Postpartum Depression

During pregnancy you are get yourself amped up for the big day and beyond.  There is so much anticipation and excitement leading up to becoming a new mommy and daddy.  I have had some people ask me a few questions about what they can expect for their first few weeks home from the hospital.  One momma sent me an email asking me all about postpartum depression.  She is about 22 weeks pregnant and has a concern that she will have postpartum depression because her mom had it after delivery.  There are a ton of questions about postpartum depression that women are looking into during their pregnancy.  I hope to answer a few!

What is the difference between “the baby blues” and postpartum depression?

“The baby blues” is something more common than mommas think.  You normally begins to see symptoms a few days after giving birth.  “The baby blues” happens because of the hormonal changes in your body happening post birth.  The symptoms include: 

• mood swings
• sadness
• crying spells
• trouble sleeping
• irritability
• changes in appetite
• trouble concentrating

All of the symptoms are perfectly normal post delivery.  They should last from 1 to 2 weeks.  It is when your symptoms last longer than this that you want to discuss it a bit further with your doctor or midwife.  

Postpartum Depression is a severe depression with some symptoms similar to “the baby blues”.  At first it is hard to decipher postpartum depression from “the baby blues” because of the similarity in the symptoms.  With postpartum depression you can have similar symptoms to “the baby blues” such as:

• mood swings
• crying spells 
• sadness
• difficulty sleeping
• irritability

The difference comes in when the symptoms become destructive to your life as a new momma.  You may find some other symptoms with postpartum depression such as:

• neglectful of your baby
• negative feelings towards your baby
• concern you will hurt your baby
• disregard for yourself
• constant exhaustion
• feelings of worthlessness
• constant guilt
• changes in appetite
• weight loss or weight gain
• recurrent thoughts of death or suicide

Is postpartum depression genetic?  What causes postpartum depression?

There are many factors that put you at a higher risk for postpartum depression.  Just because your mom had it with her children does not necessarily mean you will have it with yours.  Some things that put you at risk are:

• history of depression
• history of severe PMS
• medical complications for you or your baby during pregnancy and/or delivery
• stressful relationships
• lack of support from family and/or friends

A difficult relationship with your baby fathers or difficult family relationships will add a great deal of unnecessary stress to the already stressful new mommyhood.  This can add fuel to the fire if you are already at risk for postpartum depression.  You are also dealing with so many changes to your body after you have delivered your baby.  You may be in severe pain and discomfort and may feel unattractive with your new post baby body which can add to feelings of depression.  One of the biggest causes of postpartum depression is the drop in estrogen and progesterone.  This drop can lead to depression.

Can I prevent postpartum depression from happening to me?  How?

There are some things to do to help you ease into motherhood and keep the stress levels down.

Get sleep.  Rest as much as possible.  When your baby sleeps, you should take advantage of the time and get a little cat nap in.

Set time for you.  Talk to your partner about having some time for yourself, even if it is just to take a shower.  Have a little bit of alone time to just decompress after your long day with your baby.  Get a schedule going with your partner that allows you that time.

Get fresh air.  Taking your baby out for a stroll is the best thing for the both of you.  Some fresh air really makes the difference with helping your post delivery recovery.  There is nothing like fresh air to help a baby sleep.  Of course you can’t bring your baby out in 20 degree weather so if you have a winter baby do your best to have lights on open the shades to let the light in.

Exercise.  It is so important to be active.  It will help keep the endorphins flowing and improve any depression you may be feeling.  Studies have proven that exercise is a wonderful medicine for any depression.

Surround yourself with love and support.  Keep out any negativity!  Whether it is your in-laws or someone down the street...keep yourself surrounded with the people who will love, support and care for you.  There is no need to have any negativity around you or your beautiful family.  Negativity from outsiders will not only add to postpartum depression but it can also cause problems between you and your partner.  It is best to nip it in the bud before it starts and make a healthy choice not to be around it.

Share your feelings.  Set some time for a date night with your partner at least once a week when you and your partner can talk about how you are feeling about the new exciting things happening in your life.

Ask for help.  It is totally okay to ask for help if you are feeling overwhelmed.  Being overwhelmed doesn’t make you a bad mommy.  It is part of motherhood. 

Breastfeed.  Breastfeeding, like exercise, releases endorphins and keeps the sprits up.  it does wonders for your body and your baby.  It is natural and your body's reaction to delivering a baby,

Epidural Or Not?

So many women have concerns about the pain associated with labor and delivery.  When it is your first time having a baby, just about everything is unknown.  With pregnancy, labor, and delivery, you could be on your fifth kid and there will still be so many unknowns because every experience is different.  There are some women that will get through labor and delivery without any pain med at all and say it wasn’t so bad.  Some women need the pain relief and find it excruciating.  Every woman has a different pain tolerance.  For those women who do not want pain medication and go all natural, I have an enormous respect for you!  I wish I had been that strong, but for me it just was not going to happen.  For those of you who feel they want the pain relief, there is no shame in that.  If there are the resources available why suffer if it is unbearable for you.  Remember, you are the only one who know what you are feeling.  That being said, I just want to educate you a little bit further on your options and clear up a few misconceptions.

As with anything, before you move forward with something you should know all the facts.  Talking it out with your doctor or midwife to know your options is your first step.  If pain relief is something you are considering, you need to know what questions to ask. Here are a few questions to think about asking your doctor or midwife while considering any pain relief:

What are the different methods of pain relief available to me?

How will an epidural affect the baby?

Is there any instance I won’t be able to have an epidural?

What are the advantages and disadvantages to having an epidural?

What are any possible side effects?

What are the risks?

How is an epidural given?

How long before it begins to work?

Will it wear off?

Will I be able to move once the epidural is placed?

At what point of labor can I have an epidural?

Is it painful?

There are so many misconceptions about epidurals.  I am guilty of this myself.  I assumed so many things about epidurals going into my pregnancy when I couldn’t possibly have known.  I just want to discuss some of the things assumed about epidurals but aren’t ever really clarified.

The needle is humongous and is more painful than contractions.

This is false.  It is no more painful than having an IV inserted.  The most difficult thing about having an epidural is the possibility that you may have a contraction during the process and you must hold still.  The needle portion is about 1 minute, just long enough to insert the catheter, which is the size of pencil lead.  An epidural is inserted in your back, so for you to see the needle and know exactly what is going on back there is highly unlikely.  Make sure you breath through it, but truly the most painful part is possibly having a contraction during the process.

You are there for hours because you can’t feel anything and won’t be able to push.

Again, false.  Epidurals do help ease the pain, but they do not paralyze you.  You can feel the pressure that urges you to push.  One common thing I have found with other women’s experience, is they expect to feel absolutely nothing.  When the epidural is in and there is still a bit of discomfort, they ask for a higher dose because they are still in pain.  This is where the issue of not feeling comes in.  You wont completely feel nothing with an epidural.  If you know this going in, it will help.

You must wait until you are 5 to 7 cm before you can have an epidural.

This really depends on your doctor, but not likely.  You can ask at any point, normally around 3 cm you are able to have an epidural.  You can always ask!  One thing women don’t realize is that you are able to have the catheter placed and the medication later.  Having an epidural will help your body relax allowing your body to do what needs to be done.  For some women, they are in such pain and the anxiety is so high, the body can not relax to dilate and then there is complication.

I want to share my own experience, not to freak anyone out, but so you are aware of the reality of pain relief.  I went through an induction process so I had pain relief and medication.  I did have an epidural around 4-5 cm when I was brought down to delivery.  I absolutely could feel the sensation of needing to push when it came time.  As I was nearing the point of no return, my epidural wore off.  I want you to know this because there is no guarantee that an epidural will work 100%.  I will say I did not feel 1 contraction once I had the epidural, which, at least in my own experience, the contractions were worse than giving birth.  If you chose to have pain relief stay informed as much as you can.  Try not to blindly go in.  Ask questions, and keep an open mind.