Caffeine & Breastfeeding - Go on, Have that Latte

Good news if you are breastfeeding and exhausted...

On caffeine & breastfeeding - some factoids...

• Very little of the caffeine in coffee actually makes it into breastmilk.

• Caffeine appears in breastmilk within 15 minutes of consumption by the mother.

• Caffeine reaches maximum concentration in breastmilk within 1 hour.

• Only approximately 1% of the caffeine a mother ingests makes it to her breastmilk.
  
  Some babies, especially those with medical conditions or those under 6 months of age, may be more likely to react to this small amount.
  
  Babies who seem irritable, fussy or wakeful may be affected by caffeine intake. They may also have a harder time staying asleep (Mohrbacher 2010).
  
  CONCLUSION: if a breastfeeding mother has a moderate intake of caffeine (2 to 3 cups daily), there's almost no chance that it will affect her breastfed baby.
  
  So have that latte. You probably need it.
  
  SIDENOTE: No one should be commenting on your choice to drink caffeine, whether you are pregnant or breastfeeding. Your body, your baby, your choice. Though these people think they're being helpful, it's none of their business, and they are clearly ignorant of the facts, so feel free to educate them.
  
  Link to a comprehensive article on this topic from La Leche League International, with references:
  https://www.llli.org/breastfeeding-info/caffeine/

Healthy Mom/Healthy Baby is NOT all that Matters

They say healthy mom/healthy baby is what matters - but who is defining health?

I'm sure you've heard the term "healthy mom/healthy baby" in reference to the main goal for birth.

This term really bothers me because it is not in fact referencing health, but is simply stating that both mom & baby SURVIVED. It doesn't take into account so many factors that go into health, including, very importantly, MENTAL HEALTH.

The trauma that happens to women is often caused by unnecessary interventions & lack of informed consent, and was avoidable. But there is never any accountability for the doctors, midwives and nurses who did this to them. We’re all just supposed to be grateful we didn’t die.

When a woman has a traumatic birth, or her birth doesn't go according to plan and she is mourning it, people often use the "healthy mom, healthy baby" line to try to make her feel better. But by doing this they are minimizing her pain and her experience, often making her feel ungrateful, further adding to her guilt.

We deserve better than having the goal of birth be only survival. That is setting the bar so incredibly, sadly low. Birth can be so, so much more.

Birth Trauma & its Effects on Your Future Children

Please don’t let an unnecessarily traumatic birth experience keep you from having more children and the family you planned.

This is one of the saddest (& most frequent) stories I encounter.

The story of someone who had a traumatic birth now questioning whether they want more children.

These people had a plan - a vision of their future family - and what they were put through just erased it. Their experience of pregnancy and birth was so scary and they felt so out of control that they now question whether going through it again is worth it.

The thing that makes me the most angry?

Most birth trauma is avoidable, and therefore totally preventable in the future.

What happened was DONE TO THEM. It didn’t have to happen. It’s almost never an unavoidable fluke.

Sure, there are true emergencies that could not have been prevented. And for those situations we are all thankful for emergency medicine.

But for the most part, that’s not why birth trauma happens.

It happens because we don’t trust women and don’t trust birth.

We intervene unnecessarily. We weigh and measure and critique every inch. We scan and test and monitor.

We introduce doubt - make you second guess your instincts - and then you let us take the wheel.

So when we tell you that your baby is too big, you let us induce you or schedule a c-section. And that’s where it begins.

If you have had a traumatic birth and are questioning whether you want more children, please don’t let a bad experience take your future from you. The next time doesn’t have to be that way - you just need to choose your providers and birth location very carefully.

The more control you have, the better.

Don’t let anyone take your family’s future from you. They’ve taken too much already.

No, We Don't Need to Normalize Formula Feeding

A while back, model Chrissy Teigan started a campaign to “normalize formula feeding”. This is my response. Like all of us, you're doing the best you can in your given situation.

However you feed your baby, you shouldn't feel shame.

The situations new mothers are put in are unbearably hard, and you do what you have to to get by.

If the situation was different - if mothers were supported rather than backed into corners where something had to give, how many more of us would succeed in our goal to breastfeed?

80% of women leave their birth intending to breastfeed. By 6 months, only 15% of us are still going.

Formula is an important tool, but it's not how most women start out intending to feed their babies. And those who choose it aren't doing so because they don't care about their kids - they choose it because it's the best option given their unique situation.

But would more of us breastfeed if we had proper support?

What if instead of jumping back to your responsibilities immediately after birth, your community helped with older children & dropped off food?

What if instead of being forcibly separated from your baby at 6 weeks (or earlier) because you have to return to work, you could be home (paid) for 6 months?

What if instead of having to pump in a bathroom stall at work, there were private pumping rooms available as standard?

We have so much stacked against us as new mothers - we definitely don't need shame added to that.

So let's change the conversation. Let's talk more about how society is failing those of us who want to breastfeed so we can change it.

And let's also mind our own damn business about how other people feed their kids.

Naegele's Rule - How a Man from the 1800's Decided Your Due Date

An obstetrician from the 1800’s decided your due date.

And VERY often babies are forced out of the womb before they’re ready based on his calculations.

The obsession with a gestation of 40 weeks leads to an increase in inductions, interventions, and surgical birth - all of which have physical and emotional/mental consequences for mother and baby.

But where did this guess date even come from?

The due date calculation we use today comes from an obstetrician named Franz Karl Naegele, who invented “Naegele’s Rule”. This calculation starts with the first day of your last menstrual period, goes back three months, then adds one year and 7 days. The result is a gestation of 280 days (40 weeks).

The 40 week date is an average, meaning that about 1/2 of people will give birth before that date, & 1/2 after. It probably wasn’t seen as a hard eviction date in the 1800’s.

But today we live in a fast-paced world that runs on schedules and money. And with the ability to “control” birth via induction and surgery, this 40 week average date often turns into the day when your baby will be forced from your body.

Here are my top 3 reasons why using this calculation as a hard eviction date is wrong...

1. Naegele’s Rule is based on a 28 day menstrual cycle. If you, like me, don’t ovulate at exactly day 14 of your cycle, this calculation won’t work for you. Most people don’t know when they ovulate, and this important fact is almost never taken into account when calculating a due date.

2. Our bodies are all different - we didn’t all get our periods at exactly age 11 years 6 months and 13 days, so why would our bodies all grow babies at exactly the same rate? To use a due date as an estimate of when a baby will arrive is one thing - to use it as an eviction notice is a completely different story.

3. Many factors determine whether you are likely to have a longer or shorter gestation - if you are between the ages of 19 and 34, having your first baby, or are white, you are statistically more likely to have a longer pregnancy.

Many women have their due date estimated with an early ultrasound, which can be more accurate than using Naegele’s Rule. That being said, your due date is always a guess, so take that into consideration if you start getting pressure as that date approaches.

If we Trusted our Bodies to Birth, the World Would be a Different Place

No other mammal doubts their ability to give birth.

They seek out isolation - darkness - quiet - and they let the process unfold.

It really is silly, after all, to doubt our ability to procreate when it is quite literally what keeps our species alive.

But the indoctrination is real.

From before we can remember we’re told how painful & dangerous & impossible birth is. We’re told how long aunt Sally’s labor was & how many interventions were “required” & how she almost bled to death.

And then, once we start seeing birth on TV and in the movies, it’s always portrayed as a dangerous, intensely medicalized experience with a lot of rushing around, screaming, and machines constantly beeping.

So it’s no wonder that, by the time we get to be pregnant ourselves, we have no idea what our bodies are capable of.

But the truth is, YOU WERE MADE FOR THIS.

Are there complications in birth sometimes? Of course. But, if left alone and not messed with, the majority of births go well.

If we trusted our bodies to birth like we trust them to digest food or pump our blood or do any of the other incredible processes they do without help or even a thought, the world would be in an entirely different place.

Padsicles for Early Postpartum Healing

Cold + witch hazel + aloe = pain relief & fast healing.

If you experience a vaginal/perineal tear during birth, you can have pain, inflammation, and itching in the area where your tear occurred. This can be totally normal, but it’s also not comfortable.

Even if you didn’t tear, you can still experience pain in that area postpartum. Everything has been stretched and is now swollen.

Enter padsicles - a total game changer in early postpartum healing.

A padsicle is a sanitary pad (disposable or cloth) that has been soaked in witch hazel and aloe, and then frozen.

Cold helps to decrease inflammation and pain.

Witch hazel acts as an astringent (helps cells to contract and heal), reducing inflammation and bleeding. It also contains Antibacterial & antiviral properties to stave off infection. It also helps to heal hemorrhoids. Make sure the version you purchase doesn’t contain alcohol.

Aloe vera stimulates the proliferation and migration of fibroblasts and keratinocytes (cells that work to heal wounds). Be sure there are no dyes or other junk in your aloe vera.

The combination of these 3 elements reduces pain & speeds healing time in the early days postpartum.

Padsicles were magic for me after my second birth. I prepared multiple at a time so that when the effects of one wore off, another was just waiting in the wings.

I hope they help you, as well!

Postpartum Hemorrhage - Here's some Pitocin to Stop the Bleeding we Caused with all that Pitocin

Postpartum hemorrhage is on the rise…

Why? Likely due to the staggering increase in the use of induction, augmentation, epidurals & c-sections.

The most common reason for hemorrhage (up to 80% of cases) is uterine atony - when the muscles of the uterus have been so overworked during labor that they are too exhausted to help stop bleeding after birth.

What’s one of the top reasons for uterine atony to occur?

Induction or augmentation WITH PITOCIN.

So, let’s get this straight - we tell people that it’s too dangerous for them to stay pregnant past a certain date & administer Pitocin to get their labor started or hurry it up.

Because the contractions caused by Pitocin are more frequent/stronger/longer than natural contractions, the uterus becomes exhausted. There is more bleeding than usual because the uterus can’t clamp down & stop it. A hemorrhage is suspected (blood loss is usually visually estimated, not truly measured), and the same drug that caused the problem is given to solve the problem.

The circle of Pitocin is complete.

Because of the highly medicalized active management of labor & birth in hospitals, Pitocin is often given to everyone preventatively in the 3rd stage of labor (unless you know to decline). It’s always optional.

Are there ways to help prevent postpartum hemorrhage naturally?

YES!

- NO Pitocin (or other uterotonics) during labor
- NO pulling on the cord (cord traction)
- NO immediate cord clamping (wait for white)
- NO vigorous “fundal massage” or unnecessary manual removal of placenta

- YES to immediate skin-to-skin with baby
- YES to breastfeed baby right away after birth
- YES to waiting for the cord to turn white & the placenta to be birthed on its own

There is no Shared Decision Making

Decisions about YOUR body shouldn’t be shared.

The term "shared decision making" says women are incapable of weighing their options, doing their research, listening to their intuition, and coming to their own conclusions.

It’s your body. It's YOUR choice.

Will others have opinions? Of course.

Should you consider those opinions when making YOUR decisions? Sure.

But the decisions are ultimately up to you. Everyone else is just an advisor.

A shared decision can only occur when each person has equal stake in the game, and only YOU have to truly live with what happens to your mind & body as a result of the choices made during pregnancy/birth/postpartum.

You and your doctor are not equally invested in what happens to your body, and how that affects you and your family in the future.

Once you leave the hospital you’re on your own until your 6 week postpartum visit, which is basically to “clear” you for sex and exercise. And then you’re on your own again.

Does that sound like a system that truly cares about what happens to your body?

YOU are the one who has to live with constant back pain or numbness from a botched epidural, not them.

YOU are the one who has a higher chance of hemorrhage every time you have a c-section out of routine, not them.

YOU are the one who has a higher risk of postpartum mood disorder if you are given Pitocin to induce labor, not them.

Shared decision making has no place in maternity care. The decisions are YOURS.

How I Decided to DIY My Birth

 I freebirthed my second son on a hot summer day in 2018.

Freebirth, or unassisted birth, means birthing outside of the medical system, without a trained birth attendant. I decided, after months of deep research and unlearning of my fear surrounding birth, that this was how my baby and I would have the best chance at a safe, physiological birth. It was just my husband and me, and it was an experience that totally transformed me.

You might be thinking, but what if "something" went wrong? Well, I dug into that, what the "somethings" actually are. I learned their causes, their likelihood in an undisturbed birth (not very), how to prevent them, what to do if they happen, and when to seek assistance. I had a plan.

The more I learned, the more I felt that the risks were astronomically higher for me in a hospital - every intervention increased my likelihood of complications and decreased by chance at a physiological birth. Especially as someone having a vaginal birth after a cesarean (VBAC), it would be nearly impossible to not be met with fear, intervention and push-back at every turn. I would have to fight staff every step of the way to simply let my body do what it was designed to do - and I wasn’t going to do that. Early in my pregnancy I had actually hired a homebirth midwife, but our partnership didn’t pan out, and I was unable to find anyone else in my area. That’s when a light bulb went off and I started to research freebirth.

I wanted to birth undisturbed, which meant no one touching me, asking a million questions, intervening, placing an IV, putting me on a continuous monitor, no one confining me to bed. Undisturbed meant birthing my placenta on its own time (not necessarily within the 30 minute window a hospital will “allow”), without Pitocin or traction or someone pushing on my uterus through my abdomen. It meant that strangers wouldn't be in my birth space. It meant that I wouldn’t be put on a clock or refused food and water. It meant that I wouldn’t be subject to arbitrary hospital policies that are based on liability, not what's best for me and my baby. It meant that I would very likely avoid another unnecessary, traumatizing c-section.

I knew that as I neared my “due date” my OB would start talking about induction or a repeat c-section (since they had me sign a consent for anesthesia at my 8 WEEK APPOINTMENT), and I was not going to have that conversation. I had suffered years of PTSD, postpartum depression and postpartum anxiety as a direct result of my first, unnecessary c-section, and there was absolutely no way I would entertain that idea (outside of a dire emergency) again. At 35 weeks pregnant I stopped going to appointments and continued my care at home.

You don’t have to be a rocket scientist to take blood pressure, listen to the baby’s heartbeat, or use a urine dipstick. Without the anxiety caused by the anticipated battle at every appointment, I was able to enjoy my last days of pregnancy and get excited (rather than terrified) for my labor and birth.

After 38 hours of labor, I screamed my second son into warm water in the comfort of our home. No one separated us, poked us, or intervened. He entered the world calmly, rather than screaming as most babies do when they are forced into a cold, bright room. We slept that night, and every night since, side-by-side.

Not all birth is natural - and that's okay

“Natural” has become a dirty word in the birth world.

It’s a term that can instill a feeling of shame in people - many who wanted this type of birth, but didn’t experience it.

Whether your birth can be described as natural is NOT A JUDGEMENT ON YOU AND YOUR CHOICES. The word “natural” is simply a descriptive word meaning “from nature; not involving anything made or caused by people.” But, for some, this word can hurt.

Some recommend that “natural” be replaced by “unmedicated”. To me, these two words are far from synonymous.

A natural birth, to me, is a lot more than a birth without drugs. It means that my body went into labor spontaneously - that the hormones in my body were created by my body - that I wasn’t strapped to machines or trapped in bed - that I wasn’t numbed or given drugs - that my baby emerged from my vagina and on its own timeline (and so much more). No one word, besides “natural”, can encompass all of that.

INTERVENTIONS & SURGERY during birth, though not present in nature, are NOT INHERENTLY WRONG OR BAD. They are useful tools, sometimes life-saving, when they are truly indicated.

But when those same interventions are overutilized on people who don’t need them, they can create more problems than they solve. The PTSD, depression & anxiety I experienced after my unnecessary c-section are a perfect example of this.

My opinion is that we NEED the term “natural” in our birth vocabulary. Removing it may help some people feel better about their experience, but it also does us all a HUGE DISSERVICE by allowing INTERVENTIONS AND SURGERY to be COMMONPLACE AND NORMALIZED, rather than a rare, fringe occurrence. And this means that providers who are misusing these treatments are NEVER HELD ACCOUNTABLE, and that this practice won't change.

So "natural" will remain in my vocabulary. Will it stay in yours?

I had a miscarriage

I have always been amazed by and proud of my body - it has climbed mountains, run countless miles, lifted weights heavier than most would believe a 4’11” frame could. And I have always given my body the very best care - I eat vegetables, take whole food supplements, see my chiropractor, drink water. I trust that my body knows what it's doing, carrying on dozens of complicated processes simultaneously without direction.

So when I became pregnant for the first time (on the first try!), never did I dream it wouldn't last. I had planned a home birth with a midwife, but at 10 weeks we couldn't find a heartbeat with a Doppler, and the next day I started to bleed. I went for an ultrasound, and as I lay on my back looking at what I knew was not a healthy embryo on the monitor, the doctor looked at me and said, “I'm sorry, this isn't a good pregnancy.” I thanked everyone and walked out, no emotion on my face.

My husband and I walked back to the car where I sat and cried and asked the Universe out loud what I had done wrong, all the while knowing the answer was nothing. I just wanted something, or someone, to blame.

I made an appointment with my OBGYN to go over my options, since I was experiencing what is called a “missed miscarriage”, where the baby is no longer living but remains inside the uterus for a while. I was given the options of waiting to miscarry on my own, scheduling a dilation & curettage (D&C) procedure (the uterine contents are manually removed under anesthesia), or taking a drug called Cytotec orally to induce uterine contractions so I could miscarry sooner and at home. I chose Cytotec.

I put the pill between my lip and gums and let it dissolve as instructed before swallowing. And then I waited. It took hours before I noticed anything, but eventually felt cramping, like I was having my period. I filled the bath with warm water and got inside to help soothe the pain and sadness of what was happening to me, of what I was losing. I was naked, alternating between the tub and toilet, since the bleeding had begun. The cramps intensified, and I began to realize they were coming like waves, and happening in a pattern. These were my first contractions. After hours of build-up, I lay in the tub as one particularly intense and painful wave pulled the amniotic sac from my womb, and I fell asleep in the water.

When I awoke I moved to the toilet, and my baby slipped away from me. The amniotic sac had remained whole. I thought about looking inside to see what my baby looked like, but was warned by a friend who had also recently miscarried that it wouldn't help anything. She knew because she had seen hers. 

And then I flushed the promises and dreams of that baby down the toilet.

As a person, I'm more logical than emotional. I rarely have mood swings, even with the hormonal shifts of my cycle or pregnancy. I am able to see through my feelings and determine if they serve me. If they are holding me back, I deal with them and let them go - no sense in wasting precious time on being upset or angry.

In private I was sad, but I still had to go to work and make other people feel cared for, so I held my grief. I had told probably a dozen people that I was pregnant, and now I had to tell them that I wasn't anymore. I dreaded it. I dreaded it because it's awkward and sad to face it over and over again with each person. I dreaded it because no one ever knows what to say when you tell them you've lost a baby. They feel bad for you, but they also give off this vibe that lets you know that you have made them uncomfortable by sharing, and it's palpable. I didn't expect to feel bad about feeling bad, even though no one meant to hurt me.

The other thing I didn't expect when sharing my story was how many other women would open up and say that it had happened to them, too. I had no idea how common miscarriage was until it happened to me (as many as 1 in 4 recognized pregnancies in the first trimester). Sharing my story with others, and them sharing theirs with me, made me feel like I wasn't some freak of nature with a broken reproductive system. I was a woman who, despite a setback, had the potential to get pregnant again and become a mother, as many of my confidants had.

It wasn't quick or easy, but I would go on to become pregnant about 9 months later by Intrauterine Insemination (IUI), and to become a mother the following year. I was fearful during that pregnancy, as opposed to being care-free and joyous like I had been with my first. Every week until I heard the heartbeat I was afraid, and even after that I wasn't totally at ease. By my third pregnancy, however, I felt safe again and was able to relax and enjoy the process (when I could breathe/didn't have Restless Leg Syndrome/could feel my hands/didn't have acid reflux...).

Sharing a story of loss is hard, but it can help us to connect with others who understand our suffering, and that can help us to heal. If you have a story you'd like to share, even anonymously, consider it. You never know how many other people share your pain until you let it go.

They're not angry With me, they're Just Hurting

Opening yourself up on the internet means that you will find a lot of support, but also some SERIOUS CRITICISM. Especially with the topics that surround birth, there is so much emotion, and it’s often hard to separate the emotion from the facts.

I know that, as the Birth Uprising community grows, I have to put in place some safeguards for myself, since I am a person too. I have feelings. I get hurt by what others say.

What I’m grappling with lately, however, is what to do when the person accusing me of something, or LASHING OUT, is just doing it from a PLACE OF HURT. These people are the ones I want to help - the ones who were not given choices or information - the ones who ended up with UNNECESSARY TRAUMA.

The problem is, they don’t recognize it that way. They see the information I share and feel GUILT, SHAME, and SADNESS, and they think that I’m the cause. But they don’t dig into that - they don’t look deeper and see that it was the result of something that was done to them that was probably unnecessary. It has nothing to do with me. The information that I posted was just a trigger, and they came upon it without warning.

My posts are to provide information - to give OPTIONS and CHOICES to those who are not given any by their care providers. They are to help people question what is “normal” and “necessary”, and to have discussions about what really is best for their personal situation. My posts are NEVER to judge someone’s choice or story. There would be absolutely no point in that. What happened to you wasn’t your fault. You can’t change it. But you can learn and help yourself, and others, to not have that experience in the future.

I try to approach these type of interactions with care, because I know these people aren’t angry at me, they’re just hurting. I’m not always the best at it, since it’s hard to not get upset when someone attacks you. But if I can get someone to recognize their hurt and open up, maybe I can help them. Maybe I can give them the support I wish I had after my trauma. Maybe they can heal.