Research

Mamas on Bedrest: What’s Dad Got to do With it?

June 18th, 2017

In the birthing world, dad’s often take a very distant third place behind the baby and the mama (and usually in that order!). Many men have told me that they want to support their partners, but are unsure how, and feel left in the dark when its time to make major decisions.  My own experience having my daughter was a prime example. When my daughter was first delivered by c-section, she was having difficulty breathing so they whisked her over to the warming table to clear her airway and check her out. Meanwhile, my uterus would not contract as it should have and I began bleeding. As my obstetrician went to work on me and the neonatal team was working on my daughter, my daughter’s father was standing in the middle of the floor clueless as to what was happening. He says of that day,

“I didn’t know if I was going to come home with one of you, both of you or neither of you!”

Health care providers often neglect to acknowledge and include fathers in the perinatal process. While this oversight is almost always unintentional, health care providers and other birth workers often explain their actions with,

“I’m so focused on the well being of mama and baby, I kind of forget about the needs of the dad.”

This is a horrible oversight on the part of the medical team, and a terrible omission of a very valuable resource.

When a woman is pregnant, and even more notably when she is in labor, she’s very vulnerable. She can’t function at her normal level due to the physical changes going on in her own body, and as her body is developing the fetus. She needs her partner more than ever to help with very practical activities around the house as well as for emotional support. In my time as a doula, as much as I love supporting the women I serve, a wonderfully supportive partner almost always trumps what I can offer a mom. The bond that the couple shares having created the baby is now heightened as that baby makes its way into the world. Whether he is quietly whispering encouragement in her ear, massaging her back during contractions or literally holding her up as she labors dads’ strength and very presence are often the most soothing balm for a laboring mama.

And dads’ presences are critical to the growth and development of their children. Not only do dads give infants a sense of safety and security, as children develop, dads’ influence contributes to a lower rate of behavior problems, delinquency, depression, substance abuse and overall psychological adjustment.(1) Additionally,

“Knowing that kids feel loved by their father is a better predictor of young adults’ sense of well-being, of happiness, of life satisfaction than knowing about the extent to which they feel loved by their mothers,”

says Ronald Rohner, the director of the Center for the Study of Interpersonal Acceptance and Rejection at the University of Connecticut.(2)

Dads seem to also be responsible for giving their children persistence. Laura Padilla Walker, a researcher from Brigham Young University found that dads who provide loving but firm guidance, and encourage their children to persist-even when it’s hard-endow their children with life long persistence that is closely linked to future success. Additionally, a persistent personality, in turn, was related to less delinquency and more engagement in school over time.

“Our study suggests fathers who are most effective are those who listen to their children, have a close relationship, set appropriate rules, but also grant appropriate freedoms,” study researcher Laura Padilla-Walker.

So none of this is really anything new. We know that dads are important and that their presence and loving interaction have a tremendous positive impact on their children. So today, Father’s Day, show some dads that you know some love-whether it’s your own father, a father figure, or a guy that you know who is really giving his all to be there for his children. And it’s not whether or not a dad is in love with the mother that counts. It is important for children to see their parents treating one another with respect. But parents don’t have to be married to exert their loving positive influences on their children. It’s their presence in their children’s lives that matters most.

Happy Fathers Day to all the dads!!!

Share a story of a great father that you know in our comments section below!!

 

References:

The Huffington PostThe Important Role of Dad, By Dr. Gail Gross. June 12, 2014

LiveScience – The Science of Fatherhood: Why Dad’s Matter. Stephanie Pappas, June 15, 2012

The University of Connecticut, Center for the Study of Interpersonal Acceptance & Rejection

Laura M. Padilla-Walker, Randal D. Day, W. Justin Dyer, Brent C. Black The Journal of Early Adolescence, vol. 33, 4: pp. 433-457., First Published June 18, 2012.
Transnational Relations Between Perceived Parental Acceptance and Personality Dispositions of Children and Adults: A Meta-Analytic Review.A. Khaleque, R. P. Rohner. Personality and Social Psychology Review, 2011; 16 (2): 103 DOI: 10.1177/1088868311418986

 

“I was on the Treadmill 2 days after I delivered” And in Surgery 2 months later!

April 27th, 2017

Pushing too hard to regain your pre-pregnancy physique and activity level can actually have the opposite effect and lead to injury.

In the last post, I shared how many of my clients compare themselves and their post partum progress to celebrities, who more often than not, have a full staff of people helping them with their babies, enabling them to rest, prepare them specialized diets and personally train them to get back to their pre-pregnancy physiques. I have spoken on this topic many times before in an earnest effort to put mamas’ worries to rest that they are not “slackers” if they don’t “bounce back” to their pre-pregnancy weights immediately post partum. For Mamas on Bedrest especially, most people don’t expect you to immediately dash through your homes putting everything into neat and tidy order post bed rest. You won’t have the energy. Some of you will need physical therapy to be able to regain your strength and mobility.  So I continue to encourage you to put the comparisons aside.

I also wanted to draw readers attention to a post on our Facebook Page by the Association for Prenatal and Perinatal Psychology and Health  “Women need a whole year to recover from childbirth despite the ‘fantasy’ image of celebrity mothers, study claims” 

A whole year??! Most American women balk at this statement and as one of my readers clearly stated,

“A year… wow. I wish. That’s literally impossible for most moms in the U.S.”

What a tragic statement about the US’s concern for women’s health, maternal health and the health and well being of mamas and their babies. I could write (and have written!!) an entire post about how the US doesn’t value childbearing as evidenced by our maternity policies and birth outcomes. I’ll refrain from reiterating my utter disdain at this time. But I  do want to address some very important issues that result when women resume their pre-pregnancy activities too soon, and how it can be detrimental to their own health and the health of their newborns.

Bonding – New mamas and their babies need time to bond. While there is already a very strong connection between mama and baby from the pregnancy, new mamas need to learn “this” baby’s cues; the cry of hunger, the cry from being wet, uncomfortable, tired….seasoned mamas know that every child is different, and it takes time to learn the needs and habits of their new little one. Likewise, a newborn is being bombarded with a whole world full of new cues and stimuli. The one thing that this little one needs to know is that when he/she cries, Mama (or some other caregiver) will be there to take care of them. This is the crux of the “fourth trimester” those 8-12 weeks in the early post partum when mamas and babies get to know one another, know each others cues and form their own “communication.”

Breastfeeding – I have said it before but it bears repeating; Breastfeeding is natural but it isn’t always easy. Some baby and mama duos have a hard time establishing a rhythm for breastfeeding. Getting into comfortable positions, establishing a good latch, baby being able to suck and swallow, mom not experiencing nipple pain,…this can all take time. Asian cultures have “The Golden Month” which is the first 40 days after a mama delivers. The women of her clan come and care for her, her family, her home and the baby so that she can rest and breastfeed. Mama does no housework, in fact, mama not only doesn’t leave the house, she stays mostly in bed! The elder women prepare nourishing foods and perform time honored rituals that help mama regain her strength-and establish good milk supply.

Out of necessity, here in the US many mamas must be back at work by 6 weeks. They may or may not have established their milk supply. Many will try to pump at work, but many work places don’t have adequate facilities nor provide adequate breaks in which a woman may pump and store her milk, and clean her supplies. Sadly, this situation results in many American women not breastfeeding beyond 6 months.

According to one of my favorite websites, Post Partum Progressapproximately 15% of Post Partum American women will have post partum depressive symptoms annually. That equates to approximately 600,000 American women! Many women won’t begin to exhibit symptoms for 60 days, well after the standard 6 week post partum visit. So many American women are undiagnosed, untreated and bogged down with the inability to focus, care for their babies, themselves or their families. Post partum depression is a serious medical condition as it can progress into a major depression (sometimes requiring hospitalization) or progress to post partum psychosis which can be deadly. Women with post partum depression need immediate medical attention so that they don’t hurt themselves or their babies. More important, post partum women need careful, longer term surveillance post partum, with many experts recommending that post partum health surveillance last throughout the first year!

Bodily Injury – Due to the pressure of the pregnancy on the pelvic floor and the subsequent pushing and stretching that occurred with labor and delivery, many women lose muscular tone in their perineums and experience prolapse-when a woman’s inner organs (mostly the uterus, bladder and rectum) present outside of her body. I see this primarily in women who begin too rigorous of an exercise program too soon. While not only being uncomfortable, organ prolapse can cause serious medical complications. Currently, with the exception of (mild) bladder prolapse for which a pessary can be placed to tuck the organ back up into the pelvis, the treatment for organ prolapse is surgery. Do you see the irony? While trying too aggressively to get back into shape (after bedrest?) you can land yourself back in bed! Ladies, a gentle walk with your baby in the stroller, yoga or prenatal/post partum fitness classes are the best way to get back into shape while being gentle with your body. Always remember,

“Nine months on, Nine Months off!”

I hope that these tips have helped you to remember the wonderfully fabulous beings that you are! Mamas, you’ve created and given life and that is far more important and worth celebrating than the latest celebrity siting!

 

What are your tips for getting back into the groove post partum? Share them in our comments section below and help another mama!

Mamas on Bedrest: Pregnancy Can “Break” a Mama’s Heart!

April 13th, 2017

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 info@mamasonbedrest.com

References

Medscape

Maternal Cardiovascular Mortality in Illinois, 2002-2011

Briller, Joan MD; Koch, Abigail R. MA; Geller, Stacie E. PhD
doi: 10.1097/AOG.0000000000001981
Original Research: PDF Only