VBAC - A Hot Topic

PHOTO CREDIT - THE UNISON PHOTO CNM

Correction - ACOG is the American College of Obstetricians and Gynecologists; ICAN is the International Cesarean Awareness Network

VIDEO IS NOW HOSTED ON MY LOVE YOUR BIRTH ONLINE COURSE

What is a VBAC?

A VBAC is a vaginal birth after cesarean.

If a woman has had a cesarean and wants to plan a vaginal birth for her next, it would be considered a VBAC.

Cesarean Surgery

Cesarean section is major abdominal surgery that involves serious potential risks for both a mother and her baby.

When medically necessary, it can be life-saving. I am very grateful for this. And it is still of course a birth to celebrate.

Unfortunately, cesareans have become so routine. I believe women are not given the opportunity to explore all their options and are not offered education and empowerment to have a vaginal delivery after a previous cesarean, other than a repeat cesarean birth, if that is their choice.

Statistically, the United States ranks among the highest in the world among cesarean rates. It’s approximately 30% and rising.

It’s as high as 40-50% in some areas near to where I live, and this is absolutely unacceptable.

Benefits of a VBAC

There are many benefits to a VBAC. These are physical, emotional, mental, and spiritual.

These are only a few important benefits on the long list:

• No risks from major abdominal surgery. This is huge.  Unfortunately, a cesarean can lead to trauma to the internal organs or reproductive tract, risk of hemorrhage, complications with scar tissue, long term post operative pain, wound infection, blood clots, stroke, and possible respiratory problems for the baby. High rates of cesarean section contribute to high rates ofmorbidity and mortality – and this is occurring in modern countries such as the US, which ranks among the bottom of them in terms of outcome stats.

• Easier postpartum healing and recovery.

• Baby receives needed bacteria for optimal health, from mother when passing through the vaginal birth canal.

• Breastfeeding may be more successful

• No potential harm to future fertility.

• Feeling more positive about the birth experience

• Increased sense of empowerment.

• More involvement of family and support people.

• Less risk of postpartum depression and emotional birth trauma.

Image by midwife @lindseymeehleis after mama's triumphant and healing VBAC.

Major Health Care Regulators and Advisory Organization Support VBACS

Most major health care regulators and advisory organizations like the World Health Organization encourage VBACS.

“The World Health Organization recommends that the caesarean section rate should not be higher than 10% to 15%. According to the Society of Obstetricians and Gynecologists of Canada (SOGC), vaginal delivery represents the safest route for the fetus and newborn in the first and subsequent pregnancies” – World Health Organization website, http://www.who.int/bulletin/volumes/85/10/06-039289/en/ This is generous, as when cesarean section was originally implemented, it was intended to serve 5% of the birthing population – those with serious complications who really needed surgical intervention.

Also encouraging of VBACS are the American College of Obstetricians and Gynecologists (ACOG) (link to their website: http://www.acog.org/ , The National Guideline Clearinghouse https://www.guideline.gov/  ,  Agency for Healthcare Research and Quality, and the American College of Nurse Midwives

No words can describe this amazing mama's feelings after her VBAC, captured by @skyla_walton

“The AAFP strongly recommends that clinicians inform women who have had a prior vaginal birth, either before or after a prior cesarean birth, that they have a high likelihood of VBAC. Unless there are specific contraindications to a vaginal birth, these women should be encouraged to plan a labor and VBAC and should be offered referral to clinicians and facilities capable of providing this service, if it is not available locally. (Quality of Evidence: High)” – Source: The National Guidelines Clearinghouse website https://www.guideline.gov/summaries/summary/49115/clinical-practice-guideline-planning-for-labor-and-vaginal-birth-after-cesarean?q=vbacs

In most cases, a VBAC is a safe option.

I share the opinion of many concerned with improving maternity care and reducing our rising rates of maternal and newborn death and serious health consequences from the interventions in childbirth, that a woman should not be forced to have a major surgery against her will, rather provided research and empowered to make her own decision, considering she is having a healthy pregnancy.

AAOG removed the previous unreasonable restriction requiring immediate availability of a surgical staff for an emergency cesarean, as most hospitals around the country, let alone free standing birth centers and home settings, do not meet this criteria. Most hospitals are not able to have a surgical staff at all times and cannot perform an emergency cesarean in under 30 minutes.

Despite this, research is showing that far too many obstetricians do not offer VBACS. They routinely recommend repeat cesareans because they may fear law suits, succumb to scheduling pressures, have restrictive hospital or malpractice insurance policies, and/or feel pressured to uphold certain standards among their colleagues who are not supportive of VBAC. The hands of a midwife whose collaborative obstetrician and hospital do not support VBAC can often be unnecessarily tied as well for these reasons. Most repeat cesareans are not actually medically necessary, and are commonly recommended due to various non-medical reasons. This is very concerning.

What also concerns me is that the risks of a VBAC are magnified in conversation with women, while the risks of a repeat cesarean are downplayed, so women may feel forced, afraid and powerless.

I want women to feel like they have a voice.

Some women who want to VBAC have limited options and local doctors in the area are only offering cesareans. Some feel they have no option other than having an unattended homebirth, or labor alone at home until the last minute without any monitoring, or not be truthful with their providers about their previous cesarean birth – all of which can increase the risks for her and her baby.

A trained and experienced midwife who is continuously with the woman in active labor, can detect concerning signs and symptoms before they can become a crisis, and she be transferred and treated in time to save her and her baby’s life and heath.  A midwife wears many hats, one of which is protecting the space so the natural process of birth can proceed with ease and grace, and another is a lifeguard – to know when and how to intervene to prevent problems or manage emergencies.  There are many wonderful obstetricians supportive of VBAC who have this training and style of practice as well; they are just harder to find.

What are the chances of having a successful VBAC and who is a good candidate for a VBAC?

The stats range that 60-80% of women, who have had previous cesareans, are candidates for a successful VBAC. In actuality, most healthy pregnant women carrying healthy babies are candidates.

The chances of a successful VBAC are higher if a woman is using a midwife, even higher in free standing birthing centers and home settings.

Above photos of rockstar mama's VBAC are by @karinariveraphotographer

Going to a hospital and working with an OB/GYN with high cesarean rates, will increase the likelihood that a woman will have another cesarean.

In some hospitals, there are a lot of restrictive procedures, like continuous electronic fetal monitoring, confining a laboring woman to lay in bed, not allowing her to eat or drink, routine IVs and time limits, which increase the risk of a cesarean.

What is the main risk of a VBAC?

The risk of separation of the prior uterine scar is approximately 2 in 1000 VBACs, but often it is a mild superficial dehiscence (slight separation of some layers of the surgical wound) that has no clinical significance and does not impact the health of mom or baby. The risk of severe life-threatening emergency from a partial or complete uterine rupture of all the scar layers is significantly lower – a highly unlikely occurrence, significantly less than 1 %.  The main risk is of a VBAC is this rare catastrophic rupture of the previous uterine incision. This rare total disruption of the uterine scar risks both the mother and her baby, and can lead to catastrophic outcomes. It cannot be ignored and must be monitored for appropriately; but it cannot be exaggerated or make the risk of repeat cesarean less alarming.

Although every decision has risks, a VBAC is a reasonable, appropriate and safe option. If a woman panning a VBAC decides to give birth at home, I highly recommend working with a well trained and experienced midwife and consider the distance to a hospital (30 minutes or less driving time is ideal).

There are risks and benefits to every kind of birth and in every setting. I provide women with evidence based information, encourage each family to dig deep and look at the pros and cons to having a VBAC in a hospital setting, free standing birthing center or home, vs a routine cesarean and have informed consent for her birth.

Are there benefits to a cesarean?

A planned cesarean is in a controlled environment, and some women find great comfort in that knowing. Perhaps a woman has had a previous traumatic, long labor the first time and they just don’t want to go through that experience again. Some women are very anxious about that and they just feel safer knowing they will have another cesarean.

I take that seriously, because she won’t labor well if she doesn’t feel safe.

Like I mentioned before, the serious risks for a VBAC can be often prevented, treated or transferred to surgical care in time, with a skilled midwife or obstetrician who is attending to the laboring women, aware and mindful of the symptoms that lead up to that.

Thankfully some hospitals are now at least allowing more time for baby to get the cord blood from the placenta, skin to skin bonding, and her partner or main support person in the operating room. Some hospitals and providers are performing “gentle cesareans” – cesareans that are family and woman centered, and try to provide the environment of a natural birth as much as possible. This is a wonderful attempt to restore humanity to birthing in the operating room.

Last tips:

If a woman knows she wants to have another baby, I would start with research and education. Ask yourself: “What do I want and why?”

A woman should get the support she needs. Most women who have had a prior cesarean have issues they need to discuss. There are therapists who specialize in this.  One of my dedications and areas of expertise is creating space so a mom can debrief, process and heal from her previous upsetting or traumatic birth experience, as well as plan for a better one next time around. Schedule a consult with me here. http://homesweethomebirth.com/chat-with-anne/.

I tell mamas to do what they can to educate and empower themselves, and know they do have a voice, build their circle of support, and include in their birth team advocates to speak for them when they are in the heat of labor. I tell them to prepare for a vaginal birth. The mind, body, heart and spirit can prepare for a vaginal birth - and a deeply positive, beautiful and empowering one. This is one of my passions and main focus of my online childbirth course.

PHOTO CREDIT – THE UNISON PHOTO

A woman is more likely to have a vaginal birth if she has a natural birth. Although this is not in all cases, a woman who is educated, empowered and prepared for a natural birth has a greater chance for having one.

Things a woman can do to prepare for a vaginal birth:

• Take an excellent childbirth course! My online LOVE YOUR BIRTH course is available here. 

• Check out www.vbacfinder.com to find VBAC rates for local hospitals.

• Check out ICAN (http://www.ican-online.org) for more information; seek out VBAC groups in your community, on Instagram and on Facebook, to connect with other women who have had successful VBACS.

• Watch movies of women who have had VBACS… inspiring stories of healing, beauty and empowerment.

• Create your tribe, in your pregnancy, of like minded women who have gone through what you’re going through.

• Interview providers, and choose one that aligns with you the most – one that has high rates of VBAC and low rates of repeat cesarean. It is very important to ask them their rates, and if you are planning a hospital birth, research the hospital rates here (link to http://www.cesareanrates.org/2015/01/what-is-my-hospitals-cesarean-rate.html

   Most midwives, especially those who practice out of hospital settings, have the highest rates of VBAC and the lowest rate of repeat cesarean, but plenty of hospital midwives and obstetricians have similar stats – they just may take some work on your part to seek them out.

I also recommend hiring an awesome doula, as those who have a doula are less likely to have a cesarean.

A doula is amazing because they offer the mothering comfort and support that our ancestors had.  When women would give birth in their tribe or village, and they were surrounded by mothers, aunts, sisters, grandmothers, and the other women of their community, they received that mothering support by women who were comfortable with birth and relaxed around it. Fear has no place in birth, and a doula provides needed calm and loving support.

Lastly, I recommend drawing and journaling , mediation and visualization – which tap more deeply into her intuitive self. A woman can imagine how she’d do it differently or what she wants for herself. And she can face her fears head on, which often lessens them, or she can be with them and plow forward with courage in spite of them.

Remember, In the end it’s not in our control, and we let go and surrender,

If you do all of these things and end up having a cesarean, it’s not a failure. There is no failure in birth. It is a birth, a belly birth, and it’s the birth of your baby and you as a mother. It is the birth of your family and your partner as a parent. Stay present, stay involved and keep a positive mindset. Focus on the blessing, that you did all that you could, and thankful for modern medicine, which saved you and your baby’s life and preserved health. Also, you can ask for a gentle cesarean, which restores humanity to the operating room by doing such things as allowing your support people in with you, enabling baby to emerge from the incision simulating as much as possible a vaginal birth to help baby clear his/her own lungs, enabling you to participate by lowering the drapes so you can see your birth, giving you sterile gloves to receive your baby, delaying the umbilical cord clamping so baby can benefit from the cord blood, encouraging immediate skin to skin bonding and early breastfeeding.  

Image by angiebeehotz

Healing can occur afterwards, and may take time and lots of support. But there is no place for shame and negative self judgement here.

Image by Megan Hancock Photography

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma, planning a VBAC

Or a midwife, doula, or birth professional guiding mommas..

Regardless if you are intending to birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…

You Really Can Create The Delivery Of Your Dreams, ROCK your VBAC

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

• Understand the sensations of your body and connect your intuition with how your body is communicating and leading you towards what to do during labor

• Tap into your inner calm to deeply relax yourself,letting go of busy, stressful and fearful thoughts on demand for the health of baby

• Speak your truth from your heart in a way that deepens your relationships, sets clear boundaries, and has people listen to you and support you before, during and after pregnancy

• Trust yourself, connect with your body wisdom andcommunicate with baby in belly

• Connect with natural time and sync your body and mind up with your unique biological clock for ease from pregnancy to postpartum

• Reprogram negative patterns, stories, and beliefs that undermine your confidence, strength and self trust so you can rock your birth

Physicians and midwives around the world recommend my teachings to their pregnant clients and many Doulas across the country learn the secrets of blissful birthing from me to supplement their Doula Training & Certification process!

To learn more, visit:  LOVE YOUR BIRTH Online Childbirth Course!

It is based on my years of experience, as a midwife and yoga teacher, helping thousands of women tap into their calm and live and birth from a place of grounded relaxation and joy. 

Some other resources:

• Home birth cesarean resource (http://homebirthcesarean.org/) “This website provides support, resources, and awareness around planned out-of-hospital births that end in cesareans, referred to as Homebirth Cesareans (HBC).”

• www.Vbacfacts.com

• www.Vbac.com

• Books on my website, www.homesweethomebirth.com

In the end, how a woman births is her personal decision and the more informed she is and empowered to play a large role, the greater the likelihood is she will have a positive birth experience.

Anatomy and Physiology of Childbirth

Childbearing Classic the Series' - with Illustrations by Jan Ruby Baird.

Anatomy and Physiology of Childbirth

Women, miraculously made, are a perfectly designed vessel to bring a baby into the world.

Each body part is created for a purpose and specifically placed where and when it is so babies can be born.

It’s a dance between feminine bodies and their babies… each knowing exactly what they are supposed to do. I empower women to get their minds out of the way, and learn to work the brilliant natural process.

When given the opportunity to flourish… and to rise up to the moment…. A woman’s body has the capacity deliver almost every time.

Watch this video where CNM Anne Margolis talks about the anatomy and physiology of childbirth and what to expect physically and emotionally in all its stages. Charts used are from 'Childbearing Classic the Series' - with Illustrations by Jan Ruby Baird.

What is my body doing during childbirth?

During pregnancy, you’re looking at what your appearance is on the outside.  You see your skin stretching, meeting the physical space of encasing a growing being.

Most of the conversation is external, comments of size, possible stretch marks.

Just behind this wall of protection, lives a breathing, vibrant and meticulous ecosystem.

Swimming in a double wrapped membranous bag of amniotic fluid, lives your baby. Baby is encased in the womb, which is surrounded by the uterus. The placenta connects to the baby through the umbilical cord. All of baby’s nutrients are delivered to him or her through this cord, which also removes waste.

5 Things That Change With Pregnancy and Labor:

·         Through pregnancy, your uterus grows as your baby grows.

·         Moving into labor, your cervix changes. It is firm, thick, long, and closed during pregnancy, and during labor, it softens, thins, shortens and opens.

·         As your cervix dilates, you may release a mucus plug. This could, but not always, allow for some blood to show.

·         Your vaginal canal of muscles is stretched, holding space for your baby’s head to come through.

·         Your pelvis, which is 3 bones connected by ligaments, can stretch. It can get smaller or larger depending on your position. When we talk about station, it’s in reference to whether the baby’s head is engaged in the mid pelvis, or how many centimeters it is above or below it.

Movement and position during labor is important.

Lying down gives the pelvis less room to allow for the baby’s head. Squatting, kneeling, hands and knees, lunging, standing, walking, or dancing open up the pelvis and helps baby to navigate his or her way down.

Photo by @seasonaldoc

What does it mean if my water breaks?

Since your baby is double wrapped, in two bags of amniotic fluid, the first bag can break, sometimes in early labor, which releases no more than a few tablespoons of fluid that can make up to a pancake sized stain on your underwear. This could prompt thoughts and concerns about ‘ruptured membranes’ - your main bag of fluid breaking - and may lead to unnecessary interventions to prevent infection of risk, especially when there is a prolonged period of time between this and birth – when in actuality your water did not break.

On the contrary, this tiny gush of fluid ONCE, is usually a sign that labor is beginning, and only the first bag has broken. As long as there are no signs on evaluation, and no continual flow of fluid, the main bag is often still intact and will break during later stages of labor. It’s imperative to check with your health care provider if you have concerns over any flow of fluid to confirm what is going on.

How is my baby’s head able to make it through such a small area?

The miraculous design of a baby’s body, includes their skull, which is not fused yet… the soft spots (fontanels- between certain suture lines) on it are there because these bones are not yet closed together, so your baby’s head can mold to accommodate the pelvis. And women’s birth canals can stretch and expand to accommodate baby.

What is happening to my body before I go into labor?

Every body is different but there are some general signs.

Pre-labor could last a few weeks. Here are some signs labor could be approaching:

·         A dropping sensation as baby descends lower in the pelvis

·         More pelvic pressure

·         Trips to the bathroom more frequently

·         Easier to breathe

·         Less heartburn

·         More sensation of Braxton Hicks – as the uterine muscles warm up and ripen the cervix

·         Bowel movements become more frequent and loose

·         Excited surge of energy

·          “Nesting” – feeling the urge to clean, organize and prepare

I am humbled by the many various and unique ways women start labor!

Just as women come in so many different shapes, sizes and forms, labor is just the same.

Physical and Emotional Sensations

In general, when you start to feel a regular pattern of sensations of uterine tightening, we would consider that the onset of labor. These regular sensations, are commonly referred to as contractions, but that is a limited term, and that can create a sense of tension.

The top of the uterus does contract, so the bottom shortens, thins and expands. The sensations come and go, build to a peak and then gradually lessen as waves, with no such sensation in between, like the calm waters between the waves.  SO, let’s use the word wave instead – some mamas prefer surges, or make up their own affirmative positive term, like hugs to the baby.

They are different than Braxton Hicks.  

Labor waves tend to be felt low in the pelvis, and go around the back of the body.  They come in a pattern. This means they keep coming. Maybe one comes in 5 minutes, another in 10, then another in 7, and then another in 20… it becomes a pattern when they persist. Just like they can range in interval, they range in duration – lasting in the early stages from 20-60 seconds on average. And they feel different.

How will I feel at the onset of labor?

Early waves can feel like menstrual cramping. As they progress, the sensations become more intense, last longer and come more frequently.  They can feel like a tightening with pressure down low in your belly and sometimes low back. You’ll be able to have a conversation and go about your day. You’ll be coping well, sociable and excited.

How do I know when I am progressing in labor by how I am feeling?

Waves of the cramping will come more frequently, lasting a little bit longer. They tend to come more consistently, like every 4-6 minutes and last anywhere from 45-75 seconds.

These feel more intense, and you’ll generally not be able to speak through them. Some women will begin to moan, breathe and need to become inwardly focused. When not disturbed, laboring women make natural opiates that lessen sensation of pain and enable them to enter a trance-like state.

Midwife Pam England calls this “labor land.” This trance-like state is important because it takes us out of our thinking brain and more into an instinctual, primal and sensual experience that allows our bodies to do their job of birthing.

Photo by@amoremfocofotografia.

As labor progresses, the main bag of amniotic fluid may break. This could result in a large gush of fluid releasing at once, or periodically – either making a large puddle on the floor, soaking through your clothes and surface beneath you, or making a large maxi pad heavy like a babies full diaper after a night’s sleep. There can also be a small amount of normal bleeding, from a few streaks or spotting, to no more than a light period. Some women in transition will belch, vomit, get sweats, feel shaky and restless.

Moving into active labor, a woman needs more support.

Emotions to Consider

When the first stage of labor reaches the final stages, ‘transition’ labor feels most intense – but means progression to pushing out and meeting your baby is coming soon. Labor sensations are coming every few minutes, lasting an average of 60-90 seconds. They are still coming in waves, which rise and fall, with a delicious rest in between.

I encourage women to stay present and know what is common, so you can embrace, rather than fear it.

I like everyone at the birth to know that our birthing mom will experience intense emotions towards the end of labor and that’s normal. So no one will be scared, I reinforce to everyone that she is working hard and she is internally focused.  

It’s important for everyone at the birth to know and understand the items below, and it’s also ok for you to know the signs during this period, as it may help relieve doubt that arises.

A woman in transition may:

·         Lose her ability to cope and feel overwhelmed

·         Doubt her decision to birth in the way she wanted to

·         Want to give up

·         Ask for drugs

·         Curse

·         Panic

·         Think she is dying or that something is really wrong

These are all signs that more support is required.

At this point we bring her back to the present, let her know she is not alone, we reassure her all is well, and remind her we are moving closer to meeting her baby!

This intensity is normal and it’s healthy. It is just part of the process, necessary for the huge transformation that is about to occur.  And in the scheme of things, it does not last that long. To the mama experiencing it, it feels long, but the earlier part of labor, although easier, is usually much longer – up to several days. And in transition we are talking no more than several hours, in the course of a lifespan – around one minute plus, at a time. You can take normal healthy labor sensations for 60-90 seconds with rests in between.

So I actually should NOT push at this point?

This is something I feel very strongly about.

The medical model of care defines active labor when a woman is at least 6 centimeters dilated, and the pushing or second stage when a woman is full dilated. Fully dilated means there is no longer any cervix in front of and encircling the baby’s head.

Photo by Mary Elliot O'Haire.

This time is not to be spent trying to push before the natural urge is felt, but honored as a resting phase. Often the waves naturally slow down, and there is a sense of calm. Some women sleep to recharge, and wake up to a surge of increased energy needed for pushing. I believe we are to honor this time, and allow our body and baby to do the work they were perfectly designed to do – the vast majority of times. When the natural physiologic process of birth is allowed to progress on its own, the baby will soon lower into the pelvis on its own, and then you may feel a strong instinctual urge to push; that is the actual start of pushing, the second stage of labor, not when your cervix is examined to be fully dilated.

When a woman is told to push as soon as she is fully dilated, especially her first vaginal birth, she will exhaust herself, as the baby is not low enough in the pelvis to create the urge to push. She will have to work longer and harder, as baby is higher, she is working against her body, not with it.  It’s like pushing out a bowel movement when you don’t feel the urge to. Once baby naturally lowers and the laboring mom will have rested, her body creates a natural strong urge to push; it is much easier to wait and use that internal force to do much of the work for you.

I like to honor the resting phase when all is well. It typically lasts several minutes to an hour or more.

Baby will lower him/herself down, and a woman will feel pressure and a powerful urge to push.

Like having a bowel movement, you will know when you have to push your baby out.

Although contractions are not as frequent as they were in the latest part of labor, many women feel a renewed excitement, a renewed determination, become hyper-focused on what is happening and getting the job done.

Baby starts the descent and glimpses of her head may be seen that come and go, as it makes a few steps forward and a little back, before it begins to actually come out. The birth canal opens to accommodate. In a healthy childbirth, the baby’s head emerges and the shoulders and the rest of the body follow more easily.

Baby's head is emerging. Mama is pushing naturally, working hard, but not suffering. Mama loved her birth. Photo by @birth_unscripted

When does the placenta come out?

The third stage of labor is between the birth of the baby and the birth of the placenta.

When left undisturbed, this stage can last anywhere from 5 minutes to an hour.

This is a sacred time between parents and baby. Everyone is meeting for the first time.

Physically, you’ll know when the placenta needs to come out. Cramping will occur. It’s not like in labor but cramping increases and is accompanied by a gush of blood. It’s common to lose up to 500 ccs of blood or a bit more at birth.

The uterus clamps down and pushes out the placenta. It contains no bones, like a slab of raw meat, so it doesn’t hurt to push out.

The baby takes time to adjust to life outside the womb. She becomes very alert and an unfolding is happening… She is looking around, moving her arms and legs, and eventually starts rooting, sucking and other breastfeeding reflexes.

Women know how to birth their babies and babies know how to be born.

Let me help you not only cope with birth but love your experience no matter where you plan to give birth and despite any challenges you may face! For more info on my online LOVE YOUR BIRTH course click here. I’ve taken everything I’ve learned, trained and supported women with locally for over 20 years in my private practice and I’ve poured all of my love, passion, knowledge and experience into creating something truly special for you - it is an ultimate guide to pregnancy, childbirth, postpartum and beyond!

Learn how to LOVE YOUR BIRTH wherever it is and however it unfolds. I’ve taken everything I’ve learned, trained and supported women with locally for over 20 years in my private practice and I’ve poured all of my love, passion, knowledge and experience into creating something truly special for you and created the LOVE YOUR BIRTH online course. 

Photo by Megan Hancock Photography

 

Please let me know if you found this information useful! Also, please let me know you have any questions that you’d like to submit for our Ask the Midwife series. And I’d love if you shared this information with anyone you think may benefit!

You are supplying your baby's complete nutrition and hydration requirements, as well as your own. It is difficult to get everything you need even from the best of whole food varied organic diet. Do you need supplements? Here are some of my favorite I recommend to mamas in my practice.

Make your Red Raspberry Leaf and Nettle herbal infusion.....rich in needed nutrients and specifically nourishing for pregnancy, birth and postpartum. Place 1 oz of dried red raspberry leaf, 1 oz of dried nettle leaf in a quart-sized glass canning jar with strainer, fill it with boiling water, cover and steep for at least 2 -4 hours at room temperature. Strain and place in a covered pitcher. You can make it in larger quantities and store in the fridge. For taste, dilute with water or steep for less time (but no less than half an hour), add lemon or lime juice, mint leaves or a teaspoon of honey. Drink 1-4 cups daily hot or cold.