Your Pregnancy: Week 16

Advice from Dr. Shari E. Brasner

It’s the rare pregnant woman who hasn’t experienced at least a mild form of hemorrhoids, a condition that up until pregnancy seemed to be something remote and embarrassing, relegated to subway ads. What hemorrhoids are, actually, are varicose veins located in your rectum. Just as you might have experienced varicosities of the leg or labia, the veins of your rectum can also swell up during this time. Here are a few ways to avoid and/or manage them:

• Drink plenty of fluids.
• If you are constipated, ask your doctor whether you can take Metamucil or some other form of fiber – or be given a stool softener. A handful of prunes also helps.
• Don’t strain when you’re on the toilet.
• Take warm baths.
• Use over-the-counter hemorrhoid creams or suppositories if your doctor gives you the okay.”

Babble recommends Dr. Brasner’s pregnancy book, Advice from a Pregnant Obstetrician.

Mom-To-Mom Advice: “Prepartum” Depression

Until quite recently, depression was considered unlikely during pregnancy. Even women who had been depressed beforehand were expected to be temporarily “cured” by hormonal changes. But recent studies have shown what many have already learned from experience: Lots of women do indeed become depressed in pregnancy (sometimes even if they’re on antidepressant medication). In fact, recent estimates put the number of women who deal with depression in pregnancy at around 20%, which means prenatal depression occurs at about the same rate as the much more publicized postpartum depression.

Depression in pregnancy can be a continuation of depression before pregnancy or it can be triggered by changes in brain chemistry or life struggles while pregnant. Medication has been shown to lower depression rates, but a fair number of women remain depressed even while on them. The use of medications for depression in pregnancy is a complex issue. Many of the drugs used for depression have not been thoroughly tested on pregnant women, and some are already associated with problems. Still, since depression involves serious risks for the mother and baby, it is not always advisable for women to stop taking medication during pregnancy. Symptoms of depression should be discussed with your OB or midwife, who may work in tandem with a psychiatrist or psycho-pharmacologist if medication is recommended. Women who are depressed can also be helped by therapy or support groups.

It is important that depression be diagnosed and treated in pregnancy as in any other time of life. Untreated depression may lead to self-destructive behavior such as smoking, drinking, or poor prenatal care, all of which can have potential long-term negative impacts on your health and the health of your baby. Studies have also shown that depressed women have higher risks of certain complications and preterm births.

Most women experience feelings of anxiety and sadness during pregnancy, but there are signs of depression that really require more support and more attention.

Signs of depression (usually continuing for 2 weeks or more) include:

• Persistent sadness
• Difficulty concentrating
• Sleeping too little or too much
• Loss of interest in activities you usually enjoy
• Recurring thoughts of death, suicide or hopelessness
• Anxiety
• Feelings of guilt or worthlessness
• Change in eating habits

Babble recommends From the Hips, by Rebecca Odes and Ceridwen Morris.