Birth and Postpartum Adjustment
Understanding the Challenges
It is a common belief in our society that after a couple of weeks of delivering a new baby mothers are well on their way to feeling well and continuing their usual (pre-baby) daily routines. Although this is true for many mothers, there are many mothers who feel overwhelmed, physically drained, anxious, depressed, and sad after birth. Today's statistics show that between 60 to 80% of postpartum mothers experience postpartum adjustment challenges. An additional 10 to 20% of mothers experience greater difficulties such as Postpartum Depression (PPD) and/or Postpartum Adjustment Disorders (PAD). If left untreated, PPD and PAD can be devastating not only for mothers, but for their immediate and extended families. The purpose of this informational session is to shed some light and provide hope for mothers, their families, and professionals who care for them.
Blues, Depression, and other Adjustment Disorders…
Many expectant and postpartum mothers experience moodiness, sadness, irritability, depression, and anxiety. These feelings can be the result of stress due to infertility, concerns about the pregnancy and unborn baby, hormonal changes, lack of sleep, being bedridden or housebound during pregnancy and also due to the challenges motherhood can bring. These feelings and experiences are usually called "baby blues" and usually resolve themselves within a few weeks.
For some expectant and postpartum mothers these feelings do not subside, or they reappear after she has felt "just fine" for awhile. Depression, Anxiety and other Adjustment Disorders can occur during pregnancy, a few weeks and even up to a year after birth. Commonly experienced symptoms can include one or a few of the following (this is not a complete list of all the symptoms that can occur):
- Persistent feelings of anxiety, fear, sadness, depression, or irritability
- On-going problems with Insomnia and/or sleeping too much.
- Crying that occurs once or more a day and continues for days and/or weeks.
- Racing thoughts and /or feelings of intense anxiety
- Compulsive habits or thoughts that reoccur throughout the day.
- A sense of being displaced emotionally from the new baby and/or other immediate family members
- On-going dietary struggles (eating too much or too little)
- Persistent Feelings and/or thoughts of not being a good mother and/or not wanting to be a mother.
- Thoughts of wanting to harm yourself, your baby or others.
- Fears about leaving the house and/or interacting with others
Many mothers have a sense that, "Something just isn't right". Just as I often encourage mothers to follow their maternal instincts concerning their babies; it is equally as important for mothers to reach out for help if they feel that they are not feeling quite right.
Helpful Guides for mothers
-
Take care of yourself. It can be difficult to find time for yourself when you have a new baby. But, the simple act of taking a shower, taking a walk, running an errand by yourself, getting your hair done, or getting dressed in one of your favorite outfits can lift your spirits.
-
Make sure you sleep as much as you can when your baby sleeps. Lack of sleep is often one of the major contributors of PAD. Many Psychologists recommend that 7 hours of sleep a day is needed to help keep you balanced. This is often very difficult to do, especially if you are breastfeeding your baby or are the mother of multiples or have other children. It is so important for couples to work together and develop a "game plan" for nighttime routines so mothers are not the sole caretaker for the baby during the night. There are many creative ways to slip more sleep into a mother's day. Napping whenever the baby naps is the most important advice I can give to moms. This can be difficult for mothers with multiples or other children. In these cases I recommend that you have a family member, friend or Doula come a few hours a day to watch the baby for you to help you catch up on some much needed rest.
-
Remember that the only truly important thing a new mother needs to do is rest, eat and drink well, and take care of you and your babies' needs. Housework and juggling daily activities can all wait until you are feeling better.
-
Set up support for you and your family. Husbands, friends, and family members can be great resources for expectant and postpartum mothers. When it seems that you need support with practical tasks, breastfeeding and baby care advice and encouragement, turn to the supportive care that Doulas can provide. Doulas are certified professionals who provide supportive and practical care for families. She can help care for infants and siblings prepare meals or grocery shop, wash laundry and most importantly be a companion and confidant for new mothers. Some Doula services work directly with insurance coverage and also qualify as a tax deduction. The benefits of getting support far outweigh any associated costs.
-
Share your feelings and thoughts with those who love and care for you. Many mothers suffer from PPD and PAD in silence. Some are afraid of what their families and friends will think if they truly share how they are feeling. Others hold out that things will get better in time, and some mothers are unaware that there is help available for them to ease the difficult ties they are experiencing. I often begin my childbirth classes with an exercise for expectant mothers and their partners. I encourage them to write down their expectations of themselves as well as their partners as parents and we share them as a group to see how different and or similar they are with each other. This simple exercise opens the channels of communication about many topics few couples discuss. It fosters a sense of working together as parents and allows each parent to appreciate the role they each will play as parents and as a couple.
-
Seek out professional support. It is important to note that not all of the support systems available for expectant and postpartum mothers are truly knowledgeable and experienced with providing the support you may need. It is important to ask specific questions to the Psychologist, Therapist, or other professionals what their certifications and experience records are with expectant and postpartum mothers struggling with PPD and/or PAD. It can be difficult to know where to begin to find the right care provider, but usually your OB, midwife, Birth Center, Case coordinator at your insurance company, local Doula service and local nursing mothers group are great places to start. For those looking for support in the PA, NJ area, a few resources are listed below.
Above all else, it is my hope that we will all recognize the challenges expectant and postpartum mothers experience. Their lives are forever changed, and although we tend to celebrate the birth of a new baby and all of its excitement, I hope that mothers will feel that their loving devotion and struggles are acknowledged and celebrated on a deeper level. I encourage fathers, families, friends and care providers to nurture and care for mothers so they will be able to better care for themselves and their children.
