Osteopathy during pregnancy and postpartum

Interview of Mari Koski, osteopath

Photo by Helena Eslon

How did you discover osteopathy and what made you choose this career?

Before being introduced to osteopathy, I was working as a freelance writer and editor. I have a university degree in literature studies and philosophy. Experiencing some health issues I found osteopathy to my aid. I was astonished by its effectiveness and the whole person approach. It was fascinating to feel the subtle changes in my body during the treatment and eventually I got free from difficult traveling hand pain and menstruation pain. I had been doing pilates for some time, and while lying on the table I could feel my body align in a similar manner without using any muscles. I got treated with more straight techniques as well, but I think it was this experience of my own body’s intelligence at work that really made me want to learn more. So I applied for the Metropolia University of Applied Sciences and got in at the first try.

Your approach is very gentle. Which techniques do you use and how does it work?

Yes, from the beginning it was clear that I would be using soft techniques since it is easy for me to feel the microscopic movements, tensions and fluctuations in the body. Often times lasting results follow gentle approach. We learn the same techniques in school, but every osteopath has her own handwriting so to speak. When it comes to techniques I utilize most fascial and functional techniques, cranial osteopathy and within it the biodynamic model. Originally osteopathy has not been about techniques, but philosophy of treatment. We try to see the whole of the patient and make sure the structure and function work reciprocally, so that the body can express health. First of the tenets of osteopathic medicine says that the body is a unit; the person is a unit of body, mind, and spirit. I try to respect that and wish to do it better every day.

The frame in which we work and study extensively is anatomy, including physiology and the functional side of anatomy. So everything that happens in the treatment comes down to anatomy, body systems and body’s own self-regulatory mechanisms that work without our help. I can help your body best by giving it a little directions, but the real correcting movements come from within.

Fascial manual techniques have been studied during the recent years and my approach includes fascial work. Fascial tissue actually surrounds and assembles the body mechanically and provides the underlay for the fluids to move in the body. The central nervous system and fascia are communicating all the time through different types of receptor cells located all around body. Recent studies have shown that fascial receptors react to very gentle touch and minimal amount of pressure. I have learned that steady and gentle touch is effective and it also has it’s place in the research map for manual treatment.

Who is this man on the picture?

The man in the picture is Andrew Taylor Still (1828-1917), the father of Osteopathy. He was a medical doctor and surgeon who worked in the frontiers of the American Civil War, explorer of anatomy, and a man who lost most of his family to spinal meningitis. Dr. Still was frustrated with the medical treatment of his time (whisky, mercury, ineffective surgery etc.) and searched for cures more in line with nature. He used bodily manipulations to successfully cure infectious diseases like flux (dysentery). He was acquainted with spiritual movements of his time and inspired by Native American traditional treatment methods. First Osteopathic medical school was founded in 1892 and Osteopathic Medicine continues to be a branch of medical studies in US where all osteopaths are full licensed DO’s (doctor of osteopathy) beside MD’s (medical doctor). In Europe osteopathy is a health care profession of its own and takes 4-5 years to finish. In Finland osteopaths are registered and supervised by Valvira.

You treat pregnant people. What are the common symptoms of pregnancy that you treat here? Are there contraindications to osteopathic treatment?

The most common symptoms pregnant people come with are lower back pain and pains in the pelvic area. Also quite common are breathing problems, tiredness and swelling. Pregnancy brings big musculoskeletal and hormonal changes that alter the normal biomechanics and those changes are often followed by ligamentous strains, muscle tensions and decreased range of motion. Many times diaphragm is found to be tensed, affecting the quality of breathing and fluid exchange within the body. Osteopathic treatment aims to balance these changes and also cultivate feelings of calm, well-being and relaxation. There are few contraindications to osteopathic treatment in general, but certain techniques are outruled for pregnancy. As health care professionals osteopaths are trained to recognize the red flags and refer to a physician.

Can you help an expectant person to have an easier birth? How? Do you help with breech babies or do you do ”natural inductions”?

There are several changing factors concerning birth. It is impossible to predict them all. We work with the whole of the person and I believe balancing the whole is the key in any preventive health care interventions. This said, in osteopathy we have effective treatment methods for biomechanically balancing the pelvis, releasing tension from areas important for normal birth ( i.e. diaphragm, psoas, pelvic floor, jawline), enhancing the fluid flow and affecting the autonomous nervous system. In breech positions I work with the body in a way that it can provide better chances for the baby to turn by itself. Natural inductions are a part of my repertoire also.

Why is it important to consult after the birth, for the person who gave birth but also for the baby? What about c-section or episiotomy scars? What about if the pudendal nerve has been injured?

Consultation after birth is advisable if there has been any complications, the birth has been prolonged or the fetal presentation has been challenging. In general consulting can be a good idea for all because there can be factors mother or parents are not aware of. Some problems may start as minor, but if unattended can lead to symptoms. To name a few possible conditions in a baby: strains or compressions in thoracic outlet, neck and occiput, strain in the head and vertical fasciae due to forceps used in delivery, bodily compressions in breech babies, craniofacial compressions in cephalic posterior babies etc. The most common symptoms that babies come to see me are reflux, colic, asymmetries in the body, tongue tie issues and constipation.

After the birth osteopathy can help the body to recover faster. In C-sections both the person who gave birth and the baby are good to treat as soon as possible. Scars can be treated after the wound is closed properly. Gentle stretches and localised soft tissue work help to remodel the scar tissue by promoting the release of collagen fibres as well as the vascular and lymphatic supply to the area. Nerve injuries need special medical care, but with osteopathic treatment it is possible to help the circulation in the area concerned and that way make the conditions better for healing.

You recently organised a breakfast in a café with a pilates teacher friend of yours to introduce your services. How did it go? Do you have more events to come? Any new project?

That was fun! I love to talk about osteopathy and I’m very pleased I have found Pilates Gym Jatta for co-operation. We talked about how osteopathy and pilates can help you during the pregnancy and postpartum. Jatta told about using pilates in diastasis recti (abdominal separation). It went well and I believe we will do it again. We have already planned a workshop where you will have a chance to learn and explore effects of osteopathy and pilates combined. Currently I’m busy with the office and post-graduate courses in biodynamic osteopathy and children’s osteopathy.

What’s your motto?

I don’t have a motto, but this quote by Rumi resonates in me:

Respond to every call that excites your spirit.

Photo by Philippe Perov

Red ribbon for the newborn mother: a Turkish tradition

When Gizem and Erkka's son was born, I asked Gizem: "Tell me, do you have postpartum traditions in Turkey?". As she was on Cloud Nine, falling in love with her baby, my question took her back to earth for a few minutes. She answered: "Oh yes! Can you find the red ribbons, in the front pocket of my luggage?"

Red ribbons in the mother's mane drive the evil away. The blood-red bows prevent invisible powers from manifesting and hurting the new mother in the pit of her womb. It is also thought to regulate lochia. A game of balance. In the 40 days after birth, the mother's womb and tomb are open, meaning that she is vulnerable to infections and diseases. She needs nurturing and protection.

The Ancients didn't have the knowledge of modern medicine. They didn't know about microbes but they could see the manifestations of puerperal fever. The fever could cause hallucinations in the new mother, a phenomenon that Turkish elders would attribute to a demoniac entity.

Gizem shared with me other shamanistic traditions the Turks have inherited.

Although the baby has been brought to the world, he is not rooted before the 40th day. And as he vagabonds between two worlds, he takes his mother along. They both travel in another dimension, a dimension only the mother-baby dyad can experience. They float between Earth and Sky.

Finally, the 40th day is celebrated and the mother and baby are honoured. Grandmothers and wise women of the family organise a bathing ritual in the morning. In the bathtub, the mother and her baby are washed and blessed. Some symbolic items are used and placed in the bath:

40 stones

40 flowers (or petals)

Nazar Boncuğu (Evil eye amulet)

Silver (to represent the Moon)

Gold (to represent the Sun)

The mother and the baby will be separately watered, 40 times with 40 wishes or prayers.

The water symbolises the flow of time. By pouring scoops of water on the newborn baby and the newborn mother, we wish them a long life.

On the side, some ingredients are wrapped: Wheat flour (fruitfulness, bounty, and rebirth)

Eggs (new life, growth and hope) Salt (grounding, protection, and earthly purification) Sugar (joy, sweetness and healing)

Rice (fertility and abundance)

Coins (luck and prosperity)

Cotton (pureness, softness and strength)

The guests arrive after the bath. The mother is offered half a glass of water. According to the superstition, she has to finish it bottom up to produce a good amount of milk for her baby.

A buffet of delicious food is served to the convives.

When guests are leaving, the baby receives presents (nappies, clothes, creams...) Traditionally the mother has to visit 7 houses before the night.

Traditions surrounding birth are fascinating. If you want to share some traditions of your culture or family, please, contact me!

Behind the scenes of Läsnä - Presence

Interview of Eeva Anundi, photoreporter

Eeva Anundi, photo by Giovanni Astorino

Eeva, you’ve created a photo-reportage following doulas and families in their birth journey. This project is now exhibited in Sanomatalo gallery in Helsinki.

How was this project born?

When I was expecting my first born, I thought I would never have a doula. I didn't want any "stranger" to be there when I had such an intimate experience.

But then, I read about the benefits. Having a doula diminishes the risks of a Caesarean or the need to use a suction cup. I also read that women giving birth with a doula often rate their experience more positively than the ones without a doula.

So I had to try it out. I could not explain myself not to have a doula anymore. It was a bit demanding to meet the doula, but in the end it was such a beautiful experience! After the birth, I felt that we all participated in giving birth! So, when I got pregnant again, I asked for the same doula in very early stage. This doula was Veera Gindonis, one of the first doulas in Finland.

A year after the birth of my second born, I got the idea about documenting doula work through my camera. I contacted Veera and she got interested in joining the project of writing a book with me. I attended her doula basic course to learn more about doula work.

The impact of new born families' wellbeing on the whole society is tremendous. The society is based on entities, families. The mothers' wellbeing is the foundation of the happiness of the whole family.

So when is the book going to be published?

The book is on hold now; we have so many happenings in our lives. Nonetheless, the series of pictures has been made and since the beginning Veera has been a rich source of information and a great support.

What are you trying to say through this series? What’s the message you’d like to convey?

My main message is that birth matters! Women matter!

To women, I want to say that we can work for a good birthing experience. We can take responsibility of our own bodies and we are allowed to say out loud, when we are mistreated or when our needs and wishes are neglected during birth.

Capturing birth requires specific skills. What was your approach?

My approach in this project was pretty active. I discussed and interviewed, told my own experiences, to create trust. In the birth, I was silent and peaceful and sometimes I would put my camera off and help out. In some of the births the same patterns would repeat for hours, so I didn't have to photograph the whole time. I would press the acupoints, hold and massage while the doula was sleeping or having a break.

I know some might think this is not an appropriate way of approaching a documentary project, but I felt this was the only right thing to do. I was present.

How did the parents react at first when they are invited to share such an intimate moment of their life? Did you have parents refusing to share their pictures with the audience after reflection?

We made a contract, agreeing about the use of the photos in advance so there was no problem with publishing. About the intimate photos with genitals or breast, we discussed after birth.

I’ve seen the exhibition in Kerava and loved it. It is now in Helsinki. Where next?

I'm open for any suggestion about the next place of the exhibition!

Läsnä - Presence by Eeva Anundi Sanomatalo Gallery, 1st floor

Elielinaukio 2, 00100 Helsinki

16.–22.9.2019.

Mon–Fri 7-20

Sat–Sun 9-20.

https://www.projectpresence.fi

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The project Läsnä received a grant from JOKES (Journalistisen kulttuurin edistämissäätiö).