Matrescence – a journey to motherhood

An enormously underestimated and often under acknowledge stage in a woman’s life.

We are all aware of the term adolescence, those awkward teenage years where a young girl or boy’s body starts to change and mature. We understand this is due to hormonal and physical changes occurring alongside a shift in identity and relationships. It is widely understood that you cannot escape this transition; your body will naturally shift. We know this term and we understand it.

Unfortunately, the awareness of the term matrescense is not so widespread.

Matrescense, coined by anthropologists in 1973, refers to a time of intense transformation when a woman becomes a mother. This time is physically and emotionally profound, an identity shift. A woman’s brain is upgraded and functions differently as she journeys into motherhood. Incredible!

Many new mums experience feel confused and conflicted, like they are on an emotional see-saw as they try to navigate how to care for their newborns and themselves at the same time. What they previously knew about themselves is no longer relevant.

Wouldn’t it be great if this transition and change was openly discussed and normalised? If a mother could understand the normality of the physical and emotional changes she is experiencing? Perhaps she would feel less alone and isolated? Less like she is ‘doing it wrong’?

Matrescense is a time that requires support, understanding, education and awareness. Encourage the sharing of authentic experiences and stories, speak up and give women the space they need to become mothers.

A great resource I have found is by Dr Oscar Serrallach titled ‘The Postnatal Depletion Cure’. A book guiding you on ways to rebuild your health and energy as you move through motherhood.

Tamsyn x

Pelvic floor health postpartum

We have all heard of our pelvic floor muscles and know they are important, but do we really know how important?

What are they & what do they do?

Pelvic floor is a name given to a group of muscles and ligaments which lie deep in the pelvis, attaching to pelvic bone like a hammock, from front to back.

This sling works to support your pelvic organs and control bowel and bladder functions. When strong they allow you to ‘hold on’ when you need to and provide physical support to avoid prolapse and potentially lowering associated back and hip pain.

Pregnancy puts ALL women at risk of weakness and incontinence due to the weakening of muscles which are trying to manage the weight of a growing baby.

Additionally, hormonal changes, constipation and childbirth all contribute to pelvic floor weakness.

How do you know if you have a weak pelvic floor?

The most common symptoms include: urine leakage and or increased urgency when needing to use the toilet and difficulty with control of wind or bowel motions. Sometimes women report a heaviness or pain in their pelvic region.

Advice postpartum

Firstly, be gentle on yourself.

• Walking – After delivery early mobilisation has many benefits on recovery, including strengthening of your pelvic floor. Soon after delivery, moving gently around the room and gradually increasing over the coming days and weeks until you are able to achieve a 20-30 minute walk each day is recommended.
  * Avoid strenuous exercise for the first 3 months, allowing your muscles to regain strength before placing excess pressure on them.

• Rest, Ice & Compress:
  Key messages in reducing swelling and assisting recovery include:
  
  – Resting for at least 2 hours each day horizontally (laying down) for the first 6 weeks.
  – Use an ice pack in your underwear (inside your pad) for the days immediately postpartum.
  – Purchase supportive underwear/shapewear to support the perineum.
  
  Ideally you will be in contact with a physiotherapist in your postpartum period to assess your pelvic floor recovery.

In addition to walking, incorporating appropriate exercises in combination with specific pelvic floor exercises can help strengthen and recover.

I discuss and refer many women for physiotherapy assessments in pregnancy and postpartum. Talk with me at your next appointment if you feel you may benefit.

Tamsyn x

Advice for Dad’s!

Becoming a Dad is one of the biggest changes a man will go through.

There is a strong focus on supporting and helping mum’s navigate challenges of early parenthood, however sometimes we forget to include the Dad! It takes two to tango after all.

Dad’s often wonder where to start and how to find their individual role in their new family dynamic.

Early parenthood is a time of intense transformation, lack of sleep and a LOT of learning. Supporting a man’s transition into fatherhood is fundamental and as a society we are starting to have more awareness into mental health/well-being of Dad’s which is great! 

Below are a few tips and tricks to help navigate this new territory that is ‘being a Dad’.

Be active and involved from the beginning

This starts in pregnancy. Any appointments that you can attend is great, especially childbirth education classes which I very strongly recommend to my clients.

These classes are a great opportunity to open the dialogue, ask the silly questions and become familiar with newborn behavior and what to expect.

Share education experiences together as parents.

Be hands on with the daily cares

I’m talking nappies, dressing, baths, burping, settling and playing. Having as much tactile hands on practice will reinforce confidence and also create great bonding time between you and your baby and also support your partner’s recovery and rest.

You can also be supportive when it comes to breastfeeding. Offering water, pillows, snacks or whatever your partner needs. If you feel she needs more support with feeding, suggest it.

If you are bottle feeding, helping sterilizing bottles and preparing will be greatly appreciated.

Pay attention to your baby’s behavior

Be attentive to their cues, motions and body language. This will help you communicate with your baby and help you understand their needs.

Use words and touch to communicate

Talking, singing, reading with your baby can be calming and also will help their learning and communication development. Connecting with your baby through touch and holding again, helps foster that relationship of bonding, providing a sense of security and trust. Skin to skin time is another great option, this type of contact is known to regulate a baby’s heart rate, breathing and temperature.

Also, try wearing your baby in a sling, it promotes feelings of comfort and closeness, helps with bonding and keeps your hands free!

Look after your relationship

Welcoming a new baby into your home can put a strain on a relationship. Keep communication open, stay positive, learn together, laugh together and cry together. You are a team. Negotiate tasks and cares so you both feel heard and supported.

Learn and have access to good information

Friends, family, midwives, doctors and other parents around you are all great resources!

There are also numerous websites, a great resource is Direct Advice for Dads, DAD. This is a non-profit organisation written by Dads for Dads. 

Resources
https://www.directadvicefordads.com.au/
https://raisingchildren.net.au/grown-ups/fathers
https://mensline.org.au/being-a-dad/

Please share these with your partner of a soon to be Dad in your life. 😉

Miscarriage, you don’t need to walk it alone

A high number of us, either personally or through a family member or friend have experienced miscarriage. In medical terms, miscarriage is the spontaneous loss of pregnancy before 20 weeks of gestation.

Did you know 1:5 women who know they are pregnant will experience a miscarriage before 20 weeks, most often in the first 12 weeks?

I read an article recently by Bianca Dye, a radio personality, who discussed her miscarriage experiences and how the power of being open and honest about pregnancy loss has had a ripple effect on other women. Bianca explains her recent loss left her ‘feeling so connected to other women’ and that in sharing her IVF journey she has allowed space for other women to grieve. This vulnerability and encouragement for other’s to do the same is so incredibly necessary.

Emotionally parents can feel like they are on a rollercoaster. From conception, parents begin preparing physically, mentally and emotionally and when this process ends unexpectedly, they can be left feeling alone and isolated. Parents will experience a spectrum of emotions, commonly grief, sadness, loneliness, depression and a feeling of emptiness. Some of them will feel a sense of relief and there is no need to feel guilty if this is their experience.

There is a strange sense of secrecy and shame around miscarriages. Women often disclose their experiences to few people, if any, and feel a sense of inadequacy, that their body has failed them. It is important to remember there is usually nothing that could be done to prevent a miscarriage and often the cause is unknown. However, this rarely provides comfort.

In my experience as a midwife what have I seen to make a difference? Providing a safe space for women to talk, share stories. In allowing women this space to share we support them, nurture them and allow them to grieve and move through.

Supports available:

• Your partner, family and friends. Don’t underestimate the power of sharing your loss with your loved ones.
• Your obstetrician, midwife, GP or mental health practitioner
• Pink Elephants Support Network : www.pinkelephantssupport.com
• SANDS :  1300 072 637
• The Perinatal Loss Centre : www.theperinatallosscentre.com.au

Tamsyn x

Now I am pregnant, what next?

Congratulations!

Once you are confirmed pregnant with your GP, they will most likely arrange antenatal screening pathology to be completed prior to your first appointment with us.

These blood tests are standard for all pregnant women. The results will be faxed to us, if you receive a copy from your GP please also bring to your first appointment.

If you don’t have any tests prior to your first visit with us, don’t worry, you will receive a request then.

When should I schedule my first visit?

Between 8-10 weeks

It is during this visit Dr Marcia will order/review your pathology. Any abnormalities will prompt further testing. If results indicate you are deficient in any vitamins you will be advised to commence supplementation (the most common being iron and Vitamin D).

In this visit you will also discuss and receive referrals for genetic screening options and first and second trimester ultrasounds.

Care Options

After your first visit you will be asked to choose a care option for your pregnancy. Our options include:

1 – Care with Dr Marcia

In this option your visits will primarily be with Dr Marcia, seeing myself on occasions for education and care. This is an ideal option for first time mothers and those who are ‘high risk’ due to previous complex pregnancies or who have medical concerns.

2 – Care with Nurture Program

Our new program, Nurture, is perfect for second time mums or ‘low risk’ first time mums wanting a shared care style approach at a lower price. More of your appointments are with myself, the midwife, while being under Dr Marcia’s care. She will see you for visits at 20, 30, 36, and from 39 weeks onwards.

With both care options Dr Marcia will attend your delivery and see you for your postnatal check at 6 weeks.

Structure of visits

As mentioned, your first visit is between 8-10 weeks.

You will then have a visit every 4 weeks until you are 28 weeks. Visits then increase to every 2 weeks until 36 weeks and weekly from there on.

My role as your midwife

Throughout your pregnancy my role as your midwife is to provide evidence based education, emotional support and preparedness for labour and birth. I want you to feel ready and empowered for your transition into motherhood.

Pregnancy and becoming a mum is a time of major transformation and it’s crucial you feel prepared and supported during this time.

Hopefully this post has explained a little further how care is structured with us and what you can expect.

We look forward to meeting you and being a part of your beautiful journey into motherhood.

Tamsyn x

Probiotics in pregnancy: are they useful?

The human body is loaded with bacteria, both beneficial and non-beneficial. We house so many bacteria that it is thought to outnumber our body cells tenfold! When non-beneficial bacteria out-numbers beneficial bacteria we see symptoms such as bloating, abdominal pain, thrush, skin conditions and infections etc.

Probiotics are living microorganisms that help maintain balance in our digestive and immune systems. It is well researched that they are supportive to digestive processes and in reintroducing good bacteria that have been lost to antibiotics.

How do they assist in pregnancy?

During the first trimester women often experience nausea, vomiting, and food sensitivities with higher levels of stress and possible antibiotics. Pregnancy hormones also affect food absorption and gut motility. These factors all contribute to the altering of our good bacteria.

Women often complain of heartburn, bloating, diarrhoea, constipation and thrush which may be helped by the introduction of probiotics.

Taking a daily probiotic may:

• Reduce colonisation of the vagina by pathogenic bacteria and yeast
• Improve digestive processes and overall gut health
• Reduce vaginal Group B Streptococcus colonisation rate
• Stimulate the immune system
• Optimise a mother’s gut flora prior to birth

Are they beneficial after birth?

When your baby is born their gut is sterile and they receive their bacteria firstly from the mother. Many studies have concluded having a strong and healthy bacteria colony prior to birth greatly reduces the likelihood of eczema, asthma and allergies for the child.

Additionally, probiotics can help relieve or reduce breast pain and discomfort associated with mastitis.

My answer?

Yes, there are beneficial!

Be mindful, there are specific strains and probiotics for pregnancy and breast feeding.

If you have any questions, please bring it up in our next consultation and I can discuss further.


Tamsyn 🙂

References:

Elias, J., Bozzo, P., & Einarson, A. (2011). Are probiotics safe for use during pregnancy and lactation?. Canadian family physician Medecin de famille canadien, 57(3), 299–301.

Common nutrient deficiencies in pregnancy

What an important and growing topic this is, and a major interest area of mine. Our ability to support our body and our growing baby’s needs through nutrition and supplementation is key knowledge all women need to be aware of.

Rather than provide you with an essay length post on nutrition here, throughout the blog I will provide smaller posts, each focusing on a topic, both for information retention and for the sake of word limit!

This post will more specifically address vitamin and mineral supplementation in pregnancy and breastfeeding.

Pregnancy and postpartum is a time where a woman’s nutritional requirements are high and a diet should be balanced and rich whole foods. Due to the high demand and requirements of a developing baby, supplementation is advised.

Note: Commencing a whole foods diet with adequate supplements prior to conception is known to have positive developmental impacts – a post on this later.

What are the recommendations?

The Royal Australian and New Zealand College of Obstetrics & Gynaecologists (RANZCOG) have compiled an evidence based statement on recommendations for supplementation.

Folic Acid
Advised for ALL WOMEN.
Recommended dose of folic acid is at least 0.4mg daily. It helps decrease the risk of neural tube defects. In women with malabsorption or increased risk of neural tube defects, the dose is 5mg daily.

Iodine
Advised for ALL WOMEN.
Iodine is essential for healthy brain and nervous system development. Recommended dose is 150 micrograms daily for women considering pregnancy and those who are pregnant or breastfeeding.

B 12
All vegetarian and vegans should be encouraged to consume B12.
Pregnancy = 2.6mcg/daily            Breast feeding = 2.8mcg/daily

Vitamin D
We get this vitamin from the sun. However, due to our modern lifestyle, many women have low levels of vitamin D.
< 30 nmol/L = 2000IU per day
30-49 nmol/L = 1000IU per day
>50 = 400 IU (usually in your daily pregnancy/BF multi-vitamin)

Iron
Most pregnancy/BF multivitamins contain iron which is sufficient unless your blood results indicate that you are deficient. Depending on your haemoglobin and ferritin levels you may be advised to commence supplementation in the form of liquid or tablet.
Note: Iron is best absorbed on an empty stomach without dairy.

Calcium
Most women meet this in their daily intake. However, if you avoid dairy or don’t consume adequate calcium rich foods you may be advised to commence a calcium supplement 1000mg daily.

Omega-3 fatty acids
These essential fatty acids are building blocks for a baby’s brain and retina development, additionally being anti-inflammatory and great for cellular health for mothers.
The richest sources in our diet are from marine sources. Those who eat very little of these sources should consider an Omega-3 supplement.

References:
Coletta JM, Bell SJ, Roman AS. Omega-3 Fatty acids and pregnancy. Rev Obstetrics & Gynaecology. 2010;3(4):163-71.

De-Regil LM, Harding KB, Ota E, Payne BA, Pena-Rosas JP, Webster AC & Yap CMY. Iodine supplementation for women during the preconception, pregnancy and postpartum period. Cochrane Database of Systematic Reviews 2017, Issue3. Art. No.: CD011761. DOI: 10.1002/14651858.CD011761.pub2.

The first thousand days: optimising outcomes

Before we dive into optimising your pregnancy care and the world of pregnancy and motherhood, we need to be mindful of the first thousand days of development and the impact this has on a child’s future health.

The first thousand days is more commonly referred to as ‘conception to two years of age’. We have known that this period is important but it is only recently that we are learning just how much we can influence and optimise health outcomes of children! Strong evidence now supports the relationship between genetics, epigenetics and environmental factors during this time has lifelong influence on a child’s health and development.

A  great report has been written by The Centre for Community Child Health titled The First Thousand Days: An Evidence Paper and is an excellent reference if you want to dive deeper but to make things more succinct I have compiled key findings below.

Key findings from the paper:

• The health and wellbeing of the mother and father prior to conception influences the health of the developing embryo. This is where nutrition becomes super important.
• While in the uterus a baby interprets cues (often stress hormones) from their mother and father’s physical and mental states to predict the world they will be born into, they adapt! This can benefit or disadvantage health depending on a child’s environment and relationships during this time.
• Children’s brains and bodies are therefore shaped by early experiences and environments, not simply genetics like previously believed.

The paper also explains the importance of a mother’s diet on her fertility and pregnancy outcomes but also explains how poor nutritional status has the ability to alter developing genes including:

• Increase likelihood of developing immune and allergy responses, e.g. asthma, eczema etc.
• Influence metabolic regulation and likelihood of being overweight.
• Increase risk of developing diabetes, metabolic disorders and heart disease .

(Centre of Community Child Health, 2017)

We can see from all of this information how important it is for us to be conscious and aware of our diet, lifestyle and environmental stressors.

This will be a theme throughout the blog. Many posts will be underpinned with an emphasis on optimising the health and wellbeing of the mother, child and family. Be it through education, nutrition, movement etc. Healthy mumma = healthy baby.

Quick take homes:

• Eat a diet rich in micro and macro nutrients to optimise your nutrition status
• Slow down and be mindful of your stress levels
• Supplement your body with vitamins and minerals if you are deficient.

My next post will provide information on the common vitamin and mineral deficiencies and how you can supplement your body to provide optimal nourishment and building blocks for your baby.

Stay tuned. 🙂

Tamsyn

** Information sources:

Moore, T.G., Arefadib, N., Deery, A., Keyes, M. & West, S. (2017). The First Thousand Days: An Evidence Paper – Summary. Parkville, Victoria: Centre for Community Child Health, Murdoch Children’s Research Institute

Hello wonderful women

My name is Tamsyn and I am a Registered Nurse and Midwife working alongside Dr Marcia Bonazzi in her private practice. I have been a part of Dr Bonazzi’s wonderful team for 6 months now.

Some of you may have met me in your antenatal visits, others may not so I am here to introduce myself and our new education platform that we are excited to launch.

Briefly about myself. In addition to working with Dr Bonazzi, I also work in a busy public tertiary hospital in Melbourne. This keeps me on my toes and forever learning the continuously updating world of obstetrics and gynaecology.

I have always had a strong interest in women’s health hence my chosen career! I am passionate about not only the health of women during their pregnancy but also pre-pregnancy, post pregnancy and throughout their lifetime. As research shows the health patterns of a woman influences her entire family and for generations to come. 

This blog we are creating will be an informal platform filled with evidence based information where I will post fortnightly.

Being a health conscious and aware woman is so empowering so any specific topics you want investigating or more information on please email me at info@drmaciabonazzi.com.au and I will do my best to answer your questions or even better create a post about it!

As mentioned obstetrics and gynaecology is a field of continuous research and updated best practices, making this blog an amazing place to access the latest information that you can trust.

I will always endeavour to educate you in our antenatal visits however this space allows you access on the go!