Habits...we all have them. Ones we need to consciously think about and ones that are so ingrained we could do them in our sleep. There are ones we like and those we have a more complicated relationship with. There are the ones we think of first when you hear the word "habit" and there are ones you're not even aware of, not yet at least. Habits anchor our days, set rhythm and routine, bolster or break health, and are the steadfast behaviors we rely on to do bigger, grander things. Without habits, most of us would be awash in a mix of unorganized actions strung sloppily together until we passed out from exhaustion. Yes, habits conserve a significant amount of energy because they our brain's way of reducing the energy it takes to get through the day.
For some, the mere mention of habits causes an uptick of anxiety and overwhelm...if this is you, your probably of the mindset that habits are hard to come by, hard to break, and hard to form. And your right...to some degree. Forming and breaking habits IS effortful, because the new actions you are taking to form or break the habit is not a habit, yet. Behaviors that are not habitual require a lot of energy. So our brain doesn't like it, making the process challenging... unless you break it down!
This breaking down is what I spent a large part of my graduate education in occupational therapy (OT) school learning about. Discussion, research, and theory around habits and health abound in the occupational therapy literature. Why you may ask? Well OTs help individuals engage in their desired and necessary daily activities in spite of physical, emotional, mental, environmental, social, or even sensory challenges to engagement. So essentially, if you are finding it challenging to do what you want or need to do because of _______ (stress, broken arm, depression, sensitivity to sound, overcrowded work environment, bullying, pain or anything else creating disruption in your day), occupational therapists are THE best health professional to help you get to where you want to go. You don't need to be sick, disabled or injured to benefit from OT... in fact I mostly work with pregnant and postpartum women who often are the "picture" of health on the outside, yet are finding something in their day to day disruptive to their routines and habits.
Enough about what I do, lets get back to how breaking down habits can help you grow or break a habit...
What is breaking down a habit? Let me explain this through an example...
You want to begin a meditation routine and have a goal of 15min per day. You have tried sitting down for 15min and it simply doesn't happen... here are some ways to break it down:
-What is the tiniest little piece of that desired goal habit that you can begin doing?
How about sitting for 1min or taking 10 deep breaths or pausing to admire a flower for 30sec?
-What place are you most likely to do this?
Maybe your favorite chair, at your desk, on your bed or on a bench in the park?
-When do you feel most ready to meditate?
Is it as soon as you get home from work, first thing in the morning, after dinner?
Once you decide on those details, how does beginning the habit of meditating feel now?
Another way is to combine your meditation with another already automatic habit...everyday when you arrive home you put your keys on the hook and go pee then sit for 1 min on your favorite chair to meditate... could stringing the 3 tasks together push or nudge your closer to the ultimate habit? Does the process sound a little easier now?
Now you have taken a tiny bite out of your desired habit, and as you have success with this "tiny habit" allow it to grow. 1-min becomes 2-min which becomes 5-min and before you know it your at 15-min... voila! A habit is forming, your brain is conserving energy, and added bonus, since this is meditation, your brain has now begun to function more optimally by turning on the rest and digest (parasympathetic nervous system) everyday --- but that's for another blog post...
What habit will you begin tapping into through this approach? Share in the comments below!
We have all heard of the "baby-moon", when a couple goes away on a fun little trip before baby arrives. It arose out of the idea that this would be their last chance to get away together for a long time. Why? Because a baby is coming, of course!
This is a VERY quintessential American activity and frame of mind. I would be very curious to hear what couples and mothers from other countries think about the concept of baby-moons. Please chime in...
Now, don't get me wrong, I don't think there is anything wrong with getting away, checking out of your daily routines and having fun with your partner. What I challenge, is why it is socially acceptable for this not to be encouraged in postpartum when it may actually be more vital to the emotional, mental and sexual health of both mom and partner.
Mothers are still lovers, still sexual beings but our societal norms don't support her in returning to this place of sexuality in postpartum. Instead we nudge moms in the direction of striving to be the perfect mom, high performing employee, who keeps up the household routines, and continues to be present and open to all intimate desires of her partner. This is simply unrealistic and every mom I have interacted with has fallen well short of this in one or all areas.
A very challenging aspect of this that often gets completely sidelined because the mom is just not able to do it all is the intimacy and sexual relationship she had/has with her partner. It's the easiest one to shove to the side for a later date. I wonder though, if we supported moms to nurture this more, if that wouldn't boost her ability to show up better in the other areas of her life.
Let's take a step back for a minute and talk postpartum hormones and sexual desire. A majority of women start out postpartum breastfeeding (which I 100% support and encourage for as long as possible), however the hormone that stimulates the production of breastmilk, prolactin, also nudges the body into a menopause like state where estrogen and progesterone levels are low. These hormones are central to sexual desire and arousal in women. When these sex hormones are suppressed due to breastfeeding, it can take up to 45-min for a postpartum woman to achieve arousal. What postpartum woman has 45-min?!?! They are either passed out or breastfeeding again! So let's not just tell mom's "it will happen", "just do it quick", or "it will get better". NO, it very likely will not and this doesn't help anyone- mom, partner or baby!
The best way to reignite sexual desire and arousal in a new mom is to support her (and her breastfeeding journey) so she can step away from her mothering duties for a few days/nights with her partner. Cue the LOVER-MOON! A planned mini-vacation away from baby to support and foster the couples return to a supportive, mutually enjoyable, and sexual relationship. When a postpartum woman is able to receive trusted childcare for several days so she can step out of her role as 24/7 mom for even 48-hours. When she has the time and opportunity to quiet her mommy brain, have peaceful conversations with her partner and explore her new paths of sexuality without disruption, she may just succeed in finding a path back to her sexual femininity that much easier.
So with that, I propose supporting postpartum women in planning a Lover-moon with their partner! Leave baby with grandma, stay at a nearby resort (just in case she need some more pumped milk), enjoy each other as lovers and revel in all you have accomplished together!
#momssupportingmoms #mothershoodsexuality #matrescencesexuality
What is a regulated nervous system?
A nervous system that is functioning optimally which in turn allows the persons automatic, or not consciously controlled, bodily functions to run smoothly. This includes a stable heart rate and blood pressure, normal digestive function and breathing rate, appropriate bowel and bladder functioning and normal sexual functioning. When your nervous system is “regulated” you feel good, you feel safe, you feel comfortable, you feel calm. The signals your body is sending your conscious brain feels appropriate and helpful for the situation you are in.
How does regulating your nervous system benefit labor progression and birth?
If we consider labor, this is not an everyday experience. There are things your autonomic (unconscious) nervous system is doing that aids your labor progression and birth, but they are not normal events outside of labor. Some of these include:
For many birthing people these sensations bring about their fight-flight-freeze response because the sensations are scary, painful, intense and for first timers, unfamiliar. This raises the birthing person's fear and/or anxiety which dysregulates their nervous system. Other external factors can add to this, such as their environment and their interactions with others. If a birthing person has heightened anxiety in a medical environment or they have someone present who makes them feel uncomfortable their nervous system can be even further dysregulated.
Labor in of itself does not cause nervous system dysregulation. In fact, we don’t need to do anything consciously to birth our child. Our body will do it for us. It is our own conscious brain and our response to the signals we receive from our body and environment that causes nervous system dysregulation during birth.
What happens if my nervous system becomes dysregulated during birth?
When a birthing person becomes fearful, stressed, anxious, scared, or even mad during the labor process their emotional response interferes with their bodies automatic responses that allow labor to progress. This can result in a slower labor progression, increased perception of pain, higher muscle tone and tension particularly in the pelvic floor, diaphragm and jaw, as well as a higher risk of elevated blood pressure and difficulty controlling breathing rate. These responses can lead to more nervous system dysregulation.
So things can quickly and easily spiral out of the birthing person's control resulting in a birthing experience that is not what was originally envisioned.
How to keep your nervous system regulated during labor?
Simply understanding this spiral of events can go a long way! Knowledge is power when it comes to birth. The more you understand what is happening the better you can stay in a regulated nervous system state.
Here are my top recommendations for learning strategies that help keep your nervous system regulated during labor:
1. Take a childbirth education class. Whether it’s at your local hospital or through a private provider of childbirth education, it is priceless! Locally I would recommend: Maluhia Mama Hypnobirthing by Nadine Gilmore https://maluhiamamahypnobirthing.com
2. Take a prenatal yoga class that focuses on body awareness, breath and helps you feel good about the power of your body to birth your child. I loved the prenatal classes at Open Space Yoga- due to COVID-19 they are not open but they have an online class for prenatal yoga with teacher Yuko Kowal on their website: https://www.yogaopenspace.com/yoga-hawaii
3. Dive into meditation. Here is my blog post about meditation and learning to meditate during pregnancy: http://www.windwardmaternalwellness.com/blog/i-wish-i-had-done-this-when-i-was-pregnant#/
4. Identify what sensations comfort you best in times of stress and pain. I suggest identifying 2-3 senses that feel the most soothing to you- seeing, hearing, smelling, touching, tasting, movement, and pressure. Your senses are the way your body receives internal and external information and sends it to your nervous system. Knowing the ones that are best for calming you down gives you a direct link to some excellent comfort measure for labor. These comfort measures assist you and your nervous system to stay better regulated while your body does the work.
As your due date approaches you will be able to stay in a more regulated nervous system state if you have put in the time for self discovery and learning that comes with really engaging in any of the above recommendations. Everyone’s path to get there will look different, but we are all capable of getting there.
I wish you the best on your path to an empowered, confident, calm, and beautiful birth!
Pregnant women have unending decisions to make and choices to contemplate during their pregnancy; from what should I be eating to best support my growing baby, to why am I still so nauseous and where will I give birth, all the way to how the heck will I be able to breastfeed for an entire year as recommended! Choosing a doula is often a decision pregnant women do not even know is available to them, yet if they did know it could quite possibly make all of the other decisions and choices related to pregnancy and birth that much easier and less stressful.
A birth doula is defined as a support person for pregnant people. Our job is to provide education and support pregnant people both physically and emotionally before, during and after the birth of their baby(s). The word “doula” comes from ancient Greek meaning “a woman who serves”. For generations women have been supporting other women during labor. It just makes sense. Yet, with the evolution of modern medicine, many traditional means of supporting women during birth went to the wayside. Modern medicine took control of the birthing process in an effort to make it more predictable and safer. In this effort, whether you view it as well intentioned or misguided, the role of women supporting women in labor moved to the wayside. In the 1970s the natural birth movement shifted the focus back to supporting women through labor with the view that childbirth is not a medical procedure but rather a completely natural process. With this movement the role of a doula became a professional, paid and valued service. Whether giving birth in a hospital, birth center or home setting, doulas filled the role that traditionally female family members did, providing continuous support during labor.
When in labor in a hospital, where the majority of births still occur, there are stretches of time where there may be no in person medical support and there is never continuous 1:1 support from any hospital staff. The OB/GYN typically arrives only a short time before pushing occurs in the second stage of labor. Nurses are available but are typically helping several patients at the same time. Many women do not understand this reality and have unrealistic expectations of the kind of physical and emotional support that will be available to them from a professional.
On top of the physical and emotional support, comes the necessity in many cases to make tough decisions regarding medical procedures and options while in labor. An unprepared birthing woman may agree to something that she ultimately regrets due not having the knowledge and support to make the most informed decision when the options are presented to her.
With a doula on the care team, the birthing woman has guaranteed continuous 1:1 emotional and physical support. She will also begin labor with more knowledge regarding the potential choices she may encounter while in labor. This is because birth doulas work with their client’s prenatally to educate, plan and prepare for labor and delivery. There is a relationship that is developed during the prenatal visits that builds trust and confidence between the doula and birthing mother. This relationship establishes a framework for working as a team during labor. There is no need to spend time figuring each other out between a contraction, which often is the case with the labor and delivery nurse assigned to the birthing mother. The doula knows the birthing mothers birth preferences and/or plan as well as comfort strategies that are best received by the mother, because all of this has been discussed and often practiced before labor begins.
By having a doula present at your birth, evidence has shown that the birthing mother is more likely to reflect on her birth as a positive experience. She is less likely to have a cesarean delivery and to require an epidural or pain medication. It has also been shown that pain perception is less with doula support and the duration of labor is reduced. Some of these outcomes have more statistical significance than others but all stack the cards more in your favor for a positive birthing experience than if you did not have a doula on your care team.
Finally, imagine a birth where you are with only your partner for up to 30-60min at a time while you go through countless contractions, you have no idea how to make yourself more comfortable and feel out of control because you don’t know what to expect or what to ask. Now imagine a birth where from the moment you thought you were in labor you had support from a trained birth professional, your doula. In early labor she will coach you over the phone on what to do to rest, relax and be comfortable. She will help you make an informed decision on when to go to the hospital. Once you arrive at the hospital your doula is by your side the entire time. She is providing you with suggestions on positioning, relaxation and breathing, while supporting you physically in any position that gives you a sense of relief, rest or comfort. When and if things go not as planned, she is prepared with evidence based information to base your decision on. She is by your side every step of the way, serving your needs and yours alone. Which birth would you prefer?
I would be remiss if I did not comment on how birth doula support may look in the context of the current COVID-19 pandemic. The benefits of birth doula support are unchanged but the process may look different due to certain restrictions placed by organizations including hospitals and the CDC. To begin prenatal visits are likely to occur over a video platform such as Zoom. These visits are likely to be longer due to the need for the doula to provide more upfront education to prepare the birthing mother (or couple) on how to perform many of the physical support strategies that the doula would typically do at the birth. This is a because there is a higher possibility of the doula not being physically present during the birth due to hospital support person guidelines during the pandemic.
If the doula is unable to be present during the birth, she will be available for intermittent phone or video based check ins throughout the labor stages. This will look different for each client due to the vast variability of labor progress and presentation, as well as differing individual needs for each birthing mother. However, a typical pattern would be to check in when things change, for example when transitioning from the first to second stage of labor. During the check in the doula is available for educational and emotional support, intended to boost the mothers morale and help provide evidence-based information for any decisions she needs to make. The doula will also provide suggestions for physical support strategies that the birthing partner or nurse may be able to provide to help progress labor or provide more comfort during and between contractions.
Despite the uncertainty of today, a birth doula’s value has not changed. How we deliver services, just like the way we shop for groceries and socialize with friends, has changed. Fortunately, doula’s are masters of flexibility, rolling with the punches, remaining clear headed, calm, nurturing and last but not least supportive.
If you or someone you know may be interested in birth doula support during this exceptionally unpredictable time, please contact Windward Maternal Wellness at firstname.lastname@example.org. We are currently accepting clients for January, February and March 2021.
Learn how to meditate. Yes, I wish I had learned how to meditate and made it part of my daily routine when I was pregnant. Unfortunately, I did not and it never ever crossed my mind, nor was it ever recommended to me by anyone or in any book on pregnancy. Instead I focused on reading as much as I could about birth, labor and what the heck you do with a baby. I didn’t think much at all about my postpartum period and ultimately came to the conclusion that it wasn’t anything I could plan or prepare for so I will just have to wing it. In retrospect, I don’t believe this is entirely true. I think there are ways to prepare, but there is no way to truly understand what it will be like until you go through it. I feel the time I had during pregnancy would have been well spent learning how to meditate and would have prepared me for what was to come much better than anything else I could have done. The research behind the benefits of meditation abound and the postpartum period is likely the most stressful and transformation time in a woman’s life. Having meditation in your life and daily routine could do wonders for your mental health and overall sense of wellbeing during this time.
Let me tell you about my recent journey into the world of daily meditation while in quarantine with a 1 and 3 year old. I have meditated on and off for about 8 years, my longest stint was about 4-months when I would meditate 5-6x/week for about 10-15min in the morning. This was when I was childless and even then it felt like such a chore and was never easy or routine, so it never made it into the habit phase. Since that time I dabbled here and there, going to lectures and guided meditations whenever possible and to be perfectly honest, whenever convenient which was not often. Over the years I have read about the unending benefit of meditation and know the science pretty much not debatable. Meditation is the best medicine for our brains, hands down. I tried to learn, I tried to teach my clients what I learned in hopes it would help them, but it always felt so hard. I knew it was supposed to feel easy, what was I doing wrong? I have come to find out that I was trying too hard, too infrequently and without a clear plan or recipe to follow but rather a mish-mosh of techniques mostly designed for monks rather than “real” people.
“Wait a minute, I have been learning meditation intended for individuals who spend their entire life in meditation and there is a meditation out there designed for normal people? Why has no one been talking about this?!”
In March, I found myself furloughed from my clinic job with more time on my hands than I had ever imagined I would have until my kids left home. After the first week I had exhausted my social media and news apps on my phone. I had cleared my inbox and in doing so realized I could get a pretty sweet deal on just about any home exercise program I could possibly want yet nothing piqued my interest. Then on a childless (thank you mom and dad) drive to the grocery store I heard about Ziva Meditation taught by Emily Fletcher on some “mom” podcast. I was immediately sold by her description of the meditation she taught being for regular busy people instead of monks. I thought, “wait a minute, I have been learning meditation intended for individuals who spend their entire life in meditation and there is a meditation out there designed for normal people? Why has no one been talking about this!”. It sounded like exactly what I needed to embrace the slowing down being forced on my life. So I signed up and diligently learned the Ziva Meditation technique over a 15-day period, spending 20-30min in the early morning then another 15min in the early afternoon. I had committed to this twice a day routine with the support from my husband who graciously agreed to take over morning duty to allow me the time to meditate before coming down to greet the day. This change in routine was a life changer!
I am now about 4 months into my daily meditation routine and I have not skipped a day and have only missed a meditation about 10 times. My energy immediately surged and my mental clarity has greatly improved. My thought trains feel more clear and organized. My anxiety brain is so much quieter, I worry less, and I feel a greater sense of peace in my days. I still get overwhelmed, angry, sad, mad, stressed, and anxious but the intensity and frequency in which these unpleasant emotions arise is markedly improved. The Ziva meditation technique has made it to the level of habit. I miss it, I yearn for it, I look forward to it- especially the 2nd one of the day. Without it, I’m wiped out and exhausted by days end. With it, I can often sit down and bang out another solid 1-3 hours of focused work after my kids are asleep. This was unfathomable 6 months ago.
“Every first-time pregnant mom should take the time during pregnancy to establish a solid meditation habit and routine”
I could go on and on about my adoration for meditating twice a day, instead I am going to shout from the rooftops right now that in addition to childbirth education classes, every first-time pregnant mom should take the time during pregnancy to establish a solid meditation habit and routine.It will be a challenge to adjust the routine when your baby arrives, but I believe it can be done. For me, I would have definitely done it while breastfeeding my marathon feeder who would sometimes go for 45-60minutes! I could have been meditating instead of reading about what so and so is doing and your not and going down the “oh my god, I’m a horrible mom” train, I could have been nourishing my brain by de-stressing and finishing with manifesting what ever the heck I want- including be the best mom on the block or whatever floated my boat at that moment. Any new mom with the ability to maintain a brain that is routinely distressing and building up its reserves will function better, feel better and be better. Meditation is a new mom’s best tool for feeling like herself in the midst of complete life transformation.
“Life would have been a bit easier, a bit more hopeful, and a bit more peaceful”
So yes, I wish I had learned to meditate when I was pregnant. I wish I had this tool in my routine 4 years ago. Life would have been a bit easier, a bit more hopeful, and a bit more peaceful. I also hope that moms out there will read this and take what I have to say to heart and find benefit in their life with this advice.
Please spread the word, share this post, tell a friend, post to your Facebook page!
This post comes from my heart to yours. I have no connection what so ever with Ziva. Ziva is one method of meditating. It worked great for me and could work great for you. I encourage you to look into Ziva (Click here) but above all else I encourage you to find your own path to a routine meditation practice.
When I think about the role of postpartum doulas the word matrescence immediately comes to mind. It is a word I came across after the birth of my second daughter in a New York Times article called “The Birth of a Mother” by Alexandra Sacks, MD . Matrescence simply means transition into motherhood but encompasses so much more. Similar to the word “adolescence” it is a time of transition- emotionally, physically, mentally, socially and even environmentally. Everything about that woman’s life is different. Her body is not what it was before. She’s on a hormonal rollercoaster. There has never had so many thoughts swirling in her mind, all somehow linked to an innocent little human she just met. These thoughts run the gamut from overwhelming love, confusion, disdain, awe, and even disbelief. Her friends and family who have also gone through matrescence are sharing stories that she has never heard before and she is being welcomed into a new community. While her friends and family who don’t have children often don’t relate anymore and/or simply disappear. Finally to top it off she has a new “roommate”who needs 24-hour care and nurturing but doesn’t talk. Nothing is the same and everything can be wonderful and terrifying at the same time.
Since the beginning of civilization, traditions have existed to ease the transition into motherhood. Although slightly different from culture to culture the common thread is the new mother being surrounded by a community of knowledgeable and caring women for weeks to months after childbirth. They teach her, nurture her, heal her and most of all provide her with support to become a healthy, strong, confident mother. Fast forward to the 21-st century and you see these long held traditions breaking down with the surge of modern technology, the push for equal rights for women, and rapidly increasing numbers of women having children without skipping a beat in their profession. There are many factors at play, but the result has been a cultural push to have a baby and get back to “normal” as quickly as possible while doing it all by yourself. “I am woman, I can do all and make it look easy” is the motto.
Unfortunately, this is simply not realistic for the majority of women. Many new mothers underestimate the postpartum period as they focus on labor and delivery throughout pregnancy. Then they are hit overnight by the most overwhelming of circumstances without a community of women to back them up. This is an all too common scenario resulting in potentially poorer outcomes for both mothers and babies. Women need support. Women need a village, no matter how small, in the postpartum period. They need reassurance that they are capable. They need to be mothered themselves. They need respite from infant care that they can trust. They need to be able to focus on the developing bond between themselves and their baby, while letting go of their other day-to-day stressors. Postpartum doula’s can fulfill all of these needs and do it with kindness, knowledge, trust, sensitivity, reliability, and flexibility.
When a postpartum doula is present in the first weeks to months after delivery, mothers (and fathers) can focus on bonding with their baby. The doula can assist with reducing the daily stressors by helping with many different tasks including but not limited to meal preparation, basic housekeeping, running errands, breastfeeding support, infant care, education on infant care, respite from infant care, and referring families to community resources for additional support or skilled services such as lactation consultants. In addition to this, doulas provide emotional support to the mother during her matrescence. Often having another person who will listen, offer advice, and hold space with her, can be the difference between feeling constantly overwhelmed and feeling the bliss of new motherhood.
Postpartum doulas work to continue the wonderful traditions of generations of women that have gone before them in the care of new mothers. In the period of matrescence, postpartum doulas hold the mothers hand and guide her toward becoming the mother she envisioned.
If you or someone you know would benefit from postpartum doula support please contact Windward Maternal Wellness today. Our team of certified postpartum doulas are ready to support, educate, and partner with your family as you begin your journey into parenthood with grace, peace, and love.
This past weekend I had the honor of attending and hosting my first celebration of motherhood for a dear friend. The event included several ceremonial activities followed by the sharing of a meal that highlighted several nourishing postpartum recipes. Each guest was asked to bring flowers and greenery from their yards and a plate of food to share.
Upon arriving, the mother to be's feet were cleansed in a lavender epsom salt bath with plumeria petals. Next, each guest was given a cup of ceremonial hot chocolate to sip on together as a blessing candle was passed. The guests took turns blessing the mother to be with kind, encouraging and most of all supportive and loving words. Finally each guest contributed by making a portion of a beautiful haiku lei (flower crown) as a symbol of the community of women that surround the mother to be with love and support as she moves into her next phase of motherhood- mother of 2 boys! It was a beautiful day filled with love and community.
I had never heard of a celebration of motherhood until reading the book "The First 40 Days - The Essential Art of Nourishing the New Mother" by Heng Ou. It was recommended to me a friend, Robin Deem of Caligirl Cooking and I will recommend it for years to come. The book discusses the challenges of postpartum in our modern world and how traditional practices, though unfamiliar to most, offer support the mother needs to build strength postpartum both physically, mentally and emotionally.
In chapter 3 "Gathering", Ou lays out a 3rd trimester checklist including items like stocking your pantry and freezer, creating your nest and assembling your helping hands. Then she goes into two items I completely missed in my second pregnancy- honoring yourself and fortifying your relationship. The later calls for another post, but the idea of honoring yourself struck a chord with me. Even in 2nd, 3rd and subsequent pregnancies we often still focus on the baby! I know I did, only taking a 3 trips to a float tank the whole pregnancy for self care time. They were heavenly, but they didn't honor me, I was motivated to do it for the benefits to my baby.
Ou notes "contemporary society, is notably lacking in ceremonies or rituals in which significant passages in life are honored." What a true statement! Whether its the first or fourth time, the passage into motherhood or a new stage of motherhood is something to be honored and an opportunity to bring the mothers' community together to honor her. Labor and birth are some of the most beautiful, humbling, raw, scary and miraculous moments of a women's life. Entering this last stage of pregnancy with the knowledge that she has support, love, kindness and blessings from her community can bolster a mother to move forward with confidence, peace, and assurance that although we may not physically be with her, we are there in heart during her labor and delivery. Once baby arrives, she will be surrounded by a community of women to literally hold her hand or make her food, or watch her older children so she can heal, restore and be nourished physically, emotionally and mentally in those early days postpartum.
A celebration of motherhood is a beautiful alternative to a baby shower that shifts the attention to the mother in the most beautiful way. Every mother deserves a day of honoring.
If you would like more details about organizing a Celebration of Motherhood please contact Windward Maternal Wellness and we can offer ideas, recipes, and support in planning a beautiful day for the special mother-to-be in your life.
By the time your were about 3 years old you were potty trained. You had mastered the independence of using the toilet and further conversation about toileting and your urinary system in general rapidly declined and ultimately stopped by about age 4 or 5. No one talks to us about normal patterns around urination once we graduate to big girl panties. We carry on without little thought or concern about urination throughout childhood and into adulthood. Some of us are lucky enough to never have to think about it again, but for millions of women around the world there comes a time when urinary incontinence reappears.
When this happens, most women do not talk about it and simply find a bandaid. After all, it's pretty easy to place a pad in your panties and carry on like nothing abnormal is occurring. Who wants to talk about dribbling urine in their underwear over mom's night out cocktails? There are so many more socially acceptable things to discuss during your precious time without kids! This mindset is why so many women wait an average of 8 years without treating the completely curable problem of urinary incontinence. It's embarrassing and easily covered up! However, it also causes undesired changes in routines and habits that can add to anxiety, stress, social withdrawal, and even result in institutionalization. According to the book "The Bathroom Key" by Kathryn Kassai and Kim Perelli "urinary incontinence is a leading cause of nursing home placement in elderly women."
Urinary incontinence is any amount of leaking of urine when not on the toilet. There are 2 main types of urinary incontinence: stress and urge.
Stress incontinence is when you have leaking of urine during activity such as walking, jumping, standing up, lifting or sneezing. This type is a physiological problem related to weak pelvic floor muscles. Urge incontinence is when you have leaking of urine on the way to the bathroom or in association with an urge to urinate. Urge incontinence is both a physiological and psychological problem. The bladder has lost it's ability to regulate urges and the pelvic floor muscles are weak. Both types of incontinence can occur together and this is called mixed incontinence, which is very common. Whether you have stress, urge or mixed incontinence it is curable with pelvic floor occupational therapy offered by Windward Maternal Wellness.
We should all recognize that no degree of urinary incontinence is normal. Not during pregnancy. Not after childbirth. Not after menopause. Not ever. Seeking out professional treatment is the best way to find a resolution to your incontinence and here are a few things you can do at home.
1. Identify if you have stress, urge or mixed incontinence based on the description I provided above. Once you know what you have, you can better direct your efforts to reduce incontinent episodes.
2. Since both types usually involve weak pelvic floor musculature, I recommend making sure you can identify contraction and relaxation of your pelvic floor through the use of Kegels. Many women with incontinence have difficulty completing a full range of motion Kegel. This means completely contracting and relaxing the pelvic floor muscles. Here are 2 ways to "find" your Kegel or pelvic floor muscles:
-"Stop test"- when you sit on the toilet to urinate, try to stop your flow mid-stream then allow it to resume as usual. You must activate your pelvic floor muscles to stop or slow the urination. Be aware that this should not be done regularly during urination as it can lead to other problems. Simply use it as a diagnostic test for yourself.
-Holding in gas (or urine)- most of us do not want to pass gas when in the presence of others. To prevent the passage of gas, you must contract your pelvic floor muscles. Many of us do this almost automatically, but to better identify the sensation of your pelvic floor muscles, I ask my client's to contract their anus as if they are preventing the passage of gas. Even better, is if you can contract your pelvic floor muscles as if you are trying to prevent the passage of urine and gas at the same time.
Once you have mapped in your mind the sensation of the contraction and relaxation of your pelvic floor muscle, you are one step closer to reducing urinary incontinence. However, if this was difficult keep practicing or reach out to a pelvic floor occupational therapist.
3. For urge incontinence I recommend keeping a bladder diary. Record how many times you urinate in 24 hours for a 1-2 weeks. You should be somewhere between 6-8x per day, but most women with incontinence are much higher. Without concern for nighttime urination patterns, begin to try to stretch your daytime episodes of urination further apart by using these strategies:
-Reduce your intake of caffeine, citrus, alcohol and spicy food, which are all bladder irritants and can increase your urge to urinate unnecessarily.
-When you feel an urge to urinate, sit down and complete 3-5 SLOW Kegel exercises. Squeezing your pelvic floor muscle up as you exhale. Often this can delay the need to use the toilet by 10-15min or more.
4. For stress incontinence, I recommend learning how to link your breath with your Kegel contraction. Laying on your back with your hands on your stomach, take an inhalation and allow your stomach to rise and pelvic floor to be relaxed. With your exhalation, draw your stomach muscles inward and up toward your head, while also drawing or contracting your pelvic floor muscles up. Do this exercise 10x holding each upward contraction for 2-3seconds before relaxing completely. You can progress this same exercise from laying down to sitting and standing as you begin to feel the sensation strengthen.
As with any health condition it is often best to seek out professional evaluation, support and treatment. Windward Maternal Wellness offers pelvic floor rehabilitation in the comfort of your home. Reach out to us today to design a personalized treatment plan that will end your need for planning your day based on the accessibility of a bathroom, wearing only black or avoiding exercise that you deserve to do without leaking! Urinary incontinence is curable and we can help!
Hilary Valentine, Owner of Windward Maternal Wellness
I was born and raised in Massachusetts but I have called Oahu my home for the past 14 years. I live with my family in Kailua, including my husband, Jason, my daughters, Victoria and Gwendolyn and my parents, Nanette and Geoff. This blog is intended to shine light on both my work as a women's health occupational therapist and postpartum doula, my personal views on lifestyle topics such as parenting and women's health as well as a resource for education on topics relevant to the clients I serve. I welcome any and all comments and feedback! Mahalo!