Ask the Doulas

What is prodromal labor and how do I deal with it?
For many women, prodromal labor feels like the real thing. Contractions can cause intense discomfort and feel different from Braxton-Hicks. These contractions may follow a very regular pattern, making many women think they are in active labor. They can increase in intensity and frequency, then slow or stop. Cervical changes can happen during prodromal labor, but isn’t always the case. Prodromal labor doesn’t immediately progress you into active labor. Some women may even begin experiencing this type of contraction weeks before they are due, which can be exhausting and discouraging. Our recommendation to all of our clients experiencing prodromal labor is to rest. Uterine irritability can increase the length of your prodromal labor and lead to contractions. Hydrate well with an electrolyte-based drink. Eat light meals or snacks and take an Epsom salt bath to help your body relax. True active labor is progressional; nothing you do will stop it once it begins.

I think I have a clogged milk duct. How do I clear it?
Nursing mother’s breasts change shape and feel before, during, and after breastfeeding. The breast milk produced flows through the milk ducts and out through the nipple. When one of those ducts become clogged, milk can back up and cause tender lumps to form. A clogged duct can lead to a breast infection or worse. Use these steps to help ease your discomfort:
• Give baby the affected breast first, making sure to drain the breast thoroughly at each feeding. If there is still a lump present after baby finishes, pump or hand express until the lump softens, and milk flows out in slow drips.
• Make sure your bra is comfortable and not binding. Sometimes, plugged ducts are aggravated from a too tight shirt or bra.
• Change breastfeeding positions so all milk ducts get stimulated equally. Cradle, football, dangle and cross-cradle hold are all good options to try.
• Apply warm, wet compresses on the affected breast before each feeding to help milk flow more easily. Try taking a warm shower, letting the water hit the spot while massaging in circles over the lump towards the nipple.
• Apply gentle pressure to the plugged duct, both before and during a feeding, using a circular motion right on the lump itself.
• If accessible, position baby so that his or her chin massages the lump while nursing.

I’ve had the baby and wanted to start working out again, but I’m not sure where to begin. Do you have any recommendations?
Understanding that all women birth in their own way, heal in their own way, and do so at their own pace, we developed guidelines for returning to postpartum exercise:
Weeks 1-6
• Rest, recover, and bond with your baby.
• If no prolapse, gentle walking after your first two weeks. Pay attention to your body, pelvic floor, and incision discomfort. Slow down if there is an increase in pain or bleeding.
Weeks 6-8, once cleared by OB/Midwife
• Pelvic floor and Diastasis Recti evaluation by a Physical Therapist specializing in pelvic floor therapy and women’s health.
Weeks 6-14, minimum
• Reintegrate training of core and pelvic floor muscles. Leslie Howard’s Pelvic Floor Liberation is an excellent resource, as well as the Dia Method and Tupler Technique.
• Postpartum yoga
• Non-impact cardiovascular exercise such as walking, the elliptical trainer, recumbent bike, and swimming.
• Resume body weight functional strength training as body permits.
Weeks 14+
• Reintegration of weighted strength training as body permits. If experiencing any increase in pain, pelvic floor instability or discomfort, reduce activity and refer back to the first six weeks. Trust your intuition and seek medical attention, if necessary.

For more information, visit doulasofsouthernmaryland.com or contact Samantha and Stacy today: samantha@doulasofsouthernmaryland.com and stacy@doulasofsouthernmaryland.com

Doulas of Southern Maryland
Realizing their shared love for all things birth, Stacy Seigel and Samantha Feldman joined together forming Doulas of Southern Maryland in 2015. With more than 12 years combined experience, they have helped support and welcome 400+ babies earth-side. It is through training, established working relationships, and continued growth, that they bring their passion for birth to better serve their community. “We work hard to ensure that the voices, visions, and needs of our families are met.”