Get Well Wednesday: Did Pregnancy Give You The Blues?

Dr. Jessica Shepherd has appeared on Good Morning America, The Today Show and Dr. Oz. She’s a regular on local news stations in Dallas and she contributes to multiple national magazines and websites as a medical expert.

Dr. Shepherd has a no-holds barred approach when discussing women’s health issues and uses her platform to empower women to be health advocates for themselves.

Dr. Shepherd, also known as the #dallasgynecologist– practicing at Baylor University Medical Center, joins us to share some of the common things that happen to women after childbirth that we don’t necessarily account for.

WHY DO WOMEN OFTEN UNDERESTIMATE THE PHYSICAL, EMOTIONAL AND MENTAL CHANGES AFTER HAVING A BABY?

For so long, women have been taught to not express some of their feelings after delivery of a baby and often some women underestimate the transition.

WHAT IS POSTPARTUM DEPRESSION? WHO CAN IT HAPPEN TO?

It happens to more women than you think, PPD can affect 1 in 7 women. Around one in seven women will experience something more extreme than the typical baby blues. Women that give birth and struggle with sadness, anxiety or worry for several weeks or more may have postpartum depression (PPD).

The following factors can also increase one’s risk:

• Hormonal changes that follow childbirth
• Emotional stressors, including financial strain, job changes, illness, or the death of a loved one
• Changes in social relationships, or lack of a strong support network
• Raising a child with special needs or an infant that is challenging to care for
• Having a family history of mental health issues

WHAT ARE SOME OF THE MOST COMMON SYMPTOMS,  FROM MILD TO SEVERE?

• Feeling down or depressed for most of the day for several weeks or more
• Feeling distant and withdrawn from family and friends
• A loss of interest in activities (including sex)
• Changes in eating and sleeping habits
• Feeling tired most of the day
• Feeling angry or irritable
• Having feelings of anxiety, worry, panic attacks or racing thoughts

WHAT SHOULD WOMEN DO IF THEY THINK THEY ARE SUFFERING FROM POSTPARTUM?

Definitely talk to someone! Especially a health care provider so they can sort out what steps to take next. Women can talk to their OB/GYN when they go back to visit, the pediatrician when making a visit with the baby, a psychologist or even a family member. There are also resources and websites that are geared to help women with their recovery and emotions

WHAT CAN WOMEN EXPECT FROM THE RECOVERY PROCESS AFTER THEY HAVE A BABY? WHAT RESOURCES ARE AVAILABLE FOR RECOVERY?

Possible changes in mood, bladder function, libido, bleeding issues, vaginal pain or even pain with sex. Vaginal rejuvenation is great for women who experience issues with their bladder function, libido and vaginal pain and this can be done in the office! Some may know it as a laser-based vaginal tightening procedure.

A laser fiber is placed through a small puncture and used to shrink the tissues around the vagina. This procedure relies on your body’s natural healing and ability to create new collagen which helps restore the vagina!

IS IT TRUE THAT WOMEN CAN HAVE BLADDER PROBLEMS AFTER THE DELIVERY?  WHY DOES THIS HAPPEN AND WHO SHOULD THEY TELL?

Women can suffer from light bladder leakage and up to 1 in 4 women have experienced light bladder leakage at some point. After delivery, it can happen but many times it goes away.

THERE IS A DEBATE ON BREAST VS BOTTLE FEEDING, WHAT CAN YOU ADD TO THIS DEBATE?

Well, the American Academy of Pediatrics recommend a full year of breast-feeding, and earlier this year the World Health Organization called for at least six months of breast-feeding.

WHO research showed that exclusive breast-feeding for six months, without supplemental formula, decreases diarrhea and respiratory and ear infections, and improves brain growth.

However, there are many reasons babies are not breast-fed and that is OK! The idea is that we have healthy babies and if your baby is not breast-fed, the baby can still have a healthy life and thrive. The benefits of breastfeeding are numerous, however do not feel a sense of failure if it cannot be accomplished or if that’s not what you choose. Breast might be best, but it’s not the only way.

Dr. Shepherd answers your questions below:

My sister-in-law had her first baby last week. She has a 3rd degree tear and can barely walk. What can she do to heal faster?

Pelvic rest helps as well as taking a stool softener to help straining while having a bowel movement. Keeping the area dry, as well as taking antibiotics if they were prescribed.

 Does postpartum depression make a mother walk away from their kids and not come back?

Postpartum depression occurs when there are feelings or activities that interfere with daily life and activities; however abandonment is another psychological issue that may have different emotional stability precursors.

 Is having a baby at 43 possible and safe?

Women can have babies at 43 years of age and be safe, however pregnancy is stress on the body and as women age it can be harder on the body as well. After the age of 40, it is harder to get pregnant spontaneously and women may need help. Be sure to talk to your doctor for pregnancies after the age of 35 to ensure your health prior to pregnancy and also, if there are any medical conditions like high blood pressure and diabetes.

Is there a thing such as long term postpartum depression? I suffered a child loss while I was 7 months pregnant in November 2015 and still feel like I haven’t “shook” my depression. I freeze when I see newborns, or walk down a store aisle with baby items… I’m crying while driving just from the thought of what I’ve lost. Is this normal?

So sorry to hear of your loss. The loss of a child is a very difficult life experience, and can cause complicated grief reactions. The grieving process is very normal but when it is prolonged, it can negatively affect your psychological and physical well-being.

This is not normal when it persists for a long time and it is highly suggested that you get help so you can improve your quality of life and get the tools to help you move through this difficult time. It is helpful to use intervention approaches that should involve partners, psychotherapy and ensuring an ongoing dialogue between yourself and others.

For men who are suffering from depression or separation anxiety due to the birth of a child, who should the male parties seek medical assistance or treatment?

This is a common feature of males after the birth of a child. A report found that 10 percent of men worldwide showed signs of depression, often referred to as paternal postpartum depression or PPPD, from the first trimester of their wife’s pregnancy through six months after the child was born.

This number increases to 26% during the three- to six-month period after the baby’s arrival. Ways to help deal with this is to talk about it, sharing your feelings, incorporating exercise, eating well and anything that reduces stress. Also consider counseling or medication as well as antidepressants or anti-anxiety medication for a few months.

 Can childbirth cause vaginal dryness? What can treat it?

After the birth of a child, the estrogen levels decrease and it can cause vaginal dryness, however it usually will go back to what was your normal prior to delivery. If it persists, you can also do things like try lubricants that are silicone-based like Uber Lube and Sustain Lube. Or also there is vaginal rejuvenation laser therapy which can be done right in the doctors office!

 I’ve had 3 miscarriages. I can never get past the 1st trimester. My husband and I are getting frustrated. The last time, I was told it want a viable fetus. Every test, for both me and hubby, are normal. Any suggestions?

After two to three miscarriages in a row, it is called recurrent pregnancy loss. This needs to be addressed with a fertility specialist, as more tests can be done and there can be other issues that have not been worked up. Research your area for Reproductive Infertility specialists and even try to find some that specialize in Recurrent Pregnancy Loss.

I am a young 25-year-old Black female who just got diagnosed with ovarian cancer as I was about to have my surgery to do a hysterectomy. I found out I was pregnant a day before the surgery, now they want to push the surgery back to the second trimester. How safe is this and is it safe to have a full hysterectomy while you’re pregnan?

If you have been diagnosed with ovarian cancer and are currently pregnant, they may want to move your surgery to the second trimester to see if you can deliver the baby and potentially have a child, or due to a medical condition. If you are seeing a gynecologist oncologist, then they will definitely make the best recommendations. Be sure to ask as many questions as you can at your visit so you understand all the reasons why and feel comfortable with the decisions being made.

 I am a 39-year-old female, newly diagnosed with HPV. PAP was negative for cancer. Is there a treatment?

HPV is a virus and therefore has no cure. The HPV seen on PAP allows gynecologists to follow your tests to ensure you do not get cancer in the future. The recommendations for a negative PAP and positive HPV is to return in one year for another PAP and HPV testing.

 Doctor, should a woman worry if a menstrual cycle lasts more than 14 days?

If it happens for only one cycle that can be just a month that is abnormal and not necessarily a problem. If it persists for more than three months please see your gynecologist for a work up.

Doctor how long does it take for your body to heal after a hysterectomy?

For an open hysterectomy, it can be up to 8 weeks and for a laparoscopic hysterectomy, it can be 4-6 weeks.

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