Posts in Physical Wellness
The Birth Preferences Grid
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By Erin Erenberg

You’ve probably heard of the birth plan. Setting intentions and visualizing what we want is a great way to set ourselves up for the results we want, in just about every experience we value. But the idea of a birth plan is a charged topic.

For one thing, healthcare providers who enter into a woman’s birth experience all come with their own ideas, goals, and background. Doctors are taught to value risk. They are calculating the risks for mother and child and are trained to eliminate risk as a whole. But a woman facing her own labor and delivery is having a more singular experience. Many times, she’s prepared mentally and physically for the birth that she wants and has an attachment to how the experience will unfold. We cannot pretend that a woman doesn’t have the right to become emotionally involved with her vision. But sometimes complications arise that keep a woman from the experience she’d hoped for, and that’s where the need for flexibility and a softer grip on that vision becomes important.

We wrote a “birth plan” for baby number one, a “birth vision” for baby number two, and then were introduced to the idea of a “birth preferences grid” by Erica Chidi Cohen and her book Nurture, just before baby number three. We found this tool to be a straightforward way to communicate an intention while providing the flexibility needed in case a woman’s vision is recast by the unexpected. Here’s our example. Maybe it will help you or a friend clarify and communicate your vision.

Be informed, be empowered, mama,

Erin


Birth Preferences Grid

Name: Erin Erenberg
Partner: Victor
OB-GYN: Dr. Sara Klevens
Goal: unmedicated vaginal delivery if mom and baby are healthy; have had two unmedicated births at St. John’s (2012, 2014)


Starting Labor

Non-medical induction methods

  • Acupuncture, chiropractic adjustment, squats etc.

  • We would like to avoid medical induction unless there is a risk to mother or baby

Pushing & Delivery

Spontaneous, with varied positions

Perineal Care

  • Guided pushing and positioning, counter-pressure, massage with mineral oil

  • No episiotomy unless medically necessary


During Labor

Monitoring

  • Intermittent; want to be free to move about during labor

  • No IV or IV fluids unless medically necessary

Food & Drink

  • Access to liquids/ice according to thirst

Newborn Care & Nursing

  • Delay cord clamping and cutting

  • Quick transfer to mother for skin to skin contact and breastfeeding for as long a possible

  • Allow/assist mother to breastfeed within two hours of delivery

  • No pacifier/bottle/formula unless requested

  • If mother is asleep for feeding, please wake her


Pain Relief

  • Breathing, movement, relaxation techniques

  • No epidural desired

  • Narcotics - do not offer; Tylenol only if requested after birth; allergic to Advil; bad past experience with narcotics (Vicodin) after first birth

Placenta

  • Please save for encapsulation

 
Things You Should Know About Your Pelvic Floor - Before, During & After Pregnancy
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By Allison Oswald

When women think of the pelvic floor, they most often think kegels. But it’s time for women to know there is so much more to the pelvic floor than just that.

The pelvic floor is a key component to the core system. Giving support to the contents of the abdominal cavity, maintaining sphincter control to the bodily systems and providing sexual function and pleasure, it goes well beyond simply contracting.

Connecting to the pelvic floor is empowering, grounding and strengthening. A healthy pelvic floor functions all day, everyday, without too much recognition. Most women are not in tune to how it works until a problem or dysfunction arises. But if women could understand its function prior to that, they would be more prepared to mediate an issue, possibly prevent a dysfunction and be able to heal or recover more efficiently from an injury or childbirth.

The pelvic floor is a sling of muscles at the base of the pelvis that connect from the tailbone to the pubic bone. They contract in anticipation of movement to stabilize the pelvis, as well as lengthen to accommodate any increased pressure, such as with a cough or a sneeze. These muscles work in conjunction with the diaphragm, our major breathing muscle, which is why breath is so crucial in connecting to the pelvic floor. These two components also work together with the deepest abdominal muscles and back muscles. Together these four parts are the “core” or “stabilizing system”. Keeping these parts aligned properly also contributes to proper function. Alignment is unique to each individual, but in general it is advised to keep a neutral posture, meaning that the pelvis is neither tipped forward or backwards, and the rib cage/diaphragm is stacked directly on top of the pelvis, so that the upper chest is neither puffed up or rounded down. With this alignment and diaphragmatic breathing, the core system is set up to work as efficiently as possible.

Thinking about becoming pregnant, experiencing pregnancy and recovering from pregnancy are all phases of life where women become more attuned and aware of their bodies. This is especially so as it relates to the external appearance of the mother’s growing belly, changing posture and overall weight gain. But this is also a pivotal time for women to connect deeper to their pelvic floor, as it relates back to those physical changes as well as the emotional changes.

Here are some things women should know about their pelvic floor before, during and after pregnancy:

Preconception

Let It Go

Women hold a lot of tension in their bodies, specifically in the pelvic floor, without consciously thinking about it. In order to conceive, good circulation in the pelvis is crucial , which can be restricted with muscle tightness. One way to resolve this is to begin by making sure you are not standing or sitting with your butt tucked under you throughout the day. This position shortens the pelvic floor muscles and can cause unnecessary tightness.

Diaphragmatic Breathing

Begin a breathing practice to coordinate the diaphragm and pelvic floor system. Sit comfortably in good alignment (slight curve in the lower back). Inhale through your nose as the ribcage expands laterally and feel the pelvic floor lengthen down/relax. Then exhale through your mouth as the rib cage comes back in and the pelvic floor recoils back up and in. Getting your body in tune with this connection and movement will allow you to carry it over into your everyday life, exercise and movement practice so that it becomes more natural.

Pregnancy

Maintain Alignment As Best As Possible

As the physical changes occur during pregnancy, it can be easy to allow your body to fall into a less supported position where you hang out in the front of your hips while standing or slouch down while sitting. This will prevent your entire core system (including the pelvic floor) from functioning as best as it can, which could lead to low back pain, hip pain or incontinence.

Exhale With Any Exertion

Blowing out through your mouth as you lift anything somewhat heavy, or get up from a low position, etc...will automatically contract the pelvic floor to give you more support. Whereas holding your breath during these activities can lead to issues such as low back pain, incontinence, diastasis recti (abdominal wall separation) and hemorrhoids due to the pressure put down on the pelvic floor.

Deep Squat To Stretch the Pelvic Floor

Near the end of pregnancy, it is important to allow yourself to stretch the pelvic floor to prepare for labor and be able to breath in and out as these muscles stretch further. This is the only time you would exhale as you lengthen these muscles intentionally versus letting them naturally recoil up and in. Take a deep squat with support and breath as you visualize the pelvic floor lengthening and opening up.

Postpartum

Leaking Is Not “Normal”

Just because you’ve had a baby (vaginal or c-section) does not make urinary incontinence ok. And doing kegels is not typically the fix. Seek out a pelvic floor physical therapist to be properly evaluated and set up with a treatment plan specific to your needs.

Sex Should Not Be Painful

Painful sex, or dyspareunia, is persistent genital or pelvic pain, before, during or after sex. And it can be caused by a multitude of factors postpartum, some of which include pelvic tension, scar tissue, hormone levels and more. Working with a pelvic floor physical therapist is to determine the cause and set up a treatment plan is crucial.


 
 
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@allisonoswald

A true visionary in the realm of women’s health, Allison Oswald, PT, DPT, WCS, CPT works with women by focusing on the core as a pivotal point for well-being. While attending school to become a board certified physical therapist, Allison recognized a major gap in existing treatment, specifically related to women and women’s health issues. An area of the body that is often overlooked, the pelvis is the central anatomy from which virtually all other facets of our health operate. In 2011, Allison set up her private clinic, Plumb Line Studios in Santa Monica, CA. As a mother herself, Allison finds her passion in working with women who are in their childbearing years and postnatally, as she knows first hand, this area of health can be challenging without the proper support.

 
Baby Not Sleeping Through the Night? Read This.
 

By Totum Founder, Erin Erenberg

Mama always said, “life’s not worth living without a good night’s sleep.”

And, boy, did I hear that over and over in my head this past year, while taking a laissez-baby approach to sleep learning.  Although I’d trained our two bigger kids to sleep through the night at 3 and 5 months, I reasoned that it was too hard to sleep train Beau because we’d moved. I worried that any cry-it-out method would wake his older siblings. And let’s be real: I hated the idea of him crying. So I hoped that I could enjoy all the snuggles and sweetness of nursing him to sleep while his sleep routine naturally fell into place when we settled into our new home.

Ha, yeah right. I was suffering terribly, and I noticed that happy little Beau was cranky and agitated. It appears that unlike some other rites of motherhood that have fallen into place for me when I allow instinct to guide, sleep doesn’t work that way for us. For all three of our kids, I have needed to get serious about sleep training in order to reclaim my sanity and help our kids get the sleep they need for their growth, development and wellness.

For all three of our kids, I have needed to get serious about sleep training in order to reclaim my sanity and help our kids get the sleep they need for their growth, development and wellness.

With George (6) and Arabella (4), I used the Sleepeasy Solution (modified cry-it-out to teach self-soothing), and it worked beautifully. But since I’d broken all the big rules of that method for 12 months (feeding baby to sleep, putting him down asleep, rushing in to help him when he cried, starting sleep training too late) I decided to try a new approach. When I saw that Dream Baby Sleep was offering free 15-minute consults, I figured I had nothing to lose.

What I learned was truly life changing. I’m so excited to share it with you in case it rescues you as it did me. So here’s what I learned, in a nutshell:

  1. Move to an earlier bedtime for the baby. My routine had been to bathe all three of the kids at the same time, after dinner, around 6:30. They got PJ’d, lotioned, and hair/teeth-brushed in a line-up, and then George and Arabella were allowed 20-30 minutes of a movie while I put Beau down around 7PM. Erin at Dreambaby suggested I put Beau down no later than 6:30. Now I put him down between 5:45-6:30 PM. The early end of that spectrum is best if he skips his last nap or doesn’t have great daytime sleep. Not only has this been effective for Beau, but it’s also allowed me to have better quality time with the older kids in their last half-hour before bedtime.

  2. Separate the feed from the bedtime routine. Because I’m a rule-following kind of gal, I literally started doing Beau’s nighttime feed outside his bedroom and only move to his bedroom when it’s game-time.

  3. Keep the nighttime routine very short (15 minutes). After dinner, bath, PJs and final feed, next comes the real magic -- the tight and consistent bedtime routine. What works for us is this: Beau waves night-night to his siblings; we enter his room; we turn on the sound machine, turn down the blackout blinds (yes, you need these! Or a black garbage bag! Or these!); sit in the rocking chair; zip on the sleep sack; read one book; turn off the light; and then say good night.

  4. Put him down calm but awake. If Beau’s not calm after the book, I’ll rock him for as long as it takes me to sing two bars of a song and say a prayer with him. I only stand up to put him into his crib once I feel his little heartbeat slowing slightly. Calm is the key, but don’t let the baby fall asleep in your arms.

  5. The goodnight “mantra.” This seems simple but makes a big difference for mommy and baby. As I put Beau down in his crib, I say to him, “Night-night, Beau. It’s time for sleeping.  Mommy loves you.” Then I lie him down, calm but awake, and exit the room. The End!

Remarkably, just by following these tips, Beau started sleeping through the night in 2 nights! The first night, he cried for about 20 minutes, and I went in and checked on him 10 minutes into that cry. I didn’t touch him, just kept my calm and told him that I was right outside and he was learning to sleep on his own. The Dream Baby crew offers a number of different approaches to working through tears when babies are learning to sleep. Crying-it-out with check-ins works best for me because of Beau’s temperament and my cry tolerance. I love, though, that they offer a range of options for moms and babies so that you don’t feel lost if you don’t have the heart to hear your baby wail and baby’s not surrendering easily to rest.  

There were a few nights in the past few weeks when Beau woke up, teething. One night, I caved and brought him into bed to nurse. I felt worried about that, but I went back to our game plan the following night. And it all snapped back into place beautifully.

I’m a big believer in following your maternal instincts. But if sleep isn’t falling into place for you without some work, give these tips a try and definitely check out Dream Baby Sleep. They offer consults, sleep plans, and private Facebook Live events. I’ve found their approach completely non-judgmental, caring and EFFECTIVE!  

Hope this helps you have day after day of love and light, thanks to a good night’s sleep for you and your babies.

Dreamily,

Erin

 
Learning How to Love Your Body Right After You Have Your Baby and Always
Credit: Hylah Hedgepeth

Credit: Hylah Hedgepeth

 

By Stephanie Boxerbaum

Stephanie is an entertainment attorney and founding partner of Box Counsel. She is also the creator of The High Vibe Secret Society, a lifestyle brand for the business minded and wellness driven woman. You can check out her Facebook group here.

I remember calling my dietician right after having my first baby and asking whether I was “supposed to be” on a diet. By “right after” having my baby, I literally mean about three weeks into the whole thing. After all, there is no shortage of pre-baby/post-baby Instagram pictures with sometimes almost unbelievable comparisons or ads telling you how to “get your body back” knocking at your door. Lucky for me, my dietician knew the right things to say.

You see, I had an eating disorder years ago. Despite the fact that I was an attorney with a busy life living in Los Angeles, SO much of my energy was spent on food/workouts. Determined not to screw up my soon to be born children (and I had not even met my husband yet either!), I reached a point where I knew I needed to get help to address my issues around food. How could I bring new people into the world with the desire to guide them to the best of my ability when I thought eating a few cheerios for lunch seemed like a good idea?

After years of work on myself and these issues (of course meeting my husband in the process), I knew I was in the right headspace to have a baby and could support the idea that while my body would need to expand during pregnancy, I would be able to eventually and naturally “get my body back”. I had to feel comfortable eating more calories and knowing that my mission was to support this loving being growing inside of me. It felt uncomfortable but there was no way I was going to let my fear of how my body would look stop me from having a baby. When she arrived, I still remember after the C-section thinking that now was the time for me to really put all of my hard work into action and love my body no matter what.

After all, there is no shortage of pre-baby/post-baby Instagram pictures with sometimes almost unbelievable comparisons or ads telling you how to “get your body back” knocking at your door.

I felt truly blessed and so appreciative when my daughter was born (after 27 hours of labor!).  However, even with all of the work I had done to prepare for my post baby body’s arrival, I had my doubts. When I called my dietician that day, the answer was simple. No amount of dieting a few weeks out from having a baby would do anything except put my body in a state of deprivation (which no one needs when there is plenty of sleep deprivation happening already). My mind was in no kind of place a new mom’s needs to be. She helped to put me at ease and gave the gentle reminder that being in a state of nurturing, self-compassion and love – which is what ALL women need right after they have a baby - was the path to re-discover in my motherhood journey. I loved the reminder and really put into action true routines of self-care. 

After having my second daughter, the path was even easier to follow and truly, I want my daughters to love and honor their bodies. The messages they receive on these topics all start with me (and my husband) so I remind myself of that whenever necessary! I hear women stress all the time about their bodies, foods that they shouldn’t be eating especially around the post baby timing and while sometimes they are sarcastic (e.g., I already had my baby and still look three months pregnant), under the sarcasm typically is pain and/or shame. 

Being in a state of nurturing, self-compassion and love – which is what ALL women need right after they have a baby - was the path to re-discover in my motherhood journey.

ALL women deserve to be reminded to appreciate their body day in and day out. I am all for eating healthy and working out, mainly so you can put your energy into areas of your life you truly enjoy – especially like bonding with your baby! I call it living life from a high vibe perspective. Maximizing all of your energy to keep you in your flow. 

Many people talk about how it takes 9 months to have a baby and you should expect it to take that long (or longer) to get your body back. I would like to throw out the idea that maybe it isn’t about “getting your body back” but more that the focus is spent honoring and appreciating your body. Listening. Nurturing. Focusing on health and not listening to the inner critic inside that jumps out from time to time. Having a baby is a beautiful gift and if food and/or body image thoughts are running a little too rampant in your mind, there are people you can see to talk about it. I am here to give recommendations anytime! 

Just some tips to keep handy: 

  • If you aren’t fitting into your clothes, buy clothes that do fit. It will make you feel better instead of cringing every time you go into your closet. Body acceptance takes time and doesn’t mean that you just give up. It just means you can love yourself and appreciate everything you did to have a baby while your body finds itself again.

  • Snacks and more snacks. As new moms, we are busy, tired, busy again and then even more tired again. Have healthy snacks on hand at all times. Foods that fuel you and you can grab quickly – and foods that you love. If you don’t like carrot sticks, take those off the list! 

  • Love and more love. Every time that voice creeps in – the way your stomach looks, the way your boobs look, if your pants feel tight, whatever it is…shift toward love. You have everything to be proud of so march that body around and own its beauty!! 

  • Think high vibe thoughts. This may sound a little airy-fairy BUT…when you start questioning your body, how you look…literally tap back into your high vibe self. The part of you that honors everything, believes in everything and is just as beautiful as the new baby that has arrived in your life. You just brought ANOTHER HUMAN BEING into the world! If that isn’t high vibe, I don’t know what is! Don’t let any negativity bring you down, ever!

I would like to throw out the idea that maybe it isn’t about “getting your body back” but more that the focus is spent honoring and appreciating your body.

I wish so much love to anyone who is experiencing the joys of motherhood. If you looked in the mirror today to only think your dieting should kick in, let this be a gentle reminder that you are already amazing just as you are, no dieting necessary.

 
Six Time Saving Beauty Tips For Moms
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By Candice Peroli Cortes

Candice Peroli Cortes is an aesthetician specializing in brows and lashes, semi-permanent makeup and tattoo removal. She's also a mother of two who runs several businesses. Candice knows that moms need to feel like their best selves, but have limited time (and concern) for spending hours in front of a mirror. Here Candice gives us some of her top tips and products for how to look your best, even in a hurry.

Read more about her motherhood journey on the Totum blog.


As a busy mom, wife, and business owner, I struggle with finding a few minutes of me time every day! With the responsibilities of taking care of the kids, the household, and my business, it’s a constant rush to get things done. It is essential to carve out some time to give yourself a little TLC.

Feeling good about yourself is not a luxury; it’s an absolute necessity that will give you the energy and enthusiasm to keep up. In honor of all my fellow busy ladies, I am so excited to share my top six time-saving tips and products to help you stay beautiful, polished, and ready to take on life’s daily challenges while looking and feeling great!


1. Exfoliate

Our skin is naturally, and constantly, shedding its own dead cells. When these dead cells are shed, they sit on the surface of our skin, ready to be swept away. If they don’t, they can get caught in our skin’s natural oil and clog our pores, leading to blackheads and whiteheads. Worse, if bacteria finds these dead cells and sebum, our pores can become infected, and this is when inflammatory acne forms. One of my absolute favs is M3 Naturals Activated Charcoal Scrub.  If you are looking for a flawless complexion the natural way, this is it!

 
 

Try M3 Naturals Charcoal Scrub


2. SPF

I am always stressing the importance of SPF to everyone I come in contact with! Yes, really!  I have had basal cell carcinoma three times. You must protect your skin from sun damage and skin cancer.  Opt for an SPF that contains zinc oxide, such as Drunk Elephant Umbra™ Sheer Physical Daily Defense Broad Spectrum Sunscreen SPF 30. Drunk Elephant strives to use only clean ingredients too!

 
 

Try Drunk Elephant Umbra Sheer Physical Daily Defense Broad Spectrum Sunscreen SPF 30


3. Moisturize/Treat

Day and Night, after I cleanse my face I ALWAYS apply Amalie Beauty’s Shine Organic Brightening Oil. The heavenly scent of jasmine scent is what first sold me.  It adds a super concentrated amount of hydration, brightening and helps to correct fine lines and sun spots. I love this product so much I even include it into my dermaplaning treatments at my office! My clients are just as obsessed!

 
 

Try Amalie Beauty Shine Organic Brightening Oil


4. CC Creams

OK, I wear this every day! It Cosmetics Your Skin but Better CC Cream With SPF 50+. See SPF for the win!  It provides heavier coverage than your average CC cream, but doubles as an anti-aging serum thanks to peptides, niacin, vitamins A, C, B, and E, and hyaluronic acid. It Cosmetics also expanded their shade collection earlier this year.

Try It Cosmetics Your Skin But Better CC Cream with SPF 50+

4. Cleansers

Girl, you better wash your face! Especially before going to bed! Going to sleep with your makeup on continuously will age you faster. Everyone’s skin care needs (and reactions) are different, so be sure to consult with you dermatologist as to which cleanser might be best for you. My skin needs tend to change like the weather so I try to use mild cleansers like Mario Badescu Glycolic Foaming Cleanser and Julep Love Your Bare Face Hydrating Cleansing Oil.

5. Hair Care

Gone are the days of showering when I want. Well that’s my current situation right now with two kids under 4! I think I have tried just about every dry shampoo out there, but it’s not one-size-fits-all. Once you find the right formula for you, it’s real game changer. For extra volume, fluff your locks with the hairdryer and a round brush for a couple of minutes.

*Note: dry conditioner is a fun added bonus and I am loving it!

Try UrbanFitCo. Day Two Dry Shampoo

6. Wipes

When I am pressed for time or traveling for work, beauty wipes are a lifesaver!

Makeup remover wipes can be thrown into your purse, placed in your bedside drawer, or even in your travel bag to be used virtually anywhere, anytime. These shouldn’t replace your cleansing routine but are perfect for days when you have to take a shortcut.

 
 
 
Self-Care Cheat Sheet For The New Mom
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By Dr. Michelle Glantz

Several months ago, I wrote a post on the importance of self-care and how it becomes easy to forget about ourselves while caring for our children. To reiterate, I discussed how I am a firm believer that we need to take care of ourselves in order to take care of others. Self-care might have different meanings for you, but if you’re a happy and healthy mama, then the chances are your kids will be as well.  

Since my post on self-care, I have been asked for some simple suggestions to cope with anxiety and stress following the birth of a baby.  Many of these are geared towards the first few months following the birth of a child, but can be used at any time or for anyone.

My suggestions may not take the place of psychotherapy with a trained professional, but they can be used to provide additional care for one’s psychological and emotional well-being. Remember that you may not feel ready to do many of the things listed below, but do what you are able and take small steps. Balancing it all can be tough, so please be gentle with yourself. Remember that taking care of yourself is not only important for YOU, but you are also modeling the importance of self-care and happiness for your children.   

You’ve got this Mamas!

Remember that taking care of yourself is not only important for YOU, but you are also modeling the importance of self-care and happiness for your children.   

Self Care Cheat Sheet

Eat well. 

Take a walk (or exercise if you’re able to and cleared by your physician). 

Stay on all medications you have been instructed to take. 

Get a massage. 

Take a bath. 

Get out of the house.

Listen to music.

Light some candles.

Take calming breaths.

Rest when your baby sleeps or when someone else can provide care for baby.  Yes, here’s the age-old cliché again, “Sleep when your baby sleeps.”  We know how difficult this actually is to carry out, but even if you’re not sleeping, take a mental break or a few minutes to just zone out or meditate.  

Make your needs a priority. It’s easy to forget that the new baby isn’t the only person needing love and attention.  Remember that you can’t properly care for your child if you are not also caring for yourself. 

Seek support from friends and family.

Verbalize how you are feeling to your partner, friend, or family.

Let others know what they can do to help and be specific about what you need from others. Don’t assume that others can read your mind or that you are asking too much from others.  Our loved ones are there to provide additional support so don’t forget to lean on them. 

Don’t compare yourself to others. Every mama and every baby is different! What might be right or work for someone else may not be right for you. 

Do not blame yourself. Find ways to have compassion for yourself.  This is a difficult time and you are trying your best. 

Just do the best you can and remind yourself that you are doing your best.

Remind yourself that all changes take time.

Remember that this too shall pass.  

Remain mindful of when you need to slow down and take a break.   

Confide in someone you trust. 

Be careful asking too many people for advice. Everyone has an opinion!

Set limits with your guests. It’s okay to let others know that you are too tired or not up to having guests over.  Take care of you first!

Surround yourself with people you love.

Avoid people who make you feel bad or uneasy and set boundaries with people you can’t avoid. Okay Mamas, we all have those people in our lives. Perhaps you can’t avoid them forever, but at least give yourself an out for right now. It’s okay to screen your phone calls and If they don’t make you feel good, you don’t have to see them!

Give yourself permission to have negative feelings. Expect some good days and some more difficult ones. Allow yourself to dislike the negative parts and to soak in the positive and know that it’s okay to feel all these conflicting emotions at once.  We have all heard well-meaning versions of the message, “Don’t feel sad.” Take note that sadness is a normal human reaction and instead of telling ourselves NOT to feel, we need to remember that it is OKAY to feel and that we will be better and stronger in doing so. 

Expect some good days and some more difficult ones.

Play. D.W. Winnicott, a British pediatrician and psychoanalyst believed that playing serves as the basis for creativity and the discovery of the self. Playing, says Winnicott, opens up a space of trust and relaxation and is the key to emotional and psychological well-being . By "playing", he meant not only the ways that children play, but also the way adults "play" through creating art, or participating in hobbies, laughter, conversation, etc. Winnicott believed that play is critical to the development of authentic selfhood, because when people play they feel real, spontaneous and alive. So, go ahead and give yourselves the time and space to play! 

Laugh.  Research indicates numerous benefits of laughter including enhancing intake of oxygen-rich air, stimulation of the heart, lungs and muscles, and increases in the endorphins that are released by the brain.  Laughter can also stimulate circulation and aid muscle relaxation, both of which can help reduce some of the physical symptoms of stress and promote relaxation.  Laughter may ease pain by causing the body to produce its own natural painkillers. It also helps connection with other people and may serve to Improve mood.  

Trust your instincts. You are the expert of you. Listen to yourself and your body,  and have faith that you are sensing accurately. 

Avoid overdoing anything. 

Set small goals for yourself. 

Delegate household duties. 

You are the expert of you. Listen to yourself and your body,  and have faith that you are sensing accurately. 

Prioritize what needs to be done and what can wait.

Avoid strict or rigid schedules.  While schedules can be helpful in getting baby on a routine, adhering too rigidly to them may have the effect of creating undue stress on ourselves.  It’s okay to be flexible and deviate from the plan at times.  If your baby nurses or sleeps a bit early or late, it won’t be the end of the world. 

Finally, don’t be afraid to reach out for help from a skilled professional.  We’re always here to help. 

 
Answers to Your Questions About Postpartum
 
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Most questions we received this week were related to Postpartum OCD (ppOCD), so our brilliant and kind Dr. Michelle expounds on the topic here.  

Postpartum OCD (ppOCD) is an anxiety disorder characterized by intrusive, unwanted, and repetitive thoughts, images, or urges (obsessions), which may or may not be accompanied by compulsive behaviors. While the exact cause of ppOCD is unknown, experts believe that it results from a combination of hormonal, psychological, genetic, biological, psychosocial, and environmental factors. Obsessions and compulsions can take many forms for different people and usually focus on the baby.

Obsessional thoughts might include:

  • I’m terrified my baby will get sick and die.

  • What if my baby stops breathing in the middle of the night?

  • I’m scared someone will steal my baby if we go out in public.

  • What if I accidentally or intentionally act on an urge to stab my baby?

  • Why do I keep having an image of my baby falling off the changing table?

Compulsions can include:

  • Repeatedly checking on the baby’s breathing in the middle of the night

  • Excessive bathing and washing rituals

  • Repeatedly asking others for reassurance that baby is okay

  • Taking great measures to avoid the baby

Obsessions are unwanted, difficult to control, and increase anxiety. In order to neutralize the anxiety associated with these obsessions, one might then engage in overt or mental compulsions or avoidance. For example, a mother might have repetitive images of something terrible happening to her baby while driving in the car. As a means to decrease the anxiety associated with this thought, she may avoid driving anywhere with her baby. Another mother might have unwanted thoughts that she will act on an urge to intentionally harm her own baby.  This mother might then begin to avoid her baby altogether. It is important to understand that in the latter example, this mother does not have these thoughts because she actually wants to hurt her child, but rather she is terrified that she might act on these thoughts. The obsessions are unwanted and conflict with a person's self-image and character.

According to the International OCD Foundation, up to 80% of new mothers report having strange, unwanted thoughts. This means that most new parents have similar experiences with anxiety and intrusive thoughts, but would not be diagnosed with Postpartum OCD. A diagnosis of OCD might be made when preoccupation with the intrusive thoughts is clearly disruptive to a mother’s normal functioning and greatly interferes with her ability to care for herself and her baby. It is no surprise that this can have devastating effects on the parent-child relationship and highlights the immense need for treatment. Due to the fear of stigma and feelings of intense shame, however many women are resistant to seeking help. If you or anyone you know is experiencing these symptoms please know that you are not alone and it is okay (and important) to reach out for help from a qualified and licensed mental health professional.

Others of you wanted to learn a little more about psychological and emotional responses to weaning. Dr. Michelle responds here: 

It is not uncommon for women to feel tearful, depressed, irritable, or anxious when weaning. Not much research exists on this topic, but some hypothesize that a shift in hormones when weaning may be a major cause for these feelings. Other factors might involve feelings of sadness around the loss of this special time with your infant. These mood changes usually go away on their own, but some weaning mothers may experience more severe symptoms that require treatment.

 
Deconstructing Cravings with Compassion
 

by Daniela Kende

Daniela Kende is a Los Angeles-based holistic nutritionist, health coach, and wellness expert. She supports busy professionals in learning how to develop healthy habits on the go, prepare simple and nourishing real food meals at home, and to create abundant energy to live the life they desire. Daniela specializes in helping her clients break free from food rules and deconstruct cravings with compassion in order to get to the root underlying need, be it physical or emotional. Daniela’s goal is to help others ditch the diet mindset and find freedom with food for good.

Totum Woman Daniela Kende

One of the first things I noticed very early on in my pregnancy was the fact that I simply could not ignore how my body was feeling. Afternoon naps went from a rare luxury to an almost daily necessity. And my food preferences were distinct, particular, and ever-changing.

Pregnant or not, our bodies always have distinct needs in order to thrive –  pregnancy just has a way of amplifying those needs and making it harder (or sometimes impossible) to ignore them and push through.

I’ve coached a number of pregnant women and new moms in my private practice as a holistic nutritionist and health coach, but it wasn’t until experiencing pregnancy for myself this year that I had this aha moment: being pregnant offers women a unique opportunity to grow in compassion towards self – towards our cravings, emotions, and physical state. It’s an opportunity to embrace our needs on a new level, regardless of if they make sense or are convenient. Approaching our pregnancy cravings with compassion and patience can provide the perfect training for life with a newborn, where old expectations are replaced by a non-negotiable need to live in the here and now.

Being pregnant offers women a unique opportunity to grow in compassion towards self – towards our cravings, emotions, and physical state.

But what happens when your pregnancy cravings are for processed junk food you know you should avoid, and that chopped salad you used to love is a total turn off?

This is where we have an opportunity to become compassionate investigators, and dig deeper into our desires in order to understand our needs on a new level. When a craving arises, I find it usually falls into one of these three categories:

  1. A distinct physical desire for an ingredient: ie craving something salty. It could be pickles, potato chips, or sauerkraut, as long as there is salt. This type of craving usually comes from an actual physical need.

  2. A desire for emotional release: When we have feelings that we want to release, we often use food to help us feel a sense of expansion and freedom. This can take the form of a pizza or wine craving to find release after a challenging week.

  3. An emotional numbing or distraction: This type of craving stems from not wanting to deal with difficult feelings when they arise, and will usually manifest in a desire for something creamy, sweet, and/or fatty, such as ice cream, nut butter, or chocolate.

During pregnancy (and anytime, really!), it helps to slow down and bring more mindfulness to our cravings in order to consider the underlying physical or emotional need behind each one. By doing so, we can upgrade our reward and give our bodies and souls what they actually need to thrive.

To help you bring more clarity and compassion to your cravings, here are two of the more common pregnancy cravings I’ve seen in my clients (and myself!), and some tips for how to get what you want and take care of your health in the process:

Totum Women Daniela Kende

Common Craving #1: I scream, you scream, we all scream for ICE CREAM.

Creamy foods provide us with soothing comfort when we are overwhelmed, uncomfortable, or fatigued. Add sugar to the equation, and we’ve got an addicting new habit on our hands.

What your body and mind might actually need: An emotional hug and “time out” from the hustle and bustle of your life. Try establishing a healing nighttime bath routine following these steps:

  1. Run a bath -- just not too hot for baby -- and add a large scoop of pure epsom salts (skip brands with artificial fragrance)

  2. Add a few drops of essential oils right into your tub. I like using chamomile and lavender for night time, as they both promote deep relaxation.

  3. Next, light a candle, dim the lights, put on some relaxing tunes, and BREATHE, using your bath as a time to slow down and reset pesky stress hormones.

  4. Bonus points for bringing a cup of herbal nighttime tea with you to sip while you soak.

Sometimes, an ice cream craving means you’re going to have ice cream! Full stop, no discussion, no bath (or maybe ice cream in the bath?). For those times, try to prioritize the quality of product you choose, in order to lessen the negative impact on your health.

Upgrade your reward: Most ice creams on the market are made from non-organic dairy and have additives that disrupt your hormones and trigger bloating and indigestion. Instead, look for an organic ‘scream that contains just a few whole food ingredients. My favorite clean ice cream brands include:

  • NadaMoo! (dairy-free)

  • Luna & Larry’s Organic Coconut Bliss (dairy-free)

  • Three Twins Organic Ice Cream

  • Alden’s Organic Ice Cream

  • BONUS option: While it’s not ice cream, I find sheep’s milk yogurt to be an incredibly satisfying alternative. It is easier to digest than cow’s milk, has twice the protein, and a lot less sugar. Check out Bellwether Farms Yogurt.

Finally, a note about dairy cravings: Consistently craving dairy during pregnancy could be a sign that your body needs more calcium. Check with your doctor about adding a high quality mineral supplement (I personally take Osteoforce by Designs for Health), to help your body get what it needs to thrive.

If my work with clients has showed me anything, it’s that cravings are good - they tell us exactly what our bodies need. The trick is listening to them, specifically the emotion behind the craving.

Common Craving #2:  Carbs carbs carbs!

Especially during early pregnancy, white bread, bagels, and crackers may be the most appealing option. It’s no wonder: simple, refined carbs require less energy to digest, and are void of any strong smell or taste that could trigger sickness. The downside, beyond the lack of nutrients, is that fluctuations in blood sugar caused by simple carbohydrates can exacerbate morning sickness, which is the last thing any of us want.

What your body and mind might actually need: Rest and more rest. While increasing your nightly Zzzs might feel pretty inconvenient if you’re used to getting by on little sleep, hitting the hay a few hours earlier is the best free medicine available. When we are sleep deprived, our brains scream for simple carbohydrates for a quick burst of energy. Try committing to at least 8-9 hours of sleep per night for a week and see how it impacts your cravings for carbs. Finally, sneak in afternoon naps whenever you can. Even a 10-minute nap can go a long way in reducing cravings and resetting your mental state.

Upgrade your reward: Rather than reaching for refined white flour products, focus on fiber-rich carbs to help slow the blood sugar spike. I’m a big fan of oat, coconut, and buckwheat, all of which are more nutrient-dense and less inflammatory than refined wheat. Here are some of my favorite comforting and nutritious carbs that were a lifesaver during my first trimester and beyond:

  • Oatmeal: Try the Trader Joe’s GF Ancient Grain & Super Seed Oatmeal, which includes flax, hemp, pumpkin, sunflower, and chia seeds -- all of which are fantastic ingredients for a healthy pregnancy. Stir a scoop of plant protein powder into your oatmeal to make it a more complete meal.

  • Sweet potatoes: Rich in vitamins A, C, iron, and potassium, sweet potatoes are pregnancy food all stars. Bake a few at the top of the week and try one topped with almond butter, peanut butter, or tahini for a boost of beneficial fats and protein.

  • Cream of buckwheat: For those times when you need something VERY bland and soothing, try organic cream of buckwheat (I like this old school brand!) cooked in water or unsweetened almond milk to help settle nausea.

  • Tortillas: I’m pretty obsessed with the tortillas from Siete Foods. They are soft and flexible like flour tortillas, but are totally grain-free. Warm one up and top with organic scrambled eggs and half an avocado for a balanced breakfast taco that’ll keep you satisfied and energized.

  • Chips: I love the crunchy coconut flour chips from The Real Coconut.

  • Crackers: Try Jilz or Simple MIlls for a nutrient-dense and delicious anytime cracker.

Pregnancy is a unique journey for every woman, and a special opportunity for us to listen to our bodies on a whole new level. If my work with clients has showed me anything, it’s that cravings are good - they tell us exactly what our bodies need. The trick is listening to them, specifically the emotion behind the craving. If you can do that, you’ll see how much power you have to create a peaceful and healthy pregnancy and transition into motherhood. I’m always here to offer customized support for mamas at any stage, so don’t hesitate to reach out.

In the meantime, try my Sunflower Lemon Zest Mighty Bites recipe for a pregnancy super snack filled with nutrient-dense superfoods that will support your energy and baby’s development, and find more healthy recipes at www.danielakende.com.

Totum Women Daniela Kende
 
I Couldn’t Forgive the Way Our Healthcare System Had Almost Failed Me
 

by Dr. Robin Fawcett

I am an American MD now practicing as a general practitioner in England with my own natural wellness business. I have an MA in the History of Medicine and I'm a member of the British Society of Lifestyle Medicine. You can find me on Facebook as The Essential GP.

Totum Woman Dr Robin Fawcett

I got pregnant during my second year of residency training. I waddled bravely through 80-hour work-weeks, determined to show my physician colleagues that pregnancy hadn’t made me weaker or slower. But then I received unprofessional advice from my obstetrician, and I began to question the integrity of our entire medical system.

Specifically, my OB made two errors when I was under her care for our first child, Henry. The first was at my 18 week ultrasound, which revealed two cystic structures in Henry's brain. They are harmless in themselves but can be an indication of a chromosome abnormality. The recommended management is to offer genetic counseling and potential amniocentesis, or do nothing. Instead, I was advised to have regular ultrasounds to monitor the cysts. It was simply the wrong advice. I knew enough of the medicine to realise it, so we said no.

In fact, and as a bit of an aside, there is an epidemic of unnecessary ultrasounds in US obstetrical practices that goes against medical advice. Often, OBs comply because patients enjoy the photos, and the practice can charge a lot for the ultrasounds. This is an area of enormous concern for me because more intervention and imaging may actually cause harm, and moms aren't fully informed or consented for this additional testing. It's unethical.

The second piece of unethical guidance came when we were given a handout written by the senior OB in the practice, a very well-respected man in our area, outlining why he strongly opposes natural childbirth. It was such an inflammatory and insulting letter; he compared natural birth to a farm animal giving birth in a barn. It took my breath away. I wasn't even thinking about a birth plan at that stage, but just knowing his bias and that I'd have a 33% chance of him being my OB at delivery made us choose to walk away.

Another factor was my research into what the primary C-section rates were for the OB practices in our area. From what I could tell, it was in the area of 35-40% for uncomplicated first time moms. The World Health Organization says it should be 10%. To me, that just means unnecessary harm to moms and babies. I'm sure it's based on malpractice concerns and defensive medicine, but that isn't an excuse for hurting people.

A dear friend reached out and offered me her own birth story with a totally different vision of childbirth; at 28 weeks, I switched my care to a hospital midwife team 30 miles away. Our son Henry was born after a beautiful, powerful, and unmedicated labor.

Any doctor should know that birthing a child is so much more than a physical process, but I was still unprepared for the emotional and spiritual aspects of new motherhood. When I returned to work at 7 weeks postpartum, I felt ashamed by the panic I felt about being separated from my baby. My new mother-self felt tender, not tough. And I couldn’t forgive the way our healthcare system had almost failed me, and my career ambitions and confidence collapsed.

My new mother-self felt tender, not tough. I couldn’t forgive the way our healthcare system had almost failed me, and my career ambitions and confidence collapsed.

I’m so grateful that motherhood led me to a different path. With the birth of my second son, I experienced how powerfully I could improve my resilience – and the health of our entire family – through good nutrition, gentle physical activity, emotional openness, and a connection with nature. My medical career is now focused on lifestyle medicine and natural wellness. I want all women to know their own incredible capacity for healing.

Empowerment can be uncomfortable, I’ve discovered. Owning our stories and taking charge of our health takes inquiry and courage. There are risks: we may be noticed – and confronted – by those who feel challenged by our freedom. But the invitation to greater wellness is right there in our bodies, and there has never been a better time to say YES.

Owning our stories and taking charge of our health takes inquiry and courage.

So never doubt the power of a nutritious meal, a walk among the trees, or a good laugh/cry with a friend. Most of all, please speak up when you don’t feel heard by your doctor. Listen to your instincts. Ask questions. Be heard. You are stronger than you know.

Dr Robin Fawcett
drfawcett@hotmail.com

 
The Pelvic Floor Demystified
 
Totum Women, Lauren Spahn

Lauren Spahn

Yoga Teacher, Birth Doula, Writer


Vagina. Privates. Yoni. Lady bits. Flower. Noony.

The list of words we use to refer to the pelvis goes on and on. Take a moment to consider the word you use in your vernacular. Now what exactly do you mean when using that word? Are you referring to the external genital organs such as the labia, mons pubis, and clitoral hood (the vulva)? Or are you referring to the elastic muscular canal that extends from the cervix to the vulva (the vagina)? What about the uterus, which has the remarkable capacity to double in size during menstruation? Or the 16 different layered muscles that make up the pelvic floor?

If we consider the true anatomy of the female reproductive system, none of these terms alone effectively encapsulates the beautiful complexity. Which is why, despite its lack of sexiness and pizazz, I have consciously shifted – in my life and work - from using the term “vagina” to embracing the term “pelvis.” For, the pelvis is the sacred home of all the elements that make us women. *That is NOT to say that if you were born with extra or without certain anatomy, have had the surgical removal of organs, or identify as transgender that you are not a woman. You are a woman. Real. Whole. You.

For, the pelvis is the sacred home of all the elements that make us women.

I’ve come to observe in my time as a doula and yoga instructor, that while many elements of our bodies feel foreign, the pelvic floor seems to take the cake. Yet it is also the root of so many conditions that ail women, particularly as we cross the threshold into motherhood. Incontinence – check. Prolapse – check. Vulvodynia – check. Vaginismus – check. Irritable Bowel Syndrome (IBS) – check.  And the list goes on! If you’ve suffered from any of these, I want to assert that 1) you are not alone and 2) there is support available on all levels. If you don’t know what any of those strange words mean and don’t care to become acquainted, I encourage you to get to know your pelvic floor!

So exactly is the pelvic floor?  

The pelvic floor is comprised of 16 muscles in three different layers:

  1. Bulbocavernosus (known as the bulbospongiosis in males)

  2. Transverse Perineal

  3. Levator Ani (also known as the “Pelvic Diaphragm”)

You certainly don’t need to memorize those names, but what you do need to know is that each layer runs a different direction, creating a woven hammock in which the organs of the pelvis sit. Just as the diaphragm of our lungs billows wide and expands downward as we inhale, so does the pelvic floor. Upon exhalation, a healthy pelvic floor and diaphragm return to a neutral state almost parallel to the ground. Inviting this visualization with breath is a beautiful exercise to practice. Not only does it enhance our awareness of and connection to the pelvic floor, but it also serves to maintain a healthy range of motion for the muscles. Which leads me to my next point:

What makes a healthy pelvic floor?

To answer that question, we need to challenge the status quo of what defines a healthy muscle. Our culture often misinterprets strength and health. We assume that if our muscles are big and defined, that means we are strong and therefore healthy. Or, alternatively, we strive to elongate our muscles enough to be able to contort our legs into a pretzel, assuming that to be the epitome of health. But the reality is that those “big” muscles are simply short and contracted, while those “lean” muscles are elongated and lengthened. If all our muscles were only one or the other, our bodies would be in serious trouble. Just imagine your six pack abdominal muscles as short and contracted. Now think about how limited your breathing would be if those muscles couldn’t expand as you inhaled. Or consider how those shorter muscles create less space between your  ribs and hips, thus rounding your spine and rolling your shoulders forward (think hunchback).  

Our culture often misinterprets strength and health. We assume that if our muscles are big and defined, that means we are strong and therefore healthy.

Muscle health is, actually, elasticity. In other words, it’s the ability of a muscle to exert its full range of motion, from short and contracted to elongated and lengthened, according to use.

Let’s apply this to the muscles of the pelvic floor. When too toned or overly tight, those short and contracted (known as hypertonic) muscles can cause complications such as the constant need to urinate, irritable bowel syndrome, and painful intercourse. On the flip side, pelvic floor muscles that have no or low tone (known as hypotonic) remain lengthened and can result in the lack of urinary control with impact (like jumping or sneezing), prolapse of pelvic organs, or the passage of air through the vagina during intercourse. The reality is that many of us experience an array of these complications over the course of our lives, particularly during pregnancy and postpartum. Just as our bodies change over time, so do the muscles of our pelvic floor. In fact, sometimes the transverse perineal will be too toned while the levator ani has low tone - even though they’re woven together, they each have their own conditioning and, therefore, their own levels of elasticity.

Which leads us to our answer: A healthy pelvic floor is when each of the three layers of muscle can exert a full range of motion in accordance with the action of the body.

So how do you attain a healthy pelvic floor?

The first step is acquainting yourself with your pelvis and those ever-so-important pelvic floor muscles. Here are a few exercises for you to familiarize yourself with the vast world of your pelvis:

  1. Write the story of your pelvis - Documenting the journey of your pelvis to date is a beautiful tool of exploration and understanding. I invite you to write free form or answer any of the following questions as a prompt:

    • What is one word that you would use to describe your pelvis?

    • Is your pelvis a source of power, a source of vulnerability, or both?

    • What delights your pelvis (i.e. touch, a bubble bath, candles, music)? What frightens it (i.e. touch, strangers, childbirth, the mirror)?

    • When did you first touch your pelvis? When did you first see your pelvis? How did those experiences make you feel in the moment and how do they make you feel in retrospect?
       

  2. Breath work - As mentioned above, breath work helps to inform us about the health of many of our core muscles, including the pelvic floor. So here is an exercise for you to do once or daily:

    • Recline on your spine and find a comfortable position.

    • Place your left hand on your chest and your right hand on your belly.

    • Concentrate your breath in your chest; observe how your chest and left hand rise with each inhale and fall with each exhale.

    • Once you’ve found a rhythm to your breath in your chest, expand that breath from the chest into the belly; observe how both hands rise along with the chest and belly as you inhale and fall as you exhale.

    • Once you’ve found a rhythm to your breath in both your chest and belly, send each inhale into the chest, belly and pelvis. Just as the hands rise, feel the full expansion of your pelvis with each inhale. As you exhale, left the breath exit the pelvis, then the belly then the chest.
       

  3. Posture evaluation - Our posture tells us a lot about the natural resting state of the pelvic floor muscles, so I invite you to take inventory of your posture:

    • Stand with your feet hip width distance apart.

    • Place your hands on your hips, with all four fingers on the front side and your thumbs pointed towards the back. Now press your fingers down toward the earth and notice the tilt in your pelvis. In this position, the belly protrudes forward and the curve in the low back is exaggerated. In this position, the pelvic floor muscles are lengthened.

    • Place your hands on your hips, with the thumbs on the front side and all four fingers around back. Now press your fingers down toward the earth and notice the tilt in your pelvis. The belly is drawn in and the curve in the low back is neutralized. Just as the core and glut muscles are contracted, so are the muscles of the pelvic floor.

    • Apply these observations to your posture at different points throughout the day (i.e. when you’re standing in the kitchen, when you’re driving in the car, when you’re carrying a child on your hip, when you’re lounging on the couch) to understand the natural resting state of your pelvic floor muscles.

Whether you’re overwhelmed, excited, fearful, angry, or in awe by this information and/or by practicing these exercises, please don’t hesitate to share your experiences and reactions with me. I’m here as a part of Totum Women to hold space for you to feel heard, supported, and strong in all that you are: lspahn@gmail.com.