by Rebecca Dawson, M.A.
Watching my family member's awful struggle against postpartum depression was excruciating. At the time, I knew little about this disorder, but I knew soon enough that I wanted to avoid it. As I muddled through that season with her, possibly making matters worse, I kept thinking, “What is this?” and, “How do I avoid it?”
And so began my frantic search to gather information about motherhood and postpartum depression (PPD). What I couldn’t find was an honest, fun-loving approach to the material that both grappled with tough questions and offered a helpful Christian perspective. That became the catalyst for my book, Help! I'm a Mom To Be!: Picking Up Where Childbirth Classes Left Off, which is designed as a preventive tool to ward off postpartum depression.
Postpartum depression is classified as a mood disorder largely due to the hormonal changes occurring within the body. This disorder has three varying degrees: baby blues, postpartum depression, and postpartum psychosis.
Research suggests that while 20 percent of all women experience some form of prenatal depression, postpartum blues affect 50-80 percent of all new moms, and 1 in 5 women with postpartum blues go on to develop postpartum major depression. In a recent article on postpartum depression, The Wall Street Journal pointed out that “trying to ‘nip this in the bud or prevent’ (postpartum) depression is key.”
Motherhood hopefully brings with it the gift of joy. But, when it does not, moms are often left with the devastating feelings of being all alone and overwhelmed. Countless hours are spent during pregnancy examining how-to books on anything touching on childbirth and child-rearing. But little to no time is spent reflecting upon the emotional changes that occur from conception through early motherhood, because most women think they will never struggle with this disorder. In most cases, the child is not the problem. Rather, the problem is usually embedded in her life, and now rises to the surface with the addition of a child. A child brings sudden and absolute change. Life is no longer about her as an individual.
If PPD is largely due to changing hormone levels, then how you can prevent something that is hormonal? A great deal of research does point to hormonal and chemical changes within the body. However, recent research reveals that men and women both experience this disorder. Since men do not have the same chemical composition as women, something beyond hormones must play a role.
As a pregnancy help center, you and your staff are in a unique position to empower women with the hope that this disorder can be prevented.
Here are a few symptoms to help a mother-to-be identify this aliment:
This lengthy list is not meant to intimidate, but to train women to quickly recognize each and every symptom for the purpose of prevention, early detection, and healing. The main distinguishing element for postpartum depression is that it occurs during pregnancy or after the delivery of a child. Postpartum depression can vary from woman to woman, lasting from six months to one year.
Are there ways to prevent and ward off postpartum depression? Start with these preventive methods:
If you find yourself unsure how to help another suffering from PPD, start with:
All new moms have to start somewhere. Encourage her to start with what she already knows and then continue to grow. Help her enjoy this baby by offering preventive measures to treat postpartum depression.
1. Dawson, Rebecca, M.A. "Help! I'm a Mom To Be!" Blue Room Publications and Production. © 2010, pgs. 67-69.
2. Kahn, David A., M.D., Margaret L. Moline, Ph.D., Ruth W. Ross, M.A., Lee S. Cohen, M.D., and Lori L. Altshuler, M.D. A Postgraduate Medicine Special Report- Major Depression During Conception and Pregnancy: A Guide for Patients and Families. March 2001, pg. 110-111.
3. Moline, Margaret L., Ph.D., David A. Kahn, M. D., Ruth W. Ross, M.A., Lori L. Altshuler, M.D., Lee S. Cohen, M.D., A Postgraduate Medicine Special Report- Postpartum Depression: A Guide for Patients and Families. March 2001, pgs. 112-113.
4. Wang, Shirley S. New Dads, Too, Can Suffer Depression. The Wall Street Journal (WSI.com). 19 May 2010.
5. KidsHealth. “Postpartum Depression and Caring for Your Baby.” © 1995-2009. The Nemours Foundation/KidsHealth®. Reprinted with permission.
6. “Depression During Pregnancy.” BabyCenter, L.L.C. 1997. http://www.babycenter.com/0depression-during-pregnancy9179.bc
The following information is found at the CDC site:
Not all birth defects can be prevented. But a woman can increase her own chances of having a healthy baby by managing health conditions and adopting healthy behaviors before becoming pregnant. This is important because many birth defects happen very early during pregnancy, sometimes before a woman even knows she is pregnant.
Awareness and education are the first steps to preventing birth defects. The immediate step following awareness and education is taking action. There are a number of things you can do to increase the probability of having a healthy pregnancy and a healthy baby. Some are more challenging than others because they require that you break habits, but it is worth your effort.
Here are a variety of tips you can use to prevent birth defects as you contemplate starting or adding to your family:
Tip 1. The first and foremost tip is maintaining preconception health; eating well balanced and nutritional meals, and taking a multivitamin daily that includes the recommended 400 mcg of folic acid.
Tip 2. If you are sexually active and pregnancy is a possibility, make sure you take a multivitamin daily which includes the recommended 400 mcg of folic acid and other essential B vitamins.
Tip 3. Avoid all activities that could potentially lead to birth defects including alcohol, tobacco, illicit drugs, and caffeine.
Tip 4. Seek an annual gynecological and wellness exam.
Tip 5. Obtain genetic counseling and birth defect screening, particularly if you have any family history of birth defects or if you are 35 years of age or older.
Tip 6. Help your family or friends who might be considering parenthood by informing them that January is Birth Defects Prevention Month. You can send an e-mail and link to this page to everyone in your address book.”
Premature Birth: Important growth and development occur throughout pregnancy – all the way through the final months and weeks. Babies born three or more weeks earlier than their due date have greater risk of serious disability or even death. Learn the warning signs and how to prevent a premature birth.
Folic Acid: Folic acid is a B vitamin that can help prevent major birth defects. Take a vitamin with 400 micrograms (mcg) of folic acid every day, before and during pregnancy.
Prenatal diagnosis is now much easier and safer than ever before. But, these advances also exist within a mix of conflicting and sometimes hidden agendas. January is Birth Defects Prevention Month, so there's no better time to examine the topic and focus on the critical role PHC/PMC’s play in preventing birth defects.
The education we provide to our clients may be the determining factor in preventing a child from being born with birth defects, but this fact raises a great dichotomy to the surface: On one hand, we desire all mothers and babies to be healthy, and we should proactively educate them on how to achieve this. On the other hand, however, we must carefully construct our instruction in a way that avoids negatively influencing a client to seek an abortion if she should learn of a negative diagnosis regarding her baby.
Fetal problems are a serious rationale for considering abortion in our current culture, spurred in part by diagnosis of these abnormalities with the increased use of ultrasound, amniocentesis, and other tests in pregnancy. Ultrasound studies to determine fetal anatomy are often done at 18-20 weeks, so abortions done as a result of these scans are late abortions. But ultrasound is imperfect and analysis of the images can result in inaccurate interpretations.
Pregnant women who have declined abortion for fetuses diagnosed by ultrasound with fatal birth defects have sometimes ended up giving birth to normal babies. Other parents have resisted recommended abortions for serious anatomical problems, and had their babies undergo surgical repair after birth.
A great example of this truth comes from, Is Late-Term Abortion Ever Necessary?, an article by Mary Davenport, M.D., published on the American Association of Pro-life Obstetricians and Gynecologists website:
C. Everett Koop, M.D., the former surgeon general and renowned pediatric surgeon, was asked during the partial-birth abortion hearings if he had treated children “born with organs outside of their bodies” (omphalocele). Dr. Koop replied, “Oh, yes indeed. I’ve done that many times. The prognosis usually is good….the first child I ever did, with a huge omphalocele much bigger than her head, went on to develop well and become the head nurse in my intensive care unit many years later.”
For fatal birth defects, abortion is sometimes presented as the only option. But a better alternative is perinatal hospice. This involves continuing the pregnancy until labor begins and giving birth normally, in a setting of comfort and support until natural death occurs. It is similar to what is done for families with terminally ill children and adults. Karen Santorum, a nurse and the wife of former Senator Rick Santorum, was faced with the prospect of her own son, Gabriel, being born with a fatal birth defect. She describes how Gabriel lived only two hours, but how in those two hours “we experienced a lifetime of emotions. Love, sorrow, regret, joy—-all were packed into that brief span. To have rejected that experience would have been to reject life itself.” The sense of peace and closure felt by families experiencing neonatal death in a hospice setting contrasts markedly with the experience of families undergoing abortion for fetal anomalies. Couples who have had abortions for birth defects may suffer from adverse long-term psychological effects and prolonged grief reactions. Children who learn that their mothers aborted their siblings can suffer feelings of worthlessness, guilt, distrust and rage.
Non-fatal birth defects can be more challenging. The most common prenatal diagnosis resulting in mid-trimester abortion is Down syndrome. There has been an aggressive campaign by the American College of Obstetrics and Gynecology to use new technologies to detect Down syndrome in younger women through measurement of fetal neck-fold thickness and first trimester blood tests, now that prenatal diagnosis and abortion have succeeded in eliminating 90 percent of Down babies in women over 35. After diagnosis of Down syndrome, families are often not presented with an honest discussion of parenting their Down syndrome child, or the possibility of their Down syndrome child attending school and leading a semi-independent life. There are couples who are willing to adopt children with Down syndrome or other birth defects, but genetic counselors frequently do not give patients this information. Diagnosis of a child with a fetal anomaly is life-changing and a major stress, but many families rise to the occasion and are able to cope with a disabled child. Although parents choosing abortion may allege that the disabled child is better off not existing, disabled adults would contest that assertion. When surveyed in numerous studies, no differences have been found between disabled and “able-bodied” people as to their satisfaction with life.
A sad depiction of the haste to abort children with birth defects is captured in the following story, from LifeSiteNews.com:
GIA LAI PROVINCE, VIETNAM (May 16, 2012) --- A family is in grief after aborting a child erroneously reported to have congenital defects. The child died shortly after being born following a failed abortion. The mother, Nguyen Thi Thu T., had undergone two ultrasounds that falsely reported birth defects – one in her native Chu Se District and another in Ho Chi Minh City. She chose to abort the baby in the seventh month of her pregnancy. However, as the family gathered to bury the child, they found the baby was still alive and had no such defects. Although they rushed the child to Gia Lai Province General Hospital at 9:30 Sunday morning, it was too late.”
Dr. Gerard Nadal offers some hopeful encouragement to this discussion. He says that, while some are fearful that the newer diagnostic tests for Down syndrome will lead to a higher number of abortions, the already-staggering number of 90-93 percent of unborn Down syndrome babies being aborted can also offer a glimmer of hope.
The regrettably high number of Down syndrome babies being aborted means "there is not much room for (those numbers) skyrocketing", Dr. Nadal points out, and the advances in amniocentesis, which can diagnose Down syndrome as early as the 10th week, may actually offer parents more time to come to terms with the diagnosis and seek alternative advice earlier in the pregnancy than previously available.
Helping the parents come to terms with the reality of their child’s special needs ahead of time is critical for bonding. As those called to serve these parents, it is essential for pregnancy help medical personnel and peer counselors to understand just how devastating a negative diagnosis can be, so that we can provide help during a difficult time. The earlier the diagnosis, the more time we have to help them.
Still, there is a disturbing eugenic flavor to the fact that the American College of Obstetricians and Gynecologists (ACOG) and other groups are now recommending Down syndrome screening to all pregnant women. Many physicians are beginning to recommend that clients undergo non-invasive prenatal screening for fetal abnormalities, with a particular emphasis on Down syndrome.
As Steve Calvin, M.D., said in an article posted at AAPLOG.org January 11, 2007, “Women are reporting both subtle and overt pressure to undergo prenatal screening and to have an abortion if DS is found.”
This problem is further seen in the fact that most genetic conditions can be identified in the womb—including Down syndrome—yet, there are no available cures or therapies that can be administered before the child is born. Thus, a predominant purpose of prenatal screening is to offer parents the option of aborting “defective” babies. An estimated 70 percent of pregnant U.S. women will choose to have prenatal screening tests. A certain combination of screening results, though not definitive, can predict DS with up to 90 percent sensitivity.
Let us remind ourselves of the dignity and value of every person, who are all made in the image and likeness of God. Remember too that perfect health and a normal IQ are not required for happiness, friendship, and love of life. Rather than offering parents ways to eliminate their unborn child, we can provide them with more resources and support.
In her article found at PhysiciansForLife.org, Down Syndrome and Abortion, Susan W. Enouen, PE, wrote:
A Harvard study found that mothers who chose to continue their pregnancy after a prenatal diagnosis of Down syndrome did so for personal reasons such as conscience and religion, but also because they had gotten information about Down syndrome, either in printed materials or from talking to a parent of a child with DS. However, most of the mothers felt that their doctors did not explain DS adequately and in a balanced fashion.
This is where we can have a dramatic impact with a client who is facing a negative diagnosis. Let us become knowledgeable about the issues, develop resources for the client and extend to her the love, compassion, and prayerful support she so desperately needs.
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