Transcription:
Postpartum Wellness

Melanie Cole, MS (Host): In the first days and weeks after childbirth, a new mother goes through such a variety of emotions. She feels wonderful and excited and scared and nervous and anxious and happy all at the same time, but sometimes there are other feelings that go along with that that include sadness and things like that where you're just worried all the time. We’re talking about postpartum wellness in general today. My guest is Dr. Amanda Kane. She’s an obstetrician gynecologist at BayCare. Dr. Kane, we’re gonna start with the postpartum kind of mood, feeling that women go through. What is the prevalence of postpartum mood disorders?

Amanda Kane MD (Guest): Great. Thank you so much for having me. The prevalence is extremely high, higher than most people expect. We screen for mood disorder frequently in the hospital, at the postpartum visit, and then even at the follow up annual visit. Postpartum mood disorders can include depression, depressed mood, feeling irritable, angry. Or some women are more effected by anxiety symptoms and just feeling their anxiety kind of taking over and inhibiting their ability to take good care of themselves or their newborn baby.

Host:   So is there a screening tool? If someone thinks that they have postpartum depression or the baby blues, when should they see their healthcare provider? What would you like them to tell their doctor?

Dr. Kane:   It’s very normal to go through the baby blues for about the first two weeks after delivery. To have the ups and downs and the crying spells and just getting used to your new life as a new mother. I usually tell women if they are feeling these kinds of feeling of anxiety or depression after the first two weeks and they feel like it’s getting worse instead of better to contact their doctor or get help right away. We use screening tools in the office like the Edinburgh postpartum depression survey, but also just being able to do a quick interview. It’s fairly clear within the first few minutes whether someone’s doing well or whether they need some extra help.

Host:   Great information Dr. Kane. Thank you for telling us about that. So now, onto being a mom and you just had a baby and you maybe gained 30 pounds. In my case at four foot ten it was more like 40. How much should we reasonably able to lose in the first few months? Is that a myth that nursing helps you to take the weight right off? Tell us a little bit about exercise, weight loss after a new baby.

Dr. Kane:   So after a new baby, things will be different. You may have a new normal and that’s okay. It’s important to remember just to be patient with yourself. You're busy, you're taking care of your newborn. You're doing frequent feedings. You're not getting good rest and juggling your other responsibilities outside of being a mom. So the exercise piece and the taking care of yourself, it may be put on the back burner for a little bit and that’s okay. Some women just have the weight melt right off, but for many women they hang on to some extra weight, especially if they're breastfeeding. The breast milk has a lot of calories, very high fat content. That all has to come from your body. So to hang on to a little bit of baby weight while you're breastfeeding, and nursing is very normal. That’s where the calories have to come from.

Some women don’t feel like they're really back to normal until a year after the baby’s born, which is a lot longer than some women expect. So it’s just important to be patient with yourself and take things slow, and just remember that there are seasons in life. Your postpartum season, it’s going to last beyond just the first six weeks. It may be the first six months after having a baby, and that’s okay.

Host:   Or it could last the next 21 years. Yeah just really never know because boy kids sure do change our lives. So as far as feeding, we mentioned nursing. Some women have trouble with that. What do you want them to know—whether they are formula feeding or breastfeeding—about what to expect with baby? How often and sometimes it’s not as easy as we think.

Dr. Kane:   I would say feeding is one of the most challenging parts of having a newborn. Every baby is going to be a little bit different, and you're going to have to figure out what works for you and your individual baby. We say that fed is best. So breastmilk is wonderful, but not everybody can make breastmilk 100% of the time for the 100% of the time that the baby needs milk. So any little bit of breastmilk that you can provide is going to help your baby. Whether it’s two weeks or two months or two years. The feeding is more frequent in the beginning. Getting up in the middle of the night to feed. Baby needs all that nutrition and is growing quickly. I would say however you can feed the baby is going to be the right way for you and there is no right or wrong way to do it.

Host:   So we have a baby, but we also have maybe other children, or we also have a spouse or a partner. How do we keep all that going? We women, we feel we’re superwomen Dr. Kane. We really do. But sometimes we’re really not. So how do we balance doing all of this? Relationships, intimacy, feeding, getting ourselves back in shape. What is it you would like us to know about that superwoman syndrome that we go through?

Dr. Kane:   That’s a great question. I feel myself like I'm always juggling 10 balls up in the air and I can only keep two in the air at one time. There’s a saying that goes you can have it all, but you can't have it all at the same time. Those first several months after having a newborn, it’s never more applicable than in that time. You're dedicating so much time and energy to your newborn. You're not sleeping very well generally, and you have to make sure that after baby’s taken care of and any other children you have are taken care of that you find some time and space to take care of yourself and remember who you are outside of being a mom. Make sure that you're doing things that help recharge you and reenergize you because otherwise, if you don’t, you may feel like you have nothing else left to give to a spouse or your job or any other responsibilities you have outside of being a mom.

It’s also common for women to feel touched out. That basically means once you're done taking care of baby and your other children and you're giving, giving, giving. Frequent physical contact and nursing at the breast, you may feel like you don’t have any time or space to just be alone or just be yourself. Some people feel that that puts a strain on the relationship that they have with their spouse or their partner. It’s okay. It’s very normal. If you recognize it then you can take steps to make sure that you're recharged and reenergized and that way you will have the motivation and the energy to then devote intimacy to another person.

So it definitely can change with time and you just have to be patient with yourself. Remind yourself throughout this whole process that you are enough. You may feel like you're not doing a great job or you're doing well in this one thing, but this other thing is falling by the wayside. That’s okay. That’s life. When you wear many hats, you may not be doing everything perfectly all the time. But you are enough. You're doing a fantastic job, and to remind yourself of that and have other people close to you who can remind you of that as well is very helpful in those first few months after having a baby.

Host:   What a great sentiment Dr. Kane. So wrap it up. Best advice and what a woman can do to take better care of herself. As we say, we have to put our own mask on before we put the mask of our loved ones on. While we’re so ensconced in taking care of that new baby that we don’t always, as you said, look to ourselves. So give us your best advice really about postpartum wellness and all that goes into that time in our lives.

Dr. Kane:   The first thing I would recommend is just to be very patient. Things take time. You can't expect to achieve all your goals all at once. It’s a process that takes time and takes adjustments. Another thing is to make sure that you don’t feel alone. That you have someone or a group of people that you can reach out to. Whether it’s a parent or a sibling or a mom’s group or friend who’s going through a similar thing at the same time so that you feel like you're not alone. You don’t feel isolated. You feel like there’s somebody else who’s going through exactly what you are, and you can take comfort that you're not the only one who feels this way. You're not the only one who’s having these same struggles. So just be patient with yourself. Try to take as good care of yourself as you can because if you're not doing well then nobody else in your family is doing well.

Host:   Thank you so much, Dr. Kane. What great information and so important for women to hear. The motto ‘I am enough’ is certainly true and so many women are going through this all at the same time. Thank you, again, for joining us and sharing your expertise. That wraps up this episode of BayCare HealthChat. Head on over to our website at baycare.org for more information and to get connected with one of our providers. If you found this podcast as informative as I did, and I'm sure you have friends and family, women that are going through this that have new babies, please share it with them. Share on your social media that way we all learn from the experts at BayCare together. Be sure to check out all the other fascinating podcasts in our library. Until next time, I'm Melanie Cole.