Posts tagged midwife
Naturopathic care for Postpartum Mood Issues

Naturopathic doctors are trained to look for the root problem causing someone's symptoms, rather than just making the symptoms go away.  If we address the underlying cause, we can allow the symptoms to recede for good.  This is no different for postpartum women, and there are a number of reasons WHY women develop postpartum mood disorders.  Naturopathic doctors, especially those trained in the art of midwifery or who have had special training in pregnancy and birth, are very well-equipped to figure out how to best help each woman on an individual basis. Dr. Adriana Azacarate-Ferbel is a Portland area Naturopath who has studied Postpartum depression extensively.  I met with her last fall when I began researching this topic more myself.   She outlined the most common underlying reasons for development of Postpartum depression:

  • Fatigue and Sleep Deprivation
  • Hypothyroidism
  • Hyperthyroidsim
  • Immune system dysregulation
  • Pain
  • Low Cholesterol levels
  • Hormone imbalance
  • Neurotransmitter
  • Insulin resistance

Sometimes, it may be a combination of one or more of these that can cause postpartum mood disorders to develop.  Because this is true for many women, the Naturopathic approach is multifactorial as well.  The earlier we can recognize the symptoms and determine what's actually going on, the better.  In my office, a primary work-up to determine the underlying cause may include:

  • Thyroid testing, followed by nutritional supplementation and/or medicine to balance the thyroid gland (if needed)
  • Combination Hormone and Adrenal Saliva testing, followed by treatment with herbs and nutrients known to balance female hormones, DHEA, and/or cortisol (and are safe for breastfeeding).
  • Lipid panel, to look at cholesterol levels, followed by nutritional counseling to ensure adequate levels.
  • Comp. metabolic screen, Iron panel, and Complete blood count, to assess for blood sugar issues, anemia, and immune system problems
  • Musculoskeletal assessment to determine sources of pain that may be adding to increased stress and fatigue, followed by massage, acupuncture, or other forms of physiotherapy
  • In some cases, neurotransmitter testing will be done first.  This is especially true if someone has a marked history of depression, anxiety, or psychosis.

I could write pages and pages on this topic.  This is just a jumping-off point.  There is still a lot to learn about this realm of women's health, but we have a very good grasp on how to make the transition to motherhood a happy and healthy time.

Be strong.  Live healthy!images

Postpartum Nutrition

Good Morning!  It looks to be another beautifully sunny morning here in Portland, Oregon.  Wow, we have really been blessed with some fantastic weather the past few weeks.  Our clinic garden is looking great as well as the garden my family and I are growing at home.  I'll be taking some photos to show you all just what I mean! imagesToday I'd like to round out this series on Nutrition during pregnancy by providing some guidelines about postpartum dietary needs.  The postpartum period is defined as the time from the birth of the baby and placenta to 6 weeks afterwards.  I personally believe that this extends to 3 months after the birth at minimum, with the first 6 weeks being the time when the body makes most of it's transition back to "normal".

I put normal in quotations because it is very common for women to feel like they have a totally new body after having a baby.  images-1To a certain extent, it's true.  It's not the same body.  It looks, acts, and feels different than before pregnancy.  Therefore, it has different needs.  This is especially the case if the new baby is breastfeeding. Let's have a look at some guidelines for women in the postpartum period:

  • During pregnancy, women need 200-300 extra calories per day to grow a baby.  During breastfeeding, women may need up to 500 extra calories per day to make enough milk to feed their new baby.
  • Also needed for milk-making is WATER.  Most women will need between 2-3 LITERS of water a day to keep up with the demands of making milk.  I like to get the whole family involved in the process, stashing bottles full of water wherever mom might end up nursing the new baby.  Intense thirst universally follows feeding the new baby, and moms everywhere love having a big glass of water while they nurse.
  • Many women need extra iron after having a baby.  Moms who had a lot of bleeding with childbirth are in a higher risk category for developing postpartum anemia.  To prevent severe anemia (which can lead to excessive fatigue and lowered mood):
  1. Increase iron in the diet: red meat, eggs, enriched cereals, and blackstrap molasses are good ways to get iron.
  2. Increase Vitamin C intake: Vitamin C helps you absorb more iron from your food.  Take with meals.  Do not exceed 3000mg/day unless being supervised by a health care practitioner.
  3. No black tea: Tannins in the tea decrease iron absorption.
  4. Cook with cast-iron pots and pans.  Believe it or not, you will get good doses of iron from doing so.
  • Continue to take your prenatal vitamins through the end of breastfeeding.  You still need the nutrients.  Plus, the extra B vitamins will give you much-needed mental and physical stamina.
  • Omega-3 fatty acids with a higher DHA:EPA ratio.  Studies show that infants benefit (neurodevelopmentally) from DHA supplementation in pregnancy and breastfeeding.  Moms also need these healthy fats to help heal and replenish the reproductive and nervous system.  DHA can be found in coldwater fish and algae most readily.  Taking an encapsulated form of DHA is a sure-fire way of getting enough.

Next week I'm going to address Postpartum depression, anxiety, and mood disorders.  It's more common than you think, and there's more that can be done to help prevent it from affecting you and the ones you love.  images-2

Herbal Nutrition in Pregnancy

DSC_0606Herbal Nutrition for Pregnancy Red Raspberry Leaf (Rubus Idaeus): tones the uterus during pregnancy, prevents hemorrhage, provides excellent source of Vitamins C and E.  Also good source of Calcium and Iron.

Nettles (Urtica dioica): great tonic.  Has lots of Vitamins A, D, C, and K. Provides Calcium and Potassium as well.  The Vitamin K is instrumental in preventing hemorrhage during birth.  Also good for leg cramps and hemorrhoids.

Mint family (Mentha spp.): safe and helpful in pregnancy for digestive issues: morning sickness and indigestion.

Oatstraw (Avena sativa): good source of minerals for growing baby and for integrity of veins.  Oatstraw is calming and nourishing.  This herb is a personal favorite!

Specific issues during pregnancy*

Morning sickness:  1-2 cups Raspberry leaf tea, 1-2 spoonfuls of ginger root (Zingiber off.) decoction, peppermint of spearmint tea, alfalfa (Medicago sativa) tea for B vitamins

Varicose veins/Hemorrhoids: 1-2 cups daily of Oatstraw tea, 1-2 cups of nettles tea, raw parsley (Petroselinum sativum) in salads, witch hazel (topically)

Anemia: 1 TBS Yellow dock (Rumex Crispus) decoction per day.  Can also try teas of Dandelion root (Taraxacum off), Parsley, and Nettles.

Heartburn/Indigestion: Anise or Fennel seed tea for after meals, Papaya enzymes, raw almonds, Slippery Elm (Ulmus fulva)

Bladder Infections: unsweetened cranberry juice, Uva Ursi leaves infuse for 8 hours, then drink one cup every 12 hours.  Can add yarrow (Achillea millefoilium) if not clear with just Uva ursi.

Hypertension: garlic, cucumbers, Hops (humulus lupulus)—only during 3rd trimester, Passionflower tincture (15 drops per day), Skullcap (Scutellaria off.) 1-2 cups per day, Hawthorn berries (Crataegus off.)

Late Pregnancy uterine tonics: Black and Blue Cohosh (Cimicifuga racemosa and Caullophyllum thalictroides), Squawvine (Mitchella repens)

*Please consult a helath care practitioner before beginning any new herbal or nutritional regimen

9 months, 12 months, 3 years later

Every once in a while, I'll be out grocery shopping or doing some other errand and run into a family whose birth I attended. It's always such a a fun experience to see how the family has evolved and who the baby turned out to be. Family medicine is a big part of what I enjoy doing. In my line of work I spend 9 months getting to know a family and this new person joining their family through mom's abdominal wall, and often there are aspects of their personality apparent during this time. The family dynamics are already there. There are the quiet ones, the late-night partiers, the ones who play games of hide and seek when you're trying to listen to their heart rate, the ones who kick and punch for attention. Oh, how I wish someone could do a study on personality traits before and after birth!

They say that how you come into this life often predicts how you live it. It's interesting to ask your friends and family members if they were "early" or "late" or right on the due date, and see if that still holds true for them. Informal surveys point to many yes answers. For example, I have a friend who was born exactly on her due date, and she is always exactly on time for everything. Not early, not late. I have another friend who was born exactly one minute before midnight. Can you guess this one? She gets things done right at the last minute, but always just before the deadline. It's fun to think this way.

Getting back to the whole running into people out in public---there's just nothing like that sense of community, especially here in Portland. It's a truly special thing to be able to talk to someone (even if they are only 3 years old) and say," I saw you take your first breath--and now look at you! You're running and making mud pies and have oh-so-very strong opinions about what mom is putting into the grocery cart."

I wouldn't trade my job for anything.