A Woman's Design Doula Group Minneapolis | St. Paul Doula & Childbirth Education Services
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Allina Nurses’ Strike Begins Monday Morning

9/5/2016

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PictureAllina Nurses-Photo Credit CBS News
The nurses that work for Allina affiliated health care facilities in the Minneapolis area are planning to go on strike starting September 5th - Labor Day. They are striking for several reasons including staffing, workplace safety, and health insurance and there are about 4,500 nurses planning to strike. The strike is said to be open-ended, and that means the strike will continue until a deal is reached. It’s a challenging time for the nursing union, Allina Health, and especially for the patients that they provide care to. A Woman’s Design has no interest in discussing the politics and intricacies of this issue, but it has raised questions among several of our clients, and we hope to address those here.
The strike has several expectant mothers planning to birth at Allina facilities worried. Babies are unconcerned with the current events of the day, and they will come whenever they are ready. If that happens to be on a day when there is a nursing strike in place, what is going to happen with that mother’s birth?
Some are questioning whether they should switch care to a provider that is not affiliated with the hospitals affected by the nursing strike. Several mothers are wondering what they should be doing, considering there is a strike around the time of their estimated due dates. Others have discussed the possibility of having a “Plan B” in place just in case they go into labor during the nursing strike.
The truth is that we don’t have one answer to any of those questions since your situation is unique to you. There is no right or wrong answer. So, as with everything regarding birth, it’s important to review the facts and make an educated decision. We are glad to discuss the relevant facts with you, find what is important to you, and help you make your decision.
What we know is this.
  1. Allina hospitals will still have nursing staff available during the strike. This is not the first time Allina hospitals have had to manage a nurse’s strike since there was one back in June. They are hiring temp nurses, and bringing others in from around the country that helped with the last strike.
  2. Some services, such as water birth, may not be available during the strike if the substitute personnel are not trained in those skills. They did not say conclusively that water birth will not be available, only that it is a possibility. Availability is going to be solely dependent on the trained skill of the replacement nursing staff.
  3. The strike only applies to the nursing staff. OB/GYNs and Midwives are still going to be operational as usual, and since they will have replacement staff taking the place of the nurses on strike, the care provided by them should remain the same.

What that means in terms of what to expect for your birth is that, other than the off chance that water birth may not be available, there should not be much change in your expected care during the strike. However, if you feel that changing providers, or having a last minute plan B in place is important, we can certainly talk about those options with you. Until then, let’s hope they reach an agreement quickly so that all affected parties - including patients - are satisfied.

Sources:
http://minnesota.cbslocal.com/2016/09/05/5-questions-allina-nurses-go-on-strike/
http://www.allinahealth.org/Footer/Negotiations/

http://www.twincities.com/2016/09/02/nurses-strike-at-allina-hospitals-set-for-monday-what-you-need-to-know/

http://m.startribune.com/allina-nurses-set-strike-date/391391811/


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Things I've learned in 50 births

8/10/2016

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In the last 5 years, I’ve attended around 50 births as a birth doula. Professionally I’ve grown and expanded in the way I approach this line of work, and I’ve learned so much. Each birth is totally unique and marvelous in its own way. Its truly a humbling experience to be present for each one. To commemorate the first 50, I give you this post. In my first 50 births, here is what I’ve learned as a doula.

  1. Women are far stronger than they ever imagine or realize.
  2. The design of birth is perfect and beyond wondrous. It makes me stand in awe of creation.
  3. I’m always grateful to be at a birth. Always.
  4. Midwives are the most amazing combination of personalized care and skill that exists in all of humankind.
  5. Birth workers of all kinds really deeply care for their clients and patients.
  6. Babies have a terribly underestimated strong intuition and intelligence about them.
  7. Dads are amazing.
  8. Medication is not evil. Sometimes it’s very important.
  9. Home birth is not for everyone.
  10. Neither is hospital birth.
  11. Affirmations are powerful.
  12. Doulas deserve to be compensated for their time away from their families and it’s ok for us to practice like that.
  13. The more births I attend, the more I realize moms need more of my support and presence and less of my bag of tools.
  14. Cesareans save some moms and babies.
  15. Other times, they are terribly risky.
  16. The mind / body connection in birth is unbelievably powerful.
  17. Quality Childbirth Education is indescribably crucial.
  18. No intervention, natural or pharmaceutical, is risk free.
  19. I can summon energy from seemingly nowhere when I need to.
  20. Similarly, I can sleep anywhere, in any position, when I need to.
  21. Babies are full humans with emotional, physical and spiritual dimensions.
  22. “Textbook” labor” only exists in the textbooks.
  23. Women greatly underestimate their awesomeness, and it’s a crying shame that society does too.
  24. A birth doula and a birth activist are not the same thing.
  25. The role of a doula is totally unique to the support and care team.
  26. Dads need doulas as much as moms do.
  27. Sometimes I need a doula too.
  28. Birth is very very very hard work.
  29. It is equally empowering.
  30. Alternative care in pregnancy really does make pregnancy and birth healthier.
  31. Emotions and relationships play a woefully understated role in the way a birth plays out.
  32. Birth needs to be private. It’s not a group event.
  33. Every woman’s body responds to medication, natural interventions, and support in their own unique and unpredictable way.
  34. Castor oil really does work to induce labor. So does nipple stimulation.
  35. But nothing works for everyone every time.
  36. If moms could see themselves through my eyes, they might just be frightened by their own power.
  37. Doula work can be applied to many uncertain situations in life. For example I doulaed my dad in the months before he died. Being a doula prepared me for that in ways I could never have imagined.
  38. Doulas can not do this without the support of their families. Mine is amazing.
  39. There are two ways to look at birth: normal, or dangerous. The lens you see through will surely manifest itself in the way your birth turns out.
  40. It’s equally exciting to know the sex of the baby before the birth as it is to learn it at the moment of birth.
  41. I need to take care of me so I can take care of the family I’m serving.
  42. When doctors and midwives work together in collaborative care, unbelievably amazing things happen.
  43. Each woman has her own coping mechanism that is individual to her. She may not even know it but I recognize it.
  44. The powerful stillness of the space where a woman rests between contractions leaves me speechless every time.
  45. Natural birth is awesome.
  46. So is medicated birth.
  47. So is surgical birth.
  48. The end of pregnancy brings a discomfort that makes women desire labor to start, even though they know what kind of intensity comes with labor.
  49. Oxytocin is the world’s most powerful drug.
  50. I love this work so very much.

Inspiration for this blog came from Tiffany Miler: my doula, midwife, and dearest friend.

Written by guest contributor, Rachel Madrigal. A birth doula since 2010 and childbirth educator since 2014, Rachel recently moved to the midwest from Colorado. She has since been a regular contributor to the A Woman’s Design blog. In her career, she’s served as both the President and the Treasurer of the Pikes Peak Regional Doula Association, and the coordinator for the Colorado Springs chapter of the Birth Network. A homeschool mom to her 4 crazy kids, she enjoys family time, a riveting book, movie dates with her husband, life in the country, snowboarding, travel, journaling, and a big glass of red wine after a long week.
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Interview Questions for your Doctor or Midwife

6/29/2016

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​    It’s of the utmost importance to find a compatible care provider that will support you in pregnancy, during birth, and in the postpartum period. Your choice of care provider will influence the direction your birth goes more than any other factor. Rarely do we think of “hiring” our doctor or midwife, but when we choose a care provider that is exactly what we are doing. We are paying them to provide us a service, so it stands to reason that we should ensure we choose someone who is going to be a good fit for us.

Women today have more options for their pregnancy care than ever in history. They have their pick of several doctors, a midwives, or family physicians. They can choose someone who likes a hands-off natural approach, someone who works in a high tech medical facility, or who prefers to actively manage more medical births. They can choose to birth at home, in the hospital, or in a birth center. There is no single provider for every woman - each approach will fit for someone.

Your provider should be compatible with your personality, but they should also be compatible with the type of birth you would like. For instance, if you would like an unmedicated birth in a hospital, it wouldn’t be prudent to hire a doctor who has a 90% cesarean rate. Perhaps he has a high cesarean rate because he takes a lot of high risk cases, and you do not fit the profile of the type of patient he sees the most. He may be very nice, but his practice may not be the best fit for you so it’s probably best to look elsewhere.

Many women question whether or not they can switch doctors during their pregnancy. Let me reassure you: it’s never too late to change your provider. Doctors and midwives are no strangers to taking on a client or patient at the end of their pregnancy. Their training has enabled them to thoroughly understand your charts from your previous provider, just as in any other practice of medicine. You do not need to stay with the doctor you have just because they have seen you since the first trimester.

Finally, it’s important in your interviews to ask questions that require more than a “yes” or “no” response. This is to ensure that you get as much clarification about that particular topic as possible. If you don’t understand the answer, ask for further clarification. It’s ok to press until you feel you’ve gotten the answer you need.

With that, here are some questions to consider when interviewing a care provider:

Logistics And Approaches To Care
  1. What is your philosophy on pregnancy and birth?
  2. What was your training?
  3. How long have you been in practice?
  4. How many births have you attended?
  5. Where do you practice? Home, hospital, or birth center? Which one, and why is that your choice?
  6. What is your cesarean rate?
  7. Do you work solo or are you in a group practice? How many midwives / doctors are there, and will I get to meet them all prior to birth?
  8. Do you collaborate with midwives (if you’re hiring an OB)?
  9. Do you collaborate with OB’s (if you’re hiring a midwife)?
  10. Do you take my insurance?
  11. What are the costs involved with my care?
  12. Are you supportive of integrative medicine? Would you cooperatively collaborate about my care with my preferred alternative support care providers?

Prenatals and labor
  1. What will our prenatal visits look like? Do you provide any additional information or education during that time?
  2. What prenatal testing do you require? How would you feel if I opted out of any of those tests? Would it change your plan of care for me?
  3. What would you do if I became a “high risk” client / patient?
  4. How do you feel about doulas? Are you comfortable with my hiring one for the birth?
  5. Do you recommend that I take a childbirth class? Which one?
  6. Can I have additional family members at my birth?
  7. How would you feel if I chose to eat or drink during labor?
  8. How many vaginal exams do you routinely do?
  9. What is your policy for monitoring in labor?
  10. How would you feel if I asked an alternative care provider to come to the birth? (Chiropractor / acupuncturist, etc.).
  11. Are you supportive of my choice to labor in as many positions as possible? Can I deliver on my hands and knees, squatting, side lying, etc?
  12. What do you do if labor slows down? Do you support natural augmentation techniques?
  13. What are your preferred pain management techniques? How do you feel about medication for pain management?
  14. What complications have you seen in your practice?

Postpartum
  1. What is your preferred method for managing tears?
  2. Do you practice delayed cord clamping? (The WHO suggests delaying cutting of the cord for a minimum of 3 minutes).
  3. Can I breastfeed as soon as possible?
  4. How do you support skin to skin for your patients?
  5. Are the newborn procedures performed immediately or can they wait until I have had a chance to bond with my baby?
  6. Do you do the newborn care or that the responsibility of someone else? If it is someone else, how can I communicate my desires with them?
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Basics of the NICU (Neonatal Intensive Care Unit)

6/23/2016

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​If you find out that there is a chance that your baby will need a NICU stay, it’s good to know at least a little bit about what the NICU is like. Nobody ever plans to have their baby in the NICU, but it is a reality for many families and some basic understanding about it can relieve some of the surprise since the NICU can feel very overwhelming. Of course each baby's medical situation is going to be unique to them, so we cannot possibly explain everything you will encounter in your situation. For instance, a baby born at 28 weeks is going to need far more intervention than the one born at 36 weeks. There are some things you will do well to know, however, if you are facing a possible NICU stay for your baby.

Sanitation is VERY important. Babies have underdeveloped immune systems, and premature babies are particularly sensitive to infection. The NICU has strict guidelines about hand washing and sanitation. Sometimes a face mask is recommended as well. It is critically important that you adhere to the guidelines about sanitation every time you visit the NICU, not just for your baby but for the others as well.

The NICU is busy. At any given time, there may be neonatologists, pediatricians, NICU nurses, RN’s, lactation specialists, other parents, and sometimes social workers or psychologists in the NICU. (A psychologist can help parents process the difficulty of having a premature baby.) It can feel very crowded and this is normal.

It's OK if you're scared. If being in the NICU with your baby feels scary, that is OK. You don't need to try to look at the bright side, try to see the good, or look for a silver lining. If you're intimidated and scared, it's OK to not like it and just be present in the situation as it is.

You can still breastfeed. Premature babies benefit greatly from their mother’s milk. While it may be difficult to establish a latch with a premature baby, you can still pump and slowly work toward a latch. If you need to supplement, many hospitals have donated breast milk that you can use for your baby. A premature baby’s stomach is particularly sensitive and breast milk is going to be much easier for your baby to process and digest than formula. Talk to your pediatrician and neonatologist about the options available to your baby.

In most situations, you can still do kangaroo care. Kangaroo Care is the term used to describe a mother and baby staying skin to skin as much as possible to support baby’s development. Kangaroo Care regulates the baby’s body temperature, helps establish regular breathing patterns, and generally contributes to baby’s overall well being and health. Even if your baby has a lot of tubes or cords attached to them, NICU staff can usually get the baby to stay on you. Remember, your baby knows you and they benefit from your presence  

You are allowed to stay with your baby as much as you want. That is your baby. You have a right to see your baby as much as you want, whenever you want. Don’t forget to do some self care, but do not be afraid to insist on staying with your baby if you want to.

NICU nurses are highly skilled, and they really care about your baby. It takes a very special type of person to be a nurse. It takes an even more unique type of person to be a NICU nurse. NICU nurses truly love babies and families. They do the best they can to make sure your baby is healthy and cared for. That being said, if you have an issue with a particular nurse for any reason, you can request that person not work with your baby and your request should be honored.

A NICU stay is never the plan, but a little extra medical support can mean a world of difference for tiny babies. With a little patience and help from a supportive staff, you and your baby will be discharged and snug at home in no time.

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I'm Pregnant! now What??

6/11/2016

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I don't know about you, but the instant I saw that positive pregnancy test, my entire life became consumed by this little person that was to become.

I couldn't wait to call my doctor to schedule an appointment, hoping they would give me some personal affirmation, support, encouragement, or even that they would express a little bit of excitement to match my own. But I would always leave that initial appointment feeling a little disappointed. A standard pregnancy test very similar to the one I'd taken at home would be completed in the office by someone I didn’t know, and the pregnancy would be clinically confirmed. I would be booked for my first prenatal visit - which wasn’t until I was 12 weeks pregnant. On my way out the door, I was handed a generic pamphlet that reminded me not to eat blue cheese, lunch meat, or raw sushi. Needless to say, my need for emotional  or informational support was not met, and I walked out of the office feeling the weight of all my unanswered questions hanging heavy on my shoulders.

I was always longing for a way to be active and engaged in my pregnancy. Even early on, I didn’t want to just passively wait for my next appointment. Pregnancy is not just a physical condition requiring medical monitoring - it is a complete transformation within the life of a woman and her family.

I wanted this to be a shared, supported experience.

I wanted to be as informed as possible.

I wanted to do my best to do the right things.

I wanted to enjoy it as much as I could despite the discomforts.

I wanted to be told what I was experiencing was normal. 

I wanted my fears to be reassured by people who showed that they really cared.

I wanted face to face connection with those who were walking the same path I was.

I wanted to be affirmed as a mother - even though my mothering journey had only just begun.

And all I had was a pamphlet.

For personal reasons, we had decided to wait a while to share our news, like a lot of people choose to do. Those weeks and months are very emotional - they are exciting, scary, thrilling, exhausting, and uncertain. Prenatal visits with a primary care provider do not start until 12 weeks, since there is not much to monitor during that time. That is 3 whole months of waiting.

And waiting.
And waiting.
Alone.

Of course it’s not realistic for a doctor’s office to provide a patient with all of the emotional and physical support they need during a pregnancy. A doctor’s job is to medically monitor pregnancy for safety. Midwives spend more time emotionally investing in their clients during pregnancy, but of course they cannot do it all - nor should they.
I could write to unknown faces across the internet on places like BabyCenter or even on Facebook mom groups. But a “congratulations” from a nameless face (or avatar) is just not the same as a congratulatory hug or spoken word of encouragement.

The doulas and educators of A Woman’s Design have lived this walk. We completely understand that once you have a pregnancy confirmed, the weeks and months before the start of your prenatal visits are very emotional. It is a sensitive time of pregnancy that is not often acknowledged, especially since mom’s belly has not started to grow yet. Mom seems to be the only one who can feel the very real effects of this pregnancy - both emotionally and physically.
Wouldn't it be nice to come together with other expectant mothers to share your exciting news? Maybe you can find a pregnancy buddy to walk along this journey with and have your most common and embarrassing questions answered in a small group?
​

That is why The Nesting Place offers the Healthy Pregnancy Workshop and the Birth Consultation Services.The Nesting Place is a sister company of A Woman's Design. Classes at The Nesting Place are intended to bridge the gap between early pregnancy and the time you take a complete childbirth education series as well as encourage and enhance women and their family's confidence throughout pregnancy, childbirth and parenting. For special circumstances (bed rest, work schedule, etc.) that do not allow you to attend group classes, or for personal preference we also offer private childbirth classes.


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TOP 10 FOODS TO STOCK FOR POSTPARTUM

5/17/2016

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Let's be honest, the postpartum stage isn't an easy one, and healthy eating can be a real struggle. Time and sleep are in short supply. Fatigue is high. And none of this is helped much by the extra feedings, diapers, laundry or dishes. Making sure you're eating well may feel like a self-indulgent luxury, or just plain "too much work."

But the recovery of your body, mood, energy, metabolism + hormones requires that you get some quality nutrition (especially given how short you are on sleep and rest). If you don't want to be (as) burnt out postpartum, you need to be feeding you right, too. 

In the postpartum stage, good nutrition is incredibly important to successfully restoring balance to your body, mood, energy, weight, metabolism + hormones. Eating the quality + quantity of food that will heal your body is essential for postpartum mammas. This is a time of high stress (especially if you're breastfeeding) and your body is still physically recovering. This is not the time to diet or slide into poor dietary decisions -- poor food choices will stall your progress toward restoring your body, mood, energy, metabolism + hormones.

If you are breastfeeding, you have an even greater need to nutrify both your growing baby yourself right so that you can produce rich milk to nourish your baby. Remember that -- just like in pregnancy -- baby gets first dibs at your body's available energy + nutrients... and you get the leftovers. What you eat directly affects the nutrients, quality + availability of your breastmilk -- which is the single, sustaining food your baby gets for as long as you continue nursing.

Eating healthfully postpartum isn't a "someday" luxury -- it's a daily necessity. Your health (and the baby's) depend on it. And it can be done -- with surprisingly little to no prep -- if you keep the right foods on hand. 
So here are my 10 favorite foods to stockpile for quick, healthy, grab-n-go meals and snacks that will fortify both you and baby with the energy + nutrients you both desperately need to make it through the postpartum phase healthy + well!
NUTRIENT-RICH, GRAB-N-GO FOODS FOR POSTPARTUM MOMS
Stock up on these healthy, healing foods in the weeks prior to and following birth:
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SNACK-ABLE FRESH VEGGIES + FRUIT
In general, you can't go wrong with ample veggies and fruit (...unless you're eating fruit but no veggies, or relying primarily on fruits/veggies alone without proper intake of healthy fats + proteins). 

Digestion allows the nutrients you eat from any food -- including fruits + veggies -- to be broken down into vital compounds the body can absorb and apply directly into the cells, tissues + organs of your (and a breastfed baby's) body. 

Plus, the extra water in fruits + veggies keeps you hydrated, the vitamin C keeps you healthy, and the fiber keeps you full (and regular!).  

Healthiest Option: There are some concerns around the harmful side effects caused by the pesticides, chemical residue, and GMOs found in some fruits + veggies, especially as it relates to fetal and infant development. You may want to check out the Dirty Dozen + Clean 15 List to figure out what's worth buying organic (and what isn't).

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CANNED SEAFOOD
Canned salmon + tuna are quality, staple proteins you should keep on hand -- heck even in your purse or diaper bag. These days, you can literally tear or pop off many of the container lids (bags or pull-tab). Crab + oysters are also great options. And sardines... if you can stomach them.  ;)

These protein-rich options are very important in satiating hunger and aiding in your body's recovery. The amino acids in protein are necessary for optimal function of your immune system, energy levels, metabolism, hormone synthesis, brain chemistry, moods and weight loss. 

Healthiest Option: Stick to wild-caught seafood, not farmed. Make sure products are packed only in water + salt. Packed in olive oil is less desired, but acceptable.

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FULL-FAT DAIRY (OR COCONUT) PRODUCTS
Organic, full-fat dairy products are a great option for moms whose bodies aren't dairy-sensitive, allergic or intolerant. Same goes for coconut. 
During the postpartum healing phase, your body needs ample, healthy, whole fats to ensure production of the prostaglandins that facilitate cell, tissue + organ repair. Eating full-fat dairy or coconut products will rebalance your female hormones, energy + even help your mood (by stabilizing brain chemistry to stave off some postpartum depression!). In addition, full-fat organic rawdairy contains probiotics and enzymes that keep your gut + digestion in top shape.
If you're breastfeeding, your need for ample, healthy, whole fats is even higher -- and these foods help produce the rich colostrum + hind milk that your baby needs to grow happy + healthy.  
Here are some of the best "grab-able" full-fat dairy + coconut options:
  • Greek Yogurt - Get full-fat Greek yogurt that's free of added sugar, sweeteners + flavors. You can always add a handful of berries and a dash of cinnamon!  (There's a few coconut yogurts out there, but unfortunately, most have too many sweeteners + additives to be healthy options.)
  • Milk - Organic whole milk and/or full-fat canned coconut milk. Makes great smoothies (or mixes well with a tbsp of raw cocoa powder!).
  • Cheese - Try organic string cheese, pre-cut cheese cubes or curds, or cheese blocks if you can manage slicing.

​Healthiest Option: 
Get organic, full-fat, plain dairy when possible. Raw is ideal. If you're dairy free, lean on plain, full-fat coconut milk.

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HARDBOILED EGGS (PRE-COOKED + PRE-PEELED)
Eggs are such easy staple foods because of their size, price, availability + versatility. They roll up healthy proteins, fat, vitamins + minerals into a simple, delicious food. Most people find eggs to be a highly satiating + satisfying (if not comforting) food.

So eat eggs at breakfast. Or eat them as an afternoon snack. Or eat them at 2am feedings. Or on a boat or with a fox or in a house...  ;)  You don't have to be Sam-I-Am to get the idea.

You can buy hardboiled eggs pre-cooked + pre-peeled (or ask your hubby to cook + peel a big batch) so you can have them on hand and ready to eat without notice or prep.

Healthiest Option: organic, free-range. not packed in chemicals/preservatives.

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OLIVES
A handful of these vitamin + mineral-rich jewels can go a long way. The salt + fats in olives support healthy adrenal function, which can keep energy more stable + crashes (a little more) at bay. The salt can also help stave off dehydration + slow the loss of water-soluable vitamins (esp for you nursing moms).

Healthiest Option: only ingredients: olives + sea salt.

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NUTS, SEEDS + NUT/SEED BUTTERS
These convenient, portable healthy fat sources work wonders as nutrient + energy-dense snacks -- just a handful or smear can help nourish, energize + tie you over between meals (or feedings!). 

Healthiest Option: plain nuts, seeds or nut/seed butters without additives (except sea salt). Soaked + sprouted raw nuts ​ideal.

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SWEET POTATOES
We don't want you going carb-crazy in the postpartum phrase. The repair of your body (and the quality of your breastmilk) are best supported by your consumption of healthy fats + proteins.

On the flip-side, there's no reason to be ketogenic or carb-starved either. Most women can't go wrong with sweet potatoes -- which are high in vitamins, nutrients + the kinds of healthy, fiber-rich carbs your body needs to function through this exhausting postpartum stage of physical stress and sleep depletion.

Sweet potatoes are arguably a more nutrient-dense, lower-glycemic option than other potatoes and are a great way to get carbs that aren't processed + stripped of nutrients (or mixed with other harmful, health-destroying ingredients like sugar, chemicals, preservatives, artificial colors or sweeteners, etc). Please, please, please consider sweet potatoes in lieu of candy, breakfast cereals, granola/snack bars, breads, crackers, packaged carbs, pastas, box meals/snacks, chips, etc. You can even make them taste treat-worthy!

Over-bake a bunch of sweet potatoes (whole + in their jackets) until soft + oozing a bit of brownish "juice." Eat one warm, and keep the rest in the fridge for great snack or meal additions. When cold, sweet potatoes get a uniquely rich, caramel-y sweet flavor. To mix it up (hot or cold), try spreading with coconut oil, a sprinkle of cinnamon and a few raw pecans or walnuts!

Healthiest Option: plain, whole sweet potatoes, ideally organic (then you can eat the fiber-rich skin, too!).

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HUMMUS OR GUACAMOLE
During the postpartum healing phase, your body needs ample, healthy fats to ensure production of the prostaglandins that facilitate cell, tissue + organ repair. You also need ample, healthy fats to rebalance your female hormones + moods (help stabilize brain chemistry to stave off postpartum depression!).

And if you're breastfeeding, your need for ample, quality fats is even higher, as it they help make the rich colostrum + hind milk your baby needs most.  

Hummus and guac are tasty, energy and nutrient-dense sauces easy to mix with or "plop-on" canned seafood, meats, and salads, and also make great dips for fresh veggies.

Healthiest Option: all-natural, free of additives, preservatives + added sugar / sweeteners

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COCONUT OIL
When you can't do anything else -- you can take a supplemental spoonful of coconut oil for a quick hit of energy + nutrients.Coconut oil is not like other fats - it's an MCT fat, a unique form of fat that is quickly digested and used immediately by the body for energy.

And for all you mammas worrying about shedding the baby weight, one of the "safest" fats for supporting healthy weight loss.

Plus, it's great to rub on both your skin + baby's! (And it works wonders on mastitis).
Healthiest Option: unrefined, virgin coconut oil in raw form.

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HOT DOGS + BRATS
Here's to quick protein + fat to keep your metabolism + energy high, your body on the mend, and your baby well-fed.
Instead of reaching for a hand or bowl-ful(s) of carbs... bake (or ask the hubby to grill!) a package of all-natural hot dogs or brats, which are high in protein and easy to grab and eat at snack or meal times. Dip in mustard or smother in sauerkraut for a tasty + healthful digestive aid.

Healthiest Option: all natural, minimum ingredients. no fillers or additives. Chicken hot dogs from Trader Joes are a great option.

BONUS! THE #1 BEST FOOD FOR POSTPARTUM!

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LIVER (FROM GRASS-FED BEEF, FREE-RANGE CHICKEN OR PASTURED PORK)

Healthiest Option: grass-fed beef liver, free-range chicken or pastured pork livers.

I know, I knowww, it's not the easiest or most preferred food.
But arguably, liver from grass-fed beef and pastured chicken or pork is the #1 most nourishing, restorative, nutrient-dense food you can eat after giving birth. 

And while the cost is cheap, liver is incredibly rich in iron, minerals and fat-soluble vitamins. You and baby both need these -- especially after the exponential loss of nutrients in labor and again in nursing.
​
If you're not too into making/eating liver (popular ways are meatloaf, pate, and with bacon!) try taking desiccated liver supplements.

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​Helping women achieve the optimal health, fertility + life vitality they deserve is Laura's life mission. She became a certified N.T.P. and instructor of nutrition after recovering from bulimia, binge eating + a slew of health problems. Laura now provides holistic nutrition + food therapy support services for women struggling with food, health + hormonal issues through her private practice Greener Farmacy. She employs use of natural, holistic + nutritional therapies to resolve chronic issues with weight, hormones, blood sugar, overeating, undereating, disordered food behaviors, fertility, energy + moods. She is also a trained yoga instructor + natural family planning expert. For fun, she authors Secrets of a Binge Eater, where she explores our common mental + emotional ties to food.
 
Follow her free health posts and learn more about how Laura can help at GreenerFarmacy.com and Facebook/greenerfarmacy or contact her at Laura@greenerFarmacy.com.

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It's Okay to Need People

5/8/2016

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A few weeks ago it was determined that I would need a surgery that was long overdue. The recovery time for this procedure would be very similar to a postpartum period but not as awesome because I wouldn’t have a new adorable babe to remind me that it was all worth it.
 
During the consultation and planning of this surgery I was encouraged to start making plans for the recovery period for myself, my family and my business.
 
As a birth worker I have offered very similar advice almost weekly to expectant families during prenatal/postpartum visits and during childbirth education class. “It is important that you [mom] be taken care of so that you can focus on what is important during that time. Healing and transitioning your life with this new baby.”
 
I never thought I would be offered the same advice again since our family is complete. I also did not know what to expect as it can be challenging for me to hand over my other responsibilities and plan to just focus on myself for an extended period of time. I made this mistake during my own postpartum periods and during various times of my life when I really could have used a village…a community.
 
I started with making arrangements for my children. I am very blessed to have close family nearby and an older child who has acted as a second mother to her younger siblings. I make it a habit to not call on them often because I do not want to burn them out with last minute requests (when you are on call for a living this is not always an easy task).
 
One night during my planning my sister-in-law called me and said, “I want you to know that I have some vacation days available that I am planning on using. We can take the kids some days during your recovery.” There was silence. She said my name because I hadn’t responded in what felt like minutes. I hadn’t responded because I was overwhelmed with emotion. My sobs grew louder and as she realized what was happening she went on to tell me how much they loved me and my family and that they are there to help in any way they can.
 
I have amazing friends who have offered to make and bring over meals for my family, help with laundry and to make me laugh until I cry (which I love!)
 
A few days later I started to make arrangements for A Woman’s Design (which is my other baby). I contacted my team and had a few meetings to discuss the next few weeks and months. Not to my surprise these amazing women stepped up by taking on different roles and responsibilities even to the point of training if needed.
 
Collectively these people are doulaing me in their own ways. It is exactly the support I need to return and continue this amazing work with women and families. They think I’m driven and passionate now…
 
This Mother’s Day I encourage you…I implore you to not wait until you’re at the end of your rope to ask for help. Make it a habit to check in with yourself and reach out to those around you when you need. Don’t try to do this life alone…this parenting journey alone. It doesn’t have to be a big group of people. It can be women in your moms’ group, church group, the gym, close work friends, friends, family or the help of postpartum doulas.
 
They love you and want to support you in more ways than you know. They only need to be asked.
 
Love to you and yours,
Natalia
 
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What Is All This Testing?

4/28/2016

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We all know that prenatal care is important.  It helps ensure a healthy pregnancy, baby and birth, which is, after all, the end goal right? At your prenatal visits with your doctor or midwife, you generally undergo routine examinations that vary as the pregnancy progresses.

Testing that can be expected throughout your pregnancy is sometimes confusing and overwhelming. This can be the case particularly if the tests are simply ordered for you but not thoroughly discussed.  What are all those tests?  What are the risks, benefits, and alternatives? This post will hopefully give you some insight into some of the tests that are offered, and why.

Tests performed at each prenatal visit
There are two simple and critical tests done at nearly every prenatal visit. They can communicate a lot about the state of your health and your baby’s health to your care provider: your blood pressure is taken and your urine is tested.  Monitoring these two things alone can go a long way toward ensuring mom and baby’s safety.

A urine test is used to assess bladder or kidney infections, diabetes, dehydration and preeclampsia by screening for levels of sugars, proteins, ketones and bacteria.  High levels of sugars may suggest gestational diabetes, which may develop around the 20th week of pregnancy.  Higher levels of protein may suggest a possible urinary tract infection or kidney disease.  Preeclampsia may be a concern if higher levels or protein are found later in pregnancy, combined with high blood pressure.    

Your blood pressure can tell your provider about several things that are happening with your pregnancy.  It is normal for a woman’s blood pressure to rise slightly as the pregnancy progresses because her blood volume rises. Blood pressure monitoring is important to monitor because it is a primary symptom of pre-eclampsia.  

Periodic Tests

What about all the rest of those tests that they have you do?  Glucose test?  Amniocentesis? Blood tests?  What are they looking for?    

Here is a quick list of some of the standard prenatal tests that are performed in pregnancy:

Pap smear
This is sometimes done early in pregnancy, then repeated at the 6 week postpartum. It’s purpose in pregnancy is the same as any other time that the test is performed.  Pap smears are performed to look for abnormal cell growth on the cervix that would indicate cancer.

Gonorrhea culture (GC): The GC is also run at the same time as the pap spear.  The presence of gonorrhea in the vagina or in the cervix can seriously infect the baby’s eyes during delivery.  This is what the eye drops administered after delivery are for, whether or not mothers have a positive GC.  Gonorrhea is often asymptomatic, so as a result, every woman is tested.

Blood tests
This is what your provider is generally watching when they get your blood tested:
           A.)  Complete blood count (CBC) to check for anemia,  or iron deficiency.  Hemoglobin (HGB) values should be above 11.0 and the hematocrit (HCT) should be 33 or more.  This test is usually repeated between the 28 and the 32 weeks of pregnancy.
           B.)  Blood samples are also drawn to type your blood and rhesus group (Rh factor), which will be either positive or negative.  If the mom’s Rh is negative, the baby’s father should be tested also.
           C.) Antibody test to check your immunity to infectious diseases: rubella, measles, cytomegalo virus, toxoplasmosis, hepatitis, and AIDS.
           D.) RPR is the test for syphilis.
E.) Afp Screening.  This is a blood test to detect neural tube defects only.  This includes, anencephaly, microcephaly, hydrocephaly and spina bifida.

Amniocentesis:
This test is usually recommended between 15-17 weeks.  Most women over 35 are advised of their options regarding genetic screening.  Amniocentesis can identify down syndrome, trisomy 18, and other chromosomal defects.  Amniocentesis is performed by inserting a needle through the abdomen into the amniotic sac in order to withdraw a sample of amniotic fluid.  It is a common procedure, but it carries several risks, rh sensitization, infection, leaking amniotic fluid, and in a small number of cases, miscarriage.  

Glucose Tolerance Test:  
This test is done between 26-28 weeks to rule out gestational diabetes. Protocols vary for this test, but it usually involves fasting, drinking glucola (a very sweet, sugary drink), then checking blood sugars after the test.  There is very little evidence to support the Glucose Test, yet it is almost universally recommended for all women in pregnancy.  Some argue that the test is very unnatural, and that not all women will respond predictably to the test.  

Ultrasound:
Ultrasounds can be performed for many reasons. In early pregnancy, ultrasounds can be performed to check the gestational age of the baby and establish a due date.  Around 18-22 weeks, ultrasound can reveal the sex of the baby.  Many physicians are now requiring late term ultrasounds to measure the baby’s growth, though these are very inaccurate measurements.    

What you should know about prenatal testing

Before taking or refusing any test, ask your provider, “How will the results of this test change your plan of care for me?”  

For instance, if you choose to opt out of the glucose test, will that leave your provider anxious and wanting to induce earlier?  Or if you choose to have amniocentesis, and the test comes back with a positive for down syndrome, will the provider recommend termination?  If your decision to have the baby will not be affected by the results of the test in any way, is there a reason to have it done?

Much prenatal testing is done to simply monitor the health of you and your baby.  However if for any reason you feel that a particular test or screen is not right for you, you always have the right to opt out of any test.


Being aware puts you in the fulfilling position of taking responsibility for your care.  The more active you are in your personal care, the more empowering the whole pregnancy experience becomes.

Sources:

Urinalysis: http://americanpregnancy.org/prenatal-testing/urine-test/

BP: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20046098

Pap Smear:  http://www.healthline.com/health/pap-smear

Gonorrhea culture: http://www.healthline.com/health/pregnancy/infections-screening-gonorrhea

Blood tests: http://americanpregnancy.org/prenatal-testing/blood-test/

Amniocentesis: http://www.webmd.com/baby/amniocentesis

Glucose test: http://evidencebasedbirth.com/gestational-diabetes-and-the-glucola-test/

Ultrasound: http://www.webmd.com/baby/ultrasound
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5 MYTHS ABOUT THERAPY DISPELLED

4/22/2016

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MYTH: Only people with mental illness benefit from therapy.

TRUTH: Therapy is based in developing a relationship where you can feel safe to share your emotional experiences and life challenges. Many people seek out a therapist because they are struggling with stress, changes in life, or relationships. These are not necessarily issues of mental illness, and yet therapy can be extremely beneficial in providing essential support and a space to be heard without judgement. Often, we are concerned about “burdening” our friends and family members with our day to day stresses and worries. Working with a therapist allows you to share the weight of life with another person who is equipped to carry the load with you and help you figure out how to navigate life in a more manageable way. 

MYTH: I don’t need a therapist if I’ve got friends and family. 

TRUTH: Some people suggest that working with a therapist is like hiring a friend, and why would you do that if you already have friends? A therapist is there to support you like a friend or family member might, but they are also highly skilled in guiding you in progressing toward your goals, improving your quality of life and growing as a person. Unlike the other people you may have in your life, a therapist provides unbiased and non-judgmental feedback. A therapist is solely concerned with what’s in your best interest. They will not give you advice or tell you what to do, which is what our friends often do, sometimes leading you to feel conflicted if you don’t agree with their suggestions. A therapist does not judge you for the choices you make and cares about you unconditionally. They also carry hope for you when you can’t see it for yourself. 

MYTH: If I start therapy now, I will be going for years to come.

TRUTH: When you start and end with your therapist is your choice. It is your therapist’s job to be guided by your goals for therapy and to follow your lead, while also challenging you a bit and pushing you out of your comfort zone once in a while in order to help you grow. Most people spend a few months working with their therapist intensely to resolve the immediate issues that brought you in initially. After that, you will have likely formed a great relationship with your therapist, so you might take a break or drop down to only checking in once every couple of months. The great part about having established this relationship is that you can always return at any time if things come up in life that are difficult.


MYTH: A therapist gets paid to care about me, but I am sure I’d just be another number to her.
​
TRUTH: Therapists get into this work because they are deeply passionate about working with people in a meaningful and impactful way. Therapists are generally very empathic and compassionate people who genuinely care about and like their clients. Therapists do think about their clients outside of session because they truly matter to them. Many therapists spend much time when not with clients learning more ways to help, researching resources, consulting with other therapists about how to be most effective, and hoping that their clients are doing well in between sessions and after they have stopped coming to sessions. Our clients leave lasting impressions on our lives, too. 

MYTH: I had a bad experience with therapy in the past, so clearly it isn’t for me.

TRUTH: Finding the right therapist is like trying on shoes. Some might look great on the rack, but when you try them on, they pinch your toes, or just don’t fit quite right. Because the success of therapy is largely dependent upon a good relationship, it is essential to find a therapist with whom you feel like you “click” well. You’ll need to actually like your therapist if you’re going to building a trusting relationship and share details about your life that you might not have ever shared with anyone else. So, if you’ve tried therapy before and it did not work out, it left a bad taste in your mouth, or you did not find it helpful, give it another chance before you write all of us therapists off! Just like with people you meet in other parts of your life, you are not going to get along with everyone, and that’s ok. The right therapist for you is out there, it just might take a few tries before you find someone you feel like “gets” you and with whom you can relate. Therapy provides a sense of belonging, and in order to experience that benefit, you’ll need to find a therapist you like and by whom you feel accepted.


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Written by Lauren Robbins, MS, LPCC, LADC
Owner/Therapist
Wild Tree Psychotherapy
​
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Living Life On Call

4/21/2016

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We do it because we love what we do. It’s a beautiful sacrifice we are privileged to make to serve the mothers and babies we are blessed to have in our lives.
PictureLiving Life On-Call
Birth doulas go on call at 37 weeks gestation for our clients. We discuss with our clients as much as possible about the on call period, when to call the doula, and we assure our clients of our availability.

Sometimes, though, it seems that the weight of the words “I’m on call for you 24 hours a day, 7 days a week from 37 weeks until the birth” really doesn’t quite sink in for most people. It’s a concept that is easily overlooked as the paperwork is signed, and protocols are discussed. It sounds simple enough - just live your life as usual until you need to go. The reality of on call life can be tricky and challenging, but the rewards are more than worth it.

Life on call as a birth doula means that vacations are deliberately planned many months in advance, and we must give ourselves 2 weeks on either side of that vacation window where we will not accept due dates.

Life on call as a birth doula means that our life and our family’s life exists within an hour radius of our client.

Life on call as a birth doula means that we take an extra car out to dinner, church, family outings, or social events in case we need to leave for a birth. Our bag is always packed in the back of our with all of our supplies, including a change of clothes in case a birth happens to be longer than expected.

Life on call as a birth doula means being prepared for everything and anything. All the time.

Life on call as a birth doula means having a backup plan for every aspect of our lives - and a backup plan for the backup plan

Life on call as a birth doula means being more fully present with our family when we are with them, because we know we could be called to leave them at any moment.

Life on call as a birth doula means planning the logistics of our day - including scheduling, transportation, child care, meals, and self care, based on a possible birth, every day.

Life on call as a birth doula means saying no to much needed girl’s nights to sleep up in case of a birth.

Life on call as a birth doula means that we understand there is chance we will need to miss a child’s birthday, a family gathering, or Christmas morning and we are at peace with that.

Life on call as a birth doula means being married to the phone, waking up at odd hours in the middle of the night to subconsciously check for messages, and having a heightened sense of responsiveness to any sound that our phones make.

Life on call as a birth doula means letting go of a lot of control, and accepting whatever happens.

Life on call as a birth doula means having the privilege of being present for a baby’s first real birthday.

Life on call as a birth doula is exhausting, demanding, and unyielding. It can sometimes be hard on the body, hard on relationships, hard on the mind. Yet at the same time, it's exhilarating, thrilling, and infuses us with an undeniable sense of purpose and gravity.

We do it because we love what we do. It’s a beautiful sacrifice we are privileged to make to serve the mothers and babies we are blessed to have in our lives.

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    A Woman's Design

    A Woman's Design Doula & Childbirth Educators are here to walk along side you during such a precious time. Whether it is your first journey or tenth, empowering women and families with education and support to trust their inner wisdom and make wise choices in pregnancy, birth and early parenting is the heart of A Woman's Design. 

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Attachment Parenting | Babywearing | Birth Bootcamp | Bottle Feeding | Bradley Method | Breastfeeding | Cesareans Section (Family-Centered/Planned/Repeat) | Cloth Diapering | Epidural Birth | Home Birth | Hospital Birth | Hypnobabies | Induction | Lamaze | Multiples | Natural Birth | Spinning Babies |Vaginal birth Assisted by Medication | VBAC | Water Birth | Birth Doula | Postpartum Doula | Lactaction Support | Prenatal Education | Childbirth Education | Placenta Encapsulation |
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​At the heart & soul of A Woman's Design is the belief that every mother has the inner wisdom to make the best choices for herself and her baby in pregnancy, childbirth and early parenting. 
This is your story and we are your supporting cast. Birth. Your Way. 

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