Maternal Health Care

“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: Vote!

October 11th, 2016
image by coward_lion, courtesy of FreeDigitalPhotos.net

image by coward_lion, courtesy of FreeDigitalPhotos.net

Hello Mamas,

It’s not lost on any of us that this election season is one of the hottest messes in US election history! I’m not going to tell you who to vote for, or argue the virtues of either candidate. Who you decide to vote for is your personal business and let’s keep it that way. However, I am going to encourage you to vote. As an African American woman, I recognize the sacrifices-to the death for some-made so that I may “use my voice to make a choice!” The women who marched and protested in the 1920’s made it possible for women to vote. But for me and mine, this right was finally granted after many hotly contested, and a few bloody battles waged during the 1960’s. Knowing this history, knowing how many struggled and sacrificed, I can’t not vote! I know that many of you may be frustrated and disgusted. I know that much of what is going on is discouraging to say the least. But if we don’t vote, I fear dire consequences for our country. So please exercise your constitutional right and cast your opinions as to who and how this country should be governed.

Now I’m sure a lot of you will look at this post and think, “Now what in the h–l has voting got to do with being on bedrest?” While the presidential election has most certainly taken up much of the country’s attention, and who is elected president is surely of high importance, it most certainly isn’t the only election that matters to “We the People” and in many instances it isn’t the most important election for we Mamas on Bedrest. There is a lot of legislation pending in many states and local governments that will be approved/disapproved depending on who is elected in November-from the president on down. Very crucial legislation on paid family leave, employer sponsored benefits, health care, wage equality, childcare and other issues all crucial to us as mamas are all being considered by legislators in all 50 states and US protectorates. Implementation of these pending legislations will vary depending on the state, so if you don’t vote, if you don’t participate in this process, there is a strong likelihood that what you want to happen won’t. Perhaps you feel that your vote won’t matter. I get that. I live in Texas a very red state with conservative legislators diametrically opposed to what I believe. Yet, I will still be voting-even if it seems a useless proposition in some cases-because there are some instances in which legislation will narrowly be approved or rejected based on just a few votes. We can be deciding votes.

Many of you may be thinking, “I can’t vote, I’m on bedrest.” This is not true. You can vote by absentee ballot in all states, you simply have to request a mail-in ballot and return it by the date your state’s election board indicates.

I googled “absentee voting” and this link popped up with step by step information on how to obtain a ballot and submit it to your state’s elections office. If you don’t feel comfortable with this link, check out the Federal Voting Assistance Program’s absentee voting page. It too has very useful information about how one can vote if one is unable to physically get to the polls. Today, October 11th, is the last day to register to vote. Not sure if you are registered? Click here to find out.

As each of you is on bedrest growing your little one, give some thought to what type of world you want your little one to grow up in. Is what you are seeing on TV, on the internet, in the newspapers and magazines or what you are hearing around you what you want for your child? Is it what you want for yourself? The choices may not be as enticing as you may like, but you do still have a choice. The next chapter in our country’s history is about to be written. Make sure that you have your say in its content!