In Canada, we talk a fair bit about postpartum depression. And thanks to ongoing mental health campaigns such as Mental Illness Awareness Week, we are beginning to talk more openly about mental wellness.
But when it comes to postpartum, I fear we might be pushing the psychological aspects of postpartum to the detriment of the physiological aspects.
According to an article called “The Postpartum Period” on parenting website aboutkidshealth.ca:
“The postpartum period is commonly defined as the six weeks after childbirth. This is a very important time for both you and your newborn baby as you adjust to each other and your expanded family. In the first few hours and days after childbirth, you will experience many changes, both physically and emotionally.” (https://www.aboutkidshealth.ca/Article?contentid=414&language=English)
The article has some great descriptions about the bodily changes that accompany the 6 weeks following birth, as well as some mental changes to know about, such as postpartum depression.
Well- here is where I went Seriously wrong in my preparation for labor.
I spent HOURS of research on postpartum mental phenomena such as baby blues, postpartum depression and postpartum psychosis.
Every time I heard the word ‘postpartum’, I put a mental health word after it in my mind.
Someone would say “You think labor is going to be hard? Postpartum is the real battle!”
In my mind that would translate to:
“You think labor is going to be hard?
Watch out for postpartum depression.”
Every time I was in a birth class, I would hear the presenter say ‘postpartum’, and I would think ‘I must protect my postpartum mental health.’
And that’s Totally true- you DO need to know about postpartum mental changes. You Do need to know about things like the baby blues and how long they last and the difference between them and postpartum depression.
Those are Super critical things to be aware of- but that was my slip up- and I am willing to say- possibly our Entire western culture’s slip up when we discuss postpartum, and in how we treat postpartum mamas in those 6 weeks after birth.
It’s NOT All Mental.
SO MUCH of postpartum is about the BODY.
I can only speak to what I know- which is a traumatic first-time vaginal birth with an epidural, forceps, and a front to back episiotomy.
And what I know from that experience is that the question I Really wish people had asked in my postpartum period was not: “How are you doing??”
“How is your vagina??”
I know that sounds crazy, but hear me out.
As a type 1 bipolar person, sleep is integral to my mental wellbeing. I was on tenterhooks about the potential lack of sleep I would experience as a new mom, as were others around me in my care group.
In all of my pre-baby prep, I safeguarded against ‘postpartum’ by making a sleep schedule with my husband and family members who were set to be at my house round the clock for the first 4 weeks post-birth.
Super cool theory- but in practice, sleep was a goddamn unicorn.
NOT because I didn’t Want it- and not because people weren’t providing care for my daughter so that I could get some sleep-
But because I had a FRONT to BACK slice between the bottom of my vaginal canal to the beginning of my anus.
Does That sound comfortable to you?? In bed, afraid to move, not able to sleep on my side like I normally do because of the pain it put on my perineum, wearing my husband’s boxers, bleeding profusely into a giant diaper pad and crying by myself in the dark.
I was NOT prepared for that.
As a non-breastfeeder due to medical reasons, the day that my milk came in was another Giant postpartum bodily change that I was not expecting.
In the space of 5 hours, on day 5 postpartum, my breasts went from B cups to DD cups. They throbbed and pulsed; they were hot to the touch. They became firm. Then they became rock hard, with pebble-like extra hard clumps that felt like stones. I began to panic. I stuffed my too-tight sports bra with freezing cold cabbage leaves, then packed it tight with frozen Lansinoh gel packs and tried to go to sleep.
For both of these conditions, I was instructed to take a combination of Advil and Tylenol every 4 hours. So even if I had managed to sleep, I was setting an alarm to take my pain meds every 4 hours. The days I didn’t take my meds every 4 hours in order to get more sleep, I Really regretted it.
Pain. Constant pain.
Pain in the most intimate parts of your body.
Pain when you pee. Pain when you poo.
Fear when you sneeze. Fear when you get into a vehicle that you will sit down too hard on your aching bits.
It is those physiological factors that make the mental health questions So difficult to answer.
In our society, when your cashier at the grocery store or your teller at the bank asks you “How are you doing?”, you are meant to smile and say something positive in return.
“Fine, thank you.” “Good, and you?” Something nice that makes the question-asker happy.
This is absolutely NOT what the postpartum mama needs to be asked.
You know when a cashier asks you that question on a day when someone you know has just died, or you just found out your husband got fired, or your day at work just really sucks balls??
And someone innocently asks “How are you doing?” And you lose your shit?? Crying all over the place, apologizing, choking back tears? On a crappy enough day, when someone asks you that question, you feel self pity even if you weren’t pitying yourself before they asked that question.
The postpartum mama lives in that in-between space All. The. Time.
She is overjoyed that she has a newborn baby- and she is likely in so Much pain. And that’s only if she has physical distress. If she is experiencing postpartum depression on top of all that recovery pain, that question is beyond loaded and way too hard for a sleep-deprived mama to answer.
Which is why I’m begging people reading this post to think of better questions for postpartum mamas.
If you know the mom really well- here are some suggestions:
– Vaginal birth: Your baby is so cute. You look great. How is your vagina?
– C-section: Your baby is so cute. You look great. How is your recovery?
– Adoption: Your baby is so cute. You look great. How are you adapting?
If you don’t know them well enough to ask about their lady bits, you can just ask “How can I help you?” Or “What do you need?”
A hot meal brought to your doorstep and left there, or someone doing your laundry for you can be the Best postpartum medicine.
But Moms are heroes from the moment they become moms- we will not share our pain.
We will grin and bear it and answer your “How are you?” question with “Great, thank you,” just to keep you happy.
Unless you tell us it’s okay to Not be okay.
Unless you let us tell you that our vaginas hurt like the pain of 10,000 lightning bolts and then you let us fall to pieces in front of you.
11 years ago when I worked at a daycare in the toddler room, I congratulated a postpartum mama on the recent birth of her 4-week old daughter. She was having a rough day and she rolled her eyes and said “The baby is cute and all, but I have a few words for you. Two-inch
episiotomy.” Then she thought better of it and said “but let’s not talk about that.” And I let it go. I was 22 years old. I didn’t know what to say.
And now- as a postpartum mama myself- with my own 33-day-old, 2-inch episiotomy that’s almost recovered-
I want to talk about that.
I want all of us to talk about it.
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