#254 | February Q&A: Vomiting in Labor, Cord Traction, Pacifiers, Probiotics and Plugged Ducts, Breast Milkshake, PPH, Bicornuate Uterus

February 28, 2024

Welcome to the February Q&A with Cynthia & Trisha. To kick things off, we share some of your New Year's Resolutions--don't miss this as Trisha makes Cynthia momentarily speechless! Next, we dive into your questions beginning with: Is cord traction really necessary to birth the placenta? Another woman explains that she always throws up in labor right when her water breaks and asks if this is normal. Also, a new mother is curious if giving her baby a pacifier will be harmful or helpful...and more.  In our extended version of today's episode, we answer several more questions about the breast microbiome and the occurrence of plugged ducts, uterine prolapse and how it may impact a future pregnancy, how to care for the ntact) penis, non-stress tests, bicornuate uteri (you read that right) and what constitutes a postpartum hemorrhage.

As always, we thank you for your questions an encourage you to call in at 802-GET-DOWN or 802-438-3696.  Our extended and ad-free episodes are available on Apple subscriptions and our Patreon page. Thank you for tuning-in.

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View Episode Transcript

Hey there. This is Jessica from Atlanta. And I've actually got a question on behalf of one of my really good friends who is pregnant. And at her first ultrasound, she was about nine weeks and they said, it looks like from some angles, you have a bi coordinate uterus, what needs to be done for care of an uncircumcised baby?
An intact baby is the first thing that needs to be done. Good language could change. Yep.

What questions do I ask when I'm interviewing? A doula for my question I don't believe I've ever heard it asked before, is about pacifiers. It just feels like our bodies don't really need someone to manage the placenta every time and I'm wondering, what is the best practice as far as management of the third stage with low risk women and homebirth.

It actually helps the cervix open. That's a good thing. If it happens, if it doesn't happen, it's not a bad thing.

The throwing up helps it open really? Yeah. Like the physiologic experience of throwing up open mouth open cervix.

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.

All right,

yellow, I'm no longer saying hi.

We don't say you don't say hi. Should I don't say hi. Do I should I say hi?

No, if

you feel like FTTN people get the joke. Do you think they know that though? They would I don't know diehard fans to really know the story

they would have to have been with us from the beginning or beat? Well, there

are a lot of people binging we hear that all the time. They're starting at Monday just binge but

but we need to ask that question. We need to take a poll and see how many people who find our show. Start with Episode One.

Oh, God, forgive us. Oh, he's listening.

Go backwards, start out start current and move

back backwards until you just decide to stop. Yeah, it's it's so funny, having a podcast and just memorializing these episodes. Thank

goodness, we moved to recording this way though. I remember when we had to go to the studio and get the time and set all that up. That was that

was really nice. But editing was really hard. Remember?

Oh, yeah, way harder as we had one. But we also got to have lunch after that was great. That was That was

definitely nice. I thought that was very nice. But this is easy. This makes life quite easy. It does.

All right. Our friends, you had a good idea to pose a question on Instagram. Now that we're in February, and to ask everyone how they're doing on their New Year's resolutions? Out here, right. And I didn't look at fairness. I just posted this like an hour and a half ago. So we only got, I don't know, 20 responses or so. So I'll let me read some of these.

Well, first before you begin, what's yours? And are you still doing it? I don't think I had one. I didn't do well in this year either. This is the first time I have heard arguments against having new year's resolutions. Because it especially for a perfectionist. Because, you know, if you don't follow through, it's like, there it goes. I created a lot of new really good habits. Last year, I got really into weight training. And I took up Tai Chi and I did that in the middle of the year. It's like you don't have to, and I didn't January 1, I didn't have any pressure on myself. I just kept doing it. And I look back and think well, that's when I made the biggest change it was last summer. So I don't know. I don't know if it would serve me to do that. So I don't think I did. I think because we're reading atomic habits, I wasn't really focused on a New Year's resolution because the changes that we're trying to implement through reading the book and some of the old habits we're trying to get rid of a new habits we're trying to start just seemed more important.

I mean, who needs to start a new habit when you're reading a book about habits right. Good enough. I can intellectualize this exactly. That's why I will say talk about habits that's what I'm doing. Okay, so let's see what this says. This one says patience and kind words with my crazy dogs. Man I can relate to that. Who have been driving me nuts postpartum. We hear this so much. Right? Women are home with their babies and the dogs have needs turns out they want attention and they need to go out turns out and sometimes they make noise when we really want them to be quiet. So patients unkind words. I like the kind words there's nothing worse than your dog barking when your baby just went down for a nap. Yeah.

Be Everyone be gentle with your animals. They really don't mean to drive us crazy. No,

not at all. No, you're not thinking like that. kind words. I like that.

That's always that's just a good one to live by.

Okay, next one. I'm to make my bed every day I started one week late because we were all sick, but I'm going strong.

That's a great one. I love things that are really concise and simple like that. Like let's not let's not make it too general because then it's too hard to follow through with like, be a better person. Yeah, what does that mean?

That's a good example. Right? To be a better person. You're going alright? And to have a successful VBAC? Is a qualify as a New Year's resolution. I guess it does. Next test. This one says to not have any new year's resolution and to focus on resting while nature rests to love it. Go for that one. With drinking still going strong. Great. This one says focused deep breathing daily. Yes. has helped me navigate emotions in my first pregnancy. Excellent one, it for her to push through when I feel like quitting something. And yes, I'm still doing it. It's a little vague.

Yeah. But it's,

it's not aware of it. It works exactly.

And it's not too broad. It's like you know, you know, when you need to push through when you want to stop something and to get that urge to quit. Nope. Not gonna do it. Right.

Mine is to minimize plastic. I've been using my glass wood metal items and so far so good. cold plunge everyday in January and still going strong. Wow. And she then sent us a an amazing photo of the cold water. She's plunging into dedication.

Isn't that awesome? Yes. That's great. What Wait, she's doing that outside. Oh, yeah. That's

my son did it. He did it with them. Dewsbury. Oh, I go every January 1.

A lot of people just have cold plunge pools at their house or like some sort of, oh, no here and up in their home. So they don't have to go to a lake.

No, here, everyone goes to the beach. So to family, friends of ours, the whole families, kids and Alex joined them. In fact, when they invited Alex to go on New Year's Eve, and they were all hanging out with us. They were like, Hey, we're doing the cold plunge in the morning like we do every year. Alex do want to go. And then my son said no. And he said, which probably means I should go. So he did. And then a week later, they all did it again. So we have a video and it's adorable. They're all running in they have to dunk their heads. Really awesome. All right. This one says no booze all year and honestly, I have more way more patients. To strengthen my marriage aka kick our in laws to the side and putting us first. Good

now narrow that down. Name three ways you're gonna put your your marriage first, how

will you kick them? How far will you kick them? How are you? With what flip right or left?

I didn't make one. My goal is just to be able to shower and get ready for work before the baby wakes. That's a great one. That's is you did make one. I remember when my kids were eight and four. I took a little local parenting class was kind of nice was to the school system. It was really fun. And they said like something about your morning routine. And I decided then when my kids were eight and four that I wanted to be showered before doing the morning routine and getting Alex on the bus. And I did that I started getting up early enough to shower first because it was always harder to shower after I got them on the bus for some reason. And I I always do that. Now. I just make sure I do that immediately. Before you get out of bed news. Go straight to the shower. Yeah, that's it. Don't most people my husband has to know in the shower. Least favorite thing to do. But that's how I start my day shower.

I brush my teeth go straight to your shower.

I get out of bed. A minute later, I'm brushing my teeth. Three minutes later, I'm in the shower. Wow. 10 minutes later, I'm out of the shower. I'm dressed. I'm getting dressed. Well, how else do you decide to shower? Like when do you do it at night? Or it's just like a random time of day? I guess I'll have a shower now. It's usually

before I need to leave the house or before I need to show up for work or after my workout. No, is almost never first thing in the morning. All right, there's one more. I was gonna say one more thing about that that specifically to this woman or anyone else out there who has a new baby if it makes them feel any better. I distinctly remember after my first after Lola was born, it was not until the six week mark that I had showered, had breakfast and had an been dressed before noon. And I remember that day, so I was like oh my god. I don't at all. I'm dressed. I'm out of the house. I'm showered and I've eaten and it's before noon. No, six weeks.

Hey, Cynthia and Trisha, I just had a question about management of the placenta. And most of what I've seen in birth work is that As everyone who I've seen uses controlled chord traction after the separation dash, and after listening to Barbra Harper, I'm wondering if doing this for every single mom every single time is really necessary. I have asked, and they've said that it's because there could, quote be a concealed bleed behind the placenta. And I do understand the dangers of a postpartum hemorrhage and a concealed bleed. But I just feel like our bodies don't really need someone to manage the placenta every time and I'm wondering, what do you all do in practice? What is the best practice as far as management of the third stage with low risk women and homebirths setting? Because I'm thinking it may be a physiologic thing that could happen. So thanks.

So is it possible it's a physiologic thing that could happen? Are all the other mammals lying out there with their placenta still inside them?

Right having their fellow mammal pull on the cord to get it? can get this little tug? Grab it with your teeth? Yeah, not Yeah. Okay. The placenta can certainly be born without cord traction cord traction came into the process of active management, it was three step. process. This is how I was taught as a midwife to birth placentas. Or deliver placentas. With the use of Pitocin can control cord traction and fumble massage.

Well, and you don't support that you're saying that's how you were trained, but you're not so you're not so impressed by that, right?

No, no, I'm not. A placenta will come out on its own, especially if you get a woman upright. I mean, I think because most women in the hospital are giving birth on their back cord traction became a thing because the there's actually a curve in the pelvis. So the placenta is sitting below that curve. So it actually has to go against gravity, like the baby has to Trisha Yeah, exactly. Same curve, same curve, they both go through the same canal. And so if you don't use court traction, or you don't get them up, right, how's the placenta coming out? If it's gotta go uphill,

right? There's no fetal ejection reflex for the placenta, not unless you're upright. No, it doesn't mean flying out horizontally.

Okay, you're having trouble getting the pulse on if the placenta is not just coming. And oftentimes, it detaches. And then it's literally sitting in the back of the vagina. So you know, you can give it a little poll to get it out here, you can get a woman upright. But the risk of cord traction is that we pull too vigorously and pulled the placenta off the uterine wall before it's ready, and that can increase the risk of a postpartum bleed.

I don't know what it is about cord traction, that like tugging on the cord. I find it I can't get away from this one. First up notion. It just feels so disrespectful to me. I don't like that's the first vibe. It's like, are you really handling someone's body like this? You're tugging on something that's attached to the inside of their body. Can we not? You

can actually invert the uterus. If you pull too hard. You can literally let's hole Are you uterus? Yes, you can.

That's terrifying. If that can cut that can be inverted and like pulled out. I mean, it has been partially inverted. Yes. Or do you mean like flipped inside out? Like a like a? Like a saw? I mean that like that's, that's unlikely to happen, but it has happened.

That's, that's terrifying. No, you have to pull pretty hard. Isn't what that sounds like a calamity. Is it? Not a calamity? Oh, that's a total calamity. Yes.

I'm speechless. Congratulations.

That was my goal tonight.

That'll make for great episodes. So I dare you to do this episode without me. I dare you.

I dare you to try and

Alright. Is there anything else on that? Yes.

So the second half of the question was, you know, what do you do? What do you think is best practice? I think the best practice is to leave things alone. Usually when the placenta separates, you'll see a separation gush so you see a little bit of blood and that's how you know that the placenta has separated and then you might just ask her to get upright and see if the plus on if she feels it and have her push and bear down and birth the placenta. Sometimes if you need to just check a little you can give it a teeny little tug just to see if it still seems like it's attached but that's not contractions. So leave leave it alone. When

I got out of the tub at the birth you attended my daughter's birth, it just slipped out. I totally fell felt like it wasn't. And she grabbed it all and it just slipped out when I took my step out of the tub. So it was

back here vagina. Yeah, it can and when you stood up, and

I didn't have to bear down, I didn't have to do anything. So it also can be very easy. Turns out

Yeah, I think most women feel an urge to push when it's sitting there

and they'll they'll feel that. I never did either birth. Did you ever feel an urge to push? Yeah,

I did. Well,

I had no idea

that that's quite like a baby, though. It's it's not as powerful of an

urge. That's because the placenta doesn't have a head.

That's right. Soft. Midwives always say don't worry, there's no bones and this one favorite line.

Good morning, ladies. I love you guys. I've listened to every single episode I'm expecting this month. So excited. So my question I don't believe I've ever heard it asked before, is about pacifiers. I see that there is conflicting evidence saying that it suits babies. So I'm wondering if you guys have any opinions based on giving baby's pacifier. If they work, if I should give it in the first place, if it creates a dependency. I also wonder if it does contribute to mouth development in general. So I'm just wondering if wondering if I should even introduce a pacifier in the first place. So I really appreciate you guys. I hope that uh, I hope that you can answer my question. Thank you.

We received two questions this month from women asking the same thing. Did you excuse me?

Did your babies ever use pacifier? No, I never used a pacifier with my children. You never tried. I never tried. Most breastfeeding babies won't take them. No, some will. But a baby who's breastfeeding? Well, usually has all their sucking needs met through breastfeeding. And they often won't take a pacifier. None of mine none. If they do well, yeah, it's okay if they do, but I definitely don't encourage I definitely discourage pacifier use when establishing breastfeeding. So in the first few weeks, you don't want to introduce pacifier because it actually is any sucking opportunity. You want your baby to be at your breast when you're building your milk supply after breastfeeding is well established, and there are no breastfeeding issues. If you want to try to introduce a pacifier for limited selective use, fine, but most of them won't take it. And you have to be use it judiciously because it can interfere with milk supply if you're constantly going to the pacifier instead of putting them to the breast. So things like car rides, when the baby can't be breastfeeding or a diaper change or just very temporary use to get them calm down before you put them to the breast but I just recommend using your finger in that case, because you're not going to leave your finger in their mouth for an hour, but you might with pacifier.

She also asked if it can cause any mouth issues.

Whilst sometimes pacifiers are actually a good pacifier for breastfeeding is used for suck training exercises. So if a baby has a weakened or just coordinated suck, you might use pacifier or finger also to help them train their muscles. But of course, there's always the concern about orthodontic issues with babies who stuck on their fingers stuck on their thumb stuck on pacifiers. Yes, that can happen. I still think personally, if a baby chooses to suck up their thumb or finger that's better than a pacifier because they can self soothe. You don't have to find the pacifier in the middle of the night when they wake up. I mean, having you heard the stories of moms who put like six pacifiers in the crib at night, so if the baby wakes up? No. Is that right? Oh, yeah. You know, because they don't want to have to get up and put the pacifier back in the baby's mouth.

I did ask my mom, who is a retired speech and language pathologist, if she heard about pacifiers leading to any speech or developmental delays of any kind related to the mouth function in the mouth development, and she said she's never heard of it. She did do research on how bottle nipples could greatly impact mouse development and cause speech impediments in young children. But she finished her master's in 1970. And apparently back then the nipples that were on bottles just had basically, a sufficiently wide hole and babies had to jump their tongue forward. They didn't work at drawing the milk out, they had a horse stop, it was so fast. Yes. And then they would push out their front teeth, and it would really change that, like the mouth requires the sucking one way or another to develop appropriately. And that wasn't good. And this woman also asked if there can be a dependency. And sure that I'm sure we both seen that. Oh, yeah. I don't know how I don't know how parents To create that dependency or get away from it, but that is definitely something I would be thinking about. If I were using pacifiers, I've seen three and a half year olds walking around with, I want some relief.

I mean, I've heard plenty of stories of families who, you know, have had to put the pacifiers in an envelope and show the child that the pacifier is being mailed away, never to return. And they have to go through all these creative ways of like getting rid of the pacifier forever and helping the child to that burn the pacifier ritual and traumatize the child completely. But the

the flip side of that people say like, well, if they suck on their thumb or their fingers, you know, you can't ever take it away. And how do you ever get them to stop and people paint the fingernails with this horrible tasting stuff, so they don't suck on their fingers?

My children never sucks their thumbs. So I felt like that was an easy path. So they wanted to breastfeed constantly. So maybe it wasn't that easy. I was a little I was a little jealous at times of those who used pacifiers. I had little moments of like, my life would be so easy right now.

So did I and I tried our I tried to give all of my kids a pacifier way. This is when they were months, months old. Five months, six months old, something like that. Probably. None of them would take it.

Ladies, I did the questions for you about doulas. I am expecting my second baby next year. And I had a home birth of my first but amazing midwife. And this time around, I really think I would like to hire a doula. I really just need someone to kind of keep me mostly mentally supportive and strong and, and hopefully to kind of be in the zone. My midwife was amazing, but she definitely was not there. Do hold my hand she was there to attend the birth. So I'm looking for someone who can really just kind of help just be another woman support me in that time. My only question is, what questions do I ask when I'm interviewing a doula? I pretty much know all the questions, I'd like to ask my next home birth midwife. But I really don't know what questions I should ask for a doula and to kind of figure out if she and I would be the best fit together. Yeah, to give any insight or advice, I would greatly appreciate it.

I think the first thing is just make sure you, you spend some time with her, meet her, talk to her, and just start to see if you have a feeling like I would love this person with me and my labor. I think that tells you go with your gut instinct. If you feel like you just feel safe and good and uplifted around her. That's great. You could ask her questions like, you could tell her what you're looking for. I want someone to keep me really calm and grounded. You could say what are your some of your favorite techniques that you use for women in labor to get them physically comfortable? And then say, can you tell me some examples of what you've done? When women had moments where they've maybe felt like giving up? Or where they were discouraged? How do you typically handle that? And how does you know what what do you what do you find happens for women and what calms them and see if she's versed in that and she's experienced in that? Those are the things I'm thinking of, but mainly just go with your gut, you just should feel really good around her.

Yeah, I think that as long as you do a little background checking, make sure that they have good references with their experiences. If you have a good five a good energy with them, somebody you'd want to hang out with somebody you'd want to have lunch with, then it's probably a good fit. And the only other thing I would want to know is do they do anything postpartum? Is that included in their, in their feeds, is that separate and at what point in the labor they typically want to come and be with you? That's

so important. The post was so important. I don't even recommend doulas who don't have a postpartum visit in their contracts. I won't even recommend them. I just thought of one more. Also asked the doula if she has any other credentials. Some doulas specialize in other things, do they do placenta encapsulation? Do they have a background in massage or in reflexology? Reiki but they hobbies have they learned spinning babies rebozo technique? There are so many great skills doulas can have so find out if she does because they might not mean much to you now, but they can be really invaluable to you and labor, they really turn out to be assets.

And women often ask us the question of do you know if I if I'm having a home birth? Or I have a midwife? Do I really need a doula and we generally say yes, we think that that is a helpful addition, even if you're having homebirth because they definitely have different roles.

I said Dan, Trisha, my name is Amanda and I have a question regarding growing up while in labor. I've had two babies, one in October 2021 And my second daughter was born in August of this year in 2023. During both of my Labor's as soon as my water broke, I immediate At least threw up. The first time caught me by surprise and so threw up all over the bathroom floor. However, the second time I was prepared, and I had a trashcan near me. After I had my second daughter, I asked my midwife why I threw up those times. After my water breaking, my midwife said it had to do with the hormones changing while in labor. And then a friend of mine said she read somewhere that roughly one in five women throw up while in labor. I know in some previous q&a podcasts, there have been women who have stated that they felt nauseous throughout labor, that my experience was just throwing up as soon as the water broke. So I'm just curious what triggers this? So yeah, I'd love to hear what you know about that. And thank you so much for all that you ladies do. I absolutely love your podcasts. And I recommend it to all of my friends who are expecting little ones. Well, I think throwing up and labor is pretty normal. I'm surprised that she said one in five. I think, in my experience is more than that. Anecdotally.

I did ask a doula who's attended hundreds of births, because I was so surprised to hear how common it is because it never happened to me, and I never really knew about it that much. And she said like, 40% of the time? She said, Yeah, I

would. That's more what I would think like a third to half of women probably throw up and labor. I can't typically in transition, though.

Right. But this is that what this woman said water breaking is most commonly occurring on transition. Yeah, so we have no idea when her water broke. I mean, if she threw up with her water breaking before Labor even started, that would be unusual. But But yes, it is related to the massive shift in hormones, that happens, adrenaline increasing in the body, and it actually helps the cervix open. So it's a good thing. If it happens. If it doesn't happen, it's not a bad thing.

The throwing up helps it open really? Yeah. Like the physiologic experience of throwing

up, open mouth opens. Oh, okay, open mouth open cervix. It's

just this really overpowering opening of everything. And oh, it's also the body getting rid of everything. It's the same reason that we similar to why women usually have bowel movements. In the beginning of labor, they just like clearing the system of everything. We just got to focus on a baby. We don't want anything in the bowels. We don't want anything in the stomach.

So totally normal, even productive, totally productive. No big deal. If it happens, no big deal. If it doesn't happen, doesn't mean anything's

wrong if it doesn't happen. Great. Okay, so that's a wrap on the regular version of today's q&a episode. We will be moving on now to the extended version, which is available on Apple podcasts. Whoo. What do we call it?

It is called Apple podcasts of Apple subscription, Apple's subscription, which is Yeah, and ours is under $30 for a year, and every single episode is 100% ad free. So it's a very nice hand free flip of a switch you get with no ads ever, and always extended, extended episodes, and it automatically becomes the episode in your feed. You don't have to do anything to access it. Those are the episodes that upload once you subscribe, right? That's right.

And in subscribers. That's fine. I are yes, we are. And if you would like more, you can get the extended version over on Patreon. Plus add free episodes plus our book club plus our incredible library

of mastery live streams workshops. Yep. Yes, there's

so much good content over there. And the extended episodes on Patreon are available to any tier no matter what tier women are in. So I'm hanging out with us over there. Right on to quickies.

All right. Are non stress tests ever necessary? Or will they just stress me out? I think that they can be helpful. Yes, I think they can also be stressful when they are used routinely. But if there's a concern about the baby than an unstressed test can provide useful information.

Like what what kind of concern like because women are getting decreased fetal movement, like if the woman suspects decreased fetal movement, but what we're seeing is like, she's gone, well past her due date. They're suspecting a big baby her age. None of these are typical.

They're done routinely. They're done routinely in late pregnancy. So routine use is going to be more stressful. But is there an indication in a time when non stress test can be helpful? Yes, there would you decline them routinely? Yes, I never had one me saying but yeah, I mean, I was having hombres. We don't know him. Okay, next. Chopped up. Do I need a hip block just in case I have a history We have postpartum hemorrhage. No.

I mean, look how quick we are. Yeah, that was quick. Should we stop there before? Yes. You don't need one. Okay, fine. Let's stop there.

Let me tell you if you need an IV people can get it in you pretty fast. Right? What needs to be done for care of an uncircumcised baby? An intact baby is the first thing that needs to be done. Good language, good change. Yep. Nothing.

I mean, the care has to be when you intervene. The care is more around when you do circumcise. Now, where I think a lot of people worry that with an intact child, you have to clean the foreskin, pull it back retracted all that stuff. I never did any of that. No, you're not supposed to do any of that it's attached, you're not supposed to bother it, it will naturally retract. When it's attached. It's not going to get dirty. And it's going to keep itself clean. And you know, over time, over years, it will retract. And then you will be teaching your son in time, how to clean himself when it fully retracts. And, you know, they used to say soap and now they're saying water, you really just want to be minimalist, but he'll have to worry about cleansing himself through his life, which is appropriate. Don't bother it. Leave it alone. I've never done a thing. Does a heart shaped uterus? Look, here it comes again. Does a heart shaped uterus automatically mean a C section?

No. Well, so the women who didn't have the extended version didn't hear the long answer to this.

Oh, that's right. In the extended version, we went into a discussion about the heart shaped uterus. So if you're curious, what's one piece of advice for a mom who would like what's one piece of advice for a mom who wants to attempt a VBAC? Who I got one? Well, the first one is don't say attempt Exactly. Use has the same thought say, okay, don't use the word, don't use the acronym TOLAC trial of labor you can try. It's like your body will have a vaginal birth, you're planning or you're having a vaginal birth period. That's it. The second piece of advice would be to not go to the provider that the C section.

And the third piece of advice is avoid induction.

Look at us. We can't We can't just give one piece of advice. Oh, we have to do our best. How much blood loss is considered postpartum hemorrhage? Generally 500 severes 1000. But I think there's a movement to kind of move away from measuring blood loss and more symptomatic. It's very hard to measure blood loss after birth because there's so much stuff in with the blood. Other fluids.

So what are some of the symptoms?

Our drops severe drop in blood pressure, lightheadedness? Low blood pressure symptoms? Is the milkshake boob massage before breastfeeding actually helpful. It is really helpful. Actually. I have seen pretty impressive results for various things with using the breast milk shake. I recommend it a lot.

That thing should have gone viral.

That thing you did never have to do it again.

That's the kind of thing that should go viral. It's a good video.

I'm sure if I did a topless it would

if you do a topless milkshake, demonstration, it's gone. But I will. We

might get kicked off Instagram.

We would get kicked off it would be worth it.

Okay, what are these days you're gonna go down and start I mean, come on. No shame in the breast. Like why not?

I mean, shaking it Trisha is another story so well, that I teach women to do I shake their breasts all the time. Okay. Our lives are very different. I've never shaken a woman's breast. I have shaken many. All right. What's your favorite holiday?

I used to tell myself Fourth of July, or Thanksgiving, but on it's just Christmas. Everyone's just so it's just gonna now be Christmas.

I think the question should be what's your favorite?

Christmas, right? Excluding Christmas? What's your favorite holiday?

I mean, when I was a young woman, Fourth of July always seemed somehow romantic to me. You know, like you're out on a date with your boyfriend. And it's this hot summer night. You're wearing like a cute, beautiful dress. And there are fireworks and that was always a that a lot of really, really sweet Fourth of July memories in my life. But then Thanksgiving felt special to me just because you can't relate. I grew up in Canada on Fourth of July.

We didn't celebrate it's just have a lot of bugs. Yeah, but we weren't celebrating Fourth of July. Right? Because you would have to do the fireworks yourselves. Well, and you're in Canada, you're not celebrating the American Independence Day.

Oh, yeah, that's true. That's true. I didn't even think about the obvious and then Thanksgiving also because it's just kind of intimate. It's easy, and it's all around gratitude, which is very beautiful.

I love Thanksgiving. Yeah. Thanksgiving feels like Christmas but without the stress of presence.

Or Ruby crying. Ruby we didn't disclose that last time.

We did didn't wait. No, I

said you said I can guess which child okay never disclosed it. It's fine. She'll laugh she'd laugh about it now. Good.

She's not laughing the podcast anyway. Come on. No, of course not. I could someday she might someday she probably well, she'll finish it. Last one. If you could take one book to a deserted island, what would it be?

A soldier of the Great War by Mark Halpern.

Okay, mine would be how to survive on a desert island. Desert, smart. A deserted desert island.

So smart. Like a fool. I picked fiction.

I mean, it's got to be a book that's gonna help you some way I will not just entertain you about it. I didn't think the question was literal or, or how to build a canoe. Or it should be a book that you're willing to read like 100 times? Well,

that's what I picked. Not read that 100 times. Well, if above any other book 100 times, yes. I

was thinking more like some sort of like, A Course in Miracles or the Bible or something that requires a lot of deep thought that you could read over and over and gotten from each time. Yeah, that for me, I picked that book. That's something I wouldn't tire of. I did just reread Love in the Time of Cholera, which is just extraordinary. Um, that was delightful. Like, it's got so much humor in it. And it's so beautifully written. That's another definitely top three in my top three now. Yeah, I have not read that.

I should read it. Ah, you should read that book. It is so incredible. I mean, I was chuckling by within a few pages in there's so much humor in that book. But honestly, the writing is just unbelievable. It's unbelievable writing. Anyway,

is that it? That is it. Oh, and that means we're heading into March. And spring is around the corner. Oh, anyone in the Northeast is just

days are getting longer. Birds are coming out daylight savings in a couple of weeks. I can't wait. I know. That's the best part. The dark days of winter are behind us. All right. Anything else to say as we before we sign off.

The last thing I want to say is I would just like to read a recent podcast review. I don't think people realize how much the reviews help the podcast. So if anybody has had a thought to give a review, please just go and do it. Even if you don't want to write anything. That's okay. Just tap the five stars. I'm currently 23 weeks pregnant and thankfully your podcast has empowered me and taught me to advocate for myself. I had to fire my OB after she told me that she will induce me at 38 weeks due to me being 41 years old. And she never asked what my birth plan was. So after my plans for midwife transfer fell through I let her know I originally wanted a home birth and she stated well, your baby will most likely die if you do a home birth. I was appalled and so happy I had faxed the backup all my choices to my plan natural home birth mainly due to this podcast and the extra research I've done I fired her and was able to get help to fund my home birth with my midwife team who makes me feel safe and heard Thank you ladies so much. Oh nice. Thank you for that review and sharing episodes is really the best thing are mentioning us on social media is such a wonderful, quick way to give back if giving is your vibe. Sharing episodes is our love language and you all know how I feel about love languages. Well, in this case we support them. In this case we do.

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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