#109 | June Q&A: Confessions From Our Community; Postpartum Blues; Premature Rupture of Membranes; Breastfeeding & Oversupply; Changing Providers if High Risk; Pain Management; Foods in Labor; Making Hospital Feel Homey

June 30, 2021

We have a fun and informative Q&A episode for you this month! We kick it off with confessions and shares from our Instagram community related to: Comments from our own mothers after we give birth; Finding community when we have none; Fear of intrusive thoughts; What constitutes too much crying postpartum; Fear of managing the "pain" of labor; Best food choices for labor and more.

Next we dive deeper into our questions of the month including the topics of: Premature Rupture of Membranes; Breastfeeding problems related to having too much milk and a strong Milk Ejection Reflex; How to make your hospital birth environment feel more like a home birth; and, if and how to change providers when you are high risk.

Catch us on Apple Podcasts, Spotify, Google Play, Amazon or wherever you tune in! Follow and engage with us on Instagram for more helpful pregnancy, birth, postpartum and breastfeeding information.  If you love us, please give us a review on Apple Podcasts and thank  you for being part of our community.

Referenced Episodes:

The Terror of Instrusive Thoughts

The Fourth Trimeseter: Interview with Kimberly Ann Johnson

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Between episodes, connect with us on Instagram @DownToBirthShow to see behind-the-scenes production clips and join the conversation by responding to our questions and polls related to pregnancy, childbirth and early motherhood. You can reach us at Contact@DownToBirthShow.com or call (802) 438-3696 (802-GET-DOWN). We are always happy to hear from our listeners and appreciate questions for our monthly Q&A episodes. To join our monthly newsletter, text "downtobirth" to 22828.

You can sign up for Cynthia's HypnoBirthing classes as well as online breastfeeding classes and weekly postpartum support groups run by Cynthia & Trisha at HypnoBirthing of Connecticut

Please remember we don’t provide medical advice, and to speak with your licensed medical provider related to all your healthcare matters. Thanks so much for joining in the conversation, and see you next week!

Support the show (https://www.paypal.com/paypalme/cynthiaovergard)

View Episode Transcript

If someone can't have a home birth, What tips do you have for making a hospital birth feel more like the home environment.

But if your group B strep negative, and there's no presence of meconium in the fluid, then you really can talk to them about buying more time.

How do you find postpartum support when you live in an area with no friends or contacts you fully trust?

But if the mother is like, well, he's better than most. How do you know? Well, you don't have any of the others as your husband. It's very dismissive. Like it doesn't matter fine. Maybe he's good compared to the others. But maybe I need more than that. Maybe you know, you need to hear specifically what I'm struggling with an honor that

Yep, and hashtag This isn't about  you mom.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hello, everyone, and welcome to our June q&a episode. Trisha, I know you wanted to start by reading something. So are you ready?

Yeah, I thought it might be nice to share with our community some of the feedback we've been getting about the podcast. So our most recent review that came in was somebody brand new to us, who just found our podcast and said, l o v double exclamation point. I found you ladies on Instagram recently and decided to check out the podcast and I am so thankful that I did. I'm 11 weeks and five days pregnant and I want to have an empowering natural birth. You ladies have inspired me with questions to ask my midwife and also to take notes of things that I want my birth plan. I 100% recommend this podcast. Taylor.

I'm terrible at interpreting emojis Trisha can tell what emoji that is. It does rosy cheeks.

It's a little it's I don't know. Mine's black and white. My eyes just this little smile. It's yours. It's black and white. Yeah. That's funny. My interesting color. Okay, we'll figure that out later. Well, lucky you. Anyways, so yeah.

Amazing exclamation point. I found this podcast several weeks after giving birth to my first child. I had already researched so much about childbirth while pregnant. But this podcast continues to teach me so much more. I also love hearing other women's stories about pregnancy or life with their new baby. It's nice to know that I'm not alone with the thoughts or feelings I have during pregnancy and postpartum. I cannot give this podcast enough praise for how wonderfully helpful it has been for me. That's an awesome review.

Yeah, I wonder if that's partly in response to that incredible episode with Lisa who talks about her intrusive thoughts and her fear of knives and all things sharp, postpartum is a very emotional, and incredibly honest episode, but just so valuable. Because when women hear that they realize they're not the only ones who are, you know, we can really think we're going crazy. And it's just a textbook example of postpartum anxiety and intrusive thoughts.

Well, and that, and that indicates that we're doing our job well, right. I mean, our goal is to have this feels like a community that it's relatable, and resonates with you. So that kind of says it. All right, though.

So we have a whole lot of things that came in on Instagram first, right, Trisha that we put out a little brief, what did we say? Like question or compassion, just like a quick one liner things that you wanted to share with us that we could share on the podcast. So here are a few things that you guys said to us through our stories.

Okay, this one says, I know that people mentioned how much closer or more appreciative they feel of their own mothers after having a baby when I'm feeling frustrated with my husband and tell my mother, she says to me, you know, you have a great husband. He's good compared to the others. Wow, that one really got a lot of responses, actually. Because we responded to her and then other people responded to the conversation. Go ahead. And yeah, it's just compared to others. What does that mean? What I wrote on Instagram, I reposted my response that I wrote only one of you is sleeping with them. Because who knows anyone's partner until you're married to them and even a mother in law. And the other thing is, and this comes up so often, with postpartum women and their moms and their husbands. I feel like so many mothers who have become grandmothers, I feel like they can't get themselves out of what they're observing in the marriage. They are comparing like, does my daughter have a better husband and oh, at least he changes diapers. At least he does this at least he cooks. Sometimes their bar is really low. Right? He's not enough but they Yes, good enough or so much better than I had is so much of the message, but that irrelevant and that has nothing to do with what her experiences in her own marriage. So look, do you want your daughter to be able to go to you as an as a safe and healthy outlet when she has normal grievances about her marriage or do you not? Right? And we're not talking about abusive relationship here, we're talking a normal marriage, and everyone has to have a place to go, I hope my husband has a place to go when you often talk about me, you know, it's you need to have people that you can talk to and say, all right, I need to just breathe through this one. They really frustrated me today. But if the mother is like, well, he's better than most. How do you now? Right?

Well, you don't have any of the others as your husband, it's very dismissive. Like, it doesn't matter fine. Maybe he's good compared to the others. But maybe I need more than that. Maybe, you know, you need to hear specifically what I'm struggling with and honor that.

Yep. And hashtag This isn't about human. boundaries, right? Yeah. And it's hard. And, you know, for many women, their mom is the very closest person to them. And there's an intense love and bond. And all the more reason you have to establish really good boundaries, right, and create healthy boundaries and tell her how she can best support you for one. And what's okay to say to her and what's not. And sometimes she has to keep her own marriage and past out of what you're going through right now.

It's just something we learn over time, you know, we all learn to get better at boundaries as we mature and have more experiences.

And if we hold each other to higher standards, and get therapy.

Sure. Alright, and that's you. Let's go on to the next one. Because we have a lot to talk about today. I want to VBAC without meds for my second birth, but I'm terrified I won't be able to handle the pain. Do you have any tips on this? I remember the response to this. And I think it was excellent. I forgot what I wrote. I'm so happy. You remember, I was just thinking I remember. I remember one. I remember one component of it. And that was that you said, Don't ever say the word pain again. Yeah, strike it from your vocabulary. Yeah, eliminate that word. I mean, we talk a lot on the podcast about how it isn't. Paint at birth, it's a powerful experience. It's an intense experience. But it is not pain is something we associate with something gone wrong with something being wrong with a problem with an injury.

At a minimum, we don't want to go into it anticipating pain, because that's how you're going to interpret whatever you do experience. If you go into a marathon, being afraid of the pain, you're going to get that first little sharp sensation in your side and be like, Oh, my god, there's the pain. And you we just don't want to do that to ourselves. In this case. I did just remember the other thing I said, I said, make the goal, not a natural birth, make the goal, a safe, satisfying, positive experience where you can say Looking back, I felt heard, I felt seen. I felt respected. Make this your goal, not how do I get through this. Don't worry about getting through it, plan a satisfying birth where you feel seen and heard. And what happens is when you plan it with the right provider, and the right tools for getting to labor, what ends up happening as a result much more often than not, is a natural birth. And that's why the Golden HypnoBirthing is one example isn't a natural birth. It's a calmbirth calm and in control when you're calm and control, lo and behold, the majority of women end up having a natural birth.

And that's in part because our body is built to have its own innate natural opioid response. We actually have built in pain relief for birth if no one used the word pain, but the built

in comfort. Built in comfort Yeah. I don't even think I don't even I don't ever think the word pain, working with pregnant women and postpartum every day. I swear like that word is I hear pain. My first thought is to fake every time stubbed toe something like okay, I need help someone get me help.

But the these moms who are getting, you know, routine prenatal care with midwives or obese or having hospital births. They're being that word is constantly being put in front of them. And yes, that is how it's described. You know, how's your pain? How's your pain? How's your pain that's constantly being evaluated during birth? So it's a very scary word. How's your comfort? How's your comfort? Or how's your intensity? Yep.

They don't even have to ask me what they do. They don't. It's like if you're having sex and someone comes in and goes, how's your arousal? Are you aroused yet? How is it on a scale of one to 10? It's like, you're you're ruining my moment here. Leave me alone. This is very personal. You asked me one more time. I'm never getting around. Right? Exactly. This is what I mean. We don't want to bring her out again, experience right into her conscious mind. That's not the part of your mind that supports your birth. That's what HypnoBirthing is about. That's how every other mammal gives birth. So that's the big secret. The secret is we stopped describing our birth to others, we stop analyzing it, even contemplating what we think we're experiencing. That's why I say to partners, don't ask her questions, right? Like, I have a smoothie for you. Right, here it is. Alright, let's go to the next one. Yeah. The next one, simply says this. My husband didn't want help after the baby was born, I was so infuriated. I'm sorry, what's your husband that went home with the baby all day long? What What is this what we're talking about? is she saying that, that he didn't want to provide for professional support?

How's that? Or maybe he didn't want the mother or the mother in law, or anybody there to help her. He just wanted to keep it her responsibility, and maybe you know, the three of them.

That's, that's not his decision to make. If we're putting finances aside, and they weren't talking about how much they could afford, like, this has nothing to do with his lifestyle, if she's home with the baby, which I think is the presumption here, isn't it? Who is he to not want to help if he's a control mechanism? To me? I mean, that's, well, there are a lot of partners out there and husbands out there who say, Well, my mother never had it. And it's like, right. Do you know how much she resented your father? Do you have any idea they still married? happily at bat, when's the last time they had sex? Yeah, that's a good one. That's a good one was how much sex were they having? That's, that's funny. I like that one. But there are times in your household where one of you has a greater need for something than the other. It's like, my husband, handles everything with the cars. And the other day, I forgot what he did. But it was something extremely sophisticated that I was surprised he knew how to do. It's like, it's not for me to say you're not going to have help on this one. Take that to the dealer or you fix this yourself. I stay out of that, because that's his domain. And I respect him. And I think he knows when he needs help. I trust him to make those decisions.

And and just Yeah, but you know, when we're talking about birth, I'm sorry. But every new mother needs help. We are not meant to do this. She should have an abundance of help postpartum from the right people. But remember, everywhere around the world, when a woman gives birth, there's a village of people supporting her bringing her food, bringing her comfort, giving her What did Kimberly Johnson say the other day in our interview massages
every day daily massages for a new mom. I mean, come on. Where?

Where is that I was literally jealous. I was just like, oh my god. 40 days of massages. I'm moving to Thailand. Oh, my God. So if you didn't catch that, it is a phenomenal listen. She's the author of the fourth trimester. So make sure you listen to it. And then make sure the people who support you and love you listen to it as well, your partner, any family members, they need to hear that episode, perhaps even more than you do. How much support does the mother need? She takes care of the baby, everyone else gathers to take care of her. Alright, what's the next one cites?

How do you find postpartum support when you live in an area with no friends or contacts you fully trust?

Oh, boy, the fully trust will, I am happy to hear she's aware of that. Because that is really important. You have to find it online. If you truly don't have it there I believe you do. I believe if you look enough, and postpartum women are motivated to travel and visit with each other even once a week. I think you have to really make it your jobs to jobs, plural meaning you and the other adults in your life who love you to find friends in some kind of reasonable radius, even if it's 45 minutes, I believe they exist. Start with a yoga studio, start with see if your local hospital has a group but otherwise online support. That's what we're doing all the time to women around the country. We're online all the time.

I mean, that is one of the beauties of social media is there's so much access to people and it sounds like you're going to have to start from ground zero and find new people. So find a postpartum support group. And remember that postpartum isolation is the root cause of perinatal mood disorders. So it is extremely important to not feel isolated is extremely important to acknowledge this issue and start working toward resolution.

Yep. And you can contact us of course, if you want to be a part of any of our online support programs, we have a weekly postpartum support group and a bi weekly prenatal support group on a Friday night and we expand to additional groups when we get overflow. So there is plenty of support around you. and here if you need it. How do I find support with intrusive thoughts or fears of them when the baby arrives? a fear of fear a fear of intrusive thoughts? Same thing as the previous answer. I would say, Trisha, don't you think we just saw I think,
yeah, and also just recognizing that intrusive thoughts are just that their thoughts and they are a sign of you know, a possible underlying postpartum anxiety but they are temporary. And they are something that with the right support you can work through.

And there's nothing you're doing to cause them and they feel real, and they're not. And that's the problem with intrusive thoughts, they feel real, it feels like you're getting insight into something that's going to happen or you're getting some kind of vision. And that's only a reflection of your attachment to your baby. And that's why women suffer intrusive thoughts, but you have to remove isolation. So you have to tell your partner, they might not be educated enough to give you the support you need. But keep telling people until you get the support you need, you can always reach out to us again, it's if your partner or the people who love you are going to say things like, you know, you have to not worry so much, or you're just tired. You have to keep looking for support. You have to have a place to go where you're going to be felt and understood. Did I share the story about the woman who was running around looking, she was at a playground with her husband, and she was frantically running around looking for her child, and her child was on her shoulders and she was holding them by the legs over her shoulders. She ran over her husband like, Where's the baby? Where's the baby she frantically ran over and the baby was literally the toddler was literally on her shoulders. And you know you if you're not a postpartum Mom, you're going to laugh at that story. If you're a postpartum Mom, you're going to cry at that story. And you're going to think that could be me any day. That could be me any day.

Yeah, I feel like I can definitely relate to moments like that having had very similar experiences, so that attachment can lead to suffering. And we don't want to suffer alone. We want to realize when we're normal, and it's going to be okay, it's going to get easier. This one says, oh, how much postpartum crying is normal before you should seek help? That is so good that someone else this I never would have thought of addressing this. Tears are not your gauge. Tears are not your measurement of how you're doing emotionally postpartum. You can have postpartum rage and never shed a tear. But suddenly be swearing and cursing more than you've ever in your life or raising your voice more than ever. You can quietly suffer postpartum OCD, and you're just nervous and you're not sleeping and you're checking things a million times, and you're not crying. So tears are not your gauge. Not feeling like yourself is one of the best ways to evaluate. So if your partner says You don't seem like yourself, or if you say to your partner, I don't feel like myself. That's a textbook indicator that you need to make sure you start getting support.

Yeah, I would just also add that excessive crying is a clue. So tears are not your gauge because you can have other perinatal mood and anxiety disorders like you mentioned OCD, anxiety, rage with no tears, but somebody who is crying excessively beyond those first two weeks pass those initial kind of baby blues is certainly a clue to more of a postpartum depression
Trisha. Yes, that's a very important clarification. So you the answer to the question is officially if it's more than two weeks that you're feeling off. If it's more than two weeks that you feel like you're crying more than you might expect to just for maybe being tired or a little overwhelmed. More than two weeks is the timeline. Yeah, and and to know that with no tears, there can still be an underlying problem. And I think that's a really important point that most people don't realize.

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This is funny because at the start of the episode, we're like, you know, we'll just read through these real quick and then get on to the questions. We won't even comment. It's gonna be we're just gonna read them. Yeah. I can't help ourselves. Alright, if we didn't have stuff to say, Trisha, we wouldn't have a podcast you out. But it is kidding ourselves. It's funny that that was my intention.

Here we go. What are good foods to eat and labor. Food, eat, drink, easy things. Anything that can be consumed via a straw. Anything that's easy to digest. Anything that is electrolyte balancing, coconut water for water, people make labor aid things, you know, make their own concoctions with lemon and salt and whatever. Oh,

that's interesting. I could go for some labor aid. Yeah. Right now I made two glasses of lemonade last night I was craving labor aid. Yeah. And the reason that Trisha mentioned anything that digests quickly is that the faster you digest something, for example, you digest most fruit in 20 to 40 minutes. That's how quickly you're going to derive energy out of it. enzymes, nutrients, and your body won't be directing energy toward digesting while you're also in labor. But that said, as Trisha said, eat, just eat.

So it It also completely depends on where you are in labor in early labor, eat whatever sounds good, eat a big meal, eat whatever, eat scrambled eggs and toast, eat a hamburger eat, butter, a salad, whatever sounds good to you. Later in labor, when you're really in that active stage, you're not going to want to eat anything that you have to chew on, you're basically going to want to drink anything that is easily digestible and preferably with a straw because even just to take the energy and focus to hold a captain, you know, tilt your head back and drink and swallow is a distraction in labor. So that's why labor kits always include stress. bendy straws,

too. Are we into the full on questions? Now?

I think we are actually now ready for our questions after all those fun comments.

Okay, this one says I'm curious to know if water breaks first. And labor takes a long time to progress. Is there a way to avoid zerion section. I'm going for a VBAC after two c sections and looking for low intervention ways to be successful. Any tips would be so lovely, I love you guys, and your perspective on birth. So a few quick things on a very complex topic. When I teach this topic in class, it's a good 20 to 25 minute discussion. First of all, many women assume labor will begin with membranes releasing or water breaking, it only happens in fact, about 10 to 15% of the time. So that's the first thing to know, it might not happen. The second thing is if your membranes release, there's a question first as to whether you're a group B strep, positive or negative, if your group B strep positive, you have a special circumstance on your hands. And you need to call your midwife or doctor and talk to them about what your protocol has to be. And when they'll recommend you're getting antibiotics. If the fluid is clear, and Trisha can get into all of this, that's a different story. But the vast majority of women, it's somewhere between 80 to 85%, will go into labor at some point in the next 24 hours. So if your membranes release at three in the morning, you wake up in bed and you have this fluid that's leaking by 3am. The following day, odds are greater than foreign five labor will have begun, it doesn't mean you'll have your baby, but labor will have begun at that point.

50% of those cases will go within 12 hours.

I know and I think that's easier because when it's over 12, the providers can start to get impatient, but if your group B strep negative, and there's no presence of meconium and the fluid, then you really can talk to them about buying more time. The last thing I'll say about this I'll just because I'm keeping each of this topic short, and I want to see what Trisha has to say is many of you in third trimester are craving citrus like never before. It's one of the healthiest things you can have. Research came out in 2007 that showed when women consumed natural sources of citrus like lemons, limes, oranges, they made very strong membranes. Your amniotic sac can be vitamin C, vitamins and natural sources of vitamin C. Yeah, I should have phrased it like that. For me. I was always craving citrus. So I see it that way. Big time. Oh, it was amazing. I loved it. So you know, amniotic sacs can be thin and practically transparent, or they can be incredibly strong and thick and virtually opaque. So if you have Group B strep, or you have some kind of hope or interest in your membranes, not releasing early, though, don't worry if they do, you might want to make sure you're having a lemonade day. It's an incredibly healthy for you regardless.

Adequate protein and pregnancy is also another thing that contributes to a stronger amniotic sac. I

did not know that. Yes, I never measured protein in my pregnancy and I'm, as you know, pescatarian so I never thought about it, and made nine and nine and a half pound babies. So I didn't know if it was okay that I didn't measure it. It's just not my nature. But how much do they normally

have a you have a very healthy diet. So you probably were consuming.

I had chocolate every day of my pregnancies other than that I was eating quite well. Yeah. Nothing wrong with that. No, I agree. There wasn't.

So yes. And also just to say in her question, she said if my water breaks It takes a long time progresses are a way to avoid a Syrian. And absolutely, of course, water breaking prematurely does not necessitate a Syrian birth. So the reason that people can sometimes end up with a Syrian birth if they have premature rupture of membranes is because the provider gets involved and then the pitocin gets involved. And then the birth gets off to an induction or augmentation, which, as we know, puts you at higher risk of having a Syrian birth. If your water does break prematurely, meaning before labor begins, there are a few things to be aware of. And to think about, there is an acronym and the acronym is taco, which stands for T stands for time, it is important to take note of the time when your water's released, because there is a Cynthia said a little bit of a timeline that's put on you, especially if you are GBS positive. The second thing to take note of is the amount so you can have your bag of waters break. And it can be just a small, tiny little leak that actually can sometimes seal right back up. Or it can be a gushing explosion of all the water coming out at once, or it can be anywhere in between. So amount is the important to note because if it is, like I said a small leak, that's different than a frank rupture. So when we talk about timelines of when women go into labor those timelines a woman who has a frank rupture is a lot more likely to go into labor sooner than a woman who has a small leak. But the woman who has a small leak is also a lot less at risk of the potential downsides of having your water break early than a woman who has a frank rupture. So amount is an important piece. Color is another one and amniotic fluid is basically supposed to be clear, you might see some little white chunky things in it, but it is essentially a clear fluid. If it is not clear if it is yellow tinge or brown, that can be a sign that there's some conium in the fluid, which is not necessarily a problem in itself. But it is something to be alert to because meconium is baby's first bowel movement, which can be absolutely normal if you're near your guest date. But sometimes it can also be a sign of stress and the baby. So we have to just be alert to that. If your water breaks, and you have thick, pea soup, like looking fluid coming out of your body, that's a danger sign. So that's that that's a situation that you would want to alert your midwife or a doctor to immediately and be going to your place of birth. The last thing to take note of is odor. And basically amniotic fluid should be near odorless, it sort of has like a sea salty, sweet, briny smell, if it has any smell at all. But if you had your water break, and you noticed a really foul smelling odor, that could be a sign of infection, which would be unlikely, but it's just something to be alert for. Or if your bag of waters has been ruptured for a period of time. And over time, you start to notice a foul smelling odor. That could be a sign that infection has developed. Alright, next question. If someone can't have a home birth, What tips do you have for making a hospital birth feel more like the home environment? Well kick all the doctors out of the hospital. Burn the birth gowns and the white coats.

Yeah, I mean, how do we do without the IV pole? Yeah, there are there are two ways to look at this right one is what kind of care you'll receive. But the other she might just be asking about atmosphere. So if you're just asking about atmosphere know that you have the right to privacy in that hospital room, you have so many more rights than they will even make you aware of. You can kick people out, you can make sure there are no observers at the birth. You can have only necessary hospital staff. You can have staff replaced if you don't feel safe with any of them. You can make the lights dim you can play music have noise reduction headphones. I don't know about lighting candles in hospital Trisha, I'm guessing that's a no no.

I would just bring those little flicker ones. You know the the fake candle things. Yeah, yeah. Also, I would a few really practical pointers. Bring your own clothing. Don't you know, forget the hospital gown. We had we answered that in another q&a as well about Do I have to wear the hospital gown? And the answer is no. And you can make yourself feel a lot more comfortable and a lot more like you're at home. If you ditch the gown and you wear your own clothes. Definitely dim the lights, turn those horrible fluorescent lights off. They are not good for the physiology of birth. And they can give you a headache, really. I mean, they're just terrible. So you might want to bring your own, like dim light like a little bedside, quartz lamp or something or like a soft light. Bring some things from home that make it feel more like home. You can bring your own comforter to put on the bed. You can bring Can you bring your dog

if it's little

nephews, you can bring your cat that you can bring your cat

oh if only animals are amazing during birth, that would really be The best thing for everyone, they're so amazing during birth.

They really are, they really are. And they're so in tune with you. Another thing that Barbara Harper, in our episode on waterbirth said, Absolutely 100% no matter where you're giving birth, especially if you can't give birth in the water, bring something that has the sound of water. So like a little water fountain, or you can have a big old hospital bag with all this stuff. But just if you get one of those pods, and you put them right outside the hospital window, you deliver the things through the window. No, but in all seriousness, the sound of water is just that in itself enhances and increases oxytocin. So dim lights, water, a few things that remind you of home, be comfortable, and maybe your cat.

This one says, I listened to your Instagram Live at the end of May, about obstetrics violence and changing providers. But do you have any recommendations for someone who is high risk with very few options for alternate providers?

Are you high risk because you're 35 and considered a geriatric pregnancy? Or are you high risk because you have gestational diabetes, and you've been labeled high risk, but you truly are not high risk. So that's the first thing to do to you know, really be able to give yourself enough education about why you're high risk, ask the right questions to determine if you truly are without options, because if you are potentially labeled high risk, but of those two examples I just gave, you actually have a lot more options than you realize. Now, if you have some underlying medical condition or something that really truly limits you to very few providers who are experienced in your, whatever the complication of your pregnancy is, you are with limited options. And then all we can do with learn as much as possible about our situation. And advocate for the you know, find the things that you can advocate for like skin to skin with your baby after birth, or, or the small things like not wearing the hospital gown, or just finding the little ways in which you can feel like you have more ownership of your birth experience while still needing this high risk care.

Those are all really good points. The only thing I would add to that is no one will teach you your rights, you're not going to go to the hospital and be informed of your rights, for example, to change providers mid birth, or to have people leave the room if you want privacy, or to dim the lights. So learn your rights, and get well educated. There are three things that will determine the outcome of your birth. The first one is your provider. And according to our interpretation of your questions, you don't have a lot of flexibility there. So that's one of three things only. The second is you your physiology, your response to birth, whether you go through your birth in your most calm, trusting state, and if you are in a state right now has been worried about the welfare of your baby, we want to get you past that before you give birth. And we can that can be done. And the third thing that will determine the outcome of your birth is the position of your baby. So then you want to put whatever work you can into ensuring or doing everything you can to ensure that your baby is as well positioned as can be. And that would of course point to Gale tele spinning babies, there's so much you can do there to influence that, and to dramatically increase your likelihood of a much easier, faster and more comfortable birth. Yeah.

My baby is four weeks old and has been feeding well at the breast until recently. Now he has started to get fussy while feeding and pulls off from my breasts frequently. I'm confused because I know I have plenty of milk, sometimes so much that it spreads across the room. And I have plenty of milk stored in the freezer. So I just don't get why he seems like he doesn't want to feed. It seems like it's getting harder, not easier. Help. I think I know what's going on here. By the way, did you ever experience that hit that spray with your milk? I figured she was exaggerating. I think she probably was a little bit but she might not be I've seen it happen. I've absolutely seen it happen. I mean, you can literally hit the person across sitting across from you with it when you have a strong milk objection, self defense, maybe if needed. Clearly, she has a strong milk ejection reflex. But I think that there might also be another thing going on here, four weeks into breastfeeding if your baby was previously feeding well, and now he's starting to get fussy and pulling off your breast and you're mentioning that you have plenty of milk stored in the freezer. I think what's happening is that you are in an overproduction mode or oversupply. And this can happen for one of two reasons it can happen because mothers are pumping in addition to feeding their baby. I see a lot of moms today using the haka, which is an amazing Li helpful for breastfeeding when used properly, but a lot of times when moms and babies who are having a healthy breastfeeding relationship are collecting milk in addition to what the baby's feeding and storing it, whether that's via the haka, just collecting the milk on the side that the baby's not feeding on, or if they are pumping, maybe because they're going back to work in a few months, or they were worried about not having enough milk, and so they're just kind of in this continued pumping cycle. If you are feeding the freezer, in addition to your baby, you are putting yourself in a situation where supply and demand are no longer in sync. And your breasts are getting overly full in between feeds, which makes the milk ejection reflex even stronger and more powerful, and it can make for fussy feeding babies. So without going into too much more on this, it sounds like you probably need to speak with a lactation consultant to add four weeks breastfeeding should be getting easier, definitely not harder. And if your baby's getting fuzzier at the breast with these conditions that you're talking about, I think you are probably producing too much milk and there are strategic ways of slowing down your milk supply to get supply and demand back in sync with each other without compromising your milk production too much or potentially getting plugged box and mastitis because that can also happen when we start to slow down our supply. So this is best done with the help of a skilled lactation consultant.

Is it five o'clock yet? Oh, I can't wait. We're going to it's such a fancy dinner tonight. We're celebrating Well, we're not. You know what we're celebrating our 100th episode coming out. But also in the past 24 hours we've gotten more than 600 new Instagram followers Trisha almost 700 in the past 24 hours easy. Yeah, I know.

Awesome. Thank you for being part of our community. Thank you for being and meet us for dinner. We'll be in Westport at 530

drinks on us. I know Wait, this is a predominantly non drinking crowd.

Don't worry guys that day will come again.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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