“Don’t Push the River. It Flows by Itself”

This is a post I wrote about 4 years ago in reflection of a birth I had attended.

I recently came across an article by local Boulder-ite, author and activist for unassisted birth, Laura Shanley, and it made me re-evaluate my approach about the 3rd trimester and second stage labor and how I prepare and talk about it with my clients. Even though Laura specializes in unassisted birth, I think her article can refer to all women during pregnancy, through labor, and beyond.

After the 4th day of a long labor, a client of mine told me that she felt her prodromal labor was due to her being anxious and excited to get labor started and the reason why she agreed to get acupuncture, twice, and consented to her midwife stripping her membranes. Even though she was 40 weeks when she agreed to these procedures, she stated that she started feeling anxious around 38 weeks and now, in the midst of her 4 day labor, was revealing to me that information, support, comfort, and trust would have been useful tools for her- to re-inforce her trust in her body and allow the process to flow on its own, instead of the “pushing” and urging on of labor with acupuncture and and stripping of her membranes.

But it is hard in today’s maternity system that schedules inductions, plans for c-sections, and doesn’t place trust in the mother or on the natural process of pregnancy, birth, and even motherhood. My client was seeing a CNM practice and they were the ones to schedule her induction at her 40 week appointment. No wonder we feel the need to push things- our care providers are threatening us with pitocin, cytotec, and epidurals if our bodies do not “perform” to expectation.

No wonder women seek out “alternative” or “natural” induction methods- we are being pushed throughout pregnancy to get to the end, and then we are pushed through labor to get the final prize as soon as possible. Natural induction methods seem less threatening than medical methods, but one thing remains the same regardless if it’s medical or natural- both methods are designed to “push” or force the natural process of going into labor.

Is having an unassisted birth the only way to have an “un-pushed” birth? I don’t think so, but I do think that 90% of it is in our own minds and how we feel about our pregnancy and the upcoming birth. The other 10% depends on your care provider and their attitude towards pregnancy and birth.

Laura Shanley states that most women who decide to have an unassisted birth are not un-educated or making an un-safe decision, but says the denominating factor is that a majority, if not all unassisted-birthers, trust the birth process and want to allow it to enfold the way nature, God, Goddess (pick your preference) has intended for it to happen- without undue interference from any source- including our own minds.

How do we get to a space in our pregnancy journey that allows us to trust the process? A space that enables us to peacefully ride the gentle, undulating current that is pregnancy and birth?

It varies for every individual, of course, but for me and my doula practice I have found that mantras and affirmations can have a profound effects on our minds and our bodies. I think it’s important to recognize fear, distrust, impatience, or anything else that might be a hindrance to trust, but to not dwell on these issues. It’s important to say to ones self, “I recognize that I am uncomfortable; that I do not know what labor will bring, but I am ready when my baby is ready. My body is nourishing and sustaining my baby. My baby is surrounded with love and I peacefully await her arrival.”

There is a powerful connection between our mind, our bodies, and our babies and to dismiss that is to dismiss the inherent power within us to create, grow, and ultimately give birth to a new little human being. It dismisses the force that brings mothers and parters together, one that bonds mothers and fathers to their babies, and creates a family based on love, respect, and trust in our children, our bodies, and ourselves.

"Don't Push the River. It Flows by Itself"

I should do what with my placenta?

The popular belief is that the placenta is a bio-hazard that must be discarded as soon as possible, but I assure you- your placenta is an amazing organ and just tossing it out or incinerating it is wasting precious resources for you, your baby, or your garden.

 In most hospitals, where the majority of women are giving birth- they make it seem like taking your placenta home with you is something only a crazy person would do, or they make you go through quite a bit of red tape in order take home what rightfully belongs to you.

Just like anything else at the hospital- you can decline the pathology report in order to take your placenta home with you when you leave, or a family member can take it and put in the the fridge or freezer as soon as possible in order to maintain freshness. It’s a good idea to take your own tupperware to take you placenta home as some hospitals do not provide containers. A zip lock freezer bag works great too.

So after your placenta has delivered, ask your provider give you the “placenta tour,” as I call it. Have them show you what side was attached to the uterine wall, the membranes, and where baby spent the last 9 months of her life. There is an awesome part of the placenta called the “tree of life” where the vessels go into and out of the placenta where the umbilical cord is attached. It’s truly fascinating and when the placenta is still “fresh” or the vessels are still full, it is a great opportunity to get a placenta print.

Here’s how you do that: partner or doula can inform the nurses that you intend to make placenta prints prior to the birth so everyone is aware of what will be happening before the placenta is delivered. Before the birth, I recommend going to the local paper supply/art store to get a heavy weight, cold pressed watercolor paper. You will need something that is larger than 8.5 x 11 as placentas can be pretty big. I also recommend getting at least 5 sheets of paper so you can make more than one print.

Next: after the placenta has been delivered and mom and baby are settled in, gather some chucks pads (those blue and white pads that the nurses are always putting under mom’s bum), some gloves (they are usually in a box hanging on the wall near the door), and your baby’s placenta, and put it all near the movable table by mom so she can watch as she rests in bed.

OK- now you lay out the chucks pad on the table, don your gloves, and prepare to touch the placenta. It’s a solid organ, but like a liver, very “gooshy” and slippery, so be careful when picking it up. Lay the placenta uterine side down with the membranes out of the way. What you’ll be looking at is the tree of life, and that is what you will be printing.

You have two choices for your printing medium, either blood, or paint. Usually it’s blood because paint is hard to come by at the hospital unless you bring your own. Either way, it doesn’t really matter.

To do paint you will:

• pat dry the placenta with a paper towel and then dab on the paint with another paper towel.
• Then you will take off your gloves, pick up your paper and place it on top of the placenta,
• gently press the paper onto the placenta and then lift the paper straight up.
• Turn over the paper and look at your print.

You can make as many prints as you want, remembering to use gloves whenever you touch the placenta, but taking the gloves off when handling the paper to avoid extraneous blood or paint getting on the paper.

To use the placental blood you will do the same thing as will paint, only you will be using blood. There is no need to pat the placenta dry, but dabbing blood is harder with a paper towel so scooping blood from the placenta’s container with your hand is easier. Once you have what looks like an adequate amount of blood on the placenta make a print as mentioned before by placing the paper on top of the placenta, pressing gently and then lifting straight up.

Congratulations! You now have a placenta print.

But what am I supposed to do with a placenta print, you ask?

I say frame it and put it on baby’s wall as a beautiful reminder of the great and marvelous task the placenta had in helping to nourish, and sustain your baby.

So after you made some fabulous placenta prints, what are you going to do with your placenta?

I recommend consuming it.

Yes, eating it in some form or another.

While usual convention tells us this is gross, nasty, dangerous, whatever explicatives you want to use, cultures around the world have been consuming the placenta in one way or another, and in those cultures postpartum depression is virtually non-existent. This probably because all the rich nutrients and proteins in the placenta are going back into mom, providing deep, restorative nourishment to help mom replenish herself after a draining pregnancy and birth, and baby also benefits from the placenta through the breastmilk.

Now, along the lines of the raw food genre of cooking- or non-cooking as the case may be- the placental nutrients are left intact and available to mom only if it isn’t cooked or cooked at a low temperature. This leaves out the lasagna and other high temp cooking options. Placenta lasagna can also be very un-palatable for most people, so a nice alternative is to get your placenta made into placenta medicine.

The process for making placenta medicine is usually based on traditional chinese medicinal techniques where the placenta is either steamed first, or not, with herbs and then dried. It is next ground into a fine powder and put into capsules for consumption.

A friend of mine who experienced severe postpartum depression (PPD) with her second baby decided to be proactive and do everything in her power to prevent if from happening again, so when her third baby came around she chose to have her placenta made into capsules. She ended up not experiencing any PPD and is a happy, well-adjusted mother 0f 3 today.

In the Denver area we have several people who make placenta medicine at a very low cost. If this is an option that appeals to you, please contact me and I will forward along some information to you.

Another option for the placenta that does not involve eating it is planting it in your garden or with a tree. Many new families like to commemorate the birth of a baby by buying a favorite flowering tree and then having a planting ceremony in their yard. After digging a hole large enough for the tree, dig a little deeper and then place the placenta in the hole, cover with a bit of dirt, and then put the tree in. Most families enjoy this method because they have a beautiful reminder of the new baby every year, and more trees can be added as children are born. If your baby is born during the winter when planting is not ideal, it is OK to freeze the placenta until spring time.

So think about what you would like to do with your placenta instead of having it tossed out with the trash, or incinerated. It’s a beautiful organ that worked so hard to bring your baby into this world. Take the time to honor it in some way that works best for you.

Make Your Massage Last Longer

If you’re like me you look forward to your massage weeks in advance, count down the days and minutes, and drive with anticipation to your appointment. And then its an hour of pure bliss lying on the table while the therapist works out all the kinks and knots that have been building up since the last massage session.

And if you’re also like me you wonder how you can make those 60 minutes of bliss last longer than a few days (or hours) after your massage.

Here are a few tips that I’ve learned along the way, as both someone who frequently gets massage and as a massage therapist, to make those way too short massages (can I get a 3 hour massage, please?) last longer:

-Schedule accordingly: The best way to ruin a massage is having to rush out of there to another appointment, especially an appointment that’s high stress or necessitates a drive through rush hour traffic. Plan to have at least 30 minutes of peace after your session if not the rest of the day. No work, no miles to run, just you and your peaceful body enjoying each other. Adding in a cup of tea or a leisurely walk in the park is optional.

-Use Good Posture: This one is my main massage killer. After the massage is done I slide off the table and somehow manage to put my jello body back into my clothes. This jello feeling is a good thing. It’s my muscles feeling relaxed and open, de-stressed and at peace. I want it to last forever. But it also gives me bad posture when I drive my car, or sit at my computer, and that’s what makes me desperate for a massage in the first place. So yes, even if you dont want to, you need to use your muscles to maintain good posture immediately after and until your next massage. It’s critical to helping your massage last longer.

-Do Your Homework: Often times I make suggestions for clients to stretch, exercise, see a chiropractor, or try some acupuncture. DO IT. Not only do I want your massage to last longer too, I want you to get long lasting results from the work that we’re doing and that usually includes another type of healing modality. You want your body to feel better- that’s why you’re getting a massage. Your body will feel even better if you do your homework too.

-Drink Plenty of Water: Yea, yea, yea. You hear it all the time and here it is again. Our body’s need to be fully hydrated to work properly, and fully hydrated to heal as well. Many of the things people get massage for can be at least partly alleviated by drinking enough water. Go get a snazzy water bottle and carry it around like it’s your new best friend. And don’t forget to fill it up at least 6 times. With water. Not some other stuff that you want to pass off as water.

-Get Plenty of Sleep: People often report that the best sleep they ever got was right after a massage. Don’t cheat yourself out of the healing benefits of sleep by staying up all night finishing a project for work ( because you cut out early to get your massage), or plan on waking up super early the next day. Take full advantage of the restful nights sleep you’ll get after your massage session. And don’t forget the huggy pillow. It will be your second best friend.

-And last but not least: Schedule your next massage in advance: When we keep to a regular massage routine we keep those sore muscles to a minimum and even begin to notice an improvement in how our body feels over the long run. Don’t wait until you’re desperate for a massage to get one. The people who get massages once or twice a year wish their massages lasted longer mainly because their muscles are craving more attention a few days after the session. When starting a massage routine it might take a few sessions that are close together to work on whats been built up over a lifetime of living. Once the immediate concerns are addressed, the massage sessions can then be spaced out in a way that maintains the body over the long run.

Your massage therapist can only do so much once a year, or once a month when you come in for your session, so take care of yourself! I want you feel great in your body all the time. That what these tips are about.

And if you don’t know what a huggy pillow is, come see me for a massage.

How Often Can I get a Massage?

Getting regular massage sessions can help you feel better in your body

My specialty for massage is pregnancy and postpartum massage and this is a question I hear a lot, especially from women who are just entering their second trimester and experiencing dramatic shifts in their body.

I recommend scheduling massage on a regular basis for a few reasons.

• Pregnancy is full of changes and the one’s that happen to your body during pregnancy are unpredictable. Maintaining a regular massage schedule will help you stay on top of those changes and minimize the aches and pains that can occur during pregnancy.

• There’s no need to suffer through achy hips or sore shoulders. 9 months will seem like 90 if you are miserable in your body. Massage can help. And using the pain as ‘practice’ for labor is unfair to you and will only make you more miserable. There are two different kinds of pain when it comes to labor– one kind telling you your body is working and another telling you something is wrong. The pain you feel from sore hips and shoulder is the second kind of pain. Get help and get it quick. You will feel so much better both physically and mentally which will help you through those nine months of changes so much easier.

• Massage can help you prepare for the upcoming birth. Having a regular time and space to settle in your body, breathe deeply, and connect with your unborn baby is one of the most useful tools you can use for birth. Relaxation takes practice and tuning into your baby takes practice, too. When you go into labor the relaxation skills you practiced during your regular massage sessions will kick in instinctively. Women often say that they attribute their easier labors to regular massage sessions and found it easier to relax and focus, as well as be in tune with their body and their baby because that’s what they did during their massage sessions.

• Getting regular sessions during pregnancy is a preparation for taking care of yourself after the baby comes too. You need a time and space for someone to listen to and take care of you. Motherhood is a time when we so often sacrifice our personal comfort for those around us. This is a time when regular massage sessions are crucial to our own well-being. Many women say they did not feel ‘put back together again’ until they had that first massage after the baby came. Having regular massage sessions will save your body and your sanity.

You can receive massage as early as the first trimester and as late as the day you go into labor (and even during labor, but that’s another topic).

You can also receive massage within 24 hours of giving birth either at the hospital or in your home. Many people don’t realize that the postpartum period actually lasts 2 years- not 6 weeks, so continuing your massage sessions will benefit you immensely for years to come.

Miranda Cacek is a Certified Massage Therapist and is Certified in Pregnancy, Labor, and Postpartum Massage. She has a private practice in the Uptown area of Denver and over 90% of her practice is pregnancy and postpartum massage.

 

Finding a Wicked Awesome Pregnancy Massage Therapist

As a massage therapist who specializes in pregnancy massage I hear plenty of stories from women who go from practitioner to practitioner looking for that massage therapist who works wonders for the pregnant body. The stories about horrible massages can be quite humorous and some are quite dramatic. All could have been avoided had these women known what to look for when seeking out a specialist in pregnancy massage.

Massage during pregnancy is good for both you and your baby

Finding the right therapist does require a bit of extra work, but it will be worth it in the long run when you’ve saved a couple hundred dollars by not getting a less than stellar massage from a therapist (or a few massage therapists) you know nothing about. Here are some suggestions when seeking out a great one:

Check out their website. Go to the “About Me” page and see what they have listed there.  There should be a mention of pregnancy massage somewhere in the therapist’s list of qualifications or specialties.  You can get an idea of how much they do pregnancy massage by noticing how high or low on the list it is.  If it’s higher they probably do a moderate amount of pregnancy massage. Lower: not so much.

The order can also give us a clue as to how much they like doing pregnancy massage. If it’s near the top you can bet it’s one of their preferred modalities, if it’s lower, probably not.  If pregnancy massage is not listed at all, I suggest moving on.

See if they have specific training for pregnancy massage listed on their website. Massage therapists are proud of their additional training and rightly so. It shows a dedication to the craft and a desire to improve their skills. Most massage schools have a short introductory session on pregnancy massage, but it is usually not enough to make the average therapist proficient and confident in it. A therapist who seeks out addition training is probably one who likes doing it and is good at it too.

Call them and talk to them. Sometimes there’s not enough room to list all qualifications in a short bio on a website, especially if there are multiple therapist in the practice or wellness center.  If a therapist mentions pregnancy massage in their bio but not specifics, call them and have a chat.  Most likely, they will be more than willing to talk to you about their skills and experience.

Most wellness centers have a receptionist and he or she will be the first person you talk to.  Remember that it’s their job to book the session and will most definitely say yes if you ask if any of the therapists do pregnancy massage.  Dig a little deeper and ask which ones, what are their qualifications and would that therapist be able to answer your questions over the phone.  Be persistent, and be patient.  The extra time it takes to talk to a therapist over the phone will more likely result in you finding a good therapist without having to spend a lot on money on poor ones first.

When you do get the therapist on the phone, here are some questions to help you get the right answers:

“Do you have training in pregnancy massage?  What was it and how long was the program?”

A program with, at the very least, 16 hours, will get you a decent enough pregnancy massage therapist.  The more hours the better, in my opinion. This ensures that they have plenty of hands on training to address to pregnant body as well as the needed information and education about pregnancy to keep both you and the baby safe.

“How many pregnancy massages do you do during and average week/month?”

The more experience a therapist has doing pregnancy massage the more likely they are to be good at it, and a massage therapist who is confidant in their abilities makes for a better overall massage experience.

“How will you position me during the massage?” 

There a few variations that can happen here.  Some therapists may only do side-lying massage, some may have pillows or a cushioning system that allow a pregnant woman to lie on her stomach for a portion of the massage session. There is also a table with a whole cut out in the center that allows the pregnant belly space for the mother to lie on her stomach as well. There are varying opinions on the comfortableness of these methods. Some women do not like having to lie on their sides for the duration of the session and prefer a support system that allows them to lie safely on their stomach for at least part of the time. Others do not like the table with the cut out for the belly because it is a ‘one size fits all’ table and some feel as though they are falling through the hole.  Unfortunately, the only way to find out is to go get a massage and see what works.  The therapist should be willing to help you find the most comfortable position for you.

A Word of caution: pregnant women should not be positioned on their backs for a massage after about the 15^th through 17^th week of pregnancy and beyond.  Therapists are able to work around this by doing a combination of semi-reclined and side-lying positioning or just side-lying.  If the therapist mentions lying on your back in the late second and third trimester, I recommend finding another therapist.

What if I have a high-risk pregnancy? Can I still get a massage? Massage is definitely beneficial for most high-risk pregnancies.  There are a few rare situations in which massage is not recommended, but overall it is perfectly safe for you and the baby.  I recommend seeking out a massage therapist who has a significant amount of training and experience in pregnancy massage, including training in high-risk pregnancy massage.  Massage cannot directly harm a baby or pregnant mother, but there are additional considerations that need to be taken into account. It is not unusual for a therapist to require a high-risk mother to obtain a release from her care provider for the massage session.  Some therapists even require a release for low risk pregnancies.  If you are experiencing a high risk pregnancy feel free to ask additional questions, for example:

“How will the massage impact my condition?” 

“What extra precautions need to be taken to keep me and the baby safe? “

“Will you come to my home or hospital where I am on bed rest?”

The important thing here is the therapist being knowledgeable about massage during high risk situations and you feeling confident in their ability to take appropriate care of you during the session.  Again, keep looking if you are not sure about the therapist you are talking to and don’t hesitate to follow your gut instinct about scheduling with them or not.

Hopefully after talking on the phone with a therapist you will feel confident enough to schedule a session with them. There’s no way to tell if they are good unless you actually go see them.  Ask them any questions you may have during the intake part of the session and feel free to speak up during the massage if anything comes up or you feel uncomfortable.  Remember that it is your massage session and part of what makes it a good one is you.  Your therapist wants to know if you are uncomfortable, or if the pressure is too deep or too light, so speak up.  If you want more work in your hips or low back- speak up.  We want you to have a great session and feel good in your body when you leave.  We don’t know what you don’t tell us, and we are most willing to accommodate you so you can have an awesome massage experience.

Finding that wicked awesome massage therapist that you want to tell all your pregnant friends about can take a little extra work, but getting a great massage is worth it.  Remember to follow your instincts and don’t hesitate to ask any questions about the therapist’s training and experience. It most definitely pays off in the end.

Miranda Cacek is Certified in Prenatal, Labor and Postpartum Massage with 150 hours of training and 7 years of experience.  She has a private practice in the Uptown area of Denver where 95% of her practice is pregnancy and postpartum massage