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I have to admit that I had a very easy pregnancy. Not all women are blessed with an easy pregnancy, so I was very thankful. Throughout the nine months I was free of any complications, I didn’t gain too much weight, I continued to exercise, and I felt great. My doctor often said that I was making his job too easy, that was until my daughter was born.
As I mentioned in my post about our daughter’s arrival, she decided to enter this world with her one arm up beside her head causing some pretty significant tearing. By the way she still loves to have her arms and hands up by her face!! My doctor said after he had stitched me up that it was some of the worst tearing he had seen in a long time, not too comforting to hear. He reassured us that he had taken his time (it took almost 2 hours) to make sure that every thing was stitch up well and that it should all heal just fine. While he and another OB worked on stitching me up I did over hear something about a hematoma developing by the one internal tear but I didn’t really know what that meant. I was told it shouldn’t cause any problems, and that I would just need to take it easy for a while.
Before I left the hospital my doctor and his partner both paid me a visit to check on me and make sure that everything looked ok. Reassured that everything should be fine and equipped with the details on when I should call them I headed home. Everything was great for the first few days. I was, of course, in pain and taking the prescribed medication, but by the third or fourth day home I was off the heavy duty stuff and felt pretty good. My husband and I decided to take our daughter for a quick little walk to the grocery store (which is two blocks away) so we could pick up a few things. The walk went well and I continued to feel good for most of the day.
Around 8pm that night, the sixth day after our daughter was born, I began to notice I was bleeding a little heavier than I had been in the last couple of days and that the blood seemed to be pretty bright red (both signs of a potential problem). I didn’t think too much about it at first figuring it was just because of the walk that day and decided I would just keep on eye on things. As the evening progressed I continued to have the heavier bleeding and noticed a few small clots, I still didn’t think it was that big of a deal. By the time my daughter got up to eat at about 11pm the bleeding had gotten increasing worse and I was going though several pads an hour. I read through my information and determined that it was probably a good idea to call my doctor. I woke my husband at around midnight, gave him the baby, and called my doctor’s exchange. While I was awaiting his call I passed a very large clot (about the size of my fist) and was bleeding heavily. Understandably I was pretty freaked out, as was my husband who doesn’t do too well around blood. I explained what was going on to my doctor when he called and told him I was really scared. He advised me to wait and see what happened over the next hour, if it didn’t slow down or got any worse I should head into the ER. He explained that bleeding does sometimes happen and that it probably wasn’t anything to worry too much about. I felt a little reassured after talking to him but was still freaking out a little.
So we laid in bed and we waited, by 1am I was still unable to stand without gushing a lot of blood so we packed up and headed to the ER. By the time we arrived I had already bled through my pants and was feeling a little light headed. I advised the ER nurse of this and she quickly got me to the bathroom where I could clean up and change and then into a bed. The ER doctor came in to talk to me about what was going on and checked me out. He determined, after much poking and prodding, that the bleeding appeared to be coming from one of my tears. He advised they would send me for an ultrasound to make sure that the bleeding wasn’t coming from my uterus and he would call my doctor to let him know what was going on. I couldn’t have the ultrasound right away cause my bladder wasn’t full so I was hooked up to an IV for fluids and waited. Within minutes my doctor arrived at the hospital. We talked a little bit about what the ER doctor had seen and he said that unfortunately he would have to check me as well. Sure enough he found the same thing, bleeding from the one tear. He packed me full of gauze to help slow the bleeding and made arrangements for emergency surgery to repair the tear. Yikes, not exactly what I wanted to hear!
By 5am I was in the OR getting ready to have surgery. The next thing I knew I was waking up in the recovery room all fixed up (the wonders of modern medicine). I had lost a lot of blood both prior too and during the surgery so my doctor requested blood work to determine my hemoglobin levels. Normal for a woman is 11, my results came back at 5.6, not good. Since my levels were so low and I had lost so much blood it was determined that I would need a blood transfusion. Later that morning I was hooked up to my first of two units of blood. For the remainder of the day we sat around and waited while the transfusion was completed.
My doctor checked on me several times. On his last visit he said that once the final unit of blood was complete and my blood was draw for another hemoglobin test I could go home. He didn’t think I would get the rest I needed at the hospital and trusted my husband and I to be smart about things and call him immediately if something happened. He said he would call me the next day with the blood test results and that I should come in to see him in a few days to get checked out again. So we waited while the final unit of blood was administered and then by 9pm on the day our daughter turned one week old we were heading home, again.
So, it turns out that the hematoma that had developed under the one tear began to bleed when the swelling in the birth canal started to go down, that was what caused the hemorrhaging. There was nothing I could have done any differently, and I was assured the walk I had taken that day had nothing to do with it. The tear has now been repaired and on my follow up visit a few days later everything looked good. It was a very scary thing to have to go through but I had a great husband to help me through, and an outstanding doctor. I really can’t say enough about how important it is to choose the right caregiver for your prenatal care.
I’ve learned the hard way that things don’t always go the way you hoped after the delivery, sometimes complications come up. The important thing is to know what to watch out for, to have good communication with your doctor, and to know yourself enough to recognize when something isn’t right. It has now been two weeks since my little scare and everything seems to be ok.
Good news on the postpartum depression front. The State of New Jersey became the first state to require that all mothers be screened for postpartum depression prior to being released from the hospital. The new law became effective late in 2006.
Early diagnosis of postpartum depression, or a risk of postpartum depression, can help ensure a woman receives the right treatment to prevent PPD from taking over her life. If a mother knows she is at risk, or knows she has postpartum depression, before leaving the hospital she will be able to make the necessary arrangements to have adequate help available, start any necessary medication immediately, and begin talking to a professional.
Close to 80-90% of women have some form of the baby blues during the first days and weeks after bringing their new baby home. Postpartum depression is a more severe form of the baby blues. Postpartum depression last longer and require medical or therapeutic assistance to overcome. The rate of diagnosis of postpartum depression is up 20% in recent years partly because moms know more about the disorder and what to look for, doctors are more closely monitoring their patients for signs of the disorder, and people are more open to talking about it.
Hopefully we will see more states follow New Jersey’s lead and begin screening new moms before they leave the hospital. At the very least every mother and her partner need to know what to look for.
For more information on postpartum depression visit postpartum.net. If you think you may have postpartum depression talk to your doctor.
The birth of a new baby is a joyous and happy occasion, but it can also be very overwhelming. When you consider all the changes you body is going through, particularly when it comes to your hormones, as well as the inevitable lack of sleep, the stress of adjusting to your new schedule and new baby, and the pressure that women often put on themselves to be the best at everything it isn’t any wonder that many women suffer from some form of the “baby blues” or postpartum depression.
Luckily for many women the “baby blues” come and go quickly during the first weeks after the baby arrives. However, for some women these feelings do not go away or may become worse. The symptoms, like with any form of depression, can range from mild to severe. The following is a list of the common signs of postpartum depression.
- Feeling overwhelmed
- Feelings of hopelessness
- Feelings of helplessness
- Suffering from deep sadness or crying a lot
- Being restless and irritable
- Lack of energy and feeling sluggish or exhausted
- Feelings of nervousness or being jumpy
- Feelings of worthlessness and guilt
- Lack of appetite and associated weight loss
- Having no interest in your new baby
- Being overly worried about your baby
- Withdrawing from friends and family
- No interest or pleasure in any activities, particularly those you used to really enjoy
- Either being unable to sleep or sleeping all the time
- Unable to cope with your daily tasks
- Thoughts of death, suicide, or harming your baby
If you have any of the above symptoms you should call your doctor immediately so you can get treatment. There are many treatment options for postpartum depression ranging from counseling to medication. The best treatment options for you will depend on how severe your symptoms are. Your doctor will be able to make recommendations for you and refer you to a therapist or support group.
No one knows for sure what causes postpartum depression, but hormones are suspected to be the likely cause. Now that postpartum depression is more out in the open, hopefully more research will be done and more can be discovered about the causes. Studies have found that women with a personal or family history of depression are at an increased risk of suffering from postpartum depression. You are also more likely to suffer from postpartum depression if you suffered from it after a pregnancy.
Remember that you are not alone, many women suffer from postpartum depression. The best thing for you and your family is to get help, talk through it, and take care of yourself. Here is a very helpful website, Postpartum Support International.
Many hospitals and pediatricians advocate the practice of rooming in with your baby at the hospital. It allows for better bonding between mother and baby (dad and baby too), helps you get to know your child’s schedule and personality better before you head home, and has been found to help both mom and baby get comfortable with breastfeeding more easily.
Having the baby head to the nursery so you can get some much needed rest may sound appealing, especially if you had a particularly hard or long labor. However, researchers have found that mothers who room in with their babies and those who do not get relatively the same amount of rest. When you baby is off in the nursery you will often awake to the sound of any baby crying, worried that it is your own; and you will be woken up by the nursing staff as they will need to bring the baby in for feedings throughout the night. Although it seems like you would get more sleep if the baby wasn’t in the room, that isn’t necessarily the case.
Those early hours and days after birth are very important in the “getting to know you” and bonding process. The more time you spend together in those early days getting to know each other the faster you will learn your baby’s special personality, needs, and schedule. When you go home you will feel much more comfortable if you have spent a lot of time getting to know your baby in the hospital.
If you plan on breastfeeding your baby, which I am a huge advocate of, those early days are instrumental in being successful. Babies who spend their nights in the nursery are often given water and formula as supplements so mom can have more time to sleep. These supplements are often not necessary and can negatively impact the learning process for both mom and baby. Learning to breastfeed takes time, practice and patience. With the help of the valuable nursing staff at the hospital you can be successful, and are more likely to be successful if you have your baby room in with you. So why not?
Every situation is different so talk to your doctor about your specific needs. If you had a c-section or especially hard vaginal delivery your doctor may recommend having the baby spend the first night in the nursery so you can recover. Also, if your baby has any special needs then of course rooming in won’t be an option. The nursing staff, your obstetrician, and the pediatrician can talk to you about what is best for your situation and help you make the choice that is right for you and your baby.
No matter which option you choose remember to enjoy those first few days getting to know your new baby.