What is a doula: an interview with Jasmin Cromwell of Pathway Partner

Jasmin Cromwell, founder of Pathway Partner, is a trained doula who generously took time to give an in depth interview to explain the variety of health and wellness services she is able to provide to pregnant and postpartem mothers.

Please describe what a doula is and your personal mission.
There are two types of doulas; birth doulas and postpartum doulas. Although I was trained in both, my business, Pathway Partner, offers postpartum services. We work with women and their families after the birth of their baby. We offer non-medical, postpartum support which can include anything from being a good listener to spending the night to help with feedings while mom catches up on her sleep. Of course we offer much more support as well. 
My personal mission is to be sure that every woman who feels she needs support is able to have it. There are too many women who don't have family or friends available to support them during this very important time.

Read more about doulas here  at the Examiner.

Are you at risk for postpartum mood disorder?

When Holly Betten, 28, came home from the hospital after a rough delivery, she had one day to adjust to her new life as a mom before her husband went back to working 12-hour days as a computer-software architect.

Her son, Henry, became severely jaundiced, wouldn't breastfeed, and almost landed back in the hospital for losing too much weight. "All I could think was, 'What did I get myself into? I should never have become a mom,'" recalls Betten, of Grand Rapids, Michigan. "I felt totally overwhelmed and inadequate -- I couldn't even feed my child." Then Henry developed colic and began to wail all the time. Not surprisingly, so did Betten: "I'd be happy one minute, then crying hysterically the next. I just wanted to leave the baby in his room and walk away."

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Postpartum Mood Disorder in New Moms

ACCORDING TO Postpartum Support International, one in eight women suffer from a postpartum mood disorder. New dads (and veteran dads) should know the difference between the baby blues and postpartum depression (PPD). Oftentimes, these disorders go undiagnosed because a new mother's support system, typically the husband/partner, does not know what to look for and where to go to get help.

Working with more than 200,000 new dads over the past 19 years, Boot Camp for New Dads, a non-profit orientation programme for fathers-to-be, operating in more than 260 hospitals, clinics, schools, fire stations and churches around North America and internationally, advises new fathers to watch for signs of PPD in mom and offers tips on how to recognise it.

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Shoshana Bennett

Shoshana Bennett, Ph.D. (”Dr. Shosh”) is the author of Postpartum Depression For Dummies and co-author of Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression. Her latest book, Pregnant on Prozac, was released in January.

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Shoshana Bennett, Ph.D.

Shoshana Bennett, Ph.D. is the author of Postpartum Depression For Dummies and co-author of Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression. Her latest book Pregnant on Prozac will be available in January of '09. She's also created guided imagery audios that are specifically focused on helping moms take care of themselves. National TV shows including "20/20" and "The Doctors" feature Dr. Shoshana as the postpartum expert and news stations consult her. Several publications including the San Francisco Chronicle and the San Jose Mercury News have written articles on Dr. Shoshana's work.

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Postpartum Tps For New Moms

How can you make the postpartum experience less stressful? This should be the happiest time in my life. That, says Shoshana Bennett, Ph.D., is just one of the fantasies that new mothers buy into. Bennett, a clinical psychologist who has survived two life-threatening postpartum depressions, knows how easy it is to set yourself up to feel inadequate.

Parenting is not instinctual, and you can’t do everything yourself. “Realistic expectations make or break the postpartum experience,” says Bennett. Those first postpartum weeks are difficult. Of course you’re focused on your new bundle of joy, but you have to take care of yourself, too.

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New Guidelines for Weight Gain During Pregnancy

If you're an expecting mom or know a woman who is, we have important information for you. The Institutes of Medicine (IOM) recently released a report with new recommendations for how much weight a woman should gain during pregnancy, including how much weight she should gain week by week.

It is important for women to get to a healthy weight BEFORE getting pregnant. That's because women who are overweight or obese before pregnancy face greater health risks to themselves and their babies during pregnancy. For women who are overweight or obese and ALREADY pregnant, the report recommends that they work with their providers to carefully monitor their weight gain so that both mom and baby have a greater chance of staying healthy.

Curious about the pregnancy weight gain recommendations? Check it out.

Speak Out for Women & Children in Health Care Reform

With your help, March of Dimes is deeply engaged with Congress and the Obama Administration to make sure the health needs of women, infants and children are addressed in health reform legislation. Specifically, March of Dimes is working on:

*Ensuring that children with special health needs, such as those born preterm or with birth defects, have full access to the care they need

*Making sure all women can see a doctor before, during and between pregnancies

*Strengthening programs that help women have healthy babies, such as smoking cessation

*Protecting women and children who are currently enrolled in Medicaid / CHIP (Children's Health Insurance Program) and ensuring more children can get coverage

Be sure your voice is heard on behalf of moms and kids — contact your senators and congressman.

To learn more, click here.

Snoozing May Help Women Shed Baby Weight

New moms who can't zip up their pre-pregnancy jeans might not be catching enough zzzs.

Getting a good night's sleep, in fact, may be just as important as diet and exercise for shedding baby weight.

One study of new mothers found that those who slept five or fewer hours a day six months after giving birth were three times as likely to hold onto those extra pounds as were women who got seven or more hours of sleep.

Read on...

Hyperemesis: One Of Uncommon Symptoms of Pregnancy

The first few days of morning sickness, one of the most common symptoms of pregnancy, it was not so bad. Sure, maybe running to the bathroom once or twice, having to eat to keep from vomiting, and being fatigued were bothersome. But then the vomiting becomes more frequent, sometimes every half hour or every fifteen minutes. Salivation increases to the point of having to use a cup to spit in. Headaches set in and fatigue is so bad, it is a journey from the bed to the bathroom. This is called hyperemesis. To understand hyperemesis, it is important to understand the difference from morning sickness. Morning sickness is a common group pregnancy symptoms and it occurs in fifty to ninety percent of pregnancies.

Morning sickness tends to last from 12-20 weeks. It can affect some aspects of life such as some loss of work, but generally this may be up to 3 weeks. With the common sign of pregnancy that is morning sickness, household responsibilities can be performed at times of the day when symptoms are less intense. Fatigue generally results in some decrease of workload and resting is often recommended. Nausea and vomiting of pregnancy can also affect relationships temporarily until it is resolved. Finances are minimally affected. Psychological stress is mild, sometimes moderate, but manageable.

What happens when the normal signs of pregnancy get worse? On the severe end of nausea and vomiting of pregnancy is the condition called hyperemesis gravidarum. Generally, the pregnant woman will start with mild to moderate symptoms thinking it is morning sickness. But these can increase to a point where it becomes necessary for medical intervention.

There is no official set criteria as to where morning sickness stops and hyperemesis begins.

Read on...

Intrapartum antibiotics for known maternal Group B streptococcal colonization

Women, men and children of all ages can be colonized with Group B streptococcus (GBS) bacteria without having any symptoms; bacteria are particularly found in the gastrointestinal tract, vagina and urethra. This is the situation in both developed and developing countries. About one in 2000 newborn babies have Group B streptococcus bacterial infections, usually evident as respiratory disease, general sepsis, or meningitis within the first week. The baby contracts the infection from the mother during labor. Giving the mother an antibiotic directly into a vein during labor causes bacterial counts to fall rapidly, which suggests possible benefits but pregnant women need to be screened. Many countries have guidelines on screening for GBS in pregnancy and treatment with antibiotics. Some risk factors for an affected baby are preterm and low birthweight; prolonged labor; prolonged rupture of the membranes (more than 12 hours); severe changes in fetal heart rate during the first stage of labor; and gestational diabetes. Very few of the women in labor who are GBS positive give birth to babies who are infected with GBS and antibiotics can have harmful effects such as severe maternal allergic reactions, increase in drug-resistant organisms and exposure of newborn infants to resistant bacteria, and postnatal maternal and neonatal yeast infections.

This review finds that giving antibiotics is not supported by conclusive evidence. The review identified four trials involving 852 GBS positive women. Three trials, which were around 20 years old, compared ampicillin or penicillin to no treatment and found no clear differences in newborn deaths although the occurrence of early GBS infection in the newborn was reduced with antibiotics. The antibiotics ampicillin and penicillin were no different from each other in one trial with 352 GBS positive women. All cases of perinatal GBS infections are unlikely to be prevented even if an effective vaccine is developed.

Read more about this at Conchrane Collaborations and reviews.

Alabama study on PPD

From the Montgomery Advisor:
A study of women in Alabama with children under a year old finds that many more women in the state are experiencing this perinatal mood disorder than is recognized, and the Alabama Women's Commission wants to do something about it.

In the study, "The Status of Women with Children Age One and Below in Alabama," researchers estimate that 1 in 13 women in Alabama might suffer from postpartum depression.

Susan Fillippeli, chairwoman of the state women's commission, said the study was conducted and now is being expanded because of the need for more information about women with young children.

"One of the reasons we chose this group is because it is a very special-needs group," Fillippeli said. "Anything you can do for a woman in the first year of her child's life sets the pace for the family and child development, and I think that that's been overlooked."

Fillippeli said there are plenty of studies about families and the first year of the child's life, but there seems to be little focus on what's going on with mothers during the first year of their child's life.

The study uncovered what several state agencies, such as the state Department of Public Health and child advocacy agencies, have been saying for years -- the state's infant mortality rate is already high and is rising, and finding quality child care is a major challenge.

But what the study discovered about postpartum depression grabbed the commission's attention. Alabama moms are battling postpartum depression, but a true estimate of how many are being diagnosed and treated remains unknown.

While no data exists showing all the women in the state who have been diagnosed with postpartum depression, researchers for the Alabama study were able to estimate, using national data averages, that 15,725 of about 120,968 women who gave birth in 2005 and 2006 experienced postpartum depression.

The state does keep data on women covered by Medicaid, which covers 48 percent of births in the state. Of the 58,441 Medicaid births that took place in 2005 and 2006, approximately 2,155 women were diagnosed with postpartum depression.

Results:
The Alabama Women's Commission is using its Web site to make the most common screening tool -- the Edinburgh Postnatal Depression Scale -- available to all Alabama obstetricians, pediatricians and nurse practitioners. But it hopes to do a lot more to push the information that it has gathered into people's hands.

Fillippeli said it's a challenge because as it stands, the commission is allowed only to conduct research and report under the statute that governs it. The 15-member commission, which was created in 1971, would like to have more responsibilities such as holding a conference and even raising money, but under the law it doesn't have those powers.

A bill to expand the commission's scope failed during the last legislative session, but Fillippeli said that if Gov. Bob Riley decides to call a special session to address financial problems in Jefferson County, she would ask him to make the commission's bill a part of the agenda.

"If we can actually do some of the things that we want to do like raise money and have campaigns to raise awareness, we don't have to ask the state for money," Fillippeli said. "We would also have a little more freedom to help improve the status of women in the state without relying on legislative support."

Many new moms suffer postpartum ailments

Times of the Internet reports:

More than half of new moms suffer postpartum ailments such as incontinence, a U.S. doctor says.

Dr. Dee Fenner, director of the University of Michigan Health System's Healthy Healing After Delivery Program in Ann Arbor, says all too often new mothers are unclear about what is normal or abnormal, when to worry and when to just wait for healing to occur.

"Easily over half of women who have vaginal birth, at least their first birth, will have some problem in terms of bowel, bladder or sexual dysfunction that can occur," Fenner says in a statement.

"Unfortunately, I think many women suffer in silence in that they don't really complain or know that something can be done."

The University of Michigan clinic involves physicians, nurses, midwives, physical therapists and others who offer comprehensive postpartum care that includes education and is open to any woman -- regardless of where she delivered her baby.

The ever-debated issue of maternal age

Out of the UK: Age-old issue

Up until recently, mums over the age of 30 were considered “elderly primagravida” – in other words, first-timers so old that they generally “required” caesarian sections and extra in-hospital care, even when they didn’t.

But mums these days no longer fit into any particular mould.

The “perfect age” to have a baby has proved an illusion, as advances in women’s rights and education, combined with the pill, infertility drugs, IVF and egg and embryo freezing have all colluded to make giving birth later in life more possible – and popular – than ever before in history.

In fact, the UK is home to one of the world’s oldest mums, Patricia Rashbrook, who gave birth after IVF aged 62.

There are now more first-time mums aged 30-34 than there are aged 25-29, according to the Office for National Statistics (ONS).

The figures show that there are also 50% more mums aged 40-44 having babies than just 10 years ago. But just because you can give birth later in life doesn’t mean that you should, says London-based GP Dr Wendy Denning.

“Biologically, the best age to have a baby is between 20 and 25, because that’s when you’re at your healthiest and most supple,” she explains.

“But societally, we’ve been told we can have it all – career first and babies later, so more and more women are postponing pregnancy to pursue their professional future.

“The truth is that the longer you wait, the more you blow your chances – and the more heartbreak you’ll feel down the line.”

Keep Calling--Reaching Out to Mothers with Postpartum Depression

For some mothers struggling with postpartum depression, a phone call from a friend might be just what the doctor ordered. More specifically, phone calls from other women who have overcome PPD seem to be a catalyst to better mental health says one Canadian study. Talking with someone who has "been there" and triumphed over their difficult time has been shown to greatly benefit mothers in depressive limbo.

While many women do suffer from some degree of baby blues after the birth of their children, some display significant depressive symptoms that need further attention. One's risk for PPD is greatly increased if the depressive thoughts/feelings last longer than two weeks.

In the aforementioned study, "women who had overcome PPD were briefly trained in how to establish a phone relationship, provide support and identify depression so they could refer depressed mothers to professional care." They then made regular phone calls to "at-risk" mothers. The study included 701 "at-risk" women of which half received standard postnatal care and half got peer support. With standard care, 25% of the mothers had significant depressive symptoms 12 weeks after delivery. Only about half as many women who had peer support 14% had such symptoms.

Upon deciding that professional help is needed, the first step for mothers is to speak with their OB/GYN who can then determine the degree of help that is needed and can direct the patient to further assistance.

Here's the original article...