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Pelvic Physiotherapy can help kids too!

Pelvic Physiotherapy can help kids too!

Adults aren’t the only ones who have issues with their pelvic floor - many children deal with challenges like bedwetting, constipation, or incontinence. There is a high and growing prevalence of paediatric pelvic floor dysfunctions. Up to 50% of pediatric urologist consults are for constipation1 and 5-10% of seven year-olds experience enuresis (leaking urine).2 Pediatric pelvic physiotherapy is a high effective non-invasive treatment option for children to help improve symptoms, quality of life and may prevent chronicity.3

What we can help with:

  • Prevention of any pelvic health issues through optimal toilet learning
  • Dysfunctional voiding
  • Constipation
  • Enuresis (urinary incontinence)
  • Nocturnal Enuresis (bedwetting)
  • Encopresis (fecal incontinence)
  • Overactive bladder or underactive bladder (peeing too often or not frequently enough)
  • Fear of urinating or defecating


What to Expect on your child’s first visit

Our pediatric pelvic health physiotherapist’s first goal is to have both child and parent/guardian feel comfortable and supported, as we know bladder and bowel issues are often associated with pain, embarrassment, and anxiety. We ask questions and engage the child to participate in the assessment in a relaxed and fun way.

  • Health History: We will ask about the challenges you’ve experienced, any medical tests or diagnoses your child may have received, bladder/bowel habits, toilet learning success or lack thereof, child’s fluid intake and diet, sleep patterns and activity patterns.
  • Physical Exam: We will look at your child’s posture and breathing, joint mobility, muscle length, strength and coordination. In some instances, we may also want to evaluate the external pelvic floor muscles (visual look and/or palpation) with the consent of the child and parents/guardians. You and your child have the option to choose or refuse any part of the treatment with which you don't feel comfortable. Unlike the process for adults, there is no internal examination of the pelvic floor muscles for children.
  • Client and Family Centred Goals: We want to hear the goals of both the parents/guardians and the child, as we recognize that these issues impact the entire family.


Care Plan:

We tailor each care plan based on the findings of the assessment and on your family’s goals, while keeping it fun, and rewarding for your child. We focus our care plans around self-management support principles to ensure all aspects of a healthy lifestyle are integrated. Care plans can include:

  • Education on bladder & bowel function and its relationship to the pelvic floor, proper toilet positioning, wiping habits and more
  • Bladder and bowel retraining schedule
  • Counselling on lifestyle or behaviour modification, diet and exercise, sleep patterns
  • Manual techniques (external) if needed
  • Collaborating with the rest of your care team such as your Paediatrician, Naturopath, etc.


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 Toddler Toilet Learning & Pelvic Health workshop.

Written by Lea Damata, PT 
LeaHead Shot WOMB 002Lea is a Pediatric Pelvic Physiotherapist at The WOMB. She is a graduate from McMaster University with a Masters of Science degree in Physical Therapy, and York University with a Bachelors of Science in Kinesiology. Lea’s diverse paediatric experiences, including her work at McMaster Children’s Hospital and Holland Bloorview Kids Rehabilitation Hospital, has also fostered a special interest working with children. She was the recipient CanChild’s Paediatric Research Award in 2017. 
This email address is being protected from spambots. You need JavaScript enabled to view it.

References:
1. Burgers et al. Management of functional constipation in children with lower urinary tract symptoms; Report from the Standardization Committee of the International Children's Continence Society. J Urol, 2013;190(1):29-36.
2. Nevéus et al. Management and treatment of nocturnal enuresis – an updated standardization document from the International Children’s Continence Society. J. Pediatr. Urol, https://doi.org/10.1016/j.jpurol.2019.12.020.
3. Lonkhuyzen et al. Effectiveness of Pelvic Physiotherapy in Children With Functional Constipation Compared With Standard Medical Care. Gastroenterology, 2017;152:82–91

Conscious Conception:

The Benefits of Fertility Yoga

Yoga has many known benefits for the body, but did you know that it could improve your fertility? Aside from supporting women during pregnancy and post childbirth, yoga has the capacity to increase your ability to conceive thanks to a range of benefits. Here's a closer look at why you might consider trying fertility yoga if you are trying to get pregnant.

#1 Yoga Helps You Reconnect

Mindfulness and mental clarity are certainly at the top of the list when it comes to yoga's universal benefits. However, the ability of yoga to help you reconnect with your body is extremely beneficial if you are looking to conceive. Aside from reducing your stress and anxiety, this can help you avoid the disconnect that women often experience when it is taking a longer time to conceive. Through yoga, you will learn to love, appreciate, and work with your body.

#2 Increase Blood Flow

The deep stretches and breathing techniques employed in yoga will help you to improve your blood flow and circulation throughout your entire body, helping energy flow to your reproductive organs. Most of us live a sedentary lifestyle that leads us to sitting for the majority of the day, so yoga plays a big part in helping to open up your muscles and get the blood flowing, especially to your pelvis region--an area that often becomes tense for most women who live a sedentary lifestyle.

In traditional Chinese medicine, stagnant energy ("chi") can lead to reproductive issues, so moving in a yoga session will help you to open your body's energy channels and allow all of the stagnant energy to flow freely through your body again. Physically, it will also help to open your hips and give you relief from physical tension that's hindering your circulation and movement. 

#3 Achieve Hormonal Balance

Your endocrine system is responsible for producing all sorts of different hormones, including sex and adrenal hormones. When one element of your endocrine system is out of balance, it can lead to a domino effect, impacting much more than hormonal balance within your body. Since hormonal balance is important for optimal fertility, you should focus on stabilizing your internal systems.

Lifestyle factors, including stress, can impact your hormonal balance. Fortunately, yoga can help you counteract these lifestyle factors to rebalance your system. By calming your nervous system, your cortisol (stress hormone) levels will go down, which will help you improve your body's overall health. Yoga's ability to help you process mental challenges and difficult emotions can also help reduce your stress hormones and bring an inner balance to your body.

For those wanting to learn more about fertility yoga, reach out to The WOMB. Angela Del Franco Certified Optimize Coach and Yoga professional, runs 6 weeks course on Fertility Yoga at The WOMB (The World Of My Baby) in Burlington - Tuesdays at 8pm. Visit thewomb.ca to register.

Prenatal Yoga:

The Many Reasons It Works to Prepare Women for Pregnancy and Birth

With experts recommending at least 30 minutes of moderate physical activity a day for pregnant women, prenatal yoga is an excellent way for expecting mothers to unwind and stay physically fit all at the same time. If you're not familiar with prenatal yoga, here is a quick run-through of how it can help improve your quality of life and even promote your baby's health while in the womb.

The Benefits of Prenatal Yoga

Most childbirth preparation classes take a multifaceted approach to helping mothers stay active and healthy as they prepare to give birth, and prenatal yoga is no different. A prenatal yoga class works to encourage:

  • mental clarity
  • physical stretching, and
  • focused, controlled breathing,

All of which can lead to a number of benefits—including better, deeper sleep. In turn, that can lead to more physical energy during the day.

Research supports the safety of prenatal yoga along with its many benefits for both expectant mothers and their children. Aside from improving your quality of sleep, prenatal yoga has the capacity to reduce your stress and anxiety, both of which are linked to poor sleep, poor nutrition, and low morale. Meanwhile, prenatal yoga can increase your strength while helping you improve flexibility and even improve your muscle endurance, all of which is very beneficial for you're impending childbirth.

Prenatal yoga can even help you conquer some of the symptoms of pregnancy, such as lower back pain. It can also help in relieving headaches, nausea, and help you avoid shortness of breath by giving you powerful breathing techniques and exercises that you can utilize both in and out of the classroom. Finally, prenatal yoga gives you the opportunity to bond with other expectant mothers through shared experiences as you progress through your pregnancy journey.

What Does Prenatal Yoga Entail?

If you have never attended a prenatal yoga class before, let all of your worries fade away! There is nothing strenuous about any prenatal session and every class centers on gentle stretching, deep breathing, and a number of postures that mix sitting, standing, and prone positions to develop your balance, flexibility, and strength. Props, including cushions and blankets, are also often used to provide added support and keep you comfortable.

Every prenatal yoga class also includes a proper cool down and relaxation session where you'll get to relax and restore your body to its resting heart rate and breathing patterns. This is often when attendees are able to focus on their sense of inner calm and work on clearing their mind, which is another big part of prenatal yoga's focus.

Would you like to see for yourself what prenatal yoga can do for you? Angela Del Franco - Certified Optimize Coach and Yoga professional, currently teaches Prenatal Yoga at The WOMB (World Of My Baby) in Burlington every Thursday at 7pm. Visit thewomb.ca to learn more.

Pelvic Floor Physiotherapy – What do Kegels Have to do with it?

Hello! I’m Jenny Telfer-Crum and I am a Women’s Pelvic Health Physiotherapist (aka Pelvic Physio). This means I have regular Physiotherapy training (ie looking at pain and movement patterns through the neck, shoulders, back, hips, knees etc), but have also taken extra courses to be able to assess and treat the Pelvic Floor muscles. My goal is to educate and empower women so that they can be comfortable and confident regarding their pelvic (and general!) health. There is a lot of misinformation about bladder leaking, pelvic pain and discomfort out there, so in this blog I’m going to talk about the Pelvic Floor muscles, signs that something may not be working well for you, and how Pelvic Health Physiotherapy works.

What are the Pelvic Floor muscles?

The pelvic floor muscles are at the bottom of the pelvis, between the pubic bone at the front, the tailbone at the back, and the sit bones side to side. They go around the urethra (where we pee), the vagina in women and the rectum (where we poop). These muscles also interact with muscles and tissues in the abdomen, back, and hips (ie glutes and hip flexors). Just like any muscle in the body, we want the Pelvic Floor muscles to be strong, flexible and coordinated in order to function at their best.

pelvic floorpelvic floor2

https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=zm6406

https://www.risephysicaltherapy.com/blog/an-essential-part-of-the-core-the-pelvic-floor

Common Myths about the Pelvic Floor:

- bladder leaking/dribbling is normal after having a baby or as I get older

                -FALSE! This is something that is “common, but not normal”. Pelvic Health Physiotherapy can help to address this, without surgery.

- pain with sex is normal

                - FALSE! Pain with sex can be due to tight pelvic floor muscles/related tissues and hypersensitivity of the nerves in the pelvis. These can be addressed through Pelvic Health Physiotherapy.

- my pelvic problems are not related to my back pain

                - FALSE! All of the muscles in the body work together. If you have wrist pain, Physiotherapists look at your hand, wrist, elbow, even up into the neck! If you have back, hip, abdominal or even leg pain the pelvic floor muscles and structures can be contributing and/or reacting to the pain and muscle patterns you are using. It’s important not to overlook this piece of the puzzle.

When should I see a Pelvic Floor Physio?

The Pelvic Floor muscles work with the nervous system, abdominal pressure system and connective tissue system to support our pelvic organs (ie bladder, uterus and bowels). That means that training these muscles to contract and relax appropriately can help with problems such as:

-  bladder urgency and/or leaking (urinary incontinence)

                - stress incontinence: leaking with laughing, coughing, sneezing, laughing, jumping, running

                - urge incontinence: getting the sudden urge to pee then leaking before you get to the bathroom.

- bowel urgency or leaking (bowel incontinence)

-  pelvic organ prolapse (heaviness or falling out sensation at the vagina or rectum)

Because of the location of these muscles, they can also influence sexual function such as:

- women: pain with sexual activity (dyspareunia, vaginismus), sexual arousal

- men:  prostate-related pain (non-bacterial prostatitis or recovering after a prostate surgery), erectile dysfunction

As I mentioned above, the pelvic floor muscles also work with the neighbouring muscle of the back, hips and abdomen. If you have pain in the pelvis or these neighbouring regions it is always worth getting the Pelvic Floor muscles assessed to see if they are contributing to or responding to the pain response in the body.

back pain pregnancy

Another time to see a Pelvic Floor Physiotherapist if you are a woman is during pregnancy and/or after birth. There are a lot of physical changes that happen during pregnancy and Pelvic Health Physios have extra training to help your body move and cope it’s best during this time of change and preparation. We also have a lot of information regarding birth and recovery strategies that you can integrate into your birth plans/preferences with your midwives or OBGYNs. During vaginal birth the pelvic floor muscles and tissues are stretched and often have some degree of tearing or injury that occurs. During caesarian birth, the abdominal tissues very close to the pelvis are involved, which often contributes to changes to the pelvic floor.  Not to mention that birthing and caring for a baby is a big physical, emotional, cognitive and social demand! Pelvic Floor Physiotherapists can help to assess and address any pelvic, abdominal, back or hip concerns related to pregnancy and birth recovery. This includes rectus diastasis (the abdominal stretch that happens to nearly everyone during pregnancy to make room for Baby).  Pelvic Physios have lots of exercise ideas and recommendations to help you return to your fitness activities of choice (including lifting a three month old in their carseat!) while respecting any changes or healing that is occurring throughout the body.

What happens in a Pelvic Health Physiotherapy appointment?

Just like during a regular Physiotherapy appointment, I start by getting to know who you are and any concerns that you have. This might mean talking about any pain, pressure or leaking sensations you are having, but I also ask questions about lifestyle factors such as work, exercise, and stress levels, as these factors directly relate to pelvic AND whole body health. A Pelvic Physiotherapy session is a unique and safe space where you can ask about anything – bladder, bowel, mental and sexual health questions are always welcome, and I will share any information, strategies, exercises and resources that I have to help you along.

physio appointment

For the physical part of the Pelvic Health assessment, I tend to look at how you are moving in standing (ie back movement, walking and standing patterns, squats and lunges), then we look at the abdomen and pelvis. At the abdomen I am looking to see how you like to breathe and move your arms and legs off the bed – this gives me an idea what patterns your body is already using to get work done.

From there I can assess the Pelvic Floor muscles at the entrance of the vagina. Unlike other internal exams women are used to at the Doctor’s office, I am not using a speculum or any devices, just feeling for muscle patterns at these pelvic floor muscles. I am looking at strength (can you kegel?), flexibility (can you relax the kegel?) and coordination of these muscles (do they work well with other muscles?). I can also look to see if there is any movement in the pelvic organs, which is assessing for any pelvic organ prolapse. This internal assessment is extremely valuable to get the full picture of what is happening at the pelvis, and is always done within your comfort level and it is always your choice to start or stop this assessment at any time.

Once I figure out what your body likes to do on it’s own, my goal is to help you reconnect with the pelvic, abdominal, back and hip muscles through breath and movement. I work with you to help your muscles figure out a different way to work together in order to relieve any symptoms or concerns that you have. Treatment often consists of home exercises, a little manual therapy (often through the back and abdomen to help with general relaxation) and some lifestyle recommendations to help with bladder, bowel and stress management. We might also talk about Pain Science concepts to help calm the nervous system to decrease levels of pain or discomfort in the pelvis or neighbouring areas.

mom babe snuggle

Pelvic Health Physiotherapy is an extremely valuable modality to explore for whole body health and wellness. The best part of my job is teaching women about their bodies so that they feel more connected and in control of their own bodies and well being. I hope this blog provided some insight about your Pelvic Floor muscles. If you have any questions or want to learn more you can email me directly at This email address is being protected from spambots. You need JavaScript enabled to view it..

Take care,

Jenny

Pelvic Health Physiotherapist MSc (PT)

Helping Your Body Help Itself through Education, Exercise and Empowerment. 

Call (905) 842-2434 or book online at http://thewomb.ca/index.php/make-an-appointment 

What to expect during your Registered Massage Therapy Appointment

massage 56884

Whether you have had previous massage therapy or are new to this type of health care, we are glad you are here! We are committed to offering you quality effective treatment which addresses your concerns and progresses toward your wellness goals.

The Registered Massage Therapist (RMT) will be ready to greet you at the beginning of your appointment. If this is your first time booking a massage therapy appointment at the WOMB, the RMT will be required to ask you some questions to clarify the Health History Forms you have completed, as well as to establish your goals for the treatment. It is customary for time to be spent assessing your condition, through questioning or orthopaedic testing where appropriate. This is done to ensure that you will receive an effective treatment which addresses the concerns you have shared with the RMT, and to adhere to the Regulated Health Professions Act (1991) and the Massage Therapy Act (1991), as well as in compliance with the Standards of Practice outlined by the College of Massage Therapists of Ontario. In addition to answering any questions you may have, the Health History, assessment, and determining a treatment plan are necessary to establish informed consent and must be done prior to beginning th

e hands-on portion of the appointment.

If you are a client who has many symptoms you can expect to spend more time in discussion with the therapist than would a client who has presented with one or few symptoms. For example, if you are coming for an appointment to address neck pain you may spend a minute or two in discussion with the RMT about this. Alternately, if you are coming for an appointment to address neck pain, jaw pain, pregnancy-related symptoms, and foot pain, you can expect to spend more time in discussion with the RMT before the hands-on portion of the appointment begins.

pregnancy massage

Once you and the RMT have determined a treatment plan and you have consented to the proposed treatment, you will be given time in privacy to prepare for the hands-on portion of the appointment. This may involve removing some articles of clothing and settling on the massage table under sheets and blankets. The positioning and amount of clothing removed will not exceed what is comfortable for the client, and this will be discussed while establishing the treatment plan.

The RMT will be ready to begin the hands-on portion of the massage therapy appointment when you are settled and covered on the massage table. While you are settling in for this part of the appointment you can expect that the RMT has been using the time to begin treatment notes for the session, as well as taking time to wash hands. The RMT will knock on the door before entering, to ensure that you are settled and ready for them to enter the treatment room.

The hands-on portion of the treatment will follow the RMT’s scope of practice, which is outlined in the Massage Therapy Act as, “the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissues and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain”.

During the hands-on portion of the appointment the RMT will inquire about your comfort level and may ask follow-up questions. Some clients like to silently relax during this part of the appointment, while others prefer to converse with the RMT, and either option is appropriate. It is your right, as a client, to request a change to the treatment or even decide to end the treatment at any time.

Following this part of the appointment you will be given privacy to reclothe. During this time you can expect that the RMT will be washing their hands and continuing with the treatment notes for the session. RMT’s are legally required to maintain accurate treatment notes for each appointment so that your care can be consistent and effective. For clients who require more time to prepare for the hands-on portion or to reclothe, this will be accounted for within their scheduled appointment. Once you are finished reclothing, the RMT may share some instructions for home care, remedial exercise, or recommendations for other types of care. Your appointment will finish with the RMT offering suggestions regarding timing and duration of future massage therapy appointments.

During subsequent appointments you can expect that Health History clarification and assessment/reassessment will account for less of the appointment time, which will allow more time spent on the hands-on portion of the appointment. Whenever you experience a change in your health please share this with the RMT, and you can expect that care will be given to clarify and address the new condition(s). It is our priority to provide knowledgeable, effective, and consistent care which promotes the wellness of each unique client. We will do our utmost to ensure that your experience with Registered Massage Therapy is both pleasant and helpful.

infant massage

The Last Chapter

- A Story of Fertility and Loss

The Last Chapter
A few years ago, my girlfriends and I decided over Mexican food to write a book about being pregnant. It would be hilarious! All the things you didn’t know but you wished someone had told you. We were all on the verge of starting families. We all had a baby, some more than one. We even wrote a few chapters (the best being Chapter 3 – How do You Spell Episiotomy?). And they were hilarious.

We laughed. And then.


Of all the things I didn’t know about pregnancy, this one hit (hits) the hardest. I didn’t know how hard it could be for two responsible, financially stable, willing adults, with good jobs and a home, the means to provide, and more love to give than you can measure, to get pregnant, carry, and deliver a healthy baby.

This is the last chapter of our book on pregnancy. It is my story but it could be the story of so many other women and men who want, want, want, need – but can’t.


The Sound of Silence 
October 2017. ‘We call it a Chemical Pregnancy. A Silent Miscarriage. Really – it’s the most common type of miscarriage and most women don’t even know they conceived. You might notice your flow is a little heavier. Maybe a little cramping.’ My family doctor doesn’t look up from his keyboard where he is pecking away. ‘I blame these high sensitivity pregnancy tests. Really. Testing five days before your missed period? Your body hasn’t had time to consider whether it actually wants to be pregnant at that stage.’ He huffs, and looks up. I am silent. He says my name in a way that lets me know he is exasperated with me. ‘You were only trying for a month. This is nothing to be this upset over. It might even have been a false positive, in which case - you are upset over nothing. You will get pregnant. You have one healthy child. You can have another.’ 

I nod. I thank him. I leave. I vow never to speak to or see him again.

A silent miscarriage. Most women don’t know. Well I did know. And it felt pretty fucking loud to me.

(You were real. We got excited. We talked about new cars, and where your room would be, and the trips we could take on my mat leave. You were real. Finding out you were not coming was a hard punch.)

The Christmas Present
It is easy to get lost in yourself when you want to become pregnant but can’t. The time between cycles drags. Pregnant women surround you like a mean taunting gang of high school girls. Your Instagram and Facebook pages become celebrations of the life you want but fear you will never have. Conversations with friends become difficult. The worst is the well-intentioned advice on how to fix things. Or the inadvertent ignorant comments from people who don’t know your circumstances. You smile. You nod.

You feel more than anything so fucking alone.

You are not.

Mid November, I was pregnant. We went for the heartbeat check and I watched the little flutter. We told our parents at Christmas – early yes, but hell we had a heartbeat! The chances of a miscarriage after seeing a heartbeat drops to around 5%. I rang in the New Year with my head hanging over a toilet bowl. By the end of January, my pants were getting tight and my belly was starting to show, much sooner than it had with my son. I started making plans to turn the guest bedroom upstairs into the new nursery. I unpacked all my old maternity clothes and felt a giddy sense of excitement hanging them up in my closet. My husband insisted it was another boy. We texted potential names to each other. I was beginning my second trimester, close to the fourth month mark. I was happy.

I was unprepared.

‘You need to speak to your doctor about this exam’. The ultrasound tech, an older man with a heavy accent, stared down at me. ‘What’s wrong?’ I ask. He refuses to discuss. I demand to see the baby. He refuses at first. I cause a scene. He shows me, reluctantly, and I see…. two perfect arms, and two perfect legs and they are kicking and dancing and what the fuck could possibly be wrong? He would not let me see any more than that.

We are sitting in my OBs waiting room. We had to wait two days before we could get in to see her. It was an eternity of worry. When I checked in, I reached for the pee strips they make you do before every appointment. The receptionist stopped me. ‘That won’t be needed.’ My blood ran cold. It was bad. It was very bad. My husband is on his phone. I wonder if I should warn him. I say nothing.

It was indeed very bad. ‘Edwards’ syndrome. Trisomy 18. Your baby’s syndrome is very severe. Most babies with this syndrome don’t present on an ultrasound until closer to 20 weeks. Your baby will almost certainly not live to term. If your baby lives to term, your baby will almost certainly die within a very short period of birth.’ (I might almost certainly die of a broken heart right here in your fucking office.)

We leave the office by the back entrance. I stumble walking to the car. (Keep going, one foot after another.)

We wait days for the Genetic Department of Mount Sinai to call us to discuss next steps. (First, your baby will die. Second – nope, sorry, that is the only step.)

I walk a lot. It is February; it is freezing. I sit by the lake in High Park. One day I come home to an empty house and scream, just fucking SCREAM, at the top of my lungs, over and over, until my throat is hoarse. I feel better after that for a short while.

The Amnio and the Mobile
Tests. Blood work. ‘Confirming the diagnoses’. Prolonging the inevitable.

I am lying on my back in the amniocentesis department of Mount Sinai. I have two gowns on and mesh bags over my feet. My husband sits next to me. I’m trying not to be afraid. ‘Let’s start with the ultrasound to see where baby is positioning, before we begin the insertion phase to draw the fluid.’ Sure. Sounds great. I stare upwards as the warm gel is smeared across my belly. Someone has placed a mobile directly above the ultrasound table. Butterflies dance above my head. I want to laugh at the lunacy of this – no woman lays on this table for a happy reason. I’m so focused on marveling at the insensitivity of the fucking mobile that I almost don’t hear my husband speak. His voice is small. Choppy. ‘It sure looks different than with….’ Our son. Yes. It does. I realize he is crying. My sweet, strong, stoic husband is crying. He takes my hand, says my name. ‘Look at me’, he says. ‘I don’t see a heartbeat. I don’t think there is a heartbeat.’ I nod. I see only him, his face, his eyes. I keep nodding. The spell breaks. I turn to the doctor. ‘I’m so sorry,’ she begins.

Wailing. There is wailing (its me, its me) and there are hands, hands, all over my legs, arms. I can’t think. I need to see the baby…. And there, on the screen, there…. Slumped in the corner of my uterus, a little body, with two perfect arms and two perfect legs, no longer kicking, no longer dancing, just still, quiet, gone. (I didn’t know. I didn’t feel it. I should have known. A good mother would have felt it.)

My husband helps me walk out of the room to clean up. My legs are shaking. I’m crying. The other couples in the waiting room stare at me, horrified. In the bathroom I get changed. I’m overcome by anger, rage, shaking me to my core. I want to smash something. I pound at the soap dispenser. There is nothing else to hit. I turn on the taps and start tossing handfuls of water at the mirror, blurring my reflection. It is petty destruction. I soak the room. When I leave the bathroom, the waiting room is empty. The other couples have moved away. I understand. I am what they fear. I might be catching.

At home, I stare at my belly in the mirror until I can’t, I just can’t, look at it anymore. I avoid the mirrors after that.

My husband was right. It was a boy. My son. Our son. I lay on the floor of the guest bedroom and cry. I hold my belly and whisper to my child. (Please can you hear me? I can’t bear the thought that you died alone, in my womb. I was here. I was always right here. I have loved you from the second I knew you existed. I’m still here.) I close the door when I leave. It will be months before I go back into that room.

The Therapeutic Abortion
Almost Valentine’s Day. Almost two weeks after we first found out there was a problem. I’m being buzzed through the first of two security doors at the Morgentaler Clinic for Women. I am here to have a D&C to surgically remove the ‘product of conception’. I grimace at the jargon. Up until they found my son had passed, the doctors called him ‘the baby’. After – the ‘product of conception’.

I fill out intake forms. I’m asked if I am sure I want to have this abortion. I write ‘The Baby Died’ at the end in the ‘More information’ section. I wonder if they got the hospital’s referral. They did; everyone fills out the same forms. My forms go in a gray folder marked “Genetics”.

My husband is not allowed to go in with me. They give me an Ativan to calm my nerves. I change into my nightgown. I’m in a waiting room with other women. I wrap myself in a blanket. I close my eyes.

The doctor talks to me before the procedure. If I had been able to have the procedure at the hospital, I would have received medicine the day before to soften my cervix because of how far along I am (was), so it would be easier and hurt less when the cervix is pried open. But the hospital was backlogged. At the abortion clinics, everything is done same day. I would have to hold pills in my cheeks for an hour and a half to soften my cervix. I’m one day shy of 15 weeks. At 15 weeks, they have to give patients the pills. It’s a bright line. I can choose not to get them at 14 weeks 6 days. The doctor has dark eyes, kind, tired. ‘You have been though a lot. You can handle the pain.’ I opt not to get the pills. I just want to get the fuck out of there.

I’m on the table. There is an ultrasound screen, so a nurse can guide the doctor. There is a second nurse to hand him equipment. The first nurse is also there to help me with the laughing gas. He begins. (I’m sorry, I’m sorry, I’m sorry.) And. Pain. I feel like I am being ripped apart. My nurse slaps the mask on my face and orders me to breathe deep. The other leans over to hold my legs down. (Forgive them all, they were trying to be kind. They are soldiers in a difficult and necessary war) My head is swimming. I can’t focus on the room. The machine sounds like a vacuum, like an industrial version of a car cleaner. And. I see on the screen my baby. I blink. He is gone. Bile wells up. It is over.

The nurses help me to recovery. I’m horrified and trying to process what I saw on the screen. ‘How could you let me see that?’ I sob at them. They keep telling me it will be ok. How sad they are for me. I am not grateful. I try to spit on one. I just dribble down my chin. They barrel me into a chair. It looks like a salon chair. It’s one of many, arranged in a large circle. Like a nail salon. There are crackers. I pick up the bowl and throw it. I am a petulant drugged child. They draw the curtain around me so I don’t disrupt the other patients. After a while, one of the nurses tells me my blood pressure has returned to normal range. I wobble to the change room, get back into my clothes, stuff a pad into my underpants, and stagger out to find my husband to take me home.

That evening, I am seized by a powerful cramp. My uterus is contracting, trying to return to normal size. Something about the contraction, the unfairness of it, the unfairness of everything, of having a contraction with no baby, of having only the product of conception somewhere in some medical grade box being shipped to a fucking lab for an autopsy, just breaks me. (I am broken. I will never be not broken.)

In my aftercare package, there is a letter to give to my doctor for my follow up care appointment. It reads: ‘Dear Health Care Practitioner. Your patient has had a therapeutic abortion.” I laugh out loud. To a follow up feedback email, I write “Consider calling it something other than a ‘therapeutic abortion’. It isn’t a fucking spa”. I don’t send it. I laugh again. It is not a good kind of laugh.

My 18 month old pats my cheek. ‘Mommy sad. Mommy you ok? Hug mummy.’

Yes, mommy is sad. Yes, mommy is ok. After a few days I can move around more freely. My sister comes. She smells like the ocean. She feels like home. When she leaves, I decide to go back to work. Even broken people need to move forward.

A Bathroom in St. Joe’s
We keep trying.

It’s the end of April. I’m almost 7 weeks pregnant. I’m standing outside my OBs building. Panic wells in my throat. I feel sick. I have to pee. I’m five minutes late for my ultrasound. Heartbeat check. Milestone #1.

I swore I would never come back to this fucking place. What am I doing here? I should have insisted on another ultrasound lab.

After day 2 of a hangover, I decided I had the flu or …… Damn. I called the OB. Blood tests. Check. Game plan set – ultrasound after 6 weeks to confirm a heartbeat. Genetic test at 9 weeks to clear that hurdle. And then we would all live happily ever after.

I should have gone to another lab. This fucking place is cursed. I’m in the waiting room now. Sweating. My name is called. Its Him. Are. You. Fucking. Kidding. Me. He acts like he doesn’t remember me. I stare daggers at him. The rage I feel at seeing him is a nice distraction. (It’s not his fault, it’s no one’s fault)

There is no heartbeat. The baby is measuring a few days behind expected schedule. ‘There are many reasons, do not be worried, we will try again in two weeks’. I leave the clinic. I knew it. This fucking place is cursed.

I feel bleary. Heavy. I will not cry. I will be positive. It is going to be fine, in two weeks. (Either that or the baby is dying. Shut up, shut up, shut up.)

May 1. Instagram is a sea of Justin Timberlake. It’s gonna be MAY. I’m almost 8 weeks. Close to safety. (Hang in there.) The next night, I feel it. A twinge. An overwhelming sense of wrong. I go to bed immediately after putting down my son. If I lay perfectly still, it will pass. I can will this to pass. (Don’t leave me, don’t leave me, don’t leave me.)

I wake at dawn. Nothing. I’m ok. It’s ok. I’ve beaten it, I think. The bleeding starts an hour later.

The doctor’s office is neutral: It could be normal. Many women bleed in first trimester! Try not to exert yourself. Take a personal day. If you start passing clots, or feeling cramps, go to the emergency room.

I spend most of the day watching Netflix, laying still. Mantra on repeat: Don’t leave me, don’t leave me. By that evening, the bleeding increases. Clots. A hot dull pain starts to spread across my back. (Is this what they mean by cramps? I didn’t know it would be like this.) I start to tell my husband we need to go to the hospital. And then I think – fuck it. No. One. Can. Help. Right. Now.

I sleep. Try.

In the morning, the pain has magnified. Hot waves across my lower back. I recognize this pain. May 2016. Early labour with my son. Early contractions, before the big ones started. Its gonna be MAY. I go to St. Joe’s emergency room. I tell my husband to go to work. ‘Call you when I know anything.’ I already know it’s done. 

The emergency room is hot, busy, loud. I can’t sit. I pace, rubbing my back. I am hit by waves of tightness, pain, followed by a gush of blood. I keep changing my pad. I wait. And then,

heat across my back. Pain, stronger than ever. I rush to the bathroom. I sit. I’m panicking. Pressure on my stomach, back – I’m straining, not sure where things will exit. Everything contracts. (I’m pushing. Am I pushing? I need to fucking PUSH)

               And then relief.             Gush.               Plop.           Relief.

I’m crying, sobbing, ugly fucking hiccup sobs, because I know, I just know…. I stand and look. At my baby in the toilet. (It’s not a baby yet, it’s just cells, and tissue and blood, a little red celled gummy bear…it doesn’t even have arms and legs so it’s not a baby yet… except it is and it isn’t and oh my god just stop crying people can hear you..)

Except. Except I can see. Except I know. The pressure is less. The pain is dull again. I think about calling my husband. I don’t. I just stand, hunched over, hands on the rim, and stare. And cry. Cry until I can’t breathe. Breathe. Be numb. And then, quietly, finally quiet, I wash my thighs, wash my face, wash my hands. And flush the toilet (goodbye, goodbye, I love you, I love you). I close the bathroom door behind me quietly and go and wait for the emergency room doctor to call my name.

The Birthday Party
We keep trying.

It’s June 30, a sunny Saturday afternoon. We are in the car, heading to a birthday party for my friend’s one year old.

I’m pregnant again. I’m bleeding again. Not a lot. Just enough. (Please stay, please. I love you.)

This time it’s early. (Is that better? Its better. I’m sorry.) Just over four weeks. We had only just found out. The following week, my blood work would confirm the pregnancy. It would also confirm the pregnancy hormone levels were too low, and declining. It would not be viable. But there would be no pain this time, just a heavy red tide of death. (A Silent Miscarriage. I’m fucking SCREAMING inside.)

At the party, I pretend I am a doll. I smile. My pretend dimples show. ‘Work is great. Busy. Yes, amazing weather.’ (I’m bleeding, I’m bleeding, I’m losing another one.) I see my dear friend who is over eight months pregnant. ‘How are you feeling?’ I ask her, because I care, I really do, and ‘You look amazing!’ I tell her, because she does, she truly does. (I’m bleeding, I’m bleeding, I’m losing another one.) ‘Not drinking eh?’ says another friend, eyeing my water glass knowingly. ‘Designated driver’ I reply, smiling. She smiles back, as if we share a secret. Nope. Sorry. Wrong. (There is still hope, don’t give up.)

Mostly I try not to talk to other adults. I keep busy with the kids. My wonderful son. My friends’ wonderful children. The birthday girl. At some point during the party, I excuse myself and sneak out the front door and go and sit in my car with the air conditioning on full blast and just cry.

The Raindance
It’s Canada Day. My girlfriend and I are at Massey Hall. We are laughing. (Is it ok to laugh? Fuck it. It feels GOOD to laugh.) My stomach hurts in that good way after a really funny joke. At the end of the concert I clap and cheer and whistle. I decide in that moment that I’m alive. I am lucky. My son is happy and healthy. My husband is happy and healthy. For the first time in a long time, I am overcome by the feeling that it will all be ok.

If.

Over the next few weeks, I stop holding it all in. I randomly tell people. I need to tell people. I can no longer do this alone.

I tell my husband I think we are under a curse. He laughs at me. He tells me we can do a rain dance with our son to clear the evil vibes out of our house. The next day I put Uptown Funk on at top volume and my son and I run and jump and dance and yell. The walls shake. We laugh. 

I open the door to the guest room. (It’s not a nursery, it’s not a tomb, it’s a guest room.) I open the window. I change the sheets on the guest bed. I lay it in for a little while.

I visit with family. I lean on them. No – I throw myself at their feet and beg that they pick me up. They do. I grow stronger.

I try to forgive myself. You cannot simply love something into being, any more than you could wish a life to blossom. This is not my fault. It is not something I did. It is not something either my husband or I deserve. It simply is.

I try to stop feeling ashamed.

I try to forgive my body. My perfectly flawed and aching body, with its raging hormones, its mood swings, and its practically manic highs and lows. My hair that has thickened and then fallen out and then turned gray. My stomach, hips, thighs, each of which that have widened, drooped, dimpled, than slimmed with each passing, then widened again. My eyes, sometimes dull and sad. The fine lines around them, around my mouth. (Forget it all. It was worth it. The toll of trying. It will always be worth it.)

I say goodbye. I tell my babies I love them. I do. I always will. They are me and I am they. I will carry them with me always. But. I also have to let them go. On the east coast, I whisper words into the ocean. I tell the ocean to watch over them, tell the sun to keep them warm. On the Mira River, I swim out, alone, and say each of their names, aloud, so that the waves can carry them away. I sit on a dock with my brother until 3 am and we let each of them drift off into the fog.
I leave pieces of their souls in the places that I grew up, the places I love. They will be safe there.

I choose a day to remember them. August 16. Our son’s due date.
(I will never kiss your face, your hands, your toes, your belly. But I will be your voice. I will tell of your life, however fleeting. Your brother will know of you. My family and friends will know of you. And in doing so, you will always be loved.)

We will keep trying.

I end this chapter here. I hope for me, my husband, and for all of the people out there who are struggling with fertility issues, who have lost babies, who are losing themselves – I hope there is a happy ending. But this is life. And life is not fair or kind. Life can be cruel and wonderful and without reason. I can only wait and see.

By Anonymous

Note from The WOMB: If you are struggling, in anyway, in anyhow, we are here to support, love and lift you up. Make an appointment with our counselling team today and/or connect with other families who have experienced loss in our Healing Circle for Pregnancy and Infant Loss.

Forget the Rain and Go Online for Educational Fun

Forget the rain go online smYou’ve been looking forward to this day off with the kids, having planned a wonderful trip to the park for some fun in the sun and a picnic on the grass. But the weather has frowned on your plans, sending gray clouds and pouring rain to spoil your outing and keep you stuck indoors when you should be playing outside. It’s a bummer, but don’t fret for long because there are plenty of indoor activities that are as fun as they are educational. In fact, the little ones may learn more than they do at school with you there to guide them. Here are some ideas.

Play Math Games
Sounds boring, right? Well, it isn’t if you know where to find the right lessons, and that’s where Coolmath Games comes in. You’ll find dozens of activities that’ll have your kids adding, subtracting, multiplying and dividing without even realizing how much work they’re getting done or how far they’re advancing in their arithmetic skills. The little ones will be too busy racing taxis and escaping monsters to even care.

Study Music
It’s not hard to locate lessons for piano, guitar and flute via webcam with qualified and engaging instructors from all over the country. If your child hasn’t started playing an instrument, now’s the time to introduce to them to some different forms of music so they know what’s out there. For budding vocalists, pick a song they like, find the lyrics and sing along together while clapping your hands to the beat.

Draw Pictures
Let them amaze you with their creative talents thanks to some online drawing tutorials. They’ll be guided step-by-step and line by line in rendering a variety of fascinating pictures that include their favorite Disney characters as well as dinosaurs, animals and monsters. The only problem is there are so many options they may have trouble choosing one.

Make a Snack
You may be feeling a little peckish at this point, so it’s off to the kitchen, laptop in hand, where the kids will do most of the work in preparing a delicious and healthy snack to keep everybody going strong. You’ll even find a recipe based on the famous Stone Soup tale. If that doesn’t tickle your fancy, try the wiener weenie dogs, which should get the little ones giggling and their mouths watering.

Explore Science
Bellies full, it’s time to get to work in your makeshift laboratory, and your kitchen should serve well once you’ve cleaned up the remainder of your snack. There are plenty of hands-on projects that bring science to life outside of the musty old textbook. Your little scientists conjure up bubbling lava using nothing more than a glass, food coloring, vegetable oil, salt and water.

Tell a Story Together
It helps develop verbal fluency, expands vocabulary and builds confidence speaking in front of groups, which is quite an impressive list of benefits for a fun activity that gets kids’ minds humming. Doing it as a group allows everyone a chance to participate, and if you have any questions on how it works, visit Super Easy Storytelling for some pointers.

Get Some Exercise
Bye this point, the kids are probably itching to get up and move their bodies a little, so let them, because they could use the exercise anyway. There’s no need to go further than Youtube as they have a variety of videos that teach the tikes aerobics, dancing, stretching and even yoga.

Watch the News
The little ones have probably wondered what keeps their dad entranced in front of the TV every evening. Well, the regular news probably isn’t for them, but there is a kid-friendly format that will teach them about the world. You’ll find it at Dogo New, which provides “fodder for young minds” by keeping them up to date with the current events that they’ll find interesting.

That should make for a great day of learning with activities for any kid to enjoy. In fact, you may just want to stay inside when the sun comes out. 
Image via Pexels.

Written by guest blogger, Jenny Wise, Special Home Educator

Navigating Pregnancy Options for New Canadians

By Abigail Corbin RM, Hawthorne Midwives

It can be overwhelming when you are new to Canada and pregnant. Every country arranges their healthcare differently. Even if a title - such as “midwife” - is the same, what they do and how they are trained can be very different. 

pregnant woman asia

In Ontario, when you are pregnant, you can decide whether you want to have a midwife or a doctor. Both options are paid for, though slightly differently. Doctors are paid through Ontario Health Insurance (OHIP) and midwives are paid through the Ontario Midwifery Program. This difference means that residents of Ontario do not have to pay for midwifery services, even if they don’t have OHIP. In fact, clients of midwives without OHIP have access to a grant that pays for their laboratory and ultrasound tests and any consultations with physicians. 

In Ontario midwives are experts in low risk pregnancy and birth. They follow you throughout your pregnancy, labour and birth, and for 6 weeks after your baby is born. Midwives can order any routine tests and can consult with a physician if complications arise. Midwifery appointments are longer than doctors, which is particularly beneficial if English is not your first language. Some even provide interpretation services. 

Midwives attend births at home and in the hospital. If you do not have OHIP you will need to contact your local hospital to arrange for payment for the birth (there is no cost for a homebirth). It is best to contact the financial office as soon as you know which hospital you want to deliver at.

midwifery

An obstetrician requires a referral from your family doctor (or walk in clinic if you do not yet have a family doctor). Midwives take self referrals - this means you can access midwifery care by filling in an intake on their website or calling their office. If you know you will be moving to Ontario you can request care before you arrive.  

AbigailCorbinAbigail Corbin is a registered midwife with Hawthorne Midwives in Milton.  Hawthorne Midwives specializes in providing care for new Canadians. For more information, go to their website www.hawthornemidwives.com

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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A Father’s Day Gift – Skin to Skin from Birth: A Guide

I once took a workshop with the amazing Gena Kirby about the natural mammalian instincts that occur during the birth of a child. Given the freedom and absence of intervention, a woman most often will stand, squat or kneel to give birth to her baby. She will gently guide her baby’s entry into the world and slowly lower her baby to the ground. She will take her time to catch her breath, reconnect with her surroundings and those with her, and then lastly will acknowledge her baby. 

pregnant couple

We have done an amazing job in our community of educating, encouraging and providing the opportunity for women to do skin to skin with their babies right after birth, but what if a woman isn’t ready to receive her baby? It’s so much more common than we acknowledge. And unfortunately, without knowing this, women often feel like there is something wrong with them if they don’t have that ecstatic moment of utter connection to their little being right away. Giving women time to absorb their reality and giving partners the opportunity to be a part of the beginning of a brand new life is a win-win for all.

So the baby is just born and automatically the midwife or doctor will bring the baby up onto the mother’s belly (except in special circumstances). The umbilical cord continues to pulsate (pumping red blood cells and other great stuff into baby) and everyone oohs and aahs. Maybe everything seems frantic, maybe mom’s eyes are still closed and she is catching her breath, maybe the parents have no idea what to do next. It’s all good. Now imagine it’s you. Stay where you are and listen to what you and your body need right now. Maybe it’s connection, maybe it’s to be left alone. Maybe both your partner and the baby need connection - and you don’t have it in you right now to provide that. There’s many great reasons why that’s okay to let your partner do the parenting right now. Your doula will know that now is the time for your baby to be skin to skin with dad or partner but it may be a great idea for your birthing team (including your partner) to know that you are okay with your partner having that privilege to start. 

Skin to skin means having your baby naked (not wrapped in a blanket) and placed directly skin to skin on either your chest or your partner’s chest immediately after birth, for as long as possible.

So dads and partners, don’t worry about hairy chests, thin chests or big chests. The baby is happier just having its temperature more stable, its heart and breathing rates more stable, and hearing the familiar thump-thump of a heart beat. Skin to skin with both parents allows the baby to be colonized to the parents’ bacteria which strengthens its immune system. This, plus breastfeeding, are thought to be important in the prevention of diseases. Some other great facts about skin to skin include:

Dad preemie skintoskin

  • Even babies on oxygen can be cared for skin to skin. This helps reduce their need for oxygen, and supports good breathing.
  • The baby is more likely to latch on well to the breast.
  • The baby is less likely to cry.
  • The baby is more likely to breastfeed exclusively longer

And for those who give birth by caesarean, your partner will be invaluable to you and your baby in the operating room. Although mothers are sometimes now given the opportunity to provide this kind of skin to skin support to their babies on the table, it’s still an unfortunate rarity. So dads and partners, take this opportunity to get a stable chair to sit in and place the baby right skin to skin in the operating room. Dads and partners can prep for the baby’s caesarean birth by wearing a button down shirt and putting the hospital gown on with the ties in the front.

IMG 9984sm

Interestingly enough, studies also show that a father’s involvement from birth leads to

  • fewer behavioural problems
  • higher educational achievement 
  • higher self esteem and satisfaction
  • More satisfying sexual relationships
  • Lower criminality and substance abuse
  • Better friendships with better adjusted children

So here's the "how to do it" part: 

1. Place your naked baby’s chest directly on your naked chest in a vertical position. Don’t worry about hairiness – it’s soft and better than stubble. 

2. Allow your baby to turn its face to one side or the other, keeping its chin slightly lifted and airway open.

3. Allow your baby to stay in this position as long as it would like (preferably for at least the first 1000 minutes). Newborn procedures like checking temperature, heart rate, breathing, giving the Vitamin K injection and others can be done while skin to skin. At some point you may want to weigh the baby, but that can wait until after the baby has breastfed and then the baby can go back onto one of the parents’ skin again.

dad skintoskin


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