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Does postnatal depression affect your future fertility?

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Baby Blues

A new study has shown that postnatal depression may affect a woman’s future fertility, highlighting the need for more awareness and support for new mothers.

The birth of a child ought to be a time of great happiness for a new mother, especially if the path to motherhood has been a particularly long and difficult one.

For many women the experience is just that, with fatigue or frustration in the early days – sometimes referred to as ‘the baby blues’ – almost wholly offset by the irreplaceable bond that develops between mother and child.

But for one in 10 new mothers, childbirth is followed abruptly by postnatal, or postpartum depression (PND). This debilitating and frustrating mental illness can cause new mums serious difficulties, but beyond that, can also have a negative impact on future fertility.

“I’d read about the baby blues, but about six weeks after he was born I knew something wasn’t right,” says 34-year old Vicki, a personal trainer and mother to William, who is now four. “I was crying about 15 times a day and even the smallest tasks were overwhelming; I couldn’t be bothered to brush my teeth or shower, which is really unlike me. I just didn’t feel like me.”

After a very tearful visit to the doctor, Vicki was diagnosed with PND and prescribed the antidepressant medication The birth of a child ought to be a time of great happiness for a new mother, especially if the path to motherhood has been a particularly long and difficult one. For many women the experience is just that, with fatigue or frustration in the early days – sometimes referred to as ‘the baby blues’ – almost wholly offset by the irreplaceable bond that develops between mother and child.

But for one in 10 new mothers, childbirth is followed abruptly by postnatal, or postpartum depression (PND). This debilitating and frustrating mental illness can cause new mums serious difficulties, but beyond that, can also have a negative impact on future fertility.

“I’d read about the baby blues, but about six weeks after he was born I knew something wasn’t right,” says 34-year old Vicki, a personal trainer and mother to William, who is now four. “I was crying about 15 times a day and even the smallest tasks were overwhelming; I couldn’t be bothered to brush my teeth or shower, which is really unlike me. I just didn’t feel like me.”

After a very tearful visit to the doctor, Vicki was diagnosed with PND and prescribed the antidepressant medication ageing, where the median age of a country becomes older over time. This demographic change is mostly caused by women having fewer children, and can have significant social and economic consequences. Given that PND has a prevalence rate of around 13% in industrialised countries, with emotional distress occurring in up to 63% of mothers with infants, this research suggests that investing in screening and preventive measures to ensure good maternal mental health now may reduce costs and problems associated with an ageing population at a later stage.

For Vicki, her experience with PND has meant that though she longed for a second child, she found herself physically unable to begin the process, saying: “I was terrified it might happen again, hence why I’ve waited almost five years to get to the point where I could summon the belief that this was something I could do again.”

Whilst it has long been known that infertility can affect mental health, leading to feelings of anger, isolation and even full psychotic episodes, the idea that postnatal depression can affect fertility is less explored – let alone postnatal depression in men. It is not known exactly why PND would affect secondary or tertiary fertility but stress is commonly believed to make getting pregnant harder, in some cases even halting a woman’s ovulation entirely. The implication then that PND may be as traumatic as major birth complications would suggest that it is connected to anxiety.

It is thought that up to 15% of new mothers may experience some degree of PND, but health experts fear that it may actually be double that figure, given that many women suffer in silence.

The National Institute for Health and Clinical Excellence (NICE) states that new mothers should receive checks from a GP or a health visitor in the immediate weeks after the birth in an effort to assess the new mother’s emotional state and perspective on the challenges that lie ahead.

However, the stigma attached to PND prevents some women from speaking up about how they are feeling, with health experts renewing calls for more in-depth and detailed guidelines relating to maternal mental health so that practitioners may recognise the early symptoms.

This was the case for Danielle. At the age of 33, and having struggled to conceive, suffering multiple miscarriages along the way, she was swept under by a wave of postnatal depression shortly after the birth of daughter Flick. “I’d lost my mother to cancer in the weeks before Flick’s birth, and I think that made me particularly vulnerable,” she says.

“After being told by a midwife that my symptoms of depression would ease up after a few weeks, I was too afraid to mention the increasing sense of hopelessness that was enveloping me. I actually feared my daughter would be taken away. This may sound irrational, but as I have gone on to discover, it is actually a common misconception for mothers in the midst of depression.”

Lynne Murray, Professor of Psychology at the University of Reading, has this to say about the challenges new mothers face:

“Part of feeling depressed is that you feel guilty and you feel you’re a bad mother.

When you’ve had a baby, you probably have people coming up to you and saying, ‘Oh, it’s wonderful’, and expecting you to be on top of the world and functioning well.

“If you’re not feeling great, because depression is associated with feeling guilty anyway and low self-esteem, then that, coupled with people’s expectations that you should be functioning well, can make you feel even worse.”

The good news is there are plenty of treatments available now for both pre and postnatal depression, from the more traditional combination of medication and talking therapy to alternative options like meditation and reflexology, which can complement prescribed treatments.

Acupuncture has shown to be effective in easing the symptoms of depression during pregnancy and could help prevent the development into full PND. However, the absolute most important thing is that any woman gripped by PND gets the support and reassurance she needs.

For Danielle, who now has two daughters aged 13 and 11, it was Cognitive Behavioural

Therapy that she found most helpful in curing her depression: “I remember being quite cynical about CBT, but after a few sessions I started to feel confident again and that allowed me to open up to my friends and family, who I’d previously felt alienated from.”

It’s generally accepted that the roots of these problems take hold because most women don’t realise there is something wrong and subsequently mistake what is a serious illness for their own weakness.

Feeling disconnected from loved ones is a common symptom of most types of depression, and combined with such a life changing event it’s no wonder reaching out for help feels so hard.

“I have always been such a healthy and active person and that’s why I was so surprised when I felt so dreadful,” explains Vicki. “I felt like such a failure as a mother but also too proud to admit that I needed help. It was a friend of mine, also a mother, who noticed that I was behaving strangely and suggested I talk to a doctor.”

Vicki describes feeling a great sense of relief post-diagnosis, something not uncommon with depression sufferers, and it wasn’t long before she began getting back to her old routine. Simple things, from going for a long walk or meeting a friend for coffee, count as small actions that add up to a full recovery.

The big question is, how does this affect a woman’s approach to conceiving her second child?

“Whilst I was keen to start trying for my second child, I had the double anxiety that I would struggle to conceive and miscarry again, and then if successful, I would suffer from PND,” admits Danielle.

“In the end I was on holiday with my family in Australia and fell pregnant completely out of the blue. Thankfully everything was much easier second time around.”

Vicki is in the process of trying for her second child and says that for her, the biggest lesson has been learning to relinquish control. “I’m just trying to relax more from the get-go. I’ve started practising yoga and meditation… of course there’s no way of knowing exactly what triggers postpartum depression but having been through it before I’d like to think that this time I’d be able to recognise the symptoms quicker and get help.”

Postnatal depression is not a burden that new mothers ought to carry alone, and the more open we are about the subject, the easier it will be to support those who are suffering. From more training for health visitors to simply breaking down the taboo and protecting your future fertility, talking really is the best therapy.

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Good, Good, Good, Good Vibrations

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Good, Good, Good, Good Vibrations

Hi future mama,

We are coming up on the Thanksgiving holiday in the U.S. and though many of you are tuning in from all over the world and may not be celebrating this holiday; it’s still a good time to take stock of the things we are thankful for.

Unfortunately it’s our innate human survival response to focus on what’s going wrong versus what’s going right. The fight-or-flight response in our brains want to make sure we stay alive and so it is on heightened alert when we worry about the magical, “what if?”

What if it’s too late?
What if there’s something wrong with me?
What if we don’t have enough money?
What if I can’t heal my …. ?
What if IVF doesn’t work?
What if I can’t “figure it out?”

If you’ve been on this journey for any length of time, I’m sure you’re not a stranger to some of these thoughts. It sucks because they’re involuntary. Obviously we don’t WANT to think them, but we do.

Oddly enough if we worry it feels like we are doing something active; but of course from a Law of Attraction perspective, worrying only brings a match to more worrying. It’s so easy to go down the rabbit hole of worry and project our deepest fears into a future that hasn’t happened yet.

We aren’t really taught to focus on things going right. It feels irresponsible to the fight-or-flight part of the brain because- what if something falls through the cracks and we miss our chance? Or we just plain forget that there are things in our lives that ARE going right, because we are so consumed with the fear of ‘what if’.

The problem is that we can be looped in a cycle of fear and it can be really hard to pull yourself out of it. The more we try to force our way out of the loop, the more forcing it brings- and we can’t get out of it.

What does this mean for our bodies from a physiological perspective?

Thanks to the Law of Psychophysical Response, every positive thought creates a positive physical/chemical reaction in the body, and every negative thought creates a negative physical/chemical response in the body. So every time we replay a fear or past trauma, the body can’t tell if the trauma is happening in real time or is just being replayed mentally so the body responds as if it’s happening now. This keeps our fight or flight switch on because the brain perceives danger, and if the switch is on, the uterus is off. Not only is it not good for your mental state to keep replaying these fears and traumas, but it’s literally affecting your body too. This is not for you to go crazy being fearful that every thought you think is messing up your chances, it’s to bring awareness to your thoughts- awareness that despite what it feels like there is choice in what you think and what you become a match to. So just as with every negative thought, there’s a negative reaction in the body; so too with every positive thought there’s a positive reaction in the body. So your power is in choosing thoughts that feel better and being compassionate with your brain as it is rewired to think this way. It’s going to take time for it to be consistent, and we can’t go from gloom and doom to euphoria because we aren’t an energetic match to that.

A good way to begin to turn the tide and become more of a vibrational match to the energy and outcome you want is to establish some sort of gratitude practice.

Now let me be clear– being grateful for what IS going right now, is by no means a resignation that this is your life forever, that you don’t get to have your dream and you’re just going to have to deal with the scraps you feel life has given you.

On the contrary!

We cannot be in gratitude and fear at the same time. The energetic vibrations are too far apart. So being in gratitude at least momentarily lets us spend some time away from fear and feeling more peaceful.

Many of us think, “I’ll be so grateful when I get pregnant.” It sounds like a positive thought on the surface, but remember the universe doesn’t care what you’re saying– it’s hearing the energy that you’re putting out. So how that statement actually reads energetically is, “I’m not okay and I can’t be grateful until I’m pregnant, and I’m not pregnant so I can’t be grateful.”

When we are truly in the energy of gratitude for what is going right, we become an energetic match to being more grateful for more things going right. And truly, more things will start to go right- hence more gratitude!

When we are so consumed with Mission Baby, it’s hard to feel like anything is going right, but SO much is! From the epic, to the mundane, we all have things in our every day lives to be grateful for like:

  • supportive spouse
  • still getting a cycle
  • have a place to live
  • ate today
  • supportive family
  • have a job
  • it was nice out today

It’s so important for us to direct energy and awareness to what is going right so that we literally become a match to receiving more of it. Focusing on what you DON’T have, brings more of a match to you not having it. Focus on what you DO have and watch things change.

So what kind of gratitude practice are we talking about here?

    1. A gratitude journal. Get a cool looking journal that speaks to you (mine is leather with a Celtic tree of life embossed on it). Have it somewhere where you’ll see it every day. Each day write three things you’re grateful for/ or that went right today. It’s okay to have the same things on the list for several days, but really dig deep to some of the little or forgotten reasons. We all have so many. Commit to doing it for at least a month (preferably three months). Daily attention to gratitude and acknowledging support from the universe makes you a match to receiving more of it.
    2. If your spouse/partner is open to it, have a peak & valley discussion every night over dinner of before you go to bed. The valley is where you let your brain vent the thing that upsets you, and then the peak is the high point of your day. What happened that made you feel good today. It’s okay to start with things like – it was nice outside today, someone gave me their seat on the subway, I found a parking spot right away, a stranger complimented me, I had a really good sandwich for lunch, etc. Sometimes we have to start here first. That’s okay. The important thing is that we remind our brains that there are things going right all around us. Sometimes it helps our accountability to do this with our partner. If they’re not open, find a friend who you can text your peak and valley to- and maybe they’ll join you.
    3. A mini gratitude meditation. This is much simpler than it sounds and there’s no wrong way to do it. For example, you may want to sit with your eyes closed burning some sage or listen to soothing music. Take a few deep breaths, put one hand on your heart and begin to visualise one thing you’re grateful for. Deep inhale as you think of the thing you’re grateful for, and exhale as you say in out loud. Say each thing three times. Then sit in the feeling of gratitude (versus thinking gratitude), thank whatever your higher power is, and you’re done. This is something that can be done every day and doesn’t take more than five minutes but can be instrumental in shifting your energy.

Happy Thanksgiving to those who celebrate it and even if it’s not that holiday where you are in the world, take some time to sit in gratitude for the abundance and blessings you do have. There are so many. It’s a necessary step to move forward. Lots of love!

A’ndrea is a Reiki Master and Holistic Fertility Specialist and more information can be found on her website fusionfertility.com

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Rainbow Babies: Tips To Move Through The Joys, Fears And Tears Of Pregnancy After Loss

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Rainbow Babies

Congratulations! You’re pregnant! Everyone around you is excited except, perhaps, for you. Last time this happened and/or the time before that and/or the time before that, the pregnancy didn’t continue. You may have had a miscarriage, a stillbirth or a neonatal loss. You may have felt isolation, grief, anger.

In fact, you may have thought this pregnancy would resolve these feelings when, in fact, you’ve been noticing lately that they’re all still lurking in the background. To make matters worse, you may now be feeling petrified you’ll lose this baby too. Worry, fear and uncertainty are very commonly felt by pregnant people who’ve experienced a loss.

Here are some suggestions to help you move through the challenges and enjoy pregnancy again.

1) It was not your fault
Whatever happened last time, it was not your fault. Not all pregnancies are perfect. Not all births end up in live babies. You did your best. Shitty things happen. It was not your fault.

2) Choose the right health care provider
It’s normal to be emotionally vulnerable. It’s normal to feel anxiety. It’s normal to want a million extra appointments but then simultaneously feel like that high after your fourth ultrasound was too short-lived. It’s also normal to be happy.

Research suggests that pregnant people following a loss do better with care providers that respect their unique experiences. Most often, this can be found in a care provider that provides strong continuity. For some this is someone they’ve worked with in a previous pregnancy. Others prefer to start afresh. Good, consistent professional support that honours your individual experiences is not only important for your personal wellbeing but it also improves pregnancy outcomes.

3) Ask for what you need
After a loss, many people find the need for more personalised care to support them through their pregnancy and birth. If you think you need a more frequent schedule of visits for your own wellbeing, ask. If you want to know how to get reassurance in the middle of the night, ask. If you need them to start the appointment with a fetal heart rate check, ask. If you want an additional ultrasound for reassurance, ask. Take an active role in planning your pregnancy and birth. If you’re not finding your care providers responsive, ask to change to someone else. Research suggests that feeling a sense of control in your journey can help you enjoy your pregnancy again.

4) Build your community
After experiencing loss, it’s not uncommon to delay emotional involvement in a subsequent pregnancy and that’s okay. This is your pregnancy and your baby. You get to decide when you announce your pregnancy to the world. You get to decide how you feel about your baby. However, sometimes this valuable protective mechanism also deprives us of seeking necessary support. Many woman do not get adequate emotional and psychological support to deal with their feelings.

While you may be turning to your partner, he or she may also be processing the pregnancy differently, particularly at triggering times, for they are on their own journey of isolation, grief, anger. Bring those into your community who will be there for you when things are tough. Ask your care provider to connect you with someone who’s experienced loss. Consider seeing if there are any support groups in your area for folks who’ve had similar experiences to your own. Research suggests group support helps diminish feelings of isolation and allows for stronger relationships between partners moving forward.

5) Prepare for your rainbow baby
The vast majority of people who’ve experienced losses do go on to have healthy babies. We call them rainbow babies. For, they are the beautiful babies we welcome into the world after the storm that is loss. Just think: you’re pregnant with your rainbow baby! Find ways for you and your support people to celebrate milestones, even when you’re feeling fears to the contrary. Find ways to do the things that normalise, even if a bit of adaptation is necessary.

If you think you’d feel isolated attending a regular childbirth education class, sign up for a private one instead. Read positive books about pregnancy, childbirth and parenting. Do the silly things you always imagined you’d do. Be determined to maintain hope: your rainbow baby is on the horizon!

If you want to find more support you can contact Rishma via her website www.rishmawalji.com

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We Asked A Former IVF Patient What Is It Really Like To Go Through IVF?

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What's it really like to go through IVF

“What Is It Really Like To Go Through IVF…?” As a former IVF patient, it’s a question I have been asked frequently.

It’s a loaded question. Almost everyone knows that it can be a dark place for some, and a miracle for others. For me, there is no straightforward answer. So I decided to write my journey down in a metaphoric story as a way of explaining it…

Imagine you’re standing at the foot of a huge snowy mountain. The kind with jagged rocks and impenetrable inclines that makes you feel queasy looking up. It will take you months to climb and if you make it, the duration will take you through the seasons, changing you as a person along the way.

You’re prepared for the journey, it’s all you’ve thought about for months. You hold your personalised three-month plan in your hand. It’s oddly exciting. Milestones will have to be met along the way and you will need to pass all of them in order to progress. It’s all about you now, everyone who knows seems still, waiting for news.

Your positivity gets you going. You feel all zen-like with motherly instincts kicking in already. There’s baggage you have to carry uphill – let’s call it a 15-kilo backpack representing the weight of your parents’ dreams to become grandparents. You are weighted down by drugs too, brown paper bags filled with hormone pills, vitamins and vails for injections.

You crack on, shield up, sword outwards prepared to battle anyone who tries to knock you off the baby path to utopia. Thousands of woman have walked this trail before, and they made it just fine.

Let’s think about that utopia for a moment; imagine on the other side of this mountain is a life with a family. You catch a glimpse of another you. In this imaginary place, you are holding a tiny delicate version of yourself. You become someone else entirely responsible and in the process form a love that only real mothers can understand.

You have a mild sense of that, but it’s only imaginable at this stage. You aren’t quite there yet…

The climb begins and you stop for breaks, telling yourself that you are still strong, healthy, in control and age doesn’t mean a thing – even at 40 you feel 29. A routine begins to form and as you make progress you begin to allow yourself small treats of wonderings. You have a photocopy in your back pocket of the blastocyst – your baby in its most primitive form. What might my future look like if this works? Boy or girl?

The mountain gets snowy, some days it seems impassable. You wonder why you have to go to such lengths when others don’t have to. It’s unfair.

Climb, climb, climb…stab with needles.

Weariness takes over and your mood changes. You want to be alone. You don’t want to be alone. But you are alone. You fight yourself and enter into a new kind of torture, the torture of hope.

The control you thought you had is now out of your hands.

You are more than halfway there and have reached a critical stage. You feel like you’re winning. Everything is on schedule, you are doing what you are supposed to be doing. But it has become all-consuming and it’s taking its toll on your body.

Months pass by as you climb, climb, climb. “It will be worth it” is a mantra you find yourself saying over and over again the rockier it gets.

The path evens out, and even the weather casts a bright ray of sunshine on you. The top is nearing and it seems that unwavering positivity is driving you to the top. Mummy club here I come. You congratulate yourself and sit on a smooth rock to look at the utopia below before descending.

In an instant, you are cast from that sunny rock to your bathroom toilet peering at the pregnancy stick you just peed on. Three months to get to here.

It feels like all your efforts have been for nothing and with it, you tumble backwards, down the mountain. All the energy and drugs it has taken for your body to get this far has been wasted. You are a shell of who you were and as you tumble backwards your heart detaches from your chest.

At the bottom you sit bruised and exhausted, you feel you are a complete and utter failure. The grieving process for an embryo that never fully formed, begins. Why did my embryo not stick? Did I do something wrong? How do I tell the others?

This pilgrimage can only truly be understood by those who have hiked this mountain. When I meet other IVF couples there’s a silence that says it all. We’ve been there, our own silent war. But for some, the end goal is still worth persisting, no matter what it takes.

Personally – I have endured this journey five times and each time, I never made it even close to my utopia. The reality is that IVF is a lottery – almost impossible to win. I just hope that the next girl going up there is going to make it back down the other side.

Written by G.C.P

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