Sunnybrook Health Sciences Centre is proud to celebrate the 2SLGBTQIA+ community.

It is also working to create environments for both staff and patients that welcome diversity and are built on a foundation of respect so that everyone feels included.

This is true across Sunnybrook’s various care departments and teams – including family medicine obstetrics.

Dr. Robyn Moxley is Co-Lead of Family Medicine Obstetrics at Sunnybrook. Dr. Moxley has conducted research and done educational work on how pregnancy care providers can better serve the 2SLGBTQIA+ childbearing community through more sensitive language, behaviour and environments that affirm diverse sexual and gender identities.

Dr. Moxley spoke with Your Health Matters about what affirming pregnancy care means and why it’s important for patients and their families.

As a family doctor at Sunnybrook, you provide gender affirming and inclusive prenatal care. What does that mean?

For me it means providing care in a way that does not assume heterosexuality or cisgender identity so that everyone can feel safe knowing they will be respected for how they identify.

You are also helping to start a new prenatal outreach clinic in the area. What will that involve?

The clinic is a partnership between Sunnybrook and Vibrant Health Care Alliance, a community health centre near Yonge and Eglinton. We are accepting referrals from physicians or self-referrals for prenatal care. As one of the doctors involved, my priority for the clinic is accessibility and affirming care for queer and trans patients who might be seeking prenatal care.

When it comes to providing care that is inclusive to the 2SLGBTQIA+ community, how important is language — and what are some examples of inclusive terms?

Language is very important because the words we use can either be inviting for people or make them feel less welcome. For example, if we only refer to women or mothers when we are talking about pregnancy, somebody who is non-binary or a trans man, for example, might feel like that is not a safe space for them. I always try to use terms like pregnant person or parent, and partner or support person, so that we can include people who have different gender identities or different relationships.

What should care providers do if they aren’t sure about the best word or term to use with a patient?

My advice is to start with neutral terms and then ask the person what terms they prefer. I also suggest they explain why they are asking. And I think we should be aware that we won’t always say the right thing, so we need to accept feedback and be willing to learn if we say something that is not correct.

What are some steps Sunnybrook is taking to better educate physicians about how to provide gender affirming and inclusive care?

There are lots of opportunities to learn and there is more awareness. I think some of the changes that are coming, including the addition of fields for gender, pronouns and chosen name on some of our electronic records, will help further raise awareness.

What kind of difference can gender affirming and inclusive care make for Sunnybrook patients and their families?

It can make a difference in whether they even choose to come to Sunnybrook, so it is very important that we are providing safe care that honours gender identity for everyone.

Pregnancy is a time when we need a lot of interaction with the healthcare system so it’s essential that we don’t alienate people or make them feel uncomfortable.

As prenatal care providers, we are trying to gather a lot of information about a person and their identity and their family history. If we are not doing that in a sensitive way or explaining why that information is important, we risk making someone feel uncomfortable or even causing trauma.

It is difficult to capture clinical outcomes of gender affirming and inclusive care because that relies on people to give that feedback and disclose how they identify and how that affects their care. So there is more to learn about how we provide this kind of care and how we can improve.

What do you hope family doctors who provide care before, during and after pregnancy will keep in mind going forward?

I hope we can remember that people with different sexual orientations and gender identities can and do become pregnant and have families, and that we put aside any assumptions about a person’s identity just because they are pregnant. And I hope we can remain open to learning more and accepting feedback from our patients when we need to be corrected.

What do you enjoy most about the work you do in this area?

I love being involved in pregnancy care and childbirth because it’s such an amazing and powerful moment in a person’s life. It is such a privilege to be there to help welcome a new life into the world.

Being part of the 2SLGBTQIA+ community, I really want those patients to feel like we are providing the best care and I want them to feel safe when they are seeking care from us. So the educational part of my work is also really important for me to help support that community.

The post Why gender affirming and inclusive pregnancy care is a priority appeared first on Your Health Matters.

Thinking I had a stomach flu, I went home. Over the next five days that “stomach flu” didn’t go away and the advice at that time was to rest and it will get better. Finally, after urging from my family, my husband drove me to Sunnybrook, thinking I likely only needed IV fluids.

That night, as my nausea was treated, I went to the bathroom and noticed blood. I called in the nurse who then called the doctor, and after checking, began to gently tell me that they could no longer find the heartbeat, and in that moment, was eight centimetres dilated.

That was an emotional rollercoaster. Within 20 minutes and with no epidural, I gave birth to my stillborn baby girl. I was heartbroken. My story doesn’t end here though, as my vitals were dropping, and I suddenly found myself being rolled into an operating room, sedated and confused. My heart stopped twice, was resuscitated twice and was on three different blood pressure medications just so I could have a pulse.

I woke up six days later, after learning I was in a medically induced coma and in the intensive care unit. Turns out, I didn’t have the stomach flu, I had necrotizing fasciitis. The condition targeted my stomach and caused toxic shock. General surgery removed my entire stomach as it was completely blackened. Dead. The only way to save the rest of my organs was to remove it and figure out the best course of action.

Three other surgeries later, within the span of six days, the decision was made to staple my esophagus and my intestines shut and do corrective surgery in the future when I become stabilized.

Since my digestive system was not intact, I had two tubes coming out of my stomach, one of which was a feeding tube. Since I was not stable, I couldn’t have the reconstruction surgery right away, and lived like this for 14 months. This timeframe was the most torturous time of my life and one that I wish no one ever endures. It was in this time that I did not eat a single thing. The feeding tube nourished me with 3,000 calories a day through a machine.

But life doesn’t stop. Thanksgiving meals don’t stop. Weddings happen. I had to continue to be a mom, and prepare meals for my family, and then sit at the dinner table watching them eat, when I could not eat. Just the smell of sautéed onions smelled so good, sometimes I had to go to the bedroom just so I wouldn’t have to smell the yummy dinner. You don’t notice how many food commercials are on TV until you can’t eat what they’re advertising. It was within this timeframe that I experienced depression and suicidal thoughts, was addicted to opioids, on a ton of medication, and was in and out of Sunnybrook’s Emergency Department for a variety of issues with the unanswered question of “why me?”

The day finally came when the team of doctors performed my reconstruction surgery. This involved attaching my small intestine to my esophagus (stomach transplants are not a thing). I experienced a huge sigh of relief when they did the ‘leak test’ to see if the connection was sealed.

Seven years later, this experience has taught me major life lessons like resilience, gratefulness, thankfulness and spirituality. I have a completely different viewpoint on life altogether. I am now a self-proclaimed foodie and enjoy eating with a different lens. I learned that the joys in life revolve around surrounding yourself with people you love and to share a meal together.

I learned that my case was a once in a lifetime “career case” for the team of surgeons, with the odds of someone getting this was one in ten million people. And the people that get this don’t survive. But I survived. I had an anesthesiologist come to my room saying “I heard a rumour you were alive and I wanted to confirm.” I was famous at Sunnybrook, anytime I went into the Emergency Department, someone was bound to say “Oh, that story was you?”

The surgery team at Sunnybrook is absolutely incredible and their skilled team gave me my life back to what it was, albeit some changes. Everyone that I and my family encountered was professional, delightful and empathetic. I want to thank all the doctor teams, nurses, porters, and administrators who provided excellent patient care. I no longer experience depression, PTSD, and my body works as it should.

I’m forever grateful. Thank you.

Note: If you or a family member have experienced a pregnancy or infant loss and live in Ontario, please consider seeking support through the Pregnancy and Infant Loss (PAIL) Network.

The post My condition happens to one in 10 million – Now I have a completely different viewpoint on life appeared first on Your Health Matters.

“Age is only one factor in a multi-faceted pregnancy,” says Dr. Aviram, a Maternal-Fetal Medicine specialist at Sunnybrook. “If you’re over 40 years of age and perfectly healthy, you’re more likely to have a successful pregnancy than a 30-year-old with health issues.”

Most of the time, he says, these pregnancies are quite successful and have outcomes very similar to those at younger ages. A pre-pregnancy consult to review your health history can be helpful to learn more about what’s ahead. And Dr. Aviram encourages expectant parents to speak up and ask questions at prenatal appointments.

Dr. Aviram answers some common questions:

Do pregnancy complications increase when a patient is over 35?

Statistically speaking, these pregnancies are at a higher risk of complications, such as diabetes, or placenta related complications. The placenta forms in your uterus at the beginning of pregnancy and provides nutrients and oxygen to your baby through the umbilical cord. If there’s a problem with your placenta, your baby may be smaller than expected, or you might develop gestational hypertension or preeclampsia. Sunnybrook is currently studying preeclampsia in our patients – you can learn more here.

If I see a patient for a pre-pregnancy consult, I also look at their sugar balance, to make sure they’re not pre-diabetic, as the risk of pre-diabetes and gestational diabetes increases with age.

What about risks to the baby?

It’s true that the risk of genetic and structural anomalies in babies increases with age. You can learn more about genetic testing options here. Patients over 40 years of age at the time of delivery can do a test called NIPT for free. NIPT is a genetic test which is more sensitive than our regular first trimester screening test for Down syndrome. In addition, chorionic villous sampling and amniocentesis are options you can discuss with your care provider. We also offer patients over 40 an anatomy scan at 11-14 weeks to detect anomalies earlier in pregnancy, in addition to the 18-20 week scan.

What can I do to increase the chance of having a healthy pregnancy and baby?

First, you can maintain a healthy and active lifestyle. Second, if you have a health issue for which you are receiving medical treatment, it is suggested to you have a pre-pregnancy consult with a Maternal-Fetal Medicine specialist in order to optimize your treatment prior to conceiving.

The use of folic acid for at least 3 months prior to conceiving is also recommended to reduce the risk of spinal cord congenital defects.

If you are treated at a fertility clinic, they can run additional genetic testing on the fertilized egg prior to returning it to the uterus in order to detect genetic anomalies.

I’m using a donor egg — does all of this still apply to me?

It is important to note that some of the risks are related to maternal age (such as the risk for placental complications) and some to the age of the egg (like genetic risks). If you’re using egg donations from a younger person, some risks apply and some do not. During pregnancy we will follow the fetal growth closer to make sure your baby is growing as expected.

Is there an increase in Canada of women delaying pregnancy?

Yes, there is a measurable trend in delayed childbearing. For example, in Ontario, the average age at first birth increased from 28.4 years in 1991 to 32.1 in 2021. Across Canada, during the same years, it increased from 27.8 years to 31.4. Statistics Canada tracks birth rates and age.

The post Pregnant and over 35 (or 40?) Dr. Amir Aviram answers some common questions appeared first on Your Health Matters.

Here are Kathy’s four tips for success:

Let friends and family know you’ll need support while establishing breastfeeding

Kathy recommends telling loved ones you’ll need space and quiet time while establishing breastfeeding. To ensure sustained milk production, breastfeeding early, frequently and effectively is key. It takes approximately six weeks until full milk production is established. “Prepare family and friends for this period by telling them they can support you in a number of ways, like doing laundry, running errands, walking the dog, meal preparation and cleaning,” says Kathy. “People want to help when there’s a new baby and this provides some helpful suggestions.”

Tell your care team you’re interested in breastfeeding

Communicating your intent to breastfeed – with your midwife, obstetrician or family physician – is key before having your baby. Kathy is quick to note that your care team should have this on their radar too, and can answer any questions or concerns you may have. Make a note of breast changes during pregnancy, and practice gentle breast massage in preparation to breastfeed, suggests Kathy.

Research the value of skin-to-skin contact immediately after your baby is born

By initiating skin-to-skin contact immediately after birth, and continuing until after the first successful breastfeed, you’re setting yourself up for success. Not only does this contact establish the bond between you and your baby, it also signals to your body to start making milk and colostrum. Colostrum is the nutrient-filled fluid produced before milk is released, which can help boost your baby’s immune system and protect them from illnesses in their first few months.

Ask for help or support if you need it

Breastfeeding, like parenting, is a process. Don’t be afraid to ask for help and support along the way.

Here are some additional, trusted online resources for more information:

• Reliable scientific resources are available at Health Canada, Unicef and the World Health Organization
• Peer support is offered by LaLeche League and Breastfeeding Buddies
• Prenatal information is available on ca as well as Toronto Public Health

The post Four tips from a lactation consultant for establishing breastfeeding appeared first on Your Health Matters.

As a volunteer with Sunnybrook’s Pregnancy and Infant Loss group, I was honoured to share my story yesterday with a group of health-care workers. The purpose of the workshop was to educate and empower health-care professionals on how to deal with patients experiencing possibly the worst day of their lives and the fallout of their loss(es). Here was some of my advice:

1. Never assume.

When I was in hospital after experiencing a 20-week loss, a hospital porter entered my room with a flower delivery. As she set the bouquet near the window, she innocently looked around and asked, “Where’s the baby?”

Years later, in another hospital high risk unit I was in, I noticed butterfly stickers outside some of the hospital rooms. Those stickers symbolized to outsiders that the patient behind the door had experienced a loss. Every hospital needs something like this. And/or, ensure grieving moms don’t have to share the ward with celebrating moms.

2. Never start a sentence with “At least you have…” or “Just be grateful for…”

I tended to attract these well-intentioned comments because I have other kids. But, these comments felt like they were suggesting I wasn’t thankful enough for my current family. Losing one baby, doesn’t require a reminder (from your doctor) that you should “just focus on your babies that are alive.”

3. Please stop with the “how many pregnancies” and “how many live births” questions.

Surely, this information is already in my file. Please take a minute to find the answer before asking me to recount how many of my babies have died and at what gestation. While this might be a routine question for you, it’s triggering to someone who’s experienced loss. There were times that I was asked the same question during every weekly ultrasound, and sometimes, during the same hospital visit by various staff. Please have a better system in place.

4. Have a bad news plan.

Ensure that if bad news is delivered, your patient is going to be cared for when she leaves the appointment, is given written information on what to expect and what comes next because she won’t remember what you tell her. And, make sure she gets home OK (rather than going back to the office — which I did, more than once and, do not recommend). After one of my losses, I was given a backpack of self-care items and reading material and recall being so touched by this act of kindness, from a hospital volunteer versus another loss when I was told by the radiologist to “follow up with your doctor on Monday because he’s probably gone for the weekend since it’s Friday afternoon.”

Pregnancy and infant loss is not a “women’s issue.” It’s a terrible fact of life and it affects parents, families, companies, health-care systems and communities. I’m grateful to finally be in a place where I can share my experience without shame, and hope that through my sharing, I can help inspire small but meaningful changes in our health-care system.

The post Lisa Marie, a Pregnancy and Infant Loss Network volunteer, shares her story and advice for working with grieving parents appeared first on Your Health Matters.

The tattoo is just one way she remembers her first born son, Easton. Easton was born just shy of 22 weeks, without a heartbeat, in 2018.

Mother’s Day, for Lisa and many others who have had a pregnancy loss, can bring mixed emotions. The peer support volunteer for Sunnybrook’s Pregnancy and Infant Loss (PAIL) Network shares her journey.

What has been helpful following your pregnancy loss?

My husband Chris and I share our story of loss with anyone who is open to listening. We’ve learned to not feel embarrassed if others are uncomfortable when we talk about Easton’s death. If I were to say anything to a parent who has a loss it would be: it’s your story and you own it. You earned the right to grieve and process however it feels right for you. Regardless of “normal” timelines and expectations.

In March of 2020, your family welcomed baby Nash. Can you talk about the experience of “trying again” following your loss?

There is no right or wrong or a certain timeline in grief. I know some people feel guilty about trying to conceive after a loss. It can feel like everything stands still when you’re grieving. When I first learned I was pregnant again, I felt happy. Later, for sure, the uncertainty and concern set in, but in that moment it was joy. We weren’t “replacing” the baby we lost, we were continuing to build our family. Now, Nash is a healthy, happy and thriving toddler. He’s incredible.

How do and your family remember Easton?

We honour him on his birthday each year. And when Nash is old enough, we will have him pick a gift for the age Easton would have been that year and donate the present. We’re going to continue to be very open and speak about his brother. Both Chris and I got tattoos following the loss. I like that it’s a way to open up the conversation and our way of carrying him with us always. On my wrist, I have his hand and footprint, and Chris has the same on his chest, along with “Father of an angel.”

What does Mother’s Day mean to you now?

I remember my first Mother’s Day following Easton’s death. I kept thinking, “Am I a mom or not a mom?” It was like I was at a party I wasn’t invited to. This Mother’s Day, I don’t mind feeling sadness. The sadness comes with a bit of comfort as it means we haven’t forgotten about Easton. I have a baby, but not both of my babies. That is just our reality in how we celebrate and honour the day and really, I think speaks to the diversity of the makeup of a mom.

The post One mom’s story about having a baby after experiencing a pregnancy loss appeared first on Your Health Matters.

There is hope, and treatment, for anxiety during pregnancy.

A new study – Treating Anxiety in Pregnancy (TAP) – by Sunnybrook Research Institute and Women’s College Research Institute is looking at a type of talk therapy called Mindful Adaptive Practice in Pregnancy to determine how the treatment works in reducing anxiety. If you are 18 years of age or older, live in Ontario and are between 12 and 30 weeks of pregnancy, you may be eligible to participate.

Dr. Sophie Grigoriadis, Head of Sunnybrook’s Women’s Mood and Anxiety Clinic: Reproductive Transitions, answers questions related to pregnancy and anxiety, and about the study.

I’m pregnant and feeling quite anxious and overwhelmed. What should I do?

Don’t keep it to yourself. Talk to your family doctor, midwife or obstetrician. There is help available.

What will my doctor or midwife do when I reveal my anxiety?

Your health care provider will use screening tools and ask you questions like:

• How are you sleeping? How’s your appetite? Can you focus and concentrate?
• Are you getting pleasure out of any activities, or is everything overwhelming? Are you thinking of harming yourself?

How will my anxiety be treated?

There are different approaches to treating anxiety during pregnancy. These include community resources like support groups and apps to connect you with techniques for reducing anxiety. Your family physician, obstetrician or midwife may also refer you to a psychiatrist. Following a psychiatric consultation, you may be given resources and may be further referred for individual or group psychotherapy. Medication is reserved for moderate to severe anxiety in those diagnosed with an anxiety disorder or depressive disorder with prominent anxiety.

What’s involved if I’m selected for the TAP study?

Our team has adapted a talk therapy treatment called Mindful Adaptive Practice in Pregnancy, which can help women who are pregnant learn how to reduce their anxiety very quickly. It is an exciting and innovative treatment because it is:

• Ultra-brief in duration (one month)
• Specific to pregnancy
• Delivered in a group format
• Provided over the internet and done from home

What is talk therapy?

“Talk therapy” is also sometimes called psychotherapy. It’s a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts, and behaviour. Talk therapy is recommended to treat mental health problems but some treatments are not often utilized because they take time to learn and use. The pandemic has added another layer of burden because in-person treatment is not routinely available.

Have questions about the TAP study and eligibility? Please contact our research assistant, Morgan Sterling at morgan.sterling@sunnybrook.ca.

The post Anxious and Pregnant? You’re not alone appeared first on Your Health Matters.

Leveraging a long-standing relationship

Dr. Karen Fleming: In most cases, we’ve known our patients for years, and there’s a level of trust. Patients often feel comfortable talking to us about their concerns related to many health issues, including COVID-19 vaccines during pregnancy.

Dr. Kate Stead: I agree. I think at first sometimes patients feel a bit worried if they reveal they haven’t received their COVID-19 vaccine. I always reassure them it’s a safe space and that as family doctors we’re here to help. 

Dr. Karen Fleming: Absolutely! I’m so happy when patients ask questions; it’s a privilege to help guide decisions about their health. I reassure patients about what we do know: that vaccines have been safely given during pregnancy for decades. For example, the flu vaccine and the whooping cough vaccine. Vaccination is a standard part of what we do while caring for you during pregnancy.

Dr. Kate Stead: As family doctors who follow patients throughout their lifetime, our work is to help our patients have as healthy a life as possible. The COVID-19 vaccines are new, but the research shows they’re very effective at preventing hospitalization and reducing the chance you’ll be admitted to an intensive care unit. There’s also research that shows the antibodies are transferred to your baby through the placenta and evidence that antibodies are passed in breast milk.

Taking time to listen

Dr. Karen Fleming: Recently, I was speaking with a pregnant patient about the COVID-19 vaccine. At first, she said there was no way she could get the vaccine. We kept chatting and it came out that she’s really anxious about getting needles. I told her about CAMH’s special vaccine clinic for those with needle phobias and she was able to make an appointment. Often there’s an underlying fear that we can work through together.

Dr. Kate Stead: I’ve found the same thing. Sometimes I’ll ask patients if they’ve had an opportunity to get the vaccine and they respond they haven’t. It’s good to start the conversation and learn more about their perspectives and experience. The bottom line is that I always reassure my patients: “I care about you and I’m here for you.”

Dr. Karen Fleming is Chief of Sunnybrook’s Department of Family and Community Medicine. Dr. Kate Stead is the Social Accountability and Global Health Lead in the Department of Family and Community Medicine.

The post Pregnant and have questions about the COVID-19 vaccine? Your family doctor is a great resource appeared first on Your Health Matters.

Advice from our experts:

» What to do if you or your loved one has postpartum depression
» Pregnant or just had a baby? Tips for looking after your mental health

May 5^th is World Maternal Mental Health Day – take our quiz* to test your knowledge of postpartum mood and anxiety disorders.

*Sources are Postpartum Support International and PostpartumDads.

1. Which of the following is NOT a symptom of postpartum depression?
   1. Irritability/anger
   2. Guilt
   3. Withdrawal from friends/family
   4. Delegating chores to others
   5. Lack of energy and motivation
   6. Headaches

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: Delegating chores to others.
   [/mks_toggle]

2. Risk factors for postpartum mental health diagnoses are:
   1. A family history of mental health
   2. A preexisting mental health history
   3. A mental health diagnosis or coping difficulty in pregnancy
   4. Psychosocial stress including relationship issues, domestic violence, and a lack of social support
   5. A difficult birth experience, upsetting events and/or separation from your baby in the immediate postpartum period
   6. All of the above

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: All of the above.
   [/mks_toggle]

3. If I am worried that I might have postpartum depression, I should speak with my:
   1. Family doctor
   2. Obstetrician
   3. Midwife
   4. Public health nurse
   5. Partner
   6. Close friend or family member
   7. Any or all of the above

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: Any or all of the above. Plus, call 911 or go to your local emergency room if in crisis.
   [/mks_toggle]

4. Partners can experience postpartum depression and other postpartum mental health issues.
   1. True
   2. False

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: True.
   [/mks_toggle]

5. Postpartum depression will go away on its own. 
   1. True
   2. False

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: False.
   [/mks_toggle]

6. Untreated depression may have long term effects on children’s health and development.
   1. True
   2. False

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: True.
   [/mks_toggle]

7. Medications prescribed for postpartum depression are safe if breastfeeding. 
   1. True
   2. False

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: True.
   [/mks_toggle]

8. What is the definition of postpartum blues?
   1. A mood disorder with symptoms including sadness, frequent crying, feelings of worthlessness, irritability and obsessive thoughts. May occur any time during the first year postpartum.
   2. A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.
   3. An adjustment reaction with transient depressed mood that occurs within the first two weeks postpartum and resolves spontaneously.
   4. The process by which parents form an emotional relationship with their infant over time.

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: An adjustment reaction with transient depressed mood that occurs within the first two weeks postpartum and resolves spontaneously.
   [/mks_toggle]

9. What is the definition of postpartum depression?
   1. A mood disorder with symptoms including sadness, frequent crying, feelings of worthlessness, irritability and obsessive thoughts. May occur any time during the first year postpartum.
   2. A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.
   3. An adjustment reaction with transient depressed mood that occurs within the first two weeks postpartum and resolves spontaneously.
   4. The process by which parents form an emotional relationship with their infant over time.

   [mks_toggle title=”View the correct answer” state=”close “]
   The correct answer is: A mood disorder with symptoms including sadness, frequent crying, feelings of worthlessness, irritability and obsessive thoughts. May occur any time during the first year postpartum.
   [/mks_toggle]

10. What is the definition of bonding or attachment?
    1. A mood disorder with symptoms including sadness, frequent crying, feelings of worthlessness, irritability and obsessive thoughts. May occur any time during the first year postpartum.
    2. A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.
    3. An adjustment reaction with transient depressed mood that occurs within the first two weeks postpartum and resolves spontaneously.
    4. The process by which parents form an emotional relationship with their infant over time.

    [mks_toggle title=”View the correct answer” state=”close “]
    The correct answer is: The process by which parents form an emotional relationship with their infant over time.
    [/mks_toggle]

11. What is the definition of mental health?
    1. A mood disorder with symptoms including sadness, frequent crying, feelings of worthlessness, irritability and obsessive thoughts. May occur any time during the first year postpartum.
    2. A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.
    3. An adjustment reaction with transient depressed mood that occurs within the first two weeks postpartum and resolves spontaneously.
    4. The process by which parents form an emotional relationship with their infant over time.

    [mks_toggle title=”View the correct answer” state=”close “]
    The correct answer is: A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.
    [/mks_toggle]

The post Postpartum depression: Take our short quiz appeared first on Your Health Matters.

With the global pandemic, you may worry about how COVID-19 will affect you and your baby and have questions about vaccination. At the same time, you may have less support from family and friends due to COVID-19 restrictions.

Dr. Gail Robinson, psychiatrist in Sunnybrook’s Women’s Mood and Anxiety Clinic: Reproductive Transitions, has written about heightened depression and anxiety during the pandemic in The Journal of Nervous and Mental Disease.

Here are Dr. Robinson’s tips for women:

 

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The post Pregnant or just had a baby? Tips for looking after your mental health appeared first on Your Health Matters.