Beware the post-partum blues

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!

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