“Good” Moms are consistently, blissfully happy after childbirth…
And other myths about pregnancy and the postpartum period
By Catie McDowell, LMFT
“Good” Moms feel more alive, sensual and beautiful during pregnancy than at any other time in their lives.
“Good” Moms find parenting newborns and infants completely fulfilling.
“Good” Moms don’t complain about sleepless nights, the challenges of breastfeeding, mood difficulties, or changes in their relationship after childbirth.
While some women experience increased vitality during pregnancy, most women also feel tired, achy, unattractive, and uninterested in sex at some point in their pregnancy.
While there is joy in welcoming a new baby, caring for infants is hard, often isolating, work.
Having a baby is a cataclysmic event that affects all aspects of our lives. Most women experience physical, emotional or relationship difficulties in the year after childbirth.
Having a baby is a profoundly life-changing event. Many of us have prepared for it from the time that we were little girls playing with dolls. Over the years of imagining ourselves as mothers, we develop pictures of the kind of birth we hope to have, and self-images of the kind of mother we will be. In addition, we internalize beliefs from our family, friends and popular culture about what it means to be a “good mother”.
While as a culture we have become far more open about pregnancy and childbirth during the last few decades, certain experiences remain somewhat invisible, even in the year 2001. One of these experiences is Postpartum Depression. In our dreams of ourselves welcoming a new baby, few of us imagine feeling deeply depressed, irritable or anxious in the weeks and months after childbirth. This picture certainly does not fit our image of the “good mother” we aspire to be. So, imagine the heartache that 10-20% of women feel when this is their experience. Because these women are often isolated and ashamed, and do not talk publicly about their experience, it remains invisible, and we as a culture remain largely uneducated about it. Let’s review the facts.
Sixty to eighty percent of all women experience the “Baby Blues” in the first couple of weeks after childbirth. The “Blues” are believed to be the result of the overwhelming hormonal and life changes that a woman experiences with childbirth. Feelings of emotional fragility, weepiness, irritability, and anxiety are all indications of this common condition. These symptoms generally resolve within the first two weeks without any medical intervention. New mothers can be helped through this time by being allowed to talk about their worries, and by being reassured that their feelings are normal.
A smaller percentage of women, approximately 10-20%, experience Postpartum Depression. This medical condition can begin at any point during the first year after childbirth and likely results from the dramatic hormonal and biochemical changes that occur in the postpartum period. Symptoms may include: a pervasive sense of sadness, irritability or apathy, exhaustion, difficulty sleeping, disinterest in eating, extreme anger towards their baby, and even suicidal feelings. Women who are feeling suicidal or are having thoughts of harming their baby should seek professional help immediately. Some women experience anxiety, including symptoms of panic attacks (e.g. shortness of breath, light-headedness, increased heart rate and a sense of doom). Some of these symptoms, like exhaustion and sleeplessness, are hard to distinguish from normal experiences of early parenting. Postpartum Depression and Anxiety are distinguished by their persistence and severity. They are daily experiences, which disrupt a woman’s ability to take care of routine tasks, and last for at least two weeks.
Women may be at an increased risk for Postpartum Depression if they have had a previous episode of Depression or Postpartum Depression, if they have a family history of Postpartum Depression, or if they have a history of PMS with mood difficulties. Women who are aware that they are at risk for Postpartum Depression or Anxiety should talk to their healthcare professionals about their treatment options before or during pregnancy. Early intervention can make all the difference in a woman’s experience of new motherhood.
However, many women endure these painful feelings for months before seeking help. A misconception, or myth, that contributes to their suffering silently, is that depression is subject to choice. Uninformed, though well-intentioned friends may say, “What do you have to be depressed about? You have a beautiful baby.” Or, in a health-conscious community like ours, where many believe in the “mind/body connection”, women may be told that their mental attitude has caused their depression. This only contributes to a woman’s guilt that she is not feeling the way she “should” about motherhood. While there are psychological contributors to Postpartum Depression, it is a medical condition, distinct from the normal ups and downs following childbirth. To ask a woman to “snap out of it” would be like asking a woman to snap out of her morning sickness during pregnancy.
Treatment for postpartum mood problems may include some combination of psychotherapy, education, group support and medication. Whatever the treatment, it is critical to work with professionals who have expertise with these conditions. For some women, short-term psychotherapy focused on managing the symptoms of depression is sufficient. Group support can be tremendously comforting in that it alleviates the isolation and shame that often accompany this problem. However, Depression can be a debilitating illness, and sometimes women cannot take real advantage of counseling or a support group until their depression is lessened with medication. Women understandably worry about taking medication during pregnancy and while breastfeeding. A psychiatrist with expertise in this area can explain the current research on these questions, and help women make these difficult and very personal decisions. With appropriate treatment, the prognosis for postpartum mood disorders is excellent. The first step is for women to feel comfortable speaking about their experience, so that they can get help, and go on with the business of being the best moms that they can be.
For more information, support or referrals, call Postpartum Support International 805-967-7636 or Depression After Delivery 800-944-4PPD. Books on the topic include: This Isn’t What I Expected (1994) by Karen Kleiman and Shouldn’t I Be Happy (1995) by Shaila Misri.
Catie McDowell is a parent and a Licensed Marriage and Family Therapist in private practice in Boulder. She works with adults, adolescents and couples, and specializes in helping women and couples understand and manage the changes that come with pregnancy, a new baby, and parenting young children. This article was originally printed in The Family Connection newspaper.