“Are you mom enough?” asks the cover of this week’s TIME Magazine with a photo of a petite, thin mom standing while breastfeeding her large 3 yr old who is on a chair.  Ostensibly, this article is about attachment parenting.  However, the photo and the headline are being deliberately used to create strife and discord among mothers.

We’ve all heard of the “Mommy Wars”.  It used to be just breastfeeding vs. formula feeding.  Apparently that fight isn’t enough.  TIME feels the need to take it one step farther.  Now they are pitting mothers against each other regarding how long they breastfeed.

“Are you mom enough?” is a challenge, a call to action.  Just the headlines tell us that even if you breastfeed your child, meeting the AAP’s standards isn’t enough.

“The AAP recommends exclusive breastfeeding for about 6 months, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant, a recommendation concurred to by the WHO and the Institute of Medicine.” (emphasis mine)

Or, that meeting the World Health Organization’s (WHO) standards isn’t enough.

“Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond”  (emphasis mine)

But the TIME magazine headline isn’t about best evidence.  It isn’t about science or medicine. It’s about setting an imaginary bar so high it’s unobtainable for most women.  I think instead of promoting breastfeeding, what they’ve done is made it more of a divisive issue.  Instead of softly saying that there are some women who practice extended breastfeeding (myself included); they have hit us over the head with a giant breastfeeding hammer.

This image is the polar opposite of a formula feeding image, in terms of the “mommy wars”.  Formula feeding is often viewed as unhealthy and unnatural.  Breastfeeding an infant is often seen as pure, natural, instinctive, etc.  Breastfeeding an older toddler, or a preschooler is often seen as weird, hippie, crunchy, dangerous, unhealthy, psychologically harmful.  The image on the cover of TIME is deliberately confrontational.  It is an unnatural position in which to breastfeed a child.  Mom is defiant and strong – as if she’s giving the finger to “the man”.  I think if the picture was of the same mother and 3 yr old, in a seated, cuddling position, which is a much more normal way to breastfeed; it would have stirred up less controversy.  Of course, they stick those pictures inside the magazine… 

I think we can all agree that formula is sub-optimal in relation to breastfeeding.  However, that doesn’t mean it’s poison.  It doesn’t make it “bad” to formula feed.  It doesn’t make a woman a failure if she can’t breastfeed or if she chooses to formula feed.

So, what about breastfeeding duration?  Do we all have to follow the AAP’s guidelines of 12 months +, or the WHO’s guidelines of 2 yrs +?  No.  It is possible to do it, yes, with the right support.

Breastfeeding for 2 days is good.  Breastfeeding for 2 weeks is good.  Breastfeeding for 2 months is good.  Breastfeeding for 2 years is good.  Any amount of breastfeeding is good.  Know that.

Know that you are “mom enough”.  You are enough just as you are.  You parent as *you* see best.  Not as I see best, not as the statistics see best, as you see best.  The only one who can tell you if you are “mom enough” is your child.  The answer will always be a resounding “YES!”

Don’t let yourself fall prey to the bait TIME Magazine has laid for you.  As women we need to support each other in our choices and not allow ourselves to bicker about what ultimately amounts to a hill of beans in the grand scheme of things.  I think it all boils down to a basic lack of respect.  It’s a lack of respect from TIME magazine, for what is ultimately a personal decision.  As long as it is a truly informed decision, I will support it.

I will leave you with one last tidbit to chew on.  The AAP’s final statement on breastfeeding: “Thus, infant feeding should not be considered as a lifestyle choice but rather as a basic health issue.”  How does that affect your feelings on breastfeeding and extended breastfeeding?

Sat Nam.

We also see some other assumptions being made – 2^nd trimester bounce back and sex drive “I just have all this extra energy. Plus I’m like crazy horny.”  Too bad it doesn’t happen to everyone like that.  Some women have morning sickness that lasts past the 1^st trimester or other complications that don’t help fuel this feeling.  Other women, even if they feel this way are nervous about having sex – or their partners are nervous about having sex, so it doesn’t happen.  Individual experiences will vary.

An assumption that “I’m calling bull$#!%. Pregnancy sucks.”  Except that it doesn’t suck for everyone.  Some women have wonderful, easy pregnancies with little or no morning sickness, back pain, swollen feet or complications.  Some women will have some symptoms and not others.  Other women will have it all and feel like the quote above, hence my calling out the stereotype here.  It’s not bull$#!% if a mom says she’s having a great pregnancy – guess what, she is.  It’s also not bull$#!% if a woman says her pregnancy sucks – guess what, it does.  We all have different experiences.  All of our experiences are equally valid.

So, if sometimes the stereotypes are true does it make it wrong to portray them?  Instead of pregnant, let’s substitute black, Jewish, gay, etc… If the stereotypes for religious and ethnic groups are socially unacceptable, then why are pregnancy and birth stereotypes OK?  They aren’t.  Any time we use stereotypes we marginalize a group of people.  The “What to Expect” movie marginalizes pregnant women and their “bumbling” husbands.

I am tired of pregnant women being marginalized.  I want better of pop-culture.  I want better of our media.  I want pregnancy and birth to be portrayed realistically, too bad most of the time it’s really quite boring and uneventful.  Normal, physiologic birth just doesn’t make for good entertainment.

Speaking of marginalizing pregnant women and making them feel incompetent:  my favorite pregnancy guru, Rosie Pope, was on the Today Show this morning hawking more baby products you must have – and promoting season 2 of her show, while being heavily pregnant with baby #3.  (did you sense the sarcasm in my voice? I hope so…) I’ve written about her before.  Simply awful.

So, I will pony up the money and go see this movie.  Why?  So you don’t have to.  I intend to write a full and proper review of it for you, my readers.  I am hoping that it fails to live up to my expectations and proves better than its trailers make it out.  My confidence in this is low.

Sat Nam.

•  10:00-11:00 – FREE Mommy & Me Yoga
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• 1:00-2:30 – FREE Prenatal Yoga

Ok and now for the longer answer:

1. Your anesthesiologist won’t come to your house and you won’t be admitted to the hospital if you are too early in labor. 
2. So, what do you do while you labor at home?  How do you know when to go into the hospital?
3. What if your labor is too quick for them to insert the epidural before you need to push?
4. Did you know they turn off the epidural for pushing?  You need to feel your contractions to push effectively.  How will you cope with the new pain or discomfort you feel?
5. What about your partner? How will he/she know how to best help you?
6. What about all the other possible medical interventions?
7. Placenta?  Oh, yeah that squishy thing that comes out after the baby…
8. How about initiating breastfeeding?
9. What if you need a c-section?
10. How do you know what’s normal and what’s not?

A childbirth class is about much more than natural pain relief.  A childbirth class encompasses the whole experience from pre-term labor, to postpartum recovery.  It will help you avoid unnecessary medical interventions and connect with your partner.   A good, independent childbirth class will help you and your partner both feel more confident about your choices in childbirth and the entire birth experience.

Do check out our Confident Birthing classes.  We support all your choices in birth.

Placenta with amniotic sac and umbilical cord

There’s been quite a bit in the news this week about placenta eating.  Mad Men star, January Jones let it be known that she consumed her encapsulated placenta after her baby was born, per her doula’s suggestion.  The original article was in People Magazine “Jones’s secret to staying high energy through the grueling shooting schedule? ‘I have a great doula who makes sure I’m eating well, with vitamins and teas, and with placenta capsulation.’” 

The Huffington Post comments cite both pro and con views of placenta eating.

The Daily Mail UK says, Ayla Yavin, a Chinese herbalist and acupuncturist specialising in women’s health who also used to be a doula told MailOnline: ‘You spend nine months building the placenta and then when your baby is born you lose a huge amount of blood.’ The New York-based specialist went on to say: ‘Eating the placenta is good for a few reasons. ‘The placenta contains high levels of oxytocin – the ‘love’ hormone that stimulates milk production and helps the uterus contract to its normal size again.”

However there are flaws with this statement.  Let’s look at the science for a moment.  “Huge amount of blood loss”.  According to Science & Sensibility “Our body has built up a large store of blood during pregnancy, called by some a vascular reserve.  It is physiologically necessary for us to expel some of it during the time period from right birth into the next few weeks.  If the mother loses around 500 mL, she is likely to feel similarly to how she might feel when giving blood, and will need to sit or lie down, eat, and rest.  If a mother has one or more of the risk factors shared above, though, she might lose closer to between 1,000 – 2,499 mL of blood at birth.  Many experts use a threshold of 1,000 mL for healthy women in affluent societies, noting that they can tolerate blood loss of around 1,000 mL without decompensating.  (Walsh)  Goer shares that, ‘According to William’s Obstetrics, the obstetric bible, healthy postpartum women don’t begin to show actual symptoms of excessive blood loss until they have lost around 1500mL.’”

Hmm… so that means its normal to lose a certain amount of blood at birth, because the body has built up its stores.  The number quoted is usually “a pregnant mother has 1.5 times her normal blood volume with a single baby, or 2 times the blood volume with multiples.”  So, our bodies have already compensated for the blood loss by having more blood to begin with.

The Daily Mail says ‘The placenta contains high levels of oxytocin – the ‘love’ hormone that stimulates milk production and helps the uterus contract to its normal size again.”

Except that prolactin is the milk production hormone, not oxytocin.  Prolactin release is stimulated by birth, and by the baby sucking on the nipple.  There is some prolactin in the body during pregnancy and since it is circulated in the blood, some of it will get to the placenta.  However rates of prolactin rise dramatically after birth so that in a few days colostrum will disappear and mom’s milk will come in.

Yes, oxytocin is present in the placenta… but how much of it is destroyed during the cooking or dehydrating process.  No one knows because there are no studies on this.  How much of any of the hormones or nutrients are destroyed during cooking or dehydrating?  Again, no one knows.

There is talk about the hormone shift postpartum, as if this is a bad thing.  It is mom’s body moving from a pregnant state, where she needs certain hormones to sustain the pregnancy, to the non-pregnant state where she no longer needs the high hormone levels.  This is normal.  Some women will experience the “baby blues”, postpartum depression, or rarely, postpartum psychosis.  This is mostly due to the hormone shift, however, there are compounding external factors such as lack of sleep, improper diet, stress of caring for a newborn and relationship stress, etc.

We don’t want moms to suffer with PPD.  We do know that taking care of the external factors will help alleviate some of it.  We know that having good support at home, whether husband, grandma, postpartum doula, or a myriad of friends can help alleviate some of it.  We know that getting out of the house, being social, and doing ‘normal’ things can help too.  Talk therapy can be helpful, and in severe cases, medication.

Placenta is also used to control postpartum hemorrhage. By cutting off a small piece of placenta and asking mom to suck on it, or eat it, as her care provider is trying to control the bleeding.  However, this is used in conjunction with other techniques, such as uterine massage, to control bleeding.  So where is the bleeding control coming from?  Tough to tell if we use more than one method, and no one I know is going to try to wait to see if just the placenta is working when mom’s life is on the line from hemorrhage!

So, a quick list of the uses of placenta for mother’s benefit:

• Control postpartum hemorrhage
• Reduce or eliminate postpartum depression
• Even out mother’s moods
• Balance hormones
• Restore mother’s iron levels
• Help increase mother’s milk supply
• Increase energy levels

How can placenta be consumed?

• Eaten raw
• Cooked in a stew or stir fry
• Made into a tincture
• Dehydrated and put into smoothies
• Dehydrated and encapsulated in pill form
• I know there are other recipes but these are the most common ones.

Does it really help any of the above things?  The answer… wait for it… wait for it… maybe, but we don’t know.  A bit of a bummer, that.  Show me the science!

The studies we do have are mostly anthropological or animal studies.  We know that certain groups of peoples have consumed placenta.  We know that most of the other groups of peoples do not.  We know that most mammals consume their placentas, but some mammals do not.

We have NO studies on the benefits of human placenta consumption.  None.  There are two studies often cited for this.  The first is “Placenta as Lactagagon” Soykova-Pachnerova E, et. al.(1954). Gynaecologia 138(6):617-627.  Thing one to note is the date… 1954.  This is not what I’d call a recent study.  Thing two… I’ve read it.  Sadly, this isn’t actually a study.  There is no control group of non-placenta consuming mothers.  There is no control within the group for outside factors (1^st baby vs. subsequent, diet, demographics, etc.).  Thing three – very small sample size.  It is inappropriate to cite this as “proof” because, well, it isn’t a study.

The other study cited commonly is “Placentophagia: A Biobehavioral Enigma” KRISTAL, M. B. NEUROSCI. BIOBEHAV. REV. 4(2) 141-150, 1980 is an anthropological study.  It does not look at the benefits or biology of consuming placenta.  I’ve read this one too… all 20 pages of it….

I’ll say it again – there is NO study on the benefits of humans consuming placenta postpartum.  I would LOVE to see a study on human placenta consumption.  If you find one, please cite it for me!  I’d be glad to be wrong on this one.

So, what we have is anecdotal evidence from mothers who have consumed placenta and care providers who witness the effects.  My question then becomes is the benefit we see in the mother after consuming placenta because she has consumed it, or is this placebo effect?  Regardless of which it is, as far as I can tell there is no harm in it (other than grossing out your friends!).  If there is no harm, and there is a potential benefit, whether real or placebo, then I say go for it.  Just have the understanding that this is not an evidence based practice… yet.

Every method has its benefits.  However, every method is not for every mother.  Not every mother needs a method; not every method will work for an individual mother.

I note that we all have different personalities and different learning styles.  We come from different socio-economic backgrounds.  Some of us have been abused during our lives and that will impact our needs during birth.

Some women need a more flexible class.  Others do need to know what to do at all stages of labor and birth; they need the method, the prescription.  If a woman feels more comfortable with a specific method for birth, then she should use it.  If she feels more comfortable knowing her options and selecting those that work best for her, then she should go with what she knows to be best.

Yes, I am a Lamaze Certified Childbirth Educator (and proud of it!).  No, I don’t teach a method.  So, how does that work?  I teach the Lamaze Healthy Birth Practices.  I teach the evidence-based best practices.  I keep current with the research, studies and policy changes that are released.  I help my parents make informed choices regarding their pregnancies, births and babies.

I incorporate my yoga into class with the breathing I teach; the names of the postures and positions for labor and birth; the meditations, and visualizations come from my own experience.

I give women a selection of options from which they can choose to use, or not, as their body tells them.  I remind them not only to follow their body’s instincts, but to trust in their baby and their placenta to know how to give birth.

I do not prescribe certain breathing techniques for women to use.  Nor do I prescribe a series of positions for a woman to use during birth (like a certain Yoga Birthing method).  I do not prescribe any specific mantras, music or meditation.

Why not teach a method?  Why not give more specific instruction as to what to do when?  Because no one method will work for everyone.  There is no one right way to give birth.

If I tell you do X, Y and Z while breathing this way, I’ve stripped you of your autonomy.  I’ve taken away your ability to trust in the process of birth.

If I tell you do X, Y and Z while breathing this way and you fail to do it, for whatever reason, you will more than likely perceive your birth as a failure or perceive yourself as a failure.  This is simply not true.

The method failed, not the mother.

I work with pregnant women and new mothers all the time.  I run a yoga-based workshop called Healing from Traumatic Birth.  I’ve been teaching it for the last 3 years.  One thing that surprised me is the number of women who feel like failures because they didn’t have the “Bradley Birth”.  They “gave in” to the epidural, therefore their birth was traumatic.  Their mantras or affirmations weren’t enough to get them through, so they requested pain medication – and it was devastating for them.

Perception becomes reality.

These mothers perceive themselves as failures, therefore their births were traumatic.  Their perception is valid, their pain is valid.  However, this is not their fault.

This is a failure of the method, not the mother.  This is a failure of that educator, not the mother.  By not following through with an (somewhat) arbitrary set of predetermined, prescriptive behaviors, the woman perceives herself to have failed not only herself but her baby.

On the flip side when a birth is “successful”, and we credit the method we take the power away from the woman.  We strip her of her right to say “I DID IT!”  Instead we hear her say, “I couldn’t have done it without method X!”

In response to a shared birth story online:

Mom #1 – “Thanks so much for sharing! I love reading Hypnobabies stories since I’m using that method this time…”

Mom #2 – “I agree. I of course thought it was awesome that it was a Hypnobabies story to…“

My response – “Credit where credit is due. It’s not the method, it’s the mother. Kudos to her for birthing her baby the way he needed to be born.”

It takes the power away from the mother to credit the method for her birth “success”.  To credit the method is called “advertising”. 

• Prenatal Yoga, Part 1 – Helping your Client Choose a Class
• Prenatal Yoga, Part 2 – Breathing, Meditation and Relaxation
• The sister post on Giving Birth with Confidence – Choosing a Prenatal Yoga Class
• On our Radar: The Exmobaby
• Jumping to conclusions: Popular media spins an abstract into headlines.
• Highlights of, and thoughts regarding the AAP’s Policy Statement “Breastfeeding and the Use of Human Milk”.

Happy Reading!

In Fertility Yoga, we work with specific pranayama (breathwork) to help women learn to better manage the stress.  These techniques are something that can be used at home, work, or during their fertility treatments.  But the breathwork is for more than just stress relief.  It helps develop body awareness and helps us to open both the physical and the emotional bodies.

One of my teachers, Max Strom, has a wonderful explanation on why we need to learn to breathe:

Meditation is a sister practice to breathwork.  Breathwork can, in and of itself, be a meditation or it can be used as part of a meditation practice.  In Fertility Yoga, we use specific meditations, with visualizations to help clear some of the emotional blockages women may have.

The physical body is also addressed in a Fertility Yoga class.  We look to the belly and the hips, as well as the chest and the heart.  We work to open physically in class as well as emotionally.

So, come join us on Monday nights for Fertility Yoga.

Sat Nam.

“A better way to understand tapas is to think of it as consistency in striving toward your goals: getting on the yoga mat every day, sitting on the meditation cushion every day—or forgiving your mate or your child for the 10,000th time. If you think of tapas in this vein, it becomes a more subtle but more constant practice, a practice concerned with the quality of life and relationships rather than focused on whether you can grit your teeth through another few seconds in a difficult asana.” ~ Judith Lasater

How do we, as pregnant women, dedicate ourselves to our pregnancies, our births and our babies?  How do we dedicate ourselves, and not lose who we were before we became pregnant?  Where is this balance, this center?

Tapas is being conscientious and aware.  It means acknowledging the little one growing inside, and taking their physical and emotional well-being into account when we go about our daily lives.  That means when we, as pregnant mothers, eat a meal, we do it with the understanding that the food we eat is the food that nourishes our baby.  We are conscientious and eat with care that food that is healthy and in appropriate quantity.

It means that when we watch a movie, listen to music or other forms of entertainment, we understand that baby feels what we feel.  Babies react to loud angry music with fear, anxiety and increased heart rate.  When mama is angry or afraid, she releases adrenalin which then crosses the placental barrier to affect her baby.  When we take sensory input that is happy or pleasant baby reacts in the same way.  By practicing Tapas, we skip that sensory input that would harm baby.

On Discovery Chanel’s “Curiosity”, they spoke a bit about the sensory input affecting baby:

There is also an excellent TED talk by Annie Murphy Paul on “What we learn before we are born”. 

I’ve seen some mothers take this dedication too far, to the exclusion of all other people and activities.  I’ve seen pregnancy and birth become all encompassing, even to the point of obsession.  This is not Tapas.  When a mother neglects her husband or partner because of the baby, this is not Tapas.  When a mother restricts her activities because they are not “safe” for baby such that she becomes fearful of normal daily life, this is not Tapas.

This, of course, goes back to finding balance – balance between the woman a mother is before she becomes pregnant and the woman she is transforming into as a mother.  It means understanding that she will change.  Some aspects of her life are irrevocably gone, to be replaced with new and more appropriate ones for her role as a mother.  Her core self, her Atman, remains intact.  She will always be who she was and who she will become.  Acknowledging this is a key to achieving this balance.

How do our care providers dedicate themselves to supporting and protecting our bodies and our babies?  Our spirits?

From the care provider’s perspective, Tapas is a bit different.  I speak here more about dedication to practice and to patient (Though, I dislike that word since it gives the connotation that a pregnant mama is sick, when, in fact, she is healthy… but I digress.).  When the care provider is dedicated to caring for the pregnant mama, he will take the time to truly listen to her.  He will put her physical and emotional needs above his own needs, desires, protocol and policies.

When care providers don’t do this we see instances of labors being induced on Dec. 23^rd because the care provider is going on vacation for the Christmas holiday.  Sadly, this is not a myth.  Inducing labor or scheduling a c-section for care provider convenience is far more common than you’d imagine.  For more details – I wrote an article entitled “Scheduling Birth, is this a good option for me?”

Care providers can also look to the prenatal tests performed and the standard procedures during labor and birth for ways to better dedicate themselves to the individual mother.  What are the risks and benefits to both mama and baby?  Will a test cause fear, more testing, more fear all for naught because the test has a high inaccuracy rate?  Are you, the care provider, working to prevent a potential problem or working to solve a problem presently occurring?  Is the test or procedure being done simply because it’s “always done” or is it because there is a presenting risk factor?

Looking at labor; as a care provider, are you watching the clock?  Are you watching the fetal / contraction monitor instead of looking at the mother in front of you?  Do you offer pain medication because you feel that she is in too much pain?  Do you offer pain medication because she is asking for it and do you give her all appropriate options?  Did you discuss her pain medication options thoroughly during a prenatal appointment?  Are you aware of the mother’s desire (or not) for pain medications?

When performing the newborn examination, and administering medications to the baby do you take into account the baby’s needs and feelings?  Do you practice skin to skin contact, delayed cord clamping and breastfeeding initiation before any procedures are done (barring medical complications)?

There are more questions to be explored.  However, what it boils down to as a care provider is – do you put the health, safety and emotional well being of mother and baby before your own?  Are you dedicated to your practice?

This is not to the exclusion of the care provider’s personal life.  Care providers need to go home to their own families for dinner.  They need to take vacations.  Heck, they need to use the bathroom and get some food during a mother’s labor!  Taking personal time makes us not only better people, but better care providers.  That whole work / life balance thing…  Ensuring that, as a care provider you have appropriate back-up for when you are gone; informing a mother, fully, about that back-up; and keeping your back-up informed about the mother’s pregnancy and labor will allow for a smooth transition.

A care provider also can practice Tapas by keeping up to date with the current studies and medical advancements with regards to his scope of practice.  Dedication means ongoing study, professional improvement and flexibility to change practice with the evidence indicates change is necessary.

Tapas for both mother and care provider is dedication to the pregnancy, the baby and the emotional well being of all involved parties.  It is achieving balance between self and the role in which we are cast; a work / life balance and a woman / mother balance.

Sat Nam.

Up next: Svadhyaya (Study of the Self)