Articles in Category: General

Affirming the areas of our bodies that are often shrouded in shame and guilt

July being self care month, I thought I’d share an experience I had while driving past a construction site one early evening in March this year.     

It was bitingly cold, and a sharp wind chased snow flurries over the yard. Two men were handing pieces of cold steel piping to each other, their breath clouding the air. Suddenly, one of them lost his grip and the pipe clanged out of his hand and struck his ankle. Immediately, a rush of expletives gushed out of him. A mix of the predictable everyday expletives interspersed with a synonym for female genitalia. While certainly not new words to me, on that night they struck my ear as forcefully as the steel had his ankle.

vagina questions

I encounter these genitalia and their supporting tissues every day.  The signs of incontinence, the sensation of pelvic heaviness or the pain of difficult intercourse. Those deviations are fairly easy to quantify and describe. Often, however, there is a degree of disconnectedness, an intentional or unintentional disengagement with the areas of our bodies that are often shrouded in shame and guilt. A disembodied way of describing them and their actions. Our sexual organs and defecatory organs: vaginas, penises, rectum and anuses do not seem to be aspects of life we want to spend much time honouring or engaging with. We’d much sooner refer to them in disgust, shame, in anger, in frustration and fear. We wield these words to convey how we feel. Are we thereby conveying, simultaneously and subliminally, how we feel about the areas and functions they are describing?  Do we feel disgust, shame, anger, frustration and fear when we describe any perceived deviation of the expected ‘norm’ in sexual encounters, in passing stool or urine?

A different spoken word environment may allow us to be more engaged and feel warmer towards these amazing, intricate life sustaining organs.A haven of warmth and the gateway to our fertility and life-giving womb.That cold, barren, uninviting and uninformed construction site was and is as different to the vagina and uterus as can be.

As we celebrate self-care month I’d like you to pause and consider how amazing each and every part of your body is - even if our words don’t always affirm this.

Gerda square

Gerda Hayden is a pelvic health physiotherapist at The WOMB Burlington and takes pride in delivering holistic care.  Gerda utilises manual therapy, electrotherapy and dry needling amongst other techniques and has a special interest in postnatal clients and all Women’s Health conditions.  Gerda has been a physiotherapist for 12 years in South Africa, England and now Canada! She is a mother to young boys and has taught Pilates for the last eight years as well

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Celiac Awareness

Notice how the definition doesn’t say anything about digestive symptoms?

Celiac disease is estimated to affect approximately 1% of the population but many people suffer for years without a proper diagnosis due to the wide variety of possible symptoms. Undiagnosed celiac disease can have a significant impact on your quality of life and long-term health so it’s important for us to spread awareness and ensure this doesn’t happen to you!

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What is celiac disease?
The Canadian Celiac Association defines celiac disease as “a multi-system autoimmune disorder that is triggered by ingestion of gluten (a protein in wheat, rye and barley) in genetically susceptible individuals.” Do you notice how the definition doesn’t say anything about digestive symptoms? In all individuals with celiac disease, gluten damages the absorptive surface of the small intestine leading to poor absorption of nutrients. However, patients can present with either intestinal symptoms or non-intestinal symptoms (or both!).

celiac diagram

What are the symptoms of celiac disease?
The most common symptoms associated with celiac disease are: chronic diarrhea, abdominal pain, weight loss, and malabsorption. It can be diagnosed at any point in your life and is not just a childhood disease. In children, it is essential to screen for celiac disease if they are experiencing failure to thrive (not following their expected growth curve). 

One of the most common misconceptions about celiac disease is that the above symptoms MUST be present for a diagnosis to occur. This is not the case. The theme for Celiac Awareness Month this year is #GoBeyondTheGut. We need to start recognizing that celiac disease can be present without the classic digestive symptoms. Here is a list of just a few of the non-classical symptoms of celiac disease: 

Chronic fatigue• Chronic constipation
Recurrent Vomiting 
Iron Deficiency Anemia
Osteoporosis 
Infertility
Dental enamel defects
Neurological problems, such as peripheral neuropathy 

What is the testing process for celiac disease?
Talk to one of our Naturopathic Doctors about doing the screening blood test. If the screening test comes back positive, you’ll need to see your medical doctor for a referral to a gastroenterologist so that you can have an intestinal biopsy done to confirm the diagnosis. Celiac disease cannot be definitively diagnosed based on the screening blood test alone! 

Can’t I just try eating gluten free and see if I feel better?
Unfortunately, the answer to this question is no. First of all, you must be eating gluten to be accurately tested for celiac disease. If you start on a gluten free diet and then notice symptom improvement, you would have to start eating gluten again (often for up to 3 month) to get an accurate test result for celiac disease. For this reason, it’s ideal to get screened for celiac disease before starting a gluten free diet.  

You might be wondering why it would be necessary to go back on gluten to get a proper diagnosis if you’re feeling better anyways. Couldn’t you continue on your gluten free diet without a confirmed celiac diagnosis? Although following a gluten free diet is becoming increasingly popular, a gluten free diet by choice is very different than the gluten free diet that must be followed for the treatment of celiac disease. When you are diagnosed with celiac disease, your gluten free diet must be strict, life-long, and avoid even small amounts of gluten cross-contamination. It is important to have the proper diagnosis so you can follow the correct diet. 

celiac GF
 
How does this compare to non-celiac gluten sensitivity?
If you’ve tested negative for celiac disease but still feel strongly that you react negatively to gluten, you might have non-celiac gluten sensitivity (NCGS). There seem to be a subset of people who test negative for celiac disease but still develop symptoms when they consume gluten. 

The difference between celiac and NCGS is that people with NCGS have no celiac antibodies and no intestinal damage. There are also no biomarkers for the diagnosis of NCGS. The only way to be diagnosed with NCGS is to rule out celiac disease and then follow a gluten-free diet. If your symptoms resolve on a gluten-free diet, there’s a good chance you suffer from non-celiac gluten sensitivity. 

Do you read this and wonder if you should be tested for celiac disease? Or if your child or another family member should be tested? Book an appointment with one of our naturopathic doctors to find out whether testing is right for you. Our naturopathic doctors can also support you in starting a gluten free diet in a safe and healthy way. Check out Dr. Emily’s blog post from last year’s Celiac Awareness Month to read more about the gluten free diet and how a naturopathic doctor can support you! 

References:

Canadian Celiac Association. Retrieved from: https://www.celiac.caRashid M, Lee J: Serologic testing in celiac disease: Practical guide for clinicians. Can Fam Physician. January 2016 62:38-43. Retrieved from: http://www.cfp.ca/content/62/1/38.full

DrEmilyCasey squareDr. Emily Casey is a Doctor of Naturopathic Medicine at The WOMB Burlington.Through her own health journey, Dr. Emily has learned the importance of individualized treatment and healing the whole person. She believes strongly that your overall health begins with a healthy digestive system. Dr. Emily enjoys living an active life, including swimming and running, drinking tea, and she is always on the lookout for new and delicious gluten-free food!

No more sniffling, sneezing, itchy kids!

Preventing and Treating Your Child’s Seasonal Allergies

When springtime comes around, we want your kids to be able to play outside and enjoy the beautiful warm weather! But when your child suffers from seasonal allergies, outdoor play becomes much less fun. Did you know that seasonal allergies can be prevented and treated naturally with the help of a Naturopathic Doctor?

Why seasonal allergies?

allergies child

Seasonal allergies are the immune symptoms that develop with exposure to an environmental allergen, such as grass, pollen, weed pollen, tree pollen, animal dander, dust mites, mould spores, and more. In Canada, allergy season usually starts in April and can continue all summer and even into the fall depending on the type of allergy and the severity. By avoiding triggers, supporting the immune and digestive systems, decreasing inflammation, and consuming natural anti-histamines, we can see great improvements in allergy symptoms in children (and adults too!). Let me lay them out for you:

Avoiding Triggers

This can be the most challenging strategy with environmental allergies but the more information you can gather, the better you’re able to understand and avoid these triggers. 

Talk to an allergist (this requires a referral from your medical doctor) to get proper testing for your child. Figuring out your child’s specific allergy helps you better understand how to minimize their exposure to the allergen. 

Consider food sensitivity testing. Eliminating your child’s food sensitivity from their diet will support their immune system function, digestion, and decrease excess inflammation. The fewer allergens the body has to deal with at one time, the better. A Naturopathic Doctor can support you with getting testing, interpreting the results and establishing a supportive and appropriate diet for your child.

Supporting the Immune and Digestive Systems

Seasonal allergies are associated with an overactive immune system. Luckily, we have great options for balancing your child’s immune system. We can start with supporting the foundations of health, including sleep, stress, diet, and activity level. Then, we can consider the addition of the following two nutritional supplements. 

Vitamin D. Low levels of Vitamin D are associated with seasonal allergies. Proper supplementation can help avoid a deficiency and support the immune system. 

Probiotics. A large part of the immune system is located in the gut. Probiotics are an effective treatment for improving digestion and decreasing symptoms of seasonal allergies. 

allergies child2

Decreasing Inflammation 

When the immune system becomes overly reactive, it can cause excess inflammation in the body. Focusing on your child’s diet with the following recommendations is a great way to manage inflammation and improve allergy symptoms. 

Omega 3 fatty acids. Aim for at least 3 servings of fish per week. It can also be beneficial to consider an additional fish oil supplement to get the therapeutic dose of omega 3 fatty aids.

Bioflavonoids. These are the colourful compounds in fruits and vegetables. Work on ensuring your kids get 5-8 servings of fruits and veggies daily.

Limit added sugar. Sugar decreases the immune system's ability to function and can be even more inflammatory. It is recommended that children get no more than the equivalent of 6 tsp or 25g of sugar daily. Check your food labels for sugar added - sugar comes in many different names and forms!

Consume Natural Anti-Histamines

Did you know that anti-histamines don’t only come in the form of a pharmaceutical medication? We can find them all around us! Three amazing natural anti-histamines are vitamin C, quercetin, and stinging nettle.  Vitamin C. Aim to give your child Vitamin C from whole fruits and vegetables or from an added supplement, as opposed to fruit juices (which are high in sugar). Fruits and vegetables that are high in vitamin C include bell peppers, citrus fruits, and strawberries. 

Quercetin. This is a bioflavonoid found in most red, green, and purple fruits and vegetables, including apples, berries, tomatoes, and leafy greens. It is also available in supplement form.

Stinging Nettle. Consume nettle leaf as a tea for its beneficial effects of decreasing allergy symptoms. It has a mild flavour and is often well tolerated by kids. If not, you can try making it as an iced tea and add some honey and lemon for added flavour. 

As you can see, there are lots of natural options to reduce seasonal allergy symptoms in your kids! Also, many of these ideas are safe and effective during pregnancy and while breastfeeding. Book an appointment with one of our naturopathic doctors for more information on how you can treat your allergy symptoms. We want to help you and your kids get outside and enjoy the sun this season!

DrEmilyCasey squareDr. Emily Casey is a Doctor of Naturopathic Medicine at The WOMB Burlington.Through her own health journey, Dr. Emily has learned the importance of individualized treatment and healing the whole person. She believes strongly that your overall health begins with a healthy digestive system. Dr. Emily enjoys living an active life, including swimming and running, drinking tea, and she is always on the lookout for new and delicious gluten-free food!

Our Roots: Who Are We?

Why WOMB?

I think there comes a time in every person’s life when the age-old question starts to lurk in the back of their mind, ‘Who Am I?’ That nagging feeling that asks, now that I’m a parent, now that I have my dream job, now that I’m coming off of maternity leave, what defines me? Who am I becoming? Where am I going? IS THIS MY LIFE? 

Some would call this a crisis of the soul. Some would call this an awakening. Some would call this just part of life’s journey. Well, this is where The WOMB is in its life – on a path that twists and turns and sees something beautiful around every corner. Sometimes that path is strewn with rocks and sometimes it is as smooth as baby’s bottom (I couldn’t resist). Either way, the journey has made us sit back and ponder, “Who is The WOMB?” and “Why WOMB?”. And here is what we came up with.

tree roots

At its ROOTS, The WOMB grounds us. Its roots provide our foundation and nourish our vision and mission. They are our cause, our source and our origin of being. Today, these are our 5 core ROOTS:

1. LOVE & CONNECTION:

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Love and connection are expressed in our relationships with our family, our team, our community, our earth and most importantly with ourselves. Love and connection nourishes, nurtures, and supports these relationships through compassion, communication, kindness, respect, inclusivity, synergy, faith and trust. As Brené Brown says in her book The Gifts of Imperfection, “Love is not something we give or get; it is something that we nurture and grow, a connection that can only be cultivated between two people when it exists within each one of them – we can only love others as much as we love ourselves.” 

So find your connection at The WOMB, first with yourself through your yoga and meditation programs, counseling and healing services, then with your community in Emerging Mothers Groups, drop-in groups, fitness and workshops.

2. INSPIRATION, TRUTH & AUTHENTICITY: 

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Expressing and connecting to our individual nature and essence allows us to each grow, develop, learn and evolve into the people that INSPIRE our families, friends, community and especially our CHILDREN. With kindness and compassion, awareness, inclusivity, integrity and wisdom, we can inspire the next generations to be true to themselves too. This means being REAL. This means not only allowing ourselves to fail, but also accepting our failures as part of being human, and then evolving and learning from them. It means being courageous in times of transition (don’t we all know transition!), trying new things, being vulnerable and reaching out for support when needed. It means remembering that Facebook and Instagram are just “highlight reels” and that “sleeping through the night” often means different things to different people. It also means acknowledging that families come in different shapes, sizes and make ups, such as LGBTQ, surrogacy, adoption and mixed. So be courageous. Be your own kind of person, your own kind of parent, your own kind of beautiful. There’s lots of THEM but only one YOU. And what your family needs is YOU.

Connect to your own spirit in The WOMB’s yoga and meditation classes, understand your own individual expressions of being in Birthing from Within and HypnoBirthing® courses, gain wisdom in The WOMB Talks Pregnancy, Birth & Parenting workshops or just drop in for a tea. Oh! Maybe even a massage while The WOMB looks after your little one(s)!  

3. GRATITUDE & GIVING BACK: 

guatemala Woman and child

This one is big for us. The vision of The WOMB began with 2 women, but it has grown to encompass whole communities of love that have nourished us too! We are so grateful that you’ve not only given The WOMB your support, you have trusted us with the support of your families and referrals to your friends. You have also come together in times of need to support others in our community who are in of love and a helping hand. Because of your generosity and our desire to 'pay it forward', we’ve chosen to put together what we call our “Angel Fund”. It is a fund that sees the light in every darkness by supporting families with services that they couldn’t otherwise afford or access. It means being able to provide breastfeeding support to women in hospital ICUs, gathering resources for brave women in shelters who have left everything behind to escape an abusive situation, providing in-home counselling sessions through our Well-Mama Program with Counting Butterflies, and providing pelvic floor rehab to refugees without any means of payment. These are just a few examples of how The WOMB has helped in the past. But there is so much more we can do! Our founders are currently working with a group in Guatemala to open a home that would provide birth and postpartum support to women who have experienced rape and incest. Please contact us if you would like to support this WOMB initiative. More info is coming!

4. PRESERVING MOTHER EARTH: 

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Since I became a mother, it was as if a lion took over my psyche and changed the fire within me. I suddenly was protective with all my being. My children are my roots, my legacy, my life-giving aspect of nature and I was their sustainer of life. It’s marvelous to me that this is exactly how our earth must feel about us. She protects us by providing life-supporting air, nourishes us with water to hydrate and land upon which to sow our crops. Thus, at The WOMB we believe it is our sacred and divine duty to respect our mother earth, preserve her legacy, conserve her resources and keep it as clean as possible. We use hand towels at The WOMB, organic products whenever possible, cold water in our washing machines to save energy, recycle waste products and never forget to thank her loving and giving spirit. She in return provides us with health and nourishment! 

5. LEARNING & EVOLVING:idea

This root very much ties into our deep belief that when you know more, you do better. We acknowledge that learning is a life long process. It means growing in awareness, taking the opportunities for education, developing intuition, living by our own core values, and listening to our inner wisdom. The opportunity to learn and evolve is everywhere. From moments of complete epic meltdowns in the arms of your doula, to laughter and hilarity in an Emerging Mothers Group. There may be moments of seeking your heart’s deepest questions in childbirth preparation classes or moments of pure evidence-based treatments with your health care practitioner. The WOMB believes in the evolution of the whole person, so find your learning opportunities in the physical, emotional, mental and spiritual support The WOMB lovingly provides to you and your family every day.

So WHY WOMB? Well because The WOMB believes in YOU and your full potential. The WOMB believes in your flaws and your strengths, and loves you for both. The WOMB believes that you can evolve, grow, develop and BE your own person – just as it continues to grow, develop, evolve and support its own roots. So I’ll see you soon, right? I’ll be the one with the tea in hand and the sign over our door that says, “Free Hugs”. Take me up on it. 😊

AngieStenback3Angie Stenback is Co-Founder of The WOMB, a Birth and Postnatal Doula, Childbirth Educator, Pre- & Postnatal Fitness Trainer, mother to 4 amazing kids and wife. When not at The WOMB, she can be found most often in the hockey rinks, her "taxi" or the dance studio. She heeds her heart's call by practicing yoga, meditating, dancing or spending time amongst the trees on a hiking trek.

Pregnancy-related Pelvic Girdle Pain:

Embrace the Evidence and Move beyond Biomechanics

Originally published in the Journal of Yoga and Physiotherapy
Volume 3 Issue 5 - January 2018

Sinéad Dufour, Assistant Clinical Professor, School of Rehabilitation Science, McMaster University, CanadaSubmission: January 17, 2018; Published: January 24, 2018*Corresponding author: Sinéad Dufour PT PhD, Assistant Clinical Professor, School of Rehabilitation Science, Director of Pelvic Health, The Worldof My Baby (WOMB), McMaster University, Canada, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

back pain pregnancy

Opinion:

Imagine you are 32 weeks pregnant with your first child and you start to have pain in the low back and pubic area when you change position, sit or stand for longer periods. The painmakes it very difficult for you to function and you worry about whether you can continue to work and manage your household.You are also concerned about the upcoming birth of your baby and whether you will be able to care for your baby, an often seemingly overwhelming task without having to deal with pain. Now imagine you have seen your health care provider and havebeen told that your pelvis is separating because of the “pregnancy hormones” and that you need to put up with this until after you have your baby, as “it will probably get better afterwards”. Imagine you are also told, to be careful because “your pelvis is unstable”. These are common words of advice or explanations pregnant women with pelvic girdle pain (PGP) receive from their healthcare providers, including physiotherapists. These words are not substantiated and do more harm than good.

Pelvic girdle pain (PGP) is defined as a specific type of low backpain that can occur with or without additional low back pain [1].Pregnancy-related PGP is a specific category of PGP impacting women in the perinatal period and differs in its etiology as it is related to pregnancy and associated biopsychosocial influences.It represents a prevalent condition with an incidence as high as 46-58% [2]. The cause of pregnancy-related PGP is complex and multifactorial [1,3]. Evidence has shown an alteration in motorcontrol in pregnant women [3] and more recently, central pain mechanisms have been considered and implicated [4-7]. As such,to appropriately address the complexity of pregnancy-related PGP, physiotherapists and others must both acknowledge and part with common yet unsubstantiated beliefs surrounding the concept of “pelvic instability” [8]. Instead, current advances in pain science support the notion that pregnancy-related PGP represents sensitization of the structures of the pelvis [4-7].Thus, attention must move away from biomechanics and engage the multiple underlying mechanisms such as the stress system (HPA axis) and associated coping, inflammatory load, status (HPA axis) and associated coping, inflammatory load, status of the gut microbiome and sleep quality to name a few [5-9]. Despite the evidence supporting the need for a biopsychosocialperspective, recent research demonstrates that when it comes to pregnancy-related PGP, physiotherapists continue to preferentially use a biomechanical approach [9,10]. Guidance for an evolved evidence-informed approach is available from the the most recent published CPGs for pregnancy related PGP [4]. From an assessment perspective, Clinton et al. [4] indicate the use patient reported outcomes as an important way to capture the various assessment domains relevant to pregnancy-related PGP[4]. Specifically, among other scales, the Pain Catastrophizing Scale (PCS) is recommended [4]. The PCS has three subscales:- rumination, magnification, and helplessness and has been utilized in various populations, including the antepartum population [11,12]. Using an outcome measure like the PCS is important to aid physiotherapists and others in assessing the mental processing that is associated with pregnancy-related PGP. The significance of patients’ beliefs and perceptions about their pain and their pain experience has been well demonstrated across a wide spectrum of orthopedic conditions including in the antepartum population [13]. Perception of pain has also been linked to the development of persistence [14-16], an important consideration for pregnancy-related PGP.

preg relaxation

From a management perspective, it has been shown that pregnant women’s expectations of care are not met and that their knowledge about how to manage the condition is lacking [17]. Further, a recent qualitative study elucidated women’s experience of care for pregnancy-related PGP highlighting the importance of perceived hope and self-efficacy [18]. Thus cognitive care strategies that focus on pain neurophysiologyand stress response education [4,6], mindfulness-based stress reduction [19], and tailored exercise [3,4,6] are advocated.

Science has evolved and to clearly guide practice well beyond a biomechanical approach where pregnancy-related PGP is concerned. Physiotherapists well-positioned to educate PGP is concerned. Physiotherapists well-positioned to educate and empower women so they understand how to interpret and respond to the pain they are experiencing. Knowledge translation efforts to support the provision of evidence-informed care herein are needed.

References

1. Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B (2008)European guidelines for the diagnosis and Treatment of pelvic girdlepain. Eur Spine J 17(6): 794-819.
2. Rost CCM, Jacqueline J, Kaiser A, Verhagen AP, Koes BW (2004) Pelvicpain during pregnancy. a descriptive study of Signs and symptoms of 870 patients in primary care. Spine 29(22): 2567-2572.
3. Stuge B (2012) Pelvic girdle pain: examination, treatment, and thedevelopment and implementation of the European guidelines. Journal of the Association of Chartered Physiotherapists in Women’s Health111: 5-12.
4. Clinton S, Newell A, Downey P, Ferreira K (2016) Pelvic girdle painin the antepartum population: Physical therapy clinical practiceguidelines linked to the international classification of functioning,disability, and health. section on women’s health and the orthopaedicsection of the American physical therapy association.
5. Bergström C, Persson M, Mogren I (2016) Sick leave and healthcareutilisation in women reporting pregnancy related low back pain and/or pelvic girdle pain at 14 months postpartum. Chiro& Man Ther 24: 7.
6. Smith MC, Ramirez LO, Clarke G, John FC, Higgins MF, et al. (2017)Stress reduction therapy improves symptoms of pregnancy-relatedpelvic girdle pain and reduces salivary cortisol. Irish Pain SocietyAnnual Research Conference, Aug 26th, Galway, Ireland.
7. Felice VD, Moloney RD, Cryan JF, Dinan TG, O’Mahony SM (2015) Visceralpain and psychiatric disorders. Mod Trends Pharmacopsychiatry 30:103-119.
8. O’Sullivan PB, Beales DJ (2007) Diagnosis and classification of pelvic girdle pain disorders – Part 1: A mechanism based approach within a biopsychosocial framework. Man Ther12(2): 86-97.
9. Shoskes DA, Wang H, Polackwich AS, Tucky B, Altemus J, et al. (2016) Analysis of gut microbiome reveals significant differences between men with chronic prostatitis/chronic pelvic pain syndrome and controls. J Urol 196(2): 435-441.
10. Vandyken C, Hilton S (2012) The Puzzle of pelvic pain: a rehabilitation framework for balancing tissue dysfunction and central sensitization - a review of treatment considerations. J Wom Health Phys Ther 36(1): 44-54.
11. Dufour S, Daniel S (2018) Understanding clinical decisio making: pregnany-realted pelvic girdle pain. J Wom Health Phys Ther IP.
12. Bergbom S, Boersma K, Overmeer T, Linton SJ (2011) Relationship among pain catastrophizing, depressed mood, and outcomes across physical therapy treatments. Phys Ther 91(5): 754-764.
13. Grotle M, Garratt AM, Krogstad Jenssen H, Stuge B (2012) Reliability and construct validity of self- report questionnaires for patients with pelvic girdle pain. Phys Ther 92(1): 111-123.
14. Vøllestad NK, Stuge B (2009) Prognostic factors for recovery from postpartum pelvic girdle pain. Eur Spine J 18(5): 718-726.
15. Noren L, Ostgaard S, Johansson G, Ostgaard HC (2002) Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J 11(3): 267-271.
16. Ostgaard HC, Zentherstrong G, Roos Hansson E (1997) Back pain in relation to pregnancy: a six-year follow up. Spine 22(24): 2945-2950.
17. Crichton M, Wellock V (2008) Pain, disability and symphysis pubis dysfunction: women talking. Evidence Based Midwifery 6(1): 9-17.
18. Stuge B, BerglandA (2011) Evidence and individualization: Important elements in treatment for women with postpartum pelvic girdle pain. Physiother Theory Pract 27(8): 557-565.
19. Crisp CD, Hastings Tolsma M, Jonscher KR (2016) Midfulness-based stress reduction for military wome27: 557-565.n with chronic pelvic pain. Mil Med 181(9): 982-989.

Sex After Baby: What everyone wants to know, but sometimes is afraid to ask!

Nelia DeAmaral, Registered Psychotherapist and Coach for Women, & Jenny Telfer-Crum, Pelvic Health Physiotherapist

 

Six weeks after you give birth, you will visit with your care provider. Maybe your care provider gives you a thumbs up to resume “normal activities” (including sex). Maybe your care provider checked that everything was healed, or maybe not. Were you or are you ready? Do you feel an obligation to become ready because your partner wants to be intimate again? Most women aren’t and if you are still finding yourself “not ready” a few months later, you are not alone. Partners often are given the impression that once the body is mostly healed, that sex can resume. 

Let’s talk about what sex after baby is really like. This topic comes up over and over in our sessions with new moms, who are almost afraid to ask, but really want to know how to deal with this change in their relationship. Mostly everyone wants to know if they are normal, if things will be okay, and how to stay connected to their partner during this change. 

If you aren’t quite ready, that’s okay. If you are looking for ways to return to intimacy after baby, we’ve listed that too! There are good reasons for how you feel. Below are some factors that might influence when you return to sexual activity with your partner, and some strategies for when and how you return to these activities.

Let’s start by setting some normal expectations for sex after baby. Your first several times being intimate again, will likely require lots of talking, adjusting, and flexibility. It will be a time of “figuring out” and “experimenting” - not hanging from the chandeliers (but it’s okay if it is!). So NO PRESSURE! You will likely need to slow everything down. Your body will feel different and it will be your first time being sexual with this new body & your first time being sexual as a mother! It’s important to take the pressure away that this will be amazing sex, or the sex you had before (at least initially).Your body has been through a major change, and your first few times of being intimate can feel awkward and different. Most partners are very happy to be supportive as you explore these new sensations and experiences.

It is common if…..

1. You feel Pain or Fear of pain or Tension in the pelvic area: 

Your 6 week “go ahead” just means is that your tissues have the integrity needed to withstand the friction and stretching that occurs with intercourse. But vaginal tissues are sensitive after birth REGARDLESS of whether baby is born vaginally or by caesarean birth, whether you have stitches or not.

Imagine you pulled your bicep muscles in your arm lifting something – our first instinct is to bend the arm and hold it close to us. This is a guarding response to keep up safe and prevent further injury when our tissues are fragile and stretched. We rest the muscles for a couple of days, and without even thinking about it we will rub our arm where it hurts – this provides our tissues with normal sensory input (touch, friction, pressure) and helps us check in as to where any tenderness is and how it is changing. Then over the next week or two we will gradually start using our arm again to lift things, testing out how much we can lift. Within a couple of weeks you are pain free, doing your usual activities.

At the perineum and vagina, the same healing process occurs. First our muscles tighten in a guarding response to being stretched or torn (and in the case of caesarean births, tighten in response to neighbouring muscles being impacted). However, at the pelvic floor and perineum, we often don’t get the same normal input we do at other parts of our body. We aren’t often touching or rubbing this area apart from toileting, and women often don’t consciously relax the pelvic floor over time. So what we can have are tight and sensitive tissues around the entrance to the vagina.

Learning to relax your pelvic area again.

Fortunately, most women do very well with pelvic floor corrective exercises focusing on “reverse kegels”, which is teaching the pelvic floor how to RELAX appropriately. Gentle touch in this area can also help desensitize these tissues and bridge the gap between recovering from birth to returning to intercourse. Our Pelvic Health Physiotherapists can help identify where any tension or sensitivity is harboured in your muscles and how to work towards recovery. Research has shown that child birth, even with tissue trauma like an episiotomy, is not linked with long term impacts on sexual function.

How to talk to your partner: Talk to your partner about the worry, and keep talking even during sex. Notice when you tense up, practice relaxing with your breath, and ask for what you need (eg. slow down, pause, or stop for today). 

Remove the pressure for penetration right away. Many women find it helpful to use lubricant, or have touch without penetration for arousal or even orgasm. Try a different position such as a position of power (ie. woman on top) to control rate and depth of penetration.

Some women experience physical and emotional trauma during birth, and despite their efforts, their body doesn’t feel safe letting go. A couple of sessions with a counsellor can help you sort through feelings of self-blame & anxiety. The WOMB offers specialized support for healing from a difficult birth.

2. You feel too exhausted to have sex

This doesn’t mean you don’t love your partner or that your relationship is doomed.

It can be difficult to feel the desire to be intimate, when you are in the most exhausted state of your life! Early parenthood is a time of choosing between your various survival needs. Your frequency of sex will likely decrease because that’s what happens when we are exhausted! 

Give yourself time. It is normal for babies to have erratic schedules. Sometimes more sleep isn’t an option, but studies show that meditation and relaxation can have similar benefits to more sleep. Try these simple, and short meditations for moms and meditation for sleep. Many partners experience feeling loved through intimacy. What other ways do you and your partner feel loved? Maybe something you each already do without words or touch? 

3. You feel too stressed to have sex

The stress of being a new/new again mother is tremendous. You mind is busy and you might feel like you are constantly “on call” and ready to respond to your baby. Sexual arousal is governed by our parasympathetic nervous system, aka “rest and digest” system. When we are stressed, the increase in cortisol (stress hormone) decreases oxytocin (aka hormone of love). Stress also increases tension in the pelvic floor muscles - which can loop back up to tissue sensitivity. 

Focusing on bringing down your overall stress levels might make a little more space for feelings of intimacy. Either way, it will help you cope with the challenges of mothering with greater compassion and presence. Simple awareness practices can help you see yourself with more compassion, which is a proven way to calm down the fight or flight. Try this meditation for stress and anxiety. You can do it anytime. It’s quick and you can even do it while you feed baby. 

4. You feel touched out or too “called on” as an introverted mom

Being a mom, especially if you are an introvert, can leave you feeling like you have no time to be alone and recharge, which can be extremely draining. Some women don’t feel the need or desire to be touched especially because holding baby increases our oxytocin levels on it’s own, so you don’t feel you need to get that affection from your partner. 

It might sound counter intuitive to building intimacy, but sometimes you might just need some time alone. You’ll be surprised how much even 20 minutes can help you feel like yourself again. Time alone is especially helpful if you can step away and allow your partner to parent in their own way and you have specific and set times when you can expect a break. Read more about ways your partner can support you in the article A Mind-Reading Guide for New Fathers.

5. You don’t really like your partner right now or you feel like he’s a roommate

The demands of the early months of parenting can leave you both feeling a little disconnected or unusually irritated with each other. Virtually everyone goes through this. Know that you are not alone. Find small ways to connect that are doable for both of you. Many couples find that a couple of sessions with a counsellor or coach can help get them on track with communication and bonding. The WOMB offers sessions for couples. 


7. You don’t feel connected to your body, don’t love your body or wonder how your partner will love your body again: Who’s body is this anyway? 

Maybe you feel like your body has gone from being yours to providing a function for your baby, whether it’s feeding or caring for baby in other ways. It’s ok not to love your body. Try making friends with your body. Treat it as you would a tired, hardworking friend. Be compassionate with yourself. Many clients describe the relationship to this new body as an acquaintance or even a distant “facebook friend”. Talk to other women. It will help you realize that “bouncing back” is a myth.

Some women find themselves hiding their bodies from their partners for fear of judgement. Talk to your partner about this. Honesty is a true form of intimacy. What if this stage was a chance to be loved when you aren’t perfect? Imagine allowing your partner to love you, just as you are right now? Intimacy is more profound when we allow ourselves to be seen in our imperfection. For more on embracing imperfection look up the work of Brene Brown, a renowned researcher on whole-hearted living.

8. Mood Changes

This is a complex interplay of the physical, social and psychological factors listed above. You will feel good again! Medication given to help aid in post partum depression (SSRIs) can also dampen arousal and desire. It’s normal to feel sad, anxious and not like yourself. If you find that you are feeling this way more often than not, seeking support can make all the difference. Even just feeling normal and being understood goes a long way. 

Here are some quotes from fellow mothers in the Emerging Mothers Group in response to the question, “What would you tell your daughter at this stage of mothering if she felt as you do”?

“This experience makes you part of a community of women”

“Don’t be so hard on yourself”

“You are right where you need to be at this stage”

“You have done something amazing - a miracle. Give yourself time.”

“Let in your partner’s hugs. You don’t have to hide”

We hope this article was helpful. So much can be done to make this transition easier for women and families. Feel free to contact us to talk more or to book a time.

Sincerely, 

Nelia DeAmaral, RP

Registered Psychotherapist and Coach for Women

This email address is being protected from spambots. You need JavaScript enabled to view it.

647-456-2229

 

Jenny Telfer-Crum, PT

Pelvic Health Physiotherapist

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Counting Butterflies: The Beginning of my Postpartum Journey Towards Hope and Change

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I sat on a cardboard box in the middle of our new living room. Beside me was the portable crib my newborn daughter slept in. Her tiny mouth curled slightly to one side; she was in deep slumber. I sighed in relief, beckoning a feeling of satisfaction to mark this moment. But instead, a feeling of overwhelm took its place.

I scanned across the room at the sea of boxes that harbored all of our possessions- remnants of my old life. I wanted to be a ‘good mom’ and get some unpacking done while my daughter slept. Wasn’t that what all the ‘good moms’ did— work while their child slept? Wouldn’t that help me maximize bonding time with my daughter? I had to be more present with her today and less stressed, and that would help my milk supply- wouldn’t it?  

My body ached and my head spun with self-judgement. I knew I had so much work to do, but what I truly wanted to do was curl into my bed and wake up when my husband got home.  In that moment, a wave of reality settled in: I was a new mom. In a new house. In a new town. In the middle of nowhere, all alone. Sitting on a box containing the only passageway back to my old self. 

And I panicked.

My secret had revealed itself: This was my new life, and I wasn't sure I wanted it. My secret rose from a place so deep, I barely recognized it was my own.   This revelation took my breath away; leaving streams of tears in its place. 

Through blurry-soaked eyes, an object in the flower garden caught my attention. Wiping a stream of tears away, I saw that it was a butterfly; it was so beautiful it looked as though it was from a different world. And there it was, in my garden. My elegant guest.  I ran to grab my phone to take a picture, and as I returned, two more landed on the flowering purple bush.  

When Isabella woke from her nap, I scooped her up and fled to the garden to count more. We counted 23 butterflies in the garden that day. And the next day we counted 33.  That summer, as we nested into our new home and lives, I would stop and count butterflies along the way.  On my hardest days, I would find moments of joy, sometimes fleeting seconds, counting butterflies in the garden- and these moments gave me hope. 

I would like to say that my healing and growth during my emergence into motherhood simply came from counting butterflies that summer (there is something magical, and comforting, in the notion that growth can occur so simply). But my growth into the resilient wife, mother, and woman I am today also took courage, strength, and support. My resiliency has become my travel-companion along my life-long journey of growth... but to this day, I still stop and enjoy counting butterflies along the way.

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Michelle Brans, MACP is a published Author, Teacher, and Child & Family Psychotherapist specializing in Motherhood and Holistic-Integrative Child and Family Mental Wellness.  She is the Founder and Clinical Director of Counting Butterflies, which is guided by The Butterfly Prescription to Mental Wellness ® to nurture the transformation and resilience of children and families, by fostering a deep connection to ones' self, others, and the natural world around them. She holds a Masters in Counselling Psychology, and has received training and certifications in: Emotion-Focused Couples & Family Therapy; Mindfulness & Compassion-Based Therapy; Marriage, Family, and Cultural Systems; Attachment & Developmental-Based Care; Holistic-Integrative Wellness; Ecopsychology and Nature-Guided Therapy; and Women's Wellness. She lives with her husband, daughter, and animal-family on their ever growing Green-Care Farm & Homestead in rural Ontario, Canada. Visit her and her team at countingbutterflies.com.

 

Michelle and her team are honored to have partnered with The WOMB to offer Therapy & Support for new Mothers on their journey towards wellness through the Wellmama Home Session Program. We are currently working on an exciting Online Parent Education & Therapeutic Group for Emerging Motherhood. 

Michelle will be sharing more of her story, and other stories of Motherhood, over the coming months.  Inspired to sit with Michelle and share your own story of hope and change during Motherhood for her program? Connect with Michelle at This email address is being protected from spambots. You need JavaScript enabled to view it..counting-butterflies

 

 

Feeling stuck on the worry treadmill?

Find your “anxiety antidote”

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A lot of my work with women revolves around the powerless, and sometimes overwhelming experience of feeling anxious. My clients worry about making mistakes, they worry about being good moms, good employees, they worry about their health….they worry about missing out….they worry. Women often feel robbed of the ability to enjoy the moment, despite a deep longing to feel joy.

There is a difference between worry and anxiety…and we can move back and forth between them.

I want to tell you that you deserve to feel happy. You deserve to feel good enough. You deserve to be free of the debilitating anxiety that comes from constant second guessing, and self-criticism. Your children and family deserve to have a mother who doesn’t carry the world on her shoulders. You are so worthy, my loves…. so worthy.
 
How is worry and anxiety affecting your life? What would your family notice if tomorrow morning, your worry brain took a rest….what would be different?

I help clients find their personal anxiety antidote. I don’t suggest that you just try some generic relaxation or meditation or even just “think positively”. There is a reason that anxiety is there. Anxiety happens when something inside of us is asking for attention. Something inside is asking to be heard, seen and addressed. Sometimes we think we know what it is, so we solve the first thing that comes to mind, but we still feel anxious. I call this the anxiety treadmill! How the heck do you get off without making yourself crazy?
I want to tell you my approach to anxiety. I treat it as a super power. We use this obsessive focus and intense drive to create good feelings!  Did you know that Nasa often prefers to hire anxious people? They are great people, with lots of focus-power. But imagine if they could never turn off that ability? What a terribly stressful existence.

Finding your antidote….

Just for now, try not to “get rid of” the thoughts and feelings. Let’s set out the welcome mat, offer it a cup of tea and an open space. Let’s explore, “What is needed here?

Is there something in your life that you just can’t seem to let go of, even though you have tried? Something that your partner or family think you “make a big deal of”? A situation that you can’t seem to find clarity about, but it’s robbing you of joy in the moment?

Ask yourself a few questions to help identify your antidote:

  • Looking for exceptions to the problem. Getting away from all or nothing thinking: When is the “problem” less bad? What are you doing at these times and who are you with? What are you receiving or giving during these times that seems to help? How might this help you with your current situation?
  • Seeking help: Who can help you with this problem? What has stopped you from reaching out? How easy would it be to reach out?
  • Identifying your harmful self-talk: What belief about yourself is fueling your worry about this situation? For example, what are you telling yourself this means about you as a person that you are having this challenge? Is this absolutely true? What’s more true about you?
  • Giving yourself credit: Even if this situation isn’t perfect, and you are learning, what do you appreciate about how you are handling this? List at least 3, and for extra points ask your partner or friend what they see you doing well.
  • Surrendering control: Are you trying to make the situation perfect? … Trying to meet a standard that seems impossible (even if it is your ideal)? If so, acceptance might be your antidote. Ask yourself, what’s good about this situation? How might I see it 10 years from now?

Send me your thoughts! I would love to hear how these questions open up some new options or perspectives for you!

If this approach speaks to you, drop by for a session or 2. Many clients find that this allows them to experience an anxiety “re-set”. They gain a deeper understanding of where the worry is coming from, get some tools, and off they go. Simple…yes, brave…yes…empowering…yah baby! Lets talk! Do it for yourself, for your children, for your partner, for your family. You deserve it! xoxo

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Nelia has been coaching women during life changes & challenges for over 20 years. Her unique approach helps you approach life challenges with greater clarity, confidence & compassion. Integrate body, mind and spirit through various tools ranging from mindfulness practices, mind-body awareness, and concrete solution-focused coaching. Nelia is also an advanced Birthing from Within Mentor, Certified Doula with CAPPA Canada and a published author (Bearing Witness, Joyful Birth, Lamaze: Giving Birth With Confidence& Sage Magazine). She is also a trainer offering professional development locally & internationally on utilizing mindfulness-based strategies to help facilitate change. Book a session with Nelia!

Struggling with Infertility

By Nikki Bergen, Creator of The Belle Method, and friend of The WOMB

An inspirational trainer and creative educator with a passion for encouraging women to lead happier, healthier lives, Nikki Bergen is one of Canada’s most sought after health and fitness experts. This is her story about her struggles with infertility.

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 This might be the most personal I’ve ever gotten online. See, I’m supposed to be the one inspiring others with health and wellness – sharing pictures of perfect kale smoothies and video tips on how to get strong flat abs. I never imagined I’d be posting Instagram selfies in pre-surgery hospital scrubs and a video interview with a psychologist about my very real struggles with infertility.

But here we are.

The fact is, no matter how much acupuncture you do, or how pristine your paleo/gluten/dairy-free organic diet is, or how many Naturopath recommended supplements you take – infertility still happens. Miscarriages still happen.

There should be NO shame in this. But it still exists. Women often don’t openly share their struggles precisely because of this outrageous notion that they’ve done something wrong to deserve it – that they are somehow inadequate. Shame around this topic breeds silence, and silence is so, so isolating for the 1 in 8 couples experiencing infertility.

The fact is, women’s bodies bear the double burden of invasive medical interventions and society’s judgement when it comes to miscarriages and infertility, regardless of the cause. I’m sharing my story to let other women know they are not alone. We are stronger together. There is no more room for shame in this conversation of infertility.

Here's part 1 of my conversation with Dr. Stacy Thomas .

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