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Pregnancy at Week 28

Pregnancy at Week 28

Welcome to pregnancy week 28! You’ve made it to the third and final trimester! You’ll have your new bundle of joy in your arms before you know it!

How your baby is growing during pregnancy at week 28

Your growing baby is now about the size of a large eggplant, or about 2 1/4 pounds and is just over 14 inches in length. She has developed eyelashes now and practices blinking. Baby will turn her head toward any bright light shown into the womb. Her eyes will have likely turned a bluish color if she is Caucasian, and a darker brown or gray color for babies of African-American, Hispanic, or Asian decent.

Your baby’s lungs are now developed enough that if she were to be born today, there is a great chance of survival! This is great news! Still, it is absolutely in baby’s best interest to stay in the womb until as late as 40-42 weeks.

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She is also packing on the pounds in preparation for life outside the womb, which means her wrinkly skin will start to smooth out. Your baby is settling herself into her birthing position, with her head snugly tucked downward into your pelvis. She also is practicing hiccuping, swallowing (amniotic fluid), sucking, and coughing! Baby is working out her own sleep cycle now as well, including, some say, REM sleep, or the cycle of sleep in which humans dream. Only a little while longer before baby is ready to meet you!

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    Photo credit: http://www.babycenter.com/fetal-development-images-28-weeks

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    How your body is changing

    If you haven’t already experienced it, sciatic pain could be coming your way this week. This is a tingle that ranges from annoying to extremely painful that radiates down your hips and legs from your lower back. Try a heating pad, or think about scheduling an appointment with a chiropractor.

    With baby working out her sleep cycle, you may not be getting great sleep yourself, with all of her exercising in the middle of the night. It’s normal to worry about whether or not your baby is active enough. Generally speaking, it’s good to feel about ten movements from your baby inside of an hour’s time. If her movements are significantly less often than this, be sure to tell your practitioner. Some babies just aren’t as active, so you’ll settle into knowing what is normal for your own little one.

    Restless leg syndrome is a common pregnancy ailment during week 28 pregnancy. This is the tingly, or “creepy-crawly” feeling in your lower extremities. Often women with RLS describe a feeling that they can’t stop moving their legs. This feeling can be especially intense in the evening hours. While it’s not understood what causes RLS, caffeine may intensify symptoms, so if you’re suffering, try limiting your caffeine intake, stretching, and massaging your legs. For most women, RLS goes away upon delivering your baby.
    Your doctor will likely want to see you twice per month at this stage (changing to once per week for your final month of pregnancy). He will likely test your urine, and measure your belly and weight, as usual, but could also soon begin blood tests for significant STD’s and anything else that you or your baby may be at risk for.

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    Things to do during pregnancy week 28

    It’s a good idea to start thinking about who your baby’s pediatrician will be. Typically your baby be seen by a doctor during the first few days of birth. Many expectant mothers feel best if they can see the same doctor from the very beginning. Get recommendations for great doctors in your area from trusted friends and family with children. And while you’re thinking about it, you and your partner should make a decision about circumcision if your baby is a boy. Opinions about circumcision vary, so do some research and make an informed decision you feel would be best for your baby.

    Cord blood banking is a service many families choose. You should talk to your doctor about your options. Mothers who choose cord blood banking store blood from the baby’s umbilical cord right after delivery. They then pay a facility to safely store the collected blood to be used in a situation where the baby could benefit from its use in cases of blood and immune diseases.

    If you haven’t already done so, it’s also a great time to schedule childbirth classes. Many popular classes fill up quickly and require advanced notice to be admitted. Your doctor may be able to recommend a breastfeeding class as well. Be sure to check your insurance to see if the cost of your classes could be covered! It is completely normal to feel some anxiety about labor and delivery, especially if this is your first child! It is helpful to do your research about what to expect. Reading positive birth stories from other women can be encouraging and calming.

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    Featured photo credit: January 2013/Phaling Ooi via flickr.com

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    Published on November 30, 2018

    Signs of Postnatal Depression And What to Do When It Strikes

    Signs of Postnatal Depression And What to Do When It Strikes

    Postpartum depression (PPD) strikes about 15% of women around childbirth.[1] Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers.[2] The causes of which are thought to be linked to hormonal changes, genetics, previous mental illness and the obvious change in circumstance.

    The stigma of mental health – with or without support from family members and health professionals – often deters women from seeking help for their PPD. In this article, I will show you 10 ways to begin overcoming PPD.

    Symptoms of Postnatal Depression

    Postnatal depression is defined as depressive disorder, beginning anytime within pregnancy up to the first year of the child’s life. The symptoms of post natal depression are the same as those of depression. In order to receive a diagnosis from the doctor, 5 symptoms must be shown over a two week period. The symptoms and criteria are:

    • Feelings of sadness, emptiness, or hopelessness, nearly every day, for most of the day or the observation of a depressed mood made by others
    • Loss of interest or pleasure in activities
    • Weight loss or decreased appetite
    • Changes in sleep patterns
    • Feelings of restlessness
    • Loss of energy
    • Feelings of worthlessness or guilt
    • Loss of concentration or increased indecisiveness
    • Recurrent thoughts of death, with or without plans of suicide
    • Lack of interest or pleasure in usual activities
    • Low libido
    • Fatigue, decreased energy and motivation
    • Poor self-care
    • Social withdrawal
    • Insomnia or excessive sleep
    • Diminished ability to make decisions and think clearly
    • Lack of concentration and poor memory
    • Fear that you can not care for the baby or fear of the baby
    • Worry about harming self, baby, or partner

    Should you, a friend or your partner be showing any of these signs, I recommend you to seek medical advice.

    Causes of Post Natal Depression

    It is worth noting here that there is a difference between what is commonly known as ‘The Baby Blues’ and post natal depression.

    Postpartum blues, commonly known as “baby blues,” is a transient postpartum mood disorder characterized by milder depressive symptoms than postpartum depression. This type of depression can occur in up to 80% of all mothers following delivery. The Baby Blues should clear within 14 days, if not it is likely an indicator of something more in depth.

    It is not known exactly what causes post natal depression, however there are some correlating factors. These factors have a close correlation and haven’t been shown to cause PPD:

    • Prenatal depression or anxiety
    • A personal or family history of depression
    • Moderate to severe premenstrual symptoms
    • Stressful life events experienced during pregnancy
    • Maternity blues
    • Birth-related psychological trauma
    • Birth-related physical trauma
    • Previous stillbirth or miscarriage
    • Formula-feeding rather than breast-feeding
    • Cigarette smoking
    • Low self-esteem
    • Childcare or life stress
    • Low social support
    • Poor marital relationship or single marital status
    • Low socioeconomic status
    • Infant temperament problems/colic
    • Unplanned/unwanted pregnancy
    • Elevated prolactin levels
    • Oxytocin depletion

    One of the strongest predictors of paternal PPD is having a partner who has PPD, with fathers developing PPD 50% of the time when their female partner has PPD. [3]

    Ways to Overcome Post Natal Depression

    1. Seek Medical Help

    As knowledge of PPD grows, more and more physicians are becoming aware of the indicators and risk factors. This means that health care providers are looking for signs as early as their first prenatal care visit.

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    If you are at risk, letting your provider know early in your pregnancy means that you’ll be given extra support and care throughout the process. It is best to seek treatment as soon as possible.

    If it’s detected late or not at all, the condition may worsen. Experts have also found that children can be affected by a parent’s untreated PPD. Such children may be more prone to sleep disturbances, impaired cognitive development, insecurity, and frequent temper tantrums.

    2. Therapy

    This is the first line of defence against post natal depression and will commonly be prescribed alongside medication. Around 90% of post natal depression cases in women are treated with a combination of the two treatments.

    You don’t need to do anything special to prepare. Your counselor will ask questions about your life, and it’s important you answer honestly. You won’t be judged for what you tell, and whatever you talk about will be just between the two of you. Your counselor will teach you how to look at some things differently, and how to change certain habits to help yourself feel better.

    Therapy is personalized for everyone, but women in counselling for postpartum depression often discuss topics including; who you’re feeling, your behaviour, your actions and your life. (If you need immediate support please call the San Diego Access and Crisis Line at (888) 724-7240. The toll-free call is available 24 hours a day, seven days a week.)

    3. Medication

    There have been a few studies of medications for treating PPD, however, the sample sizes were small, thus evidence is generally weak.

    Some evidence suggests that mothers with PPD will respond similarly to people with major depressive disorder. There is evidence which suggests that selective serotonin reuptake inhibitors (SSRIs) are effective treatment for PPD.

    However, a recent study has found that adding sertraline, an SSRI, to psychotherapy does not appear to confer any additional benefit. Therefore, it is not completely clear which antidepressants are most effective for treatment of PPD.

    There are currently no antidepressants that are FDA approved for use during lactation. Most antidepressants are excreted in breast milk. However, there are limited studies showing the effects and safety of these antidepressants on breastfed babies.

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    4. Communication with Partner

    Don’t blame yourself, your partner, close friends or relatives. Life is tough at this time, and tiredness and irritability can lead to quarrels.

    ‘Having a go’ at your partner can weaken your relationship when it needs to be at its strongest. It can be a huge relief to talk to someone understanding.

    By spending time with your partner doing activities that you both enjoy, like going for a walk, can really help. This change of state, from moving location, can significantly elevate mood whilst providing ‘neutral ground’ in which to open up communication.

    Be honest with your partner and show ways in which they can support you best through this time, even if it’s just talking or letting you have time to go take a shower.

    5. Self Care and Rest

    Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired. It’s common that women are the experts at ‘being busy’ and ‘doing it all’.

    Rest whilst the baby is sleeping, and really take time to prioritise yourself. Throughout life, if you’re constantly giving out energy, you will be left feeling unbalanced. It’s important to become aware of one’s energy and making sure to give yourself energy first, before giving out is imperative.

    Your body has just been through the trauma of the birth, which is very stressful. It therefore needs time to recover so taking time to yourself is important. Things as simple as a cup of tea, or shower or listening to music will really help.

    6. Supplementation (especially DHA)

    St John’s Wort is a herbal remedy available from chemists. There is evidence that it is effective in mild to moderate depression. It seems to work in much the same way as some antidepressants, but some people find that it has fewer side-effects.

    One problem is that St John’s Wort can interfere with the way other medications work. If you are taking other medication, you should discuss it with your doctor. This is very important if you are taking the oral contraceptive pill. St John’s Wort might stop your pill working. This can lead to an unplanned pregnancy.

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    It is also worth noting that fish oil (containing DHA) is being shown to correlate with lower instances of PPD. DHA consumption during pregnancy — at levels that are reasonably attained from foods — has the potential to decrease symptoms of postpartum depression,” conclude study researchers led by Michelle Price Judge, PhD, RD, a faculty member at the University of Connecticut School of Nursing.

    7. Movement

    Before starting any exercise program, you should consult with your doctor and find a fully qualified pre and post natal specialist. That being said, there is plenty of movement that can be done prior to ‘hitting the gym’, such as walking.

    Not only does being outside positively benefit you by getting some fresh air and vitamin D. The same is said for your baby, who will likely sleep better once they’ve been outside. Exercise gets your endorphins going, which helps alleviate depression symptoms, It can also get you focused on something for yourself. In an analysis of data from 1996 to 2016, researchers discovered that moms who stayed physically active after birth experienced fewer depressive symptoms.[4] In contrast, one study found women who led a more sedentary lifestyle were, in general, more likely to experience postpartum depression in the first place. [5]

    The type of workout doesn’t matter much. Yoga for pregnant women, stretching, and cardio are essentially equal in terms of making you feel better.

    8. Socializing and Support Groups

    Do go to local groups for new mothers or postnatal support groups. Your health visitor can tell you about groups in your area. You may not feel like going to these groups if your are depressed.

    See if someone can go with you. You may find the support of other new mothers helpful. You may find some women who feel the same way as you do.

    9. Accept Help

    Some cultures believe that the symptoms of postpartum depression or similar illnesses can be avoided through protective rituals in the period after birth. Chinese women participate in a ritual that is known as “doing the month” (confinement) in which they spend the first 30 days after giving birth resting in bed, while the mother or mother-in-law takes care of domestic duties and childcare.

    Whilst this may seem extreme, it’s worth noting that being able to accept help from your friends, partner and family can be extremely beneficial.

    10. Avoid Smoking, Drink and Drugs

    Which may seem common sense, however you may be tempted by the short term ‘fix’.

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    Don’t use alcohol or drugs. They may make you feel better for a short time, but it doesn’t last. Alcohol and drugs can make depression worse. They are also bad for your physical health.

    Final Thoughts

    Most women will get better without any treatment within 3 to 6 months. One in four mothers with PND are still depressed when their child is one-year-old. However, this can mean a lot of suffering.

    PND can spoil the experience of new motherhood. It can strain your relationship with your baby and partner. You may not look after your baby, or yourself, as well as you would when you are well.

    PND can affect your child’s development and behaviour even after the depression has ended. So the shorter it lasts, the better.

    Sometimes there is an obvious reason for PND, but not always. You may feel distressed, or guilty for feeling like this, as you expected to be happy about having a baby. However, PND can happen to anyone and it is not your fault.

    It’s never too late to seek help. Even if you have been depressed for a while, you can get better. The help you need depends on how severe your illness is. Mild PND can be helped by increased support from family and friends.

    Featured photo credit: Derek Thomson via unsplash.com

    Reference

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