Taking Care of Mama

The class I’d like to see childbirth educators add to their list.

When I was pregnant with my first child, I took every class the hospital offered, from Breastfeeding to Taking Care of Baby. But what really would have helped me is a class that doesn’t exist. A class I’d like to call “Taking Care of Mama.” You know the old saying, “If mama ain’t happy, ain’t nobody happy.”



About a week after I got home from the hospital with my perfect little baby, nobody in my house was happy because I was miserable. I remember standing at the window in the early morning darkness of a cold rainy Monday watching my husband’s car leave our driveway his first day back to work. All I could think was “The world is going on without me.” I’d given up my career to stay at home with my baby, but suddenly found myself wondering what the hell I was thinking. My days now consisted of changing diapers, trying to (unsuccessfully) breastfeed a fussy baby every 15 minutes, washing endless loads of laundry and watching way too much mindless daytime television. I signed up for this?

Two weeks later I was consumed with dark feelings. When I had to force myself to eat, I knew this was a problem bigger than the “baby blues.” I knew this was postpartum depression, even though I couldn’t make my mouth form the words.

You have to understand, I was the woman who couldn’t wait to be a stay-at-home mom. So when the dark feelings came out of nowhere, I was completely unprepared. I went to all those classes to learn how to diaper and swaddle a baby. I knew how to give the baby a bath and I was even prepared for that ugly umbilical cord stump thing, but I wasn’t prepared for this.

At least one out of every ten women who give birth experience some form of postpartum depression. It’s all over the news. You’d think someone might have at least mentioned it in one of those classes. Nope. Did anyone ever say, “For the next six weeks your hormones will be on a roller coaster ride that will make you feel, at the very least, not yourself. Your body will be recovering from the trauma of birth, while at the same time being more deprived of sleep than a Marine at boot camp. Oh, and you are also now responsible for the health and well being of another human. Life as you knew it is over. Therefore, do not be surprised if you experience an adjustment period.” C’mon. Would a little warning have been so hard?

Yet, alas, none of those healthcare professionals ever seem to mention taking care of yourself as a new mama except for instructing you to wait six weeks before having sex (as if anyone who’s just passed a seven-pound baby through her nether regions needed to be told that). No, all the classes are about the baby. Taking care of the baby, feeding the baby, massaging the baby, diapering the baby and (God-forbid) administering CPR to the baby. The mother is completely left out of the equation. What about the major emotional, financial and psychological turn your life has just taken? Sorry. You’re on your own there sister.

After a few weeks of feeling awful, I went to see my doctor. He knew exactly what I was going through. He told me if I hated breastfeeding, I should stop trying (and not to feel guilty about it), to get out of the house every day and to exercise. Then he gave me a prescription for an antidepressant. I left his office feeling like I might actually survive. And that was a feeling I hadn’t had in what seemed like a really long time.

I had no idea so many other women had gone through the same thing. It sure would have helped to know I wasn’t alone and to hear stories of success from other new moms who suffered from postpartum depression. To be reassured that I wasn’t destined to be a horrible mother and feel like crap the rest of my life. But sadly, few mothers admit publicly or even to their close friends what they are going through.


So here’s what I would tell moms-to-be in my “Taking Care of Mama” class: First, you have to make time for yourself. Get out with your friends, your husband. Get a babysitter. Not only is it okay to take time for yourself, but you’ll be a better mother if you take some time to recharge. Second, everything is a stage. As new moms we have a tendency to think of now as being forever. But the baby will eventually sleep through
the night and smile back at you and laugh and life will get better. And if you are feeling depressed, it’s nothing to be ashamed of. Go talk to your doctor. He or she can help. Be empowered to do what works for you. Just because something worked for someone else doesn’t mean it’s right for you.

I’m glad I learned all those lessons. It just would have been nice if someone had given me the Cliff-Notes version ahead of time.

(Post originally submitted to CharlotteMommies)



Do you or someone you know suffer with Post-Partum Depression?  Register at SantaBarbaraMommies.com to find support!

Food for thought!

Via: Ultrasound Technician

Brit teens clueless about birth

No wonder teen pregnancy rates are so high in Britain.

A new poll reveals that 20% of18 to 25-year-olds think pregnancy lasts one year.

10% believe eating red meat influences the sex of a baby.

Here's my favourite part: 20% thought the umbilical cord was a musical note.

Hooray for homebirth

Well, hell has frozen over.

Just when I thought that the fight for homebirth in Victoria was stuck at the corner of 56th and Never Gonna Happen, Health Minister Daniel Andrews just announced that the State Government had allocated $400,000 for midwife-led home births through Casey Hospital in Berwick and Sunshine Hospital in Melbourne's west. A regional health service will also participate, but the Government has yet to decide which one.

For women who have relatively uncomplicated pregnancies, this is fantastic news and as long as the trial works over the next year, the project will be expanded throughout the public health system. While undeniably this is no good for women who may want to have a homebirth following previous caesareans (VBACs) or who are considered to be 'high risk' (e.g. obesity, 'older' mums), the fact that the State Government has actually listened to the enormous amount of feedback provided by homebirthing mums and midwives is astounding and shows real promise for a health system that can provide high quality care for women who don't want to birth in hospital.

Yay!

Maternal mortality is not sexy enough for the media

Photo credit: Marco Vernaschi, Pulitzer Center


Sometimes being a feminist academic and living in a wealthy industrialised country can screw up your view of the world.

Seriously, hear me out.

I've spent the last few weeks, recovering from a hangover of media blitzing about homebirthing and thinking about where women's interests are really best served when it comes to birth in Australia. It's so easy for me to say (and trust me, I have been) that women should be encouraged to have alternative birthing plans outside of the hospital. At the same time, however, as I teach a university subject about a history of medicine (and I hate myself a little bit for saying this) medicine has done great things for women when it comes to birth.

Don't get me wrong. I've always harbored a healthy skepticism for biomedicine and particularly obstetrics/gynecology. But before I get inundated with a barrage of emails about how evil obstetricians are and what a bad feminist I am, I have to say that each day as I scan the daily news items looking for inspiration for the blank space in front of me, every single day I flick through stories about women dying in birth in the far reaches of the world. Sometimes I write about them and sometimes my mouse keeps moving because I have the luxury (and many of you do as well) to fast forward on from tragedy if I feel like it.

But not today.

Marco Vernaschi, an Italian photographer, started off photographing war but has since moved his focus to maternal health care, particularly in Guinea-Bissau, one of the world's most dangerous places in which to be pregnant. One in eight women die giving birth and babies often don't survive the first two days of their lives.

"Standing in the only operating room in the only medical hospital in all of Guinea-Bissau, Marco Vernaschi watched a nurse take an unsterile needle out of her pocket and, without anesthetic, suture a woman’s vagina after a difficult childbirth. The woman screamed. Mr. Vernaschi took a photograph. Moments later, she was required to walk out of the filthy room and go home."

Vernaschi is now trying to shed light on the absolutely heart wrenching stories of life and death, of both mothers and babies with his photos. As I looked through these images, of women waiting on a dirty floor to give birth, of seeing women on rusty gurneys, babies dead and waiting for burial, it makes me feel very lucky to have the opportunity to live in a country where, even though birthing options are not perfect, at least women have the hope for change.

Hospitals have never been the perfect solution to such a natural process, but living in Australia, we rarely worry about dying from unsterile needles or just from having to wait too long for medical care. Medicine still saves women from pain and death and suffering.

Look at these pictures and thank your lucky stars for your life.

Worrying trend: social inductions

Western Bulldog Brian Lake* has requested that his wife be induced 2 weeks before her due date so that he can 'focus on the finals'.

Since when did it become acceptable for football to trump the birth of your first child? And why on earth would his wife agree to such a preposterous and unnecessarily risky request?

When women are induced, there are given pitocin which is a synthetic form of oxytocin, the hormone that kicks off labour. With induction, there is no gradual build up with contractions become increasingly stronger and more frequent over an extended period of time. Induction essentially sticks women right into the second stage of labour so contractions are strong straight away. Some studies have shown that induction is linked caesareans because when you don't have a gradual build up to get your body used to being in pain, women often will have an epidural because the contractions are so strong straight away. As a result, for some women labour is slowed with the epidural, they can't push as effectively, the baby can become distressed and then needs to be born surgically. There are also considerable risks with induction including brain damage to the baby as a result of lack of oxygen if contractions are too strong or too frequent.

In my mind, unless induction is medically necessary, I can't conceive of how one could justify putting the lives of loved ones at risk. When Adam Gilchrist's** son Harrison had complications after being deprived of oxygen in his induced birth before the 2002 Boxing Day Test, he wondered if the induction was partly to blame. "Looking back, it seems stupid that I got myself into that position. I should have just walked away from cricket for the critical week or weeks, however long it took," Gilchrist wrote in his autobiography True Colours.

What is really worrying is that that having high profile people in the community participate in these sorts of things, it sets a precedent by which it becomes increasingly acceptable to have interventions in birth unnecessarily.

I am befuddled that his wife's obstetrician would consent to doing this. Considering we now live in an age in which patients have power as paying consumers of medicine, is an obstetrician breaching their duty of care to the patient by ceding to the patient's wishes for a scheduled birth (and of course the same argument can be made with regard to elective caesarean)?

BIRTH IS SUPPOSED TO TAKE TIME, DAMN IT!

*this is an Australian rules football player for those of you who are outside of Oz
**Australian cricket player

Birth behind bars

According to a recent report in the New York Times, there are still states that keep pregnant inmates shackled during labour and birth. In some cases, an inmates legs, wrists and even abdomen are chained, quite obviously making medical treatment difficult. Although the Federal Bureau of Prisons last fall called for an end to the practice except in cases where inmates are a danger to themselves or others, it is thought that some women are still shackled in spite of state regulations.

After birth, the treatment of new mothers is no better. Most prisons make no provisions for inmates to be with their newborns. Infants are typically taken away from the mother immediately and either sent to live with family members or placed in foster care. According to a 2000 report in Time, New York, Nebraska and Washington State are the only exceptions; prisons in these states have nurseries in which infants are allowed to live with their mothers for a year to 18 months. Understandably, it is debatable whether infants are better off living in prison at the most critical point in their little lives. There is a dearth of research regarding long-term psychological effects of prison life on children.

In New York, however, the Bedford Hills Correctional Facility opened the nation's first prison nursery 100 years ago, and today its parenting program has had dramatic results. Only 10% of women who successfully completed the program returned to prison, in contrast to 52% of inmates overall.

There is some hope for pregnant inmates. There are a number of organisations across the US that try to organise volunteer doulas (traditional birth attendants) to help to empower pregnant inmates. The Peace Tree Prison Doulas serve incarcerated women in North Carolina penitentaries. They offer two main services to these women; each week they facilitate a pregnancy, labor and postpartum discussion group based on the womens' interests and needs, as well as provide continuous birth doula support when inmates go into labor. After delivery, they provide continuous postpartum counseling and breastfeeding support.

How can we deny pregnant women their right to a safe birth?

Grin and bear it, ladies: pain is supposed to be positive

Apparently, women today aren't as stoic as their ancestors when it comes to pain in childbirth.

Dr Denis Walsh, a senior midwife and associate professor in midwifery at Nottingham University, said: "A large number of women want to avoid pain. Some just don't fancy the pain [of childbirth]. More women should be prepared to withstand pain."

"Over recent decades there has been a loss of 'rites of passage' meaning to childbirth, so that pain and stress are viewed negatively," he added, arguing that patients should be told labour pain is a timeless component of the "rites of passage" transition to motherhood.

Now, while I think that in certain contexts epidurals are sometimes overused, why on earth should women suffer through pain if they don't have to? Does it make you a better mother?

Thoughts?

Tanzanian women dying in alarming numbers

What can I say. Heartbreaking. Horrifying.

13,000 deaths annually in Tanzania due to what are knows as the 3 delays: delaying going to the hospital, the time lost getting to the hospital and delays once at the hospital in getting treatment. Many hospitals have no obstetricians. Only 20% of Tanzanian women give birth in hospitals, and usually this is only if they need a caesar. Most women cannot afford to go to the hospital, instead giving birth at home or at a local clinic. Women in Africa, in general, have the highest death rate in pregnancy and birth. Nearly 536,000 women die annually. A shortage of qualified doctors has left thousands of women without help during birth. According to the New York Times:

"It is not uncommon for a woman in labor to arrive after a daylong, bone-rattling ride on the back of a bicycle or motorcycle, sometimes with the arm or leg of her unborn child already emerging from her body.

Some arrive too late. In October, a mother who had been in labor for two days died of infection. In November and December, two bled to death. Doctors say they think that more deaths probably occur outside the hospital among the many women who try to give birth at home.

A few minutes’ walk from the hospital is an orphanage that sums up the realities here: it is home to 20 children, all under 3, nearly all of whose mothers died giving birth to them."

This is unacceptable. Half a million African women do not need to die every year.

Pill popping/Milk stopping

Just when we thought we were making in roads in convincing women that breastfeeding is by and large very good for babies, the Daily Mail has announced that some mothers in the UK have been resorting to the HIV drug called Cabergoline, which is marketed as Dostinex, in order to stop lactation. This drug is specifically made for women who have HIV so that they quite sensibly won't risk passing on the virus to their babies through breastmilk. Nevertheless, the off-market uses are interesting. Cabergoline is used by women who don't want to breastfeed for whatever reason (because it is painful) or because they don't want to wait until their milk dries up naturally. Some of the important off-market uses of the drug are also for women who have traumatic first births or for women who have still born babies and quite legitimately don't want to be reminded of their trauma.Women are also using it for 'social reasons': some women are taking the drug because they are worried that breastfeeding changing the shape of their breasts (which pregnancy does anyway). The drug takes effect very quickly (just 2 doses over 12 hours) and some obstetricians freely administer the drug to women who ask for it. Kevin Harrington, an obstetrician with a private practice at London's Portland Hospital, said that he offered cabergoline to women who could not or did not want to breastfeed.

'The breastfeeding police frown on the use of cabergoline. But for some women their breasts are an important part of their sexuality and they don't want to use them to provide milk. There is not enough difference between breast milk and infant formula to make a fuss about it.'

I don't know how I feel about this. I know that breast isn't best for everyone but it makes me a bit sad to think that women wouldn't breastfeed solely because they have been misled to think that breastfeeding is bad for your breasts. It also makes me sad to remember that we live in a world where women's breasts have solely become the play things for men.

Standing up is better for labour

"A review of 21 studies involving almost 4,000 women concludes there is no risk to pregnant women from standing up when they start the delivery process and it may actually be harmful to lie flat."

Duh! Midwives and homebirthers have been saying this forever. The only reason women have been encouraged to lie down with their legs up (the lithotomy position) historically is because doctors it helped early obstetricians to see women's bits. Laying down works against gravity whereas walking around, squatting and standing help move things along. If you have an epidural, obviously, you have to lie down but it also raises your risk of having a caesar.

Read more: Taking a stand

Teen pregnancy: makes you fat

Is anyone else disturbed by this headline?

Teen pregnancy boosts girls' risk of getting fat

Um, last time I checked, teen girls who get pregnant have a few other things to worry about becoming obese. You know, things like trying to not drop out of school.

Placenta: it's what's for dinner.

I Ate My Baby's Placenta. Need I say more?

See more images and stories at Mom Logic. Anyone out there with a good placenta story?

No maternity leave is the new maternity leave

F*%cking fashion magazines.

According to W, the uber-hip style mag for women who wear clothing sizes smaller than their show sizes, maternity leave is sooooo 5 minutes ago and returning to work in 2 weeks or less is the new sine qua non of power mum status.

"In an era when France’s justice minister recently gave birth on a Friday and attended a cabinet meeting the following Wednesday—and when, more famously, Sarah Palin took just three days off from her Alaskan gubernatorial duties after the birth of her fifth child—an increasing number of women are making childbirth look, if not like magic, certainly a lot easier than it was for their mothers by taking mere weeks, not months, off from work."

Women in the story describe feeling torn between work and home, pressured to by their employers to go back to work in record time, fear of financial insolvency and pumping their breasts in their corner offices while, as one gal remembered “The UPS man [at my office] saw more boob in the last couple years than in his teenage heyday." Rather than thinking about these mums as superwomen for juggling home and work, you feel like this is a remarkably sad state of affairs that only reaffirms what most working mothers have been complaining about for decades.

I find it interesting that the women who went back to work fairly soon after giving birth, justify their decisions by suggesting that their children are more well-adjusted as a result. One woman, however, hired a nanny to look after her child while she worked and this clearly changes the terms of the game. As most women can't even conceive of affording a private nanny, it's sort of like, 'Duh' of course the transition back to work was easier. Realising she had more time for herself, this woman says:

“When Coco was born, I would never even have a babysitter on the weekend. I was really moral about it. And as joyous as those moments were, part of it was slightly miserable,” she admits. “I was being too much of a martyr to the mom world.”

Yikes. I'm all for women's choices, working or not, whatever. I don't know about you, but I sort of cringe at this woman's surprise at feeling like a martyr to her children. Isn't parenthood (and not just mothers are involved in this) about sacrificing most of yourself to your child for the formative years of their early life? I mean isn't that what parents do?

Read more: Born Yesterday

New book cracks open the secrets and lies of mummyhood

A new book out of the UK, Backwards in High Heels: The Impossible Art of Being Female by Sarah Vine and Tanya Kindersley, calls itself an 'instruction manual for having it all'. One chapter is called 'The Conspiracy of Silence' and it a discussion of the lies that women tell each other about pregnancy and childbirth and then a funny but slightly horrible description of what women actually mean when they say to one another that, for instance, that birth 'isn't that bad'. For example:

If you tell a friend that

1. It doesn’t matter if she gets fat, the weight will drop off afterwards, especially if she breastfeeds.

What you really mean is:

1. Her stomach will never be the same again, not even if she goes to the gym every day (which she won’t be able to because she won’t have the time), breastfeeds until her child goes to university and observes a strict vegan diet.

What are some 'lies' that you were told about pregnancy and birth?

Hooray! Eat your heart out during delivery

In case you are planning to pop out a little bundle of joy anytime soon, it's your lucky day. New research from London suggests that the age old practice of telling women not to eat during childbirth is no longer necessary. This dates back to the 1940s, when a US doctor documented cases of women breathing food into their lungs (called pulmonary aspiration) when having general anaesthesia for emergency caesarean deliveries. As long as you are not receiving pain relief meds, it looks as though eating small amounts of food or light meals does not adversely affect childbirth outcomes.

Were you allowed to eat during birth?

Read more: No need for ban on eating during labour

Surrogacy rising among military wives

The myth of the maternal instinct

A University of Warwick study suggests that many women feel ill-equipped for pregnancy and childbirth because of the demands of modern life and more specifically, because it is now routine for women to move away from their hometowns and families when they get married. Thus, women have less support and advice from female relatives in their new environment. Upon interviewing 90 women, Dr Angela Davis, Leverhulme Research Fellow in the Centre for the History of Medicine, also added that most women are in some ways disadvantaged going into childbirth because they often have never had the experience of birth (in terms of seeing one and participating in delivery) until they have their own children. Interestingly, Dr. Davis believes that there is still a lack of appropriate education for women around sex and parenting and this is a long-standing problem since the 1930s in the UK. One of the most salient points to arise from this study is that mothering is not viewed to be instinctive and that women struggle with feelings of unpreparedness.

Did you feel prepared for motherhood? Is there such a thing as a maternal instinct?

Source: http://www.sciencedaily.com/releases/2009/03/090302120104.htm

Epidurals on the way out in the UK

In Australia, it is no secret that medicalised birth is increasingly becoming the norm. With a greater push for less intervention and more one-to-one care, maternity reform is a red hot issue on the national agenda. Nevertheless, while the prospect of having wholly funded home births and more accessible birth centres throughout the country is exciting, should less intervention mean no intervention?

In the UK, doctors and patients are struggling over new regulations surrounding the use of epidurals during birth. As new guidelines have characterised the use of epidurals and caesareans as 'unnatural' in a bid to reduce interventions by up to 40%. The goal of the new guidelines is to ensure that more women are having 'normal' or 'traditional' birth. Obstetricians, however, have problems with this.

Kim Hinshaw, a consultant obstetrician at Sunderland Royal Hospital, said: ‘I have major concerns with this. I don’t think we will ever reach a figure of 60% normal delivery using this definition. For example, in Sunderland we have an epidural rate in first labours of 60%.

‘This definition implies that if you ask for an epidural for pain relief, but go on and deliver normally after a six-hour labour, your birth was not ‘normal’. That is a disgrace.’

And Professor James Walker, a consultant obstetrician at Leeds Teaching Hospitals NHS Trust added: ‘This is a very rigid definition of what normal birth should be. Epidurals should not be done without reason; they should be kept to a minimum. There are some women, however, who require an epidural because they cannot cope with the pain in any other way.’

I have to agree. While I am fully in favour of supporting national guidelines that seek to minimise the unnecessary interventions, at the same time, I bristle at the thought of women giving birth in pain and not being allowed to have relief if they ask for it.

Would you be happy with this model of care in your own country?

Source: http://tinyurl.com/ccz8vh

Octuplet mum a pregnancy addict?

“I loathe pregnancy. I hate it more than anything else in the world,” Nadya Suleman told Dr. Phil on her continuing tour de media.

For a woman who is now in the possession of 14 young children, it is hard to believe that someone would choose to endure the physical hardships of pregnancy if they hated it that much. There has been some speculation that Suleman is 'addicted' to pregnancy, although there is no known condition. Rather, some experts have been suggesting that Suleman is in denial about her ability to parent these children appropriately when in fact, the reality is that she will need her own entourage to manage her brood. Dr. Drew Pinsky, best known for his love advice on MTV, but whom also is a psychiatrist and a parent of triplets himself, told Matt Lauer on Today that the situation that Suleman has found herself in is actually far more grave than has been reported:

"It’s not mere speculation, but a matter of life and death...With octuplets, you have to have six or seven people going 24/7 in order to prevent, frankly, the death of one of these children. It’s a really serious issue."

Source: http://today.msnbc.msn.com/id/29405752/