PMS Premenstral Syndrome; A Natural Alternative Part 2

Natural Treatment for PMS

Many PMS symptoms do respond well to simple lifestyle changes and safer, more affordable,  traditional time-honored remedies. Experiment with the suggestions below and find those that work best for you. Allow a few cycles with each to properly assess their impact. But, full recovery  begins when you start by honoring your cyclic lunar nature and giving yourself permission to take a monthly hiatus. Trust your body’s inner wisdom and ability to tell you what’s needed. Use this information to reset and heal, embrace your inner wild and the full range of emotions you feel from grief and rage to joy and calm. 

The goals are to reset your body and its natural ability to heal and function optimally by: 

• Reducing root causes like inflammation, toxic exposures, estrogen excess and stresses, gut flora and blood sugar imbalance

• Getting adequate nutrients from food, nature and supplements

• Supporting your stress response, liver and regular bowel movements for detoxing

• Empowering mindset and nurturing your spirit.

SELF-AWARENESS

To increase self awareness, start a journal of your symptoms, noting when they occur in relation to your menstrual cycle, the degree to which each one bothers you or interferes with your ability to function as usual, what triggers them, and what helps. Also pay attention to the food you eat and how it affects you. Try to list at least one possible symptom and some ways in which the PMS experience can be viewed and used to your benefit, an opportunity for deeper meaning and transformation.

Identify vulnerable times and plan accordingly. For example, avoid situations likely to provoke difficulties, put off important decisions and problem solving until later in your cycle when you feel more balanced and clear, schedule extra time for rest, relaxation, enjoyable activities, and support from family and friends.

Openly acknowledge your symptoms to yourself and others most affected to enhance understanding and acceptance. Create your sisterhood tribe of like-minded uplifting women and share your experience with them. We are wired for community. Aside from feeling that you are not alone and isolated, community helps you feel connected, understood and validated, as well as loved and supported. This may also lead to a good laugh and soul nurturing hugs…both are very healing. If you don’t have a community, start by finding a local red tent meetup near you, join the red tent movement or organize your own red tent or moon lodge women’s circle.

DIET AND LIFESTYLE

A healthy diet can make a world of a difference and has short term and long term health benefits that extend far beyond relief of PMS. Maintain excellent nutrition by eating 3 whole, real, organic meals and healthy snacks throughout the day of a variety of nourishing foods. Listen to your body and eat only when you are hungry. 

Include lots of organic fresh fruits, vegetables, nuts and seeds, and fermented foods like kimchi. If you eat grains, make sure they are whole. Eat 20-30 grams protein three times daily such as in nuts, nut butters, seeds, beans, and pastured organic animal protein if not vegan (like wild Alaskan or Norwegian salmon and other fresh cold water fish from non polluted waters, organic pastured eggs, chicken, turkey, beef, lamb, and organic pastured raw goat or sheep dairy). Add a few TBS of ground flax seed to your daily smoothie, applesauce or oatmeal.

Make sure to boost your intake of cruciferous veggies like broccoli, cauliflower and cabbage to balance your hormones. Load up on healthy fats and protein if your symptoms are primarily emotional. Many women feel best physically and emotionally by avoiding genetically modified foods, cane sugar (raw honey, maple syrup, coconut and date sugar are better substitutes), soy, dairy (especially cow) and gluten (choose gluten free grains like oats, kasha, millet, quinoa, and nut flours for baking), and organic living. Eat a paleo, or ancestral diet, basically basically how we used to eat when hunting and gathering, before the mass industrialization of food. Switch to using organic foods, body and household cleaning products without harmful toxic chemicals as much as possible. 

Drink at least 64 ounces per day of filtered, spring or well water between meals (at least 20-30 minutes before or 2 hours after eating). Use cold pressed extra virgin olive oil, coconut oil or organic goat butter or ghee as your primary cooking fat, with sea salt and herbs for seasoning.

Foods to limit or avoid altogether include:

• Processed foods high in sodium, chemicals, refined (white) flours, gluten, soy, cane sugar, partially hydrogenated fat, as these substances all exacerbate PMS symptoms and cause weight gain, as well as other health problems. 

• Commercially raised meat, eggs and milk products from hormone and antibiotic medicated animals confined and not fed their natural clean diet. Depending on your symptoms, you may need to avoid dairy completely. 

• Caffeine found in coffee, black tea, soda, chocolate, and combination over the counter drugs to relieve menstrual cramps such as Midol.

• Alcohol, smoking, and street drugs.

• Toxic cosmetics and body products, household and workplace chemicals, plastic food containers and packaging, pesticides.

• Mind altering medications like sedatives, tranquilizers, sleeping pills, antihistamines and steroids, even common antibiotics and over the counter medications like acetaminophen and ibuprofen unless absolutely and medically necessary. You can aim for a medication free life as much as possible.

Investigate natural alternatives to medications. Acupuncture, Chinese herbs and homeopathy have provided relief to many women with all types of menstrual problems. They are especially helpful if your PMS symptoms are recurrent, chronic and/or so disturbing as to interfere with your sense of health and wellbeing. Try the lifestyle changes and natural supplements and herbal remedies discussed here for a few months, track how you feel and marvel at how much better you feel.

Consult some of the many resources available that discuss how to make healthy but delicious changes in your diet at home and on the road, such as Eating Well for Optimal Health by Dr Andrew Weil and Dr. Kelly Borgan’s Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies to Reclaim Their Lives. Wonderful wholesome paleo cookbooks include:

•  Well Fed: Paleo Recipes for People Who Love to Eat

• The Wellness Mama Cookbook: 200 Easy-to-Prepare Recipes and Time-Saving Advice for the Busy Cook

• Paleo Comfort Foods: Homestyle Cooking for a Gluten-Free Kitchen

•  Make it Paleo: Over 200 Grain Free Recipes For Any Occasion.

Make sure you are getting enough sleep at night, and rest during the day, and that you get plenty of fresh air and adequate exposure to sunlight during non-peak hours. Weather permitting, spend at least 20 minutes outside with nature in the early morning or late afternoon sun each day.  Allow time for enough sleep at night and rest during the day.

Regular exercise does wonders to prevent and relieve PMS symptoms. Take a brisk walk, dance or an aerobics class, swim, hike, cycle, play tennis, or do whatever moderate activity you enjoy for at least 30 minutes 5 times per week. Authentic yoga has many added benefits, such as enhancing deeper relaxation, inner balance and improving general well-being. I suggest trying a few studios to find the best fit for you, taking regular classes as well as creating your own yoga sanctuary for home practice.

SUPPLEMENTS FOR PMS

For general health and physical and emotional well-being, make sure to take the supplements here that include a whole food multivitamin, omega threes, probiotics, Vitamin D, plus:

• Calcium, 250-500mg 2-3 times daily

• Magnesium glycinate, citrate or taurate, one of the most important supplements for women, 500-800mg 1-2 times daily (aim for approximately equal amounts of calcium and magnesium, or even double the magnesium, but you can reduce the magnesium if you get diarrhea, or divide the doses throughout the day with the capsules or in tasty powder form) and bathe in it before bed for 15-20 minutes, adding 1 cup Epsom salts to your bath for a restful sleep

• Vitamin B complex, 20-50 mg 1-2 times daily with methylated folate  

• Vitamin B12 sublingual (under the tongue), in the form of methyl, hydroxo or adenosyl cobalamin,) 1000-5000 mcg daily to 2-3 times weekly depending on symptom severity and blood levels

• Vitamin E, 400 IU 1-2 times per day (higher doses with premenstrual water retention and cramps)

• Curumin (Turmeric), 500 mg 1-3 times daily to reduce inflammation linked to depression, anxiety and other mental health challenges

• Evening Primrose oil, Borage or Black Currant oil, 500-1300 mg 1-2 times daily

• Maca powder or capsules to balance your hormones, stress response and relieve PMS

• DIM (Diindolylmethane), 25 mg of 25% diindolylmethane, from Brassicacae vegetables and/or Sulforaphane, 400-800 mg daily, or add Broccoli Sprout powder to your cooking to balance the estrogen dominance

Make sure you are getting enough essential fatty acids by taking 1000-2000 mg of the fish oil with 300 mg DHA/EPA twice daily, and adding the additional Evening Primrose, Borage or Black Currant oil all with GLA (gamma linoleic acid). Metagenics, Vital Choice, New Chapter, Innate Response and Nordic Naturals make high quality, trusted fish oil supplements, tested free of toxins and pollutants. But, as with all supplements, give a 6-8 week trial of continuous use to see results.

If You Have Troubling Emotional Symptoms

Implement the lifestyle changes and natural remedies for stress and emotions that apply not only in pregnancy but beyond, and certainly are critical for relief of troubling emotional PMS symptoms. Learning how to calm yourself and activate your relaxation response is key, using a regular practice of meditative breathwork. Biofeedback, energy medicine, hypnotherapy and self-hypnosis can also do wonders, but deeper transformative healing, release of stuck emotional and past trauma energy comes with conscious connected breathwork.

Spend more time outside in the sun as mentioned above, non peak hours, ideally without or low dose all natural sunscreen. If you do not spend at least 2 hours daily in the sun (a cloudy or winter day is sufficient), buy a full spectrum bright light therapy for the indoors, and expose yourself to 2500-10,000 lux two hours per day.

BALANCING EMOTIONS

Seek balance in your emotional life, instead of going for highs and the lows that follow. Surrender to and embrace the cycles of life and its ups and downs and ups again, and know that day always follows night, and light always comes after darkness. Nothing is permanent, including waves of emotion. Learn how to ride them, move them through your body with dance or breathwork, without getting too attached to any one feeling or the story around it.

Live one hour at a time, or better yet, one moment, one breath at a time. Become intensely conscious of the present, and acutely sensitive to your feelings and inner experiences, using all of your senses. Observe, watch and allow whatever comes up without judgement or thought.

Life is stressful and always has been, and eliminating all outside stress, especially that which we can not control, is not an option. We can only work on changing our outlook about stressors we cannot change. This involves deep profound and rewarding transformation, cultivating spirituality, and an attitude of surrender, acceptance, realizing that very little in life outside of our own way of thinking and behaving is in our control, and believing that everything happens for our ultimate benefit and growth as a human being, even if we do not understand why. 

RELAXATION TECHNIQUES

You can learn to activate your own relaxation response to stressors and quiet your nervous system with breath awareness and relaxation techniques, mastery over your thoughts, and also by modifying what you can in your day to make it less stressful and more in alignment with your core values. This includes, for example:

• Cutting down on the added nonessential burdens in your life, especially if you feel overwhelmed

• Avoiding overscheduling yourself

• Changing work hours to avoid rush hour traffic

• Allowing more time to get places

MINDFULNESS AND MINDSET

A wonderful life-changing approach to internal stress, feelings of depression and anxiety is learning about present moment awareness and mindfulness, and incorporating them into your daily life.

Know that you are in charge of the thoughts you dwell on, feelings and how you react to stressful or painful situations, and that you have the ability to change your attitude and reaction to life experiences to more health enhancing responses. For example, you can surrender to and totally accept unpleasant life events over which you have no power. You can also view them as potential gifts, powerful stimulus to change, a wake-up call, an opportunity for personal growth, redirection and spiritual practice. 

You can always try to focus as much attention as possible on the now, literally without letting your thoughts wander and dwell into the past or imagined future. Mastery over your thoughts, attitudes and reactions can have a dramatic impact on your brain chemistry, balancing the hormones responsible for affecting moods and emotions, and preventing and even treating clinical depression and anxiety.

Reduce feelings of tension and increase feelings of calm centeredness and balanced grounding by taking a “healing interval” to meditate for 10-20 minutes 2-3 times per day. Sit comfortably and quietly. Keep your eyes closed and internally focused between your eyebrows or softly gazing at a low, still object or place (like where the floor meets the wall). Turn off the mental noise and think and do absolutely nothing. Simply be aware of your breathing in all its details, the present moment and everything that you notice within it. If you get lost in thought, simply bring your attention back to watch your breath.

Tap into your spiritual self and practice slow deep abdominal breathing, yoga (especially Yin, gentle and restorative), QiGong, Tai Chi, progressive muscle relaxation techniques (yoga nidra), visualization and guided imagery, or cutting edge stress reduction audio programs and courses. For example, imagine you are in a place where you feel whole, inner joy and peace, and spiritually connected. Or think of a healing or rejuvenating spiritual energy or light flowing through and around you. This is an essential, yet easy to learn, tool with endless benefits and rewards to your physical and emotional health. Locate your nearest Zen Center (Zen is NOT a religion and does not conflict with any religion) or read any book by Thich Nhat Hanh, Pema Chodron, or Shunryu Suzuki to learn the basics of meditation and Zen practice.

Listen closely to your body’s messages. You may need to either slow down or become more busy with things that bring you deeper satisfaction and enrichment. You may need more time for yourself, or you may need to focus more on giving or helping others. It is extremely beneficial to find a small way to help someone in need each day, by giving your time, energy and presence to ease the burden and increase the happiness of even one person. Focus on connections with family and friends, healing relationships, making peace and giving love.

Try to make a conscious effort to increase feelings of forgiveness, appreciation, love, joy, optimism and healing, while letting go of anger, resentment, envy, fear, sadness and negativity. Most importantly, increase your awareness of anxiety provoking, tension causing, or depressive thought patterns that are not serving you. Try to shift your attention to something more positive and ultimately change your mental state. You can actually transform them at their deeper subconscious roots with Clarity breathwork. 

Mastery over your thoughts, attitudes and reactions can have a dramatic impact on your brain chemistry, balancing the hormones responsible for affecting moods and emotions, and  preventing and even treating clinical depression and anxiety. 

BREATHWORK

Start with breath awareness - being more conscious about your breath, and simply focusing all of your attention on your breathing. Get curious about all the details of your sensations as you inhale and exhale, without trying to change anything. Notice what you are currently seeing, hearing, smelling, feeling, tasting. Just watch without judgment. This brings you to the present and is deliciously relaxing. 

Then, sit up straight but comfortably, with your eyes closed, internally keeping your gaze between your eyes, or open and focused on a nonmoving distant object or place. You can do this reclining, as long as you are not likely to fall asleep - the point is to be conscious throughout.  While breathing be mindful, and just observe and release any muscle tension working your way slowly from head to toe. Practice Ujjai breathing. This is done by breathing at the pace and depth that feels right for you, but by inhaling through your mouth or nose, directing the breath into the back of your throat which makes a sound like ocean waves. I think of it like a calm, slow, and smooth circular version of gasping on inhale and fogging a mirror on exhale. This is meditation, combined with the benefits of breathwork.

Before going to bed at night, as well as before rising in the morning, periodically throughout the day, and whenever you feel stressed, triggered, down or upset, practice the following 3-part breathing exercise: 

• Exhale slowly through your mouth with an audible sigh while consciously releasing any and all muscle tension.

• Imaging a pump expanding your abdomen and lower back as you breathe down deep into your belly.

• Allow ribs to expand with air, then inhale air into your upper chest towards your collar bone and shoulders. 

• Inhale in this way for a count of 4.

• Hold for a count of 4 while staying relaxed.

• Exhale slowly through your mouth for a count of 4, releasing in the same order as the inhale, collapsing/returning to baseline, your abdomen, ribs, then upper chest.

• Repeat this cycle a total of 8 times or at least a few minutes. This is the ideal form of breathing, as opposed to rapid shallow breathing. With each exhale, let go and relax more. 

Once you get the hang of it, play with various types of breathing. Try  several minutes of inhaling and exhaling, each to a count of 3, 4, 5 or 6 without the hold, keeping it smooth and even. Then double the length of exhalation. For example, so if you inhale to a count of 3, then exhale to a count of 6. 

See how it feels to triangle breathe for a few minutes:. Inhale for a count of 3 or 4, exhale to the same count of 3 or 4, then pause for the same count of 3 or 4, while consciously and deeply relaxing your diaphragm muscle of respiration, as well as all other muscles. Repeat for several cycles.

Then see how it feels to box breathe. To do this, inhale to a count of 3, hold for a count of 6, exhale for a count of 6, hold for a count of 3. Repeat for several minutes. Many love this type of breathing so much they do it as often as they can, such as while waiting, in transit, before rising in the morning and going to sleep at night. 

Another great breathwork technique that disengages your conscious attention from thought and relaxes the nervous system, and can be done any time (like when traveling, waiting in line, resting, bathing, or on the toilet) is forced exhalation. After a normal breath, try squeezing as much air out as possible using your intercostal muscles, then allow breath to come in naturally and deeply, but automatically. Repeat the cycle for several minutes.

These breathwork and relaxation techniques are simple to do, health enhancing, totally safe, and without side effects. If you need more personal guidance, schedule a session with me. 

CREATE A FORTRESS OF POSITIVITY AND INSPIRATION

Minimize time online, especially addictive stressful apps, social media and computer games. Try to stay away from things (like certain books, movies and news), situations and people (like those who are angry, stressed out, negative, pessimistic, critical, fearful or demanding) that agitate your mind, raise your internal tension, bring you down and worsen your emotional state. If someone who you are close with continually criticizes, belittles, demands or negates your feelings, try to give positive straightforward suggestions about approaches that would be more helpful to you, or consider having this person come with you to some professional counseling sessions. 

Surround yourself as much as possible with calm, centered, and positive people, things, sounds and places that inspire, uplift, relax and restore you to inner peace and serenity. Treat yourself to a massage every week, bring more art and music into your life, try to allow time each day to do something you enjoy, and something that makes you laugh. Collect 4-8 hugs per day. The emWave personal stress reliever from the Institute of HeartMath is a wonderful hypnotherapy and biofeedback tool to lessen your body’s reactions to stress.

WHAT’S YOUR BODY TELLING YOU?

Listen closely to your body’s messages as your body is insanely wise. You may need to either slow down or become more busy with important things, or things that bring you deeper satisfaction and enrichment. You may need more time for yourself, or you may need to focus more on giving or helping others. It is actually extremely beneficial to find a small way to help someone in need each day, such as by giving your time, energy and presence to ease the burden and increase the happiness of even one person. Focus on connections with family and friends, healing relationships, making peace and giving love.

It is important to be open and honest about your feelings to yourself and to share important ones with your partner, a close friend or family member, or a professional therapist if needed. Suppressed emotions are ultimately more damaging and they can cause all sorts of physical, psychological and relationship problems if not properly dealt with. It is also essential to periodically release pent up emotions with a good cry, followed by a good hug. Do not hesitate to tell this to your friends and family so they can be more sensitive to your needs. Join a holistic PMS support group and discuss familiar experiences, share feelings, and discuss problem- solving techniques.

For persistent symptoms, make sure to have your provider check a comprehensive thyroid panel with thyroid antibodies, your vitamin D and B 12 levels, fasting glucose and hemoglobin A1C and address issues accordingly. Do what you can to address the root of your symptoms and minimize underlying possible causes. Some women benefit from natural bio-identical progesterone two or even three weeks before the period starts. Discuss with your holistic provider about prescribing it using a compounding pharmacy. Read renowned integrative psychiatrist Dr. Kelly Brogan’s Own Your Self: The Surprising Path beyond Depression, Anxiety, and Fatigue to Reclaiming Your Authenticity, Vitality, and Freedom and take her life changing online course Vital Mind Reset.

Mindful Hatha Yoga Class Series Online Course

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HERBAL SUPPORT 

There are a variety of herbal formulas that combine some of the herbs listed below, or you can try them individually. Many of the favorites are in my online holistic apothecary under the PMS, menstrual cramping and adrenal support category. It may take several months to notice a beneficial response, so give it time as you are working on your lifestyle. 

Common herbs recommended include Chaste Tree (Vitex), 2-4 dropperfuls 1-2 times daily of the tincture or 1-2 capsules dried herb, up to 500-1000 mg daily, or Don Quai, 1 dropperful tincture or 2 capsules up to 500-1100 mg daily twice daily. 

Physician, midwife and herbalist Dr. Aviva Romm advises additional herbs like: 

• Black Cohosh, 2-4 dropperfuls of the tincture, or 40-80 mg capsules 1-2 times per day

• Peony (which is many of the herbal PMS combinations)

• Adaptogens to support your stress response, regulate blood sugar, increase calm energy, and general well-being like Asian ginseng and American ginseng, Eleuthero, Schisandra, and Ashwagandha, 2-4 dropperfuls of each tincture or 1-2 capsules twice daily

• Dandelion root, Milk Thistle, Artichoke and Curcumin (Turmeric) to support liver clearance of excess hormones, and detoxification. HerbPharm Liver Health, Now Liver Refresh and Gaia Liver Cleanse are excellent combinations.

You can use any of these herbs to calm and support premenstrual emotional stress type symptoms, to relieve insomnia, headaches, and avoid constipation.

For Bilateral Cyclic Swollen or Tender Breasts, Bloating and Water Retention

In addition to everything mentioned above, implement any of these strategies as relevant to you, to reduce bloating and swelling.

Ditch the underwire tight fitting bras (most of the time).

Regularly massage your breasts and chest gently with Almond or Arnica oil to encourage lymph drainage. You may want to ask a massage therapist for guidance. 

Apply a Castor oil pack on your breasts for 1 hour 3 times weekly  to prevent and treat menstrual breast tenderness, but not during heavy bleeding. Soak a large piece of cotton or flannel cloth with cold pressed Castor oil, fold it so it is about 4 inches or layers thick, apply to your breasts and cover with a non toxic eco-friendly plastic bag. Apply heat over it using a hot pack, hot water bottle or heating pad, then cover with another towel. Lay down on a waterproof absorbent pad and rest with it in place for 60 minutes. You can reuse the saturated cloth several times and wash as needed.

Keep well hydrated with plenty of water, as it helps to clear the excess fluid you are retaining. If you do not usually use caffeine, and are interested in a natural diuretic, drink black or green tea regularly premenstrually. Cornsilk tea and Parsley tea are also effective and without caffeine - drink 1 cup 2-4 times per day. And eat more parsley, watermelon, cucumbers, celery, beets, garlic, lemon, cranberries and other natural food diuretics 

Another safe herbal diuretic is Dandelion. Take 1-2 freeze dried 500 mg capsules 500 mg per day. If you need a stronger diuretic, try Hawthorne Berries, 500 mg per day of standardized extract during the time you have premenstrual bloating from fluid retention.

Some find that Vitamin C with bioflavonoids is also helpful. Take 200 mg per day up to 500-1000 mg three times a day premenstrually as needed and tolerated, and increase iodine in food by eating more sea veggies. Take Iodinde as directed if you are deficient. Take a homeopathic combination remedy Mastodynon for relief of breast soreness.

For Cramps and Low Backache 

Experiencing pain is humbling, and it can be a chance for personal growth. It can be an opportunity to practice techniques that will help with life and the inevitable pain that all experience at various points, as part of being human in this world. Techniques like breathing, mindfulness, befriending and relaxing into intense sensations. Pain provides a chance to learn patience, acceptance of normal bodily changes associated with pregnancy, and how to prioritize, delegate, let go of activities of overwork or those that create increased stress, and allow others to help.

Do any of the breathwork techniques discussed in the breathwork section, and throughout all the exercises, practice embracing, relaxing into and even magnifying intense sensations without the mental story about them. Can you make friends with discomfort and pain, instead of trying to escape, numb or fight them? Is there something that they can teach you? Get curious about all of their details, including the borders or edges, and parts of you that feels good, or does not have unpleasant sensations. 

Yes, there are remedies to help alleviate pain. But you will be amazed how effective this practice is, and how much it will help you to better cope with your cramps, as well as with the pain that is an inevitable part of being human. It is the suffering from the pain that is optional, so you can choose not to suffer.

In addition to the above mentioned diet and lifestyle changes:

• Eat more plant based and naturally fermented veggies (kimchi) like sauerkraut

• Stick to real whole organic foods

• Use and eco-friendly natural household and body products

• Eat more fatty fish, like wild Alaskan or Norwegian salmon

• Eliminate processed refined foods, partially hydrogenated fats, caffeine, cane sugar, gluten and dairy

• Limit red meat to low-fat cuts

. Many women report much relief after a few weeks of making these dietary adjustments.

Remedies to start before the cramping:

Apply a Castor oil pack on your lower abdomen for 1 hour 2-4 times weekly  to prevent and treat menstrual cramps, but not during heavy bleeding. Follow same instructions as mentioned above.

Add several drops of one or combination of the essential oils Lavender, Rose, Ginger, Cinnamon, Clove, Marjoram and or Clary Sage into a bottle of Almond or Arnica oil and massage them into your low abdomen each day, starting 1-3 weeks before your period. 

Start or expand on key supplements in addition to those mentioned above like omega threes and calcium/magnesium. Take probiotics as directed, up your vitamin D to 2000-4000 IU depending on blood levels, add 100 mg of each of Vitamin B1 and Vitamin B6. Also consider Vitamin E (in the alpha tocopherol form), 400 IU per day, and Vitamin C, 1000-5000 mg per day a few days before and during the cramping. During the days of heavy cramping, depending on your dietary intake and the severity of your symptoms, you can take 100 mg of Magnesium Glycinate every 2-3 hours up to 1000 mg. Too much magnesium may cause diarrhea in sensitive individuals, but loose stool is a welcome sign if you have been constipated. 

To reduce inflammation and relieve pain, take Curcumin (Turmeric), 1-2 400-500 mg capsules, and Ginger, 1-2 capsules or 500-1000 mg each 1-3 times per day. Also try, Ceylon Cinnamon 2-3 capsules (has been researched effective using up to 3000 mg day) starting the week before your expected period. These are as effective as many over the counter medications, so you can also take it when you feel cramping during the first few days of flow.

Remedies for cramps:

Try modalities for general aches and pains as relevant to you now.

Use organic disposable pads, reusable cloth pads or a Diva menstrual cup when you have cramps...it lessens cramps!

Taking an Epsom Salt bath with a few drops of any of the essential oils Lavender, Rose, Ginger, Cinnamon, Clove, Marjoram and/or Clary Sage, and also put them in your room diffuser.

Rub Menastil on the skin over the lower abdomen. Afterwards, apply locally a hot or cold pack, heating pad, hot water bottle, herbal infused hot or cold pack, or try moist heat using a hot damp towel or packs from a hydrocollator (what the professional chiropractors, massage and physical therapists use). Thermacare makes portable disposable heating pads you can wear. 

Use a TENS unit.

Drink Red Raspberry leaf and/or Chamomile tea as much as you like. You can make your own infusion by adding a handful of Red Raspberry leaf or a pinch of Chamomile to 1 qt boiling water in a glass canning jar, covering and steeping Red Raspberry for 4-8 hours or Chamomile for 15-20 minutes. Strain, then add fresh lime or lemon juice, mint leaves or a dash of honey to taste (optional). Another great herbal combination is Earth Mama Period Tea. You can also take Red Raspberry leaf capsules as directed. 

Take two dropperfuls each of Cramp Bark, Black Haw and Motherwort, with ¼-½ dropperful of Chamomile tincture in a little water or juice every few hours.

Another herb that is helpful for painful cramps is Don Quai, 2-4 dropperfuls of tincture 2-3 times per day or 2 dried root 500 mg capsules 2-4 times daily. It can be taken up to every 4 hours in some cases, but only in consultation with an experienced herbalist, doctor of traditional Chinese medicine or integrative holistic practitioner, as there are some safety concerns and herb/drug interactions. 

Black Cohosh can be taken in lower, or higher doses depending on your unique situation, but an average dose in capsules to take is 250 mg 2-4 times daily, or 1 1/2 dropperfuls of tincture a few times per day. 

Try the Chinese herb Xiao Yao Wan with Bupleurum as directed.

Dr. Aviva Romm also reports success with:Valerian (1 capsule) 225 mg first few days, - best taken at night, as it can make you sleepy, and Fenugreek 900 mg 3 times daily. She is a wonderful, trusted, and well respected resource for natural remedies and herbal medicine as a physician, midwife and herbalist, and has much to offer regarding effective alternative modalities and herbs for pain relief.

Get a menstrual or mayan abdominal massage. Initially, you may want to consult a massage therapist, although eventually your partner may be able to learn some of the basics. 

Other effective alternative practitioners you can consult include specialists in homeopathy, yoga therapy, Shiatsu, reflexology, energy work, hypnotherapy and guided imagery, acupressure and acupuncture, and traditional Chinese medicine.

If you still need an over the counter medication and you are not planning a pregnancy, take one aspirin with food each day during the week BEFORE your cramping begins, to reduce the production of substances called prostaglandins responsible for cramping during the actual period. If the cramping is still uncomfortable when your period comes, acetaminophen (Tylenol), aspirin or ibuprofen (Motrin) can be taken as directed for relief if needed on a rare occasion, but it really is less toxic to avoid these medications which are not as benign as we have been led to believe, and use the natural alternatives instead.

For additional resources, read Women's Bodies, Women's Wisdom (Revised Edition): Creating Physical and Emotional Health and Healing, by beloved integrative holistic OB/GYN Dr. Christiane Northrup and Wellness Mama - ‘an online resource for women and moms who want to live a healthier life...fact-checked by our editorial and research team and reviewed by medical advisors for accuracy.’

For any natural remedy you use, give a two to three month trial to see how it affects you. Do your own research. Just because it is natural does not mean it is safe in any amount or combination for you to take. When in doubt about herb and supplement dosing unique to you, interactions, side effects and concerns, or you simply need more personalized guidance, consult your holistic or integrative medical provider, seasoned naturopath, herbalist, or If you need personal guidance, don’t hesitate to arrange with me an online coaching call or an in person holistic gynecology appointment. 

Contact your practitioner if these suggestions do not help, especially if your PMS symptoms are severe enough to cause you significant personal or interpersonal difficulties, if your symptoms do not go away after the first few days of your period and/or last throughout most or all of your cycles, if your symptoms persist or worsen despite trying these suggestions, if you are at risk for harming yourself or others, abusing drugs or alcohol. 

Premenstrual Syndrome (PMS) Part 1

Premenstrual Syndrome (PMS) is very common, as it has been observed and described throughout the ages and across cultures. Although most women experience some degree of physical and/or psychological changes in association with menstruation, the symptoms and their severity vary greatly for each individual. So if you have PMS, you are not alone!

PMS is described as the experience of a wide variety of symptoms that occur 1-2 weeks before, and sometimes through the first few days of your menstrual periods. These symptoms can include:

• Lower abdominal cramping

• Backache

• Bloating and weight gain

• Swollen tender breasts

• Nausea and diarrhea

• Appetite changes and food cravings

• Pimples, rashes and mouth sores

• Headaches

• Joint pain

• Stuffy nose

• Dizziness and decreased coordination

• Cold sweats and hot flashes

• Palpitations and nervousness

• Depression and crying

• Insomnia

• Poor concentration, forgetfulness, brain fog and indecision

• Irritability and mood swings

• Outbursts of anger and aggression

Numerous theories have been advanced to explain why PMS occurs. Although many of the symptoms are simply manifestations of the normal hormonal changes that occur throughout the menstrual cycle, an individual woman‘s response to these PMS changes depends a great deal on her physical and emotional health, as well as her mindset. Cultural background is a significant factor, since there are a variety of chemical and nutritional imbalances, lifestyle factors and psychosocial components that help determine the degree to which the symptom is perceived and identified as a problem.

PMS can be worsened by: 

• Hormonal medications and contraceptives, which can often lead to depression among other symptoms

• Past or current depression or anxiety

• Increased stress

• Inadequate sleep

• Excess body fat

• Decreased exposure to sunlight 

• Caffeine, smoking, alcohol and drugs

• Nutrient deficiencies 

• Chronic toxic exposure (from high use of chemicals and wifi in modern living)

• High consumption of dairy from hormonally stimulated cows

• Foods high in sugar, refined white flours and partially hydrogenated fat that creates blood sugar imbalances 

• A diet low in real whole food like fruits, vegetables, nuts, seeds, healthy protein, whole grains, and essential fatty acids (present in flax, fish, olives, borage and primrose)

• Modern isolating, high-tech, corporate living that disconnects us from ourselves and others, and makes our normal experiences abnormal

• Prevalent societal attitudes that include fear, numbing, medicating or escaping symptoms of discomfort as opposed to being with them, surrendering, welcoming, honoring them, listening to and finding meaning and beneficial purpose in their messages 

The drugs commonly prescribed to help alleviate the uncomfortable symptoms of PMS not only are expensive with potentially dangerous side effects, but also have not been demonstrated to work better than a placebo in well controlled studies. Remarkably, some have not been carefully studied at all for this purpose.

Stay tuned for next month’s blog for what you can do naturally for PMS.

If you need personal guidance, don’t hesitate to arrange an online coaching call with me or an in person holistic gynecology appointment.

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INITIAL POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE: PART ONE

POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE TO THE FIRST FEW WEEKS - PART ONE

Welcome to the postpartum period, the fourth trimester, a period of healing and adjustment, of getting to know and comfort your baby, and mastering breastfeeding. All your baby needs now is love and breast milk. If you are unable or choose not to breastfeed, consider feeding baby pumped breast milk, or donor breast milk from registered milk banks. Breast milk is the ideal food for your baby, although organic goat milk formula is most similar to human milk and you can discuss best alternative options with your pediatrician. And do see the Postpartum Guide to Breastfeeding Postpartum, for initial issues specific to that.

The rest will follow naturally, as you learn on the job, take guidance from wise experienced others, and let Baby be your teacher. As in pregnancy and birth, trust your instincts and your heart. But, do not hesitate to ask for help and support as needed. Hopefully you prepared in your pregnancy so that you are well supported during this sensitive time, as it has always taken a village to raise a baby as well as new parents. A postpartum doula is a must if you do not have family and friends to help you. 

After the first week or so, but before your memory of details fades, it is a wonderful experience to reflect on your pregnancy and birth with heartfelt honesty, and write your pregnancy memories and childbirth story down in a bump to birthday journal. This is something special to share with your child one day, and it is also a wonderful gift to yourself. It can be especially helpful for healing if things were difficult, or your labor and birth did not go as planned or as you hoped. Journaling will help you express, later process, understand, come to terms and make peace with any painful feelings that come up more deeply. 

Below are some helpful hints to make the next few weeks easier and more comfortable, so you are more able to heal, enjoy and reflect upon your extraordinary new miracle. The most important advice is to slow down, stay in the moment, try to resist the temptation to do, do, do...and just be, be, be. Trust that you will heal, as you are perfectly designed to do, given the proper care and support. 

Nutrition for Postpartum Care

Maintain at least the same healthy nutrition as you did in pregnancy, especially now for recovery after birth, and during breastfeeding. This will help you to make good quality milk, and nourish your baby as well as yourself. Make sure to eat at least three whole food varied healthy meals and snacks, and even a little bit more than you would normally consume. And keep well hydrated with at least 64 ounces of water daily. 

Traditional foods for the early postpartum weeks across cultures typically include soups and stews with a lot of vegetables, including the starchy ones like sweet potatoes and winter squash, stew meat or chicken, and whole grains like barley and oats. Also, do eat plenty of eggs, seasonal fruits and vegetables. Much nourishment can be added to fruit/veggie smoothies, soufflés, whole grain hot cereals, and breads/muffins like zucchini-apple, banana-date or carrot-raisin, enhanced with almond flour or chopped nuts and seeds, nut milk, and eggs. 

Herbs and Supplements

Make sure to supplement your diet as in pregnancy, with herbs, vitamins, minerals, omega threes and probiotics to complete nourishment not supplied by diet alone. This will aid in your recovery and help supply all of your and your baby’s nutritional needs. Do increase iron foods and take an herbal iron, especially if you were anemic in pregnancy, have low iron stores, lost a lot of blood at birth, gave birth by cesarean, and/or are still anemic. 

Do continue your nourishing pregnancy herbal infusion to your diet but add alfalfa and red clover. You can have a support person make this by:

1. Blending a handful of dried Nettle leaf, a handful of dried Red Raspberry leaf, a pinch of Alfalfa, large pinch of Red Clover, and several Rose Hips. 

2. Add a pinch of Comfrey to help with healing. (optional) 

3. Brew in a mason quart glass canning jar of boiling water 1-4 hours. The longer the brew, the stronger the taste and effect.

4. Strain, and drink plain or lightly sweetened with Rose Hip infused honey and/or a splash of fresh squeezed lemon or lime juice.

5. Enjoy hot or cold, up to 4 cups per day.

 You can make it in larger quantities and store in the fridge.

Other herbal tonics for new moms to promote general physical and emotional postpartum recovery and healing include Ashwagandha and Gotu Kola (½ -1 tsp each twice daily), and Milky Oats (1/1-1 tsp 1-3 times daily), in addition to herbs mentioned below as appropriate for each specific issue.

To promote healing after birth, take 3-4 pellets of homeopathic Arnica 30 c under your tongue every few hours for the first 3 days, then three times daily for a week. You can also dissolve the pellets in a clean unused bottle of water, shake vigorously a few times, then gargle a mouthful before swallowing, which increases the strength of the remedy.

Treatment for Afterpains

Periodic cramping, known as afterpains, commonly occur as your uterus muscle fibers contract around the blood vessels that supplied the placenta. This is your body’s natural defense in order to minimize excessive bleeding and return to its non-pregnant size. They can be quite painful, and can occur with increasing intensity after each subsequent baby.  

Breastfeeding can temporarily increase the severity of these pains, which is actually helping your body heal and prevent excess blood loss. Afterpains should gradually subside over the next week and lessen significantly over the first 3 days after birth. 

Below are some suggestions to lessen the discomfort.

• Frequently empty your bladder, even though you don’t feel like you need to pee, as is common from the swelling after childbirth.

• Especially during the first 24 hours, check the top of your uterus several times per hour to make sure it is nice and firm like a hard nectarine or knuckle. Massage the top of your uterus gently when it begins to soften or feels boggy.

• Lie on your stomach with a pillow under your lower abdomen.

• Apply warm moist towel compresses, hot water bottles, hot herbal packs or rice packs heated with a few drops of essential oil of Lavender, or a heating pad to your lower abdomen. 

• Practice your breathwork, deep breathing and conscious relaxation exercises during the afterpains, dropping your focus right down into them, relaxing with surrendering to the intense sensations as you did in labor.

• Try soaking in a well-cleaned, warm bath with drops of Lavender or Chamomile.

• For an effective herbal infusion: 

  • Mix a large pinch of Chamomile blossoms and/or Catnip in 1 cup boiling water.

  • Brew covered for 10-20 minutes.

  • Strain in a glass canning jar.

  • Add honey to taste (optional).

  • Drink very warm, 1-4 cups daily.

• Take a dropperful of Motherwort herbal tincture up to 4 times daily. If without relief, try Cramp Bark herbal tincture, 1 dropperful every 30 minutes to 2 hours, then 2-3 times daily. You can add a dropperful of Black Haw tincture 3 times per day. You can make your own cramp bark infusion by steeping a handful of Cramp Bark and Black Haw with a pinch of Hops and generous pinch of Blue Cohosh root in a quart mason jar overnight.

• Take Wish Garden AfterEase herbal tincture as directed

• Take 3-4 pellets homeopathic Chamomilla, Arnica, or Caulophyllum 200 c. Try one remedy under your tongue. If no relief try the other. If the remedy works, repeat daily as needed.

• Try Moxibustion treatments by an acupuncturist.

• Try additional suggestions and remedies mentioned here for aches and pains in pregnancy. They work!

• If the pain is too much for you and interfering with your ability to breastfeed, rest and sleep, you can take ibuprofen (up to 800 mg every six hours) OR acetaminophen (up to 650 mg every four hours) ½ hour before nursing for the first several days only, as needed. But before reaching for these medications, try 1-2 grams of Curcumin (Turmeric), a natural herb studied to be as effective for pain relief than most over the counter synthetic analgesics without their associated potential risk of toxicity. 

Consult your practitioner for severe cramping or cramping that lasts longer than 1-2 weeks, or if accompanied by uterine tenderness, fever or foul smelling discharge.

Home Remedies for Bleeding

During the first two to five days, bleeding is no more than a heavy period with an occasional clot the size of a 50 cent piece or egg, dark red in color with a fleshy smell. It tends to be less after cesarean birth. Clots are simply congealed blood mostly that pools in the vagina when you are reclining, and can occasionally be as long as the vaginal canal. Sometimes bleeding increases with nursing, strenuous activity, heavy lifting and pushing motions, full bladder, and as you rise from a lying down position. 

During the next week or so, the bleeding becomes paler pink or brownish, and it lessens in amount so that you only need to change sanitary pads several times per day. Over the following two to four weeks, discharge becomes creamy white or yellow and even less in amount, but usually returns to red bleeding or spotting for a day or two around the second postpartum week.  

Some women occasionally spot on and off for longer periods of time or throughout breastfeeding. Suggestions for keeping clean and comfortable are:

• Take a daily bath in a well-cleaned tub (add Calendula tincture and Lavender oil to water if desired) or shower.

• Change disposable organic sanitary pads or herbal infused natural pads every four to six hours, and after going to the bathroom. Do not use tampons, menstrual sponges, or menstrual cups. The first day or two, especially at night, consider wearing adult diaper type pads simply because it is just easier, as bleeding can be heavier than common postpartum maxi pads can accommodate, and can leak onto your clothes and sheets. Use them with a smile.

• Wash hands before and after changing pads.

• Remove pad from front to back, squeeze a peri-bottle of warm water over perineum. If you had tearing with or without repair, you can also add 1 tsp Calendula tincture and Lavender oil to the water. Pat dry.

• Do not douche.

• Check the top of your uterus for firmness several times per hour when awake for the first 24 hours, then several times per day for three days. It should feel as firm as a hard nectarine. If it feels soft, massage it firmly so it re-contracts.

• To prevent excessive bleeding, take homeopathic Arnica 30 c as described in the supplement section.

• Take herbal Shepherd’s Purse, 1 dropperful of the tincture three times daily for the first 3-5 days.

• Wear an abdominal binder or Bellefit’s postpartum support girdle. You get a $20 off with code: ANNE20 at checkout.

• Continue your herbal iron dose until your bleeding stops in 4-6 weeks, which may need to be increased per your practitioner if there was hemorrhage. Eat foods high in iron, like red meat, dark turkey meat, eggs, dark leafy green veggies, and dried fruits.

• If bleeding becomes heavy (you are saturating more than a large maxi pad every half hour):

  • Try herbal Shepherd’s Purse tincture (1 dropperful under your tongue), repeat every few minutes as needed)

  • Add 3 dropperfuls tincture of Cotton root, 2 dropperfuls each of Lady’s Mantle, Witch Hazel and Blue Cohosh, and 1 dropperful Yarrow. Take them every 10 minutes under your tongue until the heavy bleeding resolves, but only up to an hour. 

  • If heavy bleeding persists, take 2 dropperfuls of HerbPharm Erigeron/Cinnamon tincture of Erigeron and Cinnamon  under your tongue every 20 minutes for no more than 2 hours, and add 1 dropperful of Angelica if without relief.

Report to your practitioner if you’re saturating more than one pad an hour for more than a few hours not relieved by the other suggestions above, especially if you are starting to feel lightheaded, weak, disoriented, cold and clammy with rapid shallow breathing and heart pounding. Contact them also if you’re experiencing large clots, foul-smelling vaginal discharge, severe lower abdominal pain, temperature over 100.4 after the first few days, and deviation from the described pattern of bleeding.

Perineal and Vaginal Discomfort

After delivery, your perineum and vaginal area may feel sore, swollen and uncomfortable. Any pain or tenderness should gradually lessen over the next several weeks, or longer if you had a large tear. 

Suggestions are:

• Practice good perineal hygiene as previously described in the section on bleeding.

• Don’t forget to take the homeopathic remedy Arnica 30c as directed above, in the first few weeks to support healing after giving birth, which definitely helps your perineal and vaginal areas.

• For a small tear that did not need stitches, using a peri-bottle, squeeze warm water with several drops of Calendula tincture and Lavender oil over the area as you urinate to reduce stinging. Squirt Vitamin E oil a few times daily on the tear to promote healing. Motherlove and Earth Mama make wonderfully soothing and healing herbal combination perineal sprays.

• Apply a perineal ice pack or frozen maxi pads saturated with Witch Hazel for the first 24 hours (with 30 minute respite each hour) or as long as you feel it is soothing.

• Periodically sit in a cool sitz bath during the first 24 hours or as long as you feel it is comforting.

• After the first 24 hours, take a warm sitz bath, or warm shallow bath 2-3 times per day. You can also add tea tree oil, tincture of calendula, garlic, ginger and/or lavender, or try herbal sitz bath combinations with Uva Ursi, Comfrey and Sage or Calendula and Oatmeal (both combos have Witch Hazel, Yarrow and Plantain). You can also try herbs with Epsom and Dead Sea salt or herbal salt soaks and see which feels best for you. You can use any leftover unused liquid for compresses or your peri bottle rinse.

• Use a pillow or cushion when you need to sit.

• Contract your pelvic muscles (Kegels) or even better, engage your mula bandha (all of your pelvic floor muscles) when changing positions.

• Take the homeopathic Arnica 30 c as directed above for general recovery.

Report pain that worsens or does not improve over time, an increased area of redness, swelling or pus-like discharge.

If You Have Difficulty Urinating

During the first four hours after birth, many women have trouble urinating such that they feel no urge, feel the urge but cannot urinate, or feel burning after the urine comes out. It is essential that you urinate within eight hours after birth as difficult as it may be, to prevent infection and excess uterine bleeding.  

Suggestions to help you urinate are:

• Listen to running sink water.

• Squeeze warm water over your perineum with your peri-bottle, infused with a few drops of oil of Peppermint.

• Dabble your fingers in water.

• Apply light pressure to the area above your pubic bone.

• Put oil of Peppermint in the toilet.

• Sit in a sitz bath with several drops of the oil of peppermint.. 

• Take a bath or shower.

• Blow your thumb.

• Concentrate on relaxing and opening your pelvic floor muscles while imagining the urine flowing out.

• Drink eight glasses of water per day.

• Try homeopathic Arsenicum or Causticum both at the 30 c dose.

Report inability to urinate more than eight hours after the birth, burning pain before or as the urine is coming out, feeling the urge to urinate frequently but little urine comes out, fever, or back flank pain.

Cesarean Birth 

If you birthed your baby by c-section, it will take more time to heal physically, and psychologically - especially if unexpected and unplanned, or traumatic. Trust that you will get back to your new mama self. The scar will be there but will eventually fade. Allow for at least 3 months recovery for your body from major abdominal surgery, possibly longer to heal the mind and heart. Homeopathic remedies help tremendously and definitely speed and enhance your recovery safely and naturally.  If your cesarean is planned, start Arnica 200 c three times daily the day before and continue through 3-4 days postpartum. 

Other remedies helpful to have on hand are Aconite 30 c for intense fear and panic before surgery, Bellis Perennis 200 c post cesarean to boost healing after you finish the Arnica, Staphysagria 200 c for incisional pain and healing, and Hypericum 200 c for shooting nerve type pain from the spinal anesthesia (only if needed). Use one remedy at a time and take it three times daily until you feel improvement. Consult your classical homeopath for more personal guidance.

The first week is the hardest in terms of postoperative pain, so take ibuprofen or acetaminophen if absolutely needed, then switch to more natural pain relief remedies like ginger or turmeric that are safe for you and your breastfeeding baby, but still effective. 

Use the skills from breathwork and mindfulness to center and ground yourself, stay present one breath at a time, surrender, lean into and embrace the temporary painful sensations you feel, without the story, with love and compassion towards yourself. Whenever you feel overwhelmed or stressed, take a few minutes to simply breathe, keeping your focus softly on a distant nonmoving object (drishti) or close your eyes and internally gaze between your eyebrows, relaxing deeper with each exhale. Send your love and breath (divine life force) and imagined light to areas of pain. Use visualization to support you as you desire. This is powerfully healing.

While in the hospital, it is important to take deep abdominal breaths also to keep your lungs fully expanding (use the incentive spirometer many hospitals give you), and to get up and walk within 12-24 hours after birth for 10 minutes each waking hour, especially to prevent serious blood clots and painful abdominal gas buildup. The more you walk, the sooner you pass gas and get your bowels moving, and you keep your blood flowing rather than stagnating from immobility.

Ask to be progressed from a clear to regular diet within this time, and choose healthy foods and bottled spring water from the hospital menu (if that even exists!) or have your family and friends bring you more wholesome real food meals and snacks. For gas and bloating, limit:

• Gluten containing foods found in wheat, spelt, rye, barley and some oats

• Some fresh fruits and veggies

• Cow dairy if lactose intolerant

• Carbonated liquids

• Chewing gum. 

Eat slowly, chewing thoroughly and mindfully. Natural remedies for gas and bloating include chewing Fennel seeds, drinking Fennel tea, or taking 2-4 ml of the tincture three times per day, taking Slippery Elm lozenges 3-4 three times daily, and a high quality multi species probiotic twice daily on an empty stomach. Eat and drink more fermented foods like kefir. For bad gas and abdominal pain, take 1 dropperful each of Chamomile and Passionflower, ½ dropperful each of  Hops and Lemon Balm, and ¼ dropperful of Lavender tinctures every four hours.  

The dressing over your incision should be removed within 12-24 hours, so your incision is kept clean and dry to prevent infection. You can apply a clean maxi pad over the incision if your belly is folding over it, so it does not stay warm and moist, inviting bacterial growth. You have been sewn back together in many layers, and the skin is brought together by a glue like substance, absorbable stitches or staples, or removable metal staples. While it takes time to heal, when all is proceeding normally, it is unlikely to open as commonly feared. 

Sometimes they use steri-strips over the incision which will come off eventually or you can remove them in a few days. You can definitely shower, but do not use soap initially on the incision. Dry the area gently. A little oozing of blood is common to see on the dressing, as is a tiny amount of clear, white, or yellowish fluid, as long as it is not pus- like discharge. Look at your incision so you can monitor its healing as well as work on acceptance and appreciation for the journey you and your baby needed, made especially for you both. Once you go home, you can apply herbs for perineal and vaginal tears mentioned above to soothe and enhance healing. Earth Mama makes a lovely herbal balm specific to healing a cesarean scar and there are other organic balms that also help the scar fade. 

Make sure to keep Baby skin to skin in dim quiet as much as you can, bonding and soothing baby with your love, telling Baby all is well, Baby is safe and acknowledge that was a tough journey for both of you. Get help with breastfeeding as soon as possible. Baby may be sleepy from the medications, and it takes longer for the full breast milk to come in, but you will get the breastfeeding going with excellent support and patient perseverance. 

I encourage you to love, be proud and grateful for your cesarean scar. This may take time to cultivate, but is a worthwhile goal. Do not be shy to ask for extra needed help, and get support processing and healing emotionally. For online and local group support and advocacy, there are many wonderful resources like ICAN, but you may want to consider breathwork to release the strong stuck emotions and trauma energy in your body if it is interfering with your well-being. If you are suffering from birth trauma or you suspect your baby has it as well - as is common after cesarean birth - there are resources for healing for you and for your baby.

Consult your practitioner with:

• For fever over 100.6 with general muscle aches and chills

• Persistent or worsening pain

• Area of tenderness/foul smell/pus/redness/swelling by your incision

• Area of leg swelling, redness, warmth and pain worse when you flex your foot

• Unusually frequent, urgent or painful urination

• Heavy or foul smelling vaginal bleeding

• Vision changes, nausea, vomiting, chest pain and/or headache, especially if you had high blood pressure

• Anything unusual you are concerned about. 

Obviously, if you have problems breathing, feel weak, disoriented and faint, call 911.

Constipation and Your First Bowel Movement

It is normal to go a few days after delivery without having a bowel movement. Many have loose stools before labor and pooped during pushing, and those who birthed in hospitals who don’t allow eating in active labor probably did not eat much, if at all, in labor, unless they (hopefully!) respectfully challenged that outdated policy, or simply sneaked it. So you have a few days leeway. Some mothers are afraid that a bowel movement will be painful or open their tear more or stitches if they had them. Other women are too busy and preoccupied with all that is involved postpartum to even think about taking the time. Do rest assured that although the first few bowel movements may be uncomfortable, they will not open your tear or effect the stitches. Even if you had a large tear, it’s extremely rare for them to be torn by a BM.

Suggestions to limit your discomfort and prevent constipation are similar to remedies in pregnancy with some additions:

• Replace refined highly processed foods with whole grains, lots of fresh fruits with the skin, and vegetables (especially green leafy salads).

• Drink at least 64 ounces of fluid each day, preferably filtered, spring or well water, or herbal tea. Consume between meals, at least 20-30 minutes before or 2 hours after eating.

• Do Kegels and abdominal muscle toning exercises.

• Drink warm prune juice or a cup of tea or coffee on an empty stomach.

• Drink Smooth Move Tea, which tastes yummy and works like a charm.

• Mix 2-3 Tbsp oat or wheat bran, or ground flax seed, in your hot cereal or apple sauce. Or, mix with stewed prunes or dried figs. 

• Try raisin bran muffins with black strap molasses (ask someone to make you a batch, with whole grains, or Paleo - gluten, sugar and dairy free).

• You can take these remedies in these doses for preventing and treating constipation which include Magnesium or the powdered liquid equivalent in Natural Calm, herbal Floradix liquid Magnesium, Triphala, Psyllium seed husks, or homemade Dandelion and Yellow Dock root infusion. 

• Use Colace (stool softener) as directed if your bowel movements are getting hard despite these above suggestions, and you are on opioid pain medication after a cesarean birth.

• If you are taking iron, use alternative sources of iron other than ferrous sulfate, such as ferrous fumarate, ferrous gluconate, or herbal iron.

• Do not ignore the urge to have a bowel movement, which usually occurs ½ hour after breakfast.

• Take an interesting book or magazine into the bathroom with you to enjoy some relaxing time on the toilet.

• While on the toilet, rest your feet on a low stool and avoid straining. Support your perineum by applying counter pressure with a folded tissue if needed.

• If it hurts while having the first few bowel movements, do some relaxation and deep breathing exercises, relax into the discomfort instead of fighting it and tensing up, or try splinting the perineum with your hands to provide extra give to the area.

• Avoid relying on enemas and laxatives on a regular basis.

• Ask your classical homeopath, or refer to books like Homeopathy For Pregnancy, Birth and Your Baby’s First Year by Miranda Castro, for a homeopathic remedy specific to your unique symptoms.

Consult your practitioner if there is no bowel movement by the end of the fourth postpartum day, or you experience unusual pain or bleeding.

Treating Hemorrhoids

Hemorrhoids are varicose veins of the rectum, and are a common postpartum occurrence. They resemble a pile of red grapes or marbles just outside the anal area, but they can be internal as well. They can itch, bleed and be quite painful during the first 2-3 days, before gradually becoming smaller. Refer to the suggestions for natural remedies for hemorrhoids in pregnancy as many still apply now.

Suggestions for relief are:

• Herbal sitz baths as mentioned above for your perineum, with Epsom salts, Witch Hazel, and/or Comfrey.

• Use a pillow or cushion when you need to sit on a chair.

• Sleep on your side.

• Lie down several times each day with your hips and legs elevated with pillows.

• Try gently placing the hemorrhoids back inside your rectum with a lubricated finger, and then tightening your rectal muscles around them for 2 minutes.

• Natural remedies with dosing are here for internal and topical use, and include applications of already made Witch Hazel compresses (known as Tucks in the pharmacy) or make your own by pouring Witch Hazel onto round cotton pads, plantain, pure Aloe Vera gel, clove of garlic insert, and homeopathic Hamamelis and herbal combinations in a salve or ointment.

• Shine a red heat lamp on the affected area.

• Avoid constipation and straining.  See above.

Report if pain, swelling or bleeding worsens or becomes severe.

Postpartum Dizziness or Faintness

It is very common to feel dizzy, light-headed or faint the first few times that you get up from a lying or sitting position, especially after a long, hard exhausting labor with a large amount of blood loss.  

Suggestions are:

• Make sure you are eating well and drinking enough water as described in nutrition and constipation sections. 

• Have someone assist you the first couple of times that you have to rise.

• Rise from lying down gradually. First sit, then stand slowly.

• If feeling lightheaded or woozy while standing, lie down with your feet elevated or sit down with your head between your knees. Ask for someone to bring you a few large glasses of juice, as well as a high quality whole carbohydrate, fat and protein meal. For example, a nut butter and jelly sandwich on sprouted multigrain bread, or yogurt with fruit and granola.

• If you feel faint or do faint, sniff ammonia or smelling salts. This is an important first aid item to have, especially if birthing at home.

• Open windows to get fresh air.

• Splash water on your face.

Contact your practitioner with dizziness that lasts longer than the first few days or any actual fainting.

CONTINUED NEXT MONTH….STAY TUNED!

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As always, if you need more personalized support and guidance, schedule a chat with me so I can advise you about the best supplements, remedies and dosages specific to your situation.

My Natural Birth Secrets book 2nd edition is a great adjunct to the online Guide for postpartum and holistic modalities to common issues and discomforts.

Routine Newborn Procedures

Many mamas who want a natural birth may not be as familiar with the the number of choices they need to make regarding interventions to baby postpartum. These are routine in many hospitals, with more freedom of decision making out of hospital at a freestanding birthing center or home with a midwife. Healthy babies are suctioned, all exams and procedures are done in the nursery, not by bedside, they are bathed, given Vitamin K injection and antibiotics in their eyes, and Hepatitis vaccine, and babies with a penis are told they need medical circumcision. Other procedures are pulse oximetry to screen for critical congenital heart disease not picked up on the mid pregnancy anatomy scan if baby had one, audiology screening, and the newborn screening blood test.

Healthy vigorous babies born vaginally can clear their own lungs and don't need suctioning - even with bulb syringe. That's not a gentle welcoming for them, but invasive and traumatic. Suctioning can be harmful to baby’s transition from womb to world, and isn't evidence based care. It's more effective and less harmful to do percussion and postural drainage or use ambu bag if needed. Most of the lung filled fluid is cleared with the big squeeze through the birth canal. The rest is absorbed into the body, and for ~ first 24 hours, baby spits it up, coughs or sneezes it out.

All routine baby exams and decided upon procedures can be done in room with parents. It’s an important part of bonding, nursing and sensitivity to baby’s nervous system. Baby needs to be skin to skin for warmth and comfort after birth, close to mama for nursing. There’s no medical reason for healthy newborn nurseries, with babies separated from parents in bright rooms in isolettes filled with strangers. Nurseries serve hospitals, not babies. If mama needs a rest, it can be done with baby in room cared for by another support person.

Babies born in hospitals are still be given unnecessary baths with chemically laden soaps and kept dry with toxic talc and artificially fragranced baby powder. The birth juice and meconium can be wiped with your own natural products by you or your partner, but there is no rush to wash off the skin disrupting the flora of good bacteria that protects baby’s health, and remove the vernix (the white waxy, cheesy protective material that covers baby’s skin) so most of it can absorb into baby’s skin and allow baby to receive its protective benefits. It is not only a skin moisturizer and softener, it’s also an antioxidant and skin cleanser with anti-infective properties. It regulates baby’s skin pH needed for health, helps control baby’s temperature and insulate the baby, so crucial after birth from womb to world. It might help babies latch, as the scent of vernix may trigger neural connections in babies’ brains needed for breastfeeding, and bonding with that delicious new baby smell. It also smells of mama, which can provide comfort to baby and enhance bonding after birth. The The World Health Organization (WHO) recommends waiting at least six hours — and if you can go a full 24 hours, even better to give the first bath. Since it doesn’t fully absorb until day 5-6, I’m not sure why the first bath can’t wait until then. Leave it on and even rub it in like body butter. Don’t let anyone wash it off.

Hepatitis B vaccine is given to prevent baby from blood born infection spread by contact with blood and body fluids like unsafe sex, IV drug use, accidental professional needle stick, and high risk communal settings. If baby has not had these sources of exposure, it can be delayed until prior to entering school, if you choose infant and childhood vaccinations. Refer to my blog on immunization for more info.

Vitamin K injection and Antibiotic eye ointment are given routinely to all babies born in US hospitals without considering individual situations. In some states you can refuse, in others it’s the law and they can report you to Child Protective Services - but these organizations have bigger problems to deal with and often the case is dropped after some unnecessary stress and aggravation. We don’t have these laws in most homebirth settings.

The antibiotic eye ointment is to prevent sexually transmitted infections gonorrhea and chlamydia that could cause blindness in newborns after exposure in birth. It is given within the first hour of life during the most alert time of baby after birth, interfering with vision at such a sacred crucial time when initial bonding and breastfeeding take place. It is irritating to baby and disrupts the delicate balance of flora in their eyes which can lead to other infections. Needing to give antibiotics is not relevant to babies born to mutually monogamous parents who do not have these infections. Taking into consideration that one may not know for sure there is another secret partner, these infections can be tested for in a pregnant mama at term, and if negative, the antibiotics can be refused in good faith. If you do test positive for one of these sexually transmitted infections, you and partner can be treated and retested to see if cured, but it may be wise to consider the antibiotics for baby’s eyes, since exposure can happen again. Then you can delay the medication until after you and baby look into each other’s eyes, have some time for bonding and breastfeeding.

To give vitamin K to the newborn within the first hour of birth is to prevent a rare but serious blood clotting disorder called vitamin K deficiency bleeding (VKDB). There is an early onset VKDB that happens within the first 24 hours, classical expression in 2-7 days, and late onset that usually occurs in 3-8 weeks of life. Our bodies need vitamin K to help the blood to clot when needed. Giving it to babies at the recommended dose via injection is currently evidenced based care, but still not a simple matter.

The American Academy of Pediatrics opines strongly in favor of it. The current evidence does support the injection, saying there is little risk other than rare potential allergic reaction, and that the benefits far outweigh the potential risks. The injection is mega dosed, with 20,000 times the amount new baby has at birth, 5000 times the recommended daily allowance. It is injected into the muscle, which is a more rapid route than oral. In its synthetic form, it is considered a class C drug which means its safety is unknown in pregnancy, risk cannot be ruled out, there are no satisfactory studies in pregnant women, but animal studies demonstrated a risk to the fetus or potential benefits of the drug may outweigh the risks. The package insert itself warns that it can cause sometimes fatal allergic reactions when injected into a muscle or vein, and is ideally take by mouth or injected under the skin. The synthetic medication contains concerning chemical preservatives. It is available, but not accessible in most hospitals without the preservatives, but the preservative free vitamin K still does have some chemicals to increase absorption. It is also concerning to ponder the impact of overdosing on a fat soluble vitamin that stays in the system, as opposed to water soluble vitamins in which excess is excreted out in the urine.

In formula fed babies, the risk of VKDB is negligible as the formula contains synthetic vitamin K. For babies who breastfeed, an alternative is the oral form of vitamin K, in which some protocols have not been as effective as the injection in preventing VKDB - although some of the increased risk was related to parents not administrating of all the doses. Vitamin K using the Danish protocol is just as effective at preventing VKDB, though not accepted by modern medicine and hospital practice in the USA. Several European countries have a licensed oral vitamin K available with varied protocols, for those who wish to decline the injection, which is most effective according to the research to prevent vitamin K deficiency bleeding in babies. Except the Danish protocol. The Danish protocol is preferred as it seems to be just as effective as the injection according to the studies. It is vitamin K1 - phytonadione: 2 mg orally at birth, the 1 mg once weekly for 6 months as long as breastfeeding is greater than 50% of the baby’s diet. As it is a supplement in the USA, it is not regulated, FDA approved or certified like the injection made from pharmaceutical companies, for preventing VKDB in new babies. That does not mean it is not effective or unsafe. Still many who decline the injection prefer it as a viable alternative. Finding it in the states can be a challenge, but some homebirth supply companies and midwives carry it. If doing this protocol, best to do with a feeding as vitamin K is fat soluble, to increase absorption.

Little research is available on the alternatives, such as breastfeeding mamas eating more vitamin K or supplementing (like with 5 mg daily) to boost levels in breastmilk and prevent the rare vitamin K deficiency in newborns.

But as with all other routine interventions in the entire healthy normal physiological process of having a baby, the more we study, the more we find their lack of benefit and increased risk, and that mother nature or the Divine intelligence that created it all did not get it wrong. Maybe there is a reason we do not know yet why newborns are born with low vitamin K that does not reach optimal levels until the eighth day of life, from the gut flora. Is it a deficiency if they are all born that way? I defer to Dr. Sara Wickham who has analyzed the research for over 20 years and even wrote a book on this subject alone. “Several thousand babies need to be given vitamin K in order to prevent each case of vitamin K deficiency bleeding (VKDB), a disorder formally known as hemorrhagic disease of the newborn. Unfortunately there is little research interest (as is so often the case) in questions such as 1- how we might be able to pick out the babies who are truly at risk rather than giving the universal prophylaxis and 2- whether and why it might benefit babies to have a relatively low level of vitamin K compared to adults.”

Newborn screening checks a baby for serious but rare and mostly treatable health conditions at birth. It includes blood, hearing and heart screening. The newborn screening blood test may screen for up to 50 diseases, including phenylketonuria (PKU), sickle cell disease, and hypothyroidism but know it is only a screen that leads to more testing to confirm or more likely rule out the rare diagnosis. It has a high false positive rate, as there are more than 50 false-positive results for every true-positive result identified through newborn screening in the United States. This means baby tests positive on the screen but do not actually have the disease. Screening is mandatory in and funded by nearly all states - despite the varied diseases for which each state screens; although most will reluctantly allow parental refusals on religious and other grounds, and such refusal does not usually engender civil or criminal penalty. The American Academy of Pediatrics opines strongly about the importance of the screening, but it does not control the different conditions screened for by each state. You or your partner can certainly hold and comfort baby during the blood test which hurts for a few moments.

The American Academy of Audiology supports early identification, assessment, and intervention for all types of hearing loss in infants and young children to minimize deleterious effects on speech, language, education, and social/psychological development. The screening should take place by an audiologist at 1 month of age and does not need to be done after birth. It is not an invasive screening and can be done in your room by your side, so if you gave birth at the hospital it can be more convenient doing it there. Or you can take baby to an audiologist by one months of age if you choose the hearing screen.

Pulse oximetry screening is a simple and non-invasive procedure used to measure how much oxygen is in the blood and has been found effective in screening for critical congenital heart disease (CCHD) in newborns, if done within 24 hours after birth. Current evidence supports consistent accuracy for detection of CCHDs in newborns by pulse oximetry screening in addition to prenatal ultrasound and clinical examination. Overall, early diagnosis of CCHD with pulse oximetry is judged to be beneficial, identifying disease that may be treated and lifesaving, and potential harms associated with false-positive tests are not serious, but stressful, while missing CCHDs and other serious diseases detected by hypoxemia without pulse oximetry screening can lead to serious consequences. It is interesting that this is not the position of other institutions such as the United Kingdom National Screening Committee and the Royal College of Pediatrics and Child Health. Further research is required to understand and improve the effectiveness and efficiency of the screening and its algorithm. Some mamas do not want this philosophical standard medical approach of looking for diseases, prefer to address the issue if baby shows signs, and have Divine faith that whatever happens is meant to be.

Medical (non-religious) circumcision is the most controversial routine surgical procedure done mostly in the US on babies with a penis, prior to discharge. The vast majority of boys in world aren't circumcised. There's no evidence to justify this routine procedure on medical grounds & its risks are downplayed. The American Medical Association classifies it as a non-therapeutic procedure, as it has no proven benefits and risks outweigh them. The American Academy of Pediatrics has never, in its over 75 years of operation, recommended routine newborn circumcision. The foreskin is a normal, sensitive, functional part of the body, protecting the head of the penis from urine, feces, and irritation; it also has an important role in sexual pleasure, as it has specialized, erogenous nerve endings, gliding and lubricating functions. For a thorough analysis of the literature, science & research, potential risks & alleged benefits, cultural/religious roots & human rights bioethical issues see here.
THIS ISN’T ABOUT PAST, HOW WE WERE ADVISED MEDICALLY OR CULTURED TO DO. IT’S ABOUT DECISIONS MOVING FORWARD.

I like to promote informed choice, question routine status quo, and help those interested in studying the data and what factors create opinion and dogmatic policies, as well as encourage those who wish to ponder this topic with a more critical eye and make their own decisions about their baby’s health care.

Educate yourself & make an informed decision about what you want or don't want for YOUR baby, with my online Guide to Pregnancy, Birth and Postpartum. And in adjunct, my Natural Birth Secrets book 2nd edition, as in many cases, it is totally safe and appropriate to investigate natural alternatives.