The Post-Pregnancy Handbook: The Only Book That Tells What the First Year After Childbirth Is Really All About---Physically, Emotionally, Sexually

The Post-Pregnancy Handbook: The Only Book That Tells What the First Year After Childbirth Is Really All About---Physically, Emotionally, Sexually

by Sylvia Brown, Mary Dowd Struck

Paperback(First Edition)

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While a number of books exist which deal with various aspects of the postnatal experience - breastfeeding, exercise, motherhood, post-partum depression - this is the first complete source of information on what a woman experiences both physically and emotionally in the days, weeks and months after childbirth. It is also the only book in its field which balances medical advice with practical tips and numerous references to alternative remedies. From Sylvia Brown, a mother, and Mary Dowd Struck, RN,MS,CNM, a nurse/midwife, comes The Post-Pregnancy Handbook, a wonderfully comprehensive, honest self-help guide which every new (and repeat) mother should keep by her bedside. Brown and Struck give detailed guidance on:

The First Few Days
- alleviating discomfort from the after-effects of labor or a ceasarian
- making the hospital stay more pleasant
- coping with possible medical complications

The First Few Weeks
- organizing home life with a new baby
- surviving fatigue
- breastfeeding successfully
- managing older siblings, parents and friends
- introducing a new dimension to the couple (returning to sex after childbirth)
- navigating the new mother's dietary needs
- identifying and overcoming a range of emotional difficulties from "baby blues" to severe postnatal depression
- dealing with stress, guilt and that elusive maternal instinct

The First Year
- achieving a complete physical recovery: how to get back into shape from the inside out
- restoring strength and tone to the pelvic floor
- countering the legacies of pregnancy: problems with hair, skin, and varicose veins

A thorough, straightforward guide to helping the new mother achieve an effective and harmonious recovery.

Product Details

ISBN-13: 9780312316266
Publisher: St. Martin''s Publishing Group
Publication date: 11/08/2003
Edition description: First Edition
Pages: 320
Product dimensions: 6.14(w) x 9.21(h) x 0.74(d)

About the Author

Sylvia Brown wrote The Post-Pregnancy Handbook in response to her own frustration at the lack of comprehensive information on the mother in the weeks and months after childbirth. The Post-Pregnancy Handbook is her first book.

Trained as a nurse midwife at Columbia University, Mary Dowd Struck,RN, MS, CNM has been Senior Vice President for Patient Care Services at Women & Infants Hospital in Providence, Rhode Island since 1986 and has been a Teaching Associate in Obstetrics and Gynecology at Brown University School of Medicine since 1994. Before her current appointment, she was both a nurse and administrator at hospitals across Rhode Island and New York.

Read an Excerpt

A Few Tips for a Calmer Hospital Departure  The day before you are to check out, send home as much as possible especially flowers, plants, gifts, and any large items. You probably will still be wearing maternity clothes -- or at, least ample, roomy clothes -- for another two weeks. For the next two to six months, be prepared to wear clothes that are at least two sizes larger than your pre-pregnancy clothes. When leaving the hospital, you will probably be escorted to the door in a wheelchair. Some hospitals allow you to walk to the door unescorted. Once you are released by the nurse or aide, carry only the baby and your handbag, and a burp cloth in case the baby spits up. Ask the person accompanying you home to carry everything else. A new mother walks more slowly than usual, especially after a cesarean. Take your time. Checking out of the hospital always takes more time than you think it will. If you are still taking painkillers, keep them handy, so as to be at ease on the way home. Ask the person accompanying you to bring the car close to the hospital door. If you have never put a baby in a car seat, do not underestimate how complicated this can be at first. You should have at least read the instructions beforehand and preferably practiced at home. Some mothers prefer to settle the baby into the car seat while still in the hospital, and then install the seat in the car with the baby already in place. Do not forget that you should never place the car seat in front of an airbag. Pediatricians also advise against leaving the baby in a car seat for several hours. Once on the road, resist the temptation to take the baby in your arms to comfort or feed him. If you must take him out of the seat, ask the driver to pull over to the side of the road. In winter, ask your family to turn up the heat in your home to 72F, the night before you come home, so that the temperature will be comparable to that of your hospital room. Once you are at home, you can reduce the temperature one degree every day until you reach your household's normal temperature. To save your partner needless trips to the pharmacy, buy all your sanitary napkins ahead of time for the four to six weeks during which you will be bleeding (special postpartum, extra-long and extra-absorbent for the early days or "overnight" pads, then normal ones for day and night, and finally smaller pads for light flows). Before leaving the hospital, ask for the direct number of the maternity ward and the name of a nurse or two (and their shift hours) that you call from home if you have an important question. Many hospitals provide a call service or "warm line" for new mothers with questions. *** The Nursing Mother's Diet A nursing mother produces 23 to 27 ounces of milk per day, containing 330 milligrams of calcium per quart. This requires an extra energy expenditure of at least 500 calories per day. Good nutrition is therefore just as important for you as it is for your baby.  The quality of breast milk is only affected in extreme cases of deprivation, or by excessive intake of a particular food. But the quantity of milk depends very much on the mother's diet. Food absorbed by a nursing mother not only fulfills her own nutritional needs, which are greater during the postnatal period, but also enables her to produce milk. A woman who does not feed herself properly may still have a healthy baby, but it will be to the detriment of her own health. If you lack sufficient nourishment, your body will make milk production its first priority, and your needs will go unmet. It is just the same as it was during pregnancy, when the nutritional needs of the fetus were satisfied before those of the mother. In fact, the baby, who weighs only a few pounds, will receive nearly 1,000 calories per day in breast milk!  What does it mean to feed yourself properly while nursing? We can compare a breast-feeding mother to a marathon runner-whose race will last twenty-four hours, not four.  The Basics  Increase your water consumption by one quart per day, so that you are drinking a total of 2.5 to 3 quarts. Nursing women tend to be thirstier anyway, especially during feeding sessions, because part of their water consumption goes directly to milk production. But don't overdo it: too much liquid also can reduce milk production.  Increase your daily caloric intake to 2,500 calories: you can even eat more if you are planning to continue breast-feeding for more than three months (2,800 calories per day). But again, be careful: many nursing mothers are tempted by sweets. Stick to healthy foods instead! Eat more proteins. The basic rule is to eat I gram of protein each day for every pound you weigh.  Spread your caloric intake over five "meals," breakfast, lunch, after- noon snack, dinner, and an extra snack during the evening. Each snack time is also an opportunity to drink water, eat a low-fat dairy product, and a piece of fruit. As your body is continually producing milk, it needs your caloric intake to be regular.  Stay away from tobacco. Nicotine passes directly through breast milk to the baby. if you cannot control yourself, build in a gap of at least an hour between your last cigarette and your next feeding session, so that the nicotine in your system has a chance to decompose at least partially.  Avoid regular consumption of alcohol. Alcohol passes through milk in less than an hour and if the baby consumes it in large quantities it can retard his growth. if you drink an occasional glass of wine or beer, save it for after a feeding session.  Take no medication without first consulting a doctor. Most antibiotics, sulfa drugs, chemical laxatives, and all products containing iodine are contraindicated while you are breast-feeding. Other medications, taken over a long period, can also be dangerous.  Beware of pollutants. Like nicotine, pesticide residue easily passes through mother's milk. If you are nursing, stay away from insecticides (especially in airborne forms such as aerosols or coils). Try to use natural insect repellents such as citronella.  Eat primarily unsaturated fats. Sunflower, corn, rapeseed, and olive oil provide fatty acids that are essential for building the baby's nervous system.  Eat food containing vitamin B 9. In Western countries, the only vitamin really lacking in women's diets is vitamin B 9 (folic acid). Birth control pills accentuate a woman's vitamin B 9 deficit, and may also contribute to a vitamin B 6 deficiency. During pregnancy, folic acid is vital to the development of the baby's nervous system. Nursing mothers are well advised to continue taking their prenatal vitamins. Folic acid also can be found abundantly in asparagus, cabbage, corn, chick- peas, and spinach. Many other foods, such as wheat and orange juice, have been enriched with folic acid. Check the package labels.  Take zinc supplements. According to a British study, pregnant and nursing women also often lack zinc. They should consume 15 to 20 milligrams per day. Zinc is found in eggs, meat, whole flour, and oats.  Consume 1,200 milligrams of calcium per day. A balanced diet only provides 800 to 1,000 milligrams of calcium daily. Because nursing mothers need 1,200 milligrams, a calcium supplement will probably be necessary. Calcium needs can also be partly met from dairy products, raw vegetables, almonds, and hazelnuts.  Do not rush to buy vitamin A supplements. People often talk about vitamin A supplements for nursing mothers, because their daily need rises from 1,000 milligrams to 1,300 milligrams. It is true that if the woman had a vitamin A deficiency during pregnancy, this problem may worsen after childbirth. But anyone who eats enough carrots, vegetables, butter, fish, and meat will absorb enough vitamin A.  We hear a lot about foods that can irritate the baby-turnips, celery, watercress, citrus fruits, onions, cabbage, spices, leeks, cauliflower-by giving him gas or changing the taste of his mother's milk. For example, some people say that garlic increases milk production; others say it gives the baby gas. There is no universal rule. Moreover, different cultures prefer foods that others consider to be "bad" for nursing mothers. Each baby reacts differently to the foods his mother consumes. If your baby is particularly disturbed one day, try to remember what you have eaten in the past twenty-four hours. If one food seems suspect, eliminate it from your diet for a while.  When nursing, observe your baby so you can eliminate from your own diet any food that seems to bother him.There exist nutritional supplements that are said to increase milk production. Their effects have not been proven scientifically, but they have a placebo (psychological) effect. Be careful, some of these supplements have a very high sugar content, and are therefore high in calories. Also, many midwives will tell you that fennel and beer increase milk production, and that parsley stops it. 

Table of Contents

Classical Medications and Alternative Remedies1
Classical Medications1
Alternative Remedies2
Herbal Remedies6
Acupuncture and Chinese Medicine8
Manual Therapies10
IThe First Few Days
1.A Great Physical Upheaval19
The Hormonal Revolution20
The Reproductive System22
The Recovery Process23
2.Caring for the Genital Organs28
The Uterus28
The Birth Canal31
After an Episiotomy33
3.Your Bodily Functions After Childbirth42
Fluid Retention44
The Digestive Tract45
Your First Exercises After Childbirth49
4.Coping with the Side Effects of Childbirth52
The Common Side Effects of Chidbirth52
Circulatory Problems57
After an Epidural62
5.After a Cesarean Section67
The Operation67
Discomfort After a Cesarean70
The Baby Born by Cesarean76
6.Reclaiming Your Body78
Rehabilitating the Pelvic Floor Muscles79
Recovering Pelvic Balance80
7.Possible Postpartum Complications84
Serious Circulatory Problems90
IIYour First Few Weeks
8.A Changed Lifestyle95
Your Fragile Body95
Getting Your Routine Under Control97
Organizing Your Return Home100
Relationships Change104
Surviving Fatigue110
9.Looking After Your Body114
Your Posture114
Exercises for the First Six Weeks After Childbirth119
Healing Your Scars123
Your Appearance126
10.Diet After Childbirth134
The Impact of Childbirth134
How to Get What You Need135
Your Dietary Habits139
A Word About Dieting140
11.Resuming Your Menstrual Cycle142
Your First Period After Childbirth142
Your Fertility142
The Postnatal Visit145
12.Returning to Work147
Breast-feeding for the Working Mother149
13.Common Myths About Breast-feeding153
The Importance of a Good Start154
The Truth Behind the Myths155
14.Breast-feeding: Getting Off to a Good Start159
How the Breasts Produce Milk159
The Golden Rules161
The Feed165
Breast-feeding Problems172
Mother's Milk for Premature or Sick Babies183
15.An Established Routine185
Integrating Breast-feeding into Your Routine186
16.The Nursing Mother's Diet190
The Basics191
IVEmotional Reactions to Childbirth
17.The First Days197
A Time of Change197
Your First Encounter with the Baby199
Communicating with the Newborn202
Caring for the Baby205
The Never-ending Story of Childbirth206
Special Cases207
"Baby Blues"210
18.Emotional Reactions of the First Few Months216
Overcoming Mild Depression217
Managing Stress226
19.Postnatal Depression233
Symptoms of Postnatal Depression234
The Causes of Postnatal Depression235
Healing the Mind238
Puerperal Psychosis242
20.The Mother in You243
Maternal Instinct: Is It in All of Us?243
The "Perfect Mother"244
The Impact of Our Families248
Raising a Child251
Lack of Recognition255
Expectations Management257
VThe Couple
21.The Couple Changes261
When a Woman Becomes a Mother262
When a Man Becomes a Father265
Father and Child268
Common Stumbling Blocks271
22.A Little Patience: Sex After Childbirth274
Physical Impediments to Sexual Desire274
Psychological Obstacles to Sexual Desire275
Reclaiming Your Intimacy277
VIA Full Recovery
23.First Things First: The Pelvic Floor283
The Importance of the Pelvic Floor283
Lift and Squeeze: A Brief Review of Pelvic Floor Anatomy285
What Affects the Pelvic Floor Muscles?287
Urogenital Problems290
Urinary Incontinence291
Anal Leakage293
Organ Prolapse293
Toning and Strengthening the Pelvic Floor296
24.A New Body Image300
Your Weight300
Posture and Your Back309

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