Melissa Bowley

VBAC Resources & Tips

Considering a VBAC?
Here are some helpful tools for your toolbox:

* Knowledge: learn as much as you can. Knowledge is power, really. Some good sources:

  • International Cesarean Awareness Network (ICAN)
  • The VBAC Education Project
  • Know your legal rights as a patient
  • here is a long but excellent resource, if that’s too long, try this
  • The most up-to-date (2019) American College of Obstetricians and Gynecologists VBAC guidelines can be found here.
    • An important part to note is: “The following recommendations and conclusions are based on good and consistent scientific evidence (Level A): Most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about and offered TOLAC (trial of labor after cesarean).” (pg e119)

* Find a VBAC supportive provider with whom you can develop a trusting, supportive, partnership

  • Explore midwifery care: Find a CNM (certified nurse midwife)
  • Homebirth after cesarean (HBAC) is an option that many women have had very positive experiences with. BUT it is not recommended as safe for people who have not given birth vaginally before (either before or after a cesarean). This blog links to a study that describes outcomes for HBAC (paid access only) and summarizes it.

* Consider hiring a doula (Find one on Flourish Care Experiences page and use your registry dollars to book!)

  • If cost is an issue: No-cost or low-cost doula services are sometimes available in certain facilities or to certain people; sometimes a doula student will take a client for a lower cost.

* Positive vibes: Surround yourself with positive people, positive affirmations, and positive birth stories

* Emotional processing of your cesarean birth is helpful for many people

If you decide a VBAC isn’t the right choice for you, you might be interested in exploring gentle cesarean birth. Information and sample birth plan for a gentle cesarean.

Tips for moms from moms on VBACs:
We asked moms to share their tips for moms who might be considering a VBAC, here is what they had to say.

“3 VBACs. Take classes on Natural Childbirth; read GOOD books on birth (NOT “What to Expect..”), but Ina May Gaskin, Henci Goer, Jennifer Block, and Marsden Wagner; and seriously consider a home birth with a midwife.” 

“I had two VBAC’s. Second was breech. Positive thinking. Prepare your mind. Have a good partner or doula. Take a refresher class. Find a VBAC Support group. Find a doctor, midwife that supports you.”

“I’ve had 2 VBACS
1. Hire a doula that has experience with VBACS.
2. Hire a doctor you trust to help you through it.
3. I also recommend self-care. Prenatal massages, chiropractor and pelvic-floor specialist (yes even before birth!)”

“1. You can do it!
2. Hire a birth doula who is experienced with vbacs (I hired one that personally had one)
3. If you have trauma from you c section, work on that.
4. Find a provider that knows you can do this and has a high vbac rate.
5. Get ready to feel empowered!”

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Having a Newborn & Motherhood Journey

We asked Lainy Hedaya some questions on how her motherhood journey has been during the COVID pandemic and what her struggles have been.. 

What has it been like raising an infant during COVID, the good, the bad, the ugly?

I think the hardest thing was being in a house all day and not being able to take him out or see people. I looked forward to taking him to the supermarket, and to just run around and do errands… and he can’t really do that because he can’t wear a mask yet.  The best thing was we really didn’t miss a moment of him growing. We’ve been together every day. He went from infant to walking and talking through Covid.

What is one piece of advice would you tell your pregnant self?

Ask for help! Motherhood takes a village. There is nothing wrong with needing a hand. 

What has the biggest challenge been during this motherhood journey?

Time management. I run my own business, and unless I have someone to help with Louis, it’s nearly impossible. I think a lot of people don’t know how demanding parenting is. Until your kid is sleeping through the night, you only have from 7pm-whenever you sleep for yourself. This is why we should really be taking care of the moms after they have a baby as well. Motherhood is really, truly, the hardest job in the world. 

How did you get through that struggle? What support or resources were most critical?

I usually have a nanny, otherwise I work around Martin’s work schedule. 

What do you love most about being a mother?

You will NEVER feel a love like this ever in your life. Your kid is literally your heart beating outside of you. It’s wild. You won’t ever understand the feeling until you have one.

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A Healthy Mama is Best

Breast is Best
Fed is Best
A Healthy Mama is Best

As I was packing my bag for the hospital with my third pregnancy, I contemplated making a sign to hang above my delivery room bed:

10 rounds of mastitis ✅
10 inpatient days of IV antibiotics ✅
History of breast reduction ✅
22mo and 4yo at home ✅

I know you are a “baby friendly hospital” but PLEASE don’t ask about breastfeeding, I have thought long and hard about this (plus my hormones are RAGING!).

I wanted to avoid that awful knot I got in my stomach every time I thought about it. That internal tug of war playing out in my mind of wanting SO BADLY to give my baby a hit of that “liquid gold” and the mom guilt that had eaten at me the 9 months leading up to that delivery room where I walked in carrying formula, bottles and a binky. I told my husband to smack me if I even tried to start breastfeeding after delivery. 

I should start by making it clear that I am a pediatric nurse practitioner. I was taught for years in school and practice that “breast is best” and truly believe that breast milk is the “liquid gold” it is chalked up to be.  “Winter baby born in peak viral season? Here–have some antibodies! Cradle cap or eczema? Here–throw some breast milk on there!” There are plenty of studies to support the incredible benefits of breastfeeding. In addition to the scientific data, from my own personal standpoint, there is nothing quite like the bond you have with your baby when breastfeeding. Words will not do it justice.  There is also that incredible sense of accomplishment and pride looking in the freezer at all that pumped frozen gold! (You mamas that have pumped know what I’m talking about!)

But despite my love of breastfeeding, my love of that late-night feed and bond with my babies, I also hated breastfeeding.

  • I hated that none of my friends or family who had “gone before me” had warned me about how hard it is.
  • I hated that I needed 3 lactation consultants, a nipple shield, a boppy, a breast friend pillow, a tongue tie release and for the room to be exactly 70 degrees with a southwest breeze blowing in from the window for my first born to latch.  
  • I hated that despite all my efforts, I ended up hospitalized with a raging mastitis when my first was two weeks old and had to pump and dump my Vancomycin-flavored gold.
  • I hated the vicious cycle of cabbage leaves, sudafed and ice packs in attempts to dry up my supply that only led to rounds 2-5 of mastitis and fevers to 104 (putting me out of commission while trying to be a functioning mama!).
  • I hated feeling like I was just topless all day long.
  • I hated that regardless of the size of the “hooter hider” I was wearing, my attempts to be discrete while breastfeeding in public were always met with the inevitable swipe of the cloak with nothing close to discretion.
  • I hated my inability to do anything remotely social because I would need to feed the baby within two to three hours (and we all know a childless Target trip takes at least 2.5 hours…especially if it’s next to a TJMaxx).

Despite my struggles with my first, I insisted on trying again with baby #2 because I now considered myself an uncertified lactation consultant with all I had learned from all of my other amazing lactation consultants and la leche league! Low and behold my 10lb 5oz little porker of a baby boy latched like a champ and was exclusively breastfed for 3 months until I went back to work. “Do I make this patient wait and go pump or just see them quick…ugh I’ll just see them quick” and just like that, as I stretched out my pumping sessions around my clinic schedules, so came mastitis rounds 7-10 and a 7 day admission for IV antibiotics…leaving my husband home by himself to care for a 2yo and 3mth old (SuperDad, I know!-He really is)

Well it was this same SuperDad that helped support me in my decision to ultimately not breastfeed my 3rd and I can tell you it was a decision I do not regret.  Did I still feel tiny pangs of guilt and try to collect every bit of liquid gold that leaked out in the shower and give it to my 3rd? Yep! But did I also avoid a handful of inpatient stays, fevers, and the added stress of all of the above listed stressors? You bet! My mental health was much improved with this decision. I was able to get out more. I was able to juggle three kids under 4 with the convenience of formula, or better yet, get a babysitter and go on a date without needing to pack a pump!

When it all comes down to it, I have had my experiences, and you have (or will have) yours. Some mamas breastfeed for 3 months, others 3 years. Some mamas can’t make enough milk, others make too much. Some have a baby in the NICU and struggle to pump. Some mamas may have a medical condition or need to go back on medication which may not be best for the baby. Some mamas might have had a breast reduction where “all pipes lead to nowhere” and frequent mastitis. Some mamas have a BRCA mutation and have no breasts at all. Some mamas are single mamas and need to return to work right away. Some mamas (or daddies) have adopted and wish they had the option of breastfeeding and can’t decide whether to start their baby on formula or someone else’s breast milk. This list could go on…

Mama, whatever decision you make surrounding breastfeeding is the right decision. You do not have to justify your decision to anyone or feel guilty for whatever choice you make. Likewise, whatever decision your friend, neighbor, coworker, or random mama on the park bench makes is also the right decision. You don’t know their story or how they came to their decision, nor do you need to. Respect that. Boost that mama up. 

I did not need my hypothetical sign in the delivery room to justify my decision. And I am beyond grateful that my labor and delivery and postpartum nurses not only respected my decision, but in the spirit of the nursing profession (I know I’m biased) were kind, caring, and empathetic. If only the voice inside our heads could be equally as kind, caring, and empathetic.

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Challenges as a First Time Mom Living in Another Country

We have been married for over 13 years now, but we have not had our honeymoon yet. Our first attempt was ruined by a friend who asked if he could join us! Seriously! We were young. We did not have the courage to bluntly say no to a friend. Oh well. Our second attempt was supposed to be my dream trip, but we were caught by surprise by a pregnancy that started two weeks earlier than what we thought. It was our fault, though. We were misinformed about how to plan for a desired due date.

We wanted our first child to be born at the end of April, when I would be done with my MBA courses. Instead, his due date was actually April, 10th! Did you know that week 1 of pregnancy starts counting on the first day of the woman’s last period? We had no idea! I mean…think about it. It makes no sense! That is about 2 weeks before conception! On the exact day a woman gets pregnant, it is already week two! Two weeks may not matter for most new mothers, but it is a big deal if you are trying to complete graduate school! Needless to say, my first pregnancy was challenging, but I wish that had been the only challenge. There was so much more to come.

Moving to the US – We got engaged on December 2005 and scheduled our wedding to a year after the engagement. Nonetheless, 5 months after, my then fiancée got a letter of acceptance. He had been awarded a full scholarship to a PhD program in Worcester, Massachusetts. We both wanted the adventure of living in another country, immersing ourselves in another culture, and the US was perfect because we knew the language and would be able to improve. The American Dream seemed like such a huge opportunity that we left our upper-middle class, fun, social, party-filled, year-round warm and comfortable life in Brazil to start a new chapter in a freezing cold place where we did not know anybody. But we were only 26 and most of all, we were in love, and that translates into “everything is easy and exciting”!

He came to the US in August and I stayed in Brazil to finalize the wedding planning. We had to stick to the date, December 9th, as the location and some services were already booked. Here, too, two weeks made a huge difference to us. Had we been able to marry two weeks after, my husband would have finished his final exams and would have gone to Brazil to marry and spend a few days on vacation. We could have had a honeymoon right there, after all, December is Summer in Brazil! But what actually happened was he arrived in Brazil on a Friday, married on that Saturday, and we came to the US on the next morning because he could not miss his final exams. An almost 24-hour trip, (each way!) for a 2-day long “vacation”, plus an almost $2k airplane ticket. That is precisely how much those two weeks cost us (and our parents)!

When his exams were finally over, another student’s fiancée offered us the key to her studio where she lived near NYC, as she was going to spend Christmas away. We could not afford to stay in a hotel. My husband’s scholarship was just enough to pay for groceries and to rent an attic turned into an apartment in a house built in the 19th century, even though he had a master’s degree in computer science and was working at the university 20 hours per week as a researcher and teacher’s assistant. That is the price international PhD students pay to be able to study in America, tuition free: they are turned into very cheap, highly specialized labor force. Our motto was “think long term”!

These cost-free nights in our friend’s studio was our chance to have a honeymoon and go to NYC for the first time. But another friend, a nice but inconvenient student from Kazakhstan, asked if he could come with us. He had never been to NYC either and was as excited about it as us. “Sure”, we could not avoid saying. So, the trip was not romantic, but it was still an amazing Christmas. Just not yet our honeymoon.

Pregnancy – Three and a half years later, we had accumulated enough miles on our credit card to go on my dream trip: California! We bought the tickets in advance, to use during the summer vacations, and about a month before our departure, I got pregnant! Interacting with children had always been fascinating to me and being a mother had always been my biggest dream, by far. I was extremely happy, although also extremely nauseated during our California trip. I remember being in beautiful, fun places, but hoping nighttime would come fast so I could finally lay down and rest. My head was constantly spinning. I was vomiting everywhere I went, hating the smell and taste of every food, constipated, with strong headaches, heartburn (which I was surprised to learn the name in English as it has nothing to do with the heart) and of course, I was energy deprived, to the point that even a short walk was a sacrifice. Again, our supposedly romantic honeymoon was not so romantic, but we were so happy our first child was on his way!

I suffered with these symptoms during all my three pregnancies, but this first one was the worst. Everyone told me it would go away by week 10 or 12. I was at week 20 when it started to get a little better. As if it was not bad enough, I had to suck it all up instead of resting my body and mind, because I was at the final year of my MBA and had a lot of papers, projects and presentations to finalize.

I always thought that, while pregnant, all I could do for my baby’s wellbeing was to sleep well and eat well, and mother nature would do the rest. It had never occurred to me that my thoughts or the state of my mind could interfere with my unborn baby’s health. I thought that would be the case only after he was born. Then, one day, a wise friend from India saw me stressed about a disagreement with a school teammate and told me that it deeply affects the baby. That was when it clicked with me. She recommended that I take a break from school to enjoy a relaxing pregnancy, for my baby’s sake. Nonetheless, International students are not allowed to take a break, or they lose their visa status. So, I kept going but trying as much as possible not to stress.

A colicky baby – My most stressful pregnancy resulted in an extremely colicky baby. Coincidence? Maybe. From the very beginning his colic was very intense. I remember when he was two weeks old, I asked his pediatrician about it. I said he cried a lot, not in a whining way but rather in a desperate screaming way, as if he was in excruciating pain, and to the point that he got a bluish face. She said he was too young, that colic only peaks at week 4. I was shocked to hear it! I could not imagine it getting worse. I was not sure I could make it. I myself cried every day, feeling sad watching my poor baby suffer and not being able to soothe him. Also, I felt exhausted and sleep deprived. He never slept for more than 30 minutes, not even at night. He would wake up screaming, inconsolable, constantly. We could not go anywhere because the minute we tried to put him in a car seat, he would scream incessantly, no matter how long or short the trip was. It was traumatizing! 

Eventually, we found one way to make him sleep a little longer: first, to get him to stop crying and finally falling asleep, we had to bounce him in our arms, bounce really high and briskly! You should see my husband doing it. So funny! I was afraid he would drop him down from ceiling height! I am glad in times like these my husband was able to keep a much-needed sense of humor. When finally asleep, my son had to be held in our arms, belly down. If we put him in the crib, or in a swing or bouncer, he would wake immediately, crying, and the bouncing would have to start all over again. So my husband and I took turns, every 2 hours, every single night. I read many books about baby colic at that time. The first thing I learned was that colic is not the name of a health condition. It is simply a symptom that can be caused by many different conditions. The challenge is to figure out what is causing it so you can plan on how to treat it. In my son’s case, I think there was more than one culprit. I first thought of allergies, even though he was exclusively breastfed until close to 6 months. The chances of allergens passing from the mother’s diet through her breastmilk are small, but it is possible. I lost my baby belly fast because I cut many of my favorite foods from my diet at that time: all dairy, tomatoes, soy and anything acidic, like lemons or oranges. It did not help much with his colic, but just in case I kept that diet for months. I would do anything to help my poor baby.

One of the books mentioned that some colicky babies could grow into highly intelligent people, because the colic could be caused by a very alert, therefore easily overstimulated, type of brain. But because their baby brain is not ready yet to process all of that stimuli, these babies get very irritated, overtired, and cannot rest. That makes things even worse, as rest would be the solution. So, the cycle keeps going until the brain matures enough to deal with the extra stimuli. My son is 9 years old now and has always been much ahead of his age in cognitive aspects, so that explanation could well apply in his case. Another culprit was GERD, or reflux. This one leaves no doubt. I had to buy three tall piles of large burp cloths. I think probably around 35 or 40 of them! He spit up a lot and sometimes vomited! They filled a full load in the washer, which for us was shared with three other tenants and located in the dark, dirty, scary, unfinished basement of our attic apartment, three floors below us. One day, when my baby was 1 month old, his throat was so sore that he could not swallow. He did not nurse for the whole night. I called his pediatrician and she told me that, because he was so young, I should take him to the ER, where they gave him an IV to avoid dehydration. Until around 6 months old my baby not only napped, but also slept, in a baby bouncer, propped up with two pillows to increase the angle. He was basically seated and tied with the seat belt all night. We tried to incline the crib mattress, but it was not enough.

Finally, the last culprit I can think of for his insane baby colic is gas from all the air he was swallowing while breastfeeding. I remember me asking the instructor during a newborn care class if I would have enough milk for my baby, given that my breasts are so small. She explained that the size of the breast and the production of milk are totally unrelated. Bigger breasts have more fat, not more breast glands and ducts. That was proven very much true to me. My milk first came in the very moment my son was born! It was an incredible, unforgettable moment. Two or three days after, I was engorged and felt like my skin would rip. My breasts were heavy big rocks, while the skin felt like it was burning. During a shower, I could not even take the pain of water touching my breasts. I could not find a comfortable sleeping position, as gravity would make my breasts hurt too much. Thankfully, some supporting pillows helped a bit. A few days after, the engorgement and pain got better. But still, there was always a lot of milk and when my son was feeding, milk would gush all over his face and the room if he was not focused on swallowing fast. Taking a break was not an option! That poor thing had to learn early how to coordinate swallowing and breathing with an intense flux of milk. There is no doubt he ended up swallowing a lot of air in the process. More colic! He was on Zantac for the reflux, and taking gas drops, which probably helped a bit. Just a bit, though.                                     

When he was 5 months old, we took him to a hot air balloon festival. He cried and screamed the entire drive there, as usual. When we parked our car and finally held him, we were so stressed! How I wish it was allowed, and safe, for the baby to ride on his mother’s lap. Well, after he had a long day and at night, it finally happened: he slept for five straight hours for the first time ever! He was 5 months old already. The longest he had slept so far was about two and a half hours, I think. The next night he went back to sleeping for less than three hours, but I was excited for that progress, that sign that sooner or later things would get easier. And they did. By 7 or 8 months old he was sleeping through the night! We also introduced yogurt to his diet at around that age, which may have helped with the probiotics and gut regulation. We were afraid of triggering dairy allergies, but he did just fine with yogurt, which is easier digested than milk. He also would not even try a bottle. I tried all different sizes and shapes of nipples, different formula brands, tried daddy feeding instead of me, tried letting him be hungry… nothing worked. So, he skipped from breast milk to cow’s milk in a cup when he was one year old. He also refused to try a pacifier, which would probably have helped with the screaming in the car, but he would not accept it. He kept spitting it out instead of sucking it. No, he was definitely not easy! But with time, patience and love, everything eventually falls into place. Oh, did I mention his labor was induced and I did not know the contractions are much stronger, and more painful, than when labor starts naturally? Or that I had a severe episiotomy classified as 3rd degree? The whole thing was a bumpy road, but hey, great things don’t come easy. What better reason to fight for than for our own family?  

My son was not even one yet and I was already hoping I could get pregnant again soon! I wanted him to a have a sibling to grow with, and to count on when they are adults. My children are 9,7 and 5 years old now, and life with them is great! Writing my own story and revisiting these tough times is not easy, but I wanted to share it with other moms out there, so they know they are not alone, and they are reminded that it does get much easier with time. The journey of motherhood is a quite different and unique experience to each one of us. Some might be more challenging than others, but I am sure none are made of pure joy. Our challenges might be different, but we are all fighters and admirable humans just for being mothers.

In part 2, I will share my experience on my second pregnancy, when my baby was born almost 8 weeks before his due date. Spoiler: it is a sad story but with a happy ending! Stay tuned.

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Tips for the Third Trimester

The third trimester is exciting, as we prepare to meet our little ones. Unfortunately, it can also feel like the planet that is now your belly is throwing you off orbit.  Heartburn, constipation, backaches, difficulty sleeping, and a constant need to pee are some of the most common complaints during the third trimester. Fortunately, I have found some things to be helpful in mitigating them to enjoy the third trimester as comfortable as possible.

Here are my top tips for the third trimester:

1. Diet: Focus on alkaline foods. Heartburn is very common during the third trimester as your baby pushes up on your stomach and hormones are going a little crazy. This is further aggravated by the fact that the standard American diet and most “comfort foods” are acid-forming, Alkaline foods help neutralize acidity in our body, and prevent heartburn.

What to eat/drink:

  • Fruits and veggies. This one is a no-brainer, fruits and vegetables are a rich source of antioxidants, fiber (to keep you regular), and minerals (needed for detoxification and reducing acidity).
  • Homemade vegetable juices. My favorite is a mix of kale, cabbage, and green apple. You can drink daily and mix it with some aloe.
  • Aloe vera juice or gel. I try to have about 4 oz a mix of aloe and water before bedtime to help mitigate acidity before I lay down.
  • Vegetable broth. This is one of my favorite beverages as it is super beneficial to health. It contains lots of easy to digest minerals, and minerals are essential in eliminating acid compounds in the body. My favorite is Rebecca Katz Magic Mineral Broth.
  • Apple Cider Vinegar. I take about a spoonful straight up but you can mix it with a few ozs of water. You can do this before a meal to help stimulate digestion.

What to avoid:

  • Fried foods
  • Foods that are high in fats and sugar content
  • Tomatoes and tomato sauces
  • Although citrus can have alkalizing effects once consumed I have found them to contribute to my heartburn symptoms so I stir clear for the most part.
  • Spicy foods
  • Chocolate and caffeinated beverages
  • Drinking liquids with your meals. This can interfere with digestion.

2. Exercise: Morning and evening stretch. Gentle workouts like walking, yoga, and swimming, help with circulation, strength, endurance, and relaxation. These are all great but I have found especially useful brief stretching flows in the morning and evenings. They greatly reduce back and hip pain. Doing daily stretches has been a lifesaver for me. As a bonus they help create space between the belly and ribcage, making it easier to breathe and function throughout the day. The evening stretch flow can also help you  get better sleep, which is a huge plus on this stage. 

3. Topical Remedies and Tools: Magnesium oil and salts. Magnesium is a know muscle relaxer and it comes in very handy during pregnancy. Aside from consuming mineral-rich foods like veggies and broths, I have used magnesium as a topical remedy to reduce/avoid cramps, muscle pain, and support relaxation. I take Epsom Salt baths every week and always have a magnesium oil roll-on handy.

  • Compression socks. Leg cramps are very common during pregnancy and I must confess I am a little freaked out by them. Because of this, I have been extra careful trying to avoid them and I have had great success with that, even in the third trimester. My cramp busters are: mineral-rich foods, magnesium oil, salt baths, mindful movement and compression socks. All these help stimulate circulation. I admit that compression socks  are a lot harder to put on in the third trimester. So, if my belly just won’t cooperate I will ask my partner for assistance. I do not use them for sleep but for the day, especially if I am being very active. 
  • Tools for keeping the body aligned. My two favorite tools to support postures that help me feel comfortable at bedtime and during the day are a bolster and a knee pillow. I love using the bolster for sitting as it helps me lift my pelvis and have better spine alignment. The knee pillow has been the only pillow I have used consistently throughout pregnancy. It is my favorite by far as it helps keep my hips aligned with my legs throughout the night and avoid morning backache.

4. Meditation: As the pregnancy progresses and I get closer to meeting my baby my levels of anxiety have been rising. This is a bad combo for overall mood, getting sleep, and prepping for birthing. Fortunately, I have been able to maintain meditation practices that support a positive mindset and reduce stress. My method of choice is self-hypnosis as it was amazing for my previous birthing. Every night I put on a set of earbuds ( I prefer these because they allow me to rest on my side and I can fall asleep with them on) and use a guided self-hypnosis meditation. I use Hypno-Babies but you can try any relaxation or fear/anxiety release meditation.

These go-to’s have helped me thrive during the third trimester and they are also great tools to prepare your body for postpartum. But, when everything fails my best piece of advice is to stay open and go with it. For example, if I am having a particularly difficult night and I can’t get to sleep no matter what I try, I just get up, walk to the nursery, put on my ear pods and listen to some music as I think of the miracle that is the  baby in my womb.

We can not control everything but we can manage our thoughts and outlook, that part is a choice. Your mindset is always, in the end, a choice. Staying open will allow you to enjoy this pregnancy and roll with the punches when they come. Being pregnant during a pandemic is not ideal and it brings with it lots of unexpected challenges. Being rigid just makes it harder. Take it easy on yourself, be kind, be gentle, make sure you are supported, speak your truth, and go with the flow whenever possible.

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But. We survived.

The biggest challenge I faced when entering motherhood was the physical recovery after giving birth, and mentally accepting that struggle. To put it plainly, I felt like I had been lied to by my friends, my family and the media. But it’s no one’s fault in particular; we women don’t want to scare our fellow mamas-to-be…so we don’t share the bad stuff! It makes sense. But it’s also detrimental to our mental health and I think we can all work harder to be honest while remaining positive, optimistic and supportive. 

To give you a quick rundown: I was diagnosed with preeclampsia when I walked into Mass General Hospital to push my daughter out (fun surprise!). Having preeclampsia meant I had to deliver on magnesium, which rendered me practically useless. (Imagine being blackout drunk and feeling as though your body weighs about 2,000 pounds. That was my experience on magnesium.) My hips had separated and gotten so screwed up during pregnancy that I ended up having to do physical therapy in my recovery room, and also afterwards when I came home. I had no idea this wasn’t normal until a nurse told me that other moms are usually “doing better by now.” (I appreciated her honesty – she was looking out for me. She was wonderful.) I also ended up getting a catheter because I physically couldn’t walk to the bathroom four feet away, and that led to a UTI. Then, I had an allergic reaction to the UTI antibiotics so I felt like my body was on fire for about 48 hours. Three weeks after giving birth, I was back in the hospital with kidney stones and yet another UTI. I stayed in the hospital for a full week, minus 12 hours where I went back home but my fever spiked to 104.1. I had two surgeries to insert stents. Finally, after six full weeks of being in and out of the hospital, I popped a valium, walked into the shower, and pulled the stent out myself, as per the hospital’s instructions. (Yup. You read that right.) 

I assure you, there have been FAR WORSE recoveries than mine. I am grateful that everything I dealt with was manageable and relatively non-threatening. But I also assure you: none of this was expected and I believe that at least the hip situation was relatively preventable. After my body had done the most miraculous thing for nine months, I had lost all confidence in my body and felt like I couldn’t trust it at all. It was six weeks of pure, fucking, physical and emotional hell. And all the while, I felt like a piece of shit for focusing more on myself than on my newborn baby. 

But. We survived. 

I’m grateful for my husband for stepping into fatherhood as quickly as I stepped into motherhood. Many men I know have been allowed a grace period to “ease” into fatherhood, and this was not my husband’s experience at all. He handled it with grace and warmth. I’m also wildly grateful for my mom and my in-laws who took many drives and train rides up from NJ/NYC to help us out in the first few weeks. And I’m grateful to my girl friends for allowing me to wallow in self pity for just enough time before it was necessary for me to put my big girl pants on and accept that this was the first half of my maternity leave. 

The other thing I’m really grateful for — wait for it — is social media (I know. Normally I think it’s a dumpster fire, too. But hear me out!). In particular, it got me through my week-long hospital stay because it allowed me to connect with others when I was completely alone and at my lowest. At the time, I was co-hosting a morning radio show in Boston. I was used to sharing my life with everyone. But I eventually got to a point in my postpartum recovery where I decided I simply couldn’t not tell people about this. It felt like I was lying to our listeners — and that certainly doesn’t help any future moms, either. Once I shared my story on social media, I heard from so many women about how similar their experiences were, and how no one had told them, either, about the realities of postpartum recovery. Recognizing that I wasn’t alone, and that other women had experienced the same thing and were now thriving, was a huge encouragement. And it also put me on a mission to be as honest about my recovery as possible. 

There are days where I think being a mother is the best job title I’ve ever had the pleasure of holding, and there are other days where I feel like no one should allow me to do this because I’m terrible at it. But I’m confident that every mom feels that way, and that each day (sometimes each hour or minute, even!) is an opportunity to refresh. I lost my job at the beginning of the Covid-19 pandemic, and it’s been (mostly!) a blessing. I never would have had the opportunity to be side-by-side with my daughter in the way I am now. We are attached at the hip; I see literally every single thing that she does, and we’ve formed a truly inseparable relationship (for better or for worse, ha!). I see how smart and kind and curious she is, and how her vocabulary is skyrocketing on a daily basis. I love the moments during the day where we get to nurse and snuggle together (18 months and still going strong, which I’m incredibly proud of). Most importantly though, I think the thing I love best about motherhood is that this is my chance to do better. Each day, she is my driving force to do better when it comes to how I treat people, how I value myself and what I want to teach (and not teach) her. It’s truly the best gift I’ve ever been given.  

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Breakdown to Breakthrough

When Melissa, the founder of Flourish Care by Momunity asked me to share about my experience in the first year as a mom, I began to reflect on a very emotional year with my daughter, Sky and my husband, Daniel. 

I was taken back to nipple shields, pumping, and bottle feeding: a full time job, and one I never could have imagined would be so hard.

I was taken back to the extreme sleep deprivation, and the overwhelming pressure to do everything perfectly, something I thought I had worked through and let go of.

I was taken back to the tug on my marriage, struggling to communicate with my self-employed husband, who had to return to running his company the day we got home from the hospital, working long hours to keep things afloat.

I still feel like such a new mom, there are so many varying phases we encounter moment to moment and I am in it. But I also have an entirely different lens now than I did a year ago. Despite the long, difficult and challenging road, this year has been one of the greatest gifts of my life. This year had so many turning points, a process of breaking down, in order to break through. 

My saving grace was leaning into the stories and struggles of others, which allowed me to be present for my own. People who shared what they had been through, giving me glimpses of what to expect. I believe that when we push down our stories and our struggles from a place of shame, we prevent others from sharing too. And when none of us are talking about our questions and our needs and our fears, each of us feels more and more alone while navigating this wild ride. 

So for all the expecting and new moms out there, I send you a huge hug, and an assurance that you’re not alone. You might not be able to predict anything, as scary as that is, and it just might be incredibly hard. But you don’t have to be alone.

What I came to understand after that first year, is that motherhood is what you make of it, and what you take from it. Here are the takeaways I came across over and over again, that I hope you will find helpful to.

1. You might throw out all of your tools and replace them with new ones.
I prepared for giving birth like it was my job. (Taking Care of Yourself Means Taking Care of Your Baby)  I created my vision board, something I’ve been doing for decades when I have big life transitions, to visualize how I want to feel.  
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I envisioned my husband staying home to help out. I armed myself with information, and the stories of clients and close friends, and I diligently practiced all of my tools.

And then, when the baby actually arrived, all of the tools promptly went out the window. 

I knew what they were, the tools, and I knew how to access them, in theory. But I couldn’t. Sleep deprivation, combined with postpartum anxiety, overwhelm about breastfeeding and the assumption it wouldn’t be hard for me (it was), getting my damn wisdom teeth out, my husband returning to work, and the pressure I put on myself to go back to work … it was a perfect storm.

The things that had always worked to help me find my way back to myself were no longer effective. I couldn’t move in the same way, and I felt like I was inhabiting a body that wasn’t my own. 90% of the pain was induced by stress. Fears and insecurities that I had spent years working through rose to the surface. I felt like I was being asked to sail a ship – something I didn’t know how to do – and the ship was sinking. When I went to put my life jacket on, I discovered it was punctured with holes. 

So I had to throw out the tools, and re-learn them as a first-time mother, with an entirely new lens. You can prepare as much as possible, but you also have no clue how your body and mind will handle the transition into motherhood. And this is okay. And I think we’re doing a disservice to mothers and setting them up for disaster when we don’t talk about the struggles or create unrealistic expectations.

So gather your tools, but know that you might throw them out, too. You might need to redefine and reimagine what’s going to work for you when you transition into becoming a first time parent. It will be a learning experience, and some things might not go as planned, and this will be difficult. You will persist anyway.

2. Making it a priority to take care of yourself is hard and important.

Those new tools I came to cherish? Pretty basic stuff. Sleep. Food. Movement. Taking care of myself. 

We’re told the birth is the hard part, but that was just the beginning for me.

Did you know that sleep deprivation is an extreme source of tourture in some countries? In fact, prolonged sleep deprivation is an especially insidious form of torture, because it attacks the deep biological functions at the core of a person’s mental and physical health. Sure, it’s less overtly violent than cutting off someone’s finger, but it can be far more damaging and painful when pushed to extremes. For me, it manifested in hallucinations and paranoia.

If I was going to be in an okay place mentally and physically, I realized I had to focus on actually functioning properly. I had to prioritize self care: sleep, physical therapy, massages, sits baths, alone time, foam rolling, music, slow and steady walks. And I had to stop incessantly pushing myself to make breastfeeding work, something I had envisioned going smoothly, when it simply wasn’t going to because I couldn’t produce enough milk. 

But most importantly, this was about being gentle with myself. Taking slow and steady steps to feel physically comfortable, and focusing on how I felt, not how I looked. Only then could I begin to feel at peace in my body, really be there, and rebuild my mental and physical health.

So I encourage you to prioritize taking care of yourself, even when it feels impossible (it will), because it’s essential if you want to feel like a human again. You created a human, and your body is healing. Don’t overlook the basics – sleep, food, movement. It’s all medicine. Keep coming back to the basics, as they’re truly what will get you through that first year.

3. You need and deserve the support that’s right for you.

Here is what I want you to know, most of all. No matter how independent you are, no matter how strong you are, no matter how much support you have from your partner, friends and family, it is so important to remember that you can ask for help. Sometimes we simply need someone to hold our hand.

Do not wait until you are drowning to ask for a life jacket. You need to ask for help and put the life jacket on before you encounter the rough waters.

My husband and I never could have imagined how much help would be needed, and there is absolutely, 100 percent, no. possible. way. I would have been able to navigate the rough waters and rebuild my mental and physical health if I didn’t have a support network keeping me afloat. People – outside of just family and friends – who made me feel seen, who had been through what I was going through and empowered me in the best ways.

Before giving birth my husband and I agreed on two important things: to build a solid foundation within our own relationship, and to prioritize support, in terms of where we were going to spend money. Many wonderful resources out there are free, but I was overwhelmed by all the information and products, and knew I wanted individualized support. 

We acquired used items whenever we could, and were fortunate to have hand-me-downs from my inlaws and my clients, and cut other costs where we could, so that we could instead spend money on support. For me that looked like a postpartum doula, physical therapy, and a babysitter (day care), because I wanted to return to work. 

There’s something really beautiful that happens when you are working with someone one on one, and you get to experience their journey. Having my own personal blueprint to motherhood was helpful, and made me feel less stressed, since I was able to really know what I needed. But what you need may look different than what I – or anyone else – needed. 

So notice, and prioritize, what you need. And if you’re in a marriage or a relationship, notice that your partner might have needs, too. My husband and I were affected in different ways. To say it was a tough time is the understatement of the century. And we’ve been together for 10 years.

But it also strengthened our communication and brought us closer. Our foundation needed to be rebuilt. So brick by brick, we rebuilt our foundation and got the resources we needed to feel supported. I always say burn the house and only take what you need to rebuild. Start fresh, and know that this time you might need a different foundation than you have had in the past.

Finally, I’ll leave you with words from Vienna Pharaon: your situation does not need to be the worst situation in the world, in order to give yourself permission to feel, to grieve, to slow down, to notice, and to heal.

I dealt with so many struggles in my own head, ones that I could have never prepared for, and I felt like I couldn’t talk about. It built up and built up, until I finally broke down. The challenges of carrying a family are real. And no one sees what we are processing as mothers, it’s all an internal dialogue and experience, invisible from the outside.

When I look back at my life I recall so much deep work and healing when I find myself at the bottom. Breaking down led to breaking through for me, and we cannot forget to share the hard shit mixed with all the wins. No matter who you are or what you are going through, someone, somewhere gets to know we are all in this together – life, that is – when we share from our hearts. 

Know that you can do this in a way that feels empowered, so that when challenges arise you’re ready for them. Let it humble you, and keep showing up. It will be messy, but show up as your messy self. Expect the unexpected, and don’t be afraid to throw the old tools out as a new mom. Keep coming back to the basics and prioritize taking care of yourself. Seek out a support system that makes you feel seen and cared for. 

There was freedom for me in those three lessons. And I want the same freedom for you. 

Xo,

Tessa

Resources in Rhode Island 

Like I said, you need to find the support that’s a good fit for you. For some people that might look like a mothers group or classes of some sort. For me it was an individualized approach. There’s no one-size-fits-all. But if you’re feeling overwhelmed and don’t know where to start (and you’re local to Rhode Island), below were my must-haves: the things that made an immense difference. They are all people I either have known for a while or have been personally referred to. 

Melissa Richter Bowley Founder and CEO of Flourish Care and Momunity 
How to Contact: https://momunity.co, https://registry.flourishcommunitycare.com

Lori Kelley at Center for Women’s Health Obstetrics and Gynecology 
How to Contact: https://www.southcountyhealth.org/doctors/lori-m-kelley-cnm/164

Women and Infants Day Hospital Program
How to Contact: https://www.womenandinfants.org/services/behavioral-health/day-hospital.cfm
(Nationally recognized program with top experts in perinatal mental health. If you know a mom struggling please share this program with them ASAP) 

Pelvic Rehabilitation and Women’s Health Specialist Michelle Clark, MSPT 
How to contact: [email protected], RIRehab.com / 877 RI-Rehab 

Childbirth educator, DONA Certified birth and postpartum doula, Certified lactation counselor and Newborn Care specialist: Lauren Philips Amand of Gentle Beginnings
How to Contact: Gentlebirthri.com /[email protected]/ 401.480.2460

Doula: Kristen McClanaghan Kardos (co owner at RI New Moms Connection Group)
How to Contact: www.doulakristen.com/ 401.787.0420/ Email: [email protected]

Postpartum Care: Kiira Travassos at Sweet Relief
How to Contact: [email protected] 

Postpartum Massage: Meagan Zarbar at Everyday Ohm Massage + Wellness 
How to Contact: https://www.everydayohm.com

Dr. Lauren C. Noel MD at Wakefield Pediatrics 
How to Contact: https://wakefieldpediatrics-ri.com

Jill and Sharron Lactation Specialists + Home Visiting Nurse 
How to Contact: https://www.southcountyhealth.org/programs-services/center-for-women-s-health/having-a-baby/labor-delivery-team

Financial Office at South County Hospital: 
How to Contact: https://www.southcountyhealth.org/patients-visitors/financial-assistance
Find good insurance: In my third trimester I met with Cindy who works as a patient financial advocate and explained the best coverage and options for our family. (Since my husband and I are both self employed we could switch our coverage come Jan 1st) 

Spotify playlists 🙂 MUST HAVE FOR ME 

A Shower/ Sits bath:) 

Other Resources I found helpful: 

Doctor Melissa Nassaney  PT, MS,DPT,WCS
How to Contact: https://www.performanceptri.com/TEAM/melissanassaney

Doctor Sarah Ellis Duval PT,DPT,CPT,CNC
How to Contact: https://www.coreexercisesolutions.com

Ayurveda & Yoga: Elyse Wilkie at Anahata 
How to Contact: https://www.anahatahome.com, [email protected] / 401.218.2480

Postpartum Doula: Hailey Paris of Kindred Tribe 
How to Contact: https://www.kindred-tribe.com

Musculoskeletal Education Expert: Pamela Rief 
How to Contact: https://setupstrong.com/get-started/

Ariana Raufi Pediatrician at East Bay Pediatrics 
How to Contact: She does a Live Q&A every Wednesday on Facebook live through Flourish Care 

RI New Moms Connection Group: RI New Moms (co-owner Kristen McClanaghan Kardos)
How to Contact: www.rinewmoms.com/ 401.787.0420/ Email: [email protected]

Pre and Postnatal Yoga: Emily at Newport Community Yoga 
How to Contact: https://newportcommunityyoga.com/

Finding a local moms group or online group that has women and babies who are going through similar situations as you has been super helpful to my clients and friends. 

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Questions & Answers From Expert Panelists

I’m curious about when I should start pelvic floor PT after having significant tearing (3rd degree) and stitches. My OB said to wait 6+ weeks to not disrupt healing.

Ideally we are considered “back to normal” at four to six weeks postpartum including return to exercise. Typically I recommend you follow your OB’s instructions. However it is helpful to know that science tells us that the scar from the repair is forming at three weeks and can continue to mature months later, up to two years. Realistically, simply having a BM could offer more force to the wound than a kegel squeeze. Plus, we can do gentle squeezes versus a rock star squeeze. This will help to improve healing.

How long should daytime naps last in month two?

Great question! Naps at this age can range from 45 minutes to two hours. If you notice your baby waking up after 45 minutes wait a few moments before going to get him/her because he/she might transition into another sleep cycle and go back to sleep. They usually have at least one long restorative nap of about one and a half to two hours per day.

What are your opinions on babies sleeping in your bed or in the same room for the first few months?

Sleeping in the same room is great if that is what works for you. I usually encourage parents to move their baby into his/her own room sometime around four months because it helps the baby and caregiver sleep better. I do not recommend having babies sleep in their parents’ bed because that is usually not safe – too many blankets, pillows, bodies – must be mindful of suffocation risks.

I’m planning on having my baby sleep across the hall from my room in their nursery right off the bat. Should I have the baby sleep in my room for a while? I do plan on breastfeeding.

There is no right answer to this, and you are more than welcome to have your newborn in the nursery from the start. I would say that most parents do have their newborn in their room for the first month or so just because they are physically closer when you are constantly feeding them overnight in the beginning. Try what works for you – good luck!

Is there a way to tell whether you are just experiencing baby blues/sleep deprivation effects as compared to postpartum depression?

Great question. Baby blues are normal and up to 85% of moms will experience bouts of anxiety, tearfulness, sensitivity (i.e. cry at the drop of a hat), feeling overwhelmed. The baby blues usually resolve within the first two to three weeks of delivery. Depression distinguishes itself from the baby blues in that it is characterized by inability to sleep even when the baby sleeps, profound sadness, inability to experience pleasure or interest in previously pleasurable or interesting activities, appetite loss, feelings of worthlessness, guilt, poor concentration and at its worst, feeling that life isn’t worth living. If you are experiencing any of these more severe and persistent symptoms, please let your doctor know or you can always call us at Women’s Behavioral Health and schedule an initial evaluation (virtual). 401-453-7955.

My daughter (almost five months old now) sleeps very well at night most of the time (10+ hours with a couple interruptions). However, her daytime naps are usually very short (40 minutes tops), and she usually takes three – four per day. Are there any tips on getting her to extend the length of her naps during the day?

It sounds like your baby is a great sleeper so far so that is awesome! I would say having longer naps tend to be more restorative so I agree that that is a great goal for you two. There are a few things you can try when she wakes up: soothe her back to sleep to try to extend the nap, replace the pacifier if she uses it for sleep, keep a naptime routine to set your baby up for sleeptime, try using black out curtains (light is stimulating), limit cat naps between actual nap time… so many things to consider! I hope that answers your question!

When is a good time to start pumping and when should I introduce bottle feeding?

I usually suggest pumping once you have set up a solid breastfeeding relationship and are confident breastfeeding. This is unless you have a baby who is not latching or you are struggling to breastfeed then you absolutely want to pump when needing to give your baby a bottle. Usually around four weeks you can start pumping. The best time to pump is first thing in the morning as you have the highest amount of the milk making hormone! Although there is not such thing as nipple confusion, you wouldn’t want to introduce a bottle to a baby who is still trying to perfect breastfeeding!

If there is a clicking noise does that always mean there is a bad latch? Can there be some clicking with a good latch? When I have a strong let down the baby sounds like they are getting too much and sounds like choking, grunting and milk leaking out of mouth. Baby adjusts latch to just get nipple and maybe lessen flow (not sure), I’m concerned this might turn into a bad habit and cause pain when teeth come in. Is there such thing as latch “bad habits”?

So clicking is a sign that something is not right in terms of the latch. It may not be painful on your end but something is definitely compromised in terms of the latch. Sometimes babies can have a great latch but at some point while feeding they can move their tongue a different way or maybe their lip rolls in and it can cause the clicking. I do recommend reaching out to a lactation consultant to get down to the bottom of why the clicking is happening.

I really want to breastfeed. I also want my husband to help and bond with the baby when feeding. I plan to pump and also give the baby a bottle. Should this be started right away or should I wait a certain amount of time before giving bottle and breast. I hear a lot about confusing the baby and I don’t want to do that. I will have to pump and give the baby a bottle when I return to work so I don’t want to wait too long before I get the baby used to both breast and bottle.

The desire of partners to be able to help and bond with the baby is something families often discuss while at our center, and often times there is the perception that the way to do that is feeding the baby.

It is often helpful to first get to a point of confidence and ease with breastfeeding before introducing the bottle, but this need not prevent the partner from helping and bonding with your little sweetie!

The whole family benefits when partners participate in all the other ongoing newborn care needs — diapers, soothing, bathing, etc. The beauty of this is that it meets many needs within the family:

  • Supporting deep bonding between partner and baby
  • Increasing partner parenting confidence
  • Helping mother heal and rest
  • Supporting lower stress hormones and higher “love” or connection hormones for the whole family!

I am having trouble weaning my 19 month old and I’m in my first trimester. I breastfed my last three children into toddlerhood but should I continue to push weaning even though she doesn’t seem ready at the moment?

If there is no medical reason to stop weaning then I say keep at it!

I would have a conversation with your OB or Midwife about the risks specifically for you about breastfeeding through pregnancy and as long as they are okay with it and your are as well then I would say keep on breastfeeding!

I read an article that says over 40% of women over 30 or are overweight will have delayed lactation, so their milk won’t come in within 72 hours. What do you do if you still want to breastfeed but have delayed lactation? Can you still try to breastfeed while using formula as you wait for your milk to come in? The article mentioned that in some cases it took up to almost a week for the milk to come in. I really want to breastfeed, but I am worried that I will have difficulties due to being over 40. Is it possible to still breastfeed if your milk is delayed for a long time and you have to use formula?

There are so many factors that play into when a breastfeeding persons milk “comes in”. So in the beginning you will have what is called colostrum which will not look like milk or be in large volumes. This is all and exactly what your baby needs. I usually say most will see the milk transition around day three to five but if it doesn’t, don’t panic! It can take up to a week for the milk to transition. The most important thing is to bring that baby to breast often!

If your milk is delayed and there is some concern for babies weight you can absolutely hand express or begin pumping and supplement or even use formula! As long as you continue to bring the baby to breast and also pump when offering a bottle of either expressed milk or formula. You can absolutely still breastfeed even if your baby is offered formula. Here is a wonderful resource in addition: firstdroplets.com

It can be wonderful to set up a relationship with a lactation consultant or counselor before the baby has arrived, and to plan to receive regular support for the first few weeks after baby is born. This can be a significant help to creating a successful breastfeeding relationship!

I recently had a “clash” with my temporary pediatrician (out of the country at the moment) about prolonged breastfeeding. I think this is a myth but she claimed that ‘I have no milk’ and that my milk is not nutritious anymore. I am still nursing my 14-month old. Truth? Myth? Thank you!

I’m sorry that you had that experience. I would really try to listen to your child’s hunger cues. It might be true that you don’t have as much milk as before, but I imagine your child is eating and drinking lots of other things too which is great! Continue to breastfeed as long as you want while also encouraging a well rounded diet with lots of nutritious foods. If offering other things for your child to drink I would recommend whole milk, soy milk (unsweetened) or pea protein milk – whichever works for your family… and also water!

I’m due in September. When should I get a pediatrician for my baby? I already know what doctor I want, but when do I contact them about it?

Great question! Some parents like to do a prenatal “meet and greet” with a pediatrician (especially if they aren’t sure what practice they want to go to). I do those all the time and love them! Here at Women & Infants Hospital if you already know what practice/provider you will choose then you just tell the labor team after you give birth! They will contact your pediatrician to come to the hospital and see the newborn within 24 hours (if that is something your pediatrician does). Hope that helps!

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