Pelvic floor disorders are more common than you'd think and many women shy away from seeking help.
We recently interviewed our friend, Dr. Danielle Corapi of Empowered Physical Therapy to learn more about what it's like working with a physical therapist for a happier, healthier pelvic floor.
Tell me more about you-how did you get drawn to this work?
My name is Danielle and I am a pelvic floor physical therapist, owner of Empowered Physical Therapy. First and foremost, I am a wife, mama to my daughter Rylee, and dog mom to our goldendoodle Graham! I graduated from SUNY Upstate and received my Doctorate of Physical Therapy in 2014. After graduation, I began working in outpatient orthopedics and then worked at multiple travel contracts across the country with my husband, who is also a physical therapist. Throughout the years, I had a handful of women's health patients either pregnant, early postpartum or many years postpartum. My patients were dealing with either pelvic pain, incontinence or other issues that can be found during pregnancy or postpartum. I loved working with these women but I always felt like I was missing a huge component when trying to rehab these patients, I knew I needed to learn more. This is when I started my training for pelvic floor physical therapy-and have continued to do so ever since!
What exactly does the pelvic floor do?
Your pelvic floor is a group of muscles that sit like a bowl within the pelvis and have three main functions: sexual, sphincteric- control bowel and bladder, and support- help to support all of the pelvic organs, intestines, bowel, bladder, (and baby when pregnant). The pelvic floor is also one part of four that makes up the “core”. The pelvic floor, diaphragm, abdominal muscles, and back muscles work together and form the “core”, they operate as a pressure system and allow all of us to move properly and provide stability. Although most think of the abdominals as the core, the pelvic floor muscles are an integral component.
Why might I need pelvic floor therapy?
There are SO many reasons why seeing a pelvic floor physical therapist may be useful. If your experiencing bladder and/or bowel incontinence, bladder and/or bowel urgency/frequency, pelvic pain which may include pain with sex, use of tampons, or with a gynecological exam. Many women seek out pelvic floor physical therapy while pregnant or postpartum due to the many issues that arise. Common reasons women seek out pelvic floor physical therapy during pregnancy and postpartum include all of the reasons above in addition to diastasis recti, c-section scarring, low back pain, mid back pain, and issues when returning to exercise/fitness. It may also be useful to seek out a pelvic floor PT preventatively before these issues come up, this is what I wish became more of the norm.
Why don’t we hear more about the pelvic floor during pregnancy and birth?
I wish I knew the exact reason so I could solve this! I think the biggest reason is that a lot of the focus gets put on having a healthy baby-which is obviously VERY important. However, there is not a lot of focus on having a healthy mama! Women's bodies go through SO many changes during pregnancy, birth and postpartum recovery. The pelvic floor alone can stretch up to 200% the amount during a vaginal delivery and there is significant trauma to the pelvic floor with a c-section.
Every health care professional involved in the care of mama and baby has their own area of concern and specialty, I can only hope physical therapists can start being thought of as a crucial component of the team during this time!
Are there some things that you recommend all women do to maintain healthy pelvic floors during pregnancy, and in the first year postpartum?
Yes! I think one of the most important things is to improve awareness of the pelvic floor. Many women have no idea that they have a pelvic floor let alone how it functions. One exercise that I start everyone with is diaphragmatic breathing or belly breathing. The relationship between the diaphragm and the pelvic floor is crucial for proper function. As you inhale and take a deep belly breath in your pelvic floor relaxes and as you exhale the pelvic floor contracts. By performing proper breathing, the pelvic floor will move through its full range of motion which is crucial for proper function.
To Kegel or not to Kegel?
Kegels are not always the answer! The pelvic floor muscles, just like any other muscle, can be weak however they can also be shortened or tight. If the pelvic floor muscles are tight doing a kegel (contracting the pelvic floor) would not be helpful! It would be like doing a heel raise while having a calf cramp-ouch! Research also shows that most people are unable to perform a kegel with verbal instruction alone. The bottom line is that the pelvic floor is very complex and everyone deserves an individualized evaluation to determine what is really going on.
For women who have experienced some pelvic floor weakening after giving birth, where do you recommend they even start?
I would recommend that every woman start with learning how to perform a proper diaphragmatic breath and then adding a kegel (pelvic floor contraction) in coordination with the breath. As mentioned before, as you breathe in the pelvic floor relaxes and as you exhale the pelvic floor contracts. To perform this exercise, take a belly breath in and then on the exhale draw the pelvic floor up and in to contract the pelvic floor. As mentioned above, a proper kegel is hard to perform with verbal instruction alone, having proper cues from a pelvic floor PT can help to make sure you are activating the pelvic floor correctly and not compensating with other muscles.
What can you expect from a pelvic floor therapy session with you?
An initial evaluation includes review of your medical history, a functional movement examination, an internal pelvic floor examination performed intravaginally or intrarectally to see how the pelvic floor muscles are functioning, a conversation about your goals for physical therapy, answer any questions you have, and develop a treatment plan that is evidence-based, holistic, and individualized to address your goals. I really aim to make all of my patients feel comfortable, this is why I offer visits in your own home or in the office setting. I want to tailor my treatments to help you achieve your individualized goals.
Thinking physical therapy would benefit you? Connect with Danielle and get started!
Check out more from Danielle here Empowerdpt.com
Birth and Postpartum Doula, Infant Sleep Educator
As a new parent, sleep deprivation can hit you like a ton of bricks. Parents spend countless days up late at night, up early in the morning, and for many, up for hours with a baby who thinks the middle of the night is a great time to be awake! What’s a sleep deprived parent to do? Enter the overnight postpartum doula!
What is an Overnight Postpartum Doula?
An overnight postpartum doula truly is the Fairy Godmother of the Night. She will take you from being overwhelmed, exhausted and stressed to being relaxed, well rested and ready to face the day. An overnight doula is an expert in caring for your baby overnight while you have a peaceful night’s sleep. Your doula will answer your questions and offer nonjudgmental advice to help you become more confident as a parent. She will take your disheveled kitchen and transform it, so you wake to a calm, peaceful place to drink your morning coffee. Your doula will help you catch up on the ever-growing pile of baby laundry. Sounds like a dream, right?
What does a typical overnight look like?
Every night looks a little different, depending on the needs of the family and baby, but an overnight doula’s schedule might look something like this:
9pm Your doula arrives, and she will spend some time discussing with you your day and answering questions you may have.
9:30pm You and your partner head to bed and your doula takes over care of your baby. At this point the doula may put your baby to sleep.
10-11pm This time is set aside for catching up on household tasks to assist you. Washing dishes or emptying the dishwasher, throwing in a load of baby laundry, picking up around the kitchen and living room, washing bottles and pump parts are typical tasks done.
11pm Now is quiet time for the whole house, including the doula who might try and rest during this time.
2am and 5am Baby wakes and doula will change the baby and bring the parent to nurse or she will bottle feed the baby. After the baby is done feeding, she will burp and put the baby back to sleep. If the baby is fussy during the night or awake, she will care for him so you can sleep.
5:30am Doula will finish up tasks for the night: washing any bottles used during the night, folding laundry that was washed, and when the parent wakes for the day a detailed schedule of the night’s events will be reported.
How parent’s feel after hiring a postpartum doula
”We couldn’t have done it without the help of our doula. I was struggling with postpartum anxiety and depression and the lack of sleep was making things exponentially worse. I needed to get some sleep. Our doula came to our house three nights a week and when I woke in the morning I felt like Superwoman. She was so good to talk to. I was a first-time mom and felt so lost, I had so many questions and struggled with breastfeeding. She assured me that I was a great mom. She was so patient and answered all my questions. I’m so grateful for her support.” First time mom, Camillus
“We loved our doula team! We had support five nights a week for the first three months after we had our second child. I knew as soon as I was pregnant that I wanted the extra support this time around because after we had our first child I was totally in over my head. We planned ahead to hire a doula and we were so lucky to have two experienced doulas to support our family. The thing I loved most about our doula team was that after my child’s birth I had some major complications with my recovery and our doulas cared for our baby like she was one of their own so I could get the rest I needed to recover. I tell all my friends about the amazing support I received from my doula team and recommend them to everyone.” Second time mom, Fayetteville
Who are CNY Doula Connection’s overnight postpartum doulas?
Currently the Doula Connection has four overnight postpartum doulas. Chris Herrera has been a postpartum doula for over a decade and is a mother to three children herself. She has specialized training in breastfeeding, belly binding and placenta encapsulation which are all beneficial in the postpartum period.
Sherri Morris is a mother of 4 and has been a postpartum doula for 4 years. She is a certified infant sleep educator, has additional training in breastfeeding and is currently working on her Newborn Care Specialist certification.
Roz Squitieri has been a postpartum doula for 14 years and a mother for 15 years.
Sarah Kelchner just recently became certified as a postpartum doula is the proud mother of two young children.
We would love to hear from you on how we can best support your family with your overnight sleep needs!
What is a birth doula?
Before we can address the value of a birth doula, we have to define what a doula is. According to DONA International a birth doula is a “trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.” A lot of people confuse the roles of a midwife and doula. Although both are trained birth professionals they are vastly different. Which leads us into the next section…
What does a birth doula do?
Doulas work with their clients extensively during their pregnancy, preparing them for labor and delivery along with the postpartum period. They are a hub for other birth professionals (ie. chiropractic care, prenatal massage, prenatal yoga, maternal mental health professionals, etc.) and can direct their client to other avenues of pregnancy related resources. They give information, exercises to practice, techniques to use, and support to call on any time their client might need it. Doulas accompany the birthing person (and their partner/support person) in labor to help ensure a safe and satisfying birth experience. They draw on their professional training, knowledge and experience to provide emotional support, physical comfort and, as needed, communication with the staff to make sure that you have the information you need to make informed decisions as they arise. They provide reassurance and perspective to the womxn (and their partner), make suggestions for labor progress, and help with relaxation, massage, positioning and other techniques for comfort. A doula works for the birthing person, not the hospital or caregiver. This is an important indication because so many of the issues that arise in western style birth practices happen because the staff that is assigned to the birthing person is working for the hospital/birth site and has their own policies, procedures and agendas. When a person hires a doula, that doula’s priority is the wishes of their client.
How does having a doula affect things?
During labor the body is going through a huge number of changes. The cervix is opening, ripening, and thinning. The uterus is contracting. The baby is lowering down into the pelvis and TONS of hormones are being made. One thing that can really hurt a laboring mama’s progress is stress hormones. They can slow or even stall labor. Because of this it is a doula’s duty to keep the laboring woman as comfortable as possible so her body will be releasing the happy hormones (oxytocin) rather than the stress hormones (cortisol). The doula will suggest any number of things to keep the good hormones flowing. Some things may be: having music playing in the background to keep you focused and grounded, slow dancing with your partner, kissing your partner, massage or touch of your choosing, aromatherapy, accupressure, and even sex (yes, I said it). All of these things will help keep labor progressing and keep the mama-to-be happy and calm. The most basic outcome for all births is a vaginal delivery (the doula will help you write your wishes for all other birth options into a birth plan), however, doulas are also a great support for women planning a scheduled cesarean as well. Because of all the aforementioned suggestions, and many others, the likelihood of a cesarean dramatically decreases when a doula is present (decreases 32.2% according to DONA.org). From there, all of the other options of the birthing person’s labor/delivery are more likely to happen as well for a few reasons. First being that they have one more person on their team. A doula can advocate for a woman’s wishes during labor. Prenatally the doula and the client will go over, in detail, her birth plan. Secondly, having a doula will help impart information and resources that may not have been accessed if not for the doula (ie. webster certified chiropractic care, prenatal massage, prenatal yoga, perinatal psychiatry, etc). Having a doula will also decrease the likelihood of having to use any interventions. See the flowchart above.
Photo taken from evidencebasedbirth.com, for illustrative purposes only.
There are many reasons people choose to use a doula. Yours might be different than the next person’s and every reason is valid. If you want more information on doulas here are two very informative websites:
Written by: Coral Dowsland
Coral is one of the CNY Doula Connection's amazing birth doulas! Meet Coral by contacting the office to arrange a free consultation!
Kathryn Garceau is 28 years old. She is married with three children of her own. She has been involved in birth work for 2.5 years as of January 2020. After going back and forth between a doula or a labor and delivery nurse, she decided that becoming a doula was the right fit for her. After the sudden death of her brother in early 2017, she decided to stop letting life pass her by. She trained with Doula Trainings International (DTI) in November of 2017.
Kathryn believes pregnancy, birth, and the postpartum period are all transformative times of a person’s life, each in their own way. She chose to train to be a doula after having the interaction with her own doula at the birth of her second child. Her first labor and birth was not the experience she had ever imagined so she quickly began to prepare herself for the second one long before she was pregnant. That meant hiring a doula. She considers a doula to be much more intimate than a labor and delivery nurse. A nurse is often in and out of the room, has more than one laboring person to be tending to, and much more paperwork to be filling out. Even the best labor and delivery nurses are pulled in different directions during their shift and cannot fill the gaps of care they wish they could. A doula is there from the time she is called straight through to the end when the family is settled and ready to be alone.
Kathryn also believes in the power of being informed and making decisions based on the information presented. A family does not need to have an unmedicated, vaginal delivery for a birth to be considered a great birth. All births are great, the manner in which decisions are made is what really matters in how it is viewed by the birthing person and her partner. Kathryn knows without a doubt there is so much power in having all of the information presented to a birthing person. Knowing that the laboring woman is confident in her decisions because she made the decisions that are best for her. Being present for a birth, being a pillar of support is what Kathryn knew she is meant to do in this phase of her life.
Kathryn is currently enrolled in a childbirth educator program through Birth Beautifully, and has plans to become certified in reiki and anything else that catches her heart as a calling. She has also completed her pre-requisites for an RN program. Kathryn’s five-year plan is to go for her RN in the hopes of working in an OB office with women’s health overall, moving forward to a labor and delivery nurse, then eventually coming full circle to her own midwifery practice.
In her spare time, Kathryn enjoys reading, being creative any way she can, and dancing with her kids!
Ready to schedule a consultation with Kathryn?
It has been said that a doula is like a trail guide for birth - someone familiar with the culture and landscape who can act as a navigator, interpreter, and cheerleader, pointing out the breathtaking views as well as potential pitfalls along the way. If so, then taking childbirth classes is equivalent to studying the map and learning the language ahead of time. Beginning the journey armed with essential knowledge, the experience is authentically enriched. Rather than following blindly and awaiting interpretation a traveler, or birthing person, can become fully immersed in the experience, enjoying the powerful beauty of the process while easily sidestepping many complications.
While no one can predict the specific route or outcome of any individual birth, there are collective understandings, signposts, and techniques that can serve as tools for the journey. Childbirth education arms parents with the knowledge of what is normal and how to overcome or face variations - allowing them to focus on the true work of labor rather than trying to “wing it.” Prepared and educated parents come to the birth and postpartum experience equipped with strategy and confidence; they know what to do, what questions to ask, and how to make the choices most appropriate for their individual family.
Giving birth is a physically, mentally, and emotionally exhausting process, full of unexpected challenges. In every delivery, the birthing person is required to reach down to the deepest places in themselves to bring forth strength they have never before known. A doula’s skill set provides irreplaceable support to the process, but no one can do this work for you - a doula can only stand by your side and show you the way. Who wouldn’t want to be as prepared as possible for this pivotal life experience?
Common questions such as “How do I know when to go to the hospital?” “What do Braxton Hicks feel like?” and “How do I time contractions?” are all questions that are discussed in this class. You will feel fully prepared to give birth with confidence after this 6-week series.
Sarah will be teaching a 6 week Hospital Birth class series on Saturdays from 10 am -12:30 pm, starting January 11. Each dynamic and interactive session covers an essential topic to prepare you and your family for pregnancy, labor, delivery, and the postpartum period. You will receive a beautiful full-color workbook highlighting the key points of each class, sized perfectly for slipping into your hospital bag for quick reference. Space is limited, so contact us today to reserve your seat. Gift cards for classes are also available upon request.
Sarah teaches private and group childbirth preparation classes in the Syracuse, NY area. Sarah received her certification through Birth Boot Camp and the Bradley Method. Not only is Sarah a chilbirth instructor, but she is also one of the CNY Doula Connection’s amazing birth doulas! Curious about how a doula could help you? Read this past blog post: Should I hire a doula?
Are you ready to sign up for Sarah’s class? Register here! Still have questions? No problem! Our office is available to answer your questions.
Labor and Postpartum Doula
Family sleep is a huge concern for new parents. The KEY to getting your newborn baby to sleep longer and better is to mimic the sensations they experienced in the womb. As a postpartum doula for many years and newborn sleep educator, I have tried many products on the market. Some products have stood out to me as beneficial for most babies and may help your newborn sleep better as well.
Newborn babies love to feel secure and swaddling is one way to mimic that feeling of being back in the womb. There are many different swaddling products on the market, or you can use an old-fashioned receiving blanket to swaddle your baby. My favorite method to swaddle babies is the Houdini Method, which is easy to do with blankets you already have at home. However my absolute favorite swaddle, The Miracle Blanket (miraclebabyusa.com/), is a swaddle that utilizes the Houdini Method. It may be a little tricky to figure out at first but once you get the hang of how to use it correctly babies will feel comfortable and secure. Instructions for use of the Miracle blanket can be found in this YouTube video.
Many people believe that newborn babies need silence and those around them need to be very quiet while baby is sleeping. Parents are often unaware that babies generally sleep worse in quiet rooms because the womb was a very noisy place. Your baby has become accustomed to the sound of your blood rushing through the placenta, the gurgling sounds of your belly and intestines and the thumping of your heartbeat. If a newborn baby is sleeping in silence the very startling noise of the dog starting to bark, a doorbell ringing or someone dropping something onto the floor will usually wake them. White noise will drown out those sounds and usually babies will sleep blissfully through the most jarring of noises. Most white noise machines on the market are not quite loud enough in my opinion to get babies to sleep, but at their loudest setting are perfect for when baby is asleep. To remedy this, 2 white noise machines can be used simultaneously until baby falls into a deep sleep or you can download a white app onto your phone and increase or decrease the volume as your baby settles. My preference is an app called “White Noise Baby” which has many different types of noises to use with your baby and for you to find the one that works best. I have found many babies prefer the pink noise setting which is slightly higher in pitch than white noise.
Your baby spent 9 months comforted by the noises and closeness of the womb. Once they are born, they are jarred by the brightness of this world. To encourage your newborn baby to sleep better and longer, a very dark room is comforting. Adults and older children might like a little light to make us feel secure while sleeping. Newborn babies can be stimulated by light while falling asleep or if they wake during the night. Use black out curtains or blinds (or both!) on your windows, covering or taping over any areas where light might awaken your baby, so that your baby will enjoy total darkness while sleeping.
While in the womb babies are lulled by the gentle movement of your daily activities. Have you even noticed while you were pregnant with your baby that their most active time was just as you were settling in for sleep at night? It’s no coincidence that when your movement stopped your baby woke up and decided to make their presence known! Babies love movement and are usually calmest when being rocked in your arms or in the swing, bounced gently over your shoulder or a baby carrier, or gently jostled in their stroller or their car seat while you’re driving. To help babies fall asleep and stay asleep longer movement and vibration is so beneficial. So, grab your carrier and wear your baby during naptime or spend some time rocking your baby to get them to sleep. A great newborn carrier I love is the Moby Wrap (www.mobywrap.com/shop/all-wraps) and when babies outgrow the Moby I like the LilleBaby soft structured carrier (www.lillebaby.com/collections/carriers). Dr Harvy Karp, author of two of my favorite books Happiest Baby on the Block and Happiest Baby’s Babies Guide to Sleep, shows his method to calming babies with movement in this YouTube video https://www.youtube.com/watch?v=sB2Fw3MFlhk
Sleep close to baby
Sleeping close to your baby has many benefits for both baby and parent. Newborn babies were used to spending every moment, safe and secure, close to their mother when she was pregnant. Babies do not realize that they are a separate being from their mother thus any far separation can cause babies to become stressed and unsettled while sleeping. The AAP recommends babies sleep in the same room with their parents for at least 6 months and ideally a year to help prevent SIDS. For parents, sleeping in the same room as their baby will allow for more sleep as they can quickly respond to their baby’s nighttime needs and makes overnight feeding much easier. There are many bassinets on the market to choose from. Some parents set up a pack and play in their room or even the baby’s crib, while others prefer a stand-alone bassinet. My favorite bassinet is the Snoo Smart Sleeper which features many of the calming techniques Dr. Karp suggests parents use to help babies soothe to sleep (https://www.happiestbaby.com/products/snoo-smart-bassinet). Although the bassinet is pricy the company often offers significant discounts on the Snoo and renting the Snoo is always an option as well.
For more help
If you are desiring more sleep for your family a postpartum doula can help! Postpartum doulas are available for daytime and overnight support to care for your baby while giving parents the opportunity to nap or have a full night’s sleep. Please see our website at http://www.cnydoulaconnection.com/postpartum-care.
If you are concerned about your baby’s sleep or want to learn more about how to help your family sleep better, visit my Infant Sleep Education and Support page at http://www.cnydoulaconnection.com/sleep
What are your favorite products to help your baby sleep better and longer?
Before you become pregnant and early in your pregnancy there are many options to consider while preparing for your birth. Here is a helpful guide to the options you may consider.
1. Location – In the CNY area you have two options for birth location…
A – Alternatives (what are the alternatives)
I – Intuition (what is my gut saying is the right thing to do)
N – Need time (I need some time to think about this, research this, talk to my partner and doula)
Write a birth preference plan – This is to present what you would like to occur during your birth but you are not tied to this plan. Keep an open heart and mind to your birth experience knowing that rarely does what you plan for occur exactly how you envision it.
Learn natural birthing techniques - All women would benefit from learning natural birthing techniques, as you will likely need to use them during some or all of your labor, even if your plan is medical management of pain. An excellent childbirth education class and a doula would teach labor coping strategies to you.
A doula is also a constant presence, making you feel comforted knowing we will remain by your side. Our focus is entirely on you. Most often medical providers are expected to care for multiple patients at a time, therefore usually just checking in with you periodically.
A doula will join you when asked, which may be in your home or the hospital and stay with you throughout, often with only very brief breaks.
Partners appreciate the guidance a doula brings to the birth. Partners take the childbirth class with you, read the books, then labor starts and...their mind goes blank. Don’t worry, that’s where the doula comes in! It’s hard to remember all of that. A doula doesn’t take the place of a partner doing things like counterpressure, but rather remind them of how and when to do them. A partner knows you better than anybody, so while partner may be face to face with mom, talking to you and caressing you, the doula may be giving you a foot massage.
Doulas and partners make great teammates. Together we can do a fantastic job supporting you.
Studies have shown the benefits of having a doula. These studies have concluded that having continuous labor support may decrease the likelihood of needing a cesarean, and the need for Pitocin or pain relieving drugs. Continuous support may also help you have a shorter labor and a more satisfied birth experience. (Cochrane review 2017)
Besides being present at your birth, doulas also meet with you, prenatally, to offer you informational support. We help you find reputable, evidence-based information so that you can make informed decisions about your birth. We also go over comfort measures that may help ease your labor and listen to all your birth wishes.
Doulas also come to your home during your postpartum period to check-in on how you are doing physically and emotionally. We can offer breastfeeding support and reflect on your birth.
Doulas really are there with you throughout the whole process!
So should you spend the money on a doula?
While it might seem expensive, it can still be obtainable. Although doula services are not usually covered by most insurance companies, some will pay a portion or allow you to pay for a doula out of your flex spending or health savings account. Most doulas are willing to work with clients by offering payment plans. Adding doula services to your baby registry is another creative way to pay for your doula.
Ask yourself these questions:
If you answered “yes” to these questions, we want you to know we are here to help!
Join us May 14th to find the doula you connect with at “Doula Speed Dating.” We can’t wait to meet you! (Register here)
If you are pregnant and planning to breastfeed, chances are you’re busy reading books and articles and even taking classes to learn the ins and outs of breastfeeding. You’ve read about let-down, latch, engorgement, and other lactation components, and may already have purchased a breast pump if you’re planning on using one. The truth is, however, that as important as it is to prepare and educate yourself ahead of time, once your baby is born and you are in the midst of figuring everything out, you may still be caught off guard by any number of breastfeeding obstacles. If you put baby to breast for the first time and suddenly can’t remember half of what you learned in your class, or in that book you read, you are not alone! Pregnancy is a time where you are bombarded with incredible amounts of information, and no one expects you to remember it all after giving birth. That being said, one of the most important keys to breastfeeding success is building your support team. That way, when you encounter questions and challenges, you’ll know exactly where to go to get the help you need. Lack of resources and support is a leading reason why women get discouraged and give up on their breastfeeding goals.
Here are the seven people you want in your corner to help you achieve success in breastfeeding.
1. Your partner. Whomever is going to be your primary support person at home, whether it’s a partner, spouse, relative, etc. You and your partner must be on the same page about your breastfeeding goals. It’s important for them to have information about breastfeeding, and to appreciate that breastfeeding is not always a cake walk. A partner who is unfamiliar with the process, or unaware of the many challenges that can arise while nursing, may be quick to worry that breastfeeding is not going well, and may make suggestions that go against your original breastfeeding plan.
2. Your doula. Both birth and postpartum doulas can aid in your breastfeeding success. Birth doulas not only provide you with quality, evidence-based information about breastfeeding, but the positive effects that they can have on your birth experience can also lead to better breastfeeding outcomes. Studies show that the continual support of a doula during your labor not only reduces the rates of cesareans and interventions, but also reduces the likelihood of postpartum depression, which is a contributing factor in women having breastfeeding difficulties. Women who feel supported and have positive birth experiences are more likely to have breastfeeding success. Postpartum doulas are also great to have in your support team. Coming to your home after you give birth, these doulas are also equipped with knowledge of lactation basics and can help connect you with local consultants and professionals trained in more complicated breastfeeding issues. Postpartum doulas also tackle some of the tasks on your household to-do list (laundry, vacuuming, dishes, meal prep, etc.) so you have more time to spend taking care of yourself and your baby.
3. Your baby’s pediatrician. Yes, having a pediatrician who is breastfeeding-friendly is a crucial part of your success. Some practices may even have lactation nurses on staff! If your pediatrician does not seem supportive of your choice to breastfeed, you are being told your baby is behind on the growth curve and you feel pressured to supplement with formula, you may want to get a second opinion or possibly find a new pediatrician. If you are unable to switch doctors, make sure you utilize other resources like lactation consultants to help improve your breastfeeding experience.
4. Hospital nurses and lactation staff. Those first few feeds with your newborn can get you and your baby off on the road to breastfeeding success, so make sure you make the most of your time in the hospital. You will encounter numerous lactation and labor and delivery nurses during your stay who can provide a wide variety of experience and advice. Some hospitals even have a lactation nurse that you can call up after you have taken your baby home.
5. Certified lactation consultants. Depending on where you live, you may have a number of lactation professionals in your local area. Certified Lactation Counselors (CLCs) are professionals who have undergone forty-five hours of breastfeeding management training, and passed an exam. They are also required to complete continuing education credits every three years. International Board Certified Lactation Consultants (IBCLCS) have received even more training and practical experience and their credentials are internationally recognized. You may find them working in hospitals or doctors’ offices, or they may run their own private business. Some CLCs and IBCLCs even make house calls, which can be a blessing for new parents.
6. Support groups. Lactation professionals are great for clinical help in breastfeeding, but sometimes it can be so helpful just to talk with other parents who may be having similar postpartum and breastfeeding experiences as you. Support groups and La Leche League meetings for new parents are a great way to connect with families in your area, and provide a space to be heard and receive emotional support. La Leche League is an international breastfeeding education and support network that provides resources to nursing families, as well as hosting support groups and lactation clinics in cities and towns all over the world. Visit www.llli.org to find a meeting in your area.
7. Print resources. In this day and age, a vast world of information is right at your fingertips. If you have a computer or smartphone, millions of blogs, ebooks, news articles, and forums are just a mouse click away. Libraries, childbirth educators, and doulas are also likely to have helpful breastfeeding books and materials available to borrow. Having access to books, websites, and other resources that provide information and encouragement in breastfeeding is one more tool for success. Here are a few top-rated breastfeeding resources to get you started:
If you start your breastfeeding adventure and encounter any obstacles, you’re not alone! According to a study done by UC Davis, 92% of women struggle with breastfeeding in the first few days, and many continue to encounter issues throughout the postpartum period. A major factor for women who end up supplementing with formula or who give up on breastfeeding entirely is lack of resources and support. It’s never too early or too late to start building your breastfeeding dream team, it can make all the difference in the world!
-Anna Nieves-Herrera, Birth and Postpartum Doula.
At our Birth Basics class on February 12, 2018, mental health professional Stephanie Straub, LMSW, led a much needed discussion on maternal mental wellness. In addition to unpacking five popular myths that new and expecting moms grapple with, Stephanie shared with us the “Pillars of Self-Care” that she teaches all of her clients.
Sleep. While this might sound like a joke to new parents, or pregnant women (especially in the third trimester), getting a reasonable amount of sleep is crucial to your physical and mental wellbeing. While sleep deprivation has been shown to contribute to Postpartum Depression (PPD), it can also negatively affect your physical health and lower your immune system. What does it look like to sleep decently in pregnancy or with a newborn? Every situation is different. It may mean investing in more pillows, or a mattress topper to make your bed more comfortable. It may mean going to bed at 7pm just to catch a few hours’ rest, if your newborn seems to habitually sleep from 7pm to 10pm every night. It may mean pumping milk or preparing bottles so that your partner, postpartum doula, etc., can take over some of the nighttime feedings. It may mean a soothing cup of tea and twenty minutes with a good book, just to unplug for the day and get your mind and body restful enough so that sleep is possible.
Nutrition. As basic as it seems, you may easily find yourself forgetting to eat when you’re home with a newborn. Again, food is a crucial factor in both our physical and emotional health. In Stephanie Straub’s words, even a BigMac is better than eating nothing at all! She encourages clients to first eat something, anything, and then you can worry about what you’re eating later. Food affects our energy levels, our hormones, our moods. Skipping meals can result in vitamin and nutrient deficiency, fatigue, irritability, and a general inability of our bodies to function properly. You may think your baby’s needs are more important than your own, but in reality your baby needs a healthy and happy parent, as well as a good role model of self-care.
Movement. This pillar is not at all about intense exercise. It doesn’t mean signing up for CrossFit, or going to a yoga class five times a week. Something as simple as taking yourself or your baby for a walk is enough to treat your body and mind to some much-needed self-care. Even the small act of walking has been shown to benefit cardiovascular health, combat fatigue, and improve your emotional state.
Socialization. Caring for a newborn can be an incredibly isolating experience. In those early days, while your baby is brand new and your body is recovering from birth, there may be days and even weeks where you barely leave the house. As part of your self-care, it’s important to reach out to friends, family, moms’ groups, etcetera, so that the time you spend home with your baby does not start to feel suffocating and lonely.
A common myth of motherhood is that your needs come second to your baby. This can leave many new parents neglecting basic necessities like food, water, and rest. The truth is, you deserve to thrive and enjoy in your postpartum period, and your baby deserves parents who are happy and healthy. Don’t feel as though you have to suffer through chronic sleep-deprivation, anxiety, poor nutrition, and isolation, as the price you pay for caring for a newborn. If you want to get a healthy start to your postpartum period, consider hiring a trained postpartum doula who can help you navigate and balance baby’s needs and your own.
If you or someone you know is struggling in the pregnancy or postpartum period, Stephanie Straub, LMSW, is passionate about working with women and couples in the perinatal year. Her contact information can be found on our website (cnydoulaconnection.com), under “Friends of the CNY Doula Connection.” Please feel free to reach out to any one of our trained and dedicated doulas if you feel you may benefit from compassionate and dedicated birth and postpartum support.
~Anna Nieves-Herrera, Birth and Postpartum Doula