**Please do not copy or distribute for any purposes without
written consent from Brittany McCollum, Blossoming Bellies.**
Sample Affirmations for Encouragement of
Inner​ ​Strength and Realization of Intuition
and Instinct
*from Nancy Wainer Cohen and Lois J. Estner
Laboring Person
I am a strong and capable woman/person.
I am creating a totally positive and new birthing experience.
My pelvis is releasing and opening as have those of countless
women before me.
I am accepting my labor and believe that it is the right labor for
me and for my baby.
I now feel the love that others have for me during this
pregnancy.
I am treating my mate lovingly during the birth.
I have a beautiful/strong/powerful body. My body is me.
I now see my last birth as a learning experience, from which I
am growing and changing.
I embrace the concept of healthy pain.
I am welcoming my contractions.
I have enough love to go around.
There is always enough love for me.
I am strong, confident, assured, assertive, and feminine.
I am helping my baby feel safe so that she can be born.
Partner/Birth Support Person
I am taking care of myself during this pregnancy.
I see my partner as a strong and capable woman and this does
not threaten me.
I am supporting my partner during labor even when they are in
pain.
I am expressing my love to my partner easily and frequently.
I am accepting the labor that is meant for us.
I am accepting feelings of helplessness without feeling the need
to take them away.
1
I am sensitive, tender, open, and trusting.
I am feeling the love that others have for me when I need
support.
2
Thoughts to Help Ease the Fear of Labor
Pain
Labor surges are bringing your baby closer to you
Labor surges are temporary
Each contraction you move through is one less in front of you
The break in between contractions is longer than the contraction
itself for much of labor
Billions and billions of people have done this for​ ​thousands of
years
Natural labor contractions come in waves
Endorphins are released with each contraction to numb the pain
and help relax you
Labor contractions are unlike any sensation you​’​ve ever
experienced before ​– ​their message is that of surrender as
opposed to the ​“​fight or flight​” ​pain of physical hurt
Brittany Sharpe McCollum, Blossoming Bellies, updated 2018
3
Every Laboring Person’s Rights
Consideration and respect for every laboring person under
all circumstances is the foundation of this statement of
rights.
1. ​Every person has the right to health care before, during, and after
pregnancy and childbirth.
2. ​Every person and infant has the right to receive care that is consistent
with current scientific evidence about benefits and risks.* Practices that
have been found to be safe and beneficial should be used when indicated.
Harmful, ineffective, or unnecessary practices should be avoided.
Unproven interventions should be used only in the context of research to
evaluate their effects.
3. ​Every person has the right to choose a midwife or a physician as their
maternity care provider. Both caregivers skilled in normal childbearing and
caregivers skilled in complications are needed to ensure quality care for all.
4. ​Every person has the right to choose their birth setting from the full range
of safe options available in her community, on the basis of complete,
objective information about benefits, risks and costs of these options.*
5. ​Every person has the right to receive all or most of their care from a
single caregiver or a small group of caregivers, with whom they can
establish a relationship. Every person has the right to leave their caregiver
and select another if they becomes​ ​dissatisfied with their care.* (Only
second sentence is a legal right.)
6. ​Every person has the right to information about the professional identity
and qualifications of those involved with their care, and to know when those
involved are trainees.*
7. ​Every person has the right to communicate with caregivers and receive
all care in privacy, which may involve excluding nonessential personnel.
They also have the right to have all personal information treated according
to standards of confidentiality.*
4
8. ​Every person has the right to receive care that identifies and addresses
social and behavioral factors that affect their health and that of their baby.**
They should receive information to help them take the best care of
themselves and their baby and have access to social services and
behavioral change programs that could contribute to their health.
9. ​Every person has the right to full and clear information about benefits,
risks, and costs of the procedures, drugs, tests and treatments offered to
them, and of all other reasonable options, including no intervention.* They
should receive this information about all interventions that are likely to be
offered during labor and birth well before the onset of labor.
10. ​Every person has the right to accept or refuse procedures, drugs, tests
and treatments, and to have their choices honored. They have the right to
change their mind.*
11. ​Every person has the right to be informed if their caregivers wish to
enroll them or their infant in a research study. They should receive full
information about all known and possible benefits and risks of participation,
and they have the right to decide whether to participate, free from coercion
and without negative consequences.*
12. ​Every person has the right to unrestricted access to all available
records about their pregnancy, their labor, and their infant; to obtain a full
copy of these records; and to receive help in understanding them, if
necessary.*
13. ​Every person has the right to receive care that is appropriate to their
cultural and religious background, and to receive information in a language
in which they can communicate.*
14. ​Every person has the right to have family members and friends of their
choice present during all aspects of their maternity care.**
15. ​Every person has the right to receive continuous social, emotional, and
physical support during labor and birth from a caregiver who has been
trained in labor support.**
16. ​Every person has the right to receive full advance information about
risks and benefits of all reasonably available methods for relieving pain
during labor and birth, including methods that do not require the use of
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drugs. They have the right to choose which methods will be used and to
change their mind at any time.*
17. ​Every person has the right to freedom of movement during labor,
unencumbered by tubes, wires, or other apparatus. They also have the
right to give birth in the position of their choice.*
18. ​Every person has the right to virtually uninterrupted contact with their
newborn from the moment of birth, as long as they and their baby are
healthy and do not need care that requires separation.**
19. ​Every person has the right to receive complete information about the
benefits of breastfeeding well in advance of labor, to refuse supplemental
bottles​ ​and other actions that interfere with breastfeeding, and to have
access to skilled lactation support for as long as they choose to
breastfeed.**
20. ​Every person has the right to decide collaboratively with caregivers
when they and their baby will leave the birth site for home, based on their
condition and circumstances.**
(At this time in the United States, childbearing people are legally entitled to
those rights marked with *. The legal system would probably uphold those
rights marked with **.)
©​Maternity Center Association​, 1999
modified by Blossoming Bellies, 2018
6
Evidence-Based Decision
Making
has three components.
• Research-based Recommendations
• Client Values/Belief Systems/Priorities
•
Care Provider Experience
www.evidencebasedbirth.com
7
Informed Consent and
Informed Refusal
be sure to ask:
What additional information or benefit will this
procedure provide?
What does the procedure entail?
Are there any problems or complications that could
arise from this procedure?
What does recent research say about this procedure?
What are the alternatives and their risks and benefits?
What will happen if we wait and do nothing? What are
the chances of something happening?
If feeling pressured to make a decision with which you
are not comfortable, you have the right to say ​“​I refuse
to give my consent for you to do...​” ​or ​“​you do not
have my legal consent to do...​” ​Saying ​“​stop​” ​or ​“​no​”
may not be enough.
Great Resources for Research-Based Information:
http://summaries.cochrane.org
http://www.ncbi.nlm.nih.gov/pubmed
www.evidencebasedbirth.com
8
Nutrition During Pregnancy
Helpful Tips
Eat when feeling hungry
Eat foods close to or in their natural state
Avoid processed foods
Eat meat and chicken moderately if not vegetarian
Do not limit or increase your salt intake
Eat organic as often as possible (particularly dairy and meat)
Get your vitamins through food rather than supplements
Protein intake should be 55 to 80 grams
Take in 800 mcg of folic acid per day
Take in 1000 to 2000 mg of calcium
Stay away from refined sugars and fake sweeteners
Drink half your body weight in ounces of water per day (ex: 150 lbs =
75 oz water) Ensure you are getting calcium, iron, zinc, magnesium in
your diet
Make superfoods a diet staple ​– ​broccoli, tofu, soybeans, kale, flax,
blueberries Eat more fruits, veggies, and whole grains
Where to Find the Good Stuff
Healthy Fats
olive oil, coconut oil, seeds (pumpkin, sunflower, sesame, flax), nuts
(almonds, walnuts), high fat cold water fish (salmon, mackerel,
sardines), avocado, grass-fed meats, pastured eggs
Protein
fish, beans, whole grains, tofu, eggs, tempeh, nuts, seeds, veggies
Calcium
dark green leafy veggies (kale, spinach), broccoli, cauliflower, cabbage,
okra, bok choy, figs, salmon, sardines, mackerel, tahini, dried fruit,
9
molasses, seaweeds, almonds, red raspberry leaf, kelp, dandelion,
nettles, parsley, watercress, papaya, elderberries
Iron
fish, beans, dried apricots, nuts, seeds, seaweed, leafy green veggies
(kale, spinach, dandelion, nettles), blackstrap molasses, prunes, raisins,
whole grains, beans, tofu, soybeans, oysters, almonds, walnuts
Zinc
high fiber foods (bran), Brazil nuts, parmesan and hard cheeses, seeds,
herring, meat
Magnesium
nuts (particularly almonds), soybeans, fish, green vegetables, apples,
figs, wheat germ, seeds
Vitamin A
dark green vegetables, yellow vegetables, yellow fruits (broccoli,
spinach, turnip greens, carrots, squash, sweet potato, pumpkin,
cantaloupe, apricots, liver, milk, butter, cheese, whole eggs
Vitamin D
dark leafy greens (have properties that act like Vit D in the body),
shitake/chanterelle mushrooms, oatmeal, oysters, salmon, sardines,
sweet potato, tuna, vegetable oil, alfalfa, parsley, cod liver oil, egg
yolks, halibut, fatty dairy products, good old sunshine!
Vitamin E
vegetable oils, wheat germ, green leafy vegetables, almonds, hazelnuts,
carrots, avocado
Vitamin K
dark green leafy veggies, nettles, alfalfa leaves
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B Vitamins
bananas, lentils, chile peppers, tempeh, liver oil, liver, turkey, tuna,
nutritional yeast, molasses, potatoes
Vitamin C (aids absorption of iron and calcium)
citrus fruits, kiwi, green cabbage, tomatoes, strawberries, peaches
Folic Acid (a B vitamin)
dark green leafy veggies, beans, legumes, asparagus, whole wheat
products, oranges, beans, Brussels sprouts
Herbs for Pregnancy
Red Raspberry Leaf tones the uterus (reducing pain during labor),
strengthens the female reproductive system, and eases morning sickness
(tea)
Alfalfa, nettles, dandelion provide iron and vitamin K to the body (tea or
capsules); nettles eases leg cramps and muscle spasms and reduces
varicosities; nettles also strengthens the kidneys to prevent bladder
infections
Evening Primrose Oil provides a baby​’​s developing brain with healthy
fats and helps to soften the mama​’​s cervix (3 capsules per day orally for
up to a week or 1 capsule vaginally for up to two weeks)
Amaranth, Lamb​’​s Quarters, and Violet leaves act as laxatives (cooked
or infusion)
Comfrey and nettles (used separately or together) prevent backache due
to their calcium, magnesium, vitamins C, D, and E, and B complex
(infusion)
Motherwort is a wonderful herb to help relax the body and mind without
causing drowsiness (5 drops of tincture in glass of warm water)
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**As with all holistic wellness, intent is of the utmost importance.
Respect the properties of the herbs you are using and focus on their feel
in your body to experience their full effect.**
Brittany Sharpe McCollum, updated 2018; Herbal Information from ​“​Herbal for the Childbearing Year​”
by Susun Weed
12
Induction of Labor
Induction methods are used to bring on or speed up labor
** World Health Organization recommends that ​“​No geographical
region should have rates of induced labor over ten percent.​” ​**
Medical Reasons For Induction:
Cancer
Hypertension
Diabetes
Kidney Disease
Small-for-Dates Baby
Decrease in Amniotic Fluid
Intrauterine Death With Long Wait for Labor (weeks, not days)
Non-Medical Reasons For Induction:
Past Due Date
Accommodate Busy Schedules
Reduce risk of compromised baby
Types of Induction Methods
Amniotomy​: Artificial rupturing of membranes surrounding baby
(amniotic sac) before or during labor
Possible Side Effects: places time limit on labor, increases risk of
infection, umbilical cord prolapse, malpositioning of baby
Cervidil​: Synthetic prostaglandin tampon administered before or
during early labor when water bag is intact
Possible Side Effects: nausea, vomiting, diarrhea,
hyperstimulation of uterus
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Cytotec​: ​“​Off-Label​” ​synthetic prostaglandin tablet administered
before or during early or active labor, vaginally when water bag is
intact, orally when water bag is not intact
Possible Side Effects: nausea, vomiting, diarrhea,
hyperstimulation of uterus, increased risk of infant brain damage,
uterine rupture, infant and maternal death
Pitocin​: Intravenous drip of synthetic oxytocin administered during
active labor
Possible Side Effects: doubles risk of baby being born in poor
condition, doubles risk of cesarean, increased postpartum blood
loss
Foley Balloon​: balloon portion of bladder catheter is filled with
saline solution and administered inside the cervix, between the
amniotic sac and the lower uterine portion before or during early
labor
Possible Side Effects: strong contractions
14
Alternatives to Medical Induction
Method
Possible Side Effects
Sex
None
Orgasm; Place a pillow under bottom and
allow semen to move towards cervix
Nipple Stimulation
Strong contractions (if too strong, stop
20 minutes on one side, 20 minutes on
stimulation)
the other, take a 20 minute break, repeat
Oral Sex
None
Castor Oil
Diarrhea and subsequent dehydration
(one tbsp with egg, ice cream, orange
juice, one tbsp one hour later if nothing)
Sweeping or Stripping the Membranes
Accidental rupture of bag of waters
A finger is placed inside the cervix and
“​swept​” ​around the inner rim of the
cervical os, loosening the bag of waters
from the uterine lining; usually done by a
careprovider
Herbal Induction Tea
1 liter water; 1 tbsp verbena luisa; 20
cloves; 2 pieces ginger root; 2 barks
cinnamon; honey: drink hot throughout
the day
None
Acupressure
Strong contractions (if too strong, stop
stimulation)
Acupuncture
None
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Pain Relief
Medical Reasons For Pain Relief
Cesarean Section
High Blood Pressure
Clinical Maternal Exhaustion
Non-Medical Reasons for Pain Relief
Inability to Dilate Due to Tension
Desire to Dull Pain
Types of Pain
Relief
Mode of Entry
Advantages
Disadvantages
Tranquilizers
(Valium),
Sedatives, Sleeping
Pills
Oral
Possibly allows for
rest if mild
contractions or
false labor are
preventing sleep
● interferes
with baby’s
ability to
breathe
● interferes
with baby’s
ability to
suck
● reduces
muscle
tension
Narcotics (Demerol,
Stadol, Nubain,
fentanyl)
Injection or IV
Moderate pain relief
during beginning
and end of
contraction
● sleepiness
● nausea
● vomiting
● drop in blood
pressure
● decreased
reflexes and
muscle
tension
● may affect
16
baby’s ability
to breathe
and suck
Antinausea Drugs
(Trilafon,
Phenergan)
Oral or IV
Relieves nausua
● dizziness
● drowsiness
Epidural
(anesthesia and
analgesia)
Continuous Drip of
Medication
into Nerves in
Lower Back Just
Outside Spinal
Cord
Pain Relief
May Lower Blood
Pressure
● restricted
mobility
● drop in blood
pressure
● increased
risk of fever
● total body
itching
● increased
risk of
cesarean
● weakens
pelvic floor
muscles
● requires
further
intervention
(constant
EFM, IV
fluids, blood
pressure
cuff, pulse
oximeter,
bladder
catheter)
● prolonged
labor
● occasional
incomplete
pain relief
● increased
risk of
instrumental
delivery
● increased
risk of
tearing
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● crosses the
placenta;
can cause
fetal heart
tone drop,
slowed
reflexes and
breathing in
baby
Combined
Spinal/Epidural
(CSE, Walking
Epidural, Light
Epidural)
Bolus Injected into
Membrane
Surrounding Spinal
Cord Followed by
Continuous Drip of
Medication into
Nerves Just
Outside Spinal
Cord
Pain Relief with
Better Mobility than
the Epidural
Spinal
Single Dose into
Membrane
Surrounding Spinal
Cord
● Better Pain
Relief than
Epidural
Possibly with
Better
Mobility
● Used During
Scheduled
Cesarean or
When
Cesarean is
Necessary
and other
Pain Relief
has Not
Been
Administered
General Anesthesia
Inhalation or IV
Quick
Administration for
Cases of True
Emergency
● all risks of
epidural
● increased
risk of spinal
headache
● all risks of
epidural
● increased
risks of
spinal
headache
● short term
pain relief
option
● high rate of
breathing
difficulty in
babies
● nausea
● vomiting
● risk of
18
aspiration
pneumonia
● grogginess
for first hour
after birth
updated 2018
19
Common Medical Interventions
Administration Intent
Type of
Intervention
Effects on
Mom
Effects on
Baby
Electronic
Fetal
Monitor
(EFM)
two
Monitor
*limits
ultrasound baby​’​s heart mobility
belts around rate and
*machine,
belly
mom​’​s
rather than
contraction mom,
pattern
becomes
center of
focus
*use of
ultrasound ​–
no safe level
known
IV Fluids
Intravenous Hydrate and *restricts
drip of
maintain
mobility
glucose
blood
*satisfies
pressure
body​’​s thirst
during
but mouth
epidural,
left dry
cesarean
*postpartum
birth, and/or swelling
fetal distress
*can lead to
fluid overload
and ​“​dramatic
weight loss​”
after birth,
leading to
subsequent
interventions
Internal
Fetal
Monitor
Small wire More
* restricts
*hematoma
screwed into accurately mom​’​s
*pain in
baby​’​s head monitors
mobility *
insertion site
or buttocks baby​’​s heart requires
through
rate
membranes
mom​’​s
to be
vagina
ruptured
*increases
20
risk of
infection
Intra-uterine
Pressure
Catheter
(IUPC)
Thin tube
inserted
through
vagina and
cervix
More
*restricts
*fetal injury
accurately mobility
measure
*requires
intensity of membranes
contractions to be
OR Infuse ruptured
sterile fluid *increases
into amniotic risk of
sac to dilute infection
meconium if *can
present or to decrease
cushion
risk of
compressed c-section for
umbilical
“​failure-tocord
progress​”
and/ or fetal
distress
21
PRODROMAL vs. EARLY LABOR
Prodromal labor helps ​prepare your body, your baby,
and your cervix for birth​. Often referred to as ​“​false
labor,​” ​it feels much like real labor but is ​not consistently
progressive and does not lead, without a break, to the
birth of your baby. ​It is believed that one out of every
three first full term pregnancies will experience this.
Prodromal labor contractions ​can last for hours or days
before ​“​real​” ​labor.
Contractions vary, feeling like patterned Braxton Hicks
or quite a bit stronger. You will know they are
prodromal, however, because they are ​irregular in
length, frequency, and intensity​.
They are ​under a minute ​and you will ​still be with it​. You
may be so excited to be in labor that you want to think
“​this is it!​” ​but ​remember that prodromal labor is not
creating significant change in your cervix ​– ​making
yourself believe it is active labor will only slow down the
process and may even cause unnecessary intervention!
Prodromal labor does aid the body in effacement and
positioning of the baby. Contractions may come 5-10
minutes apart for hours at a time. ​This is normal!
Thinking of prodromal labor as part of the end of
pregnancy can help greatly in reducing unnecessary
anxiety and helps promote calm and relaxation. Early
labor ​often feels the same as prodromal or even a bit
stronger and is dilating your cervix. Contractions are
22
regular in length and frequency yet under a minute long.
Treating early labor as the end of pregnancy helps mom
stay relaxed as her body begins its work. Contractions
may require the mother to stop and focus a bit yet the
laboring person remains chatty and able to sleep or
complete daily activities in between. Early labor, like
prodromal labor, can last for days. Enjoy the end of your
pregnancy and embrace the changes that are happening
in your body!
A GOOD GUIDELINE FOR ACTIVE LABOR CONTRACTIONS
ARE
4-1-1
at least ​4 minutes apart ​lasting ​one full minute
for longer than ​one FULL hour
updated 2018
23
COPING WITH LONG PRODROMAL and EARLY
LABOR
A long prodromal and early labor can be mentally and
physically trying for both the laboring person and
partner. Remember the following to help ease yourselves
through:
do not call everyone you know ​– ​it is no fun to have your
family and friends waiting and waiting...and waiting
rest and sleep ​– ​conserve your energy
eat and drink ​– ​eat hearty foods that your body and baby
can use for energy when real labor comes ​– ​keep up your
energy stores before active labor unfolds when you may
lose the urge to eat and drink
forget all you know ​– ​just enjoy these last few moments of
pregnancy ​– ​don​’​t focus on fancy breathing or relaxation
techniques
check in ​– ​let your doula know how you are ​– ​your body
is progressing even if it is not in centimeters
take a warm bath ​or a warm shower
stay in the present ​– ​breathe, let go, and let nature work
through you
Birth WorksTM
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What is Labor?
*Labor is a combination of consistent contractions and changes in the cervix*
Below are a series of loose descriptions of what many people feel during the different
parts of labor. Labor is divided into stages and phases by textbooks but, in reality,
labor is far more of an ebb and flow than a consistent progression from one stage to
the next. The process varies from person to person and cannot always fit into neatly
defined categories. The different phases and stages of labor can often share
characteristics. Each stage is referred to by its textbook definition in addition to a
better description of the physical and emotional aspects.
Stage One:
Early Labor Phase
*I like to think of early labor as part of the end of pregnancy because contractions
are fairly spaced out and short, not usually requiring a lot of external support or
touch to feel in control, and early labor can be very lengthy.*
Characteristics:
consistent and progressive contractions, at least five minutes apart or farther, under a
minute long each
dilation up to 4cm
can be several hours to several days long
pink mucus
How do laboring people often respond to these contractions?
often with excitement, chattiness, analyzing their labor and what they are feeling
although not necessarily comfortable, may be able to lie down during early labor
Suggestions:
watch a movie, cook a meal, go for walks, take a nap, shower or bath
Active Labor Phase
Characteristics:
consistent and progressive contractions, four to five minutes apart or closer, a full
minute long
dilation from 5 to 8cm
slight rectal pressure at the peak of contractions when around 6cm
on average, 8 to 15 hours of labor left when moving in active labor
bloody mucus
*if excessive bleeding or heavy bleeding similar to period, call care provider
immediately and head to the hospital*
How do laboring people often respond to these contractions?
often by becoming more focused on their bodies and labors
labor becomes all consuming
quiet or vocal with contractions
rhythmic in movement and vocalization
25
no longer chatty
need to be upright, moving
Suggestions:
hands-on touch measures, massage, verbal encouragement, position suggestions,
counterpressure
Transition Phase
Characteristics:
very long and strong contractions, 2 to 3 minutes apart and up to 2 minutes long, often
feeling back to back
dilation from 8 to 10cm
rectal pressure, hip pressure
flushed cheeks
nausea/dry heaving/vomiting
shakiness
usually no longer than one hour in first time mom, can be minutes in subsequent births
How do laboring people often respond to these contractions?
desire to be on all floors, desire to chew on something, take off clothes
loss of confidence
feelings of being overwhelmed
possible grunting at the peak of a contraction
Suggestions:
bath or shower
partners stay present
verbal encouragement
helping mom find a positive mantra to repeat (such as “yes” or “open”)
Stage Two:
Resting Phase
Characteristics:
occurs between being fully dilated and feeling the uncontrollable urge to push
slow down in intensity and frequency of contractions
contractions space to 3 to 5 minutes apart, often under a minute long
rectal pressure remains but is not all encompassing
anywhere from half hour to 2 hours in first labors, can be just minutes in subsequent
births
How do laboring people often respond to these contractions?
relief and rest
Suggestions:
allow laboring person to rest
suggest visualization to keep them calm and focused
Pushing Phase
Characteristics:
26
overwhelming urge to bear down as if passing a bowel movement
constant rectal pressure that intensifies with contractions
often appear sweaty and flushed
averages 2 to 3 hours for first time labors, less for subsequent births
leads to the birth of the baby
How do laboring people often respond to these contractions?
intense pushing several times during a contraction
closed eyes and rest in between contractions
Suggestions:
cold cloths on forehead and neck
hair tie to pull hair out of face
chapstick
if planning to delay cord clamping, inform care provider
Stage Three:
baby shows signs of wanting to nurse
placenta is ready to be birthed within a few minutes up to an hour or more (most care
providers expect the placenta to be out within 45 minutes or they will intervene)
gush of fluid
strong but short contractions
How do laboring people often respond to these contractions?
short grunts and small pushes to birth placenta
Suggestions:
love and support for new parents and baby
if planning to keep placenta, inform care provider
Is Labor Moving Faster than Expected?
*​calm​ - keep laboring person as relaxed as possible
*​reassure​ - remind laboring person that the body is working well and everything is
okay
*​catch​ - provide loving arms for your baby’s arrival
*​warmth​ - keep postpartum person and baby warm and umbilical cord intact
call care provider and/or 911 depending on birth place plans
*******************************************************
Labor Tips for Birthing Person
• commit to giving your all moment by moment and then be okay with whatever
happens
• if you cut out the pain, you cut out the intensity of some of the other feelings
• if you relax, you float. if you struggle and fight, you sink
27
• labor works best when you’re out of your mind
• embrace the moment when you feel out of control and it may pass
• do nothing extra
• ask yourself: What am I telling myself? Is this actually happening or am I imagining it?
Labor Tips for Partners
• do nothing extra
• gain a better understanding of where your partner is in labor and how things are
changing/progressing by asking where they are feeling contractions - use yes or no
questions rather than asking them to engage them “thinking brain”
• if laboring person is losing control and asking for medication when not the plan,
suggest taking five more ctx
• suggest new positions
• hydration (4 oz per hour)
• cool cloths
• chapstick
• remind your partner how loved they are
Blossoming Bellies, Brittany Sharpe McCollum, CCE(BWI), CD(DONA), 2018
28
COMFORT MEASURES FOR ACTIVE LABOR
AND BIRTH
Vocalize your own sounds
Kiss your partner
Surround yourself with fearless birth support
Drink cool water, fruit juice, and tea
Eat toast with jelly, clear soups with noodles, yogurt, honey
Massage
Pressure/touch measures
Warm and cool cloths
Music/comforting sounds
Forget your fears by facing your fears
Movement ​– ​dancing, walking, hip rotation, rocking
Keep feet firmly on the floor
Relax your hands
Urinate frequently
Semi-squat
Relax your body to release endorphins
Release endorphins to numb pain
Change position
Use deep and directed breathing exercises
Wear warm socks
Surrender to your body and its amazing ability to birth your
baby Pressure on perineum
Warm water and pressure in bath and shower
Relax your mouth
Aromatherapy
Smell your partner​’​s natural scent close to you
29
Feel your partner move with your body
Visualize your baby moving through your body
Speak affirmations out loud to yourself and your baby
Claim the territory of your birth place as YOUR BIRTH
PLACE!
Brittany Sharpe McCollum, Blossoming Bellies, 2006, updated 2018
30
Labor Position Suggestions
*Change Position Every Five Contractions To Change Space in the Pelvis, Maintain Comfort, and
Encourage the Descent and Rotation of the Baby*
Early Labor
Active Labor
Transition
Standing
*wide knees
*feet turned out/in
*pelvic tilts
*sideways stair
climbing
*vary width of
knees
*sideways lunge
with foot elevated
*labor dance
*forward lean
*knees neutral
*semi-squat
*forward lean
*sideways lunge
with foot elevated
*hip rocking
*squat
*semi-squat
Seated
*wide knees on
ball
*backwards
straddle on chair
*one foot elevated
on stool
*pelvic tilts
*sideways rocking
on ball
*vary width of
knees on ball
*one foot elevated
on stool
*forward leaning
on support person
*sideways rocking
on ball
*knees neutral
*one foot elevated
on stool
*forward leaning
on support person
*sideways rocking
on ball
*birthing stool
*birthing stool with
one foot elevated
on stool
*toilet
*leaning on ball
*cat/cow
*wide knees
*vary width of
knees
*one foot in lunge
position
*one knee
supported on stool
*knees neutral
*one foot in lunge
position
*one foot in lunge
position while
leaning on support
person
*regular all fours
“squatting back”
*wide knees
*vary width of
knees
*vary where knees
are in relation to
hips
*knees neutral
*one knee open
*vary where knees
are in relation to
hips
*knees neutral
*one knee open
*one knee up
towards chest
*one knee up
towards chest and
open
All Fours
Side-Lying
Pushing
Brittany Sharpe McCollum, CCE, CD, Blossoming Bellies Wholistic Birth Services
2018
31
Touch Measures for Active Labor
Counterpressure Techniques
Double Hip Squeeze​: With laboring person slightly forward leaning, on all fours, or seated on
ball, place partner’s hands on greater trochanter (at the top of the femur, where it meets the
pelvis) and apply gentle pressure inward. This works well in early labor to open the top of the
pelvis by pressing the bottom portion together.
Double Iliac Press​: With laboring person forward leaning or on all fours, place partner’s hands
on tops of the iliac crests and apply gentle pressure inward. This works well from about 6 cm
on; it is helpful during transition but may feel a bit intense.
Sacrum Press​: Partner applies firm constant pressure on the sacrum during and/or in between
contractions.
Hip Rocking​: With laboring person in forward leaning or all fours position, partner puts palms
on either side of sacrum and applies gentle pressure, rocking mom’s hips from one side to the
other (slow rhythmical motion).
Partner Pelvic Tilt​: With laboring person in forward leaning position or on all fours, partner
places hands on either side of the sacrum, just below the posterior superior iliac spines in the
space called the greater sciatic notch. Partner applies firm pressure in an upward and inward
motion and holds in place; if done correctly, a “cleft” will be noticed between the bum cheeks;
laboring person will feel a release in the pubic bones and in the lower back.
Massage
Neck and Shoulder
Quadricep (front of the thigh)
Hamstring (back of thigh)
Hands
Feet
Low Back Pain
Sacrum
Midway Between Iliac Crests and Sacrum
Sacroiliac Joints
Touch Measures
Energy Release
Sweep hands down back, starting at shoulder blades, moving down waist, and ending at lower
back
Back Circles
Following mom’s breath, make long slow circles over the back while providing gentle support to
the belly with the opposite hand
32
Side to Side Touch
Standing at mom’s side with flat palms at her middle back, perpendicular to her back, make
sweeping motions alternately side to side on her back and sides of her waist
Hamstring Massage
make fists with your hands and move them alternately up and down the backs of the thighs
“Shaking the Apples”
lightly hold the backs of the thighs under the bottom or on the bottom and gently “shake”
Acupressure Points
Oxytocin Release​: 4 Finger Widths Above Ankle Bone on Inside of Leg
Webbed area between Thumb and Forefinger
Area where Neck and Shoulders Come Together
Endorphin Release
Balls and Heels of Feet
Padded part of Thumb
Lower Lip
Brittany Sharpe McCollum, Blossoming Bellies Wholistic Birth Services, L.L.C., updated 2018
33
Tips for Avoiding a Cesarean in a Low Risk
Pregnancy
Stay home until active labor is well established.
Focus on nutritional quality over quantity. Eat plenty of protein, dark leafy greens,
vegetables, and whole grains. Stay well hydrated.
Avoid ripening agents such as Cervidil and Cytotec.
Avoid induction.
Labor actively - change position at least once every five contractions or so, avoid
lying on your back for more than a bit at a time, and move those hips around!
Hire a doula.
Use only intermittent fetal monitoring unless a medical reason indicates otherwise.
Understand medical pain relief options and optimal times to use pain medication if
planning a medicated birth
Remember that late pregnancy ultrasound can be off by two weeks in determining
gestational age and off by two pounds in either direction in determining weight
Push in an upright position.
Make informed decisions and know your rights in the laboring room.
Sources:
Evidence Based Birth Podcast 10: ARRIVE study; ​http://evidencebasedbirth.libsyn.com/ebb-10-arrive-study
Evidence Based Birth: Top Five Myths about Birth - Debunked! - ​https://evidencebasedbirth.com/topfive/
Birth Place Factors that Decrease Risk of Cesarean
Several studies have looked at factors in birth center and hospital settings that help
to decrease the likelihood of a cesarean. Nationally, birth centers have about a 6%
risk of cesarean while low risk hospital birth has about a 27% risk of cesarean.
The following factors have been shown by research to decrease cesarean rates.
Nurses trained in labor support, including use of movement, birth balls, etc.
34
Patience by care provider in long labors, including long inductions of labor.
Providers allowing for longer pushing time (four hours rather than three hours) in
those birthing with an epidural.
Policy to admit only after 4cm dilation in low risk labor.
Avoidance of elective induction before 41 weeks.
Use of intermittent monitoring in unmedicated birth.
Source:
Evidence Based Birth Podcast 10: ARRIVE study; http://evidencebasedbirth.libsyn.com/ebb-10-arrive-study
Absolute Reasons for a Cesarean
Umbilical Cord Prolapse
Transverse Lie
True Cephalo-Pelvic Disproportion
Placenta Abruption
Complete and possibly Partial Placenta Previa
*There are other situations in which a cesarean may be the safest option for mother and baby but
that depends on factors surrounding the situation.*
Risks of a Cesarean Section
(Coalition for Improving Maternity Services, 2010, ​www.motherfriendly.org​)
Maternal: accidental surgical cuts to surrounding organs, infection,
emergency hysterectomy due to hemorrhaging, complications from
anesthesia, pulmonary embolism and stroke (due to clots that can travel
to lungs, brain), increased risk for placental issues such as accrete and
previa with future pregnancies, status as high risk for VBAC in future
pregnancies
35
Fetal: accidental surgical cuts, being born late pre-term due to scheduled
cesarean (and the complications that come with this), respiratory
complications from cesarean without prior labor, childhood development
of asthma, sensitivity to allergens, or Type 1 diabetes
Maternal Attachment: increased separation between new parent and
baby
Cesarean Section Procedure
•
Epidural anesthesia is given - a continuous drip of medication is administered in the
lower back in a small area below the spinal cord, right outside the membranes
surrounding the spinal cord. (In rare situations in which there is not time to administer an
epidural, general anesthesia would be used).
•
Spinal anesthesia may be given. This is a one time dosage that is injected into the sac of
spinal fluid below the level of the spinal cord. It offers immediate pain relief that lasts
one to two hours.
•
Pregnant person’s breathing, heart rate, and blood pressure are monitored. An oxygen
mask may be placed over nose and mouth.
•
The birth support person puts on scrubs. One support person is allowed in the OR with
pregnant person.
•
Pregnant person is taken to the OR while birth support person waits in the labor and
delivery room until a nurse comes to get him.
•
Pregnant person is prepped for surgery - abdomen is washed with a Betadine solution, the
hair above the pubic bone is shaved, a catheter is placed in the bladder to keep it empty
during surgery, abdomen is swabbed with antiseptic, and sterile drapes are placed around
the abdomen.
•
The birth support person is brought to the OR to stand by pregnant person’s head. They
can stand up and peek over the sterile drapes if they’d like to see the baby born.
•
There are several people in the room including a nurse for pregnant person, a nurse for
baby, at least one or two nurses assisting the obstetrician, a midwife if she was providing
mom's care, an anesthesiologist, and a pediatrician. Students may also be present (you
can refuse this). The OR is cold.
•
A 4 to 6 inch incision is made through the skin and abdomen just above the pubic bone.
•
Abdominal muscles are spread and bladder may be pushed aside or taken out and placed
on the abdomen.
•
An incision is made in the low part of the uterine wall. This is called a low transverse
incision or a "bikini-cut." A classical incision, made vertically in the thicker part of the
uterus a bit higher up, may be made if the placenta is low lying. Other possible incisions
if a low transverse cut is not possible is a "T" or a "J." A large recent study of almost
36
18,000 women found that the rate of uterine rupture in VBACs with a uterus with a prior
low transverse incision is .4% (point 4 percent) vs. the rate of uterine rupture with a prior
classical incision being 2% (2 out of every 105). It is very difficult to find a care
provider who will support a VBAC with a classical incision.
•
Amniotic fluid surrounding the baby is suctioned out and the blood vessels on the edge of
the incision are cauterized. You may hear the suctioning and smell the cauterizing.
•
Pregnant person may feel nauseous due to the tugging sensation in the abdomen as the
baby is born. Pain will not be felt. The nurse will offer a basin to throw up in if she
needs to.
•
The baby is pulled from the uterus by neck and head first, the cord is cut, and baby is
brought over to the warming area for evaluation by a nurse and a pediatrician. Partner
can go with baby, talk to baby, and touch baby. Parent(s) voices are all that are familiar
to baby at that point - talk away!
•
The entire process from the abdominal incision to the birth of the baby is only about 5 to
10 minutes. The stitching up process is longer, about 20 to 45 minutes.
•
Pitocin is added to the postpartum person’s IV to encourage clamping down of the uterus.
•
The placenta is manually removed. You may keep your placenta if you wish.
•
The uterus may be removed from the body to repair it. The uterine incision is repaired
with either a single layer or double layer suture. Single layer suturing pulls together the
cut edges of the uterus and then smaller sutures are used to stop the bleeding and pull
together unopposed edges. Double layer suturing pulls together the cut edges and sutures
and then a second layer of suturing pulls the uncut tissue together on top of the first
layer. It is best to have a conversation with your doc ahead of time regarding single or
double layer suturing. Ina May Gaskin is a big proponent of double layer suturing; ICAN
(International Cesarean Awareness Network) is a proponent of single layer suturing.
Most OBs prefer one or the other; single layer suturing is typically done, particularly with
low transverse incisions. As the lower portion of the uterus thins during labor, it is more
difficult to pull together uncut tissue (and it takes longer). Research has shown that there
are fewer postpartum complications such as inflammation, infection, endometritis, and
hemorrhage with single layer suturing. One out of 11 studies found an increased rate of
uterine rupture in subsequent births with single layer closure (this is considered
inconclusive evidence). Three studies found no increase in placental problems in
subsequent pregnancies (previa, accreta) with single layer suturing. Ina May Gaskin, in
"Ina May's Guide to Childbirth," discusses the research behind suturing and uses a lot of
anecdotal evidence to support double layer suturing, particularly in reference to future
VBAC. ICAN's suturing info can be found here
http://ican-online.org/vbac/the-suture-debate
•
The bladder is then placed back inside if removed and the skin is closed with either more
dissolvable sutures or staples (staples need to be removed a few days later).
37
•
Postpartum person is wheeled into recovery where they will be with baby for at least an
hour (depending on their and baby's well-being). They will be monitored for a up to a
few hours before moving to a postpartum room.
Brittany Sharpe McCollum, CCE, CD, 2011, updated 2018
38
Postpartum Life
The postpartum period is an exciting and challenging time in your life. It is
normal to feel hormonal ups and downs during this transition. Traditional
midwifery includes the 3 months following the birth of a child as part of the
“​childbearing year.​” ​It is normal and healthy to experience emotional shifts
as your body, your mind, and your spirit adapt to new changes in lifestyle
and love (both for your baby, your partner, and the world). Allow yourself
time to be pampered in the postpartum just as you should be during
pregnancy. Surround yourself with supportive friends and family and spend
the day in bed with your baby whenever you can. Your body, your baby,
and your sanity will thank you!
80% of new mothers in the United States experience baby blues. Baby
blues show up in bouts of sudden tearfulness, mood swings, fatigue,
anxiety, irritability, insomnia, and exhaustion. The best way to beat the
blues is to relax, drink a cup of tea, go for a walk, get a massage from your
partner, take some deep breaths, and relax. Baby blues will go away on its
own and does not require treatment.
Postpartum depression is more serious. It affects up to 20% of new moms
in the United States and can occur 4 weeks up to one year after the birth of
a baby. Symptoms interfere with daily life; changes in weight and appetite,
extreme fatigue, depressive episodes, rage, forgetfulness, feelings of
incompetence, panic, sadness, poor concentration, social withdrawal,
crying spells, guilt, confusion, and lack of interest or concern for the baby
are all symptoms. Postpartum depression can affect partners as well; it is
important for both parents to be supported in the postpartum period.
Often the depressed parent is not in a state of paying attention to her/his
need for help at this point. It is up to the partner to be conscious of the
changes taking place and to help the partner seek treatment. Treatment
can include counseling, vitamin therapy, medicine, homeopathy, and herbs.
DO NOT BE ASHAMED TO ASK FOR HELP!
39
RESOURCES FOR EMOTIONAL POSTPARTUM SUPPORT
Postpartum Support International 1-800-944-4PPD
The Center for Postpartum Depression Dr. Barbara Lewin Germantown, PA
(some insurances accepted) 215-247-2114
The Pierce Women​’​s Mood Center Dr. Barbara Lewin Germantown, PA
(flexible fees) 215-248-6107 Catherine White, LCSW Germantown, PA
(sliding fee scale) 215-307-7915
Parent to Child Kathryn Snyder, ATR-BC, LPC South Philadelphia, PA
215-450-5271
Perri Shaw Borish, MSS, LSW Center City, Philadelphia, PA 215-840-3554
Post Partum Support Services Andrea Elovson
Mt. Airy, PA 215-242-4548
The Postpartum Stress Center Karen Kleiman, MSW Rosemont, PA
610-525-7527
Counseling Practice of Donna Monk Donna Monk, RN, MS, LMFT Warminster,
PA 215-343-3415
Tracey L. Dugan, SCSW Cherry Hill, NJ 856-797-6744
Dads Adventure ​www.dadsadventure.com
Postpartum Men ​www.postpartummen.com
40
Coping with Postpartum Changes
Encourage partner to be home and available as much as possible
Advise support people about importance of nurturing parents and baby
Ask for help from the baby​’​s older siblings
Limit outside responsibilities and engagements
Schedule time for the both partners
Set visiting hours and phone hours for friends and family
Take the help people offer
Have friends/family help with chores when visiting
Prepare meals in advance and freeze
Have drinks and snacks available
Create a breastfeeding nook with pillows, books, phone, snacks, and drinks
within reach
Have the numbers of local breastfeeding resources available
Let your partner know when you need help or support
Breathe
Walk
41
Wear your baby and move your body
Limit or eliminate time with people who are not supportive or positive
Get out with your baby
Seek out other new families
Attend breastfeeding and new parent support meetings
42
PHYSICAL POSTPARTUM CHANGES
While the uterus returns to its pre-pregnancy size, a vaginal discharge of mostly
blood and uterine lining is shed. This is called ​lochia​. It begins red then turns
brown, white, or yellow. It may take up to 8 weeks for the lining to shed.
increases in activity will increase the bleeding and is a sign to slow down.
Motherwort tincture can help tone the uterus to prevent excessive bleeding from
laxity of uterine blood vessels.
Continue with kegels and pelvic tilts the day after you give birth. These will help
strengthen the pelvic floor muscles ​that have been stretched by pregnancy. (It
is normal to feel like you have little control over your bladder in the first few days
after birth.) Keep the perineum clean and wipe from front to back always. Healing
can take 4 weeks or longer. Witch hazel applications, frozen arnica pads,
comfrey herbal sitz baths, warm water compresses, and raw honey provide relief.
After birth, the uterus is hard and round under the belly button. Within 6 weeks, it
returns to its pre-pregnancy size. ​Uterine contractions ​during the first
postpartum weeks can be uncomfortable or painful (more so with subsequent
births) and you may have to breathe through them as you did in labor. They are
felt more strongly while nursing as oxytocin helps your uterus return to its
pre-pregnancy size. Drink plenty of water and keep emptying your bladder.
Cope with hemorrhoids ​using witch hazel pads, black tea bags, homeopathy,
St. John​’​s Wart cream, and continuing kegels. Eat plenty of fiber and drink lots of
water.
Within 24 to 48 hours after birth, most people will have their first post-birth ​bowel
movement​. Postpartum people should not take over-the-counter laxatives or
stimulating herbal laxatives while nursing.
Increased sweating and urination ​are normal parts of eliminating the extra
body fluid that accumulated during pregnancy. This can last several months.
Many traditional cultures avoid all cold foods and ice in the postpartum period to
encourage fluid elimination. Ginger or cinnamon tea can help encourage fluid
elimination.
Vaginal dryness is nature​’s​ way of helping you to take care of your baby by
making it uncomfortable to have sex (and therefore become pregnant again!).
Use lubricant when making love​.
43
Sex can resume when your bleeding stops and both partners feel ready. ​Be
gentle to your body ​and give yourself time. Loss of interest in sex is normal at
this time due to all the changes taking place and decreased estrogen. Explore
other ways to be intimate and sexual.
Do not lift anything heavier than your baby while you are bleeding! Pelvic tilts,
kegels, and walks with your baby are enough exercise. ​Listen to your body​.
Beth Curtis, CPM, Believe in Birth; Brittany Sharpe McCollum, Blossoming Bellies,updated 2018
44
Healing from a Cesarean Section
The cesarean rate in the United States hovers currently
around 33%. The World Health Organization recommends
the cesarean rate be about 12%.
Healing from a cesarean section requires time, support,
patience, and encouragement from postpartum support
people and the person recovering. Do not hesitate to ask for
help when needed!
People experience varying levels of discomfort after a
cesarean. No matter how mom feels, rest is of the utmost
importance.
Pain in the abdomen, back, and shoulders is common due
to air trapped inside the body during surgery. The gas pains
will pass quickly on their own and are a very common part
of post-surgery recovery.
Soreness at the incision site can be expected to last for
several weeks. Many experience weeping from the scar; an
abscess at the incision site and/or opening and draining of
the incision site is not normal. A foul odor or yellowish
discharge may be a sign of infection. Call your care provider
if you have any concerns or experience excessive pain.
To prevent abscess or infection of the incision site, keep the
area clean and dry, and allow good air circulation and
sunlight to reach the belly for at least 20 minutes per day.
It is preferable to wait to take a bath until one week after
the cesarean section.
Rest is incredibly important when healing from major
surgery. Motion and flexibility is often impeded. Be extra
45
patient and gentle with yourself as you learn to hold,
comfort, and nurse your baby. Ask a nurse, doula, midwife,
or lactation consultant for assistance in finding comfortable
nursing positions.
From ​“​Natural Health After Birth: The Complete Guide to Postpartum
Wellness,​” ​Aviva Jill Romm
46
Breastfeeding Basics
Breastfeeding is an art. It often takes time and patience to ensure
comfort for both you and your baby. The effort is well worth it!!!
Benefits of the Breast
*Your body is working in the way it was intended *Colostrum
protects against infection, clears meconium, and helps prevent
jaundice
*Colostrum helps develop ideal gut flora *Antibodies pass from the
mother​’​s body to the child​’​s, improving the immune system​’​s
response to bacteria
*Release of oxytocin during breastfeeding helps uterus to return to
pre-pregnancy size quickly
*Breastfed babies very rarely get serious cases of jaundice
*Bonding between mother and baby is heightened through the
contact of breastfeeding
*The milk from cows (used in basic formula) is designed for a
mammal with 4 stomachs; soy formula or goat​’​s milk formula (for
those with allergies to cow​’​s milk formula) is pricey!
*Studies have shown that breastfed children tend to suffer less
often from obesity during childhood and later in life
*Breastfed babies have a lesser incidence of gastrointestinal and
respiratory infections
*Breastmilk adapts to the needs of your baby ​– ​for example, if your
child is born ​“​premature,​” ​your milk will contain higher levels of
protein and fat than milk of a term baby
*Breastmilk has antibacterial properties and can be used to treat
infections and irritations (pink eye, diaper rash, even earaches!)
*The milk produced by your breasts is the most complete food you
can give your child ​– ​it can sustain them until they are ready for
solid foods, anywhere from 6 months into the first year of life!
*According to studies, women who breastfeed have a lower
incidence of breast cancer than women who have formula fed (4.3%
less for every year nursing)
47
*The bonding that occurs between mother and child during
breastfeeding is so intense that mothers with adopted children can
still breastfeed!
*Once a child has weaned naturally from breastmilk, there is no
need for a substitute. Fill a cup with water and forgo the high sugar
of juice or the allergy-inducing compounds of cow​’​s milk!
*Breastfeeding is cheap! (cost of formula is $1160 - $3915/yr)
*Breastfeeding is no fuss, no muss ​– ​no bottles to wash or mixing
to do or heating up
*The temperature of breastmilk is that of the body ​– ​perfect for
your baby
*Breastmilk passes quickly through your baby​’​s digestive system,
allowing it to function at its peak *Convenience is key ​– ​your child​’​s
best source of nutrition requires no preparation
*Vary your diet ​– ​your baby gets different flavored breastmilk at
every feeding when you eat the colors of the rainbow! (maybe she
will even be a more adventurous eater later on!)
*Proper breastfeeding is painless and relaxing (the beauty of
oxytocin and prolactin!)
*300-500 extra calories are burned per day by your body​’​s creation
of breastmilk
*Breastfeeding reduces gas and colic in babies *Encourages proper
facial development and teeth alignment
*Breastfeeding is natural birth control ​– ​it is not foolproof but
nursing exclusively and on demand (day and night) is approx. 95%
effective in preventing pregnancy during the first 6 months
*Empowerment ​– ​the body​’​s ability to nurture the child is a source
of strength
*Breastfeeding is a common language of parenting ​– ​basic needs are
universal
*Your body has just worked so incredibly for 10 months to bring
your child into the world ​– ​allow the safety and assurance of the
womb to continue through that of the breast as your child
transitions into the world!
48
Preventing Sore Nipples
Throughout breastfeeding, it is completely normal to feel slight
tenderness at the initial latching on of your baby. However, if the
tenderness becomes painful and lasts throughout the feeding, there
are techniques that can be learned to change this.
*Proper positioning allows your baby to remain at breast level, with
his/her mouth covering the areola
*Complete latching on of the baby to the full areola creates proper
suction
*On-demand feeding (offering the breast frequently and at the
child​’​s first signs of hunger) prevents engorgement
*Allow child to empty breast at each feeding and offer second breast
*Keeping use of artificial nipples (bottles/pacifiers) to a minimum
prevents nipple confusion which can lead to changes in sucking
(causing nipple soreness) and breast refusal (causing engorgement)
Treating Sore Nipples
If sore nipples persist for more than 3 or 4 days, contact a lactation
consultant or breastfeeding counselor.
*Change nursing position to alter baby​’​s position on breast
*Begin nursing on least sore side and then switch when milk lets
down
*Express colostrum or milk onto breast after feeding and gently rub
onto nipples and pat dry (not when soreness is due to thrush)
*Gently pat lanolin onto dry nipples and allow to heal (organic and
pure brands are recommended); check label to ensure that nipple
does not need to be cleaned before feeding
*Go naked! Nipple soreness is often compounded by irritation of
bras or clothing. Free your breasts and let fresh air heal them!
For continued support, check out your local breastfeeding support
meetings and/or speak with a lactation consultant
Breast Infections
49
Occasionally the breast may become infected due to improper
positioning/latching on, nursing primarily from one breast, or
dehydration. Continue to nurse through the infection. (The infection
will not pass to your child.) Symptoms of infection include soreness
in one spot of the breast and flu-like symptoms such as fever and
chills and muscle aches. Do not worry!
At first sign of symptoms:
*Hydrate yourself! Drink water consistently and constantly
throughout the day and every 2 or 3 hours at night.
*Rest!
*Nurse on the sore breast first but remember to alternate breasts at
every feeding
*Nurse often (every hour is excellent!)
*Apply heat
*If symptoms persist beyond 12-24 hours (use your best judgment),
consider consulting with your lactation consultant or doctor
If you have repetitive breast infections, pay close attention to your
positioning and your babe​’​s latching on and your water intake ​–
nursing parents should have about 12 glasses of water a day.
Common Nursing Positions
Cradle hold: position babe on his/her side with whole body facing
yours, cradle baby​’​s head in crook of your arm on the side which you
will nurse, position baby​’​s body along your forearm with your hand
hugging his/her bum or thighs, ensure baby​’​s ear/shoulder/hip form
straight line
Cross Cradle Hold: position baby on side with his/her whole body
facing yours, cradle baby​’​s head in the hand of the arm that is
furthest from the breast at which he/she will nurse, position baby​’​s
body along your forearm with his/her bum or​ ​thighs in crook of your
arm, ensure baby​’​s ear/shoulder/hip form straight line
50
Football or Clutch Hold: sit on bed or sofa, position baby​’​s body at a
45 degree angle on the side of your body, support baby​’​s body with
your forearm with his/her head in your hands, baby​’​s head is under
your breast
Side-Lying: lie down on bed with baby at your side (chest level),
turn baby onto his side facing your body while you turn to face
his/her body
Latching On
Touch baby​’​s lower lip with breast
Open mouth like ​“​O​” ​to encourage baby to do same Move baby to
and from breast until mouth opens wide Bring baby to your breast
Move onto breast with chin first
Baby​’​s mouth should cover large portion of areola (dark area
surrounding nipple)
Baby​’​s nose may rest on top of breast with chin pressing into it
Do not press thumb down into breast as nipple will pull to front of
baby​’​s mouth
To reposition baby at breast, break suction by pushing down on
breast by baby​’​s mouth or inserting finger into corner of babe​’​s
mouth
Helpful Tips and Interesting Info
Colostrum is produced in small quantities before your milk comes in
and satisfies babe​’​s thirst and hunger
Bring baby to the breast - use pillows to support babe in cradle and
football holds
Support breast with thumb at top and hand underneath
Touch baby​’​s bottom lip with nipple to encourage rooting
Gently stroke under baby​’​s jaw if he is falling asleep early into
feeding
Nursing on-demand (starting and stopping when your babe desires)
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is the best way to promote healthy eating habits in your little one
and a happy breastfeeding relationship
Nurse at first breast until baby is finished then offer second breast
Baby should nurse 1-10 times every 2-3 hours (a minimum of 8-14
times per day); after milk comes in...at least 6 wet diapers and 3
bowel movements a day
Breastmilk changes throughout feeding ​– ​foremilk is watery to
satisfy thirst and hindmilk is creamy to satisfy hunger
Breastmilk digests quickly ​– ​it is normal for a breastfed baby to
wake frequently throughout the night
As milk supply is established, breasts will appear softer and less full
– ​they are still providing adequate nutrition; your supply has not
depleted!
Babies may nurse more often one day than another or more often
one week than another ​– ​this is normal and often occurs during
growth spurts
Things to Remember When Nursing
Drink plenty of water each day
Continue to eat healthy, whole foods ​– ​you may feel even more
hungry now than when you were pregnant and that is great!
For at least one feeding a day (more is even better!), think of the
concept of holistic nutrition and sit in a quiet space and drink in
your babe as they drink in you ​– ​time goes so fast and we all have a
tendency to let it slip by
Breastmilk works on supply and demand - frequent breastfeeding
creates more milk; resting the breasts does not increase milk
production
Common Misconceptions
Caffeine and breastmilk: Caffeine passes into breastmilk at .06 to
1.5% of maternal dose and peaks at 1 to 2 hours; studies show that
drinking 2-3 cups of coffee while pregnant and/or nursing is fine.
However, if intake is excessive symptoms in baby may include
irritability and crying. AAP states 5 or fewer 5 oz cups a day is okay.
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Alcohol and breastmilk: Alcohol peaks in breastmilk about 30 to 45
minutes after consumption. Maternal blood alcohol level is about
what the alcohol level in breastmilk is and the baby​’​s body then
continues to break the alcohol down.
Chocolate and Breastmilk: A person would have to consume over 16
ounces of chocolate for symptoms of irritability and increased bowel
activity to appear in her babe.
Baby​’​s Water Intake While Nursing: Breastmilk provides both
complete nutrition and hydration when it is the exclusive food of a
babe. Therefore, water, even in hot summer months, is not
necessary when a little one is purely nursing. When solids are
introduced, you may then want to introduce sips of water as well. If
a child is eating solids consistently (even if still nursing), offer water
periodically throughout the day.
Teeth and Nursing: Nursing does not have to and should not end
when your baby gets teeth. If latched on correctly, your little one
cannot bite and nurse at the same time. Biting usually occurs at the
beginning and/or end of a feeding and can be prevented by paying
attention and breaking suction.
Breastmilk and Illness: Nursing can and should be continued if
parent or child is ill (but always check how medications interact with
breastfeeding). It provides nutrition, comfort, and antibodies to your
baby.
Spicy foods and Cruciferous Veggies: If your baby is colicky after
nursing, in rare cases, altering your diet to exclude common
allergens such as dairy, wheat, and soy can change that. However,
many babes may just need a burp! Spicy foods and superveggies are
excellent for you and your milk! Breastfed babies have less colic, less
gas, and do not get constipated as formula-fed babes do. Burping
and rocking baby after eating can help with any discomfort that may
come from gas.
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Pumping and Nursing: It is completely normal to pump only a small
amount of milk. The sensation and the hormonal let- down are far
different than nursing; what you see in the bottle is not indicative of
your milk supply.
Drugs/Medicines and Breastmilk: Many drugs are safe to take while
breastfeeding because they pass negligently into your breastmilk.
Consult a breastfeeding counselor if you are prescribed something.
Thomas Hale​’​s books ​“​Drugs Approved by AAP,​” “​Drugs with
Findings,​” ​and ​“​Medication and Mother​’​s Milk​” ​can also be consulted
along with the AAP website.
Cannabis: ​“​contraindicated by AAP, small to moderate amounts
secreted in breastmilk, studies in animals suggest marijuana inhibits
prolactin and could inhibit lactation, infants exposed to marijuana in
breastmilk will test positive on urine screens for 2-3 weeks, in one
study of women who smoked marijuana during breastfeeding, no
differences were found in growth, mental or motor development.​”
(Drug/Medicine information taken from Medications and Mother​’​s
Milk, Thomas Hale, 8th Edition, 1999)
Formula in Hospital: Hospital staff may tell you that your baby is
hungry because your milk has not come in yet and then offer
formula. This would be a good time to talk to a lactation consultant
as formula can interfere with breastfeeding.
A newborn​’​s stomach is the size of a marble, intended to hold less
than a quarter of an ounce of milk. Your baby​’​s stomach grows to
the size of his/her fist during the first 3 days of life, as meconium
leaves the intestines.
Breastmilk comes in between days 3 and 6, coinciding with this
stomach growth spurt. Your baby is born equipped with extra fluid
and fat stores to enable the transition from colostrum to milk.
Breastfeeding is an amazing and intimate experience. The
nourishment provided by the mother​’​s body is the most complete
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nutrition a baby can receive. The benefits reaped from the bonding
that occurs continue to grow with time.
Local Support Resources
Nursing Mother​’​s Alliance
breastfeeding support through local meetings and counselor-staffed
warmline ​www.nursingmothersalliance.org
warmline #: 610-251-9405
Nursing Mothers Network breastfeeding support warmline
www.nursingmothersnetwork.org​ warmline #: 610-626-0220
Nursing Mothers Advisory Council local monthly meetings
www.nursingmoms.net
La Leche League International
breastfeeding support through information, local meetings,
experienced mother-to-mother help
www.lalecheleague.org
1-800-LALECHE
Lactation Consultants
(contact your local hospital, birth center, or midwife for referrals)
Childbirth Educators/Birth Doulas/Postpartum Doulas knowledgeable
resources for information regarding breastfeeding difficulties,
benefits of breastfeeding, helpful tips, and encouragement
The Nursing Mother​’​s Companion by Kathleen Huggins, RN, MS
The Womanly Art of Breastfeeding by La Leche League International
Nursing Mother, Working Mother by Gale Pryor
Brittany Sharpe McCollum, Blossoming Bellies, updated 2018
Information gathered from: La Leche League International, Dr. Thomas Hale, Birth Works
International, ALACE
55
EXPRESSING AND STORING
BREASTMILK
Wait until baby is 3 weeks to begin pumping and 4 to 6 weeks old to introduce
bottle as milk supply and nursing routine will be more well-established
Wait until parent returns to work to give bottle OR
Have partner or care provider give bottle once a day to acquaint baby with it;
babies often associate smell of breastfeeding parent with the breast and will not
take a bottle from them
Wait as long as possible to begin regular separations to build up milk supply and
confidence in nursing routine
Begin building frozen milk supply 3 to 4 weeks before beginning regular
separations
Pump about 15 to 30 minutes after a nursing, usually after the first feeding
Pumping should not be painful
Begin work on Thursday or Friday so as to ease into regular separations
Wash pump supplies after each pumping session and before the next
If planning to freeze milk, try a test batch ​– ​freeze and then thaw after a week to
ensure it is fine, if it smells rancid, it may need to be scalded before freezing
**Stimulating your Let-Down is Key to Successful Pumping**
express milk in a familiar and comfortable setting
minimize distractions
use a pre-expression ritual ​– ​apply heat to the breasts, massage, nipple stimulation,
relaxation, phone home to check on baby
mimic baby​’​s rhythm at breast
focus on baby ​– ​use a photo, tape recording, feel/smell baby​’​s clothing massage
breasts while pumping/interrupt pumping to do so
**Storing and Handling Breastmilk**
wash hands before expressing
wash containers in hot, soapy water and rinse well
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label expressed milk with month, date, year
Mature Milk Temperature Storage
*up to 77 degrees ​– ​8-10 hours
*5 to 39 degrees in insulated cooler bag ​– ​24 hours
*at 32-39 degrees in a refrigerator ​– ​5 days
In a Freezer:
*in self-contained freezer unit of frig ​– ​3 or 4 months (dependent upon frequent
opening of door)
*in separate deep freeze at constant 0 degrees ​– ​6 months or longer
***If milk smells sour, regardless of storage time/temp, do not feed it to your
baby**
** Storing Refrigerated Milk in Same Container**
freshly pumped milk can be stored in the same bottle as refrigerated milk (within a
24 hour period)**
Storing​ ​Frozen Milk**
fresh milk should ideally not be added to frozen milk
**Thawing Milk**
submerge bag of frozen milk in pot of hot tap water (never thaw milk over water
that is over flame)
hold container of milk under cool running water, gradually adding warmer water
until milk thawed and heated to room temp milk from different containers can be
added together for one feeding
shake bottle and test that it is room temperature before giving to baby
previously frozen milk that is thawed can be kept in refrigerator up to 24 hours
**Helpful Hints**
freeze milk in 2 ​– ​4 ounces so as not to waste milk and so it can heat quickly
babies exclusively taking in breastmilk may need fewer ounces per day than babies
receiving both formula and human milk or just formula (Butte 1984)
never refreeze milk that has been thawed
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never heat breastmilk in a microwave as it destroys valuable components of
breastmilk and can cause ​“​hot spots​” ​in the milk
**Choosing a Breast Pump**
Automatic double pumps are fast, easy, and economical (especially if working
outside the home full time)
For intermittent outings (such as a dinner out without the baby) a hand pump or
small motorized single pump may be best
Double pumping takes about 10 minutes
Ameda, Medela, Spectra and Hygeia brand pumps are ideal
**When to Pump If Away From Baby**
If at least 8 hours away daily, express about every 3 hours
If away 4 to 6 hours, express at least once, 2 to 3 hours after last nursing
If away less than 4 hours at a time, possibly nurse before leaving and upon arriving
to baby
Delaying pumping or nursing more than 4 hours may lead to mastitis
As baby grows and begins solid foods, mother may need to pump less
Brittany Sharpe McCollum, Blossoming Bellies, 2007, updated 2018
58
Nutrition During Breastfeeding
Helpful Tips
Eat as often as you are hungry
Drink plenty of fluids so that your urine is a light straw color
If nursing preemies, twins or triplets, or a newborn and
toddler, be sure to eat often as you need even more calories
than a mom nursing one child
Keep weight loss at no more than one pound per week (after
the first month)
Continue to eat protein, vitamins, and minerals as you did
while pregnant
Continue taking any prenatal vitamins you were taking while
pregnant if your diet is lacking in certain areas
Vegans can supplement with B12
Eat garlic (studies have shown that babies whose mothers
take garlic capsules eat more breastmilk than those who did
not consume garlic)
Allow yourself a serving or two of caffeine per day if you
desire (less than 1% of caffeine ends up in breastmilk)
Eat organic dark chocolate
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Allow yourself an occasional wine or beer
Be aware that babies may be allergic to cow​’​s milk, eggs,
fish, shellfish, and nuts (particularly if there is a strong
family history of allergy); if baby develops symptoms of an
allergy, eliminate the suspected food from your diet and see
if it makes a difference
Herbs For Nursing
Nettle increases the abundance and richness of breastmilk
(tea)
Red raspberry leaf can assist in milk production for many
women and strengthens the uterus (tea)
Fenugreek increases the abundance of breastmilk (tea or
capsules)
Chamomile (tea), passionflower (tincture or tea), and
skullcap (tincture) can soothe stress away and reduce tension
Brittany Sharpe McCollum, Blossoming Bellies, 2008, updated 2018
60
Ten Reasons to Sleep Next to Your Child
Ease of breastfeeding Injury prevention SIDS prevention
Nighttime danger prevention Suffocation prevention Emotional
bonding
Helps prevent child abuse
Reduced stress of baby, mother, and other family members
Development of love and trust Cardiovascular health benefits
1. ​Family co-sleeping takes full advantage of the ease of breastfeeding, as there
is no need to go to another room to get one's child. A breastfeeding mother in a
"family bed" can easily feed her child without having to wake fully, and can
continue to get the important rest she needs. Thus co-sleeping encourages
mothers to continue breastfeeding and all of its numerous benefits until the child
chooses to wean.
2. According to sleep researcher James McKenna, co-sleeping increases the
chances that a parent can successfully intervene to help prevent a death,
whether that is due to a physiological condition or to a physical accident. He
reminds parents that "co-sleeping gives the parent the best opportunity to hear
the baby in crisis and to respond." He adds that "since protection from SIDS may
be related to the frequency and duration of breastfeeding, and because babies
breastfeed more when co-sleeping, this practice may help to protect some
breastfeeding infants."​1
3. ​Gaps in breathing are normal during the early months of infancy, and it is likely
that the mother's breathing provides important cues to her infant, reminding him
to take a breath following exhalation, preventing a SIDS situation from
developing. Even if this reminder system fails, the mother is nearby to help by
arousing the infant. A breastfeeding mother and baby tend to have coordinated
sleeping and dreaming cycles, making her keenly sensitive to her baby. If she is
sleeping close by, she will awaken if there her baby is having difficulty. But if the
baby is alone, this type of life-saving intervention cannot take place.
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4. ​Any nighttime danger to a child is reduced if there is an adult close by. Babies
and children have perished in fires, have been sexually abused by visiting
relatives, have been abducted from their bed, have been attacked by pets, have
suffocated after vomiting, and have died or been injured in various ways that
could have been prevented had a parent been nearby to help.
5. ​Suffocation is often listed as a danger of family co-sleeping. However, this is a
real danger in only two situations: a young infant sleeping on a water-bed, thus
unable to push himself up when needed, or a parent who is too intoxicated by
alcohol or drugs to attend to a child's needs. Obviously, a child who is suffocating
for any reason (such as a ribbon on sleepwear getting around her neck, vomiting
during sleep, asthmatic attacks) is far more likely to rouse a parent who is
sleeping nearby than one sleeping in a different room.
6. ​Family co-sleeping is often misunderstood as facilitating sexual abuse of
children by a parent. However, the opposite is true. Parents who develop deep
emotional bonds with their children by remaining close by and responsive at
night, as well as during the day, are far less likely to turn to abusive behavior of
any kind toward the children they love and cherish. Conversely, the fact that a
child sleeps alone has never been adequate protection against a parent who
intends sexual trespass, and may even make it easier for one parent to keep
such activity secret from the other.
7. ​Shared sleep can further prevent child abuse by helping all family members to
obtain the rest they need, especially if the child is breastfeeding. The child does
not have to suffer needlessly or cry to bring his mother, and the mother can
nurse half-asleep. The entire family
awakes refreshed, with no lingering resentment toward the baby for having
disturbed their sleep the night before. An exhausted parent is far more likely to
abuse a child than a well-rested mother or father who has enjoyed the presence
of a happily resting child through the night.
8. ​Crying is a signal provided by nature that is meant to disturb the parents to
ensure that the baby receives the care he needs. But prolonged crying is
stressful to all the family members. The sooner the baby's needs are met, the
more rest the baby and the entire family can have, and the more energy they will
62
have for the next day. A mother sleeping next to her baby can utilize the
instinctive response a new mother has to her baby's first whimper, thus
preventing the need for the hard crying that is so stressful to the baby and to all
other members of the family.
9. ​A deeper sense of love and trust often develops between siblings who sleep
near each other, lessening sibling rivalry during waking hours. Siblings who
share the night as well as the day have a greater opportunity to build a deep and
lasting relationship. Babies and children who are separated from other family
members during the day (parents at work, siblings at school) can partially make
up for these absences and reestablish important emotional bonds by spending
time at night together, and by the delightful early morning family time that is
otherwise often missed. Of course, home businesses and unschooling can
minimize separations and deepen family bonds during the day, just as
co-sleeping does at night.
10. ​Studies of adults in coma have shown that the presence of another person in
the room significantly improves heart rate, heart rhythm, and blood pressure. It
seems reasonable to assume that infants and children derive similar health
benefits to having others in the same room with them.
A child who is cared for during the night as well as the day receives constant
reassurance of love and support, instead of having to cope with feelings of fear,
anger, and abandonment night after night. Children who have felt safe through
the night as well as the day with a loving parent close by become adults who
cope better with the inevitable stresses life brings. As John Holt put it so
eloquently, having feelings of love and safety in early life, far from "spoiling" a
child, is like "money in the bank": a fund of trust, self-esteem and inner security
which the child can draw on throughout life's challenges.
1​
James McKenna, Ph.D., Personal communication, June 2000.
Jan Hunt, ​www.naturalchild.com
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CO-SLEEPING SAFELY
Responsible co-sleeping is the safest sleep for a child.
Co-sleeping has been the normal mammalian sleeping
arrangement for millions of years and is the norm in cultures
with the lowest SIDS rates worldwide. Common sense
should be heeded and certain precautions should be taken to
ensure that your baby​’​s needs will be met.
A FEW THINGS TO REMEMBER
**do not share sleep on a sofa, armchair, beanbag
chair, or waterbed**
**keep baby smoke-free, including during
pregnancy**
** ensure there are no entrapment hazards or gaps
greater than one inch in sleep environment**
*keep baby at comfortable temperature in terms of
clothing, bedding, and environment**
64
**do not leave baby in adult bed alone**
**do not allow other children to sleep next to a baby
under one year of age**
**do not allow a child under one year of age to sleep
next to a bedrail**
**put baby to sleep in the safer back-lying (supine)
position**
Breastfeeding and bedsharing can be safely
combined when attention to the above has been
given
Non-breastfeeding babies are probably safer when
sleeping on a separate surface: crib, bassinet,
bedside co-sleeper
Sarah J. Buckley and James J. McKenna, ​Mothering​, No. 153 March-April 2009
65
Healthy Living Resources
Books
The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger
Rediscovering Birth by Sheila Kitzinger
Ina May’s Guide to Childbirth by Ina May Gaskin
Black, Pregnant, and Loving It: The Comprehensive Pregnancy Guide for Today’s Woman of
Color by Yvette Allen-Campbell
Spiritual Midwifery by Ina May Gaskin
The Thinking Woman’s Guide to A Better Birth by Henci Goer
The Birth Partner by Penny Simkin
Natural Health After Birth by Aviva Jill Romm
The Nursing Woman’s Companion by Kathleen Huggins
The Womanly Art of Breastfeeding by La Leche league International
Natural Baby and Childcare by Lauren Feder, M.D.
Movies
The Business of Being Born Orgasmic Birth
Pregnant in America
Birth into Being
Birth As We Know It
A Natural Delivery of Vertex Twins
Birth Centers
The Birth Center Bryn Mawr, PA 19010 610-525-6086
http://www.thebirthcenter.org
The Birth Center: Holistic Women​’​s Health Care Wilmington, DE 302-658-BABY
(2229) ​info@thebirthcenter.com​ ​http://www.thebirthcenter.com
66
Valley Birthplace and Woman Care Huntingdon Valley Barbara d​’​Amato, CNM
215-947-5545 ​midwives@valleybirthplace.com
http://www.valleybirthplace.com
Midwives
Rising Moon Midwifery
Kate Aseron, CPM 610-469-4905
hmebrth@aol.com​ ​http://www.risingmoonmidwifery.com
WomanWise Homebirth and Women​’​s Health Karen Webster
443-553-3370 ​Karen@womanwise.info
http://www.womanwise.info
Midwifery Traditions
Kathy Hindle, CNM and Janet Lewis, CNM Home and Hospital Births 215-249-9646
homemidwife@juno.com
Birthwise Midwifery Care Judy Politzer, CNM 215-878-7870
birthwise_midwifery@yahoo.com
WomanWise Midwifery Ronni H. Rothman Hospital Births 215-327-1547
rrmidwife@verizon.net​ ​www.womanwisemidwifery.com
Valerie Monterrey
Dove Charity Home Birth Services
Scranton, PA to Binghamton, NY. and I-81 to Tioga County, PA speaks spanish and does
hospital translations (h)570-744-1560
(c) 610-413-3099 ​vmonterrey@yahoo.com
Dhyana Heller, CPM Tannersville, PA 570-420-1226
Obstetricians
Women​’​s Medical Specialties Abigail Wolf, MD Philadelphia 215-955-5000
Abigail.wolf@jefferson.edu
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Birth Doulas
Blossoming Bellies Wholistic Birth Services Brittany Sharpe McCollum, CCE
267-261-0284
britt@blossomingbelliesbirth.com​ ​http://www.blossomingbelliesbirth.com
Marcella DeRosa
bornwithlovedoula@gmail.com
Debbie Mangel
debbiethedoula@gmail.com
Birth Arts International ​http://www.birtharts.com
DONA International ​http://www.dona.org
Postpartum Doulas
Birth Arts International ​http://www.birtharts.com
DONA International ​http://www.dona.org
Childbirth Education
Blossoming Bellies Wholistic Birth Services Brittany Sharpe McCollum, CCE
Philadelphia
267-261-0284
britt@blossomingbelliesbirth.com​ ​http://www.blossomingbelliesbirth.com
Jillian Schlacter Souderton 267-640-3545
toobeets@aol.com​ ​www.bellybirthandbeyond.net
The Bradley Method of Natural Childbirth ​www.bradleybirth.com
Lamaze International ​www.lamaze.org
Birthing From Within ​www.birthingfromwithin.com
Prenatal Breastfeeding Classes
68
Blossoming Bellies Wholistic Birth Services Brittany Sharpe McCollum, CCE Certified
Breastfeeding Counselor Philadelphia
267-261-0284 ​britt@blossomingbelliesbirth.com
http://www.blossomingbelliesbirth.com
Breastfeeding Support
Blossoming Bellies Wholistic Birth Services Brittany Sharpe McCollum, CCE Certified
Breastfeeding Counselor Philadelphia
267-261-0284 ​britt@blossomingbelliesbirth.com
http://www.blossomingbelliesbirth.com
NewBorn Concepts
Robin B. Frees, BA, CHT, HBCE, IBCLC Malvern
610-644-1379
Free Breastfeeding Support Groups and Warmline Services
Nursing Mother​’​s Alliance ​http://www.nursingmothersalliance.org​ warmline:
610-251-9405
Nursing Mothers Network ​http://www.nursingmothersnetwork.org​ warmline:
610-626-0220
Nursing Mothers Advisory Council ​http://www.nursingmoms.net​ local monthly meetings
Nursing Mother​’​s, Inc. ​http://www.nursingmoms.org​ 1-866-733-4NMI
La Leche League International ​http://www.llli.org
local monthly meetings
Breastfeeding Resources
Maternity Care Coalition Breastfeeding Site 215-972-0700
www.momobile.org/breastfeeding
WIC Breastfeeding Program 1-800-743-3300
www.northwic.org//resources/breastfeeding.htm
Breastfeeding Resource Center
appointments with Board Certified Lactation Consultants, sliding scale fee, open lactation
69
consulting hours 215-886-2433
www.breastfeedingresourcecenter.org
South Jersey Breastfeeding ​www.sjbreastfeeding.com
212 Haddon Ave. Haddon Township NJ 08108
Breastfeeding Pump and Equipment Suppliers
MOMS: Making Our Milk Safe ​www.safemilk.org
Nursing Mother Supplies Devon 1-800-943-2581
jen@nursingmothersupplies.com​ ​http://www.nursingmothersupplies.com
Solutions for Women: A Women​’s​ Health Boutique Philadelphia
215-829-5046
http://www.pennhealth.com/solutions
Maternity/Nursing Clothes
The Nesting House
606 Carpenter Lane Mt. Airy
710 Haddon Ave. Collingswood NJ
​www.thenestinghouse.net
Solutions for Women: A Women​’s​ Health Boutique 721 Delancey St.
Philadelphia
215-829-5046
http://www.pennhealth.com/solutions
Cloth
1605 E. Passyunk Ave. South Philly ​www.shopatcloth.com
Placenta Services
Tiff Hare ​karmabirthservices@gmail.com
Cloth Diapering
Cloth
1605 E. Passyunk Ave. South Philly ​www.shopatcloth.com
70
The Nesting House 606 Carpenter Lane Mt. Airy and 710 Haddon Ave. Collingswood,
NJ ​www.thenestinghouse.net
Infant Massage Services
Gwyn MacDonald Prenatal and Infant Massage ​gwynedm@gmail.com
Prenatal Yoga Center
Free infant massage video online ​www.prenatalyogacenter.com
Postpartum Exercise Classes
Yoga Child Philadelphia 215-238-0989 ​info@yogachild.net
http://www.yogachild.net
Wake Up Yoga South Philly, Fairmount ​www.wakeupyoga.com
Playgroups
Columbus Square Playground and Rec Center
12th and Reed Sts.
Philadelphia
Open Playgroup: Every Tuesday and Thursday 2:30-4:30
Capitolo Playground
1000 Federal St. Philadelphia
Open Playgroup: Every Thursday 3-5
Libraries
Philadelphia County Library Website ​www.freelibrary.org
Montgomery County Library Website ​www.mclinc.org
Delaware County Library Website ​www.delcolibraries.org
Bucks County Library Website ​www.buckslib.org
Camden County Library Website ​www.camden.lib.nj.us
Burlington County Library Website
71
www.bcls.lib.nj.us
Gloucester County Library Website ​www.gloucester.lib.nj.us
Mercer County Library Website ​www.mcl.org
PHILADELPHIA LIBRARIES Central Library
1901 Vine St. Philadelphia 215-686-5322
Charles Santore Branch 932 South 7th St. South Philadelphia 215-686-1766 Chestnut
Hill Branch 8711 Germantown Ave. Chestnut Hill 215-248-0977
Falls of Schuylkill Branch 3501 Midvale Ave. East Falls 215-685-2093
Fishtown Community Branch 1217 East Montgomery Avenue Fishtown/New Kensington
215-685-9990
Fumo Family Branch 2437 South Broad St. South Philadelphia 215-685-1758
South Philadelphia Branch 1700 South Broad St. South Philadelphia 215-685-1866
Storytimes
Charles Santore Library
932 South 7th St. (7th and Carpenter Sts.) Philadelphia
Storytime: Every Tuesday 10:30
South Philadelphia Library
1700 South Broad St. (Broad and Morris Sts.) Philadelphia
Storytime: First Thursday of each month 10:30
The Philadelphia City Institute 1905 Locust St.
Storytime: Every Friday 10:15 to 10:45
Family Doctors/Pediatricians
Total Access Medical Daphne Goldberg, MD Philadelphia 610-664-1141
dgoldberg@totalaccessmedical.com​ ​http://www.daphnegoldberg.com
Partners in Wellness Dr. Joseph Price Mt. Airy 215-248-4236
jpholistic@att.net​ ​http://www.partnersinwellness.us
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Fairmount Pediatrics and Adolescent Medicine Alexis Lieberman, MD
2000 Hamilton St. 1​st ​Floor Philadelphia, PA 19130 215-774-1166
www.fairmountpediatrics.com
Wellspring Homeopathic Care Linda Baker, MD, CCH Plymouth Meeting 610-567-3520
Homeopathy1@yahoo.com​ ​http://www.wellspringhomeopathiccare.com
Online Resources
Spinning Babies
Easier childbirth with fetal positioning ​http://www.spinningbabies.com
Childbirth Connection
Resource aid for making informed maternity care decisions
www.childbirthconnection.org
Mothering Magazine
Online forums, articles, book reviews, recipes, news
http://www.mothering.com
Breastfeeding.com ​http://www.breastfeeding.com
C-Section Recovery
Online forums, information, and more ​http://www.csectionrecovery.com
Organic Consumers Association ​http://www.organicconsumers.org
The Children's Advocacy Project of Philadelphia resources, handouts, laws, links
www.cap4kids.org/philadelphia
Chiropractors, Massage Therapists, Accupuncturists, Reiki Practitioners,
Craniosacral Therapy
Ohm Family Chiropractic
Drs. Thomas, Justin, and Jeanne Ohm Media and Philadelphia 610-565-8823
ohmchiropractic@comcast.net​ ​http://www.ohmchiropractic.com
Karen Gardner, Newtown and Huntingdon Valley
www.pregnancychiropractic.com
dr.karen@pregchiro.com
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Mat Wolfson, Wolfson Wellness Family Chiropractic
www.centercitychiropractor.com
Rhino Chiropractic Center Dr. Damien Ciasullo Philadelphia 215-844-4400
rhinochiropractic@hotmail.com​ ​http://www.rhinochirocenter.com
Prenatal Massage and Bodywork Carrie Sarlo 856-534-6356 ​carriesarlo@yahoo.com
Prenatal and Infant Massage Gwyn MacDonald ​gwynedm@gmail.com
Queen Village Holistic Health Acupuncture
Lauren Buckley, L.Ac. 215-279-3932 ​laurenbuckley@yahoo.com
http://www.laurenbuckleyaccupuncture.com
Still Waters Holistic Health Therapies Acupuncturist: Marnie Boccella, L.Ac., L.S.W.
Massage Therapist: Dan Johnson, NCTM 2428 Brown St.
Philadelphia, PA 19130 215-769-1496 ​info@stillwaterstherapies.com
www.stillwaterstherapies.com
The Reiki School and Clinic Kimberly Fleisher Philadelphia 215-238-0659
kim@thereikischool.com
http://www.thereikischool.com
Two Rivers Naturopathy
Marie Winters, MD Naturopathic Medicine, Craniosacral Therapy 215-313-4114
marie.winters@gmail.com​ ​http://www.tworiversnaturopathy.com
Naturopathic Services/Homeopathic Services/Herbal Services
Two Rivers Naturopathy Marie Winters, MD 215-313-4114 ​marie.winters@gmail.com
http://www.tworiversnaturopathy.com
Wellspring Homeopathic Care
Linda Baker, MD, CCH Plymouth Meeting 610-567-3520 ​Homeopathy1@yahoo.com
http://www.wellspringhomeopathiccare.com
Mountain Rose Herbs 1-800-879-3337 ​customerservice@mountainroseherbs.com
www.mountainroseherbs.com
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Postpartum Depression Resources
Postpartum Support International 1-800-944-4PPD
The Center for Postpartum Depression Dr. Barbara Lewin Germantown, PA
(some insurances accepted) 215-247-2114
The Pierce Women​’​s Mood Center Dr. Barbara Lewin Germantown, PA (flexible fees)
215-248-6107
Catherine White, LCSW Germantown, PA (sliding fee scale) 215-307-7915
Parent to Child Kathryn Snyder, ATR-BC, LPC South Philadelphia, PA 215-450-5271
Perri Shaw Borish, MSS, LSW Center City, Philadelphia, PA 215-840-3554
Post Partum Support Services Andrea Elovson
Mt. Airy, PA 215-242-4548
The Postpartum Stress Center Karen Kleiman, MSW Rosemont, PA 610-525-7527
Counseling Practice of Donna Monk Donna Monk, RN, MS, LMFT Warminster, PA
215-343-3415
Tracey L. Dugan, SCSW Cherry Hill, NJ 856-797-6744
VBAC/Cesarean Awareness Support Groups
International Cesarean Awareness Network ICAN of Philadelphia
Matilda Simmel
mattiethecat@gmail.com​ 267-303-7014 ​http://www.ican-online.org
Cesarean Healing Circles Maria Brooks, LCCE, CD(DONA) 646-247-8841
maria@birthmuse.org​ ​http://www.birthmuse.org
New Mothers/Fathers/Parents Groups
Parent to Child Kathryn Snyder, ATR-BC, LPC Philadelphia 215-450-5271
kathrynsnyder@comcast.net​ ​http://www.parent2child.net
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Mommy Chat
Jeanine O​’​Rourke, LCSW 215-206-2931 ​http://www.therapyforwomen.net
The Mothers​’ ​Room Laura Favin, LCSW, LMT Doylestown 917-209-6534
themothersroom@aol.com
Dads & Daughters
Joe Kelly 651-314-4508 ​joe@thedadman.com​ ​http://www.dadsanddaughters.org
Focus on Fathers
260 South Broad St. 215-985-6252 ​www.phmc.org/rch/ff.html
Parenting Classes
Parent to Child Kathryn Snyder, ATR-BC, LPC
Philadelphia 215-450-5271 ​kathrynsnyder@comcast.net​ ​http://www.parent2child.net
The Nesting House Mt. Airy 215-713-2666 ​www.thenestinghouse.net
LGBT Parenting Support Groups
Philadelphia Family Pride
family-centered social events, support groups, workshops, information 215-844-3360
www.phillyfamilypride.org
Multi-cultural Resources
Intercultural Family Services, Inc.
serves children and families from around the world 4225 Chestnut St.
215-386-1298
www.ifsinc.org
Welcoming Center for New Pennsylvanians
serves immigrants and refugees with employment assistance, social service information,
and more 1617 JFK Blvd. 13th Floor
215-557-2626
www.welcomingcenter.org
Hispanos Unidos Para Ninos Excepcionales 220 N. 2nd St
215-425-6203
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Education Law Center
promoting fairness and quality education in public school system 1315 Walnut Street, 4th
Floor
215-238-6970
www.elc-pa.org
Council of Spanish Speaking Organizations Spanish/Bilingual services including summer
camps and parenting skills 705 N. Franklin St.
215-627-3100
http://elconcilio.net
Association de Puertorrigquenos en Marcha health and social services
4301 Rising Sun Ave. 267-296-7200
http://apmphila.org
Lutheran Settlement House
bilingual domestic violence program, housing, workshops 215-426-8610
www.lutheransettlement.org
Latina Domestic Violence Program 215-763-8870 ​www.congreso.net
Southeast Asian Mutual Assistance Associations Coalition advocacy programs for
Southeast Asian community 215-476-9640
www.seamaac.org
Greater Philadelphia Asian Social Service Center 4942 N. 5th St.
215-456-1662
Einstein Support Groups for Southeast Asians Einstein Hospital 215-456-6008
Korean Women's Support Group 215-869-5703
Cambodian Association of Greater Philadelphia
help in obtaining healthcare, education, social/economic development 5412 N. 5th St.
215-324-4070
Southeastern Women Against Abuse
for women from Pakistan, India, Nepal, Sri Lanka 215-627-3922
Haitian Community Help Center
serves Haitian, Caribbean, African French Speaking immigrants 1263 E. Chelten Ave.
Germantown
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215-224-4971
www.haitianchc.org
African Cultural Alliance of North America 5521 Chester Ave. 215-729-8225
Korean Women's Support Committee 24 hour hotline 215-869-5703
Polish American Social Services 215-923-1900 ​www.polishamericancenter.org
Best Behavioral Health
outpatient psychiatric and community services to ethnically and/or culturally diverse
families 5043 Frankford Ave.
215-744-4343
www.bbhinc.org
Teen Parent Support Groups/Educational Services
Therapy for Women Jeanine O'Rourke 215-206-2931 ​www.therapyforwomen.net
Children's Aid Society of PA - Time Out for Teens and Tots
free 20 week parenting education program for teen parents 15-19 years old caring for
children 3 and under 1315 Walnut Street
215-546-2990
www.caspa.org
Elect/Teen Parent Centers (Cradle to Classroom)
assists pregnant and parenting students complete high school education 267-386-4600
www.cisphl.org
Education Communities for Parenting
free workshops for parents including teen mothers and fathers 215-496-9780
www.ecparenting.org
Project Peace
teen-mother education and life skills program for ages 13-21 years 324 Richmond St.
215-462-5998
www.pathwayspa.org
The Lighthouse
seeks to empower mothers 13-21 years with skills to compete in workforce 152 West
Lehigh Ave.
215-425-7800 x309
www.lighthousephilly.org
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Safe Haven
mother not ready to keep unharmend baby under 28 days, can take baby to any PA
hospital without getting in trouble
1-866-921-SAFE
www.secretsafe.org
**FOR BREASTFEEDING RESOURCES, PLEASE SEE BREASTFEEDING
SECTION**
Parent's Anonymous/Support Groups
Parent Action Network
prevention program with free support groups for parents, teens, and children
215-PARENTS
www.phila.gov
Focus on Fathers
260 South Broad St. 215-985-6252 ​www.phmc.org/rch/ff.html
Safe Haven
mother not ready to keep unharmend baby under 28 days, can take baby to any PA
hospital without getting in trouble
1-866-921-SAFE
www.secretsafe.org
Perinatal Loss Support Groups/Bereaved Families Support Groups
Office of Crisis Counseling and Bereavement Support counseling for loss of an infant,
child, or late in pregnancy offered by Dept. of Public Health 215-685-7448
Daddy's Spirit
support for children who have lost their fathers 610-710-1477 ​www.daddysspirit.org
Grief Assistance Program, Inc. support for early in the bereavement process 321
University Ave. 215-685-7448
Pennsylvania Prison Society
resources including support for kids with incarcerated parents 245 N. Broad St., Suite 300
215-564-6005
www.prisonsociety.org
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Center for Grieving Children, Teens, Families 1139 E. Luzerne St. 215-744-4025
Abused Women Support Groups
Nakisbendi Women​’​s Center
Bonnie Schur, Med, MFT Ardmore 610-642-1324 ​info@nakisbendi.com
http://www.nakisbendi.com
The Philadelphia Domestic Violence Hotline 1-866-SAFE x014 ​www.ppdonline.org
Women Against Abuse
24 hour hotline, information, shelter, free legal assistance 215-386-7777
www.womenagainstabuse.org
Woman Organized Against Rape helps survivors of sexual assault and abuse 24 hour
hotline 215-985-3333 ​www.woar.org
Lutheran Settlement House
bilingual domestic violence program, housing, workshops 215-426-8610
www.lutheransettlement.org
Women in Transition
early intervention and prevention services for women endangered by domestic violence
and/or substance abuse
215-751-1111
www.womenintransitioninc.org
Latina Domestic Violence Program 215-763-8870 ​www.congreso.net
Southeastern Women Against Abuse
for women from Pakistan, India, Nepal, Sri Lanka 215-627-3922
Korean Women's Support Group 215-869-5703
Menergy
services for men who are physically or emotionally abusive to their partners 25-242-2235
www.menergy.org
PA Coalition Against Domestic Violence
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lists resources for all PA counties 1-800-932-4632 ​www.pcadv.org
Child Abuse Protection
City of Philadelphia Child Protective Services 215-683-6100
Children's Crisis Treatment Center
outpatient mental health services for children 2 to 13 years old 215-496-0707
www.cctckids.org
Child Abuse Hotline
for parents worried they might hurt their child 1-800-4-A-CHILD
Child Abuse Prevention Effort
parenting skills workshops, one-on-one counseling for parents with potential to abuse
215-624-1101
Philadelphia Children's Alliance
coordinates sexual abuse investigations, support and education to children and
non-offending caretakers 4000 Chestnut Street
215-387-9500
www.philachildrensalliance.org
Support Center for Child Advocates
free legal and social services to abused and neglected children 1900 Cherry Street
215-925-1913
www.advokid.org
Adolescent Violence Reduction Partnership (AVRP) program for high-risk youth
between ages of 10 and 15 215-462-7693
Community Services and Programs
Caring People Alliance
Boys and Girls Club, Day Care, After School Program, Youth Development
www.caringpeoplealliance.org
Central Philadelphia: 1819 JFK Blvd, Suite 220 215-545-5230
South Philadelphia: 2407 South Broad St.
215-218-0800
North Philadelphia: 1701 N. 8th St.
215-763-0900
81
West Philadelphia: 3512 Haverford Ave.
215-386-4075
Healthy Start Programs health-related services
www.phila.gov/health/units/mcfh/hs/hs.html​ North Philadelphia: 215-685-2457
West and Southwest Philadelphia: 215-685-5255
COMPASS
application for social programs ​www.humanservices.state.pa.us/compass
Pennsylvania Family Support Alliance family strengthening programs and support groups
1-800-448-4906 ​www.pennsylvaniafamilysupportalliance.org
Children's Aid Society of PA
The Family Project offers programs, public assistance, day care referrals, housing info
1315 Walnut Street
215-546-2990
www.caspa.org
Education Communities for Parenting
free workshops for parents including teen mothers and fathers 215-496-9780
www.ecparenting.org
Philadelphia Society for Services to Children
specializes in helping relatives raise children other than their own, also support groups,
family therapy 415 South 15th St.
215-875-3400
www.pssckids.org
Focus on Fathers
260 South Broad St. 215-985-6252 ​www.phmc.org/rch/ff.html
Safe Haven
mother not ready to keep unharmend baby under 28 days, can take baby to any PA
hospital without getting in trouble
1-866-921-SAFE
www.secretsafe.org
Health Insurance
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Public Citizens for Children and Youth
free service for solving health insurance issues and finding insurance 215-563-5848 x17
www.pccy.org
CHOICE Children's Health Line
assistance to pregnant women and families applying for free and low-cost health
insurance programs 216-985-3301
www.choice-phila.org
CHIP (Children's Health Insurance Program)
free or low cost health insurance for uninsured kids under 19 1-800-986-KIDS
www.chipcoverspakids.com
Healthy Kids Hotline
provides information about low or no-cost health care for middle and low-income
families, including prenatal care, Medicaid, CHIP
1-800-986-KIDS
Select Plan for Women
free and confidential family planning and women's health services 1-800-842-2020
Health Centers: Medical/Dental Care
District Health Center #2 1720 S. Broad St. 215-685-1803
District Health Center #3 555 S. 43rd St. 215-685-7504
District Health Center #4 4400 Haverford Ave. 215-685-7601
District Health Center #5 1900 N. 20th St. 215-685-2933
District Health Center #6 301-23 W. Girard Ave. 215-685-3803 District Health Center #9
131 E. Chelten Ave. 215-685-5703
District Health Center #10 2230 Cottman Ave. 215-685-0639
Strawberry Mansion Health Center 2840 W. Dauphin St. 215-685-2401
Complete Listing of Philadelphia Federally Qualified Health Centers
www.cap4kids.org/philadelphia/download/PhiladelphiaHealthCenters.pdf
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Early Intervention Programs for Children With Special Needs
Health Intervention Program for Children with Special Health Care Needs
www.phila.gov/health/units/mcfh/HIP/hip.html
Northwest, North, and Lower Northeast Philadelphia: LaSalle Nursing Center
1900 West Olney Ave
215-951-5034
South Philadelphia, Center City, Lower Northeast: Resources for Children's Health
215-985-2541
The Special Kids Network 1-800-986-4550 ​www.health.state.pa.us/skn
Children with Special Health Care Needs
help in navigating the systems addressing the needs of special needs children
215-685-5236
www.phila.gov
PA Medical Home info for parents ​www.pamedicalhome.org
PA Medical Home Initiative Networking Site
social networking for families and advocates for special needs children
http://pamedicalhome4parents.ning.com
Childlink
for developmentally at-risk preschool children 0-3 years old 215-731-2110
www.phmc.org/early/early.html
CONNECT Information Services offers information for services throughout PA
1-800-692-7288
Elwyn Special Education for Early Developmental Success for children 2 yr and 10
months to 5 years old: 215-222-8054 for children older than 5 years: 215-895-5500
www.elwyn.org
United Cerebral Palsy of Philadelphia
multi-service agency for children and adults 215-242-4200 ​www.ucpphila.org
Community Organization of Mental Health and Retardation Children's Service
3825 Whitaker Ave.
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215-427-5756
www.comhar.org
Trisomy 21 (Down Syndrome) Program at CHOP 267-426-5283
www.chop.edu
Parent to Parent of Pennsylvania 1-888-727-2706 ​www.parenttoparent.org
Parent Education Network
info about federal and state regulations regarding early intervention and special education
1-800-522-5827
www.parentednet.org
Parents Involved Network of PA advocation and information 1211 Chestnut St.
215-751-1800 x214,221 ​www.pinofpa.org
Frankie's World Day Care daycare for children with special needs 1011 Poplar St.
215-763-0151 ​www.frankiesworlddaycare.com
Lauren's House
licensed Prescribed Pediatric Extended Care Center Boothwyn, Delaware County
1-888-340-9420 ​www.laurenshouse.com
Ventilator Assisted Children's Home Program 1-877-PA-VACHP
www.kidshome-vent.org
Elwyn Dental Clinic
dental clinic for children with special needs 4040 Market St. 215-895-5533
www.elwyn.org
Hispanos Unidos Para Ninos Excepcionales 220 N. 2nd St
215-425-6203
Education Law Center
promoting fairness and quality education in public school system 1315 Walnut Street, 4th
Floor
215-238-6970
www.elc-pa.org
Legal Clinic for the Disabled Children's Health Initiative free legal services
215-587-3350 ​www.legalclinicforthedisabled.org
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Health Food Stores
Essene Market and Cafe 719 South 4​th ​Street Philadelphia 215-922-1146
http://www.essenemarket.com
Natural Goodness 2000 Walnut Street Philadelphia 215-977-7749
Whole Foods Market 929 South Street Philadelphia 215-733-9788 2001 Pennsylvania
Ave. Philadelphia 215-557-0015 ​www.wholefoods.com
Weavers Way Co-op
559 Carpenter Lane Philadelphia 215-843-2350 ​http://www.weaversway.coop
Martindale​’​s Natural Market 1172 Baltimore Pike Springfield
http://www.martindalesnutrition.com
Blossoming Bellies, Brittany Sharpe McCollum, updated 2010
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