Alex White - Doula & IBCLC

Brook Farm Lactation

1. How can pregnant women prepare their bodies and minds for nursing? 

Two of the hardest things - I think - we have to overcome as people who plan to breast- or chest-feed, is to wrap our heads around using our body in a way that is completely new to us, and to sink in to the not knowing, not planning, not controlling of this feeding experience. Such tough work for us all, living in an emotional space where we cannot always plan for or control what comes next! I encourage pregnant folks to spend time learning to trust and be patient with their bodies and themselves. Practically, it’s always valuable to meet with an IBCLC prenatally to understand all the ins-and-outs of what it takes to lactate, and to start to think about what the early days of infant feeding may look like. You don’t need a ton of “things,” but you should plan to have ways to keep yourself fed and order your insurance pump in advance. 

2. How soon after birth should someone reach out for lactation support?

Breasts/chests change dramatically over the first week postpartum, so if you don’t already have a pre established relationship with an IBCLC and a plan on the books, I always recommend a visit within 48 hours from returning to the hospital. Typically that is the time when we see the milk “coming in” and we can get ahead of any issues that are about to present themselves. 

3. Can you help with latching issues, nipple pain, low milk supply, or overproduction?

When I work with a family, we do everything from a thorough background medical review to a feeding observation to review of all pump parts, feeding supplies and accessories. This is necessary to assess for underlying causes of the complaints I’m most frequently supporting families with - pain and supply concerns. With the right support and keen eye, we can always get to the root of the problem and make feeding a more enjoyable experience for everyone. There is no question too big or too small for our time together! 

Dr. Alli Urbanik Kimmel, DACM

Spreading Roots Acupuncture

1. How can acupuncture support women during pregnancy and after childbirth?

Acupuncture is a safe and effective way to address health concerns during pregnancy and postpartum. Some common symptoms that bring patients in for acupuncture during pregnancy are body aches and pains, nausea, heartburn, headaches, insomnia, congestion, and breech positioning. After baby is born, acupuncture can be helpful with many aspects of postpartum healing by helping to rebalance hormone levels.

2. What common pregnancy symptoms can acupuncture help relieve (e.g., nausea, fatigue, back pain)?

Acupuncture can help relieve common pregnancy problems such as body aches, nausea, heartburn, headaches, insomnia, congestion.

3. Can acupuncture help with breech babies or labor induction? If so, how?

For breech babies, acupuncturists will use a treatment method called moxibustion. During moxibustion treatment, sticks of compressed herbs are burned near a point on the little toe. Studies suggest a moxibustion success rate around 60-70% for turning a breech baby, and the treatment itself is painless and low risk. The best time to do moxibustion for a breech baby is between 34-37 weeks.While acupuncture cannot force labor to start, many people will seek out treatment to help get labor started. Acupuncture helps to relax the body, and shifts hormonal balance, which can help to speed up the onset of labor and facilitate an easy delivery. Sessions for labor support are recommended starting at 37 weeks.

Dr. Jacqueline Reisner, DPT

Pelvic Floor & Orthopedic Physical Therapy

1. What role does the pelvic floor play during pregnancy and postpartum recovery?

2. What are the most common pelvic floor issues you see in pregnant women?

The most common pelvic floor issues I see are urinary incontinence especially leaking, Pelvic organ prolapse (which presents as a heaviness). Pelvic pain, constipation and straining, overactive bladder, lower back pain, hip pain and painful interrcourse. 

3. What symptoms indicate that someone should see a pelvic floor specialist postpartum?

Way more people should be seeing pelvic floor specialists postpartum than actually do. A lot of symptoms are brushed off as "just part of having a baby," but they don’t have to be permanent, and they can be treated. Common symptoms to watch for are urinary incontinence, pelvic pressure or heaviness, painful intercourse, pelvic pain, contraption or bowel control issues, separation of the abdominal muscles (Diastasis Recti, unstable or weak core and C-section scar discomfort.

Robin Jones-Tropiano, CD(DONA)

Professional Birth Doula

1. How do you support women emotionally and physically during pregnancy?

Great question! To me, at least half of a doula’s support is psychological. So much of what a woman comes into pregnancy with can influence the labor and delivery of her baby: her own health history and experience with medical providers, what she has been told about labor and delivery by her friends/family/social media...and much of a woman’s perspective is often based on fear of what can go wrong.

I want my clients to focus on what can go RIGHT. To learn that their body has so much information about birth already built in – inherent cellular wisdom on how to birth!

I provide evidence-based information on whatever my client needs during pregnancy. Many times, they will call me after a routine appointment with their obstetrician and say they didn’t remember to ask a question about something, and I’ll help guide them to resources on nutrition, routine testing during pregnancy, etc.

2. How do you help a client prepare for different types of births (natural, medicated, C-section, VBAC)?

My role is to provide positive, encouraging support no matter what type of birth my client has. VBACs (vaginal birth after cesarean) are some of my favorite births! It is fabulous to support and then witness a woman experiencing a VBAC, as it is so rewarding for her.

Since labor can’t be predicted, and so often don’t go to “plan” I believe that birth “plans” are not a useful tool. Instead, I help women and their partners develop a wish list – what they would love to have during their particular labor and birth. We make those choices the priority, during an unmedicated, medicated, or surgical birth.

In the last month of the pregnancy, I offer two prenatal visits in my client’s home, where we cover all aspects of labor and birth, and they come out of the visits feeling confident, and well-prepared for whatever challenges they will face during labor, birth, and as new parents.

3. What is your role during labor and delivery? 

My role is to provide continuous emotional and physical support for my clients and their partners throughout labor. Labor & Delivery nurses (and obstetricians or midwives) come and go depending on where they are in their shift, so it is very reassuring to my clients to know that no matter what, no matter how long their particular labor takes, I’m there for them.

I help them use all of the resources possible to help reduce the intensity of contractions. Movement, warm water, and touch are marvelous non-medical tools when in labor. I help them remember to listen to their body, as the body will tell a laboring woman what position she needs to be in.

If they choose an epidural for pain relief, I assist in helping them change positions as needed, keeping the pelvis open to help move the baby down and out.

I remind them what positions can be used for pushing, and that this is the FUN part! The rush of oxytocin the body provides at the end of labor usually provides a wondrous surge of energy that assists in helping a mama gather her mental and physical resources necessary to push her baby down and out.

I stay with the mama, baby, and her partner until they feel ready for me to leave. We then see each other next at our postpartum visit, at their home, where we can go over the labor and birth and I can provide any additional support necessary to make them feel confident, and ready to continue their adventure as new parents.