Work + Life: The Juggle is Real

Finding a balance between work and life is one thing. Throw school in there, sports team practice, a science fair project, a growth spurt that requires new shoes that are only available at the store across town, and you have a perfect recipe for physical and mental burnout. Burnout can leave you feeling exhausted, drained, or even physically ill. You can’t always eliminate the stress from a busy schedule or workday, but you can learn to manage it.

Start by asking yourself: What needs to be done? Look at your task list and separate what truly must be done from less critical tasks. Things like work tasks, school events and appointments are not negotiable, while others may be. Sort through your to-do list and eliminate low-priority tasks where you can.

Create a shared family calendar. Whether you like a paper calendar stuck to the fridge, or you’re a digital family, there are templates and tools for everyone. Get upcoming events listed in one place, so everyone knows where they are supposed to be.


Wherever you are, be there. “Be present” is a trendy phrase that we hear a lot these days. But, it’s hard not to look at the 5 notifications that just popped up on your phone. When possible, set your device aside and focus your attention on what is happening around you. Maybe it’s dedicated time to play with your child or have a conversation with your spouse or a good friend. Making a conscious effort to focus on one task or person at a time will help clear the clouds of stress.


Make time for your family.
So many evenings are spent rushing to practices, classes or events, and dinners are consumed during the car ride. Try to find time each week to eat together as a family. Institute a family game night, a bike ride, or maybe a family meeting. Find ways that your family can be together enjoying each other without interruption or distraction (see point above). Ultimately those closest to you will be your front lines of support, so a weekly check-in will help catch when anyone is starting to succumb to stress.


Make time for yourself. The best way to work time for yourself into your schedule? Schedule it! Be creative (Paint! Garden! Journal!), eat a healthy diet avoiding sugar, caffeine, and carbs, have dinner with friends. Think about what truly brings joy into your life and make time for it.
Feel the burn! (Not the burnout). Exercise is one of the best ways to eliminate stress. That doesn’t mean you have to make it to a 5 AM barre class. A 10-minute walk can boost your mood and outlook for 2 hours! Find ways to work exercise into your daily routine, even if it means stretching on the sidelines at soccer practice.


Know when it’s time to ask for help. Burnout can happen at home or at work. Learn to recognize when stress is taking over, and you need help. Then ask for it. Burnout isn’t one size fits all. It can look and feel different for everyone. You may start to feel exhausted, moody or withdrawn. You may not remember what you had for lunch or where you are going when you leave the house. You may start to notice muscle pain from clenching or grinding your teeth.
If you are feeling the symptoms of burnout, seek support from those around you before you reach your breaking point. We’re here to help, too. Reach out to your primary care provider, they will help you extinguish burnout and feel like yourself again.

It’s easy to schedule an appointment with your primary care provider – simply visit our online appointment tool, scroll to find your provider, and click to schedule an appointment at a time that works for you!

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Busting Myths: Breastfeeding as a working mom

You’ve heard about the benefits of breastfeeding your baby. You know breast milk is best for your baby (the antibodies!). But let’s face it, returning to work after weeks of cozy breastfeeding sessions creates a lot of anxiety and pressure (pun intended) for mom. There’s so much information out there online and from every woman you know that’s ever had a baby. We’re here to breakdown some of the most common concerns around returning to work and continuing to provide breastmilk for your baby. Read on to learn how some common myths around breastfeeding while working are, well, busted.


Myth: Nursing less often will create more milk when I do nurse.
Actually, the more you nurse (or pump), the more milk you will produce. Your body is creating your milk supply based on demand. Feed your baby when they ask (in their own way), and your body will produce the milk they need. If you are returning to work, this will help in ensuring you are producing what your baby needs while pumping.


Myth: My baby won’t breastfeed once they get used to bottles.
You will always be your baby’s favorite way to get their milk. When your baby is with you, they will expect to be breastfeed. If your baby has a predictable feeding schedule, when you return to work ask your caregiver to hold-off on giving them a bottle close to your arrival, so you can breastfeed your baby when you return home. Also, be sure you drink plenty of fluids, avoiding caffeine and alcohol. Staying hydrated is important in general, but especially while breastfeeding.


Myth: I need a freezer full of milk to return to work.
Just when a new mom or dad feels like they are adjusting to life as parents, it’s typically time to return to work. For a mother who is breastfeeding, this transition can be especially difficult. A few weeks before your re-entry into the working world, start mixing some pumping and bottle feeding into your baby’s routine. This will help in two ways; your baby will get some practice with and be more willing to take a bottle and you will have some milk stored for backup. We recommend a minimum supply of two days’ worth of breastmilk for a smooth transition. As you pump at work, you will get into a rhythm of producing what your little one needs. You don’t need a freezer stocked full of milk in order to return to work.

Myth: I can’t breastfeed and pump at the same time.
There’s a balance between pumping and breastfeeding. Once you find it, your body will respond and produce the milk required. To start working pumping into your feeding schedule, pump between breastfeeding your baby. Pump about an hour AFTER you feed, and at least an hour BEFORE your baby’s next feeding. If you are returning to work, take note of when your baby typically eats, and pump based on that schedule. Continue to demand milk consistently and your body will get the signal to produce enough breast milk for your little one.


Myth: I will have to stop breastfeeding when I return to work.
Every mother has a legal right to take breaks from work to pump. That said, many women may still be anxious about taking this time. While you are pregnant and before you go on maternity leave, chat with your boss about a pumping schedule. That way, your boss will know what to expect upon your return and you will have some peace of mind knowing there is a plan in place to ensure you can continue to provide breast milk for your baby. Also, be sure to understand the accommodations available to you in the work place for pumping. Where is the room? Where will you store the milk you pump throughout the day? To get your questions answered, chat with a human resources rep or a colleague that recently transitioned from maternity leave and pumped at your office, to get your questions answered.


Myth: I won’t be successful at work if I have to stop and pump.
For a mother that wants to continue providing breast milk for her baby, taking the time to pump will create peace of mind, and allow you to be more focused when at your desk. You may even want to use the time you spend pumping to catch up on some emails, or read through an article or report that you can’t seem to work into your day while sitting at your desk. Some of your colleagues will understand when you excuse yourself a few times a day to pump, and others may not. The fact is, it’s your right to take time to pump during the work day, so try to focus on your baby and not the opinions of those around you. If you have concerns, talk to a manager or supervisor.


Breastfeeding is a wonderful way to take care of your baby, but it can be a struggle too. If you are feeling stressed about producing milk for your baby, make an appointment to chat with a provider. There is no “one size fits all” when it comes to breastfeeding, and they can provide the support you need as you work through challenges that come with being a new mom.


It’s easy to schedule an appointment with your pediatric provider – simply visit our online appointment tool, scroll to find your provider, and click to schedule an appointment at a time that works for your family!

Make An Appointment

Cervical Health Awareness

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MAINTAINING YOUR CERVICAL HEALTH IS IMPORTANT FOR WOMEN OF ALL AGES

Did you know that nearly 13,000 women are diagnosed with Cervical Cancer each year in the United States alone? January is Cervical Health Awareness Month, a time to take the opportunity to learn how to monitor your own cervical health for early detection of cervical cancer and human papillomavirus (HPV) related issues. It is important to stay up-to-date with cervical cancer screening recommended by your OB-GYN provider based on your age. Stay in touch with your body – here are common recommendations for women of all ages:

AGES 9-26

It’s time to get your Gardasil Immunization to prevent infection and transmission of the most common strains of HPV (Human Papilloma Virus, the most common cause of cervical dysplasias and cervical cancers). No cervical screening is recommended for young women before age 21.

AGES 21-29

When you turn 21, it’s time to start with regular cervical cytology – commonly known as the Pap test or Pap smear – every three years. If your results are ASCUS (borderline between normal and abnormal), your doctor may recommend HPV triage, which is done using the same cells taken at your screening and will look for any high-risk HPV infections. This approach may be taken between ages 21 and 24 and it is preferable between ages 25 and 29.

AGES 30-65

At age 30 it is recommended to maintain cervical cytology alone every three years, or to get co-testing, cytology and viral culture, every five years.

AGES 65 AND BEYOND

Once you reach age 65, no cervical screening is needed if prior testing has been normal. 

 

Of course, your gynecologist will chart your plan of care based on your personal screening history – it can vary, but annual care is most important!

 

Learn more about cervical health and cancer warning signs from the CDC. 

Learn more about HPV screening and safety from the CDC. 

Break Free from Pelvic Floor Disorders

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Did you know that 1 in 3 women suffer from or will develop a pelvic floor disorder during their lifetime?

Pelvic floor disorders are problems related to bladder, bowel and sexual function. They include different types of urine leakage (incontinence) or bladder control problems like going frequently, getting up at night to urinate, or getting strong, uncontrollable urges to urinate. Pelvic floor disorders also include problems related to the bowels such as accidental loss of gas or stool. Finally, a condition known as prolapse, which is a feeling that the pelvic organs (bladder, uterus, vagina or rectum) are bulging or falling out, is also a pelvic floor disorder.

The risk for pelvic floor disorders increases with age. While these conditions are often linked to having children, there are other reasons they can develop. There are also many conditions that make pelvic floor disorders worse that can be managed with relative ease. Many women suffer silently from these conditions. They assume that these conditions are a normal part of the aging process. They also assume that because their mother or sister had it, then they are destined to get it too.

Fortunately pelvic floor disorder are not life threatening. They primarily affect a woman’s quality of life. That means that they do not have to be treated right away. Depending on how bothersome the condition is, a watch and wait approach is often acceptable. However, a thorough evaluation is needed first to ensure it is safe to wait.

Once a pelvic floor disorder affects a woman’s quality of life, there are a number of treatment options available. Many of these options are conservative and non-invasive like lifestyle, behavior, or diet changes. Other treatments include medications, physical therapy and surgery in some cases. Each woman is different; therefore each woman’s treatment plan will be different.

Be open with your doctor about your symptoms and ask about treatment options. You can also ask about seeing a specialist and request a referral if needed. There are qualified specialists in your area that are willing to help you break free from pelvic floor disorders.

This article was originally published on October 20, 2014, and was updated on March 30, 2017.

All about menstrual cups

For years, women have relied on pads or tampons during their period. But, recently menstrual cups have become more popular and more widely available.
A menstrual cup is a flexible cup that is designed for use inside the vagina during your period to collect the menstrual blood. Menstrual cups are usually made of medical grade silicone, but some can be made from latex.

You can use a cup throughout your entire cycle, some users only need to empty it once every 12 hours, and some empty it more often on their heavier days.

A menstrual cup is a more expensive up-front purchase than a box of tampons or pads, however it can last for up to ten years, providing you with a significant cost-savings, and less waste. You also get more time between changes.

It’s also surprisingly easy to use. If you currently use tampons, or have used a diaphragm, you should have little trouble learning to use a cup. It folds up to a size similar to a tampon for insertion. When properly inserted, the wearer shouldn’t feel it at all, much like using a tampon.

There are some potential drawbacks to using a cup. Some women aren’t comfortable inserting them or have fit problems. That’s OK! A menstrual cup isn’t for everyone, but it’s an alternative for women looking for something different.

If you have any questions about a menstrual cup, ask during your next routine gynecological exam. Your provider can help you determine if you should give a menstrual cup a try and can help alleviate any concerns you may have.

Cervical Cancer Screening Guidelines

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In 2012, the way we screen for cervical cancer changed. There were new guidelines for PAP smear testing based on medical evidence, supported by the American College of Obstetrics and Gynecology.

The new recommendations, which IHA providers agree with and follow, start with a PAP test at age 21, followed by PAP testing every three years between 21 and 30 (if you’re low-risk). Once you reach age 30, you’ll be tested every five years with a PAP test and high-risk Human Papillomavirus (HPV) test. As long as you’re low-risk, and the tests are normal, you’ll remain at the five-year interval for testing.

If you are high-risk (you have a history of abnormal PAP tests or have had prior cervical procedures), you may not fit in these recommendations. Your provider will discuss what the best screening frequency is for you based on your history.

In certain situations, a woman may no longer need PAP testing. Generally, if you’re over 65 and have had normal tests previously, you may no longer need PAP tests. You may also be exempt from PAP testing if you have had a certain kind of hysterectomy. You and your provider can discuss and decide if that is best for you based on your risk factors.

A PAP test is a safe way to screen for cervical cancer, with little to minor discomfort. Your provider will use a speculum and a soft brush to take a sample of your cervical cells. If your PAP test is abnormal, your provider will request you come back for additional testing.

If you have additional questions about what to expect, please talk to your provider.

Benefits of Nurse-Midwifery

When you find out you’re “expecting” there are so many decisions to make. Will you find out the gender before birth? What names do you like? What items do you have and what items do you need? And, perhaps most importantly, who will deliver the baby? For most women, this means choosing between an obstetrician-gynecologist and a midwife.

There’s no right or wrong answer. Every pregnancy is different, every woman is different and every woman has a different idea about their ideal birth experience and needs to make the decision that’s right for them.

An obstetrician-gynecologist (OBGYN) manages medical complications throughout pregnancy and birth. If you have certain complications that make your pregnancy high-risk, an OBGYN will be equipped to guide you through the pregnancy and delivery, and will be able to perform a cesarean section, if needed. IHA has many trusted OBGYNs in the greater Ann Arbor area.

An OBGYN isn’t your only option, though. A certified nurse midwife (CNM) is a registered nurse who has graduate-level training in midwifery and is certified by the American College of Nurse-Midwives. IHA Nurse Midwives, who have office hours at the new Domino’s Farms building and attend births at St. Joseph Mercy Hospital in Ann Arbor, are trained to handle all aspects of prenatal care, labor and delivery for low-risk pregnancies. CNMs are trained to recognize potential complications during pregnancy and birth, like the need for a cesarean section, for example. In this case, your CNM will consult with the IHA obstetrician that is readily available on the Labor and Delivery unit.

Additionally, CNMs provide care for the well-woman including family planning, contraception, annual exams and problem gynecological visits. CNMs favor a holistic, family-centered approach to pregnancy and birth with a focus on education, support and intervening in the process only when necessary.

While you’re interviewing and considering practitioners, don’t hesitate to ask specific questions about their approach to prenatal care, labor and birth, protocols for complications and anything else that may help you make your decision. The more information you gather, the better you’ll be able to choose the right provider for you and your family.

If you’re interested in learning more about IHA Nurse Midwives, please join us for a midwife-guided tour of the hospital birthing center on October 16, 2014 from 6:00-7:00pm at St. Joseph Mercy- Ann Arbor, 5301 McAuley Drive (the first floor lobby of the birthing center).

Why Choose Breastfeeding?

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Breastfeeding, or giving your infant expressed breast milk, is the most natural source of nourishment for your infant. When you choose to breastfeed your baby, you are providing him/her with the best possible infant food, and no product has ever been as time-tested as human milk.

Mother’s milk contains all the nutrients your baby needs and is more easily digested than any other baby food. Breastfeeding provides extra protection to infants against many common childhood infections such as: gastrointestinal, respiratory, ear, urinary tract, and dental caries. Breast milk has also proven to protect against more serious illness such as meningitis, juvenile diabetes, celiac disease, childhood cancer, acute appendicitis, and liver disease. There has even been research to support that breast milk helps to reduce the risk of SIDS (sudden infant death syndrome).

Not only does breastfeeding provide so many priceless benefits to your infant, but it also turns out to the best for a mother’s body as well. The lactation process causes changes in the mother’s body that benefit her directly. Some of these benefits include: helping the uterus get back in shape faster after delivery, changing metabolic rates thereby enabling most mothers to lose pregnancy weight gradually without dieting, protection against breast and ovarian cancer, urinary tract infections, and osteoporosis.

How Do I Prepare to Breastfeed My Infant?

Reading and taking a prenatal/breastfeeding class can be helpful. Many mothers find it most helpful to talk to experienced professionals such as a lactation consultant, nurse practitioner, pediatrician, nurse midwife, or obstetrician. There is no replacement for advice from your family members or friends who have breastfed; they often have many useful tips.

However, because every mother and baby is different, the real experience will come after the baby is born. It will be a learning process for both of you, and patience is key. A supportive team of family, friends, and professionals will be valuable to you. Also, it would be helpful to check with your insurance policy before your baby is born to see if they will help cover the price of a breast pump. Most nursing moms find it beneficial for many reasons to have their own pump. Optimally, you might want a support pillow such as a Boppy, a nursing bra, breastpads, Soothies gel pads, and PureLan cream.

Who Will Help Me With Breastfeeding/Pumping After Delivery?

Your labor and delivery nurse or midwife will likely be the first person to help with breastfeeding and/or pumping after the delivery of your infant. Next, the nursing staff and lactation consultants at the mother-baby unit will be happy to assist you with breastfeeding. Once discharged home, you will have access to help through your pediatric office. IHA has many experienced pediatricians, nurse practitioners, PAs, and lactation consultants who would love to help with this life changing experience. If you have questions or concerns, or would like to schedule an appointment, please call 734.995.2950.

Patience Pays Off for You and Your Baby

It is becoming more common for mothers who are nearing the end of pregnancy to request an induction of labor early, but waiting until natural labor occurs is good for both the mother and the baby in a healthy, uncomplicated pregnancy. A pregnancy is considered full term between weeks 37-40. Even though 37 weeks is the earliest point of a pregnancy being considered full-term, there is still so much growth and development that is happening in the last couple weeks of pregnancy.

 

 

It is hard to believe that there would be any benefit to the mother to stay pregnant any longer than she would absolutely have to, but there are several reasons to not induce labor unnecessarily (elective induction). Here are a few benefits for the mother:

 

  • Increased likelihood that you will go into labor on your own when your body is ready, which can improve your labor experience
  • Fewer medical interventions to start or continue the labor process
  • Increased success with breastfeeding since the baby is more interested in eating
  • Decreased chance of having a cesarean section

 

The baby seems to get the most benefit of not electively inducing labor. Here are some things mothers can focus on in the last weeks of pregnancy so they know they are doing the most for their baby:

 

  • Important organs, especially the brain, have time to fully develop
  • Less likely to have breathing, hearing or vision concerns immediately after birth and long-term
  • Increased interest in eating and a better latch during breastfeeding
  • Better at maintaining their body temperature and blood sugar levels following birth
  • Able to transition to the outside world easier
  • Less likely the baby will be separated from the mother for testing thus decreasing the initial mother-baby bonding

 

There are many favorable reasons to not pursue an elective induction that both the mother and the baby can benefit from. Ask your provider about helpful techniques that can mentally and physically help you with the last few weeks of pregnancy. Certified nurse-midwives are knowledgeable about ways that can help pregnant women get the most out of their pregnancies even in the last couple of weeks. In addition to caring for pregnant women, certified nurse-midwives also provide routine gynecological care to women of all ages. This includes pre-conceptual care, family planning, annual exams, contraceptive counseling and menopausal care.

Adolescent women’s health: when to see a doctor and what to expect

Adolescence, simply defined, is the state or process of growing up… sounds easy enough. One’s body knows what to do: eat, sleep, drink and one day, as if by magic, it wakes up and is different. But, what about those other changes, the ones we’re not so eager to discuss; changes in mood, acne, menstruation. Is this normal? Though the simple answer in most cases is yes, there are many topics and questions a healthcare provider familiar with adolescent women’s health can help to address.

While there is no set age or reason to begin routine care with a women’s health professional, the American Congress of Obstetricians and Gynecologists recommends adolescents establish care between the ages of 12 and 15. By initiating this relationship early in one’s reproductive life, patients and physicians are more easily able to bridge communication barriers, particularly regarding the sensitive issues which arise in the course of care for adolescent women.

Unfortunately, the fear of one’s first gynecologic visit deters many young women from going to the doctor. A visit to a gynecologist does not necessarily mean a pelvic exam will be performed. In fact, a first visit is sometimes just a good chance to talk about health, healthy behaviors and answer questions a young woman may not feel comfortable asking anyone else. Initial visits can include a pelvic exam in certain situations. This may involve an external exam only or a gentle internal exam depending on a patient’s health history or concern.

In addition, there are many situations in which an adolescent woman may seek care for a specific problem or need. Common reasons to consult with your women’s health professional are: concerns regarding the menstrual cycle, pain in the pelvic region, overall sexual health, or questions about normal growth & development.

In recent years recommendations have changed for immunizations and routine health screening in the adolescent population. It is recommended that all young women be administered a HPV vaccine series. HPV (human papiloma virus) is the main cause of abnormal pap smears. The HPV vaccine is recommended between ages 11-12, though can be given up to age 26. Though the vaccine will not protect against all forms of HPV, it does offer protection against the two most common forms of high-risk HPV which cause cervical cancer.

In the case of heavy or irregular menstruation, there exists a broad spectrum of normal for young women. This is especially true of the first one to two years following menarche (a woman’s first period.) In the adolescent patient, the interval between periods may fall outside of the typically accepted normal range due to ongoing development of hormone producing centers in the brain.

Frequently missed school or participation in sports due to heavy menstrual bleeding or pelvic pain should be discussed with a physician. Any woman experiencing bleeding so heavy as to prompt evaluation in an Urgent Care facility or Emergency department, should be followed up by a thorough evaluation in her doctor’s office.