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)
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:
As I became involved in the birthing field, one of the nurse-midwives with whom I was acquainted introduced me to Jung’s quotation: “There is no birth of consciousness without pain.” (Alternately, “There is no coming to consciousness without pain.”) It struck a deep chord in me.
When I first saw the saying, “There is no birth of consciousness without pain,” intertwined with a drawing of a woman literally giving birth, the truth of the image seemed obvious to me. It become hard-wired into my underlying assumptions about giving birth. The process itself combines intense noxious sensations with mid brain emotional input into what neural science calls pain. For years, this realization has driven what and how I teach: Being fit and educated in body/mind are the tools of enlightenment and self-empowerment.
…And This Is Now
A little while ago I came across a NY Times article “Profiting From Pain.” While the article concerns the huge increase in the legitimate opioid business – products, sales, hospitalizations, legal expenses and workplace cost – it restarted my thinking about a topic fermenting in my brain between That Was Then And This Is Now: The sense of entitlement to a pain-free existence. The idea that pain free is better than painful. And the selling of this idea for profit.
Could it be that human fear of pain is being used to generate financial profit? (the opium-is-the-opiate-of-the-masses model). Perhaps once the notion of palliative care reached a certain level of acceptance for the dying within the medical community, it began to spill over into other human conditions (the slippery-slope model). Or, perhaps we don’t want transparency at all (the denial model).
In the last few days, NPR has raised the question of whether the high cesarean birth rate is tied to the payment for procedure rather than outcome model? The recovery from cesarean is more painful than the recovery from vaginal birth, has adverse side-effects for mother and baby, and was originally designed for use only for the 15% +/- of real complications that arise in normal birth. So, how is it being sold to 35% of women in the U.S,? At one point, there was a serious discussion within the medical community that if women were afraid of the pain of birth and wanted a cesarean, a care provider should do one. No discussion of why it seems painful or how to deal with pain.
The Affordable Care Act aims to improve some of the cost issues in medical care by shifting the payment incentive away from procedures and on to outcome assessment. As a result, the cesarean rate and even such seemingly innocuous procedures as fetal monitoring are coming under scrutiny. If we truly want to do a service to the mothers-to-be in the ACA transition period and beyond, I think we must discuss the question of birth and pain.
I can think of many questions that fall under this topic…Why do we call the intense phenomenon of birth “painful”? How do our genetics, behavior, training and thought-processes affect our experience of pain? What about the health care culture – has it focused on relieving pain at the expense of what we gain from working with pain short of trauma or imminent death? How do we prepare women for working with sensation without automatically labeling it pain? Is the “empowerment” often attributed to giving birth what is learned by going through the center of the “there is no birth of consciousness without pain” experience? These questions are just a start.
Let me address the childbirth educators and pregnancy exercise instructors. This is our present challenge. In my work, I feel the necessity to make all pain management strategies understandable to my clients. I find that most of the women I see in classes must deal first with self-discovery before they can assess their commitment to the view of birth they carry in their minds. The images of birth we lay out for them to consider need to include an understanding that you cannot escape the work of birth. Being present – mindfulness – can be scary and intense but it is the medium by which our consciousness expands. Cardiovascular fitness and strength are the source of our endurance and power.
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.
So let’s get on with the topic of How to Get Pregnant, starting with why do we need to know this?
In the past few decades, the average age for a first pregnancy in the U.S. has moved from the mid twenties into the mid thirties. In the same time period, the facts of conception – sperm enters egg released in mid cycle, then zygote implants in the uterus, along with how sex allows this to happen and how to prevent it – seems to have disappeared from middle and high school health classes. If that weren’t enough, as women have become more and more essential in the work force, the cost of having children as well as starting later, have driven down the birth rate. Similar conditions exist in most developed nations, although teen pregnancy rates are lower everywhere else.
The birthing population has bifurcated – we see older women (over 35) and teens as the major groups having children. On the one hand we have been working to reduce teen pregnancy while helping older and older women become first time moms. To a certain extent, they need the same information; its just that with teens we use this information to prevent pregnancy and with older women we use information to help them increase their odds of getting pregnant.
Understanding the menstrual cycle, ovulation, charting temperature – all the basic techniques of using the “natural” method of birth control – have become the first steps of the how-to-get-pregnant coaches. Beyond this, a number of sites have their own essential lists to help women be healthy and ready. Sites such as gettingpregnant.com, pregnancy.org/getting-pregnant, and storknet.com/cubbies/preconception/ provide additional information. Many suggestions – things to avoid eating, what proteins are needed for ovulation, how to reduce stress, what to do if there are sperm problems, how to find IVF clinics, donors and surrogates – are addressed.
How effective are these suggestions? Well, research tells us they are somewhat effective. None of the sites I contacted answered my query about how they measure or assess consumer outcomes when following their suggestions.
An interesting article in the NY Times 9/1/2011, entitled Are You as Fertile as You Look? openened with this sentence: “FORTY may be the new 30, but try telling that to your ovaries.” The reality is that being under 35 is still the best predictor of how difficult it may be for you to become pregnant. As the article makes clear, looking 30 and being 30 are not the same thing. Even healthy living does not prevent the loss of good eggs.
So, what conclusions can we draw? First, even if you come from a “fertile family,” it may behoove you to have your children in your late 20s or early 30s. Second, if you are putting off having children beyond that time, ask yourself what extremes you are willing to go to to have your own biological offspring. And, third, consider adoption. Frankly, it would be wonderful if adoption were easier, but in the drive to conceive at later and later ages we see the hand of biology and understand why adoption is not easy: Our own offspring – our own DNA out there in the world – is a heady motivation.
If you are on the pathway of becoming pregnant, being under 35 is the best ally you have. If not, maybe some of the suggestions on the web will work for you. Whatever you decide, all the best.
One parting comment: Regular moderate exercise – while it helps you stay young and healthy – will not prevent your eggs from being popped out every month. It will help you have a healthy pregnancy if you conceive, so stay with it!
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….
Recently, while talking with some moms in our postpartum exercise class, DTP’s Mom-Baby Fitness™ program, I realized it has been a while since I have addressed the notion of what we call “the 3rd body.” This stems from the idea that before you are pregnant, you live in your 1st body; then, while pregnant, you live in your 2nd body. After giving birth, many women feel their options are to try to get their first body back or live in what they are left with after birth. We suggest another way: create your 3rd body.
We discovered this 3rd body in working with women to gain the fitness necessary to have a healthy recovery and enjoy motherhood. What we found was that women were often becoming more fit than they had been before pregnancy, with less body fat and more muscle, yet their clothes did not fit the same. Sometimes the flaring of the ribs and/or hip bones made for a larger waist – despite less fat!
Many clients also feel a new, deeper sense of their core developed. In fact, over time they realized they actually liked this body better in some ways! After all, they came into the world with the pre-pregnancy body, but this body they actually created out of the profound experience of the physical self that pregnancy and birth provide. It extended the empowerment of birth into motherhood.
Extending this metaphor even further, of course, leads to the 4th and 5th bodies, if you have another child. Eventually, there are more bodies as women go through perimenopause, menopause, post menopause, and what I like to call the phenomenal wisdom stage. Each body represents a new opportunity to become someone strong and profound.
I figure I am to body #8 now, and in each stage I have found something incredible that I could not have at other stages. Long ago I gave up looking for my past bodies. Each one has been brilliant in some way, but in the end it had to be left behind if I was to enjoy life’s path to the fullest.
Living in the moment does require knowing where you are in time, space and energy. So, discard your past bodies with delight and move on. Use your energy to create yourself in the present.
It’s a process and you won’t fully live in your next body until you own the toll of the last one. A postpartum mom may experience hair loss, bigger feet, a mal-aligned spine, constant thirst if she is breastfeeding, exhaustion and a jelly belly. But, all these things will pass with time, if you eat right and exercise regularly. Oh, and you can bring the baby, who will have a blast meeting other babies!!