It is easy to visualize what can happen in your body when you imagine what rust does to a cast iron skillet that hasn’t been well managed.  The cast iron skillet might be essential to your meals, but it takes a lot of care to keep it clean and free of rust. Just a few hours of sitting wet in the air and you’ll have rust. Maybe you don’t event put corrosive foods in your cast iron to keep it pristine.  Imagine, then, what happens to each iron-rich cell of your body when iron and oxygen, and antioxidants, are imbalanced.

It is important to eat a variety of iron-rich foods.  Heme is a prefix used in medical terminology that derives from the Greek word, “haîma,” which means “blood.”  Therefore heme-iron is iron that comes from blood (animals).  The more blood there is in the part of the food you eat, the more heme-iron you will get.  Likewise, non-heme iron is iron that comes from food sources that don’t contain blood: a variety of dark leafy greens, cruciferous vegetables, beans, legumes, nuts, seeds, and some other plants.

Generally, heme-iron is considered more absorbable and more highly concentrated than non-heme iron.  However, the non-heme iron found in plants has a higher concentration of antioxidants, like Vitamin C, and more detoxifying properties, like fiber and chlorophyll, which help prevent inflammation that can be directly caused by iron over-consumption.

When you consume iron, especially without enough antioxidants, inflammation is a result.  When inflammation is present, the more iron you consume, the less you absorb or access.  The liver produces hepcidin, a hormone that regulates iron absorption, storage, and transport to cells.  You could consume red meat every day, take an iron supplement, or get an IV iron infusion and potentially decrease the iron you have access to because of the inflammation high iron consumption causes.  Balance is always the key.

You need iron to give strength and size to your red blood cells.  But you need a lot of other nutrients, like B9 (folate), B12, Vitamin C, and other antioxidants to reduce inflammation so the liver doesn’t stop you from absorbing the iron.  This is one of the reasons why testing hemoglobin alone is never an adequate way to assess iron levels or prescribe iron supplements.  Iron is one element inside of hemoglobin, but having low hemoglobin is usually, first, the result of low antioxidants, hydration, and an imbalanced microbiome which creates inefficient digestion.

The best way to assess anemia (low blood volume or maybe better understood as malnourished blood) is to run multiple venous-blood tests, or at least do a deep look at your diet.  Your diet should be rich in whole foods, dark leafy greens, and brightly colored fresh vegetables and fruits.  These foods reduce toxins, increase antioxidants, and improve iron absorption, as well as transport.  Sometimes, these fixes aren't quick or easy.

Sometimes, in pregnancy, we take simple supplemental approaches and have to leave the big changes for pre-conception. It isn't just about assessing the anemia, but assessing the lifestyle and what is possible for this person, this pregnancy, this moment in life.  It also depends on the time frame we have to work on the root-cause.  When we only see iron insufficiency, we can approach therapy with whole-foods, or digestive-friendly iron supplements in small doses, every other day, to increase absorption by helping to reduce inflammation.  We also need to recognize that iron absorption significantly reduces in the first trimester, so your pre-conception iron consumption needs to be top notch.  With balanced lifestyle habits, iron absorption increases exponentially in the 2nd trimester, which helps with the necessary blood volume expansion required by the third trimester.  Then, the third trimester your body works at giving your baby the iron stores they'll need for their first year of life, but may not be able to absorb much at that point.

Which labs should I test for anemia?

First, I want to say there are always a lot of tests that could be assessed to get a more full picture.  Understanding digestive history, stress loads, food pairing, and exercise routines can give you an idea of how iron absorbs and moves through the body.  But three important things we must remember are:

1. Hemoglobin is NOT Iron
2. A spot-check hemoglobin with a HemoPoint, HemoCue, Talquist Scale, or Massimo OR only looking at the hemoglobin number of a CBC is NOT adequate at all for assessing Iron
3. Serum Iron OR Ferritin alone are generally not adequate for assessing iron or supplementation/treatment needs

CBC with Differential

We can see the kinds of red and white blood cells present with a CBC. We can also see the size and shape of red blood cells, which help to determine if anemia is present and if it might be caused by either oxidation (mixed nutrient deficiencies) or low iron. In all anemias, increasing antioxidants help and you can add in these whole foods without full iron labs.

Serum Iron

This tells us how much iron is floating around in the blood, usually from recent iron consumption. It can be falsely elevated if you’ve eaten iron-rich food, taken an iron supplement, exercised, or had stress in the past 48-72 hours.

TIBC/UIBC/% Saturation

This tells us how much iron can be transported through the body by transferrin.  Total Iron Binding Capacity is the amount of "seats on the Transferrin Ferry" that are bound with iron.  Unbound Iron Binding Capacity is the amount of "seats on the Transferrin Ferry" that aren't bound with iron.  And the % Transferrin Saturation is a calculation of TIBC to total Serum Iron which gives you an idea of how much of the iron in your serum blood is actually being moved around.

Ferritin

This indicates iron taken up and stored, mostly in the liver.  With stress, too much iron consumption, or inflammation, the liver releases the hormone hepcidin which prevents iron absorption and transport.  This helps to prevent oxidative stress.

Transferrin

This glycoprotein (sugar-attached protein) transports iron to the cells.

CRP/Homocysteine/ESR/Inflammation

Testing for inflammation can help determine if iron levels can be improved by reducing inflammation and increasing antioxidants, or if iron supplements are truly needed.

The post Iron, Hemoglobin, and Anemia appeared first on Esali Birth.

While our baby might have reflexes, they’re born with to help them crawl up your belly and latch on, you’ve been shaped by your life experiences, which may not include nursing a newborn.  Nursing a newborn is not the same as nursing a 3-month-old baby when you both already have it figured out.  It’s so important to learn the optimal tips and tricks with the first baby so you have good muscle memory.

Your baby needs to nurse, a lot!  Breastfeeding is not just about nutrition and weight gain.  It:

• gives fat to nourish a rapidly changing brain
• maintains blood sugar
• develops their digestive and immune systems for life
• stimulates the vagal nerve to allow and develop nervous system regulation for life (which is vital for digestion, hormone balance, and detoxification) develops the hard and soft palate, nasal passages, tongue, necks muscles and ligaments… it’s the

Breastfeeding is the baseline of growth and health. Not breastfeeding (using a pacifier or bottle, stopping a session before baby is done, refusing nursing for comfort, or any other reason to not breastfeed on cue) is changing the baseline of health and growth for this baby.  The first 3 months are an important time when baby should be experiencing rapid developmental change.  Not just in their body, but in their brain as well.

In the first six weeks, baby has many developmental spurts.  A baby that is able to breastfeed on cue to a mother that is resting and nourished well, not having issues with latch, and supported to focus on learning how to breastfeed, will:

• almost never lose weight after birth
• almost never lose more than 10% of their birth weight even if they do lose weight
• not fall asleep while nursing (only if they’re truly full and then they’ll unlatch first)
• gain birth weight back by 1-2 weeks postpartum even if they did lose weight, and double birth weight by 4-6 months

Babies need more nervous system regulation (nursing) in times of stress (i.e. change, discomfort, home stress or busy-ness…etc.), illness, and brain development. In the first six weeks these growth and development times coincide with approximately:

• Days 2-4 as the immune system develops and breastmilk starts to increase
• Weeks 1, 2, 4, 6-8  &  Months 3-4, 6, 9, 12, 15, 18… whew… it’s a lot!

In those first few days, your colostrum is your baby’s immune system which helps protect against everything new a baby encounters and will be the basis of their microbiome for life. Their almost constant desire to nurse in these first few days helps your hormones change so that your milk starts to meet their specific needs, based on saliva feedback in your breast, and to expand to feed as many babies as you have birthed.  In fact, if you have twins that you only nurse on the same side each time, each breast will make different milk for each baby.

If you aren’t holding your baby enough, your baby will cue (lip smacking, noises, latching on fists, or crying) to affect your hormones to make you want to hold and nurse them more. This is when parenting begins and now is more about you learning to be giving and patient and meet their needs than it is about you “teaching” them not to rely on you because you don’t think they need to nurse a lot.  Babies cannot survive, let alone thrive, without their mother’s warm skin and milk available, often.  In a few, short, years they’ll be ready for more independence.

But 6 weeks is golden.  Around this time, baby can see more than the distance between your arms on your face, soothe easier as they become more comfortable in their environment, and their growth and development slow down for a bit.  Your hormones and thyroid should be past their most significant fluctuations, making it easier to manage sleep and stress.  Hang in there; these days are long, but the years are short!

The post Life After Birth: Baby’s Developmental Growth appeared first on Esali Birth.

You might be at the beginning or middle of your reproductive years, and menopause might feel like a long way off.  But it’s important to remember that these are the years that initiate your experience of perimenopause.  Every phase of reproduction sets us up for the next.  Your years prior to menses, your teen years prior to childbearing, and so on.  Lifestyle during pregnancies, between pregnancies, and simply during your cycling years will suggest what perimenopause might be like for you.  Thankfully, in our cycling years we get a monthly preview of if changes are needed.

Your cycle can help you pay attention a little more now.  Do you have heavy or painful periods now?  Do you have scant or missed periods now?  Do you have low progesterone now?  If you have enhanced mood swings, bloating, or any version of pre-menstrual syndrome, your body is telling you now that you need to make some changes so that perimenopause isn’t too overwhelming.

Perimenopause, like our first pregnancy and the transition before birth, is a transformative time.  We are meant to experience a bit of inward reflection and shed some of our personality that was needed during our reproductive years, but not any longer.  As we move to the next phase of our life, to becoming an elder, we can experience some challenging moments spiritually, emotionally, and physically.  These moments are normal if they aren’t debilitating.  Having moments where we need to say no to a little more, reduce our workload, and rest more is wise.  But being unable to move gracefully through these stages is an indication that our whole body needs a little more help.

As ovarian function reduces, ovulation becomes delayed. This causes, progesterone to decline.  LH and FSH then get a little more excited and your body might start maturing multiple follicles (eggs) during each cycle, making shorter periods or pregnancy with multiple babies more likely.  Though, as estrogen remains proportionately higher to waning progesterone, the uterine lining thickens through a longer cycle which may cause heavier periods when they do come.  Knowing how to track cervical fluid and Basal Body Temperature (BBT) can be especially helpful during this transition of fluctuation and irregularity.

It’s common to experience impatience, hot flashes, intense night sweats, bloating, fatigue, digestive changes, flooding (soaking pads during your period), vaginal dryness, reduced libido, and similar symptoms of hormonal imbalance.  These occasional imbalances can be a normal part of the perimenopausal transition.  Though, it is a reminder to nurture and nourish your body well and notice ongoing or extreme symptoms.  If these imbalance symptoms happen often for you, get help with nutritional and lifestyle changes, supplements, and herbal support.

Nutrient-dense food choices, regular exercise, and adequate sleep can do a lot to help our aging bodies filter toxins and create balance.  Many of the same herbs used during pregnancy, like red raspberry leaf, continue to be beneficial during this time.  Hormonal balancing herbs like Black and Blue Cohosh, Motherwort, and Yarrow are excellent natural options for hot flashes, mood inconsistencies, and fibroids.

If lifestyle changes and natural therapies aren’t helping, testing is ideal. OTC or prescription bio-identical hormone replacement therapy (HRT) helps some women feel more balanced in these years.  Vaginal estrogen may help with incontinence and progesterone cream may help with mood balances and sleep disturbances.

LAB TESTS

Day 3/Perimenopause Blood/Serum Values

FSH: Consistently >25 mIU/mL

Estradiol E2: Consistently <20 pg/mL

Menopause: ≥40 y.o., some symptoms,
labs, & no period for ≥1 year

(DUTCH urine/saliva ranges are different)

The post Perimenopause appeared first on Esali Birth.

First things first.  Let's set the record straight that "postpartum," is a noun, as in: the time-period after birth. Or, "postpartum" can be an adjective, as in: a descriptor of a type of depression.  But using the word "postpartum" to describe a mental state really shows how disillusioned our culture is when postpartum depression is so common that people have simply started calling their depression or their friend's depression, "postpartum."  But postpartum is not a state of dis-ease or imbalance and there are a plethora of ways to experience this postpartum time feeling nurtured and fairly well-rested, and much of this has to do with nourishment and support that begins before conception.

In pregnancy, estrogen (specifically, estradiol) and progesterone rise remarkably, working synergistically together to make the uterus sensitive to contractions, while Progesterone prevents labor from starting too soon.  It could be possible to predict when labor is imminent through labs, indicated by a slight drop in Progesterone while Estradiol remains high.  However, the most significant drop in these two hormones comes with the birth of the placenta, triggering a steep drop in these two hormones.

High progesterone warmed your body through pregnancy and should have prevented the high levels of prolactin from allowing breastmilk to flow.  If there is even a sliver of placenta left in the body, not only will your bleeding be heavier, but your milk may not quickly transition from colostrum to flowing milk.  It usually takes 24-72 hours for these milk-flowing hormonal changes to be noticeable by you.  Your breasts start feeling full and oxytocin (if you’re not too stressed) starts contracting the breasts to squeeze out (let down) the milk.  Without balanced hormonal shifts, sometimes occurring because of retained placenta tissue or lack of support, it may be 4-7 days, or longer, before you start noticing flowing milk which allows your baby to become more satisfied.

Prolactin and oxytocin together create a hormonal blend that allows mothers to feel safe and calm and loving towards their newborn.  At the same time, feeling safe and calm and loving towards your newborn increases your oxytocin and prolactin.  This cycle is enhanced by reflecting on a positive birth experience and holding your baby skin to skin often while gazing into their eyes.  So, the best way to increase milk supply and feel happy after birth is breastfeeding a lot and holding your baby a lot without distractions.  Your baby’s cues to nurse a lot and be close isn’t just for their needs; God created this to provide health and nourishment for you, too.

In the 12 months that follow birth, the thyroid system has dramatic shifts, though most of these shifts will occur within the first few months of postpartum.  As the immune system works to heal the inflammation of pregnancy and childbirth, and lack of sleep increases, thyroid antibodies and cortisol rise in the first few weeks after birth.  This naturally causes the thyroid to become overactive and release stored thyroid hormones into the bloodstream.  Because of this action, a period of underactive thyroid usually results as the thyroid hormones are used up.  With balanced pre-conception health, along with plenty of postpartum nourishment, rest, and support, these changes should be balanced.  The less you create a healing postpartum environment, or the more you were imbalanced prior to conception, the more drastic these changes can be, and feel, and may lead to baby blues or depression.

If your thyroid was overactive prior to birth, you might feel these initial changes by experiencing elevated blood pressure and an “always on” feeling.  If your thyroid was underactive prior to birth, you might feel these initial changes as extreme fatigue.  In both cases, depression is more likely and it may be more difficult for you to fall asleep when you get the chance.  By 3-4 weeks, exhaustion, and depression, peak.

After a joyful birth, many moms feel great and want to get back up to their feet as soon as possible.  But when there are health imbalances, the hormone and detoxification rhythms take a big hit in these first few weeks. If you don’t discipline yourself, ask for support, and rest in bed, your baby’s growth spurts and physical needs can really take their toll. It is worth repeating again that 3 days in the bed, 3 days on the bed, and 3 days near the bed have been prescribed throughout the recent years as a bare minimum to postpartum healing.  But historically, in most cultures that value the health of their mothers and babies, women were expected to rest for the first 40 days.

We don’t need to know all the specifics of the hormonal changes to know how much better we feel when we have adequate sleep, support, and nourishment.  Your body can’t make hormones, and can’t detoxify, without these three basic human needs.  If your baby blues aren’t going away in just 1-2 days, or any symptoms of imbalance are getting worse, it’s time for more support, a different approach to healing, and likely lab tests.

The post Postpartum Hormones appeared first on Esali Birth.

Traditional wisdom suggests that we follow the rules of three:

• 3 days in the bed, only up to the bathroom and a lot of laying down in between
• 3 days on the bed, beginning to sit up, but still only walking to the bathroom
• 3 days near the bed, beginning to sit for longer periods and walk more, but not venturing too far from the restful bedroom
• 3 hours to see if baby can latch before beginning pumping
• 3 days to stimulate milk supply nursing or pumping every three hours to ensure the milk sacs develop and are triggered properly and the milk volume expands
• 3 weeks to fix baby’s latch with position changes, bodywork, and oral revisions

Yes, there is wiggle room in these rules, but you can see how much rest is encouraged, and historically this would have been closer to 40 days of remaining near the bed.

Regardless of your restfulness, blood loss on the first day will look like the heaviest day of your period and get lighter every day.  You shouldn’t have bleeding that trickles or gushes and you shouldn’t have clots as large as a chicken egg.  Remember that 3 pads in 3 hours is time to be at the hospital. So, if you are filling pads in less than an hour, rest and nourish before it gets to that point.  If your bleeding is heavier than it was the day before, you’re doing too much (even if all you did was sit upright for a bit or make a sandwich).

Too much exercise or activity increases bleeding and damages the long-term health of the abdomen and pelvic floor.  Tissue must have a resting phase to heal properly.  Our muscles get bigger from the damage that is caused when they are overused.  Cells break down and new cells are rebuilt and scar tissue develops which attempts to accommodate the increased activity.  We’ve already overused our muscles in birth and we don’t need our muscles to get bigger or develop scar tissue. Our muscles need flexibility as much as strength, and after birth we’ve already witnessed how strong they already are.  There are a few things to do while resting.

It is important to stretch in bed and walk to the bathroom.  Circulation prevents blood clots which are more likely postpartum as our blood adapts to aid breast changes, reduce the uterus, and heal the pelvic floor.  The best exercise for strengthening the cord and pelvic floor is diaphragmatic breathing.  This can be done in bed and may begin on the first day after birth:

1. Lie on your back with your knees bent and a pillow under your knees.
2. Place one hand flat on your upper chest and the other one your abdomen.
3. Breathe in slowly through your nose, feeling your abdomen rise first and your pelvic floor expand. Keep breathing until you feel your chest rise next.
4. Breathe out slowly as your chest falls first. Continue breathing as you tighten your abdomen and pelvic floor to push up and out every last breath.
5. After three weeks, you can start walking longer to build tone and by 6 weeks you can begin other exercise activities

If you’ve had tears, it is important to use a healing herbal rinse each time you use the bathroom.  This reduces stinging, helps prevent infection, and hastens tissue repair.  If scar tissue or tight tissue remains after 6 weeks, rub evening primrose oil over the scar tissue daily to soften it and increase comfort.  If you don’t have stitches for tears, rest is even more important and walking stairs, sitting cross-legged, or sitting up on the tears should be avoided.  Once bright red bleeding has stopped, you can start herbal pelvic steaming, if desired.

Finally, tell your birth story, especially if it was challenging or traumatic.  The best way to integrate these life-changing events to prepare us for our next birth is by storytelling.  Remember, no matter what your experience was, find the joy in your birth, too, so you remember it positively.

The post First Weeks Postpartum appeared first on Esali Birth.

Imagine if we waited until everyone got into an emergency state to help them.  How much valuable time would we use to gently nurture the body back into balance with love and herbs and nutrition?  Four+ cups blood loss may not be effectively treated with herbs and nutrition alone, and then we would be at the mercy of only medication and clinical care and traumatized mothers. Additionally, the cause of PPH is not always the same and can’t always be treated in the same way as other types of PPH or other types of bleeding. Herbs are usually effective for mild to moderately heavy bleeding that is slow, over many hours.  God decides if and when any of these methods work, but He also gives us education on how to use our remedies well.  PPH is far more complex than a nosebleed, cut, or your menses, so be careful to think you can treat it in the same way you would treat a basic first aid case at home, too.

Health is going to be the first line in preventing and stopping excess bleeding.   Mom and Dad’s bond and environment are going to be the second approach.  Your birth team and the tools (including medical backup) are the last technique.  There is equal importance with a nourished body and a loving environment that prevents and heals PPH.  If a mom feels safe and loved and has been very well nourished before and during birth, her body will have everything it needs to prevent and manage most blood loss from birth.  The uterus cannot contract well without adequate nourishment, or without enough oxytocin (the hormone that rises when moms feel very safe and very loved).

Next, it is very important to assess the amount, how, and especially why bleeding is occurring in PPH.  Not all remedies work for all types of bleeding when it comes to childbirth, but there are a few ways we can assess.   When teaching new midwifery students and practicing skills, we discusses the Four T's of postpartum bleeding.

TONE (Uterine Tone/Atony)

The uterus must contract firmly to close the open bleeding vessels after birth and remain firm through rest and nourishment.  80% of postpartum hemorrhages occur from poor uterine tone.  Gently feeling the uterus, we can tell if it is less firm, larger, or in the wrong location than it should.  Anything inside, or blocking, the uterus can prevent it from contracting well, even having a full bladder.  Bleeding from low tone can look like quick continuous gushing or gushing with movement or stress, especially around separation and birth of the placenta.  Classically, this occurs with a mom that is tired, undernourished, or overwhelmed.  Sometimes blood that is filling inside the uterus starts clotting and doesn’t come out, so it isn’t visible, but it can feel firm because the clots push on the inside of the uterus.  Using our hands we may be able to wiggle or compress the uterus to expel clots and slow this bleeding until other methods take over.  Though, hard mashing of the uterus may increase bleeding. Uterotonics (herbs and medications that increase contractions, some which work on the ocytocin receptors to trigger contractions in the uterus) are used to treat uterine atony.  Treatments for uterine atony include ones such as Cotton Root Bark, Birth Root, Angelica, Pitocin (synthetic oxytocin), Misoprostol, and Ergometrine.

It is important to note that oxytocic treatments, such as oxytocic herbs and Pitocin, are only appropriate for uterine atony of the upper 2/3 of the uterus.  The further down the uterus you get, the less oxytocin receptors  there are, and hardly any in the cervix.  All of this helps with cervical dilation so that the contractions aren't working against decent of the baby and dilation and effacement.  This also helps prevent the cervix from closing up too soon after the birth to allow the placenta to come when it is ready and to allow bleeding and clots to be expelled.  However, this means that if the placenta attachment site is in the lower 1/3 of the uterus, you will anticipate heavier bleeding even without treatments (because endogenous oxytocin won't be as effective here), and these oxytocic treatments won't be very effective if bleeding is heavy.  Herbs, however, do have a different effect than the oxytocin alone does because they also are working nutritionally; though, they are generally not effective for severe PPH because they won't work fast enough (and many practitioners don't dose them correctly).

TISSUE

Retained tissue can cause uterine atony, but until the tissue is out, the bleeding won’t slow.  Placental tissue or clots can cause trickle bleeding (which can be hard to notice) or gushes in the first hours or weeks after birth.

We generally treat PPH from retained tissue the same as uterine atony: trying to contract the uterus harder.  However, sometimes, the inside of the uterus needs to be suctioned or scraped out to remove the tissue so the uterus can contract.  It only takes a sliver of retained tissue to cause heavy bleeding.  It is worth repeating here that if the placenta site is in the lower 1/3 of the uterus, bleeding will likely be heavier and require more tools to treat if there are retained tissues, especially from a partially detached placenta.

TRAUMA

Tears or hematoma inside or outside of the vagina, or hematomas, can causing a slow PPH, or more rarely may be deep enough or through an artery to cause very rapid PPH.  Holding compression on bleeding vessels may stop bleeding from tears until the tissue can be sutured.  Treating uterine atony may help, though herbs and medications that are astringent or repair tissue such as Yarrow, Plantain, Seaweed, Ceylon Cinnamon, Yunnan Baiyao, or Cayenne may help with very mild bleeding from tissue trauma.  Herbs, like cinnamon and cayanne, that shunt the blood to the peripheral parts of the body can help buy you a little time in using other methods of treatment because they move blood away from the uterine and vaginal area.  This mechanism can temporarily reduce bleeding while you treat with other methods for all-cause bleeding, including suturing.

THROMBIN

Blood clotting disorders are rare but can be one cause of heavy bleeding and usually require immediate venous access and blood transfusion.  Blood from a person with low clotting factors will often look thin and watery or may cause numerous micro-clots and bruising.  Occasionally, a slow PPH from undernourishment can be managed with herbs like Shepherd’s Purse, Spirulina, Chlorella, Chlorophyll, and Vitamin K.

No matter why or how you’re bleeding, love, a warm blanket or tea, and electrolytes for fluid replacement are always helpful alongside any other treatment techniques.

The post What is Postpartum Hemorrhage? appeared first on Esali Birth.

I hope these past posts on Journey of a Pregnancy are illustrating how much labor is influenced by choices that are happening much sooner than your full-term season. Most of the time, if mom and dad were well-nourished pre-conception, and mom continues to be well-nourished through pregnancy, spontaneous labor is likely to occur without even thinking about it. Our organs, hormones, and body systems work (or don’t) because of the food we feed them (and the nutrients we are able to digest and utilize with balanced digestion). We must trust this very important part of responsibility in our creation to trust that our body can birth in its own time. Trust… rather, lack of fear… is a vital part of spontaneous initiation and progression of labor.

Fear is the best way to start the cascade of complications because it increases adrenaline, which decreases oxytocin. Oxytocin is one of the main hormones needed to cause contractions (in the uterus, the bowels, the breasts…etc.). When adrenaline rises, it suppresses oxytocin. You could eat all the right things, do all the bodywork, and have stress from fear or just a busy schedule… and the day of labor may linger or prodromal labor follows. So, how do we decrease adrenaline and increase oxytocin?

• Loving words and touch from your husband. Looking into each other’s eyes, kissing, massage, and intimacy are the best, and safest, ways to increase oxytocin
• Get help around the house for cooking, cleaning, and general care of your family so you don’t feel overwhelmed
• Say “no” to too much – these last weeks are a time for reflection and preparation
• Go to bed when the sun goes down and support adequate sleep so your hormones can balance and you feel ready to start each day (not to mention, ready for labor to begin in the wee hours of the morning)
• Get out in the sunshine daily to breathe in the fresh air and move your body

Movement and baby’s alignment are crucial. Sometimes, mom is well-nourished and well-supported, but alignment is imbalanced. Diastasis recti, low core tone, imbalances in the pelvic floor, and tension on the many ligaments that support the uterus can prevent a baby from being well aligned in the pelvis. If baby doesn’t flex their head with their chin to their chest, or their body is hanging off to one side, you may be experiencing a lot of moving contractions that are trying to realign baby and hold everything in place.  Not only does this mean that baby’s head won’t be well-applied to the cervix (which helps trigger contractions), you’ll be exhausted and constantly wondering if today is going to be the day that labor will continue.  This is more likely with someone that sits a lot, stands in one position a lot, doesn’t walk much, has had a prior cesarean, or has had multiple pregnancies without being able to re-tone their body between each one.  A baby can only go where there is room, so it’s up to you to find balance, get bodywork, and wear a support belt when needed.

Supporting these basic aspects of balance are the way we were created to get labor started.

If we can’t achieve this balance by 41 weeks, then we could consider herbs that gently encourage labor while being informed of the increase of chances for complications like hemorrhage and breastfeeding issues.  Risks of induction in a low-resource setting like home must be carefully weighed against the risks of medication in a hospital.  Either way, this is not a decision to take lightly.

If you’re considering induction, you should have a clinical reason – more than just being tired of being pregnant.  Ideally, you would be at least 41 weeks with a baby measuring 40+.  The safest ways to encourage labor will support nourishment, balance hormones, and build body balance.  Strong stimulating inductions, including castor oil, should be performed with a medical team and where there are more resources available.

The post Journey of a Pregnancy – Getting Labor Started appeared first on Esali Birth.

Katy Bowman, an alignment and movement professional, explains varicose veins perfectly:

"Varicose veins are created when the amount of downward force is greater than the upward force in the blood vessels. This breaks the valves inside the vein. In an optimal situation, the muscles around each vein should contract and relax rhythmically to get the blood back up to the heart and lungs. When muscles are passive, or if they don’t move enough, the valves in the veins have to carry the blood without the muscle’s help by "stair stepping" it up the body, going against gravity, using only the little valve flaps. If you use the flaps (teeny tiny moving parts) instead of your muscles (giant, force-generating parts) these little flaps give out and break.  This causes the blood to bulge and mis-shape the vein from the inside. Relief from the discomfort is commonly found by elevating the legs so the blood flows without having to climb the valves. However, fixing the problem requires that you move your muscles a lot more. Most commonly found in the lower leg, bulging varicose veins come from high pressure caused by muscle tension.  This tension is created from standing long hours, sitting too much, or being in any one position for long periods of time, reducing overall movement.”

At their root, varicose veins are caused from not using the muscles enough.  In pregnancy, the force in the pelvis and legs increases, putting more work on the already overworked valves, which increases the damage.   The root solution is not through vein supplements or salves, though these may help a little.  The solution is through a lot of varied movement, particularly using the muscles more in the area surrounding where the varicose veins are the worst.  And most of this needs to be addressed between pregnancies, not after twenty weeks when the pressure is building.

NUTRITION FOR VARICOSITIES

Foods high in antioxidants, like Vitamins A, C, and E, are important for strengthening the veins’ cell-walls.  These foods include dark leafy greens, citrus fruits, and brightly colored yellow & orange, ripe, vegetables and fruits.

Eating foods that help to balance platelet levels and clotting factors, such as healthy fats from fish, avocados, or nuts as well as spicy seasoning like garlic, onion, or peppers help to create smoothly flowing blood, reduce clots, and make the vein valves not have to work quite so hard.  These, and other salves and supplements, certainly address one of the root causes and are necessary alongside other treatments, but they won’t undo the valve damage by themselves.

MOVEMENT FOR VARICOSITIES

Walk, walk, and walk some more (especially uphill) at least 3 miles, or 3, 20-minute walks, daily.  Walking is one of the best ways to get the muscles working to help blood flow in the legs (plus it’s great for birth prep).

Strength train with weights.  By building muscle, you increase the ability to move blood through your veins.  One simple way of doing this, with no added activity, is buying, or making, sand-weighted hook & loop bands that go around your ankles while you walk or work.  By adding weights to your legs, you will effortlessly build more muscle.

Squat & do pelvic stretches.  Building gluteal strength and flexibility will increase blood flow through your pelvis (make periods and birth less painful) and increase movement in your legs to improve circulation.

Legs up the wall (like in the picture).  Not only can you give your legs a break with this stretch, you also lengthen the muscles and ligaments around your pelvis, which increase mobility for baby’s movements in birth.  Resting your legs on the back of a sofa is OK as an alternative to legs up the wall, but you miss out on the stretch in that position.

Automatic, rechargeable, compression boots (or massage).  Though expensive, these massage boots add movement to your vessels when you’re resting or for long trips.

If you're the herbal crafty type, here is a salve you could try for your varicose veins:

VEIN RUB
Makes: 1/2 pint

• ¼ C Arnica Flower (or use arnica-infused oil as your base oil)
• ¼ C Yarrow Leaf & Flower
• 1/4 C White Oak Bark
• ¼ C Butcher’s Broom Root
• 1 tsp. Lavender Essential Oil
• 7 oz. Oil (can be arnica-infused, olive oil, or any combination of oils)
• 2 oz Beeswax, or to desired consistency
• 8 oz Jar with Lid & Pot big enough to sit the jar inside

Pour oil over all herbs.  Let sit in a sunny spot for 4 weeks, shaking daily.  Strain and squeeze through cheese cloth or a French press to get out as much oil from the herbs as possible

Pour a little water in a pot.  Add your strained oil and beeswax to a jar and place it in the pot.  On very low heat, heat up oil just until beeswax melts, careful not to let any of the oil bubble.  Remove from heat and quickly add lavender essential oil, stirring to incorporate.  Loosely top with lid until salve cools and beeswax sets up.  This is best made outside or with the windows open due to the amount of essential oil you’ll be using, which may be irritating to the respiratory system.  Rub over varicose veins 1-2x daily or as needed.

The post Managing and Healing Varicose Veins appeared first on Esali Birth.

If we lead a nourished and balanced life, we don’t have to think about what to do to thrive in the third trimester; it simply happens and most of the time all goes well.  A nutrient-dense, traditional diet of organ meats, fish, leafy greens and colorful fresh plants and wild foods, the movement to obtain these, and the support of a loving community are the powerhouses behind the physiologic changes that need to occur during these final months, and beyond.

As you move out of the middle phase of pregnancy, your blood volume should have expanded.  There is little you can do in the third trimester to overcome anemia or insufficient blood health.  Your body and baby are going to use so much iron and other nutrients at this point that supplements may only help to mitigate complications, not create optimal health.  Your body and baby will use its mid-pregnancy nutrient stores and peaceability to create necessary changes at the cellular level.

With adequate nourishment and metabolic function, progesterone should have increased in early pregnancy so that cervical collagen fibers became a tightly woven bird’s nest, helping to prevent preterm labor.  Collagen [being made up of all the major nutrients including amino

acids (protein), Vitamin A, B, C, D, E, Zinc, Calcium, DHA, and EPA] creates strength and resiliency of the cervix.  If nourishment has been inadequate, preterm labor threatens with changes that begin around 28 weeks.

At the beginning of the third trimester, these collagen fibers suspend in fluid (hyaluronic acid and prostaglandins), allowing the smooth muscle of the cervix to become very stretchy.  Research in this area is just beginning, but it’s confirmed that a nutrient-dense diet is needed for balanced uterine changes. This not only allows cervical ripening, effacement, and dilation to occur for spontaneous childbirth, but also encourages the increase of relaxin.  The hormone relaxin rises and begins to make the ligaments around your pelvis stretchy. This allows your sacrum to open and your pelvis to move and twist so baby’s head, size, and positioning during labor can be accommodated.

In addition to nutrients, emotional well-being is vital.  A healthy increase in cortisol levels through a bit of physical work and service to others each day is necessary to create resiliency in your mind and your uterus.  Cortisol levels begin to rise, peaking at the beginning of the third trimester.  This cortisol breaks down Type I Collagen, which held the cervix tightly together.  On the other hand, too much stress (cortisol) breaks down progesterone receptors causing the cervix to dilate too early.  Furthermore, not enough rest and joy decreases overall oxytocin levels, reducing the likelihood of spontaneous labor

at full term.  And still, a peace-filled environment can’t overcome a body that does not consume enough protein or other vital nutrients; nutrient density is needed to be able to make the oxytocin and other hormones needed for labor.

Balance is always important.  What occurs here is the next step after a whole series of steps taken in the earlier phases.  If one step is missing, we fumble over the rest, and a gentle birth formula at 36 weeks won’t miraculously create a healthy scenario for birth, regardless of if it causes contractions.

In the third trimester is when we really start to feel the effects of all our prior choices.  We no longer have the amped-up energy of the second trimester.  Our immune system is on overdrive with inflammatory increases needed for birth.  Skip a snack or glass of water, and you’ll soon start having headaches, swelling, or changes in blood pressure.  Miss an afternoon walk or avoid stretches and exercises and your aches and pains will start groaning as your baby’s weight and position pull on your muscles and ligaments in an imbalanced way.

This time is not for congratulations of making it to this point.  It is for checklists of dietary needs, balanced schedules for adequate work and sleep, reminders for movement and hydration, and nightly massages with gentle words.  In our modern world, our body needs more intention than ever before to support spontaneous labor at the end of a full-term pregnancy.

The post Journey of a Pregnancy – Third Trimester 28-42+ Weeks appeared first on Esali Birth.

Swelling is often caused by undernourished kidneys that can’t balance fluid levels and high toxins that can’t be filtered.  Oddly, dehydration is one of the main causes of swelling because water is needed for toxins to flow out of the body, and electrolytes are vital for organ function.  This kind of swelling is easily fixed with a LOT of leafy greens, fresh produce, and at least 8 oz of water hourly.  Regular movement and position changes will reduce swelling caused by a growing baby’s weight in a pelvis.  So, these are simple tests to eliminate most swelling, or to see if bigger lifestyle changes are needed.  When using the bathroom, if your pee is yellow then your kidneys are stressed.  You need more fluid, less toxins, and more nutrient-dense food. When the kidneys are stressed, toxins and albumin (protein) “spill” in the urine.

Well-nourished kidneys eliminate blood-waste created by the liver. This helps you avoid illness and helps your body (and pregnancy) to thrive in wellness.  Simply put: eat real, nutrient-dense food.  Your body can’t function when it’s missing nutrients or overloaded with toxins.  Many Americans are technically starving with a full belly.  Our region has some of the worst health statistics in the whole United States, especially with diabetes and lifestyle-preventable illness.  Food choices are a significant cause of this.

Your liver must create albumin (protein) from nourishing foods (especially dark leafy greens, colorful fruits, and protein-rich foods) so that your kidneys can work.  Albumin’s main role is to move molecules through your blood by maintaining osmotic pressure within the vessels (in other words, albumin helps your kidneys balance your fluid levels).

In pregnancy, your kidneys must filter over ½ cup of blood every minute to remove toxins, excess acids, and excess fluid (via urine or sweat).  Therefore, over 150 quarts of blood are filtered by the kidneys daily… if the kidneys are healthy.  When the liver isn’t healthy, more toxins build up and less albumin is created.  If the kidneys don’t have enough albumin, or if they’re damaged or overloaded with toxins, they can’t filter these toxins, which causes fluid retention.  This relationship between the liver and kidneys is why so many dis-eases of pregnancy (diabetes, pre-eclampsia…etc.) have similar symptoms.

One of the first signs we might be able to see for liver or kidney dysfunction is severe nausea in the first trimester.  Around 28 weeks, we might notice a lack of blood volume expansion in the form of rising, or no change in, hemoglobin.  Urine strips may show spilled protein, ketones, and high specific gravity.  Though, these symptoms may not happen before blood pressure rises, so pay attention and nourish your body with real nutrient-packed foods such as dark leafy greens and a variety of colorful vegetables and fruit.  Eat protein-rich meals, including meat and eggs, and avoid high-carbs and grains, or sugary foods.  Eat protein-rich, healthy fat, high-plant-centered meals.  Get rid of added sugar including maple syrup, honey, processed sweeteners, sugar alcohols, and grains (including corn).

Nourish yourself with at least 2600 calories daily for: hormones, blood volume, your liver, kidneys, and baby’s growth.  Nourished isn’t just a satisfied tongue and a full belly; it means getting foods in your body that have adequate balanced nutrients at least 80% of the time.  Some studies say foods today have close to 50% less nutrition than they did just 50 years ago.  Every food choice you make matters and choosing to let go of some of the foods that just taste good, but have low nutrition, will make room for foods that are good for the body and your baby.

What if we were as intentional with the nutrients we put into our bodies as the thoughts we put into our mind and the community we surround ourselves with to support us on this journey?

The post What Causes Swelling and High Blood Pressure in Pregnancy appeared first on Esali Birth.