Stuck in the Middle with You
Amazing photo by Love Roots Photography
When you leave a meeting with your doctor or midwife, do you feel fantastic? Questions answered, worries allayed, empowered and ready for the next step?
If you're like many of my prenatal yoga clients, the answer isn't always yes. For many women, their choice in maternity care provider was based on a rogue recommendation or internet search, the "preferred" list on an insurance provider page, or the person you were already seeing for your gyn-needs. Sometimes a woman winds up with the provider who was able to accommodate her first prenatal visit in the shortest amount of time. As your visits progress, if you're starting to feel uncomfortable for any reason, it's time to look outside the box.
You may have a misunderstanding of the "rules." Do you think so? Let's check.
Rules About Switching Prenatal Providers in the United States:
1. There are no rules.
Well, that was easy! Often women feel trapped with one provider even though their gut is telling them that the provider isn't the best fit. Sometimes there is nothing wrong with the current provider, but the woman meets another provider and feels so much better about that person that she's tempted to switch. And sometimes there is a poor fit between a woman and her provider and she's (interested in) running for the hills.
How to Decide Whether to Switch:
Visualize Your Birth. It's ok, I'm a yoga teacher, I'm allowed to tell you to visualize your labor and delivery. I promise, you won't hurt yourself. First, visualize with your current provider. Imagine how they will want to interact with you during your labor and delivery. Will they take charge or let you take charge, as you prefer? Will they consult you for options and make sure you are heard, or do what they are accustomed to without asking your permission/opinion? Write down how this imagined birth made you feel. Then, imagine either the provider you'd like to work with or your ideal provider and go through the exercise again. Write. Compare/contrast.
DTR: Define the Relationship. My BFF and I agree that everyone should DTR with everyone they know, weekly. We're borrowing the practice from the Mormon faith, but we think it applies to everyone equally. Before jumping ship and changing providers, have a conversation with your current provider. Tell them what is worrying you and how you'd like them to interact instead. They can tell you whether or not your wishes are possible, and that will give you grounds for a stronger relationship with them, or a new partnership with someone else.
Explore the Green Grass... with a fine toothed comb. In your current state, you might actually think that your newly preferred provider is exactly as you imagine. Before terminating the relationship with your current provider, make an appointment with this new person and DTR with them. Make sure you're getting the interactions that you wanted.
Face Value. Get honest about your reasons for switching, especially if you can't seem to find anyone that lives up to your standards. The cards you've been dealt might limit some of the options you're seeking. For instance, if you are having twins, a home birth isn't going to pan out this time. If you have certain complicating factors, explore all of the options available, but know that no provider will be able to deal you a new deck of cards.
If you decide to make the switch, know that you'll have some paperwork to do. Have a conversation with the office staff for your new provider, your insurance company, and your partner. Make sure you keep clear receipts, get the full copy of your chart and lab work from your previous provider, and keep your perspective focused on what money cannot buy: your (and your baby's) health.
Whose Body Is This Anyway?
Have you seen People magazine lately? Do they always have so many photos of pregnant celebrities or stars with their brand new babies? We know the babies are cute, but the celebrities themselves can often make us feel, well, ordinary.
This is because they have personal trainers, nannies, nutrition professionals, tailors, and other artists whose job is to make them look this way. I promise you, if you had personally custom-tailored maternity clothing, you'd look like that too. Have you ever seen what a celeb looks like first thing in the morning? Take a look in the mirror, love, because that's what they see, too.
In the 1950's doctors recommended that pregnant women gain 15-20 pounds during pregnancy. Many of our mothers and grandmothers (who lived through this era) hold that mentality as their fundamental belief and might not support the healthy changes that your body is making. Tell them that they are not helpful, and then tell them (lovingly) to go sit on a tack.
Want to know the current recommendations? They build upon your pre-pregnancy body and depend on how many buns are in the oven.
Body image is no small matter these days, and if you've always been fit it can be particularly disconcerting to watch your body grow in new and profound ways.
Find role models: there are some women who love their bellies and feel more feminine than they have ever felt. Observe their grace and try on what they are doing. If it doesn't work for you, try complimenting them and letting them know how much you appreciate their comfort with their bodies. If you can't identify any, find a picture of a happy pregnant woman who seems comfortable in her body (not a skinny pregnant woman or a supermodel). Find one that seems maternal, cozy, warm, exhuberant and joyful (they do exist).
Wear clothes that fit: Nothing makes you feel worse about how you look than ill-fitting clothes. This is true whether or not you are pregnant, but it is much more noticeable when nothing in your closet fits. Unless you are a seamstress, it doesn't make sense to alter your clothing, but it does make sense to find clothing that makes you feel good about yourself. Maybe that is a scarf or sweater, or some lovely jewelry that will fit no matter what. You might consider renting something for a special day, or even for a period of time if it will help you feel more comfortable and confident.
Focus on nutrition: This is no time to restrict calories or adopt a limited diet, so focus on eating according to the recommendations of your provider. They are most likely to suggest lots of vegetables, fruits, beans, nuts, seeds, and water because these are the most nutritious foods. Try cooking new recipes that focus on nutrition and consider what you are really hungry for. If you are eating to cope with stress, try something else to remove the stress because baby is feeling it too.
A few of my favorite recipes?
Aloo, Gobi and Chard
Hurry, Curry (lentil dip)
Believe in miracles: Because you are one. No, I'm not being a silly yoga instructor here, you are literally creating another person out of the food that you eat and the thoughts that you think. What impression do you want to give to your child? That they wrecked your body, or that they were your first experience of a true miracle?
Benefits of Prenatal Yoga
If you're reading this, someone has told you that prenatal yoga is a good idea. What did they tell you? Most likely they wanted you to feel relaxed, and maybe find a more restful sort of exercise than the six miles you usually run on a daily basis.
Well, great! Prenatal yoga offers some time for relaxation and is indeed less vigorous than running or power yoga. But what are you actually going to get out of it?
When I started teaching prenatal yoga, my answers were: mental preparation, physical strength, and a sense of community. I wasn't totally wrong! Here are what some of my prenatal clients have mentioned.
Companionship: if you are the first of your group of friends to get pregnant, or if you are far away from your closest friends and family, you will enjoy getting to know women who are a few months ahead of you. Not only do you get a preview of what to expect in the next several months, you might even make friends that will support you. And then, of course, you'll end up helping the next group who are a few months behind you.
Mental preparation: I know, I know, you're already mentally prepared for childbirth. Oh, you're not? Well I offer a special physical exercise that helps you prepare for what you might experience during labor. No, we don't simulate labor. And yes, some childbirth preparation classes offer the “hand in the ice bucket” or “safety pin on the ear” exercises, but you only do them once. Each time you attend a prenatal yoga class I put you in a safe yet uncomfortable place and ask you to stay there for several minutes. Each time you go through this exercise, you learn more about how YOU cope with discomfort and pain, what techniques you've learned are helpful and which are less helpful. Do you like to move when you're in pain? Be touched? Talk? Turn inwards? Come and find out. Also, for the record, this is the portion of the class that everyone notes after baby was born as the most important.
Physical strength: It isn't all about relaxation, your body is training for the marathon of labor and childbirth. Rather than relaxing and “saving up” your energy, you need to move (unless your provider recommends otherwise). We use specific exercises to build strength that you will use during pushing. Keep coming to yoga until your provider tells you not to! Most women practice all the way through their pregnancy and are then much more physically ready for the work of labor.
Connection: Some women instantly feel connected to their baby(ies), but most do not. Whether your pregnancy was planned or a surprise, it is important for you to spend time communicating with your baby, or opening up lines of communication. And I'm not a crazy yoga lady telling you that; your baby is affected by your hormones, your emotional response, and your stress. You don't decide when labor starts, your baby does. We spend several minutes in class opening up to this new relationship.
Information: Whether you're learning where the other participants got great deals on their cribs or asking me questions about childbirth or breastfeeding, this is an unparalleled resource of information. The internet is an ocean of details and conflicting information, and sometimes it can be quite scary. I've attended many births, read most childbirth education books, met many local birth professionals, and am pursuing my certified lactation educator credential. While I don't know it all, I'm determined to help you find the answers to your questions (without scaring the bejebus out of you).
Massage: This side perk is probably the reason that most women come back week after week. I'll teach you some techniques to work with a partner to relieve the discomforts of pregnancy, but I also offer a brief shoulder/neck rub during the last several minutes of class.
But what are the benefits of Mom & Me Yoga?
Whether you are currently pregnant or whether you are breastfeeding a child, you need to think carefully about all herbs and medications you put into your body, because you're also putting it into your baby.
Medications and herbs are more complicated when you are pregnant, because baby gets them in a different formulation than you do. When you are pregnant, your blood meets baby's blood at the placenta and nutrients and medications cross from you into baby. Some medications easily cross the placenta into baby's blood, and some do not. If a medication crosses easily, it might be overwhelming on baby's developing kidneys and liver to process the medication. This is why it is so important to have a conversation with your provider prior to taking any herbal or pharmaceutical medication.
Breastfeeding is a different story, because breast milk is made differently. You make milk from nutrients and materials in your blood supply, which could possibly include herbs and medications. However, now baby will be getting this through baby's stomach lining and intestines rather than directly into the blood via the placenta, so the chart of medications is different. Is the herb or medication easily absorbed via the digestive tract? Is it a medication that is given to infants? And at what level will it appear in the baby?
If the last two paragraphs have made you throw your arms up in the air and say, "Forget it!" take another breath. The excellent news about breastfeeding and medications is that there is a FREE app that is updated daily with information learned through clinical trials and reports from mamas and babies, and this is a great resource for you and your physician. Even if you are still pregnant, it is worth getting this app and looking at all of the medications your currently take to see if there is a better alternative while breastfeeding.
LactMed is free and updated every time there is new information. It includes the safety information, guidelines, links to research, and possible alternatives for almost every single medication out there. It should be used as a resource, not gospel, so be sure to use it as a supplement to a conversation with your provider.
The other great news: there are very few medications which are considered dangerous enough that you should stop breastfeeding. Others may recommend taking the medication an hour or two prior to breastfeeding. Your physician may not be up to date on the most current research, so if they advise cessation of breastfeeding due to a medication, it is worth consulting this app and talking about alternatives.
If you are faced with taking a medication that you must take that is incompatible with breastfeeding, talk with your physician and an IBCLC about the possibility of breastfeeding once the course of medication has completed. You may be able to pump and discard your milk for the brief stint that you need to take the medication and then return to breastfeeding later on. Simply stopping will make restarting much more difficult in the future, so discussing your best options and your breastfeeding goals with an IBCLC is critical!
What is an IBCLC? Check out my post The Breast Experts
Benefits of Mom & Me Yoga
So many mamas eagerly join me for prenatal yoga. Pregnant mamas immediately recognize the importance of self care now that they are pregnant, even if self-care was not a part of their vocabulary or their week prior to pregnancy.
But once baby is born, yoga takes a back seat. And it should. I believe, and many indigenous cultures agree, that mama and baby should have some sacred alone time for the first several weeks postpartum. Now, most mamas I know don't spend six weeks alone with their babies, because it isn't practical or appealing. After six weeks, yoga can be a great addition for a number of reasons:
Get OUT of the house: getting out of the house is a lot more complicated than it used to be, but that isn't a good reason to just stay home. M&M yoga gives you an appointment to shoot for where walking in several minutes (or even half an hour) late is perfectly acceptable. Everyone understands the blowout, the extra long nap, or the grand schlep to and from the car.
Reality check: being home alone with an audience of a newborn (or two) can feel isolating for some mamas. Rather than consulting Dr. Google about normal behaviors for mama and baby, M&M yoga can give you a weekly view of other mamas and babies. If you're concerned about rolling over or possible postpartum depression, M&M yoga can offer a nice gauge.
Breastfeeding trial run: didn't show off The Ladies in public much before baby was born? Not sure how you will feel about it? Breastfeeding is welcome during and after M&M yoga class so you can feel confident that you are in a peer group with other women who are doing the exact same thing. In fact, post-practice breastfeeding time is one of the best times of M&M yoga, especially when I bring snacks!
Date with baby: if you spend all day with your baby, you probably don't schedule dates with them. And if you're away from baby for a good portion of the day, dates are a great way to connect. When you have a date with your baby, your perspective shifts from caregiver to companion. You get to play, enjoy their company, and create a very healthy dynamic in your relationship that will last your entire life.
Well, and YOGA: rather than jumping straight back into vigorous exercise, M&M yoga is designed for the new mama whose body is still changing. We take special care to stretch muscles that ache from holding baby or awkward breastfeeding holds, build low body strength, and pull the tummy back to a healthy position. There's a little quiet time at the end, too!
Are there benefits I'm missing? Please let me know!
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I'm one of those people who loves making your life easier (and I believe in you). I am an experienced registered prenatal yoga teacher and a lactation educator.
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