Displaying items by tag: pregnancy support

Preventing Postpartum Depression

 
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:

  • Persistent low mood
  • Inadequacy
  • Failure
  • Hopelessness or helplessness
  • Exhaustion
  • Emptiness
  • Sadness or tearfulness
  • Guilt
  • Shame
  • Worthlessness
  • Confusion
  • Anxiety or panic
  • Fear of harming the baby
  • Fear of being alone or going out
  • Lack of interest or pleasure in usual activities
  • Insomnia
  • Excessive sleep or nightmares
  • Under- or over-eating
  • Agitation
  • Decreased energy or motivation
  • Withdrawal from social events or contact with other people
  • Poor personal hygiene
  • Inability to cope with routine tasks
  • Inability to think clearly or make decisions
  • Lack of concentration or poor memory
  • Fear of being rejected by partner

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:

  1. Help your client create a Support Plan. Identify all the individuals in her life who are able to help once her baby arrives. It may not be necessary to talk to these individuals ahead of time, but knowing beforehand that she has support can be vital.
  2. Encourage her to talk about her fears and expectations during the client/volunteer sessions. Also suggest the importance of discussing her fears and expectations with her spouse or partner.
  3. Discuss the framework of her childhood within a session. Ask her questions regarding how she was raised, such as: “What was common at home?” “How were you disciplined?” “Did you feel a sense of love and acceptance?” “What did you like?” “What didn't you like?” Remind her that we all start somewhere, and even if her past was difficult, she can work to change life for her and this child. Work together to compose a plan that will work for her.
  4. Encourage her to let her weaknesses make her strong. Encourage her to be aware and identify her weaknesses early on. We all have them. Admitting we are unable is often the first step towards emotional healing.

If you find yourself unsure how to help another suffering from PPD, start with:

  1. Encouragement—Ask what are the best ways you can help. Remind her she is not alone. Many women have felt similarly. After that, help support her through the battle.
  2. Convince her to seek a medical elevation.
  3. Pray and remind her there is hope for each new day.

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.


Rebecca Dawson is the author of "Help! I'm a Mom-To-Be!" She is a Master's level counselor, former adjunct Graduate Professor for the Grace College Counseling Department, a former Manager of Client Services at her local Pregnancy Center, and the mother of three wonderful little boys. Her new book titled, "Stamped on Every Child's Heart" addresses Childhood Disorders and will be released this Spring. In addition, Blue Room Publications also offers the "Help! I'm a Mom-To-Be!" Training Manual which assists Pregnancy Centers in facilitating groups and individual sessions. Rebecca can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it. Look for "Help! I'm a Mom-To-Be!" online at Barnes and Nobles and at www.blueroompublications.com.


References

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

Prepping for a Healthy Pregnancy

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.

cdclogoHere are 10 steps a woman can take to get ready for a healthy pregnancy:

  1. Take 400 micrograms (mcg) of folic acid every day. Folic acid is a B vitamin. If a woman has enough folic acid in her body at least 1 month before and during pregnancy, it can help prevent major birth defects of the baby’s brain and spine.

  2. Don't drink alcohol at any time during pregnancy. When a woman drinks alcohol, so does her unborn baby. Alcohol in the woman’s blood passes through the placenta to her baby through the umbilical cord. There is no known safe amount of alcohol to drink while pregnant. There also is no safe time during pregnancy to drink and no safe kind of alcohol. Drinking alcohol during pregnancy can cause a baby to be born with a birth defect.

  3. Don’t smoke. The dangers of smoking during pregnancy include premature birth, certain birth defects (cleft lip or cleft palate), and infant death. Even being around cigarette smoke puts a woman and her unborn baby at risk for problems. Quitting smoking before getting pregnant is best. But for a woman who is already pregnant, quitting as early as possible can still help protect against some health problems for the baby, such as low birth weight. It’s never too late to quit smoking.

  4. Don’t use “street” drugs. A woman who uses illegal—or “street”—drugs during pregnancy can have a baby who is born premature with low birth weight, or has other health problems, such as birth defects. A woman who uses cocaine while pregnant is more likely to have a baby with birth defects of the arms, legs, urinary system, and heart. Other drugs, such as marijuana and ecstasy, also can cause birth defects among babies.

    It also is important that a woman not use "street" drugs after she gives birth, because such drugs can be passed through breast milk to her baby and can affect the baby’s growth and development. If you use "street" drugs, talk with your doctor about quitting before you get pregnant.

  5. Talk to a health care provider about taking any medications. Taking certain medications during pregnancy can cause serious birth defects, but the safety of many medications taken by pregnant women has been difficult to determine. If you are pregnant or planning a pregnancy, you should not stop taking medications you need or begin taking new medications without first talking with your doctor. This includes prescription and over-the-counter medications, as well as dietary or herbal products.

  6. Prevent infections. Some infections that a woman can get during pregnancy can be harmful to the unborn baby. Learn how to help prevent infections.

  7. Talk to your doctor about vaccinations (shots). Many vaccinations are safe and recommended during pregnancy, but some are not. Having the right vaccinations at the right time can help keep a woman and her baby healthy.

  8. Keep diabetes under control. Poor control of diabetes during pregnancy increases the chances for birth defects and other problems for the baby. It can also cause serious complications for the woman. Proper healthcare before and during pregnancy can help prevent birth defects and other poor outcomes.

  9. Reach and maintain a healthy weight. A woman who is obese (a body mass index of 30 or higher) before pregnancy is at a higher risk for complications during pregnancy. Obesity in the woman also increases the risk of several serious birth defects for the baby. If you are overweight or obese, talk with your doctor about ways to reach a healthy weight before you get pregnant.

  10. See a health care professional regularly. A woman should be sure to see her doctor when planning a pregnancy and start prenatal care as soon as she thinks that she is pregnant. It is important to see the doctor regularly throughout pregnancy, so a woman should keep all her prenatal care appointments.

americanpregnancyassociationSix tips from the American Pregnancy Association:

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.”

More recommendations from the CDC:

  • 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.

  • Smoking during pregnancy is the single most preventable cause of illness and death among mothers and infants. Learn more about the dangers of smoking and find help to quit.

  • Alcohol: When you drink alcohol, so does your unborn baby. There is no known safe amount of alcohol to drink while pregnant.

  • Vaccinations: Talk to your doctor about vaccinations (shots). Many are safe and recommended during pregnancy, but some are not. Having the right vaccinations at the right time can help keep you and your baby healthy.

  • Flu and Pregnancy: If you're pregnant, a flu shot is your best protection against serious illness from the flu. A flu shot can protect pregnant women, their unborn babies, and even their babies after birth.

  • Infections: You won’t always know if you have an infection—sometimes you won’t even feel sick. Learn how to help prevent infections that could harm your unborn baby.

  • HIV: If you are pregnant or are thinking about becoming pregnant, get a test for HIV as soon as possible and encourage your partner to get tested as well. If you have HIV and you are pregnant, there is a lot you can do to keep yourself healthy and not give HIV to your baby.

  • West Nile Virus: Take steps to reduce your risk for West Nile virus and other mosquito-borne infections.

  • Diabetes: Poor control of diabetes during pregnancy increases the chance for birth defects and other problems for your baby. It can cause serious complications for you, too.

  • High Blood Pressure: Existing high blood pressure can increase your risk of problems during pregnancy.

  • Medications: Taking certain medications during pregnancy might cause serious birth defects for your baby. Talk to your doctor or pharmacist about any medications you are taking. These include prescription and over-the-counter medications and dietary or herbal supplements.

  • Environmental and Workplace Exposures: Some workplace hazards can affect the health of your unborn baby. Learn how to prevent certain workplace hazards. If you are worried about a specific substance, please click here.

  • Unborn Babies Exposed to Radiation: If you think you might have been exposed to radiation, talk with your doctor.

  • Pediatric Environmental Health Specialty Units: 
    A network of experts in children's environmental health.

Pro-Life Prenatal Diagnostics

babyPrenatal 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.”

ultrasoundDr. 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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