#154 | March Q&A: Postpartum Boundaries; Infant Lip Blisters; Newborn Separation After Birth; Legitimate Reasons For C-section; Splitting Parental Duties; Quickies

March 30, 2022

It is time for our monthly Q&A episode!  Thank you to all who submitted excellent questions. Today we are talking about managing postpartum boundaries with in-laws, newborn nursing blisters--are they normal or not? What can I do to ensure my baby is not separated from us after giving birth in the hospital--do they really need to leave the room to be examined? What are the actual reasons I might truly need a C-section? What is the best way to split parental duties after baby arrives? And finally, we finish with a round of rapid fire quickies touching on topics like leaking breasts, prolapse, enlarged feet in pregnancy, gestational diabetes, bathing babies and what surprises women most about birth!

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View Episode Transcript

I remember the conversation we were having a couple days ago via text about hospital reimbursement for vaginal birth versus cesarean. And if providers were incentivized to have vaginal birth by getting paid more for vaginal birth,

think of interventions as being chemical or mechanical. But that is very much an intervention to have your baby taken from you. That's not normal.

And it's not, it's not a benign one, it's very easy to hear what hospital policy is and to feel you have to succumb to it, even if it doesn't feel right to you. But you don't have to succumb to it. How do you know if you're with the right provider? Not just what you look for when it's wrong? How do you know when it's right cannot be that she simply absorbs having a baby and is expected to do the thing she typically did. But she might think that she can, especially like an overachiever type. Yeah, which is highly problematic. Not a good type to be or your own expectations. It's a trap. It is a trap. All right. Next question is what are some reasons a C section is required.

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, it's March and it just snowed three inches.

It's it's it's that month where you never know what it's never never see it again. T shirts one day snow boots. The next I got out and took a lovely walk in the freshly fallen snow was beautiful. So how do you want to start it? Well remember when we were talking about the nurse curse on the podcast the other day? The woman who that was sort of January q&a? Actually the other the other day? Yeah. The other day was a little while ago now. Um, you know that anyway, she heard the episode and she wrote in to explain.

She had mentioned what kind of nurse she was. And you were saying This is strange. I wonder if she's in another country because she said she was like a What did she say? She called herself a delivery nurse? Yes. And you were wondering?

Yes, that apparently it's a thing in the United States. So here's what she said. Hi, my name is Jennifer. I was listening to Episode 145 last night to January q&a. And I just wanted to say thank you for answering my question on the nurse curse birth trauma. I've been trying to switch my mindset a lot and actually doing pretty well. It makes me so ready to get out of the hospital industry and into healthcare that I believe in. Anyway, to answer your question, that delivery nurse role I do is called an admit nurse. I'm a trained postpartum nurse and have my RN certificate in Maternal Newborn Nursing. I am also trained in NRP or neonatal resuscitation. So I attend the delivery of babies and provide all their initial assessment wait length vaccines have in parentheses, and help initiate breastfeeding and provide education. I work in Denver, Colorado. So yes, I am here. And such things do exist. But most hospitals do not do this. Right. So in most hospitals, you have a labor and delivery nurse and you have a postpartum nurse. So you have labor and delivery and you have the nurse who helps assist the woman through labor. And then you have postpartum so after the baby's born, the mother and the baby are transported together to a different part of the hospital. They go to the postpartum floor. And this she's sort of in between.

And the most important takeaway is that ridiculous phrase nurse curse that's some one made up just because it rhymes and sounds catchy. That is not affecting her as a pregnant woman who was in tears. Apparently, someone came up with that.

Also, in our interview with Shelby, she said that she suffered from the nurse curse. Yeah, apparently it's very common. i It's a thing. I have three nurses in my HypnoBirthing class starting this Sunday. So I'm sure I'll be hearing much more about it. But they have their own subculture to deal with as far as those things. Is there anything among midwives? Where that comes up?

And everyone, like you had over a dozen people there at a party, that lowest birth. So they were expecting the birth to go very well and it did it. That's right. And I was expecting it to go very well. And it did. Exactly and the nurse curse is doing the opposite to nurses. It's implying that they don't expect it to go well. So that's, that's too bad because it gives them that extra obstacle to overcome.

Right? The difference is that in midwifery School where he are constantly talking about normal physiologic birth, whereas in hospital birth, you're constantly seeing all the interventions and the downstream consequences of those interventions. So your mind said is more that birth is dangerous.

Okay, well, we're glad to hear she's doing well and that she heard the episode. So let's jump in with our questions. Are you ready? Let's go. All right, so the first one says this. Let's see, I just found your amazing podcast not long ago, I have a question maybe you can answer. How do you deal with boundaries with family slash in laws postpartum, I wish to have no visitors for at least a few days, if not longer. last pregnancy I developed I developed postpartum anxiety. I had people visit the hospital in the first week and come over and just want to hold the baby. I didn't rest. I didn't need people to just come in and hold my newborn baby for hours. I'm not good at vocalizing or standing my ground around family. But this time, I want things to be different. When I talked to my mother about this, and the fact that I want to rest and bond as a family of four before receiving visitors, she said, can your husband bring the baby over to my house? Am I crazy about wanting some time to bond and rest with my baby? Absolutely not. Absolutely not. Show of hands 100% of people say absolutely not.

Can't your husband bring the baby over to my house? Is that a joke?

This is the problem that Pete as soon as you give, but you know, in pregnancy, it's all about the mother all about the mother and she gives birth and suddenly it's all about the baby. And she can sit there with postpartum anxiety. And no one is even recognizing it. Like it her daughter said, can we just stay home and bond and her mother is responding by saying well, can you bring the baby to my house like Well, that would kind of break the bond.

Right? Like the mother is thinking, well, the baby needs to bond with Me too. Which of course she's excited about. But yeah, a little respect a little boundaries, a little reverence, time will come that time will come. So as we always say the first two weeks postpartum, you need to guard them, like your life depends on it, those two, those two weeks are meant for you and your baby and your partner to just rest and recover. And mom and baby really should be together around the clock.

One phrase you hear us say this a lot on the podcast. So we're gonna say it again. Because I think it needs to become a part of everyone's vernacular, to say, this isn't serving me. It's kind of a gentle but firm boundary you can establish with anyone. So if you're having a conversation with your mom, and you're saying, Look, we want to bond as a family of four after the baby is born, and just assess how I'm feeling day to day. And she starts to push back to say, look, this isn't serving me right now to keep having this conversation, just please hear me and you know, we know how excited you are to meet the baby, we know that this is a really high priority. But it's really not serving me to try to talk about this right now and plan everything beforehand, we're just going to have to wait and see how I feel. There are gentle ways of establishing boundaries if for those of you who struggle with doing this. And then the other thing is, you know, I have a mini episode from Fall of 2021, about nonviolent communication. And it's very helpful with things like this, you can just simply say when you blank, I feel blank. So like Mom, when you ask when you get to see the baby, for you ask if my husband can bring the baby to your house. I'm not feeling heard, or I'm feeling anxious, because I feel like this is going to become a battle and the time when I want the most peace. Just practice that language and prepare yourself to say it if you really struggle immensely with boundaries, then put it in the form of an email, preferably email and not text because text gives that feeling like you have to keep responding. But just think it through carefully. Speak for yourself. Be gentle and firm and you need to act you need to practice this so that you can teach your children how to establish boundaries with you one day, honestly, everyone has to learn this from hopefully from their parents.

You can also say that your midwife instructed you to do so that this was sort of like doctor's orders. I mean, I hate that term.

But because there's no such thing.

Everybody kind of gets that. Yeah, exactly. The midwife strongly, right. I was I will say that to be like midwives orders, but ultimately it's up to you. But at least that kind of takes the burden of responsibility off you and you say, my midwife, my doctor said, I have to do two weeks in bed that it's important for my health and the health of the baby, my lactation consultant, whoever it is, blame it on somebody else, that's fine. Just say this is what I have to do.

And you deserve to relish that time. You don't get that particular time back.

And it goes so fast. You just don't realize how it seems like so much. But it really just flies by and it makes all the difference.

Next question is a breastfeeding question. So this one is for you, Trisha. My baby has white blisters on her lips after breastfeeding, but no tongue tie. Is this normal?

Hard to say.

Have you heard of that? Oh, yeah, I see it all the time. So a little bit of blistering, especially right here in the cute little you know, heart area of the lip can be totally normal. And that's just sort of from fix from friction from nursing. It If the lips are fully blistered all the way around, then it usually does indicate that the baby is struggling too much to hold on. And they're struggling to hold on either because the latch is, well, they're struggling to hold on because the latch is poor, either because they are not properly positioned, or possibly they have some type of oral restriction.

What does oral restriction mean? Lip tie tongue tie cheek tie something that is making it harder for the baby to get a wide enough grasp on the breasts. And they're working too hard to hold on. What is a cheek tie? No, it's called a buckle tie. It's where the cheeks are a little too tight to the gums is something attached inside.

Yeah, just just like you have a frenulum under your tongue and you have an upper frenum that connects your lip to your gums. And then you also have folds of skin that connect your cheeks to your gums.

You mean that's what we shouldn't have. But some babies do know you do have them you should have them. But they can be too tight. I don't think I have that. Let me say around.

My cheeks are free and clear inside my mouth.

Well, they are somehow at some point attached to your gums and the very, very back of the mouth. So as your mouth grows and stretches, these tissues also stretch but little tiny babies, sometimes they're a little too tight. And it's actually increasingly common when babies go in for tongue tie for them to cut the upper lip and the cheeks away from the gowns.

Oh, my God. No. Wow.

So I would say that this could be normal. Or it could be an indication it's a light. It's kind of like an orange flag. You know, let's take a look. Let's see what's going on. This one says, Hi, ladies, I hope you can answer a question for me. The hospital says they will have to take the baby away after a short period of bonding because the pediatrician will need to check the baby. I want to know what we can do so the baby is never without one of us. Thank you very much.

Well, the pediatrician, despite how it seems is not the priority. You have to remember you have all the rights, you can keep your baby, you can refuse to let your baby go. I mean, without a medical reason. There's there's no purpose for doing that. If you do decide to let your baby go for any reason, your partner can always go with the baby. But it's very easy to hear what hospital policy is and to feel you have to succumb to it, even if it doesn't feel right to you. But you don't have to succumb to it. And it is an evidence based it isn't better for your baby to go off without you. I don't want to like distress. Anyone who does do that? It's fine. But you have the right not to do that. And it really isn't. I don't even want to say it's fine. Honestly, it really isn't evidence based at all. I don't even want to say it's fine. I just don't want to distress anyone who's made that choice.

You want to know how midwives at home check the baby on the mother skin to skin.

Yeah, there's there's no separation. I mean, they're I mean, they might not it might not be on their body. It could be but usually

is I mean, it's that's the intention. That's the default.

I mean, I feel like most of the time, it's sort of like in the mother's lap or like next to mom on the bed, but she is in contact with their baby, it doesn't have to be like on her chest. I mean, you do have to take the baby off the mom to weigh and then you sort of it's easiest just to put the baby down on a flat surface to do the, the measuring. But the point is that the baby is never felt it's never felt that the baby is being taken away from the mother, it's she's right there, she could pick up her baby at any moment. And there's no reason in the hospital that the baby needs to go out of the room.

Hospitals have to stop doing this. It's ridiculous. It is it they have to stop doing this. They should do it exactly the same way the mother has the baby in the bed and the baby's just simply there on the bed with the mother. And they do the exam and it doesn't take long and they weren't exam can be done in a matter of minutes. We just shouldn't be doing this. It's don't let your baby out of your sight. I mean, unless your baby is going to the NICU. There's no reason it's unbelievable that they're still doing things that we know are not evidence based. And I just want to point out that bonding always happen. So if your baby was separated, or you were probably separated from your own mothers at birth, bonding always happens. But that isn't the point. The point is that the mother and baby are there still, in my opinion. And in my language, they're still one organism, they're not supposed to be separated, and that's why it feels wrong to be separated. And your body is prepared to release a whole lot of endorphins and it really can't get into that mode fully when the baby just simply isn't there, let alone what it does to breastfeeding. Right, right, a four hour window of time that your baby is out of the room. That's multiple missed feedings.

And you posted a really great item on Instagram a few days ago about the relationship between the number of times a baby breastfeed in the first 24 hours and significantly reduction in the incidence of jaundice.

Yeah, we should clarify, we should specify that that was specifically related to exaggerated jaundice. So it doesn't mean that your baby will have zero amount of jaundice because your baby can have jaundice, and it can be absolutely normal. But the number of times that a baby goes to the breast successfully, efficiently and effectively feeding out the breasts in the first 24 hours is directly correlated with their level of exaggerated jaundice meaning John does that might need to be clinically addressed. inversely correlated, inversely correlated? Yeah. So babies who went to the breast more than nine times in the first 24 hours, effectively, none of them in this particular study, which was 140 babies, none of them had jaundice that needed management is that otherwise pretty common because I know most I know most couples are told their baby has a little bit of jaundice. But it's those babies have some a lot of babies do end up having a lot of healed sticks to be tested or their be admitted for jaundice, or they have to go under the lights for a period of time. And that's just more separation, less breastfeeding. So if we can head that off, if we can cut that off at the start by you know, having the baby go to the breast nine times, that's a lot in 24 hours, though, the way we like to frame this a lot is one intervention always leads to another and just to have everyone recognize that separating the baby from you is an intervention. We don't recognize it as one, we only think of interventions as being chemical or mechanical. But that is very much an intervention to have your baby taken from you. That's not it's not a benign one. People think, oh, what's the big deal? You know, they don't need to eat right now. They're okay. They're, they're warm, they're safe.

Even clothing is an intervention. And you know, all this talk of like skin to skin like it's this funky, crunchy, New Wave idea. Every mammal on the on Earth is bonding skin to skin and we're socialized and cultured and and we have clothing and it seems like oh my gosh, remove that. Yes, of course, from nature's perspective, like, what is this thing between you and your baby so skin to skin is? It's it's optimal, because clothing in itself is an intervention. And it's very helpful when you just recognize all these things as interventions very helpful and to recognize that one always leads to another. So this is no exception separating the baby leads to other issues.

Again, skin to skin isn't just for the first hour after birth, right into skin is an ongoing thing. So the fact that we take these babies and we bundle them up and swallow them and these cute little blankets and put hats on them, and like Right, right from the get go, we're already that's a major intervention, just like you said, it's just take those clothes off, get that baby on you keep your baby with you, and everything else will work a lot easier from there. My.

Alright, next question is what are some reasons a C section is required? Not just quote recommended, but actually medically necessary? So let's talk about this. Because this is an important question. I always say to my clients, our work would be very easy if we just got hell bent on a vaginal birth and said no, no, no to any C section. But our work is difficult. And the education has to be deep and rich, because we have to be able to assess whether it's necessary. So I remember the conversation we were having a couple days ago via text about hospital reimbursement for vaginal birth versus Cesarean birth. And if providers were incentivized to have vaginal birth by getting paid more for vaginal birth, then vaginal birth would become a lot more lives would be saved, lives, family lives, lives would be saved. But the incidence of these unnecessary Syrians would dramatically decrease we know that at least 50% of them are unnecessary. And there's probably a lot more than that, actually. Because when you look at homebirth, or when you look at animes statistics, or you look at midwifery led care units, you have a cesarean rate 10 to 15% or less, and it's 6070 80% in some hospitals in the United States. So what are some of the real reasons? What are some of the actual like, Absolutely, you must have a cesarean birth, there's no way around this. Let's talk about that. So a couple things we'll do. Let's say let's start with the most common reason that people have C sections failure to progress, right. But failure to progress is a recommended and often unnecessary C section. Failure to progress is not the same as CPD, which stands for Cephalo pelvic disproportion. That means that a baby's head actually is too large to fit in a pelvis for some crazy and usually unknown reason. It's really annoying. Common, most of the time, it's really just malposition. The baby's head isn't positioned properly, so it can't fit through. And for whatever reason, we can't get that baby to make the necessary movements to get their head aligned in the right position to allow the pelvis to relax and open and the baby to fit through. So according to the American College of nurse midwives, they say that CPD occurs and one out of 250 bursts true CPD that's less than half a percent of births. That's still probably include some of those malpositioned.

Absolutely. I mean, are they really having all those women on their hands and knees or side lying? Or in the squatting position? I bet it's it has to be more has to be rarer than that. It has to be because we still write less than half a percent, right? And in C section rate is 33%. So yeah, so we're still looking at tons of C sections done for unnecessarily outside of CPD, you have cord prolapse, that that's a life threatening situation. So cord prolapse is when a baby's umbilical cord actually comes out through the cervix ahead of the baby ahead of the head. And this is a very dangerous situation because now the cord is no longer protected inside the body and the cord can be compressed and the baby's blood flow basically can be blocked. So it's it is an emergent situation. You want the head first, not the cord, right? So dangerous situation that could create restriction to the baby. And it is an emergent situation that requires Cesarean birth, most if not all of the time,

because the cord is the oxygen supply. So if it gets pinched at any point, that's your baby's source of oxygen. That will mean as your baby's head comes through. There's no way there's no other way the cord is going to get compressed and the blood flow is going to be restricted significantly. Okay. Okay, so cord prolapse. Certain types of breech we know that not all types of breech are safe for vaginal birth.

A transverse lie isn't technically considered breech, but that's the top reason for us is our infection as far as positioning, yes, yeah.

Yes, it is. So another reason that there are you know, there are four different types of breech birth and most of the time like a frank breech birth is compatible with vaginal birth. We know that we had to did an episode with Dr. Sue, but there are some breech variations that are not recommended for vaginal birth. Another one would be placenta previa. So placenta previa is when the placenta is fully blocking, the cervix is covering the cervix. So as the cervix is dilating, the placenta is potentially being stretched away from the cervix and your risk of bleeding is significant. And basically, the baby can't get through because the cervix, the cervix is blocked by the placenta, which is a dangerous situation. That's all that comes to my mind right now. I mean, obviously, fetal distress a true you know, fetal distress, a baby's heart rate that is too low and not coming back up not recovering persistent, low fetal heart rate, you know, you want that baby born as quickly as possible. And depending on where you are, in the birth process that very well, maybe via C section, and this is an important question to ask them. And what are some legitimate reasons for a C section where a C section is actually the safer means of delivering the baby. But you don't have to concern yourself with this too much. When you hire a provider, you actually completely trust. And that's where women are coming from. Sometimes when they ask this question. They're, they're so armed, they're arming themselves with this, and they want every possible scenario because they really don't feel absolute trust with their provider. So just assess whether or not that's where you're coming from with this question, but it is, it's a reasonable question to ask, just see if that's where it's coming from?

Yeah, that's why we always say one of the most important questions you need to ask your provider is, what is their C section rate? I mean, if you're working with a provider whose C section rate is more than 30%, then you've you you're you should be concerned.

Well, you can tell just by how they answer your questions, even you know, because you never really know what their C section rate is. But yeah, they admit to it being over and some do. That is a red flag. Be sure to check out our three red flag episodes from Fall of 2021 as well for a second and third trimester red flags. What's that?

Can you pull the number out of your hat? Were they one of them was 128 I think I'm gonna one eight. Hang on, let me guess. 118 I think the first one was 118 118

Your first trimester provider red flag.

Okay was the other one 120 26 124

I was for 124 provider red flags. And then what was it one was at 129 129 provider flags new third trimester. Good job two out of three. And then don't forget episode number. 122 provider green lights. So we've got three on red flags and one with our Barbara Harper, who we love on provider green lights, how do you know if you're with the right provider? Not just what you look for when it's wrong? How do you know when it's right?

I just I just want to say that in my community of all the couples I teach, I virtually never hear of anyone having a C section because of failure to progress. Because it is a non medically indicated situation, it is a manipulation of the situation to say, well, you're taking too long, and the couples I work with aren't falling for that, because that in and of itself isn't a reason versus Arian section. That's that would be a very risky thing to do, when all that's happening is prolonged labor. But the most common reason that I see is fetal positioning. And you almost can't emphasize enough for that expected couple how much it would serve them to invest in the right exercises and the right techniques and practices to increase the likelihood of a baby that's very well positioned. Yeah.

And when in labor, making sure that you are upright and mobile, because if you're not moving throughout labor, you're not getting the messages that your baby is signaling to you about how to move in a way that allows the baby to move down in to the pelvis and get optimally positioned.

Yeah, the head could be a syncretic. I mean, you don't know what exactly the situation is. But anything you can do to that is almost always the case when labor is taking too long. It's a positioning issue. And so then the question becomes, at what point do they call it CPD versus just more time?

I mean, I think the best outcome in that scenario, when it does have to be a C section is when the mother recognizes it and says, Okay, I have truly tried, I have truly satisfied this desire to experience my birth vaginally, and I recognize that it's time now to go to plan B, she has to get to the point of saying, okay, you know, of course, if there's fetal distress leading up to that, if there's an issue of medical indication leading to that point, they have to intervene. But if there isn't, she deserves to fulfill that.

Yes, when mom and baby are both doing fine, you go as long as it takes until mom decides she doesn't want to do it that way anymore.

But that isn't how we're typically seeing it. And that would make a big difference. And frankly, sometimes that difference also is what ends up giving her the vaginal birth she works so hard for because some women as difficult as it must be, they vaginally birth a baby after six hours of pushing, and it's that's exhausting. But she ends up with a vaginal birth and a much easier second birth if she has another baby in the future. That's the only thing that's the key.

I may have mentioned this on the podcast once before, but the most amazing pushing situation I ever witnessed was a woman who pushed for 18 hours 18 hours and she still ended up with a vaginal birth. And her you know, her babies had had to do a lot of molding to fit through. But it did. It did and the baby was absolutely fine. And she was willing to do that. Was it mild or intense? Because sometimes it's slower and milder and sometimes it's she slept through a lot of it not so she Okay, fully, fully dilated for 18 hours. She wasn't actively pushing for 18 hours. She was amazed, ready to push? Yeah I mean, it was she got to rest through that.

It was incredible. Yeah. But it can be done. I mean, this is just the body adapts the baby adapt the babies found a way to get through the way of the ability of a baby's head to mold to that degree and then return to normal is just it's an incredible feat of biology.

Was the head very misshapen, very much. So

I mean, you were it was sort of shocking.

I've seen some online that are honestly shocking to look at the shape of some babies heads when they come in if you do a web search on newborn head molding, you might be stunned at some of the pictures you see. And yet the heads come down. I'll go back to normal and I'll absolutely fine. I mean, this is what our bodies are designed to do. So its its nature knows, man.

Do the parents ever see the baby after birth like that and feel really uncomfortable with what the baby looks like?

Are you sure? I'm sure they do understand, however, you know, they're always being reassured that this is not how your baby's head is going to remain. It goes away incredibly quickly. Yeah, a few days, right. Yeah. Sometimes within hours. It's back to normal. Amazing. Totally amazing.

Aha, what's your best advice for splitting parenting duties after the baby is born? Don't get us started.

The mother gets two jobs. And my husband gets all the others and her two jobs are taking care of herself and the baby. That's it. Really?

I think No Yeah, I just I'm so happy that I guess Right. So we talk about this in our fourth trimester workshop. My advice is, just as when you moved in together, you had to sit down together and say, Who's doing what we live together now? How are we going to run this home? Who is typically going to do what? And you have to do that again. And the mistake that most people make, she'll somehow absorb all that housework because she's home all day. She can't. She can't do it. It's too much. It's too much for anyone to do. She's exhausted. She doesn't have the ability. She cannot absorb a baby on top of anything else that she's currently doing. There will be days, it's hard enough to take a shower. What do you think, Trisha?

Yeah, I'm thinking, Gosh, I should have done all that. saves me a lot of stress. Okay, so my comment about, you know, the two things basically applies to at least the first two weeks, ideally, the first six, right? I mean, first two weeks, we're talking, she does nothing, she doesn't touch a dish. She doesn't prepare a glass of water, she doesn't water a single plant. She doesn't feed the pets. She rests in bed with her baby. That's it. She feeds and she rests and she eats. And that's it. Beyond that, I agree with what you're saying, I think you really have to make a concerted effort to figure out what is realistic and what's not. And that's probably going to change. So you need to be checking in over time on this because most of us will feel like we can do a lot more than we can. And take it from us. We both over did things in our first postpartum experience and it didn't work out that well. They regret doing too much that perfectionist mindset and feeling like I was always behind. It's tough. It's really tough.

So I think you have to check in on it sort of regularly, like how's this going? What can I give up? What what needs to be? What needs to be shifted from my plate to yours?

I think you're right, do check in. I think that's the key because in the beginning the first two weeks Yeah, she doesn't lift a finger she doesn't pour herself her own glass of water she is taken care of while she's taking care of the baby. Four months out. It has to change she'll be exhausted and her partner should also be taking on a bit mentally exhausted. It just it cannot be that she simply absorbs having a baby and is expected to do the things she typically did before.

But she might think that she can so likely she will Yeah, especially like an overachiever type. Yeah, which is highly problematic.

Not a good type to be your expectations, please.

It's a trap. It's a trap.

It is a trap. Okay, quickies Alright, here is the first quickie. I don't normally leak in between consistent feedings and haven't seen the other breast the one she's not feeding on have a letdown at the same time. Is this any concern?

No. So you don't have to leak to have sufficient milk supply and the other breast doesn't have to drip and have a although there probably is let down in the breast it doesn't actually have to be dripping milk for you to have a letdown on either side. All right. The next one says prolapse. Is it common and fixable.

What what prolapse are we referring to? I have so many types. Megan core preps is not fixable. uterine prolapse, bladder prolapse, those are the two most common that you would have post baby and yes, difficult but fixable. Absolutely.

Yeah. With pelvic floor physical therapy, not with your obstetrician, depending on the severity. I mean, sometimes uterine prolapse results in hysterectomy.

It depends on how severe it is. After the birth. You mean like weeks later if it happened, weeks, months, even even years. Really Yeah, because the muscles just if they're very very relaxed, the the ligaments and the muscles that they just keep getting more lacks over time and the prolapse gets worse.

All right. Next one, why do some women's always wanted to know this? I'm so happy someone is asking. Why do some women's feet get bigger in pregnancy? Does that happen to you

know, happened to me where my feet got smaller after pregnancy?

I have been a size nine since like eighth grade. So I'm lucky they didn't get bigger parts of us just grow. Come on. That's the whole thing. You know, people say the funniest things like well, you weigh more, so your feet have to get bigger to balance your body. And I'm like, No, that is not. That makes no sense at all. They get a little extra growth kick and pregnancy.

No one knows why. And some for some women, it doesn't happen and for you, you went the other way. And they got Come on. They got smaller.

I don't think they actually got smaller. I swear it used to be a seven and a half just like it used to be 549453 Your quarters and the quarters.

That's so endearing. You're only five, three and three quarters and your shoe went down.

I don't know, I think shoes changed. No, no, my height didn't actually go down. I've always been. I've always been five, three and three quarters.

That's probably I was five, four. Okay, and that's, that's fine. Rounding is Okay, a little bit. It's okay. What else would everyone like to know about our feet and our height?

Okay, next quickie that wasn't very quick. All right, these are cookies. Gotta remember that. If I had gestational diabetes in my first pregnancy, will I have it in my next?

I want to say no. I want to say no, but it's possible. Yeah. Okay. So there is a correlation, if you had it once you are a little bit more likely to have it again. And that's just related to how the hormones of your body work. But there are definitely things you can do to try to not have it. Right. So balance, learning how to eat differently, losing Well, this is the perfect time to say next week, Wednesday, April 6, we have an outstanding episode dedicated, dedicated to gestational diabetes with wiliness rice. So we are definitely going to be doing a deep dive on that next Wednesday. Okay, so we'll leave it to her to answer.

Yeah, that was that's we're excited to release that one. All right. There are two more I've heard from another birth professional. So I this is clearly from a birth professional, that babies shouldn't be bathed after birth. And she writes in capitals for weeks. Is this true or false? Well, I wouldn't say shouldn't but you don't have to. They don't need to be bathed. You can if you want to. I don't think it's harmful. Today them? Maybe she's talking about vernix? And I don't think so. Because that absorbs quickly. I think she's saying should can they really go weeks? And the answer is they yes, they can. Your baby is coming out of a sterile environment and will be immaculate at birth. And you know, they don't really get dirty, you'll be taking care of the diaper area. So they're going to stay clean. Start bathing them when you're when you're ready. It's often several days or a couple of weeks in it's it's really not an issue.

I wonder if she's thinking about the cord and not getting the cord wet? Because I don't

think she I don't think she's talking about that. I think she's just talking about the fact that some providers say you can there's absolutely no rush, you can wait weeks, but she thinks shouldn't.

I think she just I think that's just her choice of words. Okay. I mean, now, some might say shouldn't some might say she didn't.

I don't know why. That's what I'm trying to. That's where my brain is going for what reasons? Yeah. The core, the vernix the skin?

I mean, the cord is off by them. The rinex is absorbed by them. I hope we answered that.

Well, I think we all know that it is safe to bathe your baby. Right? Within weeks. And if you don't want to, you don't have to. That's fine. Either way. Cool. Next question.

What part of delivery surprises people the most? Oh, we should ask people on Instagram. Definitely. Yeah, well, I'll do that.

I think Trent it's got to be transition.

Yeah, I think I was going to say see it just goes to show it's there's no clear answer. I was gonna say the the pushing stage really surprises people sometimes. Either how intense it is, or how satisfying it is. I think that stage, but yeah, transition is. I don't know, I would have said a lot of people also say the post birth like they meet the shaking after they didn't expect that. That's very surprising and unexpected. But that's a good question. We'll throw that out to our community and see what comes back. True. That's a wrap. All right. If you do love the podcast, we would be so grateful for a review on Apple podcasts as that does really make a difference for us.

Even better a share if you have a mom's group community or an Instagram page anywhere you're willing to share tag us anything that's fun and engaging with us but please share the podcast if it is serving you in any way and you think it might serve others and again, thank you so much for being a part of this. We'll catch you guys next week.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.

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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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