Happy Acupuncture Week 2019!

I love talking about how acupuncture has been part of my life for 16 years, even before @jp.boisvert brought it full circle to our clinic and home

We have used acupuncture, Chinese herbal medicine, tui na, gua sha, and cupping for years to treat fevers, stave off colds, deal with whiplash and sticky shoulders, vanquish back pain and migraines, and generally manage our health for a long time

It’s true that we also take care to move our bodies and sleep, but I definitely credit acupuncture and Chinese medicine with our family’s pretty rocking health. And I credit @jp.boisvert for being our family doctor

He has some awesome stories about how acupuncture has flipped the switch for debilitating anxiety in teens, how a Chinese herbal formula worked like a charm in families trying to get pregnant, moxabustion and turning babies at the ends of pregnancy, and more!

More than just pain management, people are looking at acupuncture as a way to manage mood, anxiety, and to work alongside our other therapies like medications or nutrients that we use to adjust our chemistry.

Stay tuned this week for Acu Adventures!

#acupuncture #chinesemedicine #cuppingtherapy #guasha #tuina #ilivewithaneedler

Miles For Midwives!!

Saturday October 19, 2019 9am-1pm

I am personally involved in planning this wonderful event that helps support birth in Washington State and the local non-profit Families of Color – Seattle.

Better yet, Rohan and I are run/walking!

Join us on Oct. 19th at Marymoor Park for a family-friendly run/walk 5K! Strollers and leashed pets are welcome to join in on this community enriching event!

Register for the race at https://runsignup.com/Race/WA/Redmond/WAMilesforMidwives5K

To learn more about Miles for Midwives please visit our website: https://www.wamilesformidwives.com/

We are also looking for sponsors. If you are interested or know a business who might be, please let me know.

I would LOVE to see you and your family/friends there – Please spread the word!

Location:

Velodrome Shelter at King County’s Marymoor Park
6046 West Lake Sammamish Pkwy NE
Redmond, WA US 98052

Join us for the MAWS Clinical Update!

We are getting together on Thursday September 26th to discuss new changes to our laws and legend drugs for Licensed Midwives in Washington state.

If you are a midwife, an aspiring midwife, or other birth attendant serving families in WA State, please come learn more about how this affects midwives, their support teams (including doulas), and families! #washingtonmidwives

The Birth of Postpartum

Hey y’all, I recently spoke on a podcast with my fantastic colleague Dr. Adam Rinde about postpartum care, stories, and how people’s lives have changed mine. And maybe how we can get better as a healthcare system, providers, and community in the way that we care for postpartum people.

He has written this really incredible piece on postpartum depression and hormonal influences, linked here:
https://www.soundintegrative.com/post/is-postpartum-depression-an-estrogen-receptor-issue

The way to get to our episode on his podcast, One Thing, is linked in the article (you can access via Apple or Android). Take a listen and tell me what you think!

Apple listeners:
https://overcast.fm/itunes1457478235/one-thing-with-dr-adam-rinde

Android listeners:
https://www.stitcher.com/podcast/one-thing/e/60556368

#postpartum #midwifeforlife #podcasting #carework #mentalhealthawareness

The Birth of Grief

A new mom and her baby had come in for their first well-child visit and her son was just 3 days old.  Mom was tired and overwhelmed as many new parents are.  She was sitting by the window, changing her son’s diaper and just watching him, and she sighed a long, heavy sigh.  And just gazed at her son quietly as he wiggled around.  There was no slow smile or beaming pride.  Just deep sadness.  

What clinical guidelines, healthcare, and social convention tell us is that she was exhibiting signs of postpartum depression.  While that may also have been true, she was also exhibiting signs of deep grief and loss. 

I looked at her across the room and just said to her, “You don’t have to love this.  Or even like it.”  I said that for her, but also for the hundreds of people I had sat with before her for whom the sadness was enveloping.  She looked at me in surprise, “Really?” She sighed again, but this time with a slow smile, and said, “Thank you.” 

What is often disclosed to me by new parents is that postpartum engenders isolation, being untethered, disembodiment, and a contemplation of mortality. Could this many people really have postpartum depression? Is it possible that this many people opt to transition to parenthood, and meet some or all the criteria for a mental health concern? Or is there another way to understand what this mom and thousands like her are experiencing?

What other process in our life looks like heavy sadness and defeat, and flattens us to the wall? 

Grief and loss.  Losing someone we love. Losing ourselves.  My curiosity is whether we can reframe the postpartum transition as a grief process. As a natural life event, but of loss.  What if our culture, our healthcare delivery, and policies all viewed and cared for postpartum people as grieving people? 

I consider the grace that we offer people who have lost a loved one: the length of time and freedom that they are given to grieve, the expectation of being changed and never quite being the same, and the ability to go deep and dark but not have it be inherently pathologic.  There is a freedom in that.  A deep breath and a slow smile. 

What kind of loss is harder?

If you have been following along for a little while, you know that one of the things I have been ruminating and writing about is loss. We all know it in some way. And we will certainly know more. To live is to love, and also to lose.

It’s not uncommon for us to ‘rank’ loss. Which kind of loss is worse, changes us more deeply, is more worthy of grieving, or warrants talking about at all. Is the loss of an aging parent worthy of years of sadness? Can you be devastated by the way divorce changes your life? Are you allowed to grieve a welcome change like the birth of your healthy and living child?

A friend shared this article written by Camille Hawkins LCSW: Miscarriage or Stillbirth: Which Is Harder? It is a powerfully written perspective on just this thing: attempting to rank our grief. She shares some interesting insights into why some griefs may be shrouded in darkness, and why some may feel more survivable.

Reading this article allowed me to realize that one element of my storytelling has not surfaced, yet. I have waded through the grieving process, felt its depth, and received its tangible gifts. But what still lurks is: are the losses I (and our family) have experienced these past few years worthy of this much grief? And when should this story end?

Another thread that I have been grasping at for some time in my clinical work is shaping postpartum depression as a grief process. Not just that grief can be normal after birth, but that the true baseline IS grief. Postpartum wouldn’t just be worthy of grief, it would BE grief. Perhaps we could surround, hold, and integrate our grieving loved ones as if they had suffered loss.

Witness that they had suffered loss.

What would we do differently? When would we feel as if that story should end?

#neverendingstory #griefworkislifework #griefworkismywork

_____________________________________

For more thoughts and storytelling, check out my Muse-letter. You can join the conversation by subscribing here

Why Does My Brain Feel Like it is Leaking?

An interesting article was published this past Summer on the very real, little-discussed changes that occur in the brain of a pregnant, postpartum, and/or caregiving person. Mommy-brain-2

There are a number of rapid and monumental changes that happen to the portion of our brains that control social-emotional processes or the “ability to atttribute emotions and mental states to other people- key to raising a human.”

“The more brain change the mothers experienced, the higher they scored on measures of emotional attachment to their babies, a finding that echoed past studies. And the changes in most brain regions remained two years later.”

Whoa.  Two years?!

What is even more fascinating is that this change was most profound in the parents who were also pregnant, but was not limited to them.  Caregivers other than the birthing parent,  including fathers, experienced some of these same changes that correlated with how much ‘exposure’ they had to the babies and children.

For many of us who have been pregnant, postpartum, and/or a parent, we already know that this is true.  It’s not just our bodies that change.  Something else changes that never goes back to its original configuration: our brains.  Maybe all the time we spend consumed with getting bodies back is more about getting our brain back; a more tangible and socially-acceptable pursuit.  All the while knowing, in the murky recesses of our changed brains, that the worry, the conjured scenes of certain death, and deep guilt over every imperfect moment will never leave us.

What if we better understood what was happening to our brains and not just our bodies?  Would it change our relationship to postpartum and parenting?  Would it reframe what we experience as depression, anxiety, or plain-old feeling like we are losing our minds?  Would we reach for help, talk more openly, or simply settle into it more easily?

Would you?

This spins other spirals of thought for me also.  Is it possible for this effect to be compounded?  If we have more than one pregnancy, more than one postpartum, and, truly, more ‘exposure,’ do our brains continue to change? Do the changes add up? Do these spaces in our brains grow deeper and wider?

I wrote a new installement of my Muse-letter, due to break later this week, before I even read this article.  Ironically, it touches upon parallel notes of exposure, changes, and leakiness of our hearts and emotional selves.  And, of course, I have to ask: what is the gift?

What new wild and remote expanses of our minds can we now saunter through that were not accessible before?  In what ways can we empathize, understand, or simply be with our fellow humans that were not as effortless?

Children and change have a lot in common. Endless. Relentless.  Generous with their gifts.

What are your favorite gifts?

#pregnancybrainisreal #postpartumbrainisreal #parentingbrainisreal #changeisreal #giftsarereal

Subscribe to my email Muse-letter for some not-so-often thoughts on parenting, pregnancy & postpartum, grief & loss and life.

Midwifing the Midwife

It goes without saying that there are dozens of people who make it possible for midwives to be there for families.  And it’s not just being able to pick up where we leave off.  It’s continuing to be on even when we return home and to work without sleep and still drifting between reality and the surreality of birth.  Despite carrying our own special streaks of wildness and independence, we must live humbly in community as it is impossible to survive without.

Our partners, kids, parents, extended families, friends and ‘framily,’ and co-workers don’t always love the life they have unwittingly walked into with us.  That wildness and independence is at once captivating and overwhelming, even for us midwives.

This article reminds me again how intensely grateful I am.  Thank you.  http://www.mothering.com/articles/married-to-the-midwife/

_______________

If you want more tips, discussion, and thoughts from Dr. Sunita, subscribe to my email list for my newsletter and inside scoop.  Thanks!

Postpartum ‘Must Haves’ That Have Nothing To Do With Buying Stuff

I would love to replace the typical birth registry of items that all new parents “need”. Instead, I want new parents to receive a different kind of checklist.  A checklist that would include ways to prepare for parenthood and postpartum that could actually help prevent postpartum depression, isolation, and suffering.  And yes, hand-me-downs would still be incredibly helpful!

I have no doubt that baby swings and swaddle blankets have saved sanity and have probably saved lives. But if we are really concerned about healthy families and getting off to a good start, why don’t we talk more about what families really need and want to be successful? First and foremost we have to be honest about a few things. Shopping for cute baby things, asking our friends and family to do the same, and happily preparing for the arrival of our little ones is more fun than acknowledging that postpartum and parenting can be hard work. Setting up a registry on Amazon and inviting people to buy stuff is way easier than truly asking for help.  Almost no one likes talking about postpartum or new parent trials and tribulations.  No one wants to hear “It’s Hard”.  Duh.

I not proposing a “The 11 Things I Wish Someone Had Told Me Before I Had My Son” news feed item.  I am proposing a punch list of actual work that I would like to see done on this project that you are managing:  Brand New Human Life.  Here are the things I would like to see more families do and be supported in doing:

Do some ‘Meet and Greets’ or re-establish care with someone you have seen.  Seeing someone with a specialty in postpartum, parenting, and/or marriage counseling are big perks, but the most important features are that you trust and like this person.  Think of a stressful time in your life- would you call this person?

  • Women’s bodies go through a lot in pregnancy and birth.  It is reasonable to think that things will not land where they once were before, no matter which way the baby comes out.  It is also reasonable to think that there may not be a lot of time or energy to get on a ‘Body Back’ program.  Honestly, even if there is, having help in this arena is crucial to avoiding sciatica, back pain, neck pain, plantar fasciitis, or other physical pain that make it difficult to care for your baby, exercise without injury, and feel human again.  This is where acupuncture, massage, and physical therapy come in.  These are not just indulgences; they are important facets to your long-term recovery, and most private insurance plans cover these services.  There are also low-cost community resources or sliding scales available if you do not have insurance coverage.  Locate these people, see them once or more in pregnancy, and start building your recovery team.
  • If you are planning to breastfeed, know who and where your lactation resources are and how you can access these services.  The first 2-3 weeks can be the toughest and is the most common time to stop breastfeeding.  Having information at your fingertips beforehand is so crucial.  Most area hospitals have lactation consultants on site who are wonderful and generally available every day.  The challenge is what to do about those urgent, after-hours, or weekend breastfeeding issues.  In case you are now wondering how often that really happens, I am here to tell you that everything involving children happens after-hours, weekends, and urgently.  There are many lactation consultants who do home visits and have after-hours phone lines.  Find out who they are, get some business cards, and keep them handy.

La Leche League International (http://www.llli.org/) has podcasts, forums, and links to almost every resource breastfeeding related.  Get familiar with the website and look up a group in your area.  I would suggest that you attend this group at least once in pregnancy so that you are familiar with a name, a face, and location before you make the trip postpartum.

  • Your pediatric provider is actually a pretty critical person for you as parents in this postpartum time.  Once you are discharged from hospital or midwifery care, you are handed over to your child’s care provider. Moms are typically seen at 6 weeks for one postpartum follow up in hospital-based care, and are seen at least 3-4 times in the 6-8 weeks following birth with out-of-hospital care.  These types of care clearly provide different ‘safety nets’ for families as they transition into postpartum and parenthood, which is why your pediatric provider may be your closest ally.  Set up some Meet and Greets and choose someone who you like and trust (sound familar?).  You are going to be seeing each other quite often in the first year.

Sometimes people come in with a list of interview questions from online sites, and there are great ones out there (http://www.askdrsears.com/topics/parenting/child-rearing-and-development/choosing-pediatrician).  Knowing a pediatric provider’s background is important, but most of that is online in his or her bio.

Use the time you have face-to-face with a prospective provider to find out a few things:  Do you like and trust this person?  Does this person seem agenda-oriented or patient-oriented? Does this person have resources if breastfeeding is challenging or your baby is not gaining weight? Will this person have a whole-family approach or a only-the-baby-is-my-patient approach? How have they handled situations regarding breastfeeding, sleep, or maternal postpartum depression or anxiety? Truly, even when the baby is the patient, the parents’ well being is critical to that baby’s health (http://parenting.blogs.nytimes.com/2013/07/17/who-will-screen-for-postpartum-depression/?_r=0).

Does that sound like a lot of work?  That’s why we get 9 months to start gathering tools and resources that will serve our entire family for months and years to come.  Your baby is not a finished product when he or she arrives, nor is this process.  And it’s actually a lot of fun sometimes too.

Enjoy!  Dr. S

______________________

If you want more tips, discussion, and thoughts from Dr. Sunita, subscribe to my email list for my newsletter and inside scoop.  Thanks!