Pregnancy

Most Commonly Asked Questions about Birth Control after Baby

Birth Control after Birth

When should I start birth control again after giving birth?

Once you are cleared for sex at your six-week postpartum check-up, you can start a new birth control regimen. This check-up is a great opportunity to discuss your plans for birth control, what has and has not worked for you in the past, and any plans for future pregnancies. It’s important to wait until your doctor or midwife gives you the OK as certain birth control medications can increase your risk for a blood clot in the weeks immediately following your delivery. This is particularly true of birth controls that contain estrogen such as combination pills, the patch and the vaginal ring. 

Is birth control safe while breastfeeding?

Yes, absolutely. The hormones that are secreted into your breastmilk are minimal and are not harmful to your baby. You will want to avoid options that include estrogen though as it can cause your supply to drop. The best birth control options while breastfeeding are the progestin only mini-pill, hormonal or hormone-free IUDs and the progestin-only subdermal implant.

What are my options for birth control post baby?

Once your doctor or midwife gives you the OK to begin a birth control regimen, you will want to decide which option makes the most sense for you. Some factors to consider include whether or not you are breastfeeding your baby, plans for future children, hormone sensitivity and convenience. Here are several of the most common birth control options and whether or not they are recommended while breastfeeding.

  • Combination pills: These pills contain a combination of estrogen and progestin designed to suppressed ovulation. They are NOT recommended while breastfeeding because of the estrogen content. 
  • Mini pill: The mini pill contains progestin only and is intended for use by breastfeeding moms.
  • IUDs:  An IUD is an intrauterine contraceptive device that is inserted into the uterus to prevent pregnancy by disabling the sperm. There are hormonal and non-hormonal options that can be used from 3-12 years, depending on the type. They are considered to be one of the most effective forms of birth control and are safe to use while breastfeeding.
  • Vaginal ring: The vaginal ring releases hormones that suppress ovulation. It is removed during the week of menstruation and then a new one is placed. While the vaginal ring is a good option for those who have trouble remembering to take the pill, it is NOT recommended for breastfeeding moms due to the estrogen content. 
  • Subdermal implant: A newer option to the contraceptive market is the subdermal rod implant that is inserted under the arm skin. With high efficacy rates and no estrogen, this is a safe and effective option for nursing moms.
  • Injectable birth control: Depo Provera is the most commonly known injectable contraceptive and has a 99 percent efficacy rate. This progestin only injection is given every 12 weeks and is safe for breastfeeding moms. However, there is some speculation that it may cause a drop in your supply. 
  • Tubal litigation: This is a surgical procedure in which the fallopian tubes are cut or sealed to create a permanent block preventing the egg from reaching the uterus for fertilization. This option should only be considered if there is NO chance that you may want to become pregnant again. There are some concerns about the procedure affecting supply but it is generally safe while breastfeeding.
  • Non-surgical sterilization: Similar to tubal litigation, non-surgical sterilization should ONLY be considered if you are done having children. With this method of contraceptive, a device is vaginally inserted into the fallopian tube that causes scarring to create a barrier that prevents the sperm and egg from meeting. This is a PERMANENT form of birth control and should not be considered if there is a possibility you may want more children in the future. This procedure is considered to be safe while breastfeeding.

Do I need to be done having kids to get an IUD?

No. An IUD is a completely reversible form of birth control. As soon as your IUD is removed, you can become pregnant. Many women worry that an IUD will affect their future fertility because it CAN be used as a long term option. However, research actually shows high rates of pregnancy following the removal of intrauterine devices.

I’ve heard exclusive breastfeeding is great birth control. Is that true?

Yes, it is true--WHEN and IF you meet all the criteria. The Lactational Amenorrhea Method is endorsed by the World Health Organization as being up to 98 percent effective. In order to rely on LAM for birth control you must meet the following conditions:

  • No period since your baby’s birth
  • Baby is under 6 months of age
  • You practice ecological breastfeeding, nursing baby at least every 4 hours during the day and every 6 hours at night. 

Learn more about about breastfeeding as birth control

Who should I talk to to learn more about my options?

Talk to your midwife or doctor to learn more about contraceptive options and for help choosing the best method for you. Consider having this conversation even before you deliver so that there is a plan in place once you receive the green light for sex and birth control. Health experts recommend waiting at least 18 months between pregnancies to allow your body to heal and reduce chances for future pregnancy complications. 

To learn more about birth control options after baby and for any and all questions related to pregnancy and natural birth, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Listeria and Pregnancy: What Is It, Symptoms, and How to Avoid Infection

Listeria and Pregnancy

Listeria is one of those scary words during pregnancy that you’ve heard but may not be exactly sure what it is. You probably know the basics about what foods you should not eat to avoid infection but what is listeria, exactly? And why is listeria so dangerous for pregnant women and their unborn babies? 

These are all excellent questions and a great place to begin when educating yourself about these dangerous bacteria. Here are the basics about listeria and why it is crucial that you take steps to avoid these bacteria while pregnant. 

What is it?

Listeria is a form of bacteria that can be found in uncooked vegetables, fruits and meats, unpasteurized milk and cheeses and processed foods. Listeria moncytogenese can originate in water and soil and animals can also act as carriers for the bacteria. When food comes in contact with listeria, it is considered contaminated and the bacteria can only be killed by cooking the food to the proper temperature or through pasteurization. 

Why is there an increased risk for pregnant women?

When a person becomes ill from the bacteria listeria, they are said to have listeriosis. While this is a rare condition, pregnant women are approximately 10-20 times more susceptible to infection than non-pregnant adults. Contracting listeriosis during pregnancy can result in serious complications for both mom and baby including miscarriage, premature delivery, infection to the newborn, and in extreme cases fetal or maternal death. As many as 1/5 cases of listeria infection in pregnant women result in stillbirth or neonatal death.

What are the symptoms of listeria infection?

Symptoms of listeriosis can begin as early as several days after exposure or as late as one month later. They may include:

  • Mild flu like symptoms
  • Headaches
  • Fever
  • Vomiting or diarrhea
  • Muscle pain

Fortunately with early detection, an aggressive antibiotic regimen can help prevent the infection from crossing the placental barrier and infecting the baby. This can greatly reduce the chances of severe complications like miscarriage or stillbirth. If you suspect you may have become infected with listeria, contact your doctor immediately who can perform a blood test to check for the presence of the bacteria.

How can I avoid listeria infection while pregnant?

With extra attention to what you eat and proper food safety and handling, you can greatly reduce your risk of coming in contact with the bacteria listeria while pregnant. Here are some tips to preventing infection during pregnancy and keeping you and your baby healthy:

  • Skip deli meats and hot dogs unless reheated to steaming (160 degrees F)
  • Avoid soft cheeses that may not be pasteurized such as Brie, feta, goat cheese, Camembert, 
  • Mexican cheeses (queso fresco, quesos blanco and panela), and blue-veined cheeses. Hard cheeses and semi-soft cheeses like mozzarella are fine, as are cream cheese and cottage cheese.
  • Do not eat pate or other cold meat spreads
  • Do not eat refrigerated smoked salmon unless it has been cooked in a dish.
  • Keep food prep areas clean
  • Wash your hands before eating or handling food
  • Cook foods to their proper internal temperatures
  • Keep your refrigerator clean and set at 40 degrees or less
  • Wash fruits and veggies thoroughly before eating
  • Avoid raw or uncooked meats and seafood
  • Refrigerate and freeze leftovers promptly.

For more foods to avoid during pregnancy, check out this article. 

Although it is important to take measures to avoid listeria during pregnancy due to the potential for serious complications, remember that instances of listeriosis are extremely rare. In the US, approximately 1,700 people each year become infected with the illness of which only 17 percent are pregnant women. With a healthy, pregnancy conscious diet and safe food handling practices, there is no need to be fearful of listeria infection. Listeriosis is fortunately very preventable in most cases. For questions about maternal and fetal health, natural birth or any and all pregnancy related topics, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Diastasis Recti: Everything You Need To Know

Diastis Recti

If you are pregnant or postpartum and your stomach seems to be protruding more than normal, you may have diastasis recti. Diastasis Recti is a common condition in pregnancy, affecting approximately 30 percent of women, in which the abdominal muscles widen causing the stomach to stick out or create a bulge. Although in many cases the abdominal separation will resolve on its own, it is important to identify the condition so that you do not engage in any activities or exercises that may worsen the separation. Here’s everything you need to know about Diastasis Recti and pregnancy and what you can do to heal it.

What causes Diastasis Recti?

Diastasis Recti is the result of a combination of the uterus growing and putting pressure on the abdominal wall and pregnancy hormones that cause softening of the connective tissue. When the abdominal muscles are stretched, the uterus, bowels and other organs are left with only a thin layer of tissue to hold them in place. This results in the stomach bulging out. You are more likely to suffer from Diastasis Recti if you have had multiple children, have large babies or are having multiples. It is also more common over the age of 35. 

How does Diastasis Recti affect pregnancy?

While you may not be bothered by a protruding stomach during pregnancy, the symptoms of Diastasis Recti can be uncomfortable. Common symptoms include back pain, difficulty breathing, pelvic floor problems, urine leakage and constipation. Diastasis Recti can also make a vaginal delivery more difficult as you will not have the same muscle support. In rare cases, Diastasis Recti can lead to a hernia. 

How do I know if I have Diastasis Recti? 

To determine if you have Diastasis Recti, you can conduct a self-abdominal separation test. To do this:

  1. Lay on your back with your feet flat on the floor and knees bent.
  2. Place one hand behind your head and the other on your abdomen. Your fingers should be parallel to your waistline at belly button level.
  3. Gently press your fingers into your abdomen.
  4. Roll your upper body off the floor into a crunch sit-up.
  5. Feeling across your midline, find the right and left side of your abdominal muscles and test for separation at, above and below your belly button.

You may have Diastasis Recti if:

  1. You detect a gap that is more than 2.5 inches when your abdominal muscles are contracted.
  2. The gap does not shrink as you contract the abdominal muscles.
  3. There is a protrusion along the length of the midline of your abdomen.

What should I do if I have Diastasis Recti?

You may not recognize the presence of Diastasis Recti until after you deliver when your stomach seems to still protrude several months postpartum. At this point, what you do NOT do is as important as what you do do in healing your abdominal separation. 

  • Do NOT strain your stomach muscles by lifting heavy objects or when constipated.
  • Do NOT do exercises that utilize your stomach muscles such as sit-ups, crunches, push-ups or planks.
  • Do NOT engage in any exercises on your hands and knees.

Although it may seem like a good way to restore your stomach strength after pregnancy, all of the above exercises and movements can actually worsen the degree of separation between the abdominal muscles. 

While minor Diastasis Recti will likely resolve on its own over time, if you are concerned or are considering becoming pregnant again, seek the help of a physical therapist. A physical therapist can guide you through exercises that are safe for the condition and will aim to strengthen your traverse stomach muscles without further separating the outer abdominal wall. Exercises may involve a belly splint or Pilates and can be effective at reducing the separation. If the separation is too great and rehabilitation is ineffective, you can undergo abdominoplasty surgery to correct the problem. 

Although Diastasis Recti may be unavoidable for many women, the best way to reduce your chances of it happening is to strengthen your abdominal muscles before becoming pregnant. Strong core muscles going into pregnancy will be less likely to separate due to the pressure of the growing uterus. It should be noted though that ALL women will experience some degree of diastasis in their third trimester as the baby grows. For questions about Diastasis Recti, pregnancy or natural childbirth, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Postpartum Core Training:

Brio Fitness for Woman leads a postpartum core training class at Health Foundations to help with Diastasis Recti. This is a gentle and informative series of classes that will walk you through the foundation of re-training your core after a pregnancy. Yoga, strength training, light cardio, and deep core work will be included in every class. You will also be given "homework" that you can do throughout each week. This series is for new and veteran mamas alike and is designed especially for women who have diastasis recti.

10 Reasons a Birth Center Might Be For You

Photo Credit: Rochelle Matos -  withlove.mn

Photo Credit: Rochelle Matos - withlove.mn

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 have lower 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 a free 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.

 
 

Sourdough Kale Strata

Sourdough Kale Strata.jpg

Eggs are an amazing source of protein during pregnancy and also contain vital nutrients for baby’s development such as choline, zinc and B-12. This delicious Sourdough Kale Strata can be easily made for breakfast, lunch or dinner and is not only full of the pregnancy super food--eggs, but also contains a hearty helping of kale which is rich in folate and iron.

Ingredients:

  • 2 tablespoons of olive oil
  • 1 large finely diced shallot
  • 6 cups of kale, washed and torn into bite-sized pieces
  • ¼ teaspoon of salt
  • 10 eggs
  • 2 cups of 2% milk
  • ¼ teaspoon of pepper
  • 4 cups of sourdough bread (best if stale) torn into bite-sized pieces
  • 1 ½ cups of shredded gruyere cheese, divided

Directions:

  1. Heat olive oil in a large frying pan over medium heat.
  2. Add shallots and sauté for 2 minutes.
  3. Add kale and salt and cook for another 2 minutes, set aside.
  4. Coat a 9-by-13 inch baking dish with non-stick cooking spray.
  5. Add kale mixture, torn bread and 1 cup of cheese. Toss evenly and spread over pan.
  6. Pour egg mixture into the dish and top with remaining cheese.
  7. Cover strata with aluminum foil and let stand for 20 minutes.
  8. Preheat oven to 400 degrees and bake for 35 minutes. Remove foil and bake for an additional 15 to 20 minutes until puffed and golden brown around edges.
  9. Let stand for 5 minutes before serving and enjoy!

Recipe transcribed from: fitPREGNANCY.com

The Top Five Fears about Having a Natural Birth

Natural Water Birth

While birth is a natural and normal experience that a woman’s body is created to do, it is common and expected to have fears leading up to your delivery. You may be feeling anxious about your ability to handle the pain, or wondering what will happen if something goes wrong. You may be worried about how you will recover from pushing a 7-10 pound baby out of your body and what you will feel like afterward. Rest assured these fears are not only normal but even healthy when they motivate you to better prepare for the experience. Here are the five most common fears about having a natural birth and how to alleviate them as best as possible. 

  1. What if I tear? Unfortunately, the chances of tearing when having a vaginal birth are high, about 90 percent. The good news is that about 99 percent of those tears are minor and superficial, requiring only a couple of stitches if any at all. While tearing may be inevitable for most women, there are some ways you can help prepare your body for the big task of pushing baby out and reduce the chances of more severe vaginal trauma. These techniques include doing your pelvic floor exercises regularly, practicing perineal massage, laboring in water, choosing a birthing position that aids in baby’s exit, placing a warm compress on the perineum when crowning begins and following your body’s lead and natural instincts when it comes to pushing. Even if you do experience some tearing or the need for a few stitches, your vagina and perineum will heal in about a week to ten days.
  2. What if I can’t handle the pain? While we won’t say that you’ll experience a pain-free childbirth, we can say that there are certainly ways to prepare yourself for the experience and natural ways to manage pain during labor and delivery. These ways include: 
    • Surrounding yourself with loving and supportive people who can help you stick to your wishes of a natural birth and provide any assistance you may need during labor and delivery. 
    • Hiring a doula to assist in your birth. Women who have delivered with the support of a doula report having less overall pain and fewer interventions.
    • Using any number of natural labor pain management techniques including massage, hypnosis, acupressure, laboring in water, guided relaxation, breathing exercises, and even the use of nitrous oxide to give you some temporary relief.
    • Prepare ahead of time. Whether this involves writing a birth plan, taking birthing classes, or having your partner learn special massage techniques, take the time to prepare for your birth as you would any other major event in your life.
    • Lastly, remember that your body was miraculously designed for the job of delivering your baby so you are already more prepared than you realize.
  3. What if I don’t make it to the hospital or birth center in time? While just about every movie that contains a birth scene depicts a woman frantically racing into the hospital in the 11th hour being rushed into the delivery room right in the nick of time, in real life labor takes time. In fact, the average amount of time active labor takes is about 8 hours and perhaps even longer if it’s your first. More likely than not, you will have plenty of time to get where you need to be for your delivery and probably even enough time to check over your bag, take a shower and drop the dogs or other kids off with a neighbor or grandparents. Not to mention, you will likely also have plenty of warning signs that baby is preparing to make his debut from intense cramping and contractions to back pain and possibly even your water breaking.
  4. What if I poop during the delivery? You may not have voiced this concern to your care provider yet but we know you’re thinking it. All women seem to worry about this one! Having a bowel movement when pushing a baby out is a completely normal and unremarkable thing given the basic physiology of the body. While the thought may horrify you (or your partner) rest assured that your midwives or doctors will not even be the slightest bit phased if you deliver more than you had planned on. If you are feeling particularly anxious about this possibility, try sitting on the toilet in the early phases of labor to empty yourself out before the pushing phase. It’s not uncommon for your midwife to recommend this strategy and it may help circumvent the issue. But, if it does happen, we guarantee you won’t care at all in all the excitement and adrenaline of the moment.
  5. What if something goes wrong? This is a big one for most expectant moms and understandably so. There are so many things that could happen during childbirth and most of them are not things we can plan ahead for. First off, trust that you have surrounded yourself with capable and compassionate professionals who have the best interest of you and your baby at heart. Should complications arise, your birthing team will know what to do and what the next steps should be. Discuss possible obstacles that may arise and how you would like to handle them ahead of time. Learn about what changes to the plan may be made in the event that you or your baby is experiencing any sort of distress. If one of your biggest fears is having a C-section, consider factors such as having a care provider that is supportive of natural birth, using a doula to assist in your birth and delivering outside of a hospital setting--- all which may reduce your chances of it occurring. Try to be flexible going into your delivery. While birth plans are an awesome way to detail your preferences and wishes for your birth experience, it’s important to prepare yourself ahead of time that things may not go exactly as planned.
Natural Birth w/ Midwife

It is completely normal to have fears leading up to childbirth. The best way to address those fears is to educate yourself through speaking with your care providers, taking classes, reading books and talking to friends who have experienced different types of births. It’s also important to familiarize yourself on the reasons why you have decided that you want a natural birth. The ‘why’ behind your desire to deliver your baby naturally will help you find the strength that you’ll need during labor to keep going. Just remember that despite your fears, you are strong, you are able bodied and you were created to do this. For questions about how you can have the natural birth you’ve always wanted contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Is Breastfeeding An Effective Form of Birth Control?

Breastfeeding Baby

If you’re a new mommy and have passed your postpartum period of pelvic rest, you may be wondering how effective breastfeeding is as birth control. While you and your partner may be eager to be intimate once again, you are likely not looking to add another baby to the family anytime soon. Fortunately, exclusive breastfeeding is actually a highly effective method of birth control during the first six months postpartum and sometimes even beyond. Here’s how to make the most of your lactational amenorrhea.

What is the Lactational Amenorrhea Method?

Lactational amenorrhea is the term used to refer to the natural period of infertility that occurs after giving birth when a woman is breastfeeding her baby and is not menstruating. This period of infertility occurs because the hormones necessary for milk production actually suppress the hormones necessary for ovulation. Consequently, the Lactational Amenorrhea Method refers to when a couple uses exclusive breastfeeding as a form of birth control. You may be wondering just how effective simply breastfeeding your baby can possibly be at preventing pregnancy. The answer to that question is very effective, if a few important criteria are met. 

In order for the Lactational Amenorrhea Method to be as much as 98-99.5 percent effective, the following factors must be present:

  • Your baby must be 6 months or younger
  • You must be breastfeeding on demand during both day and nighttime
  • Your menstrual cycle has not yet returned
  • Your baby must be exclusively breastfed with no formula supplementation or introduction of solid foods to his diet

Even after six months of age, moms who frequently breastfeed their babies and who have not had the return of their menstrual cycle are only 6 percent likely to become pregnant.

What Factors will Affect the Return of My Fertility?

Although the average time for nursing mothers to experience a return of their menses is 14.6 months, there are a number of factors that may cause you to become fertile before then. These factors known to impact fertility include:

  • The introduction of solids to baby’s diet
  • A reduction in the number or duration of nursing sessions per day
  • Your baby beginning to sleep through the night
  • Regularly pumping in lieu of breastfeeding

Every woman is different and experiences sensitivity to hormones to varying degrees. Overall, the amount of time your baby spends at the breast each day will be the biggest factor contributing to the duration of your lactational amenorrhea. If your period has returned, breastfeeding is no longer impacting your fertility and you should not rely on this method for birth control. 

Can I Increase the Length of my Lactational Amenorrhea to Prevent Pregnancy?

Yes! There are several simple ways that you can attempt to maximize your lactational amenorrhea while breastfeeding. These include:

  • Continuing to breastfeed on demand past six months. Aim to put your baby to the breast at least every 4-6 hours, day and night.
  • Cosleeping to increase night nursing. Fertility hormone production is highest during the nighttime hours making night nursing a primary factor in preventing the return of fertility.
  • Delaying solids until 6 months and offering the breast before each meal.
  • Using nursing to comfort your baby.
  • Offering breastmilk exclusively. Do not supplement with formula.
  • Skipping pacifiers and postponing the introduction of bottles until necessary.
  • Keeping your baby close to encourage frequent nursing by babywearing.
  • Nursing lying down for naps and at night.

Using breastfeeding as birth control is a safe and effective way to prevent pregnancy during the first six months postpartum and even beyond under certain circumstances. Most importantly, your baby will enjoy the limitless health and emotional benefits of exclusive breastfeeding during this critical time in her development. For questions about lactational amenorrhea or for anything related to pregnancy and natural birth, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center. 

Flank Steak and Asparagus Salad

Flank Steak & Asparagus Salad

This is a great recipe for nursing moms who need to get a substantial amount of protein each day. The asparagus salad offers a lighter complement to the hearty steak, creating the perfect nutritious meal for you and your family.

Ingredients:

  • 3 tablespoons of garlic oil
  • 2 tablespoons of fresh lemon juice
  • Salt and freshly ground black pepper
  • 12 cups of mixed spring greens
  • 1 pound of asparagus, tough ends snapped off
  • 4 large eggs
  • 1 pound of raw flank steak
  • 2 cloves of garlic
  • 1 tablespoon of soy sauce
  • 4 slices of whole-grain sandwich bread, toasted and cut into small squares
  • 8 teaspoons of grated Parmesan cheese

Directions:

  1. Preheat the grill or broiler to medium. Whisk garlic oil, lemon juice and salt and pepper together. 
  2. Place mixed spring greens in a large salad bowl.
  3. Fill a large skillet halfway with water and bring to a boil.
  4. Add asparagus and cook until tender but crisp (approx. 6 minutes). Remove spears with a slotted spoon and set aside to cool.
  5. Bring water back to a boil and poach eggs by breaking open and gently slipping them into the water. Cook over medium-low heat for 3-6 minutes occasionally spooning water over the yolks to help them cook.
  6. Rub flank steak on both sides with garlic, soy sauce and salt and pepper. Place on grill or broiler pan and cook on 4 minutes each side. Steak center should be rosy. Set aside when done.
  7. Cut cooled asparagus into 1-inch pieces and add to salad bowl along with toast squares. Toss salad mixture with half of dressing. Divide salad into four bowls and place a poached egg on each.
  8. Cut the steak on the diagonal into thin slices and arrange slices around the egg. Drizzle salads with steak juices and remaining dressing and sprinkle with Parmesan cheese.
  9. Enjoy!

Recipe transcribed from: fitPREGNANCY

Zika Virus: What Pregnant Mamas Need to Know

Pregnant Mother Traveling

If you’ve been watching the news lately, you have probably heard the growing concern over the spread of the Zika virus. Health officials around the world have declared the Zika virus a public health emergency and efforts to contain it and address the crisis are in motion across the world. Many of the warnings are directed at pregnant women regarding the serious threats the virus poses to unborn children. You may be wondering if this is something you need to be worried about in Minnesota. Here’s all you need to know about the Zika virus as a pregnant woman.

What is the Zika Virus?

Zika is a mosquito born virus that is transmitted by the Aedes Aegypti mosquito. The virus belongs to the Flavivirus family along with yellow fever and West Nile and is particularly threatening because there is no vaccine to prevent it and no medicine to treat it. The World Health Organization's Director General has called the recent outbreak an “extraordinary event” and predictions show that an estimated 3-4 million people across the Americas will contract the virus in the next year. Spread primarily through mosquito bites, symptoms of the Zika virus are typically mild and include fever, headache, muscle aches, lethargy, rash and conjunctivitis. The real risk; however, appears to be the harmful effects on the unborn fetus as the virus readily passes through amniotic fluid.

Why Are There Heightened Concerns for Pregnant Women?

The Zika virus has gained worldwide attention due to its potentially damaging effects on unborn babies. The virus has been linked to a serious neurological birth disorder called microcephaly in which babies are born with abnormally small heads. It has also been linked to other neurological abnormalities and Guillain-Barre syndrome, an autoimmune disorder that can lead to paralysis and death. In Brazil alone, some 4,000 cases of microcephaly have been reported since the fall of 2015 and are suspected to be related to the recent outbreak of the Zika virus. Currently in Colombia, there are an estimated 3,100 pregnant women infected with the Zika virus further raising concerns about the rapidly spreading epidemic and the risks to unborn babies. It should be noted that despite the serious risks the Zika virus poses to pregnant women, they are no more susceptible to contracting the virus than men and non-pregnant women. 

Should I Be Concerned About the Zika Virus?

Zika Virus Outbreaks

It’s easy to see all the hype about the spread of the Zika virus and feel afraid that you and your baby are in danger. And although several states in the US do have confirmed cases of the virus, thus far it has only been found in persons who have traveled abroad to affected areas. If you have not recently traveled to an affected area of the world or come in contact with the Aedes Aegypti mosquito, it is very unlikely that you have contracted the Zika virus. Countries and territories that currently have active Zika outbreaks include: 

  • Barbados
  • Bolivia
  • Brazil
  • Colombia
  • Commonwealth of Puerto Rico, US territory
  • Costa Rica
  • Curacao
  • Dominican Republic
  • Ecuador
  • El Salvador
  • French Guiana
  • Guadeloupe
  • Guatemala
  • Guyana
  • Haiti
  • Honduras
  • Jamaica
  • Martinique
  • Mexico
  • Nicaragua
  • Panama
  • Paraguay
  • Saint Martin
  • Suriname
  • U.S. Virgin Islands
  • Venezuela
  • American Samoa
  • Samoa
  • Tonga
  • Cape Verde

If you have recently traveled to any of the affected areas and are experiencing two or more symptoms of the Zika virus, contact your healthcare provider for further testing and examination. Even with the absence of symptoms, it is a good idea to share any recent travel concerns with your doctor to ensure that you and your baby are monitored closely going forward. It is believed that the greatest risk is posed to the fetus when exposure to the Zika virus occurs during the first trimester when vital organs are developing. 

How Can I Protect Myself from the Zika Virus?

The best way to protect yourself from the Zika virus is to postpone travel to affected areas until the virus is under control and you are no longer pregnant. The CDC has advised against travel to Zika affected areas for all pregnant women and has recommended that women who reside in those areas avoid becoming pregnant for up to two years. If you absolutely have to travel to an affected area, carefully follow all CDC guidelines to protect yourself from the virus including:

  • Using an EPA approved insect repellent over sunscreen containing deet, picaridin or IR 3535 (all are safe for pregnant women when used properly)
  • Wearing long pants, long sleeves and when possible, permethrin treated clothing
  • Sleeping in an air-conditioned or screened-in room

In addition to avoiding travel and taking the necessary precautions should travel be necessary, take extra measures to prevent mosquitos from gathering around your living space at home. This includes discarding any standing water, keeping screens closed and utilizing insect repellents. The types of mosquitos that can carry the Zika virus are present in many US locations and precautions should be taken to avoid them when possible.

If you have further questions about the Zika virus or if you are pregnant and are concerned about a recent trip to an affected area, contact your healthcare professional for further guidance to ensure that you and your baby remain healthy and thriving.

Pregnancy Pea Soup

Pregnancy Pea Soup

Not only is pea soup packed with fiber and protein, it's chalk full of essential vitamins B, A and K making it one of the healthiest prenatal meals you can eat! Try this simple recipe for a healthy meal that can be shared with the whole family.

Ingredients:

  • 1 pound of fresh or frozen peas
  • 1 large onion finely chopped
  • Dash of sunflower oil or a knob of butter
  • 2 cups of lamb stock (fresh or from a cube)
  • 1 cup of milk
  • ½ cup of plain yogurt
  • Salt and pepper to taste
  • Sprig of fresh mint
  • Mint leaves to garnish

Directions:

  1. In a pot, warm the finely chopped onion until translucent in sunflower oil or butter.
  2. Add peas and lamb stock. Bring to a boil, reduce heat and cover. Simmer for 10 minutes.
  3. Add a sprig of mint and use a handheld blender to blend soup. 
  4. Stir in yogurt and milk.
  5. Add salt and pepper to taste and garnish with mint leaves.
  6. Serve with fresh bread and enjoy!

Recipe transcribed from: Fitta Mamma

Broiled Pork Chops with Apple Slices

Pork Chops with Apples

Are you running out of healthy dinner ideas for your family? Try this quick and easy pork recipe for a dinner rich in protein and folate; two nutrients that are a must for every pregnant mama!

Ingredients:

  • 4 4-ounce pork loin chops
  • 1 teaspoon of salt
  • ½ teaspoon of freshly ground pepper
  • 2 tablespoons of vegetable oil
  • 1 apple, cored and sliced thinly
  • 1 15 ounce can of garbanzo beans, drained
  • ¼ teaspoon of cayenne pepper
  • 1 half of an orange (for juice)

Directions:

  1. Preheat oven to broil.
  2. Rub pork chops with ½ teaspoon of salt and ¼ teaspoon of pepper.
  3. Line a 10 by 12-inch pan with foil and place pork chops in pan; fold up edges of foil and set aside.
  4. Warm oil in a nonstick skillet over high heat.
  5. Add apple and cook until brown, approximately 2 minutes each side.
  6. Add beans, cayenne pepper and remaining salt and pepper.
  7. Pour juice from orange over mixture and cook until beans brown, for about 5 minutes.
  8. Reduce heat to low; cover and simmer.
  9. Place pork chops under broiler for 5 minutes on each side. 
  10. Top with apple slices and bean mixture and serve.

Recipe transcribed from: fitPREGNANCY

Cravings During Pregnancy

pregnancy cravings.png

We’ve all heard anecdotes about pregnant women indulging in peculiar snacks like pickles and ice cream because they had an insatiable craving. But where do these strange pregnancy cravings come from? And what should we do about them? 

Many women experience pregnancy cravings typically starting during the first trimester and ending in the second. Most cravings fall under the categories of sweet, spicy, salty or sour and may even be for a combination of two—like pickles and ice cream. Despite our best efforts to eat a nutritious diet while pregnant, unfortunately only about 10 percent of pregnancy cravings are for fruits and vegetables. The most commonly reported cravings during pregnancy include:

  • Chocolate
  • Coffee
  • Potato chips
  • Ice
  • Spicy foods
  • Lemon
  • Ice cream
  • Fruit
  • Candy
  • Red meat
  • Veggies
  • Juice
  • Salt
  • Dairy
  • Soda
Photo via  VisualHunt.com

Photo via VisualHunt.com

What Causes Cravings?

Although there are several theories about why pregnant women experience food cravings, the most compelling explanation is hormone fluctuations. High levels of pregnancy hormones can heighten and sensitize a woman’s senses like taste and smell causing her to be more interested in certain foods and in some cases repulsed by others. It is also believed that cravings may represent a need or a deficiency in your body. For instance, if you are frequently craving fruit juice it may be your body signaling a need for more Vitamin C. In other words, it is not necessarily that your body needs the specific food that you are craving but some component or ingredient in that food like protein, calcium, sodium or potassium. Hormone changes during pregnancy are also likely responsible for the fluctuations in appetite throughout the nine months.

When to Contact Your Doctor

While most cravings during pregnancy are harmless, they become a cause for concern if you are craving a non-food item. This condition, called pica, is characterized by cravings for non-edible items like crayons, dirt, chalk and laundry detergent that may cause serious health repercussions for you and your developing baby. Particularly, cravings for non-food items like dirt or clay that may contain lead content can cause serious developmental, cognitive and motor skill impairments in your baby. If you are experiencing non-food food cravings, contact your doctor or midwife as soon as possible for help. You may have a nutritional deficiency in iron or zinc that will require further treatment. 

What about Food Aversions?

Equally as common as food cravings during pregnancy are food aversions. The same hormones that cause us to have a hankering for certain foods may cause you to be nauseated by others. This is also thought to be the result of heightened taste and smell senses during pregnancy. Food aversions may coincide with morning sickness during the first trimester when you are most likely to be offended by unpleasant scents or tastes. Like cravings, food aversions will likely disappear by the second trimester as the hormones in your body begin to stabilize. If your food aversions are interfering with your ability to eat a nutritious diet, talk to your doctor or midwife for ways to keep you and your baby healthy.

Managing Your Cravings

Photo via  Visualhunt

Photo via Visualhunt

Here are some basic tips for dealing with cravings during pregnancy:

  • Eat a well-balanced diet to avoid vitamin deficiencies in mom or baby.
  • Watch weight gain: Excess weight gain during pregnancy can lead to dangerous conditions like preeclampsia, high blood pressure and other complications during labor and delivery.
  • Find healthy alternatives that will satisfy your cravings: For example, substituting yogurt for ice cream.
  • Indulge every once in a while and eat a healthy diet the rest of the time.
  • Decipher your craving: What does your body really need? Vitamin C? Protein? Calcium?
  • Satisfy cravings for unhealthy or fattening foods only occasionally.
  • Don’t fill up on an unhealthy craving so that you have no room left for nutritive foods.
  • Limit sweets intake and consider substituting fruit when possible.

Cravings during pregnancy are a perfectly normal and common occurrence to be indulged in with moderation and balanced with a nutritious and vitamin rich diet. For questions about nutrition during pregnancy or any and all things related to natural birth, contact Health Foundations for a free consultation with a midwife and a tour of our Birth Center.

The Home Stretch: What to Do in the Final Weeks of Pregnancy

Final Weeks of Pregnancy

The final weeks of pregnancy are filled with excitement, nerves, aches and pains and often even some impatience. Fortunately, there is plenty to do during that time period to keep you busy and ensure that you are prepared for the arrival of your baby. Here are just a few of the things that should be on your to-do list for the home stretch of pregnancy!

  • Stock up on postpartum supplies: Must have items in the weeks following giving birth include heavy duty sanitary napkins (opt for overnight strength or even Depends), comfy undies, nursing pads, lanolin nipple salve and comfortable loose fitting clothing.

Expert tip: Consider making some ‘padsicles’ by applying witch hazel and aloe to sanitary napkins and freezing them individually. Padsicles make great soothing ice packs for your recovering lady parts.

  • Sleep! If this is your first baby and you don’t have a toddler or older child running around, cherish these last weeks of uninterrupted slumber while you can. Go to bed early, sleep late when possible and catch an afternoon nap. Your body needs to rest up for the big day and the months that follow of caring for a newborn baby.
  • Nest: Many soon-to-be-moms feel the almost compulsive urge to clean and organize in preparation of the arrival of the baby. If the urge has overcome you and you have the energy, run with it and ask your family and friends to help you. Clean out the refrigerator, dust the baseboards, reorganize your closet, spot clean your kitchen and bathroom and take unwanted clothes and belongings to donate. You will have greater peace of mind bringing your baby home to a clean house where everything is in its place.
  • Stock your freezer: Now that your freezer is clean and organized, it’s time to fill it with meals that can be easily reheated in a pinch. You won’t have time to prepare dinner while you and your partner are busy caring for a newborn, so plan ahead and have some nutritional meals ready to go for when the hunger hits. 
  • Prepare your car for baby: Clean out your car and take your car seat to the fire department for instruction on proper installation. You’ll want to have this completed several weeks in advance in the event that your baby should make an early appearance.
  • Prepare a contact list: There are likely lots of people who will be anxiously awaiting the news of the arrival of your little one. Preparing a list of people ahead of time for your husband to text, email or call can remove the stress of creating it on the spot. You may also wish to give your partner’s contact info to any close friends or family that will want to check on you while you are in labor.
  • Pack your birth center or hospital bag: The contents of your bag will vary depending on whether you will be going home the day of the birth or staying a few nights. Plan accordingly with changes of clothes, toiletries, lip balm, pajamas, slippers, and anything else that you may want to have access to while you are in labor. Be sure to prepare your bag several weeks in advance as you do not want to be scrambling to pack at the last minute.
  • If you haven’t already, create your birth plan: A birth plan is a document that outlines your wishes for labor and birth experience. For help creating a birth plan, check out this article on creating a natural birth plan. Be sure to print enough copies for everyone that you anticipate will be involved in your labor and delivery.
  • Spoil yourself: These may be the last weeks that you have time to focus on yourself for a while. Take advantage of this time by doing things to pamper yourself like getting a pedicure, a massage or a haircut. Eat out at your favorite restaurant, take a bubble bath or go shopping with a girlfriend. You’ll be glad you took the time to show yourself some TLC when you are in the throes of being a new parent.
  • Finish your nursery: If you’re creating a nursery for your baby-to-be, now is the time to put the final touches on it. Wash the crib sheets and changing table covers, hang any decorations or pictures and make sure you have everything you need for baby in those first weeks at home.
  • Make space on your camera: In the age of digital cameras and smartphones, it’s not uncommon to run out of space or memory for pictures. Make sure you clean out your photos and have plenty of space to take new pictures before you go into labor. Deleting old photos is the last thing you want to be worried about when you are trying to capture your first moments with baby.
  • Spend quality time with your partner: Similar to finding time to pamper yourself, it will probably be a little while before you and your spouse have time to devote to one another. Go on dates, make dinner together, go for walks, and spend some time focusing on each other and your relationship. There are many ways to involve your partner in your pregnancy. This will help you both feel better prepared and more supported heading into the challenges of being a new parent. 
  • If you have other children, use these weeks to spend some quality time with them, remind them of their importance to the family and help prepare them for the arrival of the baby. It is also a good idea to get a gift to give to your older child “from the baby” to help lessen any initial feelings of jealousy or competition.

The final weeks of pregnancy don’t have to be stressful with a little planning, organization and time set aside to care for yourself. To learn more about having a natural birth or for any and all questions related to pregnancy and birth, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center. We are here to support you from preconception to postpartum and beyond.

Sticky Salmon

Sticky Salmon

Although some fish may be off limits while you are pregnant, eating salmon is actually great way to get essential fatty acids that are vital for baby’s brain and eye development. Try this easy sticky salmon recipe paired with brown rice and veggies to create some healthy and delicious brain food for you and your baby. 

Ingredients:

  • 2 skinned salmon fillets cut into 4 centimeter cubes

Marinade

  • 1 ½ tablespoon of soy sauce
  • 1 tablespoon of white wine vinegar
  • 2 tablespoons of ketchup
  • ½ teaspoon of sweet chili sauce1 ½ tablespoon of dark brown sugar

Directions:

  1. Place ingredients for marinade in a small saucepan and stir over low heat until sugar has dissolved.
  2. Remove from heat and pour into oven-safe dish. Allow to cool.
  3. Add cubes of salmon and turn to coat in sauce.
  4. Let marinate for one hour.
  5. Pre-heat the grill and cook salmon in a baking tin lined with foil for 5 minutes. Turn halfway through and baste occasionally until fully cooked
  6. Serve with brown rice and your favorite vegetables and enjoy!

Recipe transcribed from: annabelkarmel.com

Understanding the Risks Associated with Gestational Diabetes

Pregnant Mother Belly

If you are nearing the second half of your pregnancy, you may have heard your OB or midwife mention the infamous glucose test. You’ve probably heard tales of the syrupy orange drink that you have to consume before your blood is drawn and even more intimidating, the dreaded ‘three hour test’ required if you don’t pass the initial screening. But what is gestational diabetes exactly? And how does it affect your baby? Is there any way to prevent gestational diabetes? These are all questions that you may be wondering with your Glucose Challenge Screening approaching. Here are the answers to some of your questions! 

What is Gestational Diabetes?

To best understand gestational diabetes, it is helpful to understand how pregnancy impacts the body’s ability to process glucose (or sugar). In a healthy human body, the pancreas produces the hormone insulin which aids in moving glucose from your blood to the body’s cells where it is then used as energy. 

During pregnancy however, the placenta actually produces high levels of hormones that interfere with the process of insulin turning the glucose to energy, creating higher than normal blood sugar levels. As you progress in your pregnancy and your baby grows, your body produces more and more of these insulin blocking hormones. When your blood sugar rises to a level that is dangerous to mom and baby, this is considered gestational diabetes. 

What Are the Risks Associated with Gestational Diabetes?

If left untreated, gestational diabetes poses serious risks for both mom and baby. Health risks for your baby include:

  • Preterm labor or birth and respiratory distress syndrome
  • Macrosomia: This is when your baby is born too large (over 9 pounds) and is more likely to experience complications or injuries in the birth canal. This often results in the necessity of a C-section.
  • Hypoglycemia: Your baby may be born with low blood sugar due to the overproduction of insulin which can result in seizures.
  • Increased risk for obesity and Type 2 Diabetes later in life

Health risks for mom include:

  • High blood pressure or preeclampsia
  • Future diabetes  

Treatment for Gestational Diabetes

The good news is that gestational diabetes is a highly manageable condition that can be treated with a few lifestyle changes and some extra attention from your doctor. You can expect the following steps to be a part of your treatment plan if you are diagnosed with gestational diabetes: 

  • A healthy diet: Although you should always strive to eat a balanced diet while pregnant, it is extremely important to your health and the health of your baby if you have gestational diabetes. A diet that is rich in fruits, vegetables, whole grains and fiber and low in fat and calories will help you keep your blood sugar levels down.
  • Exercise: It is recommended that pregnant women get 30 minutes of moderate exercise per day, most days per week. If you aren’t able to do thirty minutes, try breaking it up into smaller increments throughout your day. 
  • Medication: Fortunately, only 10-20 percent of women who are diagnosed with gestational diabetes require insulin medication.
  • Daily blood sugar monitoring through at-home testing
  • Close monitoring of your baby’s growth and development. GD may necessitate more frequent visits to your care provider during the last three months of your pregnancy.
  • You may be referred to an endocrinologist or dietitian.
  • Your blood will be checked immediately following delivery and then again at six weeks postpartum. Fortunately, in most cases your blood sugar levels will return to normal following the birth of your baby. 

What are the Risk Factors for Gestational Diabetes?

There are some preexisting factors that may make you a more likely candidate for gestational diabetes. These factors include:

  • Personal or family history with high blood sugar or Type 2 Diabetes
  • Previous pregnancy with gestational diabetes
  • Previous baby born over 9 pounds
  • Previous unexplained stillbirth
  • Pregnancy over the age of 25
  • Having a BMI of 30 or higher at the start of your pregnancy
  • Non-Caucasian race: It is not fully understood why, but women who are black, Hispanic, American Indian and Asian have a higher incidence of gestational diabetes than women who are white.  

Prevention

Although the cause of gestational diabetes is not always known, there are some things you can do to lessen the likelihood of its onset. These include:

  • Seeking healthcare prior to trying to get pregnant to assess for risk level and to discuss your plans for a healthy conception and pregnancy
  • Eating a well-balanced, healthy diet
  • Engaging in regular, moderate exercise during pregnancy
  • Losing excess weight prior to becoming pregnant 
  • Staying current on routine recommended screenings throughout pregnancy. Typically, your care provider will recommend you take your Glucose Challenge Screening between weeks 24-28 of pregnancy.

Gestational diabetes is a serious condition during pregnancy that requires medical attention and healthy lifestyle changes to protect the health of you and your baby. Fortunately, however, by following the guidance of your doctor or midwife and taking the extra precautions to keep your blood sugar levels low, your chances of experiencing any complications can be greatly reduced. Because there are typically no symptoms of gestational diabetes, consistent prenatal care is necessary for its detection. If you are concerned about gestational diabetes or have questions about how to have a healthy pregnancy, contact Health Foundations for a free consultation with a midwife. Your health and the health of your baby are our top priority.