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23-week midwife appointment



 
 
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  #1  
Old December 9th 04, 04:31 AM
Rivka W
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Default 23-week midwife appointment

I went to the midwife today for my 23-week appointment. (I know that's
a weird number, but they start visits at 8 weeks and then want you to
come in every 5 weeks.)

Everything looks just great. The baby's heartbeat is strong and
regular. My blood pressure is 108/62, I don't have any swelling in my
hands and feet, and I don't seem to be spilling any sugar or protein.
She tested for anemia because I complained about dizzy spells and
shortness of breath, and my hemoglobin came back 13.6 - which is
excellent, especially for a pregnant woman.

She thinks the shortness of breath is normal pregnancy stuff, and the
dizziness is probably related to low blood sugar. She recommended that
I have three snacks a day, avoid too much sugar at once, and eat
protein at every meal and snack - so now I have to think of lots of
easy high-protein snacks. There's only so much cheese you can eat.

I am still two pounds under my pre-pregnancy weight, which has me a
little worried. The midwife isn't concerned, though. She says I'll get
hungry soon.

We spent a lot of time talking about post-partum depression. I'm
probably at higher risk, because I've had two mild depressive episodes
and because my sister had real trouble with it. I wanted to know if
there's anything I can do to reduce my chances of developing PPD after
the baby is born. She said that the most important thing is to make
sure I have a strong support system in place - including help with the
baby, having someone else to do the cooking and housework, making sure
I have opportunities to leave the house without the baby, and possibly
joining a new mother's group. She also said that I might want to
consider using formula for one night feeding, even though otherwise
I'll be exclusively breastfeeding, because PPD is linked to sleep
deprivation. Finally, she gave me the name of a psychiatrist who
regularly works with their practice and suggested that I might want to
meet him before the baby is born, so that if problems arise I will
already know who to go to for help. She tried to impress upon me the
importance of being willing to take antidepressants if necessary, even
if I'm nursing - I told her that, as a psychologist, I know enough
about the potential developmental impact of having a depressed mother
that I will be perfectly willing to take whatever medications I need.

Some of this seems like it might be more than is necessary, but I feel
better knowing that all the bases will be covered.

I got the slip for my 28-week labwork. They do the 1-hour GTT
routinely. I asked her some questions about it, and she said that if I
refused it we could talk about other options - but I think I'll go
ahead and do it. I'm planning to get Rhogam at 28 weeks. They're also
going to test for thyroid problems because there's a family history -
but she said that's just a precaution.

I continue to be very, very impressed with my midwife practice. This
visit was 45 minutes long, and I had all the time in the world to ask
questions and get them answered. We've now met all three of the
midwives, and although I still have a favorite, I will be perfectly
happy to have any of them attend our birth.

And of course, I am also very impressed with the Li'l Critter and her
stellar health and behavior. What a fine baby we're going to have!

Rivka
Li'l Critter due 4/3/05
--
Visit my weblog at http://respectfulofotters.blogspot.com


  #2  
Old December 9th 04, 09:05 AM
Anne Rogers
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Default


We spent a lot of time talking about post-partum depression. I'm
probably at higher risk, because I've had two mild depressive episodes and
because my sister had real trouble with it. I wanted to know if there's
anything I can do to reduce my chances of developing PPD after the baby is
born. She said that the most important thing is to make sure I have a
strong support system in place - including help with the baby, having
someone else to do the cooking and housework, making sure I have
opportunities to leave the house without the baby, and possibly joining a
new mother's group. She also said that I might want to consider using
formula for one night feeding, even though otherwise I'll be exclusively
breastfeeding, because PPD is linked to sleep deprivation. Finally, she
gave me the name of a psychiatrist who regularly works with their practice
and suggested that I might want to meet him before the baby is born, so
that if problems arise I will already know who to go to for help. She
tried to impress upon me the importance of being willing to take
antidepressants if necessary, even if I'm nursing - I told her that, as a
psychologist, I know enough about the potential developmental impact of
having a depressed mother that I will be perfectly willing to take
whatever medications I need.


thanks for posting this, perfect timing! I'm just about to leave for an
appointment with my psychiatrist and this is what I wanted to discuss, it
hadn't occured to be to consider ways of getting more sleep, so I think I
need to carefully consider that


  #3  
Old December 9th 04, 04:54 PM
H Schinske
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She also said that I might want to consider using
formula for one night feeding, even though otherwise I'll be exclusively
breastfeeding, because PPD is linked to sleep deprivation.


I would seriously consider NOT doing this. Getting a small baby to go back and
forth easily from bottle to breast is not necessarily easy, and adds to the
likelihood of nipple confusion and lower supply, and it seems to me that adding
this needless complication to your life would do away with any of the benefits
that a bit of extra sleep might get you. In my case, skipping a night feeding
would have meant that I'd have just woken up engorged and in pain anyway, so
nothing at all would have been gained. If your baby is one of the ones who
react badly to cow's milk or soy-based formula, matters could be even worse --
while this is a more remote possibility, it's there and should be considered.

Getting extra help so that you can get naps in the early weeks is FAR FAR FAR
more useful. Many babies have day and night mixed up and are up a lot in the
night anyway, regardless of how they're fed at night. There's no way around
peculiar sleep habits in the first weeks or months.

--Helen
  #4  
Old December 9th 04, 05:00 PM
Anne Rogers
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She also said that I might want to consider using
formula for one night feeding, even though otherwise I'll be exclusively
breastfeeding, because PPD is linked to sleep deprivation.


reporting back from my appointment, when I asked about what I can do to help
things, the first thing the psychiatrist said was sleep, but he did not
suggest missing feeds, or not breastfeeding at all, but that if I start to
not be able to get to sleep easily as happened last time before I slid into
depression that there are things I could take that should help me get back
to sleep easily but not be a problem with waking up, if this is the case,
this could be really helpful for me, as from when ds was about 4 weeks old,
I would take so long to fall back asleep after each waking that I sometimes
only got half and hours sleep between feeds


  #5  
Old December 9th 04, 05:12 PM
Donna Metler
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"Anne Rogers" wrote in message
...

She also said that I might want to consider using
formula for one night feeding, even though otherwise I'll be

exclusively
breastfeeding, because PPD is linked to sleep deprivation.


reporting back from my appointment, when I asked about what I can do to

help
things, the first thing the psychiatrist said was sleep, but he did not
suggest missing feeds, or not breastfeeding at all, but that if I start to
not be able to get to sleep easily as happened last time before I slid

into
depression that there are things I could take that should help me get back
to sleep easily but not be a problem with waking up, if this is the case,
this could be really helpful for me, as from when ds was about 4 weeks

old,
I would take so long to fall back asleep after each waking that I

sometimes
only got half and hours sleep between feeds


Could you pump after feeds during the day, so someone could do a syringe or
cup feeding at night, letting you get in 3-4 hours of sleep at a stretch?
Since Alli can't nurse yet, we're doing all feedings with EBM now, but I do
know that when we stopped trying to have her nurse and went to pumping and
feeding EBM (which let other people feed her), which let me get a longer nap
at least once a day, it really helped many of the PPD symptoms I was
starting to show. I can't go longer than 4 hours w/o pumping, but the
difference between 2 hours or less of sleep and 4 hours is dramatic.


  #6  
Old December 9th 04, 05:15 PM
Anne Rogers
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Could you pump after feeds during the day, so someone could do a syringe
or
cup feeding at night, letting you get in 3-4 hours of sleep at a stretch?
Since Alli can't nurse yet, we're doing all feedings with EBM now, but I
do
know that when we stopped trying to have her nurse and went to pumping and
feeding EBM (which let other people feed her), which let me get a longer
nap
at least once a day, it really helped many of the PPD symptoms I was
starting to show. I can't go longer than 4 hours w/o pumping, but the
difference between 2 hours or less of sleep and 4 hours is dramatic.

there are certainly tricks you can do to juggle things, I find that I would
wake at night anyway, having someone take ds out in the afternoon whilst I
napped was great, but I only managed to make that happen once or twice, but
it did have a noticeable affect in delaying things.


  #7  
Old December 9th 04, 07:05 PM
H Schinske
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wrote:

Could you pump after feeds during the day, so someone could do a syringe or
cup feeding at night, letting you get in 3-4 hours of sleep at a stretch?
Since Alli can't nurse yet, we're doing all feedings with EBM now, but I do
know that when we stopped trying to have her nurse and went to pumping and
feeding EBM (which let other people feed her), which let me get a longer nap
at least once a day, it really helped many of the PPD symptoms I was
starting to show. I can't go longer than 4 hours w/o pumping, but the
difference between 2 hours or less of sleep and 4 hours is dramatic.


For someone in your situation who has to pump and bottlefeed for a while
anyway, the equation is quite different. It's much simpler to avoid the whole
pumping/bottlefeeding hoohah to begin with, if one *can*, but if you're already
in the midst of it for other reasons, yes, it *can* work out that someone else
doing one feeding can help.

To me, reducing the general complexity of my life, so that I had few decisions
to make and few things to worry about, was the number one thing that made me
better able to relax and enjoy my babies. I was fortunate to have a sister or
grandparent around for most of my twins' first month (in addition to my
husband), and that made a huge, huge difference. I didn't have to be The One In
Charge every minute, so it wasn't nearly as scary or stressful. On the other
hand, I didn't actually need to be separated from the babies much -- they
weren't overwhelming me, because I had help.

Of course true PPD can set in absolutely regardless of how perfect your
circumstances are, and everyone has moments of thinking, "Oh, my gawd, what
have I *done*, I must have been crazy to think I could do this ..."

--Helen


  #8  
Old December 9th 04, 07:55 PM
Anne Rogers
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Of course true PPD can set in absolutely regardless of how perfect your
circumstances are, and everyone has moments of thinking, "Oh, my gawd,
what
have I *done*, I must have been crazy to think I could do this ..."


yep, but you can delay its onset and make it less severe, I think
occassional pumping and occassional bottles was a helping factor for me last
time, however minimal it was, as my PPD turned out to be very severe, in
fact life threatening, so I'm out to do anything I can to prevent it, along
with anything I can do to help at crisis points, having a freezer stash is a
big insurance, there was more than one occassion when for whatever reason I
just could not be close to DS and breastfeed him, DH would feed him pumped
milk and bring me the pump, which was doable.


  #9  
Old December 9th 04, 08:40 PM
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I felt dizzy at around this time too. My blood pressure is on the low
side like yours and wondered whether this had anything to do with it.
Hydrating more and snacking helped me and I haven't had the problem
since. I was also anaemic so I don't know if that contributed.
Fiona
DS 33 months
EDD 7 March

  #10  
Old December 9th 04, 09:02 PM
Anne Rogers
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Were you breastfeeding him? I certainly found that nursing
helped me get back to sleep quickly. If I had to wake and *not*
nurse, I had a much harder time getting back to sleep--yay nursing
hormones ;-) But maybe the PPD interferes with that.


yes, at first the falling back asleep thing was easy, but one of the early
symptoms for me was not being able to get to sleep, so I would maybe get
2hrs total the whole night, that was the first symptom that I can put a
finger on, it took less than a week from there for things to be totally
disasterous


 




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