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There is a global c-section epidemic. Both mothers and babies are suffering trauma and health risks. New research is emerging indicating that the health of society at large is being compromised as a result.

While the reasons for the epidemic are varied and complex, awareness is growing (thanks in large part to mothers, birth workers, and advocates using social media). Earlier this year, The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, jointly-issued the Obstetric Care Consensus, stating that allowing most women with low-risk pregnancies to spend more time in the first stage of labor may avoid unnecessary cesareans [1] (long understood in the world of midwifery). 

Despite the growing awareness, US C-section rates (approximately 1/3 of all births) remain far in excess of the WHO standard: “The estimated proportion of births by caesarean in the population is not less than 5% or more than 15%.”[2]  (Note that 15% is not the rate it “should be,” but the very high end of what could be expected.) 

Of course there are some hospitals and OBs with decreasing C-section rates, but the fact remains that, based on the WHO guideline, 55-85% of the C-sections performed in the US are in excess of what should be required.

Alarmingly, maternal mortality rate is higher in the US than in China[3] despite the fact that China has a dramatically higher C-section rate (47%).[4]  Worse, Abigail Higgins reports: “Eugene Declercq, of Boston University's School of Public Health, produced a short film named Birth by the Numbers discussing maternal mortality in the US. In a 2013 follow-up report, he noted that mortality rates in other industrialized nations had declined - while in the US, it increased by 30 percent in the first decade of the new millennium,”[5] partially due to C-sections. [6]

Not only are c-section rates climbing, but surgery is being forced on women against their will.  In April this year, a woman was “kidnapped” from her home by authorities in Brazil to make her comply with her doctor’s demand that she have a c-section.[7]

And just last week in what the Inquisitor said could be termed a violation of the most basic of feminine, or even human, rights, a woman in Staten Island was forced, against her will, to undergo a cesarean section.[8]

Are We Culpable in the C-Section Epidemic?

As the friends, family, and caretakers of the victims of C-section abuse, we are unwitting accomplices to the tolerance and acceptance as “normal” of C-section rates of 33% (US hospitals), and even of 90% (private hospital rates in Brazil) when, by contrast, the rate at The Farm from 1970-2000 was 1.4%[9] (lower than would be expected in any medical facility, but the statistic and their work (www.thefarmmidwives.org) merit consideration. See footnotes*)

 With one sentence—“At least you had a healthy baby”—we unconsciously endorse the system that has created the phenomenon of the “emergency birth,” and the perception that birth is dangerous enough to frequently require surgical intervention to “save” mom and/or baby.

There are dozens of reasons never to utter those words to a new mother after her C-section (all actually nuances of the single problem that it makes us accomplices). Here are the top seven. 

1.    No mother wants “the least” for herself or her newborn.

Though it may be defined differently by each of us, we all want something wonderful—the best possible.  It is never comforting to hear we got “the least.” 

2.    It implies that the baby is healthy because the mother underwent surgery.

There is tremendous and mounting evidence that the opposite is true.  Bypassing the natural birth process (in anything other than a truly life-threatening situation) compromises the mother and baby’s health in numerous known ways (emotionally and physically). Overtime we will undoubtedly discover many more ways in which the compromise to our mind/body compromises society as a whole.  

A new film called Microbirth produced by One World Birth and scheduled for release September 2014 will address this subject with grave and fascinating new evidence.

I contacted Toni Harman, Director and Producer of Microbirth, to ask about her film and the discoveries they’ve made in their research.  This is what she had to share:

     "Microbirth is a feature-length documentary that looks at how the way babies are born could have consequences for long-term health. Over the past eighteen months, we’ve been filming scientists working across many different fields who are starting to link C-section with increased risk of children developing certain chronic diseases later in life. These diseases include asthma, allergies, obesity, diabetes, auto-immune conditions, cardiovascular diseases, mental disorders and even some cancers.

The scientists are hypothesizing that this could be connected to the baby’s microbiome (its bacterial ecosystem) not being seeded properly with the mother’s own   bacteria at birth. With vaginal birth, the mother’s bacteria transfers to the baby inside the birth canal, then more is transferred via immediate skin-to-skin with the mother and breastfeeding. This bacteria innoculates the baby and helps train the baby’s immune system, helping it distinguish what is “friend” and what is “foe”.  This helps protect a baby from developing one of more chronic diseases later in life."[10]

She added that a baby’s microbiome is still seeded during c-Section, unfortunately by the operating theatre. 

3.    It assumes that something was “wrong” with mom and baby in the first place.  

We know statistically that, when we allow birth to happen at its natural pace in a peaceful, uninterrupted, supported environment, the vast majority of mothers without pre-existing conditions can successfully birth their babies without medical intervention. We also know without question that—far too often— the procedures in the hospital are actually creating the “emergency” situations that lead to C-sections. In an article called “The Cascade of Interventions,” Theresa** puts it this way:

     “We are lucky to live in the time of modern medicine, however medical interventions such as labour induction, pain relief, and cesareans—measures that have saved many lives—have been overused. In a hospital setting where your care providers are actively managing your labour, once you have one intervention it makes more interventions more likely to be needed in order to remedy the effects of the previous ones.”[11]

What was “wrong” with mom and baby is that they weren’t given the circumstances in which birth has a decent chance of occurring without surgery. 

4.    It minimizes what the mother lost in the experience.

Even when baby is healthier or saved by a C-section (again, in a small percentage of cases this is accurate), “at least you had a healthy baby” disregards the emotional and physical loss and trauma the mother experienced.  She had a dream for her birth . . .and that dream was taken away (excluding cases of elective surgery). She is experiencing loss, and is in recovery. She has the right to mourn and work through her valid emotions without having them discounted or ignored.

I contacted Lindsay Lipton Gerszt, a documentary filmmaker whose latest work is a film on postpartum depression called When the Bough Breaks, to discuss this aspect of the issue.  She said:

     “According to the National Center for Health Statistics, the C-section rate has climbed more than 50% since 1996.  Whether the C-section was medically necessary or a personal choice, many women who have had it experience postpartum depression. Although the reasons may be many and varied, one reason why women feel depressed after having a C-section may be due to the stigma surrounding it. Many are made to feel guilty for not giving birth naturally.”[12]

In a Catch-22 scenario, by not wanting to contribute to the pain these mothers are experiencing, we try to minimize it with the infamous line, “At least you had a healthy baby.”  I conducted an informal poll online with mothers of C-section, asking how they felt when hearing that statement.  One woman’s response clearly shows the complexity of the emotions mothers of C-section experience:

     "There was such a flurry of emotion. I felt angry because I knew I would have had a healthy baby without the section. I felt guilty because I knew many women who pray for the opportunity to simply have a baby . . .any way. I felt like a failure for not doing a better job of standing up for my rights and my baby's. I felt hurt from the insensitivity of that statement."

Indeed, women of C-section are not to be made to feel as if they failed or guilty for having had a C-section. Either it was truly medically indicated or they’re victims. In either instance, the mother should be supported. There is a better way to support them than pretending (in the cases where it could have been avoided) that their child was “healthier” or “saved” by the surgery. 

I believe we unwittingly perpetuate the problem and dishonor mothers and babies when we try to gloss over the serious risk and pain they endured with what we believe is the kind thing to say, but is—in fact—a benevolent, yet pernicious untruth.

I asked Theresa Morris, PhD, author of Cut It Out: The C-Section Epidemic, for her thoughts. She said,

     “Normative structures of mothering are strong, and when a woman gives birth to a healthy baby by C-section, it becomes difficult for her to question whether the C-section was necessary. Yet, we should always ask, “Would the baby and the mom have been just as healthy (or healthier) if the baby had been born vaginally?” The answer to this question, according to the World Health Organization, is yes for all but about 15 percent of women who give birth in any country in a given year.”[13]

5.    It minimizes what the baby lost in the experience.

The baby. The co-birther. This aware participant who is too often treated—at best—as an incapable, unaware “patient,” and at worst as “an object to be removed.”

Ask any birth worker who has witnessed hundreds of births, natural and surgical, “What are babies like after each kind of birth? How does their behavior differ after the different types of birth?” They will tell you that babies born naturally are generally calm and alert, while babies born of surgery—because they are drugged and shocked—are often disoriented and even difficult to rouse.

We must not allow ourselves to skirt the subject of how babies are traumatized by surgical birth in the name of protecting the feelings of new-mothers-of-c-section. It is for them and because of their experience that we must speak about this subject honestly, and protect other mothers and babies from c-section abuse.

Babies of surgical birth are traumatized. All they are programmed by nature to expect, to be ready for and capable of, is voided in birth by c-section. 

6.    It implies that the doctor has done something that was necessary—was a “savior.”  

There is enormous research indicating that a great percentage of mothers who birthed by C-section felt “pressured” to do so because they were “failing to progress” (meaning in many cases, just “taking too long” for hospital efficiency standards) and would not have chosen surgery otherwise.

In instances of multiple births and breech, many OBs simply won’t consider varying factors, “forcing” the mother to accept C-section as her only option. One mother said:

     "I was cornered into an unneeded and unwanted C-section because the obstetrician that I had didn't have the experience to catch her."[14]

7.    It encourages other mothers (and society at large) to believe that surgery is safe and often necessary to save their baby, when for the majority it’s a dangerous option involving more risk and suffering. 

     "There's the idea out there in the public sometimes that having a C-section today with modern anesthesia and modern hospitals is as safe as having a normal childbirth, but we don't think so," said Dr. Lalonde.[15]

Then What Can We Do and What Can We Say? 

What can we do about this C-section epidemic?  In an article published in The Atlantic titled “Once a C-Section, Always a C-Section?,” Whitney Pinger, Director of Midwifery Services at George Washington University, said of the situation:

     "You can’t pin it on one thing. There’s no one thing to blame, there’s no one person to blame . . .we’re all in this together; we got ourselves into it as a society."[16]

Yep, we did. And it’s high time to get ourselves out of it.  Starting with the very simple first step of never saying, “At least you had a healthy baby.”

What then do we say to mothers recovering from c-section?

We want to support all mothers after birth—and mothers who experienced any kind of trauma need particular care emotionally and physically. Again I went to a group of thousands of mothers online and asked them what they wanted to hear.  Kayla Dar, founder of Baby’s Breastie and mother of four, provided what is the simplest yet likely the perfect response: 

     "After listening to what she has to say about her birth, ask the mother:  

     How are you? How can I help?"

 

_______________________________________________

Note about C-section statistics quoted in this article and in general: In my research I found varying numbers for C-section rates by State (in the US) and by country. For example, rates in Brazil in general appear between 40-50% while there are statistics indicating that 90% of births in Brazil private hospitals are by C-section.  Further, even WHO documents and reports explain their range (generally quoted of 5-15%) differently. In one report, a nuance of the minimum range was explained this way:

“The recommended minimum necessary c-section rate at population level to avoid death and severe morbidity in the mother lies between 1-5%[17]

To further complicate matters for those wanting precise numbers, consider this nuance explained by Right Diagnosis:

“The word 'prevalence' of Caesarian Section usually means the estimated population of people who are managing Caesarian Section at any given time (i.e. people with Caesarian Section). The term 'incidence' of Caesarian Section means the annual diagnosis rate, or the number of new cases of Caesarian Section diagnosed each year (i.e. getting Caesarian Section). Hence, these two statistics types can differ.”[18] 

For purposes of this article, I’d like to suggest that the precise numbers, whether 31% or 33% or 35% for the US for example, is not of primary importance. The fact that we know close approximations—that are far too high—is the point.

[1] http://www.acog.org/About_ACOG/News_Room/News_Releases/2014/Nations_Ob-Gyns_Take_Aim_at_Preventing_Cesareans?IsMobileSet=false February 19, 2014

[2] http://www.scienceandsensibility.org/?p=483 Oct 30, 2009

[3] http://www.vox.com/2014/5/5/5680964/americans-are-likelier-to-die-in-childbirth-than-russians-or-chinese  May 5, 2014 

[4] http://usa.chinadaily.com.cn/epaper/2013-09/04/content_16943528.htm Sept 4, 2013

[5] http://m.aljazeera.com/story/201438161633539780

[6] Ibid.

[7] http://www.telegraph.co.uk/women/mother-tongue/10767161/Kidnapped-by-the-authorities-meet-the-woman-forced-to-have-a-caesarean.html  April 17, 2014

[8] http://www.inquisitr.com/1250257/mother-forced-to-have-cesarean-section-and-now-shes-suing/#UXXEWJoTczECB1Ls. 

[9] http://www.naturalbirthandbabycare.com/farm-statistics/ 

*The Farm does not serve women with preexisting conditions that make them high risk and has had varying policies over the decades about working with women with breech presentation and other situations or variations of normal.  However, the enormous difference in their statistics compared to the national average—especially given the duration of the performance—demands the comparison.

[10] Email exchange with Toni Harman, April 30 and May 14, 2014  http://oneworldbirth.net/microbirth

[11] http://thebirthingsite.com/labour/item/612-the-cascade-of-interventions.html Feb 9, 2013

[12] Email exchange with Lindsay Lipton Gerszt  April 21 and April 25, 2014.

[13] Email exchange with Theresa Morris, April 15 and April 21, 2014

[14] http://m.theglobeandmail.com/life/parenting/pregnancy/delivery/c-section-not-best-option-for-breech-birth/article1186104/?service=mobile  IL

[15]http://m.theglobeandmail.com/life/parenting/pregnancy/delivery/c-section-not-best-option-for-breech-birth/article1186104/?service=mobile  IL

[16] http://www.theatlantic.com/health/archive/2014/05/once-a-c-section-always-a-c-section/362088/ May 20, 2014

[17] http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf

[18] http://www.rightdiagnosis.com/c/caesarian_section/stats-country.htm#extrapwarning  April 18, 2014

**author’s full name as posted in the article

Monday, 07 October 2013 14:01

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Published in Postpartum Health

 

What if?

 

I  love working with new families, watching them develop and grow as they get to know one another. I love to see a new mother grab hold of their instincts,  I adore watching her confidence grow,  seeing her hold on to herself, and never let go. Newborn mothers are just as amazing as the children they bear, the have so many new experiences to adapt to, so many new things to learn, and so many parts of themselves that are opened up for exploration. 

 

But newborn mothers, just like their tiny babes, can be vulnerable. They have doubts, fears and can be unkind to themselves. For many women, that path into motherhood can also be a time of sadness as they let go of the person that they once were, and create space to become familiar with the person that they are becoming. 

 

On top of this, they have a whole new human being to care for. One whose very survival is laid at her feet, who thrives on love and connection, warmth and peace. But one that can also create storms of uncertainty within her. One who can push her to the edge like no other. 

 

What if you knew your words were the last thing a newborn mother repeated in her head before she went to sleep?

 

What if everything we said mattered, mattered deeply, and mattered profoundly? Would we be so haphazard with the things we say to others? Would we throw our advice around so non-chalantly? 

 

So what if you knew that the last thing that this mother heard, when she closed her eyes at night are your words? Would you still be so firm with your advice? 

 

What if your words replayed in her mind every time she went to pick up her crying newborn? Would you still be so harsh in your criticism?

 

What if, at that time of indecision, of wondering what to do, of thinking about how the future would unfold, of hoping, what if yours was the advice she heard?

 

Would you still tell her not to make a rod for her own back?

Would you still tell her that she was spoiling her baby?

Would you still question her decision, her instincts, her expertise?

 

Darkness can be a lonely time for mothers. Darkness brings the vulnerability, the doubt and the fear, and so often with it the words, the advice and the sentences. What if yours was last voice that she heard? Wrapped in darkness and alone, what if your voice was the one that played in her mind? Would you change your words? Would you choose different advice? Would your sentences look a little more like this?

 

Whatever you think - you are enough.

Whatever you are told - you are enough.

Whatever you decide - you are enough.

Even when you are struggling - you are enough. 

You are enough, listen to your voice, listen to your heart, listen to your child.

because you are enough, always and forever.

 

 

When words become sticks and stones, they may not be able to break your bones, but when thrown around without care, they can wedge into your consciousness and break your heart. So often, I hear of women whose confidence is torn to shreds by these unskillful words, by pieces of advice whose only goal is to justify someone else’s experience and to parade righteousness. So often these words are fired at these women by those who are hoping to help, to provide assistance, by those who love them the most. 

 

Words can also be the sticks and stones we put together to build a shelter, to build confidence and to build strength. So often when we share our experience,  our doubts and fears, all we want is for someone to tell us that we are enough, that we already have the answers, that we already know what is right. When a mother is truly seeking help and advice, would it hurt to ask her what she thinks first? I am not saying that advice is the enemy here, but often the way that it is delivered is. 

 

What if...

 

What if we wrapped our newborn mothers in the warm, gentle arms of our words?

What if our advice became the pillow, atop which they can rest soundly amid their own instincts?

What if our sentences provided her a soft place to fall, a place where she can doze in the tranquility and contentment of her own self?

 

 

What if?

Published in Baby's First Year

For those of you who are not familiar with my writing, I am a 29 year old mother of two little boys (1.5 and 3). I worked full time (while pursuing my undergrad psychology degree) while I was pregnant with #1.  After #2 was born, I stopped working (since it would have cost me more than I made to put the kids in daycare) and became a stay at home mom.  I am now pursuing a Master’s Degree in Mental Health Counseling. From the incredible amount of research and reading I’ve done as a result of my schooling, I’ve become passionate about the challenges of becoming a mom, especially when it comes to postpartum depression (PPD).   

During my first pregnancy, I lost my libido, and it has never fully recovered (more than 3 years later.)  This (among a number of other things) contributed to serious relationship issues with my husband (though we have since been able to work through our struggles and have devoted ourselves to improving communication and understanding).  What does any of this have to do with PPD?  Well among the diagnostic criteria for PPD, a libido that has not returned after you have been cleared to have sex again by your doctor is included.  Of course, everyone’s comfort level with postpartum sex is going to differ, especially if there was tearing that needed stitching.  That being said, if your baby is now a few months old and you still have no interest whatsoever in sex, it could be a sign that something else is going on.

The following is a list of diagnostic criteria (symptoms) for PPD.  The bold symptoms, even if they occur alone (but very frequently occur with other symptoms) are a major signal that a woman is experiencing some level of PPD.  The symptoms that are not in bold are still important.  I never had thoughts of harming myself or my children, nor did I have problems bonding with them; however, I did isolate myself and have excessive feelings of being tired, sad, and overly emotional about seemingly insignificant things even after my son was over a month old (and in general, your body’s hormones have leveled back out.) 

  • Difficulty caring for baby’s basic needs
  • Difficulty bonding with baby
  • Shame or guilt (even if there is “no reason”)
  • Loss of interest in activities for pleasure
  • Loss of libido (after being cleared by M.D. or O.B. for resuming sexual activity)
  • Social isolation
  • Exhaustion and fatigue (beyond the normal adjustment period)
  • Thoughts of self harm, or harming the baby

Many of these symptoms are also symptoms of depression in people who are not postpartum, but have been modified according to research with women who are experiencing depressive symptoms and who are also postpartum.  It is estimated that up to 85% of women will experience some sort of mood disturbance after delivery, but most of this is contributed to the physical, emotional, and social adjustment that comes with having a baby.  Anywhere from 7% to 25% of women may develop PPD (these numbers are estimated because most researchers believe that PPD is underreported).  Even if you have only two or 3 of the less severe symptoms, you may be suffering from PPD if you have been experiencing them within four weeks of giving birth and the severity of the symptoms is not declining as time passes.

I recently completed a project for my human development class on the potential impact of PPD on child development.  While doing my research, I discovered a wonderful paper on PPD which attempted to analyze the current state of research and views of PPD.  The author completed her own study and subsequently came up with a number of recommendations to enhance the way we diagnose, treat, an ultimately view mothers with PPD.  The most important aspect of Mauthner’s research was that while it may be physiologically and emotionally “normal” to have a challenging adjustment period after giving birth, we must normalize and validate each woman’s experience without causing women to assume that it is normal to be depressed.  Indeed the drastic hormone changes that come with labor and delivery can wreak havoc on one’s body and mind, but by saying that PPD should be seen as a “normal” experience leaves women feeling as though they are inherently damaged.  

The shift in American society to small nuclear families means that instead of growing up with child bearing women around us, we often grow up seeing a mainstream, medicalized view of birth.  Instead of navigating pregnancy with our mothers, sisters, grandmothers, aunts, and friends around to help, we are often left to our own devices while still working, going to school, tending to other children, and all of the other roles that often come with being a woman, and we often do so alone.  

Mauthner sat down with 40 women and asked them to describe their experiences in an attempt to better understand and redefine PPD.  The following bullet points are a “nutshell” version of the meaningful information from this paper.

  • Mothers with PPD frequently experience a conflict between their idea about the mother they should be and the mother they actually are.
  • The expectation of culture is that mother’s should be happy post partum.  This often leads to mothers remaining silent about their struggles because when they do reveal their feelings, they are often invalidated or criticized.  This may lead to increased feelings of social isolation and withdraw.
  • Mothers who experience PPD may be facing the challenge of a difference in what they expected the experience of motherhood to be versus their subjective experience of new motherhood.
  • A combination of factors may contribute to the development of PPD including: access to social support, quality of social support, partner support (quantity and quality), relationship strain with a partner who is present, predisposition and/or history of depression, differences between expectations and reality of motherhood, a challenging or not as expected pregnancy and/or  birth experience, self esteem issues about one’s body after having a child, infant health, infant characteristics, breastfeeding challenges, and level of fatigue and exhaustion.

Inspired by Mauthner’s study, and in an an effort to better understand women’s subjective experience of PPD, I created a survey to supplement my research project.  I created a brief (10 question) online survey an asked for volunteers to respond to the survey at their convenience. Respondents varied in locations across the world due to solicitation for volunteers through the internet (a big thanks to TBS for posting it on the wall!) Women were asked if they experienced PPD and what their experiences of the post partum period were. Respondents (N=74)  reported on level and quality of support systems, whether or not they took medication and/or attended counseling, what helped, what did not help, and their history of family and mental health.

What women with PPD said about their support systems.

  • Report less support (or significantly limited support) from friends, family and partners than women without PPD.
  • Those who felt somewhat supported often described a partner who worked and thus was not around to help as much, multiple children, and/or lack of local friends and family available to help with every day needs.
  • Report greater frequency of relationship strain with partner, and higher levels of relationship strain with partner than women without PPD.
  • Report lower frequency of partner support and involvement than women without PPD.

What women without PPD said about their support systems.

  • Are more descriptive about positive support systems and report greater levels of family involvement such as their mothers coming to stay for a week or more, and friends frequently coming to help with household chores.
  • Describe their partner as being “very supportive” more often than women with PPD.
  • Those who do report relationship strain still describe their partners as being supportive and helpful, as well as being able to mediate relationship difficulties more easily than mothers with PPD.

Women with PPD were asked about what they think might have helped them manage their PPD and daily life. 

  • Someone to talk to
  • Not being told “You’ll be fine, just be happy you have a baby”
  • Validation and acknowledgement of their experiences and struggles
  • Greater frequency and quality of social support
  • Self care opportunities (such as showering, naps, or reading a book while someone else watched the baby)
  • More preparation about what to expect life with a new baby would be like
  • Talking to other women with PPD
  • Many reported they would have liked to try counseling but were unable to due to cost and opportunity

What women with PPD who received counseling or other services said about what helped them manage their symptoms.

  • Counseling:
    • women who saw a female counselor reported positive experiences while women who saw a male counselor reported negative experiences.
  • Medication to manage extreme depressive symptoms
  • Networking with other moms (play dates, moms-only groups)
  • Self Care opportunities (and encouragement by others to engage in self care)
  • Dietary changes towards better nutrition
  • Exercise
  • Breastfeeding success (and support from others to do so)
  • Faith based activities such as attending church

So what does this all mean?  Essentially, I believe that PPD should be considered as being on a spectrum: some women have more difficulties, while others have fewer difficulties.   Women with fewer difficulties should not be overlooked as being “less important” than women suffering from severe PPD.  Between the physical, emotional, and social changes that take place when we spend 9 months creating a life and then bringing that precious live into this world, it is a TON to handle, much less handle it without much help.  Even mothers who have a great deal of help still get PPD, and there are mothers with no help who never develop PPD.  There are so many things that contribute to any mental health challenge; thus there should not be a “one size fits all” idea about PPD or any other mental health disorder.  It should not be assumed that PPD is normal, but that if it does occur, it is not necessarily abnormal.  

Many women get through PPD without any outside help, but nobody should have to.  If you have had depression before, or are depressed while you are pregnant, take a few moments to listen to yourself if you begin to feel overwhelmed after giving birth.  Just because you experienced depression before doesn’t mean that you necessarily will after giving birth, but you may be at a higher risk than mothers who have never been depressed.  Also, just because you have never been depressed does not mean that you have a significantly less chance to develop PPD than someone who had depression before.  

If you are experiencing PPD, consider seeing a licensed mental health counselor.  A good counselor will not think that you are a hypochondriac because you are concerned that you might have PPD.  In fact, most counselors believe that everyone could benefit from counseling from time to time, regardless of whether or not they meet the criteria for a mental health diagnosis.  Counseling is especially beneficial to people navigating a drastic life change, even if it is not causing extreme distress.  The benefits of having someone listen to you talk about your feelings and struggles can make a world of difference; especially when that person does not tell you that “everything will be fine,” “you’re overreacting,” or try to fix you.  Skilled counselors will refrain from trying to cheer you up and giving you advice; they will listen to you talk because they know that sometimes the best healing and change comes from acknowledging and accepting the emotional struggles we deal with on a daily basis.  

The journey of motherhood is full of joys and wonders.  If you are struggling, reach out to someone for help.  It is a failing to mothers and children that society often sweeps the struggles of mothers under the rug as if our challenges are not worthy of meaning.  There are lots of people who can help, and many will be happy to help if they know it is needed.  

As I close I leave you with this task.  Next time you are standing behind a new mom at the checkout line in the grocery store and want to tell her how lucky she is and how happy she must be, instead, say this to her: “Your baby is beautiful!  How are you feeling?  I’m a mom too and I know how it can be both wonderful and occasionally challenging.”  Maybe she won’t open up to you (especially if she is a stranger) but instead of walking away feeling guilty about her sadness, she may have some hope that she isn’t alone in this journey.  By doing this, you will be working to bring women one step closer to joining together for the greater good, rather than segregating us through the one thing we all have in common; our ability to create and nurture life.

A note to the reader: I am not yet a licensed counselor and I am in no way offering medical advice.  If you are concerned, please contact your practitioner immediately.  Also, please be aware that there is a difference in mental health licensing and titles.  Counselors are trained to listen, cannot prescribe medications (but can consult with a psychiatrist who can) an provide an opportunity to “talk through” your struggles. Psychiatrists have a medical degree and the emphasis in their education is diagnosis and treatment.  If you have had a negative experience with a mental health professional before (such as a psychiatrist who prescribed meds and “didn’t listen,” consider seeking a counselor instead.  They can be identified by their title of LMHC. (I’m not trying to bash psychiatrists and I know of many who are great listeners, but many people are not aware that there is a difference between a counselor and a psychiatrist.)

References:

Mauthner, N. S. (1999).  Feeling low and feeling really bad about feeling low: Women’s experiences of motherhood and postpartum depression. Canadian Psychology, 40(2), 143-161. doi: http://psycnet.apa.org/doi/10.1037/h0086833

Continue reading: Postpartum Depression (Part 2): Why We Must Support Mothers Struggling With PPD in More Constructive Ways

 

Published in Mom's Recovery

Bringing home your baby for the first time is one of the unexpected joys of motherhood.  Introducing him to the dogs, the bed, the couch, the bouncy seat: it is fun to start doing all of those “firsts” with the baby! The comfort of being able to snuggle and nurse my boys in my own bed while watching Star Trek and drinking my tea (yes I’m a super Trekkie) was probably the best time for me.  I spent days in bed just taking in every little bit of them while enjoying integrating them into my life and introducing them to the things I loved.  Eventually though, you start to get back into your usual responsibilities and if you are anything like me, you may find yourself doing all sorts of crazy housework.  If you have other children who are home, this “back to reality” may come even quicker.  I had the luxury of my mother taking my oldest for a week after I delivered my second so that I could recover and not be quite so tired and sore while trying to handle two little ones.  It was a huge help, but of course, I also missed my oldest and it was great to have him back home.  

There are many things about postpartum recovery that you may hear, and many things you won’t.  You’ll probably hear a lot about other women’s accounts of their levels of pain and soreness after coming home.  The key to remember is that there is no way to predict how your body will handle the return home.  Being in the hospital afforded me the opportunity to sit around and do nothing if I so chose.  But once I returned home, the dishes, laundry, and dogs were staring at me wondering why I was being so lazy and after a few days, the guilt got to me and I started getting “back to work.”  Here’s where you want to accept any and all help you can get; if someone wants to come see the baby, ask them if they can throw in the laundry for you, take out the garbage, or watch the baby while you take a shower.  We often don’t ask for help, even when we need it, so here’s your opportunity to ask for it without feeling like you are imposing.  Your activity level will be dictated by how you are feeling physically and emotionally, so try to take it easy on yourself on both accounts.  I realized I was doing too much physical activity when on my 4th day home, I began bleeding much heavier than I had since I had returned home.  When I called my OB, she told me that it was my body’s way of telling me to slow back down.  This wasn’t something anyone had warned me about, but it was nice to know that my body was trying to send me a message and trying to “push through the pain” (I had a 3rd degree tear so I was incredibly sore and in a lot of pain) was actually doing more harm than good.  My OB instructed me to slow down and continue to rest with ice packs between my legs to help relieve some of the discomfort.  Within a day of moderating my activity and tuning back into my body, I was feeling much better.

You Will Likely Be Exhausted.

I always tell people that even though I was never a big party person as a young adult, my late nights of socialization and nights where I got nearly no sleep, got up and went to work just to come home and go socialize again were NOTHING compared to the “tired” I felt as a new mom.  This too shall pass though.  Again, your body just did an amazing thing by giving birth; your body feeling tired is its way of telling you to take it easy so it can regenerate and recover.  Nap when the baby naps, (this is how I became a huge proponent of safe co-sleeping) and don’t go on a spree of doing chores.  Break it up into small tasks and do them every so often.  Don’t unload the dishwasher, re-load it, clean the counters, take out the trash, sweep and mop the floor, sort and start laundry.  Unload the dishwasher after breakfast and don’t worry about putting the dirty ones in until after lunch. Sort the laundry and let the next person who comes to visit you and the baby carry the basket and throw the load in.  

Taking it easy is going to allow your body and mind to recover, as well as facilitate bonding and the nursing relationship (if you are breastfeeding).  The more time you spend with the baby, (even if it’s just sitting next to him reading a book while he sleeps next to you - or in my case on my chest) is beneficial.  Babies who are breastfeed and have ample opportunities for attachment and bonding their moms are at an advantage.  Babies who do not get these things as often are at greater risk for attachment issues, social interaction difficulties, intellectual challenges, and many more.  

If You Are Physically Able, Wear Your Baby! 

Oh I can’t tell you how much easier it was to get stuff done when I wasn’t running back and forth between wherever I was doing something and where the baby was sleeping.  I had a video monitor and I still had to check on #1 every few minutes because I was just beside myself with joy and worry (the worry eventually subsided a little bit once I got used to being a mom.)  I had a Moby wrap, a generic sling, and a Baby Bjorn, all of which got a ton of use.  Plus, if my son was a bit fussy, he usually calmed down pretty quick by the motion of being carried around while being able to rest his head on my chest.  Here is a great article on babywear.

Use That Peri-Bottle (And Put Witch Hazel In It)! 

I still have mine, and I STILL use them occasionally!  Especially if you have stitches, you’ll love the relief of being able to rinse yourself with the peri-bottle both after using the toilet, as well as when you’re in the shower.  I didn’t want anything to do with putting pressure much less touching myself below the waist after I gave birth, so it was nice to have a clean alternative to relying on wiping to clean up.  Of course a little pat dry was necessary, but much less terrifying than the thought of wiping anything.

Try to make some time for yourself, and for your partner.  Especially if you are nursing, you are going to be literally attached to that baby for the next few months (at least).  It’s easy to get wrapped up in the love and responsibility of motherhood, but don’t lose yourself in it.  Ask your partner or another support person to watch the baby so you can take a long shower or bath, or go to the store to grab milk.  Even as little ten minutes to yourself each day where you aren’t responsible for running to the baby if he wakes up will help you retain some sense of your individuality.  Also, remember that your partner may be feeling a bit sidelined now that the baby is here.  It’s okay that you are paying so much attention to the baby, and it’s okay that your partner feels a bit left out; this is all part of trying to figure out and adjust to the dramatic change that your lives and relationship have just gone through.  Trying to make a point to spend some time together each day will allow you to retain (or potentially restore) your intimacy and relationship so that nobody feels left out.  

Here’s where I’m going to get on my soap box...

You can find my full article on Postpartum Depression here, so I won’t get too in depth here since this is about general recovery.  It is imperative that you keep your eyes and ears open to your mind and body; if you are not beginning to feel as though you are getting back to normal, talk to your practitioner.  Bringing a baby into this world is full of wonderful and challenging events.  There are a number of symptoms of PPD, but not all are required for an official diagnosis.  It is normal to feel tired and overwhelmed, but if you are feeling significantly exhausted and down for more than a few weeks, it may be in both you and your baby’s best interest to seek the help of a licensed mental health counselor.  As a counselor in training, a mother who had PPD, and as a student who just completed a major research project on PPD, I can’t stress enough that it is not something you need to suffer through alone.  If your practitioner just wants to put you on medicine, consider asking for a referral for a counselor in addition to meds (and ask if you can try counseling without using the medicine first.)  We often feel alone (even when we are surrounded by support) and sometimes just having someone to vent to that won’t judge you or feel hurt by your feelings can make a world of difference.  One of the most shocking things about the postpartum period for me was that it put a lot of strain on my relationship with my husband.  Luckily, we managed to get through, but it wasn’t easy.  PPD can also affect your baby’s development; if you are having a difficult time bonding or caring for the baby, the baby’s physiological and psychological development is potentially at risk.  Of course, not every woman will get PPD, and their babies are not necessarily at a huge risk of being damaged; but there are ways to help yourself feel a bit better which will only benefit your baby even if you aren’t suffering from PPD, but still feel a little overwhelmed and isolated.  

Everything may be wonderful and stay that way once you arrive home.  If it isn’t though, that’s okay too.  Having a baby is a life changing event in ways you can’t truly understand until it happens for the first time.  Postpartum time is your time to reevaluate and adjust your life.  This may take a while, and that’s okay too.  Just like your EDD was estimated your recovery time is not set in stone so take the time you want and need to ensure that you can enjoy this journey of motherhood as you should-the best way that is right for you!

 Go back to: Step #8: Initiating & Maintaining Breastfeeding

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Published in Mom's Recovery

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