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Giving birth under general anesthesia increases your odds of getting PPD by 54%

A new study published online in the journal Anesthesia and Analgesia found a mom's odds of having severe postpartum depression increase significantly when they have general anesthesia for a C-section delivery.

Researchers looked at hospital records for 428,204 women who had C-sections in New York State, 34,356 of whom had the surgery under general anesthesia rather than spinal anesthesia, when the mom stays awake. General anesthesia is used in emergencies where there isn't enough time to do spinal anesthesia because the C-section needs to happen ASAP or when a mom can't have spinal anesthesia because she's had a back injury or something else that prevents it.

Giving birth under general anesthesia was associated with a 54% increased-odds of postpartum depression. "General anesthesia for cesarean delivery may increase the risk of postpartum depression because it delays the initiation of mother to infant skin-to-skin interaction and breastfeeding, and often results in more acute and persistent postpartum pain," says Jean Guglielminotti, MD, PhD, in the Department of Anesthesiology and the Department of Epidemiology at Columbia Mailman School, lead author of the study.

According to Guglielminotti, "These situations are often coupled with a new mother's dissatisfaction with anesthesia in general, and can lead to negative mental health outcomes."

This research underscores the importance of postpartum support for mothers and the seriousness of birth trauma. For some women, an emergency C-section under general anesthesia is a very traumatic experience, especially in a culture which, in recent years, has seen an aspirational narrative about "natural childbirth" (all childbirth is natural, mama) take over social media.

Severe depression is not the only mental health complication that can arise from a C-section. A 2017 study examining the relationship between C-sections and Post Traumatic Stress Disorder (PTSD) found that in "patients with a high degree of dissociative experiences during the C-section, or when maternal or anesthesia complications occur, the risk for a postpartum PTSD profile increases significantly. These patients are likely to benefit from a close follow up by members of the obstetrics and/or anesthesia team. If needed, intensive psychological support should be put in place as soon as possible."

No matter what kind of anesthesia a mother has during her C-section a sense of grief may be felt afterward, especially if a low-intervention birth was her plan. It's okay to mourn the experience you wanted to have mama.

Writer Shannon Kelley had a C-section and described her grief in a piece for the Washington Post: "In the immediate aftermath, the loss of the birth I'd imagined felt as acute and traumatic as the one that actually occurred. I'd looked forward to the experience from the same place that sagged with awe at pregnancy—a mind-blowing miracle that, somehow, I'd gotten lucky enough to taste. Yet I'd experienced no labor at all. Plus, now that I'd had one C-section, I'd have to fight and bear additional risk were I to attempt a vaginal birth in the future."

Her feelings were complex and they were valid. It's okay to go through a C-section and be totally thrilled with your birth experience (after all, C-sections can be beautiful) but it is also okay to grieve for an experience you thought you would have.

What is not okay is a medical system and society that isn't prepared to support you in that grief.

New research published in the British Journal of Midwifery in September 2019 suggests, "maternity providers should consider offering a postnatal listening service to meet women's needs in relation to understanding their experience of giving birth. This will also serve to identify women with [post-traumatic stress] symptoms and offer further support."

Mothers need support, and Guglielminotti's research suggests they also need providers to avoid using general anesthesia in the first place. "Our findings underscore the need to avoid using general for cesarean delivery whenever possible, and to provide mental health screening, counseling, and other follow-up services to obstetric patients exposed to general anesthesia," says Guglielminotti's co-author Guohua Li, MD, DrPH, Finster Professor of Epidemiology and Anesthesiology.

The findings also underscore something Diana Spalding, Motherly's Digital Education Editor and author of the upcoming book, The Motherly Guide to Becoming Mama (April 2020), has said about birth plans: "Plans do not always... well, go to plan, and the last thing on earth that I want for you is to feel like somehow you failed your birth."

She wants mothers like Kelley to know that it is impossible to fail at birth. Giving birth, whether vaginally or by C-section is not something you can fail at. Having a birth plan can be good so that you can outline your birth preferences ahead of time, but there's got to be room for unexpected detours. Sometimes people have to have C-sections and that can be part of the discussions you have with your provider ahead of time, even if it isn't part of your ideal plan.

"I am a huge fan of you feeling empowered and actively involved in the decision of your birth." Spalding says.

Bottom line: Birth is beautiful no matter how it happens, but mothers deserve to be supported to ensure their birth is as close to their vision as possible—and supported after their birth occurs, too.

Who says you have to wait for birthdays or holidays to give your bestie a great gift? A sweet surprise that tells her you've been thinking of her might be the pick-me-up she needs in these more-than-trying times. We've rounded up some of our favorite go-to gifts that are certain to be a bright spot in her week. But be warned, you may want to snag a few for yourself. (You deserve it, mama.)

Here are some our favorite "just because" gifts to give our hardworking mama friends.

New Mother face + body care duo

volition face + body care duo

This correcting oil and stretch mark minimizer is perfect for the pregnant mama looking to keep her pregnancy glow. The correcting oil brightens the skin while reducing dark spots, and the stretch mark minimizer works to smooth her ever-growing belly.

$70

Allover roller

esker allover roller

This jade roller goes beyond your typical face roller and can be used anywhere on the body. It works to increase stimulation and reduce puffiness and is perfect for applying any oils to the face or body. Plus, it feels like a mini spa treatment.

$65

Kombucha making kit

farmsteady kombucha making kit

What could be a more perfect gift for the health-obsessed friend? This kombucha making kit comes with everything you need to brew your own homemade green tea kombucha. They'll think this is the tastiest gift ever.

$45

Laetitia lipstick

cupid & psyche laetitia

This red lipstick is perfect for your makeup enthusiast bestie who is looking to spruce up her life in quarantine. Crafted in the United States, these bee and vegan-friendly and cruelty-free lipsticks are created to flatter all complexions. Cupid and Psyche Beauty makes finding the perfect red lip way too easy!

$23

Jigsaw puzzle

inner piecec jigsaw puzzle

Mamas need to destress now more than ever during quarantine. This adorable jigsaw puzzle is perfect for the mama who needs a brain break! The 500-piece puzzle designed by artist Ray Oranges features an abstract gradient design that fits a standard frame when completed. Bonus: It's printed on recycled paper and the company donates $1 from every puzzle sold to youth mindfulness programs.

$30

Matilda's Bloombox

matilda's bloombox

If we have to be stuck inside, we might as well have some gorgeous florals to brighten up the space. Matilda's Bloombox locally sources blooms, delivers them to her door and provides simple tips on how to arrange it into a beautiful bouquet.

$39

'I Am Enough' bracelet

I Am Enough bracelet

Let this dainty bracelet serve as a constant reminder to your bestie that she is enough. She'll wear this on her wrist and read this daily oath to herself, "I Am Enough."

$35

Glow assorted teas

vahdam low assorted teas

This tea gift box set covers the entire spectrum of flavors from sweet to spicy. Individually packaged in beautiful tins, your gal pal will feel like a queen sipping her morning tea. Originally $40, this set is currently on sale for just $24. We'll take two, please.

$24

Find your voice journal

find your voice journal

Journaling is a great way to ease anxiety and will slow your bestie's racing mind before bed. This gift is perfect for first time journalists and includes prompts, daily quotes and coloring pages to help her unlock her potential and find her voice.

$22

Premium frother

shore magic premium frother

This gift is fitting for your latte-sipping bestie who can't go a day without her coffee. All she has to do is add two scoops of collagen to her favorite drink, and she'll have a perfectly foamy drink ready in seconds. Skipping the drive-thru line has never been so easy!

$25

Bath soak infusion kit

maude bath soak infusion kit

Say hello to hydration! She'll be feeling smooth and relaxed as ever after a long bath soaking in these salts. This vegan + cruelty-free set incorporates dead sea salt and dehydrated coconut milk powder for an ultra hydrating experience.

$32

Tiny Tags 'mama' necklace

Tiny Tags 'mama' necklace

It's a hard-earned title she answers to a hundred times per day. Whether she's new to the club or a seasoned professional, this delicate script 'mama' necklace is guaranteed to be a perfect fit.

$105

Superfood honey

Beekeeper's Naturals B.Powered honey

With a lack of sleep and jam-packed days, getting through the afternoon can be a real challenge. Send her a powerful pick-me-up in the form of a therapeutic blend of royal jelly, bee pollen, propolis and raw honey. It makes the ideal companion for tea, smoothies, yogurt or even on its on.

$17

Calming midnight mask with melatonin

Who doesn't deserve a reminder to pamper themself every once in awhile? Even better, this mask does all its work at night while you're sleeping with no extra effort needed. It's an amazing plant-powered antioxidant-packed mask that has melatonin, wild dandelion leaf and hyaluronic acid to rehydrate, repair and reset facial skin. It's so good, you might want to gift it to yourself. We won't tell, mama.

$68

We independently select and share the products we love—and may receive a commission if you choose to buy. You've got this.

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When expecting a baby, there is a lot you can test-run in advance: Take that stroller around the block. Go for a spin with the car seat secured in place. Learn how to use the baby carrier with help from a doll. But breastfeeding? It's not exactly possible to practice before baby's arrival.

The absence of a trial makes it all the more important to prepare in other ways for breastfeeding success—and it can be as simple as adding a few of our lactation aiding favorites to your registry.

MilkBliss chocolate chip soft baked lactation cookies

MilkBliss lactation cookies

Studies have shown the top reason women stop breastfeeding within the first year is because they are concerned about their milk supply being enough to nourish baby. Consider MilkBliss Lactation Cookies to be your secret weapon. Not only are they wholesome and delicious, but they were formulated specifically for breastfeeding moms based on the science of galactagogues—also known as milk boosters. They also come in peanut butter and wild blueberry flavors.

$23

Evereden multi-purpose healing balm

Evereden multipurpose healing balm

Also up there on the list of reasons women stop breastfeeding: the toll the early days can take on nipples. Made from just five ingredients, this all natural healing balm is ideal for soothing chafed nipples, making for a much more comfortable experience for mama as her body adjusts to the needs of a breastfeeding baby.

$20

Lansinoh milk storage bags

Lansinoh milk storage bags

For a breastfeeding mama, there are few things more precious and valuable than the milk she worked so hard to pump—and it's the stuff of nightmares to imagine it spilling out in the fridge. With these double-sealed milk storage bags, you can be assured your breastmilk is safe and sound until baby needs it.

$12.50

Belly Bandit bandita nursing bra

Belly Bandit bandita nursing bra

Nursing a baby is a 24/7 job, which calls for some wardrobe modifications. Because Belly Bandit specializes in making things more comfortable for the postpartum mama, they've truly thought of every detail—from the breathable fabric to the clips that can be easily opened with one hand.

$47

boob-ease soothing therapy pillows

Boob Ease soothing therapy pillows

For nursing moms, duct can quickly become a four-letter word when you suspect it's getting clogged. By keeping these soothing breast pillows in your breastfeeding arsenal, you can immediately go on the defense against plugged milk ducts by heating the pads in the microwave or cooling them in the freezer.

$25

Belly Bandit perfect nursing tee

Belly Bandit perfect nursing tee

A unfortunate reality of nursing is that it can really seem to limit the wardrobe options when you have to think about providing easy, discrete access. But by adding functional basics to your closet, you can feel confident and prepared for breastfeeding on the go.

$59

Bebe au Lait premium cotton nursing cover

Bebe au Lait cotton nursing cover

Nursing in public isn't every mama's cup of tea. But babies can't always wait until you've found a private place to get down to business if that's your preference. That's where a nursing cover comes in handy. This one is made from premium cotton and features a patented neckline that allows for airflow and eye contact even while you're covered.

$36

Lactation Lab basic breastmilk testing kit

Lactation Lab breastmilk testing kit

Curious to learn more about the liquid gold you're making, mama? The testing kit from Lactation Labs analyzes your breast milk for basic nutritional content like calories and protein, as well as vitamins, fatty acids and environmental toxins to help boost your breastfeeding confidence.

$99

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Pop culture might lead us to believe that single people are having all the good sex and us married folks are lucky to get anything at all. But, for a lot of couples, sex gets better after a walk down the aisle.

I'll put it like this: The escapades I had before my husband were a lot like fast food—quick and unsatisfying. On the other hand, married sex is like having a five-star, live-in chef. So, why is it so hard to sell the idea married people are having the best sex of their lives?

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