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Well Woman Health

Nurse comforting mama patient
well-woman health care

The fourth-trimester. AKA postpartum. You’ve heard us talk about the importance of this stage in motherhood; it’s the stage that is overlooked by many doctors, media, and even moms. Now an ally of woman’s health is also using the phrase fourth-trimester to raise the visibility of how vital it is to prioritize well woman health during this period.

A recent convening of the Presidential Task Force on Redefining the Postpartum Visit Committee on Obstetric Practice headed by The American College of Obstetrics and Gynecologists (ACOG) has produced a revolutionary article on the topic of optimizing postpartum care for the 21st Century American woman. The revolutionary part? Make it woman-focused, and woman-led.

Research has shown that women feel there is an “intense focus on women’s health prenatally, but care during the postpartum period of infrequent and late”. There’s no shortage of stories from women noting that in all their prenatal visits the topic of a postpartum care plan is rarely discussed. ACOG, in their May 2018 journal, recognizes that as many as 40% of women do not attend any postpartum visit, which leads to health disparities and an expanding array of future complications that healthcare professionals are just now realizing are tied to inadequate postpartum support. Heart disease, stroke, and future depression are among the handful of medical issues that impact women even a decade after birth, and doctors are finding that identifying and managing these issues within the first 3 weeks of delivery can positively affect a mother’s future health on the path of being a well-woman.

The holistic approach that ACOG recommends to all women is to have contact with a care provider within three (3) weeks postpartum for an initial assessment. At this visit, and new mother can consult with a healthcare provider to create a comprehensive approach to an individual woman’s needs going forward concerning a battery of health and wellness concerns. This care system planning should begin during the prenatal phase to create a postpartum plan that involves identifying who the mother’s care provider will be, address health issues (especially chronic ones), mood disorders, and external care support like friends and family.

It Takes a Village

The phrase “it takes a village” has loosely defined traditional approaches to postpartum care for decades. Robust family leave programs in other countries has underscored the poor maternal mortality rate that is scarily rising in the U.S. Today. 23% of employed women return to work within 10 days postpartum, putting a strain on a mother’s ability not only to find childcare, but find the ability to schedule a doctor appointment. Delaying these initial visits lead to undetected co-morbidities that put a woman’s life at risk.

While we wait for federal policy changes that allow for a full paid 6 week leave and well-woman health maintenance, technology can create a safety net in the interim. Phone calls, text messaging, and apps can be powerful reminders for appointments and follow-ups. Simply checking in about how a mother’s mood is, how feeding is going, and if she’s experiencing any adverse physical conditions can make a mom feel supported and be more apt to open up about any problems or concerns.

Bottom line, every woman’s health is as unique as she is, and there’s no one-size-fits-all approach to her postpartum journey. Putting as much planning into a postpartum care plan that goes into researching strollers is as instrumental to the health of a mother as it is to a baby. When a mother’s health is compromised, caring for her little one is made more difficult because small tasks like climbing stairs, doing dishes, and feeding are all potentially impacted when the fourth-trimester isn’t valued and respected. Policy changes are needed to correct an imbalance in maternal healthcare, especially for women of color, to make sure the future of postpartum care is woman-focused.

We’re wishing you Well-Woman Health!

By Anna Pederson

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Does Postpartum Pain Put You at Risk for Depression?

postpartum pain link to depression

New Research Shows Postpartum Depression May be Caused by Postpartum Pain

postpartum pain link to depression

Childbirth is a natural process, but the resulting pain associated with delivery is leading researchers to conclude that the ties between postpartum depression and postpartum pain are stronger than previously thought.

A new study presented at the Anesthesiology 2018 conference states that pain specific to the postpartum phase is more directly linked to depression than pain felt during labor or delivery, no matter the birthing method (vaginal or cesarean).

Jie Zhou, M.D., M.B.A., lead author of the study and assistant professor of anesthesia at Brigham and Women’s Hospital and Harvard Medical School, reviewed pain scores (from the start of labor to hospital discharge) for 4,327 first-time mothers delivering a single child. The same women also took the Edinburgh Depression Scale test and had those scores compared against their pain score.

What Dr. Zhou and his team found that the higher the pain score, the higher the depression score. Particularly women who had c-sections produced higher scores. Pain medication like ibuprofen or Tylenol were requested more often by mothers who had high depression scores.

Other factors that could increase risk of depression include obesity; a torn perineum; history of depression or anxiety; and a lower APGAR score, which is the scale used to measure an infant’s health 1 to 5 minutes after birth.

Dr. Zhou noted that “While ibuprofen and similar pain medications are considered adequate for pain control after childbirth, clearly some women need additional help managing pain…We need to do a better job identifying who is at risk for postpartum pain and ensure they have adequate postpartum care.”

Accordant with our mission of providing postpartum support for all women, Mama Strut fully supports this sentiment.

Medication is Not Enough

Postpartum depression affects 1 in 9 women according to the Center for Disease Control. Risk factors include traumatic birth, a preterm baby, history of depression, or low social support. It is a serious condition that many women suffer through silently and alone. It shouldn’t be this way, but one of the symptoms of depression is feeling withdrawn and disconnected from those around you, perpetuating a vicious cycle of numbness and anger that causes many to not seek help. Depression of any kind can have lasting effects on the mom’s emotional well-being as well as the baby’s due to a lack of bonding.

This vital new research on the need for better pain awareness and management opens doors for understanding how to minimize or eliminate the postpartum depression before it even begins. So much mental and physical prep work is done for labor, but popular culture, along with our own healthcare system, by and large glosses over the pain of postpartum. Lives can literally be saved when this topic becomes a natural part of the conversation of maternal health.

If you or a loved one is suffering from postpartum depression, or any mental health issue. Please reach out to a professional

Written by Anna Pederson

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The Science Behind Mama Strut Postpartum Brace

Mama Strut Postpartum Brace breakdown

We want to give a little depth to the science behind the design for the Mama Strut Postpartum Brace. New research and techniques in medicine come out constantly, and our team stays up-to-date on the most relevant postpartum and women’s health news. Which is why Mama Strut uses the sports medicine P.O.L.I.C.E. Method:

PROTECT the pelvis with gentle support that maintains a level of protection and rest of the pelvic floor.

OPTIMAL LOADING allows for gradual loading at the areas affected by pregnancy and postpartum to prevent atrophy. Icing affected areas will help manage swelling and acute pain.

COMPRESSION not only holds ice to the body, but helps new mamas reduce swelling.

ELEVATION contractions and exercise of the pelvic floor help reduce bladder incontinence.

A lot of mamas ask if the Mama Strut is a wrap or band but it’s so much more than those options. The Mama Strut is a brace that addresses the full range of needs mamas face postpartum and allows for optimal healing instead of being focused on “bouncing back” or “getting the body back” as many wraps and bands are. Our most important role is being a support you can count on during your postpartum journey.

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Every Mama is an Athlete

Every Mama is an Athlete!

Guess what, every mama is an athlete! Most of us have experienced this at least once in our lives: stepping up to the starting line for a race, walking on stage under the hot glare of lights, sitting down to an exam that might determine our future. We can probably count the number of truly self-defining moments with our fingers but often forget about the countless hours, sleepless nights, and thoughts of doubt that have taken us back a step so that we can move forward two more. The greatest competitors in the world face these challenges daily as they push their bodies further than they thought possible. And as a mama, or mama-to-be, you’re already an athlete.

Pregnancy is the training. Birth is the event. Postpartum is the recovery. You’ve been training your body for 9 months getting ready for birth, a big event that will be a defining moment in your life! And like an athlete, you express your body and heart in one go, which means taking time to recover your body on its own timeline and using support when you need it. A lot of mamas talk about how crazy it is that so much awe is shown towards pregnant bodies, but a lot of that respect goes away after having a baby. Why is that? We need more open and honest discussions about how important it is to advocate for ourselves to reduce the stigma that comes with a postpartum body. A body that is proof of incredible concentration, commitment, and strength.  

Postpartum is a wild ride, and you have to respect the journey. Recent mom and Olympic athlete Kikkan Randall was the only member of the 244 person USA team that competed in the 2018 Winter Olympics to have given birth. A professional skier since age 19, Kikkan was used to a regimented and vigorous training schedule that got her body and mindset in top shape. As told to USA Today Kikkan spoke about how even though getting active as soon as possible was important to her. She started getting active by taking walks a few weeks after birth, but  she realized her body had changed and she needed to focus on strengthening inner core muscles to protect her back, something she never had to worry about before.

We’re not all world class Olympians with trainers and personal nutritionists, but moms need a support team that give you the tools to get you back in the game. Internationally ranked tennis player, and new mama, Serena Williams shocked the world with her birth story when she opened up about near death complications following an emergency c-section. Serena admits that she’s always been hard on herself, but feeling like she was “trapped in her own body” for nearly 6 weeks after she left the hospital, feeling defeated. You wouldn’t feel ashamed icing your shins after playing a knock-out round of tennis, so why does that stigma carry over to icing your body after giving birth? In a handful of athlete recovery studies, compression garments, heat/ice therapy, diet and stretching are the most highly recommended methods of making sure you don’t suffer lifelong consequences that sometimes don’t manifest for years. Unsurprisingly this comprehensive system is the most highly endorsed approach to postpartum recovery. Let’s take a cue from these badass athletes and advocate for our bodies just as strongly!

Our bodies are capable of amazing things. So much prepping and planning goes into the big day, which make sense, you have almost an entire year to prepare! We take the vitamins, the lamaze, the prenatal yoga and swimming classes. When focus swings from pregnancy to baby, it’s important to give yourself the same level of commitment and attention. An Olympic ready body is a lofty goal, but your health at any stage in your postpartum journey is our goal. Whether you’re running a marathon, running for office, or running after you’re little one, MamaStrut is there to support you every step of the way. Every mama is an athlete, you got this mama!

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My Postpartum Story: One Year Ago Today

Mama Strut Blog One Year Thumbnail

onyear-mainA year ago, I was discharged from the hospital with nearly 20 stitches and I was still bleeding from my wound. I had lost over 500ml of blood and continued to bleed for another four weeks. My condition caused me to have hot flashes and night sweats. I had trouble sleeping, I lost a lot of hair. As my swollen organs healed, they shrank back down about 2,000% to their original size.

I also lost weight. A lot of weight. More than 24 pounds in just 2 weeks. While weight loss sounds great in theory, I assure you it wasn’t in reality. My body was loose and weak – it just left me with a saggy, empty feeling.

I got dizzy when I stood up too fast. My back always hurt and my abdominal muscles were shot, so I had to use my arms to haul myself up from a lying or sitting position.

During the first 6 months of this postpartum recovery, I also caught a few colds. And every time I coughed, I peed myself because my pelvic floor muscles were shot, too.

My body itched, my face broke out, and some parts of my skin were raw and cracked. I was constantly thirsty as my body tried to keep up producing.

I was constantly in pain, which affected my mood and at times bordered on depression. I had a short temper and difficulty connecting with my loved ones. In the early days, I couldn’t see past the pain. Most days, I just didn’t see the light at the end of this long and arduous healing journey.

I sought the advice of my doctor, pleading, “This can’t be normal. I think there’s something wrong with me.” She tried to reassure me that everything I was experiencing was typical and would “resolve itself.” And I kept asking myself, “Why wasn’t I warned about this?”

When people complimented me on how great I looked and how much weight I had lost, and I would stare back at them with a strained smile, offer a polite thank you, and think to myself, “If you only knew.”

As months went by, it began to get better. I got stronger and my wounds healed. Some were still visible; some only I could sense. But my condition had forever changed my body. It felt different now – not bad, just different.

And today, one year later, I have actually gained a great appreciation for my body and its capabilities. Before these scars, I was a different person. There are scars, they are an emblem of what has shaped me into who I am today. Strong. Resilient. A mother.

This is postpartum.

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How Painful Is Labor? More about Labor Pain.

Mama Strut Blog Labor Day - How to manage labor pain

labor painOn the one-year anniversary of my third and last labor, I look back on how I coped with the labor pain. This reflection brings up the question every first-time mama-to-be wants to know: how painful will labor be and what can I do to help myself cope with labor pain?

Maybe it’s the result of Hollywood depicting wild birth scenes or maybe it’s the abundance of unsubstantiated information on the Internet, but many mamas-to-be are developing a deep anxiety about birth – sometimes even months before delivery. This fear won’t only ruin your pregnancy, but can actually make birth more painful and more likely to end in an intervention. So, instead of focusing on the fear of pain, let’s explore how you can cope with labor instead.

You’ve Got This, Mama

To be clear – birth is a big deal and painful, Pain is a four-letter word, but not a negative one. It’s a way to express a physical sensation to others. Describing how your body feels during labor will help your caregivers provide the right support. No one should be negatively judged because they find birth painful (birth shaming and pain management are related topics that should also be addressed in light of dialogs that rank birth success depending on the amount of intervention or type of management dispensed).

Simply put, a successful birth is a healthy one for mama and baby. Do not listen to anyone that judges your birth choices.

There Are Many Options For Coping With Labor

Because labor is difficult and painful, there are numerous natural and pharmacological ways to help manage it. The degree of labor pain varies from mama to mama – contractions can range from “sensations” or menstrual cramp-like discomfort, to an intensely excruciating experience that, in the moment. you can’t imagine surviving. But don’t worry, you can’t die from labor pain.

Labor Pain Is Not Constant

The good news is that unlike any other types of pain you have felt throughout the course of your life, there are actually pain-free breaks between contractions. These breaks allow you to rest, breathe, and prepare yourself for the next contraction, as well as communicate with your support team.

Labor Pain Intensity Has Stages

Another important fact to keep in mind is that intense contractions warm up your body, starting slow and far apart and increasing in intensity.  This progression in intensity and frequency actually helps your body cope with them. Recognizing that you have managed through the last contraction will give you the confidence that you will be able to manage through the next despite the fact that it may be more intense.

It’s Not Pain, It’s Progress

Knowing what’s happening to your body during labor will help you see the pain as progress on your birthing journey, and not a sign of the body being in distress like other kinds of pain. The pain felt as the uterus contracts to help your baby exit is a positive thing – but because we have associated pain with something destructive happening to our body our entire lives, we are hardwired to interpret labor pain as a threat. Mentally recognizing that labor pain is different will help you view it as positive.

My personal birth mantra (which started off as a joke between me and my doctor) was “It’s not pain, it’s progress.” As I repeated this in my head throughout labor, it helped me focus on the task at-hand and even chuckle after a massive contraction that hurt like hell. Many mamas have report repetition and rhythm as coping mechanism to help keep them in the zone.

That being said, it is still pain and reducing that pain will increase your birth outcome and even your chances of postpartum depression. (citation)

Here are some things to consider when it comes to coping with labor pain:

Mama Musts

  • Be educated, informed, and prepared about birth and your pain management options.
  • Surround yourself with people (doctor/midwife/partner/doula) that support your wishes.
  • The positioning of your body and mobility can reduce pain – walking, squatting, and not lying on your back can reduce pressure and pain.
  • Create a calm labor and birthing environment (hospital/birth center/home birth), taking into consideration who is there, noise level, and familiarity for your personal comfort.
  • Do your best to have your baby in the optimal position for birth. See spinningbabies.com.
  • Keep hydrated but not overly hydrated – not getting enough fluid during labor can be detrimental; having too much IV fluid can lead to swelling, making birth more difficult.

Natural Methods

  • Ice and heat therapy are tried and trusted ways to relieve pain, ease cramps, and relax muscle tension.
  • Some mamas-to-be prefer massage, while others in the heat of labor might not want to be touched, so talk to your support team about listening to your cues prior to the big day.
  • Water in the form of a tub or shower can help relax muscles, reduce gravity pressures, and ease tension.
  • Movement and changing positions in labor can provide relief from pressure.

Pharmacological Support

  • Nitrous Oxide provides anxiety and pain relief, and is self-administered, so you can decide how much is right for you. Studies have not shown any significant risks to the fetus or mother, but side effects can include dizziness, nausea, or vomiting.
  • Talk to your doctor beforehand about which intramuscular opiates – pain relieving drugs – are available to you, how they are administered, and the pros and cons of each.
  • An ambulatory (walking) epidural is a lower-dose epidural, which allows you to retain sensation in your legs so you can move around.
  • An epidural analgesia delivers pain medication through a tube inserted into the epidural space in the vertebral canal.
  • A spinal epidural delivers a local anesthetic in the lower back, just outside the spinal cord, to reduce sensations in pelvis or abdomen .
  • A local analgesia is injects pain-relieving medication directly to specific area of the body.

No matter which path you anticipate, keep in mind that when you are in the midst of labor, you might end up using a different coping mechanism or a combination of methods. The best way to prepare is to be educated – and open-minded – about all the ways you can cope with labor and remember, you got this mama!