Michelle Rupp: Registered nurse Michelle Murtha, with AFMC, joins me in the studio now. Hello, thanks for joining us. So, first time in the studio?

Michelle Murtha: First time in the studio, and it’s great. It’s wonderful. And it’s good to get good information out there for everybody. Thank you for inviting me today

MR: So, we’re talking about post-delivery, post-pregnancy … It’s a pretty big umbrella, but we’re going to try to tackle a few questions. And the first one I’d start with is what are some of those questions first-time moms, even experienced moms, might want to ask their doctor post-delivery?

MM: Unfortunately, what happens is the baby takes over, and they have more questions about the baby than they do about themselves. We like for them to be educated before their delivery. A lot of questions stem from that. Also, the nurse with that mother will educate her about her post-delivery, and she will have questions from that. But we want them to be educated along the path of their pregnancy at each visit so that they know a lot about what’s going to happen and how it will happen because then the baby takes over.

MR: What are some of those post-delivery warning signs, those things that moms, especially first-time moms, could be entirely taken off guard?

MM: They can have abnormal things like chest pain, a headache that will not go away with taking Tylenol. They can have a lot of bleeding, not just normal bleeding, they can have a lot of bleeding, and that needs to trigger that there’s a problem. They can also have pain in their leg. That could be a blood clot that can travel to their brain or lungs and cause problems. But mothers need to be aware that if there’s anything that they think is not normal … and the families need to be educated about all of these issues, when they need to call 911 and when they need to contact their health care provider to get some guidance or to get help.

MR: I love what you said earlier, that women need to rely on those instincts because you know, you know …

MM: Yes, absolutely. What we don’t want is moms to ignore those instincts because they are essential. We want moms to be aware of the issues. The family – the husband, grandmother, grandfather, whoever – needs to be in tune with what that mom is experiencing, listen to her, hear her, pay attention to what she’s saying, and act on it. If their instincts are like, “we need to go get some help,” or if mom says, “I need help,” it needs to be done.

MR: Does the way you deliver impact any of those warning signs?

MM: It possibly can. You can have a section delivery. You’re more likely to get an infection than a mother who delivers vaginally, which would be an issue if the mother has other comorbidities – if she is diabetic or if she was what we call preeclamptic. If her blood pressure was high before pregnancy, it doesn’t automatically go down. And so, mothers go home, and their blood pressure is still elevated. It needs to be managed. If mom gets a headache that just does not go away … sometimes we don’t have a warning sign, and mothers will have strokes and other things that could have been prevented. It’s important to get help when your instinct is that you need help.

MR: Listen to those red flags. My last question, if you are a mom with more than one child … and just because you didn’t feel this way with one child, but then you give birth, and maybe you start feeling … I mean, is it, “Well, I didn’t feel this way with my first one. Why would I feel this

way with my second one?” Or can that switch get flipped? Not on the first three children, but the fourth child, then it happens.

MM: It can happen. If it happened with the first one, I would suspect that you need to pay attention. It’s probably going to happen with the rest of them. If it didn’t happen before, you didn’t have any depression or problems before, it’s okay. It can happen with the second, third, or fourth child that you do feel this way. If that happens, you really know there’s something different right away. “I don’t feel the way about this baby as I did for the other.” Situations may be different, but hormonal issues … We just need to seek help and see what we can do. Just maybe talking to somebody or calling your primary care provider or calling your OB doctor, and starting that conversation with them, being proactive to prevent anything else that may come up. But it’s so important to take care of yourself. Moms need to know that the baby is special and great, but mom still needs time for mom, and mom still needs to take care of mom, and it’s a beautiful thing when they’re allowed to still care about mom because it could be a huge change from the fact that, you know, it’s the first baby now. “Everybody cares about the baby, not about me.” Those kinds of things can stir up issues. We don’t want it to, but moms are important, so take care of yourself.

MR: That’s right. Great advice. Michelle, thank you so much for coming in today.

MM: You’re welcome. Thank you for having me. I hope that mothers get some good information out of this session.