The Childbearing Years

http://www.adarbirthservices.com

When you start telling people that you are expecting a child, you will quickly find that there are a sea of recommendations for preparatory reading on pregnancy, birth and breastfeeding. When I work with a new doula or prenatal massage client, I like to give them this list of books; it's short, the books are engaging and I consider them to be an excellent foundation.

All of these books are usually available at the People's Co-op Bookstore, 1391 Commercial Drive, 604-253-6442 . If they don't have one in, it is likely already on it's way. Support our small booksellers!

May's Guide to Childbirth by Ina May Gaskin

A truly wonderful book that will inspire you to embrace the experience. Gaskin is an internationally-respected midwife (the only midwife to have an obstetrical manoeuvre named after her, "The Gaskin Manoeuvre") who has attended thousands of births.

The first section of the book is dedicated to the stories of women who have had their babies with Gaskin. They describe their experiences in their own words with some commentary by the author. The births that are detailed in these stories are extremely varied and yet they are not just a rare sampling of successful outcomes as you can see when you look at her records spanning over 30 years of practice (in all that time her C-section rate has remained below 3%).

The second section focuses on the clinical aspects of natural childbirth with solid and well-presented information on the realities of current medical practise around birth.

As one reviewer said: "she once again relies on her story-telling techniques for getting across her central message: If you're surrounded by people who believe you can do it and who support your own belief that you can do it, then guess what? You can do it."

Birthing From Within by Pam England, Rob Horowitz

This a wonderful book that focuses on what each individual woman and her partner can do to prepare for their own birth as well as for the post-partum period and beyond. It has a holistic approach, meaning that it addresses not just the need for clinical-type knowledge (i.e. stages of labour, cervical dilation, Braxton-Hicks contractions etc.) but also the couple's need to explore the emotional and spiritual aspects of the radical changes that they are going through. England makes good use of creative exercises such as drawing and sculpting to encourage parents-to-be to dig deep into their unearthed feelings (positive and negative) about pregnancy, birth and parenthood.

Birthing From Within provides accurate, evidence-based information on the various options available to women, and yet it is non-judgemental in terms of individual choices. Following the exercises in this book will help couples work through their "issues" and prepare for the best birth possible for them.

The Breastfeeding Café : Mothers Share the Joys, Challenges, and Secrets of Nursing

by Barbara L. Behrmann

Another book that mixes storytelling with information, it is a wonderful companion to have at your fingertips as you negotiate the challenges and joys of breastfeeding. The stories are brief and engaging and cover a very wide range of women's experiences.

Not Recommended!

What to Expect When You're Expecting

This book is a wonder of marketing. Amongst birth professionals it is commonly called "What to Be Afraid of When You're Expecting" due to the way that it focuses heavily on the possibility of complications. As one Amazon.com reviewer wrote:

This might be good material if you are still planning and have nothing to fear. Or not.

In my case, the idea of pregnancy was a little scary at first, so I bought this book in order to be as well informed as I could... the results were: a whole week crying in desperation and fear that all those awful things could happen to me at once, and the urge to make a bonfire out of the whole book.

Another thing that gave me shivers was the authors' obsession with the nearly demonic effects of eating refined sugar. It seems that all problems in pregnancy are caused by sugar... It's amazing to think how millions of women throughout the decades have had so many kids and are still alive, in spite of the sinful sugar consumption.

Luckily, I have understanding people around me who eased off my mind from the horrors of pregnancy. Now I am prepared to enjoy every stage of this awesome part of my life. With another book, of course.

If you find that the things that you are reading are making you feel stressed, take a break and check in with you body, with your partner, or with a friend to try to figure out what it is about the book that is making you feel anxious. While reading and getting prepared for your birth are excellent endeavours, don't forget to take time to relax and enjoy yourself as well.

The Childbearing Year

Strategies for coping with your changing body:

Swollen extremities?

You probably know that raising your swollen limbs so they are above the heart level can be helpful. Another method to reduce the swelling is to take a cool or cold shower or to just soak your hands or feet in cold water. You can also combine these strategies by using a towel to fasten an ice pack or a bag of frozen vegetables to your hands or feet while also keeping them above heart level. Make sure to have the ice pack wrapped in another towel first so that it is not directly in contact with your skin, and apply it for no more than 20 minutes at a time.

Sore lower back?

Try sitting in a chair with a firm seat and full back support while your partner sits on the floor in front of you and leans back into your knees, or sits facing you and presses your knees back with her/his hands. This will help to relieve the pressure on your sacroiliac joint.

Alternatively, you can try the all-fours position on the floor while your partner presses on your sacrum. For this move it is imperative that your partner knows where the sacrum is before proceeding or you can be injured. It is important to note that this move should never hurt. Check with your Massage Practitioner, Physician or other healthcare professional for guidance if you are unsure and always proceed slowly, stopping if you experience any pain.

Sleeping problems?

Sleeping on your side doesn’t come easily for some. Making sure that you have enough support can go a long way to getting a good night’s rest. Use a variety of pillows to bolster yourself: a small wedge-shaped pillow fits nicely behind your back and a second one can support your belly. You can also use a folded towel for this purpose.

A long “huggy” pillow is good for ensuring that your spine remains in alignment by raising and supporting your top leg and arm (you hug it and hold it between your knees). Finally, get someone to help you to assess if the pillow you are using for your head is the right height to keep your head and neck in line with your spine. Perhaps that same person would be willing to give you a very light massage, just running their hands lightly over your skin to help you to relax and drift off.

Engorgement?

Any breastfeeding woman who experiences engorgement knows that it can be uncomfortable and even painful. And while some measure of engorgement is usually considered normal (and even an essential result of the body’s need to increase production as your baby grows), it is also important to know that moderate to severe engorgement should be taken seriously as it can predispose the breast to mastitis. If you think that you are experiencing unusual engorgement, you should consult your lactation consultant, midwife, community nurse or doctor without delay.

La Leche League International counsels women that, “Mothers experience less severe forms of engorgement with early frequent feedings, self-demand feedings, unlimited sucking times, and with babies who demonstrate correct suckling techniques.”[i] They also recommend a self-massage technique called, “alternate breast massage” which is done during the pauses that occur while the baby is latched and feeding, and is a combination of breast massage and breast compressions (which are well-demonstrated on video on the website of Dr. Jack Newman - http://www.drjacknewman.com/index.php?option=com_content&task=view&id=18&Itemid=42). There are other home remedies that are often very effective including hot and cold therapies, chilled or room-temperature cabbage leaves in your bra, and hand expressing or pumping to comfort. I will be addressing engorgement in greater detail in a later article.

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[i] Walker, Marsha. "Breastfeeding and Engorgement". La Leche League. June 24, 2007 .

The Childbearing Year - New Column by Aimee Sturley

Massage in the Childbearing Year

Part of a holistic prenatal care program

Although massage is thought of by many as a treat for special occasions and spa visits, many medical professionals are coming to understand its importance as a form of complimentary healthcare. Family doctors, obstetricians and midwives are all increasingly recommending massage for their perinatal patients. If you are expecting a child or have already had one (or more) you are aware of the enormous physical and emotional changes that occur in the childbearing year. Receiving regular massage is preventative, restorative and pleasurable and can help you to prepare your body for pregnancy, labour and postpartum recovery.

How does massage help?

Increased weight, the changes in both your hormones and structural alignment, combine with the emotional stresses often experienced during this time can contribute to physical distress and tension. Massage addresses many of the aches and pains experienced during the childbearing year and helps to instil a feeling of well-being.

Circulation of both the blood and lymphatic systems is also improved with massage which results in better nutrition and more efficient elimination of toxins for you and the baby, as well as decreased swelling and varicose veins. Regular massage can help to improve muscle tone, posture and flexibility, all of which will undergo heavy demands during labour and in the postpartum period as well. Massage can also help you to train your mind and body for one of the most important parts of birth: noticing tight muscles and being able to relax them. Regular massage throughout pregnancy can contribute to a shorter labour and reduce distress, complications and interventions.

A Note About Safety

As with any alternative or complimentary healthcare practise, it is important to consult your physician or midwife before engaging the services of a Pregnancy Massage Practitioner. If there are any complications with your pregnancy it is imperative that you relate them to your Massage Practitioner so that they may contact with your doctor or midwife to ensure the most appropriate and effective care. It is safe to begin massage in the first trimester, and it is highly beneficial to begin treatments early before unhelpful habits get established. Your Massage Practitioner can help you to overcome many challenges from sleeping positions, to leg cramps, to ergonomic difficulties while nursing. Getting massage every two weeks in the second trimester and weekly in the third trimester will prepare your body for labour and delivery and the demands of a new baby.

Many expectant parents are told that massage should be avoided during pregnancy because there are certain areas that can send the client into labour. These points (they reside in the shoulders, hands, legs, ankles and feet) are known to those trained in Pregnancy Massage; your Practitioner will strictly avoid these points.

Positioning

If you’ve ever gone for massage before, you have likely spent a good deal of time on your belly and this might make you wonder how on earth a pregnant woman could receive an effective massage as her belly grows. But don’t worry, when the time comes, your practitioner will be very comfortable in treating you in the left side-lying position and will make sure that you are well-supported with a variety of special cushions and pillows. This is the same position that is recommended by healthcare professionals as the safest for sleeping, ensuring unobstructed blood flow through the body and to your baby because the major blood vessels are slightly to the right of the center of your back.

Some practitioners have a table that allows the belly to hang down through a hole into a supportive net. While this may be very comfy for many women, it is also a controversial practise as it has the potential to put the undo strain of the belly’s weight on the relaxed muscles, ligaments and tendons in that area.

In Labour

When you are in labour, massage can assist with your ability to cope with contractions by providing a feeling of reassurance and by blocking pain messages.[i] Your Practitioner can also show your partner or support person a variety of massage techniques that they can use on you during labour. This in turn can lead to an increased feeling of intimacy between the two of you.

In the postpartum period, massage can assist in your recovery by relaxing the muscles that have worked so hard, encouraging structural realignment and abdominal healing (including healing from a Caesarean birth), and provide essential respite from the postural strains and emotional stresses of tending to your newborn. It is usually considered safe to begin massage as soon as you like after a normal delivery and you may wish to find someone who will visit you at home in the first weeks after delivery when getting to a studio or clinic might not be such a simple task The childbearing year is full of tremendous changes physically, emotionally, mentally and spiritually; as you give all your heart and soul to your new baby, make sure that you take the time to replenish your reserves.

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[i] Massage employs something called, “the gateway theory of pain”. The idea behind it is that the “ports” in the spinal cord can only receive a limited amount of information from the body at any one time. The nerves that hook up to these “ports” will deliver messages faster if they are wider in diameter and slower if they are narrower. Because the nerves that deliver messages about pain are narrower than those that deliver messages about touch, the touch messages can reach the spinal cord first and occupy those “ports” so that they are unable to receive the pain messages. This doesn’t make pain disappear, but it can diminish it’s influence. (Melzack, Ronald. "Evolution of Pain Theories and the Neuromatrix". Medscape Today. June 21, 2007 .)