health

When I was pregnant it felt like everyone had something to tell me about what to expect after the baby arrived. I was told I would never sleep again, that I would never wear nice clothes again, that my son would pee in my eye when I changed him and that if I breastfed the baby weight would fall right off.

Well, in my experience some of this advice was spot on (I rarely wear anything nicer than yoga pants when I’m at home) but some of it missed the mark entirely (I have yet to be peed on, let alone in the eye). There are however several lesser talked about things that can happen and I thought it might be nice to give everyone a heads up.

1. Constipation – I’ve heard horror stories about the first postpartum bowl movement being almost worse than childbirth itself, but luckily I didn’t have a problem with it. In fact I even stopped taking the stool softener that the hospital gave me because I felt that I didn’t need it. Well, the joke was on me. A few weeks after Asher was born the constipation set it. In my case, this delay may have been due to the delay in my milk coming in. You need to drink A LOT of water to support breastfeeding and to not have it affect the rest of your bodily functions. If you aren’t drinking enough then your body may pull liquid from anywhere it can to ensure that you have enough milk for your babe, which can result in some rather hostile bowl movements. I recommend, drinking LOTS of water. I try to chug a 20 oz bottle every time I nurse. I find that chugging ensures that I get it all in, because it’s easy to get side tracked when I take small sips. Stay on your stool softener, eat lots of fiber and go for plenty of walks.

2. Dehydration – I have never been a great water drinker mainly because I find it inconvenient to have to pee all the time. Prior to becoming pregnant I would often go without drinking much of anything for a whole day only to find myself parched right before bed, so I’d chug a couple glasses, which would invariably result in me needing to get up to pee in the middle of the night. When I became pregnant, I knew I had to be more disciplined about getting enough to drink so I began carrying a water bottle around with me at all times. Having a bottle handy really helped remind me to stay hydrated and the fact that I was peeing all the time didn’t really bother me because I considered it par for the course with pregnancy. If I thought being pregnant meant that I knew what it was like to be thirsty all the time then I really had no idea what I was in for. After Asher was born the thirst took on a whole knew level. I was literally guzzling as much water as I could and no matter how much I drank I still had an insatiable thirst for more. It felt like I was shriveling up from the inside out. Nothing I did helped. Luckily after several weeks it leveled off and I was able to cut back to just drinking a ridiculous amount instead of an insane amount. If I ever slack on my liquid intake I get splitting dehydration headaches by the time the evening rolls around. No fun. There is a silver lining however. I rarely need to pee! It’s kind of like a really weird parlor trick. I can drink liters and liters of water and barely have to go to the bathroom at all, how cool is that?!

3. Hairloss – Due to the higher amounts of estrogen during pregnancy most women experience a drastic decrease in the the amount of hair that they shed. (1) I have a lot of hair, but it is super fine and dead straight, so when I became pregnant I was so excited about the effect it would have on my hair. I was amazed by how plentiful and lush my hair was. I would maybe shed 2-3 hairs a day. Now I knew that this was only temporary and that once Asher was born I would eventually start shedding again. What I didn’t know is that my hair would begin falling out in clumps and that I would develop a receding hairline. At around 4 months postpartum my hair started shedding at an alarming rate. Nearly every time I showered I would get a ping pong sized hair ball. Not so tiny tumble weeds consisting of hair and dust bunnies started popping up everywhere. I once even found Asher clutching a clump of my hair in his fist, which he was attempting to stick in his mouth. One day I looked in the mirror and noticed that my hair line was receding. I asked Raf if he noticed and he said that my hair line was always like that, but I wasn’t convinced so I broke out the photo albums and did a side by side comparison. I have included a few pictures below.

Asher and I at 2.5 months postpartum:

Asher and I at 4.5 months postpartum:

Do you see the difference? No? Were you too distracted by the cute baby? Oh, well allow me to give you a closer view:

The drop off in the levels of estrogen after childbirth are to blame for the hair loss. Luckily, this too is just temporary and the vast majority of women who experience this have their hair return to it’s pre-pregnancy volume by a year. (1) So here’s hoping. In the meantime I have taken to french braiding my hair a lot in an attempt to keep the tumble weeds at bay.

1. Belgravia Centre. (2012, May 28). Postpartum Hair Loss Causes and Solutions. Retrieved May 6, 2013, from The Belgravia Centre: http://www.belgraviacentre.com/blog/postpartum-hair-loss/

Maybe it has something to do with the fact that my mother had three natural, unmedicated births but I have always known that natural birth was something I wanted to do. Fast forward to Graduate school, where I learnt all the startling statistics about the gross over use of birth interventions in this country, which factor into the alarmingly high cesarean section rate and I became an ardent natural birth advocate.

I can’t tell you how many times I’ve heard things like: “I will for sure be getting an epidural” or “I want a c-section because I don’t want to be all stretched out down there” or “I want to get induced so I can plan when the baby will arrive.” And the list goes on and on. The truth is, there is a lack of proper education about childbirth. Many young women have no real idea about what to expect and most of their knowledge comes from the media, which portrays birth as a harrowing experience. Couple this naivete with the current treatment of pregnancy and birth by much of the medical field as an illness or disability and we have ourselves an intervention epidemic.

I found it so aggravating when people would ask me if I was planning on having an epidural and they responded with shock when I told them that I was planning on a natural birth. I mean, really people?! Childbirth is a totally natural process and the female body was designed to carry out this function perfectly. Granted there are times when interventions are 100% necessary and life saving but for the vast majority of births this is simply not the case. In fact for the majority of births added interventions can actually be a hindrance and can have a snow ball effect.

The World Health Organization recommended that the upper limit for the cesarean section rate was 15%, while the optimal rate should be 5%. In the United States the most recent data show that the c-section rate is a staggering 32.8%, meaning that 1 in 3 women deliver by cesarean section. The Healthy People 2020 goal is to reduce the number of cesareans among low risk women with no prior cesarean births by 10% and yet in some hospitals throughout the country the c-section rate is as high as 50%. Furthermore there is no evidence to show that having a c-section rate that is higher than 15% does anything to reduce maternal and/or infant mortality or morbidity, in fact just the opposite may be true. An increased rate of interventions often leads to highers levels of death and disease among mothers and babies.

So what’s going on here? Well there isn’t a simple answer since there are a lot of factors at play. Birth weight plays a large roll, the fact is that we are having bigger babies than ever and it’s becoming increasingly more difficult for our bodies to deliver them naturally. This is why it’s so important to eat right and exercise during pregnancy. In fact eating right and exercising are vitally important before and after pregnancy as well, but that’s a topic for another day. Another large factor is the elective and rampant use of interventions during childbirth and I believe this stems in large part from a lack of adequate education about the topic.

The most common major interventions used other than a cesarean section itself are pitocin (used to induce or augment labor) and epidurals. The use of epidurals have become the norm and natural birth is something that is viewed as extreme. When I told people I wanted to have a natural birth, I was told ‘you don’t have to be a hero’ and asked ‘why would you do that to yourself’. Child birth is a natural process not an illness or disease and treating it as such can impair the body’s ability to do what it does best.

I said before that interventions can be a slippery slope and here is what I meant. Epidurals can weaken the contractions that your body has naturally, which then requires you to go on pitocin to strengthen the contractions, but now your contractions are stronger and longer than they should be so you get a stronger epidural to manage the pain, which in turn requires more pitocin, which finally sends the baby into distress (due to the stronger and longer contractions) and you are wheeled off the the OR for a cesarean section. The same cycle can also be true when labor is induced. While all this is true it must still be noted that many women do receive epidurals and/or pitocin without needing further intervention.

You have to remember that pitocin and epidurals are serious drugs and whatever you’re receiving your baby is receiving. Of course these interventions are wonderful and life saving when they’re necessary but they are performed far more than what is medically necessary. Too many people opt to schedule a c-section or elect to have interventions without really educating themselves about the process. A cesarean section is MAJOR abdominal surgery, which involves slicing through 6 layers of skin, tissue and muscle and then sewing the individual layers back up again. Recovery is no picnic especially considering you can’t just relax but instead you have to care for a newborn and be up all hours of the night. The International Cesarean Awareness Network is a great place to go to learn more.

The last contributing factor I’ll discuss here and perhaps the biggest are policy instruments acting at the health system level. OB-GYNs are faced with more lawsuits than nearly every other medical specialty. This is because sadly and unfairly if something goes tragically wrong during labor blame is often placed on the medical staff present. So in order to reduce liability systems are in place to push for more interventions because it is wrongly believed that more interventions means better care. In order to change this we must change policy, which starts with education.

My intention here is not to demonize birth interventions and I don’t presume to tell women how they should have their babies or ostracize women who opt for birth interventions but I do think it is important to educate yourselves about child birth. I highly recommend taking a birth class as well as watching The Business of Being Born. You can also go to The Beauty of Being Born to read real women’s birth stories and share in their experiences. Also you may want to consider opting to deliver with a midwife that practices out of a hospital or birth center.

If you read Asher’s birth story then you know that I did in fact require the use of interventions. They were all medically necessary with the exception of one: breaking my water. This was the first intervention that I received and I believe that making this choice is what lead to the complications that required me to need further interventions, but that’s just a theory, since there is no way to know for sure.

At the end of the day when it comes to labor and delivery the most important thing is to have a healthy mother and baby, no matter how you get there, I just believe that in the vast majority of cases the best way to ensure that is to have a natural childbirth.

Lesser Known Facts About the Postpartum Period

Natural Birth & The Great Intervention Epidemic