I've Had a Cesarean; Is a VBAC an Option For Me?

What is a VBAC (Vaginal Birth After Cesarean)?

It was once thought that if a woman has one cesarean delivery, all other babies she had should be born the same way. Today, it is known, that many women can undergo a trial of labor after cesarean delivery (called TOLAC). After a successful TOLAC, many women will be able to give birth through the vagina (called a vaginal birth after cesarean delivery, or VBAC). TOLAC is a good choice for many women, remembering that each situation is unique and TOLAC may not be appropriate for all women. First let’s look at some stats:

  • The Center for Disease Control (CDC) published that of all deliveries in the United States, 32% or 1 in 3 women have a cesarean (2017 data).

  • In Minnesota, the cesarean delivery rate is 27.4% (2017 data). Individual hospital statistics may differ.

  • The World Health Organization (WHO) recommends the ideal cesarean rate should be between 10-15% and a most recent study shows 19%.

  • Health Foundations Birth Center cesarean rate is 2-3%.

  • 90% of women who have had a cesarean are candidates for TOLAC.

  • 60-80%, roughly 3 to 4 of every 5 women who have had previously had a cesarean can successfully give birth vaginally.

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Research also shows, the biggest risk factor of having a cesarean is the facility you walk into in labor. That is right. The facility you walk into in labor. This is why researching the facility and provider group you are planning to deliver with is important. Ask questions. Ask what your hospital or freestanding birth center cesarean rate is. What is your provider groups cesarean rate?

What I find disheartening is that many women do not know that a TOLAC and VBAC are an option. They are told the opposite and filled with a lot of fear. Many providers say that it is an option but make it feel unattainable.

A woman who has had a previous cesarean delivery has the following choices when planning how to give birth again:

  • Chose to undergo a trial of labor and give birth vaginally (VBAC).

  • Chose an elective repeat cesarean section.

Reasons to consider a TOLAC:

There are many reasons why a woman may want to consider TOLAC. Compared with an elective repeat cesarean section, a VBAC after successful TOLAC is associated with the following benefits:

  • No abdominal surgery or risks associated with surgery

  • Less postpartum discomfort & shorter recovery period

  • Lower risk of infection

  • Less blood loss & decreased chance of blood transfusion

  • Greater chance of having a vaginal birth in subsequent pregnancies

  • Increased feeling of control in the decision-making process

  • Increased maternal satisfaction

For women planning to have more children, a VBAC may help them avoid problems linked to multiple cesarean deliveries. These problems include hysterectomy, bowel or bladder injury, and certain problems with the placenta.

What are the risks of a VBAC?

With TOLAC, the greatest concern for women who have had a previous cesarean is the risk of a uterine rupture during a vaginal birth. According to the American College of Obstetricians and Gynecologists (ACOG), if you had a previous cesarean with a low transverse incision, the risk of uterine rupture in a vaginal delivery is approximately 1 in 500 (0.2 to 1.5%). Ninety percent of uterine ruptures happen at the site of a scar from a previous cesarean section. Most studies show that for women who have had one prior C-section with a low-transverse (horizontal) incision, the risk of uterine rupture is less than 1%. Ruptures are more likely to occur during labor because a scar is more likely to give way under the stress of contractions.  A uterine rupture can be very serious and may harm both mother and baby and may lead to death.

During a cesarean delivery, one incision is made in the abdomen and another incision is made in the uterus.  Low transverse incisions carry the least chance of uterine rupture. They also are the most common type of incision used in cesarean deliveries. The risk of uterine rupture with one low, transverse incision scar when the labor starts on its own is about 5 out of 1,000 women (0.5%). Women who have had one previous cesarean delivery with low transverse incisions are candidates for TOLAC at Health Foundations.  It is not possible to tell what kind of incision was made in the uterus by looking at the scar on the skin. Medical records from the previous delivery can include this information.

Risks to the baby if there is a uterine rupture are brain damage and death.  About 10% of the time or 5 to 10 babies out of every 10,000 VBAC attempts will suffer brain damage or death (0.05% to 0.1%) when there is a uterine rupture.

What are the risks of an elective repeat cesarean?

  • Increased risk of infection (There is a greater risk of infection, with having a cesarean delivery after TOLAC than having a planned cesarean delivery.)

  • Increased blood loss or blood clots

  • Decreased bowel function

  • Respiratory complications

  • Longer hospital stay and recovery time. Three to five days in the hospital is the common length of stay.

  • Reactions to anesthesia

  • Risk of additional surgeries. For example, hysterectomy, bladder repair, etc.

  • Risk of adhesions

  • Risk of uterine rupture

  • Risk to future fertility and babies

  • Increased risk of placenta previa or other placental issues in future pregnancies

  • Risk that all future births may be surgical

  • Maternal death (very rare). (6 in 100,000 for a scheduled cesarean delivery)

According to research, 60% to 80% of women who attempt a TOLAC end up having a successful vaginal delivery. By laboring for a VBAC, a mother can reduce her risk for major complications related to multiple repeat cesareans.

Although it is not possible to predict whether TOLAC and a VBAC will be successful, several factors have been shown to increase or decrease the likelihood of success. Below are some factors that have been consistently identified as bring strong predictors of VBAC success:

  • Prior vaginal delivery

  • Spontaneous labor (not induced or augmented)

  • One or more prior successful VBAC(s)

  • Non-recurrent reason for the prior cesarean (ex: breech presentation, multiple gestation or placenta previa)

  • Favorable cervical factors

  • Strong maternal desire for a vaginal birth

Because of the additional risk involved, Health Foundations has established research based guidelines for an out-of-hospital TOLAC and VBAC. At Health Foundations a woman is not eligible for a birth center birth who (this list is not all inclusive):

  • Had had a prior vertical (classical) cesarean incision

  • Has a baby in a non-vertex presentation

  • Has a multiple pregnancy

  • Has had more than one prior cesarean

  • Has any condition of pregnancy where she would no longer be considered low-risk

  • Has an inter-delivery interval less than 18 months.

One cesarean with a low transverse incision is the most ideal scenario for a TOLAC and VBAC. However, if you are planning a hospital birth TOLAC, ACOG (The American College of Obstetricians and Gynecologists) has recently changed their guidelines to consider candidates that have had two previous cesareans with a low transverse incision, an unknown type of uterine scar and twins. Thankfully, because research shows the benefits of a non-surgical birth, most women do receive a low transverse incision to make a future vaginal birth more likely to be successful.

Health Foundations Birth Center + Women’s Health Clinic does offer VBACs to women that meet our clinic’s criteria. Please call or go to our website to schedule a consultation with a midwife!

References:

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ACOG.org






Choua Yang: How Motherhood Led to a Life of Farming

By Naveena Sekaran  

Our mental images of who farmers are might not initially coincide with motherhood, but for Choua, mother of four and farmer at Big River Farms (BRF), these two identities are inextricably connected. When she began farming, her goal was to earn an additional income to support her four sons, and the summer agricultural season fit well into her schedule as a school teacher. As she embarks on her fifth year as a professional organic farmer, she reflects that while the additional income was what had brought her to BRF, the health and wellness which her work provides for her family is why she stays. 

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As the mother of four boys, Choua is no stranger to the challenges of time management and juggling responsibilities. Health quickly became her top priority when doctors informed her that her first son, now 11, would be premature due to her own high blood pressure. Choua then made the decision to adopt a healthier, more active lifestyle. Over half a decade later, Choua was pregnant with her fourth son. She farmed both before and during that pregnancy, and proudly explains that her health was perfect. Now, all of her children can identify different vegetables and they spend their summers with their parents, learning the importance of healthy, active lifestyles. To Choua, the connection between motherhood and farming is clear: When she farms, she puts her family’s health, diet, and business first. 

Choua and her partner grow certified organic produce for Big River Farms CSA as well as farmers markets. Since 1983, Big River Farms has provided education on sustainable agriculture to hundreds of farmers that have historically been underrepresented in farm ownership, including immigrants, people of color, women and refugees. The Big River Farms CSA serves as a guaranteed market for these farmers’ produce with 4 unique share types available for purchase. Shares are delivered weekly on Wednesdays, June through October to 15 different sites throughout the Twin Cities, including Health Foundations Birth Center.

To learn more about Big River Farms, purchasing a CSA share, and how to support Choua’s small farm business, visit www.mnfoodassociation.orgor call 651-433-3676. 

Are you a Health Foundations Birth Center patient? Use code healthfoundations2019and receive $10 off any CSA share type.

Kid Photo: Choua’s four boys are Big River Farms’ cutest farmers.

CSA Half Share: Big River Farms’ Half Acre Share price averages out to less than $25/week, and includes around 7 items, 100% USDA certified organic. Our CSA also offers full shares & fruit shares.

Labor Protein Bites

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Eating and drinking is very important during labor. These easy protein bites have our favorite go-to ingredients; oats, honey and peanut butter. Once labor becomes active, moms tend to lose their appetite, so something easy and quick is ideal.

These protein bites would also be great to snack on postpartum. The oats help boost milk supply.

Labor Protein Bites Recipe

2 Tbsp of Honey

2/3 C of Peanut Butter (or any nut butter)

1/2 C Chocolate Chips

1/2 C Ground Flax Seeds

1 C Old Fashioned Oats

Mix all ingredients well in a large bowl. Using a teaspoon sized portion, form into balls and put into an air-tight container. They can be kept in the refrigerator for up to a week.

The Birth Center Experience: Understanding Why It Might Be Just What You Want

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If you’re pregnant or thinking about becoming pregnant, you may be considering your options for birth. While the majority of babies in the US are born in hospitals, there’s another option available for women who wish to birth in a homelike setting but desire many of the resources and safeguards of a hospital. This option is called a birth center. Birth centers are designed for healthy women seeking a natural birth experience under the care of midwives instead of obstetricians. Midwives embrace the idea that birth is a natural and normal process and should be approached under the wellness model of pregnancy and birth. Birth centers are able to provide routine, woman-centered care that focuses on the natural, physiological process of birth and seeks to minimize unnecessary interventions. While birth centers are not equipped for emergency medical procedures like C-sections or other serious complications, they are typically located in close proximity to a partnering hospital for quick transfers when necessary. If you are hoping for a natural birth experience in a non-medical environment yet under the care of licensed midwifery professionals, a birth center may be for you. Here are 10 reasons you should consider delivering at a birth center.

  1. You’re hoping for a natural, intervention free birth: At birth centers, pregnancy and childbirth are seen as natural and normal events. Midwives seek to empower and support women in doing what their bodies were created to do without unnecessary intervention. According to the Journal of Midwifery and Women’s Health, the rate of C-sections for low risk births is only 6 percent at birth centers in comparison with 27 percent of low risk births in a hospital setting.

  2. You want to have a midwife instead of a doctor: Midwives are uniquely positioned to provide personalized care to mothers during pregnancy and birth that not only focuses on physical health, but also emotional, spiritual and mental wellbeing. Midwives are trained professionals that support women in having optimal pregnancies and birth experiences with minimal medical intervention. Births that are attended by midwives tend to havelower rates of C-sections, episiotomies and perineal trauma.

  3. You believe hospitals are for sick people: If you are hoping to bring your baby into the world in a more homelike environment but you want the expertise and resources of skilled professionals, a birth center may be for you. In many countries around the world birth is not seen as a medical event at all but a natural, normal experience in life. Birth centers offer many of the safeguards and equipment of a hospital without the medical environment.

  4. You want to have a water birth: Though some hospitals do offer the option of a birthing tub, it is more commonly available at birth centers. Laboring and delivering in water has many benefits from pain relief, improved cervical dilation and a soothing transition for baby from womb to world.

  5. You want to be able to eat and drink during labor: While most hospitals will restrict your intake during labor due to the risk of needing general anesthesia for a C-section, most birth centers encourage you to nourish yourself as needed to keep up your energy and stamina.

  6. You want to save money: While you should check your insurance policy to confirm benefits and birth center coverage, delivering at a birth center is typically less expensive than delivering at a hospital. Reasons for the difference in cost include a shorter length of stay and fewer interventions among other variables. Typically, your out-of-pocket cost at a birth center will be about a third less than that of a hospital birth.

  7. You do not want to have continuous fetal monitoring: While your midwife will likely intermittently monitor your baby, you will not be hooked up to a fetal monitor for the entirety of your labor like you may be at a hospital. This enables you to move about freely throughout your labor to the positions that offer the most relief and comfort. You also will not have to worry about any invasive internal monitoring or unnecessary cervical checks.

  8. You don’t want to deliver on your back: Midwives are typically more flexible in encouraging the mother to birth and labor in whatever position her body tells her she should. Laboring and delivering on your back has been found to be one of the least conducive positions to helping baby move naturally through the birth canal.

  9. You don’t want to feel rushed: In a birth center you will be encouraged and supported in laboring as long as your body needs. Rather than hastening the labor process with interventions, midwives embrace the natural normal process of childbirth in which you place trust in your body to know what it needs to do and at what pace.

  10. You want your family (or friends) involved: While a hospital may limit the number of individuals allowed in the room for your birth, at a birth center you will be welcome to have whomever you feel you need to support you in your birth experience. Birth centers will often involve the family during prenatal appointments and during labor realizing that the birth of a new baby is a family experience to be shared.

If you are a healthy woman experiencing a normal pregnancy and feel that a birth center may be more in line with your hopes and plans for natural birth, contact Health Foundations for afree consultation with a midwife and for a tour of our Birth Center. We are here to support and empower you from pregnancy to postpartum and beyond.

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I'm Not Pregnant - Why Should I Consider a Birth Center for Care?

As many people know, birth centers are wonderful, home-like places to bring babies into the world. Not as many people know that the midwives at Health Foundations care for women beyond pregnancy and childbirth.

Reason #1

You want to lead a healthy lifestyle.

Certified nurse-midwives care for women across the lifespan and you can see the midwives at Health Foundations for the following reasons:

  • Routine and annual exams from puberty on

  • Contraception

  • Sexually transmitted diseases evaluation and treatment

  • Cancer screenings (breast, ovarian, cervical cancer)

  • Gynecological concerns (pelvic pain, pain with sex, prolapse, irregular bleeding)

  • Infertility

  • Menopause

  • Urinary incontinence

  • Thyroid screening and management

  • Diet/exercise concerns

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Reason #2

You are considering having children in the future (or add another child to your family).

Preconception visits are an important part of your journey toward pregnancy and birth. The National Institutes of Health, World Health Organization, and Centers for Disease Control and Prevention emphasize the importance of receiving childbearing focused care prior to conception and for planned pregnancies, preconception care is one of the most important steps a woman can take toward her and her baby’s health (Centers for Disease Control and Prevention [CDC], 2019; Tyden, 2016). At Health Foundations, your preconception visit may include:

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 Reason #3

You are looking for the perfect health care provider in a comfortable setting.

Our midwives take the time to form relationships with you and your family and listen to your questions and concerns. The team of nurses and midwives at Health Foundations wants to holistically support your individual health goals throughout all seasons of your life. In this alternative health care setting, people describe feeling more relaxed and comfortable!

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Health Foundations accepts all major insurance plans including medical assistance. We would love to answer any questions you may have or give you a tour of our beautiful birth center.

Interested in learning more?

Call 651-895-2520

Email: info@health-foundations.com

Visit our website at  www.health-foundations.com

 Blog written by: Brooke Eischens RN, student midwife

Photo credit: Kadi Tiede

References 

Centers for Disease Control and Prevention [CDC]. (2019). Preconception health. Retrieved from https://www.cdc.gov/preconception/overview.html

Tyden, T. (2016). Why is preconception health and care important? Upsala Journal of            Medical Sciences, 121(4), 207. http://doi.org/10.1080/03009734.2016.1211776

I Don't Like My Provider! Is It Too Late to Transfer?

Many women find themselves late in their pregnancy, realizing they don’t like their provider and feel that it is too late to transfer so they settle for what is planned. So often we hear this. Often women choose the provider they have always seen for their yearly exams. They feel that it is just the “right” thing to do. As they learn more about their birth options, they realize that their provider is no longer a good fit for them. We have heard things like “I don’t want to hurt their feelings”, “I have always seen the same provider, they know me well so I should just keep going to them”, “It seems too hard to make a change at this point”, etc.

But in your heart you want your birth to look like this

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Here are some red flags to look for if you feel that your provider may not be a good fit for you:

  • You have expressed your labor and birth preferences to your provider and they were not supportive or tried to talk you out of them

  • You ask questions and your provider tries and avoid answering them

  • Your provider or hospital has a high cesarean rate, here is a list

At Health Foundations Birth Center, women can transfer their care as late as 34-36 weeks. Contrary to what you might think, it is quite easy to do this. There is nothing like the excitement on a woman’s face when she realizes her preferences and ideal birth are still possible and that they matter. If you feel guilty about switching providers, remember that this is about you, not them. You don’t even have to tell them if that feels better. A records release will be sent automatically stating that you are transferring care. This can feel like a weight is lifting for some women.

Trust your instinct mama. Although your baby has not quite arrived, your motherly instinct is strong. If something does not feel right, explore your options. If you want a low intervention, un-medicated birth, a freestanding birth center is a wonderful option and definitely worth looking into. If you are worried about insurance, call them about your benefits; this too, is usually a very easy transition.

We would love to meet with you and talk to you about your birth preferences and answer your questions. Please call us to set up a tour or register here. If you are past 30 weeks, we recommend setting up a Midwife Consultation which is complimentary.




Why "Me Time" Matters

Self-care is something we hear about frequently these days and there is a reason for that, it is super important! We live in a busy, driven society. Whether you are a working mom, stay at home mom or not a mom, it is vital to find time for yourself. Many women will say “how do I fit it in?”. It doesn’t have to be a week long vacation (although if you can make that work, go for it!). Finding “me time” in your life matters because it impacts all levels of your health and outlook.

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If you are feeling drained at the end of each day to the extent of feeling like you have nothing left to give, you need me time. If you find yourself snapping at your children or partner frequently, you need me time. First and foremost you need to make sure that your basic needs are being met, such as love, rest and support. It is so easy for your needs to be put on the back burner.

Recognize your Emotions: Often we are so busy that we do not give our emotions a second thought. They come and go and we ignore them. We distract ourselves from feeling. Distraction comes easy, shopping, drinking wine, overeating, social media… If you find yourself doing this, take time to accept your emotions and sit with them. Even if it’s only for a few minutes. Be there for yourself just as you are for others.

Listen to Your Body: When we ignore emotions and sources of stress, our bodies feel it. It can come in the form off achy joints, extreme fatigue, muscle soreness and even flu-like symptoms. By creating space for yourself, you give your body and mind a rest which helps heal these types of physical aches and pains.

Journaling: Taking time to journal your thoughts and feelings each day is very healing and a way to let go of negativity. It is a way to process what is going on inside your thoughts. It is being a friend to yourself.

Empower Yourself: Making positive choices for yourself is empowering. Seeing and feeling the effects of self-care is empowering to oneself.

Sit down with your partner (if applicable) and talk about how big of a need this is for you. Sometimes we forget that our partner is quite capable of taking over when we need our me time. Schedule a once per month night out with friends. If going solo is more your style, schedule it. We schedule meetings with others all the time; why not do the same for ourselves?

What Grandmothers Need to Know

When a woman finds out she is expecting, usually grandma finds out soon after and the excitement is through the roof! Especially if this is a first grandchild. Usually the support and excitement is well received and shared. After the sweet bundle of joy arrives, grandma wants to be there and help. For new mamas this can feel overwhelming and it can be difficult to navigate where to set boundaries without hurting feelings.

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Grandmas: this blog is for you. This blog is for your special and sacred role as a grandparent. It is about you supporting your daughter or daughter-in-law during this amazing time. As the years have passed, things have changed and it is important to know what has changed!

Holding Babies and Babywearing: I remember my mom saying “If you keep holding that baby so much, you are going to spoil him!”. Babies have been closely held in their mothers womb for 9 months and it is natural and expected for them to want to be held pretty much 24/7. That is why so many people swaddle; it gives the baby the sense that they are being held. Many moms will “babywear”. This give them the option to do other things while also holding their babies.

Baby Sleeping: Cry it out no more! It has been shown that newborns that are left to cry can have long lasting effects laster in childhood. Sleep training is not suggested until 6 months of age. Parents can expect that a new baby will not have any sleep schedule at all until at least 6 weeks of age. This ties in with babies loving to be close and held.

Bonding: The newborn phase is special and sacred and a beautiful time to bond. Some ways to bond with your new grandchild is spending time with them. In the first two weeks, expect for the parents to be very protective and busy getting to know their new one. This is a time for you to help with meals, cleaning, and watching the siblings if applicable and if you are able. As the weeks pass, you may be invited to watch the baby so their parents can get some time alone, even if it is just an hour.

It is statically proven that having grandchildren close and opening time with them with improve health and even longevity!

Welcome Baby Care and Health Foundations Birth Center will be hosting a Grandmother’s Tea on February 23rd at 1:30. Tickets are $25 per person. This class is designed to prepare Grandmothers for their role as a grandparent. The topics include sleep, baby-wearing and the latest techniques for developing a strong bond with baby.

Get your ticket here

Welcome Carrie Young, CNM, APRN

Join us in welcoming Carrie Young to our midwife team. We are beyond thrilled to have Carrie a part of the Health Foundations Family again! Carrie was a Nurse and Birth Assistant in past years. Carrie has a passion for birth and lactation and is a wonderful asset to our team.

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Carrie is a graduate of Frontier Nursing University.  She has worked in Women's Health care since 2004 when she found her love for birth working in a free standing birth center in California. As a Nurse Midwife, Carrie is passionate about empowering women to make decisions about their health care.  She has a special interest in breastfeeding, natural birth and Functional Medicine.  She believes in supporting and treating the whole person; physically, emotionally and spiritually.  

In her personal life, Carrie is a mother of three including a son and twin daughters. Spending time near the ocean and traveling abroad keeps her busy in her off time.  She is an advocate for women rights, gentle parenting and breastfeeding.  


Meet Our Lactation Consultant Sara!

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Name: Sara Goff

Hometown: I grew up in Brainerd, MN, have lived in many places over the last 15 years as a military family and now we call Bayport, MN home.

Family: My husband and I have 6 children together, 2 adult children and a grandson! 

Please explain your role at Health Foundations: I am the IBCLC Lactation Consultant of the team here at Health Foundations.

What is your educational background and training? I became certified as an IBCLC in 2011 after almost 10 years as a La Leche League leader and military breastfeeding peer counselor. I have served as a birth and postpartum doula, childbirth educator as well as creating and teaching a milk program for birth workers. 

Tell us a little about your own birth: My own birth was quite the event involving an ambulance ride from Brainerd to St. Paul when my mom was 32 weeks pregnant. NICU's were very different in 1978! What always struck me when my mom has told me my birth story was how she had a wonderful young doctor who signed off on my discharge from the hospital after prescribing skin on skin care and lactation support from La Leche League. When I gave birth to my first baby at 31 weeks her story, my story, came rushing back to me and fueled me through the long NICU stay and inspired my career in lactation support. 

What is one of your favorite things to do when you are not at Health Foundations? I love to travel, team for women's retreats and create art of all kinds.

If you could get on a plane tomorrow and travel anywhere in the world, where would you go? The beach...any warm beach with rolling waves.

If you could have one super power, what would it be? Teleportation! I have beloved friends all over the world and it’s hard to be so far removed from so many. 

What inspired you to get into your field? When I was in labor with my first baby at 31 weeks knowing there was no stopping birth they started assembling a NICU team to be present. The nurse practitioner in charge introduced herself between contractions and asked if I had any questions... without even thinking the question that spilled out of me was "Can I nurse?" In that moment being able to breastfeed my baby became the most important thing to me. Without hesitation her reply was "yes, of course!". My daughter was born minutes later. During her month in the NICU, a lactation consultant helped me over and over again. After a particularly difficult day, she met me in the hallway and listened to the trials of the day and said "you should consider becoming a peer counselor". That comment became the seed that grew my passion for lactation. 

What do you love about Health Foundations and what is your favorite part of your job? I love the team and community here at Health Foundations. My favorite part of my job is seeing the magical connection between parents and their babies. 

What is your philosophy on birth? Birth and Milk are innate, instinctual and DIFFERENT for every person. I believe in the power of community and story to nurture, heal, inspire and challenge us to be our highest self in pregnancy, birth, milk, parenting, and life. 

What advice or wisdom can you share with pregnancy or new mama readers? Trust your baby, your body (and your milk!) + surround yourself with a community of people that feel supportive and empowering!

The New Year, The New You

Oh yes, News Years resolutions! It is that time of year! It can be tempting to have a long list of things you would like to change or do better. My advice is to keep the list short and realistic.

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You can exercise, eat healthy, take supplements but what about the hard stuff? What about sitting with YOU and allowing yourself to grow? Here are some points to think about moving forward into 2019:

Health Goal Setting

Take charge of your health this year. Now is the time to do it, as there are so many tools to help! There are apps, pre-made meal plans and more. Do a little research about what would be realistic for you. Don’t plan on eating baked chicken and broccoli for weeks on end, that isn’t sustainable. The recipes out there are AMAZING. There are endless blogs with recipes that are centered around clean eating. If weight loss is a part of your plan, keep the goal small.

Although it is tempting to jump into a gym membership full steam ahead, find a place that fits your needs. There are large gyms, yoga studios, barre classes, cross fit and so much more. Take your time. Many of these places will let you do a free week before joining.

14 Days

It takes 14 days to truly make a change and the first 14 days are the hardest. One day at a time. Keep that in front of you at all times as a reminder, on your fridge, bathroom mirror or anywhere that you can see it frequently.

Accountability Partner

It can be a best friend, a sibling, a significant other, a co-worker or anyone that you feel will hold you accountable. Make sure you can trust this person and that they share similar goals and values. Let them know what your goals are and why they are important to you. Set up a plan with that person and communicate to them how their support would be helpful to you. Maybe it is a daily phone call or text message to check in or perhaps it is you texting them after you have done your daily goals.

Emotional Growth

The true goal is expanding yourself emotionally. Cleaning up your physical body by eating healthy and exercising is only part of the process. Spend time with you. Be alone. Turn off your phone and computer. Even if it is for 15 minutes each day. Try meditation. A nice time to practice this is right when you wake up, even before getting out of bed. If meditating isn’t your thing just spend time in the quiet trying to release the days stresses and worries.

Let your motto be, I AM ENOUGH. You indeed are ENOUGH.

How to Stay on Track With Diet + Exercise During The Holidays

Cookies! Cakes! Fancy holiday drinks! Oh my!

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The holidays are full of family, friends and making new memories. But if you are like me, you may be worrying about staying on track! You can stay on track and indulge at the same time. I am a believer of balance and moderation. Here are some of my favorite tips!

Drink Water: Drink water throughout the day. Try and get in 64 ounces per day. The will help keep you full and also flush out your system each day.

Exercise Everyday: Even if it is just 20 minutes per day, it is helpful! If doesn’t have to be anything crazy. A brisk walk will do! Maybe sneak some yoga in to relieve holiday stress.

Eat your regular diet: Commit to sticking to your regular diet and only indulge at times of celebration or when the foods are REALLY worth it. But...that doesn't mean indulging in EVERYTHING.

Eat BEFORE you go to a party: Eat a salad or greens and drink water before heading out.

Change Your Mindset: Don't think you can do or eat whatever you want all of December and just tackle it harder in January. You are setting yourself up for disappointment and likely won't feel good in the process.

How to Help Your Baby Develop Good Sleep Habits

At best, most newborns don’t sleep more than two to three hours at a time, day or night. A newborn’s nutritional needs and developmental maturity won’t be ready for a full five to seven hour stretch for a while. However, that doesn’t mean you can’t start helping your baby develop good sleep habits. By creating a healthy, safe sleep environment and planting the seeds of good sleep habits, you’ll plant roots for a lifetime of high-quality sleep.

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A Safe Sleep Environment

Even if you set up the nursery long before your baby arrived, it’s a good idea to give everything a last check to make sure all safety measures are in place. A baby-safe sleep environment include:

  • A crib, bassinet, or playpen that meets all current safety guidelines including no head or footboard with decorative cutouts and slats that are no more than 1 ⅜ inches apart.

  • A location that’s away from windows or cords that could be reached by your baby.

  • No toys, blankets, and crib bumpers as they pose a suffocation hazard. Extra layers, as well as sleep sacks or sleep blankets, should provide the warmth your baby needs.

  • A mattress with a snug fit that’s low enough that your baby cannot crawl or fall out of the crib. You’ll have to keep an eye on it and lower the mattress as he grows.

While baby monitors aren't a necessity, they do offer peace of mind and give you some extra freedom while your baby sleeps. Be sure the cord is kept well away from the crib.

The Start of Healthy Sleep Habits

Unfortunately, babies don’t normally have a regular sleep cycle until they are about six months old. However, healthy sleep habits can begin even before your baby is able to sleep through the night. Try to:

  • Keep nighttime feedings and diaper changes quiet and dark. Nighttime feedings should be all business so that your baby is wakened as little as possible.

  • Develop a bedtime routine. Bedtime routines can start as soon as your baby comes home from the hospital. As your baby’s nervous system develops, a regular routine will help trigger the release of sleep hormones. Some classic bedtime activities include reading a book, taking a warm bath, or rocking in a rocking chair.

  • Play and stimulate your baby’s senses during the day. As your baby stays awake longer during the day, he’ll start to sleep for longer stretches at night. It also helps to start establishing those developing circadian rhythms, the natural cycles the body uses to time the sleep-wake cycle.

  • Lay your baby down when he’s drowsy, not asleep. Your baby will learn how to self-soothe as he gets used to falling asleep on his own. This can also cut down on nighttime waking as he’ll learn to put himself back to sleep as he gets older.

  • Don’t jump to soothe. Some babies fuss a little before bed to let out some pent-up tension. Let your baby fuss for a few minutes before going in to soothe him. If he continues to fuss, make sure to keep the room dark and quiet so as not to overstimulate your baby when you soothe him.

Stacey L. Nash is a Seattle area writer for Tuck.com whose insomnia led her to research all aspects of sleep. With a degree in communications from the University of Puget Sound, she helps put sleep into the forefront of the health and wellness conversation. When not researching and writing about sleep, she spends time with her husband and four children on their heavily-wooded, twelve-acre piece of heaven.

Chromotherapy for Labor

You may have heard about Chromotherapy to elevate mood; but have you heard about it for labor? As a freestanding birth center, we are always looking for different comfort measures for laboring mamas. Recently, we installed LED light systems in each of our birth rooms.

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Chromotherapy is the science of using colors to adjust body vibrations to frequencies that result in health and harmony. Each color possesses frequencies of a specific vibration, and each vibration is related to different physical symptoms. Here are the different purposes of the different colors.

RED: Red light has been shown to increase energy. This would be a great color to use when the laboring mother is feeling tired to help boost her energy levels.

ORANGE: Orange hues can increase energy levels and improve a person’s mood. In labor, moms can of course get tired and possibly frustrated. Bring on the orange LED lights!

YELLOW: Yellow color light therapy can be used to help a person feel grounded while maintaining a positive outlook. It may also help mothers in labor to feel more optimistic and lighthearted.

GREEN: We depend on the color green to feel calm. Staying calm in labor is important and helps immensely relieve discomfort.

BLUE: Blue promotes relaxation and calm. Blue exhibits tranquilizing qualities often used to relieve headaches, stress, and nervous tension. Blue is thought to have a positive effect on all kinds of pain.

VIOLET: Violet is used to calm the nervous system, soothe organs and relax muscles. Violet has meditative qualities.

The Acne Struggle is Real...But It Doesn't Have to Be

The acne struggle is real! And how do I know? Because I have dealt with it firsthand. Acne (and discoloration…but we will talk about that in another blog post) has been my skin issue since my first pregnancy, 11 years ago. And I have tried EVERYTHING (and I have the product graveyard to prove it!). I’m constantly trying and testing new products and treatments such as lotions, spot treatments, facials and peels, to name a few. I even tried a vampire facial (I can’t believe I am sharing this photo!!!) But nothing REALLY worked.

iPhoto taken June 19, 2018

iPhoto taken June 19, 2018

My chin and jawline had reoccurring breakouts and my skin was red and irritated. Trying to cover-up the breakouts with make-up only brought more attention to my problem areas and ultimately made my breakouts worse.

I couldn’t stand it anymore and went to my dermatologist’s office. The thing is, I knew what she would suggest before I even set foot in the door…I guess I was just secretly hopeful she would have THE ANSWER. But no, she recommended what I expected, a course of oral and topical antibiotics and tretinoin (retinol) cream. I didn’t take the oral antibiotics (As a Naturopathic Doctor, I know taking antibiotics for acne really only makes the problem worse in the end.). I also had tried tretinoin before and I didn’t like how much my skin literally peeled after every time I used it. I did break down and tried the topical antibiotic for a while because I felt absolutely desperate. Fellow acne suffers you know what I mean! It helped with some of the major problem zits, but the redness was still there, and the breakouts kept coming. So, I decided to do a little more investigating and see what else was out there that could help. I had been dealing with this for years, so what did I have to lose?

A little Googling and perusing Instagram and I ended up with more search results for Rodan + Fields Unblemish Regimen than I could possibly imagine. The before-and-after pictures were amazing. Horrible cases of acne were magically cured in just a few months along with the pigmentation and uneven skin that comes after the acne has healed. I had to give it a try and I’m glad I did (A 60-day supply is $162 when you become a Rodan + Fields Preferred Customer. That equates to $2.70/day.).

Photo courtesy of Rodan + Fields

Photo courtesy of Rodan + Fields

I had read it was important to follow the instructions, easing my skin into the regimen. You start using the products every other morning for one week, then every morning for the second week, then every morning and every other night for the third week, and both morning and night by week four. By week two, I started to see a calmness in my skin that hadn’t been there before. It was like one day I woke up and my complexion was smooth and virtually bump-free. It felt like a miracle. I kept looking in the mirror at myself because for the first time in 11 years I was starting to feel good about my skin. AND, I would be remiss if I didn’t mention the redness and pigmentation were diminishing, too.

Photo of a Rodan + Fields Preferred Customer

Photo of a Rodan + Fields Preferred Customer

How does it work? Unblemish uses sulfur and benzoyl peroxide to clear your skin. But, it does it in a way that actually heals it without making it dry or red - genius! That was one of the biggest problems with all the other acne products I had tried, they made my skin super dry, peely and exacerbated the redness. What I have ultimately learned from the Doctors at Rodan + Fields is the right ingredients, in the right formulations, applied in the right order are key to get the results you are seeking. That is what the Unblemish Regimen provided. (Graphic courtesy of Rodan + Fields).

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Now that I found something that actually works for my acne-prone skin, I’m sticking with it. For the first time in over a decade, since my first pregnancy, I am happy with my skin and will actually venture out makeup-free! Don’t take my word for it! Try it for yourself and let me know what YOU think! Don’t forget to take before and after pictures so you can track your progress…that’s the fun part. Here is the most recent picture I found on my phone as an update what my skin looks like now.

iPhoto taken November 3, 2018 :  Unblemish Regimen ,  Active Hydration Bright Eyes Complex ,  Radiant Defense  (Sand color)

iPhoto taken November 3, 2018 : Unblemish Regimen, Active Hydration Bright Eyes Complex, Radiant Defense (Sand color)

I am such a believer in Rodan + Fields that I have started my own business with the company. So, if you have skin questions, questions about products, are interested in ordering or becoming part of my team, I am your gal. You can learn more on my website or contact me, Dr. Amy, at Health Foundations Birth Center at 651-895-2520.

P.S. If you have tweens or teens with acne issues…Unblemish is what you need to try! Give me a call so I can help get you on the right track!

P.P.S Do you feel “stuck” with how your skin looks? Schedule a time with me and we can discuss what you would like to change about your skin and see what skin care products, supplements and lifestyle changes you can make to help you achieve your goals.