Why You Need to Know About Pelvic Floor Physiotherapy

Why You Need to Know About Pelvic Floor Physiotherapy

Naomi Mendes-Pouget

2020

My Musings... | Perinatal Resources | Postpartum Health and Well-being

Because of pelvic floor physiotherapy I no longer pee when I sneeze.

 

You know I’m always going to keep it real with you, dearest reader! Being a life-giver has real affects on this body–we’re not robots nor elastic bands that just ‘snap back’ into place after 9+ months of growing and shifting. Remember that.

In a bit I will welcome guest writer Rabia Mirza, Registered Physiotherapist including Pelvic Floor and Certified Personal Trainer, to tell us exactly why we NEED to be caring more about our pelvic floor health. She is an expert! But first, allow me to tell you my story.

Now let me backtrack a bit here…

…I actually started going to pelvic floor physiotherapy DURING pregnancy.

 

That’s right! Even before the peeing-in-my-pants thing. I was having a pretty ‘normal’ pregnancy. Radical eh, seeking healthcare proactively?! I know. We’re not really taught that we can–and I’d argue should–do that! At least I wasn’t.

If you’re thinking you don’t need to see a pelvic floor physiotherapist because you don’t have symptoms… I will argue that if you have a growing baby inside your uterus–putting weight and strain on your pelvic floor because *gravity*– you should see a pelvic floor physiotherapist. And of course, it goes without saying that if you DO have symptoms…definitely make an appointment, love! Read on to hear more about this from a professional shortly.

Back in university when I was studying midwifery, I was lucky enough to have a guest lecture about the importance of pelvic floor health (and thus physiotherapy), so I was already familiar with this concept.

Seeing a pelvic floor physiotherapist during pregnancy can help on so many levels, namely the 4 P’s: Preventative, Physical exercise, Pain, and Preparation for labour.

Wow! (Source: https://westendmamas.ca/benefits-pelvic-floor-physiotherapy-pregnancy/)

Shortly Rabia will go through some of the juicy details and benefits of pelvic floor physiotherapy, and you can also visit the link above to learn more. But seeing the physiotherapist in pregnancy got me feeling in control of my present and future health, and even potential outcomes (to *some* extent!). 

Me in my ninth month of pregnancy.

 It was so empowering to proactively care for my health and well-being, with a provider who *THRIVES* off of seeing birthers be proactive.

 

My physiotherapist taught me how to effectively BREATHE (again: wow! I didn’t realize how much of an effect the way I breathe has on my pelvic floor health!). She also taught me how to make that breath-pelvic floor connection stronger in my body and mind. Prenatal yoga was also wonderful for this.

And you know those ‘Kegels’ that everyone talks about? Well I could trust my pelvic floor physiotherapist to teach me how to do those, EFFECTIVELY. This helped me later on in pregnancy when I did experience some of those embarrassing (but common!) symptoms like losing control of my bladder.

In my labour and birth, pelvic floor physiotherapy had prepared me and my body for what was to come.

 

That awesome breath-pelvic floor awareness I had built prenatally through my pelvic floor physiotherapy sessions truly helped me in labour. It taught me how to be aware of the tension I was holding in my pelvic floor, and how to release it. That ultimately played a role in helping me shorten my labour and meet my baby sooner! What a true gift.

 

Pelvic floor physiotherapy in the postpartum period: my experience

After the birth, there was some injury sustained to my urethra area (and I say that in the most loving way… I didn’t expect immaculate birth!). My pelvic floor and core muscles also felt very wobbly and weak. Makes sense–everything was shifted around and there was no longer a giant uterus balloon taking up a bunch of space and putting pressure on everything! Aaaaand I pushed a baby out of me.

Going back to pelvic floor physiotherapy regularly, after the first six weeks I took to heal on my own, was something I looked forward to. Again, I was taking my health seriously. Especially since our society teaches people with female reproductive organs to stay in the dark and in shame about it. 

Now, since I had been taught how to do Kegel exercises effectively PREnatally…

 

…They were now easier to do POSTnatally, despite things feeling rather wonky and weak down there. It would have been like trying to learn how to play tennis with a limp arm, I think! This way I had some muscle memory to help me.

My pelvic floor physiotherapist, who happens to be Rabia, also kept me very in the loop with exactly what exercises I could and should be engaging in, and how to engage the core properly during every day movements (like picking up my baby) to avoid accidental further damage (I had some abdominal separation). 

P.S – If you’re wondering why I’m sharing this vulnerable and intimate photo of myself in the very first hour after my homebirth… It’s to bravely show you what is within the realm of normal. We never get to see and so we never get to know! It’s important to me that I can share and educate about birth and postpartum. Birth is a normal process.

Here’s yet another benefit: improvement of sex after baby.

 

Yes, I said it! I noticed in the postpartum that my vaginal muscles were holding a LOT of tension, therefore causing pain upon insertion. #SorryNotSorry #AllForTheCause #KnowledgeIsPower. So that was another thing that the pelvic floor physiotherapist really helped release and work through.

Rabia really helped my core heal properly. She was so in-tune with the connective tissue and how it was very sticky and jumbled up (my interpretation). She did physical therapy to help it un-stick, and that felt so good afterwards. Additionally, she offered me acupuncture to also help with core healing.

So, my dear and lovely reader, that’s my story. What you’ve just read highlights why I am such a die-hard advocate of pelvic floor physiotherapy from pregnancy through the postpartum. 

Fun fact: Did you know that in France, pelvic floor physiotherapy is one of the cornerstones of postnatal care?

 

The government subsidizes it for new parents. We are waaaaay behind!! As a result, way too many people think that peeing when they sneeze is just the new normal and sacrifice you make as a parent. I say HOGWASH! And now that you’re reading this blogpost, hopefully you’ll call BS too!

So without further ado, it is my HONOUR to introduce Rabia Mirza, one of the two amazing pelvic floor physiotherapists that have cared for me in the past year. She currently works out of Upper James Physiotherapy in Hamilton, and also has a clinic space in Mississauga! Rabia is passionate about body and pelvic floor optimal health, and does great work in increasing public awareness of pelvic floor health. She is here today to talk about postpartum pelvic floor physiotherapy. Take it away, Rabia! And thank you so much for sharing your wisdom and knowledge here.

What is postpartum pelvic floor physiotherapy? 

 

Postpartum pelvic floor physiotherapy is a branch of physiotherapy specifically for the needs and concerns of postpartum women. And when I say postpartum women I mean moms in general, there is no time exception for what we consider postpartum!

Our role in your postpartum journey is to make sure that all your needs concerning your pelvic floor are being addressed and cared for. The pelvic floor has a role in bladder, bowel, sexual and functioning and also has implications for low back and pelvic pain.

A pelvic floor examination involves a detailed subjective history and an internal examination of the pelvic floor muscles. After the examination we develop a plan including manual internal therapy, kegel exercises, core exercises and self-management techniques for home.

What happens to the pelvic floor with pregnancy and childbirth?

 

The greatest changes occur at the pelvic floor during pregnancy and especially during labour. With pregnancy, the pelvic floor muscles are forced to take on more of a load with the growing baby in the uterus and the relaxation of the pelvic bones as your body prepares for childbirth. Sometimes this increased load weakens the pelvic floor muscles and you develop symptoms including pelvic pressure, groin and low back pain, and sometimes urine leakage with sneezing and coughing.  During labour, the pelvic floor muscles act as a gateway and often get injured and torn in the process. The tearing of these muscles should be thought of as a tear in any other muscle in the body, physiotherapy is required for optimal healing!

Although C-section deliveries often don’t cause tearing at the pelvic floor muscles, the accompanying scar at the lower abdomen requires optimal healing and movement. This scar has implications for pelvic and abdominal pain and often requires mobilization.

Do I need postpartum pelvic floor physiotherapy?

 

The short answer is YES. Even if you aren’t having any symptoms it is still imperative to make sure the pelvic floor muscles are healing optimally. It is also important to check on the pelvic floor and core muscles before returning to exercise to ensure a healthy and safe return to activity.

If you are experiencing any of the symptoms below, pelvic floor physiotherapy is for you!

  • Urinary leakage (incontinence) with sneezing, coughing, laughing, jumping
  • Vaginal discomfort or pressure
  • Pelvic, groin, or low back pain
  • Overactive bladder
  • Pain with intercourse
  • Pain or pressure with exercise
  • Diastasis recti (ab separation)
  • C-section scar

 

Where can I go to see a pelvic floor physiotherapist?

 

To book an appointment with me you can visit Upper James Physio. We offer 1 hour initial assessments and 45 minute follow-up appointments. If you’re not in the Hamilton area I would recommend searching for a Pelvic Floor Physiotherapist online. Because pelvic floor is a speciality, not all physio clinics offer this service. Take charge of your postpartum healing and book in an appointment. 

Final thoughts…

 

Thank you so much, Rabia, for lending your expertise!

 

Dear reader, we want to know: Did you know about pelvic floor physiotherapy? Have you had pelvic floor physiotherapy? How was your experience? Drop a comment below, let’s start a conversation about this important facet of health!

 

MUCH LOVE,
XO Naomi & Rabia

 

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"We couldn't have gotten through..."

“We have three kids who were all under 2.5 years old during our time with the Doula. Naomi worked through the night a couple nights per week to give my husband and I some rest, as we had toddler twins and the newborn to look after through the day. We couldn’t have gotten through the days without the rest we got at night thanks to Naomi!” -B.F.

"We felt very comfortable..."

“Naomi saved us! We had twins and really needed sleep. She gave us a break! She was/is kind, caring, compassionate, and understanding. We felt very comfortable leaving our boys with her which is rare, given we are new parents. She exceeded our expectations tenfold! My husband, myself, and our two boys love her!” – A.F.

"Having her serene presence and focus on me, the mom,..."

“…reminding me to hydrate; listening; trying to find some solutions; was very soothing, and the other kids also felt more cared for, I believe. For a third time mom, it’s so much more about the other children… It’s so difficult to find time for myself, whilst having to take care of a newborn and worrying if the older ones will be a little left behind… no mom of more than one would enjoy the pampering and the attention and care if she felt not all the children were being looked after. So when Naomi minded them, it was bliss. In this context, not usually having the time for myself, the nutrition part was especially important. I was constantly reminded that for the family to be well, I had to prioritize my own wellbeing.” – M.B.

my mission

Helping new families have a supported and  transformative post-birth period.

Imagine: You’re in a pitch black room, and you know there is a door somewhere in that room. That door symbolizes sanity and wellness post-birth. Eventually, by feeling around, you will find the door– despite obstacles along the way. I believe in you. But imagine how much easier it would be to find the door if there was a little candle by the door, guiding you and making you feel a little less lost and disoriented, and more confident. That’s what a having a Postpartum Doula is like.

Book an appointment with The Postpartum Nest using SetMore

Get In Touch

   Want to Touch Base?

Have You Considered This for Baby’s First Bath?

Have You Considered This for Baby’s First Bath?

Naomi Mendes-Pouget

2020

Baby Love | My Musings... | Postpartum Health and Well-being

Note: there are links to some products in this post, but I am not a paid affiliate!

Also: some photos courtesy of Erika Matkovich.

My baby’s first bath was one to remember…

 

…in the best ways possible. I want to share my experience with you.

Bubs was two or three days old. Tiny little thing! And so brand new.

Indeed, it was time to bathe her, and I had thought about what I wanted to do for baby’s first bath a little bit beforehand. All I needed was the help of my Postpartum Doula to make it as close to perfect as I dare go.

I wanted baby’s first bath to be a family bath.

Yes. You read that correctly.

Thanks to my larger sized bathtub, I wanted to take my immediate postpartum body, baby, and spouse–our new trio–into the bathtub together. (And with the supervision of our cat Daisy, of course!)

 

Our family’s awesome ‘baby’s first bath’ experience

 

Ain’t no new parent got energy for showering!

 

Undeniably, in the first few days postpartum, I–and my body–were exhausted. I certainly did NOT have the energy to a) stand up in the shower and wash myself, or b) bathe Bubs!

Now this was obviously a dilemma, because I didn’t want to miss baby’s first bath!

So I followed my instinct and decided that the family bath would be a great solution.

And–spoiler alert– it was!

Our amazing Postpartum Doula got it all set up for us, and even took some great pictures of the scene, too.

Candles were lit, twinkle lights were illuminated, post-birth healing bath salts & herbs from New Life Co. (online shop coming in 2021!) were dissolving and steeping in the warm water, towels were laid out… it was a magical, spa-like scene.

Gimme allllll the oxytocin!

 

As I stepped into the water, it surrounded me like a hug. Instant relief. As far as post-birth recovery goes, it was exactly what I needed. My achy joints, bones, and muscles breathed a deep sigh of relief. My tired mind relaxed. Bliss.

And then my hunnie joined in with me. I was pretty comfortable naked, and he put on swim shorts. Doulas are supportive of postpartum bodies, so I felt free around our Doula.

She then brought bubs in– stripped down and ready to have their first bathing experience after coming out from her aqueous womb.

The Doula placed bubs in my arms, and I brought her down onto my chest. Honestly, it reminded me of the moment at birth where she also was placed on my chest. That’s how blissful the moment was.

Hunnie and I alternated pouring warm water on her small, wrinkly back. Clearly, she was feeding off of my relaxation, because she was SO CALM! She pretty much fell asleep on my chest, in that warm place that would remind her of her previous home. Yes, she was home.

While we relaxed and bonded as a new family, our Doula offered to take photos. What a gift that was. She captured these precious moments that left such an impression on me. They are beautiful photos, wouldn’t you agree? 

Following your instincts

 

After minutes of relaxing, as newborns do, bubs got hungry. Hmmm, should we get out? But it’s still so cozy in here and I’m waaaay too relaxed!

You guessed it: I breastfed her right there in the bath.

Correct me if I’m wrong folks, but is this stuff taught in prenatal classes? Honestly, you can do anything. Let your instincts guide you. If it doesn’t work, you’ll learn for next time!

Bubs fed happily, and I got to relax even further, thanks to the hormones oxytocin and prolactin surging through me. And following my instincts on this added a coin to the new parent confidence jar. Maybe I can do this.

Potentially setting the stage for calmer baths?

 

Now this part is pure speculation; but my baby loves baths.

Could it be?

Could it be that that first experience really set the tone for a secure attachment to water out here?

I don’t know, and I never will. But isn’t it a lovely thought, nonetheless?

I will honour myself and keep this thought and experience close to my heart forever.

Before my cheesiness nauseates you, let me tell you how this blissful baby’s first bath experience ended…

Hunnie was holding bubs on his chest for a little while after the feed, and — she pooped on him! It was honestly HILARIOUS. A natural and memorable ending to a natural and memorable experience!

Don’t let that turn you off, though. He showered off and all was well. We had an amazing laugh about it. Our Doula grabbed bubs into her towel, and we hopped out.

Is baby’s first bath a source of anxiety for you? You’re not alone!

 

Keep calm and carry on

 

If you have anxiety surrounding baby’s first bath, I’m here to validate that and say that’s COMPLETELY NORMAL, and super common.

Like a lot of things as a new parent, I find that a ‘fake it ’til you make it’ approach works quite well! Meaning, if you don’t feel confident, trudge on as best as you can anyways and pretend you’re confident! That will achieve 2 things:

a) it will get you through the initial nerves until the confidence can fester on its own and you get the hang of things, and

b) it might assure your baby that you’ve got them and there won’t be as much outward nervousness for them to feed off of.

With all this being said, if you’re dreading or just not looking forward to baby’s first bath, please call me and we can work it out together!

Do not hesitate to ask for help; your nerves will thank you for it! Like I said before, a lot of folks find baby’s first bath anxiety-provoking.

 

That being said…

 

 … Babies are resilient! Even newborns!

 

Yes they might cry, but don’t assume you’re scarring them for life (I know, easier said than done). It’s their way of communicating! Maybe they don’t feel like being naked at that moment. Maybe the water is a bit of a shock they weren’t expecting. Maybe they have no idea what’s going on and it’s confusing! Maybe the water is too warm or too cold and they are telling you about it.

Point is: if they cry, it could be a million things. Maybe the water is making them miss the womb! Maybe the lights are bright. Maybe they’re hungry.

But guess what: there’s not always a fix, although I know we desperately wish there could be. Your babe will be okay. Even if the baby does slip out of your hands (which probably rarely ever happens but it’s a common fear), you will pick them right back up and all will be well. They are resilient creatures! They’ve worked hard to get here; they’re not going to let one bath ruin them, if you’re right there with them.

 

So…

 

…Have faith.

 

Give yourself credit, for you too have grown so much in becoming a parent already, even though you feel like it’s the very beginning. In a way it is, but in another you’ve been at it for MONTHS already! Have faith in your instincts and abilities.

And if you need help, I’m here for you and ready for you.

 

“But Naomi, how can I have faith if I don’t even know what to do?”

 

I’ve got you. Read on, my friend.

 

Guidelines & Considerations for baby’s first bath

 

Safety first: do not leave your baby unattended in the bath at all! If you need to leave the room for some reason, wrap baby up in a towel and take them with you.

 

If you’re “sponge bathing”, here’s how to:

 

  • Try to warm up the room. You can do this by running a hot shower for a few minutes, or grab a space heater.

 

  • Have a change pad or small basin for baby, a small bowl of lukewarm water, a couple washcloths, some baby soap, baby shampoo, a scalp massage pad, and an extra towel or small blanket on hand.

 

  • Spread out a change pad and cover that with a towel to catch any rogue fluids. You could also rest baby in a small basin. As you begin washing one part of your newborn’s body, you could keep the other parts of their body nice and warm by covering them with the other towel or blanket.

 

  • Clean one of your baby’s eyes with a fresh, damp soft cloth. Repeat with other eye and with fresh cloth. Continue to clean the rest of your baby’s face. You do not need soap to do this.

 

  • Wash the rest of baby’s body with mild soap lathered on a soft washcloth. Clean under all your babe’s body creases and folds, such as in their neck, under their armpits, and behind their ears. Wash the diaper area last (unless they had a poopsplosion then you might wanna take care of that first!?). There is no need to clean any of your baby’s inner orifices, such as inside their ears, because they are self-cleaning. Make sure to rinse off any body areas that you cleaned with soap.

 

  • Shampoo your babe’s hair (if they have any) once or twice a week at most. To do this, cradle baby with your arm in a football hold, with your hand supporting their head. Hold their head over the sink and use your hand or a cup to gently run lukewarm water over their head, away from eyes. Add a small amount of baby shampoo onto the scalp massage pad and massage baby’s scalp (this may help prevent/manage cradle cap), rinse well, and towel dry right away.

 

  • When your baby’s sponge bath is done, wrap them up in a towel and pat them dry. They’re so darn cute all wrapped up!

 

References: AboutKidsHealth

 

Which bath products are right for your family?

 

Yes, with babies, the more natural the better. But please don’t take that as a cue for guilt if you’re not using handmade all-natural soaps and shampoos made with all organic ingredients.

 

Look at your budget, then look at the ingredient list (unless your paediatrician has specific recommendations). Babes will be just fine! There are good affordable options available.

 

If you are interested in affordable, handmade, natural products, the other small company I’ve co-founded called New Life Co. sells a natural, gentle soap that we love using with our babe (and one bar lasts months!!). They are also coming out soon with a natural body butter that is wonderful on babe’s skin too after the bath.

The online shop is coming in 2021, thank you for your understanding! If you are interested, please email me at naomi@postpartumnest.com

 

What about that precious umbilical cord stump?

 

The umbilical cord stump will fall off on its own between 5 and 15 days after birth. Keeping it clean and dry is the main recommendation to prevent infection.

 

Especially if you choose the family bath route, just make sure to dry the area well afterwards by gently patting it dry with a clean, dry cloth.

 

A good tip as well is to fold the front of the baby’s diapers down to prevent it from rubbing and iritating the umbilical area.

 

Furthermore, you can wash your hands before and after diaper changes and baby baths.

 

Choose loose-fitting clothing to allow air flow to the stump.

 

Avoid using antiseptic on the stump, as it can kill good bacteria that actually helps with the healing process.

 

Reference: BabyCentre UK

 

Baby hair and scalp care

 

As mentioned earlier, baby’s hair can be washed once–twice max–per week. This to prevent it getting stripped and damaged!

 

I also mentioned shampooing with the scalp massager. Using it is a way to stimulate the scalp and rub off skin flakes (which is commonly associated with cradle cap or eczema). Talk to your babe’s healthcare provider (HCP) for more information on scalp conditions. The massager also works up a nice lather with the shampoo.

 

If baby does get a scalp condition, again talk to your baby’s HCP about actions you can take if necessary. You can ask them about massaging the baby’s head with a gentle oil. New Life Co. sells one but you could also use an oil from your pantry. Just so you know, cradle cap is common: it affects 10% of infants up to the ages of 1 month, and 70% by 3 months of age.

 

Reference: Parents.com 

 

Temperatures: cozy but not toasty!

 

Babies are sensitive to temperatures! The goals are to minimize heat loss and to prevent burning. Test the water with your wrist instead of hands (the wrist is more sensitive), or use a bath thermometer and look for 37-38 degrees Celsius.

 

You can also try to keep the room warm while you bathe the baby, if possible.

 

Whew you did it! No, you don’t need to do that every day. Unless you really want to!

 

For more information on baby bath safety, here is an article from BabyCentre.ca.

 

 

Perhaps my favourite part: how your Postpartum Doula can help!

 

1. One word: fa-cil-i-tation. AKA make everything go smoother

 

When you’re exhausted, hormonal, and sensitive like in the immediate postpartum, sometimes someone there to help out and make things go smoother can be worth their weight in gold. Doing anything while exhausted is a lot more difficult! Especially if it’s something brand new, like bathing a newborn.

Your Postpartum Doula can be that person who, without judgment, will help in any way possible to make things go smoothly and easily. No questions asked. Your Doula doesn’t want to see you push yourself any harder than you absolutely need to in those early days.

Let me set everything up, brew you a tea, grab anything you need, take the baby so you can dry off, and empty the tub and clean up afterwards. Or bathe babe myself! whatever you need.

2. Capture those precious memories (even if it wasn’t exactly peaceful!)

 

Speaking from experience here– it is SO nice to have pictures that someone else took of your family in a special moment! Baby’s first bath can be one of those special moments that would only be captured by someone else, because your hands will be wet and occupied! And babies grow so fast; you’ll treasure those pictures as a brand new family.

 

3. Bathe baby while you do something nice for yourself

 

You do a lot for your baby– they are demanding! It is so crucial to keep yourself on the priority list too. Trust me on this, self-care is NOT frivolous or selfish. If your cup is more full, you will have more to give to your family, too, and generally feel happier and more able to cope. That’s important with a newborn around, as well as hormone fluctuations, and sleep deprivation.

Maybe bathing babe is something I can take off your list that day so that you can do something nice for yourself with those extra precious moments. That would be my pleasure!

 

In conclusion: YOU’VE GOT THIS!

 

I hope this post has helped you feel jazzed up about baby’s first bath. Remember to (try to) enjoy the process (if circumstances allow). If not, call me in and I’d be happy to assist!

Book a discovery call here to discuss how I can help your family.

And it would make my day if you shared this post with anyone you know who’s expecting their babe any day now or just had them!

And lastly, I want to know: how did baby’s first bath go for you!? Drop a comment below!

 

MUCH LOVE,
XO Naomi

 

 

 

You May Also Like…

Newsletter

Sign-up to hear more from me

"We couldn't have gotten through..."

“We have three kids who were all under 2.5 years old during our time with the Doula. Naomi worked through the night a couple nights per week to give my husband and I some rest, as we had toddler twins and the newborn to look after through the day. We couldn’t have gotten through the days without the rest we got at night thanks to Naomi!” -B.F.

"We felt very comfortable..."

“Naomi saved us! We had twins and really needed sleep. She gave us a break! She was/is kind, caring, compassionate, and understanding. We felt very comfortable leaving our boys with her which is rare, given we are new parents. She exceeded our expectations tenfold! My husband, myself, and our two boys love her!” – A.F.

"Having her serene presence and focus on me, the mom,..."

“…reminding me to hydrate; listening; trying to find some solutions; was very soothing, and the other kids also felt more cared for, I believe. For a third time mom, it’s so much more about the other children… It’s so difficult to find time for myself, whilst having to take care of a newborn and worrying if the older ones will be a little left behind… no mom of more than one would enjoy the pampering and the attention and care if she felt not all the children were being looked after. So when Naomi minded them, it was bliss. In this context, not usually having the time for myself, the nutrition part was especially important. I was constantly reminded that for the family to be well, I had to prioritize my own wellbeing.” – M.B.

my mission

Helping new families have a supported and  transformative post-birth period.

Imagine: You’re in a pitch black room, and you know there is a door somewhere in that room. That door symbolizes sanity and wellness post-birth. Eventually, by feeling around, you will find the door– despite obstacles along the way. I believe in you. But imagine how much easier it would be to find the door if there was a little candle by the door, guiding you and making you feel a little less lost and disoriented, and more confident. That’s what a having a Postpartum Doula is like.

Book an appointment with The Postpartum Nest using SetMore

Get In Touch

   Want to Touch Base?

Do I Need a Postpartum Doula and a Midwife?

Do I Need a Postpartum Doula and a Midwife?

Do I Need a Postpartum Doula and a Midwife?

2020

doula | midwife | postpartum | postpartum doula

(TL;DR : Yes, yes you do need a Postpartum Doula and a Midwife. They are different.)

I get it: the birth & new parenthood world can feel like a completely different universe. It can be new and confusing. SO MANY NEW WORDS!! There is lots to learn. I hear you. So if I can help clear something up for you then that makes me very happy.

If you’re here, I’ll assume for now that the terms ‘Doula’ (in this case, Postpartum Doula) and ‘Midwife’ are causing some confusion. THAT’S PERFECTLY OKAY! In fact, I’ll discuss below why it may be COMMON to mix the two up.

Luckily, I have experience as both a Student Midwife and as a Postpartum Doula! Both professionals are wonderful, complementary, and are well worth your time learning about and considering.

I’ve also invited a great friend of mine, Vishali, who is a new Registered Midwife (RM) as a guest on this post, to also share her expertise on the subject. Welcome, Vishali!

Disclaimer: this is not a definitive or exhaustive comparison of the two professions. Just some main points we’ve come up with.

midwives-and-doulas-are-different

Why do a Postpartum Doula and a Midwife Sometimes get Mixed Up?

 

Great question. There are a few similarities, along with history, that Doulas and Midwives share.

  • Doulas and Midwives tend to be natural-focused. Meaning, they view birth and the postpartum as natural, normal processes that ought to be complemented with holistic, nature-based and gentle approaches whenever possible.  *This is trend, not a rule*
  • Doulas and Midwives are experts in NORMAL.
  • Doulas and Midwives have been around for centuries! H(er)storically, A woman well-versed in perinatal health and wellness would typically support the women of their community in the perinatal year and in female sexual health matters. Generally, the female elders and relatives would typically tend to the mother in similar capacities in which a Postpartum Doula does today (with exceptions). Often the Midwife would embody the work/care of a Postpartum Doula as well. 

See? You’re not alone or crazy for getting the two mixed up. In fact, it shows that the herstory of caring for perinatal persons isn’t forgotten! Yay. Now, let’s come back to the present and explore what makes them different professions nowadays (in the Ontario, Canada context!)

 

What Does a Midwife do that a Postpartum Doula does Not?

  With GREAT pleasure I’ve invited Vishali Arumugam RM, a Registered Midwife from Durham-Markham Midwives, as a guest to shed some expertise here, and she has graciously agreed! Vishali studied Kinesiology and Health Sciences at York University, obtaining a Bachelor of Science in 2010. She then went on to study the rigourous Midwifery program at Ryerson University, where she obtained her Bachelor of Health Sciences in Midwifery after four years of full-time studies. Her journey to become a midwife was inspired by her ancestor in India who was a midwife. Vishali graduated from the Midwifery program in 2019 and is now a midwife with Durham-Markham Midwives. Welcome, Vishali!

Vishali:

Thank you for asking me to talk about midwifery in your blog post! Midwives are primary health care providers specialized in low-risk pregnancy and birth. We have four years of university education during which 2.5 years is focused on rigorous clinical training, almost like a medical residency. We are publicly funded through OHIP and are regulated by the College of Midwives of Ontario. Midwives provide care to pregnant people in antepartum, intrapartum and 6 weeks postpartum.

Antepartum:

 
  • We see people in clinic for the regular pregnancy check-ups.
  • Order blood work and ultrasound necessary to monitoring both the mother’s and the fetal wellbeing.
  • Have informed choice discussions with the parents so they are able to make the right decision about the care in pregnancy and their birth plan.
  • Prescribe medications for urinary or vaginal infections and nausea/vomiting.
  • Consult with obstetricians if any complications arise in pregnancy.

Intrapartum:

 
  • Assess the women either at home or at hospital in early labour
  • Deliver baby either at the hospital we have privileges in or at the comfort of their own home (We always carry all the necessary birth equipment and emergency medication in our car )
  • We are certified in Neonatal resuscitation (NRP) in case a baby is born with difficulties breathing.
  • We consult with obstetrician if the woman requires assistance with delivery through vacuum, forceps or c-section. 

Postpartum:

 
  • We see mom and baby 2-3 times at home within the first week of delivery to ensure the dyad are stable, healing well, support with breastfeeding and monitor newborn for issues like dehydration, jaundice and extreme weight loss.
  • We then see mom and baby at the clinic at 2, 4 and 6 weeks from delivery to ensure mom is recovering and coping well emotionally, baby is gaining well and answer any concerns parents might have.
  • Monitor moms for postpartum depression and connect them to the right resources.
  • Prescribe medication for nipple pain, breast infection, milk supply and oral thrush
  • We consult appropriately with either lactation consultants or paediatricians if there are any concerns with baby’s weight gain or health.

Closing Comparisons:

 

Unfortunately, midwifery care ends after 6 weeks postpartum and our clients are discharged back to their family physicians and paediatricians. However, you can choose how long you would like support from your postpartum doula.

Although midwives come to your house few times within the first week of delivery, we are unable to spend more then an hour since we are providing care for about 120 clients per year who all need our time to either attend their labour or antepartum concerns. So we prioritize this hour to ensure you and baby are clinically stable. Postpartum doulas are experts in providing support for new moms who are transitioning into motherhood and learning to keep up with the demands of feeding their newborns every 2-3hrs while lacking sleep. They can especially be helpful on days where baby will be cluster feeding (constantly latched on to mom) when they are going through growth spurt (this can happen every 3-4days in the first 2 weeks).

    Thank you so much for sharing your valuable insights, Vishali! My dearest reader, if you have any questions for Vishali please pop them in the comments at the end of the post!
midwives-do-home-visits

What a Postpartum Doula Has that a Midwife Does Not

 

Postpartum Doulas are set up to have more time with you

 

The biggest difference, in my opinion, is TIME. Postpartum Doulas work with their clients to determine exactly what the client wants and needs, and what kind of support will work for the family. The client dictates the time committment. The Postpartum Doula’s scope and number of clients are smaller than a midwife’s, thus we are able to commit more time to each client.

 

And that’s an intentional difference! Remember, Midwives are health care providers. They make sure you and babe are healthy. Doulas want to make sure you feel supported. That typically takes more time!

 

For example, Postpartum Doulas can do light chores around the house. You will probably have a list ready of ways we can support you, and it’ll take some time to get that done for you, and we are MORE THAN HAPPY to. Please do not expect this from your midwife at their postpartum visits!!!!

 

Postpartum Doulas are hired to make space for you and your family to do the things that will make you feel good. Space and time are one in the same.

 

Postpartum Doulas have more freedom in what they offer and how

 

In Ontario, Postpartum Doulas are not regulated, and are privately funded. (Sometimes Postpartum Doulas are available through charitable and community organizations.) Thus, our scope extends beyond the 6 weeks postpartum of midwives. And each Postpartum Doula’s time scope may be different. At The Postpartum Nest, our time scope is 6 months postpartum. But if you need support and you are more than 6 months postpartum, feel free to contact us and we can still connect you.

 

Also, since Postpartum Doulas aren’t regulated by the government of Ontario (yet), there is more liberty in the services each Postpartum Doula can offer their clients. Each Postpartum Doula has complete autonomy over their business and services! Thus, it makes it easier for you, the client, to find a Postpartum Doula that meets you and your family’s needs. Yay!

 

Postpartum Doulas are an addition to your support circle

 

Postpartum Doulas are not an either/or professional; they are an AND. Meaning, they are an addition to your support team/circle for the postpartum, and it does not exclude you from being able to access any other service. (Remember when I/Vishali explained that you can either have a Midwife OR an MD as your/baby’s health care during the first 6 weeks (unless it’s a consultation).)

The Postpartum Nest Advocates for Babywearing!

In Sum, You Should Have a Postpartum Doula AND a Midwife

 

In sum, the KEY takeaway I want you to have here is: Midwives are great. Postpartum Doulas are great. They are different professionals. The best case scenario is having BOTH! You can do that! And, I’ll argue till the end of my days, you should (and I DON’T usually use that ‘s’ word).

 

Midwives and Postpartum Doulas are complementary to each other.  Both will hopefully and probably be fierce advocates for you. Happily, Midwives are covered by the Ministry of Health (Ontario). However, Doulas are not, but maybe one day? Who knows. It would definitely improve maternal mental health outcomes in Ontario, even Canada, but that’s a discussion for another day!

 

Next Steps:

 

Look into midwives in your area and see if they might be a good fit as your perinatal primary health care provider. They are experts in normal pregnancy, birth, and postpartum health for you and your growing babe(s). If you need help finding a midwife, I might be able to help! Let me know.

 

And do yourself and your family a massive favour and invest in a Postpartum Doula! Ready? Book an appointment for a free discovery call with us today to continue the conversation. And share this blog post with someone else who you think should know about Midwives and Postpartum Doulas!

 

Thanks so much for reading!

 

Xo Naomi

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"We couldn't have gotten through..."

“We have three kids who were all under 2.5 years old during our time with the Doula. Naomi worked through the night a couple nights per week to give my husband and I some rest, as we had toddler twins and the newborn to look after through the day. We couldn’t have gotten through the days without the rest we got at night thanks to Naomi!” -B.F.

"We felt very comfortable..."

“Naomi saved us! We had twins and really needed sleep. She gave us a break! She was/is kind, caring, compassionate, and understanding. We felt very comfortable leaving our boys with her which is rare, given we are new parents. She exceeded our expectations tenfold! My husband, myself, and our two boys love her!” – A.F.

"Having her serene presence and focus on me, the mom,..."

“…reminding me to hydrate; listening; trying to find some solutions; was very soothing, and the other kids also felt more cared for, I believe. For a third time mom, it’s so much more about the other children… It’s so difficult to find time for myself, whilst having to take care of a newborn and worrying if the older ones will be a little left behind… no mom of more than one would enjoy the pampering and the attention and care if she felt not all the children were being looked after. So when Naomi minded them, it was bliss. In this context, not usually having the time for myself, the nutrition part was especially important. I was constantly reminded that for the family to be well, I had to prioritize my own wellbeing.” – M.B.

my mission

Helping new families have a supported and  transformative post-birth period.

Imagine: You’re in a pitch black room, and you know there is a door somewhere in that room. That door symbolizes sanity and wellness post-birth. Eventually, by feeling around, you will find the door– despite obstacles along the way. I believe in you. But imagine how much easier it would be to find the door if there was a little candle by the door, guiding you and making you feel a little less lost and disoriented, and more confident. That’s what a having a Postpartum Doula is like.

Book an appointment with The Postpartum Nest using SetMore

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Imposter Syndrome

Imposter Syndrome

Imposter Syndrome

2020

connection | courage | imposter | mental health | postpartum doula | vulnerability

Allo! 👋🏽 I’m Naomi. Really nice to meet you and THANK YOU for being here with me.

See, Ive been thinking of starting a blog for a WHILE now, especially on those special days where I feel I have something to contribute to the world. A topic of postpartum health and wellness; a cool new system that works for me and my family; some thoughts; an awesome recipe; a cool DIY thing…

 

But then something awful happens. An evil demon takes over my mind and tells me: “You dont have anything good to write about?! You can’t maintain a blog! Nobody even gives a HOOT about what you have to say!! You think you’re special or something???? You’re nobody. You’re an imposter.

 

OUFFF, this demon is f***ing intense!!! Butttt I suppose they’re right. 

 

And that, my friend, is where my spark of an idea gets put right out, and I agree with the demon and say “Yep, not a good idea right now, or maybe ever.”

 

But you know what?! Today is the day I say F**K that demon! So I picked up my pen and began to write. Yes, I’m old-fashioned like that. Also, my good friends gave me the push I needed (thanks, ladies!). And just like that, finally, my true self sitting in the stands with popcorn watching my pen dance on the page jumped up and gave me a standing ovation. 👏🏽 Damn it feels good. Self-love is so important to me in my life. It is a loooooonnnggg journey, that I am very much on, and have a long way to go yet.

 

So PLEASE do not EVER mistake this blog for a “Look at me, my life is perfect; I am perfect” kind of blog. If that’s your thing: YOU DO YOU!!!! I’m just myself: a recovering perfectionist; new mom of a wonderful 6-month old sunshine of my life; person who is learning to love themselves and fighter of demons; fighter of mom-guilt (and victim too); mental health enthusiast; wellness entrepreneur; Postpartum Doula; Hamiltonian 🍁; obsessive crafter; DIY enthusiast; system nerd; spouse to a great human being; proud WOMAN; binger of TV; a friend……. Very nice to meet you.

 

One of my first few reactions when my friends encouraged me to start this blog was “I’m terrified of becoming a cliché.” Why am I sharing my fears with you, person of the interwebs? Because like Brené Brown, I believe in the power of vulnerability as a tool for connection. And if you’re reading this, maybe you do too! Along this blog journey, which I am doing out of self love, if I can also inspire even one person to love themselves a bit more, and/or make their voice heard, then I am incredibly humbled and honoured. I’d be so so happy if this blog resonates with anyone. Like or comment below if it does. Tell me, what have you been putting off due to brain demons, that you could actually start today?

 

We’re all unique and we’re all somebody, with gifts for the world. So f**k off, demons! Come with me, friend, and we’ll fight together. Welcome to my crazy lovely world!

 

With love,

Naomi

You May Also Like…

Newsletter

Sign-up to hear more from me

"We couldn't have gotten through..."

“We have three kids who were all under 2.5 years old during our time with the Doula. Naomi worked through the night a couple nights per week to give my husband and I some rest, as we had toddler twins and the newborn to look after through the day. We couldn’t have gotten through the days without the rest we got at night thanks to Naomi!” -B.F.

"We felt very comfortable..."

“Naomi saved us! We had twins and really needed sleep. She gave us a break! She was/is kind, caring, compassionate, and understanding. We felt very comfortable leaving our boys with her which is rare, given we are new parents. She exceeded our expectations tenfold! My husband, myself, and our two boys love her!” – A.F.

"Having her serene presence and focus on me, the mom,..."

“…reminding me to hydrate; listening; trying to find some solutions; was very soothing, and the other kids also felt more cared for, I believe. For a third time mom, it’s so much more about the other children… It’s so difficult to find time for myself, whilst having to take care of a newborn and worrying if the older ones will be a little left behind… no mom of more than one would enjoy the pampering and the attention and care if she felt not all the children were being looked after. So when Naomi minded them, it was bliss. In this context, not usually having the time for myself, the nutrition part was especially important. I was constantly reminded that for the family to be well, I had to prioritize my own wellbeing.” – M.B.

my mission

Helping new families have a supported and  transformative post-birth period.

Imagine: You’re in a pitch black room, and you know there is a door somewhere in that room. That door symbolizes sanity and wellness post-birth. Eventually, by feeling around, you will find the door– despite obstacles along the way. I believe in you. But imagine how much easier it would be to find the door if there was a little candle by the door, guiding you and making you feel a little less lost and disoriented, and more confident. That’s what a having a Postpartum Doula is like.

Book an appointment with The Postpartum Nest using SetMore

Get In Touch

   Want to Touch Base?

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Book an appointment with The Postpartum Nest using SetMore