Ashley’s Birth

The photos and audio clips below are from a birth at Roots Community Birth Center on February 1, 2019. People in the room include: Ashley (who is giving birth); Ashley’s family members, including her mother, aunt, and cousin; Midwife Jahan Zuberi; Midwife Rebecca Polston; and Birth Assistant Britt Duncan.

Below are photos, audio, and descriptions. Click the audio as you scroll through to hear the sounds that accompany the images. Transcript coming…

F69A0277.jpg

The back entrance leading up to the birth suites, beside the back entrance to the main office and clinic spaces.

F69A0305 copy.jpg

In the birth suite kitchen, Midwife Jahan explained that Ashley left a message in the Roots online client portal and spoke to her over the phone before arriving to the birth center that morning after hours of laboring from home.

The birth suite includes a kitchen, a living/dining area, a bedroom with a toilet, shower, and bathtub, another half bathroom off of the hallway, and an additional room which is currently being redone.

F69A0278.jpg
F69A0291.jpg

Fetal monitoring options available during childbirth include external and internal monitoring, performed continuously or intermittently (for example, 20 minutes of monitoring with 40 minutes between). The handheld doppler is the most portable option, and certain models are waterproof, allowing monitoring while pregnant people labor in baths and showers as well. The midwives here perform fetal monitoring intermittently throughout labor.

F69A0392.jpg
F69A0331.jpg
F69A0300 copy.jpg
F69A0320 copy.jpg
F69A0351.jpg
F69A0373 copy.jpg

Group B Strep is a type of bacterial infection that can be found in pregnant people. The bacteria is normal, occurring in 25% of healthy adults with vaginas. When present late in pregnancy, there is a possibility that the infection can be passed on to the infant, which can be serious. Antibiotic treatment can be given to prevent this.

After taking more time to consider and review materials, Ashley decided to consent to antibiotic treatment for Group B Strep, which would occur every 4 hours throughout labor until her baby was born.

F69A0514 copy.jpg

Midwife Rebecca Polston arrives and banters quietly with Ashley’s mother (not pictured) and aunt (pictured).

F69A0536 copy.jpg

IVs can be given for a variety of reasons during labor, including in this case, providing antibiotic treatment for GBS positive laboring persons. Placing an IV can be a challenge during labor. In this case, small veins in Ashley’s forearms resulted in a few attempts before a successful IV was placed further up.

Because the purpose of Ashley’s IV was intermittent antibiotic treatment, her IV was “hep-locked” and detached. This meant that between doses, she was not hooked up to the IV line or attached to a pole and continued to have free range of motion.

F69A0540 copy.jpg
F69A0546 copy.jpg

After the grounding exercise Midwife Rebecca led Ashley through was complete, and the first dose of antibiotics was also, Ashley continued laboring in the bathtub. Her hep-locked IV was taped and not a problem to have in the water.

Getting into a warm tub of water during labor is an evidence-supported practice for managing pain, soothing aching muscles or joints, and inspiring a relaxed state of mind. Parents who practice some form of hydrotherapy during labor are more likely to delay or not request further medical pain relief.

F69A0589 copy.jpg
F69A0594 copy.jpg

Throughout Ashley’s labor she was fed and given to drink: oatmeal, oatmeal with honey, apple sauce, apple juice, water, coconut water, and Gatorade.

Evidence supports the right of low-risk laboring people to choose whether they would like to eat or drink during labor.

F69A0629 copy.jpg

Only a day after the extreme cold temperatures of the Polar Vortex had passed the pipes at the birth center were still cold, so boiling water was poured into the birthing tub to bring the water to a more comfortable temperature.

F69A0699 copy.jpg
F69A0712 copy.jpg

Ashley’s vitals and baby’s heart tones were checked regularly throughout labor, with the midwives and birth assistant working around her — not moving her from her position as much as possible.

F69A0722 copy.jpg

This adjustable handle secured to the side of the bed provides a laboring parent a greater variety of ways to lean against and hold onto the side of the bathtub.

F69A0758.jpg

After a few contractions in the bathroom, Ashley returned to the water. At her request, Midwife Jahan used a mesh net in the tub to catch any visible debris.

F69A0833 copy.jpg
F69A0840 copy.jpg

The tightening and relaxing of the uterine muscles during labor, often called “contractions” are also often called “waves” or “rushes,” words that may feel more positive or produce less anxiety in birthing people.

F69A0860 copy.jpg

The adjustable handles, previously on the sides of the birth tub, are placed under the water near Ashley’s feet by Birth Assistant Britt, so that Ashley can place her feet against them to both stabilize her position in the water and widen her pelvis.

F69A0859 copy.jpg

Both Midwife Jahan and Birth Assistant Britt feed Ashley bites of oatmeal between waves.

F69A0958.jpg

Throughout her labor, Ashley changes positions often — freedom of movement during labor, and particularly the use of active and upright labor and birthing positions, have been linked to shorter labors and less need for epidurals. Positions like this one, sitting on the toilet can encourage the descent of a baby and tap into the body’s natural response to open there.

F69A0918 copy.jpg

During labor a birthing parent can go from feeling hot to cold, or cold to hot quickly.

In the photo above, Ashley is still wearing a robe she asked for after getting out of the bathtub, just low and off of her shoulders. After expressing that she felt hot, Birth Assistant Britt then fanned Ashley with something she grabbed nearby.

F69A0966 copy.jpg

Ashley decides to move from sitting on the toilet to sitting on the bed before getting her next dose of antibiotics.

F69A0988 copy.jpg
F69A1009 copy.jpg

Birth Assistant Britt uses a rebozo to move Ashley’s hips, which can help relax the muscles around the pelvis and encourage better positioning of the baby. She also massages Ashley in this hands and knees position on the bed as labor continues to progress.

F69A1028 copy.jpg
F69A1060 copy.jpg
F69A1097 copy.jpg

The midwives ask for permission before every vaginal check Ashley receives. They also ask her to let them know when she’s ready for them to begin, and announce their touch just before she feels it. They communicate to her the information the vaginal check gave them about her labor during or after.

F69A1104 copy.jpg

Midwife Rebecca watches the sacral movement of Ashley’s body for more information about how labor is progressing.

F69A1126 copy.jpg
F69A1133 copy.jpg

There are many ways a birthing parent can get into a squatting position during labor, including this supported squat over the birth stool, where in this case, Ashley is supported by her mother sitting on the bed behind her.

F69A1147 copy.jpg

Ashley performs the lift and tuck motion that Midwife Rebecca (and Midwife Jahan at another time) recommend to help the baby descend past the pubic bone.

F69A1161 copy.jpg
F69A1170 copy.jpg

Nitrous Oxide, also called Laughing Gas, is one option for pain management during childbirth, but it’s better known for being used at the dentist. It is tasteless, odorless, and given through either a mouthpiece or a mask over the nose and mouth. It’s felt to be most useful when inhaled beginning about 30-45 seconds before a wave and then through to the end of that wave.

F69A1183 copy.jpg
F69A1198 copy.jpg

Midwife Rebecca goes under the bed to examine Ashley as she squats by the bed’s end.

F69A1191 copy.jpg

While pushing might sound like it would be intuitive, many birthing parents learn and practice how to push productively through direction and coaching during this stage of labor.

It is common in the pushing stage to begin to see the baby’s head (if the baby has descended head first) rocking out during a push and then sinking back out of sight between them. While this can be challenging for birthing parents who feel so close to done, it does encourage tissues to stretch, which may prevent tearing, to at least some degree.

As her pushing progresses, changes include: the lowering tone of Ashley’s voice, letting out less breath as she pushes, pulling her legs back and rounding her body as she pushes, and her family becomes more vocal with their encouragement, motivating her even more.

F69A1265 copy.jpg

The baby’s head no longer disappears between pushes. Laboring parents are often encouraged to reach down and touch their baby’s head at this point, which Ashley did just before the doppler is used.

F69A1302 copy.jpg

It is not uncommon for a baby to be born in stages like this needing separate pushes — possibly minutes apart — head first, shoulders through next, and the rest of the body after.

F69A1333 copy.jpg

This baby is born “en caul,” meaning still inside the intact amniotic sac. Here, the baby’s facial features can be seen pressed up against the inside of the amniotic sac lining, and below, their fingers can be seen stretching it away from his face.

F69A1336 copy.jpg
F69A1339 copy.jpg

Once born, baby is transferred immediately to Ashley’s chest, and covered with a blanket to stay warm and bond with Ashley as the next stage of labor arrives.

F69A1406 copy.jpg
F69A1493 copy.jpg

The birthing parent’s work continues after childbirth as the the placenta is born. They still feel waves and need to push to get the placenta through the birthing canal.

In Ashley’s case, the placenta is still attached to the baby through the umbilical cord, which she has chosen to delay clamping and cutting.

F69A1520 copy.jpg

Cold ice packs applied to the perineal area after childbirth can help reduce swelling and pain. Birthing parents can continue this practice at home as well, creating DIY ice packs to place externally and provide relief.

F69A1553 copy.jpg

Fundal massage, or uterine massage, is not so much a massage as much as purposeful pressure applied to the abdomen after childbirth to stimulate the uterus and reduce bleeding (preventing postpartum hemorrhage). It is often described as uncomfortable, and birthing people are encouraged to breathe mindfully through this important check as they would their waves.

F69A1559.jpg

Ashley chose to delay clamping and cutting of her baby’s umbilical cord. Delayed cord clamping allows blood circulating in the placenta to transfer to the baby’s body. Clamping is considered delayed when it happens after one minute after birth, however, it can take several minutes for an umbilical cord to go from thick, blue-purple, and pulsing (transferring blood) to white and limp (no longer transferring blood).

F69A1602 copy.jpg
F69A1632 copy.jpg

Birth Assistant Britt shows Ashley her placenta, describing how the baby grew inside the attached amniotic sac, and pointing out the smooth side where vessels form the “tree of life” pattern into the umbilical cord.

F69A1643 copy.jpg

After giving the family some space (with intermittent visits for fundal massage, stitching, breastfeeding assistance, etc.) the Roots team re-enters to perform a newborn examination.

On the topic of stitching, perineal tearing is common during childbirth, especially for first-time birthing parents. There are several degrees of tearing that can happen, requiring various levels of treatment. There are also ways to address the possibility of tearing, including perineal massage to stretch tissues. The practice of episiotomy (cutting of the perineal area to prevent tearing) is not supported by evidence for the vast majority of birthing people.

F69A1656 copy.jpg

The newborn examination took place in Ashley’s arms and beside her on the bed.

F69A1679 copy.jpg
F69A1693 copy.jpg

The Vitamin K shot is an injection given to babies within the first six hours of life to prevent Vitamin K deficiency. While rare, the potential impact of Vitamin K deficiency in newborns is life-threatening bleeding. The three main options parents have in addressing Vitamin K for their newborns are: consenting to the Vitamin K shot, choosing an oral Vitamin K regimen, or declining both.

F69A1711 copy.jpg

Ashley’s family warmed the car while she dressed herself and baby. After a final fundal massage/uterine check, the family leaves the birth center to begin the next chapter of their life at home.

F69A1714 copy.jpg

Ashley arrived at Roots Community Birth Center on February 1, 2019 at about 7:00am. She and her family left the birth center for home on February 2 at about 4:30 am. She is encouraged to call with questions if needed, is advised on particular things to call and alert the midwives to right away if she or baby experiences them, and will be visited by a birth attendant at home within the next three days.

Return to the Life’s Work landing page

 

Anissa's Prenatal Appointment

Through the photos and audio clips below you can follow this prenatal appointment between Anissa (mother of four, currently pregnant) and Midwife Rebecca Polston at Roots Community Birth Center on February 5, 2019.

This is a real example of what it looks and sounds like to check in with a medical care provider during pregnancy. While the session flowed without a spoken agenda, for clarity, we break it down into “parts” based on what Anissa and Midwife Rebecca talk about and do.

Below are photos, audio clips, and descriptions. Click the audio as you scroll through to hear the sounds that accompany the images. Transcript coming…

F69A2436 copy.jpg

Part #1: Discussing How Often to Have Ultrasounds

Pregnant people at or over the age of 35 are often referred to as being at “advanced maternal age.” The risks that come with this can change how someone approaches pregnancy and birth. Here, Midwife Rebecca begins to talk with Anissa about her options based on routine recommendations and Anissa’s exploration and preferences (and this is the resource Midwife Rebecca recommends Anissa look up).

For pregnant folks wondering what kinds of questions to ask during a prenatal appointment, Anissa gives a great example here: “What does XYZ test look for?”

Asking for more detailed explanations of tests, procedures, or recommendations that your care provider talks about can help you understand a process better, easy anxiety about something that makes you nervous, and help you decide what kinds of tests or procedures you want to say yes or no to, if possible.

F69A2442 copy.jpg

Both data and research and emotion and feelings play important roles in decision-making during pregnancy.

When Anissa expresses how monitoring can give her anxiety in the clip above, Midwife Rebecca first affirms that yes, it can be scary to go through testing during pregnancy, and then that the purpose will be to encourage more peace of mind by knowing what’s ahead.

F69A2453 copy.jpg

Part #2: Discussing How Baby is Moving

Keeping track of baby’s movements during pregnancy is an important way parents and medical providers understand more about how a baby is developing. The easiest, no-technology way to do this is by counting kick counts. Earlier on in pregnancy, a baby’s movements may be small and not so regular, but getting into the third trimester, they’ll become stronger and more predictable — that’s when a pregnant parent will really start counting.

F69A2455 copy.jpg

Part #3: Discussing Relaxation and Mindfulness

Mindfulness is the state of being fully present and aware in a given moment. You don’t need to buy anything or find a class to begin practicing mindfulness. It’s a very simple practice anyone can do at any time. And research has shown that it can have benefits including helping people cope with pain, reducing stress, and improving moods.

While some levels of stress are normal in everyone, high levels of stress can play a major role in the health of a pregnancy. And though we don’t completely understand how stress affects pregnancy, we do know that it can be connected to pre-term labor, when labor begins before 37 weeks of pregnancy.

So if you’re pregnant and have concerns about stress in your life, whether from work, family, finances, discrimination, or whatever else, don’t hesitate to talk to your care provider about it, and find stress-reducing activities that work for you.

In addition to taking more mindfulness breaks while eating lunch, Anissa tells Midwife Rebecca she’s thinking about doing prenatal yoga, going to see a chiropractor, and getting acupuncture to take care of herself too.

F69A2463 copy.jpg

Similar to mindfulness, the kinds of thoughts that we have during pregnancy can make a difference in our experiences. When Anissa says that she feels “this last trimester is going to be hard because I’m old,” Midwife Rebecca gives her a challenge to “reframe that narrative.”

What does that mean? Instead of saying to herself, “It’s going to be hard because I’m older,” Midwife Rebecca suggests Anissa says, “Isn’t it nice to have the life experience to know that I don’t have to run around?” or “Isn’t it nice to have older children where I don’t have to wipe their butts while I’m doing this?”

F69A2474 copy.jpg

Part #4: Answering a Question about Donating Cord Blood

Anissa arrived to her prenatal appointment with three questions she knew she wanted to talk to her care provider about. This is the first one.

After a baby is born, blood flows through the umbilical cord from the placenta to the baby’s body. Blood taken from the umbilical cord at this time is known as “cord blood” and it’s unique because it has stem cells. Most cells in the human body can only make copies of themselves, for example, skin cells can only make more skin cells. But stem cells can become many different kinds of cells, and because of that it can be uniquely used to treat many kinds of illnesses, including some forms of cancer.

Cord blood can be donated or banked. Preparations do need to be made for either decision before birth, so pregnant people considering saving or donating cord blood should talk to their care provider during a prenatal appointment just like this.

F69A2486 copy.jpg

Part #5: Answering a Question about Weight Loss During Pregnancy

Anissa’s second question was about some weight loss she’d experienced.

While there are a variety of reasons weight loss can happen during pregnancy, the real question when addressing this (or any other symptom or issue in someone’s medical care) is not why can this happen in general, but why is this happening in your specific situation?

Midwife Rebecca speaks to both the more general possibilities and she follows those up with questions that shed more light to Anissa’s specific situation.

F69A2488 copy.jpg

This discussion about why weight loss can happen during pregnancy opens a new piece of information about Anissa’s experience: gastrointestinal upset, aka, upset stomach, indigestion, nausea, vomiting, gas, etc.

Anissa adds that she also feels heaviness in her chest at times, not necessarily when she eats, but asks if that could be connected. Midwife Rebecca responds, “Well, I believe everything’s connected.”

Anissa asks a very practical follow-up question to Midwife Rebecca’s recommendations to switch to a low-allergen diet: “What kinds of recipes should I be looking for?”

As a recap before moving on, what began as a question Anissa brought about weight loss turned into revelations that (1) Anissa has experienced gastrointestinal upset, (2) Anissa has a family history of these symptoms, (3) a blood test to check the health of Anissa’s liver will be done, (4) a trial of a low-allergen diet will be done, and (5) Anissa and Midwife Rebecca will check in again before her next appointment to figure out how to move forward.

F69A2502 copy.jpg

Part #6: Discussing Provider Preference

Whether seeing OBGYNs, midwives, or any other kind of medical professional within a practice, it’s common for pregnant parents to begin to feel more drawn to certain providers over others based on personalities, care-taking styles and a variety of other factors.

Anissa’s third question brings this up to Rebecca, expressing more about her own feelings about who she’s connected best with throughout prenatal appointments at Roots and who she hopes will be able to be present during her birth, and the likelihood of that given Roots’ on-call system. Rebecca candidly and openly responds.

F69A2508 copy.jpg

Part #7: Lightning Round Questions

Swelling? Headaches? Visual disturbances? Nausea and throwing up? Vaginal changes? Baby’s movements? Urine? Anissa and Rebecca discuss or briefly revisit these topics before moving on.

Part #8: Discussing Gestational Diabetes Testing

Gestational Diabetes is a condition that can develop in pregnant people that causes high blood sugar levels. It can impact pregnancy, birth, and even the later health of both pregnant people and their babies. There are multiple ways that people can choose to be screened or tested for gestational diabetes, and evidence has shown that treatment is effective, lowering the risks of potential birth-related complications like large birth weight and shoulder dystocia.

Midwife Rebecca walks Anissa through the definition, risks, and screening options at Roots for gestational diabetes, and later, gives Anissa a printed handout to continue to think about after her appointment.

F69A2514 copy.jpg

Part #9: Taking Blood Pressure

A routine part of care, Midwife Rebecca takes Anissa’s blood pressure before she gets ready to examine baby.

F69A2524-2 copy.jpg

Part #10: Feeling and Listening to Baby

Midwife Rebecca asks for permission to touch Anissa and talks through each part of this physical assessment.

F69A2527 copy.jpg
F69A2534 copy.jpg
F69A2544 copy.jpg
F69A2549 copy.jpg

After hearing the baby herself, Midwife Rebecca hands the stethoscope to Anissa so she can listen as well. It sounds, she says, “Like a softly ticking clock.” Not to be confused with the sound of the softly ticking clock in the appointment room.

F69A2558 copy.jpg
F69A2563-2 copy.jpg

Part #11: Recap and Having Blood Drawn

Anissa has her blood drawn in this appointment as a follow-up to her discussion with Midwife Rebecca about weight loss and indigestion. Tests that will reveal more information about the health and function of Anissa’s liver can guide future decisions to make sure the pregnancy progresses safely and healthily.

F69A2583 copy.jpg

Part #12: Goodbyes

With a brief additional recap on next steps, Midwife Rebecca and Anissa say goodbye until they next connect. In total, the appointment lasted one hour and one minute.

Return to the Life’s Work landing page

Ashley's Postpartum Visit

The photos and audio clips below are from a home postpartum visit with Ashley and baby (name still to be determined at that time) by Birth Assistant Hayley Duke from Roots Community Birth Center on February 3, 2019.

Below are photos, audio, and descriptions. Click the audio as you scroll through to hear the sounds that accompany the images. Transcript coming…

F69A2135 copy.jpg

Birth Assistant Hayley and Ashley meet in a living area of the home. Hayley warms the sling scale she’ll weigh baby in while Ashley undresses the baby.

F69A2153 copy.jpg
F69A2162 copy.jpg

After recording baby’s weight, Hayley calms baby again to hand back to Ashley.

F69A2175 copy.jpg

Whatever infant feeding looks like for a new parent, it’s always a learning process. Ashley has decided to exclusively breastfeed her baby.

F69A2179 copy.jpg
F69A2184 copy.jpg

The positioning of a parent’s body and a baby’s body make a difference in breastfeeding. And this can look different from the parent perspective than from the outside. Having a trained professional review a feeding session early on in postpartum can help correct habits — or identify issues like tongue-ties — before they cause large or painful problems.

Here, Birth Assistant Hayley corrects the position of baby’s body against Ashley’s, and draws attention to the position of baby’s lips also, showing Ashley how to encourage his mouth into a better shape on her breast, as well as how to unlatch in a way that’s safer for her nipple.

F69A2192 copy.jpg

Milk production actually begins during pregnancy. At birth, birthing bodies often already have colostrum, an early form of breastmilk full of antibodies and nutrients. The time referred to as when “the milk comes in” is actually when milk production increases and shifts from colostrum to mature milk — this typically happens within three days of birth.

Research indicates that the timing of increased milk production is hormonally controlled, which may account for some of the common symptoms like emotional swings and shivering that parents talk about happening alongside this change. Studies show that delays in milk production can happen for a variety of reasons like type of delivery or certain interventions during labor. And they also show that we can encourage on-time milk production through actions like practicing breastfeeding, hand expressing, and skin-to-skin time with baby.

After discussing Ashley’s breastfeeding experience for these first few days some more, Birth Assistant Hayley recommends avoiding nipple shields and pacifiers as much as possible to prevent nipple confusion.

F69A2224 copy.jpg

Birth Assistant Hayley and Ashley go over wet and soiled diaper counts. Counting wet and soiled diapers in the first days and weeks of postpartum is one of the ways that parents and care providers can get a sense of whether baby is eating enough.

When Birth Assistant Hayley notices some cracks in Ashley’s nipple on one side, she and Ashley talk about how to continue breastfeeding through soreness while she’s healing.

F69A2231 copy.jpg

Birth Assistant Hayley recommends continuing to feed with only breastmilk, and sticking to a more strict 2-hour feeding schedule that will require waking baby up to feed if he’s asleep when the next session is due — later in the visit, Hayley re-emphasizes that it’s common for babies with weight loss to be sleepier during feeding time and need some help getting woken up enough to eat — and she acknowledges that that can be challenging and frustrating while it lasts.

Ashley asks if she should pump in addition to nursing baby and Birth Attendant Hayley recommends not doing that so her breasts don’t overproduce milk and cause more engorgement.

Deciding when to pump can depend largely on circumstances like when a parent has to go back to school or work, or be apart from the baby for long periods of time. While some parents produce a lot of milk naturally, generally the amount of milk production in a parent’s body is guided by the feeding pattern — the body will produce based on how often milk is removed. Engorgement is when the breast overfills with milk and becomes hard and painful.

Ashley is experiencing engorgement during this visit. Hand expressing before feeding — which Ashley will do later on — is one of the helpful ways to manage this challenge.

F69A2244 copy.jpg

One of the great concerns in the first few days after a baby is born is going to the bathroom. Peeing can often come with a stinging feeling where tissues are sore or torn, and bowel movements can be particularly painful if hard. While being nervous is normal, fear doesn’t help the first poop problem — eating mindfully, drinking lots of fluids, and using a stool softener, from prune juice to something from over the counter — these will help prepare the postpartum body. Using a peri-bottle with warm water or an appropriate herbal mix to rinse the perineal area after a pee can help with healing there as well.

F69A2247 copy.jpg

Whether a baby is born vaginally or by cesarean, the postpartum body is healing in the weeks after birth. The uterine lining and the birthing canal are often the sources of normal postpartum bleeding, passing through as a flow and/or in clots. Postpartum bleeding usually stops within 5-6 weeks. Drinking plenty of water and resting are two important ways to support timely healing.

The fundus is the name for the upper part of the uterus. The fundal checks that began just after birth continue at home, with Ashley checking on it herself. During postpartum, the fundus should descend below the bellybutton day by day, until it’s unable to be felt by two weeks postpartum. This indicates that the uterus is healing well.

F69A2255 copy.jpg

Next Birth Assistant Hayley asks Ashley about how her perineal area is feeling.

The perineal area is the area between the anus and the vulva. Caring for the perineal area during postpartum often involves healing tears from childbirth. It’s common for birthing people to experience first and second-degree tearing in any birth. Frequently changing pads, using a peri bottle, patting the area dry and resting are examples of good care habits for treating perineal tears during postpartum.

Birth Assistant Hayley also emphasizes that while showers are good for rinsing off and getting clean, sitz baths during postpartum are more helpful with supporting healing.

F69A2261 copy.jpg
F69A2293 copy.jpg

While postpartum chills aren’t fully understood, doctors speculate it’s often related to hormonal changes in the new parent’s body. It’s always a good idea to check in with your care provider, and let me them know if any other symptoms are occurring alongside this — for example, paired with a fever, chills may indicate an infection.

F69A2297 copy.jpg

Hormonal shifts, sleep deprivation, and the new challenges of parenthood naturally have an impact on new parents’ emotional and mental health. Checking in with your care provider about what you’re feeling and thinking is just as important as telling them what you’re physically feeling or experiencing.

There are degrees to the emotional signs and symptoms that new parents experience. Baby blues, which tend to last a few days or a few weeks, involve milder symptoms like mood swings, sadness, irritability, and crying.

Postpartum disorders like Postpartum Depression, Postpartum Anxiety, Postpartum Post-Traumatic Stress Disorder, or Postpartum Psychosis require intentional care from professionals for parents to manage and work safely through. Learn about these possible experiences early and know when to reach out for help.

F69A2301 copy.jpg

Typically, Birth Assistants from Roots visit with parents on day three. Hayley came to visit Ashley on day two instead because Ashley had called requesting support sooner. So in the audio clip above, she sets the plan for Ashley’s next visit to be the typical day five, but re-affirms that again she can always call if she needs to.

F69A2316 copy.jpg

Both cool compresses and warm applications can be helpful for treating engorgement before a baby nurses. Birth Assistant Hayley discusses this with Ashley based on what Ashley had already started trying herself at home.

Eye contact in newborns is an important indicator of a healthy nervous system.

F69A2321 copy.jpg

Safe sleep refers to putting a baby to sleep in a way most likely to protect them from dangers. Safe sleep guidelines include putting a baby to sleep on their back, not bed-sharing, not letting them sleep for long periods of time in strollers or carseats, and more. La Leche League has safe sleep guidelines that recognize the common desire and preference for many parents to co-sleep.

As Birth Assistant Hayley acknowledges when discussing with Ashley, safe sleep guidelines come from evidence-based research, and it’s up to parents how to use that information alongside their and their babies’ preferences and experiences.

F69A2328 copy.jpg
F69A2354 copy.jpg

The second weight check of Ashley’s baby reveals that he gained four ounces in one feeding from one breast. While this doesn’t erase earlier concerns about weight loss since birth, it is a great indicator that when properly latches, baby is getting milk, and the increased nursing schedule Ashley is set to use moving forward will help baby continue to make healthy weight gains.

Jaundice is the build-up of a substance in the blood called bilirubin. It’s common in newborns, usually happening in the first days of life. Most cases are mild and easy to treat, but severe untreated jaundice can lead to brain damage. While not necessarily something to be concerned about, jaundice may last longer in breastfed babies. Like everything else, you can to your care provider about jaundice and caring for your baby.

Hand expression is a technique of using the hands to get milk from the breasts. It can be used early after birth to express colostrum as well as regularly throughout the breastfeeding relationship to stimulate milk production or provide relief to engorged breasts before feeding. While videos of this technique are available online, if possible, it helps to have a trained professional present to watch and guide the learning process.

While you’ll only hear a few minutes worth of audio, Birth Assistant Hayley and Ashley practice and review hand expression technique for at least 30 minutes of this visit.

F69A2363 copy.jpg

Ashley’s technique changes — from the position of her fingers, to the way that they move — from the start of practicing to the end.

F69A2366 copy.jpg
F69A2373 copy.jpg

After asking for consent to do so, Birth Assistant Hayley demonstrates the hand expression technique on her breast. The differences in technique for hand expression can sometimes me easier to understand by feeling than seeing.

F69A2380 copy.jpg
F69A2390 copy.jpg
F69A2412 copy.jpg

When a first attempt at a latch is unsuccessful, Ashley goes back to hand express some more so the breast will be easier for baby to latch to in the next attempt.

F69A2422 copy.jpg

After the second session of hand expressing, the next attempt to latch is successful! Birth Assistant Hayley carefully takes Ashley’s blood pressure while baby breastfeeds.

F69A2426 copy.jpg

After answering a few additional questions about baby’s sleeping habits and pain Ashley was feeling in her hip, Birth Assistant Hayley and Ashley say goodbye. In total, the visit lasted about two hours.

Return to the Life’s Work landing page