How to Screen Yourself for Postpartum Depression

May is Mental Health Month. As childbirth education advocates, Lamaze believes that mental health during and after pregnancy is critical to the health and safety of moms and their babies. If you are experiencing depression, anxiety, psychosis, or any other mental health issues, contact your care provider and seek support and resources from Postpartum Progress and Postpartum Support International. You don’t have to suffer alone — and you don’t have to suffer. There is support and treatment available for mental health disorders. Also know that you are not alone — it has been found that 1 in 7 women will experience postpartum depression, though that rate is thought to be higher for all postpartum disorders.

So how do you know if you are experiencing a postpartum disorder? Many moms downplay or dismiss their feelings, chalking them up to “hormones,” but it’s important to take notice and check in with yourself. A postpartum disorder is more than just a “bad day,” and even if you feel as though you are coping, a postpartum disorder ultimately affects your quality of life. If you feel as though something is “off” or if your partner expresses concern about your state of well-being, you can take a free, quick, confidential, online screening quiz to determine whether you may be suffering from postpartum depression.

The Edinburgh Postnatal Depression Scale (EDPS) was developed in 1987 to help doctors determine whether a mother may be suffering from postpartum depression. The scale has since been validated, and evidence from a number of research studies has confirmed the tool to be both reliable and sensitive in detecting depression. The EPDS Score is designed to assist — not replace — clinical judgment. If you feel you may be at risk or suffering from post natal depression, please share the results with your care provider.

Congratulations to Our Mother’s Day Giveaway Winner!

Congratulations to Rachel R. who won The First Years stroller and car seat combo set! Her answer to the question about attending childbirth classes was:

I am pregnant with my first, and do plan to attend a child birth class so I will have strategies for natural child birth.

We enjoyed reading through your responses about childbirth classes. As an organization who specializes in childbirth education, it’s very helpful to understand the why or why not when it comes to taking childbirth classes. We strive to find ways to reach women everywhere to help them become informed and make the best decisions about their maternity care.

What Women Are Saying About Birth and How it Can Help You

Listening to Mothers III Report Debuts with Feedback on Birth and Maternity Care from 2,500 Women Around the U.S.

 

Last week, Childbirth Connection released the third in a series of reports (the first and second were released in 2002 and 2006) entitled Listening to Mothers. The Listening to Mothers III report is devoted to understanding the experiences and perspectives of childbearing women as a means to improving maternity care policy, practice, education, and research. Results from the first two reports have been widely used to do exactly those things.

The other intention behind the report’s findings is to increase awareness among childbearing women of the issues in our maternity care system and motivate them to seek safe and effective care. Some people like to say, “What you don’t know, can’t hurt you,” but in the case of knowing about your maternity care, what you don’t know can impact the safety and health of you and your baby. When you know all of the choices available to you, you are empowered to make the best decisions for your family.

Below is a summary of some of the key findings (excerpted from the Childbirth Connection website). I encourage you to click through and read the full report. Earmark items that you want to learn more about. Highlight things that you want to mention to your care provider. Circle things to include in your own birth plan.

The use of prenatal ultrasound has increased, including a steep increase in use for an indication that is not supported by evidence. Between the second and third surveys, the proportion of women who had two or fewer ultrasounds decreased from 41% to 30%, while the proportion who had five or more ultrasounds increased from 23% to 34%. In the most recent survey, 68% of women reported that their caregiver used ultrasound near the end of pregnancy to estimate fetal weight, compared with 51% in Listening to Mothers II. Routine fetal weight estimation is not supported by evidence or clinical guidelines.

>>Learn more about common interventions used during birth.

Many women report experiencing pressure from a care provider to have a cesarean, labor induction, or an epidural. The percentage of women who experienced pressure to have a cesarean rose from 9% to 13% between the second and third surveys, while pressure to accept an epidural increased from 7% to 15% and pressure to induce labor increased from 11% to 15%. The proportion of women who attempted to self-induce labor increased from 22% to 29% during the same period, which may be related to pressure to accept medical induction and desire to avoid such intervention. (In Listening to Mothers II, one-third of women who attempted self-induction did so to avoid a medical induction.)

>>Learn about the importance of letting labor begin on its own.

Women’s interest in and access to VBAC is shifting. The data on vaginal birth after cesarean (VBAC) suggest a small increase between the second and third surveys in the proportion of women with a prior cesarean who were interested in the option of a VBAC, from 45% to 48%. The proportion of women with a prior cesarean who reported a lack of access to VBAC grew to 56% in the current survey from 42% a decade earlier. For those who did not have the option of a VBAC, the proportion reporting that their care provider or their hospital was unwilling declined appreciably between the last two surveys, however, the proportion of mothers denied access to a VBAC for a medical reason unrelated to their prior pregnancy more than doubled (20% to 45%) across the past two surveys.

>>Learn more about VBAC options.

Hospital support for exclusive breastfeeding is improving, although women’s intentions to and experiences with exclusive breastfeeding appear to be declining. Among women intending to exclusively breastfeed, there has been a marked decrease in the percentage of women who received free formula samples or offers at hospital discharge (from 80% to 66% to 49%) and whose babies received formula or water supplementation during the hospital stay (from 47% to 38% to 29%). Across the two most recent surveys there was an increase in newborns being primarily in their mothers’ arms in the first hour after birth, a practice that facilitates breastfeeding, from 34% to 47%. However, the percentage of women nearing the end of pregnancy who hoped to breastfeed decreased over the three surveys, from 67% to 61% to 54%, as did the proportion exclusively breastfeeding at one week (falling from 58% to 51% to 50%.)

>>Learn more about the importance of keeping baby with you after birth and establishing breastfeeding.

The First Years Stroller & Car Seat Giveaway for Mother’s Day

In celebration of Mother’s Day, we have a giveaway perfect for parents-to-be! Lamaze is thrilled to be able to give away a “Wisp” stroller and “Via” car seat system by The First Years — worth $249!

New from The First Years, a truly lightweight travel system that is fashionable and durable. European-styled frame rated for use to 50 pounds all at a very affordable price. The Wisp stroller features taller handle heights, front swivel lock and rear brakes, generous lower and upper storage, a removable child tray and an oversized canopy with a peek a boo window.

The new Via Infant Seat is new from the makers of the family of 5-Star Rated Car Seats. The Via offers the features that are standard on all The First Years car seats. For use from 5 to 35 pounds with the base, the Via features double wall construction for extra support. The patented one-hand easy-to-adjust five-point harness means you never need to rethread, ever, making it one of the easiest seats to use. The Via offers one of the deepest shells in the market and is side-impact tested to International standards. The patented Rebound Energy Management handle helps manage the energy in the event of a crash and the innovative comfort carry handle with oversized elbow padding makes it easier to carry. The exclusive Information frame handle, provides a secure spot for all that important contact information.

To enter to win, answer the following question in the comments below: Did you attend childbirth classes during your pregnancy? Why or why not? 

The deadline to enter is midnight on Mother’s Day, Sunday May 12. We’ll announce the winner next week here on the blog. Unfortunately, we are limited to shipping the stroller only to the continental United States. There will be only one winner. Winner will be notified directly by email as well as announced on the blog. Prize cannot be exchanged for cash value.

 

Good luck!

Welcome to May!

Happy May 1st, everyone! Here at Giving Birth with Confidence, there is a lot going on in May. First, and most obvious, is Mother’s Day. We’ll be sharing inspiring stories and short essays from mothers, along with a giveaway or two, on the blog this month.

May is also Mental Health Month, a topic that is near and dear to our hearts. We’ll be sharing mental health resources helpful for women and families experiencing mental health disorders during pregnancy and postpartum.

And last, but certainly not least, we’ve just received news that our Great Expectations blogger, Rebecca, gave birth to her baby boy yesterday! Mom and baby are both doing very well. We won’t receive Rebecca’s “40 weeks” installment this Friday, but we will get to read her birth story later this month. Congrats, Rebecca!

What Will You Do on Your Due Date?

In the last few weeks leading up to your due date, you’re probably feeling pregnant — very pregnant. You may be feeling more tired, more sore, and generally more uncomfortable. Or you may feel physically great! It’s an exciting and sometimes nerve-wracking time. You’re wondering when labor will begin, if those last few contractions were the start of “real” labor, or perhaps, you’re soaking up every last moment of your pregnancy, in no particular rush for baby to arrive. Either way, if you make it to your due date without going into labor, it’s a milestone to be celebrated.

While your due date is just an estimate — not an expiration date — you may feel disappointed when you’ve hit your due date with no sign of baby. Planning a celebration on your due date gives you something else (with a more definite time frame) to look forward to and enjoy.  Need some ideas? How about:

  • Pedicure — the foot rub will be heavenly!
  • Prenatal massage
  • Lunch/dinner date
  • A nap!
  • Shopping with a friend
  • Movie

Whatever you do on your due date, be sure to make it an official plan — put it on your calendar, invite your friend or spouse if they’re included. And if your celebratory due date event comes and goes, and you go past your due date, plan another celebration! Treat yourself, even in a small way, for each day you go past your due date. It helps you pass the time and it’s also well-deserved — growing a baby is hard work!

What will you do on your due date?

 

Last Chance to Register for “Getting the Most Out of Your Hospital Tour” Webinar

Tomorrow is the parents’ free webinar from Lamaze called “Getting the Most Out of Your Hospital Tour.” The presentation is on Wednesday, April 24 from 12:00 p.m. to 1:00 p.m. EST and will prepare you to:

  • Feel confident that you know what to do and where to go when the big moment arrives
  • Make sure the hospital you’ve chosen can meet your personal preferences
  • Sleuth out whether hospital practices reflect evidence-based practices for a safe and healthy delivery
Your presenter, Allison Walsh, IBCLC, LCCE, is a Lamaze Certified Childbirth Educator, Board Certified Lactation Consultant, mother of three and the Manager of Parent Education and Lactation Services at Beth Israel Hospital in New York City.

Register now
 for “Getting the Most Out of Your Hospital Tour.” 

Next Week: Getting the Most Out of Your Hospital Tour

Knowing how to spot good maternity care is the key to getting it, which is why Lamaze International is presenting a complimentary webcast next Wednesday, called “Getting the Most Out of Your Hospital Tour.” The free presentation, held on Wednesday, April 24 from 12:00 p.m. to 1:00 p.m. EST, will prepare you to:

  • Feel confident that you know what to do and where to go when the big moment arrives
  • Make sure the hospital you’ve chosen can meet your personal preferences
  • Sleuth out whether hospital practices reflect evidence-based practices for a safe and healthy delivery
Your presenter, Allison Walsh, IBCLC, LCCE, is a Lamaze Certified Childbirth Educator, Board Certified Lactation Consultant, mother of three and the Manager of Parent Education and Lactation Services at Beth Israel Hospital in New York City.

Register today
 for “Getting the Most Out of Your Hospital Tour.” 

Cesarean Awareness Month: Evidence-based, Practical Cesarean Resources

April is Cesarean Awareness Month. While it can be a life-saving procedure for mom and baby, a cesarean is often prescribed when vaginal birth is a safe and sound option. Be aware that you have options, that you have a right to ask questions, and a right to know your risks. Educating yourself about birth is your best and first defense against an unnecessary cesarean. 

Throughout the month, Giving Birth with Confidence will be posting cesarean resources for moms. We encourage you to comment with your experience as well as any questions. For more information be sure to check out the International Cesarean Awareness Network Blog.

Knowing what happens before, during, and after a cesarean birth is helpful for moms who are scheduled to have a cesarean, but also for any mom approaching birth. It’s common not to want to learn about something you so desperately want to avoid, but educating yourself about a cesarean — even just a little — will help prepare you for all possibilities in birth, which could help ease your fears about the process should you need one.

There are several resources on cesarean around the web. About.com/pregnancy, however, seems to have the most complete, succinct, and practical resources. The author of About.com’s pregnancy resources is Robin Weiss, a Lamaze Certified Childbirth Educator, a doula and doula trainer (DONA), a childbirth educator trainer, author of several maternal/child care books, and mom to eight children.

Moms who plan to have a vaginal birth, but want to know more about a cesarean, may want to read:

 

Moms who have a scheduled cesarean may want to read:

 

All expectant moms can benefit from reading the following:

Great Expectations: Heather @ 16 Weeks

I love those moments when progress comes. Suddenly my husband smells better, I actually have some cravings, and I can eat my own cooking. It feels like a miracle! My figure has more visibly changed. The midwife’s best guess at this point is a girl, which means that the arguments over names may commence. We are now entering the fun stage. And of course, I love to talk about it, with my mother, other relatives, my friends with kids, the women at work or church, or anyone who’s interested. I like to hear their stories and advice. How else am I going to find out the million and one little tips and tricks that have been discovered? I’d never figure it all out on my own. One fun surprise has been that there are three other women I know who are due within two weeks of me in either direction. It’s nice to get a note saying ‘do you ever get sick of being hungry? I feel like all I do is eat,’ and to know that neither of us is alone in the craziness.

In the middle of all this sharing, I’m also discovering some great ways to kill a good conversation. If you’d ever like to do the same, I’ve found the following choices most effective:

“Yeah, I know ACOG doesn’t recommend induction before 39 weeks.”

“I won’t say I’d never have an epidural, but I wouldn’t touch the Pitocin unless someone’s life absolutely depended on it. See, Pitocin
is a synthetic form of…”

“I think I’m going to use hypnosis.”

Or any sentence containing perineal massage, placental encapsulation, informed refusal, etc. It can be kind of lonely, to differ from the local “norm” in my opinions and choices. I don’t have much to say when the stories start, and I don’t see that changing much even after giving birth. No worries. I’m fine with where I am, who I’m with, and what I see. I know essentially the direction I am headed in, and while I can’t see all that’s coming, I know where I can turn when it does. As long as baby and I stay healthy, I don’t have many lasting reservations about anything between here and delivery.

I owe this feeling to a number of wonderful people I’ve met over the years. First is my Mom, for teaching me the value of nurturing and motherly love. I saw what she was giving as what made her beautiful, and I wanted to be the same. Families and motherhood are a God-given gift and a privilege, and one I am thankful she participated in. Now I have the chance, too!
Second: women who share their experiences. Growing up, when my mother and others would talk about pregnancy and birth, I listened, fascinated. Eventually I came to understand that there were possibilities beyond the typical hospital experience, masks, drapes, ice chips, needles, stirrups and all. Not that I found that image totally unappealing, initially. It was the price you paid for the
children you loved, and the leverage you held over them for the first couple of decades.
Third: women who serve other women. This next group I met when I signed up for a class on childbirth education and doula work offered at the community college when I lived in Salt Lake. Preston and I had just married, and decided to leave the option of a growing family open. It seemed like a good time to dive in and get prepared. I just had no idea how much I needed, what would be taught, and how it would change me. I loved everyone in the class. I loved the teachers, ‘the Kristies,’ as I called them to myself (I hope they don’t mind the mention or the nickname, but just so you know, they are two of the best). Through their wisdom and experience—Kristy Huber as a birth and postpartum doula, and Kristi Ridd-Young as a doula and midwife—I developed new perspective and a greater sense of identity. I’m sure this isn’t unusual for those they work with. They taught me how to be aware of myself, of how I and others might seek comfort, and to offer it according to another’s needs. Other valuable points: trust in the best, trust yourself, ask for the support you need, do your homework and make decisions beforehand, ask lots of questions, give everyone room to make their own choices, and sometimes all you need to offer to make a difference is a comforting hand or assuring word.

It took some stretching. I remember the struggle to write the first paper: listen to the birth story of a friend and discuss how her
rights were honored or ignored. Wait, rights? As in, you can say no, or I want something different? To a doctor or nurses face? I mean,
seriously? Most especially in that time, I realized how essential those home and community networks are for us, to have the help and support of other women as we try to find our way in that world, and into motherhood. If we want to be safest, healthiest, and best, we need each other.

Subsequently, my life has been enriched by reaching out and making new friends from the Utah Doula Association, various online groups, and even authors of books—Thank you, Penny, Henci, Ina May and company!  I hope someday to work as a doula or childbirth educator. I want to offer the gift that I found. Maybe even these public musings will be of help to someone else. Though, when it comes to my friends and others I talk to, I wonder often… If I am a woman just like all the women that I talk to, and this understanding has changed my life for the better, how far do I open my mouth now? I worry that in being too outspoken, one of us will leave the conversation feeling “judged,” or invalidated. I hate it when that happens. But if the other woman knew the statistics, and the other options, and how well her body is made to handle the challenges, would she make a different choice? I want her to have that chance. If not, that’s fine. She has her own needs and priorities, and the odds say that in the end we’ll both have healthy babies and can be good mothers who raise happy, long-lived children. But maybe she knows someone else who’ll be asking. And if I don’t say anything? It’s a hard balance to find. So I only make those comments when I’m talking about my experience. I give my favorite birth books as gifts. I share random things I learn on Facebook, just trying to spread the information—all of the things that I might have missed if other women hadn’t opened their mouths. I put my thoughts out there, just like right now, and then let be. Because I’m a part of this circle, too.