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

Posted Jul 19 2011 9:16am
In P art 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:
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.
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