​Stress seems to be a normal and somewhat expected part of our lives in modern America. Pregnancy, birth, and the postpartum period are typically times where the stress only tends to increase. We all know the effects of stress and anxiety in the body of a non-pregnant body. During pregnancy, many of those effects are amplified and pregnancy poses a whole unique set of risk associated with chronic stress and anxiety. Because of this, deliberate and intentional stress reduction in pregnancy is very important for the well being of the mother and the baby.
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It’s important to note that the stress itself is not the problem – the amount of stress we experience is the problem.  In truth, a little bit of stress is healthy. It creates a fight or flight response in our bodies that is essential to our survival. However, when that fight or flight state is the only state of being we live in, our health is at risk – physically, mentally, emotionally, and spiritually. Pregnancy, labor, and the postpartum period all are affected by stress in different ways.

The effects of stress in pregnancy are being researched all the time, so we know more now than ever about its effects. It seems the more we know, the more apparent it becomes that reducing stress and anxiety is vital to a healthy pregnancy. For instance, we now know that at its worst, stress has the ability to affect the baby’s growing brain and sometimes inhibit the development of certain parts of it, though that is known to be in only extreme cases.

Cortisol, when produced by the mother, creates inflammation in both the bodies of mom and baby. Chronic inflammation is now known to be a cornerstone for a variety of serious health conditions. In small amounts, stress in pregnancy is not harmful, but there is no known “threshold” of safety for stress levels, nor is there a way to objectively measure that. Knowing this, doing your best to have a balanced and calm pregnancy can only be beneficial.

During labor, stress inhibits oxytocin, which is an essential hormone needed for labor to progress. When a mother is tense or stressed during labor, her contractions are not as effective because the stress inhibits the effectiveness of those contractions. Doulas work hard with mothers to reduce anything that contributes to stress during labor because relaxation is required for labor to progress.

During labor, stress inhibits oxytocin, which is an essential hormone needed for labor to progress. When a mother is tense or stressed during labor, her contractions are not as effective because the stress inhibits the effectiveness of those contractions. Doulas work hard with mothers to reduce anything that contributes to stress during labor because relaxation is required for labor to progress.

After birth, mothers desperately need rest and rejuvenation. In reality, this is a time where most mother’s anxiety begins to skyrocket. Between healing from birth, learning how to breastfeed, caring for a new baby, sleep deprivation, and her continued demands within the functioning of a home, life gets overwhelming – and stressful – quickly. In many cases, the pressures of this new life mean that postpartum depression isn’t far behind. Stress also has the ability to slow a woman’s postpartum healing process.  A postpartum doula can relieve a significant amount of that stress by helping mom navigate life with a newborn as well as help with the chores.

So with all these well-known effects that stress has the ability to cause, what are some effective ways to reduce your stress in pregnancy?

This is a whole topic unto itself that deserves its own blog post. But a simple, effective way to reduce cortisol levels and scale back the fight or flight effect on the body is to do deep breathing. This exercise is not only beneficial in pregnancy, it is great practice for labor and birth. Physiologically, the lower part of the lungs activates the parasympathetic nervous system, which is the state of relaxation and grounding we should live in for almost the entirety of our lives. It is the opposite of high stress and fight or flight. Deep breathing is an important and useful practice that anyone can do. Even just a few deep breaths will help to bring you back to a state of balance.

In the fast paced world we live in, you’ll never fully escape stress during your pregnancy. You should never feel guilty for feeling some stress or anxiety during your pregnancy, labor, or postpartum period. Life happens. Doing your best to give yourself a little extra TLC and trying to be deliberate about reducing your stress and anxiety during this time will go a long way for you and your baby. And hang in there – this is but a short season of life.

​We are on to part 3 of our Hypnosis for Birth series! In case you missed it, check out part 1, where we detail what hypnosis really is. In part 2, we talked about the benefits associated with using hypnosis for birth. And today in part 3, we are going to talk about the crux of using hypnosis for birth: How to use hypnosis for labor and birthing.


In short, the message is that the words that you use when you speak about pregnancy and birth have a tremendous impact on your birth outcome.


We often take for granted the power of words in our modern world. Particularly with the invention of texting, communication has been reduced to rudimentary acronyms for blurbs that we wish to communicate on a whim. It’s a shame because language matters a great deal!


And in birth, language is how we communicate with our subconscious and with our bodies to accomplish the greatest and most heroic feat of all mankind: bringing forth life.


So, what kind of language is used in our culture today to discuss birth? Grab any book off the bookstore shelf for expectant mothers today, and what kinds of terms will you find?

• Cervix
• Uterus
• Dilation
• Effacement
• Contraction
• Fetus
• Pain

What do these all have in common? These are medical terms. Yes, they are anatomically correct. But they are all somewhat detached from the human element and they are medical and physical in nature. For the purposes of medical study and physiological understanding, these are fine.


But from within, as a birthing woman, birth is about so much more than simply the sum of interrelated anatomical parts and their respective roles.


What effect does it have on our psyches to refer to a perfectly normal and healthy process that involves the mind, body, and spirit, using only its anatomical and functional terms?


We come to see ourselves as only a function of medicine, and we therefore think we are dependent upon it in order to birth.


And our subconscious mind comes to see medicine as necessary for healthy birthing.


While it’s absolutely true that medicine has a place in rare complications, it is not a requirement for birthing to be healthy or safe in most situations. In fact, evidence supports physiological birth as the safest option for both moms and babies.


Consider this. Every other branch of medicine has common, everyday terms for organs as well as their processes. For instance, you wouldn’t tell your friends that you had a myocardial infarction. You would say you had a heart attack. Similarly, you wouldn’t say that you had pyrosis. You would say you had heartburn.


Why is it that we do the opposite in birth? A woman is not a vagina who births a fetus. She is a whole human being whose mind, experiences and spirit are all in this birthing experience together! And the words that we use to communicate everything about the experience impact all of those parts of her.


So, how can we change our language in birth to better reflect and communicate with our minds and bodies?


Take a step back – and examine the language we’re using to communicate with our subconscious mind.


Rather than saying “I am dilating,” use the phrase “I am opening.”
Rather than saying “I am effacing,” use the phrase “I am softening.”
Rather than saying “My baby is at a zero station,” use the phrase “My baby is moving down.”


It’s a pretty big difference!


The word “contraction” is one in particular that is neither accurate nor useful. Because you see, the uterus is not actually contracting! The uterus and cervix are not, in fact, two separate organs – they are one organ doing several separate and distinct jobs!  The word contraction means to tense up and to make hard. During a “contraction,” the uterus and cervix are actually doing the opposite! They are pushing, softening, opening, and moving the baby!


Furthermore, a “contraction” involves more than just the work of the uterus and cervix. A “contraction” demands the entirety of a woman including her mind, the movement of her body, and the willingness to surrender to a process that feels bigger than herself.


In hypnobirthing, the term “contraction” has been replaced by the term “surge.” So rather than saying “I’m having a contraction,” use the phrase “I feel a surge building.” The term “surge” more accurately captures what is happening within a woman – both mentally and physically.


In addition to the types of words that we use, the way they are communicated has a huge impact. For instance, imagine the way a woman would experience these two phrases from her provider:


“You’re only 6 cm.”


Versus:


“You’re doing great and you’re at 6 cm!”


One plants a seed of defeat, the other of encouragement. The facts remain the same. But the language used to communicate those facts portray opposing mindsets.


Which one do you feel would be more productive for a laboring woman?


I can speak from experience as a doula, as can thousands of other doulas and midwives, that what a woman thinks about in her pregnancy is nearly almost always exactly what she gets for her birth. For instance, say a woman decides she wants to have a natural birth, but she keeps thinking she’s going to need an epidural. What ends up happening? She has an epidural.


What was she thinking about while she was preparing for her birth? The epidural.


Now hear me: This is NOT to say that epidurals are bad. It’s only to illustrate that what your mind fixates on is ultimately what leads to your experience. What you think about is what you are unintentionally telling your body to do.


So, what are you thinking about as you prepare for birth? Are you thinking about what you DON’T want? Or are you thinking about what you DO want? Are you visualizing your cervix opening, your baby moving down easily, your being in control of your surges, and holding your baby in your arms after it’s all done?


Or are you staring down your impending labor with a terrified longing?


Because what you fixate your mind on and the messages you give it will ultimately determine the way your birth plays out. The subconscious mind does not judge what we give it. It only receives and acts accordingly.


So how do you train your subconscious mind to be ready for birthing?


Practice visualization. This gives your mind the exact messages you WANT it to have as you prepare. Visualize your cervix softening and opening easily, your surrendering to the process of birth, and your surges peaking and subsiding. Visualize and practice deep belly breathing every day during the entirety of your pregnancy so that your mind and body are already practiced in the art of relaxation.


Use intentional language that creates a positive expectation for your birth. “I’m terrified to give birth” is the general feeling in our world today. “I’m confident in my body’s ability to birth” is much more productive.


In conclusion, simply being aware of the language and messages that you are taking in during your pregnancy can go a long way toward creating a healthier and more satisfying birthing experience for both you and your baby.


Happy birthing!

In all the fun and joy of preparing for birth, very few give postpartum depression anything more than an obligatory nod. Most people are inclined to skip over it when preparing for a baby, because of they, naturally, think it will never happen to them. Some may just resolve to deal with it if they face it and otherwise leave it alone.

Nobody can possibly prepare every little detail about the coming life with their baby. But a little basic understanding of postpartum depression can go a long way toward prevention and management, should the need arise. I certainly cannot provide you with all there is to know about PPD in a single blog post, but I hope you will gain some basic knowledge to help you be aware and prepare.

First, what causes postpartum depression? We still have so much to learn despite the amount of research that has been done already. Each case is unique, and the way it is experienced and manifested differs from woman to woman. Causes can be rooted in something mental, emotional, physical, or spiritual, or any combination of these.

Physically, as a woman recovers from birth, her hormones take a while to readjust to a new normal. During this time, it is likely that she is not getting adequate nutrition to support this process if she doesn’t have enough help at home. If she is breastfeeding, prolactin is at work as well, trying to perform its essential function. In addition, she is also likely sleep deprived of caring for a new baby.

Emotionally, a woman can understandably feel overwhelmed by the demanding job of caring for her new baby. If and when her partner returns to work this stress can be amplified especially if there is no additional help at home.
The symptoms of postpartum depression are easy to observe. It is classified as a condition that can be self-diagnosed. Postpartum depression is not to be confused with baby blues, which generally only last a few days after birth. Conversely, postpartum depression tends to be more extreme and rather relentless.

Many women feel ashamed about the possibility of having postpartum depression because motherhood is “supposed” to be the happiest time of your life. In theory. The reality is often much grimmer than we presupposed, as this season of life involves so much life adjustment, difficult navigation, and physical strain involved in baby care. Women are afraid to admit that they are depressed during this time for fear of being shunned.

Some general signs to watch for:

• Overall discontent
• Inability to feel pleasure
• Sleeplessness, insomnia or excessive sleeping
• Unexplained crying or irritability
• Mood swings
• Desire to hurt yourself or the baby
• Inability to concentrate
• Lack of interest
• Panic attacks

Women are more likely to experience PPD if they have:

• A history of depression or postpartum depression
• Breastfeeding problems
• Stress
• Financial issues
• Bipolar disorder
• Had a cesarean
• Not enough support at home after baby is born

The standard postpartum follow up visit with a care provider after birth is a full 6 weeks. That means a woman is sent home from the hospital on her own, and they do not see a professional who can help them for 6 whole weeks. This is a huge gap in maternity care in the US. After birth, a lot can happen in a couple of days, let alone 6 weeks.

The exception to this rule is the home birth midwife. Home birth midwives usually see their clients several times between birth and 6 weeks, but only 3% of births in the US are attended by home birth midwives. The majority of other providers do not do visits before 6 weeks.

This is significant because one of the most well-known causes of postpartum depression is the lack of support.

Both birth and postpartum doulas are in a unique position with a mother. Doulas can come and visit a mother to provide support, but they can also be a perceptive eye in this sensitive time. A doula sees the mother in her own home, in her element. Even though birth doulas generally do not to postpartum doula work, most birth doulas tend to stay in touch with their clients long after the birth. They can be a source of emotional support, and they can provide resources for professionalhelp and support should it become needed.

In theory, a postpartum doula can help prevent postpartum depression. We know that postpartum depression can be caused by stress, breastfeeding problems, emotional demands, or lack of support. We also know that the postpartum doula helps support all of these issues. When she hires a postpartum doula, a new mother does not need to juggle the demands of the household, worry about meals, or handle the housework. She can get adequate rest too since the doula helps the mother make sure she is getting some sleep. A postpartum doula can help reduce stress in an indescribable way.

If you think you may be experiencing Postpartum Depression, it’s so important to talk to someone. It can be managed in a number of ways that range from additional support to herbal supplements to medication. You must know that you are no less of a mother because you are struggling with postpartum depression – there are 3 million known sufferers in the US alone. You do not need to suffer in isolation.


For more information, check out these resources:
Preferred Counseling / Support Groups
Alexia Johnstone, LMHC
Holden, MA
Mental Health Counselor
Expressive Arts Therapist
Ph: 413-320-6453
Email: ajohnstonelmhc@gmail.com
https://therapists.psychologytoday.com/rms/name/Alexia_Johnstone_MA,LMHC_Holden_Massachusetts_271800

Maria Dolorico
Boston, MA
http://www.amomisborn.com/
Mara Acel Green LICSW
Watertown, MA
http://www.strongrootscounseling.com/


 
Massachusetts Postpartum Depression Treatment 
Boston – Massachusetts General Hospital’s Center for Women’s Mental Health
Boston – Brigham and Women’s Hospital Women’s Mental Health Program
Boston – Judith Robinson MD, Tufts Medical Center
Boston- Vivian Halfin MD, Tufts Medical Center
Cambridge – Laurie Ganberg LICSW
Cambridge – Suzan Wolpow LMHC
Lexington – Ellen Hilsinger MD, 781-863-5225
Roslindale – The Leggett Group
Somerville – Vicky Reichert LMHC
Wakefield – Janice Goodman
Waltham – Jewish Family & Children’s Services PPD Support
Waltham – Jessica Foley MA
Watertown – Mara Acel Green LICSW
Wellesley Hills – Deborah Issokson PsyD
Westborough – Carolyn Chapman MSW
Worcester – Univ. of Mass. Medical School Women’s Mental Health Program
Worcester – Birchtree Psychology, Rachel Smook PsyD
For more PPD specialists in Massachusetts, visit the North Shore PPD Task Force’s provider list
If you are seeking therapy offering a sliding scale fee based on income, or free counseling services, you might try: La Alianza (Boston, Roxbury)