Midwives in Brooklyn 01

12 Natural Remedies for Psoriasis You Must Try!

Bett — Fri, 27 Jun 2025 02:40:38 -0400

Looking for natural remedies for Psoriasis? You have come to the right place. My husband has suffered from psoriasis for years. He has had creams from the dermatologist and nothing really worked – it just flared up again. :/ Turning to natural remedies here are some that he tried and liked/worked for him. 12 Natural...

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Healing the Hurt: Addressing Racism in Nursing Practice

American Nurses Association — Fri, 16 May 2025 03:08:03 -0400

Nurses Lead Well-Being Across the Nation | American Nurses Foundation

American Nurses Association — Tue, 13 May 2025 03:59:51 -0400

Steps on How to Apply for Your ANCC APRN Certification | ANCC

American Nurses Association — Tue, 13 May 2025 03:37:25 -0400

Fireside Chat with Baycare Health System in Tampa Bay, Florida (with introduction)

American Nurses Association — Sun, 11 May 2025 05:20:16 -0400

Fireside Chat with BayCare Health System in Tampa Bay, Florida

American Nurses Association — Sat, 10 May 2025 20:54:29 -0400

Promoting Equity and Justice Through Anti-racist Nursing Policy

American Nurses Association — Fri, 02 May 2025 11:24:26 -0400

Education for Equity: Confronting Racism for Equitable Learning

American Nurses Association — Sun, 27 Apr 2025 17:02:16 -0400

2025 VOE Form Description

American Nurses Association — Sat, 26 Apr 2025 17:11:39 -0400

The Power of Nurses Unlocked: Become a member of the American Nurses Association Today!

American Nurses Association — Wed, 09 Apr 2025 02:38:28 -0400

Code of Ethics for Nurses Provision 6 | American Nurses Enterprise

American Nurses Association — Wed, 09 Apr 2025 02:04:55 -0400

Code of Ethics for Nurses Provision 5 | American Nurses Enterprise

American Nurses Association — Wed, 09 Apr 2025 02:04:32 -0400

Code of Ethics for Nurses Provision 10 (Part I) | American Nurses Enterprise

American Nurses Association — Wed, 09 Apr 2025 02:03:58 -0400

The Contemporary Landscape of Racism in Nursing: Where Do We Go From Here?

American Nurses Association — Wed, 09 Apr 2025 02:02:23 -0400

Code of Ethics for Nurses Provision 10 (Part II: Bonus Content!) | American Nurses Enterprise

American Nurses Association — Wed, 02 Apr 2025 03:13:20 -0400

What are Dunkin Donuts Drink Sizes? Here’s the 411 on the shots!

Bett — Fri, 14 Jun 2024 03:03:35 -0400

With so many different fast food stores, drink sizes can get hella confusing. Luckily, Dunkin drink sizes are kept fairly straightforward. I have to say I like this approach. Yes, I’ve got used to Starbucks drink sizes but honestly, when I first started going to Starbucks I found the whole thing pretty confusing. If you:...

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Are Carrot tops edible? And what to make with them!

Bett — Sun, 21 Jan 2024 09:31:31 -0500

If you are wondering whether carrot tops are edible – we have the scoop! If you don’t feel like reading to the end of the article for your answer, then I will simply give it to you now – YES, carrot tops are edible, so you might want to think again before you throw them...

Are Carrot tops edible? And what to make with them! appeared first on The Nourished Life - How to Eat Well, Live Healthy and Love Life with More Balance and Less Stress

Does Metamucil Help you lose weight? Spoiler: I lost 10 pounds in 1 month

Bett — Mon, 15 Jan 2024 09:47:00 -0500

If you are wondering whether Metamucil helps you to lose weight, we have the inside scoop. My parents have been using Metamucil for years to help them go to the toilet (they’re very constipated LOL). I used to rag them out BIG time and tell them how disgusting Metamucil was so I felt like a...

Does Metamucil Help you lose weight? Spoiler: I lost 10 pounds in 1 month appeared first on The Nourished Life - How to Eat Well, Live Healthy and Love Life with More Balance and Less Stress

Are Red Potatoes Dyed? Or are they Naturally Red?

Bett — Sun, 14 Jan 2024 08:32:41 -0500

Are red potatoes naturally red? Yes and no. It is indeed possible that the red potatoes you are eating are in fact dyed! I know outrageous. Why are red potatoes dyed? Well, spraying potatoes red is done by farmers to make them look super fresh. Consumers think the redder the fresher. But, that does not...

Are Red Potatoes Dyed? Or are they Naturally Red? appeared first on The Nourished Life - How to Eat Well, Live Healthy and Love Life with More Balance and Less Stress

6 Best Non Toxic Tea Kettles that are Safe to Use!

Bett — Wed, 06 Dec 2023 00:39:55 -0500

I am one of those people who just really love tea. And, it had me wondering about the best non toxic tea kettles to buy. I was using a super cool Smeg Kettle which I had knew to be non toxic but I wanted to know what other non toxic kettles there were on the...

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6 Best Non Toxic Pancake Griddles [Available on Amazon!]

Bett — Thu, 30 Nov 2023 17:08:42 -0500

If you are after the best non toxic pancake griddles you have come to the right place! We are all about non toxic living and limiting toxic chemicals like PFOAs from the equation when cooking. Why? Well PFOAs have links to cancer and no-one wants that! If you are looking for a pancake maker that...

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6 Best Non Toxic Bassinets to ensure your Baby is Protected!

Bett — Wed, 29 Nov 2023 21:48:11 -0500

Are you searching for the best non toxic bassinets? I can’t say I blame you. Your newborn is precious and you want them to sleep safely in a non toxic environment! Why would you want them exposed to toxic chemicals!? What you may or may not be aware is that tonnes of bassinets in the...

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Best Amy’s Frozen Meals Ranked & Are Amys Frozen Meals Healthy?

Bett — Wed, 15 Nov 2023 15:04:32 -0500

We frickin love Amy’s frozen meals, for frozen meals, they are literally the best thing since sliced bread. Amys was started in 1987 in California by a couple who saw a gap in the market for good quality, frozen organic, gluten free food. They named the brand after their daughter “Amy”...

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Starbucks Cup Sizes Explained so you never look like a goose again!

Bett — Tue, 07 Nov 2023 19:01:22 -0500

What Are All the Cup Sizes at Starbucks? I have wondered the same in the past. Here are Starbucks cup sized explained so you never look like a goose again! I once got handed a huge TRENTA size refresher refill at Starbucks which was seriously like a jug of liquid. I didn’t know Starbucks had...

Starbucks Cup Sizes Explained so you never look like a goose again! appeared first on The Nourished Life - How to Eat Well, Live Healthy and Love Life with More Balance and Less Stress

Who Else Wants To Know The Mystery Behind Medical Weight Loss Arlington?

Midwives in Brooklyn — Wed, 01 Nov 2017 04:07:05 -0400

Unlike a number of other weight loss programs that offer this type of service, Dr. Cherkassky does not feel that deprivation is the response. Rather, he offers goals and diets as well as helpful supplements that can help reduce cravings and outcomes. He makes it clear that his aim with his patients is not just consequences; it’s results that last.

We invite you to find out more about Michael Cherkassky, M.D. by reading a few of the many amazing testimonials available online and by giving our office a call at -LRB-682-RRB-990-4355. We’d really like to speak with you and help you pick at a time to come in for a consultation.

In his weight loss clinic, patients have come to rely on a physician who is dedicated to supplying cutting-edge services. He spends time not simply getting to know each of his patients but also customizing each of his weight loss programs carefully so as to have the ability to offer you the best possible care. He is one of the few physicians who truly understand the many struggles people can face when it comes to weight reduction. His understanding has helped him to create a great medical weight loss Arlington TX program that has helped many people to lose weight and keep it off.It can be difficult to find the appropriate techniques to pursue, when it comes to losing weight. With all of the choices out there, it’s no wonder that lots of individuals find themselves trying one diet after another. As a physician and expert in the medical weight loss community, Dr. Cherkassky has years of experience offering nothing but the very best high-quality treatments and methods. Unlike a lot of the “fad” diets out there, his approach becomes actual results that continue.

When choosing from the numerous physicians and specialists in your area, it is crucial to do your research and also to get a supplier who truly makes you feel encouraged and motivated to attain your targets. Many patients have found Dr. Michael Cherkassky to become one of the very committed and knowledgeable physicians in the diet industry. His demeanor and his approach have earned him the well-deserved reputation of being among the best specialists in his field.

Why Weight Loss Clinic Arlington Is The Only Skill You Really Need

Midwives in Brooklyn — Wed, 01 Nov 2017 04:00:49 -0400

There is no denying that it may be hard to tackle losing weight all on your own, and that is finding a weight loss clinic Arlington at which you are able to participate in a doctor-supervised program is essential. With the help of medical weight loss programs, a lot of people have managed to turn their frustration in not losing weight into success. While seemingly thousands of fad diets are all around the place, the weight loss solution is actually quite simple and involves effort.

While receiving his solutions, patients can expect to get nothing but the very best attention from Dr. Michael Cherkassky. He’s committed during the procedure to each of his patients. In your initial consultation, Dr. Cherkassky requires the time to understand your goals as well as your medical history. Based on your objectives, he will then help you invent the right treatment plan and diet plan for you. Not only does he offer you the resources but additionally, it provides beneficial supplements and advice in order to make the process as stress-free as you can.

Dr. Michael Cherkassky offers medical weight loss strategies at a few of the very well-regarded weight loss clinics in the area. He considers that losing weight centres round the principle of expenditure versus caloric intake. The weight will eventually come off, if more calories are burned off than are consumed. While this principle sounds easy, it is definitely not easy to achieve. But with his weight loss program, this physician has shown patients that it is possible to shed weight without feeling deprived and frustrated.

As one of the foremost specialists in the diet industry, Dr. Cherkassky focuses on the overall health of the patient. When choosing from the physicians in your area, it’s critical that you find a doctor who is interested in making certain that you keep healthy throughout the weight loss service. It is all too possible that the weight will begin to return on after the diet is over while losing weight might be the goal, without proper attention paid to your health. We also invite you to give us a call at -LRB-682-RRB-990-4355 to schedule a consultation with this amazing expert in his weight loss clinic Arlington TX.

Finding the Best Weight Loss Near Arlington

Midwives in Brooklyn — Wed, 01 Nov 2017 03:09:11 -0400

In his weight loss clinic, Dr. Cherkassky utilizes a proven program that he has spent years developing. It incorporates a sensible diet plan and helpful supplements as well as workout routines. He provides tips and techniques not only designed to get patients losing weight, but also enjoying the process too. During his weight loss programs, his number one priority would be apparent: to help patients lose weight in a dependable and medically safe method.

If you are interested in knowing more about Dr. Cherkassky’s approaches and techniques and how he might have the ability to assist you get rid of the weight once and for all, give us a call in -LRB-682-RRB-990-4355. Our friendly staff would be delighted to answer your questions and help you to schedule an appointment for an appointment.

Dr. Michael Cherkassky is a weight loss specialist that provides high-quality weight loss Arlington services to patients throughout the area. He’s committed to helping his patients determine real results that’s why he has spent his career honing his skills and creating weight loss regimens that actually work. His patients rave about not just their results but also their ability to be able to keep the results for years to come. Any doubt? Simply execute a fast online search, and the results are sure to yield countless accolades describing this physician’s attentive, caring approach and his positive, friendly demeanor and attitude.

Through an initial consultation in his clinic, Dr. Cherkassky takes his time to become familiar with your medical history and listen to your own struggles. Many of the existing patients have previously spent years trying hard to drop the weight only to give up time and time again. But, these same patients have come to see actual results with Michael Cherkassky, M.D.. Why is a huge distinction is his capacity to tailor each program to the needs of their patient and his devotion to continuing to assist the individual throughout the regimen. When you work with him, you’ll be encouraged to pay regular visits to his office so that he can check up on how you are doing and offer you additional strategies and adjustments to your strategy when necessary. Michael Cherkassky, M.D. is nothing if not a committed weight loss Arlington TX, practitioner.

Summer Meisner Intensive Talk with Sara Kohler – Maggie Flanigan Studio – Call 917 789 1599

Midwives in Brooklyn — Wed, 31 May 2017 16:47:46 -0400

During this interview with Katie, Sara Kohler talks about the Meisner Summer Intensive at the Maggie Flanigan Studio.

The Meisner Intensive provides pupils together with the chance to experience what this means to train as a professional celebrity. In this interview, Sara talks about her experience in the six-week summer intensive and how it was different than what she formerly believed the professional training was like.

Q: What did you think acting before you began the Six Week Summer Intensive training was?

A: I though that acting training was a great deal of what I did in school. I didnt believe it was essential for me personally. I didnt understand what training so coming here and really meant, and learning the start of the Meisner technique, I began to understand that training was nothing that I thought it was. Its just a new manner of working that I’d never even thought of and I was trying to step into these characters in my scene study classes that I ‘d no notion how to step into. I ‘d no technique and I didnt understand what I was doing. Coming here Ive began to understand how to work and Ive already learned so much.

Q: What happened during the Meisner Summer Intensive that altered your outlook on training?

A: I had been just constantly looking forward to my cue and saying a line the way that I thought Id done homework on and that it had been rehearsed by me and really I did learn the way to do assignments, which will be insane. Just thinking back to the summer, how much Ive come is astonishing and it really, really altered my entire life.

A: I was surprised to recognize and come to the final outcome that everything I had ever done was awful and possibly in high school and college I was one of the better folks in the program and things came easy for me and I was always cast as the lead. I was surprised to think back on those parts that Ive played and realized that I had no notion what I was doing. I didnt have training, I didnt possess a technique, I didnt know the way to even prepare for a function and with the Meisner technique you actually start to comprehend what its like to craft and develop a character and also a circumstance and live through something. I was just so shocked and its laughable to consider what exactly that I did before this. Its tough for me to think that I have been seen by individuals like that and its embarrassing to be somewhat honest.

Interview and this site post with Sara appeared on the studio site: http://www.maggieflaniganstudio.com/summer-intensive-program/

Hello Sunshine UPDATE: Why This Doula is Becoming a Nurse!

bethanie verduzco — Thu, 19 Jan 2017 14:54:34 -0500

Sheep brain dissection in Human Anatomy!

Hellooooooo! I know, it’s been way too long, folks. First, please let me beg your apology for disappearing on you. I see that quite a few of you lovely people are still signing up through the RSS feed (THANK YOU!) and just look at how I treat you! No blog posts for 7 months! Such a schmuck. Looks like my last post was back in May 2016—right around the time I made the choice to dive head first (or more accurately do a graceless belly flop) into the turbulent waters of a new venture. Okay, so I’m being dramatic. But starting my pre-reqs for nursing school has been a pretty big shift for the Verduzco fam and I so appreciate you all for being so patient and supportive!

So here's the story:

For the past 3 years, I have been so crazy honored to stand beside my clients, providing support and education for their growing family throughout their birth experience. I have loved it all! The long nights of catching 15 minutes of sleep here and there, crick-necked and cold on a hospital love seat; the feeling of exhaustion when a mama will not let you stop squeezing her hips because the relief during her contractions is so nice; seeing the look of awe and love on the partner’s face for mom when baby finally arrives. I have loved getting to know so many different types of pregnant people and working with Tulsa’s stellar doctors, midwives, nurses, educators and, of course, my fellow doulas. Being a doula is, indeed, dope.

But as time goes on, I’ve been feeling a stronger need to be on the other side of this dialog, to be the one providing care. (As a doula, we are there to give emotional/physical/informational support to clients, but it’s completely out of our scope-of-practice to give any kind of clinical advice or medical care.)

Why did I feel this shift so strongly? Honestly? I got tired of seeing women disrespected by doctors who were emotionally thoughtless, who gave nonconsensual episiotomies, were rough with these mothers, apathetic, patronizing, and who would break promises their patients were counting on. Just a bit of empathy and humanity from the care provider’s side would have been enough to change many of my families’ negative experiences in a lot of cases.

Of course, when my families did have a supportive care-giver, it was an absolute game-changer. I wanted to be a part of that.

The other part of the story is way more boring and practical. The emotional and financial reality of being full time, self-employed birth worker.

At a certain point I realized I could only really handle the time commitment and emotional investment of about four clients a month. At $600 each, my total monthly income was maxed at $2400. Not great…but not bad either. Right?

Well, if we look at the time and energy breakdown, it might be clearer how tough it is to support ourselves (and our families) as doulas in 2017. Each client conservatively requires:

· Free initial consult = 1 hour

· Prenatal visits: 2 x 2 hours each = 4 hours

· Prep time/paperwork/emails/phone & text convos = 2-3 hours

· In-person birth support = 12-14 hours on average (including 1-3 hours for immediate postpartum)

· Postpartum visit = 2 hours

· Travel time to prenatal visits, birth and postpartum visit = 2-4 hours

· Post-birth catch-up sleep for those labors over 20 hours = 3-5 hours

That’s a total of 26 hours for each client (on the low end of the range), which ends up being about $23/hour.

But in addition to these countable hours, there’s also the daily limitations that come with constantly being on-call. Always having to have your phone charged, on and in your pocket. Always needing to plan your day meticulously so that you have a baby-sitter (and 2 alternates) for your kids if a mom goes into labor during the school day. Coordinating schedules with your backup doula. Missing weddings, holidays and other fun lifey things because they were either too far away or during/right after a birth. Helping your kids through another meltdown as you leave for a birth right before bedtime, and the anxiety-filled conversations to be had at dinner the next several nights in a row as your little ones’ express doubt you’ll be there in the morning when they wake up. You feel even little things like not being able to stay up past 10pm, have a couple of drinks with a friend, or go out of town for a weekend. There is a toll to being constantly “on,” and it’s tough for us birth workers to maintain a balance.

And then there’s taxes. It’s pretty important to remember that self-employment taxes are generally about 15% of your total earnings. So after tax, this doula's hourly rate came in at about $19. So if you happen to have 4 clients a month (which is on the high end for Tulsa), your total income will be around $2,000. Or $500 per client.

But honestly? Most months I wasn't at my max load. I had more like 1 to 3 clients. Which puts it more at $500 to $1500/mo. And this breakdown doesn’t take into consideration the consults with prospective clients that don’t end up panning out. Or time spent answering emails or phone calls from women interested in mama-friendly doctors or midwives around Tulsa, wondering what a doula's role is, referrals for childbirth educators, placenta encapsulators, or prenatal yoga instructors. It also doesn’t include the hours (or hundreds of dollars) spent in week-long trainings and certifications, your self-employed health insurance coverage, or your LLC, marketing materials, or website fees.

Then there’s the emotional component. Whether the emotional intensity of a birth ends up leaning positive or negative, it’s most likely always going to be intense. And there are some births--especially those where power’s taken from a woman or where she or her baby were physically harmed—that can take weeks, months, or even years to work through.

Ok. We’re getting’ real, folks.

But seriously. I’m really not trying to dump on the doula parade. Being a doula is an incredible gift and could possibly be the most rewarding job on the planet. But just as we strive to be transparent with our clients and give them good information, I think we doulas should do the same for each other. It’s super important for prospective doulas to understand what this lifestyle is like as well as to go into this career having reasonable financial expectations.

I’m excited to take all of this rich and lovely doula experience with me as I head into nursing school…and at the same time, I'm excited to relish in a bit of job security, health insurance, and a steady paycheck as well. I plan to be the doula-iest nurse there ever was!

Mimi don't care 'bout productivity...

So, what does this mean for you?

Well, it means that the Hello Sunshine blog content will be in for a change. I’ll be shifting from the regular, weekly post of doula-ly advice to a much less frequent (and kind of all-over-the-place) record of my experiences as a doula in nursing school. I also hope to offer more advice and resources for those interested in becoming a doula (or doula-nurse).

Thank you so much for your love and support!

P.S. I'd love to hear from you! If you feel like it, leave me a comment below and let me know who you are, where you’re from and why you’re reading the Hello Sunshine blog! So much love, dear readers. XOXO!

Phentermine Weight Loss Doctors Require Physical Exam

Midwives in Brooklyn — Tue, 23 Aug 2016 12:21:17 -0400

If you have ever taken a stroll down the “”diet”” section in a drug store, no doubt you have been bombarded with item after piece asserting that it can help you to lose weight successfully, but what really works? Dr. Vadim Surikov is a medical weight loss physician in NYC who has spent many years examining and finding successful remedies for those who’re looking to lose weight. Along with helping his patients in New York City to confirm successful exercise habits and healthful diets, he also uses supplements such as phentermine that have been proven to make losing weight all the more potential and to reduce hunger.

What is Phentermine?

This drug is a weight-loss suppressant that can only be obtained through prescription. When used for a short time, it’s been understood to help curb hunger in patients. By thus doing, it enables individuals to better say “”no”” to their cravings and to successfully and healthfully limit the amount of calories they consume each day in order to make weight loss potential. Using this medication is combined with healthy diet and exercise routines.

Are there any Phentermine side effects?

Dr. Surikov makes it a point to thoroughly instruct his patients on both the advantages and disadvantages of all nutritional supplements he prescribes during his medical weight loss program. Before prescribing any drugs or beginning any medical weight loss program with a patient, Dr. Surikov will run a comprehensive physical examination that will consist of both blood tests as well as an in depth discussion of your medical history. You will be asked about any pre-existing health conditions you may have, especially depression, high blood pressure, diabetes, and other problems that could make this medication an unwise choice. In cases like these, Dr. Surikov will work with you to locate options that will afford the finest results during your weight loss program.

As with any drug, this appetite suppressant is not without its side effects. Some of the most often reported phentermine side effects experienced include:

hyperactivity and restlessness

dizziness and tremors

headache

insomnia

dry mouth

Reduced libido or impotence

Contact Dr. Surikov to Schedule an Appointment

Dr. Surikov is surely one of a kind in the New York City area. His weight loss program is focused on commanding hunger in such a manner as to facilitate weight reduction as well as promote healthful sleep, making him a trailblazer in his area.

To learn more about Dr. Surikov and his method of weight reduction, don’t hesitate to contact his clinic in NYC. His system is simple in its execution and there is no denying that Dr. Surikov is a real expert physician in the realm of fat loss. Since 1989, he continues to be helping patients exactly like one to lose the weight forever and successfully. Not only this, but his program is very affordable and all first-time patients receive a generous discount.

How is the drug used?

Normally, the medication will be taken as soon as you get up each morning to be able to help curb your hunger throughout the day. In situations where a complete pill either makes you too jittery or causes one to “”over control”” your desire, you may be prescribed a lower dose or simply a portion of a pill. Take note that some patients have reported having their hunger return at the end of the day when the drug begins to wear off. This can frequently make patients famished at night which has its challenges regularly when individuals choose to nosh as nighttime is.

Additionally, this suppressant has been known to become less effective with time, meaning that Dr. Surikov will probably prescribe the medication for shorter periods at a time. Dr. Surikov takes a very hands on approach with his medical weight loss patients, so rest assured that you’re in great hands. He will be happy to work with you to discover a workable alternative if you ever experience any issues with your prescriptions.

Does it make a difference what time of day I eat if I would like to shed weight?

Midwives in Brooklyn — Sun, 21 Aug 2016 14:11:10 -0400

Many of us have fought with losing weight. We’ve attempted diet after diet trying to clear our body of these irritating extra few pounds we wish might only disappear.

You may well be surprised to find out that that which you eat is actually not the most crucial element of a diet that is successful. The total amount you eat and also day’s time by which you take in could be much more crucial. Dr. Surikov can be a fat loss physician in New York Area that has used a long time acquiring his knowledge and understanding of those ideas which can make losing weight even more easy and probable.

Does it matter what timeofday I eat?

Will make an enormous difference within your trip toward a slimmer you while you eat through the day,. Many studies have been executed which have examined merely this, along with the answers are really really incredible. One research done in the San Raffaele Rome Open School was particularly eye-opening. In this study, researchers divided a group of women into two teams, one which used 70-percent in their daily calories between breakfast and lunchtime, as the different females eaten 55 percent of the calories through the same time. Each team used the rest of these calories with late-night snacking, supper, and an evening treat.

At the study’s conclusion, it was unearthed that these ladies who consumed the vast majority of the calories through the day’s earlier parts were able to eliminate inches from their waist and much more weight as opposed to different collection. Additionally they confirmed a healthier metabolism than these people who consumed more during the morning. On the three month trial’s course, the typical “”previously eater”” surely could shed about 33 percent more off their midsection and 3.75 more pounds than their ” “afterwards eater”” brethren.

Exactly what does Dr. Surikov propose to the patients at his NYC clinic?

Aid fat loss and so that you can retain a healthy diet, Dr. Surikov recommends consuming most of your calories throughout the early parts of your day. Around the flipside, supper and night eating must not be maximal. Acquiring enough sleep can be vital because it helps to boost metabolism and assist with digestion which makes slimming down more easy.

Reducing weight also means that the primary focus needs to be around the quantity of calories you consume a lot more than just what you consume. Making sure that you eat fewer calories than you expend every day is vital which is a thing that Dr. Surikov emphasizes to all his patients who are members of his medical weight loss regimen.

His weight loss program’s beauty is the fact that individuals have the ability to eat the things they like in moderation. Once you work with Dr. Surikov, he’ll allow you to build healthy diet and workout habits and will give you products when required, including phentermine which can help curb your appetite and maintain you from caving in your cravings to all.

Schedule An Appointment with Dr. Vadim Surikov in NYC

Since 1989, Dr. Surikov has been working together with clients in New York Area who have long wanted experiencing a slimmer, healthier shape and shedding the excess weight. With all of the trend diets which are promoted on a daily schedule, it could not be easy to ascertain which techniques are the most reliable. Fortunately, Dr. Surikov is just a qualified physician that is ready and desperate to reveal his experience with the individuals in his medical weight loss program and has completed the research for you all.

Doctor. a very extensive method which include substantial physical exams and services ahead of starting his medical weight loss journey is taken by Surikov. Dr. Surikov gives at his clinic, offer his office a call today at 347-599-9118.

Seek out Ny Diet Consultations Who are able to Advice you appropriately

Midwives in Brooklyn — Mon, 11 Jul 2016 11:31:24 -0400

Looking for the safest and most effective way to lose excess weight permanently might be a tricky affair. Numerous experts agree that the simplest way to attain safe and permanent weight-loss is always to follow balanced and healthy diet and acquire sufficient exercising. However, choosing NYC Diet Consultations is an excellent substitute for many weight programs about on your successful and permanent weight goals. You should look and pick diet plan that promotes eating healthily habits to in achieving weight goals and possess provisions for recommended weight maintenance. Should you simplified your options which is ready to make a choice about what Ny Diet Consultations to adopt, be sure you choose diet consultations that can advice yourself on the following:

Strong eating

Ensure you choose a weight loss program that features food all the food groups found in the nutrition pyramid while reducing calorie intake. Using this method, you won’t be deprived of the fundamental nutritional values every daily food groups can give.

Exercise programs

Diet alone couldn’t supply the necessary weight-loss goals you wish to achieve. Your weight loss program should give a exercise program that goes in hand with your specific diet to effectively manage excess fat. A sample workout plan includes 30-sixty minutes of cardiovascular activity at least 5 days weekly.

Sufficient medical supervision

Your diet plan could include a modified eating plan for a long time for instance a low-calorie diet or a diet made up of fluids. This may disrupt you present eating pattern that could present problems in the event you carry on unsupervised. Be sure to make regular consultations with a licensed medical expert before, after and during this diet program to check whether bodies are responding well on the program. It is good to determine a clinical professional personally associated with your weight loss plan.

Find out about your eating behavior

Recognizing the standards that trigger you to definitely eat is often a key element to achieving permanent fat loss. A skilled medical specialist on this element of weight-loss may help you discover factors that trigger you to definitely eat and discover to identify a pattern bringing about such inappropriate eating routine. This will help anticipate and steer clear of being caught in similar situations.

Slow but sure weight loss program

You should choose a weight plan that guarantees gradual and consistent weight reduction, not only a crash -course. Gradual fat loss of around one to two pounds every week is an excellent place to start. While these figures may change during your program, the most that your particular program should require is 3 pounds weekly to keep up a fantastic general health.

A stable maintenance plan

When you reached necessary weight levels after meticulously following on from the weight program, what next? You can easily gain back weight quicker than imaginable if the program doesn’t give a good maintenance insurance policy for your ideal weight. They must be sure you commit to incorporate the healthy lifestyle you acquired in the daily life by doing routine follow-ups and lifestyle checking.

Lose Weight With The Aid Of Diet Doctor In The Big Apple

Midwives in Brooklyn — Sat, 09 Jul 2016 20:31:23 -0400

Maybe you have visited The Big Apple Diet Doctor because you have been having trouble together with your weight? These Doctors can be caring, as other nutritional experts. However, if your medical professional tells you that you have to lose weight, or you’ll receive diabetes, heart disease, etc.that increases your stress threshold level and will sabotage your ability to lose weight and maintain fat loss. You can follow your doctor’s recommendations, but 95% of men and women are not able to maintain any weight reduction, and indeed end up gaining more weight. Remembering your doctor’s admonition, it is likely you feel doomed to illness and disease, and can not a perform aspect of it.

Each time a doctor informs you to diet to shed pounds: despite the fact that approximately 95% of diets fail, you are being setup for failure. Unfortunately, most of the people blame themselves rather than the flawed notion of dieting by eating less and exercising more.Furthermore, each diet failure leads to excess fat gain, known as the yo-yo syndrome, which enhances the problem a lot more.

Many people are convinced that hypnosis can function, however they too, end up regaining the load. The challenge with hypnosis is because they are hypnotizing visitors to carry out the same dieting behavior that brings about 95% failure rate: consume less food and workout more. This doesn’t happen work.Here’s precisely why.

Many people are chronic under-eaters, and infrequently chronic over-exercisers who have sabotaged their procedure now can’t lose weight. Over or under-eating and overweight are the signs of a foundational problem.

Now you ask, why everyone is achieving this behavior. It’s stress which is the one very common condition of all eating disorders. It is usually stress on your body. Or it can be emotional stress: losing a job, death or divorce, etc. In the event the person is stuck in fear, and not enough safety dieting, this will cause chronic stress. Chronic stress changes the entire physiology and makes dieting worse than worthless.

Ny Diet Doctor have realized that teaching Mindfulness and Mindful eating, as well as to reduce anxiety to achieve the best results for weight loss. It is time that weight loss coaches start becoming to reduce stress coaches, and teach their clients how you can eat mindfully. That alone is really a stress reliever and may help people re-begin a exposure to their body’s signals of hunger and satiation.

You will find excellent, lasting results for those who use Mindfulness to slowly and intentionally eat what they need until they are full. Many individuals ought to learn to eat more, and much more often stop stressing about every piece of food installed within their mouth. It will require time, but their body gets warmer as his or her metabolism repairs while they are self-nurturing with food. Their stress levels drop, along with their self-esteem rises.

When no meals is evil, no food becomes the object of your binge. There is no more fear about food, and death by food and the entire body can start repairing the harm that has been done from stress.

The only real remaining stressful problem is coping with well-meaning doctors, along with the public that creates fat people brunt of jokes, and feel there is a right to mock and proper them to be slothful, lazy and undisciplined.

The Big Apple Program for Losing Pounds

Midwives in Brooklyn — Sat, 09 Jul 2016 14:27:06 -0400

Perhaps you have struggled to get rid of pounds in the past? Do you feel like you won’t be able to get down to to the size you want?A great tip for losing pounds to bring along balanced diet with you if you might be away from home. A a lot of people increase the risk for mistake of not packing food using them, and they’re expected to turn to unhealthy food. It is best to put balanced diet together with you, in case you get hungry.

Avoid dietary fads and celebrity diets. Those types of diet plans are incredibly ineffective due to simple fact that they break the core principles of the healthy lifestyle that may guarantee weight loss and fat reduction. Typically those forms of diets are based on reducing take in too much or restricting important nutrients like carbohydrates and fats…yes, you will need carbs and fats to shed weight and drop fat!

The most efficient Ny Program for Losing Pounds and drop fat fast and they are 100% naturally

The everLoss Diet Program

With The everLoss weight loss program, you will discover no fad dieting, no diet pills, no nonsense! However, what will you find is a 100% natural, effective, and safe dieting and weight loss routine. If you follow this system to it’s fullest (consistency is key with any diet program), you’ll be able to naturally lose 20 pounds or higher in 30 days.And much more importantly keep the weight off.

The everLoss weight loss diet program will be the clearest dieting system I’ve encountered. It covers every facets of fat loss, fat reduction, and staying healthy for lifetime.

You’re going to get a personalized plan that may cover:

Food and diet.

Fitness and activities.

Supplements. Recipes.

Fat burning techniques.

2.Body Fat Loss 4 Idiots Program Once you begin a diet program, a few of the biggest headaches you’ll have to overcome are laziness, procrastination, and deficiencies in self-discipline.

Fat Loss, 4 Idiots program, not only helps you with safe and fast weight loss but additionally with overcoming those headaches stated previously to be able to begin and continue undertaking the interview process loss program.

Thus far, it should be the easiest eating plan I’ve reviewed. It is very simple but yet quite effective. Its primary emphasis is on proper nutrition. The best part on this diet is that you may get a personalized diet generator.

3.The Fat Burning Furnace Review Program

The Fat Burning Furnace Review program is really a high-intensity fitness program produced by fitness instructor, Rob Poulos.

Rob claims by purchasing his program you can lose weight faster and burn up fat faster without all the boring cardio exercising. This program’s main emphasis is that you will only have to exercise 15-30 minutes per day, and for only two-three times per week. This seems like it won’t work. However, many individuals have tried the program, and have the identical response.

You are able to that doesn’t all weight lifting programs burn fat .The most effective program for losing pounds is one you happen to be comfortable with, so performing all of your research and planning is essential. You will find different techniques to incorporate those possibilities into the weight loss program.

Weight-loss Exercises service for Health insurance and Happy life

Midwives in Brooklyn — Fri, 08 Jul 2016 21:10:25 -0400

Fat reduction – It is often unexpected that you can discover the method of lower your body fat both simple and easy , challenging as well. Particularly, if you need it to occur really quick.

Easy New York Weight Reduction Service becomes difficult if it’s the first time you are trying to lose extra weight and you do not possess a clue concerning how to begin. However, simultaneously, it might be easy for those who have someone along with you who definitely possess some experience regarding fat reduction or a thing that could help you with it.

However, to become honest, it is a well-known undeniable fact that it’s harmful for employ the service of the qualified weight loss expert, and clothing easy for everyone.

Still, if you don’t keep you from getting a fairly easy fat loss program immediately.You may be excited to see the consequence of this program provided you stick to it consistently. Of course, it is a promise you must make to yourself and make consistently if you need to shed the weight you’ve developed in recent times.

There are many unhealthy solutions that it is sometimes hard to make the right choices together with wanting to consume healthy food, weight reduction service might help in achieving and looking after a proper weight. Whatever your level of activity, there is a type of exercise for newbies to advanced individuals planning to take steps to arrive at well-being goals.

Many individuals of New York are extremely busy with work and residential life that fitting a good work out routine into their schedule can be a hard task. By changing tiny problems throughout your day, you will get your heartbeat up and slim down.

When heading out the door to operate or family activities, parking a lttle bit far away from your destination provides you with the opportunity walk that much more and increase the exercise one does daily. While in the office, sitting with a desk that can be done leg lifts or abs crunches while completing your projects duties and no one need know you’re exercising.

Lunchtime is a great time to atart exercising . heart-pumping aerobics by taking a walk after your meals and even training in the gym environment if there is one open to you either in your area of employment or with an establishment nearby.

Being with your kids outdoors is the best way to become more active. Students are naturally curious and energetic a visit to the park can provide extensive opportunities for exercise simply by running and using your sons or daughters.

If fitting some New York Weight Reduction Service during other items within your day isn’t an attractive option, there are many institutions where you can find a membership to make use of their facilities to improve your exercising, become healthier and slim down. Public gyms offer programs that target specific areas and goals, while park districts have services which are much like the gyms and give a much more lenient replacement for working out.

Whichever road you’re considering to adopt, many people who have traveled it before you know that weight-loss exercises can be quite a challenging undertaking, but it is realizable with effort and require.

Epidurals: What You Need to Know Before Labor Even Begins

bethanie verduzco — Tue, 10 May 2016 12:50:18 -0400

Many moms who were geared up for an unmedicated, natural labor find that at some point during labor they might second-guess that decision. Some will push past that point and go on to deliver without medication, and others will make the sometimes difficult call to get an epidural. This can happen for a wide variety of reasons—both medical and psychological. Epidurals can calm a mom who is anxious and not able to relax, they can be a way to rest after a long and exhausting labor, and they can lower blood pressure for a mom who’s pre-eclamptic. Then there’s the mystery of: what’s happening with baby? Is she in a good position or is she posterior? Is her head coming down straight or is it asynclitic? These things can absolutely affect a mom’s decision to get an epidural, as well.

Too often mamas judge themselves for choosing to get an epidural when they were hoping for a natural birth. So let’s get real: birth is tough and gritty and raw. It can be beautiful and empowering too. But the underlying theme is that it rarely goes to plan. What you decide to do during labor is your decision. Be proud that you’re already making difficult but informed choices for yourself and your baby—the first of many tough parenting decisions, right? So say no to the guilt. You’re in charge, mama. Own it.

That being said: it’s important you know the risks of the procedure, both risks to you and baby’s health as well as the situational risks—how your labor will be effected by this decision from this point on. There are many reasons why epidurals shouldn’t be taken lightly, and I’ve included some resources for further reading at the bottom of this post. But for the sake of this particular blog post, we’re focusing on what actually happens once a mom has made that educated decision to get an epidural.

So let’s say you do make that decision. What happens from that point on?

I’ll be honest, as a doula, this is oftentimes the stickiest part of a mama’s labor. Once her mind is made up, mom is already at the end of her rope. She’s decided that’s it.

But what happens next is usually pretty unexpected. The nurse responds with, “okay, hun, we need to get a whole bag of IV fluids in you and get a hold of the anesthesiologist first.” Cue: laboring mother panic. What do you mean get a whole bag of fluids? Get a hold of the anesthesiologist?! You mean it’s not going to happen right now?!

No, it’s not. It can take anywhere from 30 minutes to an hour to get a bag of fluids (if you don’t already have an IV hooked up). And the anesthesiologist might be in surgery or doing other procedures in the meantime. And, something else to consider, it usually takes about 15 minutes to feel the anesthesia after the epidural is place. So you’re looking at a possible hour+ from the point you decide you want an epidural to when you’ll actually feel the effects.

BEFORE YOU GET THE EPIDURAL:

Usually a full bag of IV fluids— from 30 minutes to an hour.
Wait for anesthesiologist on call— from 30 minutes to an hour.
continuous fetal monitoring
blood pressure monitored regularly

So once you’ve got enough fluid and anesthesia arrives, what happens next?

DURING EPIDURAL PROCEDURE:

Sometimes one support person is allowed to stay in the room during the procedure, but more often than not, support people (partners, doula, mother, etc.) are asked to leave the room and wait in the waiting room while the epidural is being placed. Just a nurse and anesthesiologist allowed to stay. Support people can expect to wait for 30-45 minutes before being allowed back in.
After support people leave, the laboring woman will be asked to sit over the side of the bed or lay on her side. She’ll then be instructed to curl over and round her back.
The anesthesiologist will clean her lower back with a sterilizing solution and then put a clear sticky tape over and around the area. The anesthesiologist will then inject a local anesthetic into mom’s lower back to numb the site. This will likely sting quite a bit.
The laboring woman will be lean forward, curling around her belly. She’s then instructed to hold her breath and sit perfectly still (which many mothers will tell you can be very hard and painful when contractions are intense).
Then a long needle is injected into the spinal column, passing through the skin, ligaments, and in between the vertebrae until it reaches the space just outside the membrane that surrounds the spinal nerves. The membrane is called the “dura,” and the space outside it is called the “epi-dural space.” The anesthesiologists will be watching to make sure the needle doesn’t pass through the dura or into a blood vessel—the long epidural needle has markings on it so that the anesthesiologist knows how far to go in. And FYI: this can still be painful even though it’s been locally numbed.
Once the needle is in place, a thin plastic catheter is threaded through the needle, about 4-5 cm into the epidural space. Then needle is actually pulled out—just the catheter remains. So important to know: the needle does not stay in your body!
After the catheter is placed, the anesthesiologist will check to see if it’s placed correctly by administering a small dose of anesthetic (usually lidocaine) into the epidural space. 3-5 minutes later, they will do a leg movement test. If the laboring woman’s leg can move, then they know it’s placed well. If her leg cannot move, it’s not in the right place and they will have to start the whole procedure over (which happens in about 5% of cases). If everything looks good, however, a bolus of anesthetic medication is administered through the catheter, and a continuous infusion of anesthetic through a drip is started. This drip can be adjusted by mom throughout the rest of her labor, numbing her body from her abdomen down. Know that it usually takes about 10-15 minutes for moms to feel the medication start to work after the epidural is placed.
The thin plastic catheter administering the anesthesia is then taped down on her back and shoulder, then on the outside of her gown, so that it has less chance of being pulled loose with movement.
A bladder catheter is then put in—remember: you won’t be able to stand up and walk to the bathroom to pee. But the catheter will go in only after you’re numb. And it will stay in until it’s time to push.
You can expect the whole procedure from the time your support people leave the room to the time they’re allowed back in, to take about 20-40 minutes.
The numbing effects of the epidural will last about 1-2 hours after delivery.

SOME THINGS TO CONSIDER BEFORE MAKING THE CALL:

Oftentimes the anesthesiologist will not automatically be explaining things to you as you go. Make sure to ask them to give you a play by play if that’s something you think you will want/need to feel comfortable and in control.
A “good epidural” is one where mom can still feel pressure, still feel a contraction and still have the urge to push. But this is ideal and doesn’t always (or even usually happen). In reality, the pushing stage can be just as difficult, if not more so, with an epidural. With sensation gone, you might not be able to feel where to push, which can make this stage longer, less efficient and can wear a laboring woman out. As a result, there’s a higher risk of forceps or vacuum extractor deliveries with an epidural.
It’s not unusual for moms to feel the epidural working on one side but not the other. So remember: epidurals work by gravity. So lying on the non-numb side is the trick to getting more even coverage (and then switching sides again when that feeling reverses).
You will likely be confined to your bed after you get an epidural. You won’t be able to walk around, squat, lunge, take a shower or bath, or get into different birthing positions that help baby move down efficiently. So you’ll need to have support from your nurse and support people to help you move from side to side every 30 minutes so that labor can progress. Ask your nurse if she or he can set you up with a peanut ball while you’re on your side. These are amazing tools for labor—especially for a woman on an epidural! They can lower your chances of having a cesarean by 80%! You might also be able to try a supported hands-and-knees position or sitting upright near a 90 degree angle and dropping the foot of the bed down, letting gravity work for you.
There’s also a risk that the epidural can slow labor down or stop it completely. This usually happens earlier in labor (before 5cm), but I’ve seen it happen later too. If labor begins to slow or stagnate, hospital staff will want to start Pitocin to get your contractions going again. But this is also not without risks—do your research on Pitocin. If you’re considering an epidural, know these two are closely connected and what possible outcomes are.
Babies do feel the effects of epidurals, and there is some research to say that the baby’s drug levels may even be higher than the mother’s drug levels at birth. Babies whose mothers get epidurals might also become lethargic in utero, which can effect how their positioning for delivery. This can carry over to breastfeeding, as well. Babies with epidurals take longer to latch on and have more difficulties with breastfeeding in the early days than unmedicated babies. Epidurals have also been known to cause respiratory depression and decreased fetal heart rate in newborns.
Also when it comes to breastfeeding, it can be hard for moms to initiate a good first latch because they’re still feeling numb and can’t support baby at the breast until later on. It’s critical that moms with epidurals have extra support to help them with breastfeeding at the beginning.
I’ve supported moms with epidurals who have said that the anesthesia wasn’t actually working at all, that it wasn’t taking enough edge off to really do anything for them. This actually happens for 10% to 15% of women. Also, it’s possible for her to feel a window of pain somewhere on her back or belly—where the epidural is working on the rest of her mid-section, but one small window is still experiencing every bit of the contraction’s intensity.
Epidurals significantly interfere with the major hormones of labor and birth, i.e. oxytocin, beta-endorphins, catecholamines. A mother’s levels of oxytocin and beta-endorphins, the lovie-feely hormones are reduced or eliminated, which can delay bonding and inhibit attachment. Also, because of a drop in catecholamines moms might have a tougher time having the energy to push baby out.
Laboring women with epidurals have longer labors—both for active labor and for pushing.
This is not a medical risk your doctor will most likely tell you about, but as a doula I know it’s important for many moms. Getting an epidural can change the feeling of your labor from something active to something passive. Many moms have told me they felt like what was before within their control, was suddenly taken away after they got the epidural. Just know: you will have to give up some of your power if you choose to have an epidural. Give up something to get something else. It’s a trade off.
Some women can get a horrible spinal headache that can last for hours or, in rare cases, days/weeks. This will happen to 1 in 100 women.
There’s also the rare possibility of permanent nerve damage at the epidural catheter site, developing an abscess or hematoma (blood clot), as well as toxic reactions in the covering of the spinal cord which could result in paraplegia.
Other risks include: shivering, ringing of the ears, backache, weakness, numbness, soreness where the needle is inserted (potentially for years), nausea, or difficulty urinating.

So whether or not you decide to get an epidural during labor, make sure you know how it can effect the rest of your labor, delivery and postpartum bonding time with your baby. Learn about the procedure and the risks so that you can make the best choice for you and your baby!

Want to learn more?

https://www.youtube.com/watch?v=tn8H5JV3lec

https://www.youtube.com/watch?v=uNDcf3Vw1vo

https://www.youtube.com/watch?v=j_FoIx1SHBs

http://www.medcentral.org/Main/EpiduralInjection.aspx

http://sarahbuckley.com/epidurals-risks-and-concerns-for-mother-and-baby

http://evidencebasedbirth.com/are-iv-fluids-necessary-during-labor/

http://evidencebasedbirth.com/what-is-the-evidence-for-pushing-positions/

youtube=http://www.youtube.com/watch?v=NjtM4EtSs34]

https://www.youtube.com/watch?v=j_qU6QL3NO0

New Study on Labor Meds & Breastfeeding

bethanie verduzco — Fri, 29 Apr 2016 12:35:06 -0400

A new study in the journal Birth has found that babies exposed to synthetic oxytocin (commonly known as Pitocin) and fentanyl epidural during labor were significantly less likely to suckle while skin-to-skin with their mothers during the immediate postpartum period.

This time immediate postpartum is often called the Golden Hour, and is extremely important for mothers and babies for a variety of reasons. Holding your baby skin-to-skin will help baby regulate body temperature, blood sugar, and breathing, as well as colonize baby with your beneficial bacteria instead of the not-so-friendly hospital bacteria. Skin-to-skin contact also helps to establish breastfeeding, and according to the World Health Organization (WHO), “increases the likelihood for exclusive breastfeeding for 1 to 4 months of life as well as the overall duration of breastfeeding.”

But synthetic oxytocin (Pitocin) and fentanyl epidural medications given during labor have been found to have an effect on babies postpartum as well, and breastfeeding can be adversely effected as a result. Check out this video from Healthy Children’s Center for Breastfeeding which features actual footage from this study.

Want to learn more?

43 Podcasts for Pregnancy & Birth

bethanie verduzco — Tue, 12 Apr 2016 10:56:30 -0400

As a mother and doula, I am a huge fan of podcasts. I listen to them in the car, while working out in the morning, while prepping dinner. And although I kind of loathe the idea of multi-tasking on principle, I also feel like it's a pretty necessary part of my life right now. Podcasts have helped me through some rough patches of motherhood, and have helped me stay on top of my doula game with near-constant continuing education.

I've been trying to find a collection of podcasts for pregnancy and birth for a while--so that I could subscribe myself as well as recommend great ones for my Hello Sunshine mamas. But oddly, after scouring the internet for what seemed like weeks, I couldn't find a thing. Bizarre, right? Podcasts have been so helpful to me over the years in so many ways that I felt like other moms on the journey should have a comprehensive list to reference and find exactly what they're looking for. So I created one!

The following is a list of 43 Podcasts for Pregnancy and Birth (and a few for breastfeeding and postpartum thrown in for good measure!). I've done my best to provide every podcast on the theme to date, but if you see a podcast you love that I don't have listed, just shoot me an email. I'd be happy to add it! Also, I'm restricting my list here to just podcasts on pregnancy, birth, breastfeeding and postpartum. There are many more on motherhood/parenthood, but I've decided not to include these podcasts unless they specifically target pregnant/brand new mamas in a big way. And, for the sake of transparency, I have to state that I have not listened to all of these podcasts. I've tried out about half of them. And while I've subscribed to more of these podcasts in the past, I currently only subscribe to the first three (marked with *). Which to choose just depends where you are on your motherly path!

Try out a few and let me know what you think!

43 Podcasts for Pregnancy & Birth

The Longest Shortest Time*: One of my favorite all-time podcasts. Hillary Frank, formerly of WNYC, explores all aspects of parenthood with a good dose of quirk and depth. The earliest episodes focus mainly on postpartum stories and anecdotes and is hugely validating to mothers struggling with life with a newborn.
The Birthful Podcast*: This is my go-to podcast for birth information. Each week host Adriana Lozada interviews birth professionals to "inform your intuition." Gold.
ToRaise Questions Doula Podcast*: Although this podcast is aimed more at birth professionals, it could be hugely valuable to mothers-to-be as well. Hosts Thérèse Hak-Kuhn and Melanie Headley talk about birth through a doula's lense, focusing on birth as a civil right and a human right. It's as much about life as it is about birth.
Stuff Mom Never Told You Podcast: Hosted by Cristen Conger and Caroline Ervin, Stuff Mom Never Told You is the audio podcast from HowStuffWorks that gets down to the business of being women from every imaginable angle. And although it's not exclusively for pregnancy and birth, it's got a good percentage of episodes that are, and I love this podcast for it's inclusive and non-judgemental tone.
Common Sense Pregnancy: Host Jeanne Faulkner offers comprehensive, medically-sound advice and insights plus conversations with women, mothers and experts in pregnancy, parenting and the power to change the world.
Taking Back Birth: Providing birth education to empowered women everywhere. It's time to take back birth.
Birth, Baby, and Life Podcast: Host Kristen Burgess from Natural Birth and Baby Care.com brings you straight talk, useful tips, and practical steps for your pregnancy, childbirth experience, and for bringing up baby. Discover how you can have a great pregnancy, safe birth, and a healthy baby... and how to enjoy life along the way.
One Bad Mother: A comedy podcast about motherhood and how unnatural it sometimes is. We aren't all magical vessels! Join us every week as we deal with the thrills and embarrassments of motherhood and strive for less judging, and more laughing.
Dr. Berlin’s Informed Pregnancy Podcast: Host Dr. Berlin sits down with pregnancy, pediatric and parenting experts to help deliver empowering information so you can make informed choices.
The Black Dad Podcast: Welcome To The Black Dad Podcast! The hosts, Jamal Press and Murphy are two brand new dads who don’t know anything about being dads but are taking it one sleepless day/night at a time... It's all sleepless. Listen in every week as they discover with each podcast what it truly means to be a father.
The Birth Hour: Blogger and Podcaster Bryn Huntpalmer interviews a different mother each week sharing their pregnancy and birth stories of all shapes and sizes including natural birth, homebirth, waterbirth, VBAC, cesarean, twin birth and more!
Pregnancy Podcast: The Pregnancy Podcast is resource to help you make informed decisions about your pregnancy and your baby, and a place where you can rest assured that you’ll find real solutions that are in line with your family and your lifestyle.
Babies and Moms: Birth and Beyond Podcast: We help you through the first few years of being a mom. We have great info and fun topics. Join us and Learn and Grow Together.
Healthy Births, Happy Babies: A weekly podcast sharing information about how to feel safe, supported and empowered during your pregnancy, birth and parenthood from prenatal and pediatric care experts in acupuncture, chiropractic, massage, yoga, lactation and birth education at the Cap Wellness Center.
Progressive Parenting: The aim of this show is to empower parents to overcome the barriers that keep them from beginning or continuing to breastfeed. Through discussion of hospital practices, milk supply, medications, returning to work, milk storage options, and more, this show will provide an informed and supportive voice for new families and established families, so that they can take charge of their breastfeeding experience from conception through weaning.
Dearest Doula: On Dearest Doula we will learn about a host of birth related topics from top professionals in our field, and connect with doulas and other birth workers so they can share their wisdom with you.
Birth Wisdom: Birth Wisdom provides practical and forward-thinking education and inspiration to a global community of birth professionals. We feature the leading experts and upcoming voices in women’s holistic health and birth in the world today, highlighting the transformative healing power of women in community.
The Cord: Your Birthing Year and Beyond: Host Amy Neuhedel connects you to the most influential people in birth and parenting today. A professional doula, childbirth educator and mom coach, Amy brings you connection, peace and empowerment in your birthing year and beyond. An American mom living in Sweden for 15 years, she also provides insight into navigating a mothering journey abroad.
Pregnancy, Birth, and Beyond Radio: An inspiration of Maternity Choices Australia, we honour a woman's right to choice, her body, her baby and her birth. We hope to inspire and inform you, our sisterhood and families, through the thresholds of birth and your unique journey to motherhood and parenthood.
Birth: Audio Documentary: Melissa and Joe Pardo are excited to announce that they are having their first baby! After being together for nearly 8 years, they will be bringing a child into their lives to share in all of their magical adventures. BIRTH utilizes audio recordings of our actual conversations between ourselves as well as family and friends.
Easier, Healthier Birth Podcast: Host Sarah Blight knows that being pregnant and giving birth is NOT easy. She's rounded up the best of the best in the pregnancy & birth world to share all these golden nuggets of info with you to make your pregnancy, labor & birth the best and easiest it can be.
Pregnancy Perfect Podcast: The Pregnancy Perfect Podcast features host Kayla Geddes interviewing new moms and/or more seasoned moms that share with their experience through their #9monthmarathon as well as offering tips, family traditions and remedies, apps that helped them and MY favorites such as their weirdest symptoms, crazy food cravings, the biggest lesson they learned AND what they would do differently in their next pregnancy.
Preggie Pals: Preggie Pals is an audio podcast that educates and entertains expectant mothers and those hoping to become pregnant. Each episode features a panel of pregnant women, at various stages and trimesters, as well as experts. Together they explore topics aimed to embrace pregnancy and encourage women to pursue their individual childbirth choices.
Pregnancy Confidential: Pregnancy Confidential is a series of 32 podcasts designed to be accessed weekly by expectant moms. Hosted by editors from Parents and Fit Pregnancy and Baby magazines, each 10-20 minute podcast walks listeners through the physical, emotional and/or lifestyle markers of that week of pregnancy.
Pea in the Podcast: Pea in the Podcast is a podcast program dedicated to guiding and nurturing you through each stage of your pregnancy. Join other moms-to-be and the experts including doctors, midwives, doulas and authors as we guide you through each week of your pregnancy.
The Healthy Belly's Pregnancy Podcast: The Healthy Belly's Radio Podcast series interconnects the listeners with our online pregnancy and parenting website. Providing a listening option for mommies on the go. With these downloadable podcasts expecting parents who desire to learn each week about the stages of their babies development that do not have the time to log on to the healthy belly.com
Baby in Bloom: Host Linda Lia from The BabyinBloom.net Blog shares tips and advice on pregnancy with special focus on first time pregnant moms. Learn about pregnancy facts versus myths and get one step closer to a more successful pregnancy.
The Lesbian Parenting Podcast: Parenting podcast for lesbian couples trying to conceive by podcast hosts Kristin and Maarit. Topics include: donor insemination, IUIs, cryobanks, and second parent adoption.
Pregnancy Awareness Month Podcast: May 2010 marks the 3rd year of Pregnancy Awareness Month (PAM). Hosts Anna & Alisa aim to empower pregnant women and new families with information, “how to” ideas and inspiration to incorporate PAM’s four key initiatives – education, exercise, nutrition & wellness and nurture – into their life routines and to show how easy it can be to make healthy changes in their lives, for themselves, and their children.
The New York Doula Podcast: Tips and tricks from host Stephanie Heintzeler, a midwife and doula living in New York. Topics include: infant sleep, breastfeeding, things to avoid in the delivery room, benefits of a doula, signs of labor and mindset for birth.
The Fear Free Childbirth Podcast: Welcome to Fear Free Childbirth podcast, with Alexia Leachman, the weekly, 9 month podcast to help parents-to-be look forward to a fear free childbirth.
The New Family Podcast: The New Family Podcast is the show that explores what families really look like today and the issues that matter to us most. Twice a week we interview some of the most compelling people whose stories represent the many forms can family can take today.
Pregtastic Online Radio: PregTASTIC is the weekly podcast by pregnant women, for pregnant women about the fantastic journey to motherhood. Full of expert information and friendly advice, opinions and different perspectives for soon-to-be moms. Weekly guests include doctors, doulas, authors etc. Hosted by "real" pregnant women with the same joys, concerns and swollen feet as our listeners.
The Postpartum Podcast: Helping new moms and moms-to-be navigate and celebrate the challenges & joys of pregnancy, childbirth, postpartum and new parenthood.
Mommy’s Milk and More Online Radio: Mommy's Milk and More is the weekly podcast for both expecting and new parents wanting to know more about pregnancy, labor and delivery, breastfeeding, parenting, babies and the emotions involved in dealing with a new infant. Whether this is your first or your fourth baby it's always a challenge to parent an infant. Hosted by Veronica Tingzon, a certified Lactation Consultant, Lactation Educator, Doula, Child Birth Educator, Medical Assistant and most importantly, MOM.
Newbies: Newbies is an audio podcast guiding new mothers through their baby’s first year of life. Episodes feature newly postpartum moms as they celebrate the joys of becoming new parents, as well as the emotional and physical struggles of caring for a newborn baby.
Postpartum Confession Podcast: This is a place for moms and dads to share their stories. And a reminder that in the beautiful and intense times of our postpartum space, we are not alone.
Well-Adjusted Mama: A podcast dedicated to educating and empowering women from preconception, pregnancy, birth, and through early motherhood on wellness lifestyle. The host, Dr. Laura Brayton, is a maternity and pediatric chiropractor who has hand-selected experts in natural, holistic health-care specialties to shine light on options and choices during this exciting phase of a woman’s life.
Bellies to Birthcast: Bellies to BirthCast will guide you through the pinnacles and pitfalls of pregnancy and natural childbirth with expert interviews, helpful tips and inspirational stories spanning birth beyond the basics, homebirth, VBAC, waterbirth, cultural childbirth practices, new baby care, breastfeeding, and more so you can make informed decisions for your family. We believe you are the expert on your body. You possess all the tools you need to give birth.
LezBeMommies Radio: Host Elizabeth Caliva interviews guests on topics related to lesbian conception, pregnancy, parenting and health. Topics include gay parenting, donor sperm, getting pregnant, natural health, the legal issues associated with lesbian parenting, sex in long term lesbian relationships, healthy pregnancy, birthing options, parenting tips, and more
Born to Be Breastfed: The aim of this show is to empower parents to overcome the barriers that keep them from beginning or continuing to breastfeed. Through discussion of hospital practices, milk supply, medications, returning to work, milk storage options, and more, this show will provide an informed and supportive voice for new families and established families, so that they can take charge of their breastfeeding experience from conception through weaning.
Breastfeeding Medicine Podcast: Stay abreast with news, reviews, and hot topics in breastfeeding and human lactation - discussions with members of The Academy of Breastfeeding Medicine.
La Leche League Podcast: Interviews and Information about breastfeeding and La Leche League. La Leche League is an international, nonprofit, nonsectarian organization dedicated to providing education, information, support, and encouragement to women who want to breastfeed.

Why It's So Hard to Take a Shower

bethanie verduzco — Thu, 07 Apr 2016 17:55:10 -0400

Why is it that moms can’t seem to find the time to take a shower especially in the first few weeks/months home with their newborn?

I remember this used to seem so mysterious to me. I would be crazy busy all day with my baby—providing a steady stream of non-stop-newborn-care—but come dinnertime I’d be so wrecked that I couldn’t even tell you what I did all day. It was all such a blur.

I remember having some beautiful moments with my newborn. She would twist her mouth in a certain way and make me giggle. Or she would curl her tiny hands around my hair as we nursed. Or we would lie on the bed in the sunshine next to our dog Booster, just looking at each other in awe. (To be fair, Booster wasn’t as into it as we were.)

But because I am all about honesty and transparency in motherhood, it’s important that I confess: most of our baby-moon moments were not so blissful. Most of our moments were stressful…and hard…and boring. (Some days I’d go through my whole arsenal of emotions in the course of an hour.) I’d gone from being a human woman who could set her own schedule for eating and sleeping and peeing and working to a mothering machine who’s whole raison d’être was to churn out feeding- soothing-changing-cleaning on repeat all hours of the day and night.

I was NOT ready for that. Could’ve used a heads up, people! (As if no one told me that parenting a newborn is hard, bah! Maybe should’ve taken them more seriously.)

But that’s why Adriana Lozada is so great! Who? Adriana Lozada is a birth doula, an eco-maternity consultant, a postpartum educator, a child sleep consultant, a best-selling author and the host of one of my favorite podcasts on pregnancy, birth and beyond, The Birthful Podcast. She created this short video called “Life with a Newborn: Why It’s so Hard to Take a Shower,” in which she demonstrates why it is SO hard to do anything, including eating and sleeping, in a 24-hour period. It’s crazy validating, folks!

So spend 5 minutes and watch her video. It’s packed full of great information on what to expect when it comes to breastfeeding, newborn sleep, diapers, and all that free time that just doesn’t exist. It’s my hope that you’ll watch this video and realize what a good mother you are to work so hard for your baby 24-hours a day!

Sex After Baby: an Interview with Dr. Corey Babb, OB/GYN

bethanie verduzco — Fri, 01 Apr 2016 21:31:54 -0400

This week I spoke with Dr. Corey Babb, DO, OB/GYN and sexual medicine specialist at OSU Medical Center in Tulsa, Oklahoma, all about sex after baby. Oooh, yeah. Dr. Corey Babb is a clinical assistant professor of obstetrics and gynecology, the clinical research coordinator for the department of obstetrics and gynecology at the Oklahoma State University Center for Health Sciences, a Fellow of the American College of Osteopathic Obstetricians and Gynecologists, and is working towards a fellowship at the International Society for the Study of Women’s Sexual Health as well as a preceptorship at San Diego Sexual Medicine. Also, and most importantly, he is happily married to his high school sweetheart and father to 3 small kids.

You know, so many of us mamas are dealing with pain/discomfort as well as low sex drive for months, if not years, after our babies births—and because this pain and low libido has become a “new normal” over time, many of us don’t even recognize it’s a problem. We choose to ignore it, maybe even grin and bear it, and hope with fingers crossed that it improves. We think: maybe this is just what sex is like after baby…? Well, no, I’m telling you, it’s not. Sex is really a human right, which sounds so ridiculous to say, but it is. And it should never be painful or something to “just get through.” That’s why I wanted to get an expert’s opinion and suss out what’s normal, what’s not, how our bodies respond hormonally after birth, and what we can do to make sex fun again.

Whether you’re trying to get pregnant, already pregnant or (congrats) have already had your baby, the following interview is chock full of fascinating and helpful information! If you’re wondering: what are reasonable expectations when it comes to sex during your baby’s first year? How long will it take to feel “normal” again? How can you get your sex drive back if it seems to be nonexistent? This is the post to read.

So do it to it and go get you some!

Hello Sunshine: Thanks so much for agreeing to chat today! So let’s break it down. Say a mom just had a baby, what kind of sex life can she and her partner expect?

Dr. Corey Babb: So immediately postpartum we obviously try and keep any type of pelvic trauma to a minimum. Usually, if you have a lady who had a vaginal delivery, no complications, no tears or anything like that, we recommend resuming intercourse in about 4 weeks or so—definitely being safe to do it at that point. Some people are going to do it sooner, but the thing you worry about is potential infection. And obviously if they’ve had any type of lacerations during delivery, any complications vaginally, or especially if they’ve had a c-section too, then you worry about damage to the stitches that are there that can cause the tissues to break down, which is never pleasant.

The postpartum period is technically done at 6 weeks. After that a lot of it really depends on couples preference but it also depends on whether mom’s breastfeeding or not and whether the parents are co-sleeping or not.

So in a mom who’s breastfeeding, one of the hormones that’s produced in large amount is prolactin. And one of the things that prolactin does is that it actually inhibits estrogen levels. What that means sexually is some loss of drive, but really the big thing is going to be that vaginal tissue and vaginal mucosa will turn almost menopausal. So you have women who go from having a very high estrogen level during pregnancy—and during this time the vagina can have increased discharge, it can appear redder, fuller, I hate to use the word “plump” because it’s such a terrible adjective to use, but it’s really true—to being very flattened and dry after baby arrives, and any friction can cause trauma to the vaginal tissue. So breastfeeding moms should always be using extra lubrication—whether than means taking extra time for foreplay or using KY or another synthetic lubricant. Of course the more natural-minded moms are okay using coconut oil or olive oil too if they’d like. But definitely use something to help lubricate the space. The other thing we talk about is breastfeeding moms breasts stop being sexual organs and start being a baby-feeding organ. Most moms have already had their breasts touched multiple times throughout the day from feeding baby so breast-play can almost become a “turn-off” during foreplay/sex.

There’s been a couple of studies that have come out of the UK, nothing super duper big, that have found that sex drive can actually be decreased if parents are co-sleeping, and that’s for mom and dad. You know most people don’t feel very randy with a baby in between them! You are just in a more nurturing mindset.

So that’s really the postpartum period. When we get to about 6 months after delivery, that’s usually where we start to see a normal increase in the number of sexual events per month. Obviously if moms are still exclusively breastfeeding or co-sleeping than that can effect the number too, but statistically that’s when you start to see things pop up. Numbers pop up! Well, ha, other things pop up too! But the things that a lot of parents, especially first time parents, struggle with too is that now they’re dealing with an extra body in the house or the bedroom and things just aren’t as they used to be. Things are just very, very different. So the normal, sexual desires that they had prior to baby may not be as strong or may not be there at all. And honestly, 6 months out is really the soonest that we’d be able to do any type of sexual dysfunction workup. A lot of it, too, at this point is the psycho-social component. If you have a partner who’s working and mom is stuck there being caregiver to baby 24/7, it’s very difficult to switch that caregiver mode off and become sexual again.

We do know that couples who “share the burden,” where partner is definitely involved and helping out a lot with housework, baby, chores, stuff like that, have a higher degree of relationship satisfaction. But that doesn’t necessarily correlate to a higher number of sexual events per month. You can have a relationship that is more satisfying for both people, but moms can’t always just switch over. It’s mom 24/7.

So when you get to a year out, many babies are not being exclusively breastfed, although of course we have those moms who still do that, they’re more independent. Switching over from so-called “saint” to “seductress” becomes easier to do but some mothers do have to really work at it. One of the things we want to emphasize is that 6 months out, especially a year out, is time with your partner. Going on dates, put the kids to bed and have adult conversation, so that she can remind herself that she’s not just a mother, she’s a woman too. Moms are half of the relationship—not just a caregiver.

If you have moms who are helping to create that time with their partners and not having any success with their libido, the next thing we look at is increasing the number of sexual thoughts throughout the day. And this takes a lot of work. I mean, people who are focused on being caregivers all the time, that’s not exactly what they think about. So I recommend getting into that whole fantasy realm. Sexual fantasy, you know, not Lord of the Rings. You know, maybe reading some kind of erotic literature, or going to a lingerie store and buying yourself something you think is sexy. Even if no one else sees it, you know that it’s there and it feels sexy to you. Just get in the mood more can help. The other things you can start to focus on is non-penetrative sexual play too. So just making out, reliving those teenage memories of making out for hours. It doesn’t have to be about just intercourse, there’s a lot more to it. That’s something we really focus on and want moms to pay attention to.

That’s the first year in a nutshell. Of course any kind of pre-existing psychological trauma, stuff with birth, there’s a bunch of other things that can effect that. But that where we start.

Hello Sunshine: How do you know when something’s a problem and not just normal?

Dr. Corey Babb: A lot of it is in your personal history—what were you like before you had baby. If you have a couple who was having sexual events every other day and they’re expecting to get back to that right off the bat, then that might not be the most realistic expectation. You have to think, you’re gonna have a baby, you’re gonna be tired, probably not going to happen as much. You know the big thing that I really focus on is that when you have moms who come in and have asubstantial decrease in desire or sexual thought at all. That’s when it starts to feel like there’s something going on. The number of events is really pretty inconsequential, it’s really about: do you get that urge at all? If your husband is touching you, maybe they’re giving you a massage or something, is it causing those little butterfly sensations or are you kind of like “ugh, don’t touch me.” That’s one of the big things we look at. If you have women who would consider themselves a-sexual prior to having a baby, there could’ve been underlying things there that could be now coming to light. Interestingly a lot of women who have had some kind of sexual dysfunction in the past, will actually see improvement with pregnancy. The hormones that are going around—especially around mid-2nd trimester, earlier third trimester—dramatically increase their sexual appetite. So if this mom was a low-drive person beforehand and now with pregnancy she’s a high-drive person, she might be thinking, “hey this is what this is supposed to be like!” And then after she delivers, bam!, she’s back to being low-drive again. That can be a sign that something might be going on.

Hello Sunshine: For moms who are experiencing trauma/pain or low sex drive, what are some secrets that can help them get back to Sexy-town?

Dr. Corey Babb: A lot of it is discovering and appreciating the changes in your post-baby body. You’ve seen those statues of fertile pagan goddesses. They’re very voluptuous—you know, they have all the curves in all the right places. And that is a sensuality that a lot of husbands and partners appreciate. After a mom has a baby, she’s got this new physique, this new form. Appreciate that. As you get a little closer to a year the breasts begin to become a little more sexual to mom too.

So you start off very slow, with just kissing. Then the next time, it might progresses to “heavy petting” (I don’t even know if people say that anymore, but…) And of course there are other ways to get your partner to orgasm that doesn’t include penetration. If you have patients that are comfortable with it, you can recommend masturbating, whether it’s mutual masturbation or singular masturbation, a few times throughout the week and see if that increases your sex drive. The more you use your libido the stronger it gets; the less you use it, the more it atrophies.

And also remember that your body changes after delivery. Things that felt good before might not feel as good now, and the opposite of that is true too. A lot of times there is anxiety with penetration itself, and that anxiety is killer for both parties—it can contribute to psychogenic erectile dysfunction for men, vaginal pain syndromes for women, and also it can inhibit arousal as well. If the couple is anxious about having sex, I’d say don’t worry about penetration. Think: “we’re just having fun!” And that can kind of ease things in. And if it gets to the point where they’re aroused and in the mood, then it can feel like success—like “Aha! I can do this now.”

Obviously there are medications that we can use too. If we have a patient who comes in for a sexual dysfunction workup and we draw labs, there are certain things that can be off that we can fix with hormone supplementation and medications for arousal. We can compound oxytocin to help with orgasm. We can also use physical therapy, and sexual psychotherapy if it really is more of a psychological thing.

This is such a taboo subject that many people don’t think to ask their providers, and unfortunately a lot of providers don’t know much about it either. I have a couple of patients who were told “just go have more sex, that will fix your sex problem.” Well, no, it doesn’t really work like that.

Sex is never something that should be painful. If you are not lubricated enough temporarily, well then okay, but it should not ever hurt all the time. No matter what age group you are in—whether that’s reproductive, postpartum, menopausal—you should still have some sex drive.

Hello Sunshine: So what should a mom do if she’s unsatisfied with how sex has been going post-baby and would like help?

Dr. Corey Babb: Sure, well, my practice is now open for sexual medicine patients. During the first visit, which is really 30 minutes to an hour long, we do a full exam, run labs, and assess for the trio of components—anatomical, hormonal and psycho-social. Okay, let me just explain that. Sexuality as a whole can be divided into 3 separate areas that we like to imagine as a triangle. First, there’s the anatomic component of your reproductive organs, second there’s the hormonal component—the hormones that control sex drive, arousal, and some of the non-sexual hormones that are important for regulating your blood pressure, heart rate, things like that. The third is the psycho-social component—looking into previous trauma, something that’s caused these sexual events to be less than satisfying, nervousness or anxiety about having sex, feelings of inadequacy, social stigma, and things around arousal as a whole. So looking at all of those things together makes up the triangle. If even one of those things is not in tact then the triangle collapses.

It’s really my job as a sexual medicine specialist to try and find out if there is something there that is an actual dysfunction or is it more just a temporary change in the norm that can be improved upon.

Hello Sunshine: Thank you so much for all this great info and for your time.

Dr. Corey Babb: Sure thing. Thank you!

If you’d like to set up a visit with Dr. Babb to talk about your sexual health, you can reach him at:
OSU Physicians Houston Center OB/GYN
717 S Houston Ave #200, Tulsa, OK 74127
918.586.4500

New Study: Moms Need More Time To Push

bethanie verduzco — Tue, 22 Mar 2016 15:09:14 -0400

Ok, I'll get straight to it. A new study published this month in the American Journal of Obstetrics and Gynecology found that allowing women just one more hour of pushing during labor can cut their c-section rate in half. In half, folks!

The American College of Obstetricians and Gynecologists (ACOG) typically gives laboring moms 2 hours to push (without epidural anesthesia) and 3 hours (with epidural anesthesia). Anything longer than that is considered a “prolonged second stage of labor,” which could lead to medical interventions. Think: vacuum extractor, forceps, or c-section.

But what if these time limits on pushing were actually arbitrary? Or if not arbitrary, definitely archaic. ACOG’s time limits 2 hour/3 hour are, seriously and this is not a joke, based on commonly held beliefs of the 1800s. (Think about how much birth and life have changed since then!) When reassessed in the 1950s, researchers did not conduct new, scientific studies, but opted to look over earlier data instead. They found that women typically took about 2 hours without anesthesia to birth their babies, and that those women who delivered within 2 hours seemed to have lower rates of infection and postpartum hemorrhage. But these were not clinical studies. There was no random control. Just opinion. And unfortunately this is still what many OBs base their decisions on today.

Of course, when medically necessary, cesarean sections are serious life-savers for moms and babies. No doubt about that! But at a whopping 13-22% over the World Health Organization’s ideal cesarean rate of 10-19%, we know we have a problem. Far too many cesareans preformed in the US each year are not medically necessary and could be prevented.

How could they be prevented? Well, in part, there’s a pretty simple solution. To just be a bit more patient. If allowing women to push for just one more hour can cut the c-section rate in half (and without any statistical difference in maternal or neonatal outcomes), imagine what relaxing time constraints on other stages and phases of labor could do as well!

This is to a large degree what the New Guidelines for the Safe Prevention of Cesarean Sections, published in March of 2014, has shown. The Guidelines state that OBs should be more patient with slow labors (especially if mom is 6cm dilated or less), that they shouldn’t be inducing moms before 41 weeks (unless there’s an actual, individualized medical reason), and that we should allow longer durations of labor on a person-to-person basis.

But haven’t we moms been saying this for a while? Just put the brakes on a bit and let our bodies do what they need to do. Of course we want our care-providers to be attentive and conscientious and to step in if medical intervention is necessary. But much of the time we just want them to sit on their hands, trust the process and let us mamas rock our birth.

Clara's Birth Story

bethanie verduzco — Wed, 16 Mar 2016 17:04:00 -0400

It's Spring Break this week and despite an ugly stomach bug being passed around our house, the Verduzco family is feelin' pretty good. With no school and no schedules, we've been doing a whole lot of nothing. Lots of yard-time, watching-others-walking-dogs-time, reading-Harry-Potter-time, and thoughtlessly-thrown-together-meals-in-front-of-a-family-movie-time. It's the best.

Those first days of Spring, when you can venture out barefoot without thinking twice and when the sunlight stretches on well past dinner time, everything just feels more possible. For me, this new weather just oozes hope and optimism. So many exciting changes on the horizon, friends.

And on that note, I'd like to share this beautiful and inspiring birth story with you. Think big babies make labor more difficult? Been told that having Pitocin will necessitate an epidural or eventual c-section? Well, this story proves that every birth is different (just like every mother and every baby) and that anything is possible when you get down to business.

So here is the story of Clara's birth, told by her amazingly strong and intuitive mother. Happy reading and happy Spring!

We started trying to become pregnant in December, when our first child was 10 months old. I really wanted to have 2 kids and wanted them close together. It didn’t happen until I stopped breastfeeding my son when he was 14 months. I got pregnant that month, April.

I found out I was pregnant on a typical Sunday. I got up super early with my son, who was up before 6am. I got him changed and went to the bathroom. I remembered that my period was a few days late, and decided to take a home pregnancy test. I didn’t think much of it, I was always irregular anyways, so I just peed on the stick and went to run after my son, give him breakfast, to eat, and so on. I forgot all about the test. Mid-morning, when I went back to use the bathroom, I saw the test laying there, with the 2 red stripes! I was pregnant!! Even though we were trying, I was super surprised! And very excited. I woke my husband up to tell him and he was very excited as well! I told my son too, who had no idea what I was talking about.

I had a good and healthy pregnancy, but felt a lot of nausea until about 5 months along. Many smells would make me gag or throw up such as poopy diapers, the hot car, and the fridge. I don’t like to take medications, so I just toughed it out, but at about week 20, I started taking medication and felt better. Since then, it was just like I wasn’t pregnant. My busy work routine and my son kept me very busy and I felt great!

As I was preparing for labor and deliver I investigated alternatives to the traditional birth assisted by an OBGYN in a hospital. I had that before and it was fine, but I wanted to have a more natural birth. I toured different facilities and talked to a lot of people, but at the end, due to finances and my family’s comfort level, I decided to stick with a hospital birth and the same OBGYN, but try for very natural birth with very little medical interventions.

At about week 32 I started feeling pressure on my lower belly and random, very mild contractions. At my 36 week appointment my doctor said that I was starting to dilate so she was confident that I wouldn’t make to my due date of December 30th and that baby would be here before Christmas!

I started my maternity leave on December 19th and the waiting period began. I was feeling lots of pressure, baby was in position, my cervix had started to dilate and efface so I knew it could be any minute! At every appointment my doctor would say that she couldn’t believe the baby wasn’t out yet, that second babies tend to arrive earlier, which made me a bit anxious as well.
Christmas came and went, my due date passed, the New Year arrived and I was feeling even more pressure on my lower belly/cervix (to the point that I was walking with my legs spread apart!).

Having had a medical induction with my first baby at 40w6d, I expected this baby to be late – contrary to what the doctor was saying, but I was adamant that I did not want to have another medical (Pitocin) induction. I wanted to wait for the baby to come whenever she wanted to!
I tried as many of the natural induction techniques as I could, I walked a lot (mostly chasing my son), bounced on the yoga ball, ate pineapple and spicy foods, drank cinnamon tea, danced, did prenatal yoga and even had 2 acupuncture sessions and kept pressing the induction points. The pressure on my lower belly was very strong and I felt contractions all day long, just not regularly. They would come and go depending on what I was doing. It was like I was in early labor for 2 weeks – just uncomfortable but not painful, but it didn’t progress to active labor.

On January 5, when I was 40w6d pregnant, I went back to the doctor who told me that I had to be induced the next day, at 41 weeks. My cervix was already 6 cm dilated and over 50% effaced. I argued that I didn’t want another induction, but compromised with the fact that they would only break my water and wait as long as possible for labor to start on its own before starting the medication. I was to be at the hospital the next day at 6am.

I was very torn and upset. On the one hand I was ready for the baby to be out, but in the other I really wanted to start labor naturally and I didn’t want another long induction, knowing that 50% of inductions end in cesarean births. I just wanted to push the baby out whenever she was ready to come out! I had a hard time falling asleep and staying asleep that night and I was very emotional.

On January 6 we woke up late, about 7am – the alarm didn’t go off! We rushed to get ready and the hospital called me to make sure that I was on my way. I didn’t care I was late – I didn’t want the induction! When we arrived about 7:30am, the nurses hurried to check me in and get me prepped, since the doctor would come and break my water before a surgery at 8am. They asked for my birth plan/preferences and started to follow them – no IV, no ties to a bed, no offer of drugs, etc. I was feeling great that morning, lots of pressure, sporadic contractions, no different than the day before.

At 8:07 the doctor broke my water. He made several “cuts” but no amniotic fluid came out, since the baby’s head was already right there, like a cork in a bottle. My cervix was 7cm and 75% effaced. He said I was a perfect candidate for having a natural birth since I was already so close. As soon as that happened, I started feeling strong contractions. I remember thinking: “Oh my gosh, this is painful! I am prepared for hours of this?“ After the nurse monitored a few contractions and the baby heartbeat, she told me I was free to walk around, but to check back in one hour.

I got up and started to walk around the maternity floor with my husband. Every few steps a contraction would hit and I had to stop and lean on him. I was walking really slowly and the contractions were very close together. It took a long time to just loop around that small area. I was just focused inward, in breathing through the contractions. My sister also arrived at that time and walked to the room with me and my husband.

Back in the room, I sat on a little stool, and when I did, my water finally gushed out. I felt like I had to push, but it had been just over an hour since by water had been broken! I asked the nurse to check me and she said that she could give me some more time before I needed to be checked. I said no – “can you check me right now?” Very slowly I laid down – it was painful and uncomfortable to lay down, I wanted to sit – and she checked me. I was 10 cm and ready to push! The nurse called the doctor and one pediatric nurse and they started to set up the room, while I set up on the bed and waited for them to be ready and the doctor to arrive for me to start pushing. I had thought that I would want to squat down, or be on all fours to push, but it was all very fast and sitting up in bed was just fine.

I pushed really hard about 3 times and in less than 5 minutes, baby Clara was out! At 8:57am, weighing 10lbs11oz and measuring 22.5 inches. I didn’t believe how fast everything was! She was already out and in my arms and crying very loudly! Her head had quite a few scratches, though, from when the doctor broke my water.

The Yoga of Parenting: 7 Practical How-To's

bethanie verduzco — Wed, 02 Mar 2016 21:38:49 -0500

Last week I sat down with Mandy Eubanks, founder of Tulsa's Everyone Yoga School, to talk about the Yoga of Parenting. Mandy has over 12 years of teaching experience, and is certified to teach pre-natal yoga through OmMama as well as a Trauma Informed Yoga Therapist and Overcoming Anxiety Clinic Facilitator. It was a fantastic conversation, one that I've probably been needing to have since becoming a mother 6+ years ago. Her insights kind of blew my mind.

So, what is the Yoga of Parenting? Mandy explains that “although we might think of yoga as a physical practice, something that we do to stretch our bodies or get stronger, the part of the yogic tradition specific to parenting is what we can do with our nervous system through meditation and self-care. We can use practices like deep breathing, meditation, intuition, and becoming aware of our thoughts and reactions, as tools to help us be more joyful in our parenting life.”

Today I want to share 7 tips to becoming a more balanced and mindful parent, inspired by Mandy's yogi-mama wisdom!

1. Practice self care. This is number one for a reason! As mamas we are constantly giving, giving, giving. Our days are filled to overflow with nursing, diaper changing, not-sleeping, soothing, errand-running, soothing, feeding, cleaning, playing, soothing and coping that we can feel totally depleted by the end of the day. Or more realistically, by 10:00 in the morning. When we're in the thick of it, it’s easy to see taking a shower, stretching, or sitting in silence, even for 5 minutes, as a luxury. But self-care is NOT a luxury—it’s an absolute necessity. How can we be patient and understanding with our babies if we’re totally frazzled and burned out ourselves? We can’t. So put on that oxygen mask, mama, and take a deep breath.

Tools for practicing self-care:

Put Post-its around the house with small reminders for yourself like, “take a deep breath,” “sit and have a cup of tea,” and “you’re are doing enough.”
Set up a few phone reminders to go off throughout the day. Whether it’s a reminder to appreciate, stretch, breathe, call a friend, or turn up the Adele and sing like a wild banshee, give yourself permission to do something for yourself in that moment.
Write a list of things you need on a regular basis to make you feel like your cup is full. Pin it to the fridge. If you’re fortunate to have a partner, they can do this too. That way you’ll be aware of what you need to feel taken care of, especially in those moments of motherly panic. And so will they.
Make a self-care chart. Write “Self-Care” at the top and divide the page into four boxes. Label the boxes: 5 minutes, 1 hour, 4 hours, 1 whole day. And then fill in the boxes with what you would do if you had each of those times all to yourself. Having a whole day to yourself might seem like outright fantasy right now, but we can usually find 5 minutes. Maybe it’s “wash my face,” or “listen to a whole song that makes me happy,” or “go outside and feel the sunshine.” Small things make a big difference.

2. Get Grounded. As mamas, we need serious tools to help ground us. When your 3 year old starts melting down in the grocery store (and you just have 2 more aisles to go!) it’s completely natural to feel your blood pressure start to rise and your head start to spin with anxiety. But if we can stop for just a moment, enough to recognize what’s happening, why our little one might be losing it, and take steps to get grounded, we might be able to survive the grocery store in one (decently healthy) piece.

Tools for getting grounded:

become aware of our body by repeating the mantra, “I can feel my body, I can feel my breath.”
Take a couple of good, deep breaths, exhaling all the way out.
Feel your feet on the ground, and wiggle your toes.
Do a mudra with your hands. How? Press the top of your pointer finger into the pad of your thumb, and curl your other 3 fingers into your palm. Squeeze gently and remember to breathe.

3. Build Up Your Resources. Whether it’s sitting in silence, meditating, walking, stretching, doing yoga or anything else that helps fill your cup, being consistent with a daily ritual is key. I know it’s not easy to find the time, and yes, some days it is impossible. But look at it as a mental health insurance policy. You’ve got to build up your resources so that when shit goes down in baby town, you’ll feel strong enough to face it.

Tools for building up your resources:

Wake up 10-15 minutes earlier each day to stretch, sit quietly or meditate before the day begins.
Use the first 10 minutes of your kiddo’s nap to sit outside, breathe the fresh air and drink a cup of tea or coffee start to finish.
If meditating alone is hard for you, start with a guided meditation. Download a meditation podcast and choose a guided meditation that fits your time frame. Maybe it’s a 3 minute meditation for relaxation or a 5 minute meditation for acceptance.
If you have a supportive partner, have them watch your child while you take 20 minutes in the evening to go for a relaxing walk or run. Pay attention to what’s around you—what do you hear, smell, see, and feel—and be present.

4. Model Self-Care. Parenting is not always sunshine and rainbows. There are days when life with a little one can be totally maddening. But we've got to remember to take care of ourselves! Instead of feeling guilty about frustration and burn out, we can actually appreciate our body’s ability to recognize these emotions. Acknowledging that we’re nearing our limit is actually a fantastic opportunity to set boundaries and model some self-care. Your little ones will see you actively asserting what you need. As parents, we focus so much on what we should be teaching our kids that we forget that we are teaching our kids. In every moment. With every interaction. Whether we mean to or not. (Oy.)

Tools for modeling self-care:

When you feel yourself getting tense or anxious, recognize that you’re feeling out of balance and check in with yourself about what you need in this moment. Maybe it’s calling in that pizza instead of trying to finish dinner, canceling that play date, or letting your toddler watch an hour (or two) of Kipper so that you can rest and recharge.
Be clear with others about what you need. And the more you can recognize this, the easier it will be to convey it to others.
No guilt! Remember that you’re teaching your little one a valuable life lesson when you take care of yourself.
Create an accountability group with a couple of close friends who have babies roughly the same age as yours. Agree that you have permission to reach out for support whenever you need to, regardless of time-of-day, before you hit your scary-mommy limit. Be sure to do the same for them in return.

5. Acknowledge Emotions (Without Blame). As much as we struggle with them and try to push them away, our emotions are there to tell us something. They always have a purpose. Emotions are flags that help us identify when something is getting out of balance, that we’re getting a bit crispy or burned out.

Tools for acknowledging emotions:

Shout your feelings towards the sky instead of shouting at the kids. Screaming things like, “I’m SO MAD right now!” or “I’m just SO TIRED!” helps you get your feelings out and, at the same time, shows your little ones that it’s okay to express their emotions neutrally, without being hurtful to others.
Label your child’s emotions when they’re having a rough time. A simple statement like “Oh, wow, you seem really disappointed right now,” can feel so validating and can help your little one develop their emotional vocabulary.

6. Practice Radical Self-Acceptance. It's as simple and as difficult as that. Trust that you’re doing the best you can. That’s all we can do, and it will almost definitely be enough. So stop judging your every-motherly-move and soften a little toward yourself. You deserve compassion and love, too, sweet mama!

Tools for practicing radical self-acceptance:

Find a mantra that resonates and makes you feel good about yourself. Maybe it’s “I am enough” or “I am love.”
Take 1 or 2 minutes to close your eyes, breathe deeply and smile.
Practice self-care again and again!

7. Find/Create Community. Parenthood can be intensely isolating. We look at other parents and they seem to be managing life with their child just fiiiiiiine. And we spend so much time on Facebook, our feeds slathered with filtered images of adorable sleeping babies and giggling children making art. We know those peacefully sleeping babies woke up screaming 2 minutes later for no known reason and those happy, art-loving children just decided they didn’t want to paint after all, right after mama got them all set up. (If this Facebook talk resonates for you, you’re going to want to read this as well.)

But really, I can’t emphasize it enough: We need to be honest and open about our struggles when talking to other parents. We cannot go on feeling so alone. As parents, we need to feel safe and vulnerable and validated, and we need to support each other.

Tools for Finding/Creating Community:

If you’re starting from community-making-ground-zero, here are a few ideas to get your started: join a Facebook mama group whose focus you care about but one that also meets in real life, do the library story time circuit, join a mommy-and-me yoga class or walking group (and stick around a bit afterwards to chat). Sometimes even a small but sincere compliment to the mom next to you at the coffee shop can spark the beginning of a friendship.
Surround yourself with people who take care of themselves. Self-care is contagious!
Be honest about how effing hard parenthood is. Finding one or two friends you can trust with your darkest motherly confessions can be a serious game changer.
Consider finding an accountability buddy for self-care check-ins. Call each other at a specified time each week (or better yet, each day!) and ask, “what are you doing in this moment to take care of yourself?” Of course, you can also check-in by text, but phone has the added bonus of actual adult-human contact (which, during those early months at home with baby, can be rare and so very valuable).
Hold space for other parents. Listen without judgement, giving advice or trying to fix their problem. Just be present for them, it will mean more than anything.

13 Questions Every VBAC Mom Should Ask

bethanie verduzco — Thu, 25 Feb 2016 18:32:26 -0500

I love working with VBAC families. I do. There’s something really special about these people. They are passionate about the birth they want and are so beautifully committed to doing the work necessary to achieve it. Oftentimes, these families have to work through some pretty intense emotion, trauma and fear from their previous birth experience. But by processing these memories and preparing themselves for a different, more empowered birth this time around, VBAC moms tend to feel an even greater sense of ownership over their experience and become quite mighty in their resolve.

It goes without saying that VBACs are different. Of course they are, and for a lot of reasons. But in my experience as a doula I've noticed that moms attempting VBACs are more likely than non-VBAC moms to experience dramatic psychological and emotional ups and downs throughout their pregnancies. Constantly asking themselves questions like: Can I really do this? And what happens if I can’t? Will I dilate? Will baby fit?

And to further clutter a VBAC mama’s head space, there’s also the care-provider variable. If you’re lucky enough to live in a city where there are experienced VBAC-friendly care-providers who trust birthing mothers as well as the current research, then yay! That is so wonderfully fantastic!

But VBACs can still be touchy for a good number of care-providers--over the past 40 years, the history of VBACs in America has been quite a saga. If you’re interested in learning more about this complex and stormy history, you can read about it here. But many OBs and midwives are not able (for insurance or policy reasons) to take on VBAC patients, and some simply aren’t interested. As Jen Kamel of VBACfacts.com says, "There are three types of care providers: those that are VBAC supportive, those that are not, and those that pretend to be until the last minute." Unless your care-provider has a rock-solid-VBAC-friendly reputation in your community (or you've had your own previous VBAC with them before...in which case you might not be reading this post...) you can never really be 100% certain in which camp they belong. But you can do your research and know what questions to ask ahead of time so that you can be prepared for the best VBAC experience possible!

13 Questions Every VBAC Mom Should Ask:

1. What’s your philosophy on VBACs? This nice, open-ended question allows your care-provider to give her/his honest opinion.

2. How comfortable are you with a trial of labor? If their answer is anywhere in the realm of “not so much,” this is a nice and tidy signal to you to start interviewing other providers. Because the truth is: if they’re nervous or uncomfortable, they will not be caring for you confidently. And this lack of confidence will not serve you, your care-provider, or your baby well.

3. What’s your philosophy on big babies? It’s not uncommon for a care-provider to sweep the VBAC rug out from under a mom because they suspect a “big baby.” The idea is that the baby’s shoulders might get stuck in mom’s pelvis, a condition called shoulder dystocia. But the American College of Obstetrics and Gynecology (ACOG) states that there is no value in inducing for “big baby” since it simply doubles the cesarean rate and does not prevent shoulder dystocia or reduce newborn morbidity. Nor do they support cesarean section for suspected “big babies.” Many care-providers do things one way simply because their comfortable in their routine. Make sure your chosen care-provider is following ACOG guidelines and making decisions based on evidence, not solely on what they've always done.

4. At what gestational week do you like to see VBAC babies born? This one is a biggie. There is a huge discrepancy between care-providers when it comes to this question. Some providers require that you’re induced with Pitocin at 38 weeks, some refuse to induce at all and require that you have an automatic c-section without a trial of labor at 40 weeks. Others are fine with you going to 41 weeks and inducing then. Still others are okay going to 42 weeks, as long as your baby’s biophysical profile seems solid. There are risks and benefits to each of these options, so do your research and ask for specifics.

5. What method(s) do you use for VBAC inductions? According to the research, Cytotec and Cervadil—prostaglandin cervical ripening drugs—have a greater risk of causing uterine rupture than Pitocin, or synthetic oxytocin. So if your care-provider suggests Cytotec or Cervadil, this might be a red flag and an opportunity to seek a second opinion.

6. What are the benefits to mothers of having a successful VBAC? Funny question, maybe. But ideally, the answer would have an emotional component along with the all of the benefits to having a non-surgical birth. Mothers who are successful at having a vaginal birth after cesarean can feel an overwhelming sense of accomplishment and pride, which carries over to a greater sense of postpartum confidence and emotional attachment with their babies. Care-providers who can appreciate the emotional aspects of birth are probably going to be more sensitive and supportive of your personal goals. No research on this. Just sayin'.

7. What kind of fetal monitoring do you require? Continuous fetal monitoring is common in most practices, but a few providers who are more comfortable with VBACs will allow intermittent fetal monitoring (i.e 20 minutes on the monitor per hour). There are some care-providers, however, who will require internal fetal monitoring (IFM), although ACOG has stated that IFM does not help in diagnosing uterine rupture. IFM also requires that your bag of waters be broken, which carries it's own risks. Read up, be informed.

8. Do you require an IV in labor or would you be comfortable with me having a saline/heparin lock? Many care-providers like their patients to have an IV in place during labor so that if they need to perform an emergency cesarean, the IV would already be in place. Others are comfortable with having just the port in and ready to go in case of emergency. IVs can be uncomfortable, can somewhat limit mobility, and can lead to breastfeeding difficulties and higher weight loss percentage for babies in the first days postpartum.

9. How does your on-call schedule work? Will you be on-call for me no matter what or is there a chance I could end up with someone else? This matters to many moms for personal reasons. Maybe they just like the care-provider they’ve chosen or maybe they’ve had trouble with an unfamiliar care-giver in the past and want to avoid a similar experience this time around. But for VBAC moms, there’s also the added element of: what if the on-call doctor/midwife isn’t VBAC-supportive? What will happen then? Flesh out these what-ifs, ask your care-provider for specifics and make an informed decision.

10. Out of the last 10 VBAC candidates you’ve had, how many have been successful? I kind of loathe the language of “successful” versus “unsuccessful” here—there is no failure in birth! But this is the language your care-provider will most likely use. So asking this question can give you an idea of how comfortable and supportive your care-provider is with VBACs. In general, 70 percent of women who are considered candidates for a VBAC end up having a successful vaginal birth. So if your care-provider’s numbers are at 7 or above, that could be a pretty good rate. You can also politely ask your care-provider to take you through the cases that resulted in cesareans—what happened and how were those births managed?

11. Once my water has broken, will I be on a time clock? At what point would you suggest a c-section? Some care-providers say as few as 12 hours, others will “let you go” a couple of days. Every provider will have a different answer to this one, so it’s important to ask.

12. Do you suggest or require an epidural? For some care-providers who feel less comfortable supporting VBACs, requiring an epidural for all patients can be a cautionary intervention in case of a c-section. If you’re already numb, it makes for a quicker cesarean. There is no actual evidence to support this. It’s simply routine practice for some care-providers and it can be a pretty clear red flag.

13. In the case that a cesarean became medically necessary, do you offer family-centered cesareans? Family-centered cesareans take the family’s birth wishes into account and provide for a more personalized and positive birth experience—mom and partner are included in and kept informed throughout the procedure, mom’s arms are free and unrestrained, the lights might be dimmed, the staff might be speaking in quiet voices, you can bring your own music, the drape can be lowered so mom can see baby being born, and baby goes immediately skin-to-skin upon delivery. Family-centered cesareans are a relatively new gig, so if your care-provider doesn’t offer them as an option, remember that you can still advocate for specific elements like skin-to-skin and/or having your arms unrestrained. It’s also helpful to have that conversation prenatally rather than waiting until you’re in the moment. And if you want to know more about cesarean options, here's a blog post with 18 amazing possibilities!

And a friendly note to end on: when posing questions to your care-provider it’s always a good idea to use a kind and non-threatening tone. You’re just gathering information you need to make a informed decision. It also helps to be understanding of your care-provider’s professional boundaries and to recognize that it’s unfair to ask them to practice outside of their comfort zone. If you aren’t happy with the answers you get, I would urge you to interview a few other care-providers and find someone who will support your goals. The decision is yours, my friend.

Quinn's Birth Story

bethanie verduzco — Wed, 10 Feb 2016 12:59:09 -0500

I am so excited and honored to be able to share Baby Quinn's incredible birth story with you guys today! All birth stories are fabulous, of course, but in how many can you expect to find a tiny Thai grandma who loudly details her secret to crispy ham while you're in labor and then offers to catch the baby for you? Not many, my friends, not many.

Written by his Xena Warrior Princess mom Alyssa, Baby Quinn's birth story is hilarious and inspirational. And it highlights how deeply birth touches us and can change who we are forever.

So here it is...

I told myself that night that I was going to sleep until 2pm the next day, no matter what. It was January 21st, 6 days before my estimated due date. That night we ate nasty hamburger helper (we NEVER eat hamburger helper in our house, but it was a long day, we were low on groceries, and had a donated box in our cabinet), then went to bed. I woke up around 11:30 am with a stomach ache. I could feel that it wasn’t 2pm, and I was very serious about my sleep goal. Well, the pains persisted so at last I opened my eyes at 11:50. PISSED. I used the rest room and when I wiped it was slightly pink. Not enough to be a bloody show though. It’s just false labor, getting me prepared for baby. So I called Alex and asked: do you have rot gut from that hamburger helper? he said no. Of course in the back of my head I kinda thought “hmmmm… labor?” No no no, I don’t want to go thinking that and then be one of those girls who had a mild stomach ache & though it was labor, you know! I told Alex to not think about it too much, & that I'd let him know if things changed. then I took a bath, and the pains stopped. Whoa! What’s that mean?! At that point I realized this is no hamburger helper, it’s probably just false labor.

The pains starting coming off and on. Not consistent at all. Sometimes very light, sometimes very short, and in weird breaks. FOR SURE FALSE LABOR. So I took a bath and had a talk with baby.

I said things like “Quinn, you can come today if you want to. We’re all so excited to meet you & love on you. Now, if you are going to come today i just need you to be a little more consistent, let me know if these are real contractions.” I wouldn’t say that immediately my contractions became more consistent and stronger, but after I got out of the bath I did start to feel them more regularly.

I decided I needed to clean up the house. I had a list of things I needed to do. So as I started doing dishes, my grandma calls me—my little fireball, bossy, Miss Independent, 4’11, Thai grandma! Now she’s got a lot to say all of the time, and in a very abrupt way. So of course here I am in some sort of labor (I’m thinking false) but it’s still intense enough to not want to deal with grandma! But I’m also all about signs and things falling into place exactly how they should. I thought to myself: “Alyssa, if you are in labor, who better to talk to than your grandma who’s had 4 children, all natural with labors lasting less than 2 hours?” So I answered.

She wanted to come over, so I said okay. When she arrived, I told her I thought I might be in labor. My grandma likes to give directions and advice—she said: “that’s why you want to clean! Before I had your uncle I was cooking meatballs and hanging clothes on the line!” DEAR GOD, here we go. I love it, of course, but I was also dealing with these weird cramps. She told me to sit down and eat, and she brought me food. Score. She would clean for me. Score. Then she starts to talk about how she gets the ham to be crispy on the edges, how my best friend Jazimine needs to take up this nanny job where she drives a huge van full of 6 children to Kung Fu, how my boyfriend needs to teach guitar lessons etc. My head is going in and out at this point. I really do want to listen, but when the cramps come I'm like: “Wuh are you talking about? Crispy ham, oh, okay...”

Pretty quickly, though I started to realize I needed some space.

But my mom calls instead. “Hi mom. Yes, grandma is here, yes, I’m having contractions. I don’t think they are the real deal…grandma is telling me that she can deliver my baby at home for me & cut the cord. OKAY, grandma, please stop talking, I can’t hear mom…”

At this point I was feeling pretty poopy. Literally. I just kept pooping and pooping. It felt really good to be on the toilet. My grandma was wanting to stick around since she didn’t want me to go into full blown labor and be all alone at my house. I appreciated this, but at the same time felt like I needed some more low key vibes.

I went back to the toilet and texted Alex: Grandma left. Jazz is coming. over. i’m pooping a lot. ruth said wait.it out. the contractions. are more spaced apart, 10 min, but more consistent, harder & longer.
He says: ha. we excite. can’t help. gonna have baby. morning. maybe? i love you so much!

After grandma left and Jazimine arrived, things started really progressing. I tried to lay down to do the whole rest thing, because I’d heard that in early labor some women can get really anxious and use up a lot of energy that they will need later on during active labor, so trying to sleep if you can or at least getting rest is very important. But I could NOT lay down. It felt terrible.

I took a little bath and then texted my midwife, Ruth. She said that we wouldn’t know for sure if this was it or not unless she checked me, and that I should head to the birth center soon. At this point things started moving very fast. I told Jazimine that we needed to get a move on. Then my mind starting going crazy because I didn’t want to forget any of the things on my birth bag list: snacks, music, crystals, oils, blah blah and blah! And I was still naked. At some point I’d shed all my clothes. So I start getting all these snacks & random things, throwing them into bags with no certain order. I also needed to put clothes on so we could get out the door, but I’m still having contractions!!

About the clothes… I ended up feeling all anxious and uncomfortable so I picked out the weirdest outfit—one of Alex’s dirty, size XL shirts, no bra, a pair of lacy underwear, and a scarf wrapped around my waist as a skirt. I looked like a hobo going to the beach.

About the contractions…once they started getting heavier I needed to breathe through them and literally stop what I was doing and move my body around. The first contractions looked on the outside like I wasn’t having any, all I needed to do to get through them was focus inward and stop talking. But with the later ones, I had to either be bent over where my knees were on the ground and I was over the couch like I was praying. Standing and shifting my hips back and forth helped. And again, being on the toilet was awesome. I couldn’t imagine being a woman in the hospital confined to the bed while having contractions. I would have been a force to be reckoned with!

We got to the birth center and I was happy to see that Alex was already there, but I was honestly more focused on myself at that point. I get out of the car and the first thing Alex says to me is: “can I help you?” I say: “I don’t know what with!” Rude, but so true.

We go into my midwife Ruth’s office, and she watches me have a contraction. She rubs my back for me, and asks if this helps at all. By golly it does! I’m not someone who really likes to be touched by people besides my boyfriend, but man I liked getting my lower back rubbed through a contraction. Then she has me get up on the exam table to check me. Now that was hard! Lying on your back while you’re having back labor takes determination. Ruth checks me and announces that I’m dilated to an 8. WHOA!! Time to kick it into high gear. I remind her that I want a water-birth in the big tub. She lets me know that it takes a while to get the water filled up because it’s so big and the water has to be a certain temp. So I’m telling myself okay, just hold on for 20 more minutes. I’m hunched over her office couch in the praying position, hating the UV lights, wondering if I’m bleeding all over her rug, and also thinking about how this is the room where all the ladies have their appointments and how I’m in there now half naked and extremely vulnerable. Alex is trying to comfort me in whatever way he knows how.

One the tub fills up enough for me to get into it, then it all starts happening! I had a lot of inner dialogue start. I’m having one contraction after another. Alex is right beside me the entire time, outside of the tub. Ruth, her assistant and my aunt—who had just joined us—kept telling me “oh, you’re doing so good.” And I’m thinking “yeah yeah, this is what you tell all the ladies.”

I didn’t have any time or care to set up my crystal medicine wheel that I had planned for, but I noticed afterwards that Jazimine had set up a few essential stones around the bath tub. She also set up her essential oil diffuser, and this is when things go primal.

I felt from the inside that I had to make noises in order to help labor progress. I read a lot of Ina May Gaskin material during my pregnancy and a few things she said were resonating inside of me. First and foremost: keeping everything loose and low. Meaning all of my noises needed to be low and very throaty, nothing high pitch or screetch-like. And I had to remind myself not to scrunch up my shoulders, clench my fists, or purse of my lips. The reason being that the cervix and vagina are directly linked to the rest of the body, so if other parts of your body are tight, so is your cervix. And your cervix needs to be completely dilated for your baby to come out. Ruth was also helping me with these things—she reminded me to keep my bottom down and not to pick it up off the tub floor during a contraction, while at the same time keeping my shoulders down and loose.

Things started to significantly pick up. I felt very very high. but it was the most clean, mentally aware high. During a contraction I was completely out of the room and physical location, but my mind was ON! My inner dialogue was so clear & concise, and my intuition was speaking to me a surreal amount. The crazy part was that when I would fade out of a contraction things would switch. I would go from thinking a lot and being completely inward, to not thinking as clearly and being aware of the room and such. It was a unique state of awareness because everything was heavy looking & feeling, but I could sense that I was THERE, in a physical place. It’s so hard to describe.

At one point I reached down to see if I could feel the baby, but I didn’t do very much touching. I was curious but at the same time scared to feel the baby’s head (if I could). Ruth saw me reach down and encouraged me to try again and see if I could feel the baby’s head. I hardly touched because, again, I was nervous. But when I did, it felt kind of soft and weird. This freaked me out. So she reached down there to check and she let me know that she could feel the baby’s head. Whenever I felt the urge to push I could try.

The assistant kept needing to check the baby’s heartbeat with the doppler and I really hated this. I think I was mildly fighting it. Ruth had to explain to me that it was very important at this stage because the baby was in the birth canal. Oh shiz, the baby is right there huh?! I did start feeling that sensation of having to poop so I knew it was time to push. I kind of didn’t have a choice actually—my body needed me to push. So I started letting it happen.

Transition started to happen (the stage where it gets real & you have the potential to some what… freak out). And my transition didn’t consist of cussing people out, yelling for drugs, crying, and all that crap you see on tv or whatev. It did consist of me all of a sudden thinking I didn’t like the tub, knowing I needed a new position besides reclining in the tub, feeling kind of scared, and asking the universe/god for a tiny break. Just a little break. I didn’t want my labor to slow down or stop, but I needed a minute to gather my strength. My inner dialogue was so intense at this point, saying, “Alyssa it’s time to have your baby, he’s going to be here so so soon, you’re going to need to push him out.” Then I’m saying to my own self, “okay I WILL but I need a break… please?”

It’s lovely how the universe and we are one…because I got a break. I’m not sure exactly how long, but I’m thinking around 2 minutes. It felt good, and when it was happening i knew my prayers were being answered. I also knew that once this moment was over it was game time.

I was truly in the moment. I remember thinking that all of this was leading me to my baby. But I was not in a rush. I knew that it would all happen. Babies always come out, as Ina May says. I think this helped majorly. During labor you really just need to be a vessel and let it all go. You can’t hold back or try to be in control. Exist moment to moment.

Okay, so after the 2 minute break the real climax of transition happened. I thought I needed out of this tub—I needed relief. My mind caught itself and said “Alyssa, you don’t want out of the tub. You’re trying to escape something that in inescapable. Once you get out of the tub then what? What does that change? Don’t you want a water birth?”

I realized “yeah, what WOULD I do once I was out of the tub?!” So I stayed. Once I had the thought of getting out of the tub I knew I needed to change positions to be more efficient at pushing. I remembered an article I’d read about squatting during labor—how it shortens your birth canal and expands your pelvis. So I went with that. I held on to Alex’s hands and pulled back with each contraction/push. I wasn’t sure how to stay loose at this point. My inner dialogue kicked in again and said “forget staying loose now, you need to get your baby out.” Also, “you’re not really pushing. I know you’re scared but it takes work to get a baby out. remember all the birth stories you read about how women sweat during this stage? You’re not sweating, and you’re not working hard enough.” I was scared. It seemed really intense to have to push life out through your life, but I knew it was time. So with all my might I pushed my bottom out and pulled the crap out of Alex’s hands (poor guy). Then I thought for a split second: this is when ladies poop! oh well, who cares. I didn’t poop though because I spent all of pre-labor on the pot! Yayayay!

I don’t know how many pushes it took…maybe 3, maybe 5? Not very many, and out came little Quinn’s head. There was some burning feeling, but it was very mild. Once I told Ruth he was coming, she got in a more hands on position.

It all got so so so so so so so heavy at that moment. Did i say so?? It makes sense because once the baby’s head emerges that’s when the highest amount of oxytocin is released. EVER IN YOUR LIFE. I could feel Quinn on the outside and inside at the same time. Whoa, feeling little squirmy legs on the inside at the same time you can feel a little head on the outside—trippy. Ruth said his head is out, now try and push the rest of his body out. I wanted to see my baby so I gave a big girl push, and ta da! Welcome to the planet, baby boy! Out came Mr Slippery and he was placed in my arms.

My first comment was: he has so much hair! I didn’t cry or anything, because i didn’t feel emotional…I just felt complete. (I know that sounds corny but, come on, this is a birth story!) I just held him so close. My little man. Ruth let me know that I needed to keep his body in the water so he didn’t get cold. She checked my cord and all was good.

I was lifted to the moon!!! Everything gets pretty fuzzy and trippy feeling from this point on. In comes Alex’s mom, my mom, and my aunt. I’m still in the tub, of course, holding the baby, waiting for the cord to stop pulsing. Then after maybe 10 minutes, Alex cuts the limp white cord. And it’s time to deliver the placenta.

Say whaaaaa? I thought I was done!

Even though I’d read 43432189420045 birth stories and I knew this was part of it, I was still surprised when Ruth said I needed to push it out. I think I felt this way because I was so lifted and just thinking about my little cutie. Even though I didn’t want to, I pushed the goopy, squishy thing out. They placed it into a bag because I was getting it encapsulated.

I was told I needed to get out of the tub, but not too fast. They were kind of treating me like a fragile being, but I felt like Xena Warrior Princess, or like an elephant sized mama lion with wings. Ha! I kept wondering what’s the big deal, I feel GREAT!! But I guess blood loss and all that—they don’t want me passing out or whatev.

Quinn Somchai Hendrix was born on Janurary 22, 2014 at 5:40 pm at Tulsa’s Special Delivery Birth Center. 20 3/4 inches long, 7 lbs 6 ounces. His labor from beginning to end took about 5 and a half hours. Ruth Cobb was his midwife, Donna Rapp as the assistant. He didn’t cry at all the whole time he was passed from person to person being held. Alex and I did skin to skin with him and he was so alert and content. And we celebrated his 0 birthday at the center with family and friends with custard cake from Freddies.

A HUGE thank you to Alyssa for sharing her incredible story. You are one baddass baby-maker! (All content and images have been used with permission.)

How to Help a Friend Through Infertility

bethanie verduzco — Fri, 29 Jan 2016 12:39:57 -0500

photo credit: Mitya Ku

I write a lot about how to cope with the challenges of birth, breastfeeding and postpartum. And as we know, there are many: how to choose the right care-provider, aches and pains of pregnancy, coping with labor, navigating medical interventions, breastfeeding, sleep deprivation, postpartum mood disorders, advocating for yourself and your child, etc., etc.

We complain about it all, and it’s all very real. But there are many out there who would give anything (absolutely anything) for the chance to experience these challenges. One woman’s arduous night marathon-nursing a colicky baby would be another woman’s dream come true. This might resonate for those trying to conceive their first baby, but also for those struggling to conceive their second.

Infertility is, indeed, a very painful struggle. The pain is similar to the grief over losing a loved one, but it is unique because it is a recurring grief. Infertile people grieve the loss of the baby that they may never know. They grieve the loss of that baby who would have had mommy's nose and daddy's eyes. But, each month, there is the hope that maybe that baby will be conceived after all. No matter how hard they try to prepare themselves for bad news, they still hope that this month will be different. Then, the bad news comes again, and the grief washes over the infertile couple anew. This process happens month after month, year after year. It is like having a deep cut that keeps getting opened right when it starts to heal.
As the couple moves into infertility treatments, the pain increases while the bank account depletes. The tests are invasive and embarrassing to both parties, and you feel like the doctor has taken over your bedroom. And for all of this discomfort, you pay a lot of money.
Reaching a resolution can take years, so your infertile loved ones need your emotional support during this journey. Most people don't know what to say, so they wind up saying the wrong thing, which only makes the journey so much harder for their loved ones. Knowing what not to say is half of the battle to providing support. —Infertility Ettiquette, Resolve.org

The topic of infertility is so vast it deserves an on-going series of posts, so I’m not going to try to cover everything today. Along the same lines, I’ll be focusing on women for the purpose of this post, but let’s remember that women are not the only ones struggling with infertility. One third of infertility is female factor, one third is male factor, and one third is combined or unexplained. Both sexes experience the emotional trauma no matter who's factor it is. More to come in later posts.

Infertility effects about 12% of women 15–44 years of age in the United States, and many of these women are struggling through their conception journey alone. Right beside us. At work, at family get-togethers, in our intimate friends circles. Because infertility is still so stigmatized and difficult to talk about, many women choose to stay quiet. The ability or inability to conceive can be intimately connected to our sense of self, it can make a person feel like there’s something deeply wrong with them. To open up about this very personal struggle can leave many feeling raw and exposed. Just one thoughtless comment from another can signal to a woman that she’s not emotionally safe and put a quick end to that conversation…sometimes indefinitely.

It can be tricky to know what is helpful to say to someone struggling with infertility and what could be hurtful instead. So I polled some people on Facebook who have experienced infertility and asked: What were the most mindless/hurtful comments you received from others (even if unintended)? And what were the most thoughtful/supportive?

About 13 people responded with their stories. One of the women shared that, throughout the course of this battle, she has done IVF, IUI, had uterine surgery, used a donor egg, and suffered 5 heart-breaking miscarriages. She’s decided to keep her journey private and tell only a small handful of trusted people. This is why:

“I think what I don't want are the comments...the looks...the pity, even though I know and fully understand those comments and those looks come from a genuine place of love...they still sting. Because then come the questions...the probing questions from people...which I also fully understand are because they are curious and want to know a happy ending to this mess just like me, but again...I can't stand it. I know I can only speak for myself, but I know that all I truly want when I openly speak about this crazy maze of courage endurance is for someone to say I'm so sorry for your loss...and I'm here if you need anything. That's it.”

The responses I got from other women in my poll were overwhelmingly of the “slapped-in-the-face” variety. The vast majority had been hurt and even shamed for their infertility, while only a couple had had any positive feedback to relay at all.

The following are some of the actual comments they got from family, friends and acquaintances while trying to conceive. Let’s just make a quick note to never (ever) say these things to an infertile woman again:

“When are you going to have kids? You know how this works, right?”
“Are you guys EVER going to have kids?”
“Wow, that’s crazy, we always get pregnant on the first try.”
“Just relax, that’s when it will happen.”
“God must have a reason.”
“My husband can donate his sperm to you guys!”
“God will give you a child when you're ready.”
"If you stop trying so hard, it'll happen in a snap.”
“Maybe losing some weight would help…”
“Someday you’ll be a mom.”
"You can have one of my kids!"
“Why don’t you just adopt?”
"Maybe it's for the best that you can't, kids are hard.”
“Don’t worry, you’re young.”
“Just enjoy your freedom! You can do anything you want without having kids.”
“Well, at least you have one child…”
Every pregnancy announcement, especially when it was an oops, was especially hard.
The person who jokingly offers you their misbehaving child.... I would love your sweet angel!!!

Now, it’s not that others are trying to be unsupportive. It’s usually just the opposite. Seeing someone we care about in pain can be unsettling, and oftentimes our first reaction is to want to help. We need to “fix the problem” so that we won’t feel so uncomfortable. And we end up saying mindless things to move the conversation along—we compare her experiences to our own, we moralize about why this might be happening, we minimize what she’s actually going through. All to make us feel better.

But the thing we need to realize is: it’s not actually about us at all. Our job as friends, family members, co-workers, human beings, is to simply to be there. That’s it. Our role is to listen, to validate, and to empathize. It’s really not important what we think.

If our friend doesn’t want to do IVF or decides to stop trying altogether, we say, “great, I support you.” If our friend decides she doesn’t want to adopt, we say, “great, I support you.” If our friend doesn’t want to talk about her infertility, we say, “great, I support you and I’m always here if you change your mind.” It’s our job to sit with our friend in her pain—whether that’s in person or from a distance. It’s not our place to judge; and it’s not our place to fix.

But that doesn’t mean being totally passive either. It can be helpful to do some research, learning a bit about infertility treatments and what it might feel like to go through them. Each round of treatment can be an emotional roller coaster ride, full of anxiety, pain and often deep disappointment. It can affect every single aspect of a person’s life and can be extremely straining on a relationship. Your friend might or might not want to talk about what she’s going through, but doing a bit of research sends the message that you care and that you’re committed to walking alongside her on this journey.

So this brings us to the very short list of things that might be appropriate to say to someone struggling with infertility:

“It’s not fair.”
“Ugh, that sucks.”
“You don’t deserve this.”
“I’m here if you need anything.”
“I love you.”

Thank you so much for everyone who responded to my questions--I am so grateful for your honesty and openness. For more about what to say/do/not say/not do, read this blog post by “Hey Natalie Jean.”

Now, for those of you who have been through infertility: What were the most hurtful comments you’ve got? And what were the kindest?

More resources for supporting a friend through infertility:
http://www.resolve.org/support/for-family--friends/infertility-etiquette.html
http://www.cdc.gov/reproductivehealth/infertility/
http://www.resolve.org/about/fast-facts-about-fertility.html
http://www.sheknows.com/parenting/articles/991981/talking-about-infertility-shouldnt-be-taboo
http://www.resolve.org/national-infertility-awareness-week/25-things-to-say-and-not-to-say.html

How to Get Your Insurance to Cover Doula Services

bethanie verduzco — Thu, 21 Jan 2016 14:21:54 -0500

While doulas are known mostly for the emotional, physical and educational support we provide to families during labor, we also happen to be a pretty effective cost-saving tool for insurers, as well! This post is all about why doula services should be covered by insurance and a step-by-step plan of how to go about attempting reimbursement.

For years, doulas have been working to get their services covered by insurance. And we’re getting there. Really, we are. One large study found that having a doula at your birth can lower the risk of costly interventions like c-sections and epidural anesthesia, lower the rate of NICU admittance, as well as increase the likelihood of spontaneous vaginal birth. The same study found that moms who have doulas at their birth have shorter labors and their babies are less likely to have low APGAR scores. Doulas can apply for their own National Provider Identifier (NPI) number, and there is now a CPT code covering birth doula (99499) and postpartum doula services (99501 and/or 99502), which makes getting reimbursed by insurance that much more possible. (CPT stands for Current Procedural Terminology, and is a copyright of the American Medical Association.)

I’ll be honest, though, the process is pretty hit or miss. So far as I know, anyways--I’ve never had a client attempt it, let alone have success. But from what I’ve heard from other doulas, it’s possible some parents may be partially reimbursed, fully reimbursed or not at all. But with more parents who attempt reimbursement, continued research and media coverage, we’re hopeful this process will start to change for the better.

On that note, a new study published in the journal Birth: Issues in Perinatal Care last week found that a certified doula’s services could save Medicaid and private insurers close to $1,000 per birth! This is huge, folks. The study compared rates of preterm and cesarean birth among Medicaid recipients with prenatal access to doula care with similar women regionally, and concluded that coverage reimbursement for doula services would likely be cost saving or cost-effective for state Medicaid programs.

In an NPR piece published last week about the study, entitled Doula Support For Pregnant Women Could Improve Care, Reduce Costs, author Tara Haelle writes:

This is the first study to show a reduction in preterm births and a net savings for public insurance. Cesarean births — about a third of all U.S. births — cost about twice as much as vaginal births, and the 1 in 10 U.S. infants born preterm (before 37 weeks) incur medical costs 10 times greater than those of full-term infants.

"What is coming together now is a research consensus and a professional consensus of the benefits of doula care," said lead author Katy Kozhimannil, an associate professor in the University of Minnesota School of Public Health. "The barriers to access are financial, cultural and geographic. The financial barrier ought to be the first to fall."

So if there’s ever been a time to put yourself on the potentially frustrating but possibly rewarding path of third party reimbursement, it’s now! I’m happy to provide you with the documentation necessary to get you moving. Just let me know you’re going to give it a shot!

HERE'S WHERE TO START:
The following is a partial list of insurance companies who have reimbursed in whole or in part for doula services. (If your insurance company isn’t listed, it’s still worth attempting reimbursement. This list was first published in 1998, so policies may have changed.)

   •   Aetna Healthcare
   •   AltPro
   •   Baylor Health Care System/WEB TPA
   •   Blue Cross/Blue Shield
   •   Blue Cross/Blue Shield PPO
   •   Cigna
   •   Degussa, a German Chemical Company
   •   Elmcare, LLC, C/O North American Medical Management
   •   Foundation for Medical Care
   •   Fortis Insurance
   •   Glencare Managed Health, Inc.
   •   Great-West Life & Annunity Ins. Co.
   •   HNTB (Peoria, IL)
   •   Houston New England Financial, Employee Benefits (Fort Scott, KS)
   •   Humana Employers Health
   •   Lutheran General Physician’s Organization
   •   Maritime Life
   •   Medical Mutual
   •   Oschner HMO, Louisiana
   •   Professional Benefits Administrators
   •   Prudential Healthcare
   •   Qualchoice
   •   Summit Management Services, Inc.
   •   Travelers
   •   United HealthCare of Georgia (San Antonio, TX)
   •   United Health POS
   •   Wausau Benefits, Inc.

HOW TO REQUEST INSURANCE REIMBURSEMENT FOR DOULA SERVICES

1. _____ Pay your doula in full.

2. _____ Get an invoice from her which includes the following information:
a. The doula's name and address
b. Her social security number, taxpayer ID or NPI number
c. The date and location services were provided
d. The CPT code for the services provided (99499 for Labor Support and/or 99502 for Postpartum Care)
e. A diagnosis code
f. The doula's signature

3. _____ Submit the invoice with a claim form to your insurance company.

4. _____ Within 4 weeks, you may receive a letter telling you that either:
a. they need more information before they can process your claim.
b. this is not a covered expense.

5. _____ Ask your doula to send you the following:
a. a copy of her certification document
b. other credentials or relevant training
c. a letter detailing her training and experience and what she did for you

6. _____ If possible, ask your obstetrician or midwife for a letter explaining why a doula helped you, was necessary, or saved the insurance company money (i.e. Did you have a high-risk pregnancy? Did the doula's suggestions appear to prevent complications or help your labor to progress more quickly? Did the doula's presence decrease your need for expensive pain medications?).

7. _____ Write a letter explaining why you felt the need for a doula and how you believe the doula was beneficial to your health.

8. _____ Submit to your insurance company:
a. the doula's letter and credentials
b. the letter from the doctor
c. your cover letter
d. abstract of 2012 update to the Cochrane Review study, Continuous support for women during childbirth.
e. abstract of 2016 Birth study, Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery.

9. _____ If they refuse it, write a letter to Health Services requesting that they review the claim, as you feel it was a cost-cutting measure and they should cover the cost. Include the abstract of both the 2012 update to the Cochrane Review study, Continuous support for women during childbirth and the 2016 Birth study, Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery.

10. _____ Follow up by telephone if necessary.

11. _____ If they refuse, write a letter to the CEO explaining why you feel that doula care should be a covered expense. Again, include the abstract of both the 2012 update to the Cochrane Review study, Continuous support for women during childbirth and the 2016 Birth study, Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery. They may not pay your claim, but they will consider it for the future.

(c) Kelli Way, ICCE, CD(DONA) 1998, Reprinted with permission.

Sources:

Hodnett, E.D. Continuous support for women during childbirth. Cochrane Database System Review. 2012.

Kozhimannil , Katy B. Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery. Birth: Issues in Perinatal Care. Jan 14, 2016. Online.

Haelle, Tara. Doula Support For Pregnant Women Could Improve Care, Reduce Costs. NPR. Jan 15, 2016. Online.

Third Party Reimbursement Resources: Dona International.

5 Ways Doulas Benefit Doctors

bethanie verduzco — Sat, 16 Jan 2016 17:16:15 -0500

Every so often I hear a mom say that her OB is “okay with doulas…as long as they know their place and don’t overstep their bounds.” Hearing this always breaks my heart a little bit. Sometimes I feel like my profession is the misunderstood (but genius! So genius!) teenager of the health care system. Because for us doulas, knowing our place is essential. If you feel uncertain about the role of a doula--what we do and do not do--and want to learn more, please click here. Each member of the birth team needs to know their role and be comfortable working within their own scope of practice. We feel like "our place" is an amazing one!

But the reason this makes us feel so heart-breakingly misunderstood is that, as doulas, we are never there to antagonistically challenge doctors and hospital staff or to ever push an agenda of our own. Never, ever. We are there instead to support a woman during labor, to help her feel safe and confident, so that she can leave the hospital the next day with a healthy baby and a positive self image. If she feels a surge of confidence from her birth experience (and this can happen no matter how she ends up giving birth!), she’ll likely feel more prepared and able to care for her newborn baby when she gets home.

But I get it. There are some people practicing as doulas who haven’t had professional training, and who also misunderstand the role and scope of a doula. There are also some doulas who have been practicing professionals for years and are frustrated with the system and just plain burned out. And unfortunately, an OB’s trust of the whole doula profession can be completely broken by just one bad experience with one individual doula.

Lucky for us, women are smart. We can usually tell the difference between a doula who is passionate and professional, who is comfortable with her scope and actively working to facilitate a cooperative birth team, and someone, on the other hand, who is under-trained, aggressive or burned out. And the more we can dialog with our care-providers about what doulas do (and do NOT do), the more mainstream doulas will become within the system and the easier it will be to uphold a certain standard of professionalism in our field.

But why would a doctor care to spend their valuable time talking about doulas? Aren’t doulas just for moms? It doesn’t effect the doctor in any real way whether or not their patient has a doula…right?

Wrong! Oh, so wrong.

The bottom line is that doctors actually benefit economically when their patients hire a doula. (I knew there had to be a reason I majored in economics!) And here are 5 reasons why:

5 Reasons Why Doctors Need Doulas

1. Because doulas provide continuous labor support—being with a mom from the time she’s in active labor through a few hours postpartum, never leaving her side for more than a minute—we can be a care-providers eyes and ears while staff is away from the room. We are experienced assessors of laboring moms. For example, we know what it sounds like when a mom begins to bear down during contractions and we can quickly let the nurses know she’s starting to push. And for a second or third time mom, this might make the difference between a doctor getting to the hospital in time to catch the baby.

Along with physically and emotionally supporting moms through labor, part of a doula’s role is to listen, observe and help moms communicate their needs. Easier and more efficient communication can improve a mom's experience during labor and ultimately lend itself to higher rates of patient satisfaction for doctors.

2. Doulas keep a doctor’s cesarean rate, NICU rate, and induction rate low as well as babies’ APGAR scores high.* According to the 2012 Cochrane Review*, the presence of a doula:
   •   decreases the risk of C-section by 28%.
   •   decreases the use of Pitocin by 31% .
   •   decreases the risk of newborns being admitted to a special care nursery by 14%.
   •   reduces labor times by about 40 minutes.
   •   makes it less likely for babies to have low APGAR scores at birth.
With more moms wanting a provider that supports natural birth these days, these lower rates can economically translate to attracting and retaining more patients.

3. Doulas help educate. We encourage our clients to take a childbirth education course, and we also do lots of education one-on-one during and in between prenatal visits. We send out packets of evidence-based reading materials, as well as recommending books and articles that target our client’s specific interests and needs. So by the time mom goes into labor, she’ll know all about the stages of labor, how to cope and manage contractions, and how to be flexible during the birth process and adapt to change.

We know that many doctors would love to be able to sit down with patients and answer any questions they have related to childbirth education, but time is a real variable. Having an experienced, professional doula on your birth team to help educate and prepare you for the road ahead, might make a doctor’s job easier in the long run.

4. Doulas have continued contact with moms after delivery. We stay several hours postpartum to make sure mom’s feeling okay—and we watch to make sure she’s bonding with baby and that breastfeeding is getting off on the right track. We know our mamas fairly well because we’ve spent many hours with her prenatally and during labor and can pick up on cues if she starts to dull, check out emotionally or any other signs of Postpartum Mood Disorder (PPMD). Many of us doulas routinely check on our mamas via text/phone support throughout the first week or two and visit the new family at home around 4-8 days postpartum. This gives us an opportunity to follow up, making sure everyone is eating well, getting rest, and feeling emotionally stable. At the postpartum visit, we are also careful to watch for any potential complications or red flags (i.e. heavy bleeding, vaginal pain, etc.). For those of us who are also certified lactation counselors (CLCs), we can alsoobserve a feeding, do an assessment and help address any issues you might have with breastfeeding—all within the first weeks postpartum, the time period where milk supply is really being established.

In practical terms, this means that doulas are helping to attend to a mom’s well-being as well as watching to make sure that their babies are being fed and reaping the countless benefits of their mother’s breastmilk…in the interim between leaving the hospital and their postpartum check up. And if anything looks at all awry, we are quick to send them right back to see their OB or pediatrician. If a mom feels supported during this time, she’s probably going to feel more satisfied with her overall care which will keep her doctor’s patient satisfaction levels soaringly high.

5. Women with doulas have a more positive birth experience.* They actually do! According to the 2012 updated Cochrane review, for a mother, having the presence of a doula throughout labor reduces the risk of being dissatisfied with her birth by 34%. And that’s amazing—if mama’s happy, everyone’s happy, right? But it also makes real economic sense for doctors. If moms perceive their experience as positive, they will most likely return to you for subsequent babies and be referring everyone they know to your practice in the meantime. Which, again (and again, and again), means more business!

Here’s the point: mothers who have the support of a doula are statistically more likely to have better outcomes and their babies are more likely to have better outcomes.* Every OB wants this. Doulas can help make it happen. We’re good for mothers, good for business, and we’re on your team!

Download this FREE jpeg and share with your doctor!

Sources:
*Hodnett, E. D., S. Gates, et al. (2012). “Continuous support for women during childbirth.” Cochrane database of systematic reviews: CD003766.

http://evidencebasedbirth.com/the-evidence-for-doulas/

If Baby Won't Latch: Your Game Plan for the First Hours After Birth

bethanie verduzco — Thu, 07 Jan 2016 15:19:45 -0500

Many babies right after birth will be placed skin-to-skin, follow their 9 instinctive stages, and latch on beautifully within the first hour or two. And that’s fantastic! These babies’ mamas can just sit back, relax and enjoy their scrumptious little newborn.

But that doesn’t always happen, and what do you do if your baby doesn’t latch on right away? What if lactation support isn’t immediately available? What can you do to make sure your baby gets fed while at the same time be actively establishing your supply?

Today, we’ll answer these questions. But first, I want to identify some of the red flags during labor and birth that can potentially create issues with latch in those first few hours postpartum. These are not things you should worry about as they’re happening—stay present with your birth! And really, they might or might not end up causing issue. But I think it’s important to have a heads up so that you can quickly get the help you need if you need it.

Red Flags for Potential Latch Issues
1. Less optimal positioning during labor (i.e. posterior, asynclitic or transverse)
2. The umbilical cord around neck
3. An especially difficult birth
4. A super fast birth
5. A super long birth
6. A medicated labor

The first 5 red flags above point to some kind of alignment issue for baby. If your baby comes down the birth canal at an odd angle, her neck could be pinched on one side, which could pull on her jaw muscles and cause tightness. Same goes for the cord being wrapped around her neck and for having an especially difficult, fast or long birth. For these kinds of muscular issues, gentle bodywork (i.e. chiropractic care, cranial sacral therapy, OMT, myofascial release therapy) by an experienced care provider could help, so interview a few prenatally and know who you can call in a jiffy.

The connection between the last red flag, having had a medicated labor, and latch issues has to do with baby feeling the effects of the medication. Babies whose moms had narcotic and epidural pain medications during labor might seem lethargic in the first hours after birth, and not have the energy to suckle effectively until the medication wears off. Also, labor drugs are typically given alongside IV fluids, which can cause swelling for mom and make her breasts more difficult to latch onto.

Now that we’ve established why you might encounter latch issues, let’s look at you can do if you find yourself in this situation. Of course, the first thing on the agenda is to call a lactation support person. Most hospitals have IBCLCs on staff during business hours to help get you and baby off to a good start. But if you’re having issues in the middle of the night or have had a home birth and don’t have immediate access to lactation support, it’s important you have a plan of action.

This can be disheartening, and even a bit scary, for a mom who has dreamed of breastfeeding her newborn right away. But all is not lost! You do not have to scrap your breastfeeding plans and fall back on formula—you can absolutely still breastfeed your baby! You just might have to take a few temporary triage steps in the meantime until you can get it chugging along.

A good rule of thumb is: if your baby hasn’t latched on to the breast and had a good feeding in the first 2 hours after birth, and it’s time to think about an alternative way to feed her…for now.

A fantastic way to do that is to hand express your breastmilk into a teaspoon and give to baby. You don’t need to have a pump on hand or any specific types of bottles, you literally just need a hand and a spoon. Talk about self-empowerment! And you won’t lose any of your precious colostrum on the sides of the pump flanges or bottles, because you’ll be expressing directly into the spoon.

Here’s a good video tutorial on hand expression, which I suggest practicing a few times prenatally. Side note: please don’t be discouraged by the mom and her massive collection bowl in the video—she has an already established supply of milk and is not expressing milk for an hours-old newborn. What you’ll be looking for in those first hours postpartum is enough milk to fill your baby’s marble sized tummy—that’s why we use spoons, not a large mixing bowl!

After you express your milk into the spoon, tip it into baby’s mouth slowly, giving her a few drops of milk at a time. Repeat this process until your baby seems full— her body should be relaxed, her hands open and be deliciously “milk drunk.” Babies need to be fed 10-12 times a day, so make sure you’re feeding baby and stimulating your breasts in order to establish your supply. If you need extra stimulation, feel free to pump after you’ve hand expressed and fed your baby—this is less about the quantity of milk that you pump and more about having adequate breast stimulation for creating milk supply.

Hopefully this gives you a few tools to use to feed your baby if you’re having latch issues in the first few hours after birth and don’t have access to support. But please do reach out for lactation support as soon as you notice an issue, and continue to try to latch baby on at the beginning of each feeding. Keep at it, mama! You and your baby do this.

Here’s to happy, latchy days ahead!

The Perfect Mocktail for Pregnant Moms

bethanie verduzco — Tue, 29 Dec 2015 20:33:24 -0500

New Year’s Eve 2015 is fast approaching. And although most breastfeeding mamas and mamas-to-be are excited at what the new year has to bring, they might also have mixed feelings about this particular celebratory eve. For those who are used to kicking back with a cocktail on New Years Eve, the night can end up feeling a bit anti-climactic. So much for the care-free New Year’s Eves past!

Depending on where you are on the childbearing spectrum, at any given moment, you might be feeling nauseaus at the sight of your colleague’s cheesy appetizers and/or your already puffy ankles might start to completely lose their shape after dancing to that 11th Adele song. You might end up spending a good part of the night pumping your milk on your friend’s bed or you might just end up standing around totally sober while your partner and fellow parent-buddies tip their glasses and loose their minds in sheer wild-eyed (kid-free) elation.

So, okay, New Years Eve 2015 might not be your craziest yet. But you do have a lot to celebrate! You’re creating and sustaining new life and you definitely need a beautiful drink in hand to toast your achievements.

So here’s a tasty suggestion. Mix up this delicious Baby Love Punch mocktail, inspired by the amazing Molly Martin of Antoinette Baking Company.

Baby Love Punch Mocktail

Ingredients:
3/4 cup grapefruit juice
2 Tbsp lemon curd
2/3 cup ginger ale
ice cubes
orange for garnish

Directions:
Mix first 3 ingredients in shaker until well blended. Strain over ice and add orange garnish. Makes one drink (but can be easily doubled!).

Cheers to a happy, healthy, baby-lovin’ new year!

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The Perfect Mocktail for Pregnant Moms

Baby Love Punch Mocktail

Ingredients:3/4 cup grapefruit juice2 Tbsp lemon curd2/3 cup ginger aleice cubesorange for garnish

Directions:Mix first 3 ingredients in shaker until well blended. Strain over ice and add orange garnish. Makes one drink (but can be easily doubled!).

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Ingredients:
3/4 cup grapefruit juice
2 Tbsp lemon curd
2/3 cup ginger ale
ice cubes
orange for garnish

Directions:
Mix first 3 ingredients in shaker until well blended. Strain over ice and add orange garnish. Makes one drink (but can be easily doubled!).