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Angie The Doula – Complications and Congenital Issues

It’s one of the worst prenatal scenarios parent-to-be’s may have to face – being told their baby will have complications or congenital issues (a disease or physical abnormality present from birth). Complications can range from a variation of normal (e.g. extra digit) to one that’s moderate but can be managed with medical care (e.g. club-foot, cleft lip/palate) to something that can range from mild to having the potential to completely change a family’s life (e.g. Down’s syndrome, spina bifida). 

This article addresses some considerations for families that are expecting a baby with complications.

How severe will the Complications and Congenital Issues be?

With the testing and ultrasound schedule commonly recommended during pregnancy, surprises are uncommon. In most cases of complications, people are made aware before the baby is born.  

Until the baby is born, it’s impossible to know for sure what the severity will be. It’s important to maintain hope and a connection with your baby. Dr. Sarah Buckley writes extensively on prenatal screening, which includes false positives (a screening or test result showing an issue when there isn’t one). In that case, a suspected problem is found to be non-existant or milder than expected. 

I’ve seen several of my clients go through this terrible roller-coaster, waiting for news, expecting the worst, and then finding everything is normal on the next ultrasounds and at the birth. It’s hard for them to ever believe their baby is OK. When parents-to-be are in limbo like this, it can lessen their attachment with their unborn baby, even after further testing confirms all is well. 

Photo by Topato at Flickr. This file is licensed under the Creative Commons Attribution 2.0 Generic license.

What do I need to be aware of?

As you learn about a condition, the list of risk factors can leave parents – especially the pregnant ones – feeling like they are to blame. Find a counsellor or other parents in the same situation to help you work through these feelings. In many cases, no one is actually to blame.

Another sad reality about having a baby with complications is that it can be very hard on the parents’ relationship. Knowing that ahead of time can allow you to find resources, strategies and counsellors to help. 

Keep in mind:

  • You can have a smart, beautiful, amazing baby that happens to have a congenital complication.
  • Many humans far surpass the limits put on them by stats and well-meaning medical care providers. Don’t limit your child! Their environment and how they’re treated can really make a difference in how their potential plays out. (Of course, that’s true for most children.)
  • Focus on your child’s strengths while also being aware of their circumstances.
  • There are countless people living normal productive lives and accomplishing great things in spite of being told they’d never be able to do it…
  • Healing and thriving happens in the community. Humans are not meant to fly solo. 
  • Almost all parents struggle with worry, exhaustion, uncertainty, feel the pain of their child when they’re unwell, are learning to navigate life with a baby, love their baby and will do anything for them, have hopes and dreams for their child. This is common to parenting no matter if your baby is healthy or not.

To Prepare:

  • Seek out support groups – in person or online. Social media can be a bit of a minefield and provides a much different experience than a setting where you connect with actual humans. It can be scary, especially for introverts, to join a group but most people are glad they did so.  
  • Find an excellent online resource or two – not 10!  
    • Good sites will describe the condition in clear, understandable and kind terms.
    • Those sites will have a section directed at parents
    • Links to articles and resources that resonate with you
  • Look at images online, only from those vetted sites, so you’ll know what to expect
  • Find out what the policy is at your birth-place regarding family bonding and skin-to-skin contact in case of known complications, and yours specifically.
  • Learn about local resources from your medical community. Many places have an excellent team of social workers, occupational therapists, medical people, therapists, geneticists that can help you navigate.
  • Find out about social and government resources. You may be eligible for grants, programs, respite plans, and all manner of assistance available for families that have extra challenges related to a child with complications. Sometimes they’re hard to find.
  • Learn as much as you can about the complication:
    • Best and worst-case scenario / mild to severe case
    • Learn the language – technical terms, acceptable language
    • What future treatments might your child need? When? Is treatment invasive or painful? Is it necessary?
    • You have choices!  What does the future hold for your child without treatment or by taking a different approach?  

How can I manage my Baby’s health?

You will be your child’s best advocate and may have to become somewhat expert in their condition. Keep a binder or digital folder of every test-result, procedure, appointment. Also, have a section for resources. Do not assume every medical care provider you meet knows the full picture of the specifics of your child. 

If necessary and if you’re able, look outside of your own geographical region for treatment options.

What words and terms should I use?

The way people talk about your baby can be unknowingly hurtful. It helps everyone if you address this with those close to you. Many people want to be helpful or at least respectful but don’t know how. They tend to either stay away or blunder through, possibly adding stress or misery to your situation. 

Here are some suggestions you can share:

  • Use language that puts the human first e.g. baby with Down’s Syndrome
  • “Birth defect” is inappropriate. Terms that might feel better: Complication, congenital disability, variation of normal, congenital abnormality. 
  • A list of acceptable terms in general and for specific issues:  https://www.ncbi.nlm.nih.gov/books/NBK64884/ 

Prepare a cheat-sheet for loved ones and those that will be in your child’s life.

  1. Unacceptable terms
  2. Acceptable terms
  3. What makes the condition better and worse
  4. Special treatment the child may need e.g. can’t digest a certain food, needs a special baby-carrier
  5. What can they do that’s normal? e.g holding the baby won’t hurt them
  6. What you need – how can they help? How can they normalize life?
  7. Welcome them to visit or participate in your child’s life
  8. Links with more information
  9. Success stories, anecdotes

Online Resources:

Cochrane Review – https://www.cochrane.org/ the gold standard for reviewing and analysing medical research 
Stanford Medicine https://med.stanford.edu/ 
Johns Hopkins Medicine https://www.hopkinsmedicine.org 
Mayo Clinic https://www.mayoclinic.org/ 
Health Link British Columbia https://www.healthlinkbc.ca/ 
March of Dimes:  https://www.marchofdimes.org/complications/ (trigger alert: great info but some harsh language)

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.

Angie The Doula – Basic Prenatal Nutrition

Once pregnancy is achieved there are many transformations taking place in the body, such as hormonal changes and increased weight of the pregnant person and the developing child. Vital organs must work harder e.g. kidneys must filter up to 150% of normal blood volume throughout most of the pregnancy. All this building and changing is best done under optimal nutrition and function by the body.

Nutritional Guidelines

In a nutshell, do this EVERY day:

  • drink sufficient purified water or herbal tea
  • eat clean (organic) whole foods and lots of them to obtain high amounts of minerals, vitamins
  • be especially diligent about meeting daily requirements of calcium, magnesium and iron
  • whole food is colorful and looks pretty much like it did coming out of the earth
  • eat quality, health protein at every meal
  • take a high quality prenatal vitamin
  • ingest lots of essential fatty acids (usually through fish oil)
  • take acidophilus daily
  • relax when you eat
  • eat 3 healthy meals and 2 healthy snacks
  • obtain trace-minerals needed for every body function and baby development
  • liberal use of Himilayan (pink) or Celtic salt (grey)
  • drops of “Trace Minerals” added to water
  • avoid the “nasty whites” (sugar, salt, flour), chemicals such as coloring and artificial flavours or sweeteners,
  • artificial/processed foods, caffeine, drugs & alcohol

Nutritional requirements are fairly straightforward. Most sources agree on the nutrients needed for fetal and maternal health, with the exception of dairy, grains and essential fatty acids (EFA). Only the newer and more holistic sources of nutritional highly recommend EFA for pregnancy (see section below). These same sources may or may not recommend foods and portions/ratios that are an integral part of the Canada’s Food Guide. Education and awareness of one’s own health is important.

Proper nutrition is vital before and during pregnancy and breastfeeding.

Breastfeeding
Photo by Anton Nossik. This file is licensed under the Creative Commons Attribution 3.0 Unported license.

Any nutrients taken in or lacking directly affect the baby. The first step is in eating enough; 2400 calories is the daily minimum. Of course quality of food is as important quantity. Nutrient dense foods are best, such as organic whole foods. Raw or lightly steamed veggies provide many nutrients and fiber. Fiber is important to prevent constipation, a common pregnancy concern. Fiber also carries out toxins and used up hormones, which decreases liver load and morning sickness.

Water: Clean purified water is essential. Water is needed to maintain blood pressure with increased blood volume, to flush toxins safely and to provide transport for nutrients through blood to placenta. The best way to increase fluid intake is with clean pure water and herbal teas from the safe list.

Eat Mindfully: The manner in which food is eaten is important too. Eating mindfully and slowly, chewing food thoroughly, and keeping liquids to a minimum with food will ensure good assimilation of nutrients. Smaller more frequent meals and healthy snacks ensure nutrients are better assimilated and blood sugar stays constant. In the case of digestive problems consider using digestive enzymes.

Eat Organic: Organic foods are higher in nutrients, especially minerals, and of course much lower in chemical toxins. Watch for “certified organic” on labels or know your farmer.

Protein: 60-80g minimum daily. Deficiency tied to congenital abnormalities and pre-eclampsia.
Vegan sources of protein include spirulina, quinoa, beans and legumes, nuts and seeds. Animal sources are usually the densest and include meat, eggs, and dairy. Organic animal foods are important, as conventional farming may use hormones and antibiotics routinely, and poor quality feed.

Prenatal Nutrition

Essential Fatty Acids: The recommended daily intake of EPA plus DHA is about 650-1000mg/day during pregnancy and lactation. Omega-3 fats, especially DHA, are needed for fetal brain and spinal cord development. Fetal concentrations of DHA are directly correlated to maternal DHA levels. Reduced fetal DHA concentrations lead to decreased visual function and altered learning and behavior. Over the past 15 yrs, breast milk DHA concentrations have decreased by over 50% so it’s important that DHA levels are maintained throughout pregnancy and breastfeeding. DHA also helps prevent premature delivery. DHA is vital for fetal brain development and health throughout life. Most prenatal supplements have absolutely no DHA.

Current recommendations are to limit and even avoid certain fish during pregnancy. Generally, the larger the fish, the more mercury contamination and other toxins it contains. Wild small fish (e.g. sardines, mackerel, anchovies, salmon) are preferable. Avoid farmed and/or large fish due to lack of nutrients, mercury & other heavy metal contamination, and toxins due to feeding and farm practices. Examples of large fish are tuna, sea bass, marlin, and halibut. Mercury readily crosses the placenta and has a high affinity for nervous tissue i.e. brain and spinal cord. Fetal mercury exposure contributes to mental deficiencies and other neurological problems.

The safest way to ingest EFAs is by fish oil or micro-algae. Supplements are not all equal. Liquids are best as they are readily digested and one can smell rancidity (only rancid fish oil smells like fish). One has to take up to 14 caps daily to get the required amount of EFAs. Good brands start with quality oil and undergo strict cleaning / processing methods. They use 3rd party tests for EPA/DHA values and are tested for contamination. The label defines EFA values. And they taste good – really!

Vitamins & Minerals Supplement a.k.a. Prenatal Vitamin

Supplement means supplemental i.e. in addition to food, not replacing it. Food based nutrients are best but the addition of a high quality prenatal vitamin ensures certain requirements are met. High-quality supplements are important. There’s quite a difference between brands and sources in terms of ingredients (fillers, natural vs. synthetic vitamins, quality of nutrients) and absorbability (the form of nutrient used and method of processing). There’s also a cost difference – don’t waste money on low-grade supplements. Small doses need to be taken throughout the day; quality prenatals are never ‘one-a-day’.

Food-based vitamins are generally the best quality. The ingredients are more absorbable and bioavailable than isolated vitamins. More nutrients are absorbed with smaller doses and the micronutrients and enzymes are present, resulting in fewer issues such as constipation and nausea.

Minerals are usually best assimilated when taken in food form or herbal teas. Once a plant has ‘processed’ the mineral i.e. taken it from the soil and incorporated it into its structure, it’s much easier for us to absorb and lower amounts are required. Take your supplemental prenatal vitamins & minerals with food.

Why Prenatal Vitamins?

Prenatal vitamins are designed to meet most of the nutritional needs during pregnancy and breastfeeding.
High doses of Vitamin A have been linked to congenital abnormalities such as cleft palate and heart problems. Daily max during pregnancy = 10 000IU. Prenatals use Beta carotene a.k.a. “Pre-vitamin A” and the body will convert to vitamin A only what it needs.
Folic acid in higher amounts to ensure the neural tube forms properly.
Calcium requirements double.
Too many other vitamins and minerals to list all the benefits.

Iron (40-80mg) with vitamin C
If taken in supplemental form, an organically based one that has gone through plant or yeast is best. For example, Floravit™ or Floradix™ are 95% absorbable and therefore do not contribute to digestive problems and constipation.

Trace minerals are involved in most physiological and metabolic processes and are required to assimilate macro minerals. Sources include kelp and other seaweeds, trace-mineral supplements, and Celtic or Himalayan sea salt (i.e. not white salt).

Probiotics are the ‘good bacteria’ that live in human bodies, mostly in the gut. Functions include:
Helps stave off Candida overgrowth during this vulnerable time (pregnant women are especially susceptible)
Protect baby through birth canal
Assimilation of nutrients
Protects digestive system from invaders
Boost immune system

Decrease or Avoid:

  • ‘Junk’ food of any kind
  • Refined & processed foods deplete minerals and promote dehydration
  • Regular salt promotes edema
  • Alcohol is a teratogen (causes birth abnormalities)
  • Coffee is a possible teratogen and promotes dehydration and mineral deficiency. The research is mixed as to the safety of one cup daily.
  • Caffeine in other forms
  • Meats susceptible to parasites, bacterial infections and high in additives e.g. cold-cuts, raw fish
  • Candida promoting foods (sugars and alcohol)
  • Unnecessary medications. See a pharmacist, medical doctor and/or holistic health practitioner for help with health issues.
  • “Street drugs”
  • Smoking
  • Phenylalanine containing supplements. E.g. – Aspartame (Equal, NutraSweet) has high levels phenylalanine and may alter fetal brain growth / development
  • Mineral oil blocks absorption of fat-soluble vitamins
  • Shark cartilage (in joint-pain supplements) inhibits the new blood vessel growth needed during pregnancy

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.

Exercise During Pregnancy – What To Know

Birth has been compared to climbing a mountain or completing a marathon.  Being physically fit is an advantage.  Exercise generally improves pregnancy, birth and newborn outcomes for people with normal pregnancies.  There may be a protective factor for gestational diabetes, congenital anomalies, miscarriage, placental problems, intrauterine growth restriction, high blood pressure or fetal death.  Evidence suggests that abnormal heart rates, cord entanglement, and the presence of meconium are significantly reduced.  While there is no increase in premies, there may be fewer postdate gestations.

Those who engage in regular, vigorous exercise require less intervention in labour, including a substantial decrease of cesarean birth rates.  They may have faster labours, both in stage-1 and stage-2, compared to those who are sedentary.   However, keep in mind that during pregnancy, ligaments and tendons soften, center of mass shifts, blood volume and oxygen levels change.  During pregnancy one is more prone to falls, muscle / joint injuries, and running out of steam.

Exercise During Pregnancy 1

There are many benefits to exercising during your pregnancy:

  • Feel comfortable in and enjoy your body
  • Increases circulation
  • Promotes tone in muscles and increases stamina
  • Promotes well-being; prevents depression
  • Oxygenates blood to reduce fatigue
  • Improves placental function
  • Reduces pelvic congestion and cramping, low backache, ligament pain and constipation
  • Prevents blood congestion in lower body, reduces leg cramps, tension, and varicosities
  • Recovery of organ tone and placement; prevents prolapsed pelvic organs post-partum
  • Gestational diabetes and blood sugar issues improve after exercise
  • Moderately high blood pressure may be lowered
  • Improves pregnancy, birth and newborn outcomes
  • Contributes to shorter labours and fewer medical interventions

(For more information on Easing Labour Pain, join me for my monthly workshop. Register here.)

Relaxation for Birth Prep

  • It’s important to do exercise and also practice relaxation.
  • Relaxation must be practiced daily to be effective, especially as a labour tool.
  • Yoga, meditation, tai-chi, or just listen to a relaxation CD.
  • Conscious awareness of relaxing muscles balance building and toning; especially important if you are muscle-bound or super-muscular.

(For more information on preparing for your birth, join me for my monthly Birth Essentials Live But Online series. Register here.)

Exercise During Pregnancy – Do’s:

  • LISTEN TO YOUR BODY; DO ONLY WHAT FEELS GOOD!
  • Continue your regular exercise program, but listen to your body; modify/stop as needed.
  • Exercise on a firm surface.
  • Balance exertion with relaxation periods.
  • Remember your center of balance / weight distribution is quickly changing.
  • Warm up and cool down well to prevent injury and pooling of blood in the extremities.
  • Feel your baby move inside you – pay attention.
  • Stay hydrated to ensure proper cooling and adequate blood expansion. Drink 4-8oz water before exercising and 2-4oz every 20-30 minutes during; double this amount at high elevations. This is in addition to your regular pregnancy water requirements.
  • Exercise in a cooled or air-conditioned room, especially in hot, humid weather.
  • Consume additional calories to sustain exercise. Moderate exercise in an average sized woman requires 600-700 additional calories daily.
  • Taper off gradually if you’re used to vigorous exercise and have to exercise less.  An abrupt drop in activity can cause constipation, circulatory problems, or nervous irritability.
  • Begin slowly if you have not routinely exercised.
    • If motivation is an issue, think of it as movement rather than exercise.
    • Start twice weekly and increase to 5 times. A 10-20minute walks is a great start!
    • Videos can help you learn to exercise but ensure they’re safe for pregnancy.
    • Discuss beginning an exercise program with your medical care provider.

Exercise During Pregnancy – Avoids:

  • Inversions and twists, especially during yoga.
  • Sit-ups or crunches as they stress abdominal muscles, weakening and lengthening them in the long run. Post-partum recovery of a tight core in this case is difficult or impossible.  In fact, every time you go from laying to sitting/standing, roll over on your side first.
  • Exercising to the point where you cannot carry on a conversation.
  • Weights or exercises that require holding your arms over your head for an extended period of time or for many repetitions.
  • Impact exercises (once they no longer feel 100% great, if you’re used to them).
  • Laying on your back for extended periods of time.
  • Any exercise that can cause trauma to the abdomen or pelvis.
  • Valsalva manoeuvres / inner pressure on pelvic floor (e.g. some breathing patterns that resemble bearing down).
  • Scuba diving due to increased pressures of submersion.
  • Sudden changes of position or level.
  • Exercises that require standing on one leg as that can cause pulling in the pubic symphysis, not to mention balance issues.
  • Starting a vigorous exercise program after 26 weeks if you’re new to exercise.
  • Strenuous exercise during last trimester, no matter how fit or used to high intensity you are (correlated with lower birth-weight babies).

Contraindications for Exercise During Pregnancy

  • Placenta previa
  • Tearing or separation of placenta (abruptio)
  • Premature rupture of membranes (PROM)
  • Incompetent cervix
  • Chronic heart disease
  • Premature labour
  • PIH (pregnancy induced high blood pressure)
  • Pre-eclampsia (a.k.a. toxaemia)
  • Fever (or presence of infection)
  • Acute and/or chronic life-threatening condition

Warning Signs or Symptoms – Stop IMMEDIATELY and seek medical attention in case of:

  • Pain or discomfort
  • Bleeding or fluid discharge
  • Feeling ill, dizzy, faint, disoriented, nauseated
  • Heart palpitations or chest pain
  • Severe headache
  • Difficulty walking or moving
  • Regular strong contractions
  • Cramps
  • Fever
  • Hyperventilation – take slow deep breaths until it passes

Conditions for Assessment

If any of these issues are a concern, then consult with a perinatal fitness specialist.  There are often things you can do to exercise during pregnancy safely with special circumstances.

  • Extremely sedentary lifestyle
  • Gestational diabetes or blood sugar issues
  • Marginal or low-lying placenta
  • History of IUGR (decreased or slow fetal growth)
  • High blood pressure
  • Irregular heartbeat or mitral valve prolapse
  • Asthma
  • Oedema / swelling of face and hands
  • Anaemia
  • Multiple gestations / foetuses (twins, triplets etc)
  • Thyroid disease
  • Three or more miscarriages
  • Excessive over- or underweight
  • Nerve compression injuries – don’t stretch to extremes or do weight bearing on the affected part

Exercise During Pregnancy – Suggestions:

  • Pelvic-floor exercises – see below
  • Prenatal yoga
  • Tai-chi
  • Walking
  • Cycling
  • Swimming
  • Dance (belly dancing is especially good for birth)
  • Daily squatting – start with supported squat for as long as feels comfortable (holding a pole or counter, or sliding down a wall) – maybe only seconds at first. Build flexibility and endurance in this position.  Feet should be parallel to each other.
  • Pelvic rocking – all fours and do cats & dogs. Start with 5 of each and build to 20 daily.
  • Any stretching that increases flexibility and flow to pelvis, such as cobbler-sit, pigeon pose, or straddles. A good prenatal yoga DVD or class can teach you these.
  • See special note below for those who participate in extreme sports or live in the mountains.

 Pelvic floor exercises are particularly important when preparing for birth:

  • Assists with relaxation of pelvis floor – prevents tearing
  • Tones pelvic floor to prevent prolapse, incontinence, haemorrhoids
  • “Elevator Kegels” – Kegels are often mentioned as a good pregnancy and post-partum exercise but need to be done properly, like an elevator, not just a urination squeeze. Relax all muscles except pelvic floor and vagina.  Tighten those muscles progressively, layer by layer, then release slowly.  Build up to cycles of 15, for a total of 50 contractions daily. Do not hold longer than 5 seconds at a time, nor perform regularly during urination, as this may contribute to urinary tract infection.
  • Squats are excellent for pelvic floor health

Posture – While Exercising or Resting

  • Maintain good posture to prevent low back pain, shortness of breath, and indigestion.
  • Hold head high (crown to sky), shoulders back, abs and lower back strong, tailbone tucked in and feet slightly apart.
  • Spend time on the floor! Carpet or a firm pillow can keep your bones comfortable.  Crawl on all-fours during the last trimester to ensure optimal fetal positioning.  Sit on the floor to open your hips.
  • Be diligent with posture, especially sitting postures, to ensure the best possible fetal position for labour and birth.
    • Sit tailor-style often – this strengthens the back
    • Sit straight up and on sitz-bones
    • Consider sitting on a ball, saddle seat, knee-chair, or sit-stand chair to ensure your knees stay below hips, and your back maintains healthy alignment following natural curves
    • Avoid slouching, reclining and upholstered furniture as much as possible

Exercise During Pregnancy 2

The rest of this article is a SPECIAL NOTE to those who are…

Extremely Fit / High Performance Athletes / and/or Living in Mountains

People in this category have a different reality.  The following are guidelines for those folks who have lived at high altitude longer than 6 months pre-pregnancy (and are therefore adapted to high altitude), are active in the mountains, accomplished in mountain or other extreme sports, addicted to Ashtanga yoga and/or super-fit compared to the general population.

Intense exercise is contraindicated in the last trimester and is correlated with lower birth weight babies.  It’s only 1 season in the grand scheme of life and could be an opportunity to try something new or softer.

The most important thing is to LISTEN TO YOUR BODY!!!  If it feels good, keep going.  However there WILL come a point where you feel tired.  You may also feel a bit clumsy as your body changes.  There is no benefit to pushing through at that point.  You’re growing a whole person inside and your baby deserves your energy and nutrients.  Play in the mountains if it feels good but be willing to stop, modify or slow down.

Anyone who exercises compulsively is particularly at risk for ignoring their body’s subtle calls of distress.  Balance exercise during pregnancy with rest and relaxation.  If you’re super-muscular or muscle-bound then consider decreasing exercise and increasing relaxation time.  Take a class specific for un-exercising muscles.  You might feel stir crazy, but learning to loosen and relax your body will pay off greatly during the birth process and for post-partum recovery.

Do your sports partners know you’re pregnant?  Is it fair to either of you to keep this a secret?  During early pregnancy, before you “show”, you’re likely to be tired and possibly nauseated.  Your play partners may assume you’ll push through.  Do not push through.  Even if they know you’re pregnant they may not understand it actually does affect your performance.  A good conversation might be in order before setting out.  I strongly encourage you to tell them, or at least think about why you’re not telling them.  Then look at those reasons and decide if you should be relying on each other for life and safety out there.

For any endurance activities lasting longer than a yoga class, be prepared to nourish yourself.  Eat and drink constantly.  Use a health electrolyte drink.  Take breaks – yes, breaks – as in rest.

Tips for Mountain Activities in addition to the ones above (see “Exercise do’s”).  Remember that high-intensity exercise is contraindicated in the last trimester, and LISTEN TO YOUR BODY!!  You absolutely must take rests and eat/drink LOTS to safely participate in these activities.

  • Cycling – tone it down before when your clipless pedals start releasing due to knees-out position. Be careful of weight distribution changes, and consider switching to fire-roads or road-biking rather than single-track.
  • Climbing – when your harness no longer fits, stop. (OK – maybe stop before that.) Do not borrow a bigger harness!  Top-roping is safest.  If you must lead use lots of pro and be extra diligent about falls.  Seriously consider leading about 3 points back from your pre-pregnancy ability.  Make your climbing partner carry the ropes and half the pro.
  • Ice climbing presents cold weather challenges in addition to the extra risks over rock-climbing. Even more moisture is lost through respiration and staying warm in the cold, so drink even MORE WATER than recommended above.  Also pay extra attention to fingers & toes and frost-bite; your blood volume and distribution are changing.
  • Altitude – almost all prenatal books warn about high altitude. If you’ve lived at altitude for longer than 6 months, then your physiology will have adapted.  Continue going to places you went pre-pregnancy but allow more time to get there.
  • Hiking – be diligent about pack weight distribution, and take rests. Yes – rests!!  Don’t wait until you feel light headed.  Take lots of snack & water breaks.  Carry that bear spray because you’re now likely the slowest runner in the group J.  Make your hiking-mates carry the heavy stuff!
  • Skiing – if it feels 100% good, do it. Seriously watch for back-country avalanche bulletins.  Make your ski-buddies break trail and carry extra gear.  Consider spending more time on track-set or groomers.  If using lifts take a big drink on every ride.
  • Yoga – if and only if you’ve been a dedicated yogi for years and are very body-aware, then it’s possible to continue your regular practise, modifying as your body tells you.

Effects of Stress and Adrenaline on Unborn Babies

The emerging field of perinatal psychology has fascinating info.  Pregnant adrenaline junkies make adrenaline junkie babies – great for fun but also a special challenge on adrenal health later in life and appropriate stress-coping mechanisms.  One big way to help baby cope is to explain what you’re about to do, that it may feel scary, but that baby is safe.  When the stressful event or adrenaline rush is over tell baby all is will now, baby is safe, and scary event is over.

Imagine you’re blindfolded, wearing ear-plugs, and can’t talk.  Then someone drops you into the craziest roller-coaster ever but doesn’t tell you anything about it.  That’s what it’s like for baby to accompany you for any event that raises your adrenaline – sports, argument with partner, work-related stress, and near-miss car crash.

A word about “they say”:

People will have strong opinions about what you’re doing and will be more than willing to share those opinions.  It’s frustrating to hear that you’re irresponsible to be climbing, especially from a non-climbing, flat-lander, possibly couch potato, who doesn’t know how much you’ve already changed your practise!  It’s even more frustrating to hear it from a well-meaning local athlete.  Some people will refuse to play in the mountains with you, feeling they’re contributing to your “irrational” behaviour.  Others may take your partner aside to try to convince you both how risky your actions are.  Fortunately many others totally “get it”!  Play with people who understand and are willing to accommodate and be safe.

What are some of your favourite exercises to do during your pregnancy? Want to know more about my online prenatal classes or in need of birth support? Please contact me!

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Optimal Recovery from Caesarean Birth

After a Caesarean birth, you will be given a list of recovery tips from your medical care provider.  The following additional information contributes to optimal recovery following a surgical birth.

Taking care of a baby is a full-time job and deserves recognition as such.  Recovery from major abdominal surgery is also a full-time job.  For most people, in 6-8 weeks life will gain a new normal but it takes longer than that to fully recover from a Caesarean birth.

FOR BIRTH MOM:

REST, REST, REST!

This is essential for recovery. Although you have a newborn (perhaps other children too) at home, do the best you can to rest and recover. Get the support needed to do this, such as from a Postpartum Doula.

  • Sleep while the baby sleeps. Really, really!!! Let the house go for now! Enlist help if other responsibilities prevent you from napping.
  • No lifting or hard exercise. Listen to your body. Any pain means stop and rest right away. This will be humbling.
  • Hire a cleaner if you don’t have good live-in support. A weekly or bi-weekly cleaning works magic for your sanity.
  • Have an open house / meet-baby gathering to entertain all friends at once rather than spend hours daily with visitors.
  • Learn to accept help. Just say thank-you! Ask for help from friends & family. They’d love to make food, babysit siblings, walk the dog, feed the pets, do laundry etc. Your turn to help another will come later.
  • Make a “guest rule”. Any visitors must bring or prepare food (and clean up their mess), and/or do a chore from a list you’ve made. Make it clear they will not be entertained! They are there to help. This gets you help and decreases visitors.

For internal healing:

Osteopathy, Visceral Manipulation Therapy, and CranioSacral Therapy help resolve trauma and restore fluidity to organs & tissues, which speeds healing, decreases pain and facilitates long-term recovery. When internal tissues are exposed to air, adhesions can form. During surgery, organs are shifted from their optimal placement. Wait 4-6 weeks before starting treatment.

If you’re into Homeopathy: Traumeel (drops or tabs) during the entire post-surgical recovery phase, or homeopathic Arnica 200CH first 3-5 days (3 granules once daily).

Emotional Recovery:

Emotions following a Caesarean birth vary from woman to woman. One may feel completely satisfied with her birth and emotional recovery is not an issue. Conversely, another may feel loss, regret, blame or disappointment. There are infinite factors that lead to Caesarean birth.

Many people will say, “At least your baby is healthy”, but a woman’s birth journey is important too. Give yourself permission to feel sadness about your birth; it doesn’t mean you’d trade your baby’s health for your “ideal birth” nor that you don’t love and appreciate your baby. There’s room for being totally in love, feeling anger or sadness or happiness – all of it!

Other well-meaning folks might say at least you didn’t have to “suffer” in labour or that you got to take the “easy way out”. Forgive their ignorance. Many people don’t realize how difficult a Caesarean birth and recovery can be, often much more so than a natural birth.

  • Rescue Remedy as needed for grief, shock, disappointment.
  • Be kind and forgiving to yourself and allow space for grieving if you need it.
  • Several local health professionals can help with emotional trauma. Some use Flower Remedies, homeopathy, Reiki, other energy work, and/or verbal counselling styles.

For the scar:

  • After the stitches have dissolved, healthy high-quality oil such as rosehip seed oil (Rosa masquetta) on the incision site as often as possible to nourish the skin and decrease scarring. Combine with an essential oil blend to decrease itching, scarring, incidence of thick scarring and to speed healing (eg Blaine Andrusek Scar-B-Gone). If you don’t have these, vitamin-E oil will do.
  • From 6 weeks on, Castor Oil packs over the incision to help with healing. Soak a cotton cloth in castor oil. Put cloth against skin, cover with plastic bag or saran wrap (to protect bedding or clothing), then apply hot water bottle. Leave on for an hour daily or until you intuitively feel you’ve had enough. If the cloth is still clean it can be folded away in the plastic and reused. Once the cloth appears to have absorbed toxins use another one. This treatment can be done for as long as you wish – weeks or months.

To Counter the Antibiotics:

While antibiotics can prevent or treat infection, they also lead to an imbalance in normal flora by killing the good bacteria in our gut. Balance can be restored by ingesting unpasteurized, fermented foods (e.g. kombucha tea, kimchi, sauerkraut) or probiotics such as acidophilus powder or caps – high quality only.  That’s the ones found in the fridge at health stores or your holistic care providers office.

  • 3 caps or ¼ tsp, twice daily for 3-4 weeks. This decreases Candida albicans overgrowth, which in turn protects the digestive system from pathogens and boosts immunity. It protects you from diarrhea, vaginal yeast infections, and painful nipples commonly associated with antibiotics, and will protect the baby from thrush (mouth sores/diaper rash).
  • If you or baby show signs of such side effects, add a third dose until 2 weeks after symptoms disappear, then go back to the regular dose. Make a little paste to apply to nipples or pinkie-finger at feeding time to dose your baby.

Nutrition:

  • Eat whole, healthy foods and lots of them.
  • Continue your high-quality prenatal vitamin for the duration of breastfeeding or 8 weeks, whichever is later.
  • High quality, easily assimilated iron supplement such as Flora Dix or placenta capsules. You’ll take less of this type of iron, absorb more overall, and avoid constipation associated with most iron supplements. Helps after blood-loss associated with surgery. (Women lose an average of up to 1L of blood after a Caesarean birth, compared with 300-500 ml with vaginal birth.)
  • Eat well and drink lots of water. Continue drinking your raspberry leaf and nettle tea, optimally 3 cups daily, for at least a month. See herb tea recipe, “Essential Herbs for Pregnancy & Nursing”
  • Ingest healthy absorbable protein; your body’s doing a lot of rebuilding now.

FOR BABY:

Caesarean birth is also traumatic for the baby. Osteopathy, cranio-sacral therapy and newborn chiropractic care by someone who specializes in newborn-care is essential.

To Counter Antibiotics Side-Effects: Acidophilus powder (see above). Continue for 3-4 weeks. This will decrease Candida overgrowth, which in turn protects the digestive system, boosts immunity, protect thrush (mouth sores), diarrhea, and diaper rash commonly associated with antibiotics. Make a paste from 1/8 tsp and rub on nipples just before nursing, twice daily. Or dip a wet pinkie-finger into the powder and let baby suck it off.

If you’re into homeopathy, there are remedies that are safe and effective for baby too, in case you notice thrush, trauma, or other long term effects.

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.

Five more steps to the birth of your dreams

Many pregnant people look forward to their upcoming labour and birth with both excitement and apprehension. We’re here to tell you that it doesn’t have to be scary. As we shared in a recent blog post, once you have a plan, a vision of the outcome you want and begin taking steps to get there, all the unknown and loss of control starts to fade away.

To help you continue preparing for a birth experience that is satisfying and empowering, here are five more steps to the birth of your dreams!

6) Care for yourself and your baby

Take care of your general health as best as you can; this is proven to support better birth outcomes and it is another thing you can control. Healthy foods in as close to their natural state as possible, proper hydration (find a fun water bottle to carry around and refill), pregnancy teas, all help to build a healthy baby. (Note: obviously if you are dealing with extreme nausea that does not allow you control over what you eat and whether or not it stays down, skip to Step 7.)

Gentle physical exercise, particularly yoga, helps prepare women for birth and a faster recovery. FInd an online class that you like. Go for walks.

Ensure your non-physical self is healthy too. What nourishes your spirit and soul? Time alone? Time with others? Time to create? Time to nest?

I wish you ease and grace in caring for yourself during your pregnancy.

7) Choose the primary care-provider for your pregnancy and birth

Doctor

Depending on where you live you might have lots of choices or limited choices in this area.

In Regina we have some midwives, but not enough. Some family doctors that also catch babies. One birth centre in a near-by community. Lots of over-worked Ob/Gyns (IMO) too.

Do the best you can to chose someone whose values align with yours. Midwives are often the first choice for women who plan natural births, and they attend both home and hospital births. If there are in short supply, then call the office early to get on the wait list.

Family doctors who attend births are a great option for a healthy woman who doesn’t need the high-risk expertise of an obstetrician. Most family doctors in our area care for women for most of their pregnancy and then transfer care to another family doc or an obstetrician.

Obstetricians are highly skilled for women with known health issues or who are at increased risk of complications but they catch most of the babies in our area and are the most common option here.

8) Be aware of your stress triggers

What irritates or stresses you now can be a big clue to what might create or adds stress during your birth?

That varies with everyone and you are the only one who gets to decide on this. For some women it is noise, or smells, or chatter, or lack of information; for others it’s lack of modesty or privacy. Someone who is in the room who irritates you; someone you wish was there with you and isn’t.

Figure out what causes you stress and do everything you can to plan ahead so you can eliminate that possibility or at least minimize its effect.

9) Maximize comfort in your pregnancy and plan to be comfortable in labour

Baby

What brings you comfort? Think of your five senses. We are sensual beings!

Do you prefer to see dim or bright lights, hear silence, medical sounds, or music of your choice? How would you like to be touched, if at all?

Practice getting effective massage and counter-pressure. Reduce internal exams during labour is possible. Wear clothes that you chose for comfort and the level of modesty that suits you.

What do you wish to smell (hint – birth companions: pack a toothbrush)? Research helpful and appropriate aromatherapy oils to use at home. Take your own pillow so you can that comfortable smell and feel.

What kind of drink would you like to taste during your birth? What foods can you enjoy during labour or afterwards? What feast can you plan to celebrate the birth!

Comfort is only possible if we first feel safe and supported so review those essentials and get things in place so you can feel secure.

10) Bring joy, fun and calm into your birth

What makes you laugh?
What calms you down?
What do you enjoy?

Remember you can laugh, be loud, be silent; you can dance, move about, wear clothing in which you feel comfortable or beautiful, get snuggly with your partner, be in the dark, enjoy sunlight, create a big personal-space bubble in the bathtub or birth pool, watch a funny movie in early labour, walk in the fresh air, have a nap.

In my thirty years as a doula I have encouraged clients first to nap and stay well fed and hydrated, and then to do something nurturing or even mischievous – make out, go for a walk to get a tea or take-out treat, take some last-day-of-pregnancy photos, meet up with friends and have contractions while you visit. Make some banana bread for later – maybe it will still be warm when you are holding your baby. (True story.)

Respect your introvert or extrovert needs and explore the possibilities!

Know of other steps you would recommend to someone preparing for an upcoming birth? Want to know more about my online prenatal classes or in need of birth support? Please contact me!

 

Article written by my wise friend and work-partner, Karen Herriot – Master Doula, Doula Trainer, Yoga Teacher.

 

Five steps to the birth of your dreams

Most women anticipate labour and birth with a mix of excitement, and fear—of all the unknown and loss of control. In the face of that kind of vulnerability, it is good to have a plan, a vision of the outcome you want and then begin taking steps to get there.

Actively preparing with easy, practical measures will lead to a birth experience that is satisfying and empowering. No client of ours ever told us “I did too much to prepare for my birth.” That is why we are happy to suggest these five steps to the birth of your dreams!

1) Choose online prenatal education or yoga classes that reflect your vision of an ideal birth.

A virtual gathering with other pregnant women in online classes that discuss pregnancy, labour and birth will help you to find support and community in which to make your choices, share ideas, and learn together.

I also lead virtual Regina Hospital tours, allowing you to become accustomed to the setting in which your birth will unfold. Attending these classes is your start to finding your tribe and building vital connections that will help you thrive in the postpartum.

2) Create your circle of support and birth-power

Expecting Couple

Take a clear-eyed look at the others on your support team. Partners sometimes feel pressured to perform and provide a level of physical and psychological support that may exceed their capacities. Many times it feels unfair to expect them to take on such a new role all on their own.

What do they need to feel supported? What things can you both do in the prenatal time? Have they talked to other non-birthing partners? Birth is a shared experience so both of you need to be mindful of what you need and communicate your expectations.

If a friend or relative is invited, are they experienced, will they add calm or stress to your birth, will they come at any time and stay as long as needed? Have you invited them or did they invite themselves? You get to decide. Birth is not a spectator sport – as the birthing woman you get to choose.

If you’re a solo parent-to-be, consider inviting someone who brings you comfort. Any person coming to the birth should attend prenatal education classes with the mother. They should be familiar with the birth setting, the protocols there, their own availability and the ability to be a helpful presence, not a distraction.

3) Hire a Doula

It is hard to navigate all the decisions you will be faced in pregnancy, labour and birth. Why do it alone?

Professional doulas support the birthing woman and her labour team members. Women who have doula support have half the rates of cesarean births as those without. They also have significantly shorter labours, request pain meds at far lower rates (less than half as often), and experience significantly fewer interventions.

Doulas are experts in comfort measures and also great information resources. Whether it is a simple question or a complex decision, your doula is there to help you through every choice you make. Partners do more when there is a doula on their team!

Plus – doulas make the process fun! We are trained to smooth out the edges, show you the ropes and be your birth sherpas! Contact me for more information!

4) Make an effective birth plan that works for you instead of against you

There are many options for labour and birth, but many people don’t know they can do some research, ask some questions and design their birth their way. It is important to know what to expect from your time in the hospital (or home if that is your choice); it is important to be informed and prepared.

There are many things you can control in the face of the vulnerability of labour and birth.

We all want to feel safe first. For our babies to be born in a cocoon of safety. And then we are allowed to want other things as well.

You are allowed and encouraged to dream big and envision the birth of your dreams, not just a birth that is safe, not just the birth you dread.

  • What makes you feel safe?
  • What stresses you out?
  • What do you need?
  • What would you love to happen?
  • Quiet respectful space to labour in?
  • A less clinical feel to the room?
  • A more clinical and monitored space? So you know both you and baby are ok.
  • Want to catch your baby?
  • Keep the cord?
  • Use your own playlist to create the vibe?
  • Wear your own clothes?
  • Use your own pillow?
  • Labour in whatever position is most comfortable to you?
  • Birth in the posture of your choice?

Your plan should use positive language, including things that are unique and important to you. Including the things that are essential for you.

5) Find and Practise tools to manage the intensity of labour

Pregnant Yoga

Whether your labour is a sprint, a marathon or a surgical experience – many women describe birth as hard work.

There are things you can do to manage this intensity! Whether you plan to labour naturally or to use an epidural to support your experience, taking the time to strategize what tools might work for you – and practice the skills while you are pregnant is essential.

Be your sensuous self and amplify your senses to distract or soothe yourself – sight, sound, smell, touch!

Mindfulness, yoga, meditation, sound/music, and visualizations/affirmations are valuable tools. Hypnobirthing is a system many women find helpful. As are hynotherapy sessions with a trained therapist. Ask me for suggestions.

Control, control, control! Find things that you can control and control the heck out of them!

Looking for more information on your upcoming birth? Interested in taking one of my online prenatal classes or in need of birth support? Please contact me!

Article written by my wise friend and work-partner, Karen Herriot – Master Doula, Doula Trainer, Yoga Teacher.

Brewer Pregnancy Nutrition

Adequate protein and good quality nutrition are required for the increased metabolic functions that accompany pregnancy. Many midwives and practitioners recommend good nutrition during pregnancy, including the Brewer Diet.  There’s an overwhelming amount of evidence to support them.

A study conducted at Harvard University found that eating at ≥75 grams of protein daily helps prevent diseases of pregnancy such as pre-eclampsia (Abubakar & al., 2011) (Haas, 1995).

In the 1960’s Dr. Tom Brewer worked with a large, high-obstetrical-risk group in California: impoverished ethnic minority teen mothers in their first pregnancy.  During the same time in other areas of the USA, this group had up to 35% rates of serious pregnancy diseases, preeclampsia and eclampsia. Dr. Brewer worked with more than 7000 pregnant women over more than 12 years. He asked each woman about her diet and determined that malnutrition was prevalent.  All of his clients were required to attend nutritional counselling and were fed good nutrition and adequate protein.  The incidence of serious pregnancy illnesses  among his patients dropped to 0.5% (Brewer & Brewer-Krebs, 1977)! This is remarkable and well documented but as there was no “control group” (a group who didn’t receive “treatment”, because Dr. Brewer felt it would be unethical to withhold good nutrition from a group of pregnant women), most medical associations don’t consider this scientifically valid research.

The basic Brewer diet recommends a daily minimum of 2600 calories, 80-120 grams protein, salt-to-taste, green veggies, whole grains, fats, and vitamin-rich foods (Jones).  The Brewer diet can be easily integrated into general good pregnancy nutrition (see Basic Prenatal Nutrition handout (Evans, 2011)).  For example, while the Brewer Diet doesn’t specify types of salt or fat, whole-mineral salts (e.g. Himalayan or Celtic) and high quality omega-3 fats are healthiest.  Special needs such as food-sensitivities / allergies, ethical choices or cultural habits can all be incorporated into the Brewer Diet.  As usual, ensure you eat 3 meals and 3 snacks daily, including protein at each one.

If you wish to check out the actual “Brewer Diet”, see diet checklists at www.blueribbonbaby.org .  They also include vegan and vegetarian options.  Below is a basic checklist you can use.

Brewer Pregnancy Diet Food Log

The list below is the minimum daily requirements according to Dr. Brewer.  You may wish to consult a holistic nutritionist if you have special needs.  Let you midwife know if you aren’t meeting these daily minimums as this requires prompt attention.

Check off a box each time you have a serving.  Each food counts as one checkmark on the lists e.g. a glass of milk counts as either “Milk” or “Protein”, but not both.  Examples for each category are presented.  Modify to fit any special considerations you have, such as vegetarian or a health issue to work around.

DAILY MINIMUMS:

oooooooo  (8) Calcium source; servings below.  Note 125ml = ½ cup

½ cup animal milk, yogurt or sour cream

¼ cup cottage cheese

1 small slice cheese

36 almonds

12 Brazil nuts

1 tbsp raw sesame seeds

1/3 cup cooked bok choy or collard greens

1 cup broccoli, cooked

½  cup kale

2 teaspoons blackstrap molasses

4 oz black olives

1 oz sardines

 

oooooooo  (8) Protein; servings below.  1oz = 7g.

Note:  See information about fish and mercury on Basic Prenatal Nutrition handout.

1 oz poultry, fish, red-meat, or organs

¼ cup canned salmon or tuna

3 sardines

1 oz cheese: cheddar, Swiss, other hard cheese

¼ cup cottage cheese

1/8 cup brewer’s yeast + 1/4 cup rice

1/8 cup sesame or sunflower seeds + ½ cup cup rice

1/8 cup beans + 1/4 cup whole rice or ½ cup cornmeal (measured before cooking)

 

oo (2) Fresh, dark green vegetables; servings below

1 cup broccoli

1 cup brussels sprouts

½ cup lettuce (preferable romaine)

½ cup endive

½ cup asparagus

½ cup sprouts: bean, alfalfa

2/3 cup greens e.g. collard, turnip, beet, mustard, dandelion, kale, spinach

 

ooooo (5) Whole grains; servings below

1 slice whole grain bread

1 corn tortilla

½ cup oatmeal, brown rice, quinoa,

1 shredded wheat biscuit

½ cup bran flakes or granola

¼ cup wheat germ

1 waffle or pancake made from whole grain

½  roll, muffin, or bagel made from whole grain

 

oo (2) Vitamin C foods; servings below

½ grapefruit

½ cup grapefruit juice

1 orange

½ cup orange juice

1 large tomato

1 cup tomato juice

½ cantaloupe

1 lemon or lime

½ cup papaya

½ cup strawberries

1 large green pepper

1 large potato, any style

 

ooo (3) Fats and oils; servings below

1 tbsp butter

¼ avocado

1 tbsp nut-butter

1 tsp algae oil

1 tbsp first/cold-pressed vegan oil – olive, flax, avocado, hemp, coconut

1 tsp cold-pressed fish oil – cod-liver, sardine, mackerel, anchovy, krill

 

o (1) Vitamin A foods; servings below

3 apricots

½ cantaloupe

½ cup carrots (1 large)

½ cup pumpkin

½ cup winter squash

1 sweet potato

 

Salt and other sodium sources—unlimited, to taste

kelp powder–to taste

soy sauce or tamari–to taste

full spectrum natural salt to taste – Himilayan, Celtic

 

Water—unlimited; drink to avoid thirst, not in response to it

Purified water is best – see http://www.angieevans.ca/pdf/Water%20&%20Hydration.pdf

Fresh, home-made juice

Unsweetened herbal tea (see Safe Herbs in Pregnancy handout)

 

 

References

Abubakar, A., & al. (2011, Aug). Lipid Profiles and Platelets Counts of Pre-eclamptic women in Selected Rural Areas of Northern Nigeria.  WebmedCentral PHYSIOLOGY: http://www.webmedcentral.com/article_view/2121

ACOG. (2002, Jan). Diagnosis and Management of Preeclampsia and Eclampsia; #33. ACOG Practise Bulletin – Clinical Management Guidelines for Obstetrician-Gynecologists: http://mail.ny.acog.org/website/SMIPodcast/DiagnosisMgt.pdf

Brewer, D. T., & Brewer-Krebs, G. (1977). What Every Pregnant Woman Should Know. The Dr. Brewer Pregnancy Diet: http://www.drbrewerpregnancydiet.com/id74.html

Evans, A. (2011). Basic Prenatal Nutrition. Canmore.

Frye, A. (2007). Understanding Diagnostic Tests in the Childbearing Year, 7th Ed. Portland, OR: Labrys Press.

good nutrition… for healthier moms and babies. (n.d.).  BlueRibbonBaby.org: http://www.blueribbonbaby.org/

Haas, A. (1995). Preventing Preeclamsia, PIH, Toxemai and HELLP by Good Nutrition. Midwifery Today .

Jones, J. M. (n.d.).  The Dr. Brewer Pregnancy Diet: http://www.drbrewerpregnancydiet.com/

Maine, D. (2000). Role of nutrition in the prevention of toxemia. The American Journal of Clinical Nutrition , 72 (1), 298-300.

NICE. (2010, Aug). NICE clinical guideline 107: Hypertension in pregnancy. NHS – National Institute for Health and Clinical Excellence: http://www.nice.org.uk/nicemedia/live/13098/50418/50418.pdf

 

 

Hospital Birth Room Set-up 101

One of the important tasks I do for my clients is to set up their hospital birth room for comfort, safety and efficiency.  Here’s a list of what I take care of I go into a birth room.  In my local hospital the birth rooms all have a small closet, mini-fridge, blanket-warmer, some empty shelves and an adjoining private washroom with a tub. If you’re DIYing then find out ahead of time what your local birth rooms are like and modify as needed.

Placenta Capsules FAQs

What qualifies you to provide this service?
Proper training and a lot of experience:  We’ve offered this service since 2009 and between us have done 500+ placentas, making us the most experienced encapsulators in Saskatchewan.  We are both OSHA certified and trained in Universal Precautions, food science and preservation.  We train placenta encapsulators through Birth Ways International.

How long does it take?  The capsules are ready in 1-2 days from when we get the placenta.

How many capsules will I get?
That depends on the size of your placenta.  Most women get over 100 capsules.  The average is around 115.  Bigger placentas can fill close to 140 capsules.

What’s the difference between gel and veg caps?
Gel caps are made from animal gelatin and veg caps are vegan, made from plant materials.  See a detailed ingredients list for our high quality capsules.

How do you clean and care for your equipment?
The processing is done using OSHA Blood Borne Pathogen Standards. All surfaces and equipment are cleaned, then disinfected, then twice-sterilized using chemical methods. (This is “over-kill” but is reassuring to us and our clients!)  We use high quality equipment that can be properly sterilized and is kept in like-new working order.

Can I keep my placenta if I have a caesarean birth?
Yes.  The steps are exactly the same.  Simply ensure your O.R. nurse knows you wish to keep it.

Am I “allowed” to keep my placenta?  Do I need permission from my doctor?
It’s yours to keep.  Simply write in your birth plan or tell your care-provider, “I’m keeping my placenta.”  Other details are for you to share or not as you choose.  Obstetrical staff at Regina General Hospital and nearby rural hospitals are quite used to women keeping their placenta.  If you’re at another hospital that has concerns, then you can sign their Release of Live Tissue waiver.  Remind the people attending your birth that you wish to keep it.

Can you make capsules from my placenta if I choose to use epidural or other medications in labour?  Yes.

Is my placenta safe to encapsulate if there’s meconium (baby poops inside) during the birth?
Yes.  The initial cleaning process and proper dehydration takes care of this.

Are there any cases where my placenta can’t be encapsulated?
In the rare case of uterine or placental infection during labour, your placenta will be taken away to the pathology department for analysis.  We’ve processed well over 500 placentas and have never received one that was infected (we do watch for it though).  All placentas are inspected after birth by midwives/doctors, who do not send infected placentas (or anything else) home with patients.

If your placenta is left at room temperature for too long then we are unable to process it.

Do you serve out-of-town clients?
Yes.  We have systems in place to make this easy for you.  We provide detailed, easy-to-follow instructions.

How do I package the placenta for you?
At Regina General Hospital, the placenta is usually put into a square plastic container; you can use that for storage and transport.  We provide detailed instructions to bring your own container as a back-up.  You can ask your nurse to get it ready.  While it’s not her “job”, most are happy to help.  At home births or other hospitals you’ll need to provide your own container (we provide detailed instructions).  If you have your baby at night or are shipping the placenta, then you’ll keep it cold (detailed instructions provided) until the morning when it’s picked up.

How do I get the placenta to you?
One of us picks it up at Regina General Hospital or at your home in Regina city limits, depending where you give birth.  If you have your baby out of town then you can have it delivered to us.  We provide detailed instructions.

How do you ensure the capsules are returned to the right person?
This is one of the most important parts of the process!  One of several advantages to working in partnership is that we can process two placentas at the same time in two separate locations. We have a triple labeling system in place to ensure 100% accuracy; your placenta is attached to a label at every stage of processing, from placenta pick-up through to delivery of capsules.  These are a matter of routine, and are followed with every client’s placenta, even though we rarely have 2 placentas in the same building at the same time.

How do I get the capsules back?
We deliver the capsules anywhere within Regina city limits.  If you live out of town then we can ship them or send them with someone going your way (we can drop the package off anywhere in Regina to that person).

How long do the capsules last?
They’re best used within 1 year, stored at room temperature in an airtight container (glass jar).  After that they don’t necessarily go “bad”, but the nutrients start to diminish.  If you wish to keep them longer, then the freezer can extend that for up to another year if they go in within the first few months.  (We don’t recommend this because we hear from so many women who put them in the freezer and promptly forgot about them.)

How do I store the capsules?
Just keep them in the glass jar.  There’s no need to refrigerate them.  They’re good for up to a year at room temperature in a cupboard.  If you wish to keep them longer, then store in a deep-freeze for up to two years.

Can you make capsules out of my frozen placenta?  Yes.

How do we proceed? 
Please follow the steps on our encapsulation page.  There’s a form for you to complete and all the information you need is there too.  We need your estimated due date and contact info.  You can send an e-transfer, post-dated cheque or provide cash with the placenta.

What if I Haven’t Made Arrangements Yet?  We can usually accommodate you.  In an ideal world everything will be set up ahead of time.  However if you just decided to do this while you’re in labour – or even after your birth – and need to make quick arrangements, please text during normal “awake” hours.  (If you have your baby after 9am or before 8am, please put your placenta in fridge or on ice and get in touch in the morning.)  Please follow the steps on our encapsulation page.

Do you buy or sell placentas, or placenta products?
We do not!  This is not only unethical and unsafe, but is illegal in Canada.  (If anyone offers to do this, please report them to the Public Health Department.)  We provide the service of turning your own placenta into capsules for your own use.