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Just the Baby Blues? Or a Postpartum Mood Disorder?

In recent media, we’ve been hearing more about women who suffer from postpartum disorders– which is good. It raises public awareness that this is a REAL illness which requires treatment. It is estimated that at least 80% of women experience Baby Blues, and at least 10% of women suffer from some type of postpartum disorder.

Families worry about being able to distinguish the difference- how do we know when to seek help? When should we be concerned?

Baby Blues is a very normal part of the transition to motherhood. (Even dads can get it!) These are normal feelings of occasional sadness, occasionally feeling overwhelmed, having doubts about being a “good enough” parent. It occurs usually for 1-3 weeks after a baby is born. Many moms feel exhausted due to sleep deprivation, overwhelmed with the responsibility of a newborn baby, and may have mixed emotions about parenthood. In most cases, these feelings will diminish over time as moms get more sleep, and become more comfortable with their new role and responsibilities. Many times just getting more help around the house, a little support, is all a mom needs to work through it.

Postpartum disorders, on the other hand, are more serious conditions which may require medical intervention. There are many types of postpartum disorders, but in general here are possible symptoms:
Feeling anxious, depressed, sad or hopeless
Inability to sleep (when you can), or excessive sleeping
Lack of appetite or excessive “comfort” eating
Worrying about baby or being a “good mom”
Not wanting to take care of yourself or baby
Feeling panicky, worrying about things you “know” you shouldn’t
Feeling alone, isolated
Not wanting to be alone, worried that something “bad” will happen
Uncontrollable thoughts of hurting self or baby– SEEK HELP RIGHT AWAY!

Most moms will report they don’t feel “right”– they know something is wrong. They may not be able to put their fingers on it, but they know they need help. If you or your family recognizes any of these symptoms, start with a call to your doctor or midwife. You can talk about treatment options and find what’s going to work best for you.

Possible Treatment Options:
Extra Help and Support— friends, family, postpartum doulas can offer help and support
around the house, and relieve you of feeling overwhelmed and isolated.

Exercise and Nutrition— 30 minutes of exercise daily raises endorphin levels which really
help moms feel better! Eat well, some vitamins or supplements can also help.

Individual or Group Counseling/Therapy— There are mental health professionals who
specialize in postpartum issues, and offer local support groups for moms.

Medication— sleep aids and/or antidepressants sometimes are really needed. They can help
a mom get back “on track” while she works on all the other stuff. Only your doctor will
know what might work for you. Many are perfectly safe to take with breastfeeding!

The bottom line– don’t be hesitant to get help. If you had an infection, you wouldn’t think twice about going to the doctor, right? Same with mental illness– it needs help, it’s not your “fault”, or “all in your head.”  You’ll be a better mom if you take care of yourself first.

Postpartum Resources:

Postpartum Support International: 1-800-944-4PPD (24/7 hotline)

Online Support, Blog and local resources:

Any Baby Can Austin– local “warmline” (answered M-F 8-5) 512-334-4444
Any Baby Can hosts a weekly postpartum support group which is free!

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What do I pack in my Birth Bag for the Hospital?

There are lots of checklists out there on what to pack… I’ve consolidated those lists into one I think is a good basic list. I always recommend you travel light when coming into Labor and Delivery- pack what you’ll need for labor, birth and a few hours after the birth. Your “postpartum” bag can include all the items you’ll need later so you don’t have to bring so much with you. Plus, many items, like your birth ball, massage items, etc you’ll need just for birth, but not afterwards. Your support person can drop off one bag to the car, and retrieve the other after you get settled into postpartum.

Labor Bag:
own gown or garment to labor in (if desired)
robe/slippers for walking during labor or for use postpartum
focal point- favorite picture, ultrasound or item that reminds you of baby
favorite music and player (laptop, CD player, ipod station)
hard candy/lollipops
lotion or oil for massage/aromatherapy– peppermint for nausea, lavendar for relaxation
rice sock or heating pad (find out if you’ll have access to a microwave)
lip balm
mouthwash/toothbrush/paste– for everyone, including support person!
nutritious snacks for partner
change of clothes for partner, include long sleeve shirt
clear fluids for mom (clear juices, gatorade, vitamin water, herbal teas)
warm socks- 2 pairs
massage tools- tennis ball works fine!
birth ball (if your hospital does not provide them)
band or clips for long hair
change for vending/snack machines
camera/video camera
extra pillows with colored cases- 2
birth plan
baby book if you want footprints

For postpartum stay
nightgowns if you prefer your own (hospital will provide gowns, panties and pads)
nursing bras/tanks- if you want
toilet articles (hospital only provides antibacterial soap)
going home outfit for mom (fit you 4-6 months pregnant)
going home outfit for baby (hat, clothing, blanket- hospital will provide all you need for baby while you are there including clothing, hat, blanket, diapers and wipes)
a little baby oil or olive oil for baby’s bottom
breastfeeding pillow

*Don’t forget to pack clean clothes and toiletries for Dad too if he’s planning to spend the night with you!

Infant Car Seat— Don’t leave home without it! The hospital will not release you without it. This does not have to come up to the hospital, you can leave it in the car until you discharge.

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Why Should I try to avoid a Cesarean Section?

Reasons to Avoid a C-section

There’s lots of information out there about WAYS to avoid a cesarean, but I still have a lot of parents ask me “Why should I WANT to avoid a c-section?” They know many friends and family who have had one, and it seems faster, easier, and more convenient for all. “Why bother risking the process of labor when there’s a chance I’ll need one anyway?” Is there really anything wrong with just scheduling a primary cesarean for no medical reason? Here’s my top 3 reasons to avoid a c-section, if you can:

1.A Cesarean Birth is still major abdominal surgery. Even though many cesareans are done every day and are considered a routine procedure, they still come with a package deal of additional risks in compared to vaginal birth including:

Increased risk of infection and being re-hospitalized due to complications

Increased blood loss for mother

Risk of accidental injury to internal organs

Recovery is longer, usually more complicated, and more painful than vaginal birth

Increased risk associated with anesthesia required for cesarean birth including respiratory problems or allergic


2. There are risks to your Baby. While some babies need to be delivered by cesarean, a healthy, low risk baby is better off traveling through the “traditional” route for various reasons.

Risk of accidental injury to baby during delivery

Increased breathing problems and need for medical intervention

Increased rate of babies being sent to the NICU

Delayed mother-baby interaction and breastfeeding

3. A Cesarean increases the risk with future pregnancies. With each subsequent pregnancy, we tend to see:

Increased problems getting pregnant again

Increased rates of miscarriage,  ectopic pregnancy and stillbirth

Increased risk of placental problems due to surgical scar tissue on the uterus (adhesions)

Increased risk you’ll need another cesarean, which starts the circle again.

I’m certainly not saying all women should avoid a cesarean. There are plenty of cesareans that save lives of mothers and babies. All women should become empowered consumers and have open communication with their caregivers about their personal situation and make choices that are right for them. For more information about Cesareans, see the Childbirth Connection website “What Every Pregnant Woman Should Know about Cesarean Birth”

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St David’s Medical Center is becoming “Baby Friendly”!

Great news for birthing families in Austin– St Davids Medical Center (32nd street location) has received their Certificate of Intent from Baby Friendly USA. This is the first step in  becoming a Baby Friendly hospital– currently there are no Austin area hospitals that are officially Baby Friendly. What does this mean? They abide by the UNICEF 10 Steps to Successful Breastfeeding. For more information

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Creating Birth Preferences

What should I consider when creating a Birth Preference Plan?

A traditional Birth Plan used to be a rigid document, stating distinct preferences, often indicating a lack of flexibility. Modern Birth Preference Plans can state your preferences while still remaining flexible, and indicate that you are open to hearing of suggestions or alternatives that might stray from your original ideas.  Your goal should to be to convey your preferences to your caregivers so they can understand how to best support you during labor and birth.

Who will support you during labor and birth? (husband, doula, friend, mother)

How do you feel about induction and/or augmentation?

Fluids by mouth or IV? Is a Saline Lock (also known as Hep lock) an option for you?

Intermittent or Continuous monitoring? Are there wireless (radio transmitted) monitors available?

Do you want to move around, walk, shower during labor? How to you want the room set up? (Lights, music, quiet voices, etc.)

What are your plans/how do you feel about pain medications? What if labor was longer or more difficult than you anticipated? How would you like the staff to handle offering pain meds?

What are your preferences for pushing? Positions? Spontaneous or directed?

How do you feel about perineal massage and/or episiotomy?

Would you consider forceps or vacuum if your provider recommended it?

What are your preferences once the baby is born? Do you want the baby placed on your belly immediately, or after drying off? Is separation ok or would you prefer no separation if not medically necessary?

What if a cesarean became necessary? Who do you want to support you during surgery and in recovery? Do you have special requests for baby?

Are you planning to breastfeed? If a boy, are you planning to circumcise?

Any other wishes for recovery or postpartum for you or baby? Anything special they need to know about you? Family, siblings, religious, cultural or dietary preferences?

Keep it short, simple,one page, easy to read.

Make it personal

Make it positive.

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Should you Delay Cord Cutting?

The debate has gone on for years. Many OB’s insist it’s dangerous to delay cord cutting for more than 30 seconds or the baby will get “too much” blood. Midwives traditionally delay cord cutting until after the cord has stopped pulsing, usually 2-3 minutes after birth… which is right?

An article in American Baby magazine (March 2010) makes reference to a recent study that was posted in the Journal of Maternal and Child Nutrition. “Following delivery iron rich blood continues to flow from the placenta to the infant, and clamping and cutting the cord within seconds-a common practice in many hospitals- leaves baby with inadequate blood volume. Missing out on extra iron can hinder motor and cognitive development.”

Parents, do your homework and have an honest conversation with your caregiver about your wishes.

For more information about delayed cord cutting, go to

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Is it really necessary to take a Childbirth Class?

With so much information available on the internet, many parents wonder if it’s worth their time and expense to take a childbirth class. Childbirth classes teach more than just  “breathing”. While a good class should include this topic in the curriculum, a thorough class will do much more.

Childbirth classes help parents learn about the normal process of birth, when to call your doctor or midwife and when to go to the hospital or birth center, what to expect during the delivery, possible variations in labor and medical interventions. They should also cover pain medications, the possibility of cesarean section, and normal recovery and postpartum. Learning all these things actually reduces anxiety during birth, allowing labor to progress normally. When labor progresses normally, there is less chance of needing medical interventions.

After taking a Childbirth Class, families report:

–Less anxiety and fear regarding their upcoming birth

–More confidence in their ability to give birth

–Dads report more confidence in their ability to support Mom

–Better communication with their caregivers

–Overall feelings of excitement and joyful anticipation of the birth of their baby.

Here’s an article that talks more about the benefits of taking a childbirth class, even when a mom is planning for an epidural:

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Rising Maternal Mortality in US related to increasing C-sections?

Here is a great link to a news story from ABC news about the rising maternal mortality rates following childbirth. There is clear indication the rising cesarean rate and rising induction rate may be related. Their message is clear, avoid elective inductions and cesareans unless clearly medically indicated!

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Should moms be allowed to eat/drink in labor?

There are differing opinions, depending on where you give birth, about the risks or benefits of eating and drinking during labor. Very traditional hospital settings restrict a mother’s oral intake to only ice chips once active labor is established. Some physicians allow clear fluids but no solids, while birth centers encourage a mother to eat if she feels she needs it, to keep her energy up and blood sugar stable.

A recent study indicates there are very few risks associated with allowing a mother to eat and drink as she wishes during labor. It makes sense her body will have the nutrients and calories needed to do the hard work of labor. If you are planning to give birth in a hospital, check with your doctor to find out their policy on eating and drinking during labor. With the right information and open communication, you and your caregiver will make a decision that’s right for you.