bed rest

“Sarah Jessica Parker looked fantastic 2 weeks post partum and I look like a blob!”

April 20th, 2017

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.

  1. 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.
  2. Learn and do pelvic floor strengthening exercises.
  3. Rest as much as possible, and whenever you can, take a nap.
  4. Let major housekeeping go and even get help with the small stuff if possible.
  5. Say no to outside activities. You don’t need to chaperone, bake cookies or make calls for any event. Focus on you!
  6. Spend time at home with family. This is precious bonding time for you all.
  7. 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!

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

Mamas on Bedrest: DOULAS SHOUL BE PRESENT AT ALL BIRTHS GLOBALLY!

April 6th, 2017

When people ask me what I think about doulas, I simply say,

“Doulas are an invaluable part of the birthing team and I wish I had had not one but two doulas when I was having my children, especially my daughter! We needed one doula for me and one for my husband!”

Doulas are birth attendants, typically women, who stay with a woman providing support, encouragement and non-medical pain relief and comfort measures to childbearing women during labor, delivery and in the early post partum. The World Health Organization has added their endorsement of birth attendants (doulas) by recommending that, “Birth Attendants be present at ALL BIRTHS GLOBALLY,” as part of the WHO Safe Childbirth Checklist Implementation Guide. This is huge, not only for those of us who are doulas and know the invaluable role we play in supporting mothers during pregnancy, labor and delivery and in the immediate post partum period, but also for mothers who may not know about doulas, or who may have been on the fence about getting a doula.

Research on the efficacy of doulas shows that when childbearing women have doulas attend their births they have:

  • Decreased overall cesarean rate (down 50%) and they are less likely to have a cesarean section delivery or other invasive interventions.
  • Shorter labors (decreased 25%)
  • Decreased use of oxytocin by (decreased 40%) a medication used to start or hasten labor.
  • Decreased requests for an epidural or other pain medications by 60%.

Doulas attend to mothers and/or couples primarily during childbirth and in the early post partum period. However, there are ante partum doulas (Mamas on Bedrest & Beyond for example) who attend to mothers who are experiencing complications prenatally and who need additional support. Prenatally doulas offer non-medical supportive care such as helping mothers on bed rest become more comfortable, attending to home duties, offering resources and tips for comfort and support, emotional support, family support, childbirth education, and lactation support and education.

Many people are under the mistaken impression that doulas are only for women having “natural” (vaginal) or home births. Doulas attend all types of births, in all types of settings; home births, hospital births or birthing centers. Additionally, doulas are as beneficial to women having cesarean sections as they are to women having vaginal births. Doulas are particularly under utilized by high risk pregnant women and yet this group stands to benefit the most from the support and emotional care.

Mamas on Bedrest, you can and should consider having a doula present at the delivery of your child-even if the father is present. This well trained, impartial birth professional can act as your advocate and as a bridge to the health care system and to providers when you are unable to advocate for yourself. They can help explain procedures, assist in getting you information on certain proposed procedures and treatments and can help be sure that you are giving informed consent when you sign forms. Doulas are present first and foremost for the mother and the needs of everyone else in the family or on the healthcare team are secondary. Doulas DO NOT MAKE MEDICAL DECISIONS for their clients, but rather hold a space so that a woman and her partner (if present) can determine the best course of treatment for them based on all the available information.

The doula model has been present historically as far back as Biblical times (Exodus 1:15-21) when women of a family or tribe attended to a birthing woman and made sure that her children and husband were fed and cared for. Doulas and Midwives nearly became extinct during the middle and latter part of the 20th century with the advent of hospital labor wards and the specialty of obstetrics. There has been a resurgence in doula use during the latter part of the 20th century and now in to the 21st century. Unfortunately, the use of Doulas has been limited to women of means as they have been the only ones able to pay for a doula as insurance companies have yet to agree to reimbursement.

But there is good news. There are many doula services that offer a sliding scale or are being reimbursed by Medicaid such that ALL women can receive this potentially lifesaving care. In Austin there are the following groups offering low or no cost doula services.

Austin

Giving Austin Labor Support (GALS)– A non-profit organization that supports women with limited or no resources for doula care so that “No woman gives birth alone.”

Mama Sana/Vibrant woman-a grassroots organization of low income women of color serving women in the community with prenatal, birth and post partum reproductive health support.

Outside of Austin, there are several programs around the country serving women from all income backgrounds:

Ancient Song Doula Services– A non-profit organization in Brooklyn New York serving low income women of color.

The Pettaway Pursuit Foundation-Located in Pennsylvania, this non-profit organization specifically attends to high risk pregnant women on prescribed bed rest. A team of contracted doulas provide care and the organization has contracts with several managed care organizations for reimbursement.

Mamatoto Village– This organization also provides very high quality birth assistance and also has its own training program for its staff.

Uzazi Village – This non-profit organization provides doula services to low income women of color in the Greater Kansas City Missouri area, and has another location in St. Louis Missouri. They also provide doula training, childbirth education, reproductive health education and lactation services. They are also now beginning to train midwives.

These are just a few of the organizations that I know of providing doula services. There are others and I am sure many more that I don’t know about. The point I wish to make is that if you would like a doula to attend your birth with you, there is likely a doula organization or solo doula that can help. Mamas, don’t forgo this vital source of support. Doulas really do make births better!

Looking for a doula? e-mail info@mamasonbedrest.com and we’ll do our best to help match you with a doula.

Know of a doula that is excellent at what she does and serves women in need? Share her information here and we’ll start a running list of doulas that are serving low income.

Know of a doula organization that offers services at low or no cost? Let us know so we can share this information.

Did you have a doula at your birth? Please share your experience in the comments section below.