you never know what’s going to happen at the last minute, and I think as much as you can focus on what you want, you know, the greater chance it is that you’re going to have that and just know that you can do it.  Take it one surge at a time.  Take it one moment at a time, and truly surrender into it.  Don’t fight it.  Just surrender into it and know that you are capable.

Kristin:  Beautiful.  So perfect.  Thank you very much, Amber, for sharing your story, and I look forward to hearing about your journey after having Miles.

Amber:  Yeah.  Thank you.

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

Kristin talks with Dr. Elham Raker about telemedicine in times of COVID and offers parenting tips for mothers . Dr. Elham is the official “Ask Dr. Mom” who has leveraged her experience as a pediatrician to help parents navigate the “shoulds” of motherhood.

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’m joined today by Dr. Elham Raker, and she is known as Ask Dr. Mom.  Welcome, Dr. Raker!

Dr. Raker:  Hi.  Thanks for having me.

Kristin:  So I would love to hear about your journey as both a pediatrician and parent coach.

Dr. Raker:  So as a pediatrician, I’ve been working for – gosh, I think close to 20 years.  I got married right after I finished my training, and my husband lived in a different city.  And I was following him.  So he was also in medicine and doing his training, so we moved around quite a bit.  And because of that, I really got to work in different environments.  So I did urgent care, private practice, hospital setting, different types of inpatient settings, and lastly, I did a home healthcare.  All of that was amazing.  I loved all the different interactions, all the things I got to learn.  What I really felt was missing was true connection with patients and parents.  And especially in the office setting, we have such limited time.  You know, there’s these, like, 10-minute visits, 15-minute visits at best, and sometimes, you know, we’re running late, and you’re waiting.  And it just seemed really rushed.  And I would come home just feeling burnt out, really, is the best word to explain it, and I know where a lot of people are going through that now for different reasons, but just feeling that, in the sense that it wasn’t satisfying.  I wasn’t providing the best care that I felt that I could.  And then I was coming home literally exhausted and then also missing out on my kids’ life.  So it just wasn’t a win-win at all.  I wanted to be able to do that.  So pre-pandemic, I actually had this idea of starting a telemedicine practice, which really was more like, absolutely be there for urgent visits because, you know, you always – something always happens after hours, right?  The baby hits his head or the earache comes up.  Something always happens.  So I knew that when my friends would call me, I would be able to at least walk them through what to do during the weekend so they wouldn’t have to go to urgent care or the emergency room.  So that was something I wanted to provide.  But also, I felt like parents were really looking for advice on Google or Facebook groups or other places that you never know what you’re going to get.  So I wanted to be a more reliable resource, especially if you maybe didn’t have a friend that was a pediatrician and you needed to ask those questions.  So that was how that aspect of Dr. Mom was initially born.  And then during COVID, I decided that I really wanted to add a little bit more of the counseling and the coaching, which is something I truly enjoy.  And I delved more deeply into parent coaching and, you know, the world of conscious parenting, which is fabulous and something I want to share with everybody.  I think it’s going to help us build such strong connections with our kids and just make kids that become grownups who are going to do amazing things.

Kristin:  So fill us in a bit more about, you know, what conscious parenting is and how we can apply it in our own families.

Dr. Raker:  Conscious parenting is really – it really makes sense when you kind of take a step back.  I think so much of what I was taught as a pediatrician, as a mom, from mom resources and other things that I did when my kids were younger just came from training or, like, this concept of, you know, we have to teach our kids that what they did was wrong by punishing them or giving them a consequence or something so that they don’t do it again.  We kind of lose the concept of, kids are just learning.  They really don’t know what’s wrong or right.  And it’s not always by punishment that they’re going to necessarily learn that, right?  Just like us, we all respond so much better to positive reinforcement than negative ones.  So why would it be any different with our kids?  So to me, it makes sense.  There’s a lot of scientific research to support it, how the brain develops.  And, you know, we know that your frontal cortex is not developed until, at best, 25 or 26.  It could be even later.  So we’re really having these expectations of our kids way before they’re ready to do what we’re asking them to do.  And then I think another really important part of conscious parenting that, for me, was a little bit of a surprise is that all of us were parented, even if we had the best parents, something was missing.  There was something that we didn’t get as children.  And oftentimes, that comes up in moments when we get triggered in our own parenting.  So when we feel the need to yell or get angry, that’s a clue that something is going on within ourselves, like an old trauma.  So that was a huge revelation for me, being a mom that yelled a lot and going through, like, recovery of that.  It’s important to learn that anger is not just something we can just make go away, right?  It’s a signal.  It’s a sign.  It’s something going on.  So just like our cues with our kids, their behavior is showing us that something’s going on, and it’s our job to figure out what.  Same with our behavior, our anger, and our – you know, those are just signs of unmet needs that we have to figure out.  So that was a lot of what we go through in the parenting course and parent coaching.  It’s really about transforming yourself.

Kristin:  That makes sense.  And the coaching is individualized based on your particular clients’ needs, or do you have a set structure that everyone goes through?

Dr. Raker:  I did a course through Jai Parenting, so they have a set course which is a 12-week course, and it’s amazing.  And you get a lot of benefits from doing a course.  But there’s also individual packages where you can just go through.  Like, I have this particular issue going on, and I just need help with that.  So there’s different ways to do it.  I think what we have to remember about coaching, just like anything else, it’s really – parent coaching is parent-centric.  It’s about you.  So it’s not behavior modification for our kids, necessarily.  That kind of happens naturally as we change ourselves, right?

Kristin:  So changing habits, like time-outs, punishment, and just figuring out a new program for the family?

Dr. Raker:  Yeah, and that’s actually a great topic, too, is punishment versus discipline versus consequence.  I think that it can be confusing, but I do think they’re all very different things.  Punishment doesn’t really have a place.  There’s no benefit to it.  Oftentimes it’s something that’s not even related to what the child is doing.  Like, you threw all the toys on the floor.  No more screen time for you.  It just doesn’t make sense.  And a lot of times, it’s more of a punishment for the parent because they use that screen time for their own time-outs.

Kristin:  Right, to get work done.

Dr. Raker:   Right.  And it doesn’t kind of flow.  And same with a time out.  Their child is not going to all of a sudden come out of time out realizing that what they did was awful and they need to correct their behavior and they’ll never do it again.  They’re just going to sit there and be mad and comply with whatever you need because they don’t want to be in time out, but they’re not really learning anything or gaining anything by that.  So punishment doesn’t really work, and I think it severs the relationship.  So anytime we want to think about what to do with our kids, I always think, you know, is whatever you’re thinking of doing going to help build your relationship with your child, build a connection, or separate the two of you?  If it’s a separation, it’s probably not the right choice.  Your child’s going to learn so much more from your love and attunement than trying to make a point with a punishment.  A consequence can be something that happens, and we talk a lot about a natural consequence, which I’m a believer in.  So, you know, if a child forgets his jacket after you reminded him and he’s cold, that’s a natural consequence, right?  You can’t really do anything about that.  You don’t have to do anything.  You can be empathetic about it.  You don’t have to be, like, cruel.  I’m sorry that you’re cold.  It’s not – you know, it doesn’t feel good, but next time, you’ll remember to bring your jacket.  Or we’ll try to stay inside more because I know you’re cold.  Right, you try to accommodate, but it’s a natural consequence.  If a child forgets their homework or if a child forgets their lunch – I mean, if they called me and said, Mom, I’m starving, I’m not going to say, sorry, your fault; you’re going to starve.  I’ll try to at least problem solve with them, right?  Can you ask your teacher, is there someone you can borrow money from to buy lunch?  You know, whatever it may be.  Can you call the school and say, my child forgot their lunch.  Is there anything – you know, whatever it is, you can help them, but it is a natural consequence.  So it doesn’t have to be a harsh natural consequence, I guess, is what I’m trying to say.

Kristin:  It makes sense.  They’re problem solving and figuring out things on their own versus being coddled and – yeah.  It makes sense.  So how do you feel about rewards, then?  Or not really bribing, but you know where I’m going.

Dr. Raker:  Yeah.  So rewards kind of goes along the same lines where we’re actually showing the child that our love is conditional.  So that means if they do something, then they get the reward, as opposed to just being who they are and being loved for who they are.  So that also is a system that doesn’t work well in the long term, and it takes away the internal motivation, which is what we’re really trying to promote, and provides an external motivation, which isn’t what we want in the long term.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Kristin: Even with toddlers, it’s sort of that.  If you have a newborn and you’re trying to focus your feeding time, then as doulas, we’ll sometimes try to distract the toddler or suggest they have a special basket with toys that comes out at that time.  Would that be considered, you know, a reward and – I mean, how do you manage a situation like that, I guess?

Dr. Raker:  No, that’s not a reward, because you’re not really rewarding them for their behavior.  That’s just something special for them during a particular time.  So I guess if you said, you behaved so well today, you get to go do the special box, right, or if you didn’t behave well or you did this, so you can’t have the special box today – that would be more along the lines of reward and punishment and being conditional.  But if you say, here’s a special box just for a special time when I’m with the baby, I’ve see that and different people talk about that.  I think I like that idea.  It just makes the child feel special.  But it’s not based on a condition of their behavior, right?

Kristin:  Thanks for clearing that up.

Dr. Raker:  Yeah.  I think that’s the main difference.

Kristin:  Yeah.  I didn’t want to give incorrect advice, and so I’m glad that that works.

Dr. Raker:  No, I think that’s great.  Yeah, I really think that’s a great thing to do, and rotate the toys every so often and just make it fun for them.  No, I think that’s just being creative, which we all need to do with toddlers, right?

Kristin:  So let’s switch gears and talk a bit about your telemedicine practice and how things have changed within physician offices with COVID.  I know you approached the telemedicine practice before COVID, but just how your practice can complement their physician visits, whether they’re in-person or telemedicine visits.

Dr. Raker:  Yeah, I think that COVID really accelerated all of that, right?  The concept of Zoom, I would say very few people had even heard of Zoom prior to COVID.  So the idea of doing things online, telemedicine, just became the norm.  So mostly I think people are just looking for convenience and the ease of being able to reach out to someone and talk to someone, which is great.  You know, I love that about what we’ve all gone through and that we can all still be connected, even though we’re six feet apart, right?  So there definitely have been some positives.  So I think from the aspect of medicine, it’s being at home, especially if you have kids and you have more than one child.  So, A, taking that child to the doctor is hard on its own, but then if you have two or three in tow, that’s really hard.  And whether you have to find daycare for them or whatever it may be.  And then I think the other thing is just the accessibility.  So a lot of times it’s hard to get a doctor’s appointment.  And the timing.  You know, I really do think – I don’t know the solution 100%, but doctors’ visits – listen, and not that I think we can’t have doctor visits anymore.  They’re obviously super important.  But emergencies happen, so there’s no way for a doctor to not run behind.  It’s just not feasible.  Even in a normal visit, there could be an issue that comes up that takes more than ten minutes, and then you’re just behind.  So there’s that concern of just trying to fit everything in.  And I think parents, especially if they have a newborn or, you know, if it’s the first child, or maybe it’s a second child that’s just totally different than the first experience – they just need a little bit more handholding.  That’s really where I think it can be a benefit.

Kristin:  And how long are your visits?  Are they ten minutes, or are they longer?

Dr. Raker:  My standard visit is 15 minutes, but I can go longer without really throwing off my schedule.  So I allow for that, and then I end up just chatting with the patients, to be honest.  I don’t make it this big cut-off time.  So it’s just nice to have that flexibility.

Kristin:  Definitely.  And then different timing.  So you would be available potentially evenings or times that, say, a physician office would not be able to?

Dr. Raker:  Yes.  Yes, exactly, since I am, you know, working from home or from anywhere, it’s a lot easier for me to just log on if someone needs me.  Like I said, oftentimes, there may be not something I can directly take care of, although I do think we’ll have more technology, like being able to look at ears at home or listen to lungs and things like that, but I can usually at least get you to stay home, you know, take care of it overnight, and then be able to see your physician in the morning.  So it’s still nicer than going to urgent care or the ER, for the most part.

Kristin:  Right, especially now with COVID.  I mean, Michigan, we’re, like, the worst in cases, and there’s really nowhere to go.  So the fact that there are telemedicine options if your child bumps their head and you don’t want to try to go to the ER at this point.

Dr. Raker:  Yeah, and just to have that reassurance and that piece of mind.  And, you know, emergencies – and thank God the emergency rooms are there when needed, but a lot of times, you can get through without it.  You know, you know when it’s an emergency.

Kristin:  Right.  Of course.

Dr. Raker:   But those in between times, hopefully I can help you stay away from it.

Kristin:  And you have a download guide on telemedicine that talks about when emergencies and when to call your provider and so on.  So tell us a bit about that and how our listeners can access your guide.

Dr. Raker:   Yeah.  So you can access it through – probably on my Instagram through Linktree will be the easiest when you subscribe.  The guide is basically – it was really at the beginning of COVID when telemedicine was, like, the only thing we were doing.  And it was just a way to kind of prepare for a visit, like what your doctor is going to know, what you can do at home.  So what we do when you walk into the office, we take your temperature.  We take your weight.  Other vital signs, like your heart rate and breathing rate, which actually are all things you can do at home, right?  It’s great to have a weight scale at home.  Even for little kids, you can weigh yourself and then weigh together and do the math.  Thermometer, of course.  I feel like everyone has that now.  And then you can just check your pulse and measure, you know, how fast your child is breathing.  So all those things are important because if there’s something wrong, that’s an important thing to know.  That’s why we call them vital signs.  And then just having – I think parents, even in the office setting, I think it’s important to give as much history as possible.  It really – there’s so much we can ascertain from a history.  Like, people always ask me about telemedicine and how do you really get to diagnose anything or how do you know.  Like, parents really know their kids best, and being able to know their level of concern helps, and the history of what’s been going on makes a huge difference.  And then any medical history, right?  So whether it’s family history or the child’s medical history, that’s all important.  Allergies, medications, history of surgeries or hospitalizations, things like that.  So those are kind of the standard things, and maybe you don’t think about those things when you go to your office because you’ve been going there since your baby was born, so they kind of know all of that, but those are just important things to think about any time you – even if you go to an urgent care or emergency room or a new doctor, those are the things that they’ll want to know.  So that was kind of my prep of what to get ready when you get on a call.  And, yeah, that was the main thing.  I mean, the physical exam is really more about seeing the child and making sure they look okay and breathing okay, and the history just makes such a difference in how to make a decision at that point.

Kristin:  Yeah, to get you up to speed on everything so you can really make a solid diagnosis and referrals.  It makes sense.  So how – I know you have a YouTube channel.  How can our listeners find you?  You have a blog.  What are your most active channels?

Dr. Raker:   Mostly, the easiest way is to go on Instagram, and that’s askdrmom_ on Instagram.  And the Linktree has everything in there.  When I publish a new blog, it’s in there.  You can also access my blog through my website, and my YouTube channel is linked in there, and I kind of announce stuff on Instagram.  I’m just the most active on Instagram, so if you have questions, it’s a good place to message me, also.  If you’re not on Instagram, then you can find me on Facebook, and that way that also links to everything.

Kristin:  We’ll include all of that in our show notes.  Any last words of advice for our moms?

Dr. Raker:  My last word of advice for moms is to trust yourself, which I know sounds like one of the hardest things to do, especially as a new mom.  Like, I know nothing.  How can I trust myself?  But you really have something that’s really important, and that’s intuition.  And a lot of the things that we’re talking about with conscious parenting, I think it just feels good.  It feels good to connect with your child versus sending them to time out.  I don’t think that ever felt good for any of us that used that method.  So question things that don’t feel right to you, and find a trusted source to ask questions, whether it be your pediatrician – you know, hopefully, your pediatrician, and maybe another one or two sources that you trust, and ask them those questions.  I always say, as long as you’re not harming your child, as long as there’s no danger to your child, do things the way that works for you and your child and your family.  That’s the most important.

Kristin:  Perfect.  Thank you so much for your time today, Dr. Raker.

Dr. Raker:  My pleasure!

Kristin:  We really appreciate it.

Dr. Raker:   Thanks for having me again.

Kristin:  Have a great day!

Dr. Raker:  You, too.

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.

Dave Howlett, founder of Real Human Being, talks to us about how elite athletes prepare mentally and physically and so should parents before birth.  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:  This is Kristin, co-host of Ask the Doulas, and I’m joined today by Dave Howlett.  Welcome, Dave!

Dave:  Hey, Kristin.  How are you?

Kristin:  Great!  So you and I first connected on the networking platform called Lunch Club, and I was really fascinated by your journey as an athlete, especially your training for the Ironman run, bike, and swim events, since you’re the most elite of athletes.  So I’m really curious and would love to have that comparison, you know, between prepping for labor and birth and also how you train both mentally and physically for your races.

Dave:  Yeah, no, I’m happy to help you out.  By the way, if you hear a meow in the background, it’s our cat, Molly.  She’s probably more of an athlete than I am, but she’ll chip at various times.  First, I love the concept of labels.  You know, what’s the old phrase, you’re either pregnant or you’re not pregnant.  There’s no halfway pregnant, right?  And I think that actually doesn’t apply to athletics.  I was a clarinet playing geek in school, and I was probably one of the least athletic people you know.  I taught scuba diving, which is cool but doesn’t take a lot of hardcore athleticism endurance.  You mostly got to be flopping around the water and breathing really slow.  Kind of like, you know, just a mellow person.  But my athleticism actually came when I met my wife.  We got engaged, and I said, what do you want to do for fun?  And she said, oh, I’ve always wanted to run a marathon.  And I thought, oh, crap.  So, yeah.  In 25 years, we’ve done 10 marathons, and together, we’ve trained for 18 Ironman competitions.

Kristin:  That is amazing.

Dave:  Yeah.  But it was fun meeting you on Lunch Club because I think there’s – the more I talked and thought about your comparison, I think it’s actually very, very good that you and I are chatting and all your listeners are hearing because I’m not pregnant.  I don’t think I’ll ever be pregnant.  I don’t think I can physically get pregnant.  But there is a really good analogy between “training to have a baby” and “training to complete a marathon.”  Or an Ironman.

Kristin:  Yeah.  And even thinking from what I know about friends who’ve competed in Ironman, you’re in training for essentially 12 months for this race; is that correct?

Dave:  Yeah, that’s it.  I mean, my wife and I, we’re kind of strange, weird people, but yeah, we use that as part of our life balance.  And usually we’ll train for an Ironman every year or every second year.  But per your point, I imagine it’s very much like pregnancy, which is you have an end date.  You’ve got a race day, right?  And just like a pregnancy, sometimes your race day gets pushed back  During the pandemic, for example, in the last year and a half, most races around the world have been delayed or canceled.  We’ve had to readjust our schedule, and I’m sure that’s – if I had a baby impending and I hired someone like you, everybody would say to me, what day are you due?  What day are you due?  What’s your due date?  But that’s sometimes flexible, too, right?

Kristin:  Oh, exactly.  I mean, it’s a guess due date is what I say.  It’s a range.  I mean, I’ve had clients go five weeks early and at 42 weeks.  So unless a client is planning a scheduled surgical birth or scheduled induction, even then, you can still go into labor before.  But having that end date in mind, you know, that range, is very helpful in preparation and women – I mean, you’re training for 12 months and women are carrying a baby 9-10 months, and so there’s all of that, thinking about nutrition and rest and a lot of things that high-level athletes are focusing on, as well as visualization, which is big with many athletes that I know.  Many marathon runners, for example, use visualization in advance of a race, and then we use that in childbirth.  So I love thinking about all of the different comparisons that athletes have to birthing persons.

Dave:  Yeah, like I said – maybe we could start a really interesting movement.  We could call it Ironbaby, right?  Hey, have yourself an Ironbaby.  I have to tell you something funny for you and all your listeners.  The first Ironman I ever did was in Lake Placid in New York, and my wife didn’t do the first one with me because the underachiever wife of mine, she had a full time job.  She was studying for her executive MBA, and she figured putting an Ironman on top of that training would be just too much at the same time.  So the first one I did, I did on my own.  I trained for a year, and I was also coaching marathon students at the same time.  I coached marathon clinics for about 8 or 9 years.  So we get down to Lake Placid, and I imagine it’s kind of like going to a hospital and getting ready to give birth.  You naturally as a human being want to compare yourself a little bit to other people, right?  So you’re looking at other people and comparing, you know, am I as good as, am I better.  So, you know, I thought I was pretty good.  I trained for an Ironman, and then all my marathon students are like, you’re a god, Dave.  You’re a god.  And if your listeners don’t know what an Ironman is, you swim 2.5 miles and then you bike 112 miles, and then at the end of the day, you run a marathon, 26.2 miles.  So it’s a long day.  So three days before the event, we’re walking down the street at Lake Placid, and athletes are coming from all over the United States, many from international to compete.  There’s about 2000 athletes.  And I see this tall couple walking in front of me with this little child.  This little kid’s about three years old; mom, dad.  You can tell they’re fit from behind.  You know, you ever see somebody from behind, you know.  They’re in athletic gear, and they’re just walking.  Good-looking tall couple.  I can’t see them from the front, but Dad, Mom, and the little kid.  And it’s nice to see a family.  All of a sudden they turn sideways.  I have never seen a more fit pregnant woman in my life.  She had the perfectly flat stomach with what looked like a medicine ball crazy-glued on her flat stomach.  I’m like, wow.  I’ve never seen this before, and I said to my wife, that obstetrician is going to need a catcher’s mitt because when that woman gives birth, that kid will come flying out the delivery room.

Kristin:  And that is something about athletes I’ve noticed.  I’ve worked with a lot of gymnasts and runners, and it’s hard for them to loosen up.  Their body is so physically tight, and labor is all about opening up and being loose and limber, and their pelvic floor, everything is so fit and tight that there can be some challenges there.

Dave:  Yeah, no, absolutely.  But here’s the good news, and it’s really cool talking to you because a lot of people say, well, I can never be an athlete, or I can never run a marathon.  And I always say, look.  If you can get up out of your chair and walk over and touch that wall and come back and sit down in the chair, then you can run a marathon.  Not today.  Not tomorrow.  But baby steps.  Inch by inch.  A year from now, I could have you complete a marathon.  You wouldn’t win it, but you’d do it with small steps every day.  And the human body was actually evolved to run.  That’s why we don’t have a lot of fur, so we can sweat a lot, and we’re upright.  So even the most out of shape person in the world has evolved to run.  And one of my brothers is an emergency room doctor, and when his wife is giving birth, he just said to her – he said, look, babe.  The human body, the female body, was evolved to give birth.

Kristin:  Exactly.

Dave:  So he said, you know, we all want to have safe, comfortable births, but he said, you know, I’ve had women give birth in the back of cabs.  One woman in a boat.  So don’t get overwrought about how something is going to go wrong.  As human beings, we have evolved that women can give birth in a whole bunch of different circumstances.  And you want to be as safe and as responsible as you can, but don’t get too worried, because he said, you know, the human body is a pretty incredible thing.

Kristin:  Exactly.  Yeah.  And then our clients who are physically active before pregnancy, during pregnancy, tend to have the stamina and do better for some of those lengthy labors.  Like, if they have some warm-up labor for a couple of days and they need that stamina when they are ready to deliver their baby, the fit and athletic clients and the clients who really prioritize rest and nourishment do end up have a better go of things than those who are not physically fit and who haven’t rested during pregnancy and haven’t made sure to nourish themselves.  Especially hydration.  I mean, as athletes, you’re all about continuously hydrating.

Dave:  Yeah.  And, you know, I’ve got about 12 points.  You and I could probably talk for five and a half hours about the similarities between being an athlete and giving birth, but I just wanted to raise a few really good points, and interrupt me any time as I yak.  When my wife and I train for an Ironman, the first and the most important thing, obviously, is the goal.  And there are two major types of goals, which is, one, I just want to finish this mile, and two, I want a certain time.  And I always tell people, the first time you do a marathon, we say, the first one’s a PB.  In other words, the first marathon is a personal best.  So it doesn’t matter how slow you go.  The real issue is, you come across the finishing line with a smile.  And I suspect the same in pregnancy.  As much as everybody wants to have a perfect pregnancy, the most important thing is that you have a healthy baby.  And to that end, you’ve got to be a little flexible.  Things may not turn out the way you want in terms of where and how it happens, but at the end of the day – unlike a marathon, where sometimes I have to counsel people because of a whole bunch of different things – they may not choose to do the marathon that day.  Usually the baby’s coming, whether you want it or not.  But expectations are a really important thing when you’re training for a race, and when I coach marathon clinics, I used to tell people, in order, in priority, you got to have three expectations.  Number one, don’t get injured.  Number two, finish the race.  And number three, have a best time.  Okay?  And those are really important because the first one, don’t get injured – you know, even you, if you think about it, you’re kind of like a pregnancy coach, right?  Is that how you would describe your profession?

Kristin:  Yes.  I am.

Dave:  Yeah.  So my wife and I use coaches.  We’ve used a lot of training coaches to help us not only plan our training but also for stretching, for strengthening drills, for nutrition.  And I think for a lot of people, having a pregnancy coach is a good thing.  It’s somebody who can give you feedback, tell you here’s a little plan.  This is what you should do.  Like, didn’t you tell me that sometimes, unfortunately, people use pregnancy as an excuse to just eat as much as they want because – what’s that old phrase, I’m eating for two now?

Kristin:  Exactly, or just to – you know, if you have a craving for fast food, it’s like using pregnancy as an excuse for wanting Taco Bell every day or whatever it might be.  When we tell our clients to focus on eating whole, nutritious food and thinking about baby, and obviously, if you’re craving something, it can be for a reason, and of course, we’re not nutritionists or dieticians, but we try to get them to focus on healthy, nourishing food that will give them energy rather than fast food every day.

Dave:  Yeah, and that’s, again, a great analogy to athleticism because I will tell you, one of the biggest issues my students had when I taught marathon clinics was they would overestimate how many calories they were burning when they were running.  So they go out and run for 8 or 10 miles as part of the clinic, and then they come back and eat, you know, a bagel with a half an inch of cream cheese in it and a coffee with sugar in it.  And when I first started teaching marathon clinics, some of my students were like, I never seem to be getting any faster, and I say, well, maybe you need to diarize your food intake.  There are a lot of really good apps out there now to help you figure out how many calories you’re burning and how much you’re eating.  And I will tell you personally, and this is something for all your listeners – you know, I wouldn’t use pregnancy as a reason to lose weight, but I also wouldn’t use pregnancy as a reason to pack on the Taco Bell or McDonald’s or fast food because food is just gas for your body.  It’s nutrition.  So it’s not about eating for two.  It’s eating well for two.

Kristin:  Exactly.

Dave:  Right?  And I will tell you, from a personal point of view, I’d done eight marathons and three Ironman, and I was still carrying extra weight, and it wasn’t until I actually downloaded an app and started diarizing my food intake.  I realized how much I’d been falling prey to fast food marketing messages, and I was eating way too much calories and way too much of the wrong food and processed food for my goals.  And what’s that whole thing, if you can’t measure it, you can’t manage it, right?  And I suspect when you find out you’re pregnant and you go in to see your doctor and they do a check-up – that’s why they take your blood pressure.  That’s why they look at your pulse.  That’s why they examine your blood level.  They’re trying to do some markers to figure out where you are.

Kristin:  Right.  Manage weight gain.  You know, you’re getting weighed every appointment, and things like that.

Dave:  Yeah.  Yeah.  But your point was an excellent one, which is, you know, the whole idea of laboring, giving birth to a child, is kind of like a race.  And if you’ve prepared properly, you know, both from a physical and nutritional point of view, race day is going to go a lot better.

Kristin:  For sure.  And staying hydrated and – you know, I tell my clients, before they go into the hospital if they’re birthing there, to make sure that they eat something with some protein, give them some energy.  Something light.  You know, nothing spicy.  And then thinking about having that energy boost – I’ve had clients who are athletes who would have those go sticks that you use and just have – you know, because then when you’re in the hospital, you’re basically liquid only, so you can have things like juice and broth and, you know, fruit pops and things like that, but for the most part, unless the hospital has a different policy, you’re not able to have snacks or a big meal or anything.  So it’s like, what will keep you going?  Honey sticks or different things to sustain energy, or electrolyte drinks.

Dave:  Yeah.  I mean, the other thing that – I don’t know if you were going to bring up, but it’s really important as an athlete – you need the support of your friends and family.  Even for sports that are considered solitary, like maybe a marathon, one of the most charming things I’ve ever seen is when a woman has almost finished her marathon and there’s her husband and her kids standing at the side of the road holding up signs, going, you can do it, Mom.  We love you, Mom.  Go, Mom, go.  Right?

Kristin:  Yeah, that’s a huge motivator!

Dave:  It is!  Yeah, and I just think, you know what, my heart goes out to women who are pregnant and they don’t have the support of friends and family.  And I think it’s really important that it’s part of pregnancy, just like it is for an athlete, that you have a support system around you, whether it’s your family, whether it’s your friends, whether it’s someone like yourself.  But I think that psychologically as well as physically, it’s so important to have a community around you.  And I think that’s part of good support in any pregnancy is to have people love you and want to care for you.

Kristin:  Yeah, exactly.  And I am there – I don’t necessarily love the word cheerleader, but I am encouraging my client, and if they have a partner or family member with them, I’m giving them some affirmations that you would use in a race.  Like, you are so strong.  You’re almost there.  You’ve got this.  You know, you are amazing.  Look at you.  And then we also use some of those markers for my clients who are seeking an unmedicated birth of, like, get through each contraction.  I used to run shorter races, but looking at, well, I’m going to make it up to that tree before I decide that I’m ready to stop, and pushing yourself a little bit more each time.  So when I had my two kids, I had unmedicated births.  My mantra was, I can do anything for 15 minutes.  And I would reassess after I got through a couple more contractions or surges.  And then just keeping going, use some positive affirmations and not focusing on, oh, this labor could be 12 hours, or my race might – you know, I can’t run for 10 more miles.

Dave:  Yeah, that’s an excellent analogy there.  I mean, my wife and I actually used the same mantra, which is, I can do anything for ten minutes.  Sometimes when we do our workouts on the bikes or runs where we’re doing sprints and they’re very taxing or arduous, doing speed work on a track, you’re on a bike – we always repeat to ourselves, I can do anything for ten minutes.  Because even on race day, our friends sometimes say to us, so how long do you think it will take you to finish an Ironman?  And I say, oh, probably 13 to 15 hours.  And they’re like, how do you mentally prepare yourself?  It’s like labor.

Kristin:  It’s a good question!

Dave:  And I said, well, you don’t think of it that way.  You think of it just, okay, I can do anything for – I’m going to run to that telephone pole over there, or I’m going to bike for another five kilometers and see how I feel, or I’m going to swim to this part, to the next buoy.  And I said just psychologically, when you start at the starting line of an Ironman, your heart’s beating a mile a minute, and you’re like, oh, I don’t know.  It’s going to be 15 hours I’m going to be out here today this.  And you just stop that and say, you know what, I can do anything for 30 minutes.  I’m just going to think about the next 30 minutes.  So I imagine the visualization of pregnancy is the same way.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Dave:  Let me share something with your listeners that had an impact on me and will likely for the rest of my life, and I think this really applies to giving birth.  My first Ironman, I wasn’t sleeping well for about two months before the race.  I was getting worried because it’s kind of like you’re training to climb Mt. Everest, and I imagine for a woman the first time – it’s different when you’ve had six kids, but the first race psychologically is always the hardest, and I bet you the first time you give birth – I don’t know, you can comment on this whether psychologically it’s a lot more stressful, right?  Because it’s the unknown.  So I went to my family doctor, and he was a pretty cool guy.  And he was doing a check-up.  It’s two months before my first Ironman.  And he said, how you doing?  And I said, I’m not sleeping well.  He goes, what’s going on?  I said, I wake up in the middle of the night and I have these dreams that I’m drowning in the lake or I fall of my bike.  And I was waiting for him to say something like, oh, just relax; it’s not going to happen.  And he said to me, okay, I have a suggestion for you.  It’s a visualization thing.  He said, so let me tell you how things are going to go on your race day.  I said all right – and this applies really well to giving birth.  He goes, you’re going to start a race at the beginning of the day with 2,000 other athletes, standing on the beach waiting for the gun to go off.  He said, your heart is going to be going a mile a minute, and you’re going to be really anxious.  And I’m like, you’re not helping me, man.  He goes, I want you to take a deep breath and just say to yourself, I’m so grateful.  I’m like, what?  He goes, take a deep breath and say, I’m so grateful.  I said, grateful for what?  He goes, say it to yourself.  I’m so grateful that I have the use of my arms and legs to do a race like this where a lot of people don’t.  I’m so grateful to have the support of my friends and family so I can do a race like this, because a lot of people don’t have that support.  I’m so grateful to live in a society where I can go out and I can train for fun, because many people live in countries where they just have to spend every day trying to stay alive or looking for food, and they don’t have the opportunity to do races like this.  And he said, when the gun goes off, I want you to try to replace your nervousness with gratitude.

Kristin:  It’s beautiful.

Dave:  It is, and it totally changed my mindset.  It’s not that I don’t compete in races and try to get a better time, but often, you know, it would be like when I’m at the hospital, and then in pregnancy, and the nurse comes by to give me some – do they still give ice chips, or is that an urban myth?

Kristin:  Yes, they sure do.

Dave:  So the nurse gives me some ice chips, and I would say, I really appreciate you doing this, and you’re such a wonderful nurse.  Thank you so much.  So that would be – it’s weird, but it actually changes your mindset from me, me, me, me, me to when you express gratitude to people around you, it takes that pressure off yourself and actually makes you feel better.  And so every race I do, when I go by a water stop, I always thank the volunteers.  I say hey, thank you so much for volunteering.  And they look surprised.  But I also express gratitude, and people are surprised and then they’re charmed, but I do it as much for myself as for them.

Kristin: I love it.  There are some great gems that you’ve shared.  So in labor, breathing is one of the most important things.  So how do you, dealing with the differences in running, biking, swimming, what is your practice with breath work?

Dave:  Good question.  You’re the pregnancy pro; I’m not.  But if I was to give a woman tips on breathing, I would say listen to your coach.  They’re the expert.  And so I’ve coached people how to breathe in running, and first and foremost, just breathe naturally.  But there is a lot of study done on the efficacy of breathing, and sometimes when you get really focused, you start taking short, quick breaths, and you don’t breathe properly.  So sometimes coaching is really important, and that’s why – because I’ve seen movies on pregnancy where they say, okay, you know, Lamaze breathing and all the other stuff.  But it’s really important that you listen to a professional who gives you guidelines on how to do it.  Because your breathing changes your blood chemistry.  And I will tell you, my wife, on her water bottles on her bike when she’s biking 112 miles, she’s got written on her water bottles, smooth and steady.  Smooth and steady.  So when she looks down when she’s in arrow position on her bike, she looks down and she sees, smooth and steady on one bottle, and the other bottle says, just smile.

Kristin:  Positive thinking.

Dave:  Yeah.  Confident thinking.  And if you talk to a lot of chiropractors, they talk about this flow that goes back and forth between your muscles and your brain, and sometimes by thinking positively, you can actually change the relaxation mode or the posture, so it actually works both ways.  So if you actually just physically try to smile, even though you don’t feel like smiling, sometimes it does change the way your brain thinks and it becomes happier.

Kristin:  Yeah, and with birth and breathing during labor, a lot of times we – you know, we don’t want our clients to hyperventilate is the biggest thing.  So you had talked about that fast pace breathing and really knowing to slow down, so for us it’s more of that yogic deep breathing.  I remind my clients to give their baby oxygen and focus on that as a way.  And then of course with COVID, at many points in labor until clients are tested, they’re wearing a mask.  So it’s that focus on slow, deep breathing and really noticing where they’re carrying tension.  And as athletes, you want to focus on making sure you’re not too tight.  Like, some people carry tension in their shoulders, and so I’m trying to get them to relax their shoulders or their forehead or their jaw is really clenched.  As you said, relaxing.  And yeah, I feel like people who are resisting labor and the sensations that they’re feeling, the pain intensifies, where if they’re relaxing into it and positive, as you’re saying, and focusing on their breath and some goals, then they are experiencing less of a sensation of discomfort.

Dave:  Absolutely.  In fact, if any of your listeners watched any of the Olympics this summer, people used to say to me, how come when I watch these runners in the Olympics and they’re standing there before their race, you see them just bend down and rub their legs, and their legs look all floppy, like the muscles look like they’re just all saggy?  And I go, that’s because they’re relaxed.

Kristin:  Exactly.  They’re not tensed.

Dave:  They’re not tensed.  Their muscles are really loose, and because if you actually understand how the muscle fibers work inside those muscles, they slide back and forth, so you don’t want any stickiness to them.  So when they actually start running really hard, those muscles tense up, but they can relax them a lot, too.  So your point is a great one, and I used to counsel a lot of my marathon runners, you know, I’m going to tell you to stretch.  Most people will not stretch properly or stretch as much as you should in between your practice runs.  So you should go get massage therapy.  I can’t say enough for the art of massage therapy.  I’m a guy, and I tell you, a lot of guys are socialized, at least in the west, not to have other people touch them.  But the art of the human touch is extremely important.  And I can tell you, I’ve been through so much massage in the last 25 years.  Even as a guy, anybody can touch me now.  Another guy can rub my butt and we can talk about football.  I don’t care anymore.  That’s one thing about real focused athletes is they understand the importance of massage, about being relaxed.  It’s not always about tight muscles.  Quite often, it’s about flexibility and relaxed muscles.  Let me add one more thing, because I think this is really important, and I’m not sure if you’re going to bring it up.  But I think checklists are really important in athleticism.  One thing you don’t want on race day is stress, and I don’t suspect you want the same thing when you’re about to go into labor.  So my wife and I are really big fans of checklists, which is, you know, what to bring to the hospital, what to do every time we’re packing to go to Europe to do a race, because the last thing you want to do is be on the way to the hospital, on the way on a flight going to Europe to do an Ironman, and you’re like, did I remember this?  Did I remember this?  Some people are natural checklist people, but other people aren’t.  So I would suggest for any of your listeners, if they’re listening to this, really believe in the power of checklists, because you literally go down your checklist and check things off, and it’s just one less thing to worry about.

Kristin:  I love that, yeah.  And like you said, everyone’s personality is maybe different, but it is very helpful to plan and prep of what to pack in the hospital bag, what people need to be called if you have other children or pets that need to be cared for, and just having everything set so you’re able to go at a moment’s notice.

Dave:  Exactly right.  And for anybody listening to this who maybe is a friend or a family of somebody who’s going to be pregnant, here’s a tip for you.  I used to tell people, when you finish your first marathon, or if you have a family member who just completed their very first marathon, do not say, what time did you do it in, because one day you’re going to meet somebody who’s climbed Mt. Everest, the highest mountain in the world.  They’ve trained for a year or two or ten to climb this mountain, and if you ever meet somebody who’s climbed Mt. Everest, you don’t say, what did you do it in.  You just say congratulations and how do you feel.  So when you meet somebody who’s completed their first marathon or their first Ironman, you don’t focus in on the time.  You just give them unconditional love and support and you ask how they’re doing.  And that’s what most people want.  And I suspect – correct me if I’m wrong, but when a woman gives birth for the first time, she just wants her friends around and not to discuss how long you were in labor and all the stuff that just happened.

Kristin:  And what kind of medication you had and did you achieve your goals, yeah.  I mean, birth is unpredictable, and so is an Ironman race or a marathon.  You could have an injury, and things can happen that are out of your control.  I love all of your tips.  Do you have any last-minute tips for our listeners as far as how you train mentally or physically?

Dave:  The last thing I just want to leave with people is, you know, as I said, I’ve got a couple of doctors in my family, and the old style of medicine was, I’m in charge.  You’re my patient.  Just listen to what I’m going to tell you to do because I’m the doctor and I’m the expert.  But now the new way of medicine is, the patient’s the quarterback of the team.  Everybody around the patient are their support system, and I think that’s the way it should be.  I think everybody – every woman who’s going to give birth should be literally in charge.  Now, it doesn’t mean she knows everything.  She may not know much about nutrition or about breathing properly or a whole bunch of other things.  So she needs the support of her coaches, her trainers, her teammates, and everything.  But at the end of the day, she’s in charge, and I think that’s really important, that the bond between a mother and her unborn child or soon-to-be born child is extremely important, and I have a lot of friends who work in hospitals, and they talk about how they’re there to support the mother and to give her guidance and advise and feedback, but they always keep in mind that this is her child and her baby.  And that’s a really good mindset to have as an athlete.  My destiny is in my hands.  I rely on a lot of people to do a marathon or an Ironman, but at the end of the day, it’s my race.  And I get the accolades when it goes well, and I accept the fact that sometimes things aren’t going to go well.  And the other thing is, I don’t look at it as one race.  I’ve had races where – I mean, two years ago, we went to Europe and the airline lost our bikes and all our equipment.  And we couldn’t do the race.  We showed up in Europe in Austria, and we had to stand there watching all the athletes go off, and then they never located our stuff until, like, four days after the race finished.  But what we realized was, we trained for a year.  We didn’t lose that training.  We still had that strength from all that training.  And so sometimes lousy things happen.  10% of life is what happens to you, and 90% is how you react to it.  And sometimes I think that applies to pregnancy, as well.  Heartbreak happens sometimes, and we have to be mindful that sometimes things don’t go as we planned, but it’s your resilience and your strength and the love and support of people around you that keep you going.

Kristin:  So true.  Now, I know we’re not here to discuss your professional background, but I do feel like it relates, since you are a motivator and keynote speaker and business leadership coach.  How can someone connect with you if they would like to reach out and have any questions for you and so on?

Dave:  Yeah.  My company is called Real Human Being.  I go around the world and talk to companies and communities about human behavior.  I’m known as the gear guy because I talk about three types of intentions: first gear, second gear, third gear.  So people who are interested in that can connect with me on my website.  Actually, my wife and I are moving to New York City in a few weeks, so we’ll be in the Big Apple.  And you’d love this; I’m actually going to start a social media brand called The Eh in the Apple.  Because Canadians say eh a lot, right?  I’m going to get a little apple design with a maple leaf stuck out the top, and I’m going to diarize my experiences in New York as a Canadian because I just love people.  I find people fascinating and curious, no matter what they look what, what religion they are, what nationality they are.  And I think at the end of the day, we all want to be amazing women or good guys, and that’s what I teach, is how to have self-awareness and how to be maybe just a little bit better than you.

Kristin:  Exactly.  I love it.  Well, thank you so much for your time today, Dave, and I’m sure we’ll connect again soon.

Dave:  It was a pleasure chatting with you, and I wish everybody a healthy and a safe birth.

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.

Today we discuss the importance of having difficult conversations with your nanny or caregiver.  Joining us is Carol Kramer Arsenault of Boston Baby Nurse & Nanny.  You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you listen to 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!

Alyssa:  Hey, welcome to Ask the Doulas.  My name is Alyssa Veneklase, and I’m super excited to be talking to Carol Kramer Arsenault.  She is a registered nurse, author of the award-winning book, Newborn 101, and then founder of Boston Baby Nurse & Nanny.  Hi, Carol!

Carol:  Hi, hello!  Thank you for having me!

Alyssa:  So I’m really excited about our topic, because we’ve never done anything like this before, and we’re going to talk today about broaching really tricky subjects with your caregivers.  I think you’re a great one to talk about this because, obviously, you have a giant nanny agency.  But I think this could relate to whether you have a nanny, a postpartum doula, your mother-in-law in your home.  Like, how do you bring up really tricky subjects with these people who are helping you care for your child, and it’s especially important right now with COVID, right?  There’s all these other touchy subject areas that we’ve never had to deal with before.  So where do you want to start with this?

Carol:  Yes, well, I will start by saying the nanny-parent relationship is tricky.  It can be complicated, and it has to be nurtured.  Unlike any other relationship, when we have a caregiver or a nanny in the home, we’re trusting this person to care for our most valuable things in our lives, our kids.  Being a mom myself – my kids are older, but it’s tough when you leave your children in the hands of someone else.  And you can vet the nanny and do the interview and the background check, but it’s really important to foster a good relationship with your nanny, again, because they’re caring for your kids.  And what I’ve found to be really, really helpful is, right from the start, be clear about job responsibilities and expectations.  Communication: huge.  I think just as a culture, it’s not easy to communicate, right?  It’s not easy.  And sometimes what I think in my head is completely different about a situation that someone else has.  And so learning to really communicate and talk to people is really important, and job responsibilities and expectations, really being clear from the beginning, and being honest and open and letting any strong emotions pass before engaging in any type of productive discussion, if it comes to that.  And it takes time to get to know each other, the parent and the nanny.  Initially, the first year or so or six months, especially – it takes time for both parent and nanny to get to know each other.  I talk to a lot of moms, and I talk to a lot of nannies.  And we support both.  Our advice is always, if you have an issue about something, in a nice, respectful way, ask the nanny: when you have time later this evening, can we talk for a few minutes?  I have a few things that are on my mind that I’d like to talk to you about.  And not waiting until we’re frothing about an issue.  Just to let her know, you know, can we have some time later?  It’s something I’d like to talk to you about.

Alyssa:  That’s kind of a good life lesson in general, I think.  A lot of conflict-avoidant people find it really hard to say, oh, my gosh, they’re doing something I don’t like, but how do I bring this up?  So that’s just hard, parent or not.  So it’s almost like if you can set these expectations really early and say, you know, I think in a parent’s mind, they have to realize, this person works for me.  I need to set these job responsibilities, and maybe for that person, it’s writing them down, going over it with the nanny or other caregiver and seeing if there’s any questions.  Is this detailed enough?  Is anything too vague?  Because, yeah, I can just see where that could be – when someone is in your home 24-7, basically – do a lot of your nannies live in?

Carol:  Most of our nannies are there 40-50 hours a week.  They’re not live-in.

Alyssa:  Okay.  So when they’re there all day, basically, while the parents are at work, like 8:00 to 6:00, maybe, you want to know you’re going to work to do your thing and then coming home and all the work at home has been done the way you want it to.  Because, I mean, worst-case scenario, your nanny is not doing what you want and now creating more work for you when you get home.  If you’re too afraid to ask, you’re in a spot, right?

Carol:  It’s so true.  Yes, you’re right on.  And along with that, during COVID, a lot of parents are working at home.  They’re working remote, and so a lot of our nannies are getting used to working with parents that are in the next room, door closed, and they’ll come out and get their lunch.  So that whole relationship dynamic is different when the parents are in the home.  Brings another level to it.  But one of the benefits of addressing any issue quickly is that your nanny will learn from you.  So by me saying to Susan, who is taking care of my kids, “Susan, I wanted to touch base with you about something later tonight,” and then when I do touch base, it’s not a huge base.  It’s, “Susan, the last two or three days, you’ve been coming 20 minutes late, and I really have to start my day at blah-blah-blah.  So I just – is there a reason why?”  And then Susan says, “Oh, I didn’t realize.  I thought you didn’t start –”  you know, so it was sort of a miscommunication, and so good to nip it in the bud.  That’s an easy one.  But what the mom has also done is set an example of having an issue and discussing it with the nanny.  Now, the nanny, when she has something, will also feel that it’s easier to approach the mom, and that’s huge because we want to make sure if there’s anything that the nanny is upset about or anything that’s going on in her mind, it’s best to speak to it, because when that builds and issues build, it takes out on the kids.  And so it’s very important.  So we set a good example when we approach the nanny, and then the nanny will approach us as well.  And the longer it sits, the bigger it becomes.  Avoiding it doesn’t go away.  And it’s funny, so many times, it’s just miscommunication.  Like, we just had that where the nanny was coming late, just a few minutes, and she really thought that the mom said, oh, come anytime between 7:30 and 8:00.  And maybe she said that, who knows.  But the mom just needed to clarify, no, I need to be on my computer at 7:30.  So the nanny was like, oh, my gosh, I’m up at 5:00.  I’m happy to come.  So it was such an easy – but then there are some things that are a little more – you know, they’re bigger issues.  And one of the other things that we say to both the mom is to pick your battles.  You know, and we can’t be critical and have these expectations because, number one, we want her to be happy.

Alyssa:  So I’m curious, when you talk about communication, how this relates to mindfulness because I see that you’re also a certified mindfulness instructor.  So what do you do in that realm with your team of nannies?

Carol:  Where mindfulness and developing mindfulness and where that comes into play is that, you know, we’re living in stressful times.  And being a parent, working full time, having a nanny, is stressful, as is the nanny’s job.  And we have these kids who are in the middle, and they’re stressed as well.  And so what we teach is a way for nannies to start getting in touch with their feelings and being able to identify what that feeling is.  We live in a society where feelings are not regarded and emotions – no, don’t, we don’t want to do this.  And they’re pushed down and they’re pushed down, and it creates resentments and creates all kinds of negative mindset.  And the whole idea about being mindful is that when something comes up for the nanny that she’s uncomfortable with, she has the understanding – she’s in touch with her feelings enough that she can identify what that is, and she can talk to the mom about it.  And then the mom, as well.  And mindfulness, the ability to shut down and be in touch with the present moment.  And so setting aside a time each day to practice mindfulness, and for the nanny to do that with the children, for the mom to do that with the children, for all of them to do that together.  And kids are like sponges.  They absorb whatever it is that they hear.  We are their role models.  And so if I come home from work and I go in the other room and I’m upset and yelling because I had a crazy day at work or something’s going on, even if my kids are in the other room, my kids hear that, and the kids are affected by that.  And this is research-proven.  It’s not anything that Carol made up.  This is research-based.  Children pick up on this energy.  And so mom’s in the other room, all upset, thinking, oh, I’m protecting the kids; they don’t hear it.  But they are affected by that.  And part of being mindful is to be aware of what it is.  Like, why am I upset?  And are there other ways for me to express these emotions?  We want our kids to be able to express those emotions in a healthy way and to regulate their emotions.  And if we as adults and as moms and nannies can regulate our emotions, then the kids are going to be able to do that as well.  But it’s something that I didn’t learn until I was in my 40s.  Things happened in my life, and one thing led to another, and I was in a place where I needed something, and it happened to be meditation.  And one thing led to another, but it has taught me that when there is an issue, if I hold it in, it gets huge, and nobody benefits.  Having a nanny and communicating and understanding the science behind it, as well, is really important.  So we try to incorporate the two.  Children are the most important piece of this.  Parents, we want what’s best for our kids, and our nannies want what’s best for our kids, as well.  And by being able to set a good example, and if we’re upset with something, to validate that and say, yes, you’re right.  I was wrong.  I should not have said that.  I’m sorry.  I know that hurts.  Validating feelings is huge, and so I think as parents and caregivers, we need to recognize that first within us, and then we can teach our kids how to respond.  I can give you an example that just popped into my mind.  I remember my daughter coming home from school and being upset because she wasn’t invited to a birthday party.  And so what I did is I said, well, that’s okay.  Come on.  Let’s have our own party.  Let’s do – you know, it’s okay.  You don’t need to be invited.  But the point being – in hindsight now, my daughter needed to feel those feelings.  And so having learned what I learned, if I had a redo, I would say, Caroline, I know.  That really stinks.  That must – I can imagine that’s making you feel sad that you weren’t invited, and I feel like that too.  It’s okay to feel sad.  And you know what?  You’re not going to get invited to everything, and that’s sort of the way it is.  But, like, acknowledging and letting the child be okay with that is huge.  And as adults, any relationship that we have, it’s important.  But again, like what we’re talking about, is the caregiver and the child.  And so for a parent and a nanny to be able to listen to each other, really listen and validate, is wonderful.  And what happens is the respect that grows between the two people is such a positive event that the kids benefit.  Everyone benefits.  And so if a nanny is having a really tough time with one of the kids, and she doesn’t know how to bring it up to the mom, and she’s really stressed because this kid’s really fresh or he’s going into her purse and stealing things – for the nanny to be able to talk to the child but then also talk to the mom and say, you know, I’m trying the best that I can, but I really need you to support me.  And then the mom will say, oh, you know what?  Thank you for letting me know.  I didn’t realize that.  That must make you feel – right, again, validating.

Alyssa:  I love that.  So are you teaching this to the nannies to then carry forward to the families?  Do the parents also have access to this mindfulness training?

Carol:  Yes.

Alyssa:  Awesome.

Carol:  Which is great, and we love it.  We make it our goal.  It’s like we truly care about the family unit, and I’m so lucky and grateful that when I started Boston Baby Nurse, I was a nurse.  I cared for patients.  And even though I have a business, I’m still a nurse first, and I’ve surrounded myself with women and caregivers and newborn care experts that really have a passion and care what they do, as well.  And if we can make a difference in their lives, that’s why we do this.  We’ve been doing this for 15 years.  And one of the things that’s come of the forefront in the last 5 years or so is, when we integrate the mind, the body, the soul – right, and it’s not just about scheduling and doing everything that we can and checking off our to-do list and taking our meds because, you know, the child has ADD – some people need medication – but the point being is that, when we can decrease anxiety by just breathing, why not do that?  And so our goal is to make people aware of that.  And there are certain – you know, just a few, slow deep breaths, the child will calm down.  And everyone calms down.  So there are just a few techniques that are so simple.  They’re almost innate, but we’ve been – I don’t know, in this society, this day and age, we’re busy.  We’ve got work.  We’ve got this and that and the kids are overscheduled, that we don’t have time to just sit and do nothing.  And by teaching our nannies – you know, kids come home from school, and let them play.  You know, let them have a little downtime.  It’s important that the parents are on the same page, as well.  At the end of the day, after a few weeks or months, you see a difference in these families’ lives.  Parents communicating better.  Parents and grandparents and the nannies.  So it really is a way of life that has many, many benefits.  We can go on and on about different ways to practice mindfulness, but especially when you have a nanny in your home or a caregiver, you want to make sure that the relationship is positive.  And we get calls from nannies all the time, and some of the calls – I’ll give you an example – the nanny said, I cannot work for this family anymore, because all I do is clean all day, and the mom is leaving me more and more and more.  And I just happened to overhear the conversation, so I said to the woman I’m working with, well, ask her, has she talked to the mom?  Oh, no.  I haven’t said anything to the mom.  Like, such a great example.  So this nanny is ready to leave.  This has been going on for six months.  And so I ended up calling the mom, and the mom had no idea.  She was – she had no idea.  And she thought it was a great set up and that the nanny liked to be busy.  The baby naps for three hours.  I thought she wanted to be busy.  And it was such a misunderstanding, but this nanny was going to leave her job, and this mom had no clue.  So there is huge disconnect.  Huge disconnect.  And it’s just natural for the nanny – she’s not going to be that loving towards the kids because she feels upset.  So again, it just all comes back to mindfulness, thinking, communicating, and listening and just being respectful of the other person and knowing that when there’s a situation that people see it differently.  Everyone’s got their own color glasses on, and the nanny might have a purple pair, and she sees the situation like this.  And mom has a blue pair, and she sees the situation like that.  So let’s take the glasses off and speak to each other about it.  What a great example, too, when these children see that.  Right?  They mimic our behavior.  And it’s interesting.  Our dynamic at Boston Baby Nurse internally with our team leaders has really benefitted from this because we all are more mindful now, not just about the parents and the nannies, but the way we interact with each other.  I have learned so much in the last two or three years about how I interact with my team and listening and slowing things down and putting things into perspective.  If we can take this information and give it to the nanny or the caregiver and the parents, we make the world a little bit of a better place because there’s a little more love.  There’s more understanding.  There’s more happiness.  Little bit at a time, and at the end of the day, that’s what we all want.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Alyssa:  So let’s say there’s a doula, a nanny, some sort of caregiver listening.  Are your courses available for just random nanny and – you know, wherever they are in the country and the world to get ahold of not just mindfulness, but do you have other courses, as well?

Carol:  Yes.  We have an online education platform, and it’s available to nannies.  We have au pairs.  We have caregivers from all over the world that take the classes, and it depends on what their interest is.  We have a whole series of mindfulness classes, but we also have caring for kids with allergies, caring for kids with special needs, caring for multiples.  There’s so many ways that we can educate ourselves, and the more that we know, the better job we can do.  So our mission really is to make this available to everyone, and a lot of times, it’s the parents who purchase these for their nanny, which is kind of cool too.

Alyssa:  Yeah, that’s a cool gift.

Carol:  Yeah.  And we have to pay for our platform, obviously.  Our goal is to make the world a better place.  And so we’re putting out this content, offering it to you at the best prices that we can, and we continue to make new classes all the time when things come up, different things come up.  And we have a team of experts, really.  We have pediatricians, and we talk to child psychologists and different types of people.  And so the information that we do put together is all approved by the American Academy of Pediatrics.  It’s researched.  It’s evidence-based.  Again, we don’t make up our own information, but we make it available.

Alyssa:  That’s great.  And then before we sign off, I would love to hear a little bit more about your book and where people can find that.

Carol:  Great, yes.  Newborn 101.  It is everything that a parent needs to know from birth to the first year.  We talk about the tough things: sleeping, getting babies on a little bit of a schedule, developmental.  We talk a little bit about baby hygiene, breastfeeding, food, pretty much the first year.  The first part of the book is focused on what we call the fourth trimester and bringing home a new baby.  The first three months is a crazy time.  I mean, it’s been a long time for me, but I remember those times, and I was ready for any information I could get.  And when I was a labor and delivery nurse, parents would say, can you come home with me?  Can I take my nurse home?  I want to take my nurse home.  And so that is where the idea from the book came.  It’s a lot of information that’s exactly what I would tell parents and patients when they were leaving the hospital.  And it’s available on Amazon.  It’s online on our website, Boston Baby Nurse, and other bookstores as well.

Alyssa:  We’ll put links to those in the show notes.

Carol:  And I didn’t say this, but I think it’s also important that the power of mindfulness with children, with kids, is greater than with adults, because their brains and bodies are still developing.  So when they are mindful or they are meditating for a few minutes, they’re literally reinforcing and strengthening the neuro pathways that underlie focus, self-control, self-regulation.  It’s crazy.  And I will tell you real quick, we did a video on teaching mindfulness and yoga, and we had a 4-year-old little girl.  She’s running.  She’s on the mat, having fun, and took a little teddy bear.  I put it on her belly, and I had a little teddy bear on my belly, and we both laid down.  And so we taught this little girl how to breathe by having the teddy bear rise up and down.  And she did it for five or ten minutes, but that whole five or ten minutes, that was meditation for her, right, because all she was doing was watching her belly go up and down, up and down.  So later that day, the mom called me and she said, I don’t know what happened to – Jo-Jo is her name – she has been an angel all day, and she helped with her brother’s bath, and she went to sleep.  She’s been amazing.  So who knows, but I just thought that was funny because she did say to me, wow, and they’ve been practicing ever since with that little teddy bear.  So we videoed that, and we ended up putting that in one of our online classes.  What kid is going to sit there and meditate?  No.  A 4-year-old?  They’re too crazy.  So those little tricks, we have those, and I think it’s really cool to do.  Like, I took a class and learned how to get their attention because the kids – we are changing the next generation and changing the paradigm of childcare.  No more time out.  It’s not like that.  Anyway, I just feel passionate about that.

Alyssa:  No, I agree.  They’re growing and developing at such an exponential rate that we’re literally creating the next generation of adults who can now self-regulate because a lot of them can’t.  They cannot.

Carol:  No, I know.  It’s so true.  It’s so true, yeah.  Good stuff.  Good stuff.

Alyssa:  Yeah.  Thank you so much for joining me today!

Carol:  Thank you for having me on your show!  It was just a pleasure.  It was a pleasure to speak with you and to meet you.  Keep up the good work!

Alyssa:  You too!

Carol:  Thank you.  Take care!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

 

Today, we sit down with Kathryn Cross, CEO & Founder of Anja Health to discuss the importance and practical uses of umbilical cord blood.  You can listen to this complete podcast episode on iTunes, SoundCloud, or wherever you listen to 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!

Alyssa:  Hey, everyone.  This is Alyssa, and today, I am talking with Kathryn Cross.  She is the founder and CEO of Anja.  Anja is a cord blood banking company, and I don’t think we’ve ever talked about cord blood on this podcast, so I’m kind of excited to get some questions answered.  You mentioned that you started this because of your brother, Andrew.  You couldn’t find a cord blood match.  Do you want to talk a little bit about the history of why you started this?

Kathryn:  Sure.  Yeah, so when my brother was 1 and I was 3, he was in a near-drowning accident that led to his diagnosis of cerebral palsy.  Prior to that, he was completely healthy, and my parents never banked his umbilical cord blood or anything like that but began to look into treatments for cerebral palsy.  And there isn’t necessarily a go-to treatment, but there are ways to sort of alleviate the symptoms of cerebral palsy and improve motor skills and such.  One of the most promising resources and studies that my parents were able to find was one related to umbilical cord blood.  So there are children who have had cerebral palsy, and their parents banked their umbilical cord blood, and they were able to use it and saw pretty substantial improvements in their motor skills, even vision, things like that.  Ever since then, I’ve been exposed to umbilical cord blood and just always kept up with the possibilities and continuing use cases because as research advances, it just continues to grow every year, and people find more and more effective use cases for it.  I’ve even been seeing it in anti-aging type related uses or athletes being able to use stem cells from the umbilical cord blood or tissue to be able to treat injury, that kind of thing.  So that’s how I got started.  And that’s also why I’m really convicted that umbilical cord blood is the future of preventative care and should definitely be something that every parent engages in.

Alyssa:  Wow.  My daughter is almost 9, and I don’t think I banked it, but I donated it.  So is there – it’s obviously banked somewhere.  What’s the difference between those two, I guess?  Do you know?

Kathryn:  Yeah, so my company allows parents to be able to bank for their own child.  So it’s always the parents’ property.  When the child turns 18, it becomes the child’s property.  For that case, it’s pretty much just autologous use, so people using it for themselves.  And it’s their property, so they could potentially give it away to someone else if they wanted to.  But just kind of the ownership and reassurance in knowing that you would always have access to it.  Whereas with donating, you donate it to a public bank, and people who didn’t have the umbilical cord blood stored at birth could potentially look into a bank for donors.  So that’s what my parents did.  They looked in banks for donors.  But the thing with public banks is, they tend to be partnered with pretty high-income area hospitals, so as a result, the donors that they get tend to skew pretty white, and matching goes by ethnicity.  So my brother and I are half Chinese and half white, so it was really difficult to find a match, and my parents couldn’t find one.  Right now, there’s just kind of a gap in public banks where people are looking with donors and looking to donate.  For especially people who have predisposition to certain illnesses and also for people who are mixed race and such, we advise that people bank their own cord blood.

Alyssa:  Yeah, that’s something that I never really knew or understood until my nephew needed blood, and I didn’t realize, because he is half Mexican, half Dutch.  And I didn’t realize that that’s a really hard combination to find.  Like, I just thought blood was – there’s blood types, and we share blood types, and I didn’t know that it had anything to do with ethnicity until he needed blood.  So, really, I mean, even if a parent didn’t have concerns about their own child or want to bank it, it’s really beneficial.  It’s kind of like putting on your license that you’ll be an organ donor.  This is kind of like, if you’re not going to do anything with the cord blood anyway, why not donate it, because someone else might be able to use it.

Kathryn:  Right.

Alyssa:  So are there certain types of things you’re finding parents do use your company to bank cord blood?  Is it more preventative?  Do they know that they have, you know, say, a genetic family disorder?

Kathryn:  I would say it tends to be just people that are interested in wellness and preventative care, definitely.  I think it for sure resonates with people who are mixed race, and a lot of especially communities like Black parents tend to be drawn to it, I think, because it can be – cord blood has been FDA-approved to treat sickle cell anemia and diabetes and just things in general that Black communities tend to have a higher prevalence rate with.  And also we offer placenta banking starting for moms who are due in November, so with that as well, the mom can potentially use it, and I know there are really high rates of maternal mortality and such, but for the most part, it’s just people that are generally interested in wellness and preventative care.

Alyssa:  I’m interested.  I didn’t know you were doing – what is placenta banking?

Kathryn:  It’s basically just the same as umbilical cord blood and tissue banking.  So we offer all three.  The cord blood and then also the cord tissue, so the cord itself, and then placenta banking.  So all of them are just cryo-preserving it for later use.  I know a lot of people do, like, placenta encapsulation and such, so yeah, it could just be using placenta encapsulation as using the placenta right after birth, or you could choose to store it later on.  And the placenta is very rich with stem cells, as well.  So it’s just an additional source of stem cells.

Alyssa:  So a parent could potentially do both or all three, you said.  Blood, tissue, and placenta?  Okay.

Kathryn:  Yeah.

Alyssa:  What is that process?  For anyone who’s either never heard of this before or thinking about doing it or maybe read about it but doesn’t know what that looks like.  Like, let’s say you’re in the hospital.  You just gave birth.  Then what?

Kathryn:  Usually, parents will have chosen to bank prior to birth.  So it can be even up to a couple days before birth, and then we can get a collection kit to parents pretty quickly.  But from that point, we send parents that kit, which contains a blood bag and some vials and a small jar for the tissue, a larger container for the placenta, things like that, inside of this collection kit.  And then it becomes essentially a part of their hospital bag.  They can take it with them to the hospital, or we’ve had clients just keep it at home if they’re doing a homebirth, and just let their admitting nurse know if they’re going to the hospital or their midwife know or anyone that’s helping out with the homebirth, and then anyone can pretty much do the collection.  It’s a very simple process.  I mean, even I would feel comfortable doing it.  It’s just a matter of sticking a needle into the umbilical cord blood vein and then letting the blood flow.  And then afterwards putting the cord and placenta into the given containers.

Alyssa:  So typically, a nurse would do in the hospital situation, I would imagine?

Kathryn:  Yeah.

Alyssa:  And then the midwife in a homebirth?

Kathryn:  Yes.  And then after that, the mom would just fill out a quick form on our website and just say that they’re ready through this form for pickup, and then within 4 to 6 hours, our shipping team will come and pick it up from wherever they are in the United States.  We’ve partnered with an international shipping team, as well.  So we’re not serving international clients, but we have the capability to do so.  Because we have this national presence with our partner, we can go pretty much anywhere very quickly.  So they can pick it up and then take it to our partner lab in New Jersey, and that is where it is cryo-preserved and kept in safety.

Alyssa:  I do remember having to fill something out online.  I got a kit, and then I just had to give that to them.  I was like, here’s this.  I don’t know what to do with it.  And they obviously did.  So it’s a lot – even though all that stuff you just said might sound intimidating for a parent, I think they just need to know, like, once you get that kit, like you said, put it in your hospital bag, or if you’re at home, you just give it to whoever is handling that.  You know, like give it to the nurse on staff or give it to your midwife, and they’re going to handle it.  It’s not something that they have to do.

Kathryn:  Yeah, and they pretty much know what to do.  Like, we’ve had – our most recent client, she was doing a homebirth and had a midwife, and we offered to walk her midwife through the whole process on Zoom, but she said her midwife had done it before and felt comfortable.  So I think for the most part, people know what to do, and we have, like, a little comic inside with illustrations and such that serve as directions, so people can do it on their own without our guidance, as well.  I think it would be pretty easy.

Alyssa:  And how long can you store the tissue and blood?

Kathryn:  Pretty much as long as you want.  Like, an entire lifetime, even.  We offer packages in 20 years, so 20 years of cryo-preservation at a time.  This is because of that ownership switch to the child once the child turns 18.  At that point, the child can decide what they want to do.  But they can renew at any time with us, and then we can continue to store it.

Alyssa:  That’s really cool.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Alyssa:  So is there anything else you think people need to know about saving cord blood or tissue?

Kathryn:  Yeah.  I mean, I think a lot of parents are under the impression that it’s sort of similar to an insurance policy, which I think is definitely a good analogy, but I always try to convey to parents that it’s more than just an insurance policy.  I really believe that if someone has access to stem cells, they will use it at some point in their life.  I mean, I was even in Mexico on vacation and saw signs for stem cell treatments at the same type of place that they were giving out Botox and such, and obviously, they’re not, like, the same, but I think it’s just that now stem cells are being seen in this light of wellness and beauty and anti-aging, sort of equivalent to Botox and such.  So even if a child spends their whole life being healthy, then they don’t necessarily just waste their money on this insurance policy, but they could even use it for, like, treating dementia or just combatting aging in general and treating injuries for athletes or improving athletic performance, like Kobe Bryant and a lot of MBA players have utilized stem cells.  Selma Blair recently announced that she was in remission from multiple sclerosis and received an umbilical cord blood treatment.  So I think it really is the future of medicine.  I think it’s not just an investment in an insurance policy but an investment in the fact that your child will someday be able to use it, and the possibilities are only growing.

Alyssa:  That’s really cool.  So if people are interested, how do they find you?

Kathryn:  Our website is Anja Health.  I named it after my brother Andrew.  We also are on Instagram and Twitter as @useanja.  On Facebook as Anja.  LinkedIn is Anja.  TikTok as fertilityfriend.  So we’re trying to be as accessible as possible through all types of different social channels, and we have our numbers listed for calling, texting, and scheduling appointments on our website.  So anything like that, we’re open for it.

Alyssa:  Very cool.  Thanks.  We’ll put links to everything in the show notes, if anyone has questions on how to find you.  Or if they do look at the website and have additional questions, you said it’s easy for them to find you to ask you specific questions, correct?

Kathryn:  Yes!

Alyssa:  Well, thanks for your time today!

Kathryn:  Yeah, thank you!

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.

Joining us today is Amanda Seymour and Katie Thomas from Hulst Jepsen Physical Therapy.  We discuss the issue of painful intercourse, its causes and the importance of speaking up among those who are impacted.  You can listen to this complete podcast episode on iTunes, Spotify, or SoundCloud.

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!

Alyssa:  Hey, ladies.  Good to see your faces!

Amanda:  Hey, Alyssa.  Good to see you.

Katie:  Hi!

Alyssa:  So we’re talking with Amanda and Katie again from Hulst Jepson Physical Therapy, and we’ve done a couple podcasts with them.  I’m excited to do a couple more.  Today we’re going to get into pain with intercourse, which I’m really interested to hear what you have to say about that.  So why don’t you two do another quick, brief introduction in case someone didn’t hear our previous podcasts, and then we’ll get right into it.

Amanda:  Yeah, for sure.  My name is Amanda.  I’m a physical therapist at Hulst Jepson Physical Therapy, our EGR location.  I’ve been a therapist for about five, five and a half years, and kind of delved into the women’s health, pelvic floor rehab world about three and a half years ago, treating patients with pelvic floor disorders.  Also, I treat as well anything from toes to nose, different orthopedic cases.  Just been really enjoying life as a therapist.

Katie:  And I’m Katie Thomas.  I work with Amanda at Hulst Jepson’s East Grand Rapids location.  And I’ve been a therapist for ten years and a pelvic floor therapist for about two.  So it’s definitely really nice to have both of us together in the clinic so we can bounce ideas off of each other and talk about cases if anything gets complicated.

Amanda:  Yeah, it’s been a blast.  And one of those cases, like Alyssa said, is in fact pain with intercourse.  This is common.  We see this a lot coming through our doors at any age, from those younger to older, before having kids, after having kids.  It can show up in anyone.  That’s what we really try to tell people, too.  Hey, you’re not the only one, because it’s kind of a scary thing when there’s pain during what’s supposed to be an enjoyable time.  Obviously, that takes the enjoyment out of it.  I wanted to throw out an interesting stat.  It says about 40-50% of postpartum females actually will experience pain with intercourse, typically three months after labor and delivery.

Alyssa:  So that far along?  I mean, obviously, we – you know, six to nine weeks is a pretty typical recovery period.  We’ll kind of warn our clients ahead of time that, you know, you might not be ready.  There could be some pain.  But even three months after, up to 50% of postpartum women could have pain with intercourse?

Amanda:  Yeah, and that, we’ll dive into, kind of maybe get more into why, because definitely when you think baby delivery – but also, I mean, we have seen it – I’ve seen it with C-section as well.  I think just the pressures from baby, holding baby.  Your pelvic floor has to hold that baby up.

Alyssa:  It’s an important statistic for moms to know, because like you said, this isn’t a topic anyone talks about.  So if you’re three months postpartum and having pain, you know, most moms probably assume, what’s wrong with me?  Nobody else has told me that they’re having this issue.  So I think knowing that 40-50% of moms are experiencing this same thing is really, really critical for them to say, okay, it’s normal in the sense that other people have it, but it shouldn’t be normal.  Like, I can fix it if somebody – hopefully, I can fix it with somebody I can talk to.  So then they can call someone like you.

Amanda:  Yeah, definitely.

Katie:  And I would also bring up, too – I feel like I see a lot of women who say, yeah, I have a little bit of pain, but it’s really not that bad.  Like, it’s what I would expect.  And I would also encourage women to think about the fact that they should be able to have sex without any pain.  Not only should they not have any pain, but it should be pleasurable.  So just being like, oh, it’s not too bad is not enough.  If you’re having any pain or discomfort at all, it’s great to see a pelvic floor physical therapist because there can be some underlying stuff that we can definitely work on.

Alyssa:  I think that’s kind of the mantra of a lot of moms.  Like, there’s a little bit of pain, but I can deal with it.  We just kind of get used to having to deal with stuff that we don’t necessarily need to.  A lot of times, we’re just afraid to ask for help or don’t even know that we can ask for help.  So, yeah.  This is huge.  Let’s keep talking about this because I don’t even know that I’ve had this conversation before.

Amanda:  Yeah, and that’s where we say, yeah, try – if you feel comfortable, come and chat with us and address us, because we also know with this pain with intercourse, it’s surrounded by so many other things, like avoidance of intercourse altogether, which can be tough for relationships.  I mean, just thinking about postpartum and having a baby, alone, is tough for relationships, and then add pain during intercourse.  That adds a whole other element.  And it’s not even always postpartum, though.  Elderly, you know, younger, it’s just the avoidance piece of it.  Or just even kind of that anticipation, that fear, once you get that experience of it being painful.  Obviously, there’s a fear that sets in, anxiety.  And some people, we do say, hey, it’s not a bad idea to just talk to someone about this, too, including us, but also sometimes reaching out to a counselor or sex therapist in that way to be helpful.  The biggest thing as a rehab specialist with physical therapy that we want to teach you guys is to say, hey, this pain is most likely coming from muscle, and they kind of term it to two different pains, I guess.  There’s superficial dyspareunia, which means pain with intercourse, or a deep dyspareunia.  In superficial, kind of as it sounds, right at the front of that vaginal opening, that’s like that insertional pain where it feels like tearing or a really, really strong stretch, ripping sensation.  And I will say postpartum, you want to make sure tissues are healed if you’ve had any stitching and whatnot.  But if it’s past that point, and your OB or gyno is like, yeah, everything is nice and healed, and you’re still having that sensation, that’s what we term more of that superficial dyspareunia because there is muscles right there, like a knuckle in that vaginal opening, that can be too tight.  That deeper pain, that goes more with those deep layers of the pelvic floor muscles, deep layers of muscle.  We kind of say, hey, that’s maybe your second knuckle of your finger into that vaginal opening or all the way to kind of that third knuckle.  And those deep layers can also be just so tight after childbirth or even not after childbirth.  It can just happen.  Stress, I will say, has been a trigger for a lot of females.  When they notice, oh, work is getting really tough, and oh, my goodness, intercourse is quite painful.  Well, we went to Florida.  We felt great.  Intercourse was pain-free.  We have noticed that with females.  So that’s going to be the same as, oh, my word, you know, I have a lot of shoulder tightness, neck tightness, when my work is getting really busy.  Well, guess what, those pelvic floor muscles can respond in that same way.

Katie:  We’ll also see that third layer be really tight and painful with the low back pain and hip pain, as well.  Because those third layer muscles also attach into our hips, if there’s any sort of rotation in your pelvis or misalignment or low back pain, even us taking a look at that, taking a look externally, and working on your back and working on the hips and working on the muscles around it can help a lot internally as well.

Alyssa:  Because one muscle can pull on another which pulls on another?

Katie:  Exactly.  It’s all connected, for better or for worse.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Katie:  I also wanted to say, too, that sometimes it’s not just intercourse that can be uncomfortable, but also anything superficial, too.  I mean, we’ve seen a lot of women who just had concerns even with their partner touching them externally.  So even if that’s the issue and you haven’t even gotten to intercourse or anything internal and you’re just feeling discomfort or fear or pain externally, we can work with that as well.

Alyssa:  So I have to imagine for women who have pain with this, it’s also – you know, like, I can’t imagine during your period, right?  Like, that time of the month, and you – even like a tampon or a cup, that has to be really painful.  So do you see that women are oftentimes just using pads or something else because they can’t do anything else?

Amanda:  Yeah, definitely.  I would say a lot of even younger females, they’ll tell me, I’ve never – or I should say this.  Older females, when they were younger, say they never could use a tampon because it was so painful, or pap smears were always painful, medical exams always so painful.  And then saying, yeah, intercourse is painful, as well, just because that pelvic floor – you know, it’s kind of like a tunnel, let’s say, and anything that inserts the tunnel, the tunnel isn’t going to want to have pressure to the sides of it because it’s so tight.  It’s going to create that pain.  And that’s something in some kind of diagnoses we do see in regards to that pelvic floor tightness or pain being associated, like endometriosis is one of them where someone will say, yeah, I’ve been diagnosed with that for a while, and the pelvic floor, we find, is quite spasmed because of that, and they’ll often have a history of tampon use being tough.  So, yeah.  They would use pads instead because just to have something in there that long is just too painful.

Alyssa:  So I’m picturing this 18-year-old going in for her first pap smear, sexually active or not, but she doesn’t know if it’s supposed to be painful or not.  You know, so she’s probably not telling her medical team or even her mom when she gets back home that it was really painful – or maybe she did say, oh, that was awful.  It’s really painful.  But then the conversation just kind of stops there.  How do we – again, like we’ve talked about before, just educating people, talking about it is the first step.  But, you know, now that I’m – I know this, right.  When my daughter turns 18, if she says that was really painful, not to just brush that off and say, well, oh, she’s not sexually active yet, so of course it’s painful.  I guess what would your recommendation for – what should that conversation look like after that?

Katie:  Yeah, so I would say that going to the gynecologist and having your first exam can be kind of a scary experience, anyway, and so your muscles – you can just tense them up while that speculum is being inserted and removed.  So if it’s a first-time experience, that might be painful regardless.  So I think some good follow up questions could be, you know, is it painful to insert a tampon?  Is it painful to insert your own finger?  That one’s a really important one because a lot of women, they can insert their own finger because they’re in control.  But then there are some women who are like, I can maybe insert half my finger, but after that, it’s painful.  So following up, I think, with the finger question would be probably the easiest way to know, like, oh, if that isn’t comfortable, or beyond that, if you can insert your finger, can you move that finger north, south, east, and west within your vagina, and if you do, do you have soreness anywhere?  And if you do, that’s not something you should have to experience.  So those could be some kind of red flags, as well.

Amanda:  And I would say, too, like with speculum insertion, is it painful right at the beginning when it’s inserted or deeper, because I don’t think pap smears are ever, I would say, comfortable, comfortable.  But is that pain right away, and then that could be – yeah, I mean, following up with kind of – I think the tampon question, too, is great, because that’s going to be so known for everyone, pretty much, to see if that’s a painful one.  Good question.

Alyssa:  I don’t mind the speculum.  It’s that dang four-foot Q-tip they put in afterward.

Katie:  Never a pleasant experience!

Alyssa:  So I’m assuming, you know, kind of like the other conversations we’ve had about the pelvic floor in general, you would ideally do an internal exam, but it sounds like you can also do an external one.  Let’s look at your hips.  Let’s look at your back.  If someone’s not comfortable – like, I’m totally comfortable having a conversation with my daughter eventually about, hey, put your finger in there.  Tell me how it feels.  But there are a lot of people, parents, who maybe aren’t comfortable having that conversation or even comfortable letting you do an exam like that.  So it’s nice to know, again, there’s a wide array of therapy that you can do and still be effective.

Katie:  Yeah, definitely.  So we do a lot of external work, just like what you said with checking the back, checking the hips.  We can also do some external muscle releases.  Amanda and I were just talking about some of those techniques earlier today where we can do some stretching of the tissues more around your buttocks.  We can do stretching in your groin.  We can give you exercises to stretch those areas.  And by stretching things close to the internal muscles, because they all connect, that can be more comfortable.  We’ve both seen a lot of women who it’s taken weeks or maybe months or maybe never to get comfortable with an internal exam, and there’s still so much that we can do.  And speaking of younger girls, I would say, and Amanda, you’ll have to let me know if you agree or not, but I would say we also don’t do anything internal on young women unless they’ve already had a gynecological visit in their past.

Amanda:  Yep, so they’re familiar with it.  They know it’s medical.  You know, just to kind of get the environment safe for them.  External, I think for sure, is really helpful for younger girls, because yeah, they want to be empowered to be able to do something for themselves at home, too.  Yeah, external tricks work great.  People come from sexual abuse where it’s like, yeah, we’re not even going to go there.  So we’re going to stay all external, and yeah, the releases are effective, and it does feel like you’re getting some of that pelvic floor, even though it’s pressure on the outside.  And, you know, with tightness, we mentioned this before about sometimes muscle that are too tight need to down regulate, we call it.  So relaxation, and that’s where you can have that conversation with a person of, hey, when you know a trigger is coming that creates that tightness and spasms, how are you going to kind of go about that, or what are some relaxation techniques or breathing techniques we had mentioned before of trying to get things to just relax and soften through the pelvic floor.  Or apps, like the Calm app or Headspace.  Just integrate that into your day to really get those muscles to relax, like you would if your neck muscles are getting really sore and tired.  We’ve found that’s really helpful for people.

Alyssa:  I love this aspect of it because we actually teach a course called HypnoBirthing, which is – you know, they learn a lot about the physiology behind what’s happening in your body during pregnancy and what will happen during birth, but it’s also a relaxation technique.  And I think that, paired with teaching yourself how to relax those muscles – you know, not just relaxing your head, but relaxing the muscles in the canal that is actually going to birth your baby, could be really important.  Now, even though talking about – well, let’s give this scenario.  Worst case, right?  Someone who has pain during intercourse is now pregnant.  They have to be so freaking scared to give birth.  Now, if something the size of, you know, a penis hurts, a baby has got to be terrifying.  So do you work with mothers in that regard, of how do we relax to prepare your body for labor and delivery?

Amanda:  Yes, I have had a female come in.  She was pregnant, and probably a couple weeks before birth, yeah, we did some external releases during pregnancy.  And we don’t do any internal pelvic floor releases, just keeping that environment safe.  But external, for sure, and teaching safe stretches will be helpful, but then obviously that breathing, that relaxation piece.  We know – I just had a client come back.  I taught her the breathing, saying, when you inhale, the pelvic floor should relax.  And she used that during intercourse with her husband.  She said, oh my word, that helped so much.  I just used that breath, and it was much more enjoyable.  Obviously, she’s probably focused more on her breath than anything at that point, but it’s just that training to basically teach that body, hey, this is okay.  We can let go and be okay with some of that friction and whatnot.

Alyssa:  Yeah, that’s got to be the first step, right?  Even if she’s focusing on her breath more than the sex, that’s a step in the right direction because she just had sex with less pain.  And then it just has to become a habit.  It gets easier to the point where she can now focus on the sex more and less on her breath.  That’s the goal.

Amanda:  Yes.  And, obviously, with baby, it’s one event during that time, but that too, I think, obviously, is really helpful, just that down regulation piece.

Katie:  Yeah, and I would say your clients who see you and who are working on the hypno-breathing are definitely well prepared for birth and then post-birth with a lot of the things we’re talking about.  And I would go back to your question about seeing women during pregnancy: I think that a lot of women during pregnancy only come and see us if they’re having some hip pain or pubic pain or SI pain.  But we do – often that pain is associated with tightness, and so we do work on a lot of stretching and relaxation techniques.  I think it’s a little bit of a myth or misconstrued that all pregnant women need to be working on their Kegels.  That’s not the case.  Just like any woman, we need to see, are your muscles too weak or too tight?  The same thing can be true for pregnancy.  You might be doing harm by focusing all on Kegels and not focusing on relaxation during pregnancy with that pelvic floor.  So Amanda talked a little bit about some breathing and some apps and stuff like that.  Some other treatments we can do, like sitting on a hot pad or a hot water bottle, can help to relax your pelvic floor while you’re doing some of the breathing or while you’re doing some stretches that we teach you.  We can also use something called biofeedback, which is pretty cool.  We don’t have a unit at our clinic yet, but we’re hoping to get one in the spring, and that’s really nice because it’s not internal.  It’s just some electrode pads that we place externally, and then the patient can see on a screen when they’re relaxing their muscles and when they’re contracting them.  Sometimes it’s really hard for us to know, wait, am I using that muscle?  Am I not?  Am I relaxing?  Am I not?  And so having a visual cue can help.  Sometimes it’s really helpful for some women to actually see, like, oh, I’m relaxing now.  And then once they can see that and associate that feeling with it, it’s easier to relax on their own later while doing their exercises.  And then other exercises, like we talked about, we can stretch.  We can stretch your glutes.  We can stretch your hamstrings, your adductors, so those inner groin muscles, and all that can help relax your pelvic floor, as well.

Amanda:  And our goal is obviously to kind of empower the patient.  So we love doing hands-on and helping, but ultimately, we don’t want the patient to rely on us.  If, let’s say, that pain came back in a year, because sometimes we do have clients who are like, hey, it’s pain-free to have intercourse, and they ask that question, like, oh, what happens if it comes back in a year or whatnot?  So we like to say, hey, these are some things that you can use at home, as well.  And with tight muscles, it doesn’t hurt to get, like, a dilator set.  And, basically, it’s different sizes of a silicone or plastic rod that you gently insert into the vaginal opening, and not everyone is comfortable with this at home, but if a client says, hey, yeah, that is something I can do, and it’s maybe more comfortable than a self-stretch with a finger, but it’s almost like a glorified tampon in a way that you put lubricant on and then gently insert that into the vaginal opening and it allows those tissues just to stretch and allows them just to say, hey, can I hold this dilator in this position for 30 seconds and feel a gentle stretch.  Not that ripping or tearing sensation.  We don’t want to recreate that familiar pain, but just that gentle stretch.  And I found that really effective with patient if they come to therapy once or twice a week and then those other days they’re working on that at home.  There’s also – I think it’s called a therawand.  People may have heard of the theracane, that shepherd’s hook that can get those knots in your shoulders or in your neck.  Well, the therawand, it does not look like the theracane, but it’s smaller and you insert that into the vaginal opening, and you find those areas.  Some people do have just one or two areas within the pelvic floor that are maybe trigger points for spasms, and just hold that pressure.  Just gently; sensitive tissue.  Just hold that pressure on that area.  Yeah, I find that really effective for patients.  So a lot of different options out there, which is really nice.

Katie:  And those dilators, too, can be used not just for stretching, but you can practice relaxing your pelvic floor around them, too.  So we’ll start with a really small size, like maybe the size of a finger, and then you can work up in size so that then you get more comfortable to the size of a tampon or more comfortable to the size of a menstrual cup or more comfortable to the size of a penis.

Amanda:  And I know there’s different companies and stuff you can get them from.  There’s a company, I forget its name, but you can actually custom size a custom size if your partner isn’t perfectly straight or something like that, if anyone has questions on that.  So not everyone’s partner is going to be the same size, either, so, yeah, there’s a lot of options.  And we give education and we have some samples of different lubricants, too.  We know that makes a big difference.  Silicone versus water.  We use Uberlube here.  We’ll give samples of that.  We’ve found good results from that.  In clinic, we use Slippery Stuff.  People seem to tolerate that pretty well.  So, yeah, that makes a big difference, as well.  We try to give education on that, too.

Katie:  Yeah, you’re really looking for a lubricant that has vitamin E in it.  So no KY Jelly.  Don’t use it.  It will make the situation worse because it’s going to dry out those tissues even more that are already sensitive to friction.  So you definitely want something with vitamin E.  We just happen to use Uberlube a lot because we got lots of free samples from them.

Amanda:  And we’ve had good feedback.  So there’s multiple different factors of why there is tightness, and sometimes it can be hormonal, too.  Sometimes if you look at the tissue, if we get the go by the client and look at their tissue of the vaginal area and it’s looking dry or bluish, to say hey, let me call your primary care or your OB or gyno, and maybe you should get estrogen levels checked.  Maybe the tissue is just not as supple as it could be and kind of dried.  That definitely makes a difference, too, of how well intercourse will feel.

Katie:  And sometimes it’s just as simple as your doctor writing you a prescription for an estrogen cream or something like that.  That’s when we definitely work more closely with the gynecologist.

Amanda:  Definitely, and keep that communication between all parties going, for sure.

Alyssa:  I love this conversation.  I honestly don’t think I’ve ever had this with anyone.  I think most women don’t have this conversation with even their friends.  I don’t know that many of them bring it up to their doctors.  So I hope that this at least spurs some conversation in people and maybe makes them think about calling someone and talking about it.

Amanda:  Yeah, we would love that.  Come on in for that 15-minute free consult or set up an evaluation.  I have had couples come together because the husband really wants to learn what he can do.  So we are open to educating as much as we can.  I know we have a sheet even on sexual positions that might be more comfortable for you.  That does make a difference, too.  Every pelvis is shaped differently, so what you see in the movies may not be comfortable for you, and that is 100% okay.

Alyssa:  Awesome.  Well, is there anything else that you want to mention before I ask you to give us contact info?

Katie:  I think the only thing – I think we brought it up before, too, but just emphasizing, too, that we work together with other healthcare professionals.  So it’s great that people are working with you guys pre-birth, during birth, post-birth, and then we’re working closely with a gynecologist, and then it may very well be beneficial to work closely also with a sex therapist, too.  So we just want to remind people that it often takes a team.

Alyssa:  We love that.  We talk about birth and pregnancy teams a lot, too.  Like, who medically, professionally, and personally, who do you need to have on your team to make this as smooth as possible?  So I think a physical therapist, a pelvic floor or women’s health physical therapist, needs to be one of those members on that team, for sure.

Amanda:  We agree!

Alyssa:  So people should look in their area to see if you have a women’s health physical therapist near you.  For those near us in the West Michigan area, how can they reach us?

Amanda:  Definitely.  You can search Hulst Jepson online.  It has a list of our locations.  On the locations page, it will indicate which locations have pelvic floor rehab.  We have about five or six clinics that now offer pelvic floor rehabilitation, and all should be able to take you through the education, treatment, plan, if you’re coming in with pain with intercourse.  That’s definitely a familiar diagnosis we see.  You’re not alone, like we mentioned before.  Katie and I are at the EGR location, and definitely feel free to give us a call.  We’re happy to talk to you, even before you come in over the phone.  We’re happy to just have you sign up for a 15-minute free consult and talk to us in person.  Or definitely we’ll take a referral or a script from a physician.  And you can even come and make an appointment without a referral with certain insurances, so definitely call our front desk and ask them as well.

Alyssa:  Thank you so much for this conversation!  I’m super excited to see what kind of comments people have and what kind of feedback we get and who is now compelled to ask some questions.

Alyssa:  That’s great.  Thank you.

Katie:  Yeah, thank you so much!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

Kristin and Alyssa talk with Nathalie Walton, CEO of the Expectful App about managing a high risk pregnancy.  Go to www.expectful.com/ask-the-doulas promocode ASKDOULAS to get your first month of Expectful for just $1.  You can listen to this complete podcast episode on iTunes or SoundCloud.

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’m joined today by Alyssa here.

Alyssa:  Hey!

Kristin:  And our special guest is Nathalie Walton.  Thank you for joining us!  Nathalie is the CEO of the Expectful App.

Nathalie:  Thank you so much for having me!  I’m really excited to be here with both of you today.

Alyssa:  Thanks for joining us!

Kristin:  We’re so thrilled to chat with you about your story.  Fill us in about, you know, your experience as a mother using the Expectful App and then later as an advisor to becoming CEO of the company.

Nathalie:   Yeah.  So for me, it all started – I was introduced to Expectful in my pregnancy, and I’m one of these people that I’m really into wellness and fitness, and I’m also Type A.  So I went into pregnancy thinking, like, I’ve got this.  I had all of my plans laid out.  I had my doula.  Like, I really was set on doing an unmedicated birth.  Like, I was doing everything, like the acupuncture.  I was really living and breathing the pregnancy, being pregnant and living my best pregnant life.  And I thought I was doing everything right.  And then around my 20 week scan, I went into the doctor’s office, and I had my bags packed because my husband and I were going to go on our babymoon later that day, and they kind of looked at me, like midway through the appointment, after you put on your clothes, and they were, what’s that bag?  Where do you think you’re going?  And I was like, on my babymoon.  And they were looking at me, and said, whoa, whoa, whoa.  You have a high risk pregnancy, and you’re not going anywhere.  You’re at risk for preterm labor.  And at 20 weeks, they told me this.  Your baby could be born at any time.  And it just came to be as such a shock, because it’s like, I’ve done every single thing right.  Like, I had everything prepared.  Are you serious?  And so for me, I became really stressed, to be quite frank, because it’s like I started living my life in weeks and days.  I was like, I didn’t know when I would deliver, if I would make it to term.  And it just created a lot of stress because I couldn’t control anything.  I was doing my best, but so much control was out of my hands.  And I found this app called Expectful, and I’ve had a meditation practice for – honestly, I’m going to sound really old, but I started young.  But I’ve had a meditation practice for almost 20 years.  And when I started Expectful and I got really into HypnoBirthing, as well, something changed, where I had been getting worse and worse, but I managed to stabilize, and actually, shortly after using the app, I just reached this place where I had a calmness that really helped me get to term, and lo and behold, I made it to term.  It was definitely a challenge, but there was just something that I had this profound experience with, like the meditation and the HypnoBirthing, that really enabled my pregnancy to make it to the end, which had a tremendous impact on me.  So that’s the story of how I was introduced to Expectful, and how I came to now lead the company was that when I was on maternity leave, I came across, randomly, this opportunity to advise Expectful, and I was like, wow.  I just used this product in pregnancy.  It just had a really big impact on my life.  Why not advise them?  And that transitioned into the CEO role, which I’m not – I’ve been in for almost a year now.

Kristin:  That’s amazing.

Alyssa:  How old is your baby now?  I’m curious.

Nathalie:  My son Everett is 20 months old.

Alyssa:  So this is all still very new and relevant to you.

Nathalie:   Yes!  Yeah.  I still consider myself a new mom.  I mean, I don’t know when you stop considering yourself a new mom, but we’re still going through many firsts, and it still – I joined Expectful when Everett was an infant, and we still weren’t sleeping through the night.  So we’re both growing up together.  Expectful is growing up.  Everett’s growing up.  I’m growing up.  It’s a lot growing!

Kristin:  We work with a lot of high risk moms.  We specialize, especially in the postpartum end of our business, in multiples: twins, triplets.  So what advice do you have personally going through a high risk pregnancy in preparing and really having some way to manage everything that’s ever-changing as a high risk mother?  I had preeclampsia.  I was in a high risk status later in my pregnancy than you were, but I can personally relate to some of what you went through.

Nathalie:  Yeah, my advice is, you know, so much of pregnancy is – and motherhood, and life – is out of our control.  But I think that in pregnancy, we have this desire to prepare and control everything and what we can.  And so that’s why I think so many people spend time – I mean, I think about the hours that I spent on my registry.  Do I have the right stroller?  Do I have the right swaddle?  And I didn’t really think about, like, how do I prepare my mind to deal with not having any control?  I never really prepared – how do I prepare for a NICU stay?  It never even crossed my mind how to think about preparing for that.  How do I prepare for an emergency C‑section?   I didn’t prepare for that, either.  So my advice to anyone in a high risk situation, or even just if you’re having the best possible pregnancy, is to build the tools and the mindset to navigate the unknown, and that’s where meditation comes in and Expectful comes in.  There’s a lot of scientific evidence that shows that cultivating a meditation practice in pregnancy reduces your chances of pregnancy and postpartum anxiety and stress.  There’s studies that show that a meditation practice can reduce pain in labor.  That’s another reason why I really got into HypnoBirthing.  And so my advice to anyone that’s going through this, or anyone in general, is to think about, what is that practice that I can cultivate that’s going to enable me to deal with the unknown, because as much as we like to think we can prepare for everything, there’s going to be something in your pregnancy or motherhood journey that you’re just like, I didn’t even think about it.  And it’s probably going to happen a lot more than once, and the sooner that you come to that reality, I think the more you will thrive.  And so that’s my advice.  And one way to do that is through meditation.   There are other ways, like cultivating a yoga practice, a HypnoBirthing practice.  Finding that thing that’s going to give you that power to navigate uncertainty is just so key.

Alyssa:  I didn’t have a high risk pregnancy, but I am a Type A friend of yours.  So I do understand that sense of – that need for a sense of control, and I think pregnancy was my first realization that all this is out of my control.  And then birth is out of our control, and then, I mean, don’t even mention postpartum.  Once you have a kid, like, my schedule is no longer my own.  Your sleep is no longer your own, for a while.  So I think just that Type A, for those of you listening that are the Type A mom as well, that we think we need the sense of control, figuring out a way to kind of release that control and allow the unknowns to filter into our life because there’s no way around it.

Nathalie:  Absolutely.  Yeah, I mean, your body isn’t your own.  If you decide to breastfeed, that is something that I had to learn.  Like, how do I share this body with another human?  So you’re right.  It’s definitely – maybe it’s harder for the Type A people.  But the sooner that you come to that realization that you just have to surrender to the process, of the beauty of creating a life and bringing that life into existence, I think the better prepared you will be.

Alyssa:  So I’m curious.  I was reading that you kind of changed, over the last several months – Expectful has grown from a meditation and sleep app for pregnancy to more of a holistic wellness program.  Can you explain what that difference is and how that has changed?

Nathalie:  Yes, absolutely.  So, I mean, as someone who’s still going through the early stages of motherhood, I realized that, you know, meditation and sleep is wonderful, but women need so much support beyond meditation and sleep.  And so I want to create this holistic wellness haven for anyone in fertility, pregnancy, and parenthood.  What that means is we’ve expanded our content far beyond meditation.  So I brought in my prenatal fitness instructor, and we have live prenatal and postnatal fitness classes and fertility flow classes.  We have all sorts of live video with experts where we talk about everything from nutrition to infant sleep.  We are launching a video library soon that just contains a ton of fitness videos and chats with experts.  What I’m really excited about, something that’s going to launch in the next couple of weeks, is the ability to subscribe to our support service.  In my pregnancy, I had a lot of questions, as I think everyone does, and you only get a few minutes with an OB, if you can even see your OB.  Sometimes I had to see her assistant, and I’m like, hmm, you know, what foods should I be eating to help me, or thinking like, you know, is this normal, and then instead of getting an answer from my doctor, I’d go to Google.  And so what we are building to solve this is we are building the ability to connect with experts as a part of our subscription.  In fact, this part is actually live now.  So we have support groups that are led by doulas or experts in pregnancy and postpartum.  So you can connect with other women and talk about what you’re going through.  We also have office hours with a nutritionist, a lactation consultant, an infant sleep consultant.  It’s really hard to access those providers, and so we’re innovating the business model in that, if you have questions, you don’t have to go to Google.  You can just sign up for our office hours and get advice directly.  And that’s part of the Expectful subscription.  So that’s all part of this journey to creating this holistic haven, a wellness haven.  And on top of that, we have the ability to get one-on-one advice and one-on-one services.  So let’s say you have a little bit more of a complex problem, and you want to chat with a nutritionist for, like, 15 minutes or an hour.  We have that ability for you to connect with a nutritionist who specializes in pre- and postnatal wellness and fertility, and you can get your questions answered, which is something that I wish I had in my pregnancy because it’s so hard to find your support village.  It’s at your fingertips with Expectful.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Kristin:  That’s amazing.  Especially during the pandemic – it’s so isolating.  We have a lot of clients that move into this community and they don’t have any support, so we launched an online course called Becoming a Mother that has a bit of that Facebook community, as well as live calls, so I love everything you’re doing, especially on a large national platform.

Alyssa:  And in that Becoming course, we actually ask our students, who are pregnant mothers, what – one particular question is, what apps are you using and what apps do you recommend to the other moms, and yours was one of them!

Kristin:  Yes, it was the top one!

Alyssa:  It’s been on our list!

Kristin:  They love it.  It’s great to keep up with, since we’re not pregnant ourselves, and the changing registry items from women in our courses and what they’re listening to in podcasts and what apps they’re using.  So yeah, that part has been quite lovely.

Nathalie:   That’s so wonderful to hear, and I love that you’re creating that course, because it’s – I mean, the word that comes to mind, and this is a big, heavy word, is matrescence.  It’s the transition to motherhood.  It’s just not talked about enough.  I love what you’re doing in terms of preparing to become a mother because so much of pregnancy and birth is all around the baby, and it’s like, hello, there’s another human being born in this process that really needs that same nurturing and care.  So I love what you’re doing and providing that community because it’s not talked about enough, and I see this on Expectful, but people just suffer in silence and they don’t know that literally everyone else is going through the same.  I mean, it might be a little bit different, but everyone struggles with this in some way or another.  So I love the community that you’re building.

Kristin:  Yeah, there are so many things that are left unsaid.  I mean, you share certain things with friends and family members, but other things like the lack of sleep and what you’re going through in things like bladder control and wanting to work out – like, we love sharing information about pelvic floor therapists and more of the services after you have baby and things that aren’t really discussed.

Alyssa:  Yeah, we love talking about all those things that I wish somebody would have told me about before they actually happened.  You know, like, oh, yeah, pooping the first time will be a little bit scary after, whether it’s a vaginal or a Cesarean birth.  That idea is scary, and oh my gosh, I went to run for the first time and about peed my pants.  Like, what are all the – like, why, and what’s going on, and how do we help it?  Instead, we just suffer, like you said, in silence and think, well, it’s just the way it is now.

Kristin:  And you have different subgroups in Expectful?  Nathalie, can you talk a little bit about that?  Like, different ways that people can join?

Nathalie:  Absolutely.  So we have everything from healing to motherhood.  I think healing as people that have experienced a loss.  I personally find, like, in just talking to so many of our users, my heart aches for anyone who’s experienced a loss.  It’s so terrifying, but what probably might even hurt just as much is just the lack of support and empathy for people that experience loss.  And so we have a healing library that’s free for anyone who wants to access it to access our meditations on how to heal and how to connect.  Our first group starts with healing, if that’s something that you need.  We have a robust fertility library of meditations, like cycle meditations.  Our biggest community is obviously pregnancy where we have, you know, a ton of support options from the chats with the nutritionist or connecting with services but also our fitness videos for pregnancy.  Something I’m excited about that just launched is we have weekly pregnancy meditations, which are super popular, and we just launched daily ones.  And I love this because, I mean, each day in pregnancy is a very special day, and it’s nice to know, like, where you are in the day and be reminded of the really awesome time that you’re in, even though it can be challenging.  So we have daily pregnancy meditations.  I’d say one of our most popular courses is HypnoBirthing, which I’m a huge HypnoBirthing fan, and that’s in our app, as well.  We have a robust postpartum library that features anything from nursing meditations to stroller meditations, catnap meditations, and then, you know, of course, all the fitness and the experts that you can connect with.  So we really do have something for anyone that’s, like, you know, has baby on their mind to actually having a baby in hand.  I really feel like anything from fertility through the first year is a really sweet spot for using Expectful.

Kristin:  So I know you’re very active in the Black maternal wellness space and using this app to move forward in getting more support for Black women, get the provider options and just information that is so necessary.  Can you speak to that, Nathalie?

Nathalie:   Yes.  So, I mean, I am a Black woman, and I think going in pregnancy, like, I knew I’d have a hard time as a Black woman when I look at so many prominent figures in the world.  I look at Beyonce.  I look at Alison Felix.  I look at Serena Williams.  Like, these are some of the most successful Black women, and they have all of the resources at their fingertips, and these women almost died in childbirth.  And I knew that if that was happening to them, it would happen to me.  It would happen to everyone, every Black woman.  And it’s true.  Like, if you look at the statistics, Black women die at a rate of three to four times of that of White women in childbirth.  And I had my fair share of complication during pregnancy.  I was frequently dismissed, which made the entire process more stressful.  I wasn’t given answers when I wanted them.  I mean, I really had a challenging time, and in fact, my son and I, we almost did die during childbirth.  It ended up being incredibly traumatic and much more so than I could have ever envisioned.  And I think that to me, the whole process made me realize, like, I did have access to everything that I could want.  Like, I had access to amazing doctors.  I had all of the wellness tools that you could imagine.  I had fantastic benefits from working in tech.  And I still – we still almost died.  And so that feeling of not being able to control, but also not being able to control something because of your race and knowing that you’re not taken as seriously as someone who’s a different race is just a really difficult burden to face on top of, you know, having a high risk pregnancy.  So I worked with several leaders in the Black maternal wellness space to come up with meditations specifically for Black women.  It’s called Black Mamas Meditate, and this is a collection of meditations.  It’s free for anyone to use.  It’s on our website; it’s on our app.  And these meditations are really meant to address the experiences that Black women might be feeling during their pregnancy journey, and so it’s my hope – I mean, this is not going to solve the problem, but for any Black woman that might be experiencing these difficulties, we have those meditations for Black women.

Alyssa:  That’s awesome.  That was going to be my next question was if you had, you know, within these subgroups, a subgroup for Black mothers.  So can you actually let us know, like right now, the people listening, like, where do they find these free – like, on the app and on the website, you said?

Nathalie:   Yeah.  So this is on the app.  If you Google Expectful Black Mamas Meditate, you should be taken to the landing page.  It’s a meditation collection online.  In the app, it’s in the pregnancy section.  There’s a sublabel in Meditate that says Black Mamas Meditation Collection.  So in either place, you can experience these.  And it’s my hope that it’s helpful because there isn’t a ton of support, and it is very isolating, so anything that we can do to help support is important to me.

Kristin:  That is wonderful.  We’ll share that resource with our clients and students.  Thank you for creating that!

Alyssa:  So when moms download the app, is there a free version where they can get these free meditations, then, and there’s a paid version, as well?

Nathalie:   So right now, it is – we have a seven-day free trial membership, and that is to experience all that Expectful has to offer, unlimited.  And then it transitions into a paid version.  That being said, I’m happy to share, and perhaps you would like to talk about, we do have a special offer for your listeners.  I think that this is really amazing for your audience, so I hope that everyone just checks out Expectful.  So for the first month, we’re offering Expectful for just $1 a month.  So you have 30 days to check out Expectful, attend a support group.  You can go to office hours with any of our specialists, listen to all of our meditations, our HypnoBirthing courses, all of our courses that we offer, you can check out just for $1 a month.  So I hope that that is of use to your listeners.

Alyssa:  That’s incredible.

Kristin:  That is so generous!  Does that expire, Nathalie, or –

Nathalie:  We don’t have an expiration date.  I mean, at some point, it will expire.  Like, maybe two years from now, but we want people to access that, and so this is a code that’s unique for your users in the future so that they can access that.

Alyssa:  And we will share a link for our listeners to that.

Kristin:  Yeah.  The promo code is ASKDOULAS on your website.   Any final words of wisdom to share with our listeners, Nathalie?

Nathalie:  Well, first of all, I absolutely love what you’re doing, so thank you for all the work that you’re doing.  My advice, my last parting words, would be that pregnancy and fertility and new motherhood is that it has its ups and downs, and it’s beautiful, but it is also one of the most challenging things that one might go through.  And my advice would really be that whatever you’re going through, you’re not going through it alone, and seek out that support so that you can get the help that you need because the help exists.  Like, it’s not normal – you mentioned pelvic floor therapy – it’s not normal to pee your pants for months on end.  It’s not normal for you to, like, have breast pains or to be in constant agony.  There’s help, and that’s what I’m trying to normalize, and I’m trying to do that at an accessible price point.  So if you’re feeling any kind of discomfort or even if you’re feeling just amazing and you want to share that with others, I just recommend tapping into the Expectful community so that you can share your experience with other moms and help people feel more supported.

Kristin:  Thank you.  We love everything you’re doing and appreciate your time today, Nathalie!

Nathalie:  Thank you so much for having me on.  It was just so great to connect with you.

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.

Alyssa talks with Maranda Bower, Postpartum Bliss Coach, about the difference between depression, depletion, and mourning our previous life.  How do our bodies change during pregnancy and how can we best support healing? You can listen to this complete podcast episode on iTunes or SoundCloud.

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!

Alyssa:  Hi.  Welcome to Ask the Doulas.  I am Alyssa Veneklase, and I am talking today with Maranda Bower.  So you’re a postpartum nutrition specialist, CEO and founder of Postpartum University, and then on the last email you sent me, I saw Postpartum Bliss Coach.  So I was like, all right.  Let’s find out what all of these are before we get started into our topic.  Let’s find out who you are first!

Maranda:  Absolutely!  So I actually was a doula and a childbirth educator for many years.  That’s where I got started about – well, over a decade ago.  And as my business grew, I started doing additional services.  I started running retreats for women, particularly in pregnancy and postpartum.  I opened up a mother and baby shop and had all sorts of, you know, nipple cream and breast pads and, you know, all of these amazing products for mom and baby.  And then as my business grew and grew and my family grew and grew, I started talking at local organizations and started speaking at universities.  I had written books.  I was showing up at conferences as speakers.  And things got a little chaotic because here I am with four kids.  I have a multitude of things.  And so I ended up shifting my business to support more people in the online space.  And so I ended up not running retreats as often.  I was still speaking here and there, but instead of showing up and doing births, which, you know, as we know, can take up a lot of time, and then evenings was childbirth education classes.  I switched into the online world and started doing more one-on-one coaching.  And, really, I felt as if, as somebody who was teaching, I was inundated in the birth world.  Everything was about birth.  And I knew that something else was there.  Something else was missing.  And that’s actually how I really started my journey into postpartum was with my own journey through postpartum depression and major anxiety.  And so I really wanted to focus more on this almost forgotten period, and so here I am.  I was in the online world.  I started creating courses and became a postpartum bliss coach, and as that transformed and grew and grew and grew, I created Postpartum University, which is not only teaching mothers about how to heal their body in the years after having a baby, but also teaching providers how to care for women better in the postpartum period and beyond.

Alyssa:  And so as a postpartum nutrition specialist, is that what you’re talking to providers about?  And then is a postpartum bliss coach like a certification that you went through, or is that like what you kind of just call yourself with the trainings and certifications that you have?

Maranda:  Yeah, that developed after taking numerous trainings and certifications.  And I felt like, you know, postpartum is one of those chapters at the end of the book.  It’s not.  You know, nowadays, we are seeing more and more certifications pop up for people who want to specialize in postpartum care, but a decade ago, that was not in existence.  And so when you learned about postpartum, again, you were picking up pieces here.  You were picking up pieces there.  I was talking with medical providers, and I was talking with midwives, and I was having conversations with women in the grocery store, right, and working with my own clients, my birthing clients.  Just really understanding what’s going on here, what was lacking, and in my own personal journey through postpartum and through healing, right?  I mentioned I had postpartum depression.  I experienced postpartum anxiety severely.  It really – I mean, I lost my relationship.  I ended up having to move back in with my family.  It was debilitating.  I later had more children and ended up with postpartum bipolar.  So I have experienced quite a range of my own, and through my own healing, have really recognized the significance of postpartum nutrition and many other factors related to postpartum that are necessary for healing that we’re not talking about in our society, that we are not engaging women in, that we’re not supporting women in the least bit.  So as someone who is a – so I have numerous certifications and degrees.  Many focus on nutrition and really honing in on that, making me, you know, the postpartum nutrition specialist, has really fueled that title.  But the postpartum bliss coach is more of an umbrella term where, you know, there’s so many more trainings that I have done.  Really, there’s more trainings that I have created and alongside other organizations that many of the experts here are taking; many of the doulas are taking, that I’ve helped create and develop.  Again, like I’m giving away my age here, but I’m old.  This was something that, you know, didn’t exist before, and I’m so grateful that it exists now.  But then, I had to kind of create what we see now.  That’s essentially what happened.  You know, the postpartum world is something that I helped develop over the last decade that wasn’t there.  So now we have these tools.  Now we have the ability to learn about postpartum nutrition, how to support women in better sleep, how to balance the hormones, and how to do so naturally in a way that feels really good for not just the mother and her partner and her baby, just the family unit as a whole, the community as a whole, and really bringing ourselves back to the basic and taking back postpartum.

Alyssa:  So let’s talk about – our topic is going to be understanding the difference between depression, depletion, and then mourning our previous life, which I feel like we could probably do three different podcasts on each of those, but that’s one of the things.  Now, when that topic came up, is that something you’ve written about, or is that something – are those topics you teach about?

Maranda:  They are.  I talk about these often, and these are really what I work my moms through when I support women one-on-one and when I’m talking in my private groups.  These are some of the topics that I absolutely teach on, yeah.

Alyssa:  So you suffered through postpartum depression.  I guess as a mother who went through that, how would you define that, and how would you say that that’s different than just feeling depleted, because that’s not just an early postpartum – I mean, I – my daughter is 8, and some days I feel depleted.  And then mourning your previous life; I feel like that is a little bit more earlier postpartum because we eventually get our groove back, right, and feel like we’re somewhat of the person we were before, but we will never be that same person again.  It’s kind of you walk this tightrope of, I know I’ll never be that single woman with no kids, but I also have this newfound love and joy as a mother, but how do I meld the two, I guess.  Or do you find that most women just need to completely separate and put it into two different boxes?  Like, this is who I am, and this is who I was?

Maranda:  Yeah, it’s actually really interesting when it comes to mourning your previous life.  I think we – you know,  yes, that often comes up in the very beginning, but for many, it lasts a very long time because so many of us are not supported in a way that we truly need to be supported, and we take on so – I mean, there’s so many shifts and so many changes and so many demands from raising a newborn and learning how to breastfeed if that’s something that we choose to do.  All of these components, right?  The responsibility of that is enormous, and oftentimes, we do go into almost this mourning, but we’re not able to really focus on it.  We’re not able to allow it to complete its journey.  We’re not able to feel the feelings, right, and allow it to get out of us.  And this is why oftentimes we see women who are two to three years postpartum, right?  They’ve got a toddler now.  They might even be pregnant with the next.  But they have an opportunity with a child who’s becoming a little bit more independent to step back from the situation.  And then we often here, oh, my gosh.  Who am I?  What am I doing here?  Like, how did I get into this place?  What am I feeling right now?  We have this complete and utter, like, crisis within us, and we see that fairly typically at that, you know, two to three, maybe even four-year mark.  And that is really where we have to step back and be like, oh, my gosh.  Like, this is – I was in a whirlwind.  I didn’t have any support.  I’m absolutely depleted, and I don’t even know what I like anymore.  I don’t know who I am anymore.  Who is this woman?  And then that’s the opportunity where I see a lot of women come in and say, oh my gosh.  That life I used to live is no more.  And now we are able to finally grieve, and we are able to mourn what we feel we have lost before having children.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Maranda:  So, you know, again I think that, yes, many of us – not all – will feel that mourning period in the very beginning, and many of us – again, not all – will actually feel that more so later in the years after having a baby.  And so I think it’s really important to recognize that because mourning oftentimes looks like depression.  It mimics depression and those symptoms, right, where we’re weepy; we’re exhausted, and we’re thinking about, this is so hard, and what if life was like this, and I wish I could just go to the movies.  We’re frustrated.  We’re angry, maybe even at our baby, at our partner, at ourselves.  And so a lot of those mourning symptoms oftentimes resemble depression, and they are not the same.  They’re not the same at all.

Alyssa:  I think another question, a big piece of that, is that word support.  So if – and maybe that’s why it kind of hit me in the beginning and then kind of went away, because like I said, I got my groove back, right?  I kind of felt like I’m my old self, but I’m just a mom doing these things.  I think in my head about my support system, and I was fully supported.  So I probably went in and out of that transition much quicker than some.  But that might be also a key component of, it can look like depression but it’s not, because sure, being supported could help depression, but not in the same way that it could help mourning.

Maranda:  Absolutely.  Absolutely, for sure.  And support is necessary in all of these components, right?  Whether or not you’re mourning or you’re going through depression, anxiety, whether or not you’re going through depletion.  Depression is one of the most misdiagnosed mental health issues that we see today because of two really key components, one being trauma.  We misdiagnose women all the time as having depression and anxiety when, really, they are struggling with birth trauma or even pregnancy trauma or postpartum trauma.  And we don’t get the full story, right?  The other key component of that is depletion, when we are literally depleted of key nutrients that our body needs in order to function.  And this is something that I speak on quite frequently, but there’s multiple vitamins and minerals that our body needs, and when we’re in the postpartum period, we digest differently, especially in the very beginning stages, and that different digestion really changes the way we get nutrients, and if we’re not eating meals that are supportive of that change in digestion, we’re going to lack even more.  And we’re lacking – you know, you can eat the meal, but if your body’s not absorbing the nutrients from it, you’re going to experience depletion that much quicker.  And you’re doing it in a time where your body is needing so much in order to heal, but also support your baby and their life outside of the womb.  And so there’s so much that’s required for our nutrient repletion and so very little that we give women.  And it’s often, looking at the statistics, really frightening to see how many women who are diagnosed with depression – I mean, this is statistical data – where, really, it was severe deficiencies within on a nutrient level that was causing that depression.

Alyssa:  So when you talk about depletion, you are talking about physical, like with nutrients.  But my brain went to depletion as in, I’m emotionally depleted.  But, really, doesn’t nutritional depletion also lead to emotional depletion?

Maranda:  Absolutely, hands down.  They are very, very interrelated.  If your body is emotionally depleted, most likely, you are nutrient depleted.  Almost 100% guarantee.  Because that nutrient repletion – the nutrients that you need run every function in your body, including hormones.  You can’t balance hormones without nutrients.  And so we often think, oh, well, I’m out of balance with my hormones.  I’m just a hormonal wreck.  We hear those things all the time.  Well, I’m just not feeling good because I’m a mother, and I’m supposed to be depleted because I’m a mother, right?  And that’s not the case, and if we actually focus on nutrient repletion and eliminating that stress from the body, we would allow the body to produce the hormones that will support us even more.  And of course, there’s more to the story, right?  Our thoughts greatly influence this.  Our support systems influence this.  If we’re never catching a break and we’re constantly go-go-go-go-go-go, of course we’re going to burn out emotionally, as well as physically.  But you can’t feel better emotionally if your body is not able to feel better physically.  That piece is absolutely required first before you get the other pieces together.  Which kind of a catch-22, right?  Like, if you’re emotionally exhausted and feeling depleted emotionally and you don’t have the support systems in place, and you’re constantly on the go-go-go, then focusing on your nutrients is going to be that much more challenging.  Like, I totally get it.  Been there, done that.  And that’s exactly what I support my clients through.  But there’s so much of this story is very interrelated, and if we’re going to talk about one, we have to talk about all.

Alyssa:  So you mentioned sleep briefly earlier, and I think the same thing with some of the sleep clients I work with is mental health is directly affected by lack of sleep, but then it’s kind of this vicious cycle where then you don’t get sleep, which then affects your mental health even more.  Do you – what do you do with sleep for your newly postpartum moms?  Because it’s such a critical part of mental and physical wellbeing.

Maranda:  It is.  And it really – it’s not just the first few weeks postpartum, right?  It’s the first several years, and we all know, if we don’t get the sleep that we need, we are not in a space emotionally and mentally to handle the stresses and the everyday stresses, right?  It’s so easy to fall into a depression when we’re in a state of exhaustion all of the time.  And so it’s very – the topic of sleep is really challenging because it’s so different for every person.  So, you know, I hear often, oh, well, if you just co-sleep, you wouldn’t have those issues.  Well, that’s not necessarily true for everyone, right?  You know, you can still have your baby in the bassinet next to you, and the definitions of co-sleeping are so different for so many people, right?  And the family situations are so different.  Many of my clients, they don’t have just one baby.  They have three, four, five babies at home.  And, you know, from toddlers to early childhood, and some are sleeping in the bed; some still have sleep issues, and the level of support is just not there, and they don’t feel comfortable asking for that support that they need.  They’ll worry, and the anxiety that they feel before going to bed keeps them up at night even when they can sleep.  Or their babies are waking up consistently, and they’re not able to get into a state and a rhythm of reaching that deep sleep necessary to regulate your hormones.  Right?  We can eat all of the nutrient-dense meals and work on supporting our body throughout the day, but if we’re not sleeping, our body can’t truly create the hormones that we need from the nutrients that you got during the day, right?  It’s a vicious cycle.

Alyssa:  Again, this vicious cycle where it’s so hard.  A new mom would just listen to this and go, oh my gosh, I’m doomed.  This just sounds impossible.  And it is so hard.  That’s why postpartum is such a hard time for new moms.

Maranda:  I think it’s really important to recognize how incredibly beautiful this time can be, too.  And we have – right now, we live in this world that is not supportive and conducive of that beautifulness that postpartum truly is.  It is a transformation, and oftentimes, this transformation is something of an unknown.  And when we don’t know something, we fear it.  It becomes scary.  It becomes something that we don’t understand, and we’re like, oh, my gosh, am I ever going to make it out alive?  And the answer is yes, of course you’re going to make it out alive.  And even more, it could be a beautiful thing, given the right support and the right tools.  And I’ve mentioned support several times, and I hear often – I mean, we’re in the world of COVID right now.  Support systems are incredibly low.  We have families who don’t have any support systems, even, you know, if COVID was nonexistent, because they live far away from family or they just moved or whatever the case may be.  Or they have the support systems and the family and the friends, but nobody knows how to support them.  That’s really key, too.  And I think that just means that we have to be even more creative in our approach, right?  When I started working one-on-one with women, it was not only because that was something that I needed for my family and to step back and create and grow in a different way into this online space, but also, I created something that I desperately needed, that I desperately needed in my own postpartum experiences.  And there’s so many other women, especially in smaller communities, who are asking for the exact same thing, the exact same support systems, who are – they’re just as desperate to get their hands on help.  I mean, in my community, I have seen moms gather together, and they watch each other’s kids for a night.  So they get at least one night a week off.  They rotate meals.  Everyone cooks a big batch of a meal, and they hand it off to each other.  If you’ve got a group of three people, you have three major meals cooked for you for the entire week, and all you did was one.  You have to get creative in your approach to finding the support systems in your life that you absolutely need.  And the other component to this, too, is getting the right kind of information.  And this is the hardest – probably the harder part.  This is harder than finding that community and creating that community because there’s so much misinformation about our bodies as women and about how we actually heal in the postpartum period.  We’re not talking about how the body changes physiologically.  We just know that our body changed, right?  Like every woman can ever attest to, yep, I had a body.  Yep, my body changed.  But nobody’s talking about how those changes took place.  What happened to your nervous system, how it changes your brain, which therefore changes the way you react to certain things, the way you communicate, the way you sleep.  Right?  Nobody’s talking about how your gut shifts and changes and how digesting your food changes and how you want to eat other kinds of foods that support repletion of your body rather than the depletion that’s going to bring you to this very stressful state.  And so we have to get into kind of the understanding – you know, it goes well beyond just support system.  It also goes into finding the right information that you can use to really and truly heal your body at that next level.

Alyssa:  Isn’t it great how sometimes our experiences as mothers is what drives us to do these amazing things with other moms?  My business partner and I did the same thing with this course.  It’s a six-week course for moms to give them the information because there’s so much out there, and how do you know who to trust and what to – you know, what do I think with all these articles I read?  But I love that you’re taking that to this next step with these one-on-one coaching sessions.  So is that with the Postpartum University?  Is that where you do the educating and one-on-ones with clients?

Maranda:  Postpartum University is actually – it’s newly being developed.  We have multitude of courses that are happening right now, but it’s generally for professionals.  And so our side for moms is going to be expanding here soon within Postpartum University, but Postpartum University right now is more geared toward professionals, providing the trainings that they need.  And by professionals, I’m not just talking about doulas who are working in postpartum.  I’m talking about nurses, midwives, doctors, chiropractors, pelvic floor physical therapists.  If your audience is working with postpartum women and women in the years after having a baby, that’s the gamut.  We have all of those type of professionals coming into our programs from all over the world, learning about postpartum nutrition, learning about how the body is shifting at this physiological level, and really how to support it better.  How do we really help women through this?  How do we provide that support in the community and the right kind of knowledge?  That’s what Postpartum University is.

Alyssa:  Awesome.  So if anyone wants to actually reach out to you, learn more about what you do, whether this is a professional listening and wants to find out more about Postpartum University or if it’s a postpartum mom who wants to learn more, what’s the best way to reach you?

Maranda:  Yeah.  So you can go to my website, and there you can find my podcast.  You can find my Facebook group and all of the things and connect with  me there on the trainings and one-on-one support or whatever it is that you are really looking for.

Alyssa:  Thank you so much for your time today.  I’m so excited I got to talk with you.

Maranda:  Thank you so much.  I appreciate it.

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

Kristin talks with Neri Life Choma, Author and Founder of Birth Coach Method.  They discuss the difference between a Childbirth Educator, Birth Doula, and a Birth Coach.  They also talk about transforming birthing person’s expectations from the “perfect natural birth” to a “positive birth experience.” You can listen to this complete podcast episode on iTunes or SoundCloud.

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!

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Kristin:  Hello, hello.  This is Kristin, co-owner of Gold Coast Doulas, and co-host of Ask the Doulas.  And I am so excited to be joined today by Neri Life Choma.  She is the author of The Art of Coaching for Childbirth and the creator of The Birth Coach Method.  Welcome, Neri!

Neri:  Thank you, thank you!  It’s a pleasure to be here with you.  I am so looking forward to our discussion here.

Kristin:  Yes!  I’d love for you to fill our listeners in a bit about your unique background as a doula and a certified childbirth educator, as well as a life coach to creating this new movement in the birth world.

Neri:  Yeah.  So, I am a seasoned doula and childbirth educator.  I’ve been doing this for 24 years.  My funny accent is Israeli.

Kristin:  It’s a beautiful accent.

Neri:  I actually established the birth support field in Israel.  There were no doulas when I began doing my work, and I am very happy to say that currently there are seven programs certifying doulas in Israel.

Kristin:  That’s amazing.

Neri:  It is amazing.  I have established a birth resource center in Israel and a doula support program in a major hospital in Tel Aviv.  And I’m a childbirth educator, as well.  I moved to the states in 2002.  January 2002, so it’s going to be 20 years soon.

Kristin:  That’s a while, yeah.

Neri:  Yeah.  And I’ve been blessed, Kristin, really blessed to be able to be a pioneer in Israel and then to come here and really smoothly starting to work here.  I think that we were here only about a few months when I was approached by the first expectant mom who asked me to be her doula.

Kristin:  Wow, that’s quick.

Neri:  Yes.  And it took about a year and a half until – of volunteering, actually.  So I started volunteering at a birth resource center located in Palo Alto.  A year and a half into our life here, I was actually offered to direct the center.  It’s called Blossom Birth, and it’s in Palo Alto.  I’ve been blessed to have two wonderful years directing the center.  And the funny – I don’t know if it’s funny.  The thing is, I was really experiencing myself as a very successful birth support practitioner, until I wasn’t.  Until I wasn’t experiencing myself as a successful and impactful one, and yes, it does relate to a birth trauma of supporting a wonderful individual, a beautiful woman, who knew exactly what she wanted and was so well prepared and so well informed for the birth.  And arriving for the hospital with everything changing in front of my eyes and the doctor being very abusive, and the nurses trying to create a ring, you know, a protective ring around my client and supporting me, really, and her.  But the whole experience was so traumatic because I couldn’t speak out my truth, and I couldn’t advocate in a way that I should have, just because I am the doula in the room.

Kristin:  Right.  We have a role, right.

Neri:  We have a role, and there are some limitations.  And the whole experience was traumatic, not only for my client, but to me, actually.  And at that time, I was doula already for about 15 or 16 years, Kristin.

Kristin:  That’s a long time.  Doulas burn out in three years, you know, is the average.

Neri:  Exactly.  And that was such a devastating experience that I actually spent the next two weeks in bed with pneumonia.  I was sure that it had to do with not being able to speak.  I felt the whole time that I was suffocating, that I’m losing my breath, that I need to practice my breathing, as if I was the birth-giver.  And I actually wanted to quit.  Can I admit that loudly?

Kristin:  Yes, of course!

Neri:  I wanted to quit.  I felt, that’s it.  I’m done.  I’m not going back to L&D.  So the question was, what’s next for me?  I enrolled in a year-long program to become a transformational life coach, thinking, well, I have the coaching part in me.  I’m really dedicated and committed to women empowerment.  But I don’t have to go back to L&D.  I can actually coach them and empower them in a variety of life areas: career-wise, relationship-wise, lifestyle.  So going over this yearlong program was revolutionary for me.  I kept thinking, oh, my God.  If only I had practice like this when I was a doula.  And, you know, sometimes when we have a wakeup call for things that we did, and we think, oh, my God; I was doing it all wrong – it comes with a profound sense of guilt, and I was lucky to have my teacher, Dr. Rosie, saying, well, how is it going to serve you, you know?  Everyone is trying to do their best with the resources available for them, and you know this because you’re a compassionate person.  Why don’t you stop beating yourself for this?  Why won’t you write your final paper for our yearlong program about, how would you do things different now with all the strategies that you have?  And so I did.  I actually sat down, and I started implementing all those amazing strategies of transformational coaching into my practice, my own doula practice first, of course.  You don’t start talking to other people before you know it’s actually working.

Kristin:  Right.  You need to test it, of course.

Neri:  Yes.  The first place was testing it.  And oh, my God, Kristin.  It was really such a revealing and freeing process, seeing my clients really claiming their own experience, getting to be accountable for their own experience, having the correct mindset that actually serves them in order to manifest their desired visions.  Also having a vision, you know, instead of a birth plan that looks like birth – like a shopping list, you know, I want this, this, this, this, this.  And so what if one thing doesn’t happen, you know?  Like, what if you went shopping and you came back home, and three of the things that were on your list are not there?  Is it a failure?  Can we say that the whole shopping experience was a failure, or can we go, oh, but you know what happened when I was shopping today, I actually met a friend that I didn’t see for 10 years, and we got to reconnect, and I heard about her daughter and about her life.  And on the way home, I saw an amazing rainbow.  That’s an amazing experience, even though I didn’t bring home three items on my list, right?

Kristin:  Exactly.  Yes.

Neri:  And so I started shifting the way that I think about birth, not as a project, not as an event, but as a process toward creating a vision, working with strategies for clarity, for alignment, helping my clients to align their belief system, their concept around birth, and other topics relating to pregnancy and birth and aligning their belief system first and perception with what they say they want, checking that there is a good alignment and connection and then looking at the steps that they’re taking, the actions toward achieving those goals or this vision, checking that there is a full alignment there.  Oh, my God.  It is such a different process.  And it is so valuable, and the outcomes are amazing.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Neri:  So I published it in a book.  And then the next step after publishing The Art of Coaching for Childbirth was, hmm, there can’t be only one that is doing things this way.  I want all my doula sisters to be able to do the same thing.  And so we need a course, right?  So another two years of just building the course.  And it is so fulfilling.  It’s an amazing process for me, a really growing process, a professional growing process for myself and for my students.  You’re one of them, so you know.

Kristin:  Yes!  And in a way, it was wonderful that you had this online format during the pandemic.  I don’t know that I would have had the time to invest seven weeks otherwise.

Neri:  Right.  Can I share a secret?

Kristin:  Sure.

Neri:  It’s becoming a four-month program.

Kristin:  Wow!  That’s neat.  I felt like we needed more time, especially with role plays, so…

Neri:  Exactly.  We got so much feedback from you, from others, we need more time.  We need more time.

Kristin:  Yes.

Neri:  And I have to admit that since I launched the course, I kept developing more and more strategies and more coaching exercises.  So we need time to implement and to practice, right?

Kristin:  Oh, I love that.

Neri:  So we’re going to have a lesson and then an implementation day after.  So the next week is going to be implementation.  So it’s double in length, in time.  I’m so excited about this.

Kristin:  Yes.  It is a wonderful program, and I learned so much through the certification process.  I’m glad that the new students have time to really connect with each other and grow the process of actually coaching and shifting the mindset for those that are already doulas or other health and wellness professionals.

Neri:  And let me just say, you know, I’m really honored because I find that those who really search and look for me and find me – you know, I don’t have a huge budget like Lamaze or DONA.  I’m a boutique business.  And those who find me, I see them, and they are aware and awake.  The doulas that enroll in my courses, they’re the ones who are actually aware and awake and understand that there is a missing link in their practice and that they are not as impactful and successful as they were hoping to be in leading their clients to healthy, empowering experiences.  And they start looking for this missing link, you know?

Kristin:  Yeah, and I know that when I was a doula in the early years, I felt very responsible for outcomes and almost felt like I failed my client if they didn’t achieve the things on the birth plan checklist.  And I later learned through other certifications that I went through that I wasn’t responsible for the outcomes, so some of that weight lifted, and I did really allow my clients to take some ownership and lead versus feeling like I needed to direct as a doula.  But there were still so many missing links that you talked about, and I didn’t have the coaching education that you do.  So this was brilliant for me and allowed me to get out of the typical process that we as doulas have with every client of when to call us in prenatal and the basics, reviewing the birth preferences and the type of support that they like.  But this is really, again, so directed by the client themselves and knowing that each individual is unique and they have different goals.  And then really encouraging them to seek out a plan that is best for them and then guiding them to the steps they need to achieve it.  And obviously as you said, things may veer off, and we can’t control how baby responds in many things in the delivery process, and even in the pregnancy.  So yeah, it’s been…

Neri:  I think, Kristin, if I may say, I think that the more I keep teaching and practicing transformational birth coaching myself, the more I understand how profound is the shift that we’re creating in the field.  So what we’ve been doing until now as birth support practitioners, whether it’s doulas or childbirth educators, even prenatal teachers, we’ve been doing a lot of informing.  And there was an assumption, you know, that when our clients are going to be informed, they’re going to make informed decisions, and this will change their experience and will help them have vaginal, healthy birth and an empowering experience in which they feel that they were on top of things, they were in control, because they were making informed decisions, right?  But the thing is, you look at the Listening to Mothers survey in California, and even the recent one, you can go on Google, and it will tell you that even though 75% of all birthing individuals in 2019 – I believe the last one that I read was 2019 – 75% of them agreed that they were well-informed.  However, only 5% of them gave birth with no major medical intervention, and I’m emphasizing major.  So that is what I say as the missing link, you know?  And I have this saying that I keep repeating, and I will keep repeating it until I’m blue in my face, until everybody will just see that informing is great if your client is about to deliver knowledge.

Kristin:  Yes.

Neri:  But it is not the best practice if she is going to deliver a baby.

Kristin:  Exactly.

Neri:  For delivering a baby, we better work on the mindset.  And the whole phrase of “informed decision,” I want to ask all of us to take a moment to think about this phrase: informed by what?  I’m saying an informed decision is when the information that you have within is taken under consideration, when you listen to your logic, when you listen to where your emotions are taking you, when you have this internal compass, you know, that is guiding you in the right direction.  This I call an informed decision, not when you are making a decision based on information that is totally external to you, and you’re now becoming your own authority.

Kristin: Right.  Yeah, it’s a huge shift in mindset, and some people don’t want to prepare by doing all the readings, and like you said, it’s as much of a mental preparation, and so it could be, for them, just focusing on reading positive stories and having a positive mindset versus taking every single class that we recommend as doulas.

Neri:  Yeah.  But they will still need to go through a process of clarifying for themselves, what is their preferred birth vision?  So let me give you the – I want your listeners to be able to bring it down to earth, you know, to understand how is it relating to their lives.  In the past when I didn’t have the transformational tools, and I was practicing, you know, with the resources that were available for me, which was informing prior to birth, making sure that my clients are informed, helping them be informed about their choices, write down their birth preference list or birth plan, as some call it, and then supporting them throughout labor with all the labor support techniques that doulas have and also help them make informed decisions when it comes to medical interventions.  So that was my practice before that.  So if a client was interviewing me as her doula, and I would ask her, so what are you hoping, and why are you hiring a doula?  She would say, oh, I really would like to have a natural childbirth.  And in the past, you know, as a doula, as a representative of the natural birth movement, I would cheer for her, and I would say, oh, that is so wonderful.  I’m so happy to hear that.  This is the cheapest way to go; this is the safest way for you and your baby.  This is the most empowering experience.  Our ancestors gave birth like this, and this is the most beautiful and natural rite of passage to becoming a mother, blah, blah, blah.  I would talk until – you know, and I would just cheer for her.  And there was a lot of information and perceptions that came from me.  I was delivering the perspectives and the information.  Nowadays, it sounds completely different.  She comes to me, and she says, I’m hiring you because I really would like to have a natural birth.  And then I go, tell me more about this.  What is natural birth for you?  How do you think it feels?  How do you see yourself behaving?  What do you see yourself doing?  What is your motivation to have a natural birth?  For example, as a transformational coach, you, Kristin, because you took the course, you already know that we have two types of motivations.  We have a motivation that is negative one, meaning I’m running away from.  I’m running away from –

Kristin:  An epidural.

Neri:  I’m running away from the needle; I’m running away from Cesarean; I’m running away from sickness.  Okay?  We have lots of negative motivations that motivate us in some directions.  You can even diet, you know, be motivated to go on a diet because you’re trying to not be sick.  Right?

Kristin:  Sure.

Neri:  But there is different type of motivation that is more on the positive aspect, and we call those aspirations.  What do you aspire for?  Those are a lot stronger because if your client is committing herself to go through birth naturally because she is afraid of the needle, let me tell you something: the moment that her fear of the increased sensation of childbirth, the increased sensation of contraction, the moment that this fear is going to be bigger than the fear from the epidural needle, then this is tilting, and she’s choosing epidural.

Kristin:  Right.

Neri:  But an aspiration can take her all the way to the end.  I aspire to – what is it that you aspire to have?  The vision?  A positive motivation?  We can tap on this in moments of crisis; remind her that she’s not a victim of this pain; she chose it.  The reason why she chose it; what is waiting for her at the other side that lead her to originally choose to give birth not taking an epidural, and this is so much stronger.  These are the materials that are going to take her all the way to the end.

Kristin:  Yes.  It is a different focus.  Some people may be motivated to birth the way their mother did, for example, versus avoiding and running from fear.  Yeah, I love it.  So how would one hire a birth coach versus a doula, or if you describe this for our listeners who are hearing this likely for the first time, and as they’re assembling their team, can you explain between the childbirth educator, the doula, and the birth coach, how they make informed decisions regarding care?

Neri:  So I think that childbirth educators are really helping clients be informed in a structured way.  And so I think that millennials, who are most of the birth-givers nowadays, they have three doctors called Dr. Google, Dr. Facebook, and Dr. YouTube.  And they have so much information at the tip of their fingers, right?

Kristin:  It’s not always the best information, but they have plenty of information.

Neri:  Exactly, exactly.  So what I see as the role of childbirth educators is to actually, first of all, sort out, you know, truth from myth, fears from reality, facts from mythology, and bring it to their students in the childbirth education class in a very structured way that helps them take all the information that they need in, in order to be able to have informed conversations with their practitioners, make informed decisions about their birth plan.  Maybe also advocate for themselves, but the advocacy, it’s really a different skill that doesn’t rely on information.  It relies, really, on your ability to speak up for yourself.  So someone can be well-informed and yet not have the ability to advocate for themselves, and we’re working on this with transformational coaching.  So this is the childbirth educator, and I love them, and I am one.

Kristin:  So am I, yes.

Neri:  And one more thing I may say is that, for me, a good childbirth education class will be one that focused on the coping techniques and really introduce a lot of techniques and allow the couples to practice those techniques, right?

Kristin:  Absolutely, yes.

Neri:  Because it’s really about – as I said, it’s not about knowing about birth.  It’s about being with the experience.  So how are you going to be with the experience, and what are you going to do?  What are you going to rely on, right?  So that’s the role of the childbirth educator, I would say.  Then the doulas – and I am a doula – most of them, if they don’t have the transformational birth coaching strategies, they will mostly meet with clients two times prior to the birth, help them finalize their birth plan, check in with them about what they want, what they want to avoid, how the partner would like to be involved, and then most of the work is then done throughout the birth experience: being hands-on, supporting, being verbal with encouragement, helping your clients maybe make informed decisions.  If you have a way of hearing the medical staff and then take a little bit of time to consult with you so that you can give them the tools.  But you’re not going to do the advocacy for them.

Kristin:  No, not at all.

Neri:  This is going to kick you out of the room, right?

Kristin:  Right.

Neri:  But what you can do is help them think, you know.  We’re using the brain model the doulas are working with, and we help them think, you know.  But the thing is, most doulas still remain within the decision-making process that relies on facts and information.  And what transformational birth support coaches do, is they send the client in.  They help the client reconnect with her own internal authority, her own internal compass and her belief system, and then we can actually make an informed decision that informs from within and is based on what’s right for me.  And I would say one thing about this, one additional thing that maybe your clients want to know, and maybe it will actually make them see how transformational birth coaches are a lot more aligned with the medical system, okay?  The medical system actually knows and embraces the idea of patient-centered care as safer and superior care.

Kristin:  Absolutely.

Neri:  So they are actually looking for ways to implement patient-centered care, patient engagement, and create partnerships between the medical staff and the patients.  And this is true to the general healthcare and in maternal care.  However, they don’t always have the tools because the medical teams are not trained with transformational coaching strategies.  When a doula walks in the room and she has those tools, and she knows that the medical systems seek this kind of care, she can lead everyone in the room.  She can actually facilitate this partnership.  She has the strategies to build the partnership between the client or the patient and the medical teams and to create a teamwork.  She has the strategies to engage the client.  She has the strategies to lead the nurse and allow the nurse to provide patient-centered care, and this is so embraced and welcomed by the medical staff that no doula that practices like this is ever going to be in conflict with the nurse.  So there are some doulas who come to the course and then they implement a series of – and you probably do that – they implement a series of prenatal coaching sessions with their clients, and so they will shift the focus off the work from supporting during birth to providing this series of prenatal coaching, creating the mindset, the confidence, the clarity, eliciting clients’ accountability, and then guess what happens?  A miracle happens, right, Kristin?  We know that.  Our clients actually spend very little hours in active phase and in transition, and they go through birth like bam, bam, bam, because the mindset allows what needs to happen.

Kristin:  Mindset is so important, yes.

Neri:  It’s everything.  And they have those shorter births that are progressing in a timely manner, and they don’t need you for 36 hours.  You get to be with them for five, six good hours, and bam.  And it’s like magic.  And there are doulas, I discovered lately – I think Naima was in the course with you, but I’m not sure –

Kristin:  Yes, she was.

Neri:  But there are more of them now that actually told me, well, you know what, I’m done being a doula.  Because the past few clients that actually hired me as a doula didn’t even call me for the birth because they were so well-prepared, and the birth went so fast.  And I actually decided that I’m not doing doula work anymore, and I’m becoming only a transformational birth support coach, which is something I didn’t even think of.  I didn’t even dream that it was going to happen, Kristin, really.  That’s like, oh, my God.  I wasn’t even ready to, you know, just stop doula-ing my clients and just provide that.  But now I am.  Now I’m saying to my clients, you know, you can hire me as a doula, and we will have those four to six sessions, prenatal sessions, because these are the sessions that are going to make your experience so much more empowering and go well and smooth and healthy.  Or you can just hire me as a transformational birth support coach, if you don’t even want to have a doula with you.

Kristin:  It’s all about options, so of course.  Yeah.

Neri:  Yeah.  Giving them the options, yeah.  How do you feel about that?

Kristin:  I, you know, am so new in the process, I haven’t gotten to that point.  I’m newly certified and really establishing that end of my practice, so I certainly, you know, early on in the course, started implementing techniques through prenatals.  Yeah.  But I love hearing what other coaches have been doing with their own businesses and what their clients are saying about it and what your own clients and how they’re responding.  Yeah, and for our listeners, since they’re located all over the US and the world, how would one find a certified transformational birth coach if they’re looking?

Neri:  Absolutely.  Great question, Kristin.  I didn’t even think about it.  So birthcoachmethod.com, and we have links on our website for a directory of all of our certified coaches.

Kristin:  And that will be growing!

Neri:  That is growing, and I’m so honored to say that we’ve had students from so many countries: South Africa, New Zealand, Australia, Israel, the Netherlands, Cypress.  I can continue – Japan.  We just had the first one in Japan.  I feel – Qatar, Dubai, Egypt.  This is really growing.  It’s amazing.  No one can stop it now because this was the missing link, Kristin, really.

Kristin:  I agree, Neri, and certainly as far as – you know, we do have doula listeners as well, including our own team members, so how – if someone is a birth worker, childbirth educator, or doula, and they’re interested in this program, how do they find out more information?

Neri:  Okay.  I’m announcing it for the first time: we are having a free event for birth professionals that will take place September 20th, and it’s going to go for five days.  We’re going to be – yes, we’re going to be on Zoom for 90 minutes each day, and we are going to go through the five game-changing principles and strategies of providing impactful and successful birth support.  And right after the event, they can go – or even before, they can actually go online, find our course, Transformational Birth Support Coaching, and enroll in the program.  And we have yoga teachers, midwives, childbirth educators, doulas, that are joining the event and that will join the course.  And as I said, our next session is going to be the first time that we’re actually going to lead a four-month program with one day of studying and then the next week, implementation day, so that you really get to implement all those new strategies and make the shift.  It’s a huge shift, right, Kristin?

Kristin:  It is.  Yeah.

Neri:  It’s really a shift.

Kristin:  And I’m thankful for the group that you created and the fact that we can have collective calls together and the Facebook community.  So I know as you evolve, we’ll also be able to keep up with the information and grow our practice.

Neri:  Absolutely.  I look forward to this, and I am so committed to doulas’ success, because here is the thing, you know, Kristin: when doulas are successful, their clients are having amazing experiences, right?

Kristin:  Yes!

Neri:  So that’s all I care about.

Kristin:  And like you said, we can’t control medical emergencies and outcomes, but as you were explaining in the grocery store experience, it’s the other takeaways.  And, you know, and their perception of being responsible for their choices and feeling empowered versus birth happening to them and feeling like everything is out of control.  So just shifting that mindset.

Neri:  Absolutely.  And being informed from within, from their gut, having this compass, saying, this is who I am.  I am not going to commit to any birth experience because I perceive it as superior or ideal or the best.  This is who I am.  This is what I want.  I’m going to try and have it my way because it’s my baby, my body, and no birth practitioner can tell me that’s a better experience for you.  I know what’s right for me.  And that is a very new position for birth workers that, until now, all of us, including me, Kristin – I’m going to be the first to admit that – we were all associated with the natural birth movement, and we were having an agenda that says that natural, unmedicated birth is better for you.

Kristin:  That is the movement, certainly.  Yeah, my practice is – we focus on judgment-free support and work with a lot of planned surgical births and clients who want an epidural right away, but when I started out as a birth doula, my clients – I would say 80% of them wanted a natural birth, either out of fear or out of, you know, just more aspiration.

Neri:  Right, or they think that it’s superior.  Someone told them that it’s the ideal birth.

Kristin:  And I said great, and I’m with you on that.  It’s like, oh, wonderful, that’s the way to go.  And – yes.

Neri:  My recent thing is to totally ditch the term “natural birth” and start talking about “positive birth experience.”  That’s it.

Kristin:  That’s it.  Yeah, that’s the goal.  A positive birth experience.

Neri:  A positive birth experience.  I’m not – every time that someone just starts talking about natural birth, I say, there is nothing like that, just like there is no natural climbing on the Everest.  So let’s skip the whole concept and go with “positive birth experience.” That’s what we’re here for.

Kristin:  Love it.  I agree.  So before I let you go, I would love for – you know, we talked about your book, The Art of Coaching for Childbirth.  How does one purchase a copy of that?

Neri:  Well, it’s on Amazon, or it’s on my website.  This is more a book for the professionals.  I don’t want your clients to be confused.  The Art of Coaching for Childbirth is actually for the professionals, but I do have a wonderful product for your expecting individuals that are listening to the podcast, and it’s called Practicing for an Active Birth, and it can be bought on Amazon, either as a DVD or a USB.  And there’s also, on my website, there’s also a version for streaming.  And we can even create a coupon that you can send your listeners so that they can get it.  It’s really two and a half hours in episodes that will enrich them with a variety of labor support techniques that they can practice.  And you know what?  In birth, practice makes better.  Just like in everything else.

Kristin:  In life, yeah.

Neri:  I tell my clients, when I try to explain to them why it’s so important that they will have a regular practice of their labor support tools, I say, hey, did you have a wedding dance?  And they go, yeah.  And I said, well, how long did you practice the steps for your wedding dance in order to know that once you hear the first notes of the music, you’re going to just own it and you’re going to rock this dance, and they go, about three months.  And I say, okay.  I want you to get to your birth day just like this.  Contractions are going to begin, and you’re just going to know exactly how to respond to them because you already have the muscle memory and you practiced those techniques.  So it’s called Practicing for an Active Birth, and three options: streamed, from video, you can purchase it on the website or the two other options are a USB or DVD on Amazon.

Kristin: Wonderful, Neri.  And so do you have any final words for our listeners as we part?  Any advice?

Neri:  Yeah.  Maybe one tip that is another thing that is a major shift that I think I am trying to lead the community: I think that we’ve been focusing a long, long time on what can go wrong.  Generally speaking, I think that all the abundance of medical exams that women go through throughout their pregnancy is setting up for a mindset of, this can go wrong, and that can go wrong.  They keep getting these messages of what can go wrong throughout the whole pregnancy and also throughout birth, you know, being hooked to the monitor.  It’s creating the mindset that, oh, we think every moment something can go wrong.  So we’re putting you on the monitor to be sure everything – you know, if it does go wrong, we can catch it on time.  I think that it’s creating a level of fear and anxiety, and it is in our hand to reverse it.  So expecting individuals will do themselves a big favor and will set themselves for the most positive and empowering experience if they actually sit down and say, if a fairy was entering the room right now, and she would have grant me my wish, what will I ask for?  What is my optimal desired birth experience?  Start writing it down.  Fantasize.  Go to fantasy land.  Don’t think about what can go wrong.  Don’t think about that.  Just really allow yourself to talk to fairies.  Sometimes it’s different than a conversation with a human being.

Kristin:  Of course.  That makes sense.

Neri:  So talk to the fairy.  Just ask her for what you want.  Write it down, and start rehearsing this scenario instead of rehearsing what can go wrong.

Kristin: Yes.  It’s all about mindset.

Neri:  There we go!

Kristin:  Thank you for your time, Neri.  This was eye-opening, and I’m so excited about the movement that you’ve created.  I’m honored to do this work.

Neri:  I’m honored, and hopefully it will really, really facilitate positive birth experiences.  Thank you, Kristin.

Kristin:  Thank you!  Take care!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

Alyssa talks with Amanda and Katie, Women’s Health Physical Therapists at Hulst Jepsen Physical Therapy, about postpartum physical therapy and what pelvic floor physical therapy looks like after having a baby.  We talk about incontinence, diastasis recti, symphysis pubic dysfunction, constipation, and so much more!  You can listen to this complete podcast episode on iTunes or SoundCloud.

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!

Alyssa:  Hello, Amanda and Katie!  Good to see you.  Today, we are going to talk about postpartum physical therapy.  You are both women’s health physical therapists at Hulst Jepson, and we’ve had some beautiful conversations in the past.  And I think we haven’t really covered what physical therapy looks like yet specifically in the postpartum period.  So, yeah, let’s get started.  What does that even look like?

Katie:  Yeah, let’s dive right in.  I think the first thing that women think about is probably their six-week follow up with their doctor.  Usually it’s at the six-week mark that they talk to their OB-GYN.  And we would love to see this visit be standard practice and standard practice for referral to pelvic floor physical therapy.  That’s common in a lot of countries.  I think France is the one that is often cited.  But often there’s a really quick check of you and baby, and you’re told, okay, you’re good to go, without a lot of other details.  So this can be a great time to talk to your doctor about a referral to see a pelvic floor therapist.  That visit should be about the baby but also about you and how your body is doing, too.  A couple things that might be red flags that you need to see a pelvic floor therapist would be any urinary leaking, any continued constipation, any pain with sexual activity, any pelvic heaviness, just to name a couple.

Alyssa:  What is pelvic heaviness?  What is that?

Katie:  People that will describe that it feels like my organs are falling out; like, it feels like there’s a lot of pressure there, or it just feels like there’s a lot of tissue there, and I just don’t have a lot of sensation around it.  Or things just feel loose.  Like, my body doesn’t feel like it felt before I was pregnant, and it felt like everything was held together more.  It feels just kind of fluffy.

Amanda:  Yeah, I’ve heard that one a lot.  Like it feels loose or feels like a golf ball is kind of hanging there.  And that’s typically – definitely your OB-GYN will take a look, we hope, to diagnose or say, hey, there’s prolapse; you know, the scary word for postpartum.  But it shouldn’t be, definitely not, because that’s something we can help with.  But that pressure sensation can be because there is some prolapse there, and that will definitely kind of – when we dig into different diagnoses we see postpartum, we’ll dig into that one a bit more because there’s a whole series of things that people come in with that they already know they have or something that we find.  And the diagnosis that we describe obviously can happen if it’s a vaginal birth or a C-section.  Obviously, it’s a different experience for mothers, and in some ways, we treat that differently, but in some ways, some of the symptoms of it can be very similar.  Obviously, a C-section, with the abdomen we pay a little more attention to that area and healing and scar massage and whatnot to kind of get the abdomen to activate, and then that vaginal delivery, it’s like, okay, questions regarding, like, kind of lochia, like that discharge and stuff.  Where are you sitting with that?  How active can we be?  To kind of help you in every part of that journey.  As Katie said, six weeks out is a great time.  Obviously, if you’re having symptoms of incontinence or heaviness feeling, discomfort in that pubic bone in the front, or if you’re feeling pretty good but just really want to get back to running or that high-intensity interval training or just walking, if walking is uncomfortable.  We love partnering with new moms or could be your fifth kid or second kid to say, hey, yeah, let’s get you back in shape for the life that you live.

Katie:  And if you don’t feel ready at six weeks, that’s fine, too.  A lot of women are overwhelmed.  There’s a lot going on.  They’re getting used to a new baby and a new lifestyle.  So it doesn’t have to be six weeks.  It can be months later.  It can be years later.  And we’re going to take into account what’s going on at home that you’re telling us, too, and try not to give you a million more things to do at home.  We’re going to try to integrate things you can do into just what you’re doing anyway for you and for baby.

Amanda:  Yeah, I just had a mom.  I asked her if she could do things at home for her low back.  She says, oh, every time I go on the ground, my three kids run and jump on me.  I’m like, well, that may not help your low back, so let’s try maybe before they wake up and after they go to sleep or during nap time.  We’ll kind of navigate that with every individual that comes in our door.

Alyssa:  That’s really good to note because, you know, life with kids is so busy, whether you have a newborn or a newborn and three other kids.  Knowing that, okay, I’m not ready at six weeks yet, but I can come in a couple months and I’m not going to ruin myself.  Or I can do these – maybe I need to get up – like, I even find personally I need to wake up at 6:30 in the morning before my daughter wakes up at 7:00 and leave the dog in the crate, because same thing, if I’m on the floor doing yoga, I have a kid and a dog on me, without fail.  So as much as I love them, I need to do that alone to get an effective workout.  So allowing moms to say, okay, this isn’t going to work for me, so here’s my lifestyle.  What can you give me to fit into that?  That’s great.

Katie:  Exactly.  I think another great example is with diastasis recti.  So you’ve heard of “mummy tummy” or the splitting of the abdominals.  A lot of people get really nervous about that.  That’s something that we can easily assess.  We can look at your core strength.  We can show you how to close that gap in your abdomen, and that can be as easy as doing a little contraction that we teach you to do while you’re picking up your baby.  Or, you know, while you’re putting your baby into the crib.  So you’re getting a workout with stuff you would be doing anyway.  You’re just slightly modifying it, like we instruct you to do, to get the most out of that routine in your day.

Amanda:  That’s huge, and that one, with the diastasis recti, there’s always going to be some sort of separation.  There has to be, because your baby has to grow.  Your belly will grow.  But what we kind of dig into is to say, okay, how is the tissue?  How does it feel?  We can diagnose it with finger widths.  We take a look at that at the belly button, above and below.  But then we take at look at, is it firm?  Is it boggy?  How is the integrity of that tissue?  And based on that, okay, you’re ready for level A type of exercises, let’s say, or hey, you can – yeah, go jump on that bar and do some pullups.  It’s fine.  Your abdomen has good integrity.  You’re not going to have any sort of herniation or anything like that.  So it’s nice to work with the patient to help them get to the level they want to be and then also kind of meet them where they’re at and say, this is where we need to start, based on our findings.

Katie:  Yeah, a lot of women will come in and say, oh, my doctor told me the diastasis would heal up just fine.  Just do some planks.  And that works for a lot of women, but not for every person.  That tear in the abdomen sometimes isn’t straight.  And so I’ve seen women where sometimes they can do, like, one half of a bicycle, like maybe the right arm and left leg, but if they do the left arm and right leg, then it will actually open the diastasis more.  So that’s why seeing us, we can help you figure out what exact exercises are going to be the best for you so that you can get quicker into whatever workout you’re interested in doing.  Plus, it has the nice side effect of flattening the stomach muscles of that abdominal canister.  And if that wall isn’t as firm as it’s going to be, then we can see some more dysfunction in your pelvic floor, since that’s also part of that.

Alyssa:  I think that’s an important note, that just because one exercise might work for most, you could actually be doing your body damage and making things worse if you don’t actually have a professional assess, hey, this is what your muscle is doing, and this is the exercise you need to do to fix it, not just this – you know, the blanket statement of, do some planks.  Right?  That’s like – everyone calls – I get calls all the time.  I have a six-month old; how do I get them to sleep?  Well, there’s no one answer just for you.  If it was that easy, I would write the book and become a millionaire.  But there’s not just one answer.  So I think knowing, especially with our bodies and different exercises, that we can really do our body harm if we’re doing – trying to do the wrong things.

Amanda:  Yeah, and I think after pregnancy, that’s a change on your body, and then labor, that’s a huge change.  I mean, your body is kind of relearning how to walk again in some ways.  So picture those muscles as just kind of a baby itself, trying to relearn, and that’s where you want to make sure it gets that neuromuscular control in the proper way.  And that takes – it definitely takes help from a professional to help you through that.  Not everyone’s the same, and just to get that repetition of the correct way, the correct cueing, the correct postural form for it.  And as Katie mentioned, the correct pressures, too, because obviously, with delivery, whether it’s C‑section or a vaginal, the pelvic floor is probably going to change a little bit.  We know that it stretches over 100% during delivery, and then baby, when you are pregnant, it has to hold up baby during that time.  And that’s where we kind of mention, hey, that pressure sensation, that that’s not – the pressure right in the canister, it can lead to pressure pushing down into the pelvic floor, and that’s where we come in and say, hey, did your – you know, with your medical exam, did they say anything about any prolapse, I guess you could say?  And if they did,  awesome.  Let’s check it.  Let’s see how you’re doing.  So that’s where we can come in and check that.  We don’t necessarily medically diagnose.  Physicians don’t love it when we do the diagnosis, but we can definitely check the integrity of the pelvic floor, if it’s kind of a boggy sensation.  And we can do postpartum via internal assessment or we can definitely kind of externally get a sense where, if you try a pelvic floor activation, do we feel pressure into our hand, or do we feel lift, and that’s really nice to do externally.  If you had a kid six weeks ago, maybe internal isn’t what you really want to go through at that point.  And then help you with breathing patterns, core activation, to help kind of get those pressures proper again.  And typically if you don’t have pain, we can help you kind of reactivate that pelvic floor to make, basically, the base of that trampoline strong again and bouncy again to get that pressure sensation off.  And that’s fun to work with females on whether they say, hey, as I walk with my stroller, ten minutes in, I get that pressure.  All right.  We’re going to train you.  I want you walking for ten minutes not feeling that pressure, and then take it from there.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Katie:  Yeah.  Going back to that prolapse, that’s when your bladder or your rectum or your uterus are collapsing into the vaginal canal, and because they’re kind of falling lower than they should sit, that can cause some pressure.  But just because you feel pressure doesn’t mean that is what’s going on.  And your doctor is the best one to assess that, but we can easily see it, too.  Like Amanda said, it doesn’t mean that we’re going to necessarily diagnose it, but we could send you back to the doctor to see if you needed some more support than what we can give you.  So we can help support, like with what Amanda said, teaching you how to do exercises that will help push those organs back up where they should be.  But some women, the exercises are going to help, but they also might need a little bit more support from something like a pessary, which is going to be like a plastic platform pushing things up in place, too.  So that’s once again where we work closely with your gynecologist to help you figure out the best solution, and not everyone has that.

Alyssa:  Because there’s obviously different severity levels?  Prolapse is, like, a horrifying word.

Amanda:  As I said it, I was like, do I dare say it?  I don’t want to scare people.

Alyssa:  No, we do have to say it because it’s a real thing, right?  It’s a real possibility, and there are different severities.  I don’t know; just knowing that it could happen, what to look for, and that physical therapy might easily help what you have.  And if not, you can work with a medical team to figure out, like, okay.  They’re going to do this, but we can also continue to work on exercises to continue to build strength.

Amanda:  Oh, 100%.  Yeah.  Definitely don’t get discouraged if they’re like, oh, we think you’d benefit from a pessary, because we work with women with pessaries to get the pelvic floor stronger to say, hey, can we live without that pessary now?  So definitely, definitely ways to make things stronger, for sure.

Katie:  Yeah.  If you hear the word prolapse, it doesn’t mean that you can’t return to HIIT workouts or can’t return to running.

Alyssa:  I think we all think of the worst; like, literally something falling, like an organ falling out of the vagina.  That’s instantly where our brain goes, and it’s like, oh my God.

Amanda:  That’s not the case!  No, no.  And then other things that we see come through our doors is obviously leakage.  That’s one that we’ll get postpartum, and I know we talked about that in a previous podcast.  We dug more into that, about helping females through that process, too.  And then constipation.  I know, Katie, you’ve had a little bit more on that.

Katie: Yeah.  So constipation is pretty common during pregnancy, after pregnancy.  I think that’s maybe something women talk to each more about, preparing themselves for that experience.  But I mean, I’ll have people coming in with constipation who are like, I’m taking MiraLAX.  I’m taking a lot of other things, and I’m still having issues, and I don’t want to be on these medications, and I’m feeling a lot of pressure.  What can I do?  And it’s amazing.  After one visit of talking about posture on the toilet, things improve so much.  So from a mechanical perspective, there’s a lot you can do to help relieve constipation and that pressure.  So we talk to people about how they’re sitting on the toilet.  Can your feet touch flat when you’re sitting on the toilet?  If you’re short like me, they cannot, and so you might need to use a stool, or I know the squatty potty, that’s been more popular mainstream.  But getting those feet to sit flat and relax is really important.  If we have our toes curled, that can tighten our pelvic floor, and if our pelvic floor is tight, it is hard to get the stool out.  So relaxing our feet and then, for some women, a slight lean forward can help.  And then we can talk about breathing to help also with getting the stool out.  So Amanda’s talked a lot about breathing and expanding the pelvic floor with inhaling, with exhaling.  You can do that on the toilet, as well.  So you can breathe out like you’re blowing on a pinwheel, and you can try to expand your belly out and downward.  And all of that can help open up the pelvic floor, open up your rectum, and make it so much easier and less painful to poop.  So even talking about that for a session makes a huge difference.

Amanda:  Yeah.  I hope some of you are running to the bathroom right now to just try that.

Alyssa:  Do you like the squatty potty overall for anyone as a general rule, even tall people, just to get your – I guess it would be your intestines or your bowel in the right position?

Amanda:  Yeah.  I think – I know for me, I’m taller, and I think just having the knees above the hips, the pelvic position, it does create a little bit more relaxed position just to allow – we tell that not only for bowel movements but for when you urinate as well, to just say, yeah, no rocket peeing.  Relax on the toilet.  Let the pelvic floor fully open.

Katie:  I would say it just depends on the person.  Sometimes, if you’re very tall, or just depending on the positioning of things in your pelvis, because every pelvis is a little bit different.  If you have your knees up way too high, it may actually cause things to compress a little bit more.  So I wouldn’t say that it’s necessary for everyone.  I think a lot of it is based on height, and then oftentimes, I’ll have people try putting their feet up maybe on a pile of books or something they have at home first, and then if they like it, then the squatty potty is a good way to go.  But it doesn’t work for everyone.  Often, the breathing is the key thing.

Amanda:  Just even a laundry basket, I’ve told people to use, too, so they don’t have to buy something new.

Alyssa:  If you have older kids, too, like my daughter has a step-stool just to get to the sink.  I’ve tried that before, too.

Amanda:  Yeah.  And like she said, it doesn’t work for everyone, but it’s nice to give it a shot, for sure.  Yeah, and kind of moving past that constipation piece, another thing we see is that symphysis pubic dysfunction, to pain right in the center of the pubic bone, kind of the center of your pelvis.  And that, we look at a lot of rotation of the hips, what’s going on there.  So once again, this is external, because obviously, those rotations can pull on that pelvic floor.  We talk about, hey, how are you holding baby; what are some postures you’re putting yourself in?  Do you have some unilateral weakness?  And those, when you’re getting back into higher level activity, is there kind of a brace or something that, just for now, could you wear to do some of those higher-level activities?  Not forever, but just during this time when it’s painful and you’re trying to get your muscles back working well.

Katie:  Yeah, that old SI belt you may have used during your pregnancy can actually be really helpful afterward to give a little bit more support to that abdomen, especially if you’ve got some of that diastasis recti or the pubic symphysis pain.  So we can help you adjust that to work for you, too.

Amanda:  Yeah.  Very common, for sure.  And again, the next one is the scarring piece, whether it’s an episiotomy or Cesarean section scar.  Teaching people, hey, it’s good to kind of massage that.  We can help with that, but mostly, hey, start working on that at home so you know where the restriction lies there.  It can affect the muscles’ activation, just resting position, and obviously, pain levels, as well.  So we both do that, too.

Katie:  And it’s never too late to work on scar tissue.  So if you have an episiotomy scar from several years ago and you’re feeling kind of just some numbness or lack of sensation there or you’ve still been having some soreness in the area, that’s something we can still work on years later is just trying to break through some of that scar tissue and get your normal muscle tone back.

Alyssa:  That’s one of the things I learned at your office, actually, is that a scar – I mean, I knew that a scar left scar tissue, but that you can break it up, and I learned that a lot of the pain I was having was from scar tissue that had just – I mean, it didn’t even – like, it wasn’t even a thought.  So I learned how to feel that and break it up, because when she did it, I was like, oh my gosh.  That’s such an intense pain.  Keep doing it because I can feel that it’s actually working.  And then it continued to be less and less painful.  But yeah, I had no idea that it could cause that much pain so much later.

Amanda:  Yeah.  They can be a little sticky.  It’s like the tip of an iceberg sometimes where the tissue underneath just has to get worked on, which it can, which is great, by yourself or with help.

Katie:  Yeah, that’s true for the C-section scar, too, because you’ll see that the scar, usually in the US, is more horizontal.  But even though the scar is horizontal, you’re actually also stitched vertically underneath, too, with the way that you were opened.  So we teach women not only to do the massage horizontally but to look above and below the scar, as well.  There’s probably some tightness in the tissue there, too, deeper.

Amanda:  So obviously a ton of things that we can help with.  We can answer questions; we can explore with someone who’s a new mom, especially where it’s all very foreign.  Or if the postpartum was just different this second or third time around.  Yeah, we can encourage, definitely, hey, exercises at home, exercises here.  We have a great setup in our gym for those returning to exercise, returning to running.  We can take you through a program with that.  Strength training is so important, especially with baby care, or if you have a toddler, as well, that you’re lifting.  We always seem to be in that flexed position, so we really encourage extension, that opening.  Breastfeeding; we can help with posture with that if there’s pain involved, how to set that up; or hey, what exercises should I do before or after breastfeeding to get rid of some of this pain, to avoid the pain altogether.  There’s just a lot of things, which is so fun.  It’s great to partner with females after birth to get them through and back to the body that they’re used to having, function-wise.  And we just have fun with it.

Katie:  Yeah.  And it’s exciting to look at the whole body.  A lot of times, we’ll have someone come in, and they’re really just focused on the leaking, maybe, that they’re having, or some urinary leaking.  Or maybe they’re just focused on some heaviness or some scar tissue.  But it’s really fun to take a look at the whole body and be like, hey, how can we help your neck and shoulders and your midback feel better with breastfeeding?  How can we make your whole body feel more like it’s yours again?

Alyssa:  That’s a really good point with breastfeeding because a new mom who’s doing that every two hours, 24/7, that takes a toll on your body.  And like you said, that position, you just constantly feel – gosh, it seems endless, and the pain in your shoulders from that or your arms.  Yeah, that’s a really good point.

Amanda:  Yeah.  I mean, I hold my seven-pound dog for 15 minutes, and I’m like, I’m exhausted.  I got to step up my game!  But yeah, strength training is huge.

Alyssa:  Well, this is awesome.  I know we’re running out of time.  Do you want to just tell people where they can find you locally?

Katie:  Yeah.  Amanda and I are located at Hulst Jepson Physical Therapy.  We’re at the East Grand Rapids location, although it’s not actually in East Grand Rapids.  It’s just outside of East Grand Rapids.  We are located on Burton between Breton and Plymouth.  So we work well here as a team, and you’re welcome to call and talk to our receptionist, Lexi, and she can definitely set you up with a visit or with a free 15-minute consult.  There’s other locations that Hulst Jepson has that may be more convenient to your home, as well.  I think we have five different locations with pelvic floor physical therapy.  And so looking online at their website to find the best location for you.

Amanda:  Yeah.  We’d love to see you and help.

Alyssa:  Awesome.  Thanks again.  This was another really interesting conversation that we just need to keep talking about.  Let these moms know that you’re here to help!

Amanda:  Awesome.  Thank you!

Katie:  Thanks for chatting with us!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

 

Kristin talks with Sarah Baker, a current client and student in our BECOMING a Mother course, about her concerns with her second pregnancy/delivery and why she chose to hire a birth doula as well as invest the time in a 6-week online course.

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, co-host of Ask the Doulas, and I’ve got Sarah Baker with me today.  Welcome, Sarah!

Sarah:  Hello.  Thank you!

Kristin:  So happy to have you here!  And Sarah, you are currently in our six-week online course, Becoming a Mother, so I have you here today to discuss, you know, how that series worked for you during your pregnancy, why you decided to join, and so on.  And for those of you who don’t know what becoming a mother is, we just launched our beta version this spring of the course, and our next series comes out on August 2nd.  It is six weeks of preparation for having a confident pregnancy, birth, and also newborn phase.  So, Sarah, why did you join the class?  I remember seeing you on our webinars that were promoting the class initially.

Sarah:  Yeah, so I have actually had a child already, and during that first delivery, everything was wonderful, but I was always interested in having a doula or interested in learning more about doulas.  And so when I talked to my sister, who had a doula for her third child, she had recommended Gold Coast Doulas and I had reached out and heard that there was this upcoming course.  And I thought, wow, what a great way to learn about so many things all at one time and just kind of get all of my information to kind of make my decision whether, you know, how I wanted to build my team, how I wanted my labor and delivery to look, and then even assessing the postpartum care, as well, which I learned that there are postpartum doulas and got to learn that, and that was super exciting because you’re not in it alone, so you can definitely get all the different resources.  So it was just really interesting to learn about the different themed weeks that you guys have for sessions.

Kristin:  And it is so interesting that I feel like the interaction component, with COVID, is so important, even in a virtual format, like the online private Facebook group.  That has been really the reason that we launched Becoming a Mother, because our clients were feeling isolated and our students in our classes that went from in person to virtual.  So Alyssa and I figured, you know, this is the perfect time to better support women, not only in West Michigan, but throughout the country, who are feeling isolated and anxious due to COVID and really needing to get some resources since a lot of things that used to be in person changed to virtual, including fitness classes and even some provider appointments at different points in COVID were virtual.

Sarah:  Right, and you bring up a great point with building the community.  You know, it has been isolating and it has been nerve-wracking, and you don’t know what to do, where to go, or you don’t want to socialize too much.  But having that Facebook group has been a huge connector with the option to reach out to other moms and other soon-to-be moms and just ask candid questions.  It was just really fun, and that was kind of before everything started and the Facebook group had launched, that was kind of – I don’t know, because I had time, sort of like before classes start, everyone’s kind of getting to know each other and throwing out questions and just those ice breakers.  It was just a really cool way to see who else in my area, and I think it is just really great to have some kind of online connection to then stay connected, because even after the six weeks are over, I can still pop on and say, okay, question about this; now I’m experiencing this.  What are you guys doing – it’s so hot, what are you guys – I’m seven months or, you know, you’re eight months pregnant in summer, and how are you guys dealing with the heat?

Kristin:  Yeah, exactly, or your baby’s teething or going through a growth spurt, and this group, the women in the course, can come and go from it but have lifetime access to all of the videos and the Facebook group.  So, yeah, to have those, not only experts like Alyssa and myself as birth and postpartum doulas but also, you know, learning from each other.  And you’ve been able to guide a lot of the first-time moms based on your experiences and other seasoned moms who are in the group, so that connection has been lovely to learn from each other and get advice about different wellness practitioners that you’ve all seen in your own communities.  So that is a lovely bonus out of all of it.

Sarah:  Absolutely.

Kristin:  So what would you say overall as far as what you – the official six weeks have ended, but we’re still connecting and asking questions to each other in the group.  What would you say were the highlights of what you got out of Becoming a Mother overall?

Sarah:  That is a great question.  I think for sure the Facebook group and just the fact that I can post a question.  I mean, like we had mentioned, I have a toddler at home, and so even just asking the question of what are you guys doing – like, how can I make sure that my older child still feels special, or what can I do when we bring baby home, and so it’s just been nice to have other moms who also have other children who have given their recommendations or have given what they’re planning on doing, as well as the live Q&A calls were really helpful, even just to listen what other mothers or expectant mothers are experiencing as well.  So it’s just been nice, again, not feeling alone in such a kind of isolating time that we’re having, and even when things kind of settle back to normal, it’s just another cool opportunity to have access.  I live close enough to Grand Rapids, but I may not be able to make the commute, you know, if it is an in-person class, if it were a six-week course or something, so it’s just cool to have a virtual option, as well.  But I just think that the course really reminded me of a lot of things that I wanted to have top of mind, like the self-care aspect of things, and the biggest things for me were understanding the doula-client relationship and what we can expect or what a doula does, and then I also laughed about the sleep training information.  So I think that was – like, what was that, week two and three for assembling your team, and then week six, so I was very excited about those courses because that’s definitely what I had struggled with the most with my first, with sleep training, and again, it’s the situation of asking for help and knowing that there are plenty of resources, and it’s not an insurmountable task.  There are local resources and very wonderful people who are out there to help.

Kristin:  Yeah, and it’s been great because we have a student from New York and one in Detroit area and one out in Seattle, so I’ve been able to connect them with resources in their communities, as well, but of course, we have a lot of West Michigan trusted providers.  So as far as – you know, you had joined at a good point in pregnancy, but if you were to give advice to any friends who are interested in potentially taking this course, at what stage in pregnancy would you say would be ideal to join a course like this?

Sarah:  So probably – I mean, I did it early.  What was it, like 10 or 11 weeks or something?  It was pretty early.  And I thought, oh, is this too early?  Like, should I not have done this?  Definitely, the second trimester and when you’re thinking about, do you want a doula – and even if you don’t, I think there’s so much information – or if you decide that that’s not the route you want to take, there’s so much information and so many tools to use throughout the pregnancy, and like you said, during pregnancy, then labor and delivery, and postpartum care.  I think there’s just so much information that whether you’re on the fence about having a doula or not, that it’s just such a great tool or such a great workshop or course, you know, to take.  And I think probably, yeah, in the 20 weeks and beyond – I don’t know if there’s too late of a time, because if you do want to get a doula, it’s probably – I can’t remember what weeks you recommend having someone like that picked out, but that –

Kristin:  Ideally, first or second trimester because we booked up.  If you want a particular doula, we tend to get booked up, but our agency is big enough at Gold Coast where we can find – we’ve had clients hire us at 40 weeks in the past.  So it can certainly work out, and as you mentioned, not everyone who is in the course plans to have a doula, but it’s also other, you know, related professionals and understanding with some of the expert videos and what we go through in week two of assembling your dream team, both personally with family and friends and also professionally, so getting into physical therapists and having videos from Webster-certified chiropractors, for example, and fitness videos and some nutrition-focused content, so figuring out in that – and I know you worked through that planning and budgeting workshop of what your insurance might cover.  Do you need a referral from your provider for, say, a physical therapist, or after having baby, pelvic floor therapy, and what might be covered if you have a health savings or flex spending.  What are your priorities and what is your budget?  Like planning a wedding, you have a budget you work with, and what are the key things?  Is sleep key or is breastfeeding support with a international board-certified lactation consultant, or is having a doula that you’re using a health savings or paying out of pocket for?  And all of those things, and if you prefer to have a homebirth midwife that you’re paying out of pocket for versus having a certified nurse midwife or an OB and delivering at the hospital.  And so factoring all of those things in has seemed to be helpful for a lot of our students to just figure out what resources are available in their own communities and then just prioritizing based on needs.  Some people want a birth photographer and pictures are very important, or newborn photos.  And so figuring that into the budget.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Kristin:  So what are your thoughts on getting through some of that planning?  What did you learn through the expert videos or even the course content in week 2 that you hadn’t known before with your first child?

Sarah:  So definitely the variety of doulas.  I mean, I think I knew of them, but I didn’t really think about it, that there’s the bedrest doula.  There’s a birthing doula, and then a postpartum doula, and it just kind of clicks, like a lightbulb went off, where it’s like, wow, yeah, if I had to be on bedrest and here my husband still has to work and there’s a toddler, how do you figure that out?  So it just gives you more to think about, as well, just to kind of overall think, okay, if something should happen, yeah, what would that dream team look like?  Would it be family, or could I have someone come in, or even just having someone, if it’s hiring someone to do some housecleaning or housekeeping while you’re expecting or after?  So it just really gave me a good opportunity to sit down and say, okay, so what do I think I need, or what do I want – kind of needs versus wants, and what do I want it to look like, and for me, the hospital room, my hospital has changed to where now any doctor – which probably could happen anyway, but any doctor could be delivering my baby, and I was thinking, okay, so you establish this relationship with a doctor for all these prenatal visits, and then Dr. Smith is going to walk in and deliver the baby, which Dr. Smith is absolutely capable and wonderful, but I don’t know Dr. Smith, and so that really is what drove me to look at having a doula who could be there, you know, throughout the pregnancy, having questions and texting and just building that relationship where it’s not so scary to go into this hospital room.

Kristin:  Right, because you don’t know your nurse, or your nurse might have a shift change and then you need to establish a new connection.  But you know your doula, so it is lovely just to have that reassurance and connection and know that they understand what your birth wishes are and regardless of who’s in the room, that you will be fully supported emotionally and physically.

Sarah:  Right.  And then when I was interviewing the doulas, it was also great to hear just the support for the partner or whoever’s going to be in the room for the delivery, so it is kind of like, yeah, you could have a really long or a really short delivery, and if it’s a really long one, you know, your partner will need a rest, too, or may need to step out for something.  So it’s just nice to have additional support that they can kind of trade off or take turns on different things.

Kristin:  Yeah, exactly.  So earlier in our conversation, you had mentioned the self-care component, so that’s part of week one, when you’re processing your feelings about your pregnancy.  And women in the course joined at all stages, like we had some women that had their baby shortly after the course began, so we’re already hearing birth stories, and some women are newly pregnant.  So just regardless of the stage, thinking about what you’re doing for self-care and what you’re doing to connect with baby and, you know, how you are taking time, especially during a pandemic, to truly care for yourself and help prepare for the upcoming birth.  So what did you get out of that first week?

Sarah:  I definitely got out of the first week that, again, you know, self-care is important, and being a mom already, you’re kind of wanting – you know, you want to make sure that your child or children are taken care of and all set, but then making sure that you know to take the time to go to bed early if that’s what you need, or take a bath if that’s what you want.  And so I definitely took some more time to go on walks and really kind of re-engage in my yoga practice, and wanting to – kind of doing sort of like the – I will do, like, a good morning baby belly rub, and if I’m putting on any kind of lotion or vitamin E oil or something, just to kind of be like, okay, good morning, baby.  And I did that a lot for my first, but as we talked about, the first, you know, it seems like, oh, there’s so much time, and then with the second, it’s like, okay, you’re running.  You’ve got all these different things.  So not wanting to let so many things slip away, and my husband and I have made an effort to take bump pictures and make sure that it doesn’t just slip by, you know, all of a sudden.  I’m like, oh, you know, when I start showing, and then it’s like, oh, wow, I’m showing already.  Like, I am showing faster than I did for my first.  So it’s like, so we’ll have more pictures, but maybe we won’t.  So a lot of that, and I think just giving myself the space and the time, that I don’t have to get it all done, either.  I think that a lot of times, you’re trying to nest or you’re trying to make sure that all of this is taken care of, and I’m like, okay, that laundry can wait until tomorrow.  So that’s been a little bit of self-care for me, as well, where I’m just like, okay.  I’ll run – you know, I’ll have my husband run the dishwasher while I tag team something else.

Kristin:  And we chatted more about assembling the team, but in the final week with me in the pregnancy and birth portion of Becoming a Mother, we talk about your actual birth prep.  So that covers everything from positions to the environment in your birthing space to, you know, a bit about your birth preference sheet or birth plan and having discussions about who will be in the room, whether it’s a doula, or depending on visitor restrictions, if you plan to have family and so on.  So, again, being a second-time mom, what did you learn from that segment that you didn’t think of with your first birth?

Sarah:  A lot of it was the environment piece, because I think so much or so often, I go places, and I think, I am the client or the guest, and they know – they do this all the time.  They deliver babies all the time in the hospital.  So I’m not going to put them out, if that makes sense.  So if the lights were too bright, I didn’t think to say, hey, can we turn the lights down.  Or if the environment wasn’t a certain – it just gave me more of an empowerment to say, okay, this is my experience, and I’m going to deliver a baby, and so I want – it needs to be good for me.  So I think that was probably the biggest thing, my biggest takeaway.  And I don’t think that – well, it’s been a few years now, but I’m trying to look back with my first delivery and how all of that went down.  But, again, I didn’t ask for a lot because, oh, they’ll let me know or they’ll tell me this.  And I’m thinking, oh, you know, I brought different things.  Like, I think I even had a diffuser or something that I brought along with me, or there were things that, you know, trying to make it more of my own space.  But again, coming into the environment, I didn’t realize how that would directly impact.  Like, if I’m having solid contractions on the way to the hospital and then I get there and now they’re ceasing, and it’s because, okay, now I’m in a weird space and my body is stopping and slowing down, and no one really – like, I didn’t think about it as, oh, your environment’s changed.  Your body’s now going into a weird, like, I don’t know where I am.  And the nurses, you know, would help as they could, but, again, I had shift change after shift change for my nurses.  So that’s been my long answer of, it was definitely kind of an empowering thing to say that this is your experience, and however you want it to be.  So I’m very much looking forward to having my doula come, and she mentioned that she brings LED candles.  And I think that it just – and to have music.  You know, we had kind of the generic hospital room experience where the TV turned on, and I was on an exercise ball, and there were just different things.  And I tried to move around, but I realized I didn’t move nearly as much as I should have been, just kind of waiting for it to happen to me instead of working with it.  So that was eye-opening and, like I said, an exciting thing.  So now I can feel more active in the event.

Kristin:  I love it.  And then getting into the overall investment in your time with the weekly – we have the live calls, which are recorded for those who miss them.  There are video lessons that are short, but there’s usually two or three videos per week, and then worksheets.  So what was that, as far as your weekly commitment, and how did you budget that time, knowing that you didn’t need to stay on track each week, although it certainly is helpful if you want to get on the live calls to have those questions answered.

Sarah:  For sure.  So the videos, I feel like, posted pretty early on, too, in the week, so it was for sure every Monday – at least by Monday, they were posted.  So I would try to jump on either Monday to download the worksheets and then take a look at the worksheets or watch the videos.  I definitely would watch the videos no later than Thursday, and a lot of times, in the evening, and I would kind of get a notepad out and jot a few questions down or take some notes.  And then I would print out the worksheets, and sometimes I would be really diligent in doing all of those worksheets, and then other times I would just kind of look over them and be like, okay, here are questions I have for it, or these are my thoughts, because I did want to join the live calls and make sure if I had questions that I was able to get them answered.  Another thing I wish that I had kind of done was, like, submitted my questions earlier, too.  That wasn’t something that I really had thought of, if I had questions, to send them in case I missed the call, so then they still would have been asked.

Kristin:  That’s a great tip, and some people who knew that they weren’t able to make the call would ask questions in advance and we’d answer them in the recorded call or within the Facebook group, if they thought of them after the fact.  So that is also helpful.  So would you say you spent maybe 30 minutes to an hour a week prepping for the calls, or what would you say your time was?

Sarah:  Yeah, probably 30, 45 minutes or so to watch the videos and do the worksheets to, yeah, prep for that live Q&A call then later at the end of the week.

Kristin:  Great.  And then the calls, depending on how many questions and how many people are on, they’re about an hour in length, just so our listeners and clients understand that.  And then getting into the final three weeks, Alyssa leads everything about baby and postpartum planning and feeding options, as well as sleep.  So what did you get out of that, again, being a seasoned mom, not a first-time mom?  What did you learn through those last three weeks that you hadn’t considered before, or what tips were helpful to you?

Sarah:  My biggest takeaway was definitely about sleep – and I hope I get it right.  I should have looked it up to make sure that I have the routine down.  But with sleep, you know, baby wakes up, feed baby, play with baby, and then put baby down again.  For my first, I definitely got into the habit of feeding to sleep, and you kind of have this close bond, and it’s sweet and it’s lovely, and it worked for a while, but then we laughed in the Q&A call where it’s like, it works until it doesn’t.  And then all of a sudden, you’re going back to work, and you have to wake up all the time, or you’re the only one who can do the bedtime routine or whatever.  That kind of starts to put a strain on things, and so for me, that is kind of an uplifting or an exciting – the ah-ha.  Like the ah-hah moment, the awakening of, oh my goodness, that just makes sense, that you wouldn’t – you know, if you want to disassociate it or not have your baby always associate it – again, I didn’t mind it, but come down the road, it’s one of those things.  So for me, the sleep was probably the most educational and just important one for me because, again, with my first, it was a totally different experience.  However, with different kids, you could have a totally different experience.  The other thing that I really liked was when Alyssa kind of did some debunking of, you know – I think there were, like, three common misconceptions or three common myths, like never wake a sleeping baby, kind of thing.  And so it’s just, again, great tools and just good information to kind of give yourself that – the approval in, like, saying that no, there are times when you will have to wake a sleeping baby.  You’re not going to let your baby sleep for all this time, and your baby needs to eat.  So that was good to hear, as well.

Kristin:  And then as far as the expert bonus videos, you all helped us create some of that content based on feedback, which was great because all of the future students are able to benefit from it, but we had noticed that a lot of the course participants had wanted more resources and support for dads, so we had an author come in and talk from the dad perspective about how to engage the father and some helpful tips, so that was one.  And also car seat installation; we added that one later in.  So as far as expert videos, give us your thoughts on some of that coming from the professional perspective versus us relaying information directly to you.

Sarah:  Again, I just think so many great tools and resources, and to be able to jump on the website and watch them and get the tidbits and get the information that you need.  And then go back and rewatch them.  There were quite a few that I watched, and I was like, these are excellent, but I don’t necessarily retain everything, so the fact that you have access to them throughout – forever, and now I can go back, and I can have my husband watch the dad author…

Kristin:  Welcome to Fatherhood.

Sarah:  Thank you, yes.  It was the WTF, that’s right.  So, yeah, I can have my husband watch the author of WTF, Welcome to Fatherhood, and same with sleep training.  Again, if there’s anything that I find helpful, it’s just a great resource that I can keep going back to, as well.  Or if I think, oh, I don’t need this right now, and then all of a sudden, oh, wait, I do actually need this now.  I need to know how to pump before going back to work or those kinds of things.

Kristin:  Exactly.  And then our HypnoBirthing instructor, Ashley, has one on breathing, and that was based on feedback that we received after the birth prep group of just, how do we get more resources in planning, especially for first-time moms, but some moms, you know, didn’t really know what to do with the pushing stage for breathing or even in the early labor.  So did you watch that one, and did that affect how you plan to focus on your breath during labor?  Especially with COVID, where until you get admitted, you’re wearing a mask through part of your labor.

Sarah:  Right.  Well, and I think – and it may have been more in conversations with you.  I may have watched the video, but again, I’m trying to remember all the different ones that I watched.  But even just not having it be – like, to breathe with it, or again, you know, kind of working with it.  I think a lot of times when you’re experiencing a contraction, it’s, again, happening to you, or you’re feeling like it’s no, ride it, or breathe with it.  I’m trying to think of the words that you may have used before, but it’s just sort of like, take it on and don’t tense up.  Just kind of – so, yeah, definitely helpful and something that I’ll be watching, even if I have rewatched it, rewatching.

Kristin:  Oh, yeah, as it gets closer, for sure.

Sarah:  Right, because again, just those reminders.  And, again, excited to have a doula on my team to then also remind me and to help me through that, as well.  Because, again, in the heat of the moment or when things are happening, sometimes things get kind of lost in the shuffle.

Kristin:  Right.  Exactly.  So, Sarah, thank you for filling us in your experience with the Becoming a Mother course, and we’re so thankful that you joined us in the early beta stage so we’re able to use your feedback as we create the next version of the course that comes out in August.  Our goal is to have them quarterly so women will have options to at least take one class during their phase of pregnancy throughout the year.  As far as what you would tell someone who’s interested, I know you had mentioned to me before we got on this podcast that you had some friends that you were planning to tell about the course.  What have you explained to them, and why should they invest not only their time but also their money into an online program?

Sarah:  Again, the community is just so incredible.  You mentioned it yourself, you know, having the experts, as well as just fellow moms-to-be, has just been an awesome resource.  And like I said, now you have this virtual community.  I really think that whether you are looking at having a doula or not, there are so many resources and, again, those expert videos are fantastic.  It’s just gaining so much information that you have access to throughout your pregnancy and then after, and any future pregnancies.  And so I think it’s just such an awesome way to go through learning – you know, I do love learning, and I love getting as much information as I can, so it’s just really helpful to have it kind of all in one place, as well.  You know, you can buy a ton of books, which you also recommend, but you can buy a ton of books and read as many books, but again, having those live Q&A calls and having someone on the other end if you’re sending an email or posting something on Facebook.  It’s just that real time connection that’s been huge for me.  And then, again, just having the experts that can give answers or provide you resources and connect you with the people who can help.  So it’s just been awesome.

Kristin:  Thank you so much for sharing, and I look forward to continuing to connect in our Facebook group.  I can’t wait to hear your birth story down the road.

Sarah:  Yeah!  Well, thank you so much for having me.  It’s been a pleasure.

Kristin:  Thanks, Sarah.  Take care!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

 

Kristin & Alyssa talk with Amber Shaw, a recent student in The BECOMING a Mother online series of classes, about some fears she had with her second pregnancy and why she took this course.  You can listen to this complete podcast episode on iTunes or SoundCloud.

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!

Alyssa:  Hi, Amber!  Thanks for joining us!

Amber:  Hello!  Thanks for having me!

Alyssa:  We’re talking to Amber Shaw today.  She’s a past and current client, and then you also just completed our very first beta launch of the Becoming a Mother course.

Amber:  I did!

Alyssa:  So we kind of want to talk to that, and Kristin’s here with us, too, today.  As you know, she teaches the first three weeks on pregnancy and birth, and then I teach the last three weeks on postpartum planning and sleep.  So we just kind of wanted to get first-hand experience for other people who might be thinking – other moms who might be thinking about taking this course, and maybe ask you some things about what you got out of it.  Kristin, do you have any questions to start it off?

Kristin:  Yeah.  So, Amber, I would love to – I know when we approached you about the concept – I would love to hear your thoughts on why, being a second-time mom, you decided to invest six-plus weeks during your busy life and pregnancy to join us in this brand new online course.

Amber:  Well, I feel like you kind of black out a little bit.  After your first child – you know, I got pregnant again.  My son is almost four, and I feel like there was a lot that I just didn’t remember about, you know, when he was a newborn, particularly.  I think your mind kind of, you know, forgets some things to protect you a little bit and make sure that you have the opportunity to have a second.  And there’s so much new information out constantly and just a million different places to get it, but I think that in general can be overwhelming to a new mom or even a second-time mom.  So, you know, I love you guys.  I used you for my first birth, so it was kind of a no-brainer to work with you again and just kind of get a brush-up on everything, and I got a lot of new information out of it, too.  So it was nice just to kind of have everything in one space from trusted sources that I can reach out to if I need to.  It’s not just like you’re getting information and then that’s it; go run with it.  So, yeah.  I like the whole concept of it and just the fact that you guys are available for questions, too.

Kristin:  And even working with doulas currently, have you found that it’s still beneficial to get that information from Alyssa and myself in different areas that maybe your doulas may not be talking to you about on the regular?

Amber:  Absolutely.  I love my doulas a lot, but I don’t want to reach out to them for every little question I have.  I don’t want to ask them about safe sleep and kind of brushing up on that stuff, so I think there’s just some things that you kind of want to do research on your own time about.  I kind of save my texts for the doulas, especially at this point, to, like, hey, is this sensation normal, not asking them about, you know, breastfeeding and all of that stuff.  So it’s a different type of – like, a different type of information area, I guess you could say.

Alyssa:  And added on to that, I think – you know, so you have a four-year-old, and now you’re pregnant again, but even if you would have remembered all the things, you’ve never birthed during COVID before, so I think that’s its own huge part of – you know, and until COVID goes away, which who knows how long we’re going to have parents and mothers in particular really nervous about giving birth during a pandemic, you know, that is a big piece of what your first or second week – probably your first week you go over that?

Kristin:  Yeah.  Well, we go over, you know, just pregnancy expectations and fears and feelings, and I think it applies no matter what stage of pregnancy a woman is at.  Obviously, with anything, it’s better to join a course like Becoming early in pregnancy, but we’ve had clients deliver their babies shortly after the class started, and they still got benefit and are interacting and have lifetime access to the videos if they have more children.

Amber:  Well, I think the good part about it is how you guys break it up so much.  Like, it’s easy to go in and find the information that you’re looking for, which I think is really nice.  You don’t have to, like, watch a whole video to kind of – you know, if you remember what section something is in that you want to brush up on or needed more information about, you can go right there.  I loved that about it, and I think it really broadly covers, like, yeah, you’re pregnant.  You know, now what do you do?  You’re faced with all these questions and decisions, but now the baby’s here.  So it’s kind of both ends of it, which I think for my first time around, being pregnant, I focused so much on preparing for birth that I don’t think I prepared enough for postpartum and what really happens when you’re bringing the baby home, and I think that probably happens to a lot of people because you’re just so angsty about the day and just thinking so much about the day of your birth but, like, that’s just the beginning of it.

Kristin:  So true!

Amber:  There’s so much that happens after that you’re constantly like, is this normal?  What do I do if this arises?  And, you know, you can’t constantly be calling your pediatrician or – well, for me, it was just the pediatricians because I didn’t have a postpartum doula, so I think that really having solid information and resources for when baby comes home is so important and something I wish I would have spent more time on my first time around.

Alyssa:  You’re not the only one.  A lot of parents say that.  Like, oh, my gosh.  We read all the books – well, it’s the exciting part, right?  Like, you find out you’re pregnant, and you’re so excited, and your brain can’t even go there yet.  You’re so focused on a healthy pregnancy, and then you get to the – oh, my gosh.  What is labor and delivery going to be like?  And then you never even get past that.  Like, once you bring the baby home, then what?  And that’s the hard part, right?

Amber:  It really is the hard part.  You’re so – it’s so overwhelming, and especially your first time around, I just questioned.  I questioned every mark on his body.  I questioned his baby acne, what it really was.  You know, if I had enough supply; is he even getting anything out of me?  It’s a really intense time.  I think the fact that you guys have so much content focused on that, and also resources.  That is huge, especially the second time around, I really, I think, focused on those because when I started the class, I already had my doulas and everything like that, and I knew that I wanted a vaginal birth, like a VBAC, so I kind of had a good idea of my care team and all of that stuff.  So I really focused on the second half of the course and the bonus videos and being active in the Facebook group and stuff like that.  That’s been really beneficial to me.

Alyssa:  Let’s talk a little more about the Facebook group because that was a big part of, when we put this class together, especially, again, during a pandemic when moms can’t get together and have that community, to have a really safe and open space where you can ask these questions that you might not feel comfortable asking in a big open Facebook moms group with thousands of people in it, and to know that you’re going to get support and answers and responses from Kristin and I that are like, hey, here’s what the evidence says, or hey, here’s a trusted resource in our area or your area who can support you.

Amber:  I think that’s invaluable.  There is too much – there’s too much out there.  It’s overwhelming.  You don’t always know if you’re reading somebody’s opinion or if it’s evidence-based.  Everybody has an opinion about everything when it comes to parenting and motherhood, and it’s really – like, you’ve got to really sift through all of that stuff and find clarity, especially when you are postpartum and already emotional.  I remember coming across so many resources when I was up in the middle of the night questioning things that just sent me down an even worse rabbit hole of thinking I was doing something wrong or making me even more paranoid.  So just to have a couple places that you go to for – where you just – yeah, you know that you’re going to get a reliable answer that’s evidence-based from somebody that you know.  It’s invaluable, like I said.

Alyssa:  Well, good.  That’s what we wanted!

Kristin:  And you’ve all helped up shape the course based on feedback from the live Q&A calls and in the group.  So we added an expert video on car seat installation.  We had the author of Welcome to Fatherhood do one for dads specifically, since dads are not in the group.  Dads and partners, I should say.  So to have something that they can look at and get involved in the pregnancy, birth, and parenting aspect of things.

Alyssa:  Yeah, we were very intentional about not having – literally, all of our other classes are for couples, and we think that’s really important and we love it, but then it’s like – I think mothers wouldn’t be so open about asking specific kinds of questions or talking about, you know, especially in the postpartum one, we talk about some – you know, the nitty gritty, like what happens to a female body afterwards, and males aren’t going to want to either listen to that or hear about it, and we’re not going to want to talk about it in front of them.  Like, as much as I love my husband, I’m not going to tell him about what happens to my body every month when I get my period.  So we were very intentional in that, too, of like, let’s just make this only for mothers.  Birthing persons only, and let them feel really safe and comfortable here.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Amber:  I was actually just watching that one the other day because I had a Cesarean with my first birth, so in a way, I feel like this is my first birth, in a way, because I have not experienced any type of labor at all.  I haven’t experience postpartum with a vaginal birth, and that was really great to hear about all of that stuff because it’s going to be my first time experiencing it, even though I’ve had a baby before.  So no matter what birth you’re on, they’re all different, and I think this information is always good to have as a reminder, even if somebody has had a vaginal birth before.  Just the reminders of prepping yourself to, this is what’s going to be happening because to not know – yeah, the more you know, the better you can go in and just be mentally prepared for whatever happens.

Kristin:  And I know you were very interested in the sleep aspect of things, and that live call was quite well attended.

Alyssa:  Yeah.  I mean, every time I talk about sleep, I remind myself I need to create a class specifically for sleep, and actually, from this beta group – and I’m almost done writing it.  Like, I feel like it would be great – because you all are pregnant around the same time.  You’re going to have children in the three- to six-month age range around the same time.  Like, this group of women who go through the course together could then, if they wanted, go through this sleep class.  It’d be, like, four different sessions for four different age groups or something.  I’m trying to work through how that would be, and then you could commiserate together of like, oh, my gosh, this is how naps are going.  But then I could be there to be like, okay, based on what you told me, here’s what you all need to do.  So I’m working through that in my head, because I know sleep is a really big issue for parents, whether first time or like you, with a toddler – I guess he’s older than a toddler at this point, but a lot of people with a one- or two-year-old at home, it’s hard, especially when they’re not sleeping well yet.

Amber:  Yeah.  I’m actually way more concerned about sleep this time around because I have another kid.  Like, the first time, you really can nap when they nap, and doing all of that stuff, and luckily Parker has always been a really good sleeper, but man, I feel like my second time around, I want to work harder at getting to know his sleep schedule and working on that, because it’s just – I just don’t have the flexibility to just be focused on him and to be sleep-deprived all the time.  So that would be so beneficial and so helpful, I feel like, for people, because I didn’t do any type of sleep training the first time around at all.

Alyssa:  Yeah, you got lucky with a kid who liked to sleep.

Amber:  I did, yeah.  Yeah.

Alyssa:  And who knows, maybe the second one will, too.

Amber:  We’ll see.  He’s very active at night already.

Alyssa:  Well, my intention with week six with sleep was just to give everyone enough info that you go, oh, my gosh, I can do this.  It’s not impossible.  I can start from the beginning creating these really healthy sleep habits so that when my baby is ready, it’s not such a problem.

Amber:  Right.  And then too, I think, remembering that just the beginning, there is no – you’re just kind of at the whim of the breastfeeding, and you are up all the time, and you can’t even look for those patterns yet.  So even just for the reminder of that, because I think you kind of forget about that time, as well, just because it’s all a blur.  Like, night is day; day is night.  It’s a very strange time.  So even just being ready to jump back into that and setting yourself up for support, I think that, like, I’ve had a lot more conversations with Ashton this time around, and this is what we’re about to be in again, and we have another kid, so I’m fine getting up, obviously, all night long, but you’re going to need to step in a little bit more in the morning hours with Parker and letting me nap throughout the day.  So I feel like good conversations have happened with Ashton and I more than they did the first time around, too, based on some of these classes and just the reminders.  And having those talks now and not later when it’s more emotional because you’re just exhausted and just trying to survive.

Kristin:  So true.  We communicate both in my section about planning and also in the postpartum section, that communication is key and setting that expectation, especially with your partner, but also with family and what their expectations are.

Amber:  Yes.  Once again, something I did not really focus on the first time around, but I am now.

Alyssa:  We’re so glad you took the course and that you enjoyed it.  And then as you know, this course is just going to keep growing and evolving, and as videos change, and who knows, baby number three comes, you’re still going to have access to all this stuff, so we can keep reminding you, and if you want to stay in the Facebook group, you can.  If you want to get out, we won’t be offended.

Kristin:  And we’ve had some great conversations in the group.  I’ve loved seeing birth stories shared as people are having their babies.  It’d be great to do some sort of virtual reunion in the group.

Amber:  It’s nice too that everybody pretty much in there at this point is local, as well.  So it would be great to kind of form some play groups from it or just actually meeting each other at some point, since we are coming to some kind of normalcy in the world.  So actually having a mom group – you know, I’m obviously part of a few of them on Facebook.  I’ve got a love/hate with all of them.  I kind of just use them when I need them and don’t scroll and don’t get into anything in there, but having women local in your area that you can reach out to and possibly create relationships with is really awesome, too.

Kristin:  Yeah.  We have a few students from other states and one from southeast Michigan, but you’re right, the majority in this one are local, so it is cool to have that connection.

Alyssa:  As the course grows, it will have a wider and wider reach, but I think that’s maybe an advantage you have with this beta course is to maybe reach out to some of these moms and say hey, you know, now that the weather’s nice, let’s plan a meet-up.  Like, let’s meet babies.

Kristin:  So what advice do you have, Amber, for women who are on the fence about investing the time and money into an online program?  And if they’re deciding or even looking at their budget as we go through kind of your budgeting and your goals, why would you say this would be important during someone’s pregnancy and newborn journey?

Amber:  Well, I think, just like with anything, being prepared is just the best way that you can set yourself up for success, and as a first-time mom, I wish I would have had something like this.  I did have doulas, so I did have support, but even with women who don’t bring doulas on, you know, just to have a place that kind of gives you a roadmap of some kind of plan to have, people, to reach out to, like a place to start, is super important because it’s all just – it’s a very overwhelming experience, especially for a first time mom, and especially during the pandemic, because a lot of in-person classes really aren’t happening anymore.  Maybe they’re starting to now, but I think just having one place to be able to get all of your questions answered and that kind of touches on everything is just – you know, it’s a huge investment in yourself and your family and the future of your sanity and how things are going to go and just kind of having an idea of what to expect, I think, is really important getting into this because there’s a lot of unknowns, even if you have done all the research.  So it’s absolutely worth it, and it’s nice because you can just do it on your own time, too.  You know, it’s not like you have to show up to a physical class every week.  I did the HypnoBirthing the first time around.  I actually did quite a few classes through you guys, but this is nice because you can just kind of sit in bed at night and watch as much as you want to, so it’s really flexible, too.  I really love that about it, as well.

Alyssa:  Well, and when you took HypnoBirthing, you were pregnant with no other children, so you could basically – you know, your schedule was your own, but now it may be really hard to get away, as much as we would want to get away every week and have something to do…

Amber:  It’s just not feasible.  Not feasible all the time.

Kristin:  And that’s why we break out the videos into short content so you can watch one video on this particular topic rather than doing a longer 30-minute to an hour-long video.  Digest information at your own pace and access it whenever you need it.  Some women got into the first couple of weeks quickly and then had things going on with spring break and so on and took some time to get back into it, so that self-paced aspect but being able to get on calls, where live, or ask questions after watching the recording, I think, has been very helpful for the group to be able to look through it and then ask questions directly versus a self-paced course where you don’t have the interaction component that we do in Becoming.

Amber:  And so many things come up during pregnancy.  It’s so important just to have that connection with people where you can ask those questions.  That’s super important, and I think something else I wanted to say, too, that I really liked about it is I feel like all of the classes go over things, and then you have resources on top of that.  So it’s like you have the breastfeeding class and then you have a lactation consultant that you guys work with.  So I think everything is paired really well, too, so it’s not just like a little bit of something and then you’ve got to figure the rest of it out.  You have all the resources in one place, so people don’t have to go looking for that stuff if they have more questions or need more clarification or support on something.  It’s right there.  So that’s also a huge added value.

Alyssa:  Yeah, I feel like we tried to do that, and we probably – I mean, we – as doulas, that’s part of what we do, too, right?  Like, we offer support but then also accompany that with resources because we know that the two go hand in hand.  So I think either intentionally or unintentionally, it just happened in this course because that’s how we live and breathe.  We want to support you in the best way we can, but we know we can’t do everything.  And then like you said, there’s way too many places to get information, so we’ve already done it; we do it all the time for our clients, so let’s just put it in one place so that it’s easy for you.  To take one thing off of a busy mom’s plate –

Amber:  Oh my gosh, yeah.  Worth its weight in gold, for sure.

Alyssa:  Awesome.  Well, thanks for taking the time to do this.

Amber:  Thank you guys!  I loved it.  I feel definitely much more prepared second time around, especially for the breastfeeding, the sleeping, and just postpartum stuff in general.  That was huge for me, so yeah, it was great.

Alyssa:  Good.  Glad to hear it!

Kristin:  Thank you so much, Amber!  We appreciate it!

Amber:  Thank you, guys!

Thanks for listening to Gold Coast Doulas.  Follow us on Instagram, Facebook, and YouTube.  If you like this podcast, please subscribe and give us a five-star review.  Thank you!  Remember, these moments are golden.

 

Kristin talks with Megan Michelotti CD (DONA) about the lymph system and manual lymphatic drainage (MLD) and how it can be helpful prenatally as well as postpartum.  You can listen to this complete podcast episode on iTunes or SoundCloud.

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: I’m Kristin, co-host of Ask the Doulas with Gold Coast Doulas, and I’m joined today by my dear friend Megan with GR Birth and Wellness.  Welcome!

Megan:  Hi, Kristin!  Thanks for having me!

Kristin:  So I’d love to have you tell our listeners a bit about your business, what you do, and, of course, our focus today is on some of your massage-specific services.  But I’d love to chat about your journey, since you and I started out as doulas about the same time.

Megan:  Yeah.  It seems like forever ago now.

Kristin:  Yes!

Megan:  It’s amazing when you kind of take inventory of that time.  Yeah, my background is in birth work.  I’ve been a doula for going on eight years.  I’m into my eighth year.  And did some placenta encapsulation for a few years, and got into massage largely because of my work in placenta encapsulation and being more a part of that postpartum period and getting really passionate about health and planning for health, mental and physical, in the postpartum period.  So it transitioned really nicely into massage.  Massage is something I’ve been a lifelong consumer of.  I say consumer, but it’s really, like, completely obsessed.  It’s my job to get massage, frankly.  So I’m always chasing my next massage appointment.

Kristin:  It’s so good for you, so it makes sense.

Megan:  So, yeah.  I am focusing still on the childbearing year.  It’s funny that people come to me, like, oh, do you do prenatal massage, and I think, yeah, I totally work on pregnant women, even though my heart, again, like I said, was led to massage really through a passion for the postpartum period.

Kristin:  Yeah, and with placenta encapsulation, you do get to see your clients in a raw and vulnerable way, and we realize, you know, when we added postpartum support to Gold Coast, like, how it is lacking.  And women are just feeling overwhelmed, and the focus on traditional healing is not where it needs to be in the US, in my opinion.  So some of the services you provide to get them back to the warm state after being in the cold state and delivery is so essential.  Postpartum massage, and I know that you have a passion for the manual lymphatic drainage service, especially for women who are recovering from a Cesarean birth.  So I’d love our listeners to learn more about the benefits of lymphatic drainage and how you work with them, what it’s like.  If you can paint a picture for us, that would be great, Megan.

Megan:  Sure.  It’s really interesting how I stumbled upon this.  An answer to some questions, actually; some health issues I had from long before I went to school for massage therapy.  But I took a certification program.  That was – I want to say it was – I can’t remember how many hours it was, but it was broken up into a couple days.  I want to say it was, like, seven different two-day courses.  So I took that in conjunction with my licensure prep.  And one of the two-day breakouts was Mommy and Me MLD.  And I was like, ooh, what do we have going on here, because here I’m learning about this awesome therapy that is highly utilized in the plastic surgery community.  It’s getting more utilized within the NFL because of the focus there on the concussions.  And I’m learning about the use on horses, like high-performance animals, and just bodies that are needed to recover quickly and perform.  And all of a sudden, we have Mommy and Me MLD.  And I’m thinking…

Kristin:  It’s perfect!

Megan:  How does this get into these other formats of using this therapy?  So I was the first person at class that day.  And I just was blown away by all the questions and things that don’t make sense and things we just don’t have an answer for that we do.  We do have an answer for it.  It’s largely the lymph system, while in pregnancy, with healing in pregnancy, breastfeeding in postpartum – the lymph system is integral to all of those things, and we learn not performing at our highest, which we aren’t during pregnancy.  The lymph system is taxed during pregnancy and in the postpartum period.  So we’re asking it to do so much at its most vulnerable.  So lymphatic drainage really helps optimize that system to make all of those little steps along the way a little bit easier.

Kristin:  Now, for a client who has a planned Cesarean birth, is it beneficial to get work done pre-surgery and then schedule post-surgery, or how does that work?

Megan: To get the most benefit out of the therapy, the protocol, the recommendation, is definitely before and after.  But either/or is also beneficial.  Because we’re talking about optimizing a system that naturally works with our body, there’s not really a wrong way to do it.  I mean, barring contraindications.  But generally speaking, if you can plan to do a series of three before surgery, you’re getting your lymph system really up and running, and you’re increasing white blood cell count, and you’re increasing the system and getting it all ready to clean up the humongous trauma that it’s about to have.  And I mean the specifically physical trauma of what happens during surgery.  To then revisit afterwards and keep the lymph system up and running is going to help further as you begin healing.  But, again, before or after is optimizing the system to meet that adversity.

Kristin:  And how long after a scheduled birth?  I mean, obviously, there’s that six weeks of healing.  When do you recommend a client come in to see you?

Megan:  So, 40 to 72 hours.  The main thing is that we just want someone who has undergone surgery to be stable, right?  So we’re taking a system that works relatively slowly and we’re bringing it up to ten times its normal speed.  So we don’t want to send this system whose job it is to clean out everything, to send all the waste products at organs that are not stable.  So after a surgery, 48 to 72 hours, and I like to get a doctor’s note, just because of that.  But yeah, that’s the window where you can start, and that’s a lot of times where swelling starts to be at its worst, too, after a Cesarean.  So it kind of works out well that way.

Kristin:  Yeah, that makes a lot of sense.  And I know I’ve seen you post on social media about having even baby with mom during the massage or lymphatic drainage.  Is that something that you are still doing, if their partner is back at work already and they want to see you?

Megan:  Yeah, absolutely.  I do mobile massage.  I try to keep my practice very diverse so I don’t even get bored.  So I do work in my studio, and then I also have some mobile clients.  But either way, because I have my background in doula work, I assume that babies are going to be with new mothers.  Right?  And that’s not necessarily something that a lot of our culture and society thinks about when we’re sending moms to certain appointments after a baby is born and having expectations after a baby is born.  So stunningly, some babies are real cooperative, and I’ve been doing MLD weekly with a post-Cesarean mom for five weeks now, and I’ve never seen – her baby is always sleeping when I’m there.  It’s always amazing.

Kristin:  Must be the atmosphere that you have set up.  The low lights, the music – chill for the baby.

Megan:  But for the most part, I’m assuming that there will be a baby, and frankly, for moms who are breastfeeding, I’m assuming there will be breasts around.  So with my background, that’s my norm to be around new moms with their babies in their natural state, and to come to them and be a tool that is working around their world in that time and not asking them to do something that’s, frankly, unreasonable, immediately postpartum or even in that first month, really, after baby.

Hey, Alyssa here.  I’m just popping in to tell you about our course called Becoming.  Becoming A Mother is your guide to a confident pregnancy and birth all in a convenient six-week online program, from birth plans to sleep training and everything in between.  You’ll gain the confidence and skills you need for a smooth transition to motherhood.  You’ll get live coaching calls with Kristin and myself, a bunch of expert videos, including chiropractic care, pelvic floor physical therapy, mental health experts, breastfeeding, and much more.  You’ll also get a private Facebook community with other mothers going through this at the same time as you to offer support and encouragement when you need it most.  And then of course you’ll also have direct email access to me and Kristin, in addition to the live coaching calls.  If you’d like to learn more about the course, you can email us at info@goldcoastdoulas.com, or check it out at www.thebecomingcourse.com.  We’d love to see you there.

Kristin:  And you mentioned one client that you’re working with who’s five weeks in.  What is the typical length to really see improvement?  Is it based on the client and their health, or how does that work?

Megan:  So it’s relative to kind of where you’re starting out.  So if we can backtrack and just do a little education, the lymph system is the width of a human hair.  It’s a really tiny system, and it sits between your skin and muscular system.  So it’s a very delicate system, and it doesn’t have much room as it is.  When you’re pregnant and gaining what’s considered the normal, healthy, 20 to 30-ish pounds during nine months, that’s still considered a rapid weight gain, and your adipose tissue is fighting for that space and really taxing the space that the lymph system already has.  And that’s why we see more swelling and more fluid retention in pregnancy.  Additionally, as your belly gets bigger and it’s compressing the cisterna chyli, which is a main lymph drain kind of right in the center of your body, baby is compressing that.  If you’re working in a job where you’re sitting and your belly is sitting kind of over onto your groin and you’re compressing into all the lymph nodes in your groin, huge filtration going on there, and that’s taxed, then, when you have a belly that’s sitting on that very delicate system.  So some women’s lymph systems are up to this job of doing this, and if you’re moving more, you know, the lymph is moving on your muscular movement, so if you’re moving more and you’re drinking a lot of water, then your lymph system is already optimized, right?  You’re already doing what you need to be doing to keep it going, and maybe it can handle what your body is producing and you don’t see a lot of swelling.  So depending on where you are or where your baseline is, it depends on what kind of “results” you’re going to see, and I use those terms, you know, just for the sake of an understanding, but it’s hard to see, right?  It is a system that you can’t see, and if it’s already optimized and you optimize it more, you might not see results.  But it’s clinically noted and it is happening, and the results are truly amazing.  But when you do have a lot of swelling, results are very obvious and pretty quick, because we’re taking a system that runs about 10 to 12 beats per minute – we’re taking that up to ten times that.  So you’re taking something that’s moving very slowly and moving it very quickly.

Kristin:  So it sounds like your touch is very gentle with this procedure versus regular massage, then?  What would a woman expect to feel?

Megan:  Right.  So I’m really careful not to call it lymph massage, which a lot of – I see that a lot of places.  I don’t even like to use the word massage with lymphatic –

Kristin:  So MLD or manual lymphatic drainage?

Megan:  Yeah, or just calling it lymphatic therapy, because if someone has it in their mind that they’re going to get a massage, they will be quite disappointed.

Kristin:  Different technique.

Megan:  It’s a completely different technique.  We use the weight of a nickel.  We don’t want to crash past the lymph system into the muscular system, which is where you get those great feelings of traditional massage is getting into that muscle and softening.  So we’re really moving skin.  It’s a very light touch, and we’re trying to move the lymph through that system, like I said, that’s just between the skin and the muscle.  So it is light touch, and it’s done in a way kind of – like if you picture this system, it has valves going both ways, so it’s not like your vascular system.  So you work from right to left, and then you work back left to right.  You work from up to down, and then you work again going down to up.  So it has two-way valves, and the system moves the lymph kind of like if you can imagine batting a balloon.  So it moves kind of like that, just slowly, puff, puff, puff, and then as you move the skin, those valves are forced to open more forcefully and stay open a little longer and then close.  You’re patting that balloon forward, if you will, those little sections of lymph.  So it’s a really different therapy.  It’s a very specific protocol where when I’m doing traditional massage, I’m kind of just letting my hands feel what I can and I let the body kind of guide me.  Where manual lymphatic drainage, the protocol is very specific, and it’s going to be the same protocol every time.

Kristin:  It sounds like when you had mentioned swelling, I’m guessing – I mean, obviously, it’s great for post-Cesarean clients, but if someone had a lot of swelling – say they had preeclampsia and had swollen ankles and had an IV.  Is that – are you seeing any clients with other issues that they’re trying to heal from?

Megan: Specifically, preeclampsia would be a contraindication because it does deal with high blood pressure.

Kristin:  Say a client was on an IV for an extended time, had a lot of fluids, and had preeclampsia.  They’re back to normal health after delivering baby, and they’re still seeing a bit of swelling.  Their blood pressure has normalized.  Is that a condition, or even just general IV fluids or general swelling that is taking its time to work itself out?

Megan:  Yeah, definitely.  Again, especially after Cesarean, where the incision is made goes directly across two main highways that connect your axillary drains, which are in your armpits, and your inguinal drains, which are in your groin.  So if you can kind of draw an imaginary line from your armpits to both sides of your pubic bone, those are main, main highways where your lymph system is getting a lot of efficient movement, and when you make an incision for a Cesarean, you are cutting right through that system.  And a surgeon repairs many, many layers, but they don’t repair the lymph system.  That lymph system is damaged for life.  And the lymph system is great.  It’s a beautiful system.  It’s made as part of our human body that orchestrates so perfectly.  So the lymph system finds another way.  It’s not like oh, lymph is going to sit there for ever more.  It’s a broken chain.  The lymph will find its way into lesser-used highways, if you will, but that is a really big highway that they just shut down, and it will be taxed for life.  So that is one issue when it comes to Cesarean.  Two, you’re not moving a lot after you have a Cesarean.  Again, the lymph system moves on muscle movement, so when you’re not moving much, again, your lymph system is not doing the best it could.  It’s also trying to heal you, so its focus is on getting white blood cells and your immune system fighting off infection.  It’s not necessarily focused on just moving out all the stuff that was pumped into you.  So it’s just got a lot of jobs after a surgery, and again, it’s at its most vulnerable.

Kristin:  That makes sense.  How long is an average session?  Is it similar to the length of a massage?

Megan:  Yeah.  You can kind of just decide how many passes you want to do.  So the protocol is to open the main drains and then kind of move up every limb toward the drain and move along those main highways, and you can do 10 passes or you can do 30 passes.  Sometimes I’ll add a mini lymph into some of my clients who are there for traditional massage if they mention swelling.  I might say, you know, do you want to try that?  We can do that for 20 minutes of your hour.  So you can do it at whatever rate you would like to, but generally speaking, yeah, just an hour treatment is what I would consider normal in a series before or after surgery.

Kristin:  That makes sense.  So do you have any other tips or advice for our listeners who are either preparing themselves for the postpartum phase or are already in that phase of healing?

Megan:  Well, I have all kinds of great tips.  The lymph system, it’s so amazing to me.  I just get so fired up and passionate about it because, again, it answered some questions for me about some things that I had experienced, but it’s truly one of these things where, for instance, we hear all the time, make sure you drink enough water.  Your body is 98% water.  Drink your water.  Drink your water.  But then when you really focus in and research and learn why and you learn how important it is for your lymph to flow through this tiny system – drink your water!  I can’t underscore that enough.

Kristin:  Especially with breastfeeding.

Megan:  And with breastfeeding, your system is competing with even more things competing for space.  When you have your system when your milk comes in, all those ducts and that whole system is also competing with some of your main lymph drains under your armpits and under the breast tissue.  So that’s where that comes into play with breastfeeding.  A lot of the things that are just normal – like, we know what to do to keep ourselves healthy.  Those are the things that will keep the lymph system healthy: movement, drinking water, deep breathing.  It’s an influx of oxygen and helps move the lymph system.  So all good tips there, but here’s my other tip, and my kids will echo this a lot: don’t wear underwear and bras to bed!  Your bra and underwear cuts off your  main lymph drain highways.  So as they get tighter through pregnancy and you’re like, oh, I’m not going to buy a bunch of new underwear and bras; it’s temporary.  They are compressing it even further, and even in people who are not pregnant, it’s a great time to let your lymph system breathe.  So my kids and my family does not wear underwear and bras to bed because we love our lymph systems.  So those are my great tips about the lymph system and keeping it optimized as best you can.

Kristin:  What about, since you mentioned bras, what about someone who just sleeps and pretty much lives in different nursing tanks?  Is that a different kind of pressure, or what do you advise for that?

Megan:  Well, I understand that for many of us, bras are a necessary evil.  So just being aware of where it’s hitting you and how tight it is, you know.  So if you’re wearing compression, like a tank, that’s great.  You’re not hitting across that – pretty much right where your band of a traditional bra would be is the main lymph highway around your back.  So trying to have it hit a little lower like with even a sports bra that’s not super tight or a tank is going to be more helpful.

Kristin:  And then how do our listeners find an MLD therapist in other areas?  You’re our go-to expert in West Michigan, but is there a directory, or how does one search?

Megan:  You know, that is a great question.  I mean, it’s not a very regulated certification, so there’s many different certifications for MLD.  It can be a little hard on the consumer that way, like anything that’s not well-regulated, but I would say a Google search is going to reveal some practitioners, and then asking those practitioners where they were certified, what their certification program was like, just their knowledge and their foundation, will give you some more information about what kind of lymph therapy they’re getting into.  I think it’s important to note, too, there are some other kinds of lymph therapy that I’m not exactly familiar with.  There are people who are expecting a very painful protocol, so there are some practices out there that people have experienced that are not my knowledge of lymph therapy, and that’s something that I always clarify with my clients, expectations versus reality, and that’s something we cover ahead of time.  What’s your familiarity with this therapy?  What are you expecting?  Here’s what I’m actually doing.  Especially from outside of the US, I’ve heard some really interesting stories about really, really painful lymph work, and like I said, I’m not familiar with exactly what these people experienced, but it just can’t be further from how I would describe what I do.  It’s such a gentle, light touch therapy.  So just asking follow up questions of the practitioner of what exactly are they practicing and who their certification was through, I think, would be – I mean, just like hiring any practitioner.

Kristin:  Yeah, like hiring a doula, the kind of questions you ask, yeah.

Megan:  Right.  Exactly.

Kristin:  How were you trained?  Are you certified?  Yeah, those type of questions.  Do you have insurance?  So, Megan, how do we find you?  What are the best channels?  How can our clients or listeners reach out to you if they’re located in West Michigan?

Megan:  Well, you can always find me with GR Birth and Wellness, and then I also have MLD Therapy of Grand Rapids, so I market it as a completely separate business, again, to really kind of fight against that unmet expectations.  It’s really so separate from what I consider to be traditional massage and what the consumer is thinking.  So I have the completely separate MLD Therapy of Grand Rapids.

Kristin:  Can you give us both of those websites, then?

Megan:  You can find me at GR Birth and Wellness, as well as MLD Therapy of GR.

Kristin:  Well, thanks so much!  You’ve educated me and I’m sure many of our listeners will look into this more, because it isn’t something that’s talked about.  I’m so glad you brought this topic up in our local doula group and that we had the opportunity to dive into it.

Megan:  Thanks so much!  I love talking about it.  I hope you can tell!

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