5 myths to debunk that will help you go back to work and still breastfeed

It would be so nice if we could continue to stay home with our little ones, but for most of us, going back to work is a reality.

For many mothers in Canada, we are lucky to have one year of maternity leave before returning to work. But for some, they need to go back sooner and for those who do get the full year, they would like to continue their breastfeeding relationship. Many ask, “Do I need to wean just because I’m going back to work?” The answer is no. It is hard enough to be separated from your baby, so being able to breastfeed when you are together benefits both of you emotionally and physically. 

Here are my top 5 myths about breastfeeding and going back to work after the one-year maternity leave.

1. I need to stop breastfeeding when I go back to work.

Absolutely not! Yes, it may be a bit challenging at first to juggle getting back into the swing of things with working and continuing to breastfeed, but it is just an adjustment. Going back to work is an adjustment in itself anyway. The benefit of continuing to breastfeed, is that you can still renew that closeness and one-on-one time with your baby when you are home - which makes the adjustment of going back to work easier for both of you. 

A side bonus is that many children who will go to a daycare setting when mom returns back to work, will come in contact with new and unexpected viruses and germs. When you breastfeed, you pass on valuable antibodies to your baby through your breastmilk. So, although it is inevitable that your little one may get sick, they will most likely recover sooner or not get as ill if you continue to breastfeed. 

2. I will need to pump when you go back to work. 

Many women have a love-hate relationship with their pump and many haven’t pumped for months. They often wonder “When will I find time in my day to pump? Where will I pump and where will I store the milk?” Of course, this is always an option and you can speak with your employer about setting up a room for you to pump and for you to store your milk (it’s their legal obligation to do so) but you don’t need to pump. Many mothers will simply hand express a bit while away if they feel too full and just breastfeed when they are with their baby. Sure, the first few days when you go back to work may be tough and you may be a bit uncomfortable and leak a little. No problem, bring an extra shirt just in case, learn how to hand express and by the end of the week your body will adjust and you will be fine!

3. I need to start giving whole milk or formula when I’m away from my baby 

Many day cares are very accommodating with what you give decide to give your baby. If you have decided to introduce whole milk into your baby’s diet, then they can definitely provide that to your little one. But many families decide not to do whole milk or dairy and know that baby can get their fat and vitamins from food sources. There are many other options. Speak with your daycare provider about what will work. If you have decided to pump and provide that milk to your baby, you can do that. Working with a naturopathic doctor will also help you decide on alternative forms of milk such as almond, cashew, coconut, or rice milk to name a few. You can also just do water during the day and baby can just continue to breastfeed when you are together. 

4. My baby has never taken a bottle so I will need to introduce one.

This is not necessary at all. If you are going back after a year maternity leave, most one-year-olds will take a sippy or open cup. In fact, many day cares don’t want to have to deal with bottles and will encourage your little one to use a cup. Even if they never had, you’d be surprised how quickly our little ones pick things up when they are surrounded by their peers in daycare who are all doing the same thing.

5. I will need to wean breast feeds before I go back to work.

Not really. Just enjoy the time you have with your baby. By the time your baby is a year old, the number of feeds has usually decreased and on average, your baby may feed 4 times during a 24-hour period. Remember, when you go back to work you may feel full for a few days but your body will quickly adjust. And your baby will also quickly realize when they are without you that they cannot feed from you so they will find another option while you are away. 

Do keep in mind, when you and baby are together your feeding patterns may change. Many babies do what we call “reverse cycling” in which they tend to feed a lot overnight. This is usually temporary when you first return to work. Often its even your baby’s way of just staying close to you as they will miss you when you are gone. But again, your baby will quickly learn the routine. And on weekends, you can resume your regular feeding patterns. On Monday you may feel a bit full again, but your body will once again adjust! Our bodies are just so cool that way! 

Anita Arora is an International Board Certified Lactation Consultant at The WOMB. Anita’s aim is to help mothers reach their feeding goals in a non-judgmental, accepting and natural approach. Anita sees women both in clinic and in the comfort of their homes to assist them with any and all feeding issues. Anita runs a Breastfeeding Café Drop In Group every month, and leads workshops for parents-to-be and mothers returning to work on a regular basis. Her next Breastfeeding and Back to Work workshop is Thursday November 2, 2017 at 10:30am at The WOMB. 

 

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

butterflies

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.

michelle-brans

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”

woman widearms

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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Neliaheadshot4

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!

Three things every birth needs

A Birth Doula answers the Partner's questions

Stanleybirth31Photo credit: Kieran Darcy

Over the past 5 years, I have had the honour of walking alongside so many wonderful families all over the GTA as they welcomed their awesome babies. It is my dream job (although it doesn’t feel like a job!) and I am so thankful for the many moms, dads, partners, grandparents and extended families that have trusted me over the years. As people find out more and more about birth doulas, the most common questions I get are ‘what does a doula do”, “what’s the difference between a doula and a midwife”, and “what about the dad/partner? What role will they have if you are also there to support the birthing mom?” All of these are great questions! But I have to say my favourite question was asked early on in my doula career by a hands on partner who wanted to know “What are the 3 things you use at every birth?”

He asked this question because he had taken lots of classes and read lots of books and felt that he was pretty well versed on how to support his wife. But, due to all of his knowledge, he also felt that he wasn’t trained specifically in the ebbs and flows of birth and wanted to know what role on their team I would uniquely fill. I LOVE this question as it is one that most people I meet with want to know but don’t think to ask.

So, here is my list of the 3 Things That I Use At Every Birth. 

#1: My Voice

During birth, your senses as the labouring mother are all heightened. And as labour progresses and gains in intensity each mother needs to find her own rhythm and ritual to aid her in breathing and letting tension go through each contraction. This is where I come in. I use a variety of gentle, guided relaxation breathing prompts as the birth sensation begins, builds and then recedes. I use the knowledge that I’ve gained in my prenatal visits with moms to use words and phrases that would best suit and motivate her. Although I do not teach Hypnobirthing or Hypnobabies, etc, I am trained in stepping in and supporting a mom who has taken these classes and wishes to use these techniques. I believe that, although there are some similarities to how each birthing mom needs support, that each birth is unique and specific to each mom. So, I pride myself in my adaptability to support every mom where she is; not to guide her to where I think she should be.

Where the partner fits in

As I am guiding mom in the breathing and relaxation techniques, this is where your parter shines! Your partner knows you better than anyone in the room. Your partner loves you more than anyone in the room does. And it is this connection with you that has amazing benefits! Oxytocin is the natural love hormone that is necessary for birth sensations to begin and to build. Who better to help foster an oxytocin friendly environment than your partner? Often partners aren’t sure what to say and how to specifically guide you through each sensation.  That’s the benefit of having me there! :) I can support mom in the ways I am trained to, and your partner can, with a touch, a presence and words tell you how amazing you are, how strong you are, and how they can’t wait until your baby is here.

#2: My Hands

Stanleybirth1Photo Credit: Kieran Darcy

How to provide hands on support for a labouring mom was a key part of my doula training. There are many different positions that not only support mom and give her some relief, but are also great positions for baby as they make their way to her arms.

Applying counter pressure via a double hip squeeze during each sensation is something that most moms absolutely love at some point during their labour. As baby makes their way out of the uterus and into the birth canal, mom can often feel more pressure in her lower back. This is where applying sacral pressure to her sacrum (located in the middle of her back, at the very bottom) can greatly assist in comfort for mom. I also have a rebozo (a long flat piece of fabric) that I can use to bring comfort to moms and also can be used to aid in babies positioning during labour. Having experienced labour and childbirth personally four different times has also heightened my senses and intuition of what may give relief and support to a mom during each sensation. Often something as seemingly innocuous as a gentle massage on mom's back in between sensations can help her greatly in getting into her rhythm and ritual mindset. I’ve often gone from performing the double hip squeeze to a rhythmic massage on her back and if I stop to take a drink, mom will turn her head and say “Please keep going! That helps so much!” :)

Where the Partner Fits In

Similar to how the parter can provide support with their words, your partner's touch can bring a huge amount of relief and reassurance. I love to show partners how I do certain counter pressure techniques and love when they gain confidence as they do them. I’m a visual learner and have found that a lot of partners are too. They often watch for the first little while and then when I suggest they step in and try, they are quick to learn how to do it. Aside from the technical moves, having your partner right beside you, holding your hand, stroking your hair or face, or giving one of their awesome back or foot rubs can bring amazing support and relief as you labour.

#3: My Patience (Holding Space)

Just like it took 10 months for your babe to grow and develop, birth can take time. Your body may have a few starts and stops over several days (or weeks!) as it preps for active labour. This pre-labour and early labour stage can be emotionally and physically draining on both mom and partner. I make it a high priority prenatally to really go over the importance of patience during this stage. I make it a point to simply BE with moms and partners during this stage. This may be to just listen, or it may be to encourage them to shift perspective - to make these next few hours and/or days before babe, a special bonding time with just them - to see how special this time is..the time between ‘almost and not yet’, and to hold space with them there. Then once labour actually begins and babe is ready to get things moving and I am on my way to them, I am very conscious of the need for me to model patience for them, and to be in tune enough to recognize the moments when my voice or my hands aren’t needed...that the greatest tool in some moments of birth is simply holding space.

And finally as baby is birthed and mom and her partner finally get to see and hold and kiss and love their new sweet baby, I quietly take pictures and videos of those amazing first moments. And as much as possible, foster an environment in the room that respects those first incredible and life changing moments.

Where the Partner Fits In

stanleybirth2 1Photo Credit: Kieran Darcy

The most common thing I hear partners say at births or prenatally is “I just want to help her.” And it really wasn’t until I became a doula that I fully appreciated how difficult and emotionally draining the role of the support person could be. And that is amplified 1000% for your partner as they love you and it can be so difficult to see the one you love in pain. And because of this enormous love and concern they have for you, sometimes it is difficult for them to remember what your birth wishes are - especially when all they want to do is take your pain away. But once your partner is able to see the tremendous value in simply holding space for you and simply BE by your side, it’s really amazing to watch what happens. It empowers the birthing mom in an amazing way! She can "read" her partner better than anyone else, so when her partner's face is lined with worry or doubt, she can see that. But, when she sees her partner calmly and confidently just BE-ing, the calm and confidence transfers to her and empowers her to trust her body.

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So those are the 3 things every birth needs! I have many other tools that I bring and use at different births and during different stages of labour, but these three things - My Voice, My Hands and My Patience are the 3 that I use every single time.

AngieStanley

Angie Stanley is a Birth Doula. She is passionate about supporting women and families and has worked with various non-profit organizations over the past 15 years.  She truly believes that the pregnancy and birthing stages are some of the most life changing and special times of a woman's life.  She considers it an honour to be present to walk alongside women and their families at such a special stage of life. Setting up a FREE consultation with a Birth Doula is easy! Visit us here!

Grandmas have vaginas too!

"My Mom/Aunt/sister has had two/three/thirteen kids and also has leaking/pain so I thought this was normal”.

incontinence lisa gillispieAs a Pelvic Health Physiotherapist at the WOMB, I work primarily with women during and after their pregnancies to help decrease back, hip and pelvic pain, treat incontinence (bladder or bowel leaking), prevent pelvic organ prolapse (uterus, bladder or bowel moving into the vaginal canal) or sexual dysfunction like dyspareunia (pain with intercourse). I cannot tell you how many times clients have said to me, “well, my Mom/Aunt/sister has had two/three/thirteen kids and also has leaking/pain so I thought this was normal”. A phrase I use all the time is it is common, but not normal’.

It is NOT normal to have leaking when you laugh, cough, sneeze or jump

It is NOT normal to have to run to the bathroom because you get the sudden urge to go NOW

It is NOT normal to wake up at night to pee until after menopause, at which time only 1x/night is expected

It is NOT normal to feel like something is falling out or pushing down on your vagina at the end of the day or with activity (or at any time!)

It is NOT normal to have pain with sexual activity (unless, of course, you choose to incorporate pain into your sexual activity in which case this is normal for you)

core

These statements ring true regardless of how many children you have had and what your age is. Why? Because all of these activities have to do with your pelvic floor and inner core functioning. Your pelvic floor is a series of muscles, and muscles can be trained at any age and any stage of life. They work to support your organs, keep your back and hips moving well, stop you from leaking and react during sexual activity.

Fortunately pre and post natal Pelvic Health Physio is growing in popularity – MDs/OBGYNs/midwives are starting to refer clients who have symptoms and the public is more aware of their options for optimizing their health both preventively and when treating any issues. But I feel a gap is being missed when it comes to the Mother’s Mother.

Grandma’s have vaginas too and they have been through a lot!

Unfortunately, women tend to believe that leaking/pain/falling out feelings are normal after kids or as they age and often don’t report their symptoms to their doctor. That’s because Pelvic Health Physio is relatively new to healthcare (compared to say dentists, which have been around since we realized we could pull teeth out when they hurt). Leaking, pain and pressure symptoms can really impact someone’s quality of life – not wanting to do certain activities in case you have an accident, not wear certain clothes in case the pad shows, not feeling sexually attractive because it hurts to have sex, or what if there is a leak!? If they do report it to their doctor, it used to be that surgery was the golden ticket, however pelvic surgeries haven’t been as successful as anticipated and can have some really unpleasant side effects.

organ prolapse
Fortunately, as I mentioned before, all of these symptoms have to do with pelvic floor muscle functioning, and muscles can be trained! Pelvic floor physio is advised as first line treatment (so BEFORE surgery) for urinary incontinence (Journal of OBGYNs Canada Guidelines) and as successful conservative management of pelvic prolapse (Cochrane review 2011). Just like the more squats you do the easier it is to get out of a chair, or the more your practice the piano the easier it is to perform more complex pieces, the more strengthening and coordination exercises you do for your pelvic floor the easier it’ll be to perform – whether this be by holding in pee, supporting your organs as you lift or having pain free sex. My job as a Pelvic Health Physio is to teach you how to do these exercises and incorporate them into your day-to-day activities.

Yes, vaginal tissues change as we age. Decreased estrogen during and after menopause thins and dries vaginal tissues. This can contribute to or worsen any leaking/pain/falling out symptoms you may have. Topical estrogen from your doctor and/or natural vaginal moisturizers (ie Mae by Damiva) can help to reduce these symptoms. Combine this with Pelvic Floor Physio to ensure your muscles are strong, flexible and coordinated, and we have a pretty great anti-aging system for your vagina!

Checking in with your Pelvic Floor Physiotherapist around when you have kids is great – we can help your body through it’s natural changes and ‘nip’ any problems ‘in the bud’. But it’s never too late to discover how to help your body help itself, whether you are post menopausal, have already had a pelvic surgery, have had no kids or 7 kids. If you are reading this as a new mom, don’t forget about your Mom/Aunt/sister who mentioned they had pain/leaking/falling out issues too. Feel free to send them this link or reach out to me personally if you have any questions.


jennytc

Jenny Telfer Crum is a Pelvic Health Physiotherapist at The WOMB specializing in return to exercise and normal function after birth. Jenny holds an Honours Bachelor of Science degree in Human Kinetics from the University of Guelph and a Masters of Science in Physiotherapy from McMaster University. She became interested in Pelvic Health after experiencing chronic hip pain that did not resolve through traditional orthopedic physiotherapy treatment but resolved quickly after seeing a Pelvic Health Physiotherapist. Set up your pelvic health physiotherapy appointment today!

I've got a baby now, and you're suggesting I take care of ME? Are you joking?

A student's experience at The WOMB

Jasleen Gakhal is a 3rd year nursing student at Ryerson University. She spent 4 months at The WOMB this year, learning what it means to be a mother, how to recover from birth, and how to care for the health of our newborns and babies. What she found is that mothers have very little time or energy left to give to themselves after having a baby. So she compiled the must knows for moms - keep it simple, keep it doable. 

Being exposed primarily to Western Medicine in her three years thus far at Ryerson, Jasleen's eyes were opened wide to the possibilities and the success of body work, restoring the body from the inside out, and the support and allies mothers need in order to transition into their new mother role. This is Jasleen's experience - what she gleaned from the experts of The WOMB and what she would want to share with new mothers.

mom and baby support group

Pelvic Health Physiotherapy Tidbits
• Every time you go from a sitting/lying position to a standing/ upright position while you are pregnant, and postpartum, use the "sexy senior" or "rolling pin technique". This prevents future diastasis recti or "mummy tummy" from occurring.
• Caster oil can become your best friend, if you have had a caesarian birth. Using the pads of your thumb, and using an up/down simple motion across your caesarian scar will help the scar tissue heal quicker and more safely.
• While having a bowel movement, it’s ideal to be in a squatting position (the squatty potty can help!) rather than in a sitting down position. This helps with ease and assists in the passage of stool. Also, if you are having trouble voiding, turn/ twist your body towards your right side – this helps “squeeze” your colon/ intestines and helps with the bowel movement.
• Nutrition, exercise, sleep and stress management are all key in determining health. They all equally contribute to your overall health and they each need individual attention.

caesareanscar

Naturopathic Medicine Tidbits
Probiotics can be very important. It is important to have a good balance of good and bad bacteria in your system - especially if you have had a caesarian birth. During a vaginal birth your baby is exposed to the natural flora and bacteria, which your vagina possesses. This promotes healthy gut flora and disgestion for your newborn. So if you've given birth by caesarean, supplementing yourself and your child with probiotics can cover for that loss.
• If you do plan on vaccinating your child, chose a time when your child is in optimal health. Moreover, a time when everyone in the household is in optimal health. It is not vital for you to follow the "regular" regime of the vaccinations schedule. It is possible to split up vaccinations, instead of doing them all at the same time. For example, if your baby needs 4 vaccinations, it is possible to get them 2 at one time and then the other 2, two weeks later. When introducing new strands of viruses to your baby, the last thing we want is your baby to be fighting something else along the way.

newborn

Breastfeeding Tidbits
• Did you know your baby does not latch onto your nipple with their mouth or lips? They actually use their tongue to curl around your breast and this is how they draw milk from the breast.
• If babies are not getting enough milk, they tend to fall asleep at your breast because they are using more energy than they are gaining.
• Breastfeeding does not have to be painful! When it does become painful this should be an indicator that something is wrong.
• Putting breast milk or colostrum on your nipple can help keep them from drying and cracking and it can help draw your baby to your nipple (milk is sweet and smells good!).
• You can actually feed your baby if you get sick! This can help your infant build antibodies.
• A helpful indicator to measure whether your infant is getting enough breast milk in the first few weeks of life is to look at the number of wet diapers they create. For example for the first 5 days of life, your newborn should make as many diapers as they are old (I.e. 4 day old should make 4 wet diapers).
• If you would like to exclusively breastfeed your child in the first 6 months of life, try to stay away from pacifiers or fake nipples. This is because a baby can become accustomed to the size of the pacifier nipple, which can make it more difficult to latch onto your breast later.

breastfeeding positioningandlatching

For more information on getting support and care for yourself and your newborn, call us or make an appointment today!

Why I Don’t Hate Crunches, CrossFit and Bootcamps for Moms

Exercise after Pregnancy

As a Pelvic Health Physiotherapist working at a pre and post-natal centred clinic (The WOMB – Milton), I see multiple clients a week navigating through the fourth trimester of pregnancy – the first 3 months AFTER birth (we also see clients throughout pregnancy - I wrote a blog about exercise in pregnancy here). The fourth trimester is a HUGE time of change.  You, as a new mom, are learning how to be a Mom – navigating how to eat, sleep and nourish yourself and your new baby (or babies!). During this time, your body is undergoing a huge amount of change as well – your organs are repositioning themselves after giving up most of their space to Baby for 9 months, your abdominal wall is re-tensioning and you may be healing from some stretching or stitches in the abdomen (from a caesarean birth) or pelvic floor (from a vaginal birth). You might have some leaking (incontinence) or maybe some back or pelvic pain. Plus, now you are constantly juggling a floppy newborn Baby – standing, carrying, feeding in seated or lying down (or somewhere in between!), picking up toys, food, disregarded soothers, car seats, strollers, and all on 2-3 hours of sleep…. Phewf! You and your body are going through a lot! Fortunately, the reality is that our bodies are strong, reliable and so dynamic! Here is what you can do to set yourself up for an optimal recovery AFTER Baby.

Phase 1: Week 1-3: Adjusting to Motherhood and Getting Back to Basics

Focus #1 – Baby
Focus #2 – Get some sleep yourself!
Focus #3 – Breathe.

During pregnancy Moms tend to breathe up into the chest because Baby is in the way, preventing full, deep breaths. Your body has learned this pattern over a matter of months and may automatically continue breathing this way unless you give it a little conscious thought. When we are using our diaphragm to breathe our abdomen rises and our ribs move out to the side and our chest is the last thing to move. This breath pattern, called “diaphragmic breathing”, naturally helps the pelvic floor to function optimally and get back on board after Baby.

I often suggest Moms try to fit this in as they feed – this is something you usually do multiple times a day and once Baby is set up you can concentrate on your breath. This is a bonus because this can also be a little mini-meditation and some quiet time to regroup.

Focus #4 – Posture

During pregnancy your weight distribution changed through the pelvis and legs as Baby grew. After pregnancy your body may be used to standing as if you were still pregnant – this is typically with the ribs back and your tailbone tucked under you. Check out an easy way to set up a more neutral posture after baby is born.

Yes, for most new Moms this will feel like you are leaning forward or sticking your booty out like Beyoncé. This is just because your body is used to being shifted back so it thinks being stacking ribs over pelvis is forward. If you keep your weight in the middle of your feet and look in a mirror as you set up your posture like in the video then you will see that you are indeed upright – if your weight is over the toes then yes, you may be leaning too far forward.

Phase 2: Week 4-6+: Returning to Activity

Around this time you might be starting to feel like you are getting into the groove at home, might be going a little stir crazy and/or want to do some exercise. (Or you might still be adjusting to new life with Baby – in which case take your time in Phase 1, no rush!). You might have your appointment with your OB or midwife where they might give you the go ahead to return to activity… with little instruction after that. Does this mean you can jump back in to running, Bootcamp, Body Bump, CrossFit, HITT, 21 Day Fix, etc?

The short answer is, it depends.

Did your OB or midwife look at your birth region (abdomen or pelvis) at your appointment? Maybe. Did they test for strength, relaxation or activation patterns of the ab muscles and pelvic floor? Probably not. Imagine you injure your bicep. Your Doctor’s job is to tell you that you have an injury, stitch you up if needed, make sure you don’t have an injection, maybe give you some meds and refer you to an expert if needed. It is your Physiotherapist’s job to assess the biceps functionally (does it work so you can lift things?) and give you some stretching and strengthening to do to help you recover. This is what Pelvic Health Physios (like me!) do for your abs and pelvic floor (and back and hips, too). We take a look to see if you have Rectus Diastasis (AKA abdominal separation AKA Mummy Tummy), we help address any incontinence (bladder or bowel leaking) issues and ensure you don’t have any prolapse (abdominal organ shifts). We also help educate you about why your might have pain with sexual activity and what you can do about it (and there is a lot we can do about it!) and help you get back to whatever form of activity you want to get back to – whether that is walking, yoga, power lifting, boxing, Crossfit, pole dancing... etc! This might be something you can get back to quickly or it might be something we will work up to as your body continues to change and recover - it really changes person-to-person.

bumppilatesIn general it is wise to start at a lower intensity and build up – for some this may start with short walks outside and build up to jogging, for others this may mean doing modified WODs with lighter weights. Your body is still adjusting to life with Baby on the outside, you might be allocating more body energy to breastfeeding, your hormones are still fluctuating and you are probably running on less sleep than before. Be patient with yourself – “know your limit, play within it”, is a great phrase to remember during the third trimester. My job as a Pelvic Physio is to help you know what your limit is.

What about sit ups, planks, Russian twists?

Again, it depends. When working well, the inner core (diaphragm, abs and pelvic floor) work to support our outer core (“6 pack” rectus abdominus, the twisting obliques, back muscles, glutes [bum muscles]) through all our movements and tasks. If your inner core is working well then sure, do all of these activities! How do you know when your inner core is working well? In general, your abdomen will automatically flatten not bulge when you do movement (this is not clenching), you will have no leaking, no pressure or heaviness in the pelvis, and no pain. However, you can definitely still have suboptimal inner core function without these symptoms that might creep in over time. One study has shown that women can develop incontinence 5-7 years after birth. Personally, my inner core coordination was off and I didn’t realize until I started running over 5km and then had hip pain. This resolved once I saw a Pelvic Health PT and did some simple rebalancing exercises.

What about CrossFit or HITT?

These forms of exercises are awesome for full body workouts - we definitely want to build you up to returning to these exercises we just have to ensure you’re working from the inside out. Learning how the inner core supports you through these exercises and how to brace for heavy lifts properly will help to prevent any issues from arising from your sport, and usually results in improved PBs (personal best) as well.

Overall, most people can return to their preferred form of exercise safely after birth as long as the inner core is serving you well. How much rehab you will need to build you up to these activities varies from person to person. As Pelvic Health Physios, we help you reconnect with your pelvic floor and inner core muscles to ensure everything is ship shape to support your through lifting and chasing after your kids as well as any other sports or exercises you want to pursue.

If you have any questions, please don’t hesitate to set up an appointment to meet with us at The WOMB or check out our Mummy Tummy workshop.

jennytc

Jenny Telfer Crum is a pelvic health physiotherapist at The WOMB. She specializes in preparing the body for birth and then helping women return to exercise after pregnancy and has taken advanced courses to help high intensity weekend warriors return to their training of choice.

The WOMB offers Mummy Tummy Workshops, Pfilates classes (pelvic floor pilates), Momma & Baby Core classes and when you’re ready Mommy Bootcamp.

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.

nikkibergen

 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 .

BelleMethod TAG

Exercise During Pregnancy

When & What? Advice from a Pelvic Health Physiotherapist

A common question I get as a Pelvic Health Physiotherapist is: “What kind of exercises are safe to do during pregnancy?”. The short answer is that most forms of exercise are safe and advocated. Maintaining fitness, preventing health issues such as gestational diabetes and preparing the body for an optimal birth and recovery are a few of the reasons why regular exercise is important. Of the different types of exercises, “core exercise” is often a hot topic for pregnant women. Although your deep core muscles do assist in breathing and pushing efforts during birth, your uterus does most of the work so you don’t need abs of steel to to have a smooth birth (another blog to come on this topic). Engaging in different types of exercise will keep you well in pregnancy and beyond.

pregnancy pool

Safety: When shouldn’t I exercise during pregnancy?
In rare circumstances there may be reasons to more drastically modify standard exercise recommendations or avoid exercise all together. If there is an underlying condition involving the uterus, placenta or your overall state of health, your primary care provider will typically indicate when this is the case. Refer to this link for more information.

What kind of exercise should I be doing?
General exercise guidelines still apply during pregnancy – cardio for lung and heart health 30 minutes, 5 times a week; muscle strengthening 3 times a week; and stretching daily. There is also a lot of new research outlining the importance of daily mindfulness to counteract the chemical stress response that most of us have in our busy lives. Try a 15 minute guided body scan (lots on YouTube), meditation, prayer or gratitude journaling.

Some women find during the first trimester symptoms of morning sickness limit them from doing strenuous activity. Be patient with yourself and give your body some time. Starting with a gentle walk for 15 mins 2x/day just to get the blood pumping and muscles moving is still beneficial. The same principles apply if you are new to exercise – start slow and gentle and progress as you are able.

What about Kegels?
A “kegel” is a sustained and repeated pelvic floor activation named after the OBGYN who started advocating for them in the 1940s (Dr. Arnold Kegel). Yes, we want our pelvic floor muscles to be strong but we also need them to be flexible; they need to be able to relax, and to be coordinated with our muscles. As a Pelvic Health Physiotherapist, I can help you set up an inner core program incorporating pelvic floor muscle training that will support you through your pregnancy, during exercise, throughout labour and into your recovery post partum. 

What about Yoga?
Prenatal yoga can help with flexibility and relaxation during pregnancy and also has the added benefit of meeting other Moms-to-be for you to connect with during pregnancy and into motherhood. Yoga is a great compliment to your strength and cardio program. Note that hot yoga is not recommended during pregnancy as the increases in core temperature can impact fetal development.

prenatal yoga

High Impact Exercise: What about Running? Crossfit? HIIT? Power Lifting?
In the media there tends to be an all-or-nothing approach to pregnancy – either all you do is yoga or you continue to power lift until the day you birth your baby. If you were performing high intensity or high impact exercises before pregnancy it is typically safe to continue these, but the intensity will taper down during pregnancy. Here are some things to remember:

You must acknowledge that your body will change during pregnancy and it is wise to honour these changes. There are a number of physical adjustments that affect your posture, breathing and your muscles' ability to generate power as the length of muscles change and the relationship of structures adjusts. Good form when executing high-impact exercise is always very important and simply put is more difficult to do when pregnant. Unfortunately, most trainers do not have the adequate knowledge to guide women through these high impact exercises in a safe and appropriate manner. Sit ups, curl ups, toes to bar, V sits, boat pose, Russia twists and double leg lowers are examples of traditional core exercises that increase abdominal pressure and overrecruit our external core which can contribute to rectus diastasis or “Mummy Tummy”. To prevent pelvic floor issues and abdominal wall issues, you are best to touch base with a Pelvic Health Physiotherapist who can appropriately guide you through the exercise program you desire.

pregnant running

Don’t forget that pregnancy is a time for maintaining your strength and endurance then tapering the intensity as your needs change. The goal is not to develop fitness at this time through max lifts or personal bests, so an adjustment in your approach to exercise and fitness is important. During pregnancy you should be able to talk throughout your workout, recover quickly and modify your movements easily.

I hear I am supposed to listen to my body – what am I listening for!?

  • Pain – of any kind, especially in the back or pelvis.
  • A feeling pressure or heaviness in the pelvis
  • Loss of control of urine – leaking with lifting, running, coughing, sneezing, laughing
  • A “tenting” or “coning” through the front of the abdomen with any movement
  • A tendency to to hold your breath to perform a movement
  • Development of hemorrhoids or varicose veins

These events signal there is a muscle and pressure imbalance through the body that needs to be addressed. Again, as a Pelvic Health Physiotherapist I can help you connect with these imbalances and educate you as to how to manage them going forward.

Take Home Message: Exercise is Medicine in Pregnancy and Beyond!
Exercise during pregnancy is safe for most women and should be fun, engaging and rewarding – physically and emotionally! You can start at a low intensity and build your way up, or continue with the work you were already doing and make modifications along the way. At the WOMB we have workshops, fitness classes and our Pelvic Health Physiotherapy team ready to support you through your pregnancy and into motherhood. 

jennytc

 

Jenny Telfer Crum is a Registered Pelvic Health Physiotherapist at The WOMB. She has a special interest in helping women exercise safely during pregnancy, prepare for labour and return to their exercise intensity of choice after birth while honouring their body along the way.

 


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