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.

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.

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.

C-19 Updates in Birth and Postpartum Care in Regina

I’ve been keeping in touch with the good people managing the units at Regina General Hospital. Here are all of the recent updates of RGH Labour/Birth Unit and Mother/Baby Units here in Regina, Saskatchewan due to Covid-19. Please note that any of these may change on short notice due to the coronavirus pandemic.

Some additional tips for navigating your birth journey:

I lead RGH Tours live but online multiple times a month.

Article: How to Set Up your Birth Room (i.e. What Your Doula Would Normally Do!)

Easing Labour Pain: An online 2-hr class offered monthly that teaches partners how to provide hands-on birth-support, comfort, and decrease labour pain.

If anyone’s looking for online prenatal classes please contact me. I teach all the sessions live but online so you can ask questions.

*****

Hospital Update

◆ As of June 12, there are 2 support persons allowed in the BIRTH ROOM. From Saskatchewan Health Authority:

“Effective immediately, expectant mothers and families across Saskatchewan will now be permitted to have two designated family members/support persons present during their birthing experience. Designated family members/support persons are chosen by the mother and family and may include but are not limited to partners, family members, coaches, doulas or cultural support persons.

All maternal patients and their designated family members/support persons will be screened for COVID-19 upon arrival and be required to have a temperature check, wear a mask, participate in hand hygiene and follow physical distancing guidelines. Designated family members/support persons who are symptomatic for COVID-19 or who have other risk factors will not be permitted. The designated family members/support persons must be consistent during the duration of the patient’s stay. They may leave the facility but cannot be switched out for another family member or support person. Only designated family members/support persons will be permitted at this time, other visitors, including siblings, will not be allowed.

All maternal patients will be offered an optional COVID-19 swab upon admission. Family members/support persons will not be offered a COVID-19 swab.”

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◆ Support people coming in on their own, i.e. not with the labouring patient, can be screened 24/7 at the main RGH doors (14th St entrance). They do not have to go to the ER doors.
◆A 24-hr support person who’s joining a birth or going to MBU for a maternal patient that has already been admitted can enter through the main 14th St doors at any time, 24/7. No need to go through the ER.
◆ A support person entering the hospital with a maternal patient will be screened at whatever door the patient enters.

Please note that while the 14th Ave entrance is open 24/7 with a security guard that can screen and let people in, the registration desk is only open from 6am-6pm. Support people can enter this door 24/7 because they are not patients (don’t need to go through the registration process).
If you’re in labour and going to RGH as a patient, then you’ll have to go to an entrance that has an open registration desk. On weekends, holidays and evenings/overnights, that will be the ER.

If you have to step outside and get back in, here’s how:

◆ 14th St main entry has a security person around the clock. If you have your proof of screening and are wearing a band it’s easy to get back in 24/7. If you’ve not been screened yet, I recommend you start at this door. If they are unable to screen you, they will send you through the ER doors instead.
◆ The ER can screen 24/7 but please save the ER capacity for people who need it.
◆ 15th St admitting doors are locked overnight. The doors below MBU at 15th St parking lot are locked 24/7. You can not enter the 15th St side of RGH overnight. If you go out those doors, you’ll have to walk around to the 14th St entry.

If your 2nd support person is not at the birth but is invited to MBU, they will be screened on their way into the hospital. They must be named when you are admitted to LBU so remember to tell your nurse. You must get a coloured bracelet for them. I expect someone has to meet them outside the unit to give them the band that will grant them access to the MBU, but ask your MBU nurse about this.

“If the patient fails screening, she becomes a Person Under Investigation (PUI), therefore the support person now becomes a PUI as they have been in ‘close, prolonged contact with a PUI.’ The support will be sent home, however, the patient may have an alternative support person or people who pass screening. ” That means anyone who has been with the labouring woman for more than 2 hours will not be allowed in if she is suspected of C-19/exposure.

Folks – you need to plan for this. Plan C. New support people who have not been with you for more than 2 hours AND who pass screening will be allowed into isolation. They will be gowned, masked, gloved throughout and will not be allowed to leave the isolation room. Food will be brought in.

◆ Again, it’s up to you to ensure that a 2nd support person has been named so they can enter the unit. Ask your nurse about this.
◆ Supports must be 19 years and older. (No, I’m not sure what happens in the case of teen pregnancy, young doulas and so on. This is just what I was told.)
◆ The health region is not on the same timeline of relaxing restrictions as the SK gov’t. Restrictions are still in place at health care facilities.
◆ You’ll see staff wearing masks throughout your stay.
◆ Bring what you would normally bring for your birth and hospital stay. Support people will be given a wristband so they can go to car later for extras and car-seat. You are still allowed to bring your pillow, clothing etc – whatever you need for comfort.

Doctor

◆ Nitrous-oxide (“laughing”) gas is available for pain management.
◆ If you or baby are at high-risk for birth complications, you may be asked to use an epidural during labour to avoid the need for a general anaesthetic in case of an urgent/stat caesarean. Best to discuss this with your OB ahead of time so you can learn your options and make a plan.
◆ Waterbirth is currently not an option in the hospital. Midwives are not lending pools out for home birth. If you have your own then waterbirth at home is still an option (contact me for info on where to get one).
◆ The installed bath-tub is available for comfort in labour.
◆ Breastfeeding is still being supported at RGH.
◆ There are plans and protocols in place so that mother-baby can stay together if mom is at risk or has symptoms of C-19 in the immediate postpartum.
◆ Even though some community restrictions are being lifted, great care should be taken with newborns once the family is home. Physical distancing and being only with members of the same household are still recommended. Anyone who enters the house can bring in pathogens/bugs.

◆I always tell people to bring their own hot water bottle or Magic Bag to the hospital. That’s because the hospital does not provide any warm tools other than blankets from the blanket warmer. They are lovely but they are not the same as a hot water bottle. The new update is that the staff are not allowed to take people heating devices to the microwave or kettle. Therefore if people want to use heat it will have to be a plug-in device or they can fill the hot water bottle with hot tap water in their own room. Stay warm and stay well during your visit!

◆ Paid parking has resumed in the RGH parking lots. You will need cash for the main lot. Also, the 15th street parking is reserved only for people who have appointments or are being admitted to the hospital. Vehicles are being ticketed again on the streets around the hospital so no more free parking that way.

◆ There is nowhere for the second support person to wait as all waiting rooms are closed. The second support person should wait at home or somewhere outside the hospital until the labouring person is officially admitted and moved to a birth room.

◆ Partners/support persons will be provided with a mask at the entry doors. (Bring a big paperclip or string if you want to save sore ears.) Check out these tips for saving your ears from mask-pain.  Everyone must wear masks in the hallways. Labouring people do not have to wear a mask once they’re in their patient rooms in the birth unit and the mother-baby unit.

◆ Food outlets now allow people to sit in.

◆ Galleys are still closed to patients in both units. The nurses will get food for you in the birth unit but not in the mother-baby unit so people have to bring their own snacks. There is no access to the microwaves, kettles, food, water-ice machines. There is no access to the big fridges and freezers, but every room has a small mini-bar fridge.

Birth Room

𝐏𝐫𝐞𝐧𝐚𝐭𝐚𝐥 𝐂𝐚𝐫𝐞

● Attend appointments, diagnostics (ultrasound, lab) solo. Routine appointments might be done over the phone or spaced out. High-risk and special circumstances will still get the extra care they need.
● Midwifery offices are doing the discussion part of the consult by phone and then a quick in-person appointment for the hands-on part. They prefer pregnant patients attend alone but will allow partners. No other family members/friends/support are allowed.
● Anyone under midwifery or GP care who tests positive for C-19 at any point in their pregnant, birth or postpartum will be immediately transferred to OB care.
● If you’re an early-bird you may be asked to wait in your car until your appointment time.

𝐀𝐧𝐭𝐞𝐧𝐚𝐭𝐚𝐥 𝐂𝐚𝐫𝐞 (𝐋𝐚𝐛𝐨𝐮𝐫 & 𝐁𝐢𝐫𝐭𝐡)

● Early discharge is being offered as an option for those that are healthy and feel comfortable with newborn care. That means to go home a few hours after your birth instead of staying 24-36 hours.
● Anyone getting a cervidil induction will be monitored and then sent home to wait for labour to start, as per usual, then rescreened at RGH doors and LBU doors upon return.
● Support people are allowed at homebirths but must be screened. If anyone in the home (residents or support people) doesn’t pass screening, then the birth must be transferred to RGH. In that case, the one support person rule applies. Home birthers – screen your people before they come over!

𝐏𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐂𝐚𝐫𝐞

● Doors that don’t have an admitting desk are locked tight; security will not let anyone in. That includes the convenient door just below the MBU.
● Families are being asked to stay in their room as much as possible.
● Support people may not visit any other patient areas.
● Food trays are being provided for new moms in the MBU.
● Breastfeeding class in the unit is still running but only birth mother and baby attend (no partners) and only up to 3 participants.
● Midwives and public health nurses are still providing postpartum home-visits. Some may be done by phone or video, depending on your needs.

Please contact me if you have any questions about this information or any of my services.

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

 

 

Doulas and Dads

Although the information here will reassure any partner, this article intentionally addresses dads-to-be. All the quotes, links and videos are made by dads for dads-to-be, about their most common concerns about birth support:  1) Value; why should I pay for a doula if I’m going to be there?  2) Why do we even need a doula; what does she have that I don’t?  3) How will I be included if a doula attends?

Use of Herbs During Pregnancy & Lactation

Herbal medicine is specific category of health-care.  Many herbs, including essential oils, are safe and beneficial during the childbearing year, while others can be dangerous.  Pregnant women must be cautious with any remedies, especially during the first trimester when the fetus is most vulnerable.  There’s a lot of misinformation concerning herbs.  Here are lists of commonly used herbs that are considered safe and unsafe through pregnancy and postpartum.