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Pelvic Floor Therapy Guest Blog

Please enjoy this guest blog from a Pelvic Floor Therapist in the Knoxville, TN, area.

This does not have to be your current or future experience.

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Hello! My name is Autumn Synowiez and I am a pelvic floor therapist.

A pelvic floor therapist (PFT) can help treat many different types of problems that women have such as:

  • urinary incontinence (it is not normal to wet ourselves)
  • stress incontinence (when we cough, laugh, exercise) or urge incontinence (always feeling a strong urge to go).
  •  pelvic organ prolapse (yes we can reduce prolapse without surgery by two stages!).
  • perineal/episiotomy scars, cesarean scars.
  •  diastasis recti
  • pelvic pain, pressure, dyspaurenia (painful sex)
  • preparing your pelvic floor for birth to reduce these symptoms after birth and help coordinate your pelvic floor for optimal pushing.
  • postpartum check ups to make sure you truly are ready for exercise and have sex again (if not we will set you up with all the exercises needed to get you on the right path, surprisingly most women are not ready for either).

    Countries like France and Sweden have women going after their 6 week postpartum check up with their OB as the norm to make sure women are healing properly after child birth. These countries have much better outcomes for women long term (fewer women suffering from incontinence, pelvic pain, organ prolapse, etc).

    Do you have to have had a baby to need pelvic floor therapy? No! Most of us are unaware of our pelvic floor and how it works with our everyday movement. A lot of women who run, heavy weight train, cross fitters, etc.,  are not coordinating their pelvic floor properly when exercising and actually causing injury and weakness in that area.

    Having chronic pelvis or back pain? No one can fix it? Could be in your pelvic floor! We have success stories of people seeing multiple doctorss and physical therapists with no relief and sometimes after just one visit with PFT they have relief.

    C section only? Yep! Pregnancy alone can weaken your pelvic floor muscles and with your abdominal muscles being cut into, that can lead to an even more weaker pelvic floor and core. They go hand in hand.

    PFT is amazing cutting edge stuff that most women know nothing about. Women in our country have been neglected in this area or are ashamed/embarrassed to talk or look down there! It’s time to change that! You are not alone I can promise you that! There’s a whole set of muscles that are very important that we need to be exercising regardless of our age or whether we have had kids or not. These muscles are our center and help hold our organs in! Can’t wait to discuss more about this soon and offer awesome workshops with Kimberly! Please feel free to ask any questions! I’m sure I left a lot of info out!

    Yours truly-
    Autumn Synowiez OTR/L
    Women’s Health Pelvic Floor Therapist
    asynowiez@gmail.com

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All Rights Reserved, Knoxville Doula, Kimberly Sebeck, 2016

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Knoxville Doula Is Growing

Knoxville Doula is growing! I will be joining a fantastic massage therapist and a fertility and pregnancy acupuncturist at our beautiful office in West Knoxville. I will still be at my current location through the end of this month. We look forward to serving the community as a whole for your fertility, pregnancy, birth, and postpartum needs! You can check out their info atTransformations Massage and Wellness Center and Tennessee Center for Reproductive Acupuncture. ‪#‎knoxvilledoula‬ ‪#‎doula‬ ‪#‎knoxvilletn‬‪#‎professionalsworkingtogetherforyou‬ ‪#‎fertility‬ ‪#‎pregnancy‬ ‪#‎reproductive‬‪#‎massage‬ ‪#‎acupuncture‬ ‪#‎childbirthclasses‬

Knoxville doula is

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What Would You Tell Ina May to Include in a Book?

I stumbled across a fabulous podcast with Ina May. The interviewer did not have a natural birth and felt as if there was missing information in Ina May’s books — at first I thought this was going to be simply a critical viewpoint of Ina May.. but it’s not.

If you have ever struggled with disappointment or a feeling of failure because you didn’t have the candle lit, in a birth pool, 100% intervention free birth — please listen to this.

At the end you are given options of how to let Ina May know what you would like included in her current or forthcoming books.

 

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Q&A With A Mentee

For over a year I have been offering a mentorship program for newer doulas. Please enjoy this Q&A with one of them, Emily Gentry.
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Q:  Can you tell us a little about yourself and your services?
A: I have two great kids, an amazing husband, and tons of support to chase my dreams of being a doula from our family. I had two really amazing, empowering births which was a huge factor in becoming a doula. The services I provide are birth and postpartum planning assistance, labor support, postpartum doula services, babywearing education, mother’s blessing celebrations, and cloth diapering education. I also work with a local photographer to offer discounted rates for maternity, birth, and newborn pictures.
Q:  What made you want to be a doula?
A: When I first started, it was because I had a very strong desire to see women be empowered by their births. I had two amazing experiences with my births and I really wanted to help other women feel like I did. I believe that child birth is a crucial part of becoming a mother and how you feel about your birth can have either a positive effect or negative effect on the first few days, weeks, months, or even years of motherhood. For me, being empowered by birth meant achieving a completely natural childbirth. As a brand new doula, it was my opinion that the worst that could happen was that a mother would end in a C-section. That opinion quickly changed when the very first birth I attended as a doula ended in an emergency C-section. The mother understood that having a cesarean was the safest option for her and her baby. She was still empowered with her birth even after MY worst fear came true. Today, I still want women to view their birth as an empowering event in their journey into motherhood. But empowerment for women varies as much as favorite flavors of ice cream. Each woman is different, each birth is different, but each desired outcome is the same. Each woman deserves to be empowered by their birth, and that is why I want to be a doula.
Q: Who did you train through?
A: I trained through DONA International.
Q:  What inspired you to become an apprentice versus striking out on your own?
A: I actually tried striking out on my own when I was young and naïve and thought that I knew all the secrets to being an amazing doula. Like I said in an earlier answer, that perspective changed rather quickly after my first few births. I realized real fast that being a successful doula meant more than having achieved a natural child birth or two on your own. My experience with child birth is not the same as what everyone else experiences. I can still draw from my own experiences and help my clients. But using that alone really limits how I can connect with my clients. Even after training I still felt that I had a lot to learn and who better to learn from than someone who has been doing it for 16 years! I wanted to see first hand what it looks like to be a veteran doula and learn as much as I could so that I could better serve my clients.
Q:  What would describe as your birth philosophy and main area of interest?
A: My birth philosophy is that every woman deserves an empowering birth as defined by her. Some women are empowered by having a cesarean. Some women are empowered by achieving a natural child birth. Some women are completely happy not knowing what they want. My philosophy can be summed up by my business motto: “Supporting Women, Supporting Labor”. I support women in what they want out of their labor and child birth. My main area of interest is definitely hospital births. I feel like that is where women need the most support for their child birth choices.
Q: What has been your favorite thing so far about being a birth professional?
A: Honestly, my favorite thing so far is the look and feeling of a mother and her partner after birth while they are getting those first precious snuggles with their baby. The way she smiles as she is looking into her baby’s eyes, smelling their sweet little head, nursing or feeding her baby for the first time and just soaking in her perfect prize. It’s a feeling that is contagious. No matter how tired I might be from supporting a laboring mom, after that baby is born there is rush of adrenaline and suddenly I’m very awake!
Q:  Where can people find out more info or contact you?
A: The best way to contact me is by email or Facebook. My email address is blessedassurancebirthdoula@gmail.com and my busness page www.facebook.com/blessedassurancebirthdoula
Thanks, Emily! We know you are going to help so many women and families with all of your services and your desire to become a CNM (certified nurse midwife). I look forward to watching this journey unfold.
All Rights Reserved, Kimberly Sebeck AKA Knoxville Doula, 2016
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Tips For Dealing With Conflict at Birth

You took your childbirth classes. You read books and websites. You created a beautifully printed birth plan. You envisioned a birth full of candles and flowers and looking like a birth goddess, or perhaps you envisioned getting pain medication and watching movies and visiting with your friends and family. And then..

Circumstances changed. Maybe you had a transfer from a freestanding birth center and went to an unfamiliar-to-you hospital. Maybe your baby stopped growing optimally and a medical induction became a reality. Maybe your no intervention birth plan is toppling so far from your preferred choices that it becomes bewildering and frightening to you.

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As an ICAN leader and experienced doula, I sometimes receive phone calls from women in these situations even though they are not my client. I had one this week. Without giving too many personal details, her situation was such that it seemed a medical induction was best for the safety of the baby. She was transferred to a high risk group. Upon arriving at the hospital she was told that the induction would be slow and could take days and there was no time clock. And then..

Multiple residents came in with different suggestions for getting the baby out now. She had researched a good deal and asked wonderful informed consent questions. Is this an emergency? Am I or the baby in danger to proceed slowly? The answer was no. Still, she called me crying at the pressure of having one doctor after another file into her room with dire warnings of distress to the baby (and worse) and predictions of a cesarean if she didn’t allow them to perform all of the interventions they were recommending, even if she was not comfortable proceeding that quickly versus giving her body a chance to swing into active labor on its own.

I listened to her cry. I listened to her fears and her disappointment that things were not proceeding as she had imagined. Then I reminded her that informed consent is actually informed consent and refusal. We went over the informed consent questions again. What are the benefits and risks of doing a certain procedure? Why is it being suggested? Were there any alternatives to what they were recommending? What happens if we employ expectant management and give things more time to progress? Would you give me a few minutes to discuss with my partner and make a decision I feel good about?

Disclaimer: I wasn’t there. I’m also not a medical provider and do not give medical advice. I am not the one responsible for the safety of that mother and baby. I am unaware if there was information that made her medical providers feel one course was the best. I am a doula. I am used to listening to women who are frightened, disappointed, and unsure of the right choice to make. I am interested not only in physical safety of mother and baby but an empowering birth experience — no matter how it plays out. I am interested in her looking back and feeling that she made the best decisions with the information available at the time. I am interested in the birth team cohesively working together to ensure a safe AND empowering experience.

She focused on finding some inner peace and asking these questions. Unfortunately, it did not go well and the pressure became strong and some not nice words, phrases, and tactics were used, per her. Her providers agreed there was no emergent reason (as in safety of mom or baby) to pile on the interventions but told her they were certain she would end up with a cesarean if she didn’t comply.

That is an awful, if not impossible, way to try to labor and open your cervix. So as I have mulled this scenario over in my mind I decided to come up with a few tips in case something similar happens to you.

  1. Ask your informed consent questions. If there is an emergency, not only will they tell you but your medical providers will already be swiftly acting. When you sign in as a patient you are giving them an agreement to save you and your baby’s life. We are not talking about clear indications for life saving measures but more those gray areas of trying to decide which path to take.
  2. Engage your nurses, if possible. In this case the charge nurse came in to speak with her and reminded her that these were the suggestions but that the mother is the one driving the decisions and that it is informed consent and refusal, should that be her choice.
  3. Follow evidence based medicine. While it should not be the case that each laboring mother has to know facts, studies, and regular or alternative standards of care and treatment, it might be in your best interest to quote recommendations given by pregnancy organizations such as ACOG.
  4. Should there be a complete personality clash between you and the provider caring for you, consider asking for a different doctor or waiting for the on call schedule to change. Again, this is obviously not always possible when there is a serious or emergent situation happening. In this case, the on call doctor changed in 3 hours and she decided to wait until she could speak to that doctor.
  5. The vast majority of providers are not there to make your experience terrible — or to get to their golf game. They really are interested in your physical safety and that of your baby. However, they may not realize how important certain decisions are to you. Talk to them. Convey not only how important certain things are but why they are. Suggest or ask if there are alternative methods to what they are suggesting. (examples would be: instead of starting Pitocin using a breast pump, instead of rupturing your membranes, sitting on a birth ball, etc.). Maybe their answer will be one of excited acceptance or perhaps they know something about your personal situation that is causing them to recommend something else.
  6. Find a place of calm. When a situation becomes tense there can be certain phrases and tactics that are used that are triggering. Stick to the facts and if there is a doomsayer in your room or someone who constantly promises you will end up with a cesarean, let those words and phrases bounce off of you in the emotional sense. Conversely you can request your provider to stop using those phrases unless it an absolute certainty that is the correct path to take. Having a baby is an emotionally charged experience! Hear the words but do not attach emotions to them. If you find yourself overwhelmed, go in the bathroom and take a nice soothing and dark shower, or walk in the halls for a change of scenery. If you are confined to the bed for actual medical reasons, play soothing music or listen to music through ear phones. Ask your partner for hugs and massage. Clear the room and ask for a set amount of time to get yourself emotionally back on track.

 

These are just a few suggestions I can think of. I would be remiss if I did not mention that having a doula is an evidence based way to ensure emotional support for you and your partner and to help you try alternative methods to keep you and baby safe but also stick as closely as possible to your desires and wishes for birth. No, doulas will not speak for you or argue with your medical providers. We will remind you to breathe, to take a shower, to relax, to ask appropriate questions, and do all we can to use our tricks and tools to help your labor progress even if it has veered off course.

What happened with the mother who called me? She texted me a photo of her beautiful baby and said the atmosphere completely changed for the better when the on call doctor changed to one more emotionally understanding of her. Just by making the decision to wait those couple of hours enabled her to relax and to make more progress and to feel good about her decisions.

Do you have any tips for dealing with tense medical situations?

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All Rights Reserved, Kimberly Sebeck AKA Knoxville Doula 2016

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A Glimpse Into Postpartum Work

I have been doing quite a bit of postpartum doula-ing lately. More clients request my birth services but I really enjoy being hired to do postpartum work, too. Sometimes people are not as familiar with what a postpartum doula does, or doesn’t do.

My services are really quite flexible and dependent on what each family needs. Some moms have me come over and basically “pick my brain” about feeding the baby, newborn care, postpartum recovery, infant milestones,  etc., and that consumes the majority of my block of time. I choose to come over to a home for a minimum of 3 hours but it can certainly be longer. Other moms understand how important rest is and feel safe and relaxed enough with me watching over their new baby so they can go take a blissful long nap, with maybe a shower thrown in. Other families want to soak in every second of the newborn period with their baby and I do errands and simple household tasks. I also attend doctor visits like the first pediatrician appointment or a postpartum visit for the new mom.

I don’t do heavy cleaning. It’s far less expensive to hire a housekeeper than a postpartum doula. I do light tasks: loading the dishwasher, laundry, running errands, sterilizing breast pumps and/or bottles, putting together infant gadgets like monitors and swings, making a snack for mom or starting a meal for dinner. Speaking of dinner, I actually love to cook for my families especially if I am going to be there for a good amount of hours for the day. I give them a list of recipes that I am familiar with and good at and let them send me to the store or give them a list of ingredients to pick up. Imagine how good it sounds to have a knowledgeable person come over to answer newborn questions, perform household tasks, and then be able to enjoy my now famous chicken and dumplings or a refreshing summer salad. If the partner has already returned to work they can come home and focus on bonding and family time instead of working all day and then coming home to a list of things to do.

Frequently the question comes up of: what will we do for 3 hours? Once I am there and a mom sees how wonderful and valuable a postpartum doula is they often request more hours in a day. It might seem awkward at first to have someone in your home but that feeling quickly dissipates. I can be the person you confide in when you’re having some “baby blues” or postpartum mood disorders and I have the resources of where to get help. I can be the person who helps you ease into motherhood without any judgment. I can give suggestions about trying to get enough sleep, how to soothe sore nipples, and also dispel some of the misinformation given out by family, friends, and online sites. Having trouble figuring out your K’Tan or Moby? I will help you practice so you feel confident wearing your baby. Those sheets you have been sweating in, bleeding on, and leaking breastmilk into? I can change those out for fresh ones.

I will help you find your way to being the best parent in the manner that suits your lifestyle. One day you will be the one telling me what the baby needs and that is exactly how being a postpartum doula works. I work myself out of a job as you grow into parenthood and recover through the fourth trimester.

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All Rights Reserved, Knoxville Doula, Kimberly Sebeck 2016

www.knoxvilledoula.com