Using the BRAIN acronym as a decision making tool during pregnancy, birth and early parenting.

During pregnancy, labour and birth and the postnatal period, in fact, any time you are faced with a decision to make about your health care, it is really important to ask questions in regards to any suggested course of action or intervention so that you are fully informed and fully aware of the implications. Health care providers, especially doctors, are usually allocated very short appointment times, so if you can arrange your thoughts and questions sequentially, it means that you make the most of the short time you have with your health care provider and get the answers to the questions you are asking. If you think of a question you need to ask your health care provider, write it down in a safe place and bring your questions along to your appointments.

The BRAIN decision making tool is best implemented when there is time to think about a certain course of action or intervention, it may be of little benefit during an emergency situation. This is why investing in antenatal education and making a birth plan are so beneficial – you are then able to consider how “routine” interventions or unexpected scenarios might affect you as an individual and you also have the opportunity to research and discuss them further with your health care provider and support people prior to birth (when the last thing you will feel like doing is implementing the BRAIN acronym!).

The BRAIN acronym looks like this:

B – what are the BENEFITS of this course of action/intervention?

R – What are the RISKS?

A – Are there any ALTERNATIVES?

I – What are the IMPLICATIONS of following this course of action? Will it make further INTERVENTIONS more likely? What does my INTUITION say?

N – What if we do NOTHING and/or wait for a period of time before doing anything?

Common examples of times that you might use the BRAIN acronym to help you organise your thoughts prior to or after a visit with your health care provider might be:

  • Induction of Labour
  • Elective caesarean section
  • VBAC (Vaginal Birth After Caesarean section)
  • Medications during pregnancy/labour/postpartum period
  • Epidural during labour

This list is by no means exhaustive, you can use BRAIN any time you need to make an important decision.

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by Amy Vaccaro, 3rd Feb, 2018.

Chill Mama Active & Mindful Birth Workshops: the who, what, why, when AND the afternoon tea.

I have been practicing yoga since 1998, midwifery since 2005, motherhood since 2007 and massage since 2010.  During all of these years of learning, teaching and observation, it became clear to me that women (especially in rural and regional areas) had very limited access to birth education that combined all of my loves – midwifery (especially teaching birth anatomy and physiology), yoga and massage.  So I went about creating a program that included them all in an effort to decrease women’s fears about birth and create more positive birth experiences.

The program that I have developed (the Chill Mama Active & Mindful Birth Workshop) is short – 3 hours, currently held on a Sunday afternoon, with the aim of being affordable, and accessible to rural and regional women so that they don’t have to travel far to access it.  The workshop is for women only, to provide an intimate and relaxing environment where questions can be raised and fears can be released.  The workshop does not tell women everything they need to know about birth and beyond (after all, it only goes for 3 hours!), but sits as a practical adjunct to hospital based antenatal education and also alongside other education such as Hypnobirth, Calmbirth and SheBirths programs, as well as education provided by other healthcare providers such as doctors, midwives and doulas.

So what happens during a Chill Mama Active & Mindful Birth workshop?

  • We participate in a prenatal yoga and meditation session to learn to recognise and practice activation of the parasympathetic nervous system – the rest and digest aspect of our nervous system that needs to be activated in order for labour and birth to proceed in a physiologically normal way.  In the Wagga workshops, the yoga component is taught by Jenny Storrier, yoga teacher and Doula from Down to Earth Birth.  Having Jenny present at the Wagga workshop enables the women present to get to know her and then have a contact point to access for yoga or doula work after the workshop is over. I teach the entire workshop in Albury.
  • We learn about the progression of normal labour, exploring both anatomical (the pelvis) and physiological (the hormones) aspects.  It is my firm belief that if women understand how normal labour physiology works and how we can best support that expression of physiology, women and their support people will be able to work together to make the best informed choices for their care during birth along with their healthcare providers.
  • We practice yoga inspired Active Birth positions to understand how to best help baby to move through the pelvis during labour and minimise pain.
  • We explore Rebozo, an ancient Mexican technique that can be used for comfort during pregnancy and labour.

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The terminology used and ideas explored throughout the workshop are cognisant of the fact that the majority of women living in rural and regional areas will birth in a hospital with care providers they may have never met before.  Also acknowledged is that, although counter to the World Health Organization which advocates for a caesarean section rate of 10-15%, the average Australian caesarean section rate is approximately 30%, so based on these figures, potentially 1 in 3 participants will give birth via caesarean section.  It is my hope that with the techniques explored and practiced in this workshop and beyond, that women who participate in the workshop will be more likely to experience a normal, physiological birth and for those women who require intervention, that their experience of birth will be positive.  I also acknowledge the researched benefit for women to have access to a known care provider (midwife or doula), providing continuity of care during pregnancy, labour and in the postnatal period, to further enable normal birth physiology, despite this being a rare offering in rural and regional areas currently.

So far, the feedback from participants has been very positive with workshops being held in Albury and Wagga Wagga and participants also coming from outlying towns such as Temora, Leeton, Gundagai, Mount Beauty, and Wangaratta.  Over time, I would like to roll the workshop out across other regional areas to enable more women to have access to this education, using the same model as Wagga – having a yoga teacher (who ideally is also a midwife or doula) teach the yoga component of the workshop, to provide that local contact point, with me teaching the rest of the workshop.  Wangaratta, you are my next point of call…

Oh yes, and there’s afternoon tea – I forgot to mention that.  Here’s a recipe for Jaffa Bliss Balls that sometimes feature during the workshop to fend off the 3.30itis:

  • 1 cups of dates (soaked for 10-15 mins in boiling water)
  • 1 cup of nuts (I like hazelnuts and almonds)
  • 1/3 cup cacao powder
  • 1/3 cup coconut oil
  • 1/2 cup coconut
  • 1 tbsp chia seeds
  • 5-10 drops DoTerra Wild Orange oil (depending on how orangy you want it)
  • 1 tsp vanilla extract (or a scraped vanilla pod if you’re feeling fancy)
  • LSA meal and cacao nibs (mixed) (approx 2 tbsp of each) for rolling and coating the bliss balls

Blitz all the dry ingredients in the food processor until fairly fine.  Drain the dates leaving some of the liquid behind (about 2-3 tbsp), add to the food processor with the wild orange oil, coconut oil and vanilla.  Blitz until it all comes together.  Roll tablespoon amounts of the mixture into balls, then roll the balls to coat in the LSA and cacao nib mixture. Set in the fridge for a couple of hours and enjoy.

jaffa bliss balls

Looking forward to sharing an Active & Mindful Birth Workshop with you soon!  For dates and locations click here, or check the Chill Mama Wellness Facebook Page, @chillmamawellness.

By Amy Vaccaro,

15th January, 2018.

 

Happy 2018 – Resolutions and Recipes

The new year is upon us.  Without a doubt, 2017 was one of the most challenging years I have experienced so far during my 36 rotations around the sun.  On January 1 2017, the oncologist came and sat with my parents and I on Dad’s hospital bed and told him that his melanoma had become an uncontrolled freight train and there would be an inevitable collision.  That freight train hit on the 20th January, the day Dad struggled for his last breath.  He held on with every single ounce of strength he could, he absolutely did not want to go.  I can hardly sit here and write about it without feeling that choke of emotion sitting right in my throat – almost one year on.  So, after this harrowing experience, 2017 saw me take a sabbatical, a step away from my career.  I resigned from my job as a university academic, taught yoga and spent the majority of my time focusing on my role as Mum and Wife.  Inevitably, this brought challenges, mainly financial, as being a yoga teacher whilst it might sound enviable and glamorous, is mostly a love job and sadly, love doesn’t pay the mortgage.  I have never been one to worry too much about money, but when you go from having a stable, well paid job, to a very unstable, uncertain and generally low paying one, a heavy spotlight is suddenly shined upon that area of life.  My ego took a battering, I cried regularly and felt like a failure most of the year.  Thank God for the unwavering support of my husband, my friends and my own personal yoga and meditation practice.  However, from this frustration, Chill Mama Wellness was born.  A way for me to share my love of working with women to promote wellness and peacefulness.  I have loved every minute of nurturing this small business and the people within it.  In early December, after yet another day of my mind questioning my own worthiness (a daily battle), I received this message from one of my clients that put all that questioning to rest (and made me cry, again!).  This client had attended prenatal yoga with me all through her pregnancy, attended an Active and Mindful Birth Workshop and also came for a massage late in her pregnancy.  It went something like this:

“I had the most amazing labour and birthing experience and I have you and prenatal yoga to thank for a lot of that!  Throughout my contractions (back labour again) I could hear you saying “breathe in through your nose, and out through your nose” which helped me stay calm and focused but most importantly when the contractions stopped, all I could think of was to “enjoy the break – don’t worry/stress about how the next lost will feel, just enjoy the break”!  I got through a lot of the last stronger contractions in supported childs pose lying over the peanut ball gently rocking and only needed gas for the last little bit and pushing!  Thank you very much for all of your guidance and your help in giving me the most amazing experience. xx”

Needless to say, after this message, I felt reassured that what I was working on was worthwhile, that I was making a difference to somebody and to keep on going, even though the road less traveled is tough on my soft feet (and ego and bank balance!).  So, now that my sabbatical is coming to an end, I need to take heed of my own words.  I feel I wasted a lot of 2017 worrying about what I was going to do next.  I didn’t enjoy the break as much as I could have.  I felt like most of the time I needed a mind epidural away from the relentless thoughts of “what next?”, “where will the next dollar come from” , “am I good enough” etc.  It’s my pattern, I know, and I’m officially taking this moment to say that in 2018 I will be continuing to work on breaking this habit – the worry habit.  As well as focusing on growing Chill Mama Wellness to give more Mamas opportunities to have birth experiences like the one above.  My words for 2018 are minimalism, strength, courage and determination.

I have also promised multiple people on multiple occasions, the recipe for my Raw Peppermint Slice that features for afternoon tea as part of the Active and Mindful Birth Workshops, so here it is (I’m a bit of this, bit of that kind of cook, so apologies if it’s not super accurate):

  • 2 cups of dates (soaked for 10-15 mins in boiling water)
  • 2 cup of nuts (I like hazelnuts and almonds)
  • 2/3 cup cacao powder
  • 2/3 cup coconut oil
  • 1 cup coconut
  • 2 tbsp chia seeds
  • 5-10 drops DoTerra Peppermint oil (depending on how minty you want it)
  • 1 tsp vanilla extract (or a scraped vanilla pod if you’re feeling fancy)

Blitz all the dry ingredients in the food processor until fairly fine.  Drain the dates leaving some of the liquid behind (about 2-3 tbsp), add to the food processor with the peppermint oil, coconut oil and vanilla.  Blitz until it all comes together.  Press into a lined slice tin (I use a tupperware slice container with a lid) and set in the fridge for a couple of hours, then cut into squares and enjoy.  You can also top with a mix of melted 85-90% dark chocolate and coconut oil for extra deliciousness (can’t remember the exact ratios, a bit of dark chocolate and a bit of coconut oil, microwave til runny, mix, pop it on the top of the slice, set in the fridge?!).

afternoontea

For those of you who have attended yoga or birth education or massages with me since August 2017 when Chill Mama Wellness was first born, thank you, from the bottom of my heart!  I am quietly and humbly looking towards 2018 with optimism and a wish to facilitate more peaceful births and relaxed Mamas, including myself (minus the birthing part, just the relaxation will do!).

By Amy Vaccaro.

 

Indigestion and Heartburn in Pregnancy

Indigestion and heartburn are very common during pregnancy. As pregnancy progresses, the expanding uterus puts pressure on the stomach forcing stomach contents upwards towards the oesophagus. At the same time, the cardiac sphincter between the stomach and the oesophagus loosens thanks to pregnancy hormones, enabling acidic stomach contents to rise up the oesophagus causing a burning sensation.   Fortunately, there are some things that can be helpful to ease the symptoms of indigestion and heartburn in pregnancy, cos they suck!

Yoga Poses:

Yoga and meditation can be useful to help alleviate indigestion and heartburn sensations.  Any postures that help to open the chest and upper belly tend to be useful.

  • Seated cat/cow stretch
  • Easy cross leg/hero pose with hands interlaced behind the body and chest/eye gaze towards the ceiling.
  • Ustrasana (Camel Pose)
  • Virabhadrasana 1 (Warrior 1) with lifted arms
  • High Lunge with lifted arms
warrior 1
Warrior 1 (Virabhadrasana 1) with hands interlaced behind the body and chest lifting towards the ceiling.

Restorative Poses:

  • Supported Reclined Goddess Pose (Supta baddha konasana)
  • Supported Reclined Hero Pose (Supta virasana)
suptavirasana
Supported Reclined Hero Pose (Supta virasana).

Poses to avoid include those where the head goes below the heart (as this encourages gravity to send stomach acid back up the oesophagus), such as downward facing dog (ardho mukha svanasana) and standing forward fold (uttanasana). Downward dog can be practiced against the wall with the chest parallel to the floor to avoid aggravating heartburn.

Other things to try:

  • Try eating smaller meals more frequently rather than large meals sporadically.
  • Avoiding foods that trigger your heartburn. Some foods that might trigger heartburn include rich tomato dishes (such as Bolognese sauce), chocolate, citrus, spicy foods, fatty foods or anything with a high acid content.
  • Stay upright for a period of time after eating.
  • Elevate the head of your bed at night or sleep on lots of pillows to elevate your head above your heart.
  • Drink 8-10 glasses of water gradually over the course of the day.
  • Dilute 1 tablespoon of apple cider vinegar in water and drink when heartburn arises.
  • Dissolve 1 tablespoon of bicarbonate of soda in a glass of water and drink when heartburn arises.
  • Eat stomach acid neutralising fruits such as pineapple or papaya.
  • Eat a couple of tablespoons of plain yoghurt after your meal to help neutralise stomach acid and introduce healthy gut flora.
  • Visit your massage therapist, physiotherapist, osteopath or chiropractor to help with your postural alignment.
  • Visit your doctor or midwife for further assessment if your heartburn is not immediately helped by any of the above remedies.

 

Please remember that this information is general in nature and may not be suitable for everyone.  Always consult your healthcare provider if you are ever in doubt.

Written by Amy Vaccaro with thanks to Jess Cant for the photos.

Reflections on my first week in the clinic…

To say that I had an amazing first week running Chill Mama Wellness would be a fairly large understatement.  After an awesome session of prenatal yoga at The Balancing Buddha Tuesday evening, I woke up on Wednesday morning, my first day offering massage at Nurture Health Group, and sat down to meditate as I always do.  The sun was just starting to rise, the sky was a beautiful orange and the world and my body was very calm, an unusual sensation giving the swirling craziness that had been present for so many weeks leading up to the launch of Chill Mama Wellness.  The uncertainty of wondering if I would have any clients, of whether I was doing the right thing with my life all just melted away and a sense of calm, clarity and purpose descended in its place.  My day at the clinic was fully booked, I paid my rent and myself and although I was exhausted, I was chuffed that I had stepped into a space where I could be an autonomous practitioner, working with women to provide them with a space to chill and fill their own cup.

Here are some pics of the my clinic space at Nurture Health Group, including a set-up for pregnancy massage where pregnant women can lie face down with their belly in a special pregnancy pillow.

I am now working on the first offering of Chill Mama Yoga Inspired Birth Education on Sunday 13th of August, which I’m also thrilled about:

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I’m looking forward to what the next few weeks brings for Chill Mama Wellness!

Amy V. xx