Newsletter for Parents
September 2017
Welcome to our first parent-focused newsletter!

This month we introduce our first newsletter especially for parents. We want to better serve both our parents and our providers who work with families, so we've created separate newsletters for each of those groups. We hope you enjoy this month's content that's tailored just for you!

This month we take a closer look at multiples and the special joys and challenges that parenting them entails, especially at the beginning. We feature interviews with both a mom of twins who dealt with postpartum anxiety and a postpartum doula who has lots of practical advice especially for parents of multiples. We've sprinkled plenty of lighter memes and self-care ideas throughout, too.

We always welcome feedback on our newsletters!
In This Issue
Jennifer Mendelson, Certified Postpartum Doula
Jennifer has been a doula, both for births and for the postpartum period, for about 13 years, and is now focused on just postpartum work. She's worked with hundreds of families, including many sets of twins. We asked her for her insights about preparing for and parenting multiples in the postpartum period.
On what's unique about parents of multiples. Surprisingly, Jennifer says, parents of multiples tend to be MORE prepared, with fewer unrealistic expectations about the birth and the postpartum period. They don't expect to exclusively breastfeed or to bed share, for example. They have thought through the idea of premature birth and NICU stays, and even details of the birth plan. "There's a kind of letting go of how we thought it was going to look." Starting out with modified expectations can actually help people to better prepare for a perinatal mood or anxiety disorder, she says.
On the most common practical struggles she sees with parents of multiples: Jennifer noted that, not surprisingly, two (or more) babies means MORE than twice the work. "That idea of having a window of time in a 24-hour period when parents are off-duty is just not there" like it might be for parents of a single baby. Feeding and sleeping are the most common concerns, since the babies' needs are not synched, at least at first.

On the emotional adjustments that parents of multiples need to make: Jennifer says that many adjustments are universal regardless of how many babies you have: your shift in identity, what it means to be a mother/father, as well as sleep deprivations, physical recovery from birth, dealing with medical complications, etc. But with multiples, it's times two (or more). 
Her top suggestions for coping in general?  
  • Jennifer suggests that the parents have a consultation with a professional before the babies are born to set up a system to make caring for the babies easier. A professional like a doula can help you set up stations on each floor for changing, feeding, "parking" the babies, figuring out where they will sleep, and so on. And having an idea of where all the baby stuff goes can decrease anxiety for the parents.
  • Once the babies are home, she emphasizes getting the babies to feed at the same time. This can be hard at first, when the babies are still learning to eat. But Jennifer suggests getting help, with friends, families, or professionals to step in to help in feeding.
  • Be diligent about self-care. Jennifer stressed taking care of the adults in addition to taking care of the babies. "We tend to be good at caring for babies, but we fall short on taking care of ourselves." This is especially the case with feeding ourselves. She suggested getting a meal train, having frozen food ready, or employing grandma's cooking to make sure the parents are eating. 
On what she wishes parents of multiples would know before they give birth. The most essential thing, Jennifer stressed, was to be gentle with oneself as the postpartum period unfolds. Know that there will be lots of stress, both physical and emotional. "We learn to tenderly take care of the wee ones, but we need to do so with the parents as well. Bring people onto the team who can help with that for the family."


Jennifer tells all new parents to "front-load" self-care. Do more now, even when you feel great, to make sure your tank is full. Put your feet up. Take baths, cuddle in bed, accept food, linger in the "baby cave." While you have people around helping, really use them. "If you can slow down in the early weeks, you do much better three months out, with much more reserve...It's like putting money in the bank," she says.

First Person
Marloes Koning, mom to twins

Marloes Koning is a mom of almost-7-year-old boy/girl twins. She talked to us about her experience of pregnancy and her postpartum period with twins, including dealing with postpartum anxiety.
What is your own journey of having and parenting twins?

Marloes shared that she and her husband had trouble getting pregnant, and used IVF to help. The pregnancy was stressful because of that. "Friends enjoyed their pregnancy, but I worried about losing them," she explained. They were born at 35 weeks 2 days, and stayed in the hospital until their 40 week date. "All this was very stressful, including the hospital, hormones, and me recovering."
What is your story of postpartum anxiety and recovery?

Marloes had a history of panic attacks, and was told to be vigilant about that after the birth. She describes having typical baby blues at first--just feeling generally overwhelmed. But soon she was crying a lot and stressed when her husband went to work. She remembers thinking that this couldn't be postpartum depression, since her symptoms didn't include sadness. "I felt like I had to be happy because we struggled so hard to get these twins," she said.

Soon serious sleep deprivation set in. She started keeping track of sleep, diapering, and feeding. "I would do anything to get more sleep. I was about to put the whole schedule in Excel to find some magical code to get five minutes more sleep." Early on, Marloes felt really torn between her two children, because one baby was needier. She says she felt so guilty giving more attention to the needier one, and this was an issue she hadn't expected.
At an appointment when her babies were 4 months old, her obstetrician asked how she was doing, and she started crying. But she still didn't feel classically depressed. She went to talk to a therapist that night, where she discovered she had postpartum anxiety. "I just sobbed and sobbed, relieved that it had a name." She also started medication.

Marloes says she regrets that she wasn't told more about postpartum anxiety and its symptoms--that not all postpartum mental health issues look like sadness.
As for her recovery, Marloes credits lots of friends and a multiples support group (she loved her PEPS for Multiples group). "I needed an excuse to get out of the house, just to be with other moms." She also credits her husband for really getting what was going on and when she just needed a break. "My husband would say, go to Starbucks and read a book," which was exactly what she needed She'd also schedule her visits from friends when she most needed help, like when she needed to feed her infants. And she walked in the afternoons, rain or shine, both so that the babies would have fresh air and for her to clear her mind and not be confined in her house.
What do you wish providers (obstetricians, midwives, etc.) would realize about having and parenting multiples? How can they better serve parents of multiples?

Marloes emphasized the important fact that just by having multiples, especially when IVF is involved, you have a bigger chance of having a perinatal mood disorder. She wishes providers would have told her about that. She also stressed how important it is for providers to talk to expecting parents about multiples support groups. "It's very important to connect with parents in the same boat, so you have some sort of support system before you have your twins."
What do you wish friends/parents/spouses would realize about parenting multiples? How can/could they best help a new parent?

She emphasizes that new parents need hands-on help, and not the type of help that requires the new parents to entertain the guests. "Do whatever needs to be done." Since the "sleeping when the baby sleeps" advice is really challenging with twins, she suggests that visitors hold the awake baby while mom sleeps while the other baby sleeps, too.
She says to be really clear about your own needs. If you need laundry done, say that. "You have to be very clear about what you need. People don't know how to help, but they want to help."
As for baby shower gifts, she says friends and family might want to do meal vouchers, vouchers for a doula, or offer specific household help, and not just give those cute little baby outfits!
What's life like for you now?

Marloes is now fully recovered from her perinatal anxiety disorder. She shared that perhaps the first two years were really hard, but then the kids realized they have a built-in playmate, which made parenting easier. "Now it's so special to see the strong bond they have." Reflecting on their births, she says "It was special to carry twins, too. I was immediately part of the "twin crowd," with other twin parents. Now I'm very happy I had twins (I had two with just one round!)"
Marloes regularly speaks at prenatal classes at Swedish, where she tells her whole story, including noticing the difference between depression and anxiety symptoms, and emphasizes to the groups to look for help if they are suffering. She has also led several monthly groups of Seattle Families of Multiples. SFOM has a PEPS-based program, called PEMS, for new parents of multiples.
Mantra of the Month

Resources For Parents of Multiples

Resources for Expectant Parents
If you're expecting multiples, taking a Multiples Childbirth Education class is an invaluable learning experience and an amazing opportunity to bond with other parents who are soon to have kids around the same as age yours! Both Swedish Medical Center and UW Medicine offer their own series of classes:
Multiples Clubs

Seattle Families of Multiples
SFOM maintains a helpful list of local parents of multiples who have offered to be points of contact for various topics (e.g. Pregnancy Complications, Feeding, Pediatric Health Issues, etc.) You need to be a member to access this list.

Other Multiples Clubs

Other Parenting Resources 

Self-Care Out of the Box
While spa days and coffee dates may sound wonderful, they may be too overwhelming or not fitting for you as a self-care, or "wellness" practice. Here are some other ideas for what may help you regain a sense of calm and feel more like yourself.
  • Organize a bathroom drawer
  • Go outside and take five deep breaths
  • Call that friend who makes you laugh
  • Buy a new coffee cup or fancy water bottle
  • Make your bed
  • Shave your legs
  • Discover a new band or podcast
  • Fill out our wellness plan and post it on your fridge.
Call Our Warm Line for Support! 

Perinatal Support Washington has a toll-free support line for new parents. Leave a message, and a trained volunteer will return your call within 24 hours. The line is staffed by a parent who has experienced a perinatal mood and/or anxiety disorder and has recovered fully, or a licensed therapist with specialized training in perinatal mental health.

We provide warm, understanding, effective, and private support, as well as professional referrals to providers who can help. We also provide details about community support groups and resources and information in the community and online. 

NEW! DADS ON THE LINE! Would it feel more comfortable to talk with a dad who has been through his own perinatal mood or anxiety disorder, or has supported a partner who has? Call our warm line and ask to talk with a dad. 
Are You a Provider?
This parent-focused newsletter would be a great resource for your families! Feel free to forward this email to them or print it out for your office. Most of our past newsletters can also be found here

Giving to Perinatal Support Washington
Employee Giving
Are you a Microsoft or King County employee or spouse of one?  
Please consider supporting us through your respective workplace giving programs. For King County employees, our code is 9187. Our tax ID is 91-1448669. If you are looking for us, be sure to check our old and new name (Postpartum Support International of Washington) if you don't see us--we are there.

Warm Line: 1-888-404-7763 (PPMD)

Support Education, Referral
(formerly Postpartum Support International of Washington)