Archive for the ‘Pregnancy’ Category

In my work as a perinatal psychotherapist, I have had the honor of hearing many women’s oral histories about their childbirth. I often see women who have nearly died in childbirth, usually due to hemorrhaging.  

DBT for Managing Emotions for New Moms 

Taking care of a newborn is all encompassing. It is exhausting. And it’s natural to want to give our all to our baby.

How can a new mom maintain emotional balance?  It would be insulting to give a simple answer to this complicated and nuanced question. 

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In May of 2018, the American College of Obstetricians and Gynecologists (ACOG) expanded the definition of postpartum care of mom and baby and embraced the inclusive concept of the “fourth trimester.”   For decades, American mom-baby advocacy groups have used the fourth trimester as a way to conceptualize newborn care in the first three months.  And now ACOG validates and identifies this conceptualization of the fourth trimester as a sensitive period of development for both mom and baby.

Since the 1950’s, the mom-baby advocacy groups, such as La Leche League, conceptualized newborn parenting in the fourth trimester as informed by the human evolutionary scale. They normalize baby’s crying by framing it as a signal to be picked up and comforted by his or her caregivers. La Leche League says that it’s normal to provide comfort for a newborn baby by way of nursing, carrying and co-sleeping. All these behaviors imitate the womb environment of warmth, movement and lots of touch. La Leche League normalizes that a baby’s crying is his or her way of communicating with and connecting with their loved ones, and is not a form of manipulation. La Leche League says “It’s normal to ‘Pick the baby up!’ ” Using the construct of the fourth trimester, La Leche League is a positive community intervention for education about and parenting the newborn.

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Postpartum Depression, Shame and Stigma

Clara just had a baby. But she was not feeling very…well, happy. Yes, she felt overpowering love for her new baby. But she also felt irritable, depressed, nauseous and she was crying alot.  Even worse, she started having nightmares. Scary nightmares that she dared not talk to anyone else about. They were, well, just plain disturbing. They centered around things that she imagined could just happen to her baby that were outside of her control.  She was trying to hide behind a veil of smiles and perky laughter.

Clara felt very scared  and very, very, ashamed of herself. She wondered why she wasn’t happy. She didn’t want to admit she was  depressed. After all, she couldn’t possibly have a mental illness! Weren’t people who are depressed kind of crazy and lazy? What couldn’t she talk herself out of this?

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5 MindBody Ways to Care for Mental Health During Pregnancy

Be mindful of your mental health during pregnancy.  For many women, pregnancy is the most joyous times of their lives, but for some women it can be a time of increased anxiety and depression. If you have certain risk factors, such as a personal or family history of trauma, depression, anxiety or bipolar disease, you have an increased chance of  becoming depressed, anxious or having a manic episode in your perinatal time.

Stress during and after pregnancy increases the likelihood of depression or anxiety.  Mindfully taking care of yourself is just as important as your doctor visits and decorating the nursery!

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Last week, we discussed the story of Betty’s traumatic birth here. This week,  we’ll discuss Betty’s healing plan from a traumatic birth. Betty ‘s husband helped her find a therapist who specialized in trauma and perinatal mood disorders by using Google and looking through Psychology Today profiles.  Betty was fortunate in that she had babysitting assistance from her mother and mother-in-law. Betty also was able to take extend time off from work, as she had been steadily employed at the same company for many years, her work was well respected and she had an understanding supervisor. Not all woman have these options. Betty knew this and she was grateful for the foundation that she had in place.

Betty approached her first visit with her therapist with trepidation. Betty was cautious. Like many trauma survivors, she didn’t want to endlessly talk about her trauma, because, somehow, talking about the incident felt like it might be re-traumatizing to her.  But she was feeling bad and she was curious about the new trauma treatments called Somatic Experiencing® (SE) and EMDR.  She had researched EMDR and found there was 30 years of research supporting its efficacy, so she was hopeful.

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Part One: Recovering from birth trauma

Betty was feeling very down, anxious and disconnected. She had given birth to her third child just twelve weeks ago! Her new baby was a joy. He was beautiful and perfect. And so much work as well!  Betty had never missed sleep so much in her life! He was her second baby, her first son. She thought she should feel very happy.  But she just felt empty. There was so much work to do, so much laundry and so much responsibility!  She was crying often and felt distant from her family: her baby,  her other child  and her husband.

She felt happiness sometimes, but often felt removed from her life, like she was standing outside her body.  Her husband researched some therapists she could try to see close to her home. At the urging of her husband and her mother, she called three and settled on someone who was trained in perinatal mood disorders and trauma therapies.

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Good question – how much stress in pregnancy is too much?

Like many things in life, the question of how stress affects a woman’s pregnancy does not have a simple answer. Because each individual has her own emotional and physical tolerance for stress, exactly how much stress is a causative factor for depression and anxiety is not known.

Plus, there are different types of stress. There is chronic stress, major negative life events and everyday stress.

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Ivy Shih Leung, postpartum depression author, activist and award winning blogger,  interviewed me for her blog. She is a passionate, outspoken advocate for women, families and social justice.

Some background about Ivy from her blog:  Ivy is  a PPD survivor.  She had her daughter in December 2004 and suffered from PPD about 6 weeks later.  Fortunately, with the help of Paxil which she started taking in February 2005, her frightening experience came to an end 4 weeks later.   Tom Cruise’s infamous rantings “There’s no such thing as a chemical imbalance” triggered an intense reaction and an overwhelming desire to tell him, and others like him, to “Shut up unless you’ve been through PPD yourself.”

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Perinatal mood disorders are the most common complication of childbirth. 15 – 20 % of women experience symptoms of depression and anxiety during pregnancy and in the first year after giving birth. Postpartum depression is the most common term used, but there are a few differential diagnoses that can be found in the perinatal mood distress category. Postpartum depression (PPD), postpartum anxiety (PPA), postpartum obsessive-compulsive disorder (OCD), bipolar disorders, postpartum psychosis and postpartum birth trauma. You can find out more about these categories at the BirthTouch® website or at Postpartum Support International.

Screening

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