Tandem Midwifery

19/08/2022

Good reminders in todays current climate.

What are my options if I don’t want to be pregnant right now?

If now is not a good time for you to be pregnant, it’s important to 1️⃣ know your options and 2️⃣ make a plan (and a backup plan). You can think of your options in three basic categories, which we’ll call Plans A, B, and C.

Plan A: Use Birth Control or Practice Abstinence. Abstaining from s*xual activity that can get you pregnant can be effective, but it doesn’t work for most people in the long term. That’s where birth control comes in. Top choices include the IUD and hormonal implant, which are almost 100% effective. Birth control pills, injections, patches and even condoms and vaginal spermicides, when used consistently, can also give you very good protection. Condoms also protect you from s*xually transmitted diseases. All of these methods require you to visit a health care provider and/or a drug store in advance, so consult our previous post about methods (see the end of this post) and plan ahead! Birth control is covered by health insurance, and many county health departments and Planned Parenthood clinics provide free or low-cost birth control.

Plan B: Emergency Contraception (EC). Think of these methods as a back-up for if Plan A doesn’t work out. Emergency contraception reduces the chances of you becoming pregnant when it is used soon after the fact. The most effective method of EC is to have an IUD inserted. This is up to 99% effective at preventing pregnancy if it happens within 5 days of having s*x. And it can be left in place to provide years of ongoing birth control.

The other method of EC, known as the morning-after pill, works by delaying the release of an egg from the o***y, reducing the likelihood that you will get pregnant. There are many brands available (Plan B, E-Contra, and others) which are sold over-the-counter in drug stores and online. You don’t need a prescription, and it doesn’t matter how old you are or what your gender is. There is also a prescription pill, called Ella (ulipristol) that can be more effective in larger-bodied people. The morning after pill can work up to five days (120 hours) after unprotected s*x, but the sooner you take it the better it works. We recommend buying the morning after pill in advance and having it on-hand just in case it’s needed (your sock drawer is a great place to keep it).

Plan C: Ending a Pregnancy - Called an elective abortion, this is a safe way to end an unintended pregnancy. There are two options: the abortion pill and an in-clinic abortion. Both are safe, very effective, and very common. The abortion pill basically causes an early miscarriage and can be taken at home or in another comfortable place anytime in the first 11 weeks since your last period. In-clinic abortions are safe, simple medical procedures provided by doctors and nurses at a health center.

Due to a June 2022 Supreme Court decision, this Plan C option to end a pregnancy is no longer legally available in all states. To find out the situation in your state and get advice, call your local Planned Parenthood office. Also at the end of this post is a list of online options that can help you find the information you need, including funds for care and travel if you need it.

Thanks to science, we now have many safe and effective methods available for people who don’t want to be pregnant right now. The key is to know your options and plan ahead so that you can make the best choices for you.

Hashtags -



File under: Reproductive Health

Here are some links that can help you find the information you need, including funds for care and travel if you need it.

Bedsider: lots of great information and tips on birth control and s*xual health https://www.bedsider.org/

Planned Parenthood: reliable and inclusive information on birth control and abortion options https://www.plannedparenthood.org/

Our Bodies Our Selves: excellent print and online reproductive health information https://www.ourbodiesourselves.org/book-excerpts/

The New York Times: state-by-state breakdown of current abortion laws https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html

Abortion Finder: online tool to find the location nearest you https://www.abortionfinder.org/

National Network of Abortion Funds: listing of agencies that can provide financial help for an abortion, including travel costs https://abortionfunds.org/

29/04/2022

For all those people with babes on Mother’s Day I wish this for you too.

Me too sis, me too😏

30/03/2022

Few of us have the kind of support we need in the days and weeks postpartum. Yet the attention, care, and CARING we receive is profoundly essential in Matrescene (the term for becoming a mother - coined by psychologist Dana Raphael who also introduced the term doula into modern use).

Those early weeks as a new mom are ones in which support - or lack thereof - may be one of the biggest factors in how that momma experiences that time of major physical, hormonal, psychological, emotional, and spiritual transition.

As a midwife I put a lot of energy into postpartum visits because they are so important. I even wrote a whole book on postpartum care called Natural Health After Birth - a phenomenal classic!

As postpartum depression is becoming less taboo, women are seeking more support, and as we're learning about postpartum trauma being so prevalent, with as many as 30% of all women reporting it in the US alone, it's important to have skills and tools we can use to support new mommas.

Yet women having babies in medical settings often don't even have a single postpartum visit until 6 weeks after birth! That's just not acceptable. And not all mamas giving birth at home get the amount of care and support that's really needed.

I personally provided a home visit on days 1, 3, 7, and 10, and had mom back to see me at 2, 4, and 6 weeks.

My postpartum care for mommas includes all this and more:

💗 Careful attention to physical needs - how her bottom or cesarean incision are healing, how her breasts and ni***es are, is she eating, hydrating, pooping, sleeping.

💗Sitting quietly and listening to help her recall and unpack her birth experience (no matter how easy, hard, satisfying, or challenging) - this unpacking can be key to preventing postpartum PTSD

💗 Preparing herbal baths/ peri-bottles, possibly moxibustion on her lower back

💗Picking up as needed around the house and checking in on the whole family system..

For mamas looking for extra support during pregnancy or once baby is here, I am so happy to share that there is plenty in my weekly Mama Support group! You can learn more on FACEBOOK at . We meet every Thursday at 1pm ET on Zoom (link announced at the FB page) - and it's totally Free thru May.

Head to the link https://www.facebook.com/groups/ideservebirthsupport/ to join!

I'd love to hear your own postpartum experiences - what was it that made the experience more positive? Less positive? Did other women play a role in your postpartum care? Your midwife or other caregiver? And of course, did herbs/ herbal medicines play a part in your postpartum experience and how?

Photographer: Jade Beall Photography

09/03/2022

Happy International Women’s Day to ALL Women!

Happy ! Today we celebrate ALL women, especially those our society does not embrace. You are seen. You are loved. You are celebrated.

02/03/2022

The Nerdy Girls at Dear Pandemic are thrilled to participate in Baby Sleep Day (Visit www.facebook.com/pedsleep for live Q&A all day or www.babysleep.com/babysleepday for the schedule of experts).

Healthy sleep during a prolonged pandemic can be tough – especially for parents who spend a lot of energy balancing their family and work demands. Sleep researchers have even coined a new term, COVIDsomnia, to describe the experience of having a hard time falling asleep during the pandemic. On the other hand, spending more time at home (and less time commuting) can be beneficial for sleep! As we continue to accept life in the new normal, here are 4 terrific reasons why prioritizing your sleep will help you get through this current period.

1. Healthy sleep enhances your immune system. If there’s any time to seek a top-notch immune system, it’s during the middle of a pandemic. Experimental studies indicate that sufficient sleep helps improve your antibody response. You should aim to get enough sleep both before and after you get your COVID-19 vaccine.

2. Healthy sleep helps improves family life. When parents and children are getting regular, sufficient, and restorative sleep, household stress goes down by reducing conflict and increasing psychological well-being. With families spending more time together than ever before, we can reduce COVID-related tension by making sleep health a priority.

3. Healthy sleep boosts your brain and thinking skills. Our brains are overloaded right now – while every household is different, one thing is for sure, we are juggling a lot of change, uncertainty, new information, and risk. Starting each day with sufficient restorative sleep helps you make good decisions throughout the day and cope with any obstacles you encounter.

4. Healthy sleep is linked to overall health. Sufficient restorative sleep is one of the three pillars of a healthy lifestyle (along with nutrition and physical activity). Long-term sleep deficiency is linked to a host of adverse health outcomes including cardiovascular disease, dementia, and diabetes, which are also risk factors for severe cases of COVID-19. Maintaining a healthy sleep schedule can help reduce the risk of adverse outcomes associated with COVID-19.
For super practical information about healthy sleep for your family during the pandemic, continue to check out https://www.babysleep.com/advice/coronavirus/



File Under: Families/Kids and Health and Wellness

16/02/2022

A new study shows that getting the COVID vaccine during pregnancy confers significant protection to infants after birth.

18/01/2022

You can order you free rapid antigen tests from the government today!

GOOD NEWS: Starting today (1/18), U.S. households can go online to special.usps.com/testkits and order 4 individual rapid antigen COVID-19 tests in even less time than it took for us to make this meme.

13/01/2022

Great information on covid and pregnant- get boosted and wear a high quality mask..

One soon-to-be mother says she's "anxious to protect this little one on the way" during this nationwide surge in cases.

31/12/2021

It’s not you, mama. It’s the absence of the village.

25/12/2021

To be honest, I miss my children being little tonight. I miss the excitement, the Santa tracker checking, the matching Christmas pajamas, my children in the church Christmas Eve nativity pageant, the excitement of putting out cookies for Santa and carrots for the reindeer. Tonight is my first Christmas with two teenagers in the house. Yet I don’t miss the anxiety of rushing though the time after dinner and church to race to get the children to bed, to race through reading them the Night Before Christmas and tuck them in because gifts still need to be wrapped, cinnamon rolls finished, stockings stuffed and me to bed.

So enjoy these moments parents of small children. Like everything with being a parent, these times will change and before one realizes, children have outgrown those moments and fit into our lives in new ways. Parenthood is so beautifully messy.

I wish you happy holidays and may you find new ways to create new joy in these tender moments of parenting.

03/12/2021

My quick go to mostly veggie lunch the past month- stir fry noodles with veggies. Starts boiling a noodle- today was sweet potato glass noodles. The scramble an egg and set ti the side. Grab whatever veggies you have and add to sesame oil, garlic and ginger. Today’s fridge veggies were mushrooms, green onions, sugar snap peas and green beans. Cook those over medium high heat, the. Add the eggs, noodles. Add a splash of rice wine vinegar, chili, light soy and oyster sauce. Brighten the meal with a squire of lime. Toss together till mixed . Today I topped with kimchi so I could eat my fermented foods. Change things up depending on what you have. Add tofu or another protein. Add more spice or other veggies.

13/11/2021

In 1969 the rubella vaccine became available, changing the concerns and fearsof pregnant people. Wonderful piece.

Our experience with the rubella virus, which can cause miscarriages or serious birth defects if a woman gets infected while pregnant, may help scientists figure out how to combat Zika virus.

11/11/2021

Scenes from the garden. Remnants of summer and signs of Texas is second spring.

02/11/2021

Afternoon at Arnosky farm for marigolds, monarchs, veggie starts and chèvre from Pure Luck Dairy. Incredible flowers at a favorite farm.

27/10/2021

Thoughts? I’m still mystified almost 17 years after becoming a mom that our system is broken for new parents. I thought then that I could find a way to afford to be home with my new baby and balance work. But instead I was back at work with a 6 week old in daycare because that was all the time my job at TPWD would give me.

The United States is exceptional.

📸

27/09/2021

New favorite quick dinner from Mark Bittman NYTines cold noodle with cucumber, chicken and sesame sauce. Added a bunch of CSA veggies and rice noodles instead of wheat noodles. So good!

22/09/2021

Spent a few hours in the garden and chicken coop this week preparing for fall weather. August and September are when I prep my gardens for cool weather greens and root vegetables. I held onto 3 of the 12 tomato plants, cut them back and gave them a good feeding of compost, in hopes that they might take on new growth. My cabinet is filled with pickles and canned tomatoes from the summer bounty. With the cold front arrival on the first day of fall, I hope you’ll find me in my kitchen garden building another vegetable bed that I plan on being my herb and medicinal garden.

10/09/2021

More reasons to love and deeply trust the staff at Central Family Practice. I’ve long recommended them for care to midwifery clients and Dr Pugh was my doctor in Austin for many years. Wishing they were here in San Antonio and wondering if I should make a 75 mile drive! Stay safe, wag your hands, wear a mask and get vaccinated friends.

Dear friends,

These are strange and uncertain times which unfortunately require that we take some additional safety measures that will not be temporary but ongoing at least for the next 6 months to a year. While it is true that the seven day moving average for hospitalizations is thankfully coming down, it is still high, and the percent of positive Covid-19 tests is over 10%, which is an uncomfortable number, and the Travis county death toll approaches 1,000.

We are a small office, and everyone who works at Central Family Practice is essential. As your health care providers we have been working hard over the last 20 months to pivot and change to meet this challenge head on. We are trying to do what we can to prevent coronavirus infections, and as flu and other winter diseases pick up, it becomes more difficult to protect ourselves both physically and emotionally.

As you read this please remember that for us, this has been 20 months of daily vigilance in our workplace, where we spend the majority of our time. The current system is not sustainable. We are frankly exhausted with the pivoting and the extra layer of stress that this has added. We want to continue to take care of you, and also ourselves. We are therefore instituting a policy of allowing only fully Covid-19 vaccinated people age 12 and above to be seen in the office for visits. Tele-medicine visits will still be available to everyone if appropriate for the problem.

This is how it will look:

• If you are not fully Covid-19 vaccinated, you can still make a video appointment. We can take care of a number of conditions via telemedicine. If your provider determines that you need to be seen after your telemedicine visit, we will have an office visit that will be directed at your problem and will be as short as possible since transmission obviously goes up by the length of exposure to corona virus. This in person visit will be charged in addition to the video visit. (This is to avoid charging everyone for the extra time if it is not needed). You will need to wear a KN 95 mask correctly, which we will provide if necessary.

• For children under 12, we will see up to two at a time for regular physical exams. However, the accompanying parent or caregiver must be fully Covid-19 vaccinated. If the child needs forms completed for school or sports, please have the forms with you and the parent portion of the form completed to minimize time in the office.

• All patients with respiratory symptoms will need to schedule a telemedicine visit first (no matter vaccine status) so we can determine the best way to evaluate you.

• Everyone who enters the office needs to be wearing a well fitting mask, fully covering your mouth and nose.

• We will continue to do labs in the office for non vaccinated and vaccinated people because they are brief and planned, but you will need to wear a KN 95 mask. Lab visits will continue to be scheduled.

• For now we will have the door locked again to help with controlling the flow.

• If you need supplements, please call ahead and let us know what you need and we will have them ready for you. You also can order them online or by phone and they will be sent out the day they are ordered.

• If you have an appointment for a visit or to do labs, pick up supplements, please call 512-371-9260 and we will expedite your entrance.

We feel that wearing masks, social distancing and vaccinations are the ways to mitigate this epidemic. We respect your right to do what you would like, but we also feel that we have a responsibility as members of this community to do what seems best for us all. We need to protect our vulnerable patients, our loyal employees and ourselves. To all of you: we honor you and care about you deeply. We look forward to taking continued care of you and your family during this time in a way that also honors and supports the health of our practice and community.

Best Regards,
Elliot Trester MD, Theresa Pugh MD, Connie Ryan WHNP-C, Eva Montes PA-C, and all the staff at Central Family