Types of Childbirth Education

shapeimage_2Rochelle Matos, Health Foundations Childbirth Educator and owner of With Love.

At Health Foundations, our patients receive lots of education about childbirth throughout their routine prenatal care.  While the midwives at the birth center spend much more time talking with and educating patients compared to what is routinely offered in the conventional maternity setting, there is so much to learn about pregnancy, childbirth, and postpartum.  For this reason, we encourage our families to take childbirth education courses.

As a Health Foundations family, you receive as part of your care two education courses: one in Early Home Care (of everything we want you to know about postpartum) and another in Managing Complications.  You also have a breastfeeding visit with a lactation consultant in your third trimester.  However, the more you can arm yourself with knowledge, the better prepared you will be for pregnancy, childbirth and beyond.

Childbirth education is a great way to prepare for labor and birth, help you make informed decisions, learn how to relax and cope during labor, name and work through your fears, help partners understand how to support mamas, and more.  Additional preparation classes may focus on specific issues such as breastfeeding, newborn care, prenatal yoga/exercise, baby wearing, cloth diapering, etc.

Health Foundations offers a childbirth education series that is designed specifically for families choosing to deliver out-of-hosptial.  We have classes for both first-time families as well as refresher courses!  We are also fortunate to live in a community with AMAZING birth resources.  To name just a few, the Twin Cities is home to The Childbirth Collective, Blooma, Welcome Baby Care, With Love, and so many more great birth educators and supporters of families giving birth and raising children in our community.

There are many amazing childbirth education classes offered in the Twin Cities.  To help you determine what may be right for you, here is a brief description of some of the popular types of childbirth education courses offered here and around the country.  Note that some local businesses and birth professionals offer their own “brand” of childbirth education courses, which can also be terrific.   The Childbirth Collective also offers donation-based Parent Topic Nights, which focus on different aspects of childbirth.

Lamaze 

When many of us think of Lamaze, we think about a specific breathing technique used in labor.  Lamaze has changed a lot in its 50+ years, moving from a method-based childbirth program to an evidence-based philosophy of childbirth.  “Today’s Lamaze affirms the normalcy of birth, acknowledges women’s inherent ability to birth their babies and promotes Lamaze healthy birth practices.”

Lamaze affirms women’s ability to give birth naturally and free of routine medical interventions but does educate women on interventions that may be necessary in some birthing situations.

The Bradley Method 

The Bradley Method also believes that childbirth is a natural process that can happen free of medical interventions (in most cases) with proper preparation.  This method emphasizes the importance of the husband or partner to the birth process, discusses diet and exercise in pregnancy, and covers natural coping and relaxation techniques for labor.  Most Bradley courses are 10 to 12 weeks long.

ICEA-based classes

The International Childbirth Education Association (ICEA) “is a professional organization that supports educators and other health care providers who believe in freedom to make decisions based on knowledge of alternatives in family-centered maternity and newborn care”.  This organization certifies childbirth educators.  The ICEA doesn’t necessarily promote a particular set of techniques for managing labor, so you may want to ask the educator what will specifically be covered in the course.

Hypnobirthing® The Mongan Method

HypnoBirthing® is a childbirth education course that embraces birth as normal and natural and refutes the idea that birth must be accompanied by pain and suffering.  This childbirth education program emphasizes relaxation, visualization, and self-hypnosis techniques to help women and their partners achieve a calm and comfortable birth experience.  Mamas using this technique will often listen to hypnosis audio recordings during pregnancy to prepare for the use of self-hypnosis (with or without the recordings) during labor.  The class is typically taught in 5 weekly sessions.

Birthing from Within

Birthing from Within is a spiritual and creative-based education experience that sees birth as a rite of passage, seeks to prevent or minimize emotionally difficult births through compassionate and honest preparation, sees value in and recognizes the profound impact of women’s birth stories, suggests expressive means of preparing for childbirth, and supports holistic prenatal care that is informative and transformative.

Calm Birth

Founded in mind/body medicine, Calm birth is a method of meditation for pregnancy and childbirth.  The course covers the physical, emotional and other benefits of meditation before and during labor and birth and offers guided meditations to help women and their partners prepare for a calm and conscious childbirth experience.

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Optimal Nutrition in Pregnancy: A Primer

At Health Foundations, we know that nutrition during pregnancy is paramount.  Overwhelming scientific and anecdotal evidence shows that excellent maternal nutrition almost always results in healthy moms and healthy babies, while poor nutrition leads to complications.

Nutrition Primer PostThe pressure of busy lifestyles and weight ideals, plus lack of knowledge about nutrition are major obstacles to optimal health for many women—add to these feelings like nausea, fatigue, and other physical stresses of pregnancy and it can be extra challenging to eat right in pregnancy.  But by educating yourself about nutrition in pregnancy, taking this time to really honor and nurture your body and your baby, and listening to your intuition; you can achieve excellent nutrition during pregnancy—when its more important than ever.

There is much to be said about nutrition during pregnancy—too much for one blog post.  In future posts we’ll explore in greater detail the fundamentals of optimal pregnancy nutrition with special focus on:

  • the essential nutrients (i.e. protein, iron, calcium, vitamins A, D, C, E, and Bs, etc),
  • optimal foods in pregnancy, and
  • the use of supplements.

For this introductory post, we wanted to share some of the top advice we give to pregnant mamas in our practice about pregnancy and nutrition.

1  Don’t “Eat for two”—Eat for optimal health.  While you should listen to your body for what it tells you it needs, it’s important not to give into frequent cravings for junk or processed foods, sweet foods, and other calorie-packed treats.

Strive to eat a wide variety of minimally processed, whole foods.  Limit simple carbohydrates such as dairy and sweets and opt for veggies, meats (or other sources of protein) and a small amount of fruits. Eat organic whenever possible and avoid high mercury fish (such as shark, swordfish, king mackerel, walleye or tilefish).  Read more about fish here.

2  In terms of serving sizes and overall caloric intake, pregnant women only need about 200-300 more calories a day in the second and third trimesters—which is the equivalent to an extra small snack a day.

3  Protein, protein, protein.  Protein is so, SO important in pregnancy, and women need a lot of it during this period.  In fact, women should aim to consume about 4-6 servings totaling 80 grams of protein every day.  Women should strive to incorporate some protein into every meal and every snack throughout the day.

4  Frequent meals and snacks will help maintain a healthy blood sugar, which is important in pregnancy.  It can also reduce unpleasant conditions like nausea and fatigue.  Women should strive to eat every few hours, keeping meals smaller and snacks frequent throughout the day.

5  In terms of beverages, it is important to stay hydrated by drinking at least 6-8 cups of water every day.  Pregnant women should limit fruit juices and milk, which are packed with sugar, and reduce or eliminate caffeine.  Besides water, good liquids to consume in pregnancy include nutritive herbal teas (tisanes) such as nettle, raspberry leaf, and chamomile; EmergenC; and POM juice mixed with a little sparkling water.

6  No ice cream!  We know some of our mamas hate this one, especially during a Minnesota summer.  But we say this with good reason (and not to be mean!).  Ice cream is too highly concentrated with fat, sugar, and calories to eat safely on a regular basis during pregnancy.  Truly, we have seen the effects of frequent ice cream consumption on many women in our practice: they often have bigger babies and remarkably more difficult deliveries.    We strongly recommend that women avoid ice cream or strictly limit it to no more than a small serving once a week at the most.

7  While food aversions may keep you away from some foods (including vegetables), do your best to eat healthy despite these limitations.  We can work with you to come up with healthy choices that don’t make you gag at the sound of them.

8  Listen to your body and be kind to yourself.  Your body intuitively knows how to nurture its creations (i.e. your baby)—pay attention to how foods make you feel and to which foods you are drawn.  Practice kindness toward yourself during this time by nourishing your body not only with good foods, but with adequate rest, movement, and relaxation.

9  Enlist support.  Seek help from your partner or other close family/friends in meeting your nutritional needs (i.e. shopping for and making healthy foods).

10   Seek help from your midwives if you have any questions or concerns about healthy eating in pregnancy.

Stay tuned for more articles about nutrition in pregnancy.

Preparing for Postpartum

newbornFamilyWhen we are pregnant, it is easy to focus on the pregnancy and the impending birth.  While is it great to focus on the present and important to prepare for the monumental experience of birth, it is also crucial that expectant mamas (and their loved ones!) think about and plan for Life After Birth.  And we’re talking more than just preparing the nursery and getting all the “stuff” of new parenthood.

Postpartum is a special time that deserves careful planning and consideration. While the postpartum period is customarily thought of as the first 6 weeks after birth; many midwives, health providers and mothers recognize that postpartum extends beyond this initial intense period of transition and healing.  In fact, midwife Raven Lang commented, “As long as the baby is still in diapers and you’re up in the night, you’re postpartum.”

While we could talk in much detail about that first year(s) of life with baby, today let’s focus on preparing for that initial month or two conventionally known as the postpartum period.

Here are five things to consider when planning for your postpartum.

 1.    Late Pregnancy Health: Nourish and Rest

A mama’s health in late pregnancy can have a profound effect on her experience of birth and the postpartum period.  A mama whose reserves are low going into birth and motherhood may find the journey much more arduous than the mama who makes self care a priority in her last weeks and months of pregnancy (of course, we encourage prioritizing self-care no matter where you are at!).

Given that our society favors the “masculine” energy of action and motion—working up until the last moments before birth, continuing to meet demanding social, professional, and other routines, and the like—it can be difficult to give yourself permission to honor the more “feminine” going-within and stillness that is needed in late pregnancy.

Late pregnancy should be a time to rest as much as possible.  Let’s repeat that, because it is important: women in late pregnancy benefit from resting as much as possible.  Light exercise and excellent nutrition are also paramount to this time.

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It won’t be long before your needs will be balanced against the intense and constant needs of another being that you will love and care for dearly.  This is a special time to really honor yourself—to treat yourself with the utmost kindness in preparing for the adventure to come.

Rest enhances recovery and reduces stress.  Lowered stress means a stronger immune system, better personal relationships, lowered risk of postpartum depression, and a more supported mother-baby bond.

So take naps, pamper yourself, eat well, take walks or enjoy light exercise (such as prenatal yoga), ask for help and invite in the calm and still energy needed to build up your reserves for the journey ahead.

 2.    Become educated about new motherhood

In our modern reality, many of us are not exposed to babies and new motherhood as much as our grandmothers and those before her were.  While so much of parenting is instinct and intuition, seeking community wisdom and knowledge can make you a more confident new parent.

Take time to learn about breastfeeding.  All our patients meet with our lactation specialist during their third trimester, but it’s also worth considering a breastfeeding class and other resources.  La Leche League is one great resource for all things breastfeeding and they have some excellent books available.  If you are interested in breast pumps, inquire with your insurance about reimbursement (more details about this can be found here).  If you plan to bottle or formula feed, educate yourself about these options.

Learn about newborns (their needs, rhythms, etc) and learn about what is common for mamas to experience physically and emotionally after birth. During your Early Home Care class at Health Foundations, offered by the wonderful childbirth educator and doula Rochelle Matos, you will learn all about what is common and normal for baby and mom during the early weeks at home.

An excellent book that delves further into the postpartum and beyond is Natural Health after Birth: The Complete Guide to Postpartum Wellness by Aviva Jill Romm.

3. Familiarize yourself with the common needs of new mothers (and share with your support circle!)

 Put simply, a new mama needs someone who will meet her needs so that she can meet the needs of her baby.  New mamas in the postpartum period also need:

  • Lots of rest
  • Time and space for reflection and processing
  • Someone who will guard her privacy
  • To feel honored, protected, and nurtured
  • Praise, encouragement, and validation
  • Noncritical support and advice
  • A good, nonjudgmental listener
  • Time out daily for a bath, nap, or quiet time
  • Nourishing food and drink
  • Time to bond with baby
  • Reprieve from the demands of daily life

4.    Make a Postpartum Plan

 Making a postpartum plan is an important pre-baby activity for an expectant woman and her partner and/or support circle (see below).  The first two weeks are all about mom and baby—establishing a bond, establishing breastfeeding, healing from childbirth, and getting to know one another.  The postpartum plan should be all about supporting mama and baby in those early weeks.

At Health Foundations, we really want our mamas to REST during the postpartum period and especially those first two precious weeks.  We recommend mamas stay in bed for the first week, except bathroom and bath breaks and NO stairs.  In the second week, we recommend mostly bed rest with a stair set once a day, max.  In the third week, you can begin slowly reintroducing additional activities, though we recommend a max of one short outing per day.  Evidence shows that the more you rest in these early weeks, the faster you heal, the quicker your bleeding will subside, and the better you will feel.

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Delegate Responsibility

Given this, it is important to make a plan for how your usual activities will happen (or not happen).  It’s a good idea to make a list of your responsibilities, delegate tasks that need to be done, and put off or plan ahead for other tasks.  Here are some examples:

  • Laundry—perhaps someone else washes the laundry and folds it, or maybe you fold it on the bed
  • Cleaning—don’t clean!  Don’t even look at what might need cleaning!  Or if something absolutely needs to be done, delegate.
  • Grocery and other shopping—try to stock up on non-perishables ahead of time (plan to have enough toilet paper, etc. on hand for a month).  You can also shop online for food and other items, which can be delivered to your door.
  • Cooking/meal preparation—if you can, try to prepare and freeze two weeks’ worth of meals to have on hand for the postpartum.  Nutrition is very important for new mamas so consider simple nourishing balanced meals.  Also, learn about take out and delivery restaurants in your area and give them a try or at least snag menus to consider for easy meals.  There are registry websites, like foodtidings.com and mealbaby.com that can help coordinate meal offerings from friends and family.
  • Bills—consider starting online bill pay, if that makes it easier (it may be easier to click a button than fill out paperwork!) or delegate this task to another house member
  • Older Children—if you have older kids, make a plan for how they will be cared for once new baby arrives—can they stay at a friend or relative’s home for a couple days?  Will dad or another family/friend be “in charge”?  Will these children attend daycare/camp/school and how will they get there?  How can you prepare them for the changes to come?  How can you make this time special for them?
  • Visitors—Just like in birth, your partner or other close support person should protect your privacy and your boundaries during the postpartum, communicating with eager loved ones about how and when you are up for company. If you are not ready for visitors, it’s okay to ask people to hold off on visits until you are ready (baby will still be there!). You might also consider a “visiting hour” during which people can stop by shortly.  Consider asking your go-to person to make it clear to others that visits are best kept on the shorter side and that visitors are welcome to bring a meal or help out while they are over—maybe they take out the trash, load the dishwasher, change over the laundry, water plants, etc.
  • Make it special—the first few weeks are dubbed the “babymoon” (like a “honeymoon”) for good reason.  This is a precious time of strengthening the love bonds between family members.  It’s also a time to treat yourself with the utmost care.  How will you make it special?  Consider gifting yourself with little treats during this time, you deserve it after the hard work of carrying and birthing your baby!

Ahead of time, maybe you:

  • Get a manicure, get your haircut, get a massage(s), or go to a spa
  • Buy new makeup, a new (nursing-friendly) nightgown, or the like
  • Save a book from your favorite author or stock up on magazines
  • Load up your Netflix or similar with movies and TV shows you’ve wanted to see.  (funny, light shows are especially good for this time)
  • Acquire some new music by a favorite or recommended band or artist
  • Put up a beautiful piece of art or a picture that you can look at from your bed (consider natural images, which have been shown to help reduce stress and boost healing)

During your babymoon, you might:

  • Consider placenta encapsulation
  • Take sitz baths at least once a day
  • Change into a new outfit, open the windows, and welcome each new day
  • Look through albums of favorite trips or special memories
  • Journal about your experiences (they are often profound even despite the sleep-deprivation!)
  • Rest, rest, rest!
  • Eat your favorite meals
  • Drink lots of fluids
  • Be unreasonably kind to yourself

5.    Create a support circle

Some experts recommend that mamas delegate a close friend or family member as postpartum support coordinator—this person can arrange “assignments” for those in your support circle such as bringing a meal on a certain night, watching older children, coming over to doing a little house upkeep, etc.  This takes any potential pressure and awkwardness off mom to ask for support from others, if this is the case.  Of course, you can also arrange your support yourself!  Consider these possible members of your support circle:

  • Husband or partner—while every partner’s ability to take time off is different, it’s helpful to take as much time as you can—whether that’s a few days or several weeks
  • Older children—older children may be given special helper tasks
  • Relatives
  • Friends
  • Other mothers (perhaps women you meet through childbirth ed classes)
  • Postpartum Doulas—these experts are trained to meet the physical, emotional and practical needs of new families
  • Hired Help—some families consider hiring help for cooking, cleaning, and other tasks

family-support

Don’t be afraid to advocate for yourself and enlist help in meeting your needs in the postpartum.  In the words of midwife Aviva Jill Romm:  “In order to fully nourish your family, you must have reserves to draw on—you need to be a full well.  Every bit of help you receive adds to your reserves. Planning ahead for postpartum care ensures that you will have the help and support necessary to keep your well full.”

What do you think?  If you have kids, what did you do or wish you had done to prepare for the postpartum period?  If you are pregnant, what are you doing to keep your well full going into new mamahood? 

Preconception Planning

PPcoupleMost couples don’t think about preconception planning—yet it can make a world of difference in fostering a healthy pregnancy and birth.

Every couple benefits from addressing their overall health and wellness in preparation for pregnancy, even if they are not having fertility issues. This preparation supports a healthy and happy pregnancy and eases the transition through postpartum into parenthood.

preconceptionP1For all the gardeners out there, consider this metaphor: preconception planning is much like preparing/improving the soil. Creating a healthy environment for your growing darlings even before they are planted optimizes their chances of thriving — sometimes in ways that later care doesn’t allow (e.g. water and sun; or, in our case, pregnancy care).

Health Foundations offers preconception planning services, including comprehensive visits to discuss your health and create an individualized plan that works for your family.

When should preconception planning begin?

Ideally, we love to see couples three to six months before they hope to conceive.  This gives us time to correct any nutritional deficiencies (such as low iron or Vitamin D), which can have a significant impact on the pregnancy.  Sperm live for approximately 3 months, so we want to get dad as healthy as possible before conception so that his contribution to the pregnancy is healthy and strong.  Eggs begin their maturation process around this time too; when, like sperm, they are most vulnerable to toxins, radiation, and nutritional deficiencies.

What does a preconception planning visit look like?

During a preconception visit, we will talk with you and your partner about your current health, lifestyle, diet, personal and family medical history, medications you are taking, work and home environments, past pregnancies, and you and your partner’s desires and concerns about getting pregnant.  Here are some of the issues we will explore during your appointment:

  • General current health:
  • Blood Sample
    • We recommend women receive a pap and cultures during a well-woman visit (which Health Foundations can provide)
    • Visit a dentist to get a cleaning and any necessary work done prior to conception
    • Talk to your provider about current medications to make sure they are safe at this time
    • Discuss any history of hormonal birth control
    • Have diagnostic/lab tests for various issues that can impact pregnancy and maternal health (all offered at Health Foundations)
  • Diet/Weight
    • Love coupleWe can work with you to optimize your diet to ensure the greatest health prior to and during pregnancy
    • Eliminate caffeine, alcohol, tobacco, and recreational drugs.
    • Drink plenty of water (aim for 8 glasses a day)
    • Weight: women 15% below their ideal weight may benefit from added pounds during pregnancy; women who are overweight, however, do not benefit from crash dieting prior to pregnancy, as this can deplete their health.  In either case, we can create a plan to create optimal health for you.
  • Lifestyle
    • Establish a consistent exercise pattern
    • Inventory your environment for chemical, heavy metal, and other toxic exposure (you may want to work with a professional on a detox plan)
    • Address emotional health and stress
  • Use of supplements
    • We recommend women begin prenatal vitamins at least three months prior to conception (folic acid is especially important to begin prior to conception to avoid neural tube defects in baby)
    • Omega-3 and DHA are also important
    • Nutritive herbal infusions such as alfalfa, nettles and red clover can support overall health
    • Vegans and vegetarians may want to begin B12 supplementation
    • Additional supplements may also be recommended based on the individual
  • Men’s health
    • Men should follow the same dietary and lifestyle recommendations as their partner
    • Men should also take a multi-vitamin for the months leading up to conception
  • Fertility awareness
    • PPchartingWe help couples understand their fertility so that they can maximize their chances of conceiving.
    • Taking Charge of your Fertility by Toni Weshler (book and website) and Fertility Friend (website) are great resources for understanding fertility awareness and how to chart your fertile periods each month
    • Inexpensive, reusable fertility test kits are available (less expensive than one-time ovulation tests)
  • Useful therapies
    • Acupuncture has proven benefits for women wanting to conceive
    • Massage, yoga, aromatherapy, and chiropractic can also help by reducing stress, balancing hormones, and overall physical wellness.
  • Having fun
    • Above all, we encourage couples to have FUN during this process!  It takes an average of 6 to 9 months to conceive—being stressed during this time will only make conception more difficult.  Plus, this is your time to really enjoy your partner and all those things that can be a bit more difficult to enjoy during pregnancy and into parenthood.