Labor Like a “PRO”: Pleasure

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This post is the first in a 3-part series of simple ways to think about maximizing your enjoyment of labor by remembering how to do it like a “PRO”:

Pleasure

Relaxation

Oxytocin

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Pleasure Principles

pleasure (noun)- 1. a feeling of happiness, delight, or satisfaction, 2. sensual gratification: gratification of the senses, 3. recreation, relaxation, or amusement, especially as distinct from work or everyday routine

The benefits of pleasure in labor:

-pleasure sensations can help “shut the gate” to the uncomfortable sensations of labor

-many things which cause pleasure also increase oxytocin levels. Oxytocin is the hormone which drives labor progress AND brings on relaxed, loving feelings. (We’ll get into it more in the third part of the PRO series.)

-pleasurable feelings aid in the ability to relax which can greatly decrease pain.

-pleasure shifts our perspective of the sensations of labor.

Grab a pencil and paper and jot down whatever thoughts come to mind about the following questions:

What brings you pleasure? (Think about your five senses.)

Sights:

Smells:

Tastes:

Sounds:

Touch: (think texture and temperature)

 

What makes you laugh/smile?

 

What other things make you feel good, happy, or satisfied?

Now, using the list you’ve made, think about what sorts of supplies you can have on hand to increase the pleasure principle in your labor.  Chocolate, candles, massage oils, essential oils, access to a bath, comfy pillows… whatever is on your list.

While this might sound too simple to work, you may be surprised to find how effective even “the little things” can be.

For more information about the importance of pleasure during labor, and to actually practice using pleasure to cope, register for a spot in an upcoming series of Prepared for Birth.  Engaging, holistic, evidence-based childbirth education really brings together all the pieces of the puzzle.

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In the meantime, stay tuned for Part Two in this series to learn more about preparing to enjoy your birth!

For Fathers, From Fathers

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Much of my work is about supporting and educating mothers wherever they are on their parenting paths. But, many don’t realize how much a doula and childbirth educator also works for the partners of expectant mothers. As Father’s Day approaches, I’ve been thinking a lot about the fathers I’ve been blessed to meet and work with. I wanted to do something to honor them, and all of the amazing fathers out there who make a difference every day. So dads, this post is for you! (I’d also like to recognize that not all labor partners or parenting partners are dads. But, since it’s Father’s Day, this post is aimed at fathers. I plan to do another post soon for all partners, regardless of sex or title.)

In Spiritual Midwifery, Ina May Gaskin says, “It does a man good to see his lady being brave while she has their baby-it inspires him.” I have certainly seen this to be true. But, it’s important for men to understand that this goes both ways. It does a woman good to see her man being supportive, loving, and involved in the pregnancy and birth of their child! As a doula, some of the most beautiful moments I witness are those first moments of becoming for the parents…the look on mom’s face, the look on dad’s face when they meet their newest family member for the first time…these moments are priceless and unforgettable. I am brought to tears every time by the tenderness, joy, surprise, awe, love, and pride I see cross fathers’ faces during labor and birth. It is always a deep honor to witness these moments and they continually inspire me.

I also truly enjoy and appreciate the participation of dads in my Prepared for Birth classes. The entire series is built not just on preparing women for labor and birth, but also on preparing partners to feel comfortable with the process and to know how to provide presence and support in a way that is meaningful to both of them. Partners offer a unique perspective and I always learn a lot from their input and questions. I feel grateful that we live in an era in which dads are welcome and encouraged to participate fully in the process of childbirth education and parenting. It bodes well for the children being born to two parents who are involved in such a loving and eager way!

But, enough about my perspective on fathers in the birth world! What we really want to hear is what the dads have to say! At postpartum visits and in surveys, I often ask partners, “What do you wish you had known before this process began? What did you learn that you would share with other partners?” I’ve gotten some great responses ranging from hilarious to game-changing. What I’d like to share in this post is some of the words of wisdom about that specific moment of *becoming* a father and the early days of parenting. Because I’ve gotten so much great response from this question, I plan to write another post soon with pregnancy and labor advice for and from partners.

I also asked the 2 wonderful men I am lucky enough to co-parent with and received some awesome insight from them both. I’ve added theirs in the list below.

With no further ado, here are fathers on becoming fathers:

“I can’t believe how much I love her. I never could’ve anticipated how much I would like things like dancing her to sleep or wearing her (in a baby carrier). My daughter is really fun to be with.”

“I know you talked a lot in class about how dads can do skin-to-skin time with the baby too and how important it is for bonding for the dad and the baby. That was really important to me and I think it helped a lot to do that right from the start whenever S couldn’t hold him.”

“At the baby’s birth, in a way unlike any other time, fathers don’t have nursing to automatically plug them and baby into each other and time near stops. Finding the way to be with their folk in those moments is a potentially deep quest, and remembering we were like that, and our fathers, etc…”

“It was so wild! I couldn’t believe it was over when she pushed him out and he was here. It went so fast (for me!) It was just the best feeling when he was out. That whole process of having a baby is so amazing. I can’t imagine not being there for that moment.”

“The first night in the hospital, you and your partner are in charge of the baby. When the baby is up in the middle of the night, you’re up. I always imagined a nurse would come in to respond, but that is not the case. Very naïve on my part but just something I didn’t know. And the guy is not supposed to say that they are tired to the birth partner the days after labor. Because the one who gave birth will be much more exhausted and in recovery.”

“Don’t expect to sleep and don’t think that if you get one good night of sleep that the next will be the same. In the words of Douglas Adams, ‘Don’t panic.’ Just relax, enjoy, appreciate, and marvel. Oh, and make yourself useful. (I don’t always agree with that cheeky train but in this instance it’s appropriate.”

“I wish I had known how hard it would be to go back to work after he was born. I just wanted to be home with them. I couldn’t think about anything else at work. I kept calling her to see what he was doing.  Dads should really get more time off to be with their kids too.”

“Relax, because you care, because you tried, you learned, and you love…You will do your best, in labor and in fatherhood… Allow the experience, and the ultimate outcome to overwhelm you and enjoy the true paradigm shift that naturally takes over when your child is born.”

“Be prepared for the most grueling and rewarding experience of your life.”

“Enjoy every second. It will be over before you know it so try to take a moment and take in the awesomeness that is the birth of your child. Trust me it is an experience you will not want to forget.”

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Heartfelt thanks to all the dads who’ve welcomed me as part of their family’s birth teams and an extra shout out to the dads who shared their words of wisdom and love.

Fathers, what thoughts do you have to share about your experience of “becoming Daddy”?

Baby’s First Bath: Who, When, and Where?

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In the discussion of what interventions and procedures may be offered for your baby postpartum, the first bath rarely makes the list.  You may wonder why it should!  A bath is perfectly harmless, right?  Could it really be considered an intervention?

If an intervention is defined as anything that intervenes in the continuous physiological process of labor, birth, and breastfeeding, then the in-hospital bath certainly qualifies as one.

Ultimately, the “burden of proof” for any intervention should lie on the intervention itself.  Are there any real benefits to a first bath being given in the hospital by a stranger?  If so, do these benefits outweigh the risks?  Rather than framing the discussion around risks of an in-hospital bath, though, let’s look at some of the wonderful benefits of delaying your newborn’s first bath, which include:

The Magic of Vernix At birth, your baby’s skin will be coated with a white, waxy or cheesy substance called vernix.  Depending on how many weeks your baby gestated, there may be a little or a lot of vernix on the skin.  Vernix provides protection in the womb from contact with the amniotic fluid (so that baby’s skin won’t wrinkle like ours does after a long bath).  Vernix also provides antibacterial protection, a true benefit in a hospital setting.  Vigorous scrubbing and bathing can remove this protective layer.  Rather than washing this natural barrier away, you can massage it into baby’s skin like lotion.

Breastfeeding Instincts Baby uses the smell of amniotic fluid on his or her hands to help initiate breastfeeding.  You may notice your baby nuzzles her hands against her nose as a cue that she is ready to nurse.  Washing away the natural smells on the baby’s skin will also get in the way of the signals provided by these smells which kick start instinctual breastfeeding and bonding processes.

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Together is Best for Mom and Baby Mother and baby both benefit from uninterrupted skin-to-skin contact for the first several days after birth.  This closeness helps with regulating temperature, heart rate, and stress hormones, as well as increasing bonding hormones, and helping to establish mom’s milk supply. Baby’s other parent is the next best habitat when mom needs a break; familiar sounds and smells are comforting and calming to baby.  Removing baby from the loving arms of his parents for a bath interrupts this bonding time.

First Bath is a Lovely Ritual Giving baby her first bath is a sweet privilege that parents can enjoy when they are ready.  Bath time can be a good way to transition to a change in setting once the family leaves the hospital and settles at home.  Or, it can wait until days later when intuition says it’s time.

Who will give your baby his or her first bath?  When and where will it occur?  This choice is up to you!

Packing Your Hospital Birth Bag

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One of the questions I am asked most often is, “What should I pack to take to the hospital?”

I have heard many great suggestions from students and clients about the things they’ve found most useful to have in their hospital bags. I have also heard often that many mothers find they’ve “overpacked”, not using half of the things in their bags. In general, my response to the question of what to pack is, “Don’t stress about it. You can always ask the hospital staff for stuff you forget or send someone home to pick things up after baby arrives.”

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However, those notorious nesting instincts make many of us feel the urge to have a definitive list to check off in order to feel truly prepared.

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So, without further ado, here is “The List”. Please feel free to add your own necessities in the comments section!

-Any toiletries you need for your own comfort. (Face cleaner and moisturizer, lotion, shampoo, cosmetics, hairbrush, toothbrush, toothpaste, deoderant)

-Lip balm (this gets its own spot on the list because it can also be used as a labor comfort device!)

-Bed pillows in bright cases which won’t be confused with the white hospital pillows

-Medications and supplements

-Robe, sweater, or sweatshirt

-Slippers/slipper socks/socks

-Pajamas with easy breastfeeding access or other comfortable clothes such as yoga pants and nursing camisoles

-Breastfeeding support pillow (I love the My Brest Friend pillow for nursing support. The Boppy isn’t as sturdy for this use but it does make a great pillow for sitting on to avoid pressure on sore bottoms after birth.)

-Any labor coping tools you plan to use. This could include massage tools, tennis balls, rice sock, yoga ball, massage lotion, affirmation cards, focal point, meditation mandalas, battery-powered “candles”, essential oils and diffusers, music players or speakers, etc.

-Snacks and beverages for labor and postpartum (Your hospital “doesn’t allow” eating and drinking during labor, you say? Check out this article for evidence-based information on making a choice about if this is a beneficial policy for your needs.)

-Camera, plus extra batteries or charger

-Phone and/or laptop chargers

-A couple of changes of clothes for baby (including something special for photos if these will be taken in the hospital)

-An outfit for you to wear home from the hospital (Maternity clothes are still the best option for fit and comfort immediately postpartum.)

-Breast soothers (Soothies or other brand) and nipple ointment (lanolin and coconut oil are both popular choices.)

-A white noise machine or app to drown out some of the constant noise of the hospital.

-An empty duffel bag in which to carry home supplies and gifts you receive while in the hospital.

Hospitals generally provide many of the care items you will need for immediate postpartum comfort including witch hazel pads for soothing hemorrhoids, ice packs, large pads and mesh underpants, stool softener pills, cooling spray for a sore perineum, perineal wash bottles, etc. You can also take many of these things home with you; just ask your nurses what’s available.

Packing for Partners

Partners will want to pack their own bags for comfort during labor and the postpartum stay. This should include many of the same items listed above, with the obvious deletions! A button down shirt that can be worn during skin to skin time with baby is also nice to have in the bag. They may also find it handy to have the handbook from your childbirth education class and/or a copy of The Birth Partner by Penny Simkin.  Or, this great cheat sheet.

I would love to hear from you if there are other “must haves” for the bag. What were the things you were glad to have on hand? Were there items you found just took up space?

Red Flags: 3 Signs Your Care Provider is Not a Good Fit for You

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(Please note: for the purposes of this list, I use they/them pronouns to refer to care providers in order to make the language open to all possibilities.)

  1. You feel anything less than SEEN, HEARD, AND RESPECTED in your visits.

You deserve to be treated as if your time, concerns and questions matter.  Do you have time to ask your doctor or midwife all of your questions or do you feel rushed?  Do you feel satisfied and confident with the responses to your questions or are you met with disapproval for asking them? Examples of “red flag” responses to questions might include: “I’m the one who went to medical school.  Why don’t you let me decide that?” or “You don’t need to ask so many questions.  I’ve been doing this for a long time,” or “You think you want a natural birth now but just wait!  You’ll be begging me for the epidural when you’re in labor.”

If someone so readily dismisses your desires or insults your values in a prenatal visit, this is not a good sign that your wishes will be respected in labor.  (A related sign of disrespect is the use of the word “let”, as in “I don’t let my patients go over 40 weeks.” You are the consumer and this is your body.  Your care provider’s job is to provide you with information and recommendations based on their education, experience, and the evidence so that you can make the best decisions for you.  It is NOT their job to decide whether or not you are allowed to do anything!

 

2. They do not practice evidence-based care.

You deserve care that is based on what the best evidence shows is safest and healthiest for you and your baby, not just care that is most convenient or routine for your care provider.

A care provider’s rates of interventions (such as induction, episiotomy, or cesarean) tell a story about the sort of birth they routinely attend and the mode of care with which they feel most comfortable.  If these rates are not within recommended guidelines or if your care provider tells you they are unwilling or unable to provide statistics on these things, then it’s red flag time.

An independent childbirth class can help you understand how to find and use evidence, and how to ask questions about your care in the moment.  Some wonderful resources for researching evidence include:

http://evidencebasedbirth.com/

http://www.improvingbirth.org/

http://www.childbirthconnection.org/

Responses like, “This is just how we do it in this practice because we’ve found it works best,” or, “Sure, I’ll let you do whatever you want as long as the baby isn’t in danger,” don’t answer the actual concern or show a willingness to make a real change in the way of practicing.  Look for specific details on how they plan to support you in having the safest and most satisfying birth for you, and a willingness to work on a solid plan with you for following through.

Outside of a provider’s statistics, the stories you hear from others about care received from them can also help paint a picture of their routine of care. I’m not suggesting you change care providers based on one negative story.  Doctors and midwives are human and therefore, like all of us, have bad days and make mistakes.  But if there is a pattern that develops in several stories, it can be indicative of a mode of practice or birth philosophy.  It’s unrealistic to think a care provider will suddenly begin behaving differently than their history suggests they have consistently behaved in the past.  When asking for feedback about a care provider, pay attention to the stories coming from people who value the same sort of birth you’re planning (whether or not they had this sort of birth).  Your local ICAN chapter may also be a good place to learn about care providers who are a good fit for your birth preferences.

 

3. You have a bad feeling.

Trust your intuition.  Even if you can’t put your finger on a specific reason, your inner wisdom has something to tell you. Those feelings coming from your gut actually play a valuable part in smart decision making!

 

Your choice of care provider has a big impact on your birth outcome and birth satisfaction.  You and your baby deserve the best possible care at this important time.

If, after reading this list, some red flags have been raised, here’s are some posts about exploring the idea of switching to a new care provider.

http://www.fitpregnancy.com/pregnancy/pregnancy-health/how-change-your-care-provider-during-pregnancy

http://pregnancy.about.com/od/choosingapractitioner/a/changingdoctors.htm

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Your childbirth educator, doula, local birth support network, or ICAN chapter can also be great resources for making this decision. 

Have you had experience switching care providers in pregnancy?  Were you glad you made the switch?  Did you have an experience that made you wish you had listened to your gut and made a switch?

I’m pregnant!? Now…I have a million questions!

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Upon discovering she’s expecting, a woman may have a variety of emotions: excitement, panic, joy, confusion, fear, anticipation, grief, relief, or a combination of these and more.  Along with a host of emotions, pregnancy also brings with it a slew of questions.

Questions about her body and what she can do with it…

-Will I have morning sickness?  Can it be prevented?

-Do I have to stop eating all of my favorite foods now?  Do I have to start eating anything special?

-What supplements and vitamins am I supposed to be taking?

-Can I stay on my workout plan?  Is exercise safe?

-Is it normal that my breasts hurt?  Is it normal that I ALREADY have to pee all the time?

-Why am I so hungry?  …or…  Why does food sound so gross to me?

-Is there something wrong with me if I don’t feel happy all the time?

 

Questions about her baby…

-How big is he or she now?

-How do I best take care of him or her?

-How will I know if s/he’s healthy?

 

Questions about her relationships…

-Will I be a good mom?

-Will I have the support I need from my partner?

-Why do I feel the need to be “mothered” so much right now?

-Is life as I know it over?

-Who can I talk to about my concerns?

 

Questions about sex…

-Is it safe to have sex?  Will it hurt the baby?

-Why do I want to have sex all the time? …or…  Why do I have no libido whatsoever?

-Will my partner still be attracted to me as my body changes?

-How will I feel about my body as it changes?

 

Questions about her prenatal care and birth…

-Is my current OB/GYN the best choice for my prenatal care?

-How do I pick a care provider?  Where do I even start?

-What’s a midwife?  Why would I choose one?  How do I find one?

-Do I want to give birth in a hospital or at home?

-Do I need all the tests I’ve read about?

-Will I be able to handle childbirth?

-What the heck is a doula?

 

Where does a pregnant woman turn for answers and reassurance about all of these questions?  Even if she has already chosen a prenatal care provider, her first visit may not be scheduled for several weeks.  Visits with a care provider may seem too rushed or she may feel too nervous to ask all of her questions.  Some questions may feel too “weird” or “gross” to know who it’s safe to ask.  Childbirth preparation classes are usually geared towards expectant parents past about 20 weeks gestation.  There are so many books on the shelves, it’s hard to know which one is a good choice.  That copy of “What to Expect When You’re Expecting” that was passed along to her only makes her feel more nervous and unsure.  The questions just keep adding up…

I remember well how it felt when I was first pregnant with my first son.  I had very few friends in a new town, and even fewer of them had children (and even fewer of them had had the sorts of births I wanted for myself).  I didn’t know where to begin finding the right care provider.  I had read about midwives but, how the heck was I supposed to find one?  They weren’t in the phone book!  Did I just pick an OB and hospital closest to my home?  I had so many expectations and hopes and dreams and wondered if they were normal or realistic.  It was a lonely time in many ways.

As a doula, I am often not contacted by clients until they are over halfway through their pregnancies.  By that point, they may have missed out on crucial information that could have helped them feel healthier, more confident, and more prepared for a satisfying birth; I often feel like we are scrambling to fill in the gaps.  I have seen a real need for a way to get important information to pregnant women sooner so that they can really ENJOY PREGNANCY!

Out of my experience and the many questions I heard from pregnant women was born the blueprint for a class.  Healthy Pregnancy is designed to help women feel informed, empowered, and confident.  I truly believe that a healthy, confident pregnancy sets the stage for a healthy, confident birth (which can set the stage for a healthy, confident start to parenting).  I want to give that gift to as many expectant mothers as I can!  Like all of my classes, this one is interactive, fun, and tailored to the needs of the individual students.  It’s a great way to learn more, ask questions, set your mind at ease, and maybe make some friends!  Not bad for a few Saturday afternoon hours.  (Plus, goodie bags and healthy and delicious snacks will be provided… what more do you need to know?)

To learn more or to register, check out my website Enjoy the ride!

 

Birth Matters!

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In the summer of 2006, I was lucky enough to be chosen for a role in Louisville’s Birth Care Network’s local production of Birth the Play. The play is comprised of 7 women’s birth stories with 7 actors playing all the characters within each story: family members, partners, doctors, nurses, etc. Part of the powerful narrative of one woman’s cesarean birth story is her consternation at how often she is told, “…but you had a healthy baby!” when she tries to express her grief at how her child was born.
At the time I was taking part in this show, I was very pregnant with my second son. My first birth had hit me face-first with surprise, dismay, fear, disappointment, and many other emotions that I didn’t quite know how to heal. Whenever we would rehearse the scene with those lines about “…but you had a healthy baby!” I would wonder if that was something people actually said to women who talked about their births honestly. It seemed like such a silly and dismissive and ignorant thing to say.

The more I have worked in the birth world as a doula, childbirth educator, and breastfeeding peer support person, the more I have heard that trite line trotted out to mothers and it never ceases to amaze me that it can be anything besides a line in a play. I have many theories about why people like to use that line so much: they’re genuinely trying to find the silver lining and make the mother feel better, they are in denial about their own birth experience and the feelings they don’t want to face about it, they just aren’t thinking about what’s coming out of their mouths…etc.
But let’s look at what’s really being said behind those words…

If a woman has a birth experience that is unexpected, scary, or traumatic in some way (and that’s really only up to her perspective, not anyone else’s), she may feel any or all of the following:
Sad
Angry
Confused
Betrayed
Like a failure
Abandoned
Lonely
Frightened
Traumatized
Depressed
Bitter

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Her feelings about her birth may affect her ability to bond with and enjoy her baby or to enjoy life in general. Her feelings may make it hard for her to connect to other people who just don’t seem to understand. She may feel jealous of other mothers whose births she perceives as having been “easy” or “perfect”. She may not want to talk about her feelings for fear of being judged. She may feel alienated by all of this.
If she does find the courage to say something about how she is truly feeling and is met with “…but you have a healthy baby!” what she is really hearing is this:
“Your baby is the only part of this story that matters. You do not matter. Your body does not matter. Your feelings do not matter. Birth does not matter.”
And I am here to tell you that none of that is true. Of course every mother wants more than anything in the world for her baby to be safe and healthy. But that hope is not mutually exclusive of everything else having to do with her birth story. In fact, all parts are connected: mother, mother’s feelings, mother’s body, mother’s experience, baby’s health. Every piece of the puzzle affects all the others.  And to tell a woman that her feelings and experience are invalid is just the sort of thing that sets us up for our current rates of postpartum depression in the United States, for an epidemic of Post Traumatic Stress Disorder following birth  (Postpartum Traumatic Stress Disorder?), and for a culture of disconnect and “dis-ease” (as in, the opposite of health).
So, what do we do about this?

For mothers:
Find the support you need. There are people out there who are willing to listen to your birth story and the feelings you have about it with no judgment. There is support for you. Contact a local birth network, your doula (or, if you did not have a doula, find one in your area who can point you in the direction of local support), your local ICAN (International Cesarean Awareness Network) chapter, a therapist, or a friend who is a good listener. Look for a postpartum wellness group on facebook. Join a positive new moms group or playgroup. Don’t stop reaching out until you have gotten what you need to process and heal. It is possible.

For others:
Watch this video .  And please, never tell a woman that the only thing that matters about her birth is her baby. Listen quietly. Hug. Bring meals. Let her cry. Let her feel her feelings. Help her find support if you feel it is more than you can do to help her by yourself.
Some of my favorite resources:
http://postpartum.net/
http://www.parentingscience.com/childbirth-trauma.html

And, one very concrete way you can work on processing your story and move towards healing is to take part in an upcoming “Unpacking Your Birth Baggage” workshop with me. In this workshop, we will work in a small group to look at the feelings we have from our birth experiences (or about an upcoming birth…read more about the workshop here) and figure out how to own our stories in a confident, freeing way rather than being held back by them. The process is powerful and so is the chance to be in a safe place with supportive women. The workshop package includes ongoing support via a private facebook group and other chances to contact after our face to face time has passed. I believe so strongly in this process and want to share it with as many women as I can.  In order to give women the specific type of experiences they need in this process, I will be offering two separate workshops: one for expectant mothers who are holding doubts, fears, and confusion about their ability to give birth; and another for mothers who have had traumatic or unexpected birth outcomes and need a safe place to process them and move on into parenting with freedom and joy.  The next workshop is set for March 11 and 18 and is intended for Mother’s who’ve given birth before.  To learn more details or to register, visit my website.

Know this: You matter. Your feelings matter. Your experience matters. Your birth matters. BIRTH MATTERS.

Sending you a hug,
Jenny Claire

Photo credit: Jana Glass, Looking Glass Photography