Taking Care of Me - The Next Step for Mom

You made the choice to take care of yourself during pregnancy. Now, itís just as important to keep taking care of yourself. We've collected ideas to help you get started when you are ready. We realize those first couple of weeks after the baby is born can be a blur. But once everyone is settled into the new routine, take the next step toward taking care of your health. Do it for you. Do it for the ones you love.

Taking Care of You

How are things going? Learn more about keeping your body and mind healthy. Read on for ideas about your next step. And donít forget to share what you learn with family and friends.

There is a time for most women, that changes us forever. It's when we give birth to a child. Whether you are a first-time mom or your family just grew again, there are so many choices to make and so much to take care of, especially yourself.

What ifÖ

How many "ifs" do you have? IF only I had more time. IF only I could get more sleep. IF only I could get a break. Sound familiar? The first six months after a baby is born can be especially difficult. Feeling weighed down or depressed is not unusual. You can take some easy steps to deal with your feelings.

Is Everything Blue?

No, we're not talking about the color blue because you had a boy. We're talking about how you feel. Almost half of new mothers feel "blue" or "down in the dumps" after giving birth. It happens because you are going through a lot of changes. Your hormones are changing again. You probably aren't getting much sleep. You may be a little anxious about caring for your baby. These feelings are normal but should only last a little while. If you still feel blue after a couple of months, or you feel like you could hurt yourself or your baby, get help. You might have a more serious condition called postpartum depression.

When To Ask For Help

If any of these signs are a part of your life, talk with your healthcare provider.

Do you...

If you feel blue or down in the dumps, rest more. Ask for help from your family and friends. Find someone you trust to take good care of your baby so you can have a break. Donít expect too much of yourself. During the first few weeks at home, a new mom should simply concentrate on caring for herself and the new baby.

When the blues do not go away or if they get worse, tell your healthcare provider.

If you ever feel like you might hurt yourself or your baby, call your healthcare provider, go to the emergency room or call 911 right away to get help.

What stresses you out?

Stress is your body's answer to life's demands. Knowing what causes your stress and taking steps to reduce it can help you feel better.

HERE ARE SOME EASY PICK-ME-UPS TO DEAL WITH STRESS

Write down what you can do when you need a quick pick-me-up.

Smoking, drinking or using medicines or drugs to deal with stress gives you a short-term sense of relief but can cause long-term health problems. If you do any of these to get rid of stress, call the NC Family Health Resource Line at
1-800-367-2229 to speak with a substance-use specialist.

Keep Your Stress In Check

Try this. Write down three things that stress you out. Then write down how you could deal with them. Is there someone who could help?

Example: This is stressful...I donít have time to take a shower.
This would make it better... Someone to watch the baby for 15 minutes a day.
I can ask for help from...My next door neighbor after her kids go to school.

My Stress Busters

Now itís your turn: This is stressful...(fill in the blank)
This would make it better...(fill in the blank)
I can ask for help from...(fill in the blank)

Before you get pregnant again, try to deal with your stress. Stress in pregnancy may cause your baby to be born too soon or too small to be healthy. Even if youíre not thinking about another baby, remember, half of all pregnancies are not planned. Being pregnant when you donít want to be can be very stressful. To prevent pregnancy, choose a birth control method thatís right for you. Use the chart below to help you decide.

Your Mouth Says a Lot

You know how good it feels to laugh at a funny joke, right? Laughing and smiling can help reduce stress and make you feel good. But did you know the extra hormones your body produced when you were pregnant could have affected your smile and your baby? Those "pregnancy hormones" and plaque on your teeth could have caused your gums to feel tender, swell or bleed. "Gum" or periodontal disease is often the result.

Women who have gum disease during pregnancy are seven times more likely to have a baby that is born too early or too small. Now that your baby is here, continue to keep your gums healthy. Brush and floss every day. See your dentist twice a year.

What is your mouth telling you?

Private Matters

Surprise! Almost half of all pregnancies are not planned. Do you want another baby? If so, when? What's your plan to avoid any little surprises? An unplanned pregnancy could mean an unhealthy pregnancy. That could lead to a lifetime of stress for you and long-term problems for your next baby. If you wait at least a year and a half between having a baby and getting pregnant again, you increase your chances of having a healthy baby.

Some Things to Think About

If you answered "yes" to any of these, you could put your next pregnancy in danger. See your doctor before getting pregnant again.

If you are having sex, protect yourself from an unplanned pregnancy and sexually transmitted diseases (STDs). See below for more information.

Family Plans? Choose and Use

It's no secret. If you have sex you can get pregnant...even if you are breastfeeding or just had your baby. To keep from getting pregnant until you are ready, choose and use birth control. Need help finding a method that's right for you? Talk with your healthcare provider. Ask questions about breastfeeding and side effects. One more thing, birth control doesn't prevent pregnancy unless it is used correctly. Even then, some methods offer more protection than others. Use this chart to learn more.

Family Planning/Birth Control Methods

Birth Control Method

Chances of NOT getting pregnant

How it works

Does it stop STDs?

Where do I get it?

No sex (abstinence)

100% - the only sure way NOT to get pregnant

No semen enters the vagina

YES - if no bodily fluids are exchanged

It's free

The Pill, Nuva Ring, the Patch, Depo Provera

99% if used correctly; 92% if not used correctly

These methods stop your ovaries from releasing an egg

NO - use a condom for protection

Your doctor

IUD (T-shaped device)

More than 99%

Your doctor puts it inside your uterus to stop sperm from joining with your egg

NO - use a condom for protection

Your doctor

Condoms (male and female)

98% if used correctly; 85% if not used correctly

"Rubber" placed on the penis or in your vagina. Keeps body fluids from mixing

YES - reduces the risk with consistent and correct use

Drugstore, doctor's office or clinic

Diaphragm

94% if used correctly; 84% if not used correctly

A rubber cup you place inside your vagina to keep sperm from reaching your uterus. Use with cream or jelly.

NO - use a condom for protection

Must be fitted by your doctor

Foams, Creams - use with another method

85% if used correctly; 71% if not used correctly

The foam or cream kills sperm. Place it in your vagina just before you have sex.

NO - use a condom for protection

Drugstores

Tubes Tied (woman)

more than 99% first year

Surgery (considered permanent). Blocks egg or sperm

NO - use condom for protection

Your doctor or partner's doctor

Vasectomy (man)

more than 99%

Surgery (considered permanent). Blocks egg or sperm

NO - use condom for protection

Your doctor or partner's doctor

Emergency Birth Control Pill - this is not a regular birth control method

89% for the progestin pill; 75% for the estrogen and progestin pill

Stops ovaries from releasing eggs, or stops a released egg from being fertilized or stops a fertilized egg from attaching to wall of uterus

NO - use condom for protection

Your doctor or emergency room within 3 days of having unprotected sex

What's That Wet Spot?

It's normal for you to have some wetness or "discharge" from your vagina. The amount is different for each woman. Knowing what is normal for you can help you notice when there is a problem. Call your healthcare provider if your discharge causes itching, swelling, burning, smells bad or is cloudy or not clear in color.

The Truth About Douching

Some women think they must douche to get rid of vaginal discharges and to feel fresh. Normal bathing in a tub or shower is enough to keep your vagina clean.

Q: If it makes me feel clean, what's wrong with douching?
A: Your vagina has "good bacteria" that helps you fight against "bad bacteria" (disease and infection). Douching washes away good bacteria. This allows the bad bacteria to grow. Douching is also linked to infections like bacterial vaginosis (BV) and chlamydia. (See "What You Need to Know About Vaginal Infections" for more information.)

Q: What about using sprays, wipes, powders or other products to get that extra-fresh feeling?
A: Some products, especially scented ones, can lead to problems. Wear panties with a cotton lining and comfortable (not tight) clothes, and keep clean and dry. Make sure you talk with your healthcare provider about any concerns or changes. Douche only if instructed by your healthcare provider.

From about age 11 to 50 a woman menstruates. About once a month she releases blood, an egg and the lining of her uterus. Every woman is different. Some have light periods. Some have heavy bleeding. Some have cramps...and some lucky women don't have any discomfort.

The first period after the birth of a baby is different for each woman. You may have spotting or bleeding off and on for the first six weeks as your body starts to recover. If you are breastfeeding, your period may not come back for a year or more. If you are not breastfeeding, expect your period four to eight weeks after your baby was born. Even if you donít have a period, you can pass an egg (ovulate). And if you have sex, you could get pregnant. If you miss a period, see your doctor.

WHAT IS NORMAL FOR YOU?

With everything going on in your life it can be hard to keep track of your period. Try using the chart below to help you remember.

Taking Care of You - Know Your Cycle

My Monthly Period

January

February

March

Date Began

Ended

Began

Ended

Began

Ended

Days Lasted

Discharge?

Days Lasted

Discharge?

Days Lasted

Discharge?

April

May

June

Date Began

Ended

Began

Ended

Began

Ended

Days Lasted

Discharge?

Days Lasted

Discharge?

Days Lasted

Discharge?

July

August

September

Date Began

Ended

Began

Ended

Began

Ended

Days Lasted

Discharge?

Days Lasted

Discharge?

Days Lasted

Discharge?

October

November

December

Date Began

Ended

Began

Ended

Began

Ended

Days Lasted

Discharge?

Days Lasted

Discharge?

Days Lasted

Discharge?

What You Need To Know About Vaginal Infections

Could It Be An STD?

Sexually transmitted diseases (STDs) are passed through sexual or "close' contact with an infected person. This means
you can get an STD in your mouth, vagina or genital area (the area near your vagina) Ė even without having vaginal sex.

Some infected women may not have symptoms or symptoms may show up weeks or months after sexual or close contact.
With or without symptoms, STDs don't get better if they are not treated.

Prevention

The best way to prevent STDs is through no sexual or close contact with an infected person. Remember, always use a condom to increase your protection against STDs. See "Family Planning/Birth Control Methods" for more information on condoms.

When To Be Concerned

Infections of any kind are a problem. If you have any of the symptoms listed below or have questions, see your healthcare provider as soon as possible. Delayed treatment could cause pelvic inflammatory disease (PID) which could make it hard for you to get pregnant again.

If you think you have a vaginal infection and are breastfeeding, let your healthcare provider know. Some infections or the medicines used to treat them can be passed to your baby through your breast milk

Before you get pregnant again, have your healthcare provider check you for infections.

Even if you are not thinking about another baby, have a pelvic exam each year. Only your healthcare provider can tell for sure if you have a problem.

Sexually Transmitted Disease

Vaginal Discharge

This Could Cause

Chlamydia

Heavy vaginal discharge.
Bleeding between periods

Pain or burning when peeing. Pain during sex.
Problems getting pregnant.

Genital Herpes

May have more "normal" discharge than usual.

Flu-like feelings. Painful sores. Burning, itching or swelling of the vagina or areas close by. Pain when peeing.

Genital Warts (also called Human Papillomavirus or HPV)

May have more "normal" discharge than usual.

Visible warts in the vagina and the areas close by including the thighs.

Gonorrhea ("The Clap")

Yellow, sometimes bloody discharge. Bleeding between periods

Pain during sex. Pain or burning when peeing. Problems getting pregnant.

Hepatitis B (HBV)

None. Pee may be dark. Pale bowel movements.

Headaches and muscle aches, stomach pain. Loss of appetite. Nausea, vomiting, and diarrhea.

HIV

May not have symptoms for 10 years or more.

HIV causes AIDS.

Syphilis

May have more "normal" discharge than usual

Muscle aches, fever, sore throat, headaches and swollen glands. Painless sores. Skin rashes, patchy hair loss and weight loss. Problems getting pregnant.

Trichomoniasis ("Trich")

Yellow, green, or gray with a strong odor.

Pain during sex and when peeing. Itching around the vagina and nearby areas.

Reproductive Tract Infections

Vaginal Discharge

This Could Cause

Bacterial Vaginosis (BV)

White, gray or thin with a smell.

Pain or burning when peeing. Itching around the vagina.

Candida (yeast infection)

Cottage cheese-looking discharge

Pain when peeing or having sex. Itching and burning of the vagina.

Urinary Tract Infection (UTI)

None, Pee may be cloudy or reddish

Pain or burning when peeing. Feeling the urge to pee, but only passing small amounts.

Taking Care of You - Up Close & Personal

Now that you've had your baby, your body needs time to get back to normal. Everything may hurt. Your legs may swell. Your belly may be sore, especially if you had a C-section (Cesarean). You may be constipated. And your breasts may be very tender. It's important that you take care of yourself after the baby is born. Get plenty of rest. Don't expect too much from yourself during the postpartum period.

Breast Care

Each month, take a few minutes to check your breasts. Note changes in the way they look and feel. Because breast cancer can affect any woman, it is important you check your breasts for changes in shape, size or appearance. Check your breasts even if you are breastfeeding.

HOW TO EXAMINE YOUR BREASTS

Check!
Lie down. Place your left arm behind your head. With your right hand, feel the left breast all around using the three patterns shown above. Then switch hands. Put your right arm behind your head. Check your right breast. Check under your arms, too.
LOOK!
Before you get dressed, stand in front of a mirror. Look at your breasts.
Do you see changes when you put your hands:

Look closely. Do you see lumps or dimples?
Are there clear drops or blood coming from your nipples?
Do you feel pain or tender spots?
If your answer is "yes" make an appointment with your healthcare provider.

The Care And Feeding Of A Mom: Get help with chores - Order take-out - Hire a sitter - Take a long nap

When you lose, you win

Sometimes our bodies need a little reshaping, especially after having a baby. If you are trying to lose some of that extra weight, make sure your healthcare provider knows before you get started. easy ways to get started. Remember, it took time to put on those extra pounds. It will take time to lose them.

If you are breastfeeding, keep in mind that your baby eats what you eat. Choose foods that help your baby grow strong. When you start to lose weight, do it slowly...about a pound a week...so you don't affect your milk supply or your baby's growth.

Before you get pregnant again, eat foods that will strengthen your body and help you have a healthy pregnancy and a healthy baby. Snack on fruits and veggies instead of french fries, chips and sweets.

Even if you are not thinking about another baby, be a good role model. Teach your family good eating habits. This is one of the most important things you can do. A good diet will improve your overall health and the health of the special people in your life.

3 easy ways to get started

  1. Cut out just one snack each day.
  2. Drink water or low-calorie drinks.
  3. Show off your baby; go for a walk every day.

3 easy ways to keep it up

  1. Find an exercise friend.
  2. Work your way up to 30 minutes of exercise, on most days of the week.
  3. Use the Daily Log on page 13 to keep track of your progress.

Now thatís not so hard to do, is it? Try it!
You will lose weight and have fun, too.
Write down your plan here:

Starting today, I will cut back on eating: (fill in the blank)

And tomorrow, I will call (fill in the blank) to go for a walk.

REMEMBER: healthy eating and exercise help control your weight better than dieting alone.

Ready? Set? Aim for a Healthy Weight
A healthy weight for your height can put you on the path to good health. Use the Body Mass Index (BMI) chart to find your "weight for height" score. This number can help you and your doctor decide how much weight, if any, you need to gain or lose. Ask how your BMI score, body shape, family history, diet, smoking or drinking affect your health.

Key:
Underweight - Less than 18 BMI
Healthy - 19-24 BMI
Overweight - 25-29
Obese - 30+

To determine a Woman's Body Mass Index (BMI):
Find your height (far left column). Using the top row, find your weight. Where your height and weight meet is your Body Mass Index score.

WEIGHT IN POUNDS

Height

in feet

and

inches

 

120

130

140

150

160

170

180

190

200

210

220

230

240

250

4'6"

29

31

34

36

39

41

43

46

48

51

53

56

58

60

4'8"

27

29

31

34

36

38

40

43

45

47

49

52

51

56

4'10"

25

27

29

31

34

36

38

40

42

44

46

48

50

52

5'0"

23

25

27

29

31

33

35

37

39

41

43

45

47

49

5'2"

22

24

26

27

29

31

33

35

37

38

40

42

44

46

5'4"

21

22

24

26

28

29

31

33

34

36

38

40

41

43

5'6"

19

21

23

24

26

27

29

31

32

34

36

37

39

40

5'8"

18

20

21

23

24

26

27

29

30

32

33

35

37

38

5'10"

17

19

20

22

23

24

26

27

29

30

32

33

35

36

6'0"

16

18

19

20

22

23

24

26

27

28

30

31

33

34

6'2"

15

17

18

19

21

22

23

24

26

27

28

30

31

32

Example, if you are 5 feet 4 inches and weigh 140 pounds you are considered a healthy weight.

VITAMINS: TAKE A DAILY DOSE

Don't forget, all women should take a multivitamin with 400 micrograms of folic acid every day. You took your prenatal vitamins when you were pregnant, so this should be a piece of cake!

If you are breastfeeding, chances are you already take a multivitamin/mineral supplement to make sure you and your baby stay healthy. Keep it up.

Before you get pregnant again, take a multivitamin to improve your health and to prevent certain birth defects. But vitamins with folic acid can only help prevent birth defects when you take them before you get pregnant. So start today.

Even if you are not thinking about another baby, take a daily multivitamin. It's good for you. And remember, half of all pregnancies in North Carolina are not planned! That means you could get pregnant when you are not ready, and your unborn baby would be at risk for certain birth defects. Don't let this happen. Start taking your vitamin today. Use the chart below entitled "What Are You Doing This Week" to help you remember to take your vitamin.

Breathe Easy

If you do not smoke, that's great! If you've quit smoking, congratulations! Keep on being an ex-smoker. If you are still smoking, we need to talk...

BODY DANGER!
You've heard it all before, cigarettes and being well just don't mix. You already know that keeping cigarettes and secondhand smoke out of your life is healthier for you, your baby and your family.

If you smoke and breastfeed, your baby benefits from your breast milk but not from your cigarettes. Chemicals from cigarettes, including the drug nicotine, pass through your breast milk to your baby. It would be best to quit. If you can't quit smoking just yet, cut back.

Try these tips so that your breast milk is as safe as you can make it:

Before you get pregnant again, try to quit. Smoking can hurt your chances of getting pregnant when you are ready for another baby. Smoking when you are pregnant can cause a baby to be born sick, too early and too small. The baby will be three times more likely to die of Sudden Infant Death Syndrome (SIDS).

HAZY DAYS?

Did the weatherman call for clouds or do you live under the haze of secondhand smoke? Secondhand smoke is unsafe for you, your baby and your family. It "ups" everyoneís chances of getting sick. This means more colds, sore throats, earaches, asthma and allergies. This turns into more trips to the doctor, medicine, taking time off from work, getting a sitter and on and on. Talk about stress. Whew! Secondhand smoke more than doubles a babyís chance of dying of SIDS.

Even if you are not thinking about another baby, it is never too late to quit smoking for life!

SPIT IT OUTÖTOBACCO, THAT IS

There is no safe form of tobacco. Using spit tobacco even for a short period of time can cause cracked lips, bleeding gums, white spots and painful sores on the inside of your mouth. The mouth sores and gums can get infected. This infection can cause your baby to be born too early and too small to be healthy. If you chew tobacco or use snuff and are breastfeeding, you and your baby get twice the nicotine found in cigarettes.

On Cloud 9 - Rising Above Nicotine

Many women quit smoking when they are pregnant. Some quit on their own and continue not to smoke after the baby is born. Others want help. Find a way that is best for you and increases your chances of quitting for good.

If You Use - Body Danger!

Breastfeeding? Even small amounts of drugs in your breast milk can harm your baby. If you use street drugs and breastfeed, get help. Stop breastfeeding until you quit using drugs completely.
Before you get pregnant again, get help now. If you are using street drugs and get pregnant, your baby could be born with health problems or learning and behavior challenges. Even if you are not thinking about another baby, get help. Drugs and alcohol change the way you think, which can lead to making bad choices. Using drugs and alcohol can put you at risk for sexually transmitted diseases or an unplanned pregnancy. Donít let drugs control your life.

For assistance, call North Carolina Family Health Resource Line at 1-800-367-2229 to speak with a substance-use specialist.

To Drink Or Not To Drink?
Body Danger!

Alcohol, like other drugs, affects the way your mind and body work. Womenís bodies are much more sensitive to the effects of alcohol and more easily damaged than menís.

If you are breastfeeding, the alcohol you drink goes into your milk and to your baby.

Before you get pregnant again, avoid alcohol altogether. There is no safe amount during pregnancy. If you get pregnant and drink, your unborn baby is at risk for fetal alcohol spectrum disorder (FASD). It is the number-one cause of preventable mental retardation.

Even if you are not planning to have another baby, limit your drinking. It can cause damage to your liver, heart, brain and nervous system. Remember: 12 ounces of beer, 5 ounces of wine and 1.5 ounces of hard liquor contain about the same amount of alcohol.

Body Danger! - Whatís in Your Medicine Cabinet?

All drugs have risks. This means you need to be careful about the medicine your doctor gives you and the ones you buy off the shelf. Read the label and any other written information to learn the side effects of your medicine before you take it.

If you are breastfeeding, tell your healthcare provider you are nursing before you take any medication. Some medicines may cause changes in your baby's sleeping and eating patterns.

Before you get pregnant again, throw out any old drugs. Only use medicine given to you by your doctor for a current health condition. If you are trying to get pregnant, make sure your doctor knows.

Even if you are not thinking about another baby, talk with your doctor before you use any new medications. Some medications you buy off the shelf can affect how well prescription drugs work. Did you know that some medications could clash with birth control pills and increase your risk of pregnancy?

8 Good-for-You Checkups

Get your great 8

While you were pregnant, you went to the doctor. After the baby, you had a postpartum visit. Now you take your baby in for well-baby checkups and shots. Whatís next? Get Your great eight "Good-for-You" checkups.

Schedule Your

Date
Completed

Next Step: Write down the results and
what your healthcare provider said

1

Physical Exam

 

 

2

Blood Pressure Check

 

 

3

Cholesterol Test

 

 

4

Diabetes (Blood Sugar) Test

 

 

5

Dental Exam and Cleaning

 

 

6

Pap Test and Pelvic Exam

 

 

7

HIV/AIDS and Other Sexually Transmitted Disease (STD) tests

 

 

8

Mammogram (x-ray of breast)

 

 

You may not need all of these tests. Your age, current health, past medical history and family history will help your healthcare provider decide when each test should be done.

What Are You Doing This Week?

Ready? Set? Let's Go!

How about taking care of you? For the next four weeks, use this chart to log some easy ways to get started.
Put a (check mark) in this box every time you eat a fruit or vegetable. Try to get 5-9 each day.
Put an (X) in the box when you take your daily vitamin.
Write in the number of minutes you exercise each day. Try to get at least 30 minutes most days.
Record the number of glasses of water, milk or juice that you drink each day. Try to drink at least six 8-ounce glasses each day.

 

WEEK 1

 

WEEK 2

Fruits

Vitamins

Exercise

Water, juice

Fruits

Vitamins

Exercise

Water, juice

Monday

 

 

 

 

Monday

 

 

 

 

Tuesday

 

 

 

 

Tuesday

 

 

 

 

Wednesday

 

 

 

 

Wednesday

 

 

 

 

Thursday

 

 

 

 

Thursday

 

 

 

 

Friday

 

 

 

 

Friday

 

 

 

 

Saturday

 

 

 

 

Saturday

 

 

 

 

Sunday

 

 

 

 

Sunday

 

 

 

 

 

WEEK 3

 

WEEK 4

Fruits

Vitamins

Exercise

Water, juice

Fruits

Vitamins

Exercise

Water, juice

Monday

 

 

 

 

Monday

 

 

 

 

Tuesday

 

 

 

 

Tuesday

 

 

 

 

Wednesday

 

 

 

 

Wednesday

 

 

 

 

Thursday

 

 

 

 

Thursday

 

 

 

 

Friday

 

 

 

 

Friday

 

 

 

 

Saturday

 

 

 

 

Saturday

 

 

 

 

Sunday

 

 

 

 

Sunday

 

 

 

 

Need more information? Call the North Carolina Family Health Resource Line 1-800-FOR-BABY (1-800-367-2229)

North Carolina Healthy Start Foundation
1300 St. Maryís Street, Suite 204
Raleigh, North Carolina 27605
919-828-1819
919-828-1446 FAX
919-828-7470 FAX for ordering materials
www.NCHealthyStart.org