Health Care Advocact
About a week ago I (re) posted an article on the Facebook Page about a study out of England which states that ‘women need a full year to recover from pregnancy and childbirth’. There was also a response by a reader,
“That’s literally impossible for most moms in the U.S.”
Sadly, she’s right. America is probably the worst industrialized nation for new mamas, not providing any sort of paid maternity leave, routine in home support for new moms or adequate resources for self care. While I have always been a fierce proponent of the “Year to grow ’em, a year to recover” philosophy, I completely understand that in America, many women MUST get back to work as soon as possible to help support their families.
Unfortunately, Far too many times I’ve had mamas “up and at ’em” just days after giving birth, trying to tackle the responsibilities of running their homes, caring for their older children, back to work full time and starting right in on an exercise regimen in order to “get back to their pre-pregnancy” physique as soon as possible. Not long after, they call me; exhausted, achey, homes and families in chaos, they’re crying at work and with faltering milk supplies. They can’t understand what’s wrong? Some women have actually sustained injuries from trying to do exercise programs that are just too rigorous for the early post partum, and I can think of two clients that actually developed organ prolapses (internal organs coming out of bodily openings) from putting too much stress on their already weakened pelvic floors.
“But Sarah Jessica Parker looked fantastic 2 weeks post partum and I look like a blob!”
What mamas fail to realize is that Sarah Jessica Parker-and other celebrity moms-usually have nannies, housekeepers, personal trainers, chefs and a hoard of other helpers that help them not only manage their homes and their babies, but also are instrumental in helping them regain that “Hollywood glow”. Most of us are lucky if our mothers can come for even a week after we deliver! Sarah Jessica Parker said as much on “The View” after the birth of her son. She shared that she was required to be back on set and able to fit into her wardrobe, so she had private pilates sessions daily, a personal chef preparing special meals and a personal assistant just to handle her affairs! She had a nanny to care for the baby which allowed her to sleep, a housekeeper and a whole host of other staff at her disposal to handle everything else. So yes, she looked fabulous just weeks post partum.
But that isn’t reality.
Mamas, pregnancy and childbirth fundamentally change a woman’s body. Even women who look utterly fabulous after their childbearing years will still have “badges of honor” indicating that they have successfully been pregnant, labored and delivered children. For some women, there will be the very slightest of slack to her abdominal muscles (until she has a tummy tuck!). Others will have faint-or not so faint-stretch marks on the belly, breasts, hips and thighs. Some women will have c-section incision scars. And still others will have invisible badges; that little trickle of urine that escapes when she laughs, coughs or sneezes, hemorrhoids, and other “inconveniences.”But all of them had to allow their bodies to recover. I can’t think of one woman who has given birth of any sort and not said,
“I never had ______ until after I was pregnant and gave birth.”
It just goes with the territory. Most of the so called “badges” are minor, simply little reminders of our journey. However, if women engage in activity that is too vigorous too soon after delivery, even returning to work before their bodies have had a chance to recuperate from the marathon that was pregnancy, labor and delivery, what may have started out as a minor inconvenience can develop into a major problem requiring more time, therapy and sometimes surgical intervention to resolve. Truly it would have been far less traumatic to simply ease back into daily routines.
American culture does not make it easy for women to recuperate from childbearing. However, women themselves can take these 7 steps to ease back into their pre-pregnancy routines.
- No vigorous activity until at least 8 weeks post partum, but if post c-section, consider waiting until 12 weeks post partum to fully heal.
- Learn and do pelvic floor strengthening exercises.
- Rest as much as possible, and whenever you can, take a nap.
- Let major housekeeping go and even get help with the small stuff if possible.
- Say no to outside activities. You don’t need to chaperone, bake cookies or make calls for any event. Focus on you!
- Spend time at home with family. This is precious bonding time for you all.
- Reduce work hours as much as possible.
I realize that some of these suggestions will be easier to implement than others. This list is also not exhaustive, but just a starting point. It’s just imperative mamas that you take care of yourselves so that you can get back to your daily routines with full strength and joy. It’s also important to fully heal from this pregnancy, especially if are planning to have other pregnancies in the future. If you start back too soon, you may set yourself back several weeks or injure yourself making subsequent pregnancies more difficult.
I know that it’s been a long haul, especially if you’ve spent weeks to months on bed rest. But please, please, please take a little more time to heal. Don’t compare yourselves to other women, especially not celebrities. Your journey is your journey and its best to honor your inner time table as much as possible, allowing your body to heal and prepare for subsequent pregnancies or to simply chart new territory as a mom! Whatever you decide to do, do it with a healthy, strong body!
Do you have a tip for recovering after pregnancy you’d like to share? Do you have a question? Share your thoughts in the comments section below. Your words could be just the thing a mama needs to read today!
Pregnancy, while one of the most joyous times in a woman’s life, is also one of the most physically and physiologically stressful times. There is no doubt in anyone’s mind that pregnancy fundamentally changes a woman’s body; some women will gain as much as half of their pre-pregnancy weight during their pregnancies. Others will develop gestational diabetes, pregnancy induced hypertension or, in more severe cases peripartum cardiomyopathy (enlargement of the heart) or kidney failure. During pregnancy, the body increases its blood volume by 50 to better be able to nourish the growing fetus and maintain mama. Most women will “sail” through their pregnancies, labors and deliveries, have healthy children and will “live happily ever after”. Others won’t be so lucky and they or their children will perish from primarily preventable forms of heart disease.
Cardiovascular (heart) disease is a leading cause of death in the United States. A recent article published in Obstetrics and Gynecology reports that researchers in Illinois found that from 2000-2011, nearly 20% of all maternal deaths were heart related, Here is what they found:
- Most of the deaths occurred in the third trimester or within 6 weeks of the post partum period.
- Most of the heart related problems happened in women ages 30-39, while the most severe cases occurred in women over 40.
- Cardiomyopathy (enlarged heart)in pregnancy is a rare cardiac occurrence, is almost exclusively caused by pregnancy and occurs more often in young women, 20-29 years.
- Death from cardiomyopathy is more likely to happen in very young women, less than 20 years old.
- Black women have significantly higher rates of pregnancy related heart disease compared to White or Hispanic women.
- 28% of all of the deaths were potentially preventable.
Yes, you read that last bullet point correctly. Twenty eight percent of the cardiovascular deaths that occurred during or just after pregnancy in the Illinois report were potentially preventable deaths! So what should you, as a Mama on Bedrest do to protect her heart?
- Schedule and maintain your regular prenatal visits. Early detection and early action are the hallmarks of treatment success for any disease, but especially cardiovascular disease during pregnancy.
- Notify your health care provider immediately if you notice any heart palpitations, difficulty breathing, unusual swelling in the hands, feet, face, changes in urine output. Now this may be difficult as you are likely experiencing all of these symptoms as a result of your pregnancy. Suffice it to say that if you have an increase in any of the symptoms or if they suddenly occur where they didn’t previously exist, then consult your health care provider.
- INSIST ON FOLLOW UP AFTER YOU HAVE YOUR BABY!! One of the key points that came out of the points that came out of the Illinois study is that most of the heart disease related deaths occurred after 6 weeks post partum. Many women have their post partum follow up visits with their obstetricians and then don’t return for a year or unless there are other issues. If you had a problem, even a minor problem during your pregnancy, FOLLOW UP FOR UP TO A YEAR POST PARTUM. Many conditions will “flare” with the fluctuation of hormones during the post partum, i.e. get worse, so you want to be closely monitoring for symptoms.
It is imperative that mamas receive comprehensive care of cardiac problems and are fully treated to avoid-or at least mitigate-heart problems in the future. Thankfully not all mamas who have heart problems will die, but many will have life long problems as a result of incomplete care. Be sure to have ongoing follow up and let all subsequent providers know that you experienced heart problems while you were pregnant.
The authors also note that providers must do a better job of
- educating their patients about the signs and symptoms of cardiovascular disease
- referring patients immediately to specialists when problems occur
- continuing to monitor their patients’ conditions well into the post partum period, as long as a year post partum.
As this article clearly states, death from cardiovascular complications is very often preventable. Patients and physicians alike must be aware of the signs and symptoms of cardiovascular disease and both must have a low threshold for seeking evaluation; patients from their obstetricians, physicians from their specialists colleagues. Finally, it is imperative that women who developed cardiovascular symptoms during or just after pregnancy be evaluated for an extended time in the post partum, often up to one year post partum.
What is it like to have a pregnancy related heart problem? Hear a mamas story.
Have you experienced a heart problem during your pregnancy? Please share your story.
If you have more questions, email email@example.com
According to WalletHub.com “2016 Best and Worst Places to Have a Baby”. Wallethub.com is a virtual financial planning company that helps individuals track their spending and saving, help repair credit and help individuals protect their credit history including protecting identity. Wallethub.com tracks people and money and in their opinion, if you cannot afford to have a baby, you shouldn’t. When the parameters of delivery budget (cost to have a baby, cost of living and cost/availability of health insurance), overall health care ranking (maternal and infant mortality, rates of prematurity, availability of professionals such as midwives and pediatricians, etc.. ) and baby friendliness (i.e. parental leave, available childcare, support for new moms, etc..) were analyzed for the 50 states and the District of Columbia, Vermont ranked number 1 as best place to have a baby by wallethub.com.
It is important to plan for children as unintended pregnancies can cause huge financial strains on families and can have serious health implications for mothers and infants if pregnancies occur too close together. But there are other, equally important issues to consider before becoming pregnant; availability of and access to quality prenatal care, adequate food resources, housing, how will the mama/family fare without mama’s income, childcare and availability and accessibility of resources such as transportation that may pose potential roadblocks to a healthy pregnancy and birth.
The article in question alluded to the fact that if a couple cannot afford a child, they should not have a child. Well, I live in Texas where availability of and access to family planning information and resources is extremely and increasingly limited. So what is a couple to do? Perhaps they cannot afford a child but in Texas, there is not readily available contraception and virtually no access to abortion. Should people simply stop having sex? That won’t happen!
I agree, finances should factor into the decision of whether or not to have a child. The reality is that conception is happening regardless of financial status (or even couple status!!). In my opinion, the best states or more pointedly, the best places to have a baby (because there are little oases within what I will call “maternity deserts”, areas that are fairly void of any sort of maternity support or reproductive health care) are places with the following:
- obstetricians and midwives, and facilities that allow both to perform deliveries
- birthing facilities that use the least amount of intervention that is safely possible
- birthing facilities that allow fathers and doulas to be present to support mama during labor and delivery
- birthing facilities that allow mama to freely move during labor
- birthing facilities that believe in immediate skin to skin bonding between mother and baby (even before wiping off the vernix, provided there are no health complications in either mother or baby!)
- birthing facilities that promote breastfeeding and provide immediate and readily available lactation support to new mothers
These characteristics should define whether or not a provider, a hospital or birthing center, a city or town or a state is “best for mama and baby.” The worst state in which to have a baby according to Wallethub.com is Mississippi and yet I would bet that within that state there are a few hospitals or birthing centers that are supportive of childbearing women and offer quality care and support. In addition to financial considerations, prior to pregnancy (or at least prior to birth) mamas and their partners should research health care providers and the health care facilities available to them in their states, cities and communities. For sure some cities will have more resources than others, and some states will have more resources than others. But that doesn’t mean that having an uncomplicated, normal healthy birth is absolutely impossible. It just means that mamas will have to be savvy, do research about what is available and collect as many resources for themselves as possible.
Mamas, be careful what you read. The headline “Vermont is the best place to have a baby” is misleading alone, may have had many mamas ready to relocate and truly doesn’t give mamas and their families tools and tips to evaluate birthing resources and facilities in their area that may in fact be “Mama and Baby Friendly”. I believe that every woman can have a healthy, uncomplicated pregnancy and birth a healthy full term normal weight infant. This is much easier to do in some areas where resources are more readily available than in others, but it is possible none the less. Use the aforementioned list as a guide to evaluating resources and with a bit of research, you too can make your pregnancy, labor and delivery mama and baby friendly-no matter where you live in the United States!
Mamas on Bedrest & Beyond is committed to helping mamas have safe, healthy pregnancies, labors & deliveries and healthy full term babies. If you need help finding resources in your area, e-mail firstname.lastname@example.org.