Posts Tagged ‘childbirth’

Have you written a postnatal care plan yet?

October 10, 2016

You wrote a birth plan, because birth is a big deal. But did you write a postnatal care plan? After your baby is born, your whole body and mind are in transition. Transition can be so tough, it’s even got a psychiatric label attached to it (Adjustment Disorder). Your body is physically transitioning in crazy, magical ways, and you are mentally transforming to get used to being instantly interrupt-able, having strange sleep patterns, putting yourself second, and grieving your lost carefree past. You are learning to know and love your baby. (Honeymoons were designed to help you love your new partner. Babymoons should also be designed to help you love your baby). Your brain is processing the birth. The list goes on and on and on and on. So, don’t just go home and hope for the best. Here is an example of what your postnatal care plan might look like:

“My Postnatal Care Plan

I have written a postnatal care plan because I very much want to enjoy my first few weeks getting to know my baby. I am aware that I have a tendency to do too much, and to feel guilty when I’m not getting stuff done. I want to ensure that this doesn’t happen following the birth of my baby, and so I am planning how to take care of myself in the first two precious weeks with my baby.

Generally, I wish to spend time skin to skin with my baby, I wish to establish breastfeeding, and I would like my husband to be an integral part of this with us.

Immediately upon coming home:

My husband would like to carry me and our baby over the threshold.

I would like a warm bath with rejuvenating bath salts, and then I would like to get into fresh (new) pyjamas and into our king size bed with new fresh sheets, and my baby.

I would like the lights kept low, my phone and my remote control next to me.

I would like to eat a huge, warm, filling meal of cottage pie and peas, washed down with camomile tea and a glass of champagne.

I would like my husband to join us as much as possible in bed.

For the first two weeks after coming home:

I would like visitors to stay away for at least 12 hours, apart from the midwife and my lactation consultant, who I have pre-arranged support with.

In the first three days, I would like very close members of my family only, to visit.

I do not want my baby to be held by anybody else in the first three days, other than her father.

We have arranged for a food delivery of fresh fruit, salads, sandwiches, chocolates and champagne. There are plenty of ready cooked meals in the freezer too.

I have arranged for a cleaner to come in every other day to tidy and clean the house, as per my husband’s requests (she will not clean our bedroom).

I have specific herbal/homeopathic remedies that I will be taking each day.

After the first three days, I have arranged for a postnatal doula to come in and provide emotional and practical support every three days.

My husband will help to ensure that I get plenty of rest, by regularly encouraging me to go to bed, and ensuring that the household and visitors are taken care of.

My husband will take a few hours out of the house each day, to do something to help him to feel refreshed also.

According to how I feel, I plan to spend most of the first two weeks in and out of bed. I might take a walk or potter around the house if I feel restless, but if not, I will stay in bed to recover and adjust, both physically and mentally, and to help me to fall in love with my baby and establish breastfeeding.”

What do you think? If you are thinking “that’s a bit overindulgent” then you are totally not getting how important this time is. If you are thinking “it’s only relevant to rich people” then drop the champagne and the au-pair, but stick with bed and help from family. If you’re thinking “what if I’m a single mum” then think even harder about your postnatal care plan, because support matters, whether its from a husband, a mother, the NHS, a best friend or social services.

It’s my prediction that postnatal care plans will become more and more common. If you’ve ever used one, I’d love to hear from you.

Mia Scotland

Perinatal Clinical Psychologist

http://www.yourbirthright.co.uk

Birth Trauma – Can it be fixed?

January 21, 2013

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The word “traumatised” has become like the word “starving” and the word “depressed”.  It has been watered down,  from something quite serious and potentially life threatening, to something we flippantly say when chatting about our experiences.  We might say “I am absolutely starving” instead of “I’m famished”.  We might say “I was so depressed” because our Christmas pressie turned out not to be the long awaited diamond ring.  And we might say “it was traumatic” when we mean “it was horrible”.  But we all know that to actually be starving means something very different.  And we might or might not know that to actually be depressed is a miserable state of being, a condition, not a fleeting  emotion.

So what about trauma?  If something was really scary and upsetting and horrible, were we traumatised?  Well, to a psychologist, trauma is as much about the aftermath of an experience, as it is about what actually happened. It is about how it leaves us feeling, long after the event.  It is not always about what actually happened, or even about how bad it was at the time. I’ve heard some birth stories that are so horrible, my insides are shrinking when I hear them.  But the mums are fine with it.  In fact, sometimes, the mums are remembering the experience fondly (I kid you not!  It must be the oxytocin).  I hear other birth stories that sound wonderful when described.  But the mums are sobbing with grief and horror while they tell me, even when the birth was years before.  How can that be?

Trauma is about the injury, not the event.  It’s like breaking a bone.  I might fall down a big flight of stairs, and walk away unscathed.  On the other hand, I might trip up over nothing, and break my ankle.  One cannot predict this, or control it.  The person who broke their ankle is not weaker or more stupid, and they cannot “pull themselves together”.

So when we are listening to a birth story, we don’t need to know about the event. We need to know about the reaction to the event. I want to know “can you talk about it without crying”.  I want to know “does it impact on your dreams”.  I want to know “do you try to shove it to the back of your mind, but you find it impossible”.  I want to know “what impact is it having on your life”.  I want to know “how long ago did it happen”.  If it is less than a few months, and the person is telling me about it, the chances are, she will be okay.  Usually, I’m hearing the story years later, because the person is pregnant again, and this flares up the previous trauma.

Is birth trauma treatable?

Yes.  I have been treating trauma for over 20 years, with an enormous amount of success.  It is treatable.  I promise you.  Time isn’t always enough. Some people go all their lives traumatised, until they receive treatment.  War veterans have suffered for decades with PTSD , until a short course of treatment lifts it.  And it can really feel like something has been lifted.  As one person once said to me “it was here – in my forehead – I couldn’t get rid of it – always there – always in my way.  It has gone.  I can’t believe it, it has totally gone”.    There are treatments out there that work.  We aren’t exactly sure what the treatments actually do, we just know they work.  They seem “move” the memory from the “I’m not safe” (threat activated) part of the brain, and lay the memory to rest in the “it was awful but it’s over” part of the brain.  While traumatised, the person feels as if it as just happened, and the body and brain are in a state of hyper-arousal.  This might involve nightmares, flashbacks, irritability, moodiness, tearfulness,  sleep problems , anger with your loved ones, constant memories of the incident, and efforts to push it out of your mind unsuccessfully.  If you are a new mother, it has even more consequences, because it interrupts the process of bonding with your baby.  Furthermore, the normal chaos that comes with adjusting to a new baby is heightened to create a potentially miserable cocktail.  Fathers can be traumatised by the birth too, but they often go under the radar, so we know very little about this. Mothers have been going under the radar for a long time, because many cases of PTSD were misdiagnosed as post natal depression.  We are only just beginning to realise how common post natal depression is in fathers (almost equal to mothers, in some studies) and the fact that this might be related to birth trauma in fathers.

In our society, we are led to believe that we should be able to control our emotions, but if we have been traumatised for 6 months or more, then trying to control it may exacerbate the problem. This is because, with PTSD, the more we try to “control” the emotions (in other words, the more we try to push the memory to the back of our minds), the more the problem anchors itself in the brain, because you are preventing the brain from processing  the event properly.  This is where therapy can help.  Therapy enables the brain to change the memory, so that it becomes processed into the “history” part of the brain rather than the “I’m not safe” part of the brain.  Before that, the memory seems to be stuck in the “oh my god I’m not safe and this is awful” part of the brain, leaving the person with “symptoms” as outlined above.

There are many effective therapies out there. I’ve tried a few of them. I now mostly use the rewind technique (a hypnotic technique, taught to me by the Human Givens Institute) which seems to be the most effective, the quickest, and the least distressing.   It can be one session.

I am now teaching this fast, fairly painless and effective technique to professionals who find that they want to help parents let go of the horror of a difficult birth. It’s a two day course which gets great feedback. It gets great feedback on the day, but also great feedback when people start applying the technique. There really is nothing better than knowing that you have made a dramatic difference to some-one’s life. To find out more about the upcoming training workshops, go to http://www.traumaticbirthrecovery.com/courses-for-professionals/

Mia Scotland

Clinical Psychologist

http://www.yourbirthright.co.uk