World Doula Week Is A Thing! But Why?

“Birth is not only about making babies.  Birth is about making mothers – strong, competent, capable mothers who trust themselves and know their inner strength.”       ~ Barbara Katz Rothmans

The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily. Read more from Dona and CAPPA, the two agencies where I completed my birth and postpartum doula trainings, respectively. 

World Doula Week is celebrated, every year from March 22-28. The purpose of World Doula Week ("WDW") is to empower doulas all over the world to improve the physiological, social, emotional, and psychological health of women, newborns and families in birth and in the postpartum period. The World Doula Week events take place all over the world during the same week, stating the benefits of the presence of doulas in birth and in the postpartum period:

* Reduces the incidence of c-sections      

* May shorten the length of labor      

* Reduces epidural and analgesic requests      

* Increases breastfeeding initiation and continuation     

* Increases mother’s satisfaction of birth experience      

* Can reduce the incidence of postpartum mood disorders     

* Increases new parents’ confidence in the care of their newborn

Celebrate with me! I Love What I Doula!

Breathtaking Birth Photos That Celebrate Doulas

Why I Hired A Doula

Day 1: Doula Selfie

The Price And Value Of Doulas

Day 2: Favorite Quote
Pregnancy, childbirth, breastfeeding, child rearing... this applies to all.

What Is A Postpartum Doula? 

Day 3: Favorite Tool
My Heart and My Hands
Since I am also a nutritionist and massage therapist, I find that I do my best work with my hands, using my heart as a guide.

The First 72 Hours Postpartum

Day 4: Client Testimonial
Humbled

Mothering The Mother

Day 5: Your Doula Bag
I try to keep the amount of items that I take into the home to a minimum. I do use teas, coconut and essential oils for mom. In an effort to Go Green, I use my iPad quite a bit to show videos, share resources, and entertain older children.

What Is The Difference Between A Doula And A Midwife

Day 6: Doula Mentor
I work within a small community of birth and postpartum doulas, but I am influenced by birth workers from all over the world. 

Postpartum Support... In Japan

Day 7: Where You Work
I live and work in Memphis, the city where my husband and my child were born.
We are at the top of every bad list and at the bottom of every good list...
so there is lots of room for improvement and lots of work for doulas to do!

Video: Alarming Health Disparities In The Midsouth

Yo! Microphone Check One, Two! What Is This?! Phife Dawg, Diabetes, and Maternal Wellness!

So nowadays I go and see wifey just to cure me from stress

Lay my head on her breast, Sugar Dumpling knows best

Explaining all my problems to her, gettin' things off my chest
A lil hug up, squeeze up and no more am I vexed
Aye yo Sun, without my peeps I'd be truly assed out
Making sure I have my medications so I wouldn't pass out 
~Stressed Out, Phife Dawg, A Tribe Called Quest 

Now Here's a Funky Introduction of How Nice I Am... 

Before I was a mother, childbirth educator, yogini, nutritionist, or lactivist, I was hip-hop. Although I grew up in suburban Ohio, and attended a Catholic school, I was deeply connected to hip-hop (even if just in my heart and mind). I was in a breakdancing group, where my classical ballet, tap, and gymnastics lessons helped me to stand out; I had a rap alias: Def Lady J; I memorized and recited other artists' rhymes in my sparer time- many of which I still know; I spent every dime of my allowance in the brand new, but very tiny, rap section of my local record store; between 1987 and 1992, my mother made sure that I didn't miss a rap concert within the tri-state area... and I sold dubbed copies of songs that weren't available in stores- I'm still not revealing my sources, but I don't  get down like that anymore. Today, I'm always blasting Backspin and marauding for ears at classic Hip-Hop Karaoke events. I love and live this stuff.

Check The Rhyme

Hip-Hop Karaoke

Heartbeats & Hip-Hop

My Aura's Positive, I Don't Promote No Junk

Why does any of this matter, and what does any of it have to do with maternal health and wellness? Last week, beloved lyricist, and member of the quintessential rap group, A Tribe Called Quest, Malik "Phife Dawg" Taylor, passed away at the age of 45, after a 25+ year battle with juvenile diabetes. Even though his struggles with the incurable disease have been largely public and referenced in his own rhimes, interviews, and the terribly difficult-to-digest documentary Beats, Rhymes, and Life, the hip-hop community was still buggin' out that the 5 Foot Assassin had met his final day. In the middle of the night, as I cruised the Internet for information to share with my new and expectant moms, I saw the first posts and tweets about the Funky Diabetic. I initially prayed that it was one of those sick Internet jokes. It wasn't. Phife is gone. It is difficult to accept that our contemporaries, those whom we've watched grow up, are now too soon passing away from health related conditions: J-Dilla,  Guru, Nate Dogg, Heavy D, DJ EZ Rock, Sean Price, and (maybe) Chris Lighty. Now Phife Dawg adds to that number and brings subject of diabetes to the forefront. It's time to expand the subject matter that touches everybody, so that it reaches everybody. 

Atlanta's Traffic Reporter Mark Arum Is On Point With This Phife Dawg Tribute

Styles Upon Styles Upon Styles... 
Three Types of Diabetes

Diabetes or diabetes mellitus (DM), is a group of metabolic diseases in which a person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. Individuals with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia). There are three types of diabetes: Gestational, Adult Onset. and Juvenile- the latter was Phife's kryptonite.

Gestational diabetes begins when a pregnant woman's hormones interfere with her ability to make and use all the insulin she needs for growing her baby. Gestational diabetes affects a mother late in pregnancy who is often asymptomatic; therefore pregnant women are routinely tested for this condition during their second trimester. The condition shows up in women not previously diagnosed with diabetes. It typically resolves after the birth of the baby, but the mother is now at greater risk for developing type 2 diabetes, while the child is at a greater risk of being a "big baby", becoming obese, and also developing type 2 diabetes later in life. Having a big baby (8 lbs. 3 oz., or heavier) can lead to additional discomforts toward the end of the pregnancy, and long term pelvic floor damage beyond pregnancy. More importantly, women with gestational diabetes are more likely to develop preeclampsia, be on bedrest, go into preterm labor, request an epidural, be induced, receive an episiotomy (or natural tear), or have a planned or emergency C-section. Incidentally, all of these complications can make breastfeeding more challenging. However, breastfeeding decreases the risk of the infant developing both type 1 and type 2 diabetes, so ask for help from a lactation consultant early and often. 

{Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in a woman whose blood pressure had been normal. Even a slight rise in blood pressure may be a sign of preeclampsia. Left untreated, preeclampsia can lead to serious — even fatal — complications for both you and your baby. If you have preeclampsia, the only cure is delivery of your baby}

During the process of vaginal birth, this big baby is at a greater risk for nerve damage, shoulder injury, or even brain injury. If a woman’s diabetes was not well controlled during pregnancy, her baby can very quickly develop low blood sugar after birth. The baby’s blood sugar must be watched for several hours after delivery. Often gestational diabetes can be controlled through eating healthy foods and regular exercise. Sometimes a woman with gestational diabetes must also take insulin during pregnancy. Even if the diabetes does go away after the baby is born, half of all women who had gestational diabetes develop type 2 diabetes later. It's important for a woman who has had gestational diabetes to continue to exercise and eat a healthy diet after pregnancy to prevent or delay getting type 2 diabetes. She should also remind her doctor to check her blood sugar every 1 to 3 years.

20 Essential Songs By A Tribe Called Quest

I Drink A Lot Of Soda, So They Call Me Dr. Pepper 
Diabetes Type 2

Adult onset, or Type 2 Diabetes, is the most common type. The name can be misleading as more American children are being diagnosed with type 2 diabetes because of our high sugar and high fat diets, along with our increasingly sedentary lifestyles. In type 2 diabetes, the body produces more blood sugar than it is able to use efficiently, without overtaxing other organs. There are many factors that can place an individual at risk for type 2 diabetes, including a genetic predisposition, extra weight, excess glucose from the liver, poor communication between cells, and metabolic syndrome.

{Metabolic Syndrome describes a group of conditions including insulin resistance, high blood glucose, extra fat around the waist, high blood pressure, high cholesterol, high blood pressure, and high triglycerides, that increases the risk for diabetes, heart disease, and stroke}

Women who have polycystic ovary syndrome (PCOS), have given birth to a baby weighing over 9 pounds, or as mentioned previously, gestational diabetes, are also at an increased risk for developing type 2 diabetes. Over time, mismanaged blood sugar can cause complications with the heart, arteries, veins, kidneys, eyes, nerves, digestion, libido, wound healing, and of course pregnancy. Having type 2 diabetes at the onset of pregnancy can cause birth defects early in the formation of the baby, unlike gestational diabetes, which does not begin to complicate the pregnancy until after the baby has already been formed. Type 2 diabetes is also a risk factor for preeclampsia and its associated issues. Embracing a general healthy lifestyle can decrease in one's risk of developing type 2 diabetes. Enjoying a well-balanced, nutrient dense, low sugar, low-fat diet; exercising regularly; managing weight and  stress; getting adequate rest; and not smoking; are ways to minimize the risk of developing type 2 diabetes, as well as reversing it if a diagnosis has already been given. 

Random Facebook Conversation Among Some Headz, Just Days Before Phife's Transition

When's The Last Time You Heard A The Funky Diabetic? 

Diabetes Type 1

Phife was diagnosed with the less common, but more complicated Type 1 Diabetes, a few months before his 20th birthday. His grandmother, a nurse, recognized one of the signs (frequent urination) and tested him after a show. In type 1 diabetes, the body does not produce insulin, the hormone needed to get glucose from the bloodstream into the cells. Type 1 diabetes is incurable and is not preventable. There are known factors that increase the risk of developing type 1 diabetes, including a family history and genetic susceptibility. There are additional risk factors, including Viral exposure: Exposure to Epstein-Barr virus, coxsackie virus, rubella or cytomegalovirus may trigger the autoimmune destruction of the islet cells, or the virus may directly infect the islet cells. Low vitamin D levels: Research suggests that vitamin D may protect against type 1 diabetes. However, early intake of cow's milk — a common source of vitamin D — has been linked to an increased risk of type 1 diabetes. Other dietary factors: Drinking infant formula and water that contains nitrates may increase the risk of type 1 diabetes. The timing of the introduction of cereal into a baby's diet also may affect a child's risk of type 1 diabetes. Between the ages 5 and 7 months appears to be the optimal time for introducing foods. The current recommendation is to skip rice cereal altogether, and certainly, DO NOT put it in a bottle with breastmilk or formula, no matter what Nana says! Proper education on maternal and infant nutrition, could help to decrease the numbers of those affected by diabetes, and save billions of dollars in health care costs.

Skip The Rice Cereal! Start With These Foods Instead!

Can I Kick It? (Yes You Can!)

Lifestyle Management

It is often a challenge to talk about health conditions that can be managed by lifestyle changes, without making the individual or parent feel guilty or defensive. Diabetes- all types- is one of those conditions. Type 1 diabetes can affect nearly every major system in your child's body, including the heart, blood vessels, nerves, intestines, eyes, bones, immunity, and kidneys. Long-term complications of type 1 diabetes develop gradually, so it is important to stay on alert of even subtle changes in health. Eventually, if blood sugar levels aren't well-controlled, diabetes complications may be disabling or even life-threatening, requiring dialysis or kidney transplant. Phife had both. The good news is that keeping the blood sugar level close to normal most of the time can dramatically reduce the risk of these complications. Maintaining a healthy diet, that includes plenty of fruits, vegetables, and whole grains, while limiting processed, high fat, high caloric, and high sugar foods, is a great first step. Eating on schedule, exercising regularly, checking insulin, taking medication, and resting well, are other important ways to manage type 1 diabetes.

Rare Phife Dawg Freestyle From 1999

Stressed Out, Stressed Out 
Other Considerations

People with diabetes have an increased risk of depression and anxiety, which may be why many diabetes specialists regularly include a social worker or psychologist as part of their diabetes care team. Women with any type of diabetes during pregnancy are at an increased risk for developing postpartum depression, and should be assessed and monitored accordingly.

When it comes to diabetes and infertility, there IS a connection for both men and women. In men, DM is a triple threat to fertility. It causes erectile dysfunction, lowers testosterone and libido, and reduces ejaculate volume. For women, diabetes alone does not keep them from getting pregnant, but it often times keeps them from staying pregnant. In many cases, “a woman with higher than normal glucose levels does get pregnant month after month. Unfortunately her diabetes status prevents that embryo from implanting in the uterus, causing a miscarriage before she ever realizes she is pregnant.” In this case, the diabetes isn’t preventing conception, but is preventing an ongoing pregnancy. High glucose levels are reported to increase a woman’s chances of miscarriage by 30-60%. If a couple is having fertility issues, insulin levels may be the culprit.

Prediabetes is a “pre-diagnosis” of diabetes— a warning sign. Take heed! It’s when your blood glucose level is higher than normal, but it’s not high enough to be considered diabetes. Prediabetes is an indication that you could develop type 2 diabetes if you don’t make serious lifestyle changes. It is possible to prevent prediabetes from developing into type 2 diabetes. Consistently eating healthy food, losing weight, and being physically active can help you bring your blood glucose level back into the normal range.

Phife As A Spokesperson For Diabetes 

With All These Trials And Tribulations, Yo! I've Been Affected

Addressing prevention or lifestyle management in the time of a loved-one's passing, or failing health, can seem calloused or accusatory, but I feel confident that Phife himself would want his illness and subsequent transition to be used to benefit others. He spoke often about not taking his health seriously but wanting to help others. He had been very candid about having challenges managing his diet, exercise, and rest needs. Maintaining a healthy lifestyle may not be easy or convenient, initially, but it does not have to be dull or restrictive. In fact, it is nothing more than the lifestyle from which we could all benefit every day. The routine can become second nature, especially within a supportive environment. It is essential for all of us to be educated about how and why we need to make healthy choices and encourage our favorite mothers, children, and hip-hop icons to do the same. For Phife, let's all eat and move like our lives depend on it.

Put One Up For The Phifer, It's Time To Decipher

The Ills of the World Make The Situation Lighter

Phife Dawg's Final Interview and Flow

Rest in Peace, Power, and Love

Phife for Life!

7 Things Every Breastfeeding Mother Actually Needs

Behind every successful woman, is a tribe of other successful women who have her back. 

At 2 o'clock this morning, as I ended a text conversation and sent happy thoughts to a new, but frustrated breastfeeding mom, for whom I had just provided lactation support, I ran across this adorable blib about 7 Things Every Breastfeeding Mother Needs. Exhausted, yet intrigued, I opened the article and discovered a gear-happy list of super cool niceties, but very few necessities. Here is a more accurate list of actual needs, not stuff. 

SELF-EFFICACY

The belief that you can, along with the internal desire to, breastfeed is of paramount importance. Several ongoing studies have even determined that self-efficacy is the number ONE predictor of breastfeeding success. Confidence? That's it? It may sound wonky, but simply believing that your body is sufficient to feed your baby is enough to overcome many of the challenges that breastfeeding presents... with additional support. 

Breastfeeding, Mood, and Self-Efficacy

IRON CLAD SUPPORT

Because breastfeeding is natural, but not always easy, challenges may certainly arise. A strong support system, including direct access to experienced breastfeeding mothers; a partner who understands and respects your decision; a peer support group such as Breastfeeding USA, La Leche League, ROSE Community Transformers, or a Baby Cafe'; and health care providers that inquire about your breastfeeding journey and can refer you to a lactation consultant, if necessary. 

What Is A Baby Cafe'?

BREASTFEEDING EDUCATION

Expectant moms are in information overload. We all are, but especially expectant and new moms. They are in a position to make seriously life-altering decisions at every turn, and each mother, whether it's what she feeds herself, what kinds of exercises she performs, or what she feeds her baby, wants to make informed decisions, based on sound evidence. While online support, peer support groups, books, and childbirth education classes can be important resources for providing information about breastfeeding, attending a specific breastfeeding education class, taught by a trained breastfeeding educator, will help separate myths from facts, and present timeless, current, biological, physiological, emotional, and economical information about breastfeeding. 

Blossom's Bookstore

BREASTFEEDING FRIENDLY ATTIRE

Before the concept was laid out in any business school text book, breastfeeding moms and babies followed the simple principle of supply and demand. The more often the baby is at the breast, or the more often a mother expresses her milk, the more milk the mother will make. Every 2-3 hours is the recommendation and biological norm, especially early on. Therefore, having easy and frequent access to the breasts is essential in providing piece of mind, burning the day and overnight. It does not have to be fancy, expensive, or specifically for nursing, but it does need to be accessible... and machine or hand washable. 

How Breastfeeding Changes As Baby Gets Older 

KNOWLEDGE OF WORTH, RIGHTS, AND BENEFITS

I can't remember hearing about so many breastfeeding stories in the news and on social media, before  I bacame a breastfeeding mother, but my goodness, they are everywhere, everyday. Breastfeeding mothers need to understand that their bodies were made for breastfeeding, and that breastfeeding extends beyond just providing nutrition for the baby. Infants and toddlers nurse for a variety of reasons, and it's important for mom (and others) to understand that during times when nursing seems otherwise excessive or unnecessary. It's also essential for a mother to understand where she can nurse, which in all but one state, is anywhere that the mom is legally able to be. There are also many insurance and tax benefits related to breastfeeding, such as covered breast pumps and refunds for breastfeeding service and supplies. 

What Are The Breastfeeding Laws In My State?

A RETURN TO WORK (and get out of the house) PLAN

The United States is the only industrial country that does not mandate maternity leave, paid or otherwise. As a result, many mothers return to work earlier than ideal, in terms of establishing a milk supply. Even if a mother does have a paid leave, but plans to breastfeed beyond her leave, it is important for her to talk with her employer about breaks and logistics for pumping or nursing, as well as space for storage. There are federal and state- specific laws to protect breastfeeding mothers and guide employers in the workplace, but they are not well known and often subject to interpretation. The mother needs to let her boss and co-workers know that although her day may look somewhat different for a while, she is still a valuable employee who will be much more productive knowing that she is able to continue providing for her child in a supportive environment. She also needs to help caregivers, baby-sitters, and day care providers understand the frequency, duration, volume, and storage considerations of breast milk and the breastfeeding child. 

Childcare and Breastfeeding

TIME. PATIENCE. NUTRITION. REST. 

For the sake of paralleling the initial article, we will keep the list to 7. These final four can be related. In many cultures, the postpartum period is considered a sacred time, where the new mother is wholly cared for, as she nurtures and nourishes her new child. These traditions give mothers the opportunity to get to know her child, her body, their routine, and the baby's feeding cues. It also allows her to recuperate, not just from labor and the birth process, but also the entire pregnancy. Providing a new mother with ample water and nutrient dense foods, that she does not have to prepare herself, is ideal as she is using everything within her to nourish her child. Helping with their children and chores is of great benefit as well. 

Whether you are currently breastfeeding, intending to breastfeed, still discovering the benefits of breastfeeding, or are in a position to support a breastfeeding mother, please take note and evaluate whether all of these things are in place. If they are not, make them happen. Perhaps you can combine the lists and make for the trendiest and most supported breastfeeding mother ever!

Legislation and Lymphedema Awareness

Lord, I thank you that you value the calling of motherhood. As I work to serve my family and build our house into a home, I pray for wisdom, endurance, energy, and joy. Help me to know that raising children is a significant and high honor. I don't have to be in an office to be significant. Thank you for the privilege of building strong and lasting values into my children.

The wise woman builds her house, but with her own hands the foolish one tears hers down. Proverbs 14:1 ~ Tara's Second to Final Facebook Post, February 14, 2013

Everybody has a cause. Every cause has a ribbon. March 6th is World Lymphedema Awareness Day. This year, I did not make a big deal about the designated day, because it has little to do with pregnancy, breastfeeding, and postpartum care, which is where my passion lies at the moment. However, for the past 10 years, I have been a certified lymphedema therapist, which easily led to my interest in oncology rehabilitation and wellness. From the single day lecture that we had in occupational therapy school, I knew that I would one day pursue this specialization. I loved this work and remain grateful for and connected to the Lymphedema and (breast) cancer communities. However, with March also being dedicated to women, nutrition, developmental disabilities, pregnancy after loss, and birth psychology awareness, all of which are relevant to Blossom, I decided to let someone else wave a flag for Lymphedema. 

March is also the month that one of my dearest friends transitioned to peace after a long battle with breast cancer. The last time I saw her healthy, she was weeks away from delivering her third child, a daughter this time. She had already beaten cancer... twice, and she was absolutely full of love and life. Shortly after her daughter was born, she was diagnosed for a third time. This time, everything was bigger, more aggressive, and more resistant. I can remember her telling me that with this bout, she had never gotten a good report from the doctor. Through it all, she continued to not only smile, but also encourage others- daily. As in, every single day on Facebook, she offered a scripture-based meditation, that rarely mentioned her cancer, and was always applicable to anyone's life. Even during my own challenging pregnancy, she encouraged me, insisted on being my daughter's godmother, and even (jokingly) offered me an anti-nausea pill while we were at an event where she was being honored, as somehow I felt sicker than she looked. That was the last time I saw her, ever. Three months later, while she was in the hospital getting pain and nutrition management, I was in the hospital laboring for 23 hours. She stayed up texting me nearly the entire time. She said nothing of her pain and fatigue, but offered constant help with mine. She made me smile. She transitioned two months later. My daughter's birth and her death are inextricably connected in my mind and in my heart. Thinking of her, especially this month, reminds me of all of the courageous cancer survivors whom I have known, loved, and treated. That's my justification for writing this piece... that, and the presidential election. 

The pain, isolation, chemotherapy, radiation, and surgery associated with cancer is enough for anyone to handle. Still, roughly 30% of women with breast cancer, have an additional, incurable complication called lymphedema. Lymph is a thin, clear fluid that circulates throughout the body to remove wastes, bacteria, and other substances from tissues. Edema is the buildup of excess flluid. Lymphedema occurs when too much lymph collects in any area of the body. People can be born with lymphedema, where it can show up in childhood, or later on, in adulthood.  Lymphedema can also present itself after some assault to the lymphatic system, usually after surgery or radiation. If lymphedema develops in people who’ve been treated for breast cancer, it usually occurs in the arm and hand, but sometimes it affects the breast, underarm, chest, trunk, and/or back. 

Lymphedema may be on a spectrum from barely noticeable to mildly annoying to debilitating. It may be very well controlled in common situations, but become more significant during more physically or emotionally stressful times. Lymphedema treatment includes a special kind of massage, compression bandaging, exercise, and skin care. The treatment is rigorous, time consuming, expensive, and has limited (and in some cases, no) insurance reimbursement. The maintenance is lifelong, requiring new compre$$ion garments, AT LEAST once a year. What does any of this have to do with the election? Plenty. For many years, there has been a push by the lymphedema community, including patients, family members, and therapy providers, to encourage insurance companies to provide comprehensive, lifetime coverage to lymphedema patients. 

Lymphedema Treatment Act

Whenever patients lamented about their insurance coverage being insufficient for their prescribed lymphedema therapy, I suggested that they contact their congressmen about the Lymphedema Treatment Act. A blank stare was the typical response. They were usually too distracted, too hopeless, too confused, or too ill to make any progress, but I always gave them the information, including a form letter, telephone speech, and contact information. I had written our congressmen on their behalf, each year, since 2006. Sometimes, my patients just did not believe that there was any connection between their condition and their congressmen. By 2010, the lobbyists were fairly close to getting the full support needed in the House of Representatives. However, following the mid-term congressional elections in that year, most of the support was lost. There was a ground zero type of re-grouping required, and we are still in the first phase of having the act sponsored, supported, and passed, even in The House, which is an early step. When I revealed this fact to patients who were otherwise thrilled about the election results, they were dumbfounded. They never considered this impact of their vote. As we move closer to the general election, we could find ourselves in a similar situation. There are 469 seats available in the 2016 November election- 34 Senate seats and all 435 House seats. 

SchoolHouse Rock... Remember?

In this ridiculous, hostile, and confusing political climate, the following questions need to be asked, about this and any other issue that concerns you. Are your representatives representing? Does this matter to you? What does? How do you decide who gets your vote? If not this one, what issues would move you to support, oppose, or abandon a candidate? Are you willing to speak to your congressmen about the issues that are important to you?  Find out here if your congressmen are attached to this bill, and learn what more you can do to help the process. 

Lymphedema ACTion Across The United States

Pregnancy, Breastfeeding, and Developmental Disabilities

There is no greater disability in society, than the inability to see a person as more. ~Robert M. Hensel 

Occupational therapy is my first love in health care. When I was in high school, I wanted to be an accountant, just like my father. On Easter Sunday of my junior year, my oldest brother was in a tragic accident, that left him paralyzed. Throughout his recovery, I learned about his physical therapist, who had the charge of helping him to achieve his highest ambulatory abilities. Unfortunately, the prognosis for my brother was grim, and his providers knew early on that he would never walk again. This was a somber reality for our family, including his wife and young children. He then began to tell me about his occupational therapy. I had never heard of occupational therapy. He told me about a woman who helped him to bathe, dress, and use the bathroom independently. I was intrigued by this career, that helped people to be their best selves, in spite of differences; and in a single telephone conversation, I knew that accounting was no longer for me. I pursued the field of occupational therapy, and have loved the many facets of it ever since. 

The easy assumption was that is would specialize in helping those with spinal cord injuries, but my foyer into occupational therapy was working with children with special needs. From neonatal intensive care units (NICU) to early intervention programs, in homes and day cares, to schools and outpatient clinics,15 years later, these children and their families continue to hold a very special place in my heart. I have also worked with adults with developmental differences, in their homes and work places, and I am a witness to the limitless abilities of these individuals. It was as if I were able to get a sneak peek at what was to become of my little patients. 

Photos of Kids Born Prematurely, Now Holding Their Own Baby Pictures 

In the 1970s and 1980s, there was a movement to deinstitutionalize facilities that housed and cared for children and adults with special needs, which laid the foundation for social change, acceptance, accessibility, and supportive legislation. In 1987 President Ronald 
Reagan declared March “Developmental Disabilities Awareness Month.” This proclamation called upon Americans to provide the “encouragement and opportunities” necessary for people with developmental disabilities to reach their potential. 

Today, as a maternal wellness consultant, I still enjoy working with families, either by helping a new mother breastfeed her with special needs, as a lactation counselor, or helping a family adjust to life at home, with this same  child as a postpartum doula. Much love, miracles, and blessings to all of the families, teachers, employers, and individuals  who have the good fortune of being touched by an individual with developmental disabilities.

Pregnancy And Disability 

Children's Books About Inclusion 

Genetic Testing During Pregnancy

Breastfeeding A Child With Special Needs

ACOG Recommendations for Exercise During Pregnancy

For some time now, it has been reported that exercise during pregnancy is not only safe in most cases (consult with your care provider first), but beneficial. ACOG's paper reiterates that for uncomplicated pregnancies, regular physical activity does not cause miscarriage, poor fetal growth, musculoskeletal injury, or premature birth, as was previously believed by both doctors and expectant mothers (and is still sometimes believed, though inaccurate).  

Recently, the American Congress of Obstetricians and Gynecologists (ACOG) released a revised "Committee Opinion" paper on "Physical Activity and Exercise During Pregnancy and the Postpartum Period." The paper reflects the latest scientific research on the safety of, recommendations for, and reasons to avoid exercise during pregnancy and in the postpartum period.

As cited in the ACOG document, benefits of exercise before, during, and after pregnancy include:

• Increased physical fitness
• Prevention of excessive weight gain 
• Reduced risk of gestational diabetes, preeclampsia, cesarean surgery
• Decreased postpartum recovery time

The ACOG paper answers common key questions surrounding pregnancy and exercise, which we have extracted and summarized below. We encourage you to also read the complete paper for more in-depth information.  

When can I start exercising? 

After you talk with your care provider (doctor, OB, or midwife). ACOG states: "A thorough clinical evaluation should be conducted before recommending an exercise program to ensure that a patient does not have a medical reason to avoid exercise."

How much exercise is recommended?

150 minutes per week, spread throughout the week. That's roughly 20 minutes a day for 7 days, 25 minutes for five days, or 30 minutes for four days. 

What are the risks of not exercising during pregnancy?

ACOG says: "In pregnancy, physical inactivity and excessive weight gain have been recognized as independent risk factors for maternal obesity and related pregnancy complications, including gestational diabetes mellitus (GDM)."

Can I continue my pre-pregnancy exercise routine even if I participated in a regular high intensity exercise?

After consulting with your care provider, yes (unless you have any conditions that would make it unsafe). ACOG states: "pregnant women who habitually engage in vigorous-intensity aerobic activity (ie, the equivalent of running or jogging) or who are highly active 'can continue physical activity during pregnancy and the postpartum period, provided that they remain healthy and discuss with their health care provider how and when activity should be adjusted over time.'"

What about starting a new exercise routine if I was not active prior to pregnancy?

It's fine as long as you consult with your doctor and move into your pregnancy exercise routine gradually. ACOG states: "Pregnant women who were sedentary before pregnancy should follow a more gradual progression of exercise."

Are there exercises I should avoid?

Those that require laying flat on your back for prolonged periods of time (like certain yoga poses); scuba and sky diving; and exercises where the risk for abdominal trauma (injury to your abdomen) is high, like contact sports (hockey, soccer, basketball, football, some racquet sports, and boxing), and skiing, surfing, off-road cycling, gymnastics, and horseback riding. "Hot" or "Bikram" yoga or "hot Pilates" also should be avoided. 

What types of exercise are recommended?

Walking, swimming, stationary cycling, low-impact aerobics, yoga and Pilates (modified), running or jogging, some racquet sports, strength training.

What should I keep in mind to stay safe while exercising?

Many of the same safety precautions you would take during pre-pregnancy can be applied during pregnancy. Additionally, ACOG states: "During exercise, pregnant women should stay well-hydrated, wear loose-fitting clothing, and avoid high heat and humidity to protect against heat stress, particularly during the first trimester." It's also important to eat sufficiently and nutritiously before exercising. 

What kinds of warning signs should I look for that may signal a problem during exercise while pregnant?

Vaginal bleeding, regular, painful contractions, amniotic fluid leaking ("water" breaking), difficulty breathing prior to exercise, dizziness, headache, chest pain, muscle weakness that affects balance, calf pain or swelling. 

What conditions might make exercise unsafe for me during pregnancy?

Anemia, unevaluated maternal cardiac arrhythmia, chronic bronchitis, poorly controlled type 1 diabetes, extreme morbid obesity, extreme underweight, history of extremely sedentary 
(inactive) lifestyle, intrauterine growth restriction in current pregnancy, poorly controlled 
hypertension, orthopedic limitations, poorly controlled seizure disorder, poorly controlled, 
hyperthyroidism, and heavy smoker. 
What conditions would prohibit me from exercising entirely during pregnancy?

Hemodynamically significant heart disease, restrictive lung disease, incompetent cervix or cerclage, multiple gestation at risk of premature labor, persistent second or third trimester bleeding, placenta previa after 26 weeks gestation, premature labor during current pregnancy, ruptured membranes ("water" broken), preeclampsia or pregnancy induced hypertension, severe anemia. 

For more information, including a section on physical activity on the job and exercise during the postpartum period, check out the complete ACOG Committee Opinion document, "Physical Activity and Exercise During Pregnancy and the Postpartum Period."