Thoughts On My Two Postpartums (and Maybe Yours, Too)

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My sons, myself, and my midwife at our final postpartum visit.

I had my final postpartum visit last week. My last postpartum visit EVER. Bittersweet, yes. I feel a mixture of grief and motivation. Part of me wants to apologize (to whom, I do not know) for being melodramatic. The rest of me knows no apology is needed — postpartum time deserves far more attention and care than it typically receives.

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“Some hundreds of years ago, Colonial Americans thought it fit for a woman who had just given birth to keep to her bed for three or four or more weeks. For the length of the ‘lying in’ period, as it was called, the new mother would rest, regain her strength, and bond with the baby as her womanly attendants kept up the household. Several of these ladies would be relatives, and others not; none were paid, and all expected to be similarly cared for following their own deliveries.” – Hillary Brenhouse, Why Are America’s Postpartum Practice So Rough on New Mothers?

After my first baby, I learned about postpartum life by living it. No one trained me, prepared me, held my hand through it, or insisted I lay in for a month. It’s just simply not the standard approach of my culture, especially not the medicalized system into which my first son was born.

My prenatal care provider didn’t mention one word about what to expect postpartum. Neither did anyone else, but you’d think of all people, the one I paid to look after me in pregnancy-related matters would share a hint or two from his years of experience with freshly post-birth mothers.

It turns out he may not have had as much interaction with them as one would expect. You see, he was there when I birthed my son, went on vacation the next day without notice or so much as a “How are you?” or “Goodbye,” and I wasn’t graced with his countenance again until six weeks later at our only postpartum visit.

Then, I was the kind of woman who resumed regular chores and shopping trips almost immediately. My sanity suffered for this belief that doing all the same things I did pre-pregnancy — as if nothing paramount had happened between then and now — would prove my healing and strength. I’m sure you can guess where the story wound up.

My postnatal anxiety and depression went overlooked for so long I couldn’t tell if it was my fault (how could I concede I was not Superwoman?) or if I should feel too ashamed to ask for help (did I even need help?) and for this I couldn’t admit until long after it was over that my determination to get right on with ‘normal’ life had, in all its irony, cast a memorable darkness over two years of postpartum.

So with a hopeful heart, after my second baby, I planned for the best instead of the worst.

I set boundaries for visitors. I asked for help when I needed it — even when I simply wanted it. I didn’t impose limitations on the perfunctory ‘laying-in’ part of the laying-in period that most other cultures view as a normal extension of the childbearing process.

The second time, I made a point to surrender to the necessity of just being instead of doing. Of acknowledging the bigness of what had just happened in my life and within my body — a pregnancy, a birth, and now an involution of those withering energies.

Yes, I got bored, helpless, and frustrated at times. I’m not much of a ‘sitter’; I like to stand and move. Feeling tethered to the bed or couch isn’t really my idea of the ultimate peace.

But miracles were still happening and the boredom would be fleeting. I had a whole body of my own that politely reminded of its need for tending, and a whole baby that must have my constant devotion to recreating a womblike environment for him.

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*****

Having been around the block once, I knew what I might expect this time:

I’ll still be contracting. I’ll still look pregnant, maybe just for a little while, maybe forever. I’ll have a linea nigra. And maybe stretch marks. Probably loose extra skin. I might smell funky thanks to hormone shifts. It’s not beyond the realm of possibility that I might be dealing with a tear/cut, swelling, hemorrhoids, and/or a cesarean wound. I’ll feel blessed to have mesh underwear, impossibly long pads, or adult diapers. I’ll experience some degree of baby blues. Milk stains, spit-up, tiny towels smeared with baby neck-fold debris and endless waste collections in cloth diapers. I’ll be braless by necessity rather than by choice. I’ll need more personal space than most may understand, but I won’t want to be left alone either. I’ll be deliriously tired.

After a woman has a baby, she’s ‘back’ to her body, but it’s not really hers. Certainly not what she remembers, I mean. An in-between thing. It’s no longer recognizable as the body she once knew. She resents every time she’s heard she can “get her body back.” As if her postpartum form doesn’t count as a legitimate body; as if it’s some flawed state of illness instead of an empowered one that expertly crafted a body for a spirit.

It’s said that it takes two years for a woman’s body to fully recover from a pregnancy and childbirth. Even then, she’ll never again be the same. But dare a woman lament, lest she be reminded with a finger wag: “A healthy baby is all that matters.”

And dare a woman openly process her experience lest she be guilt-tripped for floundering as Supermom right out of the gate, or treated as though her struggles no longer count as ‘postpartum’ after a certain number of weeks.

I must accept that this is my new normal.

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*****

Pregnant mothers-to-be are the hit at the party. For them, people throw showers in celebration, nobly give up their seats and patiently hold doors ajar, designate special parking spaces, offer massages and advice (solicited or not), and call frequently to check on her and the baby’s condition.

In American society, it’s not common practice for the same people to dote on a newly postpartum woman with the same enthusiasm, or to put as much attention toward her special needs in the transition period called ‘the fourth trimester.’

Here, the new mother hungrily awaits a return to something resembling her pre-baby routine. She plans for a return to work, whether out of obligation or longing. She focuses on losing the pregnancy weight. Recovery from pregnancy and childbirth is measured in pounds, stitches, stretch marks, baby bottles, sleeping ‘through the night,’ and length of maternity leave.

When a woman returns from laborland, she often suddenly becomes an afterthought. Calls flow in from individuals who are curious about the baby, wondering how he is, what he needs, when they can stop by to see him. Baby, baby, baby.

So now the baby is here. But to his mother, the baby was always here. Here was, in fact, ‘in her.’ She feels as though they hold unified space still, but others fail to see how they’re transitioning back into the world together. (Thankfully, this is not my own current postpartum. Was it yours? I’ve seen it over and over).

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When it comes to the mother, she may feel pressure to regale others with her birth story (likely at the tip of her tongue yet completely unprocessed), or forced to entertain guests in her home when all that should require her energy is her recovery.

Well, her recovery, and of course… the feeding of her infant. As breastfeeding regains popularity as the healthiest method of nourishment for babies, much less is said about what breastfeeding does for the mother. Breastfeeding causes the uterus to clamp down and involution occurs at her ideal rate. Oxytocin surges help peak the mother’s mood as her hormones level out. Making food for a baby raises the mother’s metabolism too, reigniting her bodily processes after a sluggish nine months.

And as much as it pours warm, fuzzy love into her heart, it drains the rest of her body. She is always drained, and she needs her tribe to notice when her cup needs refilling.

“Some version of the lie-in is still prevalent all over Asia, Africa, the Middle East, and particular parts of Europe; in these places, where women have found the postpartum regimens of their own mothers and grandmothers slightly outdated, they’ve revised them.

The U.S. seems only to understand pregnancy as a distinct and fragile state. For the expectant, we issue reams of proscriptions—more than can reasonably be followed. We tell them what to eat and what not to eat. We ask that they visit the doctor regularly and that they not do any strenuous activity. We give them our seats on the bus.

Finally, once they’ve actually undergone the physical trauma of it, their bodies thoroughly depleted, we beckon them most immediately to rejoin the rest of us.” – Hillary Brenhouse, Why Are America’s Postpartum Practice So Rough on New Mothers?

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We know postpartum mood disorders are real, but too often we neglect to realize we all know a woman who has suffered or is suffering from them, even months or years after birth. Acting as though a postpartum woman can, will, or should spring right back into business can seriously threaten her health. Studies have shown that unsatisfactory experiences after pregnancy sharply increase the risk factor for postnatal depression, postnatal anxiety, post-traumatic stress disorder, and postnatal psychosis.

Struggles with insufficient milk supply are rampant in the Western world, too. A woman’s body is often first to blame, but closer inspection into her emotional state and support system is well warranted. A mother’s denial and society’s ignorance of her well-being are compounding contributors to these acute clinical conditions.

We’re so accustomed to the prevalence of the postpartum mood disorder, aren’t we? And so familiar with the still-common Western practice of mother-baby disengagement.

A plastic box becomes a baby’s first Earthly habitat in hospital nurseries. Overuse of pacifiers impede on mother’s instinct to soothe her baby with her breasts between meals. Babies are routinely left to cry-it-out alone in their cribs. These parallel (or reflect?) the continued disconnect many modern mothers feel from their births and babies.

Nature intended postpartum to be a time for bonding and melding, but somehow it has become a time for separation. We’ve become so terrified of dependency that a new mother is taught to disallow this ‘overindulgence’ of her newborn. Cut the cord at once; avoid looking as though a little baby needs you; get that baby to sleep on his own in the other room or he’ll never be independent.

And why should a new mother know any different? She’s typically left to fend for herself in her most vulnerable state, too: after birth, pretending not to tremble under the quake of her swinging hormones, asking for space because she fears others will notice her sadness, accepting crowds of entitled observers because she’s too obliged, letting her own cup run emptiest of all.

She isn’t allowed the cosseting of dependence either. The neediness would make her that much weaker and lesser than other women and men. She’s compared to others who did not just give birth; her great accomplishment is presented like a clock with a broken hand. Tick, tick, tick… baby’s out, time’s up. Back to work like the others. Back to taking care of the kids and house like the others. Back to normal physical routines like the others.

(On the note about work, we all know American protocol for maternity leave is abysmal. However I’d need at least another post to get into that).

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Pregnancy and birth are normal and natural processes, yes. Still, a postpartum woman is recuperating from injury: her body works to make up for blood loss and to perform normal bodily functions as comfortably as possible, her mind struggles to catch up to massive hormone shifts, she’s in a state of healing and it does take time. “Bounce back” is a phrase too casually applied to the modern American postpartum.

Above and beyond that, pregnancy and birth are rites of passage. When a man returns home from battle, a rite of passage in its own light, he is celebrated. His efforts are traditionally commemorated. The act of destruction is remembered, regarded with intrigue, handled tenderly.

To the contrary, creation is women’s work — the creation of life, in this way.

She was brave. She was transformed. She will put herself back together before anyone notices that pieces of her had fallen apart, while nurturing the other being she made whole in nine months.

You see, it’s not that she ‘gets’ to lie in, it’s that she needs to.

We must not overlook the individual experience. A mother should be asked how she’s doing, the same as she’d be asked during pregnancy. And she should feel safe enough to be honest when she answers.

For ideas about manifesting “13 Ideas for A More Pleasant Postpartum,” read my next post.

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