​This past weekend I had the honor of attending and hosting my first celebration of motherhood for a dear friend. The event included several ceremonial activities followed by the sharing of a meal that highlighted several nourishing postpartum recipes. Each guest was asked to bring flowers and greenery from their yards and a plate of food to share. 

Upon arriving, the mother to be's feet were cleansed in a lavender epsom salt bath with plumeria petals. Next, each guest was given a cup of ceremonial hot chocolate to sip on together as a blessing candle was passed. The guests took turns blessing the mother to be with kind, encouraging and most of all supportive and loving words. Finally each guest contributed by making a portion of a beautiful haiku lei (flower crown) as a symbol of the community of women that surround the mother to be with love and support as she moves into her next phase of motherhood- mother of 2 boys! It was a beautiful day filled with love and community.

I had never heard of a celebration of motherhood until reading the book "The First 40 Days - The Essential Art of Nourishing the New Mother" by Heng Ou. It was recommended to me a friend,  Robin Deem of Caligirl Cooking and I will recommend it for years to come. The book discusses the challenges of postpartum in our modern world and how traditional practices, though unfamiliar to most, offer support the mother needs to build strength postpartum both physically, mentally and emotionally.

In chapter 3 "Gathering", Ou lays out a 3rd trimester checklist including items like stocking your pantry and freezer, creating your nest and assembling your helping hands. Then she goes into two items I completely missed in my second pregnancy- honoring yourself and fortifying your relationship. The later calls for another post, but the idea of honoring yourself struck a chord with me. Even in 2nd, 3rd and subsequent pregnancies we often still focus on the baby! I know I did, only taking a 3 trips to a float tank the whole pregnancy for self care time. They were heavenly, but they didn't honor me, I was motivated to do it for the benefits to my baby.

Ou notes "contemporary society, is notably lacking in ceremonies or rituals in which significant passages in life are honored." What a true statement! Whether its the first or fourth time, the passage into motherhood or a new stage of motherhood is something to be honored and an opportunity to bring the mothers' community together to honor her. Labor and birth are some of the most beautiful, humbling, raw, scary and miraculous moments of a women's life. Entering this last stage of pregnancy with the knowledge that she has support, love, kindness and blessings from her community can bolster a mother to move forward with confidence, peace, and assurance that although we may not physically be with her, we are there in heart during her labor and delivery. Once baby arrives, she will be surrounded by a community of women to literally hold her hand or make her food, or watch her older children so she can heal, restore and be nourished physically, emotionally and mentally in those early days postpartum. 

A celebration of motherhood is a beautiful alternative to a baby shower that shifts the attention to the mother in the most beautiful way. Every mother deserves a day of honoring.

If you would like more details about organizing a Celebration of Motherhood please contact Windward Maternal Wellness and we can offer ideas, recipes, and support in planning a beautiful day for the special mother-to-be in your life. 

By the time your were about 3 years old you were potty trained. You had mastered the independence of using the toilet and further conversation about toileting and your urinary system in general rapidly declined and ultimately stopped by about age 4 or 5. No one talks to us about normal patterns around urination once we graduate to big girl panties. We carry on without little thought or concern about urination throughout childhood and into adulthood. Some of us are lucky enough to never have to think about it again, but for millions of women around the world there comes a time when urinary incontinence reappears. 
When this happens, most women do not talk about it and simply find a bandaid. After all, it's pretty easy to place a pad in your panties and carry on like nothing abnormal is occurring. Who wants to talk about dribbling urine in their underwear over mom's night out cocktails? There are so many more socially acceptable things to discuss during your precious time without kids! This mindset is why so many women  wait an average of 8 years without treating the completely curable problem of urinary incontinence. It's embarrassing and easily covered up! However, it also causes undesired changes in routines and habits that can add to anxiety, stress, social withdrawal, and even result in institutionalization. According to the book "The Bathroom Key" by Kathryn Kassai and Kim Perelli "urinary incontinence is a leading cause of nursing home placement in elderly women." 

Urinary incontinence is any amount of leaking of urine when not on the toilet. There are 2 main types of urinary incontinence: stress and urge. 
Stress incontinence is when you have leaking of urine during activity such as walking, jumping, standing up, lifting or sneezing. This type is a physiological problem related to weak pelvic floor muscles. Urge incontinence is when you have leaking of urine on the way to the bathroom or in association with an urge to urinate. Urge incontinence is both a physiological and psychological problem. The bladder has lost it's ability to regulate urges and the pelvic floor muscles are weak. Both types of incontinence can occur together and this is called mixed incontinence, which is very common. Whether you have stress, urge or mixed incontinence it is curable with pelvic floor occupational therapy offered by Windward Maternal Wellness. 

We should all recognize that no degree of urinary incontinence is normal. Not during pregnancy. Not after childbirth. Not after menopause. Not ever. Seeking out professional treatment is the best way to find a resolution to your incontinence and here are a few things you can do at home. 

1. Identify if you have stress, urge or mixed incontinence based on the description I provided above. Once you know what you have, you can better direct your efforts to reduce incontinent episodes. 

2. Since both types usually involve weak pelvic floor musculature, I recommend making sure you can identify contraction and relaxation of your pelvic floor through the use of Kegels. Many women with incontinence have difficulty completing a full range of motion Kegel. This means completely contracting and relaxing the pelvic floor muscles. Here are 2 ways to "find" your Kegel or pelvic floor muscles:
        -"Stop test"- when you sit on the toilet to urinate, try to stop your flow mid-stream then allow it to resume as usual. You must activate your pelvic floor muscles to stop or slow the urination. Be aware that this should not be done regularly during urination as it can lead to other problems. Simply use it as a diagnostic test for yourself. 
        -Holding in gas (or urine)- most of us do not want to pass gas when in the presence of others. To prevent the passage of gas, you must contract your pelvic floor muscles. Many of us do this almost automatically, but to better identify the sensation of your pelvic floor muscles, I ask my client's to contract their anus as if they are preventing the passage of gas. Even better, is if you can contract your pelvic floor muscles as if you are trying to prevent the passage of urine and gas at the same time. 
Once you have mapped in your mind the sensation of the contraction and relaxation of your pelvic floor muscle, you are one step closer to reducing urinary incontinence. However, if this was difficult keep practicing or reach out to a pelvic floor occupational therapist. 

3. For urge incontinence I recommend keeping a bladder diary. Record how many times you urinate in 24 hours for a 1-2 weeks. You should be somewhere between 6-8x per day, but most women with incontinence are much higher. Without concern for nighttime urination patterns, begin to try to stretch your daytime episodes of urination further apart by using these strategies:
         -Reduce your intake of caffeine, citrus, alcohol and spicy food, which are all bladder irritants and can increase your urge to urinate unnecessarily. 
              -When you feel an urge to urinate, sit down and complete 3-5 SLOW Kegel exercises. Squeezing your pelvic floor muscle up as you exhale. Often this can delay the need to use the toilet by 10-15min or more. 

4. For stress incontinence, I recommend learning how to link your breath with your Kegel contraction. Laying on your back with your hands on your stomach, take an inhalation and allow your stomach to rise and pelvic floor to be relaxed. With your exhalation, draw your stomach muscles inward and up toward your head, while also drawing or contracting your pelvic floor muscles up. Do this exercise 10x holding each upward contraction for 2-3seconds before relaxing completely. You can progress this same exercise from laying down to sitting and standing as you begin to feel the sensation strengthen. 

As with any health condition it is often best to seek out professional evaluation, support and treatment. Windward Maternal Wellness offers pelvic floor rehabilitation in the comfort of your home. Reach out to us today to design a personalized treatment plan that will end your need for planning your day based on the accessibility of a bathroom, wearing only black or avoiding exercise that you deserve to do without leaking! Urinary incontinence is curable and we can help!