Postpartum Exercise - Tummy Workout

The best way to get your body back into shape after having a baby is to exercise!

Here's a quick and simple abdominal exercise shared with me by my sister, a certified fitness instructor:

Using slow, controlled breathing, inhale deeply. Allow your belly to fill up and rise with the air. As you exhale, tighten your abdominal muscles to push the air back out. Repeat with each breath as many times as desired.

This can be done in the bath tub or whenever you have a few moments to focus on breathing. It's also safe to be done immediately after giving birth, as long as you feel up to it. It's simple and can help strengthen your stomach and core.

Postpartum Belly Binding

The concept behind belly binding is to support the muscles and skin of a woman's midsection after having a baby. I know all too well how loose everything is after giving birth, and it seems to take a very long time for everything to knit back together, and most women will tell you that your belly will never be the same after having a baby.

Here's an interesting snippet about the history of belly binding:

"For centuries, Japanese mothers have used their “Sarashi” to speed up weight loss and toning of the abdominal muscles and skin after childbirth, while Hispanic mommies believe their “faja” helps bring all the muscles used in the birthing process back together again. No matter what she calls it, women in Indonesia, Thailand, Singapore, Latin America, Mexico, Spain, England, and the Philippines have benefited from using an abdominal compression wrap after childbirth."

My husband who is a massage therapist says that from a muscular standpoint belly binding makes complete sense. The vertical abdominal muscles separate during pregnancy to allow the belly to expand and accommodate the growing baby, leaving a large gap after giving birth. Ideally, we want those muscles to come back together, but in many cases it takes months for that to happen. He says that belly binding would, in theory, hold those muscles in their proper place and facilitate faster healing.

Another interesting note is that we see weight lifters and construction workers wear wide support belts to support their back and core. It makes sense to me that a woman who has just given birth would need that kind of support as well.

I have found a few websites about belly binding. The Belly Bandit is one that sells belly wraps starting at about $40, but they also have some good information about the history and purpose of belly binding. EZY WRAP has post-op abdominal binders available starting at about $13. Another website discusses belly binding and says there is one made by Body Glove that can be purchased at Big 5 stores for about $5-$8, which would most likely be made of neoprene. I haven't found any available for purchase online for that low a price. I think it would be worth a call or trip to your local Big 5 store for a good support belt. I'm definitely going to look into it for my next pregnancy.

*UPDATE Dec. 4, 2008 - This post gets far more hits than the rest of my posts combined. I'm glad that people are interested in this topic, but I admit that I'm not an expert and have no experience personally with belly binding. I would love to get some feedback from my readers about their own experiences with belly binding, which binders have worked for you and what the results were. Please also feel free to make suggestions on how I can improve this post and make it more informative and helpful. Thanks!*

When Baby is in a Posterior Position

The ideal position for a birthing baby to be in is head-down in an Occiput Anterior position (OA), which means the baby's head is down and the baby is facing the mother's spine, with its own spine out toward the mother's front. Most babies will naturally move into this position during labor, some earlier than others.

When the baby has not moved into the OA position (about one in four begins labor in this position) is it referred to as Occiput Posterior (OP) or a posterior baby. Most babies will turn into an anterior position at some point during labor, but some will actually be born in a posterior position with their face upward or "sunny side up" as they emerge from the birth canal. When a baby is posterior it can lead to longer labors because it takes time for the baby to move into a favorable anterior position.

Another problem with posterior babies is that it tends to cause back labor, or back pain during contractions. I had back labor with all of my babies, and I don't know whether or not it was linked to the position of the baby, because I never asked for my doctor to check the position. I know from personal experience how hard back labor is, and I would recommend if you experience it in labor, ask someone to check the position of the baby to see if the baby is possibly in a posterior position.

There are many things you can do to correct the baby's position if your baby is posterior. First, try to determine the position of the baby. You can sometimes feel where the feet and hands are by where you feel kicks and punches, and from there locate the baby's back on the opposite side from the movement. If you feel the movements in the front of your abdomen this can be an indication that the baby is in a posterior position. If you feel movement on the right side it could mean your baby is in a Left Occiput Posterior (LOP) position, and if the movements are on the left, it could indicate a Right Occiput Posterior (ROP) position. Your doctor or midwife can also help determine the baby's position by palpating your abdomen to locate the baby's back, or by feeling the baby's head by doing a vaginal exam. If the baby is found to be posterior, you can try the following positions to help turn the baby*:

1. Open knee-chest. From a hands and knees position, move your knees backward and outward and lower your head and chest to the floor or bed. Make sure your buttocks are high in the air and your thighs are angled away from your belly so that your knees are slightly behind your buttocks. Try to stay in that position for 30 - 45 minutes. Your partner can help you maintain the position by kneeling next to you, facing your head, placing his or her hands on your shoulders, and pulling up and back slightly. This position can help reposition a baby in very early labor.
2. Leaning forward. These positions include hands and knees or kneeling; standing; or sitting while leaning over something such as a birthing ball, bed, or a counter, and may help reposition the baby. They also help take pressure off of the sacrum to help relieve back labor.
3. Pelvic rocking. In a forward leaning position, rock your pelvis forward and back or in a circle. This movement helps dislodge the baby within the pelvis, and encourages repositioning from a posterior position. I remember this movement was particularly comforting for me while in labor.
   
4. Abdominal lifting. During contractions, while standing, use your interlocked fingers to lift your abdomen up slightly in while bending your knees. Doing this can help relieve back pain and encourage the baby to move into a more favorable position.
5. Abdominal stroking. In hands and knees position, you partner can reach under your abdomen and firmly and repeatedly stroke in the direction the baby should rotate (if you know your baby is in ROP or LOP, this is especially helpful to stroke from the side your baby's back is on to the other side). It's best to do this between contractions and should feel very good. If it's uncomfortable, then stop the movement, and do not try the movement if you don't know the baby's position.
6. Standing, walking, and stair climbing. These positions use gravity to encourage the descent and movement of the baby into a favorable position because of the movement of the pelvis.
7. Slow dancing. Stand and sway side to side while allowing your partner to support your weight. This is a great alternative to walking.
8. The lunge. Place a chair securely (so it cannot slip) to one side of your body. Place your foot closest to the chair on it and slowly lean toward the chair, allowing your knee to bend as you lunge. You will feel your leg muscles stretching. Hold the position for a count to five, and then ease yourself back upright. Do this during contractions for 5 - 6 contractions. If you know the baby's position, lunge toward the side where the baby's back is. If you don't know the position of the baby, then alternate sides and continue lunging on the side that is most comfortable to you.
9. Side-lying. This is a common recommendation during pregnancy and labor. Place a pillow between your legs with your knees bent. If the baby is LOP, lie on your left side. If the baby is ROP, lie on your right side. If the baby is direct OP (baby's spine lined up with mother's spine) choose a side and watch for repositioning of the baby.
10. Semi-prone. Lie on your side with your lower arm behind you and your lower leg stretched out. Place your upper leg on a doubled-up pillow with your knee bent and roll toward your front. If your baby is ROP, lie on your left side. If your baby is LOP, lie on your right side.
    

*Positions and suggestions were taken from the book Pregnancy Childbirth and the Newborn, by Simkin, Whalley & Keppler.

Reader Input and Questions

In an effort to plan my posts effectively and try to present information in an orderly manner, I would like to ask my readers for their input. If you have any questions or suggestions for my blog, please feel free to comment on any relevant posts or email me directly at cherylynd@gmail.com. Comments are set so that anyone may post a comment anonymously. There are no dumb questions, and I appreciate any on-topic conversation we can get going. So please, give me ideas of what you'd like me to write about, and I'll be happy to oblige!

Hypnobabies Class Series in Orem, UT

As I mentioned in an earlier post, I've been researching some childbirth methods, and one that is really intriguing to me is Hypnobabies, because it offers the possibility of natural painless childbirth. So far I've found two Hypnobabies instructors in Utah County. Littia Sellers is one who has experienced natural pain-free childbirth first-hand through the Hypnobabies method and is now an instructor helping other women achieve the same wonderful experience. I'll be observing her next class series starting November 1, and I'm really excited about it!

Laura Lund is another Hypnobabies instructor in Utah County. She has experienced and taught both Hypnobirthing and Hypnobabies, and prefers the Hypnobabies method. Her next class series begins in January. I've added links to both instructors websites on the right side of the page for anyone interested and for future reference.

Preparing For The Unexpected

Childbirth in general is unpredictable. The best way to prepare for a smooth labor and delivery is to take care of the mother through proper nutrition, exercise, prenatal care and education, and emotional support. Sometimes even after a smooth and uneventful pregnancy there can be unforeseen complications during labor and birth. It's primarily for this reason that I feel it's important for expectant parents to properly educate themselves prior to their baby's birth.

What happens when the bag of waters ruptures spontaneously and there are no detectable contractions or progress? What if labor draws on longer with little or no signs of progress and the baby is possibly at risk for infection? What if the baby is posterior (backwards) or breech (head-up position)? What can be done to turn a baby that's not in a favorable position for birth? What can be done to help augment labor naturally? What are the risks and benefits of augmenting labor artificially? What are the risks and benefits of pain medications like narcotics and epidurals? When is a c-section medically necessary? These are just some of the questions to be considered.

Women are generally given lots of information packets and forms at the first prenatal doctor or midwife visit, but how many actually read the information given? Even when a woman is admitted to the hospital for labor and birth she is given consent forms to sign. These forms have vital information about the possible medications and procedures that will be given and used during labor and their many side-effects, and by signing them a woman is saying that she has read and understood them. But how many actually read the long paperwork, particularly if the mother is already experiencing labor and focusing her attention on the contractions rather than the paperwork? When in the middle of labor the unexpected happens, does a woman know what her options are and is she prepared to make the best decision for herself and her baby? Is her partner prepared to make these important decisions for her if she's unable to make them herself? Sometimes there is the luxury of time to discuss options and make an informed decision in the middle of labor, but many times a decision needs to be made quickly for the sake of the mother and baby.

Whether you have a doctor or midwife; whether you plan to birth at home, in a birthing center, or in a hospital; whether you are planning a natural labor without medication or a fully medicated childbirth, you should prepare yourself for what's to come.

Plan for the best, but prepare for the worst. I certainly don't feel we should expect the worst, but prepare ourselves to be ready to make informed decisions when needed. With the last two of my baby's births I had a birth plan outlining how I wanted things to be done, as well as providing contingency options for possible changes to the plan. I knew beforehand what decisions I would make in various circumstances and felt fully prepared for what was to come. My doula and my husband were both instrumental in assuring that my plan was carried out by the hospital staff and doctor, and everyone worked together as a team. This is why I feel education and preparation is so vital in preparing for the birth of a child.

One metaphor I've heard is that when someone is making a big change or purchase they do research and explore their options before making the final decision. When one buys a new car they may visit several dealerships and look at different models, options and prices. They take their time finding the best deal for what they want and need. We should approach childbirth with as much interest in exploring options and making the best decision for ourselves and our family.

Why Use a Doula?

Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences.

DONA International doulas are educated and experienced in childbirth and the postpartum period. We are prepared to provide physical (non-medical), emotional and informational support to women and their partners during labor and birth, as well as to families in the weeks following childbirth. We offer a loving touch, positioning and comfort measures that make childbearing women and families feel nurtured and cared for.

Numerous clinical studies have found that a doula’s presence at birth

• tends to result in shorter labors with fewer complications
• reduces negative feelings about one’s childbirth experience
• reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
• reduces the mother’s request for pain medication and/or epidurals

Research shows parents who receive support can:

• Feel more secure and cared for
• Are more successful in adapting to new family dynamics
• Have greater success with breastfeeding
• Have greater self-confidence
• Have less postpartum depression
• Have lower incidence of abuse

*This is an excerpt from DONA International

What is a Birth Doula?

The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth.

Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.

A Birth Doula

• Recognizes birth as a key experience the mother will remember all her life
• Understands the physiology of birth and the emotional needs of a woman in labor
• Assists the woman in preparing for and carrying out her plans for birth
• Stays with the woman throughout the labor
• Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
• Facilitates communication between the laboring woman, her partner and her clinical care providers
• Perceives her role as nurturing and protecting the woman's memory of the birth experience
• Allows the woman's partner to participate at his/her comfort level

A birth doula certified by DONA International is designated by the initials CD(DONA).

*This is an excerpt from DONA International, the largest association of doulas which helps educate and certify doulas all over the world. It's also the organization I am certifying through as a doula.

Infant Mortality: U.S. Ranks 29th of 37 Countries

The Centers for Disease Control released new numbers this month on infant mortality rates. You can click here to read the report, but I'll paraphrase what I feel are the key parts.

The U.S. ranks 29th out of 37 countries, with statistics showing that nearly seven babies die out of every 1,000 live births. Each year in the U.S. more than 28,000 babies die before their first birthday. Premature birth is a factor in more than two-thirds of infant deaths. From 2000 to 2005, the U.S. preterm birth rate went up from 11.6% to 12.7%.

"The U.S. infant mortality rate is higher than rates in most other developed countries," note CDC researchers Marian F. MacDorman, PhD, and T.J. Mathews. "The relative position of the United States in comparison to countries with the lowest infant mortality rates appears to be worsening."

I don't post this to scare anyone. I feel it's an important piece of information, and in my opinion emphasizes the need for better education and choices in prenatal and postnatal health care. The U.S. has greatly improved its infant mortality rate since 1960 when there were 26 deaths in every 1,000 live births, and we certainly have modern technology and medicine to thank for those great improvements. What makes me sad is that the United States is apparently not keeping up with other developed countries in improving those rates further.

The Business of Being Born

"Birth: it's a miracle. A rite of passage. A natural part of life. But more than anything, birth is a business. Compelled to find answers after a disappointing birth experience with her first child, actress Ricki Lake recruited filmmaker Abby Epstein to explore the maternity care system in America. Focusing on New York City, the film reveals that there is much to distrust behind hospital doors and follows several couples who decide to give birth on their own terms. ...Should most births be viewed as a natural life process, or should every delivery be treated as a potential medical emergency?"

Click on the above picture to be directed to the official site for the movie and click here to hear a very short interview with the film's executive producer, Ricki Lake.

Leila Ali Shares Her Birth Story

Leila Ali shared the story of her baby's birth on the CBS Early Show. You can see it here

The clip is just over 3 minutes long. In it, Leila talks about her feelings that women should find out what their birth options are and choose what is best for them. I feel that her feelings mirror my own on this subject, and it's an important message.

My Amazing Sister

I just want to say congratulations to my amazing sister on the arrival of her baby girl! My sister was given pitocin to augment her labor and she still accomplished her goal of a natural chilbirth with no pain medication. It was hard, but she was blessed with the support she needed, and her baby arrived safely and healthy after a very long and exhausting labor. I'm so thrilled and proud of my sister for being so strong. I admire you Katie.

Natural, Pain-Free Childbirth?

I've added a link on the right side of the page with a list of Childbirth Education Organizations. Generally I will avoid listing information on my blog unless I have researched it myself. However, I've not yet been able to research each of the childbirth methods I've listed. I think it's important to provide resources and allow people to do their own research and decide what is best for them. With that in mind, please don't take the opinions expressed on here as fact. I am opinionated because of my personal experiences and the direction of my research. I want to help facilitate education and informed choices.

I have done some research on Hypnobirthing and Hypnobabies, so I'll explain a little bit about them for you. Both are based somewhat on Grantly Dick-Read's Fear-Tension-Pain Syndrome, covered thoroughly in his book Childbirth Without Fear. The concept is that fear, conscious or subconscious, creates tension in the body, which is what causes the pain in childbirth. Women have been conditioned over the years to believe that childbirth is always painful, and Dr. Dick-Read disagrees. He postulates that in many cases is it the fear of the unknown or fear of outcomes that lends to the physical pain in labor and delivery.

I know from personal experience that there can be a number of fears for a woman approaching childbirth. With my first labor I was afraid of having a c-section, afraid of being out of control, of not understanding what was happening with my body, despite my best efforts to educate myself. I was afraid of pain and the unknown. I know a woman who has always wanted a natural childbirth. She had a c-section with her first baby and has had more than one vaginal birth since then, but still the fear of possible uterine rupture keeps her from being able to let herself go without an epidural. Fear is powerful! Dr. Dick-Read wrote that the key element to dispelling fears related to childbirth is prenatal education, along with proper nutrition, exercise, relaxation techniques, and proper support from friends, family and professionals.

Hypnobirthing and Hypnobabies are the only childbirth methods I'm aware of that offer the option of natural, pain-free childbirth. Hypnobirthing was designed specifically after Dr. Dick-Read's extensive research and practice, and Hypnobabies incorporates the Fear-Tension-Pain Syndrome in its method, along with other practices including learning to tap into the body's natural anesthesia and send it to specific parts of the body, particularly during childbirth. Many women have used these methods and have felt no pain, and had beautiful, exhilarating birth experiences.

The concept of natural, pain-free childbirth is incredibly appealing to me. In the natural births of two of my children there was much pain, albeit well-managed. I will be taking a full 6-week Hypnobabies series in November as part of my doula certification requirements, and I'm very excited!

Here I am!

I've embarked on a journey, and it's the most exciting ride of my life! I finally feel like I have found what I'm meant to do.

I've always wanted to be a mother and raise my children. When I was pregnant with my first baby I wanted to learn as much as I could about pregnancy, childbirth and babies, but at that time my perspective and sources were limited. As I had more children, the desire to learn and grow became stronger, until after having my fourth baby I realized I wanted to do more than learn for myself; I wanted to help other women learn as well! This is about more than simply educating women. It's about empowering women and helping them to realize their beauty and their strength. It's about helping women plan and achieve the birth that is right for each woman and her baby.

I have four children. With my first pregnancy I said I wanted to have a natural childbirth, but I would take medication if it got too hard. The labor was hard and there were interventions made, including pitocin and epidural. My baby was born healthy and happy, and that's what mattered most. My second baby was also induced and I had an epidural with that as well. It was a smooth labor and was a wonderful experience.

When I was pregnant with my third baby my husband was in massage therapy school and he worked with a massage therapist who was also a doula. She asked if I would be interested in having her work with me in childbirth. I had heard of doulas but had no idea what they actually did. I decided to meet her and talk with her and see what she could offer me. She and I hit it off really well, and she was able to answer all of my questions about childbirth, and helped me put together my personal birth plan to have a natural medication-free childbirth. She was my support, along with my husband, and the labor and birth were incredibly beautiful and empowering. As soon as I discovered I was pregnant with my fourth baby I called my doula and asked her to work with me again. Another natural childbirth was achieved, along with a healthy and happy baby.

When my baby was just a few months old I decided that I wanted to become a doula myself and be able to help other women in some of the ways my doula was able to help me. Since then I have registered for doula training (happening next month!) and started studying like crazy. I've read book after book about pregnancy, childbirth and babies. I'm learning about different birthing methods and I'm soaking in all the information I can get my hands on!

I feel that each woman should know what her options are and be able to make informed decisions about her own care and childbirth. I feel that each woman should be loved and supported in her personal choice of how to birth her baby. I want to support all women in their unique circumstances and needs. I see each woman as beautiful and strong, and I want each woman to also see herself as such.

My goal in this blog is to reach as many women as I can and to share what I'm learning with as many people as will listen. Please join me in my journey; I'm sure it will be an exciting ride!