Endometriosis Awareness Month

March is Endometriosis Awareness Month.

Endometriosis. It’s a disease that you’ve likely heard of but don’t know much about, and this is why the entire month of March is dedicated to raising awareness of a disease that affects so many women. In fact, 1 in 10 women have endometriosis, which is roughly 176 million women worldwide. If you menstruate then you are at risk of getting endometriosis.

Every month the lining of the uterus, the ‘endometrium’, is shed and expelled from the body as a period. It is the shedding of the lining of the uterus that causes endometriosis. Science is not exact on how endometriosis is caused, but there are two common theories.

The first theory is that during menstruation a small amount of menstrual blood is sucked up the fallopian tubes and spilled in to the pelvic cavity. This is known as ‘retrograde flow’.

The second theory relates to women who have had caesarean sections. When the uterus is cut during surgery, tissue from the uterus is accidentally introduced in to the pelvic cavity.

Once the lining has made its way in to the pelvic cavity it then attaches to various organs and begins to grow, becoming endometriosis. Because the tissue is effectively uterine lining, during the monthly cycle hormones stimulate the endometriosis, causing it to grow, break down, and bleed- as it would a period. However, this internal bleeding, unlike a period, has no way of leaving the body. This then leads to inflammation, pain, and the formation of scar tissue, known as adhesions, which act like glue and bind organs together. And because the blood from the endometriosis cannot be expelled from the body, it continues to float around, spreading the endometrium cells, and attaching to more areas of the body.

Endometriosis has been found in every organ and anatomical structure of the body including the kidneys, eyes, liver, brain, bones, heart, skin, and nasal cavity. The only place it has not been found is the spleen. For most women, however, the lower abdominal cavity, specifically the reproductive organs, is the most commonly affected area. And because of this, 30%-50% of women with endometriosis will experience some level of infertility. And that is what happened to me.

I gave birth to our first child by emergency caesarean section in December 2014. We had conceived him after only three months of trying and my pregnancy had been smooth sailing. His birth had been traumatic and I needed to wait for my both my body and mind to heal from the experience before we tried to conceive again.

That time came in March 2016. I was 30 years old. We were mentally ready for another child, our son was finally sleeping through the night, and I felt that my body could handle whatever came our way. Luck, however, was not on our side. In April 2017, after 13 months of trying to conceive, after countless tests, both non-invasive and invasive, I underwent a Hysterosalpingogram- a radiologic procedure that investigates the shape of the uterine cavity and the shape and patency of the fallopian tubes. The results were instant and conclusive. I was infertile. We were devastated.

After our initial shock wore off and we had wiped away our tears we were given two options; We could do IVF or I could undergo exploratory surgery to try and find the cause of my infertility. We wanted a baby, yes, but we also wanted answers, so we opted for the exploratory surgery.

On June 28, 2017 I was wheeled in to surgery. On June 28, 2017, I was diagnosed with extensive endometriosis of the uterus and fallopian tubes, and endometriosis of the ovaries, bladder, and bowel. The endometriosis had grown around my fallopian tubes like vines and had bent and twisted them so badly that sperm had zero chance of getting through, and this was the cause of my infertility.

I was lucky. I can say that now. Looking back, I didn’t feel lucky. I was infertile, I had been diagnosed with an incurable, chronic disease, and I was told that the endometriosis that had been removed during my surgery would likely grow back. But now, 9 months on, I know I’m one of the lucky ones. I’m lucky because my endometriosis was discovered accidentally after only 7 months of tests. In the United States it takes an average of 10 years for women to get a diagnosis from the onset of their symptoms. In the United Kingdom, it takes 7.5 years for a diagnosis. There are many reasons for this.

Symptoms vary drastically in each woman and symptoms can mimic those of other illnesses. Often women are diagnosed and treated for other illnesses before discovering that it was endometriosis all along.

Endometriosis can only be officially diagnosed visually during surgery; It does not show up on ultrasounds or x-rays. Because it needs to be sighted to be diagnosed, doctors will only operate as a last resort, meaning women can live for years with horrendous pain and life altering symptoms before their doctor will consent to surgery.

The saddest reason of all, in my opinion, is that many women simply aren’t believed. They are brushed off by their healthcare providers and are told that the pain they are experiencing is in their head and that pain during a monthly cycle is normal. It is not normal.

There is a huge lack of knowledge about endometriosis, both in the health sector and in the public arena, and because diagnosing this disease is not as simple as a blood test, it is often up to the patient to push for further testing. With knowledge comes power, and the more awareness and information people have of this disease, the more confident they will be to advocate for themselves, for their daughters, and for their friends and family.

Symptoms of Endometriosis:

• Painful periods
• Pain during intercourse
• Pain during bowel movements or urination
• Excessive bleeding during menstruation
• Bleeding between periods
• Infertility
• Chronic Fatigue
• Also, diarrhea, constipation, bloating, or nausea, expecially during menstruation.

Bravo Birth DFW would like to extend a huge thank you to guest blogger, Alex Hughes, for sharing her experience with endometriosis. Alex is a New Zealander currently living in Singapore with her husband and their three-year-old son. She’s a cinephile, bibliophile, gourmand, and traveler extraordinaire. When she’s not out having adventures and eating delicious food, you can find her organizing or doing something nice for a friend.


Oh, Crap! | What I Wish I Knew

Constipation After Birth

Welcome to part two of our blog series entitled What I Wish I Knew. You can find part one here.

In this series we explore topics that now-experienced parents wish they would have known more about before they went through pregnancy, birth, and postpartum. When we asked this question, the most common answer we received (by a long shot) was that many mothers wish they would have known that the first bowel movement after giving birth can be quite a struggle. Although it may be an uncomfortable topic, we want you to be fully prepared to tackle this unpleasant issue.

We are so grateful for professionally trained birth doulas and postpartum doulas, but after hearing several horror stories of postpartum bathroom problems, it’s clear that what Fort Worth, Dallas, and the rest of the world really needs is postpartum constipation doulas. Someone to hold our hand and talk us through relaxation techniques on the toilet. Someone to bring us water and wipe the sweat from our brow when we need a break from pushing. Someone to wholeheartedly support our decision when we request medication to ease the process a bit. Okay, maybe we’re kidding, and we can guarantee that almost any birth doula or postpartum doula would actually do all those things for you, even while using the restroom. No extra certification for constipation support necessary.

So what causes this intimidating phenomenon?

Constipation tends to be very common during pregnancy due to several contributing factors. Your digestive system slows down considerably, prenatal vitamins often have a high iron content, physical activity tends to decrease, and your diet may be lacking adequate fiber and water. If you are struggling with hemorrhoids, another common side effect of pregnancy, this can complicate constipation issues even further.

During birth, there are additional components that may lead to constipation. You may forgo food and water longer than you normally would, resulting in dehydration. If you are breastfeeding, you may be further at risk for dehydration. Certain narcotic pain medications or anesthetics given during labor or a cesarean birth can cause your muscles to be sluggish and slow down your digestive system. After birth, your pelvic floor muscles may be weakened. Discomfort in the perineum or from the surgical site may cause you to delay using the restroom longer to avoid pain.

What can you do to avoid constipation?

All of these issues in pregnancy and birth have the potential to pave the way to an unpleasant restroom experience after birth; however, with a little mindfulness and preparation, you may be able to avoid the worst of it. Many of these tips may also help prevent hemorrhoids, as well as make for an overall healthier pregnancy.

1. Drink plenty of water during pregnancy, labor, and postpartum. Lots and lots of water.

2. Remain active during pregnancy. Resting is important to your recovery after birth, but depending on the circumstances, a little bit of walking may help to keep things moving.

3. Eat foods high in fiber, such as whole grains, legumes, fruits, and vegetables. Avoid low fiber foods made with refined white flour.

4. Seek regular prenatal chiropractic care. Not only is this great for keeping your spine and pelvis aligned for optimal health for the mother and child, it also restores function to the nervous system, which helps constipation to resolve naturally.

5. After birth, try not to hold things in. This will only makes it worse and potentially cause more pain. Try to use the restroom as early and often as you can.

6. If you are already constipated, temporarily adding prune juice or senna tea to your diet in small quantities may help to get your bowels moving. You may want to avoid drinking too much to prevent having the opposite problem of diarrhea.

7. Asking your health care provider for a stool softener after birth may be beneficial. Stool softeners increase water absorption in the stool, making it easier to pass. In more severe cases, a laxative may be necessary. Laxatives stimulate the digestive tract walls, speeding up the bowel movement process.

We hope this information makes the first trip to the toilet after birth a more positive experience. And if you need additional support, we’re confident we can doula you through it.

Postpartum Night Sweats | What I Wish I Knew

Please enjoy the first installment of a new blog series that was inspired by our Facebook followers when we recently asked what they wish they had known about pregnancy, birth, and postpartum before they had a baby. Having a child is often accompanied by many surprises, and while you can’t always plan for everything, sometimes it helps to learn from the experiences of people who have already been there.

Postpartum Night Sweats

One commenter shared, “I wish I’d been warned about the hormonal night sweats post delivery. I legitimately thought I was dying when I woke up that first night shaking and shivering, drenched in sweat. Honestly, my postpartum night sweats were horrific. I don’t miss that!” – Alex H.

This is a pretty common complaint among new mothers and while it may be alarming at first, it typically isn’t anything to worry about. Oftentimes, within the first week or two after giving birth, you may find yourself being awoken at night, not only by your newborn, but also by intense sweating, potentially alternating between shivering and hot flashes; however, the increase in sweating probably isn’t from that sweltering Dallas-Fort Worth heat. Let us explain!

During pregnancy, your body retains fluid to support you and your baby. Toward the end of pregnancy, you may even experience swelling in your hands, face, feet, and ankles from the fluid retention. Additionally, during labor you may be given supplemental IV fluids. Once you give birth and you no longer need all the fluid your body has been holding onto, your hormones rid your body of it by causing increased sweating and frequent urination. This generally normal phenomenon can happen at any time during the day, but more frequently happens at night.

Is it dangerous?

While it can be quite uncomfortable, increased sweating after birth is typically a not a cause for worry. If you notice this happening for more than a couple of weeks, you may want to discuss it with your care provider. It’s also important to report it to your doctor or midwife immediately if you experience any other symptoms such as fever, dizziness, intense pain, or difficulty breathing. These may be signs of an infection, and should always be taken seriously.

What can I do to stop sweating?

Unfortunately, you may not be able to prevent this from happening, but you can make yourself more comfortable. Consider dressing in lose fitting, breathable pajamas. Keep an extra set of pajamas within easy reach in case you need to change in the middle of the night. You may even want to make your bed with several sets of sheets, so if you happen to sweat through one layer, you can easily remove it and have another set right underneath. Sleep with a fan on and be sure to keep yourself well hydrated.

This element of the postpartum experience may be something we don’t look forward to, but thankfully it doesn’t last forever and can be a sign your body is functioning properly. Be sure to check back next week for Part 2 of the “What I Wish I Knew” blog series.

Celebrating (Surviving) the Holidays with a New Baby

Congratulations! You had a baby this year and now you get to enjoy all the wonder and beauty of their very first holiday season. These tips from our seasoned experts will help you prepare for all the excitement the end of the year brings.

1. Stock up on Wine.

This is the first and most important step. This will set the tone for the next two months, so it’s imperative you don’t skip this one. If you don’t care for wine, that’s no problem. Eggnog, apple cider, or Irish coffee work just fine, as long as they are spiked with the alcohol of your choice. Be sure to carry your festive drink with you wherever you go.

2. Have your local pizza delivery shop on speed dial.

Let’s be honest, you don’t even like turkey the other 364 days of the year. The stuffing and pie might be tempting, but with a newborn, you won’t have time to cook a big meal from scratch. Just surrender to the fact that this year you’re saving your sanity and ordering pizza delivery. If you want some variety, chinese take-out is a good substitute.

3. Sign up for an Amazon Prime membership.

Forget the Black Friday sales. Don’t even think about stepping foot in the mall. All your baby wants is an empty cardboard box and some wrapping paper to tear up. For everyone else, there’s Amazon Prime. We live in a world where we can have anything we could possibly need delivered to our front doors with free two day shipping. This is the true holiday miracle.

4. Stay home.

Speaking of avoiding crazy parking lots and long shopping lines, just stay home altogether. Yes, holidays are meant to be spent with those you love, but it’s cold and flu season and you don’t want your baby getting sick. Use this as an excuse to stay home and avoid your drunk Uncle Al and judgmental Aunt Cheryl. If nobody buys that excuse, just tell your in-laws you’re spending time with your family this year and tell your family it’s the year to spend with your in-laws. You can sort that out next year.

5. Set your child’s expectations now.

It may be tempting to buy your baby all the popular toys and start a bunch of new traditions, but by setting the bar low early on, you’re actually setting yourself up for success when they’re older. For example, Elf on the Shelf may seem like a cute idea now, but wait until your child wakes you up at 5 a.m. crying because Elfie has been “resting” in the same spot for four days. When it comes to gift giving, tell people you’re raising your child to focus on relationships instead of material items. This will make you seem sophisticated.

6. Put your holiday decorations in storage.

Plan to keep them there for approximately 10-15 more years. Whether it’s Christmas lights and glass ornaments, a Hanukkah menorah, or a Kwanzaa kinara, they’re all basically death traps for babies. There’s no way to baby proof everything, so don’t even try. You can have nice things when your child is in middle school, or possibly in college.

7. Get a babysitter for New Year’s Eve.

This is the one holiday of the year when it’s acceptable to ditch your child and spend time with other adults without a baby screaming in your ear. You won’t get another chance at this until next year, so ignore the spit up on your cute dress and go let loose.

8. Have fun!

In all honesty, all you need is your sense of humor and a little patience. Try to take it easy. Enjoy your baby, your loved ones, and all the excitement (and food!) this time of year brings. The holidays will never be the same!

Meet the Owner

Hello! I am Alexandra Bravo, owner of Bravo Birth DFW. I am so excited to launch my new website and return to working with families in Dallas and Fort Worth, after enjoying my own maternity leave for the past several months. Here’s a little bit of information about me and my journey to becoming a Birth Doula, Placenta Encapsulation Specialist, and more. I’m hoping I’ll be able to get to know you, as well!

My interest in birth work was sparked in 2008, during my pregnancy with my first daughter. At the time, I had never heard of a doula, but I read and researched everything I could regarding pregnancy, birth, postpartum, breastfeeding, and parenting. As I gained knowledge, I naturally became a support person and a source of information for many expectant people in my life.

Around 2012, during my pregnancy with my second daughter, I discovered that supporting people emotionally and sharing knowledge the way I had been for years was an actual career. I hoped that one day I would be able to train as a professional doula, but having a preschooler and an infant at the time, I decided to file that plan away for a future date.

I continued to raise my young children and take college courses over the next couple of years and in 2014 my third child, a baby boy, was born. In my free time, I continued to learn as much as I could regarding birth and postpartum support, and I decided when my son turned a year old, I would feel comfortable completing the necessary work to become a certified birth doula. In 2015 I took a training course, and began serving families professionally in pregnancy and birth as a doula.

In 2016, I trained and added placenta encapsulation to my services. I also began school for massage therapy, with the intention of offering prenatal massage, labor massage, and postpartum massage therapy to my client base. In the spring of 2017, my fourth child was born and I took advantage of my maternity leave to learn kinesiology taping for pregnancy and postpartum, as well as postpartum bengkung belly binding.

Over the past few years, I have been fortunate enough to provide professional doula services for families in DFW in hospital and home births, as well as encapsulate many placentas. I always strive to support my clients in the birth and postpartum experiences that reflect their personal choices. It’s truly an honor to be trusted by my clients during times of transition in their lives.

In the future, I plan to continue to expand my knowledge base and professional services to offer even more comprehensive support for expectant and new families in Dallas and Fort Worth. My goal is to always offer up to date information and unbiased, non-judgmental support to meet the needs of the community.