Professor Jayashri Kulkarni, from the School of Psychology at Australia's Monash University, found that "women using the pill had an average depression rating scale score of 17.6, compared to 9.8 in the non-user group. The women involved in the study were aged over 18, not pregnant or lactating, had no chemical history of depression, and had not been on anti-depressant medication in the previous 12 months." Subsequent research conducted by www.aphroditewomenshealth.com found that "57 percent of respondents reported mood swings, and 69 percent felt anxious and depressed after taking hormonal contraceptives. Over 50 percent of respondents who were taking anti-depressant medication were doing so to treat depression that occurred after beginning hormonal contraceptives."
HOW TO SUPPORT A NEW MOM!
Information is so empowering especially when we have to talk to doctors about how were feeling. Before you see your OBGYN or Physician or Midwife take this questionaire from progesteronetherapy.com.
TESTING OPTIONS FOR POSTPARTUM IMBALANCE:
All perinatal imbalance is likely to result from a combination of three factors: biological, psychological and social. This is referred to as the biopsychosocial model. In other words, Perinatal Imbalance is likely to result from a combination of factors relating to Mind, Body & Spirit:
Mind (psychological, emotional)
Body (biochemical, nutritional, hormonal, neurochemical)
Spirit (connections to society, source and self)
A Standard way evaluate women’s mental health throughout pregnancy and the postpartum period by using the Edinburgh Postnatal Depression Scale (EPDS). It's a series of 10 questions that are designed to help a new mom identify any imbalance. I find if a mom is scared she might not want others to know what she's really thinking for fear that her child will be taken away from her so it's important that she know she's got rights and that she is safe with the person doing the evaluation. Many moms prefer to fill it out themselves in the privacy of their own home.
BODY - BIOCHEMICAL IMBALANCE
Nutrients are essential for brain growth and development, as well as for good physical and mental health. According to an article written by Drs. John Neustadt, ND and Steve Pieczenik, MD, PhD, NBITC, antidepressants can be helpful but they don’t treat the underlying biochemical causes of postpartum imbalance. Antidepressants just treat symptoms. After all, no one has a deficiency in Prozac. They state that pregnancy is a tremendous stress on the body. It increases a woman’s risk for nutritional deficiencies and subsequent depression. Post-partum depression is therefore simply the manifestation of subclinical nutritional deficiencies and the spectrum of biochemical changes that can occur in pregnant women. The underlying biochemical causes of post-partum depression can be treated. NBI Testing and Consulting Corp. (NBITC, www.nbitesting.com) tests can determine deficiencies in specific amino acids, vitamins, minerals and fats that are the underlying causes of post-partum depression. Through the use of Targeted Nutrient Therapy™, customized programs are provided to clients that replenishes their deficiencies and promotes health.
BODY - HORMONAL IMBALANCE
There is a wonderful company called ZRT Laboratories which performs salivary hormone testing. Saliva samples are collected in the home and mailed directly to ZRT Laboratories. Your trained postpartum specialist (Midwife, Physicians Assistant, OB/GYN, HRT specialist, or Medical professional) will work with you to review your results. Moms are tested for estradiol, progesterone, testosterone, DHEA, and Cortisol. It is important to have all five of these hormones tested! It usually costs $150 to test estradiol, progesterone, testosterone and DHEA and $150 to test Cortisol which is tested at 4 different times in a day. Follow these steps for testing your hormones with ZRT:
Step 1: Contact your insurance company in advance to find out if saliva testing is covered under your policy, if they cover saliva testing through a non-participating provider (ZRT Lab.), and what percentage of saliva testing is covered. If your insurance is not one that ZRT will bill directly, find out if and how you can manually submit for reimbursement following testing. Gie your insurance company the following CPT codes: (Estradiol 82670), (Progesterone 84144), (Testosterone 84402), (DHEA 82627), (Cortisol AM 82530) Saliva testing is covered by several insurances, but not all insurances and not all policies ZRT does bill some insurances directly, and ZRT would need to be contacted directly to see if your insurance would be included. (Tip: assume your insurance is not going to pay for it, but hope that it will and you won't be disappointed) Medicare pays for testing 100% in most cases. If your insurance doesn't cover the entire cost of your test, you are responsible for any remaining balance.
Step 2: If billing to Insurance company, ask your postpartum specialist to write a prescription to complete saliva testing. (note: if you are not submitting to insurance you don't need a prescription). Submit your prescription from your postpartum specialist with your saliva sample. The prescription must order "Saliva Hormone Testing" and a list of the hormones to be tested on the prescription along with an ICD-9 diagnostic code (259.9 Hormone Imbalance). It should be signed and dated by the postpartum specialist with a date prior to testing.
Step 3: Your postpartum specialist will give you your ZRT kit. Fill out the patient requisition form inside the kit (female side) including the symptoms, current hormes, etc. Also include a copy of the front & back of your insurance card, and the signed ZRT Insurance Authorization form with your sample submission. Do not take any hormones or use any facial creams within 12 hours of collecting saliva.
Step 4: Collect your saliva between days 19-21 of your menstrual cycle (use the first day of your period as day one). Saliva should be collected within the first two hours of awakening. When you wake, don't eat, drink, brush your teeth or floss. Wash your hands to prevent any contamination. Rinse your mouth out twice with water to clean your mouth and begin collecting saliva in the tube(s). Tubes must be filled between half and three-fourths the way full. If you are collecting evening cortisol, collect the sample at bedtime (no food, drink, water 2-3 hours before). Label tube with name, date and time and put in plastic bag with the ZRT patient requisition form, prescription, copy of the front and back of your insurance card and the signed ZRT Insurance Authorization form. The results will be sent to you along with a copy to your postpartum specialist within 2-3 weeks from the date mailed. Following saliva testing you, your specialist and your compounding pharmacist can communicate to prepare a recommendation for your hormone replacement needs.
(NOTE: If you can't find a postpartum specialist you have the option of going to a compounding pharmacy in your area for an individual consult to review your history, symptoms and hormone levels to prepare a letter of recommendation for your physician.)
(m o r e t o c o m e)
INFORMATION EVERY MOTHER SHOULD KNOW ABOUT
NUTRITIONAL, HORMONAL AND NEUROCHEMICAL BALANCE
AS IT RELATES TO POSTPARTUM
1) NUTRITION: The structure and function of every organ, gland, muscle and bone in our bodies are dependent upon adequate nutrition. Most physicians are ill informed about the mysteries of biochemical nutrition - the study of nutritional building blocks as they relate to the form and function of the body. You can test MicroNutrients in a blood test or you can do MicroNutrient testing to assess your vitamin, mineral and antioxidant deficiencies on the cellular level.
2) TESTING: Every person's nutrient needs and hormonal or neurochemical balance are different. Some might require higher levels of a certain nutrient than others, and what may be a very minor, nonproblematic nutrient, hormonal or neurochemical deficiency in one person can cause significant symptoms in another. Lab tests (blood tests, urine tests, saliva tests, stool tests and /or hair analysis) can be used to find the root of the imbalance. The science of laboratory testing becomes an art are when it comes time to interpret the results. (see Testing 101)
3) PREGNANCY: A baby's body is built entirely from the nutrient reserves of its mother. If a developing baby is in need of key nutrients when there are not enough to go around, the baby's needs always come first. The mother goes without and any nutritional deficiencies affect the mother unless there is severe nutrient deficiencies which can also affect baby's development and health. While most prenatal vitamins have enough of the basic vitamins and minerals to fulfill the needs of the growing baby, they fall short of supplying adequate amounts for both baby and mother. In addition, some of the most crucial nutrient building blocks for the baby's body are completely missing. (See Supplements 101)
4) A MOTHER'S BODY: A new mom's body is in constant overdrive. Functioning on little sleep with a body that has been through great challenge mom's face the task of caring for a baby. The resources for accomplishing this stressful transition come from the nutrients that make up our tissues and enter our body in the form of food or whole food supplements. Breastfeeding is a continuous drain on the protein, fat and mineral reserves of the mother's body. Every time a mom breastfeeds it's like running 5 miles - nutrition must be impeccible. Stress uses up more of all the nutrients needed to keep the body working smoothly and a diet high in refined carbohydrates, sugars and unhealthy fats such as those in fried foods will actually rob a mother's body of vital nutrients especially if a mom has lost a significant amount of blood during delivery or had to have an emergency C-section.
5) HORMONE BALANCE: Hormones are so delicately balanced in pregnancy that a variation of only a few miligrams of hormone can prevent or interrupt a pregnancy or cause prematre or late delivery. When it comes to pregnancy, birth and postpartum months, there is really no such thing as "normal". Each woman requires individualized attention. Hormones can shift into an unbalanced state leading to anxiety, depression and other psychological and physical problems. This state of imbalance will differ from woman to woman - not only because of large differences in hormone levels, but also because each woman's body is unique in the way it responds to those hormones. A new mom's estrogen levels (our natural anti-depressant) plummet by 90 to 95 percent and progesterone levels (which makes us relaxed) fall to nearly zero within forty-eight hours of giving birth. This huge shift in hormone levels can have powerful emotional repercussions, including anxiety, depression and moodiness. Estrogen and progesterone stay low for some time, usually until the mother begins to supplement her baby's diet with solids or formula. While reproductive hormones estrogen and progesterone are the primary hormones of pregnancy, other hormones also have an important effect on the health and well-being of Mama and Baby, especially postpartum. These include hormones produced by the adrenal glands, thyroid gland, pancreas and pituitary gland.
6) HORMONE TESTING: To find out if hormones are out of balance a new mom needs to test her hormone levels. Most of the usual tests used in physicians' offices cannot pick up on your levels of "free," or bioavailable, hormones. The exception to this rule are the thyroid hormone test and the glucose tolerance test for insulin activity. Estrogens, progesterone, and DHEA must be measured with either the saliva hormone radioimmunoassay (RIA) which measures the levels of those hormones in saliva) or a twenty-four hour urine hormone test, rather than blood tests. The saliva and urine tests give a more accurate measure of whether a deficiency of those hormones merits further nutritional support or natural hormone supplementation. This is because blood tests measure protein-bound, in-active hormone, while the saliva and urine tests measure unbound, free, active hormones. ZRT Labs provide separate test kits for specific hormone profiles. The test kits contain step by step instructions and specimin tubes which can be sent back to labs via regular mail. New Mom's will benefit greatly from a Baseline Hormone and Adrenal Profil which tests estrone, estradiol, estriol, progesterone, testosterone, DHEA-S and cortisol. (Source: ZRT Labs)
7) SLEEP: For postpartum mom's sleep is vital for optimal brain function. During REM, the brain replenishes glycogen and rebuilds the brain's cache of neurotransmitters, neural growth factors and cell building proteins depleted in waking hours. Chemicals important to the immune system are also secreted by the brain during sleep. Sleep deprivation sends the brain in a tailspin and profoundly affects the amygdala involved in emotion related processes and instrumental in calming down the fight or flight reflex. Inadequate rest results in temporary depression and anxiety. Two or 3 good nights sleep can restore brain function. And 7 deep breaths sweeps fresh oxygen to the brain making mom's feel more relaxed and clear minded. (Source: The Winner's Brain, Brown, Jeffrey)
.(more to come)
A problem cannot be solved on the problem's level.
To achieve clarity, we often must see it from higher ground.
Meditation lifts us there - out of the maze of circular logic to a place of vistas"
--Judith Orloff, M.D. Author of Positive EnergyMIND, BODY, SPIRIT SYSTEM CHECK
Many years ago I began my career in New York City as a book publicist. It was the early '90s and new age books were everwhere. Dynamic authors like Marianne Williamson and Melodie Beatie were teaching us to "awaken our consciousness". And I found myself stretching beyond my upbringing and opening to the possibility that life was more beautiful than I was led to believe. My small world opened to another perspective... that we are part of somethng greater than we ever imagined, that our lives are no accident and that we hold the key to our own happines. Thus I began a sacred journey of self-knowledge, learning to connect with my true essence so I could see myself, situations and other people more clearly. And my greatest tools became self-observation and acceptance.
Today, nearly twenty years later, I can say with confidence that I remain committed to the greatest journey... the journey within. I've learned from countless masters how to live my life on purpose. And more imporantly, what to do when I feel out of sorts or iimbalanced. I've created what I call the "Mind, Body, Spirit System Check". And it's as easy as 1, 2, 3!
To begin the "Mind Body Spirit System Check" it is important to understand the following premises:
- The natural state of the human body is vibrant health. We were not designed to get ill. We were designed to self heal. If you have discomfort, illness, disease or sickness or upset you are out of balance. Our Symptoms point to an imbalance. It is important not to suppress the symptom but to treat the imbalance so there are no more sysmptoms.
- You are the ultimate source of information regarding your health and well being. You are mind, body and spirit. What your mind doesn't handle, your body will try to resolve, draining spiritual energy in the process.
- All Illness comes from a combination of four things that throw us out of balance: 1. trapped mental and emotional stress, 2. too many toxins in the body (this includes thoughts and what you say), 3. nutritional deficiencies and biochemical imbalance and 4. exposure to electromagnetic chaos.
- The pain that you create now is always some form of non-acceptance, some form of unconscious resistance to what is. On the level of thought, the resistance is some form of judgement. On the emotional level, it is some form of negativity. The intensity of the pain depends on the degree of resistance to the present moment, and this in turn depends on how strongly you are identified in your mind. (Ekhart Tolle "The Power of Now")
- When a problem becomes overwhelmingly complex, seek simple solutions.
- Helplessness sets the stage for anxiety, depression, pessimism and guilty thinking. The way out of helplessness is taking 100% responsibility for our choices and our life. (For example: When trauma happens we have three choices: Attribute the problem (1) to ourselves, (2) to some person or (3) to a force outside ourselves/ to chance. If we look at ourselves as the cause of our troubles we can either take responsibility for our actions in a way that leads to insight and growth or we can engage in self blame which leads to pessimism and victim thinking. If we attribute problems to others, a force outside ourselves, or chance we foregoe learnings and insights and disown responsibility - which makes us feel helpless.
- When your courage and power are stuffed into your small "ego self", and you are living in an angry hole, you are choosing to be a victim. Unable to handle difficult situations by honest and straightforward expression of needs and feelings, victims hope for salvation by engaging the pity of an oppressor. Victims need aggressors to oppress them. They then can feel enraged at their ill treatment, which is how they compensate for helplessness and fear, experiencing a temporary surge of power and an adrenalin rush. Are you in an angry hole? Do you perceive others as oppressors? Are you repressing needs and feelings? Are you perpetuating victim patterns?
--more to come
Each year hundreds of thousands of women experience pregnancy and postpartum imbalance (commonly referred to as perinatal mood disorders). In conventional medicine, these disorders range from mild hormone-related mood disturbances known as the "baby blues" to a spectrum of perinatal mood and anxiety issues. As a holistic health counselor, I prefer to use the term "imbalance" instead of "disorder" for the simple fact that these issues are temporary and treatable. For example, biochemical imbalance (hormonal, neurochemical, nutritional) inhibits our body from manging stress and experiencing positive moods. When a new mom get's proper treatment in these areas, she becomes more balanced so she can meet the challenges of new motherhood with grace and ease.
As a mom who has healed many of these imbalances myself, I know that the terminology used can be a bit frightening and stigmatizing but it's important to know the terms so you are familiar with them when you speak with a licensed medical doctor. Think of them simply as words to help doctors communicate instead of labels. If you don't buy into the labels, they won't.
The terms most commonly used to describe this spectrum are: antepartum depression and anxiety, postpartum depression, postpartum anxiety, postpartum OCD, postpartum psychosis and postpartum post-traumatic stress disorder. Symptoms begin as early as pregnancy and can first appear any time in the 12 months after birth.
One thing I know from first hand experience is that postpartum imbalance is temporary and treatable when a new Mama seeks the help of trained physicians (Functional Medicine is particularly important), holistic health care providers and soul centered therapists who specialize in postpartum imbalance. However, many women do not get the treatment they need because they are looking for help in the wrong places. There is a misconception that every OB/GYN or physician will know how to promote healing in this area. Many new mothers are baffled that their own doctors don't know how to help them partly because there is very little detail about it in medical and nursing books so it's neglected in medical schools. And because there is so little training, OB/GYNs don't know how to properly diagnose it. Even worse, some are so misinformed that they don't think it's serious until a woman threatens suicide. Don't let this happen to you. If you feel your doctor is dismissing you, seek out a specialist immediately.
Until a mom can get to a postpartum specialist, I suggest she write the following intention down on a piece of paper: "I am safe, I am not alone. I will regain my balance and feel like myself again. I am receiving loving care and effective treatment as I partner with a postpartum specialist to heal any imbalances so I may become reclaim my magnificent self."
DEFINING PERINATAL IMBALANCE
According to A Natural Guide to Pregnancy and Postpartum Health by Dean Raffelock, D.C., Robert Runtree, M.D., and Virginia Hopkins and Melissa Block, the scientific consensus is that postpartum depression (PPD) is multifactorial, which means there are many variables - hormonal, psychological and neurochemical. These factors share one important and commonly overlooked characteristic: The balance of each of these systems relies upon proper nutrition. If the nutritional building blocks that the body needs to make hormones, neurotransmitters, and other mood-altering body chemicals are not present in adequate amounts, mood and physical health can both be compromised." And since the mind and body follows spirit, we must start healing at the spiritual level.
Although you'll read countless articles and books that say we don't know what causes these imbalances, I'm here to say that we do! Research shows perinatal imbalance is likely to result from a combination of three factors: biological, psychological and social. This is referred to as the biopsychosocial model. Another way to simplify this is to say that Perinatal Imbalance is likely to result from a combination of factors relating to Mind, Body & Spirit or what I like to call the biopsychosocialspiritual model:
Mind (psychological, emotional)
Body (biological, biochemical, nutritional, hormonal, neurochemical)
Spirit (energy, connections to society, source and self)
The key in treating perinatal imbalance is to find caregivers who can do 3 things:
1) Screen for risk factors.
2) Provide a comprehensive assessment.
3) Co-create a multifaceted biopsychosocialspiritual treatment plan that identifys the spiritual, psychological, biochemical, nutritional, hormonal and/or lifestyle support a new mother needs.
The key for us as Mothers is to commit to the spiritual journey back to the self - to become empowered and enlightened! To MPOWER-UP and ENLIGHTEN-UP! We MPOWER-UP when we become informed. When we become informed we can make wise empowering choices. (For more info check out our MPOWER-UP and FAST FACTS pages)
SPECTRUM OF POSTPARTUM EMOTIONAL REACTIONS
Nutritional, hormonal and neurochemical imbalance can affect women differently. Below are a list of symptoms compiled from (I'm Listening: A Guide to Supporting Postpartum Families, www.postpartumprogress.com, www.postpartumhope.com) and my personal experience working with Moms):
Antepartum Depression or Anxiety (13%-15% Moms / Onset Pregnancy) "I'm so afraid"
Sadness and unusual weepiness, lethargy, anxiety, insomnia, fear of pregnancy, low appetite, rumination, regret, intense fears.
Baby Blues (60-80% Moms / Onset within first 2-3 weeks) "This is hard - I'm overwhelmed"
Crying, irritability, anger, insomnia, exhaustion, tension, anxiety, restlessness.
Normal Adustment to change and Marathon of Motherhood: Crying/tearfulness, irritability, anger, sleep disturbance, fatigue, dysphoria (sadness), appetite changes, loss of interest in formerly favorite things/activities, anxiety, emotional lability (moodiness), feelings of dout, postpartum exhaustion (denial of depression/anxiety, feeling over-whelmed, unable to sleep/rest, head or stomach aches)
PostPartum Depression (10-20% Moms / Onset within 1st year) "I can't do this - I will never be able to do this." Mama's feel hopeless and trapped and want to run. (This is a worsening of baby blues or normal adjustment symptoms) depressed feelings that don't go away no matter what one does, feeling sad most of the day, more days than not, no energy-tired all the time, frightening feelings and thoughts, over-concern or no feelings for the baby, exaggerated anger or frustration, even over little things; these feelings targeted at baby or spouse, feelings of inadequacy (feeling like a failure most of the time), inability to cope, guilt, helplessness, hopelessness -see no hope of things will get better in the future, lack of interest in sex in spite of physically "being ready" to resume sexual relations, inability to enjoy things one used to enjoy, exaggerated highs or lows, inability to sleep even when the baby is sleeping, no appetite, no enjoyment of food or constant cravings and compulsive overeating, feeling that one would be better off dead than feeling this way, suicidal thoughts.
Postpartum Anxiety or Panic (10% Moms / Onset Any time first year) Rapid heartbeat, temp fluctuations, feeling of dread and apprehension, insomnia, dizziness. Comon fears: goin crazy, illness, losing sight or ability to breathe. Fear of being alone. Fluctuates in intensity and frequency.
Postpartum OCD (3%-5% Moms / Onset Pregnancy through first year) Repetitive and intrusive images, thoughts or fears that are disturbing or abhorrent to the mom. Anxiety about specific places (open spaces seem to trigger this) or activity, ritualized avoidance or compulsive controlling behaviors. Repetitive fears about health and safety.
Postpartum Psychosis (.1%-.2% Moms / Onset Birth-12 months) Hypomanic or manic symptoms, delirium, periods of delusional thought, possible auditory or visual hallucinations. Suspiciousness, withdrawal. May be denial of birth or glorification of baby.
Post Traumatic Stress (1.5% - 6% Moms / OnsetPregnancy through first year) PTS can result from anything that is 'experienced' as life-threatening. Symptoms are: Anxiety, panic, or intrusive thoughts related to specific event (e.g., birth or past trauma.) Recurrent images or nightmares, fears, ruminating, withdrawal and anger. Dissociation and depersonalization.
MAJOR RISK FACTORS
Baby Blues: History of premenstrual depression
Postpartum Depression: 50-80 percent risk if mom had a previous postpartum depression, clinical depression or significant anxiety during pregnancy, personal or family history of depression or anxiety, abrupt weaning, social isolation, poor social support, history of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), mood changes while taking birth contrl pill or fertility medication, thyroid dysfunction.
In an ideal world, when you become pregnant, your doctor or midwife would ask you for a health history to identify whether you are at high risk for Postpartum Depression. And, if needed, test you for nutrient depletion, brain neurotransmitter and hormonal imbalance to identify what kind of nutritional, hormonal or lifestyle and emotional support you will need. They will will have resources available: mental health professionals with postpartum training, contacts at family support agencies and organizations, information about free self-help support groups for pregnant and postpartum families and childbirth educators/Doulas/Mother Coaches to help create postpartum plans for practical and emotional support. In the real world however, that doesn't always happen. This is why we must become our own advocate starting in pregnancy. That way, even if we don't have the perfect practitioner, we can prompt them to provide us with optimum health care now so we don't pay later!
For example: We know now that we can screen for stress hormones at 25 weeks of pregnancy to head off adrenal imbalance, a major factor in postpartum depression because many hormonal imbalances are the direct result of Adrenal insufficiencey. Recently a study (conducted at the University of California, Irvine) suggested that postpartum depression is the result of hormonal imbalances. Is this new information? No, there are countless doctors, books, research that point to hormonal shifts as a factor in postpartum depression. However, this study is the first of its kind to associate CRH (Corticotropin-releasing hormone) with postpartum depression and recommends that a routine blood test be performed around the 25th week of pregnancy in order to assess the risk of developing this condition. And this gives us leverage to request the test when we need it!
The study said that Stress induced hormone release is considered normal when the brain discharges minute amounts of Corticotropin-releasing hormone, or CRH, to help the body cope with stress. During pregnancy, however, the brain could potentially release copious quantities of CRH to help the mother during labor and thereafter drastically reducing the production of this hormone by contrast. This sudden rise and fall of hormonal levels can cause the endocrine system to behave abnormally and create havoc for the mother during the postnatal phase. CRH is also known to trigger a surge of activity in the pituitary and adrenal glands, resulting in an unusually high output of the stress hormone, cortisol. Abnormal levels of stress hormones produced by an endocrine system out of balance can lead to conditions such as anxiety/depression. (see also Hormones 101) Important to note, according to studies, the brains of suicide victims, upon examination, revealed elevated levels of stress hormones.
Mama's are a tricky bunch when we have postpartum depression and many of us won't volunteer to let our doctors, friends and family know what we're going through. In fact, Childbirth Connection's 2008 report found that 3 in 4 mamas with depressive symptoms had not consulted a professional about health problems. This happens for many reasons. Understandably, we're scared and confused and it's hard to articulate everything that's happening. We may not understand our treatment options and fear separation from our babies during treatment. We may be in toxic relationships that don't provide a safe place for us to share what is really going on for us or we are being told it's all in our head and to snap out of it. On a financial front, we may not have the resources to handle healthcare issues. And the list goes on and on. For this reason doctors have the added responsibility of asking the right questions and one of the best ways to do this is with the thoroughly validated screening tools available, such as the Edinburgh Postnatal Depression Scale.
Well informed Doctors know that a mother requires a full 12 months to recover from the rigors of pregnancy and birth and that maternal mood imbalances can occur anywhere in the first year or more. In fact, many new mothers, biological and otherwise, are chronically malnourished. Nutritional deprivation can become part of a vicious cycle of broken sleep patterns, lack of appetite and poor nutrional intake and assimilation.
Misinformed but well meaning Doctors may have been taught that postpartum mood imbalnce only happens within the first 3 months. If your Doctor says this to you and refuses to test your hormones and treat you holistically (Mind, Body, Spirit), it's time to find someone who can. Doctors of Functional medicine, Midwives and OBGYN's and Physician Assistants who also specialize in Postpartum Mood Disorders will be a great place to start.
According to Penny Simkin, a leader in the childbirth education movement, Postpartum recovery has taken place when the following items below have been accomplished. I have added a few in pink that I believe are important (For More Info Check Out Our Self Nurturing Plan Page):
Maternal physical factors relating to pregnancy and childbirth are normal or nearly so, such as: all incisions or lacerations have been healed; involution is complete; feeding - breast or bottle - is well established; adequate sleep is occurring regularly; and all physiological systems are functioning well. Mothers should be receiving optimal nutrition, exercising regularly, practicing self-care and nurturing and taking part in activities that provide spiritual upliftment and joy.
Maternal psychosocial factors are normal, or nearly so, such as: support system is adequate and functioning well; relationships with father/partner and extended family are positive; mother's emotional state is normal and stable; mother-infant attachment indicators are positive; and mother is ready and able to resume some pre-pregnancy interests and activities.
Infant development and temperament factors are healthy and normal. The infant is: thriving physically; responsive to parents' attention; suckling well; consolable, sooth-able; able to give cues to indicate some needs; and is successfully integrated into the family."
A Natural Guide to Pregnancy and Postpartum Health by Dean Raffelock, D.C., Robert Runtree, M.D., and Virginia Hopkins and Melissa Block
Postpartum Recovery and Adjustment: A Definition (handout), Penny Simkin, 2000
I'm Listening: A Guide to Supporting Postpartum Families, Jane I. Honikman, M.S.
"Wherever you go, go with all your heart" - Confucious
Women are amazing miracles! Life is our power. We bring life into the world through our mind, body and spirit. We are about connection and creation.
In addition to giving life, women have an infinite capacity for healing and transformation. Kundalini Yoga pioneer Gurmukh Kaur Khalsa, one of my dearest teachers and author of Beautiful, Bountiful, Blissful, says "Think of pregnancy as boot camp for your soul, a time when you will be conditioning for the challenge of labor and the ongoing challenge of motherhood. Giving birth is an act of surrender. As we surrender to love, we let our "self” fall away and become something greater than what we have ever imagined."
From a soul centered perspective, the "self" we are called to let fall away during motherhood is actually our "ego", our small unawakened self. Our reactionary mind and emotions. The "something greater" is our "authentic self "- our higher consciousness where creation and wisdom reside. In our authentic self we are pure love and acceptance. Here we have a willingness to take 100% responsibility for our lives. We are open to what is unfolding as we awaken to ourselves as a loving spiritual being and a mother. And though we have been taught that love is an emotion, in actuality, it is a vibratory frequency. Love is always present. We don't have to do anything to earn it. We simply have to open to it. Thus Motherhood is opening to love.
So how does all this relate to Mothering? Well, the ego doesn't like change. It will fight for control when it feels threatened with the process of "letting go". After all, the ego has been running the show for decades filling our lives with accomplishment and achievement based on "doing". But to be a Mother we need to reach a deeper place of "being" so we can listen to and be present to our babies needs. This is a huge shift for many new moms whose very identity is being challenged. And it comes as a shock to many of us when motherhood does not provide outer focused feedback.
No other job requires a woman to put in so much energy to get so little back. Of course there are precious moments where we are bathed in love for our child and that is sublime. But there is no salary, no title and no positive reinforcement when we do a good job. Our egos aren't being fed anymore. Our babies need one thing from us - to "be love". To swim in it. To share it. They don't need us to be perfect. They just need us to be real. And in being real, we find that we have spent a lifetime in ego, repressing our emotions and our authentic self.
At this point, many new moms can feel absolutely raw. Their ego is being stripped away and their sense of self challenged. They wonder how they can start sharing their deepest selves and emotions when they've been conditioned to believe (especially in our western culture) that the definition of health is being free of distressing internal experiences. This social training leaves new Mamas highly vulnerable because the process of living, by nature, involves pleasant and unpleasant situations.
So let's take a minute to imagine what all this looks like for a new mama. She has just given birth and is feeling overwhelmed with a rush of biochemical changes in her body, raw emotions and the responsibility of caring for an infant 24/7. Society expects her to be sunshine and daisies yet she has a mixed bag of love and fear. Unpleasant thoughts and emotions are coming up but she doesn't know how to share them or deal with them because she's been taught to stay in control. Thus, she holds on tighter at a time when what would really benefit her is to let go...to uncover, discover and release her feelings. Her ego starts to create protective shields to keep her from feeling. She may distract herself in a highly constricted day to day routine, or become over concerned with the baby's schedule scouring book after book for how to keep her baby under control. She may become depressed or anxious or shut down her body so she doesn't have to feel the anger/rage, loss, guilt and shame. She fights to hold onto the illusion of the "perfect woman, the "perfect mom". In essence, she begins to constrict like an egg in a shell. She hides, in a soupy state hoping it will pass. She is trapped in her small self, sacrificing participation in her new life for the illusion of control. As she controls her mood she loses control of her life.
In one of my favorite books, Birthing From Within, authors Pam Enland and Rob Horowitz address this issue of control. They share that "our successful evolution to parenthood depends largely on our accommodation to the vast changes which are unfolding beyond our control. Learning to accept loss of control is an integral part of both birth and motherhood/ fatherhood.
So what does all this mean? Simply that as we give birth to our babies, we give birth to our "authentic selves". And no one can do it for us. It is the first time in our lives when we must have our own backs. Motherhood requires that we rise like the phoenix out of our small selves like a bird breaking free of its shell. Our babies require a strong mama willing to excavate her deepest fears so they can be diffused and replaced with self love and acceptance. We simply cannot stay small and meet the needs of our children. If we haven't done our empowerment work we will most assuredly begin it now.
Perhaps that's why women give birth, because we have the ability to surrender to love. To go through profound transformation by accessing a deeper intelligence. In The Birth of The Mother, authors Daniel Stern, Nadia Stern and Alison Freeland state that "having a child radically changes a woman's life, reshaping her values and priorities, restructuring her closest relationships, and redefining her role in her family. It is an intimate psychological experience as a woman is consumed by powerful emotions - fierce love, aching protectiveness and a driving need to care for and nurture a new life."
As you can see, Motherhood is not for the faint of heart. It is a powerful rite of passage. It is an empowering experience which unveils our true dignity, divinity and grace. Motherhood flows when we listen to the voice inside us that knows what to do. When we learn to observe our children and receive their cues for feeding and comfort. Motherhood is self trust, self esteem, self reliance and self-expression. Motherhood is honoring our commitment to ourselves. Motherhood is a beautiful journey where we wrap ourselves in a blanket of loving compassion, forgiving our judgments, healing and surrendering our past and freeing unconditional love to flow within us, to our babies and the world!
For this, I believe Mothers should be recognized for what they have accomplished and become. Have you thought about how you might like to be celebrated after you've given birth to your baby and your "authentic self?" How will you mark this passage? I challenge you to show the world your beautiful self! Be seen. Be Heard. You are the phoenix! You are Pure Mother Love!
Baby Sleep Expert Nicole Johnson's Article on 4 Month Old Sleep Regression (contact: email@example.com)
I love sleep coach Nicole Johnson's website...www.babysleepsite.com. Nicole has two boys of her own and has created a great free downloadable pdf on 4 Month Old Sleep Regression. This is something I think all parents need to learn about since the change in sleep patterns at 4 months can be a bit tricky. download it at http://www.babysleepsite.com/MediaKit/BabySleepSite_4MonthOldSleepRegression.pdf
4 Month Sleep Regression Explained
Countless parents come for help with their 4 month old’s sleep. Why? This article will explain why “good” sleepers sometimes turn “bad” around the 3, 4, or 5 month old mark. How a newborn baby sleeps in the early weeks When a newborn falls asleep, she immediately goes into deep sleep (also known as REM sleep, but I will avoid too much technical talk because that’s one reason The Baby Sleep SiteTM, so you won’t have to learn the whole history of sleep if you don’t want to (or can’t stay awake to!)).
Newborns spend a lot of their time in deep sleep, which is why it is hard to wake them up (even to eat!) in those early days.
A 4 month old sleeps (and sometimes as early as 3 months or as late as 5 months)… We all go in and out of light and deep sleep. As adults, we might change positions, look at the clock, or reposition our pillow. Up until now, you may have rocked your baby or simply given him a pacifier and he slept for hours without waking up.
Well, at 3 or 4 months old, your baby is now sleeping more like an adult. Now when she falls asleep, instead of entering deep sleep, she enters lighter sleep, first. That’s why if you help her fall asleep, then put her down she is likely to wake up because she isn’t in her deep sleep, yet.
4 month olds enter deep sleep…
Initially in the night, your 4 month old will enter deep sleep relatively quickly, within 30 minutes (this changes as we get older). However, as I said, we all cycle in and out of light and deep sleep. A child’s sleep cycle is about 45-50 minutes. So, your baby will briefly awake 45-50 minutes after she has been asleep. To put that in perspective, if you are holding your baby to sleep, you would need to hold her for at least 30 minutes to make sure she’s in deep sleep and then she might wake up 15 minutes later. Sound familiar? Overall, though, your baby’s deepest sleep is in the early part of the night, so after that first sleep cycle, she might sleep just fine for a few hours. So, you’re golden right? Just hold her for an hour? Nope!
A 4 month old sleeps the rest of the night… The technical definition of “sleeping through the night” is 5 hours of continuous sleep (i.e. no feedings) and many babies can/will do this by two or three months old. The beginning of the
night is your baby’s deepest sleep and after the first 5 hours (if not sooner, depending on just how challenging he is), he will cycle between light and deep sleep, but not as deep as the beginning of the night. This is where the problem of sleep associations really come into play. If your baby needs your help to go to sleep in the beginning of the night, sometime after midnight or so, he will continue to need your help every 1 or 2 sleep cycles (that means every 45 to 90 minutes or as I often hear, every 1-2 hours).
Between 4-6 a.m., approximately, is the lightest sleep of the whole night (parents’ complaints alone make this true, in my experience, aside from my reading). In the very early morning hours (about 30 minutes to an hour before waking up), he will again go into the very deep sleep. Although babies commonly wake up early, be sure it is truly their waking up time and not just this lighter sleep and that they are having trouble sleeping. You might notice they want a “nap” just 30 or so minutes after “waking up”. What you experienced was a night waking, not starting the day.
4 month old sleep regression
You might have heard about the 4 month sleep regression and wonder if your baby will go back to sleeping well. Some parents will be one of the lucky few whose baby will go back to sleeping well in 2-4 weeks, however, not all of us will be that lucky. For example, I find that babies who need a pacifier to sleep where you are replacing it many times per night do not stop needing that pacifier to sleep. You might get lucky and not have to replace it 10 times (maybe “just” 3-4), but maybe not. It is usually better to solve the root of the problem than to hope you are one of the lucky ones. So, maybe wait a few weeks, but if things aren’t better, plan to make changes. I talk to parents of 8 month olds and even 20 months old who are still waiting for their “baby” to grow out of their sleep problems.
4 month olds sleeping through the night…
How can you help your 4 month old sleeping through the night? Read The Baby Sleep SiteTM blog (free article updates via e-mail) and be sure to check out my free guide, 5 Ways to Help Your Baby Sleep Through the Night at http://www.sleepthroughnight.com.
If you have any questions or comments on this handout please e-mail firstname.lastname@example.org.
turn off your TV, leave your house, know your neighbors, greet people, look up when you're walking, sit on your stoop, plant flowers, use your library, play together, buy from local merchants, share what you have, help a lost dog, take children to the park, honor elders, support neighborhood schools, fix it even if you didn't break it, have pot lucks, garden together, pick up litter, read stories aloud, dance in the street, talk to the mail carrier, listen to the birds, put up a swing, help carry something heavy, barter for your goods, start a tradtion, as a question, hire young people for odd jobs, organize a block party, bake etra and share, ask for help when you need it, open your shades, sing together, share your skills, take back the night, turn up the music, turn down the music, listen before you react to anger, mediate a conflict, seek to understand, learn from new and uncomfortable angels, know that no one is silent though many are not heard - work to change this.