Understand your cycle.
If you haven’t already, pick up the book Taking Charge of Your Fertility. Understanding how your cycle works, how to identify your fertile periods, and how to maximize your chances of pregnancy is half the battle.


Record your cycle. 
Understand what your “normal” looks like. Not every woman’s cycle is exactly the same. Your cycle may be 28 days, 30 days, or as long as 35 days! Establish what your normal looks like so you can more easily understand your fertile window.

For help with understanding and recording your cycle, you may consider trying the following:
1. Fertility Awareness Method
2. Technology such as OvuSense or MiraCare

Strive for a healthy weight.
Being either overweight or underweight can disrupt a woman’s endocrine system. Without enough fat, the body cannot adequately produce progesterone which is required to sustain a pregnancy. When a body has too much fat, there is stress on the adrenals and the thyroid which causes progesterone levels to fluctuate in an unhealthy way.


Eat more healthy fats. 
Healthy fats are good for every part of the body. They reduce inflammation and promote healthy circulation, as well as enhancing the health of the reproductive system. Most of the fats in your diet should be polysaturated or monosaturated. 


Reduce stress
Stress is a fertility killer. It causes the body to exist in a fight or flight state. When anxiety levels are high, the body perceives a threat. Whether or not a threat is real, the body responds by existing to help you survive. So as a method of protection, it suppresses fertility. ​

​Supplement with Vitamin D
Vitamin D is essential for proper hormone regulation as well as many aspects of overall health. 

Take a prenatal vitamin
Most of the time, we think of a prenatal vitamin as something you take during pregnancy. But if you are trying to conceive, it’s best to start before you establish a preganancy. Now, a single prenatal vitamin will not give you all that you need to be healthy as you are trying to conceive. However, it will help supplement some of the things your body may be lacking.


Supplement with iodine
The thyroid has been called “a woman’s third ovary” by some health professionals. It is critical that the thyroid is operating optimally for someone that is trying to conceive. The thyroid requires iodine to be fully functional and operational. Most Americans are deficient in iodine and many people believe that the US recommendations for iodine intake are far too low. 


Avoid Unfermented Soy products
Some studies suggest that soy can interfere with a person’s endocrine system, whether male or female. There is conflicting information on this, however some studies have seen an increase in fertility when soy products have been removed from the diet. If you’re trying to conceive, it may be a good idea to try removing it for a while.

There are several pathways to midwifery. Choosing the best midwife for you may mean considering a different birthing environment.

For those wanting a hospital environment for their birth, but a more balanced approach with expectant management of their maternity care through the pregnancy and birth of their baby, Certified Nurse Midwifery should be considered.

A hospital-based nurse midwifery team follows the same ACOG recommended visit schedule of care and screening options as any standard OBGYN practice. A certified nurse-midwifery practice has several midwives whom you could meet with prenatally. Typical prenatal office appointments last approximately 15-30 minutes. During labor, they often provide an initial pelvic exam to determine dilation and if you should be admitted to the hospital after you have been triaged by a registered nurse. CNMs have an on-call rotation, so it’s uncertain who will be with you when you are birthing, or if you will have the same provider catch your baby as who has been with you throughout labor. Your midwife will ensure the safe delivery of your baby with intermittent check-ins with you or your nurse, considering changes from the curve of normal physiological birth, facilitating any interventions, catching your baby or transferring your care to an Obstetrician (OB/GYN). After the birth of your placenta and routine check of your perineum and fundus, your provider will leave your recovery care to the nursing staff who will be in charge of the care for you and your baby for about 2 hours following your birth. You will then be transferred to a postpartum floor and assigned a new nurse for each shift for the duration of your hospital stay.
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Most Medical insurances will cover certified nurse midwives for a planned hospital birth. However, Nurse midwives are not available in every hospital, or may not be available 24/7.

Some Nurse Midwives will attend home birth. Though CNMs have licensing in the state of Massachusetts, medical insurance will not reimburse home birth any more than other midwives.

Research has shown the home to be a safe location to birth for low-risk pregnancies, allowing the natural birth process to unfold with the skillful and compassionate care of professional midwifery services. Home birth midwifery care decreases unnecessary interventions and increases a new family’s confidence and satisfaction in birth and parenting. A professional home birth midwifery team follows the same ACOG recommended visit schedule of care and screening options as any OBGYN office. Midwives offer evidence-based care, unencumbered by routine practice or hospital policy. Instead of a 10-15 minute appointment, they are typically with you for 60-90 minutes every meeting. Rather than planning birth under hospital lights with strangers, you’re planning your birth in the comfort of your home with providers you’ve come to know and trust. While you enjoy getting to know the sweet newborn baby in your arms, the team will prepare nutritious postpartum food and tend to your home before tucking you into bed for a truly good night’s rest, often leaving 4-6 hours following the birth of your baby. Your midwife returns within several times within the first week postpartum for check-ups.
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Some medical insurances cover home birth, and often if they do not cover the birthday, they will often cover your prenatal and postpartum care with a homebirth midwife. Contact your insurance company to find out if birth at home is covered. Do not let finances be the reason for choosing your birth setting or provider. Deductibles for a hospital-based birth may be more than the cost of birthing with a home birth midwife. Many CPMs will offer a payment plan to help you afford a home birth in Massachusetts, Connecticut, or Rhode Island.

Community midwives have followed a traditional education before organized learning opportunities. Their education has been received by hands-on learning and the passing down of knowledge from the generations of midwives before them. There is a variety of care in this midwifery title, and it's important to ask questions about education, continued education, care practices, and about emergency protocols.

It’s important to note the difference between doulas and midwives. A doula is more like a birthing coach, but a midwife is a similar trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling to a woman and her baby throughout the childbearing cycle. While a midwife and doula may offer many of the same philosophies and qualities, it is the midwife that will deliver or “catch” the baby and perform necessary medical examinations throughout pregnancy, labor, delivery, and postpartum.

Birth Doula Support can be a complimentary team member for your family. They provide childbirth education, support during pregnancy, and continuous physical, emotional and informational support to you and your partner during your labor and birth. Birth doulas are meant for those wanting natural birth, epidural birth, home birth, hospital birth, hypnobirthing, and cesarean!
After the birth of your baby, there may be new challenges during the first weeks of parenthood. Postpartum doulas provide a wide spectrum of support which include breastfeeding assistance, newborn care, sibling care, physical help around the home cooking healthy meals, laundry, and emotional support to new parents who may be experiencing the new anxieties of parenthood.
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We help provide RESPECT, SUPPORT, ENCOURAGEMENT, and nurture your transition to parenthood with CONFIDENCE and PEACE!

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​Over the last decade, increasing media attention has people asking, “What does a doula do exactly?” With tv shows White Collar and Season 21 of The Bachelor to celebrities Alanis Morrisette and Alicia Keys, the word “doula” is a buzz!
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A doula is often mistaken with a midwife, but more accurately referred to as a birth coach, birth assistant, childbirth educator, or pregnancy concierge. However, these are incomplete definitions. A doula is an assistant, but there are several different types of doulas; Antepartum, Birth, and Postpartum Doulas.

Antepartum doulas specifically care for families during pregnancy. They often provide guidance in navigating emotional and physical changes as they grow a little human or may physically care for the mother or birther while on bed rest. They provide considerations for deciding which new hip products on the baby block are important on your baby shower registry or help organize a nursery.
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​Birth Doulas are trained professionals able to assist childbearing families with emotional, physical, and educational support. Birth doulas fill a gap in modern obstetric care.  Though they provide many of the same services as an antepartum doula, their main focus is meeting with families prenatally to prepare for labor and delivery, and the initial breastfeeding. The cascade of interventions can lead to 1 in 3 women having a surgical cesarean birth. Studies have shown doula support can decrease unnecessary interventions and increase maternal satisfaction. Birth assistants can decrease the need for pain-relieving medications like an epidural. They are skilled in techniques for natural pain relief, such as massage and touch, counterpressure, acupressure, rebozo, aromatherapy and offer suggestions throughout labor to help a birther feel more comfortable. We help facilitate communication by considering questions you may ask and offer alternative methods to discuss with your birth team. Most importantly, birth doulas provide a complimentary care that not only brings confidence as mothers approach their birthing time, but helps new parents feel calm, capable, and a ready to take on parenthood!

Postpartum doulas work within the budding family’s home to help for the new mom, dad, parents, grandparents, siblings and newborn adjust. They may prep food, provide breastfeeding support, bottle feed your baby, attend to older siblings, or care for baby as parents recoup with a shower and much-needed sleep. Sometimes a postpartum doula may be referred to as a night nurse or night nanny when providing overnight baby care so families can feel more rested. They may help with the emotional changes the whole family experiences in the postpartum or postnatal period and guide the strengthening of bonds.

There are dozens of doula training organizations and all doulas are not created equally. Although all doulas are sincerely passionate, all doulas work differently! Some doulas are hobbyists, others balance a full-time work/doula life, while still others have built a full-time professional service. They offer different services, different packages, have different skills and experience ranges. They may have stopped their education after a 2-day online doula training, taken an in-person hands-on training and certified, or have additional hands-on complimentary education such as rebozo, Spinning Babies, or massage.

It’s important to ask questions when determining if the doula you’d like to hire may fit your expectations and is the right fit for you!

New Life Blessings offers Birth and Postpartum Doula services including overnight support for you and baby. Read more.

​As birth doulas, we see women do amazing things. They struggle, they wonder, they bond, they nourish, they comfort, they love fiercely. The birth with all the power of humanity and in these moments they are vulnerable. They are scared, they are excited, tired, and raw.

Birth reveals much about us to ourselves and to those around us. As a doula, I’ve watched the power of the mind/body connection become more real and tangible than in any other area of the human experience.

The body responds in profound and sensitive ways to stress, thoughts, stimulation, and suggestion. In many cases, whatever a woman thinks about for her birth is exactly what happens. This sounds like it’s in stark contrast to the line that says “things never turn out how we plan”, but there is a difference between a plan and a thought process. So here is what I’ve learned about the mind/body connection in birth work.

Women need to be deliberate in choosing their thoughts for their birth. If they fixate on their fear, that fear will most certainly manifest itself. Fears are real and should be validated, but not given the benefit of too much consideration. For example, if a woman fears that her water will break and contractions will not start on their own, the body interprets this thought process as an instruction. Practicing mindfulness or meditation can go a long way toward honing the ability to be deliberate about thoughts.

The words that a care provider chooses to use during pregnancy and labor have a profound effect on a woman. The phrases “You are only at 4 cm” and “you’ve progressed all the way to 4 cm” convey the same clinical information: cervical dilation to 4 cm. But they communicate profoundly different messages that will be interpreted by women differently. One tells a woman that her body is essentially defective. The other communicates capability. When a woman thinks she is defective, her body may respond to this as stress, which fights with oxytocin. When she is given confidence, her body opens up to its capabilities.

Women should speak what they want for their birth. Affirmations work. Again, the body receives them as instructions and blueprints rather than formless thoughts or whims. Choose your words carefully because both your body and your mind are receiving them.

Women should communicate to those around her that she doesn’t care to hear all the bad stories. Birth stories are like war stories. The worse they are, the more we want to tell them. As soon as someone starts with “well when I had mine….” and you know where the story is going, it’s ok to politely stop the person talking, and ask them to refrain from telling negative stories.


Doulas have seen women dream that their baby has a shoulder dystocia and it happened.

We have seen women say they knew they were going to “need” Pitocin – and they did.

We have seen women say, during their whole pregnancy, “I’m going to show up at the hospital pushing” and they barely make it to the delivery room.

Doulas have stories to tell of women who spoke absolutely everything that ended up happening in their birth, down to the finest detail – both good and bad.
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We know of women who desperately did not want a hospital birth, but felt they had no choice, yet they dreamed of delivering at home. Those births happened so fast that moms barely even had a chance to get out the front door.


You get what you speak. You get what you think. And you get what you fixate on. Print some affirmations and say them to yourself every day. You may be surprised to find just how much your mind influences your body.

​Marijuana Use In Pregnancy


One of the more controversial topics of discussion in the birth and parenting community of late has been the use of marijuana and marijuana-based substances during pregnancy. With the legalization of recreational use in Massachusetts on the dawn, discussions abound with big opinions on both sides of the highly polarizing argument.


Women want to know:

• Is it a safe alternative to many of the drugs prescribed for various pregnancy ailments?
• Can it be used during breastfeeding?
• What are the risks?
• And since it’s legal, can I use it without repercussions from the medical community?

Since marijuana is now legal in many states, many people assume that it is therefore considered safe. Women who have decided to use marijuana during pregnancy have reported that it is an effective remedy for everything from morning sickness to back pain. The internet is filling more and more all the time with anecdotal reports from parents claiming that they used marijuana during pregnancy and turned out to have a healthy child.


But unfortunately, anecdotal reports simply do not give us enough conclusive information to say for certain that it is safe for use during pregnancy. More research is needed. Yet researching marijuana use in pregnancy is more difficult than it sounds.


It is unethical to knowingly expose a patient, including a fetus, to a substance that may have unknown risks. Due to the ethical complications of such a study, it may not be done – at least not any time soon. The only way to compile research would be to follow women who admit to marijuana use during their pregnancies and document their outcomes.


But here again, this presents a few problems.


There are still many in the medical field who will report a woman to CPS (Child Protective Services) if they admit to using marijuana while pregnant. Women are understandably scared to share this information with their providers, so we really don’t know how prevalent it is or if there were any side effects from their use.


It gets even more complicated when we start trying to decide if marijuana based substances are safe as well, including CBD products that do not contain the psychoactive THC component. Is CBD safe in pregnancy?


We really don’t know.


Pharmaceuticals that are prescribed during pregnancy have well known and documented risks and benefits, giving doctors a confidence about prescribing them. Pharmaceuticals are somewhat predictable. Doctors are more comfortable prescribing a drug whose risks are known and documented that they are with “allowing” a woman to use marijuana, whose risks are still widely unknown.


So, is it safe?


Well, the jury is out, simply because there is not enough evidence about marijuana use in pregnancy. It’s starting to come out more and more that pregnant women have been using marijuana safely for many years. That’s not to say it is unsafe – but it’s not to say it’s not either! It just means we need more data to draw any sort of evidence-based conclusions.


What about breastfeeding? Here again, we must wait for data to say for sure. We do know that THC, the psychoactive component of marijuana, has been found in the breast milk of mothers who were using marijuana while breastfeeding. What sort of effect does that have on the nursing baby? We really cannot be sure.


As a doula, I tend to work with a population that values a more natural lifestyle. Some parents argue that marijuana is a plant, and therefore it’s safe for consumption and use. But please know that just because it’s a plant doesn’t mean it’s risk-free, and particularly during pregnancy, caution is prudent.


So for now, it’s up to you to make the decisions best for you or to hold off completely. Until there is more research showing that it is a safe alternative, it is considered best practice to avoid it during pregnancy.


For additional information, please check out the following:
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Professional Survey of Medical Use of Marijuana https://www.scribd.com/document/241019203/Medicinal-Use-of-Cannabis-Aviva-Tracy-Romm
Cristen Pascucci of Birth Monopoly and  Birth Allowed Radio interviews Heather S. Thompson PhD Marijuana and Pregnancy: http://birthmonopoly.com/ep-15/
CDC Centers for Disease Control: https://www.cdc.gov/marijuana/factsheets/pregnancy.htm
ACOG American College of Obstetrics and Gynecology: https://www.acog.org/Patients/FAQs/Marijuana-and-Pregnancy?IsMobileSet=false

​Clinically, a pregnant woman is considered to be full term at 37 weeks. It’s important to note, however, that clinical definitions do not reflect the actual readiness for life outside the womb for every baby. When allowed to gestate until they are ready, most babies will go to 40 weeks and beyond, and waiting until they are ready is safest for baby. But sometimes babies will come on their own from 37 weeks on, and those who do tend to need very little medical attention. Because the definition of a term pregnancy is considered 37 weeks, a labor that starts anytime before 37 weeks is called “preterm.” Any kind of labor is defined by contractions that cause the cervix to change. Many women experience contractions before they reach 37 weeks, but if they do not cause the cervix to change, it is not considered to technically be preterm labor.

​In short, nobody knows. There are a number of things that can contribute to a woman’s preterm labor, but each situation is different. For the most part, modern medicine does not fully understand all the mechanisms contributing to preterm labor. Because they do not understand it, they do not have all the appropriate the tools to treat it.

​The signs to watch for in preterm labor are the exact signs of regular labor. The only difference is that they take place before 37 weeks gestation. Do not hesitate to go to the hospital if you think you suspect preterm labor. The earlier it is caught and diagnosed, the easier it is to manage and stop. There are many signs of labor, but the primary sign to watch for is contractions that are getting stronger, longer, and closer together. In any kind of labor, you may feel a bit nauseated, lose the mucous plug, and your bowels may empty. If your water breaks, you are definitely in preterm labor and you should go to the hospital right away.

​When you arrive at the hospital in preterm labor, you will first be sent to triage for assessment and monitoring. This is the same as if you were having a full term labor. The triage nurse will notify your care provider (doctor or midwife) of the situation. Your care provider will then give care orders to the nursing staff and they usually manage the majority of your care.
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Depending on the intensity of your contractions, the staff may choose to simply monitor you and your baby to see if labor progresses. They will be watching for the cervical change. If labor does not progress and it appears that you are only experiencing minor contractions, you will likely be sent home with instructions to rest and hydrate. However, if your cervix is changing with your contractions, you will probably be given a medication to manage the situation, depending on the severity.

​If you are diagnosed with preterm labor, the hospital will want to act quickly to attempt to stop your labor and there are a variety of medications they may want to use.

If they need to slow your contractions, they may choose to give you a classification of medication called a tocolytic. This is a medication that causes muscles to relax. Since the uterus is a muscle, it often times responds to this medication. This classification of medicine usually lasts several hours, so your nurse will monitor you until the effects wear off. They will want to see if labor starts up again on its own without medicine. For many women, a single tocolytic shot is all that is needed to stop a preterm labor.

However, if labor picks up again after the shot has been given, labor is indeed starting and there is not much they can do to stop it. Depending on how far along you are in your pregnancy, they may decide to give you another dose of tocolytic. If they opt to do this, they are trying to buy you as much time as possible. (The long term use of tocolytics is generally not recommended, except in very early pregnancies where the birth would be extremely dangerous.) If your pregnancy is further along and the first tocolytic dose does not work, your provider will likely allow labor to continue to progress on its own, and they will manage it like a regular labor.

In some cases, a mother can be given a steroid shot which will encourage the baby’s lungs to develop faster. After giving the shot, they will wait as long as possible to get the baby out; sometimes they will wait days, sometimes weeks, depending on the situation.

If your waters are broken and your provider wants to give the baby as much time as possible to develop in utero, sometimes they will give you antibiotics to prevent infections from developing. As long as there is no infection, chances are baby can still stay in utero and develop a while longer.
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Modern medical advances have been lifesaving for many babies and mothers experiencing preterm labor. Many preterm labors can be safely managed, and fortunately many very early babies can be saved. It is never optimal to have a baby before they indicate that they reach full development, but most of the time it is manageable. The most beneficial thing that moms can do during pregnancy is to take good care of themselves and their health to the best of their abilities. Then, love on those babies whenever they arrive.

​Placenta Encapsulation has been a topic of great discussion for the last decade or so. More and more moms are choosing to have it done and many are experiencing the tremendous health benefits.

Recently, however, the birth community at large has created an uproar surrounding placenta encapsulation. This is because many insist that their way of doing it is the best way and only way. It has created a shameful and unnecessary division among birth professionals, who seem to be losing sight of the main goal of birth and postpartum work: a woman’s choice. 

The conflict does not surround the benefits of placenta encapsulation. We all agree on that. Rather, some placenta encapsulators insist that their methodology is the only acceptable one. 



Their way goes like this: 

• The client brings the placenta home from the hospital. (The encapsulator does not, under any circumstances, pick it up.)
• The client’s placenta is prepared and processed in the client’s home after she arrives after birth. The placenta encapsulator cannot process it anywhere else. They insist that this provides every client with the best peace of mind about the handling and processing of their placenta.

That is all. I and many others in the birth profession have a few problems with insisting on these methods as the only safe and acceptable ones.

Choice
Most importantly, as I mentioned, the client gets no choices in the matter. If she does not want it processed in her home, regardless of her reasoning, that’s too bad.

Length of Time
Most moms stay at the hospital for a day or two after giving birth. If a woman has had a cesarean, she may stay for 4 or 5 days. During that time, the placenta is being stored by the hospital for her to take home. The fact that a placenta remains at the hospital while the mom is staying in a mother-baby unit does not guarantee it’s being handled safely or properly.

Most hospitals see a placenta as medical waste, and they do not always have systems in place for storing, labeling, and preserving a placenta that someone wants to be processed. Having a placenta encapsulator pick up the placenta soon after birth ensures that it is going to be handled and processed quickly.

In addition, the longer a placenta sits unprocessed, the greater the risk of contamination, spoiling, or mishandling becomes. The safest option for producing a quality product is to process it as soon as possible. I’ve heard stories of women learning after the fact that their placenta was mislabeled, and therefore they didn’t even know it was theirs! In another situation, a woman’s placenta was being held by the hospital staff for her when it mistakenly got sent to the pathology department. When it came back to her in shreds, she could not encapsulate it.

Placenta encapsulation provides the greatest benefit to women as soon as possible after birth. That means that the longer it goes unprocessed, the longer a woman’s body goes without getting the benefits that are critical in helping women manage those first several days. 

Conversely, a placenta encapsulator can pick the placenta up soon after birth and have placenta pills processed and delivered the day after birth when the mom’s hormones are at their greatest need for stabilization. She can have her placenta pills even before she leaves the hospital.

Location
What if a client does not want the placenta processed in her home? There are plenty of valid reasons that a woman may not want a placenta to be processed in her home. A placenta encapsulator that does not honor those reasons is providing a disservice and a lack of choice to that woman. Most women just want to be left alone at home to rest after birth. What if a woman has a pet that she is concerned will try and eat the placenta as it’s dehydrating? (That has happened!) Furthermore, some women simply may not want the smell in their house and that is fair because even after birth, a woman’s nose is sensitive to smells.

Sterilization
Finally, to claim that the placenta owner’s home is the best place because it can be most sterile is unjustified. I could refute that by claiming that my method is safest because I sterilize equipment by a certified sterile supply technician with steam sterilization in an autoclave when other encapsulators are only trained to disinfect. If you hire a placenta encapsulator to make your placenta pills, you can ask questions in the interview about how they process it, what certifications and methods they use, and how they ensure safety. Just because it’s being done within the client’s home doesn’t mean it’s automatically safer there. 


Conclusion
I offer both in the home and in office placenta encapsulation, and I feel that is what gives my clients the most options. In my experience, most choose NOT to have it processed at their home. Still, a few choose to have me do it in their homes, and I am certainly glad to do it that way for them! What’s important is a woman’s CHOICE in the matter. After all, birth professionals all over the world advocate for women’s choice – and they deserve to have that choice extend to their placenta encapsulation options as well.