Oh, baby! A good start to the ‘fourth trimester’

Wellness
Dr. Selander cares for Luna as the family's older daughter, Nora, grapples for some motherly attention.

Dr. Selander cares for Luna as the family's older daughter, Nora, grapples for some attention.

The team at Tidelands Health Women’s Center helps families navigate pregnancy and childbirth every day. Now, one of the practice’s physicians – Dr. Monica Selander – has invited us to be part of the journey as she and her husband, Tidelands Health orthopedic surgeon Dr. Earl Han, welcome a second child to their family. Follow us on Facebook, check out our Twitter feed and stop back here often to get the latest updates.

Over the past three weeks, Dr. Monica Selander has fielded a lot of questions about her newborn new bundle of joy.
“Is Luna eating well?”
“Is she sleeping through the night?”
“Does she act like her sister?”
Dr. Selander is happy to report that Luna is eating very well – so well she had gained a full pound by her two-week checkup.
“That’s a lot when you only weigh seven pounds!” Dr. Selander says.

Baby Luna enjoys some time swaddled in a blanket with her pacifier.

And while she’s not sleeping as much as she’d hoped, Dr. Selander herself is feeling pretty good, too. She delivered Luna, her second child with her husband, Tidelands Health orthopedic surgeon Dr. Earl Han, on June 24 via cesarean section.
Dr. Selander, an OB-GYN at Tidelands Health Women’s Center, tells patients they should expect some discomfort for about a week following a C-section, but the pain should subside with each passing day. She has found that scenario to be true in her case, too.
“After about a week, I started to notice a lessening of my pain with movement, and I no longer required pain medicine to stay comfortable throughout the day,” she says.

Good news

At Dr. Selander’s first follow-up appointment following Luna’s birth, the focus was on looking for evidence of complications such bleeding, infection, high blood pressure and blood clots.
“I personally have not had any issues with these possible complications,” she says, “and at my post-operative visit, I was grateful that everything was looking just fine.”

Tidelands Health OB-GYN Dr. Jay Heineck, who was part of the team that delivered Luna, holds her at a post-operative appointment.

Tidelands Health OB-GYN Dr. Jay Heineck, who was part of the team that delivered Luna, holds her at a post-operative appointment.

But that’s not always the case with women in their “fourth trimester” of pregnancy. In recent years, the rate of childbirth-related deaths in the U.S. has increased, a trend that is concerning to physicians such as Dr. Xaviera Carter, an OB-GYN and colleague of Dr. Selander’s at Tidelands Health Women’s Center.
“We call the period after the birth the ‘fourth trimester,’ though it isn’t a technical term,” says Dr. Carter, who was part of the care team that helped deliver Luna. “It’s a colloquialism we as providers use to help women understand the importance of taking care of yourself after the birth of a baby.”

Risks continue

It’s essential mothers realize that childbirth-related risks don’t end once the baby is delivered and the mother is discharged from the hospital. Dr. Carter says a woman’s body continues to undergo significant pregnancy-related changes that can increase the risk of health complications for up to 12 weeks following delivery.
Those health problems can include high blood pressure and preeclampsia, blood clots and vascular issues, infection and heart disease. If not addressed, the conditions can lead to stroke, seizures, heart failure and death.

Tidelands Health OB-GYN Dr. Carter enjoyed some time with Luna after the birth. Dr. Carter was also part of the care team that delivered her.

Tidelands Health OB-GYN Dr. Xaviera Carter enjoyed some time with Luna after her birth.

“There can be really vague symptoms an overtired mother taking care of newborn may ignore,” Dr. Carter says.
That’s why at Tidelands Health Women’s Center the care team sees postpartum patients at two weeks and again at six weeks after birth.
“Seeing patients at two weeks gives us an opportunity to check their blood pressure and do postpartum depression screenings earlier. We can also talk about contraception, which can help reduce short pregnancy intervals,” Dr. Carter says.
Multiple studies have found shorter pregnancy intervals – those less than a year apart – increase the risk of maternal death and severe complications such as uterine rupture.

Education is key

Both Dr. Selander and Dr. Carter say it’s important to educate mothers about the risk of health problems following either vaginal or surgical deliveries.
“With any type of operation, there’s an increased risk of blood clot and infection,” Dr. Carter says. “Plus, any person who has been pregnant is at an increased risk for blood clots. When you add in surgery and other health conditions such obesity, the risk increases further.”
Mothers should be honest with their providers regarding their mental health, too. Dr. Selander says it’s common for women to experience the “baby blues” about two weeks after delivery, and some women can develop persistent postpartum depression.

Being a newborn is tiring! Luna sleeps in a safe position tightly swaddled on a firm mattress with tight-fitting sheets and no bumpers, toys or other items that can create a suffocation risk.

Being a newborn is tiring! Luna sleeps in a safe position tightly swaddled on a firm mattress with tight-fitting sheets and no bumpers, toys or other items that can create a suffocation risk.

“Hormonal changes, not sleeping well and, unfortunately, not eating well and trying to figure out how to manage a new baby can cause mental health problems for a new mom,” Dr. Selander says.
Mothers who struggle with mood swings, panic attacks, insomnia, fear, anxiety and feelings of hopelessness shouldn’t be afraid to have an open and honest conversation with her health care provider.
“We’re there to treat you and help you,” Dr. Selander says. “That’s an important thing for people to understand.”
Even though it’s often difficult to get the baby and older kids packed up and out the door for a postpartum doctor’s visit, it’s extremely important women make their own health a priority.
“The evidence is clearly showing an increased risk of maternal morbidity and mortality, so it is very important that we put it out there that women need to take care of themselves after they give birth,” Dr. Carter says.

Tidelands Health Women’s Center provides comprehensive care for women at all stages of life. The practice is staffed by Dr. Xaviera Carter, a board-certified physician who specializes in general obstetric and gynecological conditions, teen pregnancy and contraception; Dr. Eduardo Martinez, a board-certified physician who specializes in urogynecology, obstetrics and gynecology; Dr. Jay Heineck, a board-certified physician who specializes in obstetrics and gynecology; Dr. Monica Selander, a board-certified physician who specializes in obstetrics and gynecology; certified nurse midwife Kathleen Augustine, who specializes in obstetrics and gynecology; and nurse practitioner Ashley Miller, who specializes in gynecology.Tidelands Health Women’s Center has all-new offices in both Myrtle Beach and Georgetown. To schedule an appointment, call 843-546-3132.

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