An update.

Dear readers,
     It is with the utmost excitement that I confess to you, a secret. I am going to have a baby. I'm entering my 6 month of pregnancy and so far, it has been a wild ride. I'm writing this blog post for very similar reasons that I started this blog in the first place. I get asked many questions, most of them all surrounding the same topics. I tend to think that if our conversations and thoughts navigate in certain directions, those subjects deserve some attention. So, let's get to it!

1. How was my first trimester?
       Health wise, my first trimester was incredibly simple. I ate whenever I started to feel poorly, and overall avoided most of the unpleasantness associated with morning sickness, fatigue, etc. That being said, I did experience all the scary things of the first trimester. I had bleeding on a regular basis, I experienced "higher than normal" cramping, but all the while my midwife assured me that I was ok. Then, around 8 weeks, I was sitting at my desk (scrolling through strollers) and a message popped up. And long story short, my husband and I were offered positions in our dream town. We've been here 2.5 months and I we couldn't be happier.

Here's what I've deduced from the first trimester: I am under regular chiropractic care. As a product, I haven't had any low back pain, I didn't really have any morning sickness to speak of, and my fatigue was really mild. Between the support of my chiropractor and my midwife, I've maintained a fairly low stress approach to my pregnancy that I honestly believe would be completely different without them.

2. Where am I going to deliver?
     My husband was born at home, his brother was born at home and his sister was born in a birth center. I was born via c-section due to health risks to both my mother and myself. My goal throughout this pregnancy is to do what is best for the longevity of my health and the health of my baby. In considering what I wanted and what I believe to be the best path with least intervention, my husband and I decided to hire a midwife and pursue a home birth. I was nervous that I would "opt out" due to high blood pressure or other health concerns that my mother had, but so far (22 weeks) nothing has come up. We are also planning to participate in a Bradley birth class to help us prep.

3. When am I due?
     August. I'm willing to accept July 29th-September 3rd. But really any time in that window is fine by me.

4. What cravings am I having?
     Pickles, deli sandwiches, french onion dip (gross, I know), sparkling flavored water (La Croix) and spicy foods. I'm specifically not enjoying peanut butter, bread, bacon, or sweet things.

5. How is my husband doing?
      Like he always does, my husband is my greatest cheerleader and the best support I could ever ask for. Keep an eye out, the next blog will be about dads :)

6. What are you having?
      Hopefully a baby. :) We opted to not find out. But so far we know that baby has ten fingers and toes, 4 heart chambers, a spinal cord, a brain, and a wicked kick.

That's all for now. Check out the next blog in which I make a huge apology to dads.

Chiropractic and Birth

For the sake of this post we will only discuss pelvic floor and mechanistic views of the pelvis for labor and delivery. There is A LOT more at hand, but this is the best entry point for what will later prove to be a pretty complex relationship.

Round Ligaments
These are best described as the ropes that tether the top of a hot air balloon. Before conception, these ligaments sort of hang off the top of uterus like arms. The fibers of the round ligament actually descend so far as the labia majora (external female genitalia). As the uterus expands to accommodate the growing baby, the round ligaments look like the ropes that go over the top of the hot air balloon keeping it on the ground.

This balloon is tethered, and look how roomy it is! This is what we want the uterus to look like. If a woman has a traumatic pelvic trauma like falling off of a bike, falling off of a horse, even some hard falls when she was a baby, these ligaments can have different tensions. This would lead to something like this:

This is an exaggeration, but our goal is to give baby as much room as possible to flip and flop and wiggle around all they want until the time comes to get serious. Then, when it's time to get serious we want baby to engage and exit with as much ease as possible, for mama and baby.

Sacrotuberous ligament
This ligament deserves a regal entry. This dude is the unsung hero of all pregnancy. So, the sacrotuberous ligament makes a lot of things work: it attaches the spine to the leg (sacrum to biceps femoris, aka major player of the hamstrings), it protects the pudendal nerve (responsible for muscle tone in the perineum--wowzas!!), contains branches of the gluteal artery, Similarly to the round ligaments, if a woman has pelvic trauma, this ligament can lose it's flexibility, thus preventing the pelvis from opening properly during labor.

Sacrospinous ligament
The fibers of the sacrospinous ligament are integrated into the sacrotuberous ligament, but this job of this ligament is to essentially create the greater and lesser sciatic foramen. If you have ever been pregnant, and developed sciatic-like nerve pain...this ligament could be a contributing factor. Again, this ligament, as it is so closely related to the sacrotuberous ligament is going to have heavy influence on the pudendal nerve, which is the nerve that helps determine the muscle tone in the perineum; if the perineum is taut, you are more likely to have perineal tearing and postpartum incontinence [1]

Abdominal muscles
The abdominal muscles are an accessory in birth. While the myometrium of the uterus is responsible for the actual contraction, the abdominal muscles are there for backup and extra "oomph". Guess where the insertion of 2/3 of the abdominal muscles are? Either directly on the vertebrae in your spine, or on the tissue that is attached to those vertebrae,

Pelvic girdle
The Pelvic girdle consists of muscles, bones, and ligaments of the pelvis that ideally open symmetrically to allow baby to exit. Pelvic girdle pain is exceptionally common in the last trimester and up to 16 weeks postpartum. Many of the muscles in this area are innervated by the pudendal nerve. Previously we said that the pudendal nerve was closely related to the sacrotuberous ligament, and that between the round ligament, the sacrotuberous ligament, and the abdominal muscles, the attachment sites for all of these are either on the spine or directly to the bones of the pelvis.

So what does Chiropractic have to do with any of this?
Chiropractors who specialize in pregnancy should know how to address all of these ligaments and bones. Our pelvis is responsible for keeping us moving. Think of it in terms of survival; our arms are held on by a flimsy articulation and 4 main muscles. You can lose an arm and still get away from the lion chasing you.Your legs are held on by one solid ball in socket articulation; in our body this is the most stable a joint can get and still move. Beyond that, there are at least 5 ligaments and 4 muscle groups (multiple muscles working together) to keep your leg on; because you need the leg to escape the lion. So then amplify that by a million, when we incorporate a mother's protective reflex, and you begin to realize the significance of this hammock that we make while pregnant.

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279110/

NFP vs. Fertility Awareness: Change your language to change the world.

I recently had the honor of speaking with a group of women that all brought different experiences and input on fertility and womanhood. Coming from a higher learning perspective on health and fertility, I was amazed at what I learned. Below are some of the high light take away points:

1. Just because you have said the same thing a million times does not mean that it should not be said a million and one times. My goals in practice are not to have women exclusively home birthing, breast feeding for 5 years, and having baby only touch fair trade organic grown and washed diapers. That's a nice dream, but that isn't reality. A woman delivers her baby, a woman (and partner) makes the decisions concerning the birth and parenting of her child. A woman needs to know what she wants and surround herself with people who will support those wants and desires. Sometimes that means a C-section. Sometimes that means 'sposies. It is not my goal to tell them how wrong they are; it is my goal to empower them to know that what they want is what they are capable of. 

2 . If you want to change the world, change your language. I didn't learn this at this event, but I said it. I wasnt the first person to say this, but it is my mantra concerning Chiropractic and up until this point it never occurred to me that NFP needs a language change. Let's break it down: Natural Family Planning. So, fertility is purely for families? And purely for families looking to manage the number of children they have? OH! No, no no. Fertility, as I have said before is the 7th vital sign! Women, and men for that matter, are fertile outside of marriage. For women, the menstrual cycle is an amazing insight to health. NFP (henceforth known as fertility awareness on this page) is something to be aware of years before sex is even an option. So, despite my beautiful business cards that tout my certification as an NFP instructor, I am a fertility awareness teacher, focusing on Marquette Method. 

3. Pea Salad is WAY tastier than it sounds :) 

I implore you to consider the ramifications of your words. The words we use today will impact how our children and future generations speak on these topics. Speak to your children about their bodies, and use the terms that you want them to use as adults. Teach them early that menstruation is more than just the sloughing of endometrial lining of their uterus. Don't let your children learn about fertility the same way you did. Fertility does not imply sexuality. Sexuality is a different conversation, possibly for a different time. 

Chiropractic Principles

If you are part of the 85% (rough estimate) of people who do not regularly see a chiropractor, it may surprise you that there is a philosophy and accompanying principles to receiving care. Most of them are pretty straight forward, a quick Google search will give you all 33 principles, but today we will focus on my favorite:

Principle No. 6: The principle of time- There is no process that doesn't require time.

That's it...verbatim. It hurts to read doesn't it? If you are remotely concerned with grammar, your eyes are probably bleeding a little from an official statement from a profession...an ENTIRE profession... with a double negative tucked in. It hurt me. I had to do a project on the principles my first quarter of my doctorate program and I complained IN the project about the grammar. Let's consider that a speed bump and keep on trucking. If it's more of a road block, go pace for a few minutes in the sun and come back and start below:

Time. 

In the previous post we discussed weight loss as a measurement of health. Weight loss is an easy representation of our culture's inability to perceive "time in" versus "time out". Most people do not wake up 40 pounds heavier than the day before. If this happens to you I would suggest seeking medical attention because that implies a serious issue. Plenty of people are on "ask yahoo" or random weight loss forums asking, "How can I lose 30 pounds in 2 weeks?" They probably didn't gain 30 pounds in 2 weeks, yet they expect to lose it. 

However, I would argue this isn't the most alarming form of disregard for time. The worst is when a person makes poor decisions for, let's say 10 years, and after some time their body begins to show signs of neglect: inflammation, pain, dysfunction. These consequences usually surprise people, and the instant reaction is to take a pain killer. And WOW! Those pain killers really work! I should know, I took them in bulk store proportions for about 10 years. Often times we want to cut corners. We want "insta-health". 

Insta-health sounds great doesn't it? Do none of the work, none of the input and boom! You wake up one day with a 65 BPM heart rate, 110/70 blood pressure, ideal body fat percentages, and did I mention you'll look great naked! (And make a 6 digit income, and drive a drool worthy car...I mean if I'm dreaming here, let's go big!) And imagine if all of the bad habits we accumulate could be undone over night with the use of a pill. This sounds like heaven.

The reality is that we are a culmination of chemical compounds that have been assembled and disassembled trillions of times in their existence; but right here and now, you are you. Our parents made a decision to DTD (do the deed, for my non-NFP folks) and sperm meets egg, morula, zygote, fetus, infant, toddler, kidlet, tween, teen, young adult, adult, senior, and then you will one day die. So will I. But the point is that you did not begin your existence today. Maybe you did...maybe today is a new you and a new way of life. Or maybe the life you lead to day was determined by the diet your great great great grandfather ate 250 years ago. The point is that every aspect of our existence, our observations, our interactions, and our world is dependent on time. Time creates and destroys mountains. 

Often times when people start Chiropractic Care, they are surprised or upset when they find that they will need to come in for 3-6 months. The brilliant thing about Chiropractic is that if you ARE in pain (you do not have to be in pain to see a Chiropractor), you most likely won't be in pain for those 3-6 months. Most often pain resolves fairly quickly. However, much like weight gain (consider this a clumping with the pain/inflammation/dysfunction), typically you don't just wake up one day in pain. Aside from acute macro-trauma (car accident, falling, etc), most of us spend decades with poor habits that lead to that sudden onset of pain. So, if we use the idea of "Time", it makes sense that putting a decade of, let's say looking down at your lap to read a text or the morning paper, into your spine may take more than 2 weeks to rectify. You may not experience pain, but as more and more research shows, pain is sort of the last stop on the Body's "Hey Something's Wrong!" Train. So if we take into consideration that pain is NOT a marker of function, and the objective is to be healthy and functional, the goal is for you to NOT need constant Chiropractic care. The goal is for your body to properly function and adapt to it's environment. In this sense the chiropractic adjustment is re-teaching the body where it belongs in space. So while the pain goes away, the body is still accustomed to it's previous position. The care plan that a patient receives should be an estimate of how long it will take the body to re-learn proper proprioception.

Now, this discussion opens itself to a number of critiques. Because I am in the process of opening this can of worms, let's list out a few:

1. If time causes subluxation, why does a baby need to be adjusted?

2. Why would I need to see a chiropractor if I am not in pain? 

3. What can a chiropractor do for proprioceptive issues?

These are totally future blog questions. Next up though, I'm going to give you a little background on Marquette Method and NFP in general...quirky title name to come. :)