Dealing with postpartum issues challenging
Q. I’m a new mom. Why wasn’t I more prepared for postpartum? I’m no longer your student but I remember how safe you made me feel as a teen. You always said we could reach out to you anytime. Anytime is here. We planned this pregnancy. I was so happy pregnant, even at the end. My birth was pretty smooth, not easy, but not traumatic. Our baby is beautiful, healthy, and perfectly formed. I’m happy sometimes, I really am. But my body is sore, not just in my perineum but all over, like someone ran over me with a truck. I thought I’d have my body back after birth, but I look like I’m 6 months pregnant. I see celebrities’ pics postpartum, and they look great. Not me. My nipples are dark and big. I’m constipated (TMI?). I have zero energy. My husband is a champ. He gets up at night with her and brings her to me to nurse. I love her, I do, but I didn’t expect it to be this hard. I read everything I could get my hands on about childbirth. Why do I know so little about this? My husband is worried I have postpartum depression. I cry sometimes, but I don’t think overall I’m depressed. My mom says it gets better, but it’s been two weeks. When does better start? Is this normal?
– 33-year-old
Mary Jo’s Response: I am honored you remembered me. Yes, you can reach out anytime.
What you’re feeling during postpartum is hard. It’s also part of most people’s birth experiences. I refer to the time of giving birth as the childbearing year. Becoming a mom is a physical and emotional adjustment that lasts after the baby is born. Is it normal? Everyone is different, but what you’re describing is a story I’ve heard many times. Your concerns are important.
Let’s talk:
1. Loving your baby doesn’t mean these challenging feelings – both physical and emotional – aren’t real. Your hormones are on a roller coaster and your emotions are too. This too shall pass, but right now isn’t easy.
2. Giving birth is a physical event. Yes, your energy level is lower, and yes, you can feel sore and still be healthy. Still, check with your health care provider to be sure all is well physically. Your provider may ask questions like these: What’s your temperature? Describe your discomfort. Is your energy level intermittent during the day or constantly low? Are you feeling anxious, or do you have scary, racing thoughts? I want to reassure you – yes, this is normal. I also want to remind you that you have a provider for a reason. Check in – that’s why they’re there.
3. Your body is a postpartum body – for now. It will change. Nipples darken and may get bigger during nursing … it’s nature’s way of giving your baby a good latch. It takes at least six weeks for the uterus to return to pre-pregnancy size, and your abdomen will gradually look less and less pregnant. Two weeks is early for your body to return to its pre-pregnancy state. Avoid celebrity pics. Photoshop is common.
4. Your GI system is affected by your birth and by nursing your baby. Drink lots of fluids, eat more fiber, and check with your provider. You may need a gentle laxative but check first since you are nursing.
5. Mood swings can also be normal. Postpartum depression (PPD) needs professional attention and is more than feeling blue or an occasional cry. The APA (American Psychological Association) says 1 in 7 women develop PPD after birth. Their information sheet on PPD can be found here: https://www.apa.org/pi/women/resources/reports/postpartum-depression.
6. Look for support groups for postpartum. In Washington, you can connect with the Postpartum Depression Project (https://www.ppdproject.com/). Online peer to peer support is available at Postpartum Support International (https://www.postpartum.net/get-help/psi-online-support-meetings/).
I was once a birth doula for a woman who said at our two-week postpartum visit, “This was the dumbest thing I ever did! My body will never be OK again.” In time, this woman had two more children and adjusted to those births as well. It’s amazing how bodies can bounce back, but it takes time.
I also taught childbirth classes from the 1970s. I covered postpartum but had the sense most people didn’t really hear the information. The birth was all that mattered. You’re not alone.
Congratulations on your birth. Please know you may continue to reach out. I’m here. Good luck!
Have a question? Send it to Dr. Mary Jo Podgurski’s email podmj@healthyteens.com.