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Beware the post-partum blues

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During pregnancy, your world turns inward as you literally belly-gaze and form a bond with your growing baby. As a pregnant woman, you are performing a fundamental evolutionary function: ensuring the survival of the species. So the rest of humanity gratefully makes a big fuss of you too – opening doors, giving up seats and such-like. But the more you enjoy the pre-partum fuss, the more you may miss it once it’s gone. And it’s not only extroverts who struggle to adapt, post-pregnancy. Experts agree a sense of let-down after the nine months of carrying your child is extremely common.

Dr Andy Taub Da Costa, a Johannesburg-based GP with a special interest in perinatal care, says she sees new mothers “starting to slip” in her practice all the time. One reason is that “we live lives in which the demanding outside world intrudes into private spaces too often. You’ve only just had a baby and everyone wants to see it, preferably on the cover of a magazine!” she says.

“We have lost touch with rituals – for example, in Chinese culture where the grandmother comes to stay with mom and baby, and together they may not leave the house for 30 days. Cultural practices like these can make a new mother feel like she inhabits a special place, she’s done something very valuable, and she deserves this period of nurturing. Instead, nowadays she’s more likely to be overwhelmed with visitors, where she has to be on display but is not really valued for her role in the birthing process.

Pregnancy is an absorbing process, and pregnant women usually find it hard to visualise life after pregnancy – ie, when there’s a baby around. That’s because, though intrinsically linked, the two states couldn’t be more different – and you have no idea what to expect of the reality of motherhood.

Then there’s that little detail – the BIRTH – to consider. Professionals find that expectant mothers fixate on the delivery of their baby instead of life afterwards.  And how could it be any different? Giving birth is the great unknown. Says Dr Taub, “People plan a wedding day, but they don’t plan a marriage – and then can be surprised by the reality. Likewise, they plan a birth but not parenthood.”

“When I ask women in my practice – in retrospect – what could have prepared them for motherhood better, they tend to say that antenatal classes need to be more realistic,” Dr Taub continues. “But we know that expectant mothers choose not to hear the advice. So the important thing is to let to them know where to go if things start slipping. Your midwife, doctor, nurse, breastfeeding clinic, or other new moms are good places to go to for advice and support.”

When your baby arrives, grandparents and friends will want to coo – and only one or two may remember to glance at you during their visit to ask how you are. Yup, there’s a new kid in town. And guess what? You’re gonna have to get used to it, because from now on, you’ll be “Johnny’s mom” first and “Jane, queen of the dance floor” second (if at all). Is it any wonder that, to some women, life after the birth feels like an anticlimax?

Your task now is to adapt to your new role: motherhood.

It’s the most challenging role of your life, and it comes at the expense of some others. You have become less independent. You no longer carry the status of being pregnant. You may have lost a job and an income and outside validation – people can be dismissive of someone who’s staying home to be a mom. You have to manage and mourn the passing of all those other identities while trying on your “new mom” dress.

“With every gain there is a loss,” echoes Dr Taub. “Marriage involves losing independence. Moving home means losing your old home. And having a baby is partly a loss too. Don’t underestimate it.”
Culturally, we don’t feel comfortable referring to our babies as “losses”, but having a baby often involves losing “the mirror that you hold up to the outside world,” says Dr Taub.  “You can see how good you are by the responses people give you: your promotion, your salary, were once your mirrors of affirmation, your acknowledgement. Now your mirror is your baby – and that baby can’t say, ‘Thank you, Mommy, for being an amazing woman. You look after me so well and keep me alive! I love you so much.’ Your baby only knows how to cry and make demands.”

Dealing with this is much easier if you have established a ‘self’ or a rich identity before having a baby – and older mothers are at usually at an advantage here,” adds Dr Taub. Sure, the rewards of motherhood will eventually become apparent – being a parent is deeply enriching – but they may not be apparent in the first few weeks of motherhood! And during that time, you’ll need your identity to be resilient.

It doesn’t help that you’re only just starting to navigate your way around motherhood when the advice starts coming from all quarters: “Bath the baby in the morning; bath at night; don’t bath every day; bath as often as you like...” If you’re feeling vulnerable and clueless, getting (often conflicting) advice can dent your confidence. Maybe you don’t feel like motherhood is coming to you as naturally as you’ve heard it “should”.

Once again, Dr Taub agrees that “we are bombarded from the outside. The trick is to choose one or two people that you listen to and let the rest go in one ear and out the other. Be disciplined about this. Under stress, your brain loses the capacity to make decisions and the resulting confusion can be devastating.”

And then there’s Mother’s Oldest Friend: good old guilt.

If you’re struggling with negative feelings you may feel ungrateful or that you’re not aware enough of how lucky you are. After all, your child is healthy and perfect.

But remember that those first few weeks of motherhood are tough! You’re sleep-deprived. You’re in physical pain. Your breasts are leaking. You have no idea whether this all gets any easier (it does!) - and you don’t have two minutes to yourself to reassure yourself that the end is in sight! It’s no wonder more than half of new moms get a dose of the “baby blues” a few days after delivery. There might be a day or three where you feel particularly unable to cope, sad, weepy or overwhelmed. But if your feeling of “let-down” persists, it could be that you have developed a clinical depression. About one in ten women do suffer from post-natal depression (PND) after the birth of one or more of their children.

What to look out for if it's more than just 'the blues':

So if you have feelings of anxiety, panic, sleeplessness, agitation and irritability, or if you feel that you have lost the familiar ‘you’ in all of this, if you have loss of appetite, or obsessive thoughts, and your feelings last for longer than a few days, and especially if you are having thoughts of harming your baby, you might have developed PND. It is a real disease and responds to treatment (counselling or drugs) – so seek help! The South African Post-Natal Depression Support Association is just one place you can start looking for help. Go to www.pndsa.co.za or phone their national helpline on 082 882 0072.

Dr Taub stresses that “any adjustment takes time”.  So give yourself a bit of time to “grieve” for the “old you” and hang in there. Motherhood will soon be such a part of who you are, it will feel like your second skin!

How to deal with the blues:

1.    Pamper yourself while you’re pregnant. This is your time! (And it will run out once baby is there...)
2.    Try to take time out for yourself even when baby has arrived. A cup of tea with a friend – and minus baby – can remind you there’s still an “old you” inside the new mom. And confiding in a good friend, or a professional, is vital if you feel you’re not coping.  
3.    Don’t bother with guilt. It’s such a destructive emotion. Remind yourself you’re doing a good job under tough conditions.
4.    Trust your instincts while everyone is flooding you with advice. You’re the one who is responsible for your baby, so you might as well learn to listen to your own inner voice now. What feels right to you is usually right for your baby!
5.    Give yourself time. Recognise that your feelings are a normal reaction to new motherhood. Adjustment doesn’t come overnight. You may only being to “feel like a mother” after some months of changing nappies, but that time will come!

Real moms’ experiences

Lisl
“My mother in-law and I had a good relationship pre-baby. Then I fell pregnant. She couldn't be happier especially when she found out we were having a boy, so the family name would be carried on. She was protective and motherly towards me and would stand up for me when hubby stepped out of line. She was always mothering me, which annoyed me. She would uncross my legs when I had them crossed telling me that the blood flow will slow down, my heart rate would go up and would have to work twice as hard and would compromise the baby. I have a big issue with personal space, so imagine my horror when she would invade it by touching the bump and would talk into my tummy!

Then came the babies... and I played second fiddle. She would just arrive at our house with no warning (she has a key). She’d do anything to get to the babies. She has total disregard for any instructions or the routine I was trying to implement. And would always be sure to remind me how tough it was in her day. I might as well not even exist.”

Guilia
“When I got my spell of baby blues a few days after giving birth, I was surprised that I felt really sad about not being pregnant anymore. I had had an easy pregnancy, and I think I was hankering for that happy state, where my midwife fussed over me and people in the street told me how special and amazing being pregnant was. I missed a state that I was in control of – instead of feeling thrown in the deep end with a strange new baby, who now came first. Also, nine months is quite a long time and one becomes used to being pregnant. I felt I needed to mourn the passing of that identity for a little while and give myself time to make the transition to my new identity: motherhood.”

Stacey

“My pregnancy was unplanned just as my career was taking off, so it came as a shock. When I booked into the hospital, we were at the pinnacle of this event that had been built up for nine months of antenatal classes and preparations. I received a constant stream of SMSes asking for updates. The Facebook page to announce the birth was set up. My “announcement” SMS was already written and prepared. Then went into theatre, and in literally eight minutes it was all over. Travis had an Apgar of 9 – and then suddenly something was wrong. He wasn’t sucking or breathing properly and he was whisked away. I sat there all alone in the recovery ward. Everyone had disappeared, including my husband and the grandparents. During this hugely emotional experience, I was left in a void. When I was wheeled into my room, nurses kept doping me and I couldn’t get a grip on the situation. Nobody talked to me and everyone assumed I knew what was going on. I only saw my son that night in a glass ICU ventilator and I was so drugged up I couldn’t process it emotionally. Because there was “a problem”, now all the SMSes and enquiries were about Travis.

He was eventually diagnosed at eight months with de Morsier’s Syndrome ¬- and then obviously it was even more “Travis, Travis, Travis”. Of course the advice started coming from everybody. I felt myself as an individual fading into the background. Only a few weeks before his second birthday I started remembering what it was like to be Stacey again. Now we have a healthy balance. We had to spend time finding out everything about his condition to ensure we were meeting his needs - and now I can finally start thinking about meeting some of my needs again. I love being a mom now. But at the beginning I felt like I had erased my entire identity.”

Cristine
During my pregnancy, people waited for me to enter a room so they could pat “the belly”, ask me how I was doing, compliment me on how well I was carrying. I was waited on hand and foot by my husband. I loved it! D-Day arrived and Ashlyn was born. I realised that things would be different when more than half a dozen visitors arrived that evening and I had to stand at the viewing window for an hour (only two hours after a 10-hour delivery). We arrived home to family visiting and the only chair available to me was a footstool as all the positions around the carry-cot were taken. The love affair between my husband and daughter began almost immediately as well and I began to realise that the spotlight had shifted. No more special attention. 

I felt like an outsider in my own home when even my doting husband had less time for me. It came as a huge shock but priorities shift and you start to see how it needs to be more about your child and less about you. Still, to this day, over a year down the line, I am referred to as Ashlyn’s mother. I don’t have a name - but everyone knows who my daughter is. I suppose it comes with the territory when you have a gorgeous baby!”

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