Selfcare for postpartum depression

If you're diagnosed with postpartum depression, start your recovery by seeking professional care. In addition, you can aid in your recovery. Try these tips:

• Get as much rest as possible. Make a habit of resting while your baby sleeps.

• Eat properly. Emphasize grains, fruits and vegetables.

• Engage in moderate exercise.

• Stay connected with family and friends.

• Ask for occasional help with child care and household responsibilities from friends and family.

• Take some time for yourself. Get dressed, leave the house and visit a friend or run an errand.

• Talk with other mothers. Ask your health care provider about groups for new moms in your community.

• Spend time alone with your partner.

Treatment

To evaluate you for the possibility of postpartum depression, your health care provider most likely will want to review your signs and symptoms in person. Because a great number of women feel tired and overwhelmed after having a baby, your health care provider may use a depression-screening scale to distinguish a short-term case of the blues from a more severe form of depression.

Postpartum depression is a recognized and treatable medical problem. Treatment varies according to individual needs. It may include:

• Support groups

• Individual counseling or psychotherapy

• Antidepressant medications

• Hormone therapy

If you're breast-feeding, discuss this with your health care provider before taking antidepressant medications. Some of these drugs can be safely used during breast-feeding, but others can affect breast milk.

If you experience depression following childbirth, you have an increased risk of depression after a subsequent pregnancy. In fact, postpartum depression is more common in second-time mothers. With early intervention and proper treatment, however, there is less of a chance for serious problems and a greater chance of a rapid recovery.

Urinary tract infection

After giving birth, you may not be able to empty your bladder completely. The remaining urine provides an ideal breeding ground for bacteria, which can cause an infection of your bladder, kidney or urethra — the tube that transports urine from the bladder during urination. Urinary tract infections (UTIs) can occur after either vaginal or Caesarean births. They rank second to endometritis as the most common complication after Caesareans. You're at increased risk of developing a UTI if you have diabetes or if you keep a catheter in longer than normal after surgery.

Signs and symptoms

If you have a UTI, you may have a frequent, almost panicky urge to urinate, pain while urinating, a mild fever and tenderness over the area of the bladder. If you get home and experience any of these signs and symptoms, call your health care provider. You'll need to provide a urine sample so that it can be tested for bacteria.

Treatment

Treating a urinary tract infection generally involves taking antibiotics, drinking plenty of fluids, emptying your bladder regularly and taking acetaminophen (Tylenol, others) for the fever.

GLOSSARY

active labor. The phase of labor where steady progress in the dilation of the cervix can be expected, often accompanied by stronger contractions. This phase extends from 4 centimeters to full dilation at 10 centimeters. afterbirth. The placenta and membranes discharged from the uterus after childbirth. afterbirth pains (afterpains). Uterine contractions that help control bleeding. alpha-fetoprotein (AFP) test. A specific protein produced by the fetus but not present to any degree in nonpregnant people. Testing the levels of this protein has implications for the baby's well-being. amniocentesis. A test in which a small amount of amniotic fluid is removed from the mother. Used to detect various genetic characteristics, evidence of infection or lung maturity of the unborn baby. amniotic sac (bag of water). A sac formed of two thin membranes that contains watery fluid (amniotic fluid) and the fetus. The membranes either rupture spontaneously during labor or may be ruptured to hasten labor. anemia. A condition in which the blood has too few red blood cells. It can cause fatigue and lowered resistance to infection. anencephaly. A neural tube defect that results in the abnormal development of the baby's brain and skull. antibodies. Protein substances that the body makes to help protect itself against foreign cells and infections. Apgar score. A rating or score given to a newborn at one and five minutes after birth to assess color, heart rate, muscle tone, respiration and reflexes. Zero to two points are given for each. Scores close to 10 are desirable. apnea. Cessation of breathing.

areola. The circular, pigmented area around the nipple of the breast. asphyxia. Organ malfunctions due to a lack of oxygen, a buildup of carbon dioxide and a low pH. assisted birth. Delivery that is assisted by medical intervention, such as an episiotomy, forceps-assisted birth or vacuum-assisted birth.

assisted reproductive technologies. Medical intervention that aids conception, such as in vitro fertilization.

baby blues. A period of low mood (dysphoria), occurring in as many as 80 percent of new mothers.

biochemical testing. Use of chemical analysis of blood or amniotic fluid to detect a fetal condition. Examples include alpha-fetopro-tein, estriol, inhibin and pregnancy-associated plasma protein testing. biophysical profile. An assessment of fetal status based on heart rate testing and ultrasound findings. birth plan. A written or verbal guide prepared by you and your health care provider that explains how you wish to deliver your baby. blastocyst. The rapidly dividing fertilized egg once it enters the uterus, having cells committed to placental and fetal development. bloody show. Blood-tinged mucous discharge from the vagina either before or during labor.

bradycardia. A sustained period during which the heart rate is slower than normal. Braxton-Hicks contractions. Irregular uterine contractions that occur during pregnancy but do not result in changes in the cervix. Sometimes referred to as false labor. breech position. A position in which the baby is positioned with feet or bottom toward the cervix at the time of birth.

Caesarean birth. An operative birth in which an incision is made through the abdominal wall and uterus to deliver the baby. Sometimes called Caesarean section or C-section.

cephalopelvic disproportion. A circumstance in which the baby's head won't fit through the mother's pelvis because the head is too large for the birth canal. cervical incompetence. A condition in which the cervix begins to open without contractions before the pregnancy has come to term; a cause of miscarriage and preterm (before the 37th week) delivery in the second and third trimesters. cervix. The neck-like lower part of the uterus, which dilates and effaces during labor to allow passage of the fetus. chorionic villus sampling (CVS). A procedure that removes a small sample of chorionic villi from the placenta where it joins the uterus, to test for chromosomal or other abnormalities. circumcision. A procedure on male infants that removes the foreskin from the penis. colostrum. The yellowish fluid produced by the breasts until the milk "comes in"; usually noticed in the latter part of pregnancy. congenital disorder. A condition that a person is born with. contraction stress test. One of several tests designed to help evaluate the condition of the fetus and its placenta. It measures the fetal heart rate in response to contractions of the mother's uterus. contractions (labor pains). The tightening of the uterine muscles.

deep vein thrombophlebitis (DVT). A blood clot inside a vein, which is a potential complication of childbirth. dilation. Indicates the diameter of the cervical opening and is measured in centimeters; 10 centimeters is fully dilated. Doppler. Commonly used to refer to a device with which your doctor can hear a fetal heartbeat by about the 12th week. Named for the Doppler effect, intrinsic to its function. dystocia. Difficult labor for any reason.

early (latent) labor. The earliest phase of childbirth, during which uterine contractions begin to change the cervix, but changes are often gradual. This phase is almost always over when the cervix reaches 4 centimeters dilation. ectopic pregnancy. A pregnancy that occurs outside the uterus; the most common variety is tubal pregnancy. effacement. The progressive thinning of the cervix as its connective tissue is drawn up around the baby's head. It may be measured in cervical length in centimeters or as a percentage of thinning. 100 percent indicates total effacement. embryo. The fertilized ovum from shortly after the time of fertilization until eight weeks. endometritis. An inflammation and infection of the mucous membrane lining the uterus. endometrium. The lining of the uterus, in which the fertilized egg embeds itself. epidural. An anesthetic method used to decrease or eliminate discomfort during labor. This is sometimes called an epidural block. episiotomy. Surgical incision in the perineum to enlarge the vaginal opening. external version. A doctor's attempt late in a pregnancy to turn a poorly positioned baby into a better birthing position.

fallopian tubes. Structures that pick up the egg as it is released from the ovary while propelling sperm toward its end where fertilization can take place. The fertilized egg is then nourished and delivered to the uterus through these tubes. fetal alcohol syndrome (FAS). A condition caused by alcohol consumption during pregnancy. It can cause birth defects such as facial deformities, heart problems, low birth weight and mental retardation. fetal fibronectin. A substance held between the fetal membranes and uterine wall. The substance can be tested to assess the risk of preterm (before the 37th week) delivery. fetus. An unborn baby after the first eight weeks of gestation. follicle-stimulating hormone. A hormone that fosters the development of eggs in the ovaries.

fontanelles. The "soft spots" on a baby's head where the skull has not fused together. At birth, a baby has these soft spots on the top and back of the head. The back one closes about six weeks after birth, and the top one takes up to 18 months to close. forceps. An obstetrical instrument that fits around the baby's head to guide the baby through the birth canal during birth. fundal height. The distance from the top of the uterus to the pubic bone; used to help assess the growth of the fetus in the uterus.

genetic disorder. A condition that an individual can pass on through parentage and may have acquired from a parent. gestational diabetes. A form of diabetes that develops during pregnancy, resulting in improper regulation of glucose levels in the blood.

glucose challenge test. A test that screens for gestational diabetes by measuring your blood glucose level after drinking a glucose solution. group B streptococcus (GBS). A bacterium that is part of the normal floras of the genital tract in many women. This bacterium can cause severe infections in newborns if passed to the baby during birth.

human chorionic gonadotropin (HCG). A hormone produced by the placenta. Its measurement is the key to all pregnancy tests. human placental lactogen (HPL). A placental hormone that alters your metabolism to make nutrients available for your baby and stimulates your breasts to prepare to produce milk.

hydramnios, or polyhydramnios. An excess of amniotic fluid. hypoglycemia. A condition in which the concentration of sugar (glucose) in the bloodstream is lower than normal. _|_

induction of labor. A means of artificially starting labor, usually by administering oxytocin, a prostaglandin medication, or by breaking the bag of water.

intrauterine growth restriction (|UGR).

Significant slowing of fetal growth, usually defined as less than the tenth percentile for a given gestational age.

In vitro fertilization (IVF). The process by which eggs and sperm are combined in an artificial environment outside the body, then transferred back into a woman's uterus to grow.

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