Postpartum

Conventional wisdom says the birth of a baby is a joyous and exciting time in a mother’s life. Certainly there is joy and excitement. But there are many challenges too. And for some women, the emotions of new motherhood are downright scary.

According to the American College of Obstetricians and Gynecologists, about 70–80 percent of women experience the “baby blues” after childbirth. And around 10 percent  develop postpartum depression (PPD), a serious medical condition that develops during the first months after childbirth.

We’ll take a more in-depth look at these numbers in coming posts, and we’ll be looking at some of the ways our modern American life may sabotage new moms. We’ll also suggest ideas for help.

Kathleen Kendall-Tackett, author of The Hidden Feelings of Motherhood, says that our modern way of looking at women may be one of the culprits. Things were definitely different before the 1970’s. Families tended to be bigger, lived closer, and new moms were expected to stay home with a new baby for about a month. Kathy says, “We gave it away when we said, I don’t need anything, don’t come over, I can do it myself.”

Need to be convinced? Here’s a little world tour with some of the customs we might enjoy in other cultures. I’m not saying it’s better to live in any of these other places, or that it’s even better to be a woman there. I’m just saying it might be worth it to consider what we’re doing, and how we could be better to each other – and ourselves. (One of the best articles about this topic is Multidisciplinary perspectives on postpartum depression: An anthropological critique, in Social Science and Medicine, 17, 1027- 1041 by Stern and Kruckman (1983).

Lying-In

Lying-in? There’s a term we don’t hear anymore. But our pilgrim and pioneer mothers knew what it meant. It’s a time when new moms are expected to rest, and let others do for her.

In Colombia that means your comadrona (a wise woman/mentor/midwife) will help you make the transition to motherhood, and it will take a good forty days.

In Korea no visitors are allowed for the first twenty one days. And there’s a special celebration when the baby sees its hundredth day. I wonder whether our traditional six-week check up comes from this sort of a tradition, as there’s really no magic about the 42 days here in the United States!

Contrast this with our own culture, where moms are sometimes made to feel like there’s something wrong with them if they’re not out and about by the end of the first month. But I know moms who are barely able to get snacks, or a shower, because they are overwhelmed by the needs of their newborn. And too often, the shadow of returning to work darkens their days.

The well-know Boston pediatrician T. Berry Brazelton once noted that no mother should have to go back to work before three months. That’s because it take most moms at least that much time to feel like they are competent. Send them back sooner and they are relieved that someone else – who knows something – is going to take care of their baby.

Protection and Pampering

Here we are in the mountains of Colombia again where no stress is allowed for mom. Instead, people bring gifts for her, not the baby! Mom is the center of the postpartum celebration!

Many cultures have special wraps, massages, and foods for these lying-in days. The mother’s abdomen is the target of much of this care. One anthropological study in Vietnam found that grandmothers and the “old women” were very concerned about future intestinal upsets if moms ate the wrong foods.

Sometimes hair washing and bathing are taboo for these weeks. I spend most of my college days with frozen hair (synchronized swimming practice winter mornings before class) so that seems strange to me. But we do know that getting chilled can influence your immune system – and our immune systems are working hard postpartum. Maybe someday a study will explain this widespread practice!

About twice in my career at the Birthing Center we’ve had moms receive a postpartum massage as a gift. I also remember one of the loveliest scenes ever – a dad tenderly massaging his wife’s belly in the first day postpartum, with massage oil. She had a very blissful look on her face. I think this is a tradition we need to have here in Brattleboro! That’s a lot better than the complaints I hear about fundal massage in the early hours of postpartum!

Nutrition and Nurturing

Of course food is such an important part of the celebrations of our lives. We are so happy to have our Room Service menu in the Birthing Center (thank you Jamie Baribeau and Dietary!). New moms are hungry moms!

Food is magic too. Around the world there are “special foods” for postpartum. These special foods often have spices or ingredients that are meant to help the mother’s intestines get back into shape, or make her milk more nutritious. The older women know what these special ingredients are – and they lend their help and advice. It’s a wild list – from seafood soup in Korea, to foods with lots of turmeric in Vietnam, to the chicken soup and herbal teas of Jamaica.

Help around the House

In Myanmar, there’s a special word for a postpartum mom. It means “she who sits by the fire” – and she’s sitting there because her family is doing housework, and she is feeding her baby. In India, mothers may move back to their own family of origin for the birth, getting help from their own mom and sisters through the last part of pregnancy and on into the postpartum.

I don’t want to romanticize postpartum in other cultures – women are not respected and treasured the way they should be in many places around the world. Helaine Selin in her book Childbirth Across Cultures notes that women in Nepal are kept in darkened rooms until day eleven, as they must be shielded from the masculine face of the sun. In addition, the normal and healing bodily fluids of childbirth and postpartum make the woman unclean. Unfortunately this can mean moms are quarantined in a cold shed – out with the animals.

But we’re not going to get many awards here in the United States for the great way we treat postpartum women. We’ll take a look at Misery and Moms next week – who’s at risk for postpartum mood disorders?