Pregnancy Preparation-Reducing Anxiety

Pregnancy

pregnancy

 

I am starting a series about pregnancy and over the next few months “Parenting in the Loop” will feature topics that are relevant to women, who are expecting a baby. Hopefully, parents and grandparents alike will find this series interesting.

Pregnancy can be a scary situation for both women and men, but this need not be so. Although it is a normal condition, for the first baby it is all new. New can be nerve wracking with all the physical and emotional changes that accompany the pregnant state of being.

If you are a planner then taking time to do some preconceive planning may actually be a stress reducer.

To erase some of the anxiety from this normal reaction of fear, some couples plan a preconception checklist. Preparing for pregnancy helps to squash some of the fears about situations that you actually do have some control over.

The March of Dimes has compiled a short list that might help with deciding if you are ready to become pregnant. You want to be in the best health that is normal for you.

Here we go:

Some items may or may not apply to you.

  • I’ve talked with my partner about having a baby.

It is important to for partners to be on the same page here. Support is essential.

  • I’ve stopped smoking, drinking alcohol and doing drugs.

Smoking, drinking alcohol and doing drugs is harmful for a growing fetus especially in the early days of pregnancy when you may or may not realize you are even pregnant.

  • I’ve started saving money for the baby.

Babies are costly. Having a little “cushion of cash” can help with expected  and unexpected expenses and decrease worry.

  • I’m taking a multivitamin with 400 mcg of folic acid in it every day.

Folic acid is an important vitamin for baby growth and development.

  • I’ve had a medical checkup before trying to get pregnant.

Being in your best health possible for you is a good start for any mom-to-be.

  • I’ve asked my provider about medicines I take.

All medications should be reviewed with your physician as many of them can cause deformities.

  • I’m at a healthy weight.

It would be good to be at a healthy weight or take care to weight manage during these nine months.

  • I know which maternity costs my insurance pays.

Having a baby can be costly, so a review of your insurance coverage would be helpful in managing expenses so that finances do not bring on more worries.

via Preconception checklist | Pregnancy | March of Dimes.

 

 

 

PostPartum Depression- You Do Not Have to Suffer.

postpartum depressionPostpartum depression …you do not need to suffer through it!

The holidays can seriously effect our mood. After having a baby around the holidays, a bout of postpartum depression can hit hard and come right out of nowhere during a time when a mom feels that she should be rejoicing over the birth of her baby.

If a new mom has recently suffered a loss in her life, the holidays can add another burden of trying to “carry on” when she just doesn’t feel up to it.

Grief combined with the emotions and adjustment of having a newborn certainly can predispose a new mom to postpartum depression because she may already be somewhat depressed.

The following is a post I wrote a year ago.

If you or anyone you know is at risk for PPD this may be a helpful read.

If you are depressed please seek help…in an emergency go to your nearest emergency room.

If you want to find a therapist call your Ob-Gyne doctor for a referral…do not suffer on your own…you do not have to be in mental and physical pain…there is help available.

January 30, 2012 by lorettelavine

POSTPARTUM DEPRESSION

Postpartum depression is a serious problem that can occur after having a baby…it can occur up to one year after delivery. Sometimes the signs and symptoms can just be an overall sense of anxiety and an inability to enjoy your baby.  As a new mom, if you just don’t feel happy you can attribute it to many things especially lack of sleep and the many changes occurring over such a short period of time but you could be suffering from postpartum depression (PPD).

Personally, I did not experience PPD but there were days when I did not feel in control of all the responsibilities of motherhood. It was positively overwhelming. Back in the day…postpartum depression was somewhat overlooked and under treated.  A new mom was made to feel like she  ”just had to suck it up” and get it together. Fortunately, since them that attitude has changed and most obstetricians screen for PPD at the time of the postpartum check-up.

I thought that I would post a list of symptoms of postpartum depression.  If you have more than one or two of these symptoms or are feeling generally depressed for more than two weeks you should check in with your doctor.

The symptoms of postpartum depression are the same as the symptoms of depression that occurs at other times in life. Along with a sad or depressed mood, you may have some of the following symptoms:

  • Agitation or irritability
  • Changes in appetite
  • Feelings of worthlessness or guilt
  • Feeling withdrawn or unconnected
  • Lack of pleasure or interest in most or all activities
  • Loss of concentration
  • Loss of energy
  • Problems doing tasks at home or work
  • Negative feelings toward the baby
  • Significant anxiety
  • Thoughts of death or suicide
  • Trouble sleeping

A mother with postpartum depression may also:

  • Be unable to care for herself or her baby
  • Be afraid to be alone with her baby
  • Have negative feelings toward the baby or even think about harming the baby Although these feelings are scary, they are almost never acted on. Still you should tell your doctor about them right away.
  • Worry intensely about the baby, or have little interest in the baby

via Postpartum depression – PubMed Health.

Weekend Reads: October We Save Breasts, Pregnancy Weight Gain, Easy Meals

 

Friday…

the end of a busy week.

some reads that came across my screen this week.

have a great weekend everyone!

what are your plans?

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October is Breast Cancer Awareness Month…but do you really know how to prevent breast cancer…it is not eating foods with “pink ribbons” on it. Jessica’s points are well taken in her post on Broadcast

I dread October. I dread the pink ribbons that will adorn everything from known carcinogens to rifles to football gloves and shoes. I detest the three day walks, the tales of survivorship from breast cancer including an estimated 25% who had DCIS.

via October: The Month Where We Save Breasts (But Not Women) | Broadscast.

 

One of the big questions…how much weight should you gain when you are pregnant? It varies but gaining too much weight is not a good thing.

 

So how much weight is a woman supposed to gain while growing a baby in her belly? According to the Mayo Clinic a “normal” sized woman should gain about 25 to 35 pounds and an overweight woman should gain about 15 to 25 pounds.

via Study Confirms: Gaining Too Much Weight During Pregnancy Could Be Bad for Your Kid | Babble.

 

 

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One of my easy meals…

How important are quick and easy dinners during your week? I personally love ideas for fast foods that are homemade…do you?

 

The goal on weeknights is to get dinner on the table in under 30 minutes. The trick is to be sure it is healthy, tasty, and something my whole family will enjoy. It starts with a well-stocked pantry — a shelf full of canned goods so vegetables are always at the ready, a variety of spices to compliment any recipe, and staples like potatoes and rice to round out the meal.

via Easy Meal Ideas in 30-Minutes or Less.

Bump Club and Beyond…Gearapalooza

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This week, I was fortunate to be able to attend The Bump Club Chicago’s Gearapalooza at Galt Baby.  Baby Guy NYC (Jamie Grayson) was there along with “Angry Baby” sharing all the information parents and parents to be need to know, in order to choose baby gear that is best for their lifestyle.

Gearapalooza was held at Galt Baby in Chicago, where many sponsors were available to show you their products. I was so impressed with the quality of the carriers and strollers as well as the car seat information and the ability of the gear to grow with your baby. Galt Baby is a one stop shop for baby gear.IMG_6548

If you have not heard of Gearapalooza and it is coming to a city near you, San Francisco, CA, Austin, TX and Boston, MA,  be sure to sign up early. Here in Chicago, it was sold out for two evenings with a wait list.

As you know, I am the “Baby Grandmother” since I became one almost 5 years ago. At the time, I was overwhelmed with what I did not know and all that has changed since raising my own children. As a former maternal child nurse, I wanted to fill in the gaps in my baby gear knowledge.

Today’s parents have the advantage of so many technology improvements on their side as well as the competitiveness of companies that are trying to give them what they need when it comes to making life easier at home and on the road with one baby or multiples.

It is not easy for moms and dads or grandparents to navigate all the available baby/children strollers, carriers, cribs, mattresses, breast pumps and other products. This is where  Baby Guy NYC , Bump Club and Beyond  and Galt Baby become valuable connections. They are the people that you can trust to truly help you decide what will be best for you, your baby and your lifestyle.

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Jamie Grayson is fun and energetic….he shares a lot of information in one session…he makes it fun and is more than happy to answer questions.

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To make the evening complete there a light dinner served and a raffle…where some valuable prizes were given out to some very lucky moms to be, in addition to fabulous gift bags.

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If you are a mom-to-be visit,  Bump Club and BeyondGalt Baby, and of course visit Baby Guy NYC to keep up on what’s new in baby gear before it is even available for purchase.

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Thank you to  Bump Club Chicago and Lindsay,who started Bump Club,  for including me in this event…it was a wonderful evening!

 

Premature Babies-How We Treat Them Fifty Years Later

preemie

 

WASHINGTON — Fifty years ago this summer, the nation was transfixed by a medical drama that is now largely forgotten: the desperate struggle to save the life of Patrick Bouvier Kennedy, the first baby born to a sitting president and first lady since the 19th century.

It is hard to believe that fifty years have passed since President Kennedy and Jackie lost their prematurely born son, who died from hyaline membrane disease soon after his birth .

It was a very sad time.

Today, a baby born five weeks premature would have a 95% chance of survival due to all the medical advances since 1963.

Fifty years later,the pediatricians that took care of Patrick Bouvier Kennedy speak out. It is interesting to read what they have to say.

I wonder how the story would read if these events occurred today?

Jackie tried to mourn the loss of her child privately with her family…so tragic that the following November she would be mourning the loss of her husband as well.

 

The Upside of Post Partum Depression!

face of depression

Is there an upside to postpartum depression?

I am not so sure, but perhaps it was the case for Susan Benjamin Feingold, a psychologist who, herself, experienced postpartum depression over 20 years ago.

For those experiencing this sometimes devastating disorder it could be an opportunity for a  “new beginning” if the mom gets the appropriate help.

Twenty years ago, as we know, this disorder was not taken very seriously and was mostly known as the “baby blues” and was mostly left untreated. It was felt that “baby blues” was hormonal and self limiting. So when the postpartum period was over in about six weeks after delivery the baby blues would go away with it.

We now know, postpartum depression is more complicated and serious than the “baby blues”.

Personally, I like Ms. Feingold’s approach. As a clinical psychologist, “she encourages women to view postpartum depression as they would any other difficult time in life that would provide an opportunity for personal growth and transformation.”

Stigma is still attached to mental conditions and postpartum depression is not immune to this stigmatizing. After all, what is wrong with a mom who cannot find joy and happiness in her newborn?

Hopelessness can follow the delivery of a baby for various reasons and whether or not it is stimulated by a change in hormones does not diminish the seriousness of postpartum depression.

With the proper professional help moms suffering from this disorder can actually have a very good outcome. They can make changes and perhaps as they put the pieces of their life back together they will have learned that they are stronger and better for the experience.

The medical journal JAMA  Psychiatry reports that, 1 in 7 women suffers from PPD.

The largest study to date shows that as many as 1 in every 7 women suffers postpartum depression. And the study, published in the journal JAMA Psychiatry, finds that among women followed for a year after delivery, some 22 percent had been depressed.

The study also recommends that all pregnant women and new mothers be screened for depression.

via Postpartum Depression Affects 1 In 7 Mothers : Shots – Health News : NPR.

According to Feingold, PPD symptoms fall into four areas or clusters.

  • depression cluster- overall lack of joy, loss of appetite, desire to sleep all the time, feeling of hopelessness 
  • anxiety cluster- insomnia, racing thoughts, worry, tension headaches
  • panic disorder-panic attacks, which mimic a heart attack
  • associated obsessive thoughts such as hurting the baby- feeling that something is going to happen to their baby

Feingold also mentions in her new book that women who successfully work through their postpartum depression sometimes then begin to work on other pre-existing symptoms and improve the overall quality of their lives as women and mothers.

It sounds like Feingold’s approach to postpartum depression and its treatment could be just the answer for many of the moms who suffer from this disorder. It could be the “new beginning” leading to the “happy ending”.

Feingold has written a new book, “Happy Endings, New Beginnings: Navigating Postpartum Disorders,” that offers advice, including when to seek medical help. But it also encourages women to view postpartum depression as they would any other difficult times in their lives that would give them an opportunity for personal growth and transformation.

via Book looks at upside of postpartum depression – chicagotribune.com.

 

Smiling Little Girl

 

Weekend Reading…

Robin in Snow

Robin in Snow

 

I love reading to my granddaughter…so this list was of great interest to me. See what you think.

What are your favorite books to read to the children in your life?

 

The simple act of reading with our children can inspire a love of books that will last a lifetime, but do you know which children’s classics you should have on your bookshelf? We’ve rounded up 15 of the most well-known, timeless tales that every child deserves to know.

Pregnant women read and get so much information…but are public health messages making moms to be feel that they can avoid most defects. As a nurse, I know what defects are preventable by taking care of yourself but I also know that some defects are not preventable no matter how well you take care of yourself.

What do you think of these messages that are directed toward pregnant women?

 

Public health messages that suggest mothers can prevent most defects by taking care of themselves during pregnancy abound.

In an article focused on the many sources of misinformation available to women attempting to research the safety of particular medications and the contradictory advice women receive from doctors, Dr. Mitchell’s words are directed at institutions and professionals who have failed to give pregnant women the information they need.

 

 

I have to mention this news item related to “diet”. It is not something new but it is verified now by a study that was presented this week. For those of you who are interested in the Mediterranean diet this is very good news and may be an excellent reason to look into eating more olive oil, legumes, nuts, fruits and vegetables as well as fish and enjoying several glasses of wine each week!

One group assigned to a Mediterranean diet was given extra-virgin olive oil each week and was instructed to use at least 4 four tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of the mix each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least three servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least seven glasses of wine a week with meals.

They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.

On a lighter note…yesterday March 1st…which is considered the first day of Spring in meteorology, I saw a robin in my front yard trying to hide from the falling snow.

So Spring is on its way!

Miscarriage…coping with the “unspeakable”

 

Miscarriage, like early pregnancy, is still a largely private affair. Unlike births and deaths, it has no rituals to mark it. Even close friends can feel at a loss with no script to follow. Co-workers rarely hear of false starts. One’s life moves on as if it never happened.

via Finding Hope After Miscarriage – NYTimes.com.

 

In recent weeks, I have been reading quite a bit about miscarriage on blogs. There seems to be a common thread throughout the stories…unresolved grief.

In my early years as an OB-GYN nurse, circa late 1970’s, I remember seeing young women, who had or were experiencing a miscarriage…what I do not remember is how they grieved their unspeakable loss…maybe because such losses were just that “unspeakable”.

It bothers me that so many years later, miscarriage is still in many cases an “unspeakable” loss.

In the 70’s, I was working at NYU (Langone) Medical Center…the OB-GYN physicians were some of the finest in their field and the loss of a pregnancy was taken seriously but generally the emotional toll on the woman was not always acknowledged or treated.

During those years, it was common for women to stay overnight in the hospital after a miscarriage…it was left up to the nurses and the woman as to whether or not she would remain on the obstetrical floor or be moved to the gynecology floor to recover from her loss.

Surprisingly, I remember that many women actually chose to stay on the obstetrical floor to recover…they wanted to “face” their loss and talk to the staff about what they had just experienced, while others chose to leave the obstetrical unit to grieve their loss in a more private way. Ultimately, it was always up to the woman to make this very personal choice.

Early pregnancy losses are fraught with emotions and questions. Understandably, no answer really relieves the grief nor in some cases the guilt that sometimes accompanies miscarriage.

These days many pregnant women find out about their pregnancy in its very early and most precarious stage. I find this to be somewhat of a mixed blessing…on the one hand, once there is a positive pregnancy test, a woman can take better care of herself getting more rest and eating well, in addition to avoiding certain foods and alcohol, she can also check in with her doctor or begin planning her prenatal care.

On the other hand, this early detection of a pregnancy is a very vulnerable time for miscarriage, a complication that many times cannot even be clearly diagnosed in the very early stages of gestation…even with all the high definition ultrasounds and blood work that is available.

So it seems, along with early detection comes a time of uncertainty and vigilance to make sure the pregnancy gets established in the uterus without complications.

What does “without complication” mean to the newly pregnant woman?

Usually, without complication, “simply” means, that during the first two to three months of pregnancy the mom-to-be remains free from severe morning sickness, cramping, pain and or bleeding.

A very common couple question is whether or not to announce an early detection pregnancy to family and friends…what if there is a miscarriage…does the woman want to deal with telling those same friends and family her “story” if something unforeseen happens? These are all dilemmas that a woman may experience during early pregnancy.

Early pregnancy should be a happy time and for most women it is, but sadly as we know, for others this is not the case.

It seems to me, as I look back on my many years in women’s health, that early detection pregnancy is definitely something that brings with it a mixed bag of feelings, happiness in some cases, and a period of worrisome vigilance in other cases depending on a woman’s previous experience.

Pregnancy loss is accompanied by a cascade of emotions enhanced by a woman’s hormone changes. Dealing with loss and grief is always personal and each one of us grieves in our own way. For some, a miscarriage is a very private loss and only shared with close few, while for others it is a time to recover and grieve by sharing with family and friends and deriving a sense of support from them.

… there is not a typical response to loss as there is no typical loss. Our grief is as individual as our lives.

The five stages, denial, anger, bargaining, depression and acceptance are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief. Not everyone goes through all of them or in a prescribed order. Our hope is that with these stages comes the knowledge of grief ‘s terrain, making us better equipped to cope with life and loss.

via The Five Stages of Grief – Elisabeth Kübler-Ross & David Kessler | Grief.com ~ Because Love Never Dies

 

Some women find that sharing their sadness helps and are surprised by the support that is just within their reach when they are able to tell their story…sharing one’s sadness is not easy but many find that it is just the therapy they need… again this is such a personal choice.

I was nervous about writing about miscarriage, but once it was out there, I felt nothing but support. It made me wonder why we hesitate to share this kind of hurt. It is personal, and it does seem strange to tell the whole world that I’m grieving. But the world is full of hurt. What’s wonderful is that so many people are willing to share a bit of mine – even the smallest bit – and enough people doing that really does make me feel better. I didn’t anticipate that writing about miscarriage here would be so therapeutic. The writing itself is actually sort of painful, in a good way I guess, but sharing the experience has been healing.

via Recovery | Science of Mom.

coping with the emotions of miscarriage, friends, family and shared personal stories.

 

It would be remiss of me not to include the “dad” in the grieving process…he can be very emotional as well while trying to be supportive of his partner. Charlie Capen wrote a beautiful post about his feelings.

But she had been right. She had been pregnant. Our doctor’s office, a place we had been so excited to visit, to witness a beating heart, to learn the sex of our baby and confirm life, was now an unfair place that just kept taking from us, over and over.

It’s been four months since that late night in Texas. It took me a while to write about it, and even now I am riddled with guilt for experiencing grief over a theoretical baby that mightn’t have existed at all. I’m asking myself why I’m posting this. How do you end a post a like this? Why even write a post like this?

So, I can let it go. Now.

Charlie Capen: IOUD.

 

I have been moved by the honesty of the feelings expressed in the above posts.

Miscarriage is such a sad experience for a mother and dad to be. There is no prescribed way to mourn the loss of what was to be. Yet many, who experience such a loss feel compelled to quickly move on, sometimes without healing physically and emotionally themselves.

Attachment, loss and grieving are part of all of our lives…these are the words I remember best when I was grieving, “Be good to yourself“. These are the words I would say to anyone who has experienced a miscarriage.

Tips for an Easier Labor…seriously.

Preparing for childbirth doesn’t just mean hiring a doula and packing your hospital bag; it also means getting ready for what might be the most challenging physical task you’ve ever faced. Improve your odds of having an easier, shorter labor by incorporating these healthy habits during your third trimester:

via 3 Surprising Tips For An Easier Labor – Fit Pregnancy.

  • Eat dates
  • Sleep more
  • Strengthen your legs
Doesn’t this sound easy …it is! Check out Fit Pregnancy’s article for some simple things you can do to make your labor easier. 
Who would not want an “Easier Labor”.
Have any of you ever used any of these tips?
What was you labor like….easier….what you expected or difficult?

How much control do you want during childbirth?

After recently reading a post about “who makes the decisions when you are in labor” my own labor and deliveries came to mind. Alongside were the memories of the numerous labor and deliveries that I attended as a nurse.

When I began my career, my first position was as an L & D nurse at a university teaching hospital in the Bronx. Starting out was frightening and never having had a child I had absolutely no experience of my own.

It was the early 70s and at this particular hospital, many of the patients did not want to be awake for the delivery of their baby.

Today, it is difficult to imagine such a time when moms did not want to control everything  about pregnancy and delivery even before they actually conceive.

The young mom of the 70’s would actually ask to be ” knocked out ” for her labor and delivery. Usually she would add “just like my mother was when she had me”. 

So back in the day, moms, who so wished, were given “twilight sleep” which was a mixture of several medications, one of which caused amnesia. So although a laboring woman could follow commands, move and talk, she had no recollection of what she was saying or doing or what was happening to her while in labor.

Husbands, significant others and family members were not allowed to be with a laboring woman who was medicated with this “cocktail”.

It was a privacy issue….since mom was unable to filter what she was saying. The medication was a type of truth serum of sorts. Sometimes during the stress of labor, a mom would call for someone other than her significant other which could indeed be problematic.

When it came time for delivery…mom would be taken to the delivery room. More often than not, general anesthesia was administered and a forcep delivery was done. Once the anesthesia was given the baby had to be delivered promptly which necessitated the use of forceps.

Natural childbirth, lamaze, and epidurals were the exception rather than the rule at this labor and delivery unit and in many units around the country. This was a standard of practice of the time.

After about a year at this particular hospital in the Bronx, I decided to move on to another university hospital in Manhattan.

It was a not only a change of hospital but I found myself in an entirely different world when it came to the practice of obstetrics.

Most women wanted to be awake for the birth of their baby, many had taken childbirth classes and epidurals were used frequently. There ware still forcep deliveries but there was no general anesthesia used for vaginal deliveries unless there was a complication.

In the 70s, doctors made most of the decisions and were not questioned too much, save for the few women who attended childbirth class with Elizabeth Bing, the founder of Lamaze here in the States.

Elizabeth Bing was adamant about teaching her mothers, who was the “boss” in labor and delivery.  She encouraged moms to advocate for the type of delivery that they wanted, she gave them the tools to help question their doctors regarding any decisions that were being made during labor. It was really the “birth plan” in its infancy. Elizabeth Bing was a physical therapist not a nurse and she was opinionated with very strong beliefs in “natural childbirth”. I had much respect for her and took her LaMaze teacher certificate course so I could understand and support my patients in their effort to have less intervention during their labor and delivery.

The role of the obstetrician is, in my opinion, a very important one especially if intervention is needed. I know the statistics in the United States are not overwhelmingly better than other countries but I also know what I have personally experienced in my own deliveries and while taking care of other laboring moms. These experiences definitely skew my view in this area.

My one child had only an initial Apgar of 1 for a faint heartbeat at birth due to complications of a C-section for a transverse lie (sideways position of the fetus). Upon my arrival in L & D, I was already 8 centimeters dilated, which meant, get the baby delivered before the water broke and the cord prolapsed causing severe lack of oxygen to the baby. It was a scary moment for me and my husband…both of us medical professionals. My doctor moved swiftly while I cried not wanting a C-section but knowing that I needed one. I felt confident in their haste and let them do their work…I was not awake…although every attempt was made to allow me to remain so. The discomfort was just too much…so asleep I went. I did not see my little girl for over 24 hours due to her own medical needs.

As for who should make the calls during childbirth…that is a very complex question with many variables. As best as I can figure, it takes a “Village” to raise a child but it also takes a “Village” sometimes to deliver a healthy baby to a healthy mom. I wish that all deliveries and pregnancies went smoothly and that all doctors could be “kind” at all times with great bedside manners. Unfortunately, we are all human and at a time of “flight or fight” you want someone who is able to “fight” for you and your baby based on good sound medical decisions which sometimes have to be made quickly without much hand holding.

Believe me when I say no one wants a less than perfect child and no one wants to lose a mother or a newborn.

So when you write your birth plan do it with your doctor or your midwife and be comfortable with them making some important decisions when and if it is necessary to do so.

Who Makes the Calls in Childbirth? You or the Doctor? | Being Pregnant.