Transcript: Creating Your Postpartum Plan

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Preggie Pals
Creating Your Postpartum Plan

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Please be advised, this transcription was performed by a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

SUNNY GAULT: Hey Preggie Pals. Have you listened to Newbies yet? It’s our new podcast for postpartum moms through their baby’s first year. Each week you’ll hear great episodes featuring experts and real moms as they explore the challenges of caring for themselves and their new baby. Subscribe on iTunes and listen on the go to our free apps. Babies don’t come with instruction manuals. That’s why there’s Newbies, for new moms and new babies.

[Intro/Theme Music]

LAURA KELLER: In addition to feelings of love and wonderment, the postpartum period will almost certainly bring more stress and challenges than expected. Preparing a postpartum plan to share with those who'll be providing you support can make the transition into parenthood much smoother. I’m Laura Keller, childbirth educator, doula and lactation educator. Today we’ll be discussing how to create your postpartum plan. This is Preggie Pals.

[Theme Music]

STEPHANIE GLOVER: Welcome to Preggie Pals broadcasting from the Birth Education Center of San Diego. Preggie Pals is your online, on-the-go support group for expecting parents and those hoping to become pregnant. I’m your host Stephanie Glover. Are you just now tuning in to Preggie Pals? We’ve covered over 130 topics so far. Visit the episode guide on our website to scroll through the topics. Listen directly on your computer through iTunes or download our free apps available on the Android, iTunes, and Windows Marketplaces. Be sure to check out on our new network app where you can listen to all your favorite New Mommy Media shows on the go. Here’s Sunny for more information about how you can get involved with Preggie Pals.

SUNNY GAULT: Alright. Hi everybody. So Stephanie was just telling you about our apps and we have a segment where we like to review apps and we’re always looking for our listeners to recommend different apps perhaps apps you already have on your phone that you really like and you think other pregnant mamas could really benefit from. So that’s one segment you can participate in. We have an Ask the Expert segment where you can ask any of our experts any of your pregnancy questions. So that’s another. And then we also just love to hear from our listeners. So if you have any ideas for future episodes you would like us to explore or if you would just want to share how Preggie Pals has impacted you and your pregnancy, we would love to hear from you and we’ll read some of the comments on the show. So the ways you could submit for that, you could go to our website at www.newmommymedia.com, click on the contact link and you can email us. Or if you actually want to share your story yourself or ask the question yourself, you can call our voicemail at 619-866-4775 and leave us a message and then we’ll play that on a future episode.

STEPHANIE GLOVER: Great! Thank you Sunny! So let’s get started by doing some panelist introductions. I will start. Like I said, I’m Stephanie Glover, I’m 33, I host Preggie Pals and I’m also a trained childbirth educator. No due date but I have 2 kiddos. My 4-year-old is Gretchen and she was my c-section baby and my 2-year-old is Lydia and she was my VBAC. Kristen?

KRISTEN STRATTON: Hi I’m Kristen Stratton. I am a birth doula and a postpartum doula and I am also the host of our sister show, Newbies. So check out Newbies. I have 3 kids in 3 ½ years. That’s crazy. I have a 5 ½-year-old, a 3-year-old and a 2-year-old. So there you go.

STEPHANIE GLOVER: There you go. You’re busy and Shannon, how about you? Introduce yourself.

SHANNON: Hi I’m Shannon. I’m 31. I am a stay-at-home mom and part-time photographer. I just delivered my second child. His name is Emerson and he’s 8 weeks now and it was my second cesarean.

STEPHANIE GLOVER: Awesome. Thank you so much for joining us.

SHANNON: Thanks.

[Theme Music]

SUNNY GAULT: Okay. So before we get started today, we have a headline that we wanted to talk about. This headline is: stress leads many mothers to resume smoking after pregnancy according to a new study. So here’s the scoop. It says new research shows that the strains of motherhood are leading up to 90% of women who had quit smoking to resume smoking especially those from poor backgrounds.

It says the study of interviews with 1,031 women have found out that some women who have given birth go back to cigarettes under pressure from friends or because they see it as a way of regaining their identity. Which is I thought was really, really—that last part of regaining your identity like I can kind of relate to that, not from the smoking end of it but sometimes you just feel so lost in the beginning right? And you want to regain something—

STEPHANIE GLOVER: something from your pre-baby existence.

SUNNY GAULT: Right so smoking might not be the healthiest to regain. But you know different things for different people. And so I kind of wanted to throw this out to you guys and see what you thought. 90% seems really high to me but I don’t know if you guys have experienced working with women in your own practices and stuff that this has happened to but just want to see what you guys thought. Stephanie.

STEPHANIE GLOVER: You know I’ve never been a smoker. The study does not surprise me because we all come up with some sort of coping mechanism to deal with stress of new mommy-hood. It’s disappointing only because I’m thinking about the health of the kiddos.

SUNNY GAULT: The secondhand smoke kind of thing?

STEPHANIE GLOVER: Yes. And my dad was a heavy smoker when I was young. And I had chronic headaches which only really in my adulthood have I started linking them perhaps. I don’t get them anymore. Well I’m not around smoke anymore so you know I think it’s disappointing but certainly not surprising.

SUNNY GAULT: Kristen, what do you think?

KRISTEN STRATTON: I think like you said, it’s a very, very stressful time and I think whatever your coping mechanism was pre-pregnancy is probably going to be your postpartum coping mechanism whether that’s extreme exercise. I’ve had clients who just throw themselves into very rigorous exercise routines to get their identity back, their body back. Or for like me. It was a thing of bad injuries then. My knees were great which is not very healthy either. But like Stephanie said, it can lead to chronic health issues both in the parent and the children.

And we do know that there’s also a correlation between smoking in the home and sids. So it think it would certainly be a good goal for providers to work with those postpartum moms and just be even more vigilant about giving them options for quitting—support groups, medications, therapies, whatever that is. And then for family members to be aware of how stressful it is to be a new parent and that they need to be more vigilant about reaching out and helping those new parents.

SUNNY GAULT: Okay. Anybody else? Any ideas? Thoughts?

LAURA KELLER: I think that having open communication with your provider also helps because they might not have known that you were a smoker previously especially if it was just a part of your life before or it was just a part of your identity. And having that open communication will help your doctor provide you with other skills and give you people to talk to or reach out to or support groups or things like that so that you have another outlet to cope during your pregnancy. If you weren’t smoking, how you were coping during the pregnancy because pregnancy is stressful. I can definitely relate to not only picking up your habits once you’ve had a child to cope but also when you add children, when you already have one, it just compounds the stress.

SUNNY GAULT: Just a little.

LAURA KELLER: So I think having that open communication will definitely alleviate a lot of that pressure to go back to bad habits.

STEPHANIE GLOVER: And I think tying into our topic for today which is postpartum plans, going into—I’m sure that it will be difficult to quit smoking even during pregnancy especially if maybe it was a surprise pregnancy, you weren't planning on it. But it is a big adjustment and there’s a lot of thing surrounding our postpartum experience that we need a lot of support from our family, our friends, and those around us. So making that part of our postpartum plan would be how do I continue not smoking and making that conscious effort that it takes a lot of support for as well.

SUNNY GAULT: Okay. Thanks ladies.

[Theme Music]

STEPHANIE GLOVER: So today we’re discussing how to prepare for your postpartum period. Joining us here in the studio is Laura Keller. Laura is a certified childbirth educator, doula and lactation educator. She works with expectant parents to help prepare them for their postpartum period, childbirth preparation and breastfeeding classes. Welcome to Preggie Pals Laura and thank you for joining us.

LAURA KELLER: Thank you for having me.

STEPHANIE GLOVER: So many expectant parents are familiar with what a birth plan is. But what is a postpartum plan?

LAURA KELLER: Sure. A lot of expectant parents spend a lot of time and energy focusing on creating their birth plan and getting ready for everything surrounding labor and birth experience. But creating a postpartum plan is just as important as having a birth plan. And what a postpartum plan is, it’s just a plan for what’s going to happen after the baby is born and what kind of support and resources do we need.
You’re probably familiar with the concept of the fourth trimester which basically means baby has been 40 weeks inside mama’s belly and they have all their needs met. They are warm and cozy and never hungry. And then they’re adjusting to life in the outside. And so those early weeks and months of a baby’s life takes so much time and energy and focus from parents that we all just need our village, our resources surrounding us. So postpartum plan is just thinking about what resources do we need and how can we plan ahead to make that transition smoother.

STEPHANIE GLOVER: And would that plan include a certain—well you mentioned the fourth trimester. So would that be immediately following delivery through the first few months?

LAURA KELLER: Sure. It would encompass of course those first few weeks. It can be sometimes the most challenging. But the several months after you know becoming a parent can be full of transitions as well. So a postpartum plan would include not only those early days but support for several months afterward.

STEPHANIE We’re all parents so I think we can agree that right when you think you got something handled, you got to land another curveball in your face.

LAURA KELLER: Absolutely.

STEPHANIE GLOVER: So at what point in pregnancy should parents begin creating this plan.

LAURA KELLER: Definitely well before the birth. A great time to start thinking about your postpartum plan is as you’re also creating your birth plan and thinking about how that whole phase of your experience will go. A great time to start working on it is also when you have any sort of baby shower or celebration or time when maybe your family and friends are getting together. Prior to that you can think about what kind of support specifically will I need from my family and friends. And then when you’re all celebrating and getting together, you can maybe have people sign up for specific ways that they can support you and commit to something specific that they’ll do for you after baby comes.

STEPHANIE GLOVER: Okay. So take us through some of the main things. Maybe start thinking about resource-wise. We are just going to start here assuming that the mom has had an uncomplicated delivery and recovery. Because I know that that can also affect how you plan if you have something a little bit more complicated. But let’s start with just sort of a simple scenario. What are some things to include in your planning?

LAURA KELLER: Sure. I will say the process of creating the postpartum plan, just like with the birth plan is just as important as the plan itself. So it's a way for you to sit down with your partner and your family and think about what kind of expected challenges we might be working through together. Some of the things postpartum plans might include would be a list of support people and how specifically they might help you. Maybe it’s bringing meals over, helping with not only baby care but really focusing on the other aspects of your life—taking care of other kids, other pets—how they can logistically help you focus completely on your baby. The important thing is that those early days, bonding with your baby, establishing breastfeeding and any way that other people can help you just focus on that is what you would include in a postpartum plan.

You also might think about hiring a postpartum doula which is somebody who is a specifically trained professional who will help you with all of the different aspects of becoming a new mom, breastfeeding support and baby care as well. You would also want to have a list of breastfeeding resources if you’re going to be breastfeeding and you experience any challenges along the way. There are resources available in your community that you would want to research beforehand. Also just having a plan for self-care for both you and your partner. So you’re kind of establishing your new normal and settling into life as parents. And that comes with a lot of adjustment, a lot of time and energy focus and lack of sleep. So building in time and ways that you can simply just take care of yourself and your partner also can take time to just rejuvenate. Because for you to be the best parent possible, you need to make sure that you’re taking care of yourself as well.

STEPHANIE GLOVER: Put on the oxygen mask first before assisting another.

LAURA KELLER: Exactly.

STEPHANIE GLOVER: Now Shannon, you are a mom of two. So were you able to kind of create that postpartum plan with your first pregnancy? And how did it differ once you added the second child?

SHANNON: Oh it differed significantly. So with our first child Gabriella—we were in Tampa. We were home and my in-laws lived there. My mom was in town. I had all of my friends and stuff like that nearby. My husband had just joined the navy. So we were preparing for him to leave us to go to boot camp when Brie was 8 weeks old. So we stayed with my in-laws for the first 8 weeks and then I went up to my mom while he was in school in boot camp and I was there for the next 6 months so I had a great postpartum support team. My village was strong. I learned a lot. I got to spend a lot of time with my grandmother and she bestowed some of her wisdom on me as well. It was just really, really ideal. Everything just kind of fell into place with the first time around.

STEPHANIE GLOVER: And then how did it change since you moved away from your tribe?

SHANNON: We drove across the country because my husband’s first duty station is here in San Diego and we knew that wanted to become pregnant pretty soon after we moved. So when I got that positive, I went to find my team basically. And I’d already known who my obstetrician was going to be because I'd heard about him through ICAN and had already got my insurance settled and that was taken cared of but I knew that I wanted a doula because I was going to attempt to VBAC. So I asked ICAN and got some good recommendations and settled with Linda Goldsmith at Pregnancy Sanctuary. That was the first step and everything else fell into place. It wasn’t until my second trimester when I got that burst of energy that I started to think okay, who do I want to fly out here when? Because it was really important to me to have support, but also I’m the type of person where there are a lot going on, I'm not satisfied laying on the bed with the baby. I want to be in the middle of things, enjoying it as well, especially when I have a family in town that I don't get to see otherwise throughout the year.

STEPHANIE GLOVER: So I don’t want to nap through this. I want to see my mom. I want to hang out.

SHANNON: Exactly. So what I did that helped us is I staggered my help. So for the first 8 weeks, my mom was here and then she left. My father and my stepmom will be here for Thanksgiving and then my in-laws are going to come for Christmas and New Year’s. So the fourth trimester has been covered. It’s really been good. The only thing I did was when we moved here, I started to not only think about who I needed to have through pregnancy but also afterward like as far as meals were concerned. And my mom was here and she cooked and stuff. It was helpful. But also my local friends in my community were asking me what do you need for the baby shower, what do you want? And a lot of times I was like I don’t really need blankets.

Can you bring me over a casserole dish, lasagna or something that I can throw on my freezer and that’s been instrumental? I still have food on my freezer from my neighbors and things like that that have really, really stepped in to donate and help me stay out of the kitchen when it gets overwhelming. You know one thing I learned too was with those meal trains and whatnot even though maybe mom is in town, they're so busy doing other stuff particularly when they're taking care of an older sibling, they kind of need to be cooked for too. And so we received meals for a good 6 weeks. And my mother-in-law was equally appreciative I remember. Because she even needed some self-care because they’re doing so much for us, things that we can't do.

And the tendency is to think about what are we going to need for dinner? What do I want for dinner and I had one of my friends bring over lunches. Because it was the middle of the day the baby was asleep. My oldest daughter Brie, she still naps so we’d be sitting there like 12:30 having gone through what I call the morning rush. And now it’s lunchtime and we’re pooped. So Shay would come over with sandwiches and platters and things like that. We’d have lunch and nap while the kids were sleeping. It made it so much easier.

KRISTEN STRATTON: Someone coming over with some bagels and fruit salads in the morning.

STEPHANIE GLOVER: Kristen how about you? Were you able to formulate postpartum plans with any of your pregnancies?

KRISTEN STRATTON: My story is a little similar to hers in that with our first, my husband deployed when our daughter was 4 weeks old. So I actually did move back in with my mom for about half of the deployment and then towards the latter half moved back into our house on the base.
Then we had our second and we moved 2 weeks after he was born to San Diego. I immediately had already researched and signed up for MOPS and I found MOPS. And even though my baby was 4 weeks old by the time it started, they did a meal train for me and had me forever in their debt. Please sign up for MOPS. If you’re listening go to MOPS.

STEPHANIE GLOVER: Mothers of Preschoolers if you’re wondering what it is.

KRISTEN STRATTON: Go to MOPS. And then when we had our third, we were still in San Diego but again we’re a military family so even though our family is about 1 ½, 2 hours away, it’s still a lot for them to come down on a regular basis. So again with the meal trains, to be honest in retrospect, I didn’t really know what a postpartum doula was. But next time if we have another baby, I’m saving for a postpartum doula because I just really think that I had a lot more help with breastfeeding and with laundry and with dishes. It would have been a lot nicer those first few weeks. Sorry husband. Thank you for being married to me. And then my mother-in-law- She was very, very sweet and generous with her time. She did come down in the weekends when she wasn't working and she would just do all of our laundry that was just piled high to the ceiling. She would do all of it in one sitting. I'm like how do you get it done that fast?

STEPHANIE GLOVER: Because I'm not nursing the baby.

KRISTEN STRATTON: I think now that I know what I know now as a postpartum doula, I would: one, hire of one; and two, I would definitely be more organized. I learned the hard way.

STEPHANIE GLOVER: And so let’s touch on that very quickly. For those people who maybe didn’t even know a doula was a thing. You mentioned that they do live in a household.

KRISTEN STRATTON: I know. It was insane. And then I became one. Like wow, this is great.

STEPHANIE GLOVER: I would imagine too particularly with a military family. If you’re somewhere where you don’t have other resources, how instrumental it could be?

KRISTEN STRATTON: And such as when you first move because maybe you’re going to have your military wives that you bond with but when you first move, it’s stressful. You don’t know anybody. You’re in this new place, you’re trying to find the church, you’re trying to find the post office, you’re trying to find the grocery store. So you’re just so consumed by that that building and bonding with other people is kind of last on your list until you have time for it, especially with a new baby.

So basically what a postpartum doula is she’s trained in baby care and mommy care. She’ll come in, she’ll help feed you. The first thing she does when she gets in, she makes sure you have water, do some laundry for you, do some tidying around the house, maybe hold the baby while you take a shower so you can shave. That’s really nice. That makes you feel like a human again. So I would definitely look into it and see if you can budget for that. It’s a luxury but it’s amazing.

STEPHANIE GLOVER: When we come back, we’ll discuss things to consider if postpartum becomes more complicated than expected. We’ll be right back.

[Theme Music]

STEPHANIE GLOVER: Welcome back. Today we’re discussing how to put together your postpartum plan. Childbirth educator, doula and lactation educator, Laura Keller is our expert. So we all know that labor and postpartum can be pretty unpredictable. Are there some common unexpected outcomes to plan for in the postpartum period Laura?

LAURA KELLER: Sure. And of course not a great complication we can predict. But we do our best and just kind of anticipate some of the needs that we might have. One of the most common unexpected outcomes might be if you have an unexplained cesarean delivery. And of course if that's your case then you would be having a little bit more of a longer recovery time. You want to spend some extra time being gentle to yourself and might even have a bit longer of a hospital stay at the beginning.

I would say any of the unexpected outcomes that we talked about, education is one of the most important ways that you can prepare. So hopefully you’re taking a childbirth education class. And if you do, they will cover, no matter what kind of class it is, they'll cover what would happen during some of these unexpected outcomes like if you have a cesarean delivery. And if you are for some reason have a higher likelihood of having a cesarean or other complications, of course, you want to do research and just educate yourself about what to expect if those complications do arise and how to better prepare and put your postpartum plan surrounding that.

Another unexpected outcome might be if you have your baby would have complications and they might spend a little more time in the NICU which is the Neonatal Intensive Care Unit. And of course, if that were your situation, you would need a lot of extra support not only physically and logistically but emotional support. So again researching your hospital's resources beforehand especially if maybe you’re at high risk for premature birth or having multiples, you might kind of anticipate and understand what resources are available to you.

So oftentimes, your hospital network would have support groups and resources where you can connect with other parents who have had similar situations. And you can take that extra support that you would need. And again, just postpartum period is all about taking time to let yourself heal and recover. So if you have any tearing or stitches or you just kind of have some physical exhaustion just from being a new parent. There are so many situations where you just want to make sure you're taking that extra time to take care of yourself. Limiting physical activity. You don’t lift anything heavier than your baby. For those first several weeks and take the time to gradually ease yourself back into your exercise and your normal life.

Another unexpected outcome might be breastfeeding challenges and these challenges can arise not only in the early weeks but even in the early months. There are a lot of different ways that breastfeeding is a wonderful and amazing thing that we do. But there can be a lot of times where it can be difficult. There are a lot of resources available in your community after the fact so lactation consultants, breastfeeding support groups. But again the education piece is just so, so important. So I highly recommend taking a breastfeeding class. The more you know about breastfeeding before you give birth, the higher the likelihood that you’ll have a successful breastfeeding experience. And you’ll kind of be able to anticipate some of those challenges and understand what’s happening with the whole process. So again, education is just key for all these outcomes. And just be gentle with yourself and allow yourself time to heal, to adjust to your new normal.

STEPHANIE GLOVER: I think I know the answer but for our panelists did either of you have unexpected outcomes that affected your postpartum period?

KRISTEN STRATTON: Yes I did. I had unplanned cesarean births and that was not only emotionally difficult but physically difficult. I mean you’re recovering from major surgery so you can’t move about as you would have you had an uncomplicated vaginal birth. And I know some people have a really difficult vaginal birth and feel similar in terms of their mobility. So self-care is just really important. You really can't rush up these so you really are relying on the kindness of others so that’s actually something that I really recommend to moms and dads or partners. To really think about having the right people over at the right time. Because while your friend may be really, really funny and really, really great to be around, she may be a terrible cook or really terrible at laundry.

SHANNON: And if you have a c-section and you’re laughing at the beginning, it really hurts or sneezing. My mom and sisters are telling some funny stories about how they got lost in the hospital. And I was still in the hospital after my C-section and I was crying because it was funny. But you have to stop I can't even look at your face right now.

KRISTEN STRATTON: It feels life your tummy is a ball of jello.

SHANNON: And have the funny friend come over in 3 months.

KRISTEN STRATTON: And if you have someone that is not particularly helpful and will probably want you to entertain them, they should probably come at the latter half of that fourth trimester as compared to someone who’s just like yeah, give me the laundry. You go upstairs and go to sleep. I'm going to do this for you. Those are people you want to come to immediately. As was mentioned before, you might want to have people sign up so that those people can come at the right time. Very important.

STEPHANIE GLOVER: Good. How about you Shannon?

SHANNON: yes I ended up with another c-section too and I was 39 weeks along and 4 days and I fell down the stairs. So that landed me in the hospital. And with my c-section and I wasn’t planning for that at all. But luckily because my mother was already in town because I was due in like a week, it really, really made it a lot easier. My husband had time off so I think that having the support and planning ahead like that cannot be stressed enough. It really, really can be instrumental when things can change very quickly and also having care for Brie, my neighbors were like okay you’re going to the hospital. I’ll pick her up and I’ll keep her for this night. Emerson has jaundice. You have to stay another night in the hospital so he can stay on the lights. I’ll do this, this and that. So it was really, really good. Really great!

STEPHANIE GLOVER: And I remember too because I’ve had each type of birth and I thought especially if you have another young child and older sibling to care for, you take for granted that you still have to rest and heal. And so when I had my vaginal birth I thought I’d be up and running around and jotting and doing this. And I still had to give myself a good 6 weeks to chill out. And so I was so thankful that my mother-in-law was there the whole time and would remind me like look, you can't lift that. We went to IKEA together and I was trying to move something off the shelf and I really thought my vagina was going to fall out. And I didn’t expect to feel that way because I think I pulled something. And I’m like I’m just going to go sit in the car. So because I think we try to be super mom and do too much too soon and it’s a good reminder too.

SHANNON: It can be difficult for the older child too like I had guilt because Brie, she wanted to climb on me and she wants to play with me. And I remember lying in the bed and Emerson was asleep with my husband. And Brie toddled up the stairs. “Mama, mama” and she gets on the bed and she’s like walking towards me because why would you crawl on the bed? Of course, stand up and walk towards me. I was terrified of her.
I was like she was going to fall on me and I'm going to bleed out up here. And no one is going to find me for like an hour because I’m supposed to be on nap.

KRISTEN STRATTON: You know what are funny about that is even years after having cesarean births, I still am very protective of that spot. It’s automatically reactive about that when my son comes to jump on me. I’m like no!

SHANNON: Absolutely. Me too!

KRISTEN STRATTON: Yes. You’re right. You really have to be careful.

STEPHANIE GLOVER: Thankfully today we’re better at recognizing postpartum mood disorders and how they are actually common. There are better ways to diagnose and treat them. But what are some ways to prepare in the event that mom develops a postpartum mood disorder whether it be depression or anxiety?

LAURA KELLER: Postpartum mood disorders are more common than you might think. And a lot of women, a lot of people in general don’t really talk about them as much as we should. And everybody kind of expects you to be its a happy time and you have a new baby. But it is quite common for a woman to experience postpartum mood disorders. And we’re probably familiar with the baby blues right? So up to about 80% of women experience just mood swings, anxiety just some general over the first few weeks of having a new baby you might experience some of these symptoms being irritable, crying for no reason or kind of experiencing a lot of hormonal shifts. That usually go away within about a week or 2 but if it doesn’t then it might be a sign of postpartum depression or another postpartum mood disorder.

This basically means again that baby blues are a lot more common. But some women do experience postpartum depression which doesn’t necessarily go away on its own. Some of the signs and symptoms are similar but they may be more intense and last longer and might even interfere with your ability to care for your baby. Some of the symptoms of postpartum depression would be just kind of a general depressed mood or mood swings, crying excessively, having difficulty bonding with your baby, feeling withdrawn from your family or friends, experiencing changes in your appetite either you just can't sleep or you feel like just want to sleep all the time more so than is just normal for that exhausting time period.

Just feeling extreme fatigue, loss of energy and it kind of comes along with some emotional side effects too. Feeling like you’re not a good mother, you just can't get past some of those anxieties. So both postpartum depression and postpartum anxiety are very real disorders that affect about up to 15-20% of women. And what a lot of people don’t realize is that the symptoms might appear later on so it’s not necessarily just in those first early weeks. The symptoms could appear 6 months or up to a year in postpartum.

STEPHANIE GLOVER: So yes, it’s just educating yourself than knowing what to look for and probably getting partnering on that conversation as well because sometimes we don’t see it in ourselves. But the partner can be like you’ve been acting kind of funny. Your sleep’s been off and that’s a way that you could probably include that into your plan.

LAURA KELLER: Exactly. So being aware of having others around you also help you recognize the symptoms because you just kind of assume well this is probably normal. I’m just probably really tired because of the baby and others around you might recognize the outside of normal. It definitely can be something. Again education is the key and as you’re creating your postpartum plan and just thinking about what resources are available to you. There are a lot of resources in most areas whether it’s support groups. If you do experience a postpartum mood disorder like postpartum depression or anxiety you definitely want to talk to your care provider about that and whether its therapy or medication kind of a general idea about postpartum mood disorders, depression and anxiety are that they’re sometimes the hardest to diagnose but they’re some of the easiest to treat. So there is help available and it’s something that’s quite common that women experience. So there is help available for you.

STEPHANIE GLOVER: Shannon, do you have any experience with preparing or experiencing postpartum—

SHANNON: Yes. So with my first daughter, I had baby blues and it lasted for about 2 weeks and it’s just alleviated on its own. This time around we’re dealing with some really hard family things. My grandmother passed away 9 days before I delivered Emerson so there’s a lot of grief there going on. My mom was here like I said and I noticed when she left and things started to quiet down, it was hard for me to engage with my son and to get excited about him and just have that rush of emotion that I experienced with my daughter.

I broke down one time because I was like when he cries my milk doesn’t even let down. With Gabriella, I could hear her across the room. I could hear another baby cry and I would be like where’s my pump? I need to express. And I’m just not experiencing that right now. And my husband kind of mentioned to me “You seem a little bit different and challenged”. And it took one day where I just broke down over something silly as I was making soup and burned dinner. I was like, this was going to be the thing that I did amazing today and I failed at this day. It’s terrible. I had a total meltdown and I called the doctor immediately.

The next day I got an appointment. I have an appointment Monday with the therapist so I’m on the mend. But it's definitely something that if you know what to look for and if you’re not yourself even more so than just being tired or anything like that. If you’re having thoughts about your children not being your world or anything like that then maybe step away and do more than your usual self care than you would for yourself and get the support that you need because it really is a lot. And it's not something that is commonly discussed. It's not something that everyone knows is common. I didn’t know it was common. I haven’t dealt with depression until now. So I think that having your support team and a good relationship with your provider is so instrumental.

STEPHANIE GLOVER: And it sounds like you were educated to recognize that even within yourself.

SHANNON: Absolutely. Yes. The baby blues helped a lot the first time. Like okay, I’m still feeling this way times a million.

STEPHANIE GLOVER: You had a gauge.

SHANNON: Yes exactly.

STEPHANIE GLOVER: Thank you for sharing. So thanks for joining us Laura and thank you to all the panelists that have sat in on today’s show as well. For more information about Laura as well as information about any of our panelists, visit the episode page on our website. This conversation continues for members of the Preggie Pals club. After the show, Laura is going to discuss how to help create a postpartum plan for your baby’s older siblings. To join our club, visit our website at www.newmommymedia.com.

[Theme Music]

MOLLY: Hi Preggie Pals. This is Molly from Akron, Ohio. I am currently pregnant and this is my very first pregnancy and I’m really excited. But unfortunately, my husband does not seem to be anywhere near as excited as I am. He has no interest in going to any of my appointments, doesn’t even care when my belly—when the baby’s kicking, he doesn't want to feel it. And I just don’t know if this is normal. I mean how can I be so excited and he’s not at all? So I’d like to kind of know what’s going on inside his head. And if you could help me with this, I’d really appreciate it. Thanks so much.

Danny SINGLEY: Hey Molly. I’m Doctor Danny Singley, licensed psychologist specializing in men’s issues and the founder of basic training for new dads parenting class. You raised an excellent question. One that guess at how men and women tend to express their feelings pretty differently. It’s understandable why you’re confused about what seems like your husband's lack of enthusiasm on having a new baby. So what I’d encourage you to do is to realize that there’s likely much more than just experience being an expectant dad than meets the eye. Most dads than moms to be experienced a wide range of emotions, excitement, curiosity, anxiety and even sadness. However while women in this country are typically socialized to be more verbal and vocal about expressing their feelings, men simply aren't typically accustomed to doing so. For example, paternal postpartum depression and anxiety are fairly common. But it’s not widely understood that men tend to express them differently than women.
More than symptoms can begin during pregnancy. We tend not to express these things until they are shown largely on to the radar. Your fellow is likely to be ambivalent about the impending arrival and clamming up about it is a very common way that men deal with very concerning questions like how will I provide financially, what will my work-life balance look like, will I ever have fun again or see my friends, how is my relationship with my wife going to change, will I be able to care for a baby?

Dads are "supposed" to be very excited about having a baby and expressing these types of concern to mom flies directly in the face of the John Wayne guy code. For example when my wife was pregnant, I wanted to be the sturdy oak and keep my feelings to myself about concerns ended up going too far because I didn't include her into the stresses I'm judging until they've gotten pretty far along. Ultimately talking to her about it was pretty helpful although very difficult. Also for some dads the baby just doesn't seem real until it's born or until it starts to do more gross motor activities like rolling over and crawling or stereotype of I really like him most when he can throw a ball. It's an old one. It's pervasive. But usually after the birth, dad gets riding in there and start feeling connected with their baby. Another point is they're supposed to be highly involved with their partners and babies but rarely had the chance to observe their own dads or other types of concrete models about exactly how to do so. Most parenting classes for expecting parents aren't much help because they tend to give dad a message that the only way to support baby is to support mom. But the reality is dads can be virtually everything that mom can do with the infant except nurse them.

So what to do? One gives dad as much practice swaddling and scooping and even burping as much as possible. I would also sign up your hubbies to receive a weekly email from an online service. Something like www.babycenter.com which gives a brief executive summary of baby and mom's development as well as how the circumstances are changing. Another point is just don't expect him to express himself in a traditionally feminine way. If or when he starts engaging in so-called daddy-connected activities like buying stuff and building and painting and stressing about finances, just recognize this as a way that men are socialized to do and not feel. Another is just realizing he does need your support even if you can't tell but he also needs that outside of your relationship. So encourage him to go spend time with his friends and bonus points if there happen to be buddies of his who are engaged dads who can talk about what a great experience it is.

Finally if you or your husband has experienced a history of anxiety or depression then you're at elevated risk to develop postpartum mental health issues so you should be proactive like consulting with a mental health provider as soon as possible. But 1 in 10 men experience postpartum depression and of those who have partners who have postpartum depression, 50% of those men themselves develop postpartum depression.
So it's important to be armed to navigate the transition of parenthood as effectively as possible. You could also go to www.postpartummen.com it has some great information about how postpartum depression plays out. I hope this info has been helpful to you. And best of luck in the journey ahead.

STEPHANIE GLOVER: That wraps up our show for today. We appreciate you listening to Preggie Pals.

Don’t forget to check out our sister show:

• Newbies – “Holla Kristen”. For postpartum moms during baby's first year
• Parent Savers for parents with infants and toddlers
• Twin Talks for parents with multiples and
• The Boob Group for moms who breastfeed

This is Preggie Pals. Your pregnancy, your way.

[Disclaimer]
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

SUNNY GAULT: How would you like to have your own show on the New Mommy Media network? We're expanding our lineup and looking for great content. If you're a business or organization interested in learning more about our co-branded podcasts, visit our website at www.newmommymedia.com.

[00:40:52]
[End of Audio]

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Episode Transcript

Preggie Pals
Creating Your Postpartum Plan

[00:00:00]

Please be advised, this transcription was performed by a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

SUNNY GAULT: Hey Preggie Pals. Have you listened to Newbies yet? It’s our new podcast for postpartum moms through their baby’s first year. Each week you’ll hear great episodes featuring experts and real moms as they explore the challenges of caring for themselves and their new baby. Subscribe on iTunes and listen on the go to our free apps. Babies don’t come with instruction manuals. That’s why there’s Newbies, for new moms and new babies.

[Intro/Theme Music]

LAURA KELLER: In addition to feelings of love and wonderment, the postpartum period will almost certainly bring more stress and challenges than expected. Preparing a postpartum plan to share with those who'll be providing you support can make the transition into parenthood much smoother. I’m Laura Keller, childbirth educator, doula and lactation educator. Today we’ll be discussing how to create your postpartum plan. This is Preggie Pals.

[Theme Music]

STEPHANIE GLOVER: Welcome to Preggie Pals broadcasting from the Birth Education Center of San Diego. Preggie Pals is your online, on-the-go support group for expecting parents and those hoping to become pregnant. I’m your host Stephanie Glover. Are you just now tuning in to Preggie Pals? We’ve covered over 130 topics so far. Visit the episode guide on our website to scroll through the topics. Listen directly on your computer through iTunes or download our free apps available on the Android, iTunes, and Windows Marketplaces. Be sure to check out on our new network app where you can listen to all your favorite New Mommy Media shows on the go. Here’s Sunny for more information about how you can get involved with Preggie Pals.

SUNNY GAULT: Alright. Hi everybody. So Stephanie was just telling you about our apps and we have a segment where we like to review apps and we’re always looking for our listeners to recommend different apps perhaps apps you already have on your phone that you really like and you think other pregnant mamas could really benefit from. So that’s one segment you can participate in. We have an Ask the Expert segment where you can ask any of our experts any of your pregnancy questions. So that’s another. And then we also just love to hear from our listeners. So if you have any ideas for future episodes you would like us to explore or if you would just want to share how Preggie Pals has impacted you and your pregnancy, we would love to hear from you and we’ll read some of the comments on the show. So the ways you could submit for that, you could go to our website at www.newmommymedia.com, click on the contact link and you can email us. Or if you actually want to share your story yourself or ask the question yourself, you can call our voicemail at 619-866-4775 and leave us a message and then we’ll play that on a future episode.

STEPHANIE GLOVER: Great! Thank you Sunny! So let’s get started by doing some panelist introductions. I will start. Like I said, I’m Stephanie Glover, I’m 33, I host Preggie Pals and I’m also a trained childbirth educator. No due date but I have 2 kiddos. My 4-year-old is Gretchen and she was my c-section baby and my 2-year-old is Lydia and she was my VBAC. Kristen?

KRISTEN STRATTON: Hi I’m Kristen Stratton. I am a birth doula and a postpartum doula and I am also the host of our sister show, Newbies. So check out Newbies. I have 3 kids in 3 ½ years. That’s crazy. I have a 5 ½-year-old, a 3-year-old and a 2-year-old. So there you go.

STEPHANIE GLOVER: There you go. You’re busy and Shannon, how about you? Introduce yourself.

SHANNON: Hi I’m Shannon. I’m 31. I am a stay-at-home mom and part-time photographer. I just delivered my second child. His name is Emerson and he’s 8 weeks now and it was my second cesarean.

STEPHANIE GLOVER: Awesome. Thank you so much for joining us.

SHANNON: Thanks.

[Theme Music]

SUNNY GAULT: Okay. So before we get started today, we have a headline that we wanted to talk about. This headline is: stress leads many mothers to resume smoking after pregnancy according to a new study. So here’s the scoop. It says new research shows that the strains of motherhood are leading up to 90% of women who had quit smoking to resume smoking especially those from poor backgrounds.

It says the study of interviews with 1,031 women have found out that some women who have given birth go back to cigarettes under pressure from friends or because they see it as a way of regaining their identity. Which is I thought was really, really—that last part of regaining your identity like I can kind of relate to that, not from the smoking end of it but sometimes you just feel so lost in the beginning right? And you want to regain something—

STEPHANIE GLOVER: something from your pre-baby existence.

SUNNY GAULT: Right so smoking might not be the healthiest to regain. But you know different things for different people. And so I kind of wanted to throw this out to you guys and see what you thought. 90% seems really high to me but I don’t know if you guys have experienced working with women in your own practices and stuff that this has happened to but just want to see what you guys thought. Stephanie.

STEPHANIE GLOVER: You know I’ve never been a smoker. The study does not surprise me because we all come up with some sort of coping mechanism to deal with stress of new mommy-hood. It’s disappointing only because I’m thinking about the health of the kiddos.

SUNNY GAULT: The secondhand smoke kind of thing?

STEPHANIE GLOVER: Yes. And my dad was a heavy smoker when I was young. And I had chronic headaches which only really in my adulthood have I started linking them perhaps. I don’t get them anymore. Well I’m not around smoke anymore so you know I think it’s disappointing but certainly not surprising.

SUNNY GAULT: Kristen, what do you think?

KRISTEN STRATTON: I think like you said, it’s a very, very stressful time and I think whatever your coping mechanism was pre-pregnancy is probably going to be your postpartum coping mechanism whether that’s extreme exercise. I’ve had clients who just throw themselves into very rigorous exercise routines to get their identity back, their body back. Or for like me. It was a thing of bad injuries then. My knees were great which is not very healthy either. But like Stephanie said, it can lead to chronic health issues both in the parent and the children.

And we do know that there’s also a correlation between smoking in the home and sids. So it think it would certainly be a good goal for providers to work with those postpartum moms and just be even more vigilant about giving them options for quitting—support groups, medications, therapies, whatever that is. And then for family members to be aware of how stressful it is to be a new parent and that they need to be more vigilant about reaching out and helping those new parents.

SUNNY GAULT: Okay. Anybody else? Any ideas? Thoughts?

LAURA KELLER: I think that having open communication with your provider also helps because they might not have known that you were a smoker previously especially if it was just a part of your life before or it was just a part of your identity. And having that open communication will help your doctor provide you with other skills and give you people to talk to or reach out to or support groups or things like that so that you have another outlet to cope during your pregnancy. If you weren’t smoking, how you were coping during the pregnancy because pregnancy is stressful. I can definitely relate to not only picking up your habits once you’ve had a child to cope but also when you add children, when you already have one, it just compounds the stress.

SUNNY GAULT: Just a little.

LAURA KELLER: So I think having that open communication will definitely alleviate a lot of that pressure to go back to bad habits.

STEPHANIE GLOVER: And I think tying into our topic for today which is postpartum plans, going into—I’m sure that it will be difficult to quit smoking even during pregnancy especially if maybe it was a surprise pregnancy, you weren't planning on it. But it is a big adjustment and there’s a lot of thing surrounding our postpartum experience that we need a lot of support from our family, our friends, and those around us. So making that part of our postpartum plan would be how do I continue not smoking and making that conscious effort that it takes a lot of support for as well.

SUNNY GAULT: Okay. Thanks ladies.

[Theme Music]

STEPHANIE GLOVER: So today we’re discussing how to prepare for your postpartum period. Joining us here in the studio is Laura Keller. Laura is a certified childbirth educator, doula and lactation educator. She works with expectant parents to help prepare them for their postpartum period, childbirth preparation and breastfeeding classes. Welcome to Preggie Pals Laura and thank you for joining us.

LAURA KELLER: Thank you for having me.

STEPHANIE GLOVER: So many expectant parents are familiar with what a birth plan is. But what is a postpartum plan?

LAURA KELLER: Sure. A lot of expectant parents spend a lot of time and energy focusing on creating their birth plan and getting ready for everything surrounding labor and birth experience. But creating a postpartum plan is just as important as having a birth plan. And what a postpartum plan is, it’s just a plan for what’s going to happen after the baby is born and what kind of support and resources do we need.
You’re probably familiar with the concept of the fourth trimester which basically means baby has been 40 weeks inside mama’s belly and they have all their needs met. They are warm and cozy and never hungry. And then they’re adjusting to life in the outside. And so those early weeks and months of a baby’s life takes so much time and energy and focus from parents that we all just need our village, our resources surrounding us. So postpartum plan is just thinking about what resources do we need and how can we plan ahead to make that transition smoother.

STEPHANIE GLOVER: And would that plan include a certain—well you mentioned the fourth trimester. So would that be immediately following delivery through the first few months?

LAURA KELLER: Sure. It would encompass of course those first few weeks. It can be sometimes the most challenging. But the several months after you know becoming a parent can be full of transitions as well. So a postpartum plan would include not only those early days but support for several months afterward.

STEPHANIE We’re all parents so I think we can agree that right when you think you got something handled, you got to land another curveball in your face.

LAURA KELLER: Absolutely.

STEPHANIE GLOVER: So at what point in pregnancy should parents begin creating this plan.

LAURA KELLER: Definitely well before the birth. A great time to start thinking about your postpartum plan is as you’re also creating your birth plan and thinking about how that whole phase of your experience will go. A great time to start working on it is also when you have any sort of baby shower or celebration or time when maybe your family and friends are getting together. Prior to that you can think about what kind of support specifically will I need from my family and friends. And then when you’re all celebrating and getting together, you can maybe have people sign up for specific ways that they can support you and commit to something specific that they’ll do for you after baby comes.

STEPHANIE GLOVER: Okay. So take us through some of the main things. Maybe start thinking about resource-wise. We are just going to start here assuming that the mom has had an uncomplicated delivery and recovery. Because I know that that can also affect how you plan if you have something a little bit more complicated. But let’s start with just sort of a simple scenario. What are some things to include in your planning?

LAURA KELLER: Sure. I will say the process of creating the postpartum plan, just like with the birth plan is just as important as the plan itself. So it's a way for you to sit down with your partner and your family and think about what kind of expected challenges we might be working through together. Some of the things postpartum plans might include would be a list of support people and how specifically they might help you. Maybe it’s bringing meals over, helping with not only baby care but really focusing on the other aspects of your life—taking care of other kids, other pets—how they can logistically help you focus completely on your baby. The important thing is that those early days, bonding with your baby, establishing breastfeeding and any way that other people can help you just focus on that is what you would include in a postpartum plan.

You also might think about hiring a postpartum doula which is somebody who is a specifically trained professional who will help you with all of the different aspects of becoming a new mom, breastfeeding support and baby care as well. You would also want to have a list of breastfeeding resources if you’re going to be breastfeeding and you experience any challenges along the way. There are resources available in your community that you would want to research beforehand. Also just having a plan for self-care for both you and your partner. So you’re kind of establishing your new normal and settling into life as parents. And that comes with a lot of adjustment, a lot of time and energy focus and lack of sleep. So building in time and ways that you can simply just take care of yourself and your partner also can take time to just rejuvenate. Because for you to be the best parent possible, you need to make sure that you’re taking care of yourself as well.

STEPHANIE GLOVER: Put on the oxygen mask first before assisting another.

LAURA KELLER: Exactly.

STEPHANIE GLOVER: Now Shannon, you are a mom of two. So were you able to kind of create that postpartum plan with your first pregnancy? And how did it differ once you added the second child?

SHANNON: Oh it differed significantly. So with our first child Gabriella—we were in Tampa. We were home and my in-laws lived there. My mom was in town. I had all of my friends and stuff like that nearby. My husband had just joined the navy. So we were preparing for him to leave us to go to boot camp when Brie was 8 weeks old. So we stayed with my in-laws for the first 8 weeks and then I went up to my mom while he was in school in boot camp and I was there for the next 6 months so I had a great postpartum support team. My village was strong. I learned a lot. I got to spend a lot of time with my grandmother and she bestowed some of her wisdom on me as well. It was just really, really ideal. Everything just kind of fell into place with the first time around.

STEPHANIE GLOVER: And then how did it change since you moved away from your tribe?

SHANNON: We drove across the country because my husband’s first duty station is here in San Diego and we knew that wanted to become pregnant pretty soon after we moved. So when I got that positive, I went to find my team basically. And I’d already known who my obstetrician was going to be because I'd heard about him through ICAN and had already got my insurance settled and that was taken cared of but I knew that I wanted a doula because I was going to attempt to VBAC. So I asked ICAN and got some good recommendations and settled with Linda Goldsmith at Pregnancy Sanctuary. That was the first step and everything else fell into place. It wasn’t until my second trimester when I got that burst of energy that I started to think okay, who do I want to fly out here when? Because it was really important to me to have support, but also I’m the type of person where there are a lot going on, I'm not satisfied laying on the bed with the baby. I want to be in the middle of things, enjoying it as well, especially when I have a family in town that I don't get to see otherwise throughout the year.

STEPHANIE GLOVER: So I don’t want to nap through this. I want to see my mom. I want to hang out.

SHANNON: Exactly. So what I did that helped us is I staggered my help. So for the first 8 weeks, my mom was here and then she left. My father and my stepmom will be here for Thanksgiving and then my in-laws are going to come for Christmas and New Year’s. So the fourth trimester has been covered. It’s really been good. The only thing I did was when we moved here, I started to not only think about who I needed to have through pregnancy but also afterward like as far as meals were concerned. And my mom was here and she cooked and stuff. It was helpful. But also my local friends in my community were asking me what do you need for the baby shower, what do you want? And a lot of times I was like I don’t really need blankets.

Can you bring me over a casserole dish, lasagna or something that I can throw on my freezer and that’s been instrumental? I still have food on my freezer from my neighbors and things like that that have really, really stepped in to donate and help me stay out of the kitchen when it gets overwhelming. You know one thing I learned too was with those meal trains and whatnot even though maybe mom is in town, they're so busy doing other stuff particularly when they're taking care of an older sibling, they kind of need to be cooked for too. And so we received meals for a good 6 weeks. And my mother-in-law was equally appreciative I remember. Because she even needed some self-care because they’re doing so much for us, things that we can't do.

And the tendency is to think about what are we going to need for dinner? What do I want for dinner and I had one of my friends bring over lunches. Because it was the middle of the day the baby was asleep. My oldest daughter Brie, she still naps so we’d be sitting there like 12:30 having gone through what I call the morning rush. And now it’s lunchtime and we’re pooped. So Shay would come over with sandwiches and platters and things like that. We’d have lunch and nap while the kids were sleeping. It made it so much easier.

KRISTEN STRATTON: Someone coming over with some bagels and fruit salads in the morning.

STEPHANIE GLOVER: Kristen how about you? Were you able to formulate postpartum plans with any of your pregnancies?

KRISTEN STRATTON: My story is a little similar to hers in that with our first, my husband deployed when our daughter was 4 weeks old. So I actually did move back in with my mom for about half of the deployment and then towards the latter half moved back into our house on the base.
Then we had our second and we moved 2 weeks after he was born to San Diego. I immediately had already researched and signed up for MOPS and I found MOPS. And even though my baby was 4 weeks old by the time it started, they did a meal train for me and had me forever in their debt. Please sign up for MOPS. If you’re listening go to MOPS.

STEPHANIE GLOVER: Mothers of Preschoolers if you’re wondering what it is.

KRISTEN STRATTON: Go to MOPS. And then when we had our third, we were still in San Diego but again we’re a military family so even though our family is about 1 ½, 2 hours away, it’s still a lot for them to come down on a regular basis. So again with the meal trains, to be honest in retrospect, I didn’t really know what a postpartum doula was. But next time if we have another baby, I’m saving for a postpartum doula because I just really think that I had a lot more help with breastfeeding and with laundry and with dishes. It would have been a lot nicer those first few weeks. Sorry husband. Thank you for being married to me. And then my mother-in-law- She was very, very sweet and generous with her time. She did come down in the weekends when she wasn't working and she would just do all of our laundry that was just piled high to the ceiling. She would do all of it in one sitting. I'm like how do you get it done that fast?

STEPHANIE GLOVER: Because I'm not nursing the baby.

KRISTEN STRATTON: I think now that I know what I know now as a postpartum doula, I would: one, hire of one; and two, I would definitely be more organized. I learned the hard way.

STEPHANIE GLOVER: And so let’s touch on that very quickly. For those people who maybe didn’t even know a doula was a thing. You mentioned that they do live in a household.

KRISTEN STRATTON: I know. It was insane. And then I became one. Like wow, this is great.

STEPHANIE GLOVER: I would imagine too particularly with a military family. If you’re somewhere where you don’t have other resources, how instrumental it could be?

KRISTEN STRATTON: And such as when you first move because maybe you’re going to have your military wives that you bond with but when you first move, it’s stressful. You don’t know anybody. You’re in this new place, you’re trying to find the church, you’re trying to find the post office, you’re trying to find the grocery store. So you’re just so consumed by that that building and bonding with other people is kind of last on your list until you have time for it, especially with a new baby.

So basically what a postpartum doula is she’s trained in baby care and mommy care. She’ll come in, she’ll help feed you. The first thing she does when she gets in, she makes sure you have water, do some laundry for you, do some tidying around the house, maybe hold the baby while you take a shower so you can shave. That’s really nice. That makes you feel like a human again. So I would definitely look into it and see if you can budget for that. It’s a luxury but it’s amazing.

STEPHANIE GLOVER: When we come back, we’ll discuss things to consider if postpartum becomes more complicated than expected. We’ll be right back.

[Theme Music]

STEPHANIE GLOVER: Welcome back. Today we’re discussing how to put together your postpartum plan. Childbirth educator, doula and lactation educator, Laura Keller is our expert. So we all know that labor and postpartum can be pretty unpredictable. Are there some common unexpected outcomes to plan for in the postpartum period Laura?

LAURA KELLER: Sure. And of course not a great complication we can predict. But we do our best and just kind of anticipate some of the needs that we might have. One of the most common unexpected outcomes might be if you have an unexplained cesarean delivery. And of course if that's your case then you would be having a little bit more of a longer recovery time. You want to spend some extra time being gentle to yourself and might even have a bit longer of a hospital stay at the beginning.

I would say any of the unexpected outcomes that we talked about, education is one of the most important ways that you can prepare. So hopefully you’re taking a childbirth education class. And if you do, they will cover, no matter what kind of class it is, they'll cover what would happen during some of these unexpected outcomes like if you have a cesarean delivery. And if you are for some reason have a higher likelihood of having a cesarean or other complications, of course, you want to do research and just educate yourself about what to expect if those complications do arise and how to better prepare and put your postpartum plan surrounding that.

Another unexpected outcome might be if you have your baby would have complications and they might spend a little more time in the NICU which is the Neonatal Intensive Care Unit. And of course, if that were your situation, you would need a lot of extra support not only physically and logistically but emotional support. So again researching your hospital's resources beforehand especially if maybe you’re at high risk for premature birth or having multiples, you might kind of anticipate and understand what resources are available to you.

So oftentimes, your hospital network would have support groups and resources where you can connect with other parents who have had similar situations. And you can take that extra support that you would need. And again, just postpartum period is all about taking time to let yourself heal and recover. So if you have any tearing or stitches or you just kind of have some physical exhaustion just from being a new parent. There are so many situations where you just want to make sure you're taking that extra time to take care of yourself. Limiting physical activity. You don’t lift anything heavier than your baby. For those first several weeks and take the time to gradually ease yourself back into your exercise and your normal life.

Another unexpected outcome might be breastfeeding challenges and these challenges can arise not only in the early weeks but even in the early months. There are a lot of different ways that breastfeeding is a wonderful and amazing thing that we do. But there can be a lot of times where it can be difficult. There are a lot of resources available in your community after the fact so lactation consultants, breastfeeding support groups. But again the education piece is just so, so important. So I highly recommend taking a breastfeeding class. The more you know about breastfeeding before you give birth, the higher the likelihood that you’ll have a successful breastfeeding experience. And you’ll kind of be able to anticipate some of those challenges and understand what’s happening with the whole process. So again, education is just key for all these outcomes. And just be gentle with yourself and allow yourself time to heal, to adjust to your new normal.

STEPHANIE GLOVER: I think I know the answer but for our panelists did either of you have unexpected outcomes that affected your postpartum period?

KRISTEN STRATTON: Yes I did. I had unplanned cesarean births and that was not only emotionally difficult but physically difficult. I mean you’re recovering from major surgery so you can’t move about as you would have you had an uncomplicated vaginal birth. And I know some people have a really difficult vaginal birth and feel similar in terms of their mobility. So self-care is just really important. You really can't rush up these so you really are relying on the kindness of others so that’s actually something that I really recommend to moms and dads or partners. To really think about having the right people over at the right time. Because while your friend may be really, really funny and really, really great to be around, she may be a terrible cook or really terrible at laundry.

SHANNON: And if you have a c-section and you’re laughing at the beginning, it really hurts or sneezing. My mom and sisters are telling some funny stories about how they got lost in the hospital. And I was still in the hospital after my C-section and I was crying because it was funny. But you have to stop I can't even look at your face right now.

KRISTEN STRATTON: It feels life your tummy is a ball of jello.

SHANNON: And have the funny friend come over in 3 months.

KRISTEN STRATTON: And if you have someone that is not particularly helpful and will probably want you to entertain them, they should probably come at the latter half of that fourth trimester as compared to someone who’s just like yeah, give me the laundry. You go upstairs and go to sleep. I'm going to do this for you. Those are people you want to come to immediately. As was mentioned before, you might want to have people sign up so that those people can come at the right time. Very important.

STEPHANIE GLOVER: Good. How about you Shannon?

SHANNON: yes I ended up with another c-section too and I was 39 weeks along and 4 days and I fell down the stairs. So that landed me in the hospital. And with my c-section and I wasn’t planning for that at all. But luckily because my mother was already in town because I was due in like a week, it really, really made it a lot easier. My husband had time off so I think that having the support and planning ahead like that cannot be stressed enough. It really, really can be instrumental when things can change very quickly and also having care for Brie, my neighbors were like okay you’re going to the hospital. I’ll pick her up and I’ll keep her for this night. Emerson has jaundice. You have to stay another night in the hospital so he can stay on the lights. I’ll do this, this and that. So it was really, really good. Really great!

STEPHANIE GLOVER: And I remember too because I’ve had each type of birth and I thought especially if you have another young child and older sibling to care for, you take for granted that you still have to rest and heal. And so when I had my vaginal birth I thought I’d be up and running around and jotting and doing this. And I still had to give myself a good 6 weeks to chill out. And so I was so thankful that my mother-in-law was there the whole time and would remind me like look, you can't lift that. We went to IKEA together and I was trying to move something off the shelf and I really thought my vagina was going to fall out. And I didn’t expect to feel that way because I think I pulled something. And I’m like I’m just going to go sit in the car. So because I think we try to be super mom and do too much too soon and it’s a good reminder too.

SHANNON: It can be difficult for the older child too like I had guilt because Brie, she wanted to climb on me and she wants to play with me. And I remember lying in the bed and Emerson was asleep with my husband. And Brie toddled up the stairs. “Mama, mama” and she gets on the bed and she’s like walking towards me because why would you crawl on the bed? Of course, stand up and walk towards me. I was terrified of her.
I was like she was going to fall on me and I'm going to bleed out up here. And no one is going to find me for like an hour because I’m supposed to be on nap.

KRISTEN STRATTON: You know what are funny about that is even years after having cesarean births, I still am very protective of that spot. It’s automatically reactive about that when my son comes to jump on me. I’m like no!

SHANNON: Absolutely. Me too!

KRISTEN STRATTON: Yes. You’re right. You really have to be careful.

STEPHANIE GLOVER: Thankfully today we’re better at recognizing postpartum mood disorders and how they are actually common. There are better ways to diagnose and treat them. But what are some ways to prepare in the event that mom develops a postpartum mood disorder whether it be depression or anxiety?

LAURA KELLER: Postpartum mood disorders are more common than you might think. And a lot of women, a lot of people in general don’t really talk about them as much as we should. And everybody kind of expects you to be its a happy time and you have a new baby. But it is quite common for a woman to experience postpartum mood disorders. And we’re probably familiar with the baby blues right? So up to about 80% of women experience just mood swings, anxiety just some general over the first few weeks of having a new baby you might experience some of these symptoms being irritable, crying for no reason or kind of experiencing a lot of hormonal shifts. That usually go away within about a week or 2 but if it doesn’t then it might be a sign of postpartum depression or another postpartum mood disorder.

This basically means again that baby blues are a lot more common. But some women do experience postpartum depression which doesn’t necessarily go away on its own. Some of the signs and symptoms are similar but they may be more intense and last longer and might even interfere with your ability to care for your baby. Some of the symptoms of postpartum depression would be just kind of a general depressed mood or mood swings, crying excessively, having difficulty bonding with your baby, feeling withdrawn from your family or friends, experiencing changes in your appetite either you just can't sleep or you feel like just want to sleep all the time more so than is just normal for that exhausting time period.

Just feeling extreme fatigue, loss of energy and it kind of comes along with some emotional side effects too. Feeling like you’re not a good mother, you just can't get past some of those anxieties. So both postpartum depression and postpartum anxiety are very real disorders that affect about up to 15-20% of women. And what a lot of people don’t realize is that the symptoms might appear later on so it’s not necessarily just in those first early weeks. The symptoms could appear 6 months or up to a year in postpartum.

STEPHANIE GLOVER: So yes, it’s just educating yourself than knowing what to look for and probably getting partnering on that conversation as well because sometimes we don’t see it in ourselves. But the partner can be like you’ve been acting kind of funny. Your sleep’s been off and that’s a way that you could probably include that into your plan.

LAURA KELLER: Exactly. So being aware of having others around you also help you recognize the symptoms because you just kind of assume well this is probably normal. I’m just probably really tired because of the baby and others around you might recognize the outside of normal. It definitely can be something. Again education is the key and as you’re creating your postpartum plan and just thinking about what resources are available to you. There are a lot of resources in most areas whether it’s support groups. If you do experience a postpartum mood disorder like postpartum depression or anxiety you definitely want to talk to your care provider about that and whether its therapy or medication kind of a general idea about postpartum mood disorders, depression and anxiety are that they’re sometimes the hardest to diagnose but they’re some of the easiest to treat. So there is help available and it’s something that’s quite common that women experience. So there is help available for you.

STEPHANIE GLOVER: Shannon, do you have any experience with preparing or experiencing postpartum—

SHANNON: Yes. So with my first daughter, I had baby blues and it lasted for about 2 weeks and it’s just alleviated on its own. This time around we’re dealing with some really hard family things. My grandmother passed away 9 days before I delivered Emerson so there’s a lot of grief there going on. My mom was here like I said and I noticed when she left and things started to quiet down, it was hard for me to engage with my son and to get excited about him and just have that rush of emotion that I experienced with my daughter.

I broke down one time because I was like when he cries my milk doesn’t even let down. With Gabriella, I could hear her across the room. I could hear another baby cry and I would be like where’s my pump? I need to express. And I’m just not experiencing that right now. And my husband kind of mentioned to me “You seem a little bit different and challenged”. And it took one day where I just broke down over something silly as I was making soup and burned dinner. I was like, this was going to be the thing that I did amazing today and I failed at this day. It’s terrible. I had a total meltdown and I called the doctor immediately.

The next day I got an appointment. I have an appointment Monday with the therapist so I’m on the mend. But it's definitely something that if you know what to look for and if you’re not yourself even more so than just being tired or anything like that. If you’re having thoughts about your children not being your world or anything like that then maybe step away and do more than your usual self care than you would for yourself and get the support that you need because it really is a lot. And it's not something that is commonly discussed. It's not something that everyone knows is common. I didn’t know it was common. I haven’t dealt with depression until now. So I think that having your support team and a good relationship with your provider is so instrumental.

STEPHANIE GLOVER: And it sounds like you were educated to recognize that even within yourself.

SHANNON: Absolutely. Yes. The baby blues helped a lot the first time. Like okay, I’m still feeling this way times a million.

STEPHANIE GLOVER: You had a gauge.

SHANNON: Yes exactly.

STEPHANIE GLOVER: Thank you for sharing. So thanks for joining us Laura and thank you to all the panelists that have sat in on today’s show as well. For more information about Laura as well as information about any of our panelists, visit the episode page on our website. This conversation continues for members of the Preggie Pals club. After the show, Laura is going to discuss how to help create a postpartum plan for your baby’s older siblings. To join our club, visit our website at www.newmommymedia.com.

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MOLLY: Hi Preggie Pals. This is Molly from Akron, Ohio. I am currently pregnant and this is my very first pregnancy and I’m really excited. But unfortunately, my husband does not seem to be anywhere near as excited as I am. He has no interest in going to any of my appointments, doesn’t even care when my belly—when the baby’s kicking, he doesn't want to feel it. And I just don’t know if this is normal. I mean how can I be so excited and he’s not at all? So I’d like to kind of know what’s going on inside his head. And if you could help me with this, I’d really appreciate it. Thanks so much.

Danny SINGLEY: Hey Molly. I’m Doctor Danny Singley, licensed psychologist specializing in men’s issues and the founder of basic training for new dads parenting class. You raised an excellent question. One that guess at how men and women tend to express their feelings pretty differently. It’s understandable why you’re confused about what seems like your husband's lack of enthusiasm on having a new baby. So what I’d encourage you to do is to realize that there’s likely much more than just experience being an expectant dad than meets the eye. Most dads than moms to be experienced a wide range of emotions, excitement, curiosity, anxiety and even sadness. However while women in this country are typically socialized to be more verbal and vocal about expressing their feelings, men simply aren't typically accustomed to doing so. For example, paternal postpartum depression and anxiety are fairly common. But it’s not widely understood that men tend to express them differently than women.
More than symptoms can begin during pregnancy. We tend not to express these things until they are shown largely on to the radar. Your fellow is likely to be ambivalent about the impending arrival and clamming up about it is a very common way that men deal with very concerning questions like how will I provide financially, what will my work-life balance look like, will I ever have fun again or see my friends, how is my relationship with my wife going to change, will I be able to care for a baby?

Dads are "supposed" to be very excited about having a baby and expressing these types of concern to mom flies directly in the face of the John Wayne guy code. For example when my wife was pregnant, I wanted to be the sturdy oak and keep my feelings to myself about concerns ended up going too far because I didn't include her into the stresses I'm judging until they've gotten pretty far along. Ultimately talking to her about it was pretty helpful although very difficult. Also for some dads the baby just doesn't seem real until it's born or until it starts to do more gross motor activities like rolling over and crawling or stereotype of I really like him most when he can throw a ball. It's an old one. It's pervasive. But usually after the birth, dad gets riding in there and start feeling connected with their baby. Another point is they're supposed to be highly involved with their partners and babies but rarely had the chance to observe their own dads or other types of concrete models about exactly how to do so. Most parenting classes for expecting parents aren't much help because they tend to give dad a message that the only way to support baby is to support mom. But the reality is dads can be virtually everything that mom can do with the infant except nurse them.

So what to do? One gives dad as much practice swaddling and scooping and even burping as much as possible. I would also sign up your hubbies to receive a weekly email from an online service. Something like www.babycenter.com which gives a brief executive summary of baby and mom's development as well as how the circumstances are changing. Another point is just don't expect him to express himself in a traditionally feminine way. If or when he starts engaging in so-called daddy-connected activities like buying stuff and building and painting and stressing about finances, just recognize this as a way that men are socialized to do and not feel. Another is just realizing he does need your support even if you can't tell but he also needs that outside of your relationship. So encourage him to go spend time with his friends and bonus points if there happen to be buddies of his who are engaged dads who can talk about what a great experience it is.

Finally if you or your husband has experienced a history of anxiety or depression then you're at elevated risk to develop postpartum mental health issues so you should be proactive like consulting with a mental health provider as soon as possible. But 1 in 10 men experience postpartum depression and of those who have partners who have postpartum depression, 50% of those men themselves develop postpartum depression.
So it's important to be armed to navigate the transition of parenthood as effectively as possible. You could also go to www.postpartummen.com it has some great information about how postpartum depression plays out. I hope this info has been helpful to you. And best of luck in the journey ahead.

STEPHANIE GLOVER: That wraps up our show for today. We appreciate you listening to Preggie Pals.

Don’t forget to check out our sister show:

• Newbies – “Holla Kristen”. For postpartum moms during baby's first year
• Parent Savers for parents with infants and toddlers
• Twin Talks for parents with multiples and
• The Boob Group for moms who breastfeed

This is Preggie Pals. Your pregnancy, your way.

[Disclaimer]
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

SUNNY GAULT: How would you like to have your own show on the New Mommy Media network? We're expanding our lineup and looking for great content. If you're a business or organization interested in learning more about our co-branded podcasts, visit our website at www.newmommymedia.com.

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