By Dr. Sonal Patel

"The 4th trimester is three months after the birth of a baby more commonly referred to as postpartum. By relabeling it as the 4th trimester, society, science, and the medical community can better understand the massive changes mothers are going through while newborns are adjusting to the world outside the womb. The most alarming data in discussing the 4th trimester is the fact that we are losing more moms during this period than the first three trimesters combined. Dr. Sonal Patel explores the economic impact of losing moms during the 4th trimester, a solution that can reduce maternal mortality, and thus positively impact our national economy. Dr. Patel's journey started as a moment of exhaustion in her own 4th trimester courtesy of her 4 sons and now is creating a movement of truly understanding the socioeconomic impact of maternal mortality. Sonal Patel is a board-certified pediatrician, neonatologist, and breastfeeding specialist. Born in Lucknow, India, her family moved to Omaha, Nebraska when she was 9. She attended Emory University, Atlanta, Georgia, from 1995-1999. She studied medicine at the University of Nebraska Medical Center graduating in 2003. She did her pediatric training at LSU in New Orleans, Louisiana. Thereafter, she pursued neonatology starting at LSU and finishing at Tufts University in Boston. She moved to Denver in 2009 and joined Denver Health as a Neonatologist. Through her professional and personal experiences, she noticed the gaps in postpartum care in Colorado. In 2017, she founded NayaCare: Newborn Speciality Clinic at Your Doorstep. She has been a guest on several podcasts and featured on local Denver 7News and 9News. Her articles on the 4th trimester and maternal mortality have been published in many journals. She debuted her first non-fiction book, The Doctor and Her Black Bag. This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx"

By: Nurse Zabe | September 24, 2019

Mayo Clinic Guide to a Healthy Pregnancy
Being pregnant can be an overwhelming time in a woman’s life. I often encourage moms to stick to reading books or consulting with their doctors for pregnancy related information to avoid getting misinformed. The Mayo Clinic Guide to a Healthy Pregnancy is a great resource because it is comprehensive and discusses fertility, prenatal care, pregnancy, and childbirth.

By: Science Insider | October 17, 2021

"High-risk obstetricians Laura Riley and Dena Goffman debunk 16 postpartum myths. They talk about how breastfeeding will not prevent pregnancy, why baby bumps don't disappear right after you give birth, and how breastfeeding doesn't always come naturally. They also debunk the myth that you'll need to keep having C-sections if you've previously had one.

Riley is the chair of OB-GYN at NewYork-Presbyterian and Weill Cornell Medicine. She specializes in maternal fetal medicine. You can learn more about her work here: https://weillcornell.org/laura-e-rile...

Goffman is the chief of obstetrics at NewYork-Presbyterian and Columbia University. She is also a maternal fetal medicine specialist. You can learn more about her work here: https://www.columbiaobgyn.org/profile..."

​By Claire Gagne and Claire Sibonney

By: ​Bethany Braun-Silva

"Expecting parents have multiple checklists of everything they need to get ready for their baby’s arrival. Cribs, bottles, car seats, and strollers are just a few of the essentials you need to consider before welcoming a new baby. But even before any of that, there’s the hospital bag checklist. A robe, a nightgown, slippers, and a few blankets are sure to make the list, but oftentimes, a postpartum recovery kit gets overlooked.

A postpartum recovery kit has what moms need to help with bleeding, soreness, and overall discomfort. You can create your own kit by buying things like disposable underwear, ice packs, and perineal spray separately, but there are also ready-made kits for moms that include all these things and more.

Many moms agree that postpartum recovery kits are a great choice. The Frida Mom Hospital Packing Kit for Labor, Delivery, Postpartum, for example, has over 1,000 five-star reviews on Amazon and a near-perfect 4.8-star rating. “I would 100% say that every postpartum experience needs this kit,” writes one customer. “I think it’s well worth the price for the comfort you’re getting.”

The Miloo Mom Hospital Labor and Delivery Gift Packing Kit for Delivery, Postpartum is also a great choice available on Amazon. One reviewer writes, “I was very impressed with my kit, and I used all of it when I was in the hospital.”

Convenience is so important when you have a new baby, especially when it comes to your healing. The first six weeks after giving birth are a critical time in the healing process, and having the right tools handy can make all the difference in your physical (and mental) health. If you’re pregnant or know someone who is, check out the postpartum recovery kits below."

By: Cedars-Sinai Staff| October 21, 2019​

"The biggest misconception women have about exercising while pregnant is that they can't do it at all, says Dr. Keren Lerner, OB-GYN at Cedars-Sinai. "It's not uncommon for women to wonder if working out during pregnancy will put the baby at risk," says Dr. Lerner. "I get asked that a lot."

Not only is it safe for pregnant women to exercise, but engaging in physical activity while pregnant can be beneficial for the health of a woman and her baby.
It can reduce the risk of preeclampsia, gestational diabetes, and hypertensive disorders during pregnancy. It can also minimize discomfort.
The American Pregnancy Association recommends at least 30 minutes of physical activity every day for women who have a normal, healthy pregnancy. 

The best types of workouts for pregnant women
It's important to know that not all pregnancy workouts are created equal. 
Dr. Lerner says workouts like Barre and Pilates are great because they focus on core strength, which can make the delivery and recovery process easier. 
"Prenatal yoga classes can be great for mind, body, soul, and core," Dr. Lerner says, as long as women are careful not to overextend their backs with deep bends or twists.
She also recommends swimming, especially in the third trimester.
"When there's more weight being carried, a lot of women end up with back pain," Dr. Lerner says.
"Because gravity is less of an issue in the water, women tend to be more comfortable in the pool."
No matter what workout they choose, pregnant women should drink plenty of water and take a rest if they start to feel dizzy or lightheaded while exercising.

​Workouts to avoid when pregnant
All pregnant women should avoid contact sports, as well as activities like skiing, snowboarding, rock climbing, horseback riding, and scuba diving.
If the pregnancy is high risk, women should talk to their doctor about their workout options.
Women should also seek medical advice if they get injured while exercising.
While 30 minutes of daily activity during pregnancy is recommended, women who enjoy working out aren't limited to this, Dr. Lerner says.
"Certainly those who are used to working out or have active jobs or lifestyles can endure more," Dr. Lerner says.
"They just need to be sure they're listening to their bodies." 

"How can you tell if you're struggling with mental health during pregnancy and postpartum?"

By: Women's College Hospital

By: Catherine Pearson | 10/28/2020

"When Jane gave birth to her baby 10 years ago, she very quickly began experiencing significant postpartum depression. It felt as though her brain had been abruptly “rewired,” and her symptoms grew worse over time.

“It felt like there was this thing in me that took root and grew,” said Jane, 47, who asked to use only her first name for this story. “Especially feeling suicidal. Those thoughts had a life of their own.”

As the months passed after giving birth, Jane found herself making clearer and clearer plans for how she’d take her own life. She recalls at one point, when her son was 3, nearly pointing out an overpass from which she could easily jump while strolling with her toddler and husband — then immediately recoiling. Not from the thought itself, but from the fact that she had almost casually given her “secret” away.

When her son turned 4, Jane finally recognized her own need to get help and got a prescription for Prozac. Practically overnight, her thoughts of suicide disappeared. And despite the fact that it was years after she had given birth, the roots of her depression felt obvious.

“For me, it could not be more clear that what I had was postpartum depression,” said Jane, who often worried she’d sound “crazy” if she opened up about what she was experiencing — particularly because she adored her son. “It felt almost like my brain was rewired during pregnancy.”

New research published in the journal Pediatrics this week supports what parents like Jane, as well as mental health professionals who specialize in the issue, have long known: that “postpartum” depression is not just something that strikes in the weeks and months immediately following childbirth. It can last for years and grow worse with time.
In the study, which tracked 5,000 mothers in New York over time, one-quarter of the women experienced elevated depression symptoms at some point in the three years after giving birth.

Of course, up to 80% of new moms experience some version of the so-called “baby blues” in the first few weeks after delivery. They may feel sad, anxious and cry a lot. Their moods may shift rapidly as their hormones fluctuate and they learn to care for a vulnerable new infant on extremely little sleep.

Postpartum depression may be more severe (though not always) and lasts longer, often appearing weeks after giving birth but sometimes not for a full year — or, as this new research suggests, even longer. It builds on a recent scientific review that found up to 50% of moms with postpartum depression struggle beyond the first year.

​Expanding our collective understanding of how long postpartum depression can persist is important largely because of screening.

The American College of Obstetricians and Gynecologists — which sets the guidelines OB-GYNs and other women’s health providers often use — recommends at least one screening for postpartum depression using an official tool or questionnaire. The American Academy of Pediatrics recommends pediatricians screen for mental health issues in patients at various points in the first six months after they’ve given birth.

But that timeline may not do enough to catch those who are struggling, particularly because many patients with postpartum depression are reluctant to speak about what they’re experiencing out of a sense that their symptoms somehow mean they are bad parents.

That is why the authors of the new study clearly state that screening within the first year after giving birth is insufficient and that pediatricians should consider assessing patients for at least the first two years after they have a baby.
“We know that if a PMAD [perinatal mood and anxiety disorder] is untreated, it can continue. The symptoms can become worse, and many women can ride them right into a subsequent pregnancy,” echoed Paige Bellenbaum, chief external relations officer for The Motherhood Center, a mental health clinic based in New York City.
​
Even so, Bellenbaum believes far too few pediatricians, OB-GYNs and midwives meet even the current bare minimum recommendations for screening patients for depression and anxiety — to say nothing of assessing how they’re doing years down the road."

Opinion| Megan Markle: The Duchess of Sussex

"Perhaps the path to healing begins with three simple words: Are you OK?"

"It was a July morning that began as ordinarily as any other day: Make breakfast. Feed the dogs. Take vitamins. Find that missing sock. Pick up the rogue crayon that rolled under the table. Throw my hair in a ponytail before getting my son from his crib.

After changing his diaper, I felt a sharp cramp. I dropped to the floor with him in my arms, humming a lullaby to keep us both calm, the cheerful tune a stark contrast to my sense that something was not right.
I knew, as I clutched my firstborn child, that I was losing my second.

Hours later, I lay in a hospital bed, holding my husband’s hand. I felt the clamminess of his palm and kissed his knuckles, wet from both our tears. Staring at the cold white walls, my eyes glazed over. I tried to imagine how we’d heal.
I recalled a moment last year when Harry and I were finishing up a long tour in South Africa. I was exhausted. I was breastfeeding our infant son, and I was trying to keep a brave face in the very public eye.

​“Are you OK?” a journalist asked me. I answered him honestly, not knowing that what I said would resonate with so many — new moms and older ones, and anyone who had, in their own way, been silently suffering. My off-the-cuff reply seemed to give people permission to speak their truth. But it wasn’t responding honestly that helped me most, it was the question itself.

“Thank you for asking,” I said. “Not many people have asked if I’m OK.”

Sitting in a hospital bed, watching my husband’s heart break as he tried to hold the shattered pieces of mine, I realized that the only way to begin to heal is to first ask, “Are you OK?”

Are we? This year has brought so many of us to our breaking points. Loss and pain have plagued every one of us in 2020, in moments both fraught and debilitating. We’ve heard all the stories: A woman starts her day, as normal as any other, but then receives a call that she’s lost her elderly mother to Covid-19. A man wakes feeling fine, maybe a little sluggish, but nothing out of the ordinary. He tests positive for the coronavirus and within weeks, he — like hundreds of thousands of others — has died.

A young woman named Breonna Taylor goes to sleep, just as she’s done every night before, but she doesn’t live to see the morning because a police raid turns horribly wrong. George Floyd leaves a convenience store, not realizing he will take his last breath under the weight of someone’s knee, and in his final moments, calls out for his mom. Peaceful protests become violent. Health rapidly shifts to sickness. In places where there was once community, there is now division.

On top of all of this, it seems we no longer agree on what is true. We aren’t just fighting over our opinions of facts; we are polarized over whether the fact is, in fact, a fact. We are at odds over whether science is real. We are at odds over whether an election has been won or lost. We are at odds over the value of compromise.

That polarization, coupled with the social isolation required to fight this pandemic, has left us feeling more alone than ever.

When I was in my late teens, I sat in the back of a taxi zipping through the busyness and bustle of Manhattan. I looked out the window and saw a woman on her phone in a flood of tears. She was standing on the sidewalk, living out a private moment very publicly. At the time, the city was new to me, and I asked the driver if we should stop to see if the woman needed help.

He explained that New Yorkers live out their personal lives in public spaces. “We love in the city, we cry in the street, our emotions and stories there for anybody to see,” I remember him telling me. “Don’t worry, somebody on that corner will ask her if she’s OK.”
​
Now, all these years later, in isolation and lockdown, grieving the loss of a child, the loss of my country’s shared belief in what’s true, I think of that woman in New York. What if no one stopped? What if no one saw her suffering? What if no one helped?

I wish I could go back and ask my cabdriver to pull over. This, I realize, is the danger of siloed living — where moments sad, scary or sacrosanct are all lived out alone. There is no one stopping to ask, “Are you OK?”
​
Losing a child means carrying an almost unbearable grief, experienced by many but talked about by few. In the pain of our loss, my husband and I discovered that in a room of 100 women, 10 to 20 of them will have suffered from miscarriage. Yet despite the staggering commonality of this pain, the conversation remains taboo, riddled with (unwarranted) shame, and perpetuating a cycle of solitary mourning."

"​Moms of color have an increased risk of experiencing PPD and related disorders than women in other ethnic groups, but fear is keeping them from getting the treatment they need. Here’s why, and how Black families can get the right mental health support."

"During her first year as a mom, Karen Flores, then 31 years old, was afraid she was not emotionally stable enough to take care of her daughter. On the particularly hard days, Flores would take a walk with her daughter on the beach. “Out of nowhere, this bizarre thought came to my mind ‘push the stroller over the rocks and see what happens,’” she wrote on the site Maternal Mental Health Now. “I was paralyzed by the thought but forced myself to keep on walking while wondering where it had come from—'Oh, My God, am I crazy?' I wondered.”

Flores, now 50, was not crazy. She was suffering from postpartum depression, a condition that affects up to one in seven women, according to the American Psychological Association. Flores didn’t immediately seek out help. “I was extremely anxious and ashamed thinking that I was losing my mind and that my baby would be taken from me,” she says. “I tried praying and did a lot of cardio.” Before her daughter’s second birthday, she began working with a therapist to manage the symptoms of her depression.

​Black women like Flores are less likely to get help for postpartum mental health issues compared to both white women and Latinas, according to a study published in the journal Psychiatric Services. Part of this hesitation is caused by fear—these women fear they will be considered unfit and have their children taken away from them by Child Protective Services. These fears are not unwarranted since one in nine Black children will spend time in foster care by the time they're 18, according to data from the Adoption and Foster Care Analysis and Reporting System. This is the second-highest risk racial/ethnic group to end up in the foster care system behind Native American children.

“There’s a lack of trust of medical practitioners within the Black mom community nationwide,” explains Shivonne Odom, LCPC, LPC, founder of Akoma Counseling Concepts, LLC, in Silver Spring, Maryland, who specializes in maternal mental health counseling for mothers with perinatal disorders. “Many medical practitioners are not trained to refer or treat perinatal mood disorders so when they hear patients report typical symptoms of postpartum depression, practitioners mistake the severity of the symptoms for abuse.” Odom, who is Black herself, adds that many practitioners do not recognize a difference in how perinatal mood disorders present among ethnic groups. “This leads to improper treatment or poor rapport between practitioner and client,” she says.

Postpartum depression, anxiety, and other perinatal mood and anxiety disorders can affect any mother and can manifest up to one year after delivery. However, there are cultural nuances during pregnancy, labor, and delivery that can increase the risks of experiencing PPD for Black mothers. Statistics show that Black women are three to four times more likely to die during or after delivery than white women. From 2011 to 2015, there were 42.8 deaths per 100,000 live births for Black non-Hispanic women—a higher ratio than any other ethnic group. “These statistics along with birth trauma and untreated mental health issues prior to and during pregnancy may lead to postpartum depression,” Odom says.

Suffering in silence

Odom says she often sees the same themes preventing Black mothers from seeking mental health therapy. First, there’s the fear of losing control, independence, respect from others, or mental sanity. “Sometimes holding in this fear leads to a manifestation of irrational thoughts—'I’m not a good mom,’ ‘I feel empty,’ ‘I’m not emotionally connecting to my baby,’” she says. “The belief that something is wrong, which must mean I’m doing something wrong and I’m a bad mom is an extension of these irrational thoughts.”

Then she often hears that these women would prefer to seek help from their friends, family, and church rather than a mental health professional. “There’s definitely a cultural stigma discouraging mental health counseling in the Black community,” Odom explains. “Some believe that if you go to therapy you have to be admitted to a psychiatric hospital or will be required to take addictive prescription medications. Some people’s religious beliefs also shape their views on mental health and can impact their help-seeking behaviors.” There’s also concern passed down from generation to generation that mental health practitioners are suspicious of Black mothers."

By: Shanicia Boswell | August 26, 2020

"​Raising awareness about the history of Black breastfeeding and the factors that contribute to low rates of Black mothers breastfeeding is an important way to close the gap."

"I sat on the sofa crying silently between my mother and my fiancé. Tears spilled over my cheeks as we watched a movie and I held my newborn daughter. I was three days postpartum and my breasts were painfully engorged with milk. How was this happening? I had survived a med-free labor and delivery. This was supposed to be the easy part. Looking back nearly eight years ago at my breastfeeding journey, I always remember this day. I was a first-generation breastfeeder.

​That day and many other days, I sat between people I loved the most and felt completely alone and isolated. My partner could not help me with breastfeeding because he was a man who had no experience around breastfeeding. My mother could not help me because she had not breastfed me or my brother. My friends could not help me because I was the only one in my friendship circle who had a baby. Like many Black millennial women, I was embarking on this journey alone.

​Without the proper resources, my breastfeeding journey only lasted six months. I felt defeated. In fact, the statistics show that Black women are less likely to start breastfeeding than any other race of mother and even less likely to continue breastfeeding for six months. Only 69 percent of Black women initiate breastfeeding compared to 85 percent of white women. The question that is often asked after hearing statistics is why? There are many reasons. There are unfortunate events deeply connected to our race as a people: a history of wet nursing, oversexualization, lack of economic and familial support, are a few. For me, the question became how do we raise the numbers?

This is where Black Breastfeeding Week comes in. Black Breastfeeding Week is August 25 to 31, 2020, and is a campaign that has been part of National Breastfeeding Month for the past eight years. This year, through virtual events, Black mothers, lactation experts, and public health professionals have space to discuss their breastfeeding journeys, raise awareness, and explore public policies that address the disparities in statistics around Black maternal and infant care. Black Breastfeeding Week has become even more controversial this year because we are in a time where extreme emphasis has been placed upon race and it creates a space where white mothers feel isolated. White mothers are asking why Black women are choosing to segregate themselves, even down to the topic of breastfeeding. 

As the creator of Black Moms Blog, a collaborative blogging platform for mothers of color, I am no stranger to the "why aren't we included" questions from white mothers. The truth is, weeks like this should not have to exist. Platforms like mine should not be a necessity—but they are. The needs of Black mothers as well as the specific barriers we face are left out of the overall breastfeeding conversation. The historical and cultural context as to why is important.

​The History of Black Breastfeeding

Cultural reference should always be considered when discussing breastfeeding. During slavery, Black women were used as wet nurses. A wet nurse is someone who breastfeeds another woman's child. The true definition of a wet nurse states "employed," but replace that word with "forced," and the reality becomes clear. It is generational that Black women have developed a disdain for breastfeeding due to our historical relationship with wet nursing. Because of wet nursing, many Black women were unable to breastfeed their own children. Can you imagine the psychological effect that must have had on a moment that every mother should enjoy?"

"The coronavirus pandemic has brought on a slew of challenges for expecting women and new parents. With so much uncertainty, women must take care of their mental health. Because COVID-19 has disproportionally affected people of color, mothers in these communities need more support than ever, as people of color have less access to mental health services compared to white people. Moreover, when they do receive care, it is likely to be of poorer quality.

​In honor of National Pregnancy and Infant Loss Awareness Month, we spoke with Shonita Roach, executive director and spokesperson for the 2020 Multicultural Maternal Mental Health Conference, to learn why discussing issues that directly affect maternal mental health will positively impact women of color.

"This awareness month is very dear to my heart, as I also lost my son to an accidental death nearly 18 years ago, and I suffered postpartum depression and even contemplated suicide," Shonita told POPSUGAR. "Through extensive therapy, parenting classes, and spiritual healing, I have been able to thrive, create a loving family with my three boys, and serve as an advocate for women and mothers."

How a Lack of Diversity in the Medical Field Is Affecting Black Maternity Health

It's widely known that Black women experience higher chances of maternal health complications than white women in the US, and unfortunately, the lack of diversity in healthcare professions isn't making it any easier for women of color to get the help they need.

"When you talk about mental health or seeing a therapist or even taking medication for the condition, there is a lot of judgment and misnomers," Shonita told POPSUGAR. "So when you take into account the implicit (and explicit) bias against Black women and healthcare, it makes it especially challenging. The lack of multiculturalism in mental healthcare, from a discrepancy in diverse professionals to the lack of community-based services, creates a major barrier that is difficult to overcome."

Additionally, having more nonwhite doulas and medical professionals can have a positive, lasting impact on maternal health across the board. "Studies show that having doulas of diverse backgrounds contributes to reducing maternal and infant mortality rates," she explained. "What I love about doulas is that they are community-based and do a lot more intimate, one-on-one work with women. They fill the gap where the traditional healthcare system lacks."

How COVID-19 Has Negatively Impacted Black Maternal Health

COVID-19 has disproportionately affected communities of color, and in turn, has extended to Black maternal healthcare. While Shonita is encouraging families to do whatever they can to limit their exposure to the virus, she knows that can be difficult to do when you're pregnant or have just welcomed a child.

"It's important that communities everywhere practice the safety precautions to reduce the spread of this deadly virus," she explained. "However, those same precautions, such as reducing the use of public transportation unless absolutely necessary, isolating yourself, and staying home puts further strain and stress on expecting and postpartum women."
​
"Not only that, the acceleration of the need for accessible technology and internet services proves to be paramount during the pandemic," she continued, noting how access to telehealth is a privilege and can be a challenge for marginalized communities. "The pandemic is also very isolating when it comes to prenatal visits: women are having to attend these alone without their partner or support system. Also, your friends and family are no longer allowed to visit the hospitals during and after delivery. The entire situation is so unfortunate and does not create a conducive environment for a healthy state of mind as you transition into motherhood, whether you're a first-time mom or a mother to multiple children."

Black Women's Struggle With Accessing Reproductive Healthcare

We would be remiss if we didn't mention some of the historical and cultural reasons that Black women have struggled to get adequate access to reproductive healthcare in the US.
​
"Medical experimentation on the bodies of women of color and the oversexualization and degradation of Black breasts — which contributes to negative stigmas on Black breastfeeding — are just two examples of why it negatively impacts the sexual and reproductive health of Black women," she said. "This creates barriers of mistrust, misinformation about our bodies. All of this plays into the current disparities and stigmas surrounding reproductive health in marginalized communities."

"​Following the birth of her third child, Jorgia Hamel Nevers experienced Postpartum Depression (PPD) for the first time. The 30-year-old from Robeline, Louisiana, identified her symptoms and spoke with her husband, Travis, and a counselor. They informed her doctor during a 6-week postnatal follow-up appointment. He prescribed Zulresso, the first FDA-approved drug designed to treat postpartum depression. It is an IV treatment which can reportedly help patients feel relief from symptoms within 48 hours. Soon, Nevers felt a loving, healthy attachment to her baby River and her 2-year-old and 5-year-old sons again. She decided to share her story because she says she wants women who are experiencing PPD to know that they can speak up, seek treatment and get better. This is her story, as told to PEOPLE.

River was born August 27, 2019. I started having some PPD symptoms a week after her birth. Since she’s my third child, I knew what PPD was from warnings in pregnancy classes I’d previously taken and also from my social work courses. (I’m currently a full-time social work student at Northwestern State University in Natchitoches, Louisiana.) My PPD symptoms showed up as irritated and depressed moods; I wouldn’t get out of bed, had severe anxiety attacks, would cry for no reason and wasn’t feeling a true connection with River or my two sons. On top of that, I felt guilt for what I was experiencing and how it was affecting my family as a whole. I just had a lack of will to do anything at all — except for being alone.

While I experienced the depressive moods and crying in the beginning, it then progressed to the other symptoms. The lack of will was difficult because inside, part of me was still saying, “Get up, take care of your family, do your schoolwork.” But my body just would not move. I felt paralyzed. And as it progressed, I started not to care. I’d think, “River is crying, oh well, Travis will get her. She doesn’t need me anyway,” or “Sammy has something at school for parents to attend, but I don’t want to get up, oh well.”

This is completely the opposite of who I was before PPD. The lack of maternal connection played into the lack of will. At first, I didn’t feel like River was my child. Then I didn’t care anymore about trying to build that bond with her, or to maintain the bond I had with my sons. The anxiety attacks were physically debilitating, in particular. My entire body would tense up, I would cry, I couldn’t breathe, and I was just terrified each time they came. (I had these symptoms until my treatment of Zulresso was completed.)

I had never experienced “baby blues” or PPD with my other two children. After about a month of having symptoms, I told my husband that I felt like something was wrong. I didn’t fully say PPD, just that I wasn’t feeling like myself. Then, a classmate and friend of mine sent a message to check on me. I told her what I was experiencing, and she advised me to see a counselor and tell my doctor. I didn’t want to admit to myself that something was wrong, but I was taking a course about mental health and read about depression symptoms in the Diagnostic Statistical Manual. I sat in my chair and checked off “yes” to almost all of the symptoms listed. That woke me up.

At that point, I decided to tell my professors what was going on, to make a therapy appointment, and to inform my doctor at my routine 6-week checkup. I am lucky that Dr. Olatinwo was involved in the trials for Zulresso. He saw its potential for me.

My physical experience of the treatment involved staying in a hospital room for three days with an IV that administered Zulresso and other fluids. It is a 60-hour infusion, so I had food brought to me and I was checked on every two hours. I watched a lot of Disney+ and just focused on getting better. My husband would also bring me snacks, and he brought River (while the boys were in school and daycare) to the hospital for a visit. I also FaceTimed with them in the evening to say goodnight. After being on the treatment for 30-35 hours, I started feeling better — more like myself. I had the urge to get up and take a shower. I wanted to take care of myself."

By Cassie Shortsleeve| July 14, 2020

"Six weeks after I gave birth to my first daughter, I found myself in my OB/GYN’s office for my postpartum checkup. After a quick conversation and a physical exam, my doctor told me that I was “cleared.” I could resume all regular pre-pregnancy activity.

I went home, fed my baby and went on a run — and had to stop after a half-mile. My pelvic floor felt like it was going to give out and — although once an avid runner — I felt clumsy. That night, I lay awake, milk-stained and sweaty. Nothing about me felt “cleared.”

Despite the fact that in 2018, the American College of Obstetricians and Gynecologists recommended that, to optimize women’s health, postpartum care should become more of a rolling process rather than a single encounter, for many new moms, the six-week postpartum appointment remains the only touch point with the health-care system that birthed her baby.

If Latin America has la cuarentena — a 40-day period when women take care of a new mom while she rests — and the ancient Indian medical system of ayurveda teaches us that we must nurture women for 42 days postpartum for the health of her next 42 years, the United States, traditionally, has this: one lone appointment that, in many senses, gives a message of closure to the fragile and monumental postpartum period.

"The four- to six-week time frame has historically been thought to be enough time for women to be able to go back to do more physically demanding jobs, like farming, without having any serious medical issues,” explains Heather Irobunda, a board-certified OB/GYN in New York. Your uterus has usually shrunk back to a pre-pregnancy size, lacerations have healed, soreness from birth has resolved.

But physical changes persist for longer — probably six months or so, says Kecia Gaither, director of perinatal services at NYC Health+Hospitals/Lincoln. Around then, pelvic floor and abdominal musculature tone returns, changes in hair normalize, and the menstrual cycle might become more regular (if it’s returned).

Some research even suggests women wait 12 months to conceive again. But how long does it take for the body to recover? It depends on where you look.

The Centers for Disease Control and Prevention, for one, says that a “pregnancy-related” death is a death of a woman while pregnant or within one year of the end of pregnancy, but “maternal mortality” is defined by the World Health Organization as the death of a woman while pregnant or within 42 days of the end of pregnancy.

The Diagnostic and Statistical Manual of Mental Disorders, often called the “bible” of psychiatric health conditions, defines postpartum depression as depression “with postpartum onset: defined as within four weeks of delivering a child.” But, says Cindy-Lee Dennis, a professor at the University of Toronto who studies the postpartum period, “it’s fairly standard in the research literature to consider postpartum depression up to one year postpartum.” (Take a landmark 2013 study published in JAMA Psychiatry of 10,000 mothers: It found that 1 in 7 women develop PPD within the first year postpartum.)

Birdie Gunyon Meyer, a registered nurse and director of certification for Postpartum Support International, a nonprofit group that lobbied to extend the period following delivery in the definition of PPD, says: “I don’t think anybody really believes that the postpartum period is over at four or so weeks, but we give that impression when you come in for your four- or six-week checkup."
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The truth is, the adjustment to parenthood takes time. It takes more than a couple of weeks and more than a couple of months. Researchers say Year 1 is critical for children and parents alike. “For the child, the brain is growing rapidly and the experiences that happen and the neurological pathways that are developed stay with the child for a lifetime,” says Dennis."

By: Ash Spivak Natalia Hailes

"It's no secret that the postpartum period is just hard. After growing and carrying a human for almost 10 months, you perform what is likely one of the most challenging physical and emotional feats of your life—birthing that baby. And then you find out you're just getting started!

During postpartum, you're healing physically and emotionally while a new, adorable human is entirely reliant on you (and requires way more work than while you were passively growing them). Add in little sleep, changing hormones and doing this all during a pandemic.

Becoming a parent forces us to confront some of our biggest fears—loss, lack of control, change, the unknown. But here's the thing about being in the postpartum period during this pandemic. You are sharing those fears with a whole lot of people out there: all of us are being forced to confront them.

It's like we're arriving at a jungle with no paths and no maps. But whether you recognize it or not, you are already starting to pave your way.

We have no control over how long this pandemic will last or what the outcome will be. The only thing we do have some control over is how we move through it.

One guaranteed way to move through postpartum during a pandemic with more grace and ease is to prioritize your own well-being. Taking care of yourself is taking care of your baby. The actions we are being asked to take to minimize the spread of COVID-19 mimic those that are necessary in the early postpartum days: stay home and slow down (if you have the privilege); care for yourself so that you can care for others. Just like on the airplane, you need to put your mask on first.

For some, circumstances will make this even more challenging (those who have lost jobs, are working full-time and homeschooling and in the postpartum period, those needing to return to the frontlines, and those in essential jobs). While our capacity may be great, we are also only human. We never really know the path. We can only focus on how we move through.

Here are some ways to prioritize your postpartum well-being right now, even during a pandemic.

Ask for help

You can't do it all on your own. While the physical isolation from your support systems is no joke, it's important to remember that you are not isolated in this experience. Even during these times there are ways for others to pitch in. Have someone set up a meal train or set up a fundraising page if you are in a tough financial time. Therapists, postpartum doulas and lactation consultants are all working virtually. Book appointments and put it all on your new baby registry—way better than another onesie!"

By: Katelyn Denning

"When was the last time you felt overwhelmed? Last week, yesterday, earlier today? My guess is, it probably wasn't that long ago. If your triggers are anything like the moms I work with, overwhelm can hit you at any point and in any situation.
Sometimes it's in the middle of the workday when the responsibilities and stresses of the job get to be so much that you think there's no way you'll ever climb out of this hole, let alone your inbox.

Sometimes it's in the evenings when you look around at the mess in your house, a pile of laundry and no certain plan for dinner that you feel like you've let your family down and what you should really do is quit your job so you could actually stay on top of all of it.

Sometimes overwhelm shows up when you're surrounded by two children who are wallowing in their own overwhelm of emotions, crying and whining, that you think life will be this way forever. And you're overwhelmed by the fact that you are the adult here.

Or sometimes, overwhelm waits to hit you until the craziness of the day has ended and you have your first quiet moment to yourself. When you finally sit down, exhale a big sigh of relief, and think about doing it all over again tomorrow, the crushing weight of overwhelm sits on you making it hard to breathe.
Can you relate?

No matter how it shows up for you, overwhelm feels heavy. It creates the feeling of being out of control in terms of practically everything you can think of. And like the temper tantrums we often witness in our children, it can be hard to snap out of.

Trust me—we have all been there and some of us probably more frequently than we would like to admit.
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But just like we're taught how to approach and calm a toddler who is stuck in an emotionally overwhelming moment which often manifests as a screaming fit, there are things that we can do to help ourselves snap out of it, too. Things that can help us stop spiraling into that feeling of being out of control, and instead, grounds us in the present moment.

You will get through this.

Everything is not lost.

This is only temporary.

You've got this.

So the next time you feel that feeling, you know how it goes—your breath becomes short, your head starts to feel heavy, you can't see past your own nose and you just might break into tears if anyone asks you if you're okay—try one (or try all) of these things to catch your breath and reset."

No, lying flat after sex won't increase your chances of conception. 

By Jen Gunter, MD| April 15, 2020

"​As an ob-gyn, I’ve personally encountered many fertility myths in my office or online — some of them even during my training. Why do they persist? Sex education, particularly about the physiology of reproduction, is typically incomplete and subpar. And when we do talk about fertility and reproduction, we don’t talk about it directly — euphemisms for the uterus, menstruation, the vagina and the vulva are still common, and when you can’t use a word, the implication is that the body part is shameful. And, of course, many myths persist simply because they’re alluringly fantastical, and we’re inclined to believe these tall tales over the stodgy facts. Here are seven fertility myths that need to be forgotten.

1. Phases of the moon affect menstruation 
This is not an uncommon belief-some women even refer to menstruation as their "moon time." The confusion is understandable: The 29.5-day lunar cycle (from new moon to new moon) is very close to the average 28-day menstrual cycle. But studies show no connection between the moon and menses. Moreover, it is hard to envision how a moon-menstruation would be biologically beneficial to human reproduction. 


2. Reproductive hormones need to be ‘in balance’ 
This is a common modern myth in gynecology exam rooms all across North America-and it results in a lot of unnecessary testing of hormone levels. The truth is that, for women of reproductive age, the hormone levels for FSH, LH, estrogen and progesterone change not only day to day, but also often hour to hour. When a women has certain symptoms-for example, an irregular menstrual cycle or infertility-hormone testing may be recommended to make a diagnosis. But in these situations, doctors will look at individual levels in conjunction with symptoms, rather than comparing levels with some mythical "balance." Being "in balance" may sound natural, like a person who is "in tune" with her body. But it is simply not a factual statement, or even a good analogy, for what happens biologically."

By Penny Simkin| October 27, 2009

"Author/lecturer, doula, childbirth educator, Penny Simkin, PT, talks about pain in labor and the concept of "when pain becomes suffering."

By Penny Simkin| Oct 30, 2015

"Author and educator, Penny Simkin offers an introduction to the serious topic of traumatic childbirth including symptoms of PTSD and suggestions for facilitating postpartum recovery from a traumatic birth experience. 

Traumatic childbirth occurs in as many as 25-34 percent of all births. Approximately one-third of those women may develop Posttraumatic Stress Disorder (PTSD). 

For more information, visit pattch.org. Penny is one of the founders of PATTCh, Prevention and Treatment of Traumatic childbirth, whose vision is "a world where women, infants and families, experience optimal physical and mental health in pregnancy, childbirth, and the postpartum period." 

Research on this condition is only about 10 years in the making. 

By Julie Revelant 

"When I had my first child six years ago, I was grateful breastfeeding turned out to be, for the most part, a smooth ride. 

After a visit with the hospital lactation consultants, who showed me the best breastfeeding positions and gave me the support I needed, I was on my way, and continued to breastfeed exclusively for the next 12 months. 

In those early months, though, I'd experience something odd-and often frightening-that I never told anyone about. When my daughter latched on and my milk let down, an intense feeling of anxiety, panic, and doom would wash over my entire body. For a brief moment-about 20 to 30 seconds-I had a sudden irrational fear that something bad was going to happen. 

And as quickly as the feelings came, they went. 

It was always unsettling and, at times, scary, but becuase I had struggled with anxiety for as long as I could remeber, I chalked it up to biology and hormones. 

When I gave birth to my second child two years later, I wasn't surprised those same feelings surfaced once again. It was still unsettling, but thankfully, it didn't affect my ability to breasfeed her for 13 months. 

Yet it continued to nag at me, and as a health journalist, I wanted to know why I'd often write about breastfeeding, and when I asked my sources if this was common, most of them had no idea what I was talking about. Then one day, I spoke with a lactation consultant and she told me what I had experienced  was real and it had a name: D-MER: Dysphoric Milk Ejection Reflex.  

ABC rejected the commerical about postpartum recovery, claiming it was "too graphic."

By Ashleigh Carter| Published on 2/11/2020

"A postpartum ad that was supposed to air during the Oscars is gaining attention online after ABC rejected it for being too "graphic."

The 60-second commerical made by Frida Mom shows a new mom waking up in the middle of the night and struggling to use the bathroom, while using different products to help her, including mesh underwear. The ad ends, saying "Postpartum recovery doesn't have to be this hard," followed by products the company sells. 

Frida Mom posted their ad on YouTube and introduced it by saying, "The ad you're about to watch was rejected by ABC and the Oscars from airing during this year's award show. It's not 'violent, political' or sexual in nature. Our ad is not 'religious or lewd' and does not portray 'guns or ammunition.' 'Feminine hygiene & hemorrhoid relief' are also banned subjects."

The compnay submitted the commercial to air during the 2020 Oscars, but according to Health.com, it was rejected for being "too graphic with partial nudity and product demonstration."