• Skip to main content
  • Skip to footer

Midwifery Traditions

  • Services
    • Home Birth
    • Hospital Birth
    • Gynecology
    • Insurance + Payments
  • About
    • Meet the Midwife
  • Resources
    • Client Documents
    • Local Providers
  • Birth Stories
    • Submit Yours!
  • Blog
  • Schedule
    • I’m a New Client
    • Current Clients
  • Contact

Uncategorized

Breech Week at Midwifery Traditions

March 1, 2019 by Midwifery Traditions

It’s been a crazy week here at Midwifery Traditions with more breech inquiries in one week than in almost 40 years of practice!

According to baby-center.ca “Where there are experienced doctors available and strict guidelines are applied, vaginal birth can be as safe as caesarean birth”.

As of 2009 The Society of Obstetricians and Gynecology in Canada has switched to supporting most vaginal breech births.

When will the United States catch up? Currently, there is a trend in the United States to perform caesarean delivery for breech births. The ACOG (American College of Obstetricians and Gynecologists) states that the mode of delivery should consider patient wishes and experience of the healthcare provider, unfortunately, there are very few experienced healthcare providers because of the trend to default to caesarean births when breech.

Thankfully, locally, there are a few physicians who are providing breech births!

During our research we found that Maternal Fetal Medicine at Jefferson hospital and one physician at Reading Hospital are offering breech vaginal births (for mothers who have had previous deliveries).

Filed Under: Uncategorized

Paid Family Leave in Pennsylvania

April 18, 2016 by Midwifery Traditions

national paid leave***Attention fellow Pennsylvanians and all who support  paid family leave in the United States – There is currently a bill pending in the PA State Senate (SB 541) which would mandate 12 weeks of paid leave for workers in PA! This ground breaking legislation needs your support! Your letters, phone calls, emails, and in-person visits are needed to get this legislation passed. Let the PA State Senate hear your voices by contacting the Committee Chair (Lisa Baker) responsible for bringing this bill to a vote (please see contact information below).***

_________________________________________________________________

A National Look at Paid Leave Progress in the USA

For the first time in American history paid family leave has been a focal point of discussion among the presidential candidates, citing points such as retention of women in the workforce, supporting low income and single parent households, and increasing health and quality of life for American families. While a majority of other nations around the world with highly developed economies have mandated national paid leave programs, the United States has NONE –ZERO-ZIP. Lets take a quick look at what other developed nations are doing…Maternity-leave-chart-final.png

A more recent source from 2015 cites the UK as offering 39 weeks and Canada 52 weeks of paid parental leave [1]. Can you even imagine? Having 52 weeks (13 months) to bond with your baby, transition with your family, and heal from childbirth/sleep deprivation before having to return to work? For many American families it seems unfathomable since many individuals in the USA return to work at 1-6 weeks postpartum, or risk loosing their livelihoods.

20150123-PaidLeave-01

While the American Family and Medical Leave Act (FMLA) guarantees 12 weeks of unpaid leave for individuals who birth/adopt a baby, need to care for sick family members, or need time off for serious personal health conditions, this law only applies to individuals employed by companies with at least 50 employees, for at least 12 months, for 20 hours or more a week [2]. Even if individuals manage to meet these employment requirements, many chose to return to work sooner than 12 weeks because of the financial constraints of being unpaid.

FMLA-Leave-640x360.jpg

I truly hope that federally mandated paid leave passes into law in the USA one day soon, but I would like to take a moment to focus on state mandated paid leave. Currently five states have some form of paid family leave in place, including California, Washington, New Jersey, Rhode Island, and (recently) New York. New York passed the most progressive paid leave bill yet (yay!) at the end of March, 2016, allotting 12 weeks paid leave to individuals welcoming a child or caring for an ill family member. This doubles the 6 weeks allotted in California and New Jersey and triples the 4 weeks of paid leave mandated by Rhode Island. The requirements to qualify for NY paid leave are less stringent and much more inclusive than FMLA, expanding access to more Americans from diverse backgrounds. Side note- NY also passed a bill to increase the minimum wage to $15/hr (rock on, NY, rock on)! For more information on leave requirements and plans for implementation in NY check out this article [3].

posterpenn.jpg

On to examining the wonderful progress in my home state of Pennsylvania! Senator Daylin Leach of Senate District 17 has proposed a bill that would offer 12 weeks of paid leave to workers in PA. Unfortunately, the bill has not gained much traction in the Labor and Industry Committee where it sits, waiting to be called to a vote. Please help push this bill through by calling, emailing, and sending letters (the most noticed form of communication) to the committee chair, Lisa Baker [R]. Click this link to electronically contact Senator Lisa Baker and send your heartfelt words of support for PA Senate Bill 541, Paid Family Leave!

if_you_lived_cropped_sm-1
Senator Lisa Baker
Senate Box 203020
Harrisburg, PA 17120-3020
Room: 362 Main Capitol(717) 787-7428
FAX: (717) 787-9242

Here are some reasons why individuals support paid family leave (all or some of which can be cited in your note to the senator)

  • Bonding and healing after welcoming a child
  • Time for partners to bond and support the drastic family transition of welcoming a child
  • Establishing a breastfeeding relationship, which has longterm health benefits for moms, babies, and the national healthcare system as a whole
  • Supporting low income families, specifically single parents, in caring for themselves and their families while still maintaining economic viablity
  • Allowing individuals to care for aging parents and sick family members
  • Because every other developed nation in the world does it!!

For more information on the benefits of paid leave for women in the workforce, check out this article. For those of you concerned about the impact of this legislation on businesses, check out this article (hint-research shows that paid leave does not harm employers).

Thank you for taking the time to engage in the political process in a meaningful way! If enough of us show our support, we could could realistically become the sixth state in the USA to join the paid leave ranks, making not only a national political stand, but also greatly increasing the quality of life for the millions of people who live in PA!

 

 

 

[1] http://www.oecd.org/els/soc/PF2_1_Parental_leave_systems.pdf

[2] http://www.dol.gov/whd/fmla/

[3] http://nymag.com/thecut/2016/03/new-york-revolutionary-family-leave-paid-time-off.html

Filed Under: Uncategorized

Your Baby’s Position (and why it matters): Part 1

December 29, 2015 by Midwifery Traditions

You may have heard from your provider that you want your baby to be “vertex”, or positioned head-down in your pelvis for the delivery. However, head-down status is not the only consideration. There are, in fact, many varieties of the vertex position, and tons of factors contributing to how your labor and birth will proceed. This two-part series will explore:

  • varieties in fetal position
  • the parts of your anatomy, and how they can affect your baby’s position or the progress of your labor
  • healthy body mechanics for pregnancy and how to encourage optimal fetal position
  • techniques to correct issues

The baby’s inability to achieve optimal fetal positioning due to outside factors, such as the uterus/uterine ligaments, pelvis, and supporting musculature, is known as intrauterine constraint.

Fetal Position

6228c309f03bedaa9349fdf3f6636984

Your baby’s position in the uterus is named by 1) the presenting part, or which part of your baby is entering pelvis first and 2)whether that part is facing the front, back, or side of your body.

About 96% of all babies will go vertex by 36 weeks, due to the weight of their head.

Some head down babies’ heads may be asynclitic, with their head tilted towards one shoulder, or posterior, with their spine towards the mother’s back. These positions, while not ruling out the option of a vaginal birth, are not ideal and can make for challenging labor patterns, a potentially more difficult second stage, and an increased likelihood of operative delivery.

 

Let’s review some essential uterine and pelvic anatomy during pregnancy.

The Bony Pelvis

joints-of-the-pelvis

The pelvis is not one bone, but four: the two innominate bones (you can feel the crests of these at the top of each hip), the sacrum, and the coccyx, or your tailbone. The symphysis pubis, the hard spot you feel at the base of your abdomen under your mons pubis, is commonly referred to as the “pubic bone” but is not actually a separate bone. It is the cartilaginous joint of the two innominate bones of the pelvis. There is a similar joint on either side of the sacrum, connecting all three of these bones together to create the pelvic bowl. These joints are called the sacroiliac (SI) joints, and are a common location for aches and pains during pregnancy when weak or misaligned. Finally, a 4th joint attaches the coccyx to the base of the sacrum. These areas of cartilage are somewhat flexible, and the hormones of pregnancy increase this flexibility.

When the SI joints are misaligned, the shape of the pelvic bowl may be altered and can limit the baby’s ability to descend into the pelvis or rotate adequately, leading to asyncliticism or posterior lie.

The bones of the pelvis come together to create the passage through which your baby will pass during delivery. The shape of this passage varies and is classified into one of four pelvic types. 50% of Causcasian women have a Gynecoid pelvis and nearly half of African American women have an Anthropoid pelvis (a shape also associated with a higher frequency of Occiput Posterior fetal position).

4-Pelvic-Types-edited

“The variety of shapes, combined with the variety of fetal head presentations, plus size variations, mean that labors vary greatly.”   -Spinningbabies.com 

The Ligaments and Fascia

Uterine ligaments act like a sling that supports the uterus.

Round ligaments: attach to pubic bone and top of uterus

Broad ligament (not pictured): connects sides of the uterus to the walls and floor of the pelvis

Uterosacral ligaments: attach the posterior side of the cervical uterus to the sacrum.

These ligaments suspend the growing uterus in the abdomen. If any of these ligaments is tight or torqued, the uterus may be altered in shape and restrict the baby’s ability to freely move. Asymmetry of the ligaments can torque the lower uterine segment and change the alignment of the cervix, making dilation more difficult and painful.

Fascia is the membrane that wraps around all of the body’s muscles and organs and can be damaged by trauma, scar tissue development from surgery, or from poor body mechanics over time, leading to obstruction of movement.

The Muscle

 Many of your muscles can contribute to your stability and well-being in pregnancy. Some of these may also affect your baby’s position.

The psoas, or ‘hip flexor,’ is a posterior abdominal muscle that helps to stabilize the pelvis. It attaches at the thoracic vertebrae and wraps around, over the pelvis, and attaches at the top of the thighs, creating support for our abdominal organs. During pregnancy, the psoas helps support the growing uterus and assist with core stability.  The psoas should be stretchy and mobile, and when tight can encourage pelvic misalignments and prevent fetal descent in labor.  Prolonged sitting, postural imbalances, cycling, and running may all contribute to the tightening of this muscle.

Alternately, excessively lax abdominal tone ( which may be result of previous pregnancies, see our post on diastasis recti) can lead to a pendulous abdomen, where the baby extends too far outward from the mother’s body.  The result is a fetal head that is not settled directly into the pelvis and applied to the cervix, potentially impeding labor progress.

To learn more about the various pelvic types, intrauterine constraint, and optimal fetal positioning , visit spinningbabies.com or attend one of their spectacular workshops.

Stay tuned for part two of this article, where we discuss what you can do to correct these problems and  encourage optimal fetal positioning for labor and birth!

Filed Under: Pregnancy, Uncategorized Tagged With: baby, birth, exercise, fetal position, labor, position

Pelvic Floor Health

November 18, 2015 by Midwifery Traditions

Pelvic floor dysfunction is an issue that we rarely discuss in the United States, yet more than 50% of American women suffer from it in one way or another.[1] Pelvic floor dysfunction (PFD) can present itself in several ways ranging from urinary issues (including stress and urge incontinence, urinary retention, incomplete bladder emptying, and hesitancy), to stool incontinence, chronic constipation, painful sex, an unexplained feeling of heavy pressure or pain in the pelvis, and outright organ prolapse. Women with PFD frequently experience several of these symptoms at once, but commonly do not discuss concerns with providers.[1] Similarly, many providers do not facilitate conversations about pelvic floor health and function, which leaves a very important, core area of the body neglected and operating at a suboptimal level. I propose we start the dialogue with a little anatomy review…pelvic-floor-exercises-4

The pelvic floor is a sling of muscles spanning from the pubic symphysis to the sacrum and coccyx. This group of muscles works along with the boney aspects of the pelvis to provide support to the pelvic organs. Normal contraction of the pelvic floor works to shorten the muscles, lifting the pelvic organs higher into the pelvic cavity. Normal relaxation of the muscles allows the organs to settle back into their original position. If these muscles or structures are not functioning properly, a wide array of pelvic disturbances can develop. [2] Female-Pelvic-Floor.jpg

Until recently, the cause of PFD was poorly understood. Many providers blamed weak muscles, or “low tone,” recommending a vigorous regimen of Kegels or multiple contractions of the pelvic floor muscles (squeezing the muscles as hard as you can).[3] In theory, Kegel exercises work to strengthen the maximal contraction of the pelvic floor, with the goal of creating strength and stability in the musculature. However, the most recent research indicates that PFD is in fact much more complex than the oh-so-revered one- dimensional Kegel. Many physiotherapists go as far as to say that Kegel exercises sometimes do more harm than good.[1]

One of my favorite physiotherapists (with a background in engineering) who addresses this topic is Katy Bowman. She explains that doing Kegels repetitively causes the muscles to contract and shorten, pulling the sacrum into the pelvic bowel towards the pubic arch. This continual contracting motion eventually causes shortening and tension in the muscles. Short, tense, contracted muscles cannot move through their full range of motion properly, leading to weakness and dysfunction.

Picture-5-150x150Picture-8-150x150.pngPicture-7-150x150.png

(The pic on the left is of a healthy sacrum and long, taut pelvic floor. The middle pic depicts the action of the Kegel, shortening the muscles and bringing the sacrum forward. The pic on the right shows what happens to the muscles after repeatedly forcing the sacrum forward. They get slack and weak) *This image is shared from http://www.katysays.com/1234-we-like-our-pelvic-floor/)

Basically what Katy and other physiotherapists are saying is that many people’s pelvic floors are “too tight,” not too loose.[3] One of Katy’s favorite sayings is “tension does not equal strength,” which is perhaps best explained by thinking about a bicep contraction.[6]  When you contract your bicep, you shorten the muscle. If you kept your bicep muscle in a constant state of contraction, you would no longer be able to generate any force or strength with it (meaning you wouldn’t be able to lift anything or have a functioning arm). What makes a muscle strong is its ability to not only contract, but to also stretch and lengthen. Without these opposing forces you are left with short, tight, dysfunctional musculature. Katy does an awesome job explaining the physiology in more detail here.

So what causes pelvic floor dysfunction anyway? Some of you may have been told that pregnancy and vaginal childbirth are to blame for all of your pelvic floor woes. While pregnancy and birth, specifically interventive births with episiotomies, forceps, or vacuum deliveries, are risk factors for pelvic floor dysfunction, it is far from the only cause.[4] Women who have never carried a pregnancy or given birth suffer from pelvic floor issues, and so do men for that matter (read sexual dysfunction and prostate disorders).[3] Lets take a look at some other risk factors contributing to tight and weak pelvic floors.

Sitting on our sacrum is perhaps the biggest threat to our pelvic floors. The constant pressure forces the sacrum inward, chronically shortening the pelvic floor muscles and restricting full range of motion.[6] Humans were not designed to sit on their butts for long periods of time, but rather meant to change positions frequently with lots of walking, bending, and variations in movement. Constant sitting at work, in the car, and at home Mar302011Post_Pic1has contributed greatly to loosing the full range of motion in our hips and legs. One way to combat this is to walk as much as possible during the day. If you work at a desk, take frequent brakes to walk and stretch (we will go over the stretching in a minute). Standing workstations are great options for people with more workplace flexibility. Here is a post from Katy about alternating sitting positions.

The way that we stand also affects pelvic floor function. Many people have a tendency to roll their pelvis forward, or tuck their tailbone under while standing. Another habit that contributes to this posture is clenching of the gluts in an effort to contain urine, feces, and flatus (in other words squeezing your butt muscles trying to hold it).[1] Both of these actions move the sacrum towards the pubic symphysis, while also disengaging the opposing force of the glute muscles.[5] When the pelvis is shifted in this way, our ligaments instead of the boney prominences of our pubic bone work to support the postures2.jpgpelvic organs. Unfortunately, ligaments are not pliable like muscles tissue, and once stretched, they don’t recoil well. By rocking our pelvis back in a neutral spine position, our bones and muscles do the work like they are supposed to, keeping our organs well supported.[3] Check out this helpful video one pelvic range of motion and finding a neutral spine.

Another bad postural habit is chronically “sucking in our stomachs.” Sucking in the stomach causes similar issues that butt clenching does to the pelvic floor; causes tension![6] This increased abdominal tension does not improve strength, but rather causes the pelvis to tilt forward, further tucking the tailbone under. The key here is learning to relax both the core and pelvic floor muscles while also stretching them and encouraging them to lengthen.

Before we get to the stretching, we have to discuss stress. Our modern lives are plagued with chronic stress. Stress causes tension in all of our muscles, including the pelvic floor.[1] We could all benefit from a regular practice of meditation, deep breathing, and yoga to decompress and bring awareness to clenching or tension that we hold in our pelvic floor. Here is a great guided relaxation for the pelvic floor and here is a nice pelvic floor breathing exercise. Remember, muscles have to be able to relax and lengthen as well as tighten in order to function properly.[3]bc9a62ae9bc5cfca70e99d826292feeb

So some of you may be wondering, what do we do to facilitate this taut yet supple pelvic floor? The two most important things we can do is strengthen our glute muscles and increase flexibility in our hips, knees and calves. [6] Strong glutes create opposing force on the sacrum, encouraging it to move away from the pubic bone, thereby lengthening the pelvic floor.[3] There is one wonderful movement that addresses both of these issues: The squat.

Before the advent of modern comforts (cars, chairs, sofas, toilets) humans spent a heck of a lot of time in the squatting position. Anthropologists and physiotherapists agree that this movement is biologically important to human health. Unfortunately, many of us were raised in environments where squatting was obsolete, so our bodies lost the ability to preform this range of motion properly. Our hips, calves, and groins are tight, contributing to our pelvic floor dysfunction and other elimination difficulties (including constipation).[6] If you want to see a perfect, Squatinstinctual squat, watch a toddler squat to pick up a toy. It is a movement that we intuitively do as children, only to be lost to modern conveniences.

For those of us who are not in the habit of squatting regularly, it may take some time to ease into the proper posture. This video explains how to work on proper squatting form from a seated position (this is a good place to start if you are really tight in the hips and weak in the glutes). In this blog post, Katy explains the importance of untucking the tailbone while squatting, showing step-by-step ways to slowly ease the body into proper squatting alignment. Here is Katy’s follow up post with more squatting tips. Squatting is the perfect exercises for the pelvic floor because it works in two ways. First, it works to lengthen the muscles on the way down and second it works to strengthen the glutes on the way back up. You can also vary your glute exercises with one like this. Pay attention to alignment in this exercise, keeping the thighs rolling inward and in alignment in the hips (we tend to let our legs flop out wide, which doesn’t engage the muscles in the same way).

In addition to squatting, there are other exercises that can be done to open up the hips and stretch the legs. Here are two more from Katy. One for stretching the deep hip muscles and one for tight calves. Many yoga poses can also help with hip flexibility including these ones and these ones.Pigeon-pose

Walking outdoors on an incline (read NOT** on a treadmill…the moving belt on the treadmill discourages proper use of the glutes) is great for building gluteal strength. When dealing with pelvic floor issues, specifically incontinence or prolapse, it is really important to avoid high impact activities like running. Running increases the force on the pelvic floor, causing it to strain and work harder to hold the weight of the pelvic organs. [6] Also, any abdominal exercises that increase abdominal pressure should be avoided, including crunches and sit-ups.[1]  For some ideas on safe abdominal exercises check out my other post here.

As I am sure you can tell by now, I think Katy is the coolest person ever. Her work is revolutionizing pelvic floor health and the general principals of alignment and wellbeing. Here are some other posts that I highly recommend addressing high heels and their negative effects on the pelvic floor and using a squatty potty to help get those daily squats in the mix.Fig.1A-1B-1C.png

Incorporating these exercises and alignment strategies into your daily life will help support pelvic floor health, but they are not substitutes for working with a qualified pelvic floor physiotherapist. A physiotherapist will be able to asses your unique pelvic floor needs, including the degree of muscle weakness, muscle tightness, scar tissue, and trigger points that may be effecting muscular function.[1]  Pelvic floor therapists implement many healing strategies including pelvic massage, myofascial release, trigger point therapy, scar tissue release, biofeedback, and neuromuscular electrical nerve stimulation to help restore function to the musculature.[2] They can also recommend individually tailored exercises to work on tension or strength. Many insurance companies will cover at least a few sessions of pelvic floor physical therapy, allowing patients to bring exercises home with them for continued training.

This link  explains the internal work associated with pelvic floor PT and here is a video explaining some simple techniques to assess tension in your own pelvic floor. To find a therapist near you who trained with Katy, check out this link. Last but definitely not least, check out Katy’s DVD with more recommendations for pelvic floor exercises.

Well, I have officially been sitting on my sacrum for way too long writing this post, so time for me to get moving. Best wishes for your self-care endeavors!

 

Copyright © Midwifery Traditions and Associates 2015 all rights reserved

 

THIS BLOG claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please E-mail with a link to said image and it will be promptly removed.

[1] Berzuk, K. (2014). The Pelvic Floor Muscle: the Link Between Bladder, Bowel, and… Sex? A Review of Current Pelvic Therapy Approaches for Diagnosis and Treatment of Sexual Disorders. Current Sexual Health Reports, 6(3), 192-200.

[2] Hartmann, D., & Sarton, J. (2014). Chronic pelvic floor dysfunction. Best Practice & Research Clinical Obstetrics & Gynecology, 28(7), 977-990. Research Clinical Obstetrics & Gynaecology, 28(7), 977-990.

[3] Faubion, S. S., Shuster, L. T., & Bharucha, A. E. (2012, February). Recognition and management of nonrelaxing pelvic floor dysfunction. In Mayo Clinic Proceedings (Vol. 87, No. 2, pp. 187-193). Elsevier.

[4] Rogers, R. G., Leeman, L. M., Borders, N., Qualls, C., Fullilove, A. M., Teaf, D., … & Albers, L. L. (2014). Contribution of the second stage of labour to pelvic floor dysfunction: a prospective cohort comparison of nulliparous women. BJOG: An International Journal of Obstetrics & Gynaecology, 121(9), 1145-1154.

[5] Bowman, K. (2010, May 17). 1,2,3,4 We like our Pelvic Floor! Retrieved November 17, 2015, from http://www.katysays.com/1234-we-like-our-pelvic-floor/

[6]Bowman, K. (2012, April 30). TooTightPelvicFloor 2. Retrieved November 17, 2015, from http://www.katysays.com/tootightpelvicfloor-2/

Filed Under: Exercise, Pelvic floor, Postpartum, Pregnancy, prenatal, Uncategorized Tagged With: GYN Care

Healing Abdominal Muscles After Pregnancy

September 3, 2015 by Midwifery Traditions

One component of the six-week postpartum visit is the assessment of the rectus abdominis muscles. Separation of these muscles is normal during pregnancy as the muscles and connective tissue stretch and thin to accommodate your baby. It can take several months for these muscles to begin to heal and move closer together after giving birth. For some individuals, the separation can remain significant, a condition called diastasis recti. This condition can lead to a weak core, back pain, and a stubborn postpartum belly. Fortunately, diastasis recti can be greatly improved or healed all together with the slow implementation of certain core stabilizing exercises.diastasis-recti-check-yourself-before-you-wreck-yourself-b8a4c

First, it is helpful to
check for the degree of muscle separation. Lying on your back, lift your head and shoulders slightly off of the floor (like doing a mini crunch) and push your fingers down into your belly button. If your fingers sink into your abdomen, you have a separation of your rectus abdominis muscles. You can then move your fingers above and below your belly button to feel the different degrees of separation in different areas. Becoming familiar with your degree of separation is helpful when beginning exercises in order to track your healing progress. Here is a demonstration on how to check for diastasis recti.

 

Before we talk about exercises we that should be doing to premote diastasis closure, lets quickly review what we shouldn’t bdiastasis-recti-1e doing. Abdominal exercises like crunches, sit-ups and planks are counterproductive when dealing with diastasis recti and can, in fact, make the condition worse. Any exercises that cause the abdominal muscle to bulge away from the body (put your hand on your stomach while doing a crunch to feel it for yourself) put additional pressure on those already weak abdominal muscles. Planks force the abdominal muscles to support the internal organs, also increasing abdominal pressure and outward force. Once your diastasis is healed, these exercises can be added back into your routine, but it is important to avoid them while rebuilding your foundational core.

One of the first exercises to begin with after your 6-week postpartum visit is a simple breathing exercise that can help to isolate your core abdominal muscles. Lay on your back, knees bent, with the arch of your back pressed against the ground (you want a flat spine). Place your hand on your belly and take a deep breath, trying to expand your abdominal muscles to push your hand up and away from the floor. As you exhaled, contract your abdominal muscles and pull your belly button towards your spine. This “pulling your belly button towards the ground” action is the foundation for all of the other exercises to follow. You can do this simple exercise in repetitions of ten several times throughout the day until you feel that you have a good grasp on the technique.

Next add the “pelvic tilt” to your practice. Here, start in the same position on your back with your knees bent. This time curl your hips towards your ribcage while engaging your abs and pressing your lower back into the ground. This is a very subtle movement, which works both the core abdominal muscles and the pelvic floor muscles. Check this out for visual examples of the pelvic tilt.
As you progress in your strength and technique, you can add other exercises into your routine. Here is a great guide to 6 exercises for healing diastasis recti (some oabdominal-muscles-diagramf which we already discussed above).

Lastly, here are some other gentle, beginning exercises to work with…
Ultimately, a physical therapist is going to be able to best asses your muscular weaknesses and tailor individual exercises. If you feel that you would benefit from professional physical therapy, please speak to your provider about a referral.

Here are a few physical therapy resources for the local Philadelphia, PA area (**note that we do not endorse any of these providers. This list is simply a place for you to start your own research).

Action Physical Therapy

Central Bucks Physical Therapy LLC

Select Physical Therapy diastasis_recti_illustration3

Image Property of Fit2B https://fit2b.us/how-to-check-for-diastasis-hd/

We know how busy families are with life, children, and especially new babies. I am sure that you are laughing at the idea of exercising with a 6-week-old infant at home. Fortunately, these exercises are really quick and simple and can be broken up throughout the day or even integrated into floor play with little ones. The sooner that you implement gentle core exercise (after getting the go ahead from your provider of course), the better your body will heal. Even if you had your babies many years ago, it is never too late to strengthen these important abdominal muscles! Glute-bridge

For those of you planning on having more babies, check out this post on healthy musculature/pelvic structure and their important role in optimal fetal position for delivery.

Next time we will address pelvic floor dysfunction and how to regain strength in your pelvic floor. To kegel or not to kegel? That is the question! Best wishes for your self care endeavors!

 

 

 

Copyright © Midwifery Traditions 2015 all rights reserved

THIS BLOG claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please E-mail with a link to said image and it will be promptly removed.

Filed Under: Uncategorized

Essential Water Birth Shopping List

August 31, 2015 by Midwifery Traditions

Featured imageMany of our clients are interested in water birth and ask us to recommend products. Giving birth in the water can be an excellent pain management option for women birthing at home and a gentle transition to extrauterine life for your baby. The following list includes the necessities, as well as some of products that I have seen work best over the years.

Let’s start from the bottom:

Protecting your floors

Whether you plan to place the tub on hardwood, laminate, or carpet, a solid tarp that is larger than the circumference of your pool is a great idea. You will likely be frequently be getting in and out of tub and drips will inevitably happen. If you don’t have a very cushy, inflatable bottom (or even if you do), your knees may appreciate some extra padding under the tub. A comforter, sleeping bag, or egg crate foam under your tarp works great.

Will the floors on my second story be able to accommodate the weight of the filled pool? 

I have yet to see a birth pool fall through the floor. Waterbirth International reports the weight of a filled birth tub to be equivalent to 4 adults sitting at a table, or 840 pounds. If you are still concerned, consider a part of the floor with a load bearing wall beneath. Ultimately, you will want your birth tub to be on the same floor as a bathroom and, ideally, near to the bed or other location where you will spend your first few postpartum healing days.

For carpeted floors, consider a plastic drop cloth walkway from your tub to your bed and bathroom. Some drop cloth plastics create a slippery, dangerous situation. Home Depot and other stores with painting supplies offer Self-Adhesive Carpet Protection Film, a temporary, sticky backed carpet protecting drop cloth plastic. It works great, staying in place throughout the day, even with a lot of traffic.

The Tub 

You have many options at a range of prices, listed here beginning with the least expensive/most simple.

1.) “The Fishy Pool”  At under $30, this pool comes at the right price. This is a simple blow-up inflatable children’s pool, without a heating mechanism, handles, cup holders, or other niceties. I have seen all sorts of pools in use, but the most frequent problem encountered is insufficient height. In order to achieve the buoyancy and weightlessness needed for the best pain management in labor, you will ideally have at least 21″ of water (The water should cover your belly while you are in a kneeling/squatting position). Look for three rings and at least 24 inches high. (Hint: You’ll know you’ve hit the jackpot if all of the top Amazon.com reviews are from home birthers!)

Intex Swim Center Ocean Reef Inflatable Pool, 75″ X 70″ X 24″, for Ages 6+

2.) La Bassine Waterbirth Pool: For the taller person, someone intending to use the tub multiple times, or someone who wants a few birth-related amenities, this birth pool might be for you. The side walls of the La BassLa Bassine Eco Water Birth Poolsine have vertical inflatable pockets which create a sturdier feel. The bottom of the pool inflates to a nice cushion, which you will appreciate after several hours of kneeling, and plastic handles are fixed on the inside walls.  La Bassine makes fitted liners for easier clean-up between users and covers to keep the water warm when you are not inside.

Regular Size (75″ x 54″ x 28″): $120.00, www.yourwaterbirth.com

MAXI (75″ x 65″ x 28″): $140.00, www.yourwaterbirth.com

3.) Birth Pool in A Box Eco: This popular option comes with multiple amenities. The BPIAB comes with 6 exterior handles, threeBirth Pool In A Box Eco Water Birth Pools adjustable height rings, an inflatable seat, and a built in cup holder. The “My Anchor” accessory birth pool strap is available for purchase. Some sites include liners, covers, and accessories in one water birth package, or they can be purchased a la carte. This sturdy pool will hold up for many uses. (Personal note: I like this pool and so do my clients, but I feel compelled to mention that I have never once seen anyone use the seat, the handles are used far less frequently than a support person’s hands, and the cup holder is awkward and the drink gets stuck in it. I wouldn’t use these factors alone in the choice of this pool over the less expensive options.) 

Regular (76″ x 65″ x 30″): $210.00, www.yourwaterbirth.com 

  Mini (65″ x 57″ x 28″): $195.00, www.yourwaterbirth.com

Air Pumps for inflating your tub range from manual hand pumps ($5) to quick-fill electric pumps ($25) and are easily found.

4.) The Aqua Doula: This self-heating tub is a unique option for someone who does not want to worry about keeping their water at the perfect temperature. The sidewalls are made of rigid and study foam covered plastic, which some users complain is less comfy to drape themselves over. Additionally, the height is only 24″, just high enough to meet the minimum amount of water needed. At over $1,000.00 to purchase, most people interested in this tub choose to rent from someone local. Ask your midwife if she knows of anyone offering this service. Bonus: rental services typically offer liners, hoses, adapters, and pumps. Some offer set up and clean up as well.

Learn from our mistakes: Protect the integrity of your inflatable pool by keeping pets who like to scratch away!

Getting the Water In and Out

Hoses: A clean, potable hose is needed to put fresh, safe water into your birth pool. Those designed to be drinking water safe are appropriate because they are free of lead and other harmful chemicals. You will be filling your tub from either a sink faucet or shower head, so measure before you buy to get the right length.

Camco TastePURE Drinking Water Hose 25′, $9.97, www.amazon.com

Adapters: You will need a hose adapter for your shower or faucet. These are a couple of dollars and can be purchased online or in hardware stores. Every faucet is different. Please do a trial run in plenty of time to reorder if needed.

Dechlorinating filter: Occasionally, my clients are concerned about the chlorine content of their water, especially if they are getting water from the city (not well water). If this is a concern for you, dechlorinating water filters for your shower can be purchased here for around $40.00 and kept in place for chlorine-free showers.

Water pump: For removing the water from your tub after your birth, you have various options. Pumps can be external (connects to the hose outside of the pool) or submersible. External pumps are least expensive, but very loud. The EcoPlus Eco 396 Submersible Pump, $22.44, www.amazon.com, is an affordable option and comes with multiple adaptors for various hose fittings. You will need a second length of hose to go from the pump to wherever the water will be disposed.

OUR FAVORITE: The two-way siphon. These devices, designed to empty and refill aquariums, are the ultimate for home birth with an inflatable tub. These allow you to remove cool water from the tub and replace with warmer water from the faucet throughout labor. No more messy bailing with buckets and boiling pots of water on the stove. When you want to remove water from the pool, you simply flip the switch near the faucet connection and turn on the water, creating a siphon and sending water down the drain.

Python No Spill Clean and Fill Aquarium Maintenance system-25 ft, $39.99, www.amazon.com

 

 

Another great pump that has been used: https://www.amazon.com/Pump-Marvel/dp/B0742HFT37/ref=sr_1_1?keywords=pump+marvel&qid=1552672732&s=gateway&sr=8-1

Everything Else

  • Towels. So, so many towels. Water Birth Accessories
  • Flashlight
  • Floating thermometer
  • Debris removal net. (hint: Solo or styrofoam cup with holes punched in the bottom work in a pinch)
  • A provider who is comfortable with water birth

You are finally ready to bring your baby into the world in this gentle, lovely way. Remember that not every person ends up delivering in the water. Your midwife may ask you to get out of the tub for some complications or you may decide in labor that you need a change of scenery. If you are planning a hospital birth, you may still like having a tub at home for labor before you go in.  Happy birthing!

Filed Under: Uncategorized, Water Birth Tagged With: home birth, labor, midwifery, natural, pain management, water birth

  • Go to page 1
  • Go to page 2
  • Go to Next Page »

Footer

Quick Links

  • Services
  • Request Initial Appointment
  • Schedule an Appointment
  • Birth Stories

Office Locations

North Office
24 Mainland Rd
Harleysville, PA 19438

By appointment only

Get In Touch

Phone: (215) 249-9646
homemidwives@gmail.com

  • Services
  • About
  • Resources
  • Birth Stories
  • Blog
  • Schedule
  • Contact

© 2022 Midwivery Traditions - All Rights Are Reserved
Site by Chris Hershberger-Esh

Copyright © 2022 · Genesis Custom on Genesis Framework · WordPress · Log in