Copyright © 2005, Annette Avery. All rights reserved. Reprinted with permission.
Last updated: December 2005
CONTENTS
Dealing With "Baby Blues"--and Worse
By Annette Avery, guest columnist
Introduction
Author's Note: This article is an outgrowth of a discussion on the International Cesarean
Awareness Network email support list and my own research. I gratefully acknowledge the many wise and experienced women who helped me with this
project--and with my own PPD.
Many women feel down during the first little while after having a baby.
Often this is called "baby blues" and a mother may be led to believe it's normal and there's nothing to do about it. It may start any time during the
first year or more after birth, and it may last anywhere from a few days to months or years. (Some professionals define it as during the first year and
if it continues longer than that it gets renamed.) Sometimes it can lead to a belief that the baby would be better off not being alive. Whether it's
"just baby blues," post-partum depression, or post-partum psychosis, it is a real problem and it deserves to be dealt with.
A traumatic birth can contribute to Post-Partum Depression (PPD), but having a better birth may not mean that you don't get
PPD. There are many contributing factors that can lead to PPD, and one of the leading causes today in our culture is the lack of good support in the
early days and weeks after birth. PPD is not "normal," no matter what your healthcare provider(s) and others might tell you. It can be dealt with in
many ways, and it does deserve to be dealt with. Sometimes it might take time, but in the meanwhile there are ways to cope better while you live with
it.
The variety of possible approaches to PPD can be broken down into the following general categories: healthy lifestyle, physical support, mental
support, professional mental health care, and alternative therapies. A post-partum mother can do some of them
herself; others she may need help with. A caring family may provide that help, or she may need a post-partum
doula or other help from the community.
Healthy Lifestyle
It's a little-regarded fact that a mother's body is in a delicate transitional condition during the first several weeks after a pregnancy.
She needs to eat nourishing foods (healthy, whole, unprocessed foods, especially soups) get plenty of rest and gentle exercise, and drink lots of
water.
Whether or not she is breastfeeding, she needs to take special care of herself physically while her hormones, bones and joints, uterus, and other body parts adjust to a non-pregnant state. Even after an uncomplicated pregnancy and childbirth, the body is not ready to "bounce back" within days. It needs time to rest and recover strength--maybe time just sitting in an easy chair.
It's better to have someone else bring her nourishing soup and other foods, and lots of water. It's especially important to eat properly and regularly. Don't skip meals.
Physical Support
Don't try to keep up with a normal modern life immediately after having a baby. Know what to expect and arrange support accordingly. You will need
someone physically present to help you, so during pregnancy either hire a post-partum doula or arrange to have as many friends as possible waiting to
help out with bringing meals and taking care of you. If money is an issue, post-partum doulas may
work on a barter basis or accept payment over time.
If your support falls through, have back-up people who can step right in to fill the gap. Communicate with support people who become unsupportive. They may have issues of their own. Work through it together.
Not everyone is good at providing post-partum support. If your mother's presence, for example,
would be a hindrance to you rather than a help, be realistic about that and plan for other sources of support.
Get to know other cultures and their traditional approaches to supporting a new mother. (If you can enlist the help of friends from those cultures,
they might make great support people for you!) In any case, what you need is people who will not put time limits on you or be judgmental. You need
people who are willing and able to help you for as long as you need it without telling you (or implying) that you're taking too long to recover
from pregnancy and birth. The body is not a machine and it takes as long as it takes, but at least 6 full
weeks is generally needed.
Some specific things helpers might do include taking your child(ren) while you have a bath, coming over with a dinner casserole,
or doing laundry. In the meantime, let the laundry go and learn not to let that bother you.
Don't open mail or pay bills. You can let them go for weeks. Don't vacuum, clean bathrooms, or iron. Even if you feel like the house is coming apart
at the seams, do not do more than your body feels comfortable with. Other members of the household or outside helpers can do those things
occasionally. You need to rest and be taken care of.
You need plenty of time to focus your energy solely on nurturing yourself and your new child. The baby may need more attention than conventional
wisdom might suggest. Look into "attachment parenting," including things like co-sleeping and baby-wearing.
Finally, take care of your baby's mother. Exercise regularly (though gently at first) and get plenty of sleep.
Mental Support
This is a very important need of a new mother, and the one that seems to be most often lacking in our culture today. Many other cultures respect
motherhood as a valued role in society. They often have rituals designed to celebrate a woman's arrival to motherhood, even after second and later
births. As a result, they have no PPD. We have lost a lot of knowledge about how to provide a new mother with mental support during the post-partum
period.
Before even getting pregnant, be sure you and your partner are in agreement about birth plans. Having a well-supported labor and birth can be an
important first step in having a good post-partum experience. Plan to have great support at the birth, a caring healthcare provider, and a
pediatrician who is supportive of the family's values and needs.
Plan before the baby is born for the first several weeks post partum. Arrange to have someone to share with, including loving, caring relatives, a
devoted significant other, and friends. Give yourself permission to feel whatever your emotions are, including sadness, rage, or other negative
feelings that can be perfectly normal and natural during the early days with a new baby. Become informed so that you will be aware of what PPD is and
whether what you experience is normal or not.
The following are some books that may be useful:
After the baby is born, keep a journal of your experiences. Write every
chance you get. This is not a cheerful record of baby's early days, but an honest account of your feelings and experiences as a mother and an
individual.
A couple of websites that talk about ways of celebrating are:
Take time to mentally work through the changes that this new child will
bring to your own life and to your family. Re-evaluate yourself including your changed body after this pregnancy. It's normal for your body to look
and feel different every time.
Take care of yourself by pampering yourself with things like listening to relaxing music, ignoring the phone, talking to someone who always makes you
feel better, spending hours alone with the new baby, or whatever is soothing and comforting to you. Use clean, comfortable blankets and pillows, and
treat yourself to chocolate, a new haircut, makeup, an occasional babysitter, and time out with friends.
It could be very valuable to find one or more support groups to participate in. These could be groups you belonged to during pregnancy, groups for
mothers like La Leche League, or any group in your community or online where you can get support for this time of your life. Even if the stated
purpose of the group is not PPD support, feel free to bring up your needs to the people you know.
After your body has had the time it needs to recuperate from the pregnancy and birth, doing something outside your home that brings a sense of
fulfillment can be very important.
If you find that you do have any depression, even if it's "just the baby blues," it can be very helpful to admit to yourself and perhaps to someone
else that you feel this way. It may be important to relieve the stress of trying to appear strong, together, a great mom, and a wonderful wife by
putting the fact that you don't feel that way into words. Admit out loud that you can't handle everything by yourself.
Take comfort in knowing that what you are feeling is common and a normal possible result of many things that go into making the post-partum period
what it is: hormones, sleep deprivation, cultural lack of support, any problems with the birth experience, change, etc.
Have someone in your household keep a sharp eye on you to be aware if you are becoming dangerously depressed so you can get help including from
healthcare professionals.
Professional Mental Healthcare
In some situations, professional mental healthcare can be helpful. This usually consists of either medications, talk therapy, or both. Ask
your birth attendant or your baby's pediatrician for a referral. There are several helpful medications that will not interfere with breastfeeding.
Therapy may include marriage counseling, family therapy, or counseling for other individuals in the household.
Alternative Therapies
Some women prefer not to pursue mainstream mental healthcare. Another option is taking the time to work through it on your own or with an
alternative healthcare professional or a friend. Natural dietary supplements like herbs and homeopathics are an approach for those who feel
that pharmaceuticals may just mask the problem. Cognitive therapy (cognitive behavior therapy) is another avenue to try.
Traditional Chinese Medicine and other modalities recommend ingesting the placenta or even just holding a piece of it under the tongue. There are many different ways this can be done: capsules of dried-placenta powder, placenta shake, placenta loaf. Acupuncture may also be very helpful in preventing and/or treating PPD.
Conclusion
Finally, it would be a good thing if our culture could re-gain as a whole what we have lost in regard to supporting post-partum women. We need more
post-partum support options, a tradition of community helping mothers take a 6-week or longer time-out, improved attitudes toward the value of motherhood,
respect for mothers and the maternal feminine body, and better nutrition for post-partum women.
For further information, see the following article:
http://cms.psychologytoday.com/articles/pto-20030224-000002.html
Copyright © 2005 Annette Avery. All rights reserved. Reprinted with permission. No portion of this work may be reproduced or sold, either by itself or as part of a larger work, without the express written permission of the author; this restriction covers all publication media, electrical, chemical, mechanical or other such as may arise over time.