Mothers are released from hospital anywhere between two and three days after the birth and are back into the routine of caring for their family as if nothing had happened. I am not surprised by the alarming numbers of mothers who suffer from depression and exhaustion. We accept this as the “norm”. We are wrong to do so.
There is no established recovery from the trauma of birth and the problems resulting from this lack of care may only become apparent in the future.
There seems to be this unspoken competition between post partum women regarding who can get back into shape the fastest. Who has lost the weight the quickest? Who is winning this race?
What race? The number of women who rush back into their pre pregnancy exercise routine is frightening.
I believe that it is the lack of post partum care and support that has given rise to the epidemic of post partum depression.
Melisa Schuster – a clinical social worker, who lives in my town, specializes in post partum depression and discussed this issue at length with me. I had assumed that her interest in post partum depression was like mine -directly related to her own personal situation. On the contrary, Melisa had a wonderful experience giving birth and loves being a mother. We did both agree that it is and will always be the hardest job in the world. She is very involved with women’s issues and is also a Birthworks™ childbirth educator.
Melisa went on to express her concerns about women expecting too much from themselves and from being a mother. She warns that some new mothers have totally unrealistic expectations and that they set themselves up for failure from day one. She presents workshops dealing with the realities of becoming mothers. Melisa laughs as she describes the women who tell her that none of these problems will happen to them. These are the ones she worries about. Let’s face it; parenting is a long, hard road.
I have always been a little shocked by the women who have said they were not asking mothers/sisters/friends to help in the early days as they wanted to just be a family and get to know each other. This is fine, but become a family while someone else is taking care of everything. You are recovering from what amounts to running three or four marathons. Add onto to that, hormones that do not know whether they are coming or going, lack of sleep, feeding and looking after a baby whose schedule may not coincide with yours.
I truly support Melisa when she suggests the new mother stays in bed for up to ten days after the birth .You do need this time to recover, and this is when you need to have someone else take over the running of your household. You may not get along with your mother/mother-in-law but, believe me; they know what it is like and are only too glad to be helping. So relax and take advantage. Remember they love your baby as much as you do. My mother-in-law stayed with me for a year after the birth of my third daughter and while it was stressful at times, I have to admit it made life much easier for both myself and my children. I had time to spend with the older two while grandma took care of the baby.
Looking after a baby takes every ounce of energy you have. It is constant and is physically exhausting. In childbirth education classes, really what they should prepare women for is the long haul after the birth.
Women are very well looked after during their pregnancy compared to the postpartum period. Where are the post partum doctor visits or the books on recovery or even the post partum exercise class? It seems as though they have been swallowed up by a black hole. Post partum women are severely neglected and this is really the time to be looking after them. Their exercise sessions become their sanctuary, so be prepared. Make time to listen to their concerns. Educate yourself on the signs of depression.
My own postpartum story is one of depression and panic. I was alone in a foreign country and scared to death. I went from being a very active dancer, fitness instructor and just plain old socialite to being completely alone a few weeks after my baby was born. My mother was half a world away and my husband traveled most of the week. My sister in law very kindly arrived from England to help me for several weeks but she had left her own young daughter at home with her mother and needed to get back. My dancer friends were far too busy to help and since I was a newcomer to the country, I had yet to make very many friends. I made the mistake of staying home long after it was necessary for my health. It became a habit that was hard to break. After a while the mere thought of leaving my house was overwhelming and I would break out in a sweat just thinking about it.
Things went from bad to worse and I sunk into a depression that lasted fourteen months. At that time, I thought every mother felt like this and that it was “normal”. Every time I saw a pregnant woman, I wanted to run up to her and tell her not to do it, that it was hell.
Because I had been too scared to exercise while I was pregnant, getting back into shape afterwards was difficult. I made the mistake of trying to exercise at the level I had left off at when I got pregnant. I had no understanding of my body and what it needed.
I did come out of the depression by myself and exercise certainly played a big part in my recovery. According to Melisa Schuster it is sometimes just a case of chemistry that can be put right with medication or a combination of counseling, nutrition and exercise. Not all of her clients are candidates for medication and she stresses that everyone is different and responds to different methods. I believe that I should have been on something and that it would have made such a difference to being a new mother. It was only when I began talking about it that the people around me mentioned they had been very worried about me. How I wished they had taken the initiative to convince me to seek help. I know it must have been hard for them too. I felt like I had missed a whole year of my daughter’s life. I have always felt guilty about this.
When I talked to Melisa though, she reassured me that relationships can and do heal. I think I have a very good relationship with my eldest daughter now.
I wouldn’t wish post partum depression on anyone and I encourage you to watch for the signs in your clients. Some mild depression is normal after the birth as your hormones start to settle. However, if they begin to feel worse after about two weeks, please have resources on hand to refer them to. New motherhood is a highly stressful, life changing event.
As a passionate exerciser I do have to say that exercise can greatly help alleviate feelings of depression. I keep a close watch on the post partum ladies in my classes and encourage them to keep coming to class even if they don’t feel like exercising. Just getting them out and in the company of other women going through the same thing, is therapy enough. They always end up exercising, too!
We need to give women permission to be post partum and have them understand that it is a journey into another way of life that needs time to adjust to. Some women have a great transition and move forward naturally, but for some, it takes more time to adjust, especially if this life is totally different from the one they left behind.
Most importantly for new mothers is to be acknowledged. Yes, they are very thankful for the healthy baby but they are dealing with a huge change in life and sometimes they are frustrated and resentful. These are normal feelings that should not be brushed aside and dismissed. The issues they have with their bodies are also real and need to be dealt with.
However, when it comes to exercise, especially as a postpartum exerciser, many programs do not take into consideration that the postpartum body is different from the pre pregnancy one and while it is different, it is by no means worse. If we all changed our mindset about how we should look as young girls, young women and then new mothers, older mothers and finally the grandest achievement of all-GRANDmothers, we would see that each stage of our lives is to be experienced in the present and to accept the body changes that come with it. So often I hear people trying to “get back into shape” after their babies. What shape would that be? You now have a body that has just done something AMAZING! Treat it with the respect and love it deserves and understand that recovering the body after birth is about restoring, strengthening and nurturing.
Exercise need not be intense and overwhelming to be beneficial. Just after the birth, many women can begin a program of restoration using deep breathing and simple movements of their bodies. The exercises should be simple enough to perform anywhere and at any time. Rehabilitation of the pelvic floor, realignment of the pelvis to the spine and general stretching and releasing are all truly beneficial and will work wonders even though they are gentle.
I believe in the Asian tradition of binding the abdominals of the postpartum woman and even encourage them to perform their gentle exercises while using the binder. The binder technically holds both the ribcage and pelvis stable allowing the overstrained surrounding muscles to realign without undue stress. Nutrition and rest are equally important to help restore the body.
Beyond calming and relaxing the new mother, deep abdominal breathing will also act as a pump for the lymph system and will help remove excess hormones and fluid from the body. Deep abdominal breathing also activates the deepest abdominal muscle the tranversus abdominus as well as the pelvic floor and helps to strengthen these muscles.
All in all postpartum should be a period of quiet gentle nurturing of both the mother and child, filled with respect and awe for the miracle that has just happened.