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Taking Care of Yourself

By Guest Blogger, Krista Maltais PCD(DONA), CLC, B.S. Family Studies.

“In the day-to-day grind of it all, it’s easy to get stuck thinking, “the day is too short, the to-do list is too long, and gosh darn it, people need me!”. This is especially true for parents. But, in order to take care of others, you have to first take care of yourself. “

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I begin this blog while at an airport returning from the first vacation I have had in years. As I sit here waiting for the plane to depart, I can’t help but reflect on the necessity of taking care of one self.

In the day-to-day grind of it all, it’s easy to get stuck thinking, “the day is too short, the to-do list is too long, and gosh darn it, people need me!”. This is especially true for parents. But I have learned, and this vacation has re-inforced, that in order to take care of others, you have to first take care of yourself.

As a postpartum doula and lactation counselor, I see how burned out new parents, especially new mothers, can get when they go-go-go and try to take everything on themselves. There is only so long that level of intensity (and the adrenaline that fuels the intensity) can sustain itself before stress, fatigue, or full-on exhaustion, shows itself. It may reveal itself in emotional outbursts, illness, accidents, or physical pain.

Amongst the daily tasks of parenting, it can be difficult to remember to eat and shower let alone remember how crucial it is to recharge. However, taking care of one’s self doesn’t have to mean a full week’s vacation (although, I highly recommend it!). Self-care can, and should, be found in a daily routine. Here are some ideas to try and incorporate into your life:

  • Take deep breaths. Breathing deeply helps move your body out of fight-or-flight mode and into the relaxation response and has been proven to help combat fatigue, anxiety, and depression.
  • Eat nutritious small meals and snacks throughout the day and drink to thirst. Set up snack bags and water bottlesin the places you spend the most time (in the living room, next to your nursing chair, in the car, etc). A hungry parent cannot fully function, may become short tempered, and is less likely to deal with parenting tasks/challenges calmly.
  • Exercise and socialize. Moving your body helps reduce stress and has numerous health benefits as does socializing with family and friends. It’s easy to combine the two by going for a walk with your spouse or signing up for a new exercise group with friends. As a bonus, there are many parent-baby exercise classes available in our area which may make this easier to accomplish.
  • Go for regular body work. Parenting is emotionally and physically demanding. It may seem difficult to schedule an appointment amongst the busyness of the day, but having proper physical care through chiropractic and/or massage will make it easier to sustain the tasks of parenting.
  • Ask for help. This is especially important for spouses to remember! Communicate as openly and honestly as possible about how you are feeling and what you want/need. People are usually willing to offer a helping hand and may feel more comfortable taking an active role if told specifics. Don’t have family or friends close by or don’t feel comfortable asking? See the next suggestion…
  • Hire professional support. Certified postpartum doulas are trained to know what new parents want/need. Do you just want a long, hot shower, and a nap? No problem! However, postpartum doulas can also offer education about newborn care techniques, mother care, partner and sibling adjustment, early childhood development, postpartum mood disorders, breast and bottle feeding as well as coping skills. Want something warm to eat that you didn’t have to prepare? Sure! Postpartum doulas can also assist with your family’s daily needs such as organizing the home, running errands and providing additional local resources. Are you breastfeeding? A certified lactation counselor can provide personalized breastfeeding assessment and support to ensure pain-free and successful nursing experiences in the privacy of your home.  There are all kinds of professionals out there to help you – house cleaners, dog walkers, landscapers, etc! Just ask!

The airplane’s safety announcement has just come on. The flight attendant has checked our safety belts and is telling us that in the event of an emergency, air masks may drop and that you must always put on your own oxygen mask before assisting others. How true. It’s not easy and sometimes it can feel selfish to take care of yourself, but the earlier and more regularly you incorporate self-care measures into your life, the easier and healthier your life will be.

About the Author:

Koru Care Postpartum Doula Services
Krista Maltais, PCD(DONA), CLC, B.S. Family Studies
Koru Care Postpartum Doula Services provides in-home postpartum doula and breastfeeding support to families in Southern Maine, Southeast New Hampshire, and Northern Massachusetts. Krista’s mission is to provide the highest quality of care and education to your entire family so that you may achieve the confidence, skills, and resources needed to build a strong and successful family foundation.

About Healing Hands Chiropractic:

Healing Hands Chiropractic is a full-service family wellness center specializing in Webster certified prenatal & family chiropractic care, acupuncture, cognitive-behavioral therapy, reiki & aromatherapy, massage therapy, pregnancy & birth classes and breastfeeding support.

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Massage Therapy and Postpartum Depression

By Shalon Da~Nai, LMT
May was a beautiful month as the world  came alive and new beings were birthed into existence.  The grasses grew, trees budded and blossomed, and flowers sprouted and bloomed.  Pairs of birds filled their nests with chirping young and many human babies were also born.   It couldn’t be a more fitting time to focus our energies towards the health of new mothers.   May is the official “Postpartum Depression Awareness Month”.  Earlier this month we hosted a charity event at Healing Hands Chiropractic Family Wellness Center to raise money for the cause.  We had a successful “Day of Relaxation” as participants enjoyed sample treatments from the team at Healing Hands.  There was massage therapy, acupuncture, reiki, yoga and local healthy foods.

In honor of May and mothers who experience depression, I want to discuss the benefit that massage therapy can have.  Unlike drug treatments that medical doctors might prescribe, massage has no negative side affects to a mother or nursing baby.  It is gentle, safe and effective.  Women who receive massage therapy during pregnancy have less pain and lowered stress levels.  This translates to the fetus’ and the infant’s stress hormones are also reduced.  We can continue these affects after birth with postpartum massage  and infant massage.

Massage for moms helps to reduce pain and trigger points developed during pregnancy, allowing her body to quickly transition back to its pre-pregnancy state.  It aids in the balance of hormones, which play an important role in depression.  Massage can help regulate sleep and induce relaxation.  Without proper rest it is very hard for the body and mind to heal.  Fatigue is a contributing factor to depression.  And most beneficial is the ability of massage therapy to reduce the stress hormone cortisol which puts stress on all body systems.  Taking time to receive massage gives Mom time for herself, where she can be nurtured with healing touch and be able to offer more nurturing care to her new child.  Infant massage can help to lessen the effects of postpartum depression.  Through massage a mother learns to calm the discomforts of the infant from digestive issues and colic.  Massage has the same affects on baby as they do on the mother, balanced hormones, reduced stress levels and enhanced sleep.

A relaxed baby means a baby that cries less and therefore a relaxed mom.   Performing infant massage enhances the bond between mother and child.  Communication becomes clearer because mom can learn to identify the body language and other cues their baby uses to express themselves.  With this understanding she will have more confidence in her new role as a mother.  Shalon Da~Nai, LMT is Certified in Prenatal and Postpartum Massage Therapy.  She offers one on one Infant Massage classes to parents and caregivers.
All appointments and classes can be scheduled online at ShalonLMT.com or http://www.healinghandsnh.com/massage-therapy/massage-therapy-online-booking/


Links

www.postpartum.net

http://www.medscape.com/viewarticle/471895_4 for research on Massage/infant Massage for postpartum

To reach the Postpartum emotional support group  call 603-663-8927

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What is a Doula Worth? How We Come Up With Our Fee.

by guest blogger, Allison Connor of Birthroots Doula

How a doula sets her fees is a mystery to many people; We offer this information so that you have a better idea of what you’re paying for. (adapted from www.gentlebirth.org)

Hours – Couples having a first baby may imagine that their doula will only be spending a few hours with them during the labor and birth.  In reality, an eight-hour labor would be considered pretty fast; most first labors last at least 24 hours; the longest continuous time we’ve spent providing labor support is 51 hours.  The average time we spend with a woman for her labor and birth is about 13 hours.  We spend another 10 hours in prenatal and postpartum visits, another hour or two in phone calls or email, and up to six hours travel time.  Using those averages, our fee translates to an hourly rate of about $25/hour, before expenses and self-employment taxes.

Clients per Week – When we make a commitment to be available to attend you in labor, we have to limit the number of clients we put on our calendar so as to avoid birth conflicts and to ensure that we are reasonably rested when you go into labor.  The rule of thumb for birth professionals providing in-home services (compared to someone working a shift in a hospital or sharing call with another provider) is that one client per week is a full schedule.  Because we also do a lot of teaching, we find that two to three clients per month is a full-time workload.

Clients per Year – When we put your due date on our calendar, we commit to being available two weeks beforehand and two weeks after that date.  This means that when we schedule a vacation, or attend a conference, or have a commitment that we cannot miss, we have to add another four weeks during which we cannot accept clients.   We have averaged about 25 clients a year the past few years.

Being Self-Employed – The rule of thumb is that a self-employed professional’s income is only half of what they earn, after deductions for vacation and sick time, self-employment taxes, insurance, and business expenses. As you may imagine, our communication expenses are high – business phone, cell phone and computer connection.   We also have typical professional and office expenses, continuing education expenses, and unusually high transportation expenses since we primarily travel to people’s homes.

Putting It All Together – Although we are dedicated to this work, being on-call all the time requires a very high level of personal sacrifice, including a willingness to be awoken after half an hour of sleep to go attend a labor for the next 40 hours.  About 25% of our clients have some kind of early labor which starts and stops, resulting in multiple phone calls – often in the middle of the night.  In past years, we have spent our birthdays at a labor, our families have spent Christmas day without us, we’ve had to cancel (and then reschedule) numerous classes and appointments, and find middle-of-the-night childcare when our husband’s were away on business.  We cannot take weekend trips away from the area, and even day trips to the spa or the mountains have to be judiciously chosen.  We never know what we’re going to encounter at a particular labor – we may end up wearing out our body’s supporting the woman in different birth positions; We may take catnaps sitting in a chair; we may eat nothing but crackers and dried fruit; we may end up holding a vomit bowl for someone vomiting with every contraction during transition; we may end up with blood, meconium or worse on our clothes.   Thank goodness we LOVE our work!  But the financial reward for this?  The annual income of someone providing labor support services with a responsible client load and a strong commitment to being available for birth is 1/2 the number of clients per year times their fee per client.

Experience Factor – When we step into a birth, we bring not only our hearts and hands and training, but our experience from over one hundred fifty births and continual research on subjects relating to birth.  As a doula and educator, we must keep up-to-date on the latest studies, procedures, protocols, and policies surrounding birth and area hospitals and providers.  Did you know that doctors, midwives, and nurses usually only know their way of doing things?  As a doula, we see the variations from hospital to hospital, between care providers, and over time.  Being able to work with many different care providers, we learn all their different approaches and tricks, which we think is unique to the doula profession.  And considering that every birth and every family teaches us something new, we have a wealth of knowledge and skills to bring to birth.

Bottom Line – Nobody’s getting rich doing doula work.  But every doula should be able to make a decent living as a doula without making her life unbearable.  We wish we could offer our services at a rate that everyone can afford, but that would require that we make even greater financial sacrifices than we are already making to do this work.  We are a self-supporting professional, and our options are to earn a living wage working with birth or to have a more conventional job, which would pay much more. There are people offering doula services at significantly reduced prices.  They are either offering less time and services, are still in training, or are in a financial position to offer free services.  If you need free doula services, there are many ways we can help you find a free doula; otherwise, you are doing future birthing women a disservice by making labor support an underpaid profession that cannot attract or keep talented, skilled individuals.  If you end up selecting a doula who is undercharging for her services, we strongly encourage you to pay her more than she is asking; otherwise, she may not be around to help you with your next child.  The most common cause of doula burnout is feeling overwhelmed by the commitment and uncompensated for one’s time and dedication.

Advocacy Suggestions – Doula services are rarely covered by medical insurance plans, even though the statistics prove that doulas can save insurance companies lots of money by reducing the use of medications, interventions, time in the hospital, and surgical (Cesarean) births.  You can talk with your Human Resources representatives to ask them to lobby to include all doula services as a covered option in your plan.  Also lobby your State legislature to include doula services in state-funded healthcare so that low-income women have access to experienced doula support and doulas don’t have to further their financial burden by attending these births for free (that is what we do now).  Additionally, you could talk with your midwife or doctor to encourage them to offer universal doula care to their clients.  By hiring several doulas to be on-call for their clients, they could substantially reduce the cost per birth (and make their job easier) – although in this model the doula might be someone you’ve never met before.  You could also advocate for the hospital to provide universal doula care, so that it would be covered in the same way as their in-house lactation consultants are covered.  By all means, tell everyone you meet about the support you received from a doula – spread the word about doula care so that more doulas are needed and are well-paid and can continue their work for generations to come.


BirthRoots Doulas offers labor support in Southern and Central New Hampshire.  Our doulas provide caring support to birthing mothers and their families.  They attend births in hospitals, freestanding birth centers and homes in Southern and Central New Hampshire, including greater Concord, Manchester and Nashua areas and the Monadnock Region.

Dr. Jessica L. Caruso, is the owner of Healing Hands Chiropractic Family Wellness Center. Dr. Jess is certified in the world renowned Webster Technique for pregnancy. She is also a proud member of the American Pregnancy Association, Holistic Pediatric Association and International Chiropractic Pediatric Association. Dr. Jess highly recommends doulas to all her pregnant patients. Learn more about natural pregnancy care at Healing Hands Chiropractic Family Wellness Center‘s website.