Preparing the birth canal

(Rather than pictures of birth canals, I am including photos of my happy baby on this post. :)

 

Here is the opening paragraph from my article titled "Good Health Begins in the Gut:"

The human gut, which to the best of our knowledge is sterile until birth, is designed to be populated with its first colonies of indigenous (beneficial) bacteria in the infant's first 20 days of life outside the womb. The primary mechanisms for this to take place are vaginal birth, during which the infant swallows bacteria and other microorganisms from the birth canal, and breastfeeding, which confers the mother’s unique microflora (microorganisms that inhabit our bodies in tremendous variety, also known simply as flora) to the baby through breast milk and skin-to-mouth contact. Babies who are born by Cesarean section do not receive this first important benefit, and those who are fed formula develop entirely different indigenous flora. Infants that experience neither vaginal birth nor breastfeeding, or whose mothers pass unhealthy microflora on to them, are therefore at a great disadvantage. 

Why does microflora matter? Unhealthy microflora that persists and worsens over time can lead to very serious problems down the road, including food intolerances, behavioral disorders, learning disabilities, autism, ADHD, serious digestive problems, failure to thrive, functional malnutrition, anemia, self-limited diets and pickiness, eczema, autoimmune issues, mental health problems, tantrums, poor immune function (frequent illness), and strong cravings for high-carbohydrate foods...among other things.


I owe my knowledge of inner and outer microflora, limited as it is, to the work of Dr. Natasha Campbell-McBride, author of the book Gut And Psychology Syndrome, and originator of the "GAPS" diet. She has some wonderful and enlightening information available at www.GAPSdiet.com, including the section below on preparing for the act of giving birth. As you may know, microorganisms from the stool migrate to and populate the entire groin area in both men and women, which means the vagina (birth canal) is populated with countless microorganisms, some "good" and some "bad," which are supposed to stay in a harmonious balance, with "good" ones predominating. However, the prevalence of yeast infections and urinary tract infections that modern women now experience, as well as the fact that some 1/4-1/3 of women test positive for the Strep B bacterium during the third trimester, which is typically treated with antibiotics during labor (yikes!), indicates that the vaginal ecosystem of the average woman is anything but harmonious. For that reason it is extremely important to make preparation of the birth canal an integral part of your prenatal routine.

Here is what Dr. NCM writes (you may read the rest of the text which is mainly about diet, by clicking here):

"It is essential to prepare your birth canal for the baby, which is something women used to do in traditional societies. In order to prepare the birth canal you need to populate it with beneficial flora. To do that every day after your bath or shower apply a handful of your *homemade yoghurt or kefir all over your genital area, as well as all over your breasts and armpits. Let the kefir or yoghurt dry on you before dressing up. Once a week insert a capsule of a good quality probiotic into your vagina at bedtime (alternatively you can use a piece of cotton wool soaked in kefir or yoghurt as a tampon, inserted into the vagina for a few minutes). As those areas get populated by beneficial flora, they will be protected from anything pathogenic, and when your baby goes through the birth canal it will acquire beneficial flora from you. Populating your breasts and armpits with good bacteria will help to prevent mastitis and supplement your baby with probiotics, so carry on with this procedure after your baby is born." 


*I should mention here that you can use organic commercial yogurt (whole milk, plain), or even better, raw yogurt or kefir. It does not have to be homemade. The yogurt that is most easily digestible and lowest in lactose in homemade raw yogurt cultured for 24 hours.

In my opinion, this is by far some of the most brilliant advice I have read on the topic of preparing for birth. A baby with healthy flora in its digestive system will be a happy baby as he will have a happier, more settled stomach. I'm sure you've heard people talk despairingly of their baby's colic, acid reflux, profuse spitting up, gas, and more, all of which can cause babies to be unusually fussy if not downright inconsolable. I can attest to Weston's peaceful temperament as compared to Oliver's hard-to-soothe antics, and I attribute this to my improved health (achieved through traditional foods and the GAPS diet), the natural medication-free (and antibiotic-free!) birth, complete lack of vaccinations (Oliver had the Hep B in the hospital -- vaccinations interfere with gut flora), and also to my practice of applying yogurt a few times a week, and a probiotic suppository once a week, during my third trimester. (I also applied yogurt on my breasts and armpit areas several times, but found it difficult to do since it creates an abundance of tiny flakes after it dries. Nevertheless, it's a good practice as well.)

Weston rarely spits up at all, let alone anything more than about a teaspoon of milk (babies do spit up some to regulate the quantity of milk), he does not have gas or grunt while passing a stool, and he is a very peaceful and content baby, crying only when hungry or very tired. The ease of caring for him is what allowed me to return to work, voluntarily, when he was only 2 months old. Based on our experience with Oliver I doubted I would have it together enough to get back to work before 3 months at the earliest. I have been happily surprised, to say the least!

One last thing to make note of here: partners share their flora during sex....so this means that you (as the woman) could have great gut flora and an excellent vaginal flora profile, but if your spouse or partner isn't equally healthy he may be sharing some stuff with you that is really upsetting the balance -- and of course, you will in turn pass this along to your baby. I can think of many clients of mine for whom this has been the case; after all, it's really common for men to have gut dysbiosis, too! I can also think of many of my clients' husbands who are completely intractable when it comes to changing their diets....so guess what, ladies? This is putting you (and your baby) at a real disadvantage when it comes to the health of your vaginal flora. What to do about this problem, assuming you really want to do everything possible to have a healthy baby? I recommend the following:

1. Be extra diligent about applying raw kefir on a daily basis throughout your pregnancy (I would recommend kefir over yogurt since it's stronger and more probiotic, and has good yeasts as well as good bacteria)
2. Be sure you are using a high-quality probiotic suppository (vaginal) at least once a week, maybe more
3. Avoid the following: douching, spermicides, synthetic underwear, chlorine-bleached sanitary products, all tampons, strong soaps (use mild natural soap), deodorizing sprays, and tight-fitting clothes that don't allow the groin area to "breathe" (especially after working out or sweating a lot)
4. Abstain from intercourse for as long as you can in the days/weeks/months preceding delivery. If this is going to be problematic, hold off for your final month of pregnancy at least, but abstain longer if you can. This would allow your vaginal flora to really benefit from all the other steps you're taking.

Here are a few tips to knowing whether your partner's flora might be the culprit:

1. he has digestive issues (gas, belching, diarrhea, constipation, abdominal pains, reflux/heartburn, serious digestive problems)
2. he flat-out refuses to (or is unable to) give up high-carb foods (starches, bread, sweets, sugar, cereals, beer, etc.)
3. he struggles with depression, ADHD, mental fog, or other mental health issues
4. you've noticed feeling slightly itchy or "yeasty" ever since you've been in a physical relationship with this person
5. you have a history of UTIs or yeast infections over the course of your physical relationship

If this sounds like you (and him) I would urge you to get this book and make it required childbirth preparation reading for both of you!

My pregnancy diet checklist

Towards the end of my pregnancy I decided to keep a checklist so I would remember all the various foods and supplements I was trying to eat or take on a daily basis. As you can see, the list was quite long and could be difficult to keep track of. I am still more or less eating the same way, though I'm not drinking the teas anymore or taking all of the supplements.

This checklist (the food portion at least) was developed with the Weston A. Price Foundation pregnancy diet in mind, which is designed for ensuring the developing baby (and its mother!) obtain all the nutrients they need on a daily basis. Here are the other things I added, as well as a few that I tweaked to suit me better:

1) first, I don't tolerate plain raw milk very well so instead of having 1 quart daily (recommended by the Foundation) I aimed for 1 cup kefir, 1 cup yogurt, and 1-2 servings of cheese (cottage cheese, or aged raw cheeses). All raw of course. The kefir and yogurt I made myself. I felt this was actually a better way of consuming dairy since it was much more highly digestible and provided probiotic benefits. Also, raw cheeses provide highly concentrated nutrients and if they are aged they are a good source of vitamin K which plain milk is not.

2) 2 tsp. of fermented cod liver oil is recommended for pregnancy and breastfeeding to supply natural (not synthetic) vitamins A and D. It also helps to either consume high-vitamin butter oil or plenty of raw grass-fed butter alongside the cod liver oil; they work synergistically to provide the best results.

3) 4 tbsp. daily of raw grass-fed butter was difficult for me since I don't eat the butter "vehicles" that I used to before the GAPS diet (like oatmeal, potatoes, toast, etc.). I increased my consumption of raw Jersey cream in conjunction with butter; butter is 4 times more concentrated than cream, which means that 1/4 cup of cream (4 tbsp.) is equivalent to 1 tbsp. of butter. There were times earlier in my pregnancy that I was eating over a cup of raw cream a day, and it helped tremendously with cravings!

4) clay -- I took 1 tsp. of Bentonite clay (Redmond brand) daily for iron and its great digestion-regulating benefits

5) thyroid capsules -- 2-4 of these daily from Dr. Ron's line of organ and gland supplements. Consuming animals' organs and glands is a traditional practice that provides essential nutrients to our own corresponding organs and glands. I wanted a little extra insurance for my thyroid and liked using these capsules since these days it is virtually impossible to obtain actual thyroid gland from an animal -- not to mention that it probably wouldn't be very fun to eat!

6) my vitamin D level was low (27) in the summer, so I grudgingly added in a D3 supplement. I consider this a synthetic supplement since it is made by exposing lanolin from sheep's wool to ultraviolet light, but it was something I had to do since cod liver oil alone wasn't cutting it. I have since observed that many (if not most) people living in NYC are low in vitamin D, including those eating a healthy traditional-foods diet that contains foods high in vitamin D like pastured pork lard and fermented cod liver oil. The lack of exposure to quality sunlight seems to be the main issue since in summer we don't spend much time outside exposing lots of our skin, and for 6 months out of the year we have what is termed a "vitamin D winter" which means we can't synthesize vitamin D in our skin even with sun exposure, due to the latitude at which we live. Pollution contributes to dimming of the sun's rays as well, which makes things still more difficult. I still don't like taking a D3 supplement, but unless I can eventually afford to fly off to sunnier climates every few months to soak up some rays this is going to have to be it -- along with plenty of cod liver oil and lard of course!

7) I continued cooking with my iron skillet to help boost my iron levels.

8) vitamin K supplement -- I used the Jarrow brand supplement that is derived from natto, a traditional fermented soybean dish and the richest known food source of vitamin K. I decided to add this supplement because I planned to skip the vitamin K shot for Weston, which is given to all babies at birth unless you opt out. Eventually we decided to give the vitamin K drops based on the anecdotes my midwife shared with me on her experience with babies who hadn't received vitamin K, or whose parents had chosen the K drops but hadn't continued with the protocol past the first few weeks (you need to give it over the baby's first 12 weeks of life!). She and all the other NYC homebirth midwives had seen babies with hemorrhagic disease (vitamin K prevents this) in their practices -- despite the international statistics that cite much lower incidences of this disease (is it 1 in 10,000? something like this -- a much lower number than Joan and the other local midwives had observed). When she told me about a baby who had needed a brain shunt I decided I really didn't care what I had read about the incidence being so low, and about the ability to boost K content in breastmilk by taking supplements, eating high-K foods, and drinking nettle tea. It seemed the natural vitamin K drops were the way to go. We ordered them along with our home birth kit from Birth With Love. At $31.00 instead of $13.00 for the pre-filled vitamin K syringe, this seems like a lot more to pay for just a little supplement, and I can see why hospitals don't bother carrying the oral drops. However, when you consider all the bad stuff that is in the vitamin K injections, the drops are definitely the way to go!!

9) teas -- nettle tea to boost vitamin K, and Final Countdown Tea from Divine Daughters Herbal, a line of pregnancy-specific herbal products that is created by Karen Rose, master herbalist of Sacred Vibes Apothecary in Flatbush (Brooklyn). [To order, you can call Sacred Vibes or visit their Etsy store]. This is what is written about the tea: "Our 'Final Countdown' Tea was formulated with the 9th month of pregnancy in mind. We included Squawvine which has been used traditionally by North East native Americans to strengthen the uterus for birth. We blended it with supreme uterine tonic red raspberry leaf tea and cramp bark along with wild yam to ease the tension that sometimes comes along with Braxton Hicks contractions in the final weeks of pregnancy to support efforts to rest. 1 cup a day from week 36 onward offers supreme herbal support for your body and its process." (P.S. I also used their Motherwort analgesic herbal tincture postpartum for cramping and loved it!! I only had to resort to Ibuprofen twice when the cramping was very bad. It was also helpful for some terrible headaches I had in the first week, probably from anemia.)

10) bitters -- an herbal tincture that promotes good digestion of fats by prompting the liver to release bile (you can read more in this great article about the role of bitters in promoting digestion). I took about a dropperful of this before each meal. [Have just ordered the Digestive Tonic from Sacred Vibes and am excited to try it! Note: when ordering, it seems the shipping costs about $4.00 less if you order through the Etsy store -- I wish I had known this.]

11) probiotics -- I continued taking my 2 daily capsules of BioKult, which I've taken since starting the GAPS diet early in 2010 (Note: when starting any probiotic, you should always begin with a very small amount of the powder, released from the capsule, and increase gradually to a therapeutic dose to avoid "die-off," which is detox symptoms from pathogenic microorganisms dying off in the digestive tract.)

12) EPO (evening primrose oil) & EPO suppository -- begun at Jessi's (my doula) suggestion towards the end of pregnancy to support the production of healthy prostaglandins. Jessi also recommended that I insert an EPO gelcap vaginally every night to help my cervix get "ready."

13) yogurt application & probiotic suppository -- will write about this in a subsequent post!

Remembering Oliver's first weeks

Remembering pregnancy cravings

Many of us -- pregnant or not -- try hard to follow diets that we believe are healthy or ideal, all the while denying what we deeply long for. I was following a vegetarian diet for the most part during my pregnancy, but my body drove me on a few occasions to break my own rules.

One day I smelled bacon that was being cooked at a street cart, and I promptly went and purchased a package of bacon, cooked most of it, and ate several strips. I still wasn't satisfied, though, until I realized what I really wanted was the liquid fat in the frying pan! After eating many spoonfuls I felt much better. Several months later I learned about the profound need for vitamin D and fat during pregnancy and realized that what my body really wanted was good old-fashioned bacon fat (also known as lard!) which has traditionally been high in vitamin D (animals raised outside in the sunshine will store lots of vitamin D in their fat). During my pregnancy I ate in a way that I believed was very healthy, but I now see how what I was eating -- and not eating -- was closely linked to the issues I faced, including hypothyroidism, extreme foot swelling, strong cravings for starches and fried foods, and, worst of all, my inability to dilate during labor which resulted in a c-section. (More on this later, but I should just mention that swelling and cravings for processed carbs like white bread and pasta are both signs of protein deficiency. Too many processed foods and sugars, too much soy, and too few high-quality fats in the diet are linked to thyroid dysfunction.)

There was also the occasion where I walked a mile in the dark and cold to buy fast food fried chicken! I shudder as I remember this, but I was absolutely DRIVEN! I only wish that I had known then what I know now, because I would have definitely been able to feed myself and Oliver far better, and would have had a happier time of it.

After the birth, though I still wanted to remain a (sometimes cheating) vegetarian, I asked my mother to make me steak every day for lunch for a week. I found out several days later that I was very anemic, but I really didn't need a blood test to know that I could not deny my need for meat -- I was incredibly weak and utterly exhausted, and the meat definitely helped. The beef that I ate was standard grocery-store fare, which makes me wonder: if I had known how much more satisfying grass-fed meat is at that time, perhaps I would have made sure I got this instead, and maybe the cravings for it would not have lasted as long as they did. It's interesting to consider.