author: Dr. Alli Cain
read time: 5:00
this post is sponsored by the government of York Region
Today, October 10, is world mental health day.
On this important day, where we call attention to the fact that there is no true health without mental health, I've partnered with the York Region Government to specifically highlight maternal mental health.
There is a general understanding that throughout pregnancy, a woman’s body changes. As baby grows, a bump shows, weight is gained, expecting moms experience different food and smell aversions, their joints loosen to get ready to deliver a baby. The growth of baby and mom are monitored through regularly scheduled appointments and categorized into three trimesters.
We would be well-served to have just as much awareness about the incredible change in reproductive hormones throughout pregnancy, how this affects our mental health and I contend spend time discussing the "fourth trimester" with just as much vigor as the other three.
You see, after we birth our babies, our physical body begins to change again, but it's our hormones that experience the most sudden and dramatic change of all.
The third trimester of pregnancy is characterized by heightened estrogen and progesterone.
When baby is born, both of these hormones decline rapidly. In fact, this decline can be described as the single greatest hormonal change that any human experiences. Ever.
It’s because of these substantial hormonal changes that there is a heightened vulnerability for new moms to a spectrum of mood disorders including anxiety and depression.
Add in a lack of sleep, an immune system that is recovering from it's suppressed state during pregnancy and the new stress of caring for an infant and we begin to understand why this fourth trimester requires just as much awareness, support and care as women received throughout their pregnancy.
New moms are going to find themselves somewhere on the spectrum of a mood disorder. This will impact moms emotional health, actions and relationship with loved ones. Although everyone will respond differently, no new mom is immune.
However, there is much being done already to provide support to new and expecting moms. Where I live,York Region, we are so fortunate to have access to free maternal physical, mental and emotional health support.
Here are just some of the programs available to expecting & new parents in our community:
Transition to Parenting is a 12-week course offered every six weeks for mothers with babies up to one year and pregnant women who are experiencing mood changes or are looking for support while adjusting to parenthood.
Health Connection provides up-to-date, accurate public health-related information to York Region residents, organizations and health care providers.
eChat offers expectant and new parents the ability to ask a registered nurse health questions confidentially and anonymously through online chat.
Free newsletter, YorkParent, to receive useful tips and resources
Whether you're family planning, expecting or a parent these are incredible resources for you to support the holistic health of mom.
On a personal note, I had great difficulty with breastfeeding after the birth of my first son. I made 5 separate trips to the public health breastfeeding clinic.
At each appointment, I felt supported, heard and helped. Each nurse spent one on one time focused on me. With the support of these clinics, I was able to decrease my stress and make a plan to move forward to support the health of my baby, and also support my mental health.
They say it takes a village, and our community is here offering so much support, to rise up and ensure you’re not alone in this, momma.
- Dr. Alli
Are you looking at belly binders and wondering if you should get one?
I was asked this question the other day in my prenatal workshop, and my answer was.... well, it depends.
Like so much in science, there is a lot of gray when it comes to the use of belly binders.
Here are some things I want you to consider:
A Belly Binder is going to offer you support, help to alleviate aches and pains and make holding that baby a little easier on your back and pelvic floor.
Anything you can do to gain comfort in the immediate post partum period can be helpful just to survive the day.
A Belly Binder can create more problems than it solves when:
+ it creates too much compression
+ it disrupts our normal breathing pattern
+ it becomes a crutch you cannot function without
Supportive braces have a time and a place. In my chiropractic office, I look at orthotics and knee braces the very same way.
"How can I help my patient gain functional strength and wean them off of a support device that is actually hindering them!"
The goal for my patients is supporting their bodies to function well in the short term, while we set them up for long term success.
A supportive brace for a few weeks to allow them to get through their activities of daily living is OK, so long as they recognize & undergo a proper post partum rehabilitation core + more strengthening program.
Life long strength is the goal here.
This study found that wearing an elastic belly binder post caesarean may help to alleviate pain but had no impact on postoperative hemorrhage.
While this randomized-control study found that patients who wore abdominal binders reported less pain, lower SDS scores, and higher hemoglobin and hematocrit levels following cesarean delivery.
A large part of post partum rehab is the prope restablishment of intra-abdominal pressure (IAP) within the core. Improper IAP can lead to low back pain, pelvic floor disccomfort, leakage and prolapse. So it's very important!
Belly Binders have been questioned in regards to if they are supporting this goal or hindering it.
This study compared elastic binders vs no elastic binders and compared the effect of IAP.
"Elastic binders have relatively little effect on IVP and are more helpful at promoting postoperative recovery than non-elastic binders. Therefore, elastic binders are more suitable for clinical use."
So the answer to your belly binding question?
But please know that n o t h i n g will take the place of taking the time to properly rehabilitate your breathwork & your core. The payoff will pay dividends over your lifetime!
- Dr. Alli Can
Dr. Alli is a chiropractor, and owner of a multi-disciplinary wellness centre in Georgina, ON. She is a mom to one-year old Logan, and wife to Dr. Jordan Winberg. She runs an evidence-based, and highly sought-after post partum rehab series- helping everyone from high level athletes, to women with diastasis recti and prolapse. She is passionate about supporting women in the post-partum period to make informed choices and heal their bodies properly .
Training doesn't make you stronger. Say What?!
The act of exercising is catabolic which literally means "break down." Your whole body is under stress: muscle fibres are damaged, tendons and ligaments strained and glycogen stores are depleted. Yet, following a fitness program consistently will allow you to keep upping the weights, add muscle to your frame, and look + feel good. So what gives?
Simple - you are gaining strength, repairing damaged muscles & refilling glycogen stores during your recovery stage.
Scheduling days where you slow down, walk, stretch, flow or completely rest are just as important as scheduling your workouts. Yet, often it's hard for people to take a day or two off because of the belief that it will set them back in their performance and progress.
It seems easier to get to the gym and bust your butt than take a recovery day.
Squat 1RM stalled? More squatting!
Fat loss stalled? More cardio! is commonly the first thing people do in an attempt to get better results.
Here are 4 reasons why you need to make a mental adjustment and start believing that days in the yoga studio, or taking full days off from fitness are good for you, your strength, your fitness & your body composition.
1. REST BUILDS MUSCLE.
When you engage in strength training, you are essentially 'tearing' muscle fibres. The repair of these small tears is what causes the muscle to grow - for you to become stronger and for the change in your body composition to add muscle definition. Without a period of relative rest, your body does not get the opportunity to repair and grow. You are not getting the full benefit of your training if you are not resting.
2. YOUR PERFORMANCE WILL NOT SUFFER & WILL IMPROVE.
Generally speaking, it takes about 2 weeks of inactivity before you see a noticeable dip in your performance level. A day, or two off from training will not set you back from the hard work you've been putting it. In fact, a day or two off can lead to an even better training session when you return!
3. STAY SHARP
Taking a period of relative rest can keep your hunger for progress sharp, and help to prevent burnout. Mental fatigue can be as detrimental as physical fatigue. Taking a day off can recharge your body, and keep you excited for your training.
4. REST PREVENTS INJURIES
Taking a day off when something hurts might be common sense but still I hear "I thought it would go away" daily in my chiropractic clinic. Pushing too hard without time off can lead to overuse or repetitive strain injuries. These can take weeks and even months to recover from. Taking days off can be preventative and contribute to your longevity as an athlete.
Just like setting your performance goals, set your rest goals. What is something you want to accomplish on your day away from the gym? Get into the yoga studio for a flow? Hop on a spin bike for some steady state evercise? Go for a walk? Spend time playing pick-up with your kids? Look at your schedule and pick your weekly rest days. A day where your intense activity is limited to allow your body to recover. Try adding in a regular weekly rest day and I promise your fitness and health will only benefit.
- Dr. Alli Cain Winberg
Dr. Alli Cain owns a health centre in Keswick, ON that houses a fitness facility, yoga studio, spin studio and full health clinic. Her mission is to act as a catalyst for you to make a meaningful change to improve your health. She hosts pre + post partum fitness workshops as well as has written a comprehensive nutrition ebook to support the health & wellness of women everywhere.
Get caught up with Part 1 and Part 2
Once we came out onto the other side of the struggle -- our relationship was stronger, we gained clarity on what we want to do & how we want to feel each day and week and month, and we were able to gain some much-needed downtime with our now 6 month old baby.
As I moved back to more regular work hours, and Jordan returned to his normal hours we started to establish a routine. Looking back at the trial & error of establishing a routine with a baby, this is what I found:
Here's what didn't work:
- booking patients in at random times to try to be accommodating. I want to be there so badly for people when they need me that I will often put myself out. I was never OK with sticking Logan in the playpen and leaving him behind the front desk (supervised, of course!) and heading into the treatment room with a patient. It wasn't fair to Logan, to my staff, to my patient or to me. To get work done, it is better when Logan is not with me at work. I am a better doctor when all I have to think about are my patients.
- having Logan at Post Partum Fitness class. Originally, I had created this program as a way to work with Logan. And it was great! Until he started to move :) To give the highest quality classes to my patients and clients, he needed to start staying home.
Here's what worked:
- Having Logan with a family member or friend a few hours a week and adding treatment hours then.
- Adding Saturday Treatment hours.
- Working out in the morning so that I get home earlier.
- Using OTRmeals to support my nutrition because things are still busy.
- Being outside and having friends come to us to visit!
- Starting a 100 day movement challenge (more on this later).
- Doing a split shift whereby I go into the gym in the early AM, come home for 3-4 hours while Logan naps and then head back for the evening.
We still are in the routine that we established at this time, with a few tweaks! There are still things that I want to work on to feel more in control, and present.
I gained 37lbs while pregnant, and I was even more patient with my weight loss than I had anticipated! I had been on domperidone to help with breastmilk production which can increase appetite - and it did. Although everyday I found ways to get in movement, and worked to eat as well as I could it wasn't until summertime that I came close to hitting my pre-pregnancy weight. Once I was close - I was super motivated! I began a personal 100 days of movement challenge to stay inspired and followed the lifestyle eating principles I write about in my ebook "mindshift macros" -- the result? A total of 50lbs lost, eating that makes sense without restriction or fearing social situations and I'm back to where I left off in the gym minus a few skills I haven't practiced at all.
I love summer, and I loved summer with my family of 3.
- Dr. Alli
Just as you ease into what you consider a "new normal" with a baby, they throw you a curveball and everything does a 180.
As we entered into April-May & June, this is exactly what happened. Except it wasn't Logan who was making the major changes.... it was mom & dad.
It became necessary for me to start working 14h+ days after a business partner & staff member walked away from the business.
Then, my husband needed to have hernia repair surgery putting him off work for 6 weeks.
Then, one of the clinics we were working at terminated our contract while I was on mat leave.
It would have been enough to deal with this stressful situation as a young couple.
But add in the lack of sleep, worries of a first-time parent and ..... to say it was tough to stay positive.
Not even in our worst case scenario planning, had this scene came to our minds.
But here we were.
And we don't run away when things get tough.
I am loving writing this year in review, because as I think over the lowest moments of 2018 here in January 2019, the personal and professional growth is so clear to me. So much good happens as a result of taking your lows, putting your head down and getting to work.
I went back to work not only at my clinic, but covering Jordan's too while he recovered from surgery.
Family and friends stepped up to help us out in the care of Logan.
Putting in the extra time at work forced me (and my partner) to prioritize where time was best spent, and allowed us to the freedom to hire people who wanted to work hard, and we're even better than us at certain roles! Focusing on hiring good, hard-working people led us to win "Young Entrepreneurs of the Year!" We would not have done that without the small set back as a catalyst for our massive 2018 growth.
Covering for Jordan in his clinic - a full role reversal from the 3 months prior - allowed us a glimpse into each other's lives. For him, it was eye-opening just how tough it can be to stay home all day. When you're away from the house you can start feeling like the other person has it easy - but it's not.
For me, I understood just how stressful it can be going from clinic to clinic, and being away from my new baby for full days.
This glimpse into each other's life was so important in our understanding of how we can support each other as partners.
Being forced away from a stable income meant trusting myself and my skills to build from scratch. It meant going all-in on something, rather than sitting on the fence. It was a blessing in disguise to learn just what we're capable of. It was a lesson in business to work through the emotions to not take someone else's business decision personally.
These three months were tough, and to be frank, I would never want to re-live them. I DO regret not being able to be present with my baby and missing important moments of his newborn life. However, I am forever thankful for the teachable moments of 2018, and for the massive growth that it afforded me. Sitting here, "safe" in January 2019, I am able to truly say I would not be where I am lucky enough to be, both personal and professionally. I've learned invaluable lessons about life that I will carry with me forever.
What were your teachable moments of 2018?
- Dr. Alli
P.S. if you want more insight into all things pregnancy & post partum join me LIVE on January 24 at Anchor as I sit alongside a panel of experts. Reserve your spot here -- it's free!
Is there anything that can describe the first year with your first child?
My husband and I welcomed our first son, Logan Cain Winberg on January 30, 2018.
I launched a brand new post partum health course.
Our business "ANCHOR" grew in so many ways.
and we won Young Entrepreneur of the Year.
I'll admit, I spent much of the end of 2017 worrying about what 2018 would look like -- running a business with a baby. So I'm taking stock on one of the most tumultuous years of my life.
I'm big on goal setting, and know that in order to launch forward, a review of past wins and teachable moments is critical.
In the past, my yearly reviews have only been done in my private, purple journal but as more and more of my friends, family, patients & clients become working moms I thought I would share my journey here in hopes it could help others with their journey.
When I first found out I was pregnant, I googled "how to be a successful chiropractor with a baby"
A world wide search brought up: ZERO.
So, if you're a health care practitioner, or really any independent contractor without the financial support of mat leave and you're thinking about having a baby, pregnant, or recently welcomed a new addition to the world... c o n g r a t s <3 and I'm here to support you.
2018 and the first year as a mom brought SO many highs, a few lows and I wanted to break them all down and review so that I can relive 2018 over and over again because if nothing else, it was a complete and total BLUR.
It can be so easy to look back on a year and think about all of the things that I didn't get done... but in reality some really BIG things got done!
If you've never done a year in review, I challenge you to do it so that you can look back and say YES GIRL, I've come so far!
JANUARY - MARCH 2018
At the beginning of the year, my husband and I welcomed two (!!) new additions to our family - 11 days before the birth of our son, we adopted a 2 month old puppy, Frankie.
You can read Logan's birth story here.
The first 8 weeks went exactly according to plan. He was covering both of my clinics (bless him), while I stayed home with the baby.
I had been planning to wait until 4 months post partum to launch a new course I had been working on, but I was so antsy to launch it to the world that I threw it out to the world at 2 weeks post partum and started the first sessions at exactly 4 weeks post partum.
I look back at this and still don't think I was crazy. Being able to get out of the house, support the health of other women who were going through the exact same thing as me (all the babes in that first course were 3 days apart!) and make a little bit of money was hugely helpful in the post partum physical and mental healing. The moment I stepped into lead my patients, I immediately felt at home. Being able to bring Logan with me and work was exactly what I had wanted to be able to do.
January - March wasn't easy with the lack of sleep, constant appointments and weekly worries about the health of a new baby.
Looking back on this time I am forever grateful for the support of my family and friends in this important time.
The Highest High: Welcoming Logan Cain Winberg to the World on January 30th, 2018
The Biggest Lesson: No amount of planning prepares you for a baby. But I am grateful I had people I was able to ask for help. My family, friends and colleagues continued support was everything I needed to get a tough & transformative time.
- Dr. Alli
I began pushing at about 1am.
The nurse had me pushing 3 times for ten seconds with one breath in between.
Insert CrossFit WOD cliche here - but it truly was!
My midwife asked me if I wanted to have a mirror at the end of the bed to watch, and I said yes.
I'm so glad that 1) I said yes and 2) I had the epidural ... the process of watching Logan be born was absolutely incredible. We could see his blonde head of hair right away!
His head remained in the same position for what seemed like forever. I couldn't really feel the contractions but I could feel the pressure build, and hear his heart rate drop on the monitor - this was my indication to push.
The nurse was amazing [shout out to kelly for calling in to put her with me]
She gave me just the right kind + amount of encouragement. She was on my right holding my leg, and Jordan was on my left. The 2 midwives and the OB were at the end of the table waiting to catch Logan.
After about 45 minutes of pushing, there was a brief period during a contraction where Logan's heart rate dropped dangerously low - "you have to push hard, alli!" my midwife said "or else we'll have to do an episiotomy.....!"
Well, that was enough for me! With one a huge p u s h with everything I had, I felt Logan's head POP through, and with one more push the OB pulled him earth-side. Logan gave two quiet cries to announce his arrival and within seconds he was lying on my chest seemingly so content.
How do you even describe what it's like to meet your baby for the first time?
I still haven't found the words.
All I can remember saying is "hi baby! hi baby!" and Jordan remembers looking at him and saying to me "he's perfect."
Time stood still as Logan lay on my chest.
Jordan cut the cord, and then we waited for the placenta to come.
The OB has theorized that there was something wrong with mine due to his lack of growth over the final 6 weeks of my pregnancy. When it came, I had Jordan take pictures of it [the report showed that nothing was wrong with the placenta, but it was small].
The routine measurements occurred, and within the next 90 minutes they had brought a wheel chair into the room to bring me to our private room where we would stay for the next 36 hours.
pre-baby plan: blog about baby + me weekly
post baby plan: get the blog up 9 weeks later...
When Jordan and I woke up on Monday, January 29, we had no idea that had been our final sleep as a family of 2. We took our dog for a walk and decided jokingly it was about time we got the car seat installed since I was due in 2 weeks. It was 11am when we finally got back into the house and I saw that I had a missed call from my midwife with the results of my recent ultrasound,
“Baby hasn’t grown much and we’d like you to go to the hospital to see the OB.
Pack your bags, as we may have to induce you.”
Not the news we wanted to hear, but we did our best to remain calm as we got everything we thought we needed together, We made quick arrangements for our puppy, and set out for the hospital.
Although small for a full term baby, and not growing in the final weeks like a baby “should,” the anatomy and fluid were normal.
The OB checked me out and reported I was 2cm dilated and 80% effaced. She presented me with an option: go home and wait 1-2 weeks with constant monitoring, or have my water broken manually and get the process started today.
Jordan and I had joked that a Monday would be the ideal day for a birth since it's his shortest day in the clinic - I guess we manifested this! We opted to proceed with breaking my water and started to let family know.
Within 3 hours of seeing the OB, my midwife arrived at the hospital and manually broke my water. Little bit of a pinch but nothing too bad. I wandered around the room, ate some lunch, chatted with Jordan and texted friends for the next 4 hours. Nothing but small cramps starting to happen,.
My birth team was disappointed that I hadn’t dilated further, and we proceeded to the next step — induction with an IV pitocin. I was hooked up on the left with the IV and on the right with a fetal heart monitor. I wasn't going anywhere!
Within 20 minutes, the REAL contractions started. And boy, they came on strong.
I worked to breathe through them, shut my eyes so tight, and took my breath right down to my pelvic floor for a count 1-2-3 and then back out 1-2-3. The contractions went from 20s in duration to a full minute within the hour with just a one minute break in between.
It was horrible.
I thought about how my mom had done this with no epidural, and all of the women I knew who had managed.
The stories of delivering in cars, or on the side of the highway.
Even the nurse said to me “I had 2 without an epidural - so you can do it.”
I was surprised at the self doubt I showed myself here:
“are these nurses judging me that I can’t handle this pain?!”
“am I less of a women for the fact that I am struggling to make it through?”
but the overriding thought was what my friend had told me about her epidural - “it was a dream!”
When I was checked again, after an hour of this 11/10 pain I had still only progressed another cm.
“We won’t see this baby for another 12 hours” quipped the nurse.
12 hours?! I thought. "There’s no way I can manage this for another 12 hours!"
Although I had a rough outline of what I had hoped his birth would look like, I had put flexibility first.
Whatever is safest for baby.
Whatever I’m feeling in the moment.
And in that moment “give me that epidural!”
By 10:30 I was given the epidural — and yes, it was a dream.
My mom stopped by, as did Jordan’s family and I was able to smile and have a real conversation with them.
I progressed quickly and just after midnight the nurse informed me, it’s time to P-U-S-H!
photo: lace photography
Giving birth to Logan is a day that has forever changed me.
But this is not that story.
I shared the picture because how could I NOT show the world his sweet face.
No this story is different....
I was 21 years old, recently graduated from university and unsure of what my next step was. Having recently finished up playing varsity sports at Wilfrid Laureri University and Durham College, I turned to bodybuilding type fitness to fill the competitive void in my life. This led to me spending sometimes up to 4 hours a day at the gym, working on isolation training and cardio with the sole purpose of burning X number of calories.
One day, one of the trainers at the globo gym told me his client had said to him "I want to look like her" pointing at me while I was on the treadmill for session number 2 of the day
he responded "if you want to do that, you'll need to find 4 hours in your day to dedicate to your fitness"
to which his client responded "nevermind."
You see, his client was a 30 year old mother of 2, working full time and was still prioritizing her fitness. However, she didn't have 4 hours/day 7 days a week to spend at the gym.
This feedback struck a nerve.
The professional identity I was trying to create at that point was to be a positive influence in the health and wellness journey of others.
Most people cannot, and should not be spending 4 hours a day in the gym.
To my dismay, I realized the very people I wanted to influence could in no way relate to a 21 year old female who had endless hours a day to spend at the gym.
Training with the sole purpose of looking a certain way was not healthy for me physically or mentally. And it was actually hindering the very career I was wanting to foster.
I had to make a change.
CrossFit truly changed my life.
An amazing workout in 60 minutes or less, that shaped my body, gave me strength I never knew I had, boosted my cardio to levels I never had even as a varsity cross country athlete and most of all - allowed me to stop focusing my workouts solely on aesthetics.
Now, as a new mom I get it even more.
I don't have and I don't ever want to feel the need to dedicate my life towards my looks. Working out with an aesthetic goal in mind is totally OK, but it will never again be the sole purpose I get out of bed in the morning.
Right now, I have to try really hard just to carve out 20 minutes for me a day.
I felt like the most badass mom ever this week when I got my 3-week old baby into the stroller and my puppy hooked up to the leash and made it around my 800m block for a walk.
I have created a post partum fitness series to give mom's a place where they can work on their fitness post baby, in a supportive environment that isn't just focusing on lbs lost. Of course, we want to feel good in our skin, give our unused wardrobe the attention it deserves but it cannot be the only reason we prioritize fitness in our busy lives.
We train to build a strong pelvic floor, so we aren't peeing while be laugh for the rest of our lives.
We come together and train so we can spend time swapping stories, or learning how other momma's are coping with aspects of their child's development.
We train in a place where we can bring our babies because otherwise, there's just no chance we could make it out of the house for fitness.
We train because showing our little one's the important of self care and momma strength is so important.
I hope you'll join me.
hey there mama,
It may have felt like the day would never come, but you've finally got the all clear from your health care provider and you're ready to start exercising again. But now what?
Where can you go with baby in tow?
What is the safest, most effective way to gain strength, stamina, endurance and perhaps shed a few lbs?
Even with a smooth delivery, it's important we spend time on the basics of working out
before diving back to 100% intensity. Even if you were in the best shape of your life just a year ago,
it's important to take this time to connect with your postpartum body.
let's do it together
monday + wednesday
starts monday march 5
bring baby with you & connect with other moms through health & fitness
post partum is forever, but moms who have had babies in the last 20 weeks will benefit most from this fitness series..