Tree Life Birth Care in White River Junction, VT, is our newest location for Total Pregnancy Fitness. The center is dedicated to providing balanced, evidence-based support to women and their families during pregnancy, labor and postpartum. They offer doula care, childbirth education, prenatal dance classes, and lactation consulting in the Upper Valley region of Vermont and New Hampshire. For more information, visit http://LifeTreeBirth.com or email Mary Etna Haac at DoulaMaryEtna@gmail.com.
Mary Etna R Haac, MPH, PhD, DONA-trained Birth Doula. Bilingual: English-Spanish. 703-447-98-94.
Women’s Health & Fitness Programs
Many important health issues for girls and women involve matters of reproductive
health, childbearing, fertility and aging. Research informs us that an active, healthy
lifestyle provides a number of benefits throughout a woman’s life span:
reduced discomforts from pregnancy, labor, birth, recovery & menopause
reduced risk of hypertensive disorders of pregnancy and premature birth
potentially shorter active labor and reduced risk of cesarean delivery
more rapid return to joyful activities, less excess weight following birth
mother-infant interaction, leading to infant psychomotor enhancement
reduced rates of obesity, cardiovascular disease, and type 2 diabetes
reduction of some cancers, osteoporosis, falls and loss of muscle mass
improved social support, networking and stress management skills
greater belief in one’s ability to be strong and capable (self-efficacy)
As part of our mission to contribute to safe motherhood around the globe, DTP is promoting the work of CleanBirth.org. This organization works to make birth safer in southern Laos, which has the highest rates of infant and maternal mortality in the region. The vast majority of women give birth without a trained attendant or clean supplies, but CleanBirth.org is making a difference, improving outcomes through simple initiatives that provide life-saving birthing supplies and information.
To promote hygienic birth, CleanBirth.org partners with a Lao non-profit, Our Village Association (OVA) to train local nurses to distribute Clean Birth Kits – the life saving birth supplies that cost a mere $5 each. The nurses then train a volunteer from each village to distribute and track the kits and spread information about safe birthing practices.
$250 sponsors a nurse who serves as many as 1o villages
Think of this as your Valentine present to the world. Safe Motherhood is a major global movement, and organizations such as CleanBirth.org are the on-the-ground work force that is bringing about improvements in maternal and newborn survival.
In the generations since birth moved from the home to the hospital setting, it has become less and less frequent that women in developed nations see birth first hand and accept it as a natural part of life prior to their own first birth experience. The “epidemic” of fear surrounding birth may well be partly a result of this phenomenon. In a recent post published in Midwives magazine, a publication of the UK’s Royal College of Midwives, DTP director Ann Cowlin wrote a blog entitled ‘Exercise and Body Trust in Birth.’ The post addresses the confidence in one’s body that accompanies training specific exercise and how this applies to pregnant women and their preparation for birth. Here is the link to the blog post: http://community.rcm.org.uk/blogs/exercise-and-body-trust-birth
DTP: When did you first work or study with DTP? HSB: We first discovered DTP in 2011 while researching evidence-based exercise programs for pregnant women. DTP was exactly what we were looking for! So in January of 2012, Healthy Start Brooklyn trained three former clients and one staff member to teach free DTP classes to low-income pregnant women in Central Brooklyn. It took some time for us to get the program up and running, but we have been offering classes since March of this year and they have been continuing successfully ever since.
DTP: Describe the focus or mission of your work. HSB: Healthy Start Brooklyn is a federally funded program that seeks to improve the health and wellness of women, infants and families in Central Brooklyn. Rates of infant death, premature birth and illness in the neighborhoods of Bedford-Stuyvesant, Brownsville, Bushwick, East New York, and Flatbush are far higher than elsewhere in New York City and the U.S. as a whole. HSB provides support services, education and training to reduce these inequalities and improve the lives of Central Brooklyn residents. Our DTP classes, as with our childbirth education and doula programs, are aimed at trying to offer our clients free services that are available to more affluent women to help offset some these inequalities that can have a negative impact on birth outcomes.
DTP: What do you most enjoy about your work? HSB: We enjoy seeing our clients coming back to class every week. Some of them have very little support systems in their lives, and it is extremely rewarding to see them participate in class each week and stay after class to talk to each other and share stories. It is our hope that the class not only positively affects their physical health, but also their mental health as well, serving as a place where they can de-stress and socialize with other women in similar situations. We also really enjoy receiving pictures of the babies that our class had some part in helping enter the world healthy!
DTP: What is the most important or interesting thing you have learned from working with moms, moms-to-be, or other women clients? HSB: Pregnant women can move! In the beginning, we were nervous about making our class routines too high intensity for some of the women who were further along in their pregnancies. We were surprised to find that they could all keep up and were even requesting the higher intensity routines.
To learn more and see more photos, go to the DTP Blog:
In Part 4 of our continuing series on DTP’s offspring, meet Renee Crichlow, ACSM Certified Personal Trainer from Barbados, whose REAC Fitnessbusiness includes Mum-me 2 B Fitness Series (prenatal), After Baby Fitness Series (postnatal) and 6 week Jumpstart Body Transformation Program (general female population).
See photos and read more about Renee’s business on the DTP Blog here. The adventures of one of her students is featured in a recent series of articles in Barbados Today.
Renee is a women’s fitness specialist, targeting all stages of a woman’s life cycle from adolescent, child bearing years, prenatal, postnatal to menopause. I design various exercise programmes to help women get into shape. As a trainer, friend and coach, I am committed to guiding, motivating and educating women to exceed their fitness goals and to permanently adopt healthy lifestyles. She started studying with DTP in March 2012 and completed the practicum in May 2012.
I most enjoy the good feeling associated with knowing that I am helping women to positively change their lives through exercise. I have learned that we are connected and not separate from each other. Sharing our challenges and triumphs enable each of us to grow and have a sense of belonging like a sisterhood. The baby and pregnancy stories always amaze me and I learn a lot considering I don’t have children of my own. I am also fascinated by the fact that as the pregnant mummies bellies grow, they are still moving with lots of energy and I feed off of that energy. I just love working with pregnant ladies and mothers.
I have long wanted to write this post. Recently two articles appeared in the NY Times prompting me to move forward. One article dealt with how it is that ongoing vigorous exercise produces brain enhancements. The second article dealt with how running creates its “high” and explained why the resulting addiction is an evolutionary benefit for human survival.
Every day in Africa a gazelle wakes up.
It knows it must run faster than the fastest lion or it will be killed.
Every morning a lion wakes up.
It knows that it must outrun the slowest gazelle or it will starve to death.
It doesn’t matter whether you are a lion or a gazelle.
When the sun comes up, you better be running.
Ethiopia, circa 1974
The pregnant mom who exercises vigorously and regularly – the one who runs or swims or does aerobic dancing – is not the one at risk, or whose infant is at risk, of a lack of tolerance for the rigors of labor or for lifestyle health problems. It is the sedentary or low activity mother and her offspring who are at risk. I have written at length on this reality in my chapter on Women and Exercise in Varney’s Midwifery.
This realization has plagued me for ages, and the two articles in the Times convinced me to make this statement, explain why it is true and exhort women of childbearing age to become aerobic animals.
In the contemporary world, we are not as active as previous generations. Few women exercise to the extent required to develop the capacity to withstand the rigors of birth. It is little wonder that so often health care providers hear that women are afraid to exercise, and childbirth educators hear that pregnant moms are afraid of birth and don’t have confidence in their ability to do it. There are solutions for these issues…
The biggest bang for the buck is aerobics. This gets almost everything that helps you in labor. It increases endurance, strength and range of motion. It improves breathing capacity (you get more oxygen + less fatigue). It reduces your need to tap your cardiac reserve (your body works hard in labor but not to the degree it must if you are not fit). Plus, regular participation in a good cardio or aerobic workout gives you the mental toughness and confidence you need to know that your body is capable of the work and the recovery – what we call body trust. Fit Pregnancy has discussed the myths surrounding how hard a pregnant woman can work out.
Learning useful positions and movements is extremely helpful. Be sure that your workout also includes strength and coordination movements – such things as squatting, core movements for pelvis and spine, and other motions that aid your progress in labor. Being upright and moving are keys to a healthy labor. These require strength and coordination.
Mental focus and being present teach you to work with your body. Activities such as relaxation training, yoga, pilates for pregnancy and dance help you develop the mental skills (mindfulness and deep breathing) that accompany your movement. Learn to recognize your body’s signals so you know when it’s time to push.
A truly effective use of your time is a one hour class a couple times a week that combines all these elements. We have known this for decades. The evidence is clear that it works. Keep moving…right into labor and birth!
Sometimes it is fun to look back at the long road to the present! Recently, I was interviewed by our local online media outlet (the Branford CT Patch) and was really thrilled with the resulting story. It focused on the 30 year road of DTP and I thought you might find it interesting.
What started as a “fledgling experiment” has become one Branford woman’s life work.
Thank you for taking a look!
Still looking for new ways to develop core strength & coordination for new moms…start with the posture on the left (inhale) and move to the one on the right (exhale). Keep the transverse abdominal sucked in. Repeat….
This is the time of year many of us consider where to make our charitable contributions. We have assembled a list of groups to which you might want to consider giving this year. By donating to these organizations you can help improve the lives of mothers, newborns,children and families around the world. Most will also send a card or email message to a mom in whose honor you give the gift.
UNICEF Inspired Gifts. You can choose gifts that improve education, water, health, nutrition, emergency care and other factors that affect the well-being of women and children.
The Fistula Foundation. This group exists to raise awareness of and funding for fistula treatment, prevention and educational programs worldwide. Fistula is the devastating injury cause by untreated obstructed labor.
The Preeclampsia Foundation. This organization supports research to prevent and treat one of the most dangerous disorders of pregnancy, one that accounts for a large percentage of premature births and low birth weight infants. Having preeclampsia is also a risk factor for later heart disease for the mother.
Clean Birth. Clean Birth Kits are designed to provide birth attendants and/or expecting moms with the tools they need to ensure a clean birthing environment. The Kits ensure the WHO’s “6 Cleans”: clean hands, clean perineum, clean delivery surface, clean cord cutting implement, clean cord tying, and clean cord care.
March of Dimes. The “mother” of all charities for helping prevent and treat disorders and diseases that affect children.
The challenges to safe motherhood vary depending where in the world you live. In some areas the challenge may be to get adequate nutrition or clean water; in other areas, it may be to prevent infection; and in still other locations it may be trying to avoid pregnancy before your body is ready or getting access to prenatal care. In the U.S., it may mean avoiding being sedentary and making poor food choices, or having to deal with the high technology environment of medical birth that can sabotage the innate physiological process of labor and birth.
Birth begins the bonding or unique love between mother and child.
The biology of birth is a complex series of cause-effect processes…baby’s brain releases chemical signals to the mother and the placenta begins to manifest the maternal immune system’s rejection of the fetus.
To help the ball get rolling, relaxation (the trophotropic response) helps promote the release of oxytocin. With the help of gravity, the head presses on the cervix, amplifying the uterine contractions. After an ultra-distance aerobic endurance test, the cervix opens enough to let the baby move into the vagina and the mother’s discomfort moves from sharp cramping into the bony structure as she transitions to the strength test of pushing. She transitions. Relaxation modulates into an ergotropic – adrenal – response to gather her power.
Pushing is an interesting term…more masculine, I think, than the one I prefer: Releasing. Releasing or letting go of the baby. It’s a catharsis. In this portion of the labor another set of important processes help the baby clear its lungs of amniotic fluid, stimulate its adrenal system and challenge its immune system, as the contractions drive the baby downward. The mother’s deep transverse abdominal muscles – if strong enough – squeeze the uterus like a tube of tooth paste, to aid this expulsion. In the meantime, the labor is helping set up the mother to fall in love and produce milk. When the baby emerges and moves onto the mother’s chest, s/he smells and tastes the mother, recognizing her mother’s flavor and setting up the potential for bonding.
Any way you slice it, there are two parts to safe motherhood. One is a safe pregnancy…healthy nutrition, physical fitness, safe water, infection prevention, support and a safe environment. The other is a safe labor. In a safe labor, there is both an environment that promotes the natural process of labor and the means necessary for medical assistance when needed. Women die at an alarming rate from pregnancy or birth-related problems. Despite some progress made in recent years, women continue to die every minute as a result of being pregnant or giving birth.
What keeps us from having a better record on motherhood is often lack of care in the developing world and too much intervention in the U.S.. They are two sides of a coin. Mothers’ experience and health needs are not on equal footing with other cultural values. In places where basic prenatal care or family planning are low priorities, at-risk women are vulnerable to the physical stresses of pregnancy and birth. In the U.S., machine-measured data is paramount, even if it produces high rates of false positives, unnecessary interventions or counterproductive procedures. We are learning that obesity and sedentary lifestyles have detrimental effects, but fewer pregnant women than their non-pregnant counterparts exercise.
Despite the money spent to support the technological model of pregnancy and birth in the U.S., there are parts of the world with lower rates of maternal deaths – especially Scandinavia, Northern Europe and parts of the Mediterranean and Middle East (Greece, the United Arab Emirates, Israel, Italy and Croatia). In fact, in the U.S., maternal deaths are on the rise.
It’s a tricky business. Clearly Western medicine has a lot to offer the developing world when there are medical concerns. On the other hand, importing the U.S. model could create more problems than it solves. Instead, the micro-solutions now being developed in many locations will be observed and evidence collected by organizations such as the White Ribbon Alliance and UNICEF.
There is an effective international midwives model adopted by JHPIEGO, the Johns Hopkins NGO working toward improved birthing outcomes. It assesses the local power structure, social connections, potential for trained birth assistants, and location of available transportation to create a network so that locals will know when a labor is in trouble and who can get the woman to the nearest hospital.
In the U.S., there are in-hospital birth centers that allow low-risk mothers the opportunity to labor and birth in a setting designed to encourage the innate processes. Women are beginning to vote with their feet…staying home for birth. Women are going abroad to give birth. At the same time, women are coming to this country to give birth, believing it is safer than where they are. There are several ways these scenes could play out.
But, I’ll wager, improving outcomes will involve compromise: Watchfulness and support in most births, plus better ways to assess danger and provide technology. No matter where you live in the world, the solution may be essentially the same.