Pregnancy Massage

The Benefits of Massage During Pregnancy

by Liz Green, CD (toLabor), LMT, CR

Prenatal massage helps to manage the aches and pains of pregnancy, increases quality of sleep, improves mood, decreases edema, releases hormones in the body that counteract stress, fear and anxiety, and it feels great for baby too! It can help pregnant bodies to maintain good balance and alignment in the pelvis which can encourage baby to have good positioning in the uterus. This has the potential to decrease the length of labor and facilitates quicker postpartum healing. Healthy tissues have better blood flow, stretch easier and heal faster.

Pregnancy MassageMassage is safe for the client and baby anytime during a healthy, low-risk pregnancy – from conception until baby comes. When complications arise during pregnancy, the client should get approval from their healthcare provider before getting a massage, but it is usually still safe in most circumstances.

I only offer prenatal massage in a side-lying position – this means the client lies on their left and right sides during the massage. With the use of various pillows and bolsters, it is a comfortable and safe position for the client to lie for an extended period. If I need the client to be face-up during the massage, I will do a semi-reclined position with an extra small cushion under their right hip to ensure the baby isn’t resting on the vena cava, and potentially decreasing blood flow to the baby.

While prenatal massage tends to focus extra time on the lower back, hips, posterior pelvis (the booty), and legs during a prenatal treatment, a full-body massage is safe and provides the most effective overall relaxation for the client. There are only a few areas I avoid or use extra precautions. Pregnant clients have increased risk of deep vein thrombosis so I avoid or use caution on the inside of the leg, a common area for blood clots, to avoid potentially releasing a blood clot. Belly work can be very relaxing, and it can also address round and/or broad uterine ligament pain, but I only massage the client’s belly in the second and third trimesters and only by request or with permission of the client. I generally avoid the psoas (hip flexor, accessed on the inside edge of the hip bones) or only apply gentle pressure there, since to palpate it, I have to enter ‘baby space’ in the lower belly. While I can provide normalPhoto Massage Amanda 2 massage techniques to the ankles and feet, I do avoid vigorous stimulation to the inside ankles since that is a reflexology point for the uterus.

All pregnant clients deserve weekly massages, but at a minimum one massage a month is recommended, or more if a client starts to develop more body discomfort or pain. It is an effective, safe and enjoyable way for prenatal clients to manage how their bodies change during pregnancy and prepare for birth.




The Day I Became a Father

by Ethan Ruzzano

My beautiful baby girl was born in early April on a whirlwind day of thoughts and emotions. Cocoon Birth doula Kari Gallinger attended our natural birth at Mountain Midwifery Center. Even now I can’t comprehend everything that happened, but I wanted to put a few of the memories from that day in writing before they’re lost. Here’s a little vignette of what I can recall:

Waking up around midnight and being told that the contractions had been steady for the past hour.

Bringing my wife a peach and a blueberry yogurt as she labored in the dark in our bathtub, and then sitting next to her eating the one she didn’t choose.

Looking over at her as she hugged the back of our car seat and told me I was doing a great job driving to the birth center; she was working through contractions every few minutes and took time to tell me that I was doing a great job driving…

Watching the midwives and doula as they lovingly supported my wife and hearing their continual assurance, “you’re doing good work, mama.”

Having my heart break at every new contraction as I watched my wife’s face contort into pain.

Thinking helplessly about how insanely tired she was and that there was still so much left to do.

Standing over her, sobbing as I held her face and told her I wished I could do it all in her place.

Sitting in shock as I was all at once humbled, honored and thrilled to be a new dad.


Some of the things I learned during this one important day:

That natural childbirth is a difficult, harrowing, beautiful and amazing experience.

That midwives and doulas are worth their weight in gold.

That a child can shoot out of a mommy like a cork out of a champagne bottle.

That my wife is my hero and stronger than I had ever imagined.

That I would instantly fall in love for the second time in my life.

That I would make threats to imaginary future boyfriends within five minutes of my daughter’s birth.

That I thought I knew a lot about life, God and the universe and after watching the insane miracle that is birth, realized that I knew very little.

After the birth, I was overwhelmed with a flood of different thoughts. I thought about how we had just gone through this transformational, life-altering experience and how the midwives do it everyday. I gave gratitude for the fact that we had a whole team working with us and that I was able to work with them to support my wife through this journey. I then realized that there are single moms out there doing all of this on their own, and it broke my heart. If you are a single mom reading this: I’m proud of you, my heart goes out to you, and I’m sending love your way.

As I looked at my daughter for the first time, my thoughts turned to her. I thought about the future: helping her tie her laces, teaching her to read and the millions of other things we would be responsible for teaching her. I thought about how she would grow into an amazing woman, the boys we would have to chase away, the college she might attend and the fact the she might also be a parent someday. I thought too about all that I had learned over the last few decades; all the triumphs and failures, the heartaches and blessings, the life stages traversed and the fears overcome. And I thought about the fact that all of it was starting right here, right now, at this very moment, for her.

With that last thought still echoing in my mind, I leaned down for the first kiss I would ever give her and quietly whispered “welcome to the world.”

ethan-profileEthan writes for The Dad Dynamic, a community for modern dads. He lives happily in babyland (Stapleton, Denver) with his wife, Casie and daughter, Olivia.




Placenta Encapsulation for Postpartum Wellness

Placentas have been used in various ways for thousands of years, whether it has been simply honoring them, or in the practice of placentophagy (ingesting the placenta). It placentacordpsiralis believed that taking your encapsulated placenta pills can help to restore balance within your body after childbirth. Although no large studies have been done on this practice and its effect on mothers, many women who have chosen to have their placentas encapsulated report postpartum benefits including a decrease in mood fluctuations, a reduction in bleeding, an increase in milk supply and energy, and an overall easier postpartum recovery. In my experience encapsulating hundreds of placentas, the feedback from my clients supporting these claims is overwhelming!

The process of encapsulation is fairly simple, and follows guidelines drawn from Traditional Chinese Medicine. Your placenta is first cleaned, then steamed and dehydrated, and finally ground and put into capsules. Some encapsulators, myself included, choose to make a print and umbilical cord keepsake for their clients. You receive back what some like to call “happy pills” for the instant mood boost you experience when taking them. High in iron and nutrients, they are like a perfect multi-vitamin, made by and especially for you.

twinplacentaAn experienced encapsulator handles this whole process with minimal disturbance to you as a family, and with the utmost attention given to efficiency and safety. You should expect instructions for storing your placenta, timely transport, and guidelines for taking your pills. You should also expect your encapsulator to practice responsibly within strict guidelines for handling and sanitization to ensure your and your encapsulator’s safety. Your placenta should never be in contact with anything other than the storage container it is placed in, and with dedicated, sanitized equipment and surfaces. With a credible encapsulator, placentas are only processed one at a time, so there is never the chance that your placenta will be mixed up with or contaminated by anyone else’s. When seeking out an encapsulation specialist, feel free to ask questions about her or his specific practices!


Dedicated dry prep area for placenta encapsulation.

Dedicated dry prep area for placenta encapsulation.

Dedicated wet prep area for placenta encapsulation.

Dedicated wet prep area for placenta encapsulation.









Erica_LundgrenErica Lundgren is an experienced Labor Doula and Placenta Encapsulation Specialist, and loves the chance to do encapsulations for mothers because she believes it is a great tool for an easier postpartum transition! She has a dedicated space in her home for encapsulations, follows strict safety guidelines, and takes great care preparing placenta pills while maintaining a quick turn around time.


What is Evidence-Based Care…and Why Should You Care?

Evidence-based is a term that gets used frequently in the world of childbirth. The dictionary definition of evidence-based is this: “in medicine, pertaining to the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” ( So what does that really mean, and why should families and practitioners care?

The birth world is one in which passions and opinions are plentiful. So many doulas, midwives, care providers, and nurses enter into birth work because of their own experiences with childbirth or the maternity care system. In this environment where personal experience is so embedded in our own beliefs, evidence-based practice is the driving force behind providing the best possible care to families. Evidence, as in research, needs to be at the heart of birth work because its use makes it possible for us to give the best care.


“Evidence-based maternity care means practices that have been shown by the highest quality, most current medical evidence to be most beneficial to mothers and babies (reducing incidences of injuries, complications, and death), with care tailored to the individual.” -from

If we are going to call ourselves evidence-based practitioners, we need to access and understand the research and evidence behind what we do. It is not enough to practice based on what we believe is “common sense” or implement a practice because it “feels right” or something else “feels wrong”. If a client asks us to present the evidence that has formed our practices and our opinions on a specific topic, we need to be able to produce it. We must be vigilant about ensuring that we adhere to this standard, and not allow ourselves to slip into a practice that is based only on our own personal experience, our feelings about what is right, our opinion of what is logical, or our own routines.

Having an evidence based practice is hard work. The evidence changes frequently, is not always perfect, and sometimes we prove ourselves wrong. Regardless, it is the very best we can offer to families, and that makes it the right thing to do.


The Face is the Key to the Pelvis

There is a little secret I like to share with all the parents in my childbirth classes. It is such a small detail, but can make a huge impact on labor. It is, simply put, the face is the key to the pelvis.

I want you to scrunch your face up as hard as you can. Do it, right now! What happens to your abdominal and pelvic muscles when you do this? Do you feel them tightening right along with your face? Well, this is what is happening when a laboring woman clenches her jaw and squeezes her eyes shut.


Of course, this tightening and lifting of the pelvic floor is not really what we want during labor. It would be much better to have a relaxed pelvic floor and abdomen and a grounded woman. Relaxing the face is an easy way to get more calm and grounded.

Partners or doulas need to watch for the scrunched face. They can help remedy this tension by reminding the woman to relax her eyes and relax her jaw. Smoothing massage along the jawline can help, as can compresses over the eyes. The relaxed face then helps to release the pelvic floor and allows easier passage for the baby’s descent.

During pushing, letting go of tension in the face helps the woman direct her energy downward. Pushing with the face is not very effective, so again encourage people giving birth to avoid this practice and help them guide their efforts down toward the perineum by releasing the energy from the facial muscles and pushing it down toward the vaginal opening.

You can also practice this yourself on a daily basis. Simply focus on releasing tension in the eyes, face, and jaw. You will be amazed how much you are holding there once you work on letting it go. You might even find you reduce eye tension, headaches, and neck pain by using this easy little tip.

Skin to Skin for Every Baby and Every Birth!

by Katie Halverstadt, BSN, RN, IBCLC

hudloblog8 years ago I had my first emergent Cesarean birth. My first delivery ended with a 3 hour separation from my baby. I awoke in the recovery room alone, no nurse, no husband, and no baby. I was pretty naïve as to the rights and options I had as a mother with my first child, but 6 years later I knew exactly how my birth story would go. With my second baby I was practicing hypnobirthing and striving for a VBAC. I made it to 7 centimeters and started bleeding. My 2 midwives confirmed my trial of labor was over and I was wheeled back to the operating room. Once again, the curtain went up, and after delivery my baby was swaddled and handed off to my husband. He then held her up against my cheek. I lay there longing to hold her in my arms, but this time our outcome was different, we were never completely separated and I was able to hold her within 30 minutes. I was awake and alert; a much better experience than the 3 hours I lost with my son.

I believe a woman’s body is made to have a natural, un-medicated birth; however, this is not always achievable. I know there are times, due to medical circumstance, history of a previous cesarean, or even a mother’s right to choose, that a surgical birth can happen. These moms (myself included) need a voice. Our standard of practice in the hospital has to change. Mothers and babies cannot be separated after delivery unless it is medically indicated. Even then, these interventions should be few and far between. We need to focus on the fact that Skin to Skin contact is the easy solution for all parties involved. This practice is best for moms, babies, and medical staff. Skin to Skin stabilizesbaby’s vital signs, protects her immune system, and increases mom’s milk production. Most importantly, baby feels safe and secure in a parent’s arms, increasing oxytocin levels (the love hormone) and enabling families to bond right away. But this well researched practice is not happening for every birth, especially for moms with Cesarean births, and this is not acceptable.

I have come to peace with my birth stories but I know it can still be better and different for other moms. I have met too many mothers who wanted a natural or vaginal birth, yet this was not the outcome. Instead of feeling that a piece of their birth story is missing, they can feel whole and connected by the cascade of hormones and bonding that ensues when baby is placed upon their body during the surgery. This is the safest place for baby to be. This is their new home.

I am an advocate for all mothers. My mission, and my dream, is to encourage every mom to trust her instincts, listen to her body, embrace her power and own her birth. I want moms, regardless of method of birth, to be treated equally and to know they have rights, no matter how their baby is delivered.

I am now part of a team who implements Skin to Skin care in the Operating Room at Lutheran Medical Center outside of Denver, Colorado. My hospital helps moms and babies to experience Family Centered Cesareans and strives to make the operating room a more natural and loving environment. In conjunction with this, my husband and I have created a line of Skin to Skin clothing to assist in these processes. The name of our company is Hudlo, after our two amazing kids: Hudson and Harlow. We have created a Skin to Skin shirt which can be worn in the operating room during and immediately after Cesarean surgery to facilitate Skin to Skin. We have also designed the first true Skin to Skin baby carrier for infants that allows mom and baby to experience hands free Skin to Skin all day long.

Please help to bring Skin to Skin to every baby and every birth by supporting Hudlo in our mission. To donate to our crowd-funding campaign and bring our Skin to Skin clothing to more families, please visit:

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Camp Mommy Con Rocked!

We had such an amazing time at Camp MommyCon last weekend in beautiful Winter Park, CO! Getting to rub shoulders with awesome bloggers like Jessica Martin-Weber from The Leaky Boob, Jamie Grayson of The Baby Guy Gear Guide, Bunmi Latidan of The Honest Toddler, Jennifer Anderson of Our Muddy Boots (did you know she is now a local?), and of course our dear Friend Jen McLellan from Plus Size Mommy Memoirs was cool enough, but there were so many other fun things going on during the event. We had the opportunity to do workshops on Friday and Saturday and spread the word about how wonderful doulas are and why everyone should have one! photo 2 (1) Our own Doula Hula contest (thanks to Laney of MommyCon for the great idea) was a hit, with lots of folks, including little ones and even little ones still in the womb, participating. Our contest winner hula’d (is that even a word?) for almost 12 minutes to win our delicious goody basket full of prizes. IMG_0923 We’d like to extend a huge thanks to our Cocoon Birth doulas who came and womanned our table at the event. Heidi Roark, Erica Lundgren, Barb Lines, and Kari Gallinger were there to help us make sure every detail was in place and tell the world about Cocoon Birth. They were our doulas, bringing us coffee (and tea), making sure we fed ourselves, and generally keeping the stress level to a minimum! It was also great to see Cocoon Birth doulas Erika Jones and Beth Jones at the event. Beth was there to do daily babywearing workouts with parents, which was a great addition to the MommyCon event schedule! It was also lovely to see some former and hopefully future Cocoon Birth doulas. Jessica Bejot was there with Birth Rocks! and we were excited to reminisce a little. IMG_4105 We spent some quality time with Matt and Katie from HudloBaby and Aubre, Heather, Joel, and Mattie from Mountain Midwifery Center, networked, shared ideas, and met some incredible families and families to be. photo 1 (4) We rode the gondola and enjoyed little bits and pieces of Winter park. We ranted and cried and ate popcorn during The Milky Way movie. We got fired up and inspired and then filled our cups to the top with a visit to Hot Sulphur Springs for a soak on the way home. What a weekend! Can’t wait to see MommyCon in Denver again! photo 1 (3)

Professional Communication for Doulas

As doulas our profession is one that is infused with passion. We are passionate about the families that we serve and the beliefs that we hold, but unfortunately a doula’s passion does not always translate into professional communication. There seems to be a never ending obstacle course for doulas in their struggle to conduct themselves in such a manner that honors the profession that they have chosen. Unprofessional conduct from doulas spans from scope of practice violations to lack of respect towards fellow doulas and other providers such as nurses, midwives, and obstetricians. How many times have you read a doula’s post criticizing a nurse or provider’s actions at a birth she recently attended? Have you met a doula who is quick to speak negatively about another doula behind her back or criticize a doula for doing things differently? Doulas then wonder, “Why isn’t the nurse more accepting of me?” or “Why doesn’t that doula refer clients to me?”

Unprofessional conduct is not only an obstacle to a doula’s personal practice but breaks down the level of professionalism within the doula community as a whole. Professional conduct is actually an easy skill to master. At the heart of professionalism lies communication. With the advent of electronic communication, personal communication skills have seen a significant breakdown. If you don’t use it, apparently you lose it. Luckily, by adhering to the following communication 101 principles a doula can maintain a level of professionalism at all times.


1. Think before you speak/act/email. Remember the old adage to count to 10 before speaking? Turns out that this isn’t just a line your parents made up but is a timeless truth. Taking a moment before responding whether in person or by electronic communication, can easily avoid a knee jerk response that can cause irreparable harm. When it comes to electronic communication, think about whether you would actually say what you are typing if the person was sitting in front of you.

2. Speak with integrity. Choose your words carefully! Avoid words that intentionally inflame or create gossip. Ask yourself, “Is this how I would like to be spoken of/about?” Keep private subjects private, and avoid flaming or gossiping about other professionals in public forums.

3. Keep your promises. If you say you can back someone up, help with an event, etc. then do it. If you aren’t sure, don’t commit. Be clear when you communicate expectations around working with other professionals so that miscommunication doesn’t cause you to go back on your word. Don’t leave other professionals or clients in the lurch.

4. Don’t Assume. I am sure you know the expression about assuming! If you are ever unsure, clarify with the person directly and by directly I mean in person as long as it is conceivably possible. While electronic communication can be an effective tool for a quick message, tone and body language are totally lost and these are integral to meaningful conversations. To not take the time to sit down and talk in person might send a negative message about your level of professionalism and respect for clients or colleagues, no matter what profession you are in.

5. Treat others the way you would like them to treat you. Is the provider at your client’s birth less than pleasant? Is a particular doula not giving you a warm fuzzy? You have no idea what that person has gone through that particular day. Maybe that person is struggling. Perhaps their loved one is critically ill. Perhaps they have been up for 24 hours working non-stop. Rather than taking it personally and speaking ill of that person behind their back, try extending that individual some grace and empathy. Ask yourself, “How would you like to be treated?”

By following these communication 101 skills, you can not only improve your own personal practice but you can help to further the level of doula professionalism as a whole. Be an advocate for all doulas by starting with your own professional conduct!

A Call For Collaboration!


“Collaborate,” intransitive verb meaning, “to work with another person or group in order to achieve or do something”. This is one of the founding principles of Cocoon Birth. Cocoon Birth originated in 2004 when a community wide grant became available that allowed us to provide childbirth services to underserved families in Clear Creek and Gilpin counties in the mountain communities of Denver, CO. Cocoon started collaborating with the Nurse Family Partnership and the Clear Creek County Public Health Department to help reduce low birth weight outcomes. During this time in the early years of our business, we learned that collaboration had distinct advantages to families. Actively collaborating and partnering with other businesses and agencies improved access to services and resulted in greater use of those services! Because of this, we at Cocoon Birth have continued recognize collaboration as one of the roots of our business success and the best practice for ensuring that all families have access to evidence based services and care.

We at Cocoon Birth have also been very active over the years in the formation and running of the Colorado Doulas Association, an organization designed to improve access to professional doula and childbirth education services to families. In 2008, Cocoon Birth began collaborating with Mountain Midwifery Center, another proponent of the importance of partnerships that benefit families. Cocoon Birth works with MMC to provide doula services and childbirth education to birth center clients. Since that time our circle of collaboration has grown exponentially as we have partnered up with many excellent, evidence based professionals in our community. We lovingly refer to these amazing practitioners and businesses as our Community Partners. At Cocoon Birth we understand the value and power behind collaboration in order to meet the needs of families.

The opposite of collaboration is division, or in business, exclusivity. This is proven to be a counterproductive approach in service industries that only decreases access and often causes clients to view the profession more critically. Collaborating does not mean the giving up of intellectual property, or a lack of proper compensation for work! It means willingness to work together to make the profession the best it can be and to provide the highest quality service to clients. We are excited to see our group of collaborators grow in 2014 and we encourage any professional that would like to work alongside us to contact us at

Merriam-Webster. (2014). Collaborate. Retrieved online March 30, 2014

World Doula Week


March 22-28 is World Doula Week, a time to celebrate the amazing works of wonder of doulas across the world. The work of a doula is not for everyone. Doulas are special, strong, phenomenal women. Doulas must balance the most intensely emotional moments of a family’s life with evidence based knowledge and practice. They accept the journey of each mother and work to uphold the experiences the family desires, even when sometimes they had hoped for something else for that family, knowing that they must help create a unique experience that belongs only to that mother, partner, and baby. They toil tirelessly to help foster a dream that they themselves can never own because they know the mantra of the excellent doula is “not my birth”. They make every birth wondrous, regardless of how far the actual events stray from the “plan”.

How do they do it? How do doulas simultaneously so deeply embrace the family and all they wish for, while remaining objective enough to be the voice of wisdom whispering in a mama’s ear, “This is normal, you are strong.” They do it because the reward is beyond compare, and the privilege is indescribable. The unparalleled gift of being part of another woman’s childbirth experience is something doulas embrace so fervently, that despite exhaustion, odd hours, time away from home, never being able to have a drink or go on a vacation,  doulas soldier on. They know they hold the key to a more nurturing and empowering experience for all mamas and families, and so they press on, because they want every woman and every family to know that they are honored and revered.

Happy World Doula Week to all the awe-inspiring doulas out there. Know that you are appreciated, cherished, and admired. Know that the work you do is so incredibly important, today and every day.