Health Care After Your Pregnancy

You should have the opportunity to stay in close contact with doctor or midwife in the week or two after the birth. Although most of the significant complications of labor and birth occur in the first few hours after birth, some complications may not appear for days or weeks.

If you have a problem with yourself or your baby, call early and often. Your health care system is well-acquainted with the “hysterical” parents over-reacting to common problems. In most situations the solution is only a phone call away and the problem is not severe. However, newborns are relatively fragile, and their physical condition may deteriorate rapidly in worst-case scenarios. Likewise, the mother who has just given birth is relatively vulnerable, too. She may be anemic, probably is fatigued, and slowly becoming more sleep-deprived. This leaves her vulnerable to complications which may prolong her recovery period.

If you have a problem, call your doctor or midwife. That is exactly their role…….to provide you with the care you need.

First-time breastfeeding mothers should be seen with their baby 2-3 days after being released from the hospital. If all is going well, and no problems arise, the new mother need not see her doctor or midwife again until 4-6 weeks postpartum (although a 2-week postpartum visit may be a bonus for some women).

Postpartum Infection

Some women develop uterine infections after childbirth. Prior to the availability of antibiotics, infection and hemorrhage in new mothers was a primary cause of death in young women.

If you develop a fever (a temperature over 100.4), muscle aches, chills and lower abdomen pain, call your doctor or midwife immediately. Usually, a course of common antibiotics will help your body fight infection. But the body also needs its own defenses in addition to antibiotics. Your nutrition is an important factor in keeping your immune system working well. You need high-quality proteins, fresh fruits and vegetables, and probably a vitamin supplement if you develop an infection. If you are anemic, you need supplemental iron in daily doses of 100-300 mg of ferrous sulfate, ferrous gluconate or ferrous fumarate…….but you probably do not need any more than this.

Postpartum Depression

Postpartum depression, postpartum “blues”, or depression by any other name is often under-appreciated, under-diagnosed, and under-treated in the postpartum period. Commonly, the depressed new mother is trapped in the hole of depression lacking the internal energy and resources to pick up the phone and call for help.

If you feel depressed, call your doctor or midwife. Depression in the postpartum period may be largely overshadowed by the excitement of a 9-month pregnancy ending in a climactic event. Often, a depressed new mother is home alone quietly suffering. Unfortunately, many midwives and Ob/Gyn doctors have insufficient training in the treatment of depression. If you feel that your midwife or doctor may not appreciate the gravity of your situation, call a mental health professional.

Although the use of antidepressant drugs may not be a first course of action, they are increasingly used with high degrees of success even in mild cases of “postpartum blues”. Many antidepressant drugs take days or weeks to achieve “therapeutic levels”, but a common side effect of the older “tri-cyclic” antidepressants is drowsiness. Since new mothers are commonly sleep deprived, and insomnia is a common symptom of depression, this “side effect” is often incredibly helpful and usually has some immediate effect. Sleep has some amazingly positive effects on the health of the brain, and depression is a disorder of the brain and the chemicals which make it work.

New information about the use of antidepressant drugs in breastfeeding women seems to indicate a level of comfort and safety that in the past was not recognized. Although the data is inconclusive and long-term studies have not yet been done, recent studies have suggested that the benefits of antidepressants may outweigh any small or theoretical risks to the breastfeeding infant. If your doctor or midwife feel that you need an antidepressant drug, consider the depth of your depresssion, and consider using the drugs, if even for a short period of time.