Tag Archive | woman

Depression in Pregnancy

Depression occurs almost as commonly in pregnant women as it does in non-pregnant women. While the increase in hormones is often blamed for many of the mood swings and other emotional and psychological occurrences in pregnancy, they are only one part of the puzzle when it comes to pregnancy and depression. For some women the stress of pregnancy brings on depressive symptoms, even when the pregnancy is planned. These feeling might intensify if the pregnancy is complicated or unplanned, or if life itself is stressful.

What factors increase my risk of being depressed in pregnancy?
• Having a history of depression or PMDD
• Age at time of pregnancy — the younger you are, the higher the risk
• Living alone
• Limited social support
• Marital conflict
• Ambivalence about the pregnancy

What is the impact of depression on pregnancy?
Depression can interfere with a woman’s ability to care for herself during her pregnancy. You may be less able to follow health recommendations, and sleep and eat properly; jeopardizing proper nutrition, sleep habits, exercise and following prenatal care instructions from your healthcare provider. Depression can put you at risk for increased use of substances that have a negative impact on pregnancy (tobacco, alcohol, illegal drugs).

Depression may interfere with your ability to bond with your growing baby. A baby in the womb is able to recognize the mother’s voice and sense emotion by pitch, rhythm and stress. Pregnant women with depression may find it difficult to develop this bond and feel emotionally isolated and detached from their unborn child.

Many of the signs of depression can mimic pregnancy symptoms. It can be hard to determine what is normal fatigue in pregnancy and what is depression. This can lead to an underreporting of the problem to their healthcare provider. There is also a tendency of people to ignore depression in pregnancy simply because this is supposed to be “a happy time in their life,” and this includes the pregnant woman herself.

Signs of Depression
• Problems concentrating
• Problems with sleeping
• Fatigue
• Changes in eating habits
• Feeling anxious
• Irritability
• Feeling blue

How does pregnancy impact depression?
• The stresses of pregnancy can cause depression or a recurrence or worsening of depression symptoms.
• Depression during pregnancy can place you at risk for having an episode of depression after birth (postpartum depression).

Are there any other things I should know about?
Treatment during pregnancy involves several avenues. Developing your support network is extremely valuable. Having yourself surrounded by supportive individuals that you know can be beneficial, particularly if they have experienced the same feelings. Talking to a professional or psychotherapist can be very helpful, particularly since there are major physical, mental and emotional changes occurring during pregnancy. Medications can also be used during pregnancy under the care of a practitioner who has experience with using antidepressants and other medications during the course of pregnancy and breastfeeding.

So what are my options if I’m depressed during my pregnancy?
• Preparing for a new baby is lots of hard work, but your health should come first. Resist the urge to get everything done — cut down on your chores and do those things that will help you to relax. And remember, taking care of yourself is an essential part of taking care of your unborn child.
• Talking about the things that concern you is very important. Talk to your friends, your partner, and your family. If you ask for support, you’ll find that you often get it. If you are not finding relief from anxiety and depression by making these changes, seek your doctor’s advice or a referral to a mental health professional.

The key to preventing problems that stem from depression in pregnancy, which may also increase the likelihood of postpartum depression, is getting the support and help you need as soon as you realize that you are experiencing a problem. With more than two out of three pregnant women having depressive symptoms it’s important to recognize that you are not alone and that help is available. Talk to your healthcare provider if you are in need of help. Be open and honest with your concerns and realize there is help.

Angel J. Miller, MSN, CNM

Group B Strep in Pregnancy: Frequently Asked Questions

1. What is Group B Strep (GBS)?
GBS is one of many common bacteria that live in the human body without causing harm in healthy people. GBS develops in the intestine from time-to-time, so sometimes it is present and sometimes it is not. Group B Strep or GBS can be found in the intestine, rectum, and vagina in about 2 of every 10 pregnant women near the time of birth. GBS is NOT a sexually transmitted disease, and it does not cause discharge, or itching. Unfortunately, it can cause a bladder/urinary tract infection.

2. How Does GBS Cause Infection?
At the time of birth, babies are exposed to the GBS bacteria if it is present in the vagina, which can result in pneumonia or a blood infection. Full-term babies who are born to moms who carry GBS in the vagina at the time of birth have a 1 in 200 chance of getting sick from GBS during the first few days after being born. Occasionally, moms can also get a postpartum infection in the uterus.

3. How Do You Know if You Have GBS?
Around your 35th to 36th week, during a regular prenatal visit, your healthcare provider will collect a sample by touching the outer part of your vagina and just inside the anus with a sterile Q-tip. If GBS grows in the culture that is sent to the lab from that Q-tip sample, your provider will make a note in your chart, and you will be notified at your next prenatal visit that you are GBS positive, The GBS protocol for a positive culture will be discussed at your next visit with your healthcare provider and the expectations of care when you are in labor.

4. How Can Infection from GBS Be Prevented if My Culture is Positive?
If your GBS culture is positive within 4 to 5 weeks before you give birth, your healthcare provider will recommend that you receive antibiotics during labor. GBS is very sensitive to antibiotics (penicillin or penicillin family) and is easily removed from the vagina. A few intravenous doses given up to 4 hours before birth almost always prevents your baby from picking up the bacteria during the birth. It is important to remember that GBS is typically not harmful to you or your baby before you are in labor.

5. Do You Have to Wait for Labor to Take the Antibiotics?
Although GBS is easy to remove from the vagina, it is not easy to remove from the intestine where it lives normally and without harm to you. Although GBS is not dangerous to you or your baby before birth, if you take antibiotics before you are in labor, GBS will return to the vagina from the intestine, as soon as you stop taking the medication. Therefore, it is best to take penicillin during labor when it can best help you and your baby. The one exception is that, occasionally, GBS can cause a urinary tract infection during pregnancy. If you get a urinary tract infection, it should be treated at the time it is diagnosed, and then you should receive antibiotics again when you are in labor.

6. How Will We Know if Your Baby Is Infected?
Babies who get sick from infection with GBS almost always do so in the first 24 hours after birth. Symptoms include difficulty with breathing (including grunting or having poor color), problems maintaining temperature (too cold or too hot), or extreme sleepiness that interferes with nursing.

7. What Is the Treatment for a Baby with GBS Infection?
If the infection is caught early and your baby is full-term, most babies will completely recover with intravenous antibiotic treatment. Of the babies who get sick, about one in six can have serious complications. Some very seriously ill babies will die. In the large majority of cases if you carry GBS in the vagina at the time of birth and if you are given intravenous antibiotics in labor, the risk of your baby getting sick is 1 in 4,000.

8. What If You Are Allergic to Penicillin?
Penicillin or a penicillin-type medication is the antibiotic recommended for preventing GBS infection. Women who carry GBS at the time of birth and who are allergic to penicillin can receive different antibiotics during labor. Be sure to tell your healthcare provider if you are allergic to penicillin and what symptoms you had when you got that allergic reaction. If your penicillin allergy is mild, you will be offered one type of antibiotic, and if it is severe, you will be offered a different one.

Provided by Angel J. Miller, MSN, CNM