May is Maternal Mental Health Awareness Month...

May is Maternal Mental Health Awareness Month. Though we don't often hear a lot about mental health during pregnancy and the early postpartum period,  perinatal mental health issues (including postpartum depression, anxiety,  and other mood and thought disorders) are considered the most common complication of childbirth. Up to 20% of new moms will experience a significant mental health issue during pregnancy or in the first year postpartum. In honor of Maternal Mental Health Awareness Month, and all the moms and families out there who have experienced perinatal mental health issues, here is some information that could help you, or someone you know.

• Mental health issues don't always start after baby is born. Many women first experience mental health issues during pregnancy. Moms with a history of mental health issues are more likely to experience a perinatal mood disorder, but even moms with no history are at increased risk during the childbearing year.

• Postpartum Depression is not the only mood disorder affecting new moms. While up to 15% of new moms experience postpartum depression, 6-10% experience pregnancy and postpartum anxiety disorders, and some moms experience postpartum OCD, PTSD, or bipolar mood disorders. Postpartum anxiety can look very different from postpartum depression. Instead of exhibiting low mood or sadness, moms with anxiety may seem very alert, worried, and panicked.

• Postpartum psychosis, a rare, but very serious illness, affects less than 1% of new moms. Despite what you may see on TV, postpartum psychosis, in which moms experience delusions or hallucinations, is very rare. It is however, always an emergency if a mom is experiencing these symptoms and immediate treatment is important.

• There are a wide variety of treatment options that can help mood and anxiety disorders get better.   For some women increased self-care and social support may be enough to see a reduction in symptoms. For others talk therapy may be the best option. Some women may to use medication to see a reduction of symptoms. Luckily, there are many safe medication options for women who may be breastfeeding.

• Postpartum mood disorders don't only affect new moms. Having a baby is an important adjustment for everyone in the family. It is estimated that up to 10% of new dads may experience postpartum mood or anxiety disorders as well. It is important that anyone experiencing symptoms  for more than two weeks gets help, since it won't just go away on its own.

• Some great online resources to learn more or to find help:
• Postpartum Support International: www.postpartum.net
• Postpartum Progress: www.postpartumprogress.com

2014 Annual Report is Now Available!

Lamaze Family Center Ann Arbor's 2014 Annual Report is now available. Click here to read the full report. Thanks to all of the families, businesses, and friends who made 2014 such a great year for us. We feel honored to work with so many families and their little ones!

Doulas are awesome, but not magic...

By Elizabeth Satterley, LCCE, CD(DONA)

There has been a ton of good press about doulas in recent months.  Bastions of baby info like Parenting and Baby Center, as well as more mainstream news sources such as The Huffington Post and  New York Times are all touting the benefits of having a doula at your birth.  What is a birth doula, you ask? A birth doula is a professional labor support person who provide physical, emotional and informative support throughout labor.  They are extra hands and calm hearts in the labor room.  They do not provide any clinical care like OBs, midwives or nurses.  They help with positions and comfort measures to cope with pain, they provide a cheering section and commiseration when needed and they help families get the information they need to be empowered to make informed decisions for their birth. They are possibly the one face you recognize continuously throughout your labor experience. They are awesome, but they are not magic.


I love doulas.  Let me just say that up front.  I had doulas (yes, multiple) at both of my own births.  I work closely with doulas in many capacities of my multiple jobs.  And, oh yeah, I'm a certified birth doula with DONA International. I have been blessed to attend 40 births over that last 8 years and I could not be more proud of the work I have done.  By and large, I have received thanks and praise from the families I have worked with and it touches me deeply to hear that these families value my support in their journey to parenthood. That said,  I am not magic.

Let me explain.  There is tons of great research coming out these days that shows the value of having a doula attend your birth.  There are very credible research studies that show the value of the type of support doulas provide.  In one particular study in the Cochrane Review doula support shows fewer inductions, less use of pain medications, shorter labors, less cesarean births, fewer instrumental vaginal deliveries and healthier babies.  This study goes on to state that there are no risks to doula support and that all women should have continuous support throughout labor and birth.  In another, newer study in the American Journal of Managed Care shows a 60-80% reduction in likelihood of a cesarean birth if a doula is there for support.  Finally, even the American College of Obstetricians and Gynecologists (ACOG) and Society for Maternal-Fetal Medicine (SMFM) in an Obstetric Care Consensus named doula support as "one of the most effective tools to improve labor and delivery outcomes."  This is amazing press and evidence-based back up for what doulas do.  Support in labor helps.  It helps health outcomes and, it stands to reason, helps emotional outcomes as well.  Women and families have the opportunity to improve their birth experience with a doula present.  But, they are not magic.

 Ok, doulas do sound magic.  I get it.  All this research shows how helpful they can be.  It sounds like they can make the potentially scary hospital a more welcoming place.  It also sounds like they can make that labor pain you've been hearing so much about (or possibly dreading on this, your second or third time around) disappear.  It sounds like they are your ticket out of the OR.  The truth is, you are and can do those things.  The doula cannot make you choose the right care provider, they cannot make you ask questions of your doctors, midwives and nurses so you understand what they are recommending.  They cannot magically eliminate labor pain with a smile and wave of a cold pack.  They cannot force you into a position that will help move this labor along when you are so tired you just want to quit. You and your partner do those things.  We can suggest, we can present options, we can massage, we can cheer for you, we can cry with you but YOU make all the calls. The doula is just an extension of your choices and wants for your birth.  We are there to help boost all those things to the next level, but if you change your mind, we move with that and support your new choices.


I sometimes worry that some women and families see us as the panacea for all things scary in labor.  I know that every mom I've worked with was capable of having a good birth without my help.  I also know that I could have had my babies my way without those doulas present.  I also know that the doulas present at my births made it easier to do it.  I hope that I did that for my clients too.  It is not to the doula's credit that a family avoided a cesarean or pain medication, it is to that family's credit.  Sometimes mom needs an induction. Sometimes I can't make all the pain go away (thank you, back labor ) and mom really needs pain meds. Sometimes my families still have a cesarean birth after hours of work.  Birth is crazy and cool and a miracle every time, but we never know what we are going to get and sometimes, despite all efforts on everyone's part, we don't get what we planned.  A doula is there to help cope with these little twists and turns in the road, not to keep you on the one straight path.  You choose the path, your doula will do her best to make that path smoother. 


So, we are not magic.  We can't wave a wand and make your birth happen how you are picturing it. We will do everything we can to support your decisions and choices and ease your pain and relax you so that you can make the best decisions for you and your baby. We can't do it for you but we can do it with you.  Mom, you are magic.  You can do this!  But we would love to be there to help.

Welcome 2015 and a Recap of 2014!

As we welcome 2015, here's a link to a great summary of advances made in the world of maternal care
in 2014.
Some highlights include:

• A focus on the high rate of primary C-sections and some rethinking about "normal" labor patterns and progress. New guidelines for the stages of labor have been incorporated into all of our childbirth classes.

• For those families who do undergo cesarean sections, there has been increasing focus on "family centered" cesareans. Hospitals that offer family centered cesareans try to make cesarean births more respectful of families physical and emotional needs. This can include things like immediate skin to skin contact in the operating room when appropriate, involving partners in traditional birth rituals like cutting the cord, and having music of the mother's choice playing during surgery.

• A research study in the journal Birth, which found that use of non-pharmacologic pain management (i.e. the comfort measures and labor positions taught in our childbirth classes) reduces the need for medical interventions during labor and delivery. 

• Increased focus on the importance of the human microbiome and the impact that the increase in cesarean births may have on infant gut bacteria colonization.

We can't wait to see what 2015 brings!