Spring Newsletter Editorial: Love Thy Labour

By Stephanie Ondrack

This is issue is all about labour. Often, birth is portrayed in movies and other media as a fast, dramatic cascade from waters breaking to agonized pushing; a rapid escalation fraught with peril and screaming, with the mother a victim rather than a participant. In reality, labour usually moves pretty slowly, especially for first time moms. While fast labours do happen, the more common pattern is a more leisurely, gradual ascension as labour builds dilatory momentum, heading tortoise-pace towards the birth of the baby, contraction by contraction, hormone by hormone, punctuated by swaying and deep breathing. We see the mother not as a victim of labour, but as the creative force channelling it. When the oxytocin is high, time seems to slow down, almost stand still, revealing an altered space in which the mother can lose herself in the task of bringing forth new life.

In this issue we explore different approaches to labour, different choices you can make, different ways you can spend this slowing of time. Every birth is unique, every mom experiences labour differently, but we hope you find one or two insights in here that might be useful for you. Our wish for you: Love thy Labour!

ASK CHILDBEARING: What can I do to try to have a good birth experience?

ASK CHILDBEARING: What can I do to try to have a good birth experience?

By Stephanie Ondrack

Q: What can I do to try to have a good birth experience?

A: Good question!

We know from surveys of new mothers that one of the main factors in the experience of giving birth, is feeling respected and “heard” during the process, and retaining the power to make the decisions and call the shots. Whether the birth is vaginal or caesarean, natural or medically-assisted, doesn’t seem to impact a woman’s feelings of satisfaction as strongly as whether she understood and agreed with any interventions being performed, and had the final say in all decisions made. Women who feel that procedures were done to them without their full understanding of the reasons, or without their explicit consent and endorsement, sometimes feel traumatized after the birth. Some women look back with regrets, questions, and doubts, feeling like a victim in events that spiralled out of their control. On the other hand, women can experience these exact same interventions with pride and ownership if they were on board with all decisions, and felt sure of their power to agree or decline at every step along the way.

Undisturbed Birth

Another approach is aiming for an “undisturbed” birth, as much as is possible according to your circumstances. When women are able to labour freely—free from restrictions & limitations, free from unwanted advice, free from inhibitions, free from time limits, free from expectations, they can more easily slip into the hormonal “high” that colours the birth experience. The cascade of hormones that causes cervical dilation and effective contractions, also diffuses the mother’s mood, allowing her to relax, ‘space-out’, and be carried gently along with the labour with no sense of concern or urgency. The hormones can buoy her experience so that her awareness is hazy, peaceful, and positive. The hormones in question, however, are shy hormones, highly vulnerable to interruption and stress. The slightest disruptions such as the turning on of a light, whispers in the background, a new person entering the room—can cause a small pause, a long stall, or an

abrupt halt to the labour’s progress, as well as the mom’s sense of peace, which can instantly give way to tension, stress, or panic. Imagine how much the gentle flow of hormones can be affected by a common interruption such as a cervical exam, a drive to the hospital, or some poorly chosen loud words by someone in the room. An entirely undisturbed birth is rarely possible nor desirable, since a certain amount of observation and monitoring does improve outcomes, but aiming for the fewest disruptions within one’s personal scope (taking all safety and medical considerations into account), can allow the mom’s hormones to do their work of giving her a quicker labour, and a more peaceful experience. For example, limiting the number of vaginal exams down to medical necessity only, or barring medical students from repeating procedures, or whatever steps make sense for you.

 

Labour Support

As you may know, research shows us over and over again another key influence on birth experience is labour support. The support must be in addition to the woman’s partner, who, as wonderful as he or she might be, is also experiencing the birth of their child and the novelty of becoming a parent. The partner cannot double as an objective yardstick and advocate, since he or she is primarily involved, and intimately connected to the mother. It can be hard to stand by a loved one without wanting to “rescue” her from the experience, which can undermine the mother’s progress and intentions. Effective labour support has to come from a third party: a professional doula, a family member, or a friend with some birth experience. Having a doula, or other labour support person present, greatly reduces the risk of almost all medical interventions, while greatly increasing both parents’ reports of satisfaction with the birth.

 

Even in the case of a surgical birth, or other medical necessities, all the above suggestions apply. The experience for mother and baby will still be optimized if all procedures take place within a context of dignity and respect. As much as possible, medical interventions can be fully explained, the family’s concerns and choices can be accommodated, and the sanctity of a mother’s right to make decisions on behalf of her own body and baby can be faithfully upheld. Even at a scheduled caesarean birth, a labour support person (doula or doula-like friend) can help with comfort measures and communication, preceding and immediately following the birth, as well as ongoing postpartum support. If medically safe, allowing labour to start on it’s own prior to a caesarean delivery—and even labouring for a few hours!—can further contribute to both mother and baby’s positive birth experience. The hormones from labour help prime both parties for imprinting and bonding, and also activate breastfeeding instincts in both parent and child. They are also associated with a safer third stage labour, higher likelihood of breastfeeding success, and lower risk of postpartum depression. Some medical conditions are not safe for trials of labour prior to a caesarean, but in other cases the only downside in scheduling inconvenience, which might be outweighed by the benefits bestowed by the hormonal cascade.

 

Choosing the right Caregiver

Finally, choosing the right caregiver should be the final consideration for a great birth experience. Every doctor and midwife has their own philosophy, their own beliefs, and of course their own personality. It is important to find someone who can support whatever kind of birth you want, who will answer all your questions, who makes you feel comfortable and in control. Your caregiver should be willing to discuss pros and cons of different decisions, and should always make it clear that the decisions are yours. And you should like your caregiver. Despite his or her credentials, you must have a simple feeling of rapport and trust in this person. If you have misgivings, your labouring hormones are less likely to flow freely.

We cannot control or predict much about our births, and there is nothing we can do to guarantee that birth will unfold according to any particular ideals. But we can learn from other women’s experiences, and set ourselves up to handle whatever circumstances arise as much as is in our power. We can buffer ourselves with information, with labour support, and with a plan to allow birth to unfold in as uninterrupted a way as possible, while remaining flexible and open to the unforeseen. We can’t control what cards we are dealt, but to a certain extent we can stack the deck in our favour, and we can definitely control how we play the hand we get.

Chiropractic Care for Labour

Chiropractic Care for Labour

Dr. Stephanie Bonn,DC,FICPA

A woman’s spine and pelvis undergo many changes and adaptations to compensate for her developing infant in each trimester of pregnancy. Previous stresses and injuries (years at a workstation or athletic injuries) as well as present physical, mental and chemical stressors can cause imbalances in her nervous system which may cause symptoms like pain or the baby to be in the incorrect position for birth. Chiropractic care prior to the onset of labour, ideally throughout each stage of pregnancy and even before conception, can assist with a more comfortable pregnancy, foetal positioning, decreased strain on the infant while developing in utero and a less invasive birth for your baby.

 

As a mother moves through each trimester, her weight increases, centre of gravity shifts and her ligaments become more lax due to

the hormonal changes of pregnancy. These structural and hormonal changes may cause symptoms such as back pain, neck tension, headaches, rib strain, carpal tunnel syndrome, plantar fasciitis and reflux. Spinal misalignments may also contribute to conditions such as torticollis (neck strain) in the infant due to a torque in the uterus from a pelvic imbalance, leaving less space for the baby to be in the optimal position prior to birth. When the spine and pelvis are aligned, the baby is in a better position to support his/her developing spine as well as for the birth itself. If the baby is not in the proper position at 32 weeks of pregnancy, the chiropractic Webster Technique can be performed which helps the infant move into the head down occiput anterior position as well as assist with more effective external versions and less complicated breech vaginal deliveries.

 

Another factor to consider comes from a study reported in the European Journal of Obstetrics and Gynecology and Reproductive Biology on hypolumbarlordosis. Women with hypolumbarlordosis (decreased lumbar spine curves) are more likely to have preeclampsia as well as decreased blood flow to the iliac artery than women with average lumbar spinal curves. With chiropractic, the function of the low back can improve to decrease the chance of preeclampsia in women with flattened lumbar spines.

 

More mobility and less strain allows the mother to be more active throughout her pregnancy which assists with her having to work or care for other children as well as a faster postpartum recovery following the birth. Within one to two weeks postnatal, it is highly beneficial for the mother to have a realignment as well as a newborn assessment to decrease any stress in the infant’s neuromusculoskeletal system. Paediatric chiropractic adjustments are very gentle and can assist with common newborn issues such as gas and colickiness, latch problems, trouble with sleep, oversensitivity, reflux and torticollis.

 

Along with exercise, nutritional support, ergonomic awareness, adequate sleep and stress-relieving techniques, chiropractic care is an integral component for a healthy

pregnancy and in preparation for a non-invasive labour and delivery. Benefits will continue with postnatal care to assist with the healing from the pregnancy and birth, neck and back tension from caring for your newborn and neurologically boosting your immune system which can be compromised from unavoidable sleep deprivation. Paediatric chiropractic will help to decrease any strain in your infant’s system and natural support with issues they may have in their growth and development especially the first year of their life.

 

Dr. Stephanie Bonn, BSc, BPHE, DC

Dr. Stephanie is dedicated to optimizing health and wellness through chiropractic care. From newborn to adolescence to adulthood, Dr. Stephanie uses techniques specific to the individual to bring balance to the spine. Dr. Stephanie is dedicated towards helping families have healthy pregnancies and births. As a mother of three following doula and midwifery-assisted homebirths, she supports attachment-parenting and helps families through the challenges of breastfeeding, co-sleeping and baby-wearing. As an advocate for holistic healing, Dr. Stephanie helps clients surpass their health goals. Dr. Stephanie is active in the community presenting seminars and writing articles ranging from perinatal care, stress management and ergonomic assessments to backpack safety and injury prevention. As an avid runner and enthusiastic mother, she integrates her knowledge and experience into her family practice in the Yaletown community.

For more information, please contact Dr. Stephanie Bonn at bechiro.ca and the International Chiropractic Paediatric Association at icpa4kids.org.

Stephanie can be seen personally as the guest speaker at our postpartum class on Babywearing, on Monday 19th March 2018, 12:30 – 2pm.

Natural Birth

Natural Birth

By Debra Woods

What will you say when you look back on your birth and describe why it was rewarding and satisfying? How are you envisioning your birth experience? What’s most important to you? The majority of expectant parents answer this with ‘a healthy baby’ or ‘a healthy baby and healthy mom’. How can you achieve this? What are the crucial elements that can optimize health and safety? As in life, there are no guarantees, but you can certainly prepare for the best possible outcome. How? The answer lies, first and foremost, in the belief that birth IS a natural healthy experience, and secondly, the commitment to have that experience.

What exactly is natural birth? What are the factors that define natural or physiologic birth? Physiologic or normal birth means:

 

  • spontaneous onset & progression of labour
  • biological and psychological conditions that promote effective labour
  • vaginal birth of the infant and placenta
  • normal blood loss
  • facilitates optimal newborn transition (skin to skin contact) and keeping the mother and infant together in first hours post birth
  • early initiation of breastfeeding

 

“According to physiological law, all natural, normal functions of the body are achieved without peril or pain. Birth is a natural, normal physiological function for normal, healthy women and their healthy babies. It can, therefore, be inferred that healthy women, carrying healthy babies, can safely birth without peril or pain.” Dr. Jonathan Dye, 1891

Normal birth is designed to ensure safety. It optimizes the health of baby and mother. Having evolved over millions of years the ancient wisdom of birthing mothers has been proven.

 

Birth by its very nature:

  • is a healthy, involuntary process directed from deep within the limbic system of the woman’s brain and body (out of her conscious control)
  • allows a woman to respond and surrender to physical instincts
  • proceeds with the action of hormones that keep this process safe

 

Normal birth isn’t a medical emergency or a medical event. For the majority of healthy, low risk pregnant women, birth proceeds without the use of medical technology. When birthing women are supported to respond to their instincts, with trust in the process and belief in their body’s ability, better outcomes are the result. In fact, when there is an overuse of routine medical intervention, this can lead to complications that otherwise wouldn’t have occurred, putting the safety of mother and infant at risk.

 

This quote from Dr. Kloosterman states:

“Spontaneous labour in a normal woman is an event marked by a number of processes so complicated and so perfectly attuned to each other that any interference will only detract from the optimal character. The only thing required from the bystanders is that they show respect for this awe-inspiring process by complying with the first rule of medicine – nil nocere (do no harm).”

 

As a doula who has attended several hundred births, I’ve seen firsthand how when birthing women are not unnecessarily disturbed, are supported to trust their bodies, feel they are not being watched, creating a sense of personal privacy, their labours progress normally. There is an energy in the body that takes over, driven by the autonomic nervous system that propels a woman forward, organically building momentum that culminates in the vaginal birth of her baby. It is truly magnificent to witness. Women are in their power, tapping into ancient DNA that provides them with an instinctual knowing. This enhances the capacity to open to the experience, entering into an altered state that seems to transmute pain, much like an endurance athlete experiencing a ‘runner’s high’. The level of beta endorphins available to the birthing woman are as potent as the narcotic morphine. The sensations, produced by birthing hormones, actually inform the woman so that she assumes various positions that facilitate labour progress, so it efficiently unfolds. The sensations are accepted as allies, to provide direction for the woman, so she intuitively navigates her labour.

 

For the most part, this is not the commonly held view that modern women read or hear about today. Western society perpetuates the idea that labour is unbearably, agonizingly painful. This belief has led pregnant women to be terrified of birth, far outside a healthy fear of the unknown. In some countries the cesarean section rate has reached astronomical numbers as high as 80%, because women wish to avoid birthing vaginally. Western obstetrics hasn’t helped with dispelling this myth of labour as so painful that women shouldn’t have to suffer. Viewed as something to eliminate, women avoid it completely, for example, by using an epidural. Entirely removing the sensations can disrupt normal labour, leading to a medically managed birth, due to increased risks for mother and baby. Beliefs of terrible pain combined with birth as a medical event needing interventions sets women up for that experience – a self-fulfilling prophecy.

“Resistance to the flow is one of the biggest triggers of pain in childbirth.”

 

Birthing women’s belief in themselves is severely undermined with fear crippling their confidence. A climate of doubt leads them to accept pain meds and interventions that may be harmful. More accurately, the ‘pain’ of labour is both purposeful and beneficial. Birthing hormones assist women to engage with their experience. Oxytocin, released in pulses working with endorphins, creates a sense of well-being and induces feelings of euphoria, confidence and self esteem.

“There is a power that comes to women when they give birth. They don’t ask for it, it simply invades them. Accumulates like clouds on the horizon and passes through, carrying the child with it.” Sheryl Feldman

 

What about women who come to their birth wishing to experience it, who understand the tremendous benefits to having a physiologic birth, for themselves and their newborns? Benefits that carry over into the immediate postpartum period facilitating secure attachment and bonding, early and successful initiation of breastfeeding, quick recovery, no separation of newborn and mother, and newborns transitioning smoothly.

As Dr. Sarah Buckley says, “When a mother’s hormonal orchestration is undisturbed, her baby’s safety is also enhanced, not only during labour & birth, but also in the critical postnatal transition from womb to world.”

Where can these women find support for physiologic birth? Who are the care providers who stand with them to stay the course and hold them to their intention? What is the most conducive environment that is fundamental for women to labour as they are designed for – moving freely, uninhibited, accessing their instinctual wisdom and in their authentic power?

“The whole point of woman-centered birth is the knowledge that a woman is the birth power source. She may need, and deserve, help, but in essence, she always had, currently has, and will have the power.” ~Heather McCue

 

For healthy pregnant women who joyfully anticipate this long awaited event, excited to fully experience it, to actively participate, prepared to be transformed, where can they access encouragement, guidance and support for this vision of birth? Fortunately the numbers of women are on the rise who desire and have had this experience. Its evidence is seen on You Tube videos, written about in birth blogs, on personal and group Facebook pages and through birth photography. Mothers are speaking out sharing entirely different birth stories than those inducing fear and doubt. A new paradigm is here – one in which women are choosing to birth from a place of autonomy, recognizing it as a normal healthy experience in their lives, so as to embrace birth as an act of loving surrender.

 

If you feel inspired to learn how to optimize a normal physiologic birth, to explore society’s and your own beliefs, to be freed from excessive fear, or to understand how your birth can be empowering and even pleasurable, you can attend The Childbearing Society’s seminar on natural birth. This class will change the way you view birth, opening to your innate intelligence within, to help determine how you want to give birth, for the ultimate benefit of both your baby and yourself.

 

To register here for the next natural birth seminar.

Help! How to get the labour support that’s right for you

Help! How to get the labour support that’s right for you

By Aimée Sturley, Doula (HCHD)

As a doula, the question I’m asked most often is, “How can I make sure that I (and my partner) get the birth we want?”

My answer is always that you need to make sure that you create a support team that fills you with confidence. The question, then, is what is support? It really does vary! For one person, a gentle touch and a quiet, reassuring voice reminding them that they are strong will create a sense of strength and support. For another, that could be their greatest irritation.

For first timers, the question of how to figure out what will be good support can be a confusing one, especially when you hear in your prenatal class and from friends that sometimes things don’t go as planned. Nonetheless, you can still have a pretty good sense of what will likely be supportive and what will drive you bonkers.

For those who’ve given birth before, previous experience can be both helpful (if you know even better this time what you need) and unhelpful (if thinking about a previous birth makes you anxious about ensuring you get what you need).

Some things to consider:  

  • What are you like in your day-to-day?
  • When you are undertaking a challenging task, do you like to have someone there to encourage you along? Do you do better when you can just focus internally?
  • How do you respond to various kinds of stress? What helps?
  • What tends to make you worried or anxious?
  • What kind of touch do you like? What kind of touch makes you uncomfortable, or hurts?
  • What makes you feel that someone is respecting you?

Answering these questions for yourself can be a starting point for thinking about how you can talk with your birth team about what support means to you. Everyone wants to be the best support possible for you; in the absence of info, they will simply do the best they can with their general knowledge and years of experience. With specific info about *you*, they can hone that expertise to serve you throughout your birth.

 

How can I get my caregivers to best support me?      

Ask questions and be clear about your decisions and preferences in your prenatal visits. Listen carefully to what your caregiver tells you, and always assume the very best intentions on their part. They are there to offer the very best of their training and experience. They want you to understand what you can expect from them. Share your feelings and thoughts so they have a good idea about where you are coming from.

Some useful questions to ask about any given topic are:

  1. What are you comfortable with in this regard?
  2. When patients have decided to go beyond your normal comfort level, how have you handled that?

This is not to set up an expectation that you and your caregiver will be at odds with one another, but just to get an idea for their feelings around patient autonomy and how they communicate, should differences arise.

If you leave a visit feeling badly about the questions you raised, that might be a cue that you need to speak with your caregiver at greater length about your relationship and what you expect from them in terms of listening and respecting your voice. In labour, it’s a lot harder to do. If you don’t come to a resolution that feels right in your gut, try again, perhaps with support from a staunch ally, or by approaching the conversation from a different angle. If you are unable to resolve that gut feeling, you may want to ask around about switching providers (your prenatal instructor, doula, or knowledgeable friends might be able to help you here); it’s never too late to make these inquiries, as last-minute openings are usually available.

 

Find yourself a doula

Unless you have strong feelings against it, having a doula is one of the best things that you can do to ensure that you look back on your birth with a feeling of satisfaction. If you feel overwhelmed by the cost associated with hiring a doula, find some doulas who are

recommended to you, or that you find online, and ask them about sliding scale and/or fee instalments; even a doula who can’t accommodate your request may have helpful suggestions for who else you could try. Whoever you chose, make sure that you feel confident in their ability to support you, no less than any other member of your care team.

A doula is someone who will be by your side to make sure that you are treated with respect and dignity, and that your voice is heard. Although they cannot speak on your behalf, they can certainly remind you of your options and let you know what questions to ask every step of the way.

 

A Word About Cervical Exams  

  

This deserves its own category, because in the media and (often) in our own experiences, cervical exams are done at the behest of the care provider and are not presented as being optional, when in fact, your body is always your own, and – especially in this area – you have the right, and the responsibility to yourself to be honest and clear about what you want and need. Are you concerned about the introduction of bacteria? Do you find internal exams to be painful or anxiety-provoking? Do you want to know that you can ask for exams to ease particular fears you might have? These are legitimate reasons to talk with your care provider about requesting, minimizing, avoiding, or refusing internal exams. You can give your reasons or keep them to yourself. This article about the evidence behind prenatal cervical exams, has some helpful advice that can be applied to exams in labour as well.

 

Birth Plans: A Good or Bad Idea?           

Communicating your wishes and needs in a birth plan is vaunted by some and denigrated by others. I feel they can have a place, but it does pay to be aware of the effect that they can have on your mindset, i.e. what happens to your state of mind if your birth doesn’t go according to your plan?.

Be specific: If you feel that particular preferences are important for you to communicate to your team, make sure you are very clear about what you mean. For example, indicating that you would rather not have your waters broken unless it’s medically necessary is only half the info; the other part is: what does that mean to you and to your care provider? This is important to talk about before the birth. And make sure that you bring your questions with you, written down, or nine times out of ten, you’ll leave the appointment and think of all the things you’d intended to say! Deeper discussions with your caregiver are a great part of creating a document like this.

In the absence of direction, your care will be the best that they can provide without specific info about who you are and how to best support you. If you hired a counsellor, and didn’t discuss your goals, the counsellor could do their best by just starting out with questions about your relationships, or your childhood. If you told them that you wanted to improve your ability to create clear boundaries while being close to someone (for example), that would provide a guiding principle for their work with you. The same is true for nurses, midwives, and doctors.

It may be helpful for a birth plan to be re-imagined as a “birth preferences” document. This implies an understanding that birth can be unpredictable. The answers to the questions I posed at the outset of this article are great to include in your Birth Preferences; they can help the care team to understand who you are and how best to help you. In a recent episode of The Birthful Podcast, the guest speaker introduced a great new way of thinking about birth plans/birth preferences documents. Her offering is the term, “Birth Principles”, which I think is brilliant. You can hear the whole thing here.

 

First Two Hours Postpartum

Here’s another topic that often falls under the radar when considering a birth preferences document. Those first moments with your baby are so precious and vulnerable, and you are at your height of lovingness and gratitude to those around you; if you don’t have your wishes written down, you are unlikely to bring them up if the routines of your care team move things along differently. Help them to help you by letting them know what you want, and (again) be specific! For example, for most caregivers in Vancouver, physiologic (aka, “delayed”) cord clamping is now the norm; but different parents (and different caregivers) have different ideas about what that means for them. If you’ve spent some time learning about how long it takes for the baby’s blood to transfer from the placenta into their circulatory system, preferring that the cord not be clamped for x number of minutes, don’t be afraid to bring it up at a visit and to write that down as well.

How long to you want to have your baby in your arms, skin-to-skin, before weighing and measuring are done? Remember that, in the first hour, you’ll not only be snuggling your baby but also:

  • Birthing the placenta.
  • Cutting the cord (unless you’re having a lotus birth),
  • Getting frequent checks of your and baby’s well-being. These include heart rate, temp, and, for you alone, blood pressure.
  • Commonly, though not always, having uncomfortable and, at times, painful external uterine stimulation to prevent postpartum haemorrhage.
  • If necessary, getting stitches for a perineal tear.

It’s usually in the second hour that you get that uninterrupted calm and the cozy cuddle that you probably envision. If you’re at the hospital, the room is no longer full of people, checks on your and baby’s health are less frequent, you’re all cleaned-up and tucked into bed, and any pinpoint lights that were required for immediate postpartum care have been turned off. If you ask for two hours of uninterrupted skin-to-skin time with your baby, you get this whole second hour to just marvel at your little one and hold them close.

 

Other Considerations

Do you want erythromycin ointment for the baby’s eyes? The standard blood panel? The vitamin K shot? Your caregiver should bring up these options when you are close to your 38th week.

Do you want the care team to say anything about the baby (comments on its size, sex, beauty, cuteness, etc.), or do you want to discover these kinds of things for yourself?

Would you like to have as much quiet in the room as possible after the birth?

How do you want to approach feeding your baby? If you are breast feeding or chest feeding, do you want to try on your own first? Do you want help from anyone who can offer? Or do you prefer to get help from a particular person? If you are planning to use formula, do you want your care team to keep quiet about the benefits of breast feeding?*

Do you want the care team to give you a little time together as a family as soon as possible after the birth, without anyone else in the room?

If you are in the hospital, do you want a “please do not disturb” sign for your postpartum room? You’d be surprised at the numbers and types of visits some hospitals allow. Who might be knocking at your door? You’d expect, of course, any guests you admit, your primary caregiver, the paediatrician, the lactation consultant, and your nurse, but don’t forget about food service, cleaners, someone who has the wrong room, and the hospital photographer! A sign on the door lets everyone know that only those who really need to attend to you should be knocking.

Take a deep breath

If all of this feels overwhelming, remember that your care team recognizes that this is a special day. Birth never fails to be amazing, whatever path it takes! But for you and your family, this is the special day. The desire for a safe delivery for you and your baby is a given, but you also deserve to be heard and respected, and that’s a great guiding principle to start with.

*There could be many reasons for someone not wanting to or not being able to breast or chest feed, and the moment of birth is a particularly vulnerable time; not a great time to feel judged! 

 

About Aimée

“I’ve been a birth doula in Vancouver for fourteen years (partnered with Aleksandra Henderson since 2014), and a perinatal massage practitioner for sixteen years. I also rent out TENS units for late pregnancy, birth and the early postpartum period.

I love the work I do. It provides me with the opportunity to always be learning more about what it means to be present and aware; a witness to human strength, caring, and vulnerability.”

Adar Birth Services

adarbirthservices.com

778-847-2273

Pinecone Parenting Classes

Pinecone Parenting Classes

 

 

Pinecone Parenting presents

Smoothing out the Struggles:

Practical & Useful Tips to Make Parenting More Enjoyable for Everyone

Coming to our Commercial Street location

Sundays – April 22nd & 29th

7 – 9pm.

Visit our website for details

 Contact pineconeparenting@gmail.com to register

Do you ever feel stuck in parenting patterns that aren’t working? Do you ever wonder what motivates your kids to do the things they do? Is parenting fine, but you’d enjoy a deeper understanding of what goes on in your child’s head?

Attachment-based, effective, and well worth the time, this class will change the way you see your kids and your own role as their parent. Treat yourself and your kids to an easier, more enjoyable family life.

Winter Newsletter Editorial: Twins- Double your Fun!

Winter Newsletter Editorial: Twins- Double your Fun!

by Stephanie Ondrack

 

Double your pleasure, double your fun! But also sometimes double the feeding challenges, the tears, the health concerns, and the all-nighters. Every aspect of having a new baby is multiplied with twins, from the good to the bad, the exhausting to the exalting. Generally speaking, the learning curve is steeper, and the need for extra hands greater, but there are also joys specific to multiples, such as the unique bond they form with each other. And of course with two babies, those moments of pure parental delight, when your baby first smiles at you, or laughs for the first time, or says something uncanny and hilarious…these heart-swelling moments happen twice as often.

For this issue on twins, it seems appropriate to include doubles: two birth stories, two questions of the quarter, and two articles about living with twins. We hope the birth and baby stories resonate, and that the tips are useful, whether you have one, or two, or even three, babies.

ASK CHILDBEARING: Is it possible to produce enough milk for two babies?

ASK CHILDBEARING: Is it possible to produce enough milk for two babies?

by Jennifer Landels

Q: I have been told I’m likely to have to supplement my breast milk in order to feed twins, but I’d rather breast feed exclusively. Is it possible to produce enough milk for two babies? 

A: Absolutely!

Breast milk production works on a supply and demand basis, so if you provide the demand (two babies rather than one) your breasts will rise to the occasion. Be aware that it will take longer to establish your supply than it would with a single baby, simply because you have to create twice as much milk. We expect a singleton to return to birth weight at around two weeks old; twins, however, will probably take at least three weeks to make it back to their birth weight. As long as they appear healthy, do not continue to lose weight past the first few days, and are gaining weight, even if slowly, there should be no need to supplement. In fact you should avoid supplementing with anything (even expressed milk) if at all possible, since the best stimulation for your milk supply is nursing your babies.

 

It is extremely important as well to nurse on demand, and avoid schedules. Newborn stomachs are tiny, about the size of a chickpea at first, and preterm babies’ stomachs are even smaller, which means they need to refill frequently. This means for the first few weeks you will be doing almost nothing but breastfeeding, as by the time you’ve nursed one baby, the next is ready to feed again. Fortunately, this helps bring your milk in even faster. Eventually you will learn to breastfeed both at once, and your babies will start to synchronize their schedules so that you do get breaks while both are asleep. But for the first while, have someone around to bring you food and entertainment as your hands will be busy full time!

 

If your babies are very small, they could have trouble latching and sucking, and you may need to feed them expressed colostrum with an eyedropper, syringe or supplemental nursing system (SNS). If this is the case it is still worthwhile putting your babies to the breast, even if they’re not accomplishing much. The skin to skin contact and incidental suckling will benefit them and stimulate your breasts to produce more milk. There are a variety of herbal galactogogues such as blessed thistle and borage to help increase milk production. My personal favourite is fenugreek, which not only increases milk supply but also helps soothe colicky babies. It is inexpensive, free of side-effects, and certainly worth a try before resorting to more expensive prescription medication for increasing milk production.

 

If you encounter feeding difficulties, or your babies take more than three weeks to regain their birth weight, don’t delay in seeking help from a lactation consultant. There are many other avenues of breast feeding support in the community as well, including La Leche League and our own postpartum circles and breast feeding clinics. Remember you can also call your prenatal class instructor who is able to offer advice by phone or email, and can sometimes make home visits.

 

Most of all, persevere. Looking after twins is time consuming enough without having to sterilize bottles and prepare formula. Even though it may not be easy at first, exclusive breast feeding will save you hours of time and provide hours of contentment for both you and your babies. There’s nothing quite like the feeling of two little bodies tucked up under your arms and four little eyes staring up at you in rapt pleasure, so enjoy it as long as you can!

 

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