Dr. Amanda Tavoularis has been committed to excellent dentistry for over 20 years. She studied at the University of Washington School of Dentistry and has gone on to complete over 200 hours of study at the prestigious Kois Center located in Seattle. She belongs to numerous dentistry networks include the American Dental Association and the Wellness Dentistry Network. With being a female dentist on the Dentably team, Dr. Amanda can provide her expertise for dental care for women as well as expecting mothers. She has a son of her own and is committed to providing the most accurate information possible for patients.
When you become pregnant, your body begins changing and preparing to bring a new life into the world. While it’s important that you remain as healthy as possible for yourself and your baby, it’s important to take special care of your teeth and gums while pregnant. In fact, many women can develop gingivitis during pregnancy. This is often referred to as pregnancy gingivitis and according to the CDC, 60 to 75 percent of pregnant women develop this disease while pregnant.This is important because gum disease can cause complications that result in premature births.
While pregnant it is vital that you take care of your gums to help prevent this disease. I have been practicing dentistry for nearly 20 years and have worked with women on prioritizing their dental health during pregnancy so they can safely carry their baby to term.
1. Have a Good Dental Care Routine
The best way to take care of your teeth and gums is to have an effective dental care routine during your pregnancy. This will help prevent gum disease and gingivitis. Good dental hygiene consists of brushing twice a day, flossing once a day, and using an antimicrobial mouth rinse. Another great way to keep your mouth healthy during this special time is to avoid sugary foods. Excessively eating foods high in sugar can lead to tooth decay and gum disease, so try incorporating more vegetables, lean proteins, and nuts and seeds into your diet to help prevent any disease.
2. Schedule Regular Dental Visits
You will also want to continue visiting your dentist during pregnancy to try and prevent gum disease. Professional dental cleanings are more important during your pregnancy and are essential to preventing tooth decay and gum disease. Your dentist can also evaluate your periodontal health so you both can work together to decrease the chances of pregnancy complications and delivering prematurely. Let your dentist know that you are expecting, and they will be able to accommodate to yours and your baby’s needs.
3. Seek Treatment Immediately
If you’ve been diagnosed with gum disease or believe that you may have it, it’s important to seek treatment quickly. The bacteria from gum disease can attack the ligaments, gums, and bones surrounding your teeth to create infected pockets similar to large infected wounds in the oral cavity. These pockets can provide access to your bloodstream and allow bacteria to travel throughout your body, down to the uterus and placenta. Visiting your regular dentist is the best way to treat your gingivitis or gum disease.
Most doctors recommend waiting until your second trimester before receiving dental procedures. Your dentist will give you a deep cleaning to get rid of plaque and build-up that’s contributing to the disease. If your gum disease is severe, your dentist or doctor may prescribe antibiotics to help combat the infection. Your doctor will know which medications are safe for you during your pregnancy, but be sure to let them know of any allergies that you have. It’s important that you take precautionary measures to make sure your mouth is as healthy as possible for you and your baby because premature births are more common in mothers with poor dental health. Regular dental visits, seeking treatment, and continuing a good dental care routine the best ways to help prevent gum disease and preterm birth.
Remember also to enjoy this time in your life and embrace the changes happening to your body. :)
Are you transgender or non-binary and wanting to start a family? Congratulations! You’ve taken the first step on a remarkable journey. There aren’t too many models out there of trans folks who have gestated babies or contributed their genetic material in order to become parents, and we have our work cut out for us because of transphobia and (cis)sexism. Luckily, there are more and more of us headed down this path, in spite of the oppression and microagressions we may face. This guide is for people who are unsure of where to start and are feeling overwhelmed with the process.
If you are or are planning to be a gestational parent, you will need to get clear on what feels important to you about your journey. Mapping out a timeline can be helpful, especially if you are taking hormones and need to stop so that you can start bleeding again. It can take some time for cycles to regulate themselves, so giving yourself more time than you think you need may be helpful.
PRO-TIP: You can get pregnant while on Testosterone. Even though T might have stopped your period, you can still ovulate, so making sure you are having protected sex until you are ready to be pregnant is really important if you are encountering sperm on the regular. Also, Testosterone and fetal development don’t mix, so if you do get pregnant while on T, please consult your healthcare provider.
You will want to begin thinking about what works for you in terms of tracking your cycle. Will you take your temperature every morning? How do you feel about the word “ovulation”? Think about what makes YOU most comfortable, which includes the words you want to use for your body.
In order to prepare your body, consider taking a prenatal vitamin and drinking pregnancy tea or taking a supplement to get ready. You may want to price all these out in advance so you can get a clear idea of what makes sense for your budget. Acupuncture can be very helpful in regulating cycles, and going to a community acupuncture clinic can make it more affordable.
If you want to contribute sperm to make a baby but are considering beginning feminizing hormones, you will want to bank your sperm before starting. Spironolactone and Estrogen can lower your sperm counts and make conception difficult.
PRO-TIP: Some transfeminine folks can lactate using medications and breast pumps! It’s a journey you want to do a lot of research on, but know that it is possible. Definitely consult your healthcare provider and discuss with others who have done it before.
Have a trans friend who has been on a fertility journey? Luckily, our communities are resourceful, and can be a wealth of knowledge. Listen for the names that come up again and again, and contact those folks. If you don’t have insurance or a lot of financial resources, consider asking about sliding scale offerings. Some birth professionals will do consults online so if you are located in an area with a lack of resources, this might be an option for you. Have a healthcare provider you trust who isn’t a birthing professional? Ask them. They are likely well-connected and may be able to find someone you can work with.
Don’t be afraid to ask your providers about their experiences working with trans and gender expansive folks around fertility. If a provider looks at you sideways when you ask this question, this probably isn’t someone you want to work with. It’s not your job to educate your providers about your experience, and only you can decide whether you have the energy to offer much needed education. If you feel uncomfortable with someone, you don’t ever have to go back to see them. Ever. It may take a little longer to get your ducks in a row, but you deserve competent and affirming care no matter what. If you feel up for it, you can tell a professional that they misstepped, or offended you, or you can email them later. But only if you have the energy. This is a demanding journey, and you want to feel empowered as you are imagining your little one into being.
Sometimes folks write up a card with information about their pronouns, what words they’d like professionals to use for body parts, what words they want people to avoid, what they plan to be called as a parent, and any other relevant information. You can give it to your provider up front, before any questions are asked. This can be helpful for you and can act as a reference guide for your provider. It can also alleviate awkward feelings if someone slips up because you have something to refer back to if you need to. Remember, pregnancy and birthing have been talked about in binary terms forever and ever, but things are changing, and you are a part of that!
Connecting to others who are going through this process or have been through it is super important. There are a few support groups online that can help to alleviate the feelings of loneliness, with people who understand that dysphoria crops up constantly around trying to get pregnant for trans and non-binary folks. Your nearest LGBTQ center may have some ideas about where to go for more support. No one should have to go through it alone if they don’t want to. Since we have to imagine alternate models of family building than the ones our straight and/or cis coworkers, friends, and family members do, we need to hold each other closely during this time. This goes for non-gestational parents too, whose mental health needs are often overlooked.
Finding a therapist to validate your experience, listen to your feelings, help you make sense of it all, and be with you through this time can be a game-changer (see above on navigating provider relationships).
Audre Lorde said “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.” Do what you need to ensure that you’re breathing, showering, eating, hydrating, taking it slow, and showing up how you need to show up. Having compassion for yourself is such a HUGE step in this process, even when it feels near impossible. You may experience some new feelings of dysphoria that haven’t shown up before. Roll with those. The tension around being a masculine birth parent or being a parent who lactates but isn’t gestating a child can be a challenging experience. Being super gentle with the feelings you’re having, finding support, and doing what your body needs to do can be an antidote to shame and frustration.
Consider what gives you life as you are trying to create life. Under our cis-centric, binary system, we might not feel like we have a lot of choice. Remember, no matter what kinds of changes you go through in this process, you do have choice and agency around your care. Being a parent does not have to be a gendered experience, and certainly doesn’t invalidate your gender.
If you are struggling to identify these things and finding the journey harder than you thought, feel free to get in touch with me at email@example.com. I am a trans therapist who is invested and involved in providing conception and birth support for transgender, non-binary, and gender diverse communities.
Did you know that the healthcare industry is the largest producer of waste in the United States? And the United States is the largest polluter in the world, producing a total of 236 million tons of waste annually. Although we make up only 5% of the world’s population, we produce a whopping 30% of the world’s waste. It is sobering to think about how much of that waste is generated by hospitals and the health care system.
We are currently in the most dire period of climate change in human history. NASA states that the carbon dioxide levels are up 409 parts per million, meaning that CO2 levels are at their highest in the last 650,000 years on this planet. The global temperature has risen 1.8 degrees Fahrenheit since 1880. 13.2% of arctic ice melts every decade. The UN Environment Programme estimates that 200 species go extinct every day.
Climate change doesn’t affect everybody equally, however. Environmental racism plays a central role in the climate change crisis. The people affected most by the natural disasters resulting from the rising temperatures of our planet are people of color in the Global South. While the “first world” produces most of the world’s pollution, the poor people in the “third world” are the hardest hit. Even in the United States, people of color are much more likely than white people to live near polluters, breathe polluted air, and drink poison water.
Similar inequities exist in our healthcare system, particularly when it comes to maternity care. Did you know that black women/birthing people are 3 to 4 times more likely to die in childbirth than white women/birthing people? In cities like New York, black women/birthing people are actually 12 times more likely to die in childbirth. The inequities of our healthcare system mirror the inequities of climate change- the most disenfranchised are the most likely to be injured or die.
While Capitalism has benefits for many, it is also a system causing death and destruction for most- including our planet. Since the Industrial Revolution in the 18th Century, greenhouse gases have risen 260%.
Interestingly, this was about the same time that doctors and the Western
Medical System began gaining a foothold in the United States. (White, male) doctors began replacing community healthcare providers and midwives, completely altering the collective approach to healthcare and gaining control over populations.
In 1844, Samuel Morse invented the telegram, allowing for rapid communication and unprecedented industrial expansion in the United States. The American Medical Association was founded just three years later, an organization which lobbied extensively against midwives and other community healthcare workers. They insisted, through new legislation, powerful connections with the government, and effective slander campaigns, that the population’s healthcare move under their domain.
These newly powerful white male doctors assumed that nature was flawed, and that they could improve human birth by intervening in the process with drugs and technology. This assumption led to the (supposed feminist) invention of twilight sleep in the early 1900s, which was the practice of sedating a woman to unconsciousness during childbirth. This intervention necessitated the routine use of forceps (because birthing people could not push). Thousands of birth injuries resulted from the common misuse of forceps during deliveries. Doctors also began the practice of separating babies and mothers at the time of birth due to a completely imagined risk of infection, and managed to essentially eliminate breastfeeding for a time, thinking that factory-made formula could provide better nutrition to human babies than human milk.
This erroneous assumption that the female body needed technologies and interventions to birth and feed our babies coincided with the societal trend towards industrialization. In the same decades that more medicalized childbirth grew in popularity, Orville Wright made the first powered airplane flight and Henry Ford created the Model T. As humans invented more and more technologies and the world became reliant on fossil fuels, we began to deeply medicalize birth in our society.
Nestlé, the largest producer and distributor of formula in the world, got cozy with the American Medical Association in 1932 when the AMA passed a law stating that the formula industry could only advertise to the medical profession. In the 1930’s, about 77% of infants were breastfed; by 1972 the number dropped drastically to 22%.
In the late 1970s when the general public and many medical professionals realized that breast is best (surprise!), Nestlé and other large formula companies began a powerful campaign in the Global South for women to feed their babies with formula. The same places that are the hardest hit by climate change are the countries that have the highest rates of formula use. And first world companies continue to profit. The global baby formula market is expected to be worth about $62.5 billion dollars by 2020.
We can no longer afford to waste so many resources. The oceans are filling with plastic and our water supply is becoming increasingly contaminated with pharmaceuticals and other chemicals. Not only are we wasting incomprehensible amounts of material resources- we are wasting whopping amounts money. It is estimated that the US healthcare system wastes $765 billion annually- about a quarter of what it actually spends.
It’s time we reinvent the healthcare system so that we can heal ourselves, and mitigate the damages we have caused our planet. We need to cut unnecessary wastefulness in our healthcare system (NPR provides some great ideas here). We need to invest more in preventative forms of healthcare, including non-Western modalities such as acupuncture and other forms of eastern medicine. We need to re-center midwives as the primary providers for low-risk birthing people (the countries that do this have much better outcomes than the countries that don’t).
It’s time to reform our healthcare system. The planet depends on it. Female bodies (and humanity in general, birthed from these bodies) depend on it. Scientists estimate that by 2035 we will hit an unprecedented change in the earth’s atmosphere. Our home is changing rapidly. We have already seen huge climate transitions in our lifetimes, and many of the world’s powers have yet to make committed decisions to get behind renewable energy sources and leave fossil fuels behind.
Let’s ameliorate climate change disasters as much as possible. Let’s re-learn how to respect our earth, the original Mother. And with this, may we remember to respect the female body again.
One thing the whole Dr. Christine Blasey Ford and Kavanaugh process reiterates: we live in a violent and sexist culture. But, things are changing.
Never before have conversations about sexual harassment and sexual violence been so frequently spoken in our media or political sphere. People everywhere are getting behind the #BelieveWomen and #MeToo platforms. And while we have a very long way to go, I feel hopeful we will get there, eventually.
One thing that the courageous Dr. Ford’s testimony shows is how traumatic experiences can affect us for our entire lives. Anybody with an ounce of compassion could see, during her testimony, how the trauma and violation of her experience with Kavanaugh as a teenager still haunts her deeply.
It goes without saying that sexual traumas are far too common in our society. Another trauma that is all too prevalent in the United States and throughout the globe is birth trauma. Although the two are related, I would argue that birth trauma is the most common hurt people experience in our society, because it affects each and every one of us.
Almost everybody in our modern society has experience with birth trauma. Those born in the 1930s-1960s experienced the trauma of having mothers who were unconscious from twilight sleep, being pulled out by forceps, separated from their mothers for up to a week, and/or denied the benefits of breastfeeding. While most of these practices have evolved or changed since the 1960’s, birth trauma persists. Birthing people report being verbally abused by their care providers during labor, given unnecessary surgical procedures like episiotomies or c-sections, and/or generally emotionally dissatisfied with their prenatal care and birth experiences. Babies born under these conditions (a.k.a. most of the humans in this world), have our first experiences of this world marred by this painful and confusing phenomenon. We are affected by these traumas in more ways than we consciously know.
Sexual and birth traumas are inextricably connected. Of course a society that does not respect or value the female body will relate to birth the way we do. The Western Medical System is deeply sexist and patriarchal, controlled by the some of the same old white men who are running our country.
The good news is- humans have an innate and powerful capacity to heal ourselves. Whether it relates to birth, sexual trauma, or any other form of hurt, we are absolutely capable of healing. And not only are we capable of healing ourselves- we help each other heal. We are getting more and more connected, building movements which offer hope to future generations. For the first time in history, white men are the minority of house Democratic nominees. Women of color and trans folks are winning key elections. Birth justice is finally a part of the conversation, with states like New York and California creating initiatives to attempt to address the birth disparities facing black birthing people and other birthing people of color. We have so much more to do in changing the hospital system, making midwifery care more accessible to more people, and eliminating sexual violence from our culture. But, things are changing.
Blessings to Dr. Ford, everybody healing from sexual traumas, and all of us healing from our births.
In the wake of the #MeToo movement, there is one group of people’s voices that still remain silent: birthing people.
It’s wonderful that more and more women, female-bodied, queer, and trans people are speaking out against the sexual harassment and violence they have endured and continue to experience in our society. It’s wonderful that this information is so public that it is hard, even for the most privileged, to ignore. Sure, we won’t see an immediate end to sexism, male violence, and harassment. But it’s a step in the right direction.
I am concerned, however, about a huge blind-spot that our culture has: birth.
Birth is an intimate, vulnerable, and intensely human experience. UNICEF estimates that about 353,000 babies are born each day around the world. And every day, thousands (or hundreds of thousands) of birthing women experience violence during the births of their children. Birthing people are often coerced, threatened, and violated during their labors, births, or postpartum times. They are separated from their babies, ignored, or forced to experience any number of inhumane acts perpetrated by the patriarchal hospital system.
Obstetric violence is yet another form of sexual violence female-bodied people are consistently experiencing in our society.
There have been many stories coming out in the last 5 years where women or birthing people have reported cases of obstetrical violence. Caroline Malatesta won her lawsuit against the hospital where she gave birth after suffering PTSD and permanent nerve damage when the nurse forcefully held her baby in her vagina while she waited for the doctor to come into the room. “Kelly” sued her obstetrician for assault and battery after he conducted a multiple-cut episiotomy even though she explicitly sad “no.” Doulas report a “hidden epidemic” of doctors abusing women in labor.
However, there are still millions of cases globally where the rights of birthing people are ignored, where their genitals are touched or cut without their consent, or their bodies are used in ways they explicitly refused. It is not uncommon to see doctors forcefully conduct vaginal exams on women during labor, even while they explicitly tell them to stop, for no medical reason whatsoever. This is, by definition, rape.
Especially for immigrants, people of color, and poor folks, these stories all too often go unsaid and/or unheard. It takes privilege to stand up and say that one has suffered sexual harassment, abuse, and rape. With every story told with the #metoo hashtag, thousands of stories go unheard by women around the world who are not able to tell their stories for fears of greater violence or disenfranchisement. With every story about obstetrical violence we hear, thousands of other stories go unheard, getting internalized in women’s bodies and passed on to future generations.
My partner’s mother was raped when she went to her doctor for a routine prenatal checkup. She stopped going to that doctor, but she didn’t report him to the hospital because of the race and class dynamics that made her feel (rightly so) that the institution wouldn’t listen to her.
My grandmother, who survived the Auschwitz concentration camp when she was 15 years old, is more willing to talk about the horrible atrocities she suffered during the Holocaust than she is about her first birth experience in a hospital in Brooklyn, New York, in 1962. The experience of being strapped to a bed, verbally abused, and locked in a room alone during the birth of her first child was, for her, torture. She was then separated from her baby for a week and discouraged from breastfeeding. Subconsciously, she never forgave my aunt for having to live through that experience, and it continues to affect their relationship 56 years later.
There are some wonderful obstetricians in this world. Many male, female, queer and trans doctors advocate strongly for patient rights and autonomy and provide excellent, respectful, and compassionate care to their birthing patients. Unfortunately, these doctors are not the norm. They have managed to hang on to their sense of humanity through their journeys through medical school and their participation in the Western Medical System.
It’s not that doctors are bad people. The vast majority of doctors have good intentions, and want to take care of their patients as best they can. But they work in a system that does not prioritize consent, that positions their patients as less knowledgeable about their own bodies than they are, and that sets up a power dynamic where doctors can exploit their knowledge to get inappropriate access to their patient’s bodies.
Did you know that James Marion Sims, known as “the father of modern gynecology,” conducted experiments on female slaves, without their consent and without anesthesia? Did you know that medical students are sometimes taught to perform pelvic exams on anesthetized women, without their knowledge or consent? And that this is only illegal in four states? The Western Medical System has an abominable track record for prioritizing consent.
We need to start connecting the dots between the sexism, the violence of the patriarchy, and the Western Medical System. We need to start calling obstetric violence what it is.
Just as men who are true allies to women need to be actively engaging with other men to end rape culture, so must obstetricians, doctors, and other influential members of the Western Medical System band together to stop obstetric violence. Just as men need to stop thinking that they deserve control over female bodies, doctors need to stop thinking that they know better than their patients, and that they can do anything they want to their bodies under the guise of practicing medicine.
The midwifery model of care offers a much-needed alternative to Western obstetrics. Midwifery, a century-old craft, means “with woman,” and it does exactly that. The midwifery model of care prioritizes holistic female well-being (along with caring for the safety of the fetus/newborn). It is not only about keeping the birth safe. It is about keeping the birthing person feeling safe, which is an important part of protecting the physiological process of birth.
Just as cis- and trans- women in our modern society need advocates leading us to a world where we are not vulnerable to gender-based violence, birth needs midwives and other birth advocates to be a voice for the truth.
The health and healing of humanity depends on us changing the way we see birth in our society.
After all, we are ALL born. If mothers feel unsafe, violated, or abused during births, their newborn babies will store those experiences in their nervous systems. Medical research agrees: birth affects us in deep, lasting, and powerful ways. Whether we are born through a cesarean section, vaginally in a hospital with an epidural, or at a homebirth, our birth experiences affect us for the rest of our lives.
Tarana Burke, the founder of the #MeToo movement, said, "I see all these people who are interested in this issue. Sexual violence is deeply pervasive and touches everyone across race, class, gender and ability and we have to find a way to move the needle." Similarly, obstetric violence affects women and birthing people across race, class, gender, and ability. While every woman is vulnerable to obstetric violence, we are not all affected equality. Because of racism, women and babies of color are more vulnerable to the horrors of obstetric violence. In the United States, black women are dying in childbirth three to four times as often as white women, and Latina women die twice as often as white women. Black babies are more than twice as likely as white babies to be born prematurely.
We need more midwives, especially midwives of color, caring for more birthing people in this country. We need more women and birthing people to know what their options are around giving birth. We need our society to provide empowering images of birth to everybody, especially young people. We need people to know how mighty the female body is- that it can grow a life, and birth it into this world, with power and grace. When we are empowered to have our children in this way, we will birth a new generation that understands consent, body autonomy, and true empowerment. And that’s exactly what our world needs.
Let’s build on the momentum the #MeToo movement has built and end obstetric violence. Let’s make birth the safe, empowering, and connected event it should be. #BirthMatters.
Marea Goodman is a licensed midwife living in the California Bay Area. She is passionate about the liberatory power of birth and sees it as a key feminist issue. Marea believes that if we can change the way this society views birth, that it will have a key and lasting effect on the health and healing of future generations.
This article was written by Sage Staggs, a licensed acupuncturist specializing in treatment for queer and trans folks in our community. Sage offers support for menstrual regulation, fertility, conception, pregnancy, postpartum, and menopause, and has expertise in supporting families and individuals who are trying to conceive via insemination, IVF, IUI, and other assisted reproductive therapies.
For more from Sage, visit https://www.sagestaggs.com/.
Learning to track your menstrual cycle
Where are you in your cycle right now? How was your last period- was your bleeding heavy or light, dark or pale, clotty or smooth? Any cramping?
If you are a patient of mine and you menstruate, then you are familiar with this conversation. By asking about details from your cycle, I learn about your constitution and how to apply effective acupuncture and herbal strategies that support your overall vitality, help ease discomfort, support healthy periods, and optimize fertility.
Although tracking these signs is crucial for those who are trying to conceive (and also those wanting to avoid pregnancy), it is also helpful for folks experiencing conditions such as PCOS, fibroids, amenorrhea, endometriosis, or perimenopause. By keeping a detailed record of your emotional and physical experiences at different times of your cycle, you can track your responses to treatments along with diet and lifestyle changes.
Photo by Raul Petri on Unsplash
The list of symptoms you may want to track varies depending on what your health goals are. Here’s a list of the basics and what they tell you:
Cycle length: The most basic aspect of tracking your cycle is simply counting how many days it lasts. “Day 1” is the first day of menstruation, and the count starts over every time you get your period. An average menstrual cycle lasts 28 days, with bleeding for the first 3-5 days and ovulation occurring around day 14. Your cycle may not fit into this template, and tracking the date that you start bleeding every cycle will help to establish a pattern (or lack thereof in the case of irregular menstruation due to PCOS or anovulation).
Premenstrual symptoms: Are you bloated, cranky, tired? Do your breasts feel sore? Having night sweats? How many days before your period do you start experiencing these symptoms? This can help determine what needs to shift in order for you to experience more pleasant cycles with less of the above.
The period: How many days do you bleed? Does it start or end with days of spotting, or turn on and off like a faucet? Is your bleeding heavy, medium, or light? What is the quality of the blood- big clots, small clots, thin and watery, or thick and viscous. Is it bright red, dark red, brownish or purple? Tracking these details can help to illuminate the nature of any imbalances in your cycle.
Basal body temperature (BBT): This is your waking temperature, taken within moments of awakening, before you get out of bed. By measuring this temperature down to a tenth of a degree, you can verify if and when ovulation has occurred. When measured over the course of three or more months, you can use this information to help predict your fertile window- the 6 days of each cycle when your body is able to become pregnant. In addition to fertility support, basal body temperature can be a useful tool if you have especially long or irregular cycles, or if you are perimenopausal and suspect that you may be having anovulatory cycles. The patterns in temperature shifts on your basal body temperature chart can be interpreted to bring to light possible issues with your cycle that can be addressed by acupuncture, herbs, diet, and lifestyle changes.
Cervical fluid: You may have noticed that you have more vaginal discharge on some days than others. If it is relatively odorless and clear or whitish in color, then this is likely healthy cervical fluid that increases in flow around ovulation. By observing the timing, amount, and quality of cervical fluid over a number of cycles you can predict your fertile window, and also the likely date of your next period, since the time between ovulation and menstruation is a set number of days for most people.
Cervix position: If you have yet to feel or look at your cervix, you may want to try it out! During ovulation, the cervix opens slightly, becomes soft, and sits high within the vagina. The rest of the time it is closed, firm, and rests lower within the vagina. By feeling it with you fingers, or viewing it with a speculum and mirror, you can track its position and density and add these to your other signs of ovulation.
Other physical signs of ovulation: Some people experience bloating, back pain, ovarian cramping, and other unique physical symptoms when they ovulate.
Tests: The most common at-home test used to monitor ovulation is an ovulation predictor kit (OPK). OPKs measure the amount of luteinizing hormone (LH) in your urine, which surges right before ovulation. Some OPKs measure the increase in estrogen that happens right before the LH surge, too. Recording the results of your estrogen or LH tests helps to establish a pattern of ovulation, and can be used during the cycles you are actively trying to conceive to plan your timing.
If you haven’t already, I recommend that you start using a cycle tracking app (or devise a handwritten system of record keeping- printable charts can be downloaded here). Apps to check out are Kindara (my favorite), Ova Graph, and My Flo. Clueis the most gender neutral and easy to read app, but as of this writing, their BBT function isn't adequate. The most detailed book on cycle charting is Taking Charge of Your Fertility by Toni Weschler. She expands upon the methods I mention here and explains why and how to track each particular symptom.
If this is all new to you- no worries, we are all learning! Now is a great time to slow down and listen to the messages your body is sending. If you’re not sure what they mean, or you’d like to shift into a place of more ease, call me for a consult: 503-939-1051, or book online!
Stories on Birth and Parenting
Reflections on Motherhood: Lenea Kalima Salde-Azzam (11/18/17)
Lenea: Heavenly Flower (Hawaiian)
Kalima: Speaker; Mouthpiece (Arabic); “The formal declaration of faith” in Islam.
The Huge Decision
We prepared as much as we knew how to. My partner and I are community organizers, and we know how to plan! We know how to put together outlines and benchmarks and work lists, etc. We had binders of research, and tracking forms, and food and exercise plans. We documented midwife visits, came with questions, did acupuncture, took the herbs, went to birth education class. And yet, the only thing we were pretty sure about was that we weren’t really sure what we were doing. Even with all the support, love, and care from Marea, our midwife, there was really no way we could have prepared for this beautiful chaos.
The process was hard. I had had a miscarriage in 2017 and when I got pregnant six months later, I was afraid to be excited. My partner and I went to the hospital the first time around for an intrauterine insemination (IUI) procedure, and when we went back the second time around they were no longer doing IUI’s. We were totally heartbroken because we thought that that was our only option. We sort of stumbled upon midwifery, did our research and called one midwife and asked her a series of questions and then decided to work with her for the the IUI procedure. We were shocked at how different the experience was and how grounded we both felt during the process. When we found out that I was pregnant, we immediately called our midwife, who then talked to us about home birth and invited us to a movie screening and roundtable discussion.
We decided to “entertain” this idea, but were definitely not sold until we watched The Business of Being Born and talk to other midwives, doulas, and pregnant women at the screening. We both agreed that night that we felt we could provide the space in our home to bring the baby into the world the way we wanted — in a calm, warm, musical environment. After deciding to work with a midwife and have a home birth, our midwife informed us that she too was pregnant. So, she referred us to Marea Goodman, whom we grew to love very much. Marea held space for our family to go through this process in such an incredible way. She not only provided the knowledge and medical support that we needed, but she did it in a way that was thoughtful and caring. She upheld our rights when we hadn’t even realized that we had had experiences in healthcare that were both humiliating and traumatizing. Marea treated us with dignity and supported us through worry and fear. Our family is eternally grateful for the love that Marea helped bring into our lives.
Reflections on the Labor
This was the most intense “moment” of my life. What I remember now, four months later, are shades of memories. I am reminded of the time we spent in our beloved space at home, so carefully arranged so that we might bring life into it. The lights are dim and my partner is looking deeply into my eyes, waiting for me to tell her what to do, how to help. But, I gaze back at her and without words she knows that her presence and the ways she is squeezing my hips is enough. I look at her and think, “everything is about to change my love.” The words won’t come out, but we both know the moment is upon us.
My last day of work was Wednesday; I remember I also had a meeting that evening. I checked in about how excited we were and how nervous I was to have 2 weeks off before the baby would be here. But she had her own plans. That night I woke up to contractions. I felt a little sick and felt sweaty while going through each one. By the morning I was only experiencing some tightening, so thought whatever it was, had passed. I drove my partner to work in the morning and went home. I started to have more contractions, so tried to get in touch with Marea to see if it would be okay to go to get acupuncture. I went to see Marea that evening and she confirmed that I was in early labor. We went to eat and then went home.
That night the contractions intensified, coming every 6 minutes. With each surge, I felt more empowered to get our baby here. I felt ready and aware of all that was around me - every ancestor and every candle lit for the welcoming of our little one. Around 3:00am, the contractions started to spread out to every 8 minutes, and then increased in time to every 20 minutes by 7:00am. I felt disappointed and tired. The next day was difficult. My best friend and partner stayed with me in our bedroom. I remember the smell of mom cooking spaghetti in the kitchen and the sounds of Jeanelle and Nikki sitting on the bed talking about how the night had gone. I hadn’t slept more than 20 minutes at a time the night before, so Nikki went to get me Benadryl so that I’d be able to get some shut eye. I buried my face in the pillow and felt comforted by Nikki’s lingering smell.
4:00PM approaches and by now I’m getting scared. The contractions are starting to get closer together and it makes my heart beat faster. All of sudden I’m overwhelmed by fear. I’m afraid that I won’t be able to do this, so I tell Nikki to call Marea and tell her I want to go to the hospital. Marea gets on the phone and talks me down and says that she’s going to come over. I pray that she will get to the house soon, and help me. I can barely keep half a banana and a bite of spaghetti down as the contractions start to get closer together. They have stayed at 8 minutes apart for hours and hours. I’m so exhausted and now Nikki and Jeanelle are talking about putting on Star Wars. I stand next to the bed so that I can watch too — but the surges are just too strong. I can’t concentrate on anything but the baby. Marea comes behind me and rubs my back and gives me water. Hours have passed and the lights have been dimmed. I look up and see the prayer flag that my community has given us. I look around at the confirmations that Nikki and I have written: “God is with us.” I rock on my bouncy ball, head in Nikki’s arms, thinking about the women that we met in the Philippines, who gave birth in grave conditions, women who were taken from their babies when they became political prisoners, women who died giving birth at checkpoints. I lift my eyes to the sky and breathe. In this moment I’m overwhelmed. I feel like my heart is going to fall out of my chest. I pray that my own mother and mother figures in my life know the love we share. I feel their life in my veins.
I climb into the water, but am too exhausted to keep myself up. I stay there, laying back in the water to rest, and come up to the side, embracing each surge as it prepares me to bring forth life.
I struggle through each one. But, I can’t anymore. I climb onto the bed and the women around me hold me as I push. I trust when she tells me to push. I trust when she tells me to push down. I trust when she tells me not to be afraid. And then. Then she is here. “She’s healthy.” WHAT?? We had a girl? And then the tears come. The hyperventilating silence and awe. I am feeling her on my skin, breathing and looking up at me.
When I think of how I might be as a mother, I hope that my daughter knows that she was raised collectively, and that she is a product of hundreds of years of resilience and strength that she might know in her lifetime, collective liberation. I hope that she knows the love of community and works for the good of the people. I pray that she will have a spirituality that connects her to God and all that is beloved. I hope that she stays connected to the earth and the water and loves to be in the water as much as she loves to splash around during bath time. I hope that she has passion for what she loves and uses her voice in the same way she takes her pacifier out to say what she wants to and then puts it back in by herself so that she can rest more easily. I pray that stay connected to her mother/father/parent figures so that they may give each other life.
The Revolution Will Be Midwifed!
Midwifery care is not only for pregnant people. Midwives perform basic health checks for people of all ages and sexes, offer screening for sexually transmitted diseases, order labwork, and provide our children with thorough, accurate, and compassionate sexual education. Throughout history and across cultures, midwives have held many different roles in societies. We have cared for people through the generations- from birth to death. We have helped to support everybody, regardless of age, sex, and gender, to be healthy and connected to themselves.
For centuries, humans held control over our own healthcare. We used food and herbs and different traditions to help keep us healthy and to nurture future generations. Midwives were, in most cultures, some of the most appreciated and respected for our practical and spiritual knowledge of health and wellbeing. As community members, our roles were to empower others with the knowledge of what they needed to be healthy and well, so that they in turn would become their own best caretakers.
Today, in American society, we have lost the collective ability to care for ourselves. We are trained to look outwards for health: to doctors, to pharmaceutical medications, and to ever-changing technologies aimed to make us healthier and happier. Low-income and communities of color are the hardest hit with limited or no access to fresh fruits and vegetables, increased exposure to environmental toxins, and a lack of preventative healthcare options. As a culture, we no longer revere midwives as bedrocks of community healthcare, and we have lost the trust in our own bodies that we once had. This decline in respect for midwives and autonomy over our own healthcare is entirely intertwined.
In the United States in the early 1900’s, the newly formed American Medical Association began gaining power. They conducted a smear campaign against midwives, painting us as dirty, untrained, and inferior, and introduced the culture of looking to (male) doctors and hospitals for care. Not only did they dishonor midwives: they sowed the seeds of fear and mistrust in our own bodies. A new culture of medicine was born. One in which we thought that we needed doctors to tell us when we were healthy or unwell. Where we thought that we needed obstetricians to keep us and our babies safe during childbirth. Where we needed machines, professionals in white coats, and medications to keep us alive.
Western medicine has created this absurd idea that the female body would not be able to give birth without doctors to keep them safe. If that were true, how could we have possibly survived as a species? There have absolutely been some important advancements in birth that the Western medical system has offered. Antibiotics have protected babies and birthing people from infections, anti-hemorrhagic medications have saved countless lives, and cesarean sections have allowed many babies to live when they would not have been able to be born vaginally.
Unfortunately, we often take the benefits of Western medicine too far. We have gotten to the point in our society where we have overused antibiotics for humans and animals resulting in the creation of super-bacteria which are resistant to all of the medications we have. In the US, we perform major surgeries for the births of 32% of our babies, where only about 10% are considered necessary by the World Health Organization. Almost 10% of our children between ages 6-17 are on some type of psychiatric medication, with proportions increasing for low-income children of color.
When hospitals and doctors took the place of community healthcare and midwives, we forgot how to care for ourselves. We began to fear birth, even though our ancestors had done it successfully for thousands and thousands of years. We began to control and regulate the female body, to conceal sexual knowledge from our children, and to insist that everything be treated with pharmaceutical medications.
We lost autonomy over our own healthcare, because the power of our autonomy was more that our patriarchal society could withstand.
Imagine we lived in a world where children grew up knowing about their bodies and how they work, where they learned about the local plants that could help keep them healthy, and where they had healthcare providers who had known and cared for them since before they were born. Imagine we lived in a world where men took it upon themselves to teach young boys about consent and intimacy, and where all children had community members they could talk to about their changing bodies and sexualities. Imagine women and other people with uteruses knew how to strengthen or restrict their own fertility. That when they decided to have a baby, they could be supported and accompanied by someone in their own community who knew best how to care for them because of their longstanding and trusting relationship. Imagine that when people died, they could be surrounded by the friends and family they were closest to, cared for by loved ones with a sense of connection and whole-ness.
This reality is not so far-fetched. In today’s modern world, where the internet connects us globally like never before, we have access to unbelievable quantities of the information we need to take back our healthcare. Online health forums, medical blogs, and high-quality research is accessible to anyone with curiosity and basic technological skills. The internet is packed with online parenting groups and discussion boards for people considering unassisted homebirths or attempting to heal cancer naturally. We need to learn the critical skills to sort through various qualities of information and determine what actually applies to us and our communities. The knowledge is here: both through written knowledge and ancestral wisdom, ready and ripe for us to remember.
In this moment in US history when our collective access to healthcare is being threatened to an even greater extent than it already has, we need to re-learn how to keep ourselves and each other well. We must take our healthcare back into our own hands. I am not advocating to disregard Western medicine and the tools and technology we already have. I am, however, arguing for a change in our collective paradigm of healthcare. We need to re-create a culture where we are connected to our bodies, our babies, the earth, and our humanity. We need midwives to again become central parts of our communities’ healthcare systems, and to teach us how to care for ourselves and each other. No doctor can save us. Let’s support each other to save ourselves.
Do you have ideas on how to create and support community-based healthcare that is accessible to everyone? Please comment below!