How a Birth Doula Can Help Make Labor a More Intimate Experience

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Chantal Traub, CD, CCCE, LCCE,

Pregnant mothers may be unsure if they want to work with a doula because they would like their labor and birth to be an intimate experience between them and their partners and wonder whether having a doula would encroach on their intimacy.

The role of the doula is to help ensure a healthier, safe and positive birth experience for the whole family. She will provide emotional support, physical comfort and the information needed to make informed decisions as they arise in labor at home or at the hospital. She will present reassurance and perspective to the birthing woman and her partner, offering various positional ideas for relaxation and labor progression and hands-on comfort measures like touch, massage, counter pressure and breathing techniques.

One may wonder how an intimate experience can be enhanced with the presence of a doula and the medical staff. Intimacy refers to the feeling of being in a close personal association and belonging together. It is the familiar and very close affective connection with a bond that is formed through knowledge and experience of the other. This intimate experience can be created by having the partner taking a role in the birthing process. The experienced doula will include the partner.

The doula’s presence offers a great sense of relief for both of you, especially for your partner who may begin to feel concerned with the responsibility of supporting you and may not know what normal is in this situation. If you’re having an intimate moment with your partner, an experienced doula will know when to step in and when to step back. She will encourage and allow you both to have that moment. In fact, she will look out for and suggest opportunities for you to be together. She will gently pull your partner back if your partner is feeling overwhelmed or feels worried seeing you in pain and give your partner the tools to help support you. If your partner needs a break or a breath of fresh air, the doula will be there, so that the partner can take care of themselves knowing the doula will take care of you.

The role your partner takes depends on the two of you. If your partner would like to roll up their sleeves and offer physical support or prefers to remain emotionally present from a distance, your doula will guide you. The doula may suggest ways for your partner to hold you or breathe with you. She can show your partner ways to massage and apply pressure while you are laboring. If a partner cannot participate physically for various reasons, they may choose to assist in other ways like getting ice and water while the doula manages the physical part, or merely remain emotionally present in the room. The intimacy is in the experience, allowing your partner to remain confident and emotionally present with you.

Whether your birth is unmedicated or medically complex, every family can benefit from the guidance and support of a doula at this often vulnerable and overwhelming time in their lives.

Chantal is originally from Cape Town and after years of working in film she began teaching yoga in 1996 and in 2003 she became a Certified Doula and has been assisting women in labor ever since. She is also a Certified International Childbirth Educator and a Certified Pre/Postnatal Yoga teacher. Her Prenatal classes are informative and educational and are designed for Labor and Delivery. Chantal has been teaching and assisting families in the New York Metro area for over 15 years and she combines her wisdom and knowledge to help families prepare for a positive birth experience

Chantal Traub, CD, LCCE, CCCE

 www.chantaldoula.com

Certified Doula (CD)

Lamaze International Certified Childbirth Educator (LCCE)

Certified Cooperative Childbirth Educator (CCCE)

Chantal Traub is a certified doula with over 15 years of experience and is a board member for the Childbirth Education Association of Metro New York. Originally from Cape Town, South Africa, Chantal received her BA of Fine Arts and after working for many years in film as an art director, she began teaching Yoga in 1996. Chantal is a White Lotus Foundation Certified Yoga Teacher, Pre/Postnatal certified Yoga teacher and Certified Traditional Ayurvedic Bodyworker. Chantal started her Birth Doula practice in 2003 after receiving her certification from A.L.A.C.E. In 2007 She became a Certified Childbirth Educator by Lamaze International and by the Childbirth Education Association of Metropolitan NY. Chantal is trained with Kate Jordan Pregnancy and Postpartum Massage Therapy and with The Julie Tupler Maternal Fitness Technique. She’s also Certified Kangaroula by Dr Nils and Jill Bergman. She lives in Brooklyn with her husband and two children, Naomi and Noah.

You’d Prepare for the Marathon: Why Not Your Birth!

 

– Ashley Brichter

Fall always makes me excited for the New York City Marathon. What’s not to love? Cheering for thousands of people who have chosen to participate in an awe-inspiring test of endurance. I leave the sidewalk full of endorphins, adrenaline pumping! You may be surprised to find out how often I reference the marathon in childbirth preparation classes. Here are the eight ways I think running a marathon is analogous to having a baby:

You can prepare, mostly.

First time competitors never run 26.2 miles before race-day. They do, however, spend at least 16-20 weeks preparing physically and mentally for the main event. By running regularly and practicing complimentary strength training and stretching they move their body towards optimal conditioning. Pregnant people can work towards optimal conditioning by staying active throughout their pregnancies and receiving massage, chiropractic care, physical therapy, or acupuncture. And, like distance runners, hydrate and nourish their bodies well. Taking a comprehensive childbirth education course to understand what lies ahead, learning about pelvic floor muscles to understand pre and postnatal physiology, and exploring mindfulness practices to reduce anxiety and decrease pain are all essential preparation tools.

 Breathing is essential

Muscles need oxygen! That is probably more obvious for runners than for those in labor. The uterus is a broad muscle, contracting regularly in labor, pushing the baby down while helping the cervix dilate. Deep breathing also reduces anxiety!

The pain is temporary

The vast majority of pain in labor is caused by uterine contractions, not the baby passing through the birth canal. Labor contractions last about 60 seconds and are followed by minutes of rest and relaxation. It can be helpful to know that both individual contractions and the process as a whole will not go on forever!

Find your rhythm, stay steady.

Don’t start out too fast! When running a marathon, the excitement and adrenaline can lead you to do too much too soon. Similarly, in childbirth you are in it for the long haul, and early on your focus should be on conserving energy. Contractions should become ritualistic and having coping strategies is essential. Some people need music, others mantras. You can practice many different coping strategies ahead of time so you’re comfortable on game day.

Stress can slow you down

Oxytocin is the our love and trust and bonding hormone. It is released when we feel safe and relaxed. Oxytocin causes the uterine contractions of labor. Fear and stress diminish the amount of oxytocin produced in the body in turn slowing down or stalling your labor.

There will be moments of self-doubt

Because it ain’t easy. And endorphin production is on a slight delay. But, you can do it!

Support can make a huge difference

It’s always a good idea to have people cheering you on. No one can “run this race” for you, but people by your side can make it more possible.

It’s worth it

For Inspiration: Sarah Moore, Founder of FigTree Childbirth Services and Doula extraordinaire ran her first New York City Marathon last year, She wrote the names of 26 clients/friends/mentors on her arms so she could look down and thing of each of them  and the power they were able to muster when things got hard. doula

Ashley Brichter is a Certified Cooperative Childbirth Educator, Certified Lactation Counselor, Birth and Postpartum Doula in New York City.

PH101: Improve your Birthing Experience

Fiona McMahon, PT, DPT

pregnancy

Having a baby is exciting, fascinating, and nerve wracking. If you have never been through the process before, chances are you have a lot of questions and concerns about what changes your body will go through during your pregnancy, what the birthing process entails, and how your recovery will go once you’ve had your baby.

Join us  and childbirth specialist, Ashley Brichter, in our final Pelvic Health class of the year to discuss the ins and outs of having a child.

Register at pelvichealth-101.eventbrite.com  today.

Location:

110 East 42nd Street, Suite 1504

New York, NY

10017

Time: 7pm on May 4th, 2017

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PH101: Optimize your Reproductive Health

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Fiona McMahon, DPT

Being able to get pregnant is sometimes a little harder than society will have us believe. The female reproductive system is a complex and intricate part of our bodies and there are many factors that go into fertility. If having children is a goal of yours, do not miss our free reproductive health seminar on April 27th at 7pm with physical therapist, Melissa Stendahl. Melissa will be discussing how both nutrition and pelvic and abdominal tissue health can optimize your reproductive function and help with painful reproductive conditions like endometriosis and pain with intercourse.

Register at pelvichealth-101.eventbrite.com  today.

Location

110 East 42nd Street, Suite 1504

New York, NY

10017

Check out our upcoming courses!

pelvic-health-101-spring-2017

Beyond Basics’s Pro-Bono Clinic for PT Day of Service!

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Victoria LaManna, DPT

October is around the corner! And a busy month for many. Whether you are getting back into the swing of school or work after summer vacation, preparing your Halloween costume or getting ready for all the upcoming holidays right around the corner – there is a lot going on!
This time of year is also an opportunity to do good and give back. October is National Physical Therapy Month, where physical therapists celebrate their amazing field of healing and getting people back to optimal function. In addition, many of the PT’s throughout the U.S. give back to their communities during this month. This year we are taking it up a notch. Physical therapists WORLDWIDE are getting involved for the second annual Global PT Day of Service Saturday, October 15th. Whether it is by hosting a pro-bono clinic, serving in a soup kitchen, participating in a 5k for a cause, or cleaning up a community garden – physical therapists globally as a profession are coming together to make a positive impact on the world around them.
At Beyond Basics, we have decided to host a pro-bono clinic Saturday, October 1st to give back to those in the New York City area who may not have insurance or access to physical therapy. We are providing 30 minute one-on-one evaluations and recommendations for home programs to up to 30 participants. For more information and to sign up please visit: http://signup.com/go/Nu1T4Q
You can also check out PT Day of Service here and follow on twitter (#PTDOS) to see how the day unfolds! http://ptdayofservice.com/
The American Physical Therapy Association (APTA) is also involved in hosting National Physical Therapy Month. This year the APTA’s focus is on it’s national public awareness campaign, #ChoosePT. This campaign lets consumers know about the risks of opioid use and that physical therapy is a safe, non-opioid alternative for managing pain.
I encourage you to check out educational resources provided by the APTA (www.apta.org) and Move Forward PT (http://www.moveforwardpt.com/Default.aspx). Learn all about how physical therapy can help you overcome pain without the use of opiods, improve mobility and maintain independence throughout your lifetime.

day-of-service

Why Do I Still Look Pregnant: Part II

Fiona McMahon, DPT

Diastasis-Recti-Repair

Diastasis recti (DR) can be the bane of many women who are trying to decrease the size of their stomach following pregnancy. DR occurs when the two six pack muscles (rectus abdominus) separate from one another, leaving the appearance of visible gapping and bulging of the stomach, creating the look of a belly or paunch. We most commonly see DR following pregnancy; however, it can be seen in men and women with abdominal obesity, children with bowel issues, and people who have undergone abdominal surgery. Aside from its cosmetic effects, DR can also cause problems with the low back, bowel, and bladder.

Most physical therapists are trained to recognize and treat the musculoskeletal components of DR. We know to release the tight structures that are preventing the full closure of the abs, we correct alignment to reduce pull, we use sports tape to encourage the abs to activate, and we strengthen our patients’ core. It usually works wonderfully, but what if it could work better?

Staff physical therapist and resident “thinker outside of the box”, Melissa Stendahl, PT lead an inservice earlier this May to instruct the crew at BBPT on how to incorporate visceral mobilization to improve the results of traditional DR treatment.

 

If DR is a dysfunction of the musculoskeletal system, why treat the viscera?

In pregnancy the uterus grows and as it enlarges and becomes an abdominal organ. The intestines don’t have much say when this happens and get pushed behind the uterus in order to accommodate their new neighbor. After pregnancy the uterus returns to her old home, however the intestines may remain “sticky” from the trauma of being squashed by the uterus, leading to pull on the abdominals from the inside, which prevents the full closure of the abdomen. By treating the organs (AKA the viscera) we can help reduce one more factor impeding the full closure of the abdominal muscles.

How do I know if my organs are playing a role in the failure of my diastasis to close?

Some of the signs of visceral involvement with DR include low back pain, left sided sciatica, lower extremity joint pain, distention or bulging of the lower abdomen, difficulty digesting raw vegetables, and weakness in the lower extremity following workouts, secondary to reduced bloodflow.

What type of results can I expect from visceral mobilization?

According to Brandi Kirk, pioneer of this approach for DR, resolution of DR using visceral techniques can take from 12 visits to 1 visit depending on the severity of the separation.  She was able to demonstrate in her visceral mobilization class the following closures:

 

Class 1

Patient Diastasis Width Before Diastasis Width After
A 2 finger widths 0.5 finger widths
B 3 finger widths 0.5 finger widths
C 1 finger widths 0 finger widths

 

Class 2

 

Patient Diastasis Width Before Diastasis Width After
A 2 finger widths 1 finger widths
B 3 finger widths 1.5 finger widths
C 2 finger widths 0.5 finger widths

 

If you have struggled in closing your diastasis independently or are experiencing some of the symptoms mentioned above, it is time for a little extra help. Come see the physical therapists at Beyond Basics, who are trained to give you the most complete treatment for your DR. You deserve it!

Ooo La La, La! Rééducation Périnéale: Pelvic Floor En France

Fiona McMahon, DPTpregnant en frnace

Bonjour les femmes et les hommes! Did you know that in France, after you have a baby, you get government sponsored pelvic floor physical therapy? That’s right, the French send their new mothers to pelvic floor reeducation, La Rééducation Périnéale. It is free of charge and this type of physical therapy has become the standard of care for postpartum mothers.

We all know childbirth can cause things “down there” to need a little TLC and that after childbirth, things like sex and maintaining continence may become more difficult. Women in France as well as in all countries, including the US, regularly benefit from programs of pelvic floor physical therapy, to address restrictions and areas of tightness in the vagina, vaginal muscle tone changes, and teach the muscles of the vagina to work properly again. What makes France standout is that for women in France, these postpartum physical therapy sessions are free.

The French healthcare system is a little different than ours. The people of France receive government insurance (which draws its financing from a 5.25% of earned income, paid into social security by every French worker), but they also may pay for private insurance to cover any costs that fall outside of what is covered insurance. In France the entire cost of pelvic floor physical therapy is covered by the government.

For new mothers, 10 weeks of pelvic floor physical therapy are provided after giving birth. There are a bevy of think pieces (many cited below), that recount the experience of American- expats’ feeling like they had been magically gifted some strange and exotic European vagina personal training. In these pieces, the explanations for why France foots the bill to rehab your pelvic floor are varied and not all in agreement. Some of the authors cite that because of the European Union’s already dwindling population, and that rehabbing their pelvic floors allows mothers to return to baby-making more quickly than they would have had they only received the 6 week post-partum OBGYN checkup, which is common practice in the United States.

Another more practical explanation is, that because France’s healthcare system is largely funded by the French state. It behooves the French to foot the relatively small bill of pelvic floor physical therapy, versus paying for more expensive problems like incontinence and prolapse, which can occur if pelvic floor issues are ignored. It really is a wise investment for both the French government as well the new mothers, who are investing their time in treatment.

Regardless of the rationale, French women are given a great service. The benefit of Pelvic floor physical therapy has been shown over and over again in many different studies. Rehabbing your pelvic floor after a traumatic event like childbirth, both cesarean and vaginal, can help relieve troublesome symptoms like pain, incontinence, and symptoms of prolapse. It is important that if you feel you need some extra help after your birth, that you seek out a pelvic floor physical therapist. The rewards can be great, and they are much easier to obtain the sooner you enroll in physical therapy! To read more about the benefits of pelvic floor physical therapy, check out these blogs from our archives!

Sex After Pregnancy

https://beyondbasicspt.wordpress.com/2015/06/10/sex-after-pregnancy/

The Pain No One Wants to Talk About

https://beyondbasicspt.wordpress.com/2015/05/13/the-pain-no-one-wants-to-talk-about/

Sources

Giovanni J. We will teach you to make love again. The Guardian.  Wednesday 25, March 2009

Lundberg C. “The French Government Wants to Tone my Vagina”. Slate. Accessed October 14, 2015. http://www.slate.com/articles/life/family/2012/02/postnatal_care_in_france_vagina_exercises_and_video_games.2.html

Rochman B. “Why France pays for postpartum women to “re-educate” their vagina. Time. Feb 22, 2012