Secondary Infertility: The inability to become pregnant or to carry a baby to term after previously giving birth to a baby.  There are many causes, which can be diagnosed and discussed with your care provider.  I would like to take a few moments to talk about the emotional and physical toll secondary infertility can take.  
 
It is very easy for people (who I am sure have good intentions) to say, “At least you have your first child… what a blessing!”  Yes, my son is a blessing but the bottom line is that my family is not complete yet.  
 
The stress is unbelievable. I never in my wildest dreams thought that I would be undergoing hormone treatments and egg retrievals.  Our son was conceived on the second round of Intrauterine Insemination (IUI).  This time around we found ourselves in the midst of egg retrievals and embryo transfers after unsuccessful IUI’s.  My body felt depleted and we were emotionally spent.  I was going to the doctor at 5 a.m. multiple times a week on and off for about a year.  My son would kiss my “booboos” from my injections and it felt like we just keep waiting in anticipation.  I started to have heart palpitations when I would see my nurse calling with updates.
 
In an earlier post I wrote about my experience trying to conceive my son and how I learned way more about my fertility than I ever wanted to know.  I felt defective.  But that’s nothing compared to now.
 
The good news is that for us all the hard work and stress paid off because we are pregnant again! I must add, though, that it’s not all amazing and blissful.  My anxiety has continued into pregnancy as I sort of “wait for the ball to drop.”  I am so incredibly happy to be pregnant again but I don’t think I will really feel at ease until our baby is safely in our arms.  
 
I feel that I have gained another level of sensitivity through this experience.  I don’t ask families anymore if they “want more children,” which I frequently did before.  I can also personally relate to expecting parents who are nervous throughout pregnancy that something may go wrong.  
 
Life is so fragile and bringing a life into this world is an amazing feat.  My heart goes out to those of you that are struggling with fertility and my ears are open to hear your story.

​Eat lactation cookies, drink a special tea, eat steel cut oatmeal around the clock, drink beer, take herbs, drink extra water, sleep… the list just keeps going!
 
The truth is that there is no magic solution to making more milk.  And after you have tried the list above you will likely feel exhausted, frustrated and perhaps defeated.  I’m also concerned about the number of herbal supplements that are recommended to nursing moms without a thorough look into that mom’s medical history.  I believe there are herbs that can be highly effective BUT depending on your medical history you can have adverse effects such as making even less milk!  The only thoroughly researched and backed up SAFE method is to pump and/or breastfeed frequently and effectively. 
 
Newborns eat often and they don’t like schedules.  They nurse when they are hungry, thirsty and when they just want a little snack!  I often here “but he just ate, he can’t be hungry again” 15 minutes after a baby supposedly finished eating.  Yes – he may want to eat a little more – maybe he wants desert with that meal!  This doesn’t mean you aren’t making enough milk and that he didn’t get enough milk in his last nursing session.
 
And if all really doesn’t seem ok then meet with a lactation counselor (ME!) to asses how your baby is nursing.  If I can’t help you, you can rest assured that I have a team of professionals in my network that can help guide you even more.
 
In the meantime, practice some self-care.  Try to take a few minutes for yourself every day, make a cup of tea that you like, and if you are looking for a yummy fall treat I’ve got a great recipe I found. 

**I made a few adjustments to the recipe – the original can be found here: https://www.browneyedbaker.com/apple-cupcakes-cinnamon-cream-cheese-frosting/

APPLE CUPCAKES WITH CINNAMON-CREAM CHEESE FROSTING
 
YIELD: 10 cupcakes
Spiced apple cupcakes topped with a cinnamon-cream cheese frosting… A perfect fall dessert!
 
INGREDIENTS:
For the Cupcakes:
         1¼ cups all-purpose flour
         1 teaspoon baking powder
         ½ teaspoon salt
         ¼ teaspoon ground cinnamon
         ¼ teaspoon ground ginger
         ¼ cup unsalted butter, at room temperature
         1 cup granulated sugar
         1 egg, at room temperature
         ½ teaspoon vanilla extract
         ¼ cup + 2 tablespoons buttermilk, at room temperature
         2 cups shredded Gala apples (about 2 medium apples, peeled)
 
For the Cinnamon-Cream Cheese Frosting:
         ½ cup salted butter, at room temperature
         4 ounces cream cheese, at room temperature
         1½ teaspoons vanilla extract
         1 cup powdered sugar
         1 teaspoon ground cinnamon
 
DIRECTIONS:

1. Preheat oven to 350 degrees F. Line a standard muffin pan with paper liners.
2. In a medium bowl, whisk together the flour, baking powder, salt, cinnamon and ginger and set aside.
3. Using an electric mixer on medium speed, beat the butter until soft and creamy, about 2 minutes. Add the granulated sugar and beat until light and fluffy, about 2 minutes.  Add the egg and vanilla extract and beat until completely combined, about 1 minute.
4. Reduce the mixer speed to low and beat in half of the flour mixture until mostly combined, then pour in the buttermilk (the mixture may begin to look curdled – that’s okay), then add the remaining flour mixture, mixing until just barely combined. Finally, fold in the shredded apple, as well as any accumulated juices.
5. Divide the batter between the 10 muffin cups and bake until a toothpick inserted in the center comes out clean, about 25 minutes. Remove from the oven and cool for 5 minutes, then remove the cupcakes from the pan and place on a wire rack to cool completely.
6. Make the Frosting: With an electric mixer on medium-high speed, beat the butter until fluffy, 2 to 3 minutes. Add the cream cheese, vanilla and salt and continue to beat for an additional 2 minutes. Reduce the mixer speed to low and add the powdered sugar gradually and mix until smooth and combined. Add the ground cinnamon, mix until it is incorporated, then increase the mixer speed to medium-high and beat until light and fluffy, 1 to 2 minutes.
7. Using a spatula, frost the tops of the cupcakes. The cupcakes can stay at room temperature for a few hours, but should be refrigerated in an airtight container for longer-term storage up to 4 days. Bring the cupcakes to room temperature before serving.

My little guy just can't get enough of these cupcakes!

​If you are looking for a doula, you have likely already started thinking about your “birth plan.”  I would like to encourage expectant moms, dads and partners to think more along the lines of “birth preferences.”  Birth is really hard to “plan” for.  You don’t know exactly how you will feel in the moment and what your baby may feel like doing!  It is incredibly beneficial to know your options ahead of time, think about how you would like things to go, maybe even have a “Plan B,” and then just roll with it. 
 
In our prenatal visits leading up to the birth of your little one, we will go over an array of preferences and create your birth preferences worksheet together. 
 
Some things to consider:

1. Who would you like present at the birth?  Different hospitals have different protocols; many will only allow your doula and one other person.
2. Do you want an epidural?  If so, at what point in your labor?
3. What keeps you calm?  Dim lights, music, lavender, meditation, etc.?
4. Do you want to eat and drink during your labor?
5. Do you want to move around during your labor?
6. What positions do you think you would find most comfortable? (Don’t worry; we will go over some options!)
7. Do you want to view your baby being born with a mirror?  Touch his or her head while he/she is crowning?
8. Who would you like to cut the umbilical cord?
9. Do you want to breastfeed?
10. What procedures would you like to have done immediately with your infant?  What would you like to be delayed?

 
As your doula I will provide evidence-based research to help you create your preferences worksheet in our prenatal visits.  These preferences will be shared with your care provider and changed if necessary.  Then during your labor and delivery I will help you achieve your preferences and be a sounding board if things need to change.
 
I am so excited to meet you and am honored to be a part of this process!

Click here to get more information on my birth doula services.