Archive | February 2013

Me and PPD (Postpartum Depression)

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My daughter and I during Thanksgiving at 13 months postpartum, loving life!

 

When I was a kid I had severe anxiety and some insomnia off and on until the end of high school. I never knew that it was a type of depression until I was in college and I was reading about the different types. Nobody knew about any of it except my parents who I once disclosed my horrifying fears to, but they had no idea what was going on. My dad replied that if it kept happening that they would take me to a priest, so that shows how much knowledge they had about anxiety and depression in children. Sometimes my fears and anxiety would be paralyzing at night and I would lie awake practically until morning. My mom took me to talk to the school counselor in grade school and he talked about how I could imagine that noises I heard at night were just the cat outside or the wind or whatever, but I only saw him that one time and he didn’t help me. My mom doesn’t even remember any of this when I talk about it now, except for the fact that I could never spend the night at any of my friend’s houses as a kid, and if I did I would never sleep.

So when I became pregnant for the first time I knew I was at risk for PPD. My anxiety started up again toward the end of my pregnancy and I recognized the same fears and emotions I had as a child. The worst of it was after I delivered my daughter, it was very scary at night, so scary that I can’t disclose my thoughts or feelings that were happening to anyone except the therapists and support group that I was seeing. To this day my husband doesn’t believe that I even had PPD, and I think it is because I act so normal on the outside while I deal with everything on the inside alone, just like I had done as a kid. I never took medication for it because the worst of it ended after about the first month or so, but I wasn’t completely normal again until about nine months after I had delivered my daughter. I don’t trust those meds and all of the scary side-effects they can have. In the end PPD became my number one fear, really my only fear, about having children.

Right now I am researching ways to prevent PPD. Getting a lot of sleep, encapsulating my placenta, and keeping my diet healthy are what I plan on doing. I also need to get in touch with a good therapist and support group which helped me so greatly before. Even joining a mother’s group or breastfeeding group will help so much. I was a part of a breastfeeding group led by a wonderful RN when I was living in the bay area. She had also experienced PPD and we were able to talk and share thoughts and fears, which helped me so much. You just want to know that you are not going crazy and that you are not alone and what you are going through is normal for many mothers, at least that is what I needed.

I have had some down days and some mild anxiety up to this point, but I am worried that it will get worse. However I do not expect it to be as bad as it was the first time. I have a lot more good things going for me now: I no longer live with my intrusive mother in law, and I live just minutes away from my family instead of hours. I wish my husband could understand this about me, but it’s difficult for him for some reason. I am praying that the placenta capsules will do wonders for me, and I plan on writing a post about the benefits the capsules have for mothers and their babies. Meanwhile I am doing well, I have emotional days, but overall I am very happy and loving my life and I feel extremely blessed by what the universe and what God has given me.

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My Birth Plan

Hello to the staff at Sutter Memorial Birthing Center!

We are the S family expecting our second baby girl who we are naming Vera. We are very excited that you will be helping and sharing her birth with us. Please let us help you to get to know us better by reading our wishes for this birth which we have summed up for you here. We are planning an unmedicated vaginal birth, our second one! We know that, with your help and the absence of complications, that this will be an amazing natural birth. We believe that flexibility and having an open mind for all our parts is key. We would like to ask to be attended by staff who are best capable at and who are the most excited about helping with an unmedicated birth. We look forward to getting your support and your advice throughout our experience. Our birth team consists of myself, my husband, our doula Teresa and my sister Kristalle.

Labor

I am happy to move around and change positions for more comfort and to speed up labor.

I would like the room to remain dim with no bright lights during labor and after delivery.

I would like to sip water or coconut water throughout labor to prevent dehydration.

In the absence of complications I would like minimal interventions such as pain medication, vaginal exams, internal monitoring and IV.

Please help me by not asking if I want pain medications since I or one of my birth team members will let you know if I change my mind. If interventions become necessary, please allow us time to review all the risks and benefits with you.

I would like to forgo continuous monitoring unless it becomes necessary.

Episiotomy

I would prefer not to have an episiotomy unless it is absolutely necessary to hasten Vera’s delivery.

Delivery

Please help me to try a variety of positions including the squatting bar.

I would like to push only when I feel the urge and would like direction in my low grunting and vocal noises.

If possible my husband would like to help deliver or catch Vera.

After Delivery

I want my daughter placed on my stomach/chest immediately after delivery to allow us to bond.

We do not want the umbilical cord to be cut until it has stopped pulsating and until Vera has received all of the blood from the placenta. My husband would like to cut the cord when the time comes.

Please delay all noncritical measures: We would like all non-emergency routines to be postponed from being administered to Vera until at least 1 to 2 hours after her birth so we can immediately bond with her and begin breastfeeding.

We do not want Vera to receive the Vitamin K Shot/injection

We do not want Vera to receive Erythromycin eye ointment

If my daughter must be taken from me to receive medical treatment, my husband will accompany her at all times.

We want to request a private room whenever one is available.

Please do not announce our daughter’s birth to family members who may be waiting outside, we will let them know after Vera has breastfed.

Placenta

We want to keep the placenta, please do not discard it

We prefer to allow the placenta to be delivered without assistance, pulling, or medication.

We plan on encapsulating the placenta and have brought a cooler filled with ice for the placenta to remain in until transfer by us.

Breastfeeding

I would like to avoid all artificial nipples including pacifiers and bottles.

If Vera and I have any trouble with breastfeeding I welcome your guidance and support to help us along with our latching and with any other problems we may have.

This will be my second time breastfeeding a newborn and I plan to nurse on demand and exclusively.

In case of Cesarean

I would like my husband present at all times, as well as my doula if the anesthesiologist allows it.

As long as we are both stable, please facilitate a minimal separation between Vera and I so I can breastfeed and bond as soon as possible.

Thank You

We would like to thank you ahead of time for your help and participation in our unmedicated birth of our baby girl Vera! We understand that in the event of an emergency flexibility is required, and we will discuss necessary changes to our birth plan with the hospital staff and medical team. Thank you for helping us make the birth of baby Vera unique and special.

How to Make a Successful Birth Plan

Midwife and Jessica Breese, a Certified Nurse ...

Midwife and Jessica Breese, a Certified Nurse Midwife from Colorado, pose with new mother Amy and her son Austin. (Photo credit: Wikipedia)

What is a Birth Plan?

  • A Birth plan is a form of written communication that expresses needs and desires for the birth you want to achieve.
  • A Birth Plan can help to build relationships that are positive between people on your birth team.
  • Demonstrated knowledge and preparedness.
  • Reflects a welcoming attitude, uses language that anticipated good outcomes and cooperation toward your goals.

What a Birth Plan IS NOT:

  • A directive. A birth plan should never use demanding or authoritative language.
  • Inflexible. A birth plan should always have room for flexibility so that it will be adaptable in various unforeseen cases or situations that may arise during labor and birth.
  • Controlling: A birth plan should not be an attempt to control outcomes instead of using communication and knowledge. The benefits and risks must be willingly discussed and taking into account. Parents must be knowledgeable and able to have these discussions in order to make the best decisions based onĀ  informed consent.

How to Begin a Birth Plan

  • Research Birth Plans online and find a worksheet if possible.
  • Make sure you read every page and that you highlight the things you do not understand.
  • Research the answers to the best of your ability.
  • Go over your birth plan with your midwife or doctor, your doula, your partner and whoever else will be with you at your birth.

Before you create your birth plan it is a good idea to take a tour of the place you will be giving birth and to discuss to great extent what will be allowed and what will not be with your doctor or midwife and place of birth. This will help to shorten your birth plan and make it less redundant for those who will be helping you during labor and birth. For example, if you are delivering at a hospital, you may want to ask if it is possible to move around and try different positions. If the answer is yes and you are able to move freely, you may want to put less detail about which birthing positions you are going to do.

One of the most important questions you should ask is whether or not your doctor, midwife or place of birth will put a limit on how long they will let labor continue before they will intervene. This also brings up the question of how long you will want to labor at home. Some women will want to wait as long as possible before they leave home, while others will want to go to the hospital or birthing center as soon as possible. Finding out how soon your place of birth will admit you will also be important.

After labor and delivery are over, you may have plans for what you would like to happen afterwards which you should also put into your Birth Plan. For example, if you want immediate skin to skin contact with your baby after birth, write it down in your Birth Plan. If you want to keep your placenta for later use you should also put this in your birth plan. A Birth Plan can also be made if you are scheduling a C Section and is especially important for expressing how you want your baby to be cared for after delivery.

Adapted by Cheriena Serganin from the worksheet “Birth Plan Counseling” from the DONA Certification Workshop by Debbie Levin.