I have many mothers join my practice during pregnancy with the thought that it won’t be needed once baby arrives. I have several others who call for their first appointment shortly after birth begging for relief of new found pains and problems. It doesn’t take either mother long to understand just how valuable chiropractic care is as a standard of care in a healthy lifestyle.
I have shared much information about care throughout pregnancy here on the blog and within my book, but I feel as though the topic of postpartum chiropractic care is an extremely important topic within itself. I am not just talking about the week after having your new baby, which of course is highly needed, but also the months – and even years for some – after having children.
After giving birth, you may not consider one of your first outings should be to the chiropractor, but once you think about the journey you have accomplished, you may think again. That first visit after birth is wonderful for both mother and baby. Your baby has just experienced quite the ride – no matter how she entered this world. Her positioning within your uterus may or may not have been ideal, the birth process is strenuous, and the world can be a hard place to adjust to. A great family chiropractor is exactly what she needs! I’ll save those details for a future blog, but know that a newborn definitely can and should be seen after birth.
Today, though, I want to talk about YOU… the mother.
As you may (or may not) have realized, your body has changed significantly throughout birth:
- Ligaments have loosened
- Bones have spread
- Nerves have been pinched
- Back Pain has persisted
- Weight has shifted
- Posture has changed
- Balance is different
- Hormonal tides have caused chronic complaints
After giving birth, some of these problems disappear while most linger and new ones arise. The body immediately begins working to tighten the ligaments and realign organs and bones, but it is a process. This can take months, even up to a year to completely occur. And while this is happening, you are altering your body by holding a baby, leaning to breastfeed, survive in a state of exhaustion. To put it mildly, your body is not in its peak performance state.
Seeing a chiropractor immediately after birth grants you the ability to jump start your body’s healing process. Chiropractic care ensures proper blood flow to these tightening ligaments, aligns the spine to allow proper neuron reception and movement, and can alleviate aches and pains.
There are, of course, the most common areas needing adjustment after birth; the pubic bone, sacrum, and lower back. While pregnancy can alter these areas, birth significantly throws them out of place. A good adjustment will ease the body into motherhood with far less pain than a mother who does not get adjusted. Continual chiropractic care throughout the postpartum period speeds the recovery time as a whole, too.
Postpartum chiropractic care can also be responsible for the following:
- Correcting Posture
- Speeding Pelvic Floor Recovery
- Alleviating Sciatica and Nerve Pain
- Aiding in the Prevention of Postpartum Depression
- Relieving ‘New Mother Wrist’ Pain
- Subsiding Headaches
- Providing Comfort for Better Sleep
If you are planning to have more children, it is even more important to help heal your body properly. Future pregnancies deserve a strong foundation and healthy start.
It can be so intimidating that most women forego writing one altogether.
Don’t let that be you. Skipping your birth plan means that you are skipping the educational aspect of giving birth. You are walking in blind – uniformed – and unprepared for the possibilities that lie ahead.
You may have the birth of your dreams without a birth plan in hand, but if just one domino falls, your birth has the chance of not being what you were hoping for. How does a birth plan change any of that, you ask?
Like most things in life, it isn’t so much about the end result, but the journey to get there. Your birth plan is a culmination of your research; a brief proposal of what you would like, how things should be handled, and how you deserve to be treated.
Before writing your birth plan, tour your birthing facility and schedule a time to talk with your doctor (or practice of doctors), or midwife. You cannot begin this until all of your questions are answered. You need to know what the standard of care is from the moment you enter the facility until the second you are wheeled out. (Are you allowed to walk out? -simple questions like that need to be asked too!)
Once you have a basic timeline of events, you can dig into the research and figure out your priorities. I have yet to ever see two identical birth plans.
Make sure to bring your birth team a copy of your plan after it is written. Pack a few copies in your birth bag and have your partner pull them out upon arrival when you are in labor. Everyone can receive a copy – the doctor, all nurses, anyone who enters the room can be asked to take 2 minutes to ‘Please review my partner’s birth wishes. We would really like to be team through this, and I want her priorities to be known. Thank you!’
Now it’s time to write.
The easier the plan is to read, the higher the chances are that it will be read. There are three basic formats to choose from:
Bullet Points: Simple, brief statements listed under different headings (example: Early Labor, Active Labor, 2nd Stage, 3rd Stage, After Delivery for Mom and Baby)
Chart: Each procedure listed with the mother’s thoughts or wishes next to it, in charted form.
Paragraphs: Harder and longer to read, paragraph format is typically done under headings like bullet points, but contains longer thoughts.
*Remember not to include WHY you are choosing these things, that does not matter. Keep is SIMPLE and include everything important to you.
A birth plan is not written in stone. No matter what though, YOU SHOULD NEVER BE PUSHED OR TALKED INTO ANYTHING. If situations arise, take the time to talk about your options, risks, and make informed decisions.
This is a sample birth plan. Yours will be your own, but feel free to start here and add/delete and alter as you see fit. It is based on a plan for a natural hospital birth without medical intervention. Remember, you may not agree with my plan, but that’s the beauty of it – you get to make your own!
SAMPLE BIRTH PLAN
I would like to have an unmedicated, peaceful birth with the help and support of you as my birth team. My partner and I are educated and understand that unexpected situations may arise. If anything occurs, please help us to continue on the most natural path as possible, granting us time to make decisions and supporting us through the process.
In case of emergency, save both mother and baby in any way possible.
*There will be a photographer with us, and she is allowed to stay with us in all situations.
- I would like to let labor begin naturally, even past my due date, and do not want any interventions to begin labor.
- If water breaks before labor begins, I would like 48-72 hours before any interventions are suggested. I agree to have my fluid levels monitored.
- If I arrive before active labor has begun, I would like to leave and come back further into labor – even if my water has broken.
- I deny antibiotics for GBS and will watch for fever and signs of illness after birth.
- I would prefer no heparin lock be put in place, but will compromise if an IV will not be attached.
- DO NOT OFFER PAIN MANAGEMENT MEDICATIONS.
- My partner will remain with me and be included in all discussions.
- I would like a peaceful, calm, and intimate environment with minimal interruption.
- I would like to move freely and labor in any position comfortable.
- I will eat and drink throughout labor.
- I would like access to the birthing tub (if available).
- No cervical checks unless requested.
- No artificial rupturing of membranes (water breaks naturally or baby is born in the caul).
- I would like baby’s heartbeat to be monitored intermittently through Doppler or stethoscope. No electronic fetal monitoring, internal monitoring, or wireless monitoring. If continuous monitoring is needed, wireless monitoring will be permitted so I can still walk freely.
- As long as my baby and I are fine, I would like to be free of time limits and not have my labor augmented.
2nd Stage Labor:
- No episiotomy unless I am naturally tearing toward my clitoris.
- No vacuum or forceps. Instead a change of position.
- I will wait until my body naturally begins pushing before I push.
- Please do not instruct my pushing, I will listen and aid my body, taking breaks when needed.
- I do not want to be laying on my back to push.
- I would like access to the squatting bar and birth stool.
- I would like to ‘catch’ my baby, or have my partner catch the baby.
- My partner will announce the baby’s gender.
- Baby will immediately be placed skin to skin on my chest.
- We will let the umbilical cord pulse to completion before clamping.
3rd Stage Labor:
- No medical interventions to birth the placenta.
- I wish to see the placenta.
- Placenta will be kept in the provided cooler to be encapsulated.
- A c-section will only be performed once all options have been exhausted and it is a medical emergency.
- My partner will remain with me throughout the procedure.
- I would like to have feeling and the ability to move my arms. (Avoiding general anesthetic.)
- I would like a family-centered c-section with a clear curtain, mirror, and inclusion in the birth conversation.
- Baby will be placed directly on my chest with the umbilical cord and placenta still attached to the baby.
- Take extreme care with incision and sutures to support a future VBAC and more pregnancies.
- My partner or child will cut the cord after it has finished pulsing.
- No separation from baby. Hold off on any newborn checks. Anything needed can be done with baby on my chest.
- In an emergency, my partner will accompany the baby everywhere needed.
- Breastfeeding will be attempted before any weighing or measuring takes place.
- All procedures will be held off until initial bonding has been established.
- Vernix will be rubbed into the baby’s skin, please do not wash it off.
- I decline the Vitamin K injection and antibiotic eye ointment.
- NO VACCINES: I decline the hepB vaccine and any other vaccines or injections offered.
- DO NOT CIRCUMSIZE if baby is a boy (or a girl).
- Do not bathe baby.
- No formula.
- No Bottles.
- No pacifiers.
- I would like a lactation consultant to be available as soon after delivery as possible.
C-sections occur in more than 1/3rd of births in the US now. It is more than just a trend, and seems to only be rising.
Research shows us that babies born by cesarean have increased chances of obesity, asthma, celiac disease, autism, chronic illnesses, and type 1 diabetes later in their lives. This research suggests that it is the differences in the gut flora that plays a part in the rise in these diseases.
Allowing the body to labor on its own, without intervention, provides many benefits for posi both mom and baby, but allowing baby to pass through the birth canal takes the cake, folks. Apparently, our bodies are so amazing that we not only grow humans, but our own gut flora is passed to those humans as they grow (through the placenta).
It gets even better! Our gut flora travels from our gut into the birth canal during labor. These bacteria then are absorbed through baby’s skin, eyes, nose, mouth, and genitals as he passes through the birth canal and is welcomed to the world.
By having these bacteria absorbed into their bodies, babies have a decreased risk of the above mentioned illnesses, as well as many more.
I know that 1 (or 2) out of every 3 of pregnant women reading this will end up electing or requiring a c-section for birth, but YOU are who I am writing this for. Science has found a way for you to grace your baby with your ‘seed.’
If you are HIV negative, and having a C-Section, I highly recommend you read on. If you are GBS positive, talk to your doctor about vaginal seeding.
What is Seeding?
Dr. Maria Gloria Dominguez-Bello, an associate professor in the Human Microbiome Program at the NYU School of Medicine, presented the process to do what is called an inoculum or “seeding” for the infant.
- Take a piece of gauze soaked in sterile normal saline
- Fold it up like a tampon with lots of surface area and insert into the mother’s vagina
- Leave for 1 hour, remove just prior to surgery and keep in a sterile container
- Immediately after birth apply the swab to the baby’s mouth, face, then the rest of the body
Yes, it is recommended to take vaginal swabs from the mother and putting them over the body and in the mouth of the baby to help restore the delicate balance for babies who were born by cesarean. This new research was recently shared at a conference of the American Society for Microbiology by a group of other physicians. It is now being practiced across the country by doctors who are up to date on their research.
Vaginal Birth vs. C-Section Birth
“Vaginal birth triggers the expression of mitochondrial uncoupling protein 2 (UCP2) in mice, which is important for improving brain development and function in adulthood. The expression of this protein was impaired in mice born via caesarean section. The communication between our guts and brains appears to rely, in part, on the vagus nerve, and is bidirectional in nature as reported in this 12-year prospective study that looked at relationships between gut problems like irritable bowel disease, anxiety, and depression.”
There is a large difference between the microbiome of a baby born vaginally compared to a baby born by c-section. During a vaginal birth the baby is seeded by the mother’s vaginal and faecal bacteria, as well as bacteria from her gut. A baby born by c-section is seeded by the bacteria in the hospital environment and his mother’s skin. These bacteria are incredibly different, and these differences may be the reason for the long-term increased risk of some diseases for babies born by c-section.
With interventions like Pitocin, antibiotics, C-section and formula feeding, the gut flora transfer from the mother to baby is interfered with or missed completely, leaving the baby’s microbiome “incomplete”. This means that the baby’s immune system may never develop to its full potential.
Most Beneficial Bacteria
The most beneficial gut flora are found in babies who are born at full term (39 weeks or further), vaginally (unmedicated) at home, and are breastfed exclusively. This is because these babies come in contact with ONLY the bacteria of their family during the prime ‘seeding’ the period.
The following are ways you can increase the chances of positively seeding your baby:
- Have a vaginal birth at home.
- Avoid vaginal contact: cervical checks, etc.
- Avoid unnecessary antibiotics during labor. If antibiotics are required, consider probiotics for mother and baby following birth.
- If the baby is born by c-section, follow the procedure of vaginal swabs to ‘seed’ the babies. The preliminary results are that the microbiome of swabbed babies are more similar to vaginally born babies.
How to Help After Birth
After birth, the baby continues to receive gut flora through contact with the environment and breastfeeding. The differences in the gut of breastfed babies compared to formula fed babies is immense. The beneficial bacteria are transported to the baby’s gut by breastmilk. The gut health of a formula fed baby plays into the health risks and chronic illnesses linked to formula. http://www.cmaj.ca/content/185/5/385 and http://www.livescience.com/26312-gut-bacteria-infant-colic.html
Ways to help increase positive gut flora:
- Skin-to-Skin: Immediately following birth, and in the first days, baby should spend a lot of time naked on his/her mother’s chest skin-to-skin.
- Avoid bathing baby for at least 24 hours after birth, and then only use plain water for at least 4 weeks. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2315785/
- Minimize the handling of baby by non-family members during the first weeks.
- Exclusively breastfeed.
- Avoid giving baby unnecessary antibiotics. http://www.nature.com/ijo/journal/v35/n4/full/ijo201127a.html
- Probiotics may also be beneficial for babies suffering from colic.
The commonly accepted belief that the baby inside the uterus is sterile, while the membranes are still intact, is being challenged recently. Research shows that the gut bacteria from the mother may be able to reach the baby (Through the placenta via the blood stream). Why is this a concern? Our modern lifestyle is not very microbiome friendly, and many of us have dysbiosis (an imbalance in gut bacteria). Dysbiosis and too much of the ‘wrong’ bacteria have been linked to premature rupture of membranes and premature birth, not to mention the links of gut health to chronic illnesses.
Gut health contributes to proper immune function because 80% of the immune system is in the gut. The gut, which houses at least 10 times as many human cells as there are in our bodies, and 150 times as many genes as are in our genome, controls many vital operations and is responsible for synthesis of neuroactive and nutritional compounds, for immune modulation, and for inflammatory signaling. Poor gut health can predispose us to everything from autoimmune disease, allergies, asthma, skin problems like eczema and psoriasis, cognitive difficulties, depression, anxiety and metabolic problems like obesity and fatty liver.
During pregnancy, your microbiome (also known as gut flora) is not only crucial for your health, but for your baby’s health as well.
The mother’s intestinal bacteria is also found in her breastmilk and is continually passed to baby.
An unhealthy, unbalanced gut flora in the mother can cause problems such as preterm labor, and once baby is born, issues like colic, cradle cap, asthma, food sensitivities, ear infections, reflux, GERD, etc. Healing the gut when pregnant should be a high priority for the mother so the baby can have a healthy start to life.
A study obtained stool samples from women during each trimester of pregnancy and analyzed the bacteria present. They found that bacteria typically linked with good health decreased over the course of pregnancy, while bacteria associated with diseases generally increased. In addition, signs of inflammation in the gut increased. These changes in gut bacteria may play a role in changing a pregnant woman’s metabolism. Two changes that happen during pregnancy are an increase in the amount of body fat, and reduced sensitivity to insulin, the hormone that controls blood sugar.
“The findings suggest that our bodies have coevolved with the microbiota and may actually be using them as a tool — to help alter the mother’s metabolism to support the growth of the fetus.” http://www.medicinenet.com/script/main/art.asp?articlekey=160986
Research also shows, during pregnancy, the microbes actually become less diverse and the number of beneficial bacteria decline while disease-related bacteria increase. Under normal circumstances, such changes could lead to weight gain and inflammation, but in pregnancy, they induce metabolic changes that promote energy storage in fat tissue so the fetus can grow. http://www.ncbi.nlm.nih.gov/pubmed/22863002
No matter how you look at the research, women’s gut bacteria changes during pregnancy. Ideally, women should try to head into pregnancy with a healthy microbiome and then maintain it, so that as the flora is altered during each trimester, it has a strong base in which it began.
If antibiotics are needed before or during pregnancy, repopulating the gut with friendly bacteria and eating a diet containing minimal toxins will help counter-act the harmful effect on the gut the antibiotics cause.
Toxicity flows from the gut throughout the body and into the brain. This continually challenges the nervous system, preventing it from performing its normal functions and processing sensory information. Virtually any toxic exposure can be the “straw that broke the camel’s back” and cause a chronic illness, allergies, even symptoms of autism, and/or any number of other neurological problems.
As noted by Scientific American: http://articles.mercola.com/sites/articles/archive/2014/12/27/seeding-baby-microbiome.aspx#_edn7
“Scientists have long wondered whether the composition of bacteria in the intestines, known as the gut microbiome, might be abnormal in people with autism and drive some of these symptoms. Now a spate of new studies supports this notion and suggests that restoring proper microbial balance could alleviate some of the disorder’s behavioral symptoms.”
In recent years, it has been discovered just how important the mother’s bacteria is for the baby throughout pregnancy and birth. The way the child enters the world sets the stage for his own gut flora. The process of “seeding” a baby at birth is when the bacteria is passed from mother to baby.
Keeping healthy levels of bacteria throughout pregnancy, seeding your baby’s microbiome, and optimizing your vitamin D level (make sure you have this checked while pregnant) will provide a strong foundation for creating a strong and healthy gut in your baby. However, the hazards of chemical exposures during pregnancy to endocrine disruptors like BPA and phthalates, and pesticides from the environment and foods can have wide-ranging and long-term health effects.
While you may not be able to avoid all toxic exposures, it’s important to take whatever proactive measures you can to reduce your toxic burden, especially before and during pregnancy. For example, avoiding any and all unnecessary drugs and vaccinations is one aspect you have a large degree of control over. Below are several more.
It is not the time for a full on detox, but you should remove as many toxins from your diet and environment as you can. Use non-toxic cleaners and eat a whole foods diet rich in prebiotics and probiotics, with as much organic as possible. This helps the body to detoxify at a rate that supports your ability to get pregnant while creating a healthy environment for your little one.
- As much as you’re able, buy and eat organic produce and free-range, organic foods to reduce your exposure to agricultural chemicals like glyphosate. Steer clear of processed, prepackaged foods of all kinds. This way you automatically avoid pesticides, artificial food additives, dangerous artificial sweeteners, food coloring, MSG, and unlabeled genetically engineered ingredients.
- Maintain optimal gut flora by eating raw food grown in healthy, organic soil and ‘reseeding’ your gut with fermented foods. (This is absolutely essential when you’re taking an antibiotic). If you aren’t eating fermented foods, you most likely need to supplement with a probiotic on a regular basis, especially if you’re eating processed foods.
- Optimize your vitamin D level.
- Exercise regularly throughout your pregnancy. Previous studies have shown that, in general, women who exercise throughout their pregnancies have larger placentas than their more sedentary peers. The volume of your placenta is a general marker of its ability to transport oxygen and nutrients to your fetus, so it stands to reason that having a large, healthy placenta will lead to a healthier baby.
- Once your baby is born, try to breast feed for as long as you’re able—ideally at least six months. Breastfeeding helps ensure that your child’s gut flora develops properly right from the start, as breast milk is loaded both with beneficial bacteria and nutrient growth factors that will support their continued growth.
- Rather than eating conventional or farm-raised fish, which are often heavily contaminated with PCBs and mercury, supplement with a high-quality purified krill oil, or eat fish that is wild-caught and lab tested for purity.
- Store your food and beverages in glass rather than plastic, and avoid using plastic wrap and canned foods (which are often lined with BPA-containing liners).
- Have your tap water tested and, if contaminants are found, install an appropriate water filter on all your faucets (even those in your shower or bath).
- Only use natural cleaning products in your home.
- Switch over to natural brands of toiletries such as shampoo, toothpaste, antiperspirants and cosmetics.
- Avoid using artificial air fresheners, dryer sheets, fabric softeners or other synthetic fragrances, as they often contain phthalates, which have been linked to reductions in IQ and other chronic health problems.
- Replace your non-stick pots and pans with ceramic or glass cookware.
- When redoing your home, look for “green,” toxin-free alternatives in lieu of regular paint and vinyl floor coverings.
- Replace your vinyl shower curtain with one made of fabric, or install a glass shower door. Most all flexible plastics, like shower curtains, contain dangerous plasticizers like phthalates.
- Avoid spraying pesticides around your home or insect repellants that contain DEET on your body. There are safe, effective and natural alternatives out there.
- Minimize stress. Stress messes with your gut microbiota.
- Avoid antimicrobial skin products (eg. handsoaps), and house cleaning products
- Avoid unnecessary medications
- Stop smoking