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Postpartum Depression

"mood changes are common after childbirth?
After having a baby, many women have mood swings. One minute they feel happy and the next begins to mourn. They may feel a little depressed, have difficulty concentrating, loss of appetite or find that they can not sleep well even if the baby is asleep. These symptoms usually begin at about three or four days after giving birth and may last several days.If you're a new mother and have any of these symptoms, you have what is called "baby blues" . The "baby blues" is considered a normal part of early motherhood and usually go away within ten days after delivery. However, some women have worse symptoms or symptoms that last longer. This is called postpartum depression.

What is postpartum depression?
Postpartum depression is a disease like diabetes or heart disease. Can be treated with therapy, support networks and medications such as antidepressants. Here are some symptoms of postpartum depression:

• Loss of interest or pleasure in life.
• Loss of appetite.
• Less energy and motivation to do things.
• Difficulty falling asleep or staying asleep.
• Sleeping more than usual.
• increased or lloroseo crying.
• Feeling worthless, hopeless or overly guilty.
• Feeling restless, irritable or anxious.
• loss or unexplained weight gain.
• feel that it is not worth living.
• thoughts about hurting yourself.
• Worrying about hurting your baby
• Although many women are depressed right after childbirth, some women do not feel "down" until after several weeks or months . Depression that occurs within six months after childbirth may be postpartum depression.
  

Who gets postpartum depression?:
Postpartum depression is more likely if you have any of the following:

• Previous postpartum depression.
• Depression not related to pregnancy.
• premenstrual syndrome (PMS) pain.
• Marital difficulties.
• Few family members or friends to talk to or depend.
• stressful life events during pregnancy or after delivery.
  

Why do women get postpartum depression?
The exact cause is unknown. Hormone levels change during pregnancy and immediately after childbirth. Those hormone changes may produce chemical changes in the brain that play a role in causing depresión.Sentirse depressed does not mean that you're a bad person or that you did something wrong, or that you did this to happen.

How long does postpartum depression?
Hard to say. Some women feel better in a couple of weeks, but others feel depressed or "not themselves" for many months. Women who have more severe symptoms, or depression, or have had depression in the past may take longer to get. Just remember that help is available and can be improved.

What kind of treatments help with postpartum depression?
Postpartum depression is treated much like any other depression. The Support, counseling ("talk therapy") and medications can help.

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Other ways to give birth

Many women seek alternatives to traditional delivery when bringing a baby into the world
is an option for mothers who prefer a more natural method. Instead of the traditional operating room, choose a more intimate setting and comfortable, where they feel they control the situation.
Once contractions begin, she is immersed in a tub, separate pool of 10 cm. filtered or potable water to about 37 degrees.
The aquatic environment is very pleasant for the mother because the warm water relaxes muscles and stimulates production of endorphins, reducing pain sensation. In addition, it accelerates the expansion phase and reduces episiotomies to soften the perineal tissues.
Some experts say that the vertical position occurs in the water birth, the same as previously adopted, facilitates the delivery of the baby thanks to the weight of the baby more pressure by the action of gravity. As for the baby, the water birth is a less traumatic to come into the world. Allows the transition from amniotic fluid, which was for nine months, other aqueous medium. It also maintains the same body heat, from 37 degrees inside the mother at the same temperature in water.
Sometimes the expansion work goes into the water and if the woman you prefer out of the tub at the time of expulsion. But once the child is born, the woman goes to the chair of labor to delivery phase consisting in the expulsion of the placenta. If you have any problems at any stage of labor can be transferred to the mother immediately to the operating room to perform a caesarean section if necessary.
Before deciding on this type of delivery, it is important to remember that it is an expensive method and information centers that practice.

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Amniocentesis

Who: Women with a higher risk of having a baby with certain birth defects or other chromosomal conditions .

Why: to detect certain chromosomal abnormalities, genetic birth defects and other conditions.

When: number Between weeks 15 and 20 of pregnancy.

How: Guided by ultrasound, the doctor inserts a thin needle through the mother's abdomen. Removes a small amount of amniotic fluid (the fluid surrounding the baby) to submit to a test. Risks: A small risk of spontaneous abortion (1 in 200 women or less). Some women experience pain, light bleeding or amniotic fluid leakage after the procedure. More serious complications are uncommon.

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After a cesarean delivery Cesarean delivery

If you are awake during surgery, you can probably have her baby in her arms immediately. The lead to a recovery room or directly to your room. It regularly monitor your blood pressure, pulse rate, respiratory rate and abdomen.
If you want to breastfeed, be sure to indicate to the doctor. Having a cesarean does not mean you can breastfeed her baby. Should be able to breastfeed immediately.
may need to stay in bed for a short time. The first few times you get out of bed, ask a nurse or another adult.
Shortly after surgery the catheter is removed from the bladder. You will receive intravenous fluids after birth, until you can eat and drink. The first few days you feel pain in the abdominal incision. Your doctor may prescribe pain medications can make you pass the anesthesia. There are many ways to control pain. Talk to your doctor about options.
The hospital stay after a cesarean delivery is usually 2 to 4 days. The duration of stay will depend on the reason why the caesarean was performed and the time required by your body to recover. When you return home you may need special care and limit their activities.

When you return home:
The healing process abdomen requires several weeks. While recovering, you may need:

1. mild cramping, especially if you are breastfeeding.
2. discharge or bleeding for about 4 to 6 weeks.
3. bleeding with clots and cramping.
4. pain in the incision to prevent infection for several weeks after caesarean you should not put anything in the vagina or have sex.
5. Let some time elapse to allow the healing process before strenuous physical activity.
6. Call your doctor if a fever, heavy bleeding, or if the pain worsens.
   

Finally ...
A cesarean may be necessary for many reasons. Many birth centers offer classes for couples who may need cesarean birth. If you have questions or concerns about cesarean birth, talk to your doctor.

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Sometimes the baby can not be born through the vagina of the mother. In those cases, delivery can take place by caesarean section. Cesarean delivery is when the baby is delivered through surgical incisions (cuts) made in the abdomen and uterus.

Reasons for cesarean delivery:
cesarean delivery may be required for many reasons. It may be the best method of birth for you and your baby. Caesarean section can be planned in advance when they meet certain conditions. In some cases, when problems arise, the decision was taken during labor. Sometimes a woman
requested cesarean delivery. This is a complex decision that must be carefully considered and discussed with the doctor.

Multiple Pregnancy:
Women will have two or more babies may need a cesarean. Many women who have twins can give birth by vaginal delivery. However, if babies are born prematurely or are not well placed in the uterus, it may need a cesarean. The likelihood of cesarean delivery increases with the number of babies a woman carries.

When work labor does not progress:
Roughly one third of cesarean deliveries were performed because labor does not progress. In these cases, the contractions can not open the cervix enough for the baby to move through the vagina. Sometimes the doctor can initiate or speed up labor with medication if labor is progressing slowly. You may be required several hours to determine that labor is not progressing properly. Because of this, doctors can observe for several hours before deciding that you need a cesarean.

Concern for the baby:
The baby may develop a problem during labor and may need a caesarean section. The reason may be that the cord is pressed or compressed or not enough blood flows to the baby from the placenta. Sometimes fetal monitoring can detect abnormal heart rhythms. If this problem persists, it may be necessary to perform a caesarean section.

Another possible reason for a cesarean birth: A baby
-large.
-breech or feet.
-Infections of the mother (such as immunodeficiency virus or human herpes).
-medical conditions of the mother.

-Placenta previa is an irregularity in which the placenta is under the baby and covers all or part of the cervix. This will block the baby's exit from the uterus. Another problem that may arise is the premature detachment of the placenta. This happens when the placenta separates before the birth of the baby and cut the flow of oxygen to the baby. These two irregularities can cause heavy bleeding and may require cesarean delivery.

after Cesarean Birth:
Having had a baby by caesarean section earlier effects on the need to have another caesarean again. Many women who have given birth by caesarean section before they can give birth vaginally. However, a vaginal birth after cesarean delivery is not a good option for women when there is a substantial risk of uterine rupture.
deciding whether you can give birth vaginally after a cesarean delivery, a factor is the type of uterine incision, no skin incision, used in the previous birth by cesarean section. Sometimes a vertical incision is used (called classical incision), which increases the risk of uterine rupture during labor. If you have this type of incision should not attempt to give birth vaginally.
procedure.
In most hospitals, your partner can stay with you in the operating room for cesarean delivery. However, this may depend on whether you will be awake during surgery and emergency surgery. In some cases, cesarean delivery can be performed as an emergency and no time to prepare in advance.
Preparation.
Before a cesarean delivery, a nurse will prepare for the operation. You may be given a drug that helps reduce acid in the stomach. This will help prevent stomach acid from reaching their lungs and causing problems. Also clean the abdomen and perhaps shave. Then a catheter (tube) into your bladder. Keep an empty bladder reduces the likelihood of injury during surgery. I placed an intravenous catheter in a vein in your arm or hand. This will allow fluids and medications during surgery.
Anesthesia.
will be given anesthesia so they do not feel pain during surgery. This can be general anesthesia, epidural or spinal anesthesia. If general anesthesia is used, you will not be awake during the birth.
The epidural numbs the lower body. An injection in an area of \u200b\u200bthe spine in the lower back. It is possible that a small catheter is inserted in this space for more medication to manage through it later if necessary. In this way, do not need another injection. Spinal anesthesia is similar to epidural anesthesia. It also numbs the lower body and is administered in the same way, but the drug is injected directly into the cerebrospinal fluid.
The type of anesthesia used depends on many factors, including the welfare of you and your baby. The doctor will talk to you about the types of anesthesia and take into account your wishes.
Delivery.
The doctor makes an incision through the skin and abdominal wall. The skin incision may be transverse (horizontal) or vertical, just above the pubic hairline. Move the muscles of the abdomen and, in most cases do not need cutting. Another incision is then made in the wall of the uterus. The incision in the uterine wall is also transverse or vertical.
is preferred transverse incision whenever possible because it is at the bottom and thinner of the uterus and results in less blood loss. Also heals better. Sometimes, however, requires a vertical incision, for example if you have a very premature baby and the baby's head is not in vertex (head down). The baby is removed through the incisions, then cut the umbilical cord and placenta is then removed. The uterus is closed with stitches that later dissolve in the body. To close the skin stitches or surgical staples used.
complications.
As with any major surgery, cesarean birth involves risks. These problems occur in a small number of women and generally required treatment is simple:
The uterus and nearby pelvic organs or the incision in the skin may become infected.
You can lose blood, sometimes enough to require a transfusion.
You can develop blood clots in the legs, pelvic organs or lungs.
can injure the bowel or bladder, or having a reaction to medication provided.

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Care for pregnant teenagers Teenage pregnancy

is likely that at their first prenatal visit, you will perform a complete physical examination, including blood and urine. You will be tested to rule out sexually transmitted diseases and to detect if you have been exposed to other diseases, like measles, mumps and rubella. Your doctor will also indicate the following:

• often should attend antenatal care.
• What might be feeling, both physical and emotional level
• What changes in your body can expect
• How to handle some of the troubling side effects of pregnancy such as nausea and vomiting
• Knowing what to expect can allay some of the fears your teen may have because of your pregnancy.
• your child's doctor will also prescribe daily prenatal vitamins to make sure you get enough folic acid, iron and calcium. Folic acid is particularly important during the first weeks of pregnancy and plays a crucial role for the healthy development of the neural tube (the precursor structure of the brain and spinal cord).

For more interest, highlight the information provided by Article parents troubled teens at the birth of their children.

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"Mom, I'm pregnant."

For some parents, this is one of the most feared phrases from the mouths of their children. Knowing that your daughter is pregnant and plans to have a baby means there will be many changes in his family. And while certainly not what most parents expect, it happens every day: Every year, approximately half a million adolescent girls give birth.
If your teen is about to become a mother, can be overwhelming for her and for you. How can you offer support to his daughter for the changes and challenges ahead?

What may be feeling:
parents experience a wide variety of reactions when they find out that your teen is going to have a baby. In the news leaves some stunned and upset, and angry with his daughter for his "irresponsibility." Some are disappointed and saddened, knowing that the dreams they had for her daughter are about to change forever. Other worry about the future: will your teenage daughter to handle the demands of motherhood? Will you end school? Can you go to college? Will work?
Other parents feel guilty, as if her daughter's pregnancy was due to some mistake they made in their parenting role. Are likely to think that if they had done more to protect her daughter, this would not have happened. And while some parents are embarrassed by the pregnancy of her teenage daughter and are worried about the reaction of family, friends and neighbors, others are happy about the news of the arrival of a grandchild, especially if the adolescent is older and has a mature relationship.
Whether you experience one or all of these feelings are not alone. This is usually a difficult moment in the life of almost any family. The important thing is that now realize that your teenager needs you more than ever. It is extremely important to communicate (especially when emotions are overwhelming). Teenagers who carry a pregnancy have special concerns about their health, and his daughter will have a healthier pregnancy (both from the standpoint of the physical and emotional) if you know you're not alone. Without the support of parents, some teens are more likely to make poor decisions with even worse consequences (such as escape household).
So what you can do as a parent of a teenager who is going to have a child? Acknowledge your feelings and work on them to accept and support her daughter. This does not mean it has no right to feel disappointed or even angry. These reactions are common and not at all unexpected. You may have to cope with a flood of emotions, particularly at first. But the reality of the baby means that you must overcome their initial feelings for the sake of his daughter and her baby.
If you need help to accept the feelings it creates the situation, talk to someone you trust or seek professional help. A neutral third party can be an excellent resource in a time like this.
What may be feeling his teenage daughter
Until recently, the biggest concern for his daughter may have been out with friends and think about what to wear. Now you have to deal with nausea and doctor visits. If you think your world has changed completely, can you imagine what you feel your teen?
Most unmarried teens do not plan to become pregnant and often feel frightened when this occurs. Many teens, especially younger ones, they keep their pregnancies secret because they fear the anger and disappointment of their parents. Some may even betray themselves who are pregnant; In these cases, is even more important for parents to get involved and care for her daughter as soon as possible. Teenage pregnancy, particularly younger age, are considered high risk because their bodies have not finished growing and have not yet fully mature.
Teenage boys who will become fathers also need the help of their parents. Although some may accept the opportunity to take part in your child, others feel frightened or guilty and may need support to meet their responsibilities (the father is legally responsible for the economic support of the child in all states.) However, this does not mean you have to press your teen to marry, if not what you want. Offer your advice, but remember that your opinion or threaten to impose a teenager can eventually backfire. In these cases there is no single solution. Open communication between you and your teen will be helpful when thinking about the future.

special concerns of pregnant teenagers
While most adolescents are biologically prepared to give birth to healthy babies, it often depends on whether they received adequate medical care , in particular in the early months of pregnancy, which are crucial. Adolescents who receive proper medical attention and care for themselves are more likely to have healthy babies. Those who do not receive medical attention are more likely to:

1. stillbirth.


2. Hypertension.


3. Anemia.


4. Complications during labor.

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Stages delivery.

not known what causes that precipitate labor, but it is believed that substances produced by placenta, the mother or fetus, and mechanical factors as the size of the baby and its effect on muscle uterine contribute to delivery. Therefore coordinated effects of these factors are the cause of the occurrence of contractions.
We talk about the onset of labor when you combine several situations such as uterine contractions, effacement (or shortening the length of the cervix) and dilation of the cervix.

First stage of labor: The
onset of labor occurs when uterine contractions occur every 3 minutes, with a duration of 30 ssegundos or more each and increasing intensity. The contractions are becoming more frequent and more intense until one every two minutes and produce effacement and dilatation of the cervix, allowing call this period as "period of expansion." The duration of this period is variable depending on whether the mother's first pregnancy (average of 8 hours) or multiparous (average of 4 hours). The stage ends with complete dilation (10 cm) and effacement of the cervix.

second stage of labor:
Also called "second stage". It is the passage of the child through the birth canal, from the womb to the outside, thanks to powerful uterine contractions and abdominal contractions pushes].

Third Stage of Labor:
Mother and newborn with unmilical cord still attached, in a bathroom
is called "enlightenment" and begins in the expulsion of the placenta , cord and membranes and this takes between 5 and 30 minutes. For many authors, the delivery end there but others consider a fourth term would be the immediate recovery and ending two hours after delivery. In this period called "early puerperium, the mother and child should be closely monitored due to the increased possibility of complications such as uterine atony.

Anesthesia for childbirth:

Although for centuries childbirth has been done without any anesthesia in the past few decades have developed much of painless childbirth techniques. Initially
infiltrating the skin of the perineum with local anesthetics to ease the pain of the episiotomy or incision of the perineum to prevent tearing. In recent thirty years it is increasingly frequent number of deliveries performed with epidural anesthesia or epidural anesthesia. This is the introduction into the epidural space by a catheter to be injecting small doses or a continuous infusion of local anesthetic and the right amount sufficient to eliminate the pain but not the force of contraction. In this way you can really enjoy a painless childbirth, it can contribute to the contraction and awake at the time of delivery with which you can enjoy the moment of birth. Epidural anesthesia should be performed by experienced anesthesiologists to minimize adverse effects.
epidural anesthesia is also used in the event of childbirth cesarean become . only need to strengthen the local anesthetic dose through the epidural catheter.
Complications of epidural anesthesia are minimal in the hands of experts.

Complications of childbirth:

delivery complications can occur during any period of birth and require prompt and effective intervention to prevent damage to the mother and her baby.
The progress of labor can not be due to uterine contractions weak or irregular not produce cervical dilation is usually treated with intravenous synthetic oxytocin or prostaglandin gel cervical topic.
also may be due to fetal pelvic disproportion due to fetal macrosomia or narrowing of the pelvic canal.
Fetal distress is the appearance of signs indicating fetal biophysical deterioration. The term fetal distress is falling into disuse in recent clinical literature, and are using the "suspected fetal welfare loss" or "loss of fetal well-being." The signs to which reference are basically did before altering the normal pattern of fetal heart rate. To this the mother is monitored with a tococardiografía Fetal which establishes a certain relationship of two variables that are fetal heart rate and the frequency and intensity of uterine contractions. In yet another sign that suggests the loss of fetal well-being is the appearance of amniotic fluid green or tinged with meconium (fetal stool), which is expelled when the fetus or chronic incidentally has a deficit oxygen. Both
no labor progression and fetal distress are treated by shortening the period of expansion, either by forceps, vacuum extractor or practicing an emergency cesarean.
puerperal fever in the past has been a major cause of maternal death due to poor asepsis during labor, as well as increased susceptibility to infection by the mother if she has anemia or malnutrition. For delivery
spent in the most physiologically possible both the mother and her partner must be sufficiently prepared for the "proof" that they face.

Social aspects of childbirth:
Labor, which in most cases without incident, has become a high-tech medical process, which occurs in delivery rooms of large hospitals, with a team composed of multidisciplinary medical obstetrician, midwife, anesthetist, pediatrician ... In Western society
developed countries the birth of a child has been medicalized to dangerous extremes, where the emphasis is on getting a healthy baby at any price and where it tends to increasingly frequent practice of cesarean births. Sometimes C-sections are more common in private hospitals than in public for several reasons.
Delivery is conceived by the society as a painful process, almost like a disease when it is a physiological process in which pain is present. There is much panic to pain, that spinal anesthesia (epidural anesthesia) is a medical act increasingly in the delivery of Western world.
At delivery, where the main protagonists are the mother and the child is born, traditionally have been denied the father's presence and collaboration in the delivery. In some societies, childbirth is barred to all men. In the last decades of the twentieth century, the father has an increasingly more active.

Childbirth psychoprophylactic

This article or section needs sources or references appear in a reputable publication such as textbooks or other publications on the subject.
refers to the birth of a child vaginally, without anesthesia, in which the woman works and trust in their reproductive role in their inner wisdom, as well as their ability to give birth. Trust in the weight that the mind can exert on the body and delivery conceptualized as a full and joyful experience.
Recent research shows that the support of the perinatal educator (who has accompanied the couple during pregnancy in preparation for this moment, and which has already established a relationship of trust), brings great benefits in the management of pain, better development and lower cesarean delivery. Therefore, for successful delivery psychoprophylactic, experts recommend the presence of it during labor, without supplying the support and respect the space of the father.
order to carry out deliveries of this type is critical that a medical team, in addition to a high professional level, be sensitive to assess the benefits of natural childbirth without anesthesia and profoundly human experience is for women , your partner and your baby to live birth psychoprophylactic. The attending physician labor should be in favor of birth is as natural as possible