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Ask a Doula

by Tenisha Bibbs

Giving birth is a joyous moment, but it also brings moments of awareness. After birth women go through so many different changes; they have to remember so many different steps and they also have to deal with postpartum depression (PPD) during the 4th trimester. Also known as postpartum blues, it may go away in some while it may last forever in others. Having a full understanding as to what is happening is important as we continue to develop new cases.

Research is also being done to get a better understanding of the changes that women go through after birth. Unfortunately, there are so many stereotypes about pregnancy and postpartum. Many birthing families enter pregnancy without enough information and education about how to prepare for their new bundle of joy or what changes mom will go through over the next few weeks. The moment should be happy and exciting, when in reality, not every mom will be excited. We have to take into consideration the trauma that she might have experienced during her life; from childhood all the way into adulthood. Consider her triggers, which could be things like whether she’s had a miscarriage or experienced the loss of an infant.

PPD starts just after childbirth. Baby blues can last for one week after childbirth. This is a normal thing, but if it goes for more than two weeks, then it is called postpartum depression. You may experience the following symptoms in PPD:

• Crying a lot without any reason

• Feels moody and irritated over little things

• Trouble sleeping (insomnia) and loss of appetite

• Anxiety/panic attacks

• Delusions and obsessive thoughts about the baby

• Reduced concentration on everything around

• Difficulty in bonding with baby and feelings of guilt that you are not taking care of the baby properly

"If you go through postpartum depression, immediately seek help from your health care professional to relieve these symptoms. Also, seek the help of your partner and loved ones." - Tenisha Bibbs

If you go through postpartum depression, immediately seek help from your health care professional to relieve these symptoms. Also, seek the help of your partner and loved ones.

Most of the time you hear a lot about PPD or baby blues. Let me introduce you to PMAD, Perinatal Mood and Anxiety Disorder. PMAD brings more awareness on how to identify when something is not quite right after birth. Unlike PPD or baby blues, it goes away and it only lasts a short period. PMAD is much longer and requires medicine, consistent counseling and family awareness if anything seems unusual. Social isolation and birth trauma during COVID-19 also increased the awareness of PMADs. The birthing family was isolated from their support group while giving birth, the resources that they needed were limited due to everything going on in the world, there was limited perinatal care, and if the baby was in the NICU, there was almost no contact. This can definitely add to mood and anxiety disorders.

What is PMED?

P - Perinatal (in pregnancy or the postpartum period)

M - Mood (depression, bipolar, psychosis)

A - Anxiety (GAD, panic, OCD, PTSD)

D - Disorder (get in the way of daily functioning)

These can affect mom before, during and after birth. It mostly starts during the 4th trimester. Familiarizing yourself with this disorder can help the situation before it is too late. We are birthing family advocates and we can provide the best advocacy and observation during the 4th trimester period.

How can PMEDs affect the family?

During the postpartum period, a woman goes through different emotional, behavioral, and physical changes. These changes sometimes depress her. Women demand extra care, affection, and time after childbirth, but sometimes it becomes difficult for the family to give proper time to a new mom due to their busy schedule. As a result, the woman loses her confidence, the communication gap breaks her relationship, she becomes overwhelmed which can lead to depression.

How should the family act during the 4th Trimester?

Family members should be involved in taking care of a postpartum woman. Health care professionals should educate her family about her condition and ask them to act accordingly. Emotional support is the most important support for women after childbirth. A woman who receives proper care and affection during the postpartum period from her partner and family becomes more confident and happy in her life and less likely to suffer from postpartum depression.

After childbirth, it is important for mom to focus on her health and self-care while taking care of the baby. Take steps to relieve body pains, don’t miss an appointment with your doctor, drink plenty of water and eat food that is rich in fiber. You shouldn’t sit idle all the time. You must go on small walks every day. You can prepare a postpartum recovery kit even before your delivery. A good postpartum kit must include:

• Maternity pads

• Don’t use tampons as they can cause a bacterial infection

• Cotton underwear and nursing bra

• Itch spray to relieve pad itching

• Painkillers suggested by the doctor to relieve abdominal cramps

• Laxative powder suggested by the doctor to fight constipation

• Vitamins containing Omega-3 fatty acids

• Coconut oil to moisturize itchy and dry skin

• Any informative book about the postpartum period and child care

If you or anyone you know is experiencing depression, please don’t hesitate to call and get the support that you need. You can also read more about this condition in Baby Whisper Magazine.


Tenisha Bibbs is a Dr. of Humanitarianism, Pregnancy & Postpartum Coach/Doula, Lactation Counselor, Speaker, Author, and Perinatal Mental Health Coach

Ask A Doula Newborn Services LLC.



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