By: Dr. Tanya Cotler, Clinical Psychologist
Don’t tell but I had that awful daydream again: New moms and scary thoughts.“ Every time I would descend a stairwell with baby Nila* I imagined falling with her. The day nightmare changes – sometimes I fall on her, or she cracks her head. Sometimes I just shake my head to make the ugly thought go away. ”Molly* sat in front of me curled in a ball , half hiding her face as she slowly shared with me the “day nightmares” she’d been referencing for several weeks in therapy but had been frightened to share. As I sat and listened, Molly’s body slowly unfolded out of its contorted shape and relaxed a bit more into the seat. She shared that she expected my face to be horrified, and opened up about her fear that if she let anyone know the scary thoughts she was having then they would be horrified or maybe worse actually take her baby away. I helped Molly label these thoughts- they are intrusive thoughts- they are uninvited and come on their own without invitation and indeed can be quite disturbing, but, they are actually quite normal.
As new mothers the idea of being solely responsible for the well being and protection of a precious new little life can be quite overwhelming and indeed anxiety provoking and therefore intrusive thoughts are quite normal and common. These thoughts are a common way for the human mind to test out scenarios especially when it’s an issue of importance or the person is in a state of increased anxiety. Well, here we are new mom (common increased anxiety) and something she cares about (clearly it’s her baby) and so intrusive thoughts show up.
Donald Winnicott, a prominent English pediatrician and psychoanalyst, coined the term “maternal preoccupation” to describe the early mental process when a mothers mind is constantly focused on her baby. He depicted the optimal “holding” environment for a new baby to thrive as one in which the mother is psychically and physically present for the infant’s needs. That is, just as a new mother is constantly physically occupied with her newborn baby’s needs (diaper, feed, nap repeat!), so too is her mind constantly occupied by nap times, feed times, and concerns over baby‘s physical and emotional safety and health. Winnicott explained that the mother’s mental preoccupation, and sensitive responding to baby, facilitates the building of a secure attachment bond which is grounded in mom and babe tuning in to one another’s feelings, thoughts and behaviors. Moreover, there is now scientific evidence to support the normalcy of maternal preoccupation. There are brain changes such as changes in grey matter, that occur in most women post partum. These changes help the mother to be increasingly empathic toward her baby’s experience, while devoting less “brain space” to other trivial stuff like memories of what was for dinner the day before (Insert “mommy brain experience” here).
Despite worrying being part of a normal maternal mental process, at times this experience of preoccupation can also cause a mother undue distress. A mother may feel her mind is unrelenting with thoughts of baby’s well being or she may constantly obsess over bad things happening. When the anxiety feels inescapable, even the most basic decision making becomes difficult. For many this is exacerbated by the information overload and constant opinions from well meaning friends, family (and strangers in grocery lines!). When the scary thoughts feel all consuming and interfere with daily functioning or when a mother starts to develop behaviors to attempt to ward off the “bad” from happening, then it’s possible the mom is struggling with postpartum anxiety or post partum OCD. Indeed, If a new mother finds herself wondering whether her worries and scary thoughts are too much, or she struggles to know what is real or not real, then it is very important to seek professional opinion and support. A mother should not feel alone and plagued by these thoughts.
Indeed, it is common to avoid seeking advice or support because the constant worry and anxiety feels embarrassing or shameful. The problem is that shame over scary thoughts, perceiving them as dangerous and unacceptable, or as evidence of being a bad mother, can make these thoughts even more pervasive. That is, the secrecy and shame increases feelings of sadness, loneliness and guilt which perpetuates the scary thoughts themselves. Alternatively, sharing these thoughts with a trusted friend, family member or professional may help with tolerating and accepting the dichotomy of emotional experience in motherhood- the love and hate, happiness and sadness, anxiety and calm. The goal when experiencing these scary thoughts is to be able to notice these thoughts, acknowledge them, and then let them go.
A word on trauma: if a new mother has experienced an overwhelming, incomprehensible and devastating psychological experience (be it in childhood, throughout her lifespan, in pregnancy or previous pregnancies, or in labor or birth), scary thoughts can emerge as a fear of the experience reoccurring or as a fear of something else uncontrollable happening. Like a lighthouse, the mind starts to scan the environment for the next ship- the next bad thing- as if catching it before it happens will keep her safe. This form of “hypervigilance” gives power to the scary thought: it’s the belief that the mother is protecting herself or her baby by obsessing/not taking her mind off of the bad that may happen. If you are worried about how a difficult experience has affected you – and wonder if you are reacting to it or if your scary thoughts are connected to it, talking to a professional is really important and you deserve the support.
The important take home? If you would like to consult a professional about your experience of worries and scary thoughts post partum, you should always feel you can. It may be normal to worry as a new mom, but you should never be suffering in your worries. If you do not know where to turn, you can always look at PSI (post partum support international) for a list of professionals trained in perinatal mental health in your area. You are not – and should not- feel alone.
For further information or to contact the author
Dr. Tanya Cotler
This month we thought we would introduce you to the world of Osteopathy. Osteopathy is a non-invasive manual therapy that works on the muscles, joints and spine to enhance your body’s natural health. In other words, an osteopath will stretch your body for you, allowing the muscles and joints to move more freely.
What can it treat?
Ok, ok, we’ll be a bit more specific. Osteopathy is great at treating any and all sports related injuries as well as that chronic pain (read headache) that just doesn’t seem to go away.But beyond that osteopathy can help those things you may not think about when it comes to manual therapies. Our osteopath Marine is able to treat things such as insomnia, gastrointestinal problems and varicose veins! Definitely something to look into!
By Amy Gildner
And for all you breastfeeding Moms out there- Marine has techniques that could help stimulate milk production! To me, this sounds much better than downing Domperidone and Fenugreek!So if any of this sounds like something you might need help with book with Marine today!She is available on:
Wednesdays 8:30am-12pm, 3:30pm-7pm
What is Pelvic Floor Physiotherapy?
Physiotherapy is a holistic healthcare profession that aims to help those affected by injury, illness or disability. Physiotherapists specialize in the assessment, diagnosis, and treatment of a variety of neurological, orthopedic, and cardiorespiratory conditions. In Ontario, individuals can see physiotherapists without a doctor’s referral.
Pelvic floor physiotherapy is the assessment and treatment of various conditions including, but not limited to, conditions of the muscles, bones, connective tissues, and ligaments surrounding the pelvis. This is a specialty within the physiotherapy profession, and is conducted by registered physiotherapists who have also undergone further education.
A typical initial appointment will include a detailed internal and external examination of your pelvis, a discussion of the findings as well as a possible treatment plan specifically tailored to your needs. This treatment may include additional internal pelvic floor therapy, bladder retraining, stretching, and strengthening techniques.
Why is Pelvic Floor Physiotherapy so important?
As women, our bodies can end up going through a lot. In addition to the maintenance of overall health and strength, pelvic floor health is equally as important, especially pre- & postpartum. Some conditions that can be treated through pelvic floor physiotherapy include:
- Vaginal pain
- Urinary incontinence
- Pain during sex
- Pelvic organ prolapse
- Low back pain
- Sacroiliac pain
- Piriformis syndrome/sciatica
Contact the clinic to find out more information!
By Dr. Elisa Petricca
A healthy mom translates into a healthy baby. So why not do everything you can to have a safe, healthy and natural pregnancy!?
This post focuses on educating pregnant mum’s on how to prepare for the birthing process and the value of chiropractic care during pregnancy. A pregnant woman who trusts her body to do what it is naturally designed to do is much more likely to experience a healthy, natural birth than someone who is stressed and fearful. The brain responds to fearful emotions negatively during pregnancy, releasing hormones that can slow labour and dilation.
How to Prepare for Birth
Scientific research strongly suggests the following principles for a natural and healthy pregnancy and birth:
- A fully functional nervous system: This is essential to assist the body in adapting to stressors associated with pregnancy and support development to the baby.
- Proper dietary intake: This is required for optimal fetal development.
- Movement and exercise: This will encourage optimal brain and cell function, hormonal balance, strength and mobility.
- Positive thoughts and emotions.
- A nurturing environment: It is important to be surrounded by loving and supportive relationships to help minimize stress and create an optimal environment fir a relaxed birth.
- A birth support team: Comprised of loved ones and health professionals to assist in a natural birth.
The Value of Chiropractic Care
Chiropractic care during pregnancy is vital in supporting normal and physiological function of mom and baby. Chiropractic care can help with pregnancy and birth by:
- Reducing interference to the mother’s nervous system, allowing for optimal function.
- Helping to create balance in the pelvis, allowing for an easier birth.
- Removing tension on the ligaments that support the uterus.
- Decreasing the potential for interventions and increasing the potential for a natural birth.
How does chiropractic care support the developing infant?
- Encourages optimal infant development by removing interference from the mother’s nervous system.
- Helps to create more room in the uterus, allowing baby to move and develop without restriction. This allows the baby to move into the best possible position for birth.
- Regular adjustments greatly reduce the possibility of dystocia (delayed birth) as well as birth trauma that can be caused by intervention.
What are the main things you should take away from this whole article?
- Chiropractic provides structural balance and stability (specifically in the pelvis) for the mother, resulting in a more comfortable pregnancy.
- Research has shown that pregnant mothers who receive regular chiropractic care throughout their pregnancy generally have a shorter labour with less medical intervention.
- Chiropractic care throughout pregnancy can help to create a healthier and more comfortable in-utero environment for the infant.
From the moment your child enters the world their cranium, spine and nervous system undergo trauma, starting with the birth process. A baby goes through much exertion when travelling through the birth canal and even during a C-section they are removed from their environment suddenly which can cause trauma as well. As your child matures and engages in various activities of life they will continue to experience spinal and cranial subluxations, which put massive pressure on the nervous system and the body’s ability to function properly. Early in life, these subluxations, or misalignments in the spine, can lead to a host of symptoms ranging from minor discomfort, trouble with feeding and digestion, ear infections, colic and decreased immune system function. When left untreated, these can become chronic pain and headaches and much more in adults.
Many chiropractors and other medical professionals believe that the trauma of birth can contribute to infant issues such as colic and acid reflux. An article published in “Paediatric, Maternal and Family Health” in 2009 written by Dr. Erin Ulster found that symptoms of colic and acid reflux could be resolved with chiropractic treatment. Dr Ulster notes: “These results suggest a causal link between birth trauma, upper cervical injury, and colic / acid reflux onset. Correcting the injury to the upper cervical spine (with chiropractic adjustments) appears to eliminate colic and acid reflux.”
If your infant is suffering from symptoms of colic and acid reflux a Chiropractor will assess your baby and ascertain if subluxations are causing issue for your baby. A Chiropractor focuses on misalignments in your baby’s spine that can impair your baby’s overall nervous system. Chiropractic adjustments can help to restore proper function to the nervous system allowing the body to work properly again.
Symptoms of Subluxations
Because an infant is unable to express its issues verbally, you can watch for a few signs that may indicate necessity of a chiropractic examination to determine whether a subluxation is responsible:
- If your baby is constantly tilting their head to one side
- If they seem to have restricted head movement favouring one side
- If your baby cannot sleep without disturbance every hour or two
- If your infant is unable to breastfeed or has difficulty doing so
- If your infant has difficulty breastfeeding at one breast or the other
- If your baby often arches back
- If your baby tugs on one ear lobe often
- If your baby is very gassy or difficult to soothe
- If your baby has flat spots or very prominent bumps on the skull
As your child matures there are many symptoms that can point to spinal subluxation and nervous system stress, such as:
- Recurring earaches
- Recurring sore throats
- Complaints of headaches
- Complaints of growing pains
- Clumsiness or frequent falls
- Trouble with gait
Your baby will continue to exert themselves as they progress and learn to lift their heads, sit and crawl and of course toddlers undergo daily challenges as they learn to walk falling roughly several times a day. Learning to skate, playing sports, wearing heavy back packs, and falls during play can all cause spinal subluxations or misalignments. Even normal growth and development can be an adjustment to the body. As such, it is important that children continue to have regular care throughout childhood to improve the body’s ability to deal with these stresses and develop to their greatest potential.
A visit to your Chiropractor will allow your child to undergo an assessment early in life and any misalignments can be corrected before they can cause issues into adulthood.
Recent news has made the disconcerting report that women often have misguided ideas about their caloric requirements during pregnancy.
The findings of numerous studies continue to prove that moms-to-be need to be careful about what they’re eating and avoid some dangerous behaviours like over-indulging their cravings. Why? Because what you eat can directly affect the development of your child, in both the fetal stage and infancy.
For example, research shows that women who eat a higher sugar diet may have bigger babies. The sugar consumption triggers the baby to produce more insulin, which in turn promotes growth.
The reason for this- and one of the key “takeaways” from this article- is the fact that everything in a mother’s diet has a collective impact on her child’s development. While medical science used to believe that the placenta could filter out unwanted or unneeded nutrients, we now know this isn’t the case. So when a pregnant woman chooses to eat things that are high in sugar and low in nutritional value, those decisions are also being made for her child. And when these decisions are made consistently, your baby’s body will react and develop accordingly. A poor prenatal diet can even affect the infant’s eventual likelihood of developing chronic disease.
The nutrients that babies feed on and physically process in the womb also help determine the types of cravings they’ll have in infancy, because the mother’s diet shapes her baby’s sensitivity and receptiveness to certain tastes. So skip the sugar and greasy, processed foods. Make it a strict habit to exercise dietary balance, high nutrient density, and moderation.
Yes, moderation. As the article points out, it’s important to understand what it means to be “eating for two.” This is a misleading expression because the volume of food you need to consume while pregnant is never going to double. In fact the view that pregnancy is a time to “let go” contributes to the problem of compromised fetal nutrition. When women eat empty calories, avoid exercise, and indulge repeatedly in high-sugar, high-sodium or high-fat food cravings, their pregnancy weight gain begins to exceed the targeted and healthy range of 25 to 35 pounds.
Of course pregnancies are subjective and body weight, nutritional needs, and gestational health concerns vary. However, understanding your personal needs is a good place to start. Consult Health Canada’s pregnancy weight gain guide, set up a diet plan based on your own cravings and aversions, and try to remind yourself that the right combination of nutrition knowledge and discipline could go a long way in keeping your child healthy.
Often when women think about labour prep they think about things like pain management, positions, and breathing techniques. One critical thing that can be easily overlooked is fuel! Giving birth is an enormous physical undertaking that will demand endurance and strength. As such, it requires that you prepare as you would for any other event: by fueling your body to succeed.
Now, of course you can’t eat throughout the entire labour and birthing process for a number of reasons. In the event of emergency medical intervention for example, general anesthetic requires that you have an empty stomach to avoid the risk of regurgitating food.
Secondly, as labour progresses many women simply don’t feel like eating. And lastly, once you have an epidural you aren’t able to eat or drink. Even with any one of these scenarios in mind, it’s still very important to be mindful of your physical needs pre-labour and in early labour. Here are some general tips that will help you stay nutritionally equipped for birth.
1. Fuel up in the final days: Toward the end of your pregnancy, stay vigilant about your eating habits. Make sure you’re getting enough carbohydrates and proteins and rest as much as possible. This will allow your body to store glycogen to provide you with energy throughout labour and to prevent ketosis. Eat up to store up: Birth is a major event that will require plenty of strength!
2. Safe snacking during labour: In early labour, choose dry carbohydrates for the slow release of energy over the hours to come. If you can add some protein to the mix, do so. Snack suggestions include bananas, dates, yogurt and crackers. Avoid big meals in case of nausea and vomiting during labour.
3. Listen to your body: So much is happening during labour that you might find yourself solely tuned into the heart rate monitor and contractions, forgetting to properly address hunger and thirst. But remember that taking care of yourself is important so that you have the energy to push. Between contractions- especially in the early stages- stop and assess. Are you feeling nourished? Hydrated? Do you have supplies like water and sports drinks nearby?
4. Hydrate. Many women get thirsty during labour and you might find that your delivery room is extremely warm for the baby. Quench your thirst and cool yourself down with plenty of cold water or natural juice. Isotonic beverages are great too, as these will replace your electrolytes and absorb quickly. If you’re not able to eat during a long labour, these sports drinks can help keep your energy up.
5. Check with other moms. Ask around and see how far into labour other moms kept snacking, or how soon before contractions they had their last pre-birth meal. Check out registered dietician and blogger Kath Younger’s pre-labour breakfast here, and her full birth story here. She started labour with a full bowl of oatmeal, nuts and fruits, and later snacked on dates, banana slices with peanut butter, and coconut water. On her blog she notes at the start of labour “There’s no way I can do this hungry!”
As the arrival of your baby approaches, you’ll need to modify your diet according to many variables: the length of your labour, the wait time until you hit active labour, and the type of medication you use (if any). Whatever your birth plan, remember to have some fuel on-hand during the final weeks of your pregnancy!
One of the most overwhelmingly common first-trimester symptoms among pregnant women is –as we all know- morning sickness. The degree to which women experience nausea and vomiting will vary, not only woman to woman, but also from pregnancy to pregnancy. Some women will experience severe and intense morning sickness during their first pregnancy and milder, shorter-term nausea the second or third time around. This can make it hard to predict what your palate will and will not tolerate, at a time in your life when your health and nutrition are critical.
So what’s the deal with morning sickness?
When you get pregnant, your hormones peak. Estrogen and hCG begin to circulate in your bloodstream, and they’re at their highest concentration during the first three months. These hormones are believed to take the lion’s share of responsibility for triggering nausea, but evidence shows that other lifestyle factors can sometimes exacerbate pregnancy side effects as well, like stress, an empty stomach and fatigue.
While “morning sickness” is the term we often use for nausea and vomiting during early pregnancy, these symptoms can strike at any time of day, and certainly don’t encompass all symptoms (as anyone who has been through a pregnancy already knows). Heartburn, exhaustion, cravings and aversions can all affect nutrition and appetite as well.
What if I’m not eating enough (or keeping enough down?)
Naturally nutrition is a major worry for women who suffer from intense and prolonged nausea and vomiting. Sometimes women will even lose weight during the first 12 weeks of pregnancy, which can be very alarming, especially for a first time mom. The good news is that in the initial weeks of pregnancy, your baby is getting most of his or her nourishment from nutrients already stored in your uterus.
Still, the full course of a pregnancy places completely new and important nutritional demands on the expectant mother. Here are some ways to ensure that your body is getting the nourishment it needs to take you and your baby through a healthy pregnancy.
Get plenty of sleep: If you have any opportunity to adjust your sleep patterns to cover your typical bouts of nausea, go for it! If you’re consistently nauseous at 7am, try going to bed later and sleeping until 8. If you get hit with morning sickness every day at 10am, plan for a snack and a nap at 9:30. For most women however, this isn’t an option- either because symptoms are too severe to sleep through, or because work and other commitments prevent so much rescheduling. In this case- sleep when you can. If you can take a 30 minute nap before dinner, do it. If you can get to bed earlier in the evenings, do it. Feeling overtired can sometimes make nausea feel even worse.
Avoid triggers: Since pregnancy nausea is often triggered by foods and smells, over time you may be able to identify the foods that consistently make you recoil. This can be difficult if you’re experiencing many different cravings and aversions. If it feels like a different food is setting you off each day, try keeping a “trigger” log. Monitor these foods for patterns or a common thread that you may have overlooked –are the turn-off foods primarily from one food group? Are they all breakfast foods? Do they have a similar texture? These might clue you in to some useful and consistent aversion factors.
Check with a health practitioner about herbal solutions. Always consult before taking a herbal course of action, but many remedies have proven effective at combating negative pregnancy side effects. These include ginger, elm bark and mint.
Supplement your diet with shakes, vitamins, or nutritional supplements. Again, make sure you consult with a health practitioner if you plan to take supplements. However, if you know you’re short on protein or vitamins from your diet, toss some ingredients into the blender or juicer.
Keep snacks on hand- Choose something dry and bland like crackers or dry cereal. Sometimes when women wake up they find that eating something immediately can help to offset nausea. Avoid any snacks that are heavy or flavourful. Keep it boring until the hormone-storm settles!
Hydrate. To make up for lost fluids, make sure that you drink plenty of water. Hydration is critical when you’re pregnant, and it helps to facilitate the absorption of nutrients to the fetus. Drinking lots of fresh water can also help to reduce swelling and retention.
Part of the challenge of meeting your nutritional needs and effectively managing morning sickness is the sheer unpredictability of it. After a few weeks of getting more familiar with your symptoms, you’ll be equipped to work out a plan of action. Occasionally women will suffer debilitating nausea for a sustained portion of their pregnancy. If you’re suffering this severely, we urge you to talk to a natural health practitioner! With the right assistance, you can regain activity and productivity while finding the right strategies to stick to a nutritious diet.
by Maya Hammer, M.A., Counselling Psychology | www.mayahammer.ca
We all know about the “baby blues”, a common experience of emotional ups and downs in the first week or two postpartum. Many of us, however, have never heard of the “baby pinks,” or The Highs, a feeling of intense happiness or euphoria following birth.
Symptoms of postpartum hypomania include:
-being very active
-decreased ability to concentrate
-impulsivity, e.g., shopping
-decreased need for sleep
These symptoms can be triggered by childbirth and usually subside after 6-8 weeks postpartum. In some cases, however, postpartum hypomania is an early indicator for bipolar disorder, depression, or psychosis. Therefore, it is very important to seek treatment if you or a loved one you know is experiencing.
Pregnancy and childbirth can trigger mental imbalance because of physiological changes such as stress, dysregulated cortisol, increased inflammation, decreased serotonin, and hormonal fluctuations. In addition, psychosocial factors can impact mental well-being including disrupted sleep, the demands of caring for a baby, lack of support, life stress, marital difficulty, or trauma. Genetics plays a part too: a personal or family history of mental illness, in particular bipolar disorder, predisposes a woman to prenatal and postpartum mental illness.
It is important to seek treatment immediately if you notice unusual behaviour in your partner or loved one. Treatment can involve:
1) mood stabilizer medication
2) therapy to stabilize mood and regulate daily schedule
3) support and education for partners and families
For further reading, check out these resources:
A blog post on postpartum hypomania and mania
A mom’s experience of hypomania induced by anti-depressant medication
A study on the prevalence of postpartum hypomania
And another study demonstrating that hypomanic symptoms can be used to correctly diagnose postpartum bipolar disorder.
As well, check out an article in Today’s Parent, and Maya’s appearance on CTV Canada AM talking about the baby pinks.
When you find out you’re pregnant, you begin a mental checklist immediately. The list of things you could benefit from purchasing, eating and reading is endless. In spite of all of the advice and “to-do’s” available, there are a few smart investments and purchases that may be easier to overlook.
1. Orthotics: many pregnant women experience some common foot problems that may increase in severity over the course of their pregnancy. These include over-pronation, swelling and pain in the arch and heel. Weight gain puts a great deal of added stress on feet and orthotics are a smart investment to increase your comfort and health. As this awesome article “Pregnancy and Your Feet” from Mount Joy reminds us, hormonal surges cause ligaments in the feet to relax, which can flatten arches. New shifts in how you bear weight can also result in over-pronation, a condition we’ve mentioned before with respect to orthotics. This can make walking painful, and increase strain on the legs and lower back. Since many of these discomforts are already a concern for pregnant women, minimizing additional stress from foot problems is an important move for avoiding unnecessary and potentially serious discomfort and injury.
2. Pre-natal massage: While some pregnant women might see this as a luxury, having a pre-natal massage can be a highly effective treatment to lessen symptoms of pregnancy and its toll on your body. Massage reduces strain on muscles, nerve pain and swelling, while improving circulation, which is particularly important during pregnancy due to the elevated risk of blood clots.
3. A therapeutic outlet: whether it’s a psychotherapist, a support group, or a pre-natal yoga class, it’s important to have a space to relax and work through some of the more emotionally complicated aspects of pregnancy. The fact that you are undergoing a major (and exciting!) life change, in addition to onslaughts of hormones can produce any mixture of feelings including tension, stress, guilt, and anxiety. The proper form of therapy can help to foster a healthy and calm state of being, which will better prepare any expectant mom for labour, delivery and motherhood.
So don’t just be good to yourself during your pregnancy- be great! Tackle unaddressed discomforts- whether physical or emotional- with these natural, body-friendly treatments.