New Website for Beyond Postpartum!!!

Hey y'all I am thrilled to announce that you can now find this blog, Beyond Postpartum at http://www.beyondpostpartumblog.com/.  I hope that this address will be easier to remember and therefore easier for you all to successfully share with others who you might discover through conversation would find it helpful.  Not to worry...you'll still be able to get here via the old blogspot address, as well.

A few of my Fave Summer Posts on Parenthood

From "A Savvy Mom":

Why must we try to raise other people's kids on the internet?

From Babycenter:
7 Reasons mom needs a night off

From Babble:

Some reassuring news that we are going to screw up our kids no matter what we do

and
Could a Mom Have Written Go the ____ to Sleep?

From "Pick the Brain":
10 Surprising Findings on Happiness
And, just because I love my phone:

An iphone baby monitor with unlimited range

Preparing for a positive postpartum experience after surviving a PMAD, Part Two

In Part One, I offered the background for how I came to an unexpected decision to have another child after surviving a devastating perinatal mood and anxiety disorder.  Today, in Part Two, I am going to offer a more practical perspective.  I will share with you the list that was written on that tattered sheet of paper nearly a year ago and also provide some insight into why those items made "The List" and offer some helpful tips or links so that you can learn more about the topics.  Some of what I share will be globally helpful and other resources may pertain more to what is available here in Atlanta, but I trust you will be able to research what might be more applicable to you in your part of the world if and when the time comes for you to prepare.  I also want to mention that these tips might be helpful for women who are at high risk for a perinatal mood or anxiety disorder, even if they are considering pregnancy or adoption for the first time or have not had PPD with previous children (i.e. those who have not suffered in the past).

SLEEP:

• Share feedings with your partner.
• Contract with a baby nurse several times per week in order to get eight hours of continuous sleep regularly.
• Have your partner be in charge of any older children during the night hours.

HOME ENVIRONMENT:

• Create a "sanctuary" in a room that is quiet and dark (or whatever is calming and restful for you).
• If possible, have two bedroom options for yourself.  One that is away from your spouse and any older children and one that can be shared with your spouse on nights when you have respite or want to spend part of the night together.

FOOD:

• Consider buying a second freezer.  Stock up on prepared frozen meals either from a store or by cooking and freezing meals that can serve many people before you give birth.
• Ask a close friend or family member to invite people to sign-up to bring you meals during the first 4-6 weeks after you give birth.  Choose times when you won't already have help cooking at home.
• Put together snacks for yourself ahead of time so that you can easily grab something healthy to eat while feeding the baby or in between meals.  This is one of the things my postpartum doula did for me that helped to keep my energy up and kept me well-nourished.

SUPPORT:

• Schedule childcare for older children and/or the baby in advance.  Try to get as many volunteers from your circle of friends, faith community or family members and then fill in with a paid babysitter when and if necessary.
• Consider hiring a postpartum doula so that you have an ally and resource with expertise and experience available to you during those precious, yet fragile, first weeks at home.
• Consider your older child's needs, if applicable, when thinking about school once the baby arrives for him/her.  Does your high energy child need more stimulation and physical exertion than you or others in your household can provide?  Or, will he/she be more clingy and need to spend more time with you, your partner and the baby once it arrives?
• Be clear that any visitors (both long-term and for short visits) should plan to be there to help, not just visit with you and hold your baby.  It is much too draining for a new mom to "host" company when she is recovering from childbirth and sleep-deprived.  It's also not great for bonding when a plethora of others hold your baby during the first couple of weeks of life.  Consider creating a to-do list of things that visitors can do that will be helpful to you while they are in your home.
• Talk with your partner about how they can help and support you.  Read "What Am I Thinking?" together.  Create a list of things your partner should (or shouldn't say) to help you.

MENTAL HEALTH:

• Continue (or begin) seeing a therapist who specializes in PMADs regularly before and during pregnancy so that you can make your personalized plan together and he/she has background knowledge and a barometer of your mental health in order to compare if any changes in your mood occur.
• If you have a network of PPD survivors or experts with whom you interact, share your plans to get pregnant or the news that you are expecting with them so that they can offer support and insights with you.
• If your therapist is not your psychiatrist, continue or begin seeing one regularly before or during pregnancy so that if you plan for medication (or in case you find that you need it at some point) during or after pregnancy you have already established a relationship with him/her.  Or, find a treatment program and research it in case you find you want/need to participate.
• If you were medicated during pregnancy or postpartum the last time you suffered, but have since gone off meds, discuss with your doctor the appropriate plan for pregnancy or postpartum this time.  Good doctors will evaluate your risk for relapse and help you to determine whether going on medication prophylactically or taking a "wait and see" approach is best for you.
• Participate in a support group during pregnancy so that you are comfortable with the group and they know your background before you give birth.
• Make several copies of the EPDS (a screening tool used for PMADs) so that you can take it a few times during pregnancy and each week postpartum to evaluate your mood and have tangible information for comparison purposes.

PHYSICAL HEALTH:

• Make a plan for your physical recovery from childbirth.  If you are having a vaginal birth (or expect to) consider how you will help yourself to heal and rest after labor and delivery.  If you are having a scheduled c-section (or are at risk for an unexpected Cesarean), plan for a longer recovery period and research methods and resources that will help you to heal faster.  Since I decided to have a scheduled "natural" and family-centered Cesarean with #2, I purchased a special belt that was one of the best choices I made regarding postpartum health.  It allowed me to be much more physically active and experience less pain postpartum this time.
• Plan to be screened for conditions that could mimic or exacerbate perinatal mood disorders such as thyroid disease, anemia, a vitamin D deficiency, etc.
• Once you are able to and your doctor clears you to, plan to exercise.  The exertion can actually energize you and provide you anxiety and stress relief.  The endorphins are also excellent for women who have mood issues.
• Consider planning ahead to do things that could potentially help your physical healing and mental health such as acupuncture, placenta encapsulation, massage therapy, cranio-sacral therapy, chiropractic, etc.

RISK FACTORS:

• Review the list of risk factors for PMADs.  Consider how you might address them ahead of time so that you can feel they will have the least impact on your mental health.
• If you had a difficult or traumatic childbirth or recovery, breastfeeding experience, or other complication previously, consider being proactive so that you can feel well-armed with information and experience this time.  This might involve taking a "class" or hiring someone such as a doula or lactation consultant who is an expert in the field so that you are well-supported.

The above bulleted points outline my personal plan shared in a way that could be applied to anyone in a similar situation or with a similar history.  It is not an exhaustive list, nor are any of the items a "prescription", nor does doing each and every thing on the list guarantee you a positive experience.  However, I have found that considering these factors and resources, as well as putting much effort into planning ahead allows you to be more prepared and aware in order to take the shock factor out of the picture.  Please take only your health care provider's advice  into greatest consideration when preparing for your personal and individual experience.  Together you will know best.

Best wishes,



* In full disclosure, I have not received any compensation for writing this content and I have no material connection to the brands, topics and/or products that are mentioned herein.  The links provided are simply resources that I personally have found helpful.

Preparing for a positive postpartum experience after surviving a PMAD, Part One

It took so very long for me to get okay with even the idea of having another child after our first postpartum experience that I truly believed I would just never get "there".  And then?  I started having moments of more than just wanting for my son to have a sibling, but rather yearning occasionally for another child myself.  First it was finding that "cute" maternity store and thinking about how I actually enjoyed the simplicity of dressing and accessorizing myself while pregnant because of the limited choices in my closet.  Then it was the walking past the newborn section at Target and seeing the baby clothes and gear and finding them interesting rather than nauseating.  Then it was admitting to my husband that I was having those thoughts and feelings.  Next, I shared it with some friends who knew me really well and had walked the journey with me the first time.  This was important to me because when I wasn't well my lens was foggy and out of focus.  But, they were there and theirs was clear.  I needed them to tell me the truth.  Do you think I can do this again?  Do you think I can prevent getting so sick this time?  And, the most important question..."WILL YOU WALK THIS JOURNEY WITH ME IF I DO GET SICK AGAIN?"  I needed to know that those people who held me, literally and figuratively, would do so again if needed.  I couldn't have done it without them then and I knew I wouldn't be able to another time, either.

Clearly you know the answer to the above questions, so we'll fast forward a bit...
Several months later I talked with my OBGYN about my concerns and while he wasn't an expert (and still isn't, though I have to give him huge credit for all he has done to better educate himself and care for his patients recently by reading what I share with him and making the EPDS standard practice in his office now), he assured me that he, too, would walk the journey with me and do all he could to support me and help me make choices that would assist the process.  He also promised to consider my preferences as they related to pregnancy, childbirth and the postpartum period, no matter how unusual, alternative or unorthodox they were.

And then we moved forward.  I had my IUD removed.  And I was scared.  Not in the "Holy crap, put that thing back in RIGHT NOW" way, but in the "Wow!  This is a really important and life-changing decision" way.  And, then, and now, I believe this is a healthy way to feel.

Four months later, after taking a yoga class on one of M's rare days off, I realized I was feeling a bit unusual.  Since I had two tests already in the medicine cabinet I figured I would take one just to rule that out.  Sure, it hadn't happened that quickly this time.  M lay on the bed, dozing off, while I sneaked into the bathroom just a few feet away from him to secretly pee on a stick.  I couldn't believe my eyes when the words "pregnant" appeared.  It wasn't a faint line, it wasn't a questionable plus sign, but the word, in bold pink letters, staring right back at me.  I capped the test, stomped out into the bedroom and placed it so close to M's face that he couldn't even read it.  But, he knew.  "Really?", he asked.  "Are you sure?", he said.  The exact. same. response. he had had almost four years prior.  He never seems to believe I am pregnant until we have an ultrasound, but that's a story for another day.

And, there you have it.  The story of how we decided to have another baby and how God blessed us with a quick conception.  That, my friends, was the easy part.  The rest?  Well, it's a blessing, too...but a lot more complicated.

The following month, now October 2010, I was in Pittsburgh, eleven weeks pregnant, at the Postpartum Support International/Marce Society Conference.  The first day I attended was to participate in the PSI training so that I would have the same training and accurate information as all my other colleagues who had received this training.  As I sat in the conference room of the hotel, during several of our 30 minute breaks, I made a list on a tattered piece of legal pad paper.  That list I carried with me for my entire pregnancy.  When I got home from the hospital with little four day old L2, I sat it on the coffee table and read and re-read it.  Then, a few weeks ago, I organized my office area and filing system and put it in a folder marked "L2".  This morning, I flipped through the hundred or so pieces of paper in that folder that contains dozens of hospital bills, hearing test results, information about newborn care, etc. and found that one precious sheet.  Now, it sits right in front of me, preparing to serve me, probably for the last time, as I share its contents with you.

Because this post is already so long, I have decided to make it a two-part series.  Consider this the background or "Foreward" to the more important chapter.

Thanks to Grace you are reading this post, as I have been wanting to write it for so long, but simply couldn't find the time or energy.  Knowing that she is preparing for her precious baby boy #2 gave me the motivation.

The Foggy and Out of Focus Lens of PPD

When I think back to how I felt postpartum after having my first son lots of adjectives come to mind, though it is hard to articulate exactly how it feels to someone who has not experienced it.  One of the ways I often describe it is being in a "fog" or being deep in a dark and dangerous place with no sense of direction and no idea how far from safety you are.  In fact, the image I chose for the header of Beyond Postpartum was carefully selected to show how I had finally emerged from a place I liken to a huge, dark and desolate location, like being lost among tall, towering trees that seemed to go on forever.  If you look at that image you'll see that the sun at the edge of the forest does indeed exist and that once you emerge from the darkness the path becomes clear and light.

PPD creates all kinds of distorted and scary perspectives.  When you think about and look at your life while suffering from a perinatal mood disorder you see things very differently than you would well.  It's not like having had a few margaritas or taking a pain pill.  When under the influence of a substance you realize that your thinking must be skewed because of that and that it will be a very temporary experience.  Just the opposite occurs when you have postpartum depression.  You don't (and can't) realize that your lens has been twisted out of focus, scratched and fogged up.  You think that what you are seeing and feeling is very real and accurate.  You might see your spouse as a totally different person than the one you married and think that he must have changed overnight.  You might look in the mirror and think that surely aliens have abducted the "real" you and that she's permanently gone into outer space.  You might consider your parenting and see an inept mother, yet observe the women at your playgroup and think they are all Mother Theresa.

I am here to tell you that you are wrong.  If you are seeking treatment and support for your PPD, working hard to get better, reaching out for resources, even just reading this blog, then those things ARE NOT true.  You are not a bad mom.  The other women are not Mother Theresa.  Aliens have not abducted the real you.  You are just temporarily ill.  You can and will get better.  And when you do your current lens will be replaced with a more clear and rosy one.  One that will allow you to look at your life and smile.

Blessings,

We are not invincible.

How many of you are perfectionists?  Raise your hands.  Yeah, me, too.  It's part of the deal.  We want to do everything for everyone.  ALL. THE. TIME.  And?  We want to do it "perfectly", as if there is such a thing, anyway.

Having PPD the first time taught me a lot of things.  I have talked about many of them right here on this blog.  About patience, about understanding, about sympathy, about resilience.  All of those things and so much more.  I'm not typically a rosy-glasses or glass half-full person, but in hindsight I choose to think about my perinatal mood disorder in a positive light.

This time around I've also learned a lot of things.  Some of the lessons I am learning again.  But, some, one in particular, I am learning for the first time.  This time, I learned that I am not invincible.  That no matter how much I planned, orchestrated, took charge and willed myself not to get sick, I still did.  Just 47 hours into being a mom of two the stack of cards collapsed.

Like addictive substances or substance abuse, whichever way you think of it, I believe that PPD is a project or product of the devil.  Maybe not in the red-horned kind of way, or even in the ruler of Hell kind of way, but in the most evil and heinous way.  It steals mothers of enjoying the miracle that pregnancy and childbirth are.  I can think of no more incredible and amazing process and outcome than conception through infancy.  (Okay, well cell phones and space shuttles do, kind of amaze me, but still.)  Seriously, though, even now when I read a children's book about pregnancy to L1, I am just as in awe as he is that a mommy and daddy come together to make a baby and that it works!  Just like his little book says, the puzzle pieces fit exactly together to create a completely and entirely new and separate human being!  The fact that for some women the positive emotions around that are not allowed to emerge and be enjoyed and experienced because of perinatal mood disorders is beyond devastating.

Yet, devil or not, there is so much good that I believe has come from these experiences for me.  Even though I wasn't invincible, I was prepared.  I was armed with knowledge, resources and support.  I knew exactly who to contact when and had all of the safety nets in place.  And, on top of all of that, I was open with my family of faith so that they could pray for and with me and offer a type of healing that no one else could.  And, thanks to all of that, after a scary but brief early onset of postpartum anxiety, just two or three weeks later I was at the pool with friends having a Memorial Day picnic and watching L1 splash around with his friend while L2 slept happily beside me.  All with a smile on my face.

So, no, there is no perfect.  There is no invulnerability in perfectionism or preparation.  There is, however, loads of strength and absolutely indestructible power in joining forces with others who understand and being proactive about treatment.  Each day I look in the mirror now I see a woman I recognize.  She's the one I have seen for most of my 35 years.  I celebrate that this time I am not a stranger to those I love or to myself, no matter how imperfect I am.

This Sums It Up!

I am so grateful and blessed.  This experience has been amazing.  What an absolute miracle to actually be enjoying enjoying (not a typo) my baby.

Have hope, Survivor Mamas who are considering another, what seems impossible is indeed very attainable.