Bone broth for Postpartum Healing

Bone broth for Postpartum Healing
I’ve spent the day making bone broth to put in my freezer for safe keeping until after I have this new little one in a few weeks. I always have a stash of bone broth for when we aren't feeling well. I also add it to make rice or other grains or of course make yummy soups! 
Today’s work made about 100oz of pork bone broth. I make it easy on myself, I save bones from dinners in a gallon bag in the freezer. When it’s full, (in this case two bags because we’ve had lots of pork bones from our half hog we bought last fall) I drop it in the instant pot. Cover with filtered water, add salt, pepper and a couple flush of apple cider vinegar. And in about 2 hours delicious golden broth. I actually did two round with these bones to make this much (see picture!)

here’s an excerpt from my case reflection to earn my Pregnancy & Postpartum Physical Therapy Certification:

“She was instructed to continue to log roll for bed mobility and to use a pillow to splint for coughing and sneezing. She was educated, and issued written resources on nutrition for postpartum healing including nourishing chicken soup with bone broth and collagen smoothies. There is a lack of evidence which supports specifically advising collagen supplementation postpartum, but there is also no evidence that shows it’s detrimental and anecdotally we see improved outcomes when mothers are nourished in the postpartum period. There is cultural wisdom in this practice from Asian ethnicities and their confinement period traditions.”

I truly believe there’s some ancient wisdom that we’ve lost when it comes to postpartum recovery, but these are the two scientific articles are the ones I read to support my last sentence:
  1. Fok D, Aris IM, Ho J, et al. A Comparison of Practices During the Confinement Period among Chinese, Malay, and Indian Mothers in Singapore. Birth. 2016;43(3):247-254. doi:10.1111/birt.12233
  2. Chen LW, Low YL, Fok D, et al. Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study. Public Health Nutr. 2014;17(9):1930-1938. doi:10.1017/S1368980013001730

And this is my favorite blog post I give to all my postpartum patients. The one that started me down this path! Now I’ve also read the Nourishing Traditions books which really are the OG bone broth resources. 

So there you go! My quick round up all about bone broth. Enjoy!

The Patient side of healthcare in covid-19

This week I've flipped from healthcare provider to patient. 

Sunday night, right before bed I had a sore throat. It came out of nowhere. I sucked on my favorite Thieves lozenge and went to bed. At 1:30am I got up to get another one. My throat bothered me all night. When my alarm went off Monday morning, I knew I wasn't going to work, since if one is experiencing any symptoms of covid-19 we are supposed to stay home. I did my employee health's online questionnaire and contacted the necessary people at work. 

I took a nap, and when I woke up, I was worse. I was really weak, I was having chills, sweating, I had a fever. I must have slept 20 hours on Monday. 

I heard back from employee health and they set me up for a covid test later that afternoon. 

Tuesday morning, I was so much better, but my throat was still killing me. Now, me, being a medically inclined and experienced patient advocate, I thought to myself, hmm maybe this is strep throat, I should go to urgent care and get a test. 
So that's what I did. I still had a mild fever, and turns out, my rapid strep test did come back positive. 

So anyways, I've just been thinking, I wish I would have gone to urgent care on Monday for the strep test. I still can't go to work because my covid results aren't back yet, but I didn't need to suffer all day Monday. Even if my symptoms were caused from covid, I guess it just seems weird to me that I wasn't instructed to do anything except the standard talking points. Wash yours hands, quarantine, wipe down commonly used surfaces. I wasn't even told to seek care from my primary physician. So it seems we really aren't treating people until their symptoms are severe enough to warrant an urgent or emergent department visit. 

I think I'm going to submit the feedback to employee health that everyone should have an e-visit with a provider after they submit the symptoms screening tool. I think anyone in family/primary care would have been able to differential diagnose me with strep throat pretty easily. Instead it was all covid related. 

I can just imagine that this happens for lots of other people, and we're maybe not doing the best job we could be in this pandemic. 

How to do all the mom things without neck and mid back pain

How to do all the mom things without neck and mid back pain

I think we focus a lot of attention on pregnancy and postpartum care in the pelvis and lower body. This makes sense, it's where the majority of change is happening. It's more common to have pain in the lower body, with walking or sleeping or movement in general. 

The upper body is super important though. A lot of changes in posture, especially bad ones, start in the neck and shoulders. During pregnancy, your boobs are growing which places extra stress on the muscles to hold your chest up. Then you have the baby, and there's lots of holding, carrying, and lifting. Nursing too, even with a boppy pillow, has a tendency to cause us to lean forward for long periods of time.

My favorite upper body exercises to get my patients started with are bodyweight exercises or with resistance bands. This does not apply to those of you who are already in a weight lifting routine. You go ahead and crossfit and be awesome (as long as you also aren't peeing yourself doing deadlifts, because that ain't right!)

A favorite routine of mine is called Ts, Ys, Is, and/or sometimes Ws are thrown in there too, because these are the letters a person will make, somewhat, with her arms when performing the exercises. These can be modified to almost any position, which is why they are some of my favorites. Options are:

1. while sitting on an exercise ball, with light weights, or a resistance band

2. leaning over the ball while kneeling (during pregnancy with a belly). This second position is slightly more challenging because of gravity on the weight of your arms

3. Standing with light weights or using a resistance band

Here is a video link from YouTube to give a demonstration over the ball. Again, this is easily modified with a pregnant belly

An excellent resource for exercises that are core, pelvic floor, and prolapse safe is FemFusion Fitness on YouTube, run by Dr. Bri PT, DPT. I love her videos and her story about advocating for herself when her healthcare providers brushed off her prolapse symptoms. (We won't hold it against Bri that she uses doTerra oils, spread that EO love! )

Here's a great video from Dr. Bri about chest opening and stretching

I’m currently in process of researching several pregnancy/postpartum fitness programs on the market. I have previously recommended Every Mother, and I loved working with them, and still think it is a great product, but now that my contract has ended I want to explore everything else! Stay tuned for that

How to do a postpartum workout...safely...without feeling like everything is going to fall out!

This question is one I get most often from postpartum women. How do I work out after having my baby?


The easiest answer is to walk. There's so much you can do with walking to scale up the intensity of the exercise: distance, speed, push the stroller with baby in tow or find a hilly park! 


But eventually, most moms tell me they get tired of walking and they want to be able to do workouts like they used to pre baby. More than just moving their bodies. A real sweaty workout. Some try to get back to the classes they liked pre-pregnancy, some try to run after walking for a while. Inevitably some of them always come back to me with some complaints. They leaked, or felt pelvic heaviness, like everything was going to fall out. 


My easy solution to this, if you want to feel like I'm there with you, coaching you on how to protect your abdominals and pelvic floor is to join Every Mother. This regimen is evidence based to close diastasis recti (read strengthen the abdominals safely) and involves body weight, low impact, definitely get you sweaty workouts. It's like a class at the gym, but you can do it from home or anywhere with the app on your smartphone. I know for me it’s hard to workout with the littles crawling around my legs, but I try to incorporate them into the exercise. I also love that most of the workouts are around 10 minutes, max of 20. I can often get that in before everyone wakes up, at nap time, with them around, or even sometimes in between patients at work!


I love the message of Every Mother. They are doing a great job of supporting all aspects of maternal health through their EM Village and online support groups. 


Check it out and I promise you'll love it! Let me know


Loretta's birth story

Loretta Rae Inman. Born October 12th, 2019 at 8:42 a.m.  8# 5 ounces, 21 inches long.

I had been feeling some Braxton Hicks or prodromal labor on and off for maybe a week. On October 9th, as I drove home from work I was feeling this again. When I got home, we got dinner ready, and ate. After dinner I rested on the couch and the contractions stopped entirely. I got up went to work on Thursday morning, and same thing, after working all day, up and down on my feet, I started feeling contractions on the commute home. Anselm’s sister had previously agreed to babysit so we could have a date night before the baby came. Well, let me tell you, that was good timing. I decided I wanted some spicy food, to see if we could keep the contractions going and get labor started. We got ramen and walked around a little and it worked! My contractions started again, so we ended up going home early. But then I went to sleep easily.

Around 3:30 a.m. I was having them every 10 minutes and they were lasting about 35 seconds. This continued until I got up at 8. I had texted my mom around 6 that she should better come over when she could since she was going to stay with Estelle. When I got up and had breakfast and started walking around, everything stopped. Maybe 1-2 contractions in an hour. Ugh. 

So, I rested. We went on some walks. I did a miles circuit and tried to rest some more in case it did start again. I took a shower around 8 p.m and things picked up again. This was for real!

I think maybe around midnight I told Anselm I was ready to have Anna, my doula, come over.  I labored mostly in my living room and kitchen, switching positions, Anna helping with compression while I leaned against Anselm. Both of them reminding me to breathe and relax my muscles. 

We kept the on-call midwife in the loop, when I thought things were getting pretty hard, she listened to me have a contraction and didn’t think it was long enough for us to come in yet. She recommended I get in the shower, which I did. I have zero idea what time it was at that point. Eventually, I did feel like my water broke, and we left for the birth center pretty quickly after that. This was at 4am. 

I was definitely in transition during the car ride and when we arrived. I had a contraction in the lobby of the birth center and was laying over the couch. I remember yelling to Anna I needed her to compress my pelvis. It’s the only thing that felt good and was helping me get through the contractions.

When we got into our room, I spent some time in the bathroom sitting on the toilet laboring. Then it was everywhere around the room. In the shower, lay in bed, sit on a squat stool, in the tub, I don’t remember what order. I was in long and hard labor. 

I remember saying in the tub “I don’t think I can do this anymore.” Anna rolled some valor on the back of my neck. I remember asking Ali, the on call midwife, to check my cervix so I could have some idea if it was going to end soon. She said she would if I wanted her to at the next time they were going to listen to the baby. Again, I don’t know what time this was, or how much time passed until I actually delivered Loretta, but I never did end up having that check. 

I made the most progress in some form of water during my labor. When I took the second shower at home, in the shower at the birth center right before I got in the tub to deliver her. I was in the shower on hands and knees and started to feel a lot of pressure, and then finally maybe her head. That’s when they had me get into the tub. I was on my knees leaning over the back of the tub for a little bit, then the midwives had me turn around in a reclined position, I think because they saw her head too? Anyways, once she was there, it took one push to deliver her head, then I waited for the next contraction to push again and she came out fully. 

For a good chunk of labor at the birth center, I was basically screaming through my contractions, and it felt good to bear down with them. I’m not sure if this counts as my pushing. It probably does, but as I said before, I was in all different positions during this time, so I must’ve been helping Loretta come down into my pelvis and birth canal. 

Labor was hard. Delivery was so different and not as hard and beautiful. We got to cuddle in the tub and wait for her cord to stop pulsing, deliver her placenta and then snuggle in bed just the 3 of us. I’m so grateful it went the way it did, it was really healing for me after Estelle’s birth and NICU stay. 

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