America has a widespread misunderstanding on just how delicate the postpartum period, or often referred to as the fourth trimester, is for a woman, both physically and emotionally. And in a world where motherhood is glorified by the general media and where new mom’s post pictures of “Mommy perfection” or “snap backs” on social media, it’s not hard to understand why mothers are left to feel embarrassed or inadequate when they may be struggling emotionally with their new role as mother or physically as they are far from feeling “back to normal.”
Mothers are (hopefully) warned by their OBs prior to discharge that it can takes weeks to properly heal from childbirth and that overexertion can lead to complications such as increased uterine bleeding, infection, prolapse and even depression. But then they arrive home and reality hits! There is no food in the house, there are dishes in the sink, there’s a baby that needs to be fed and changed every couple of hours and all the words of caution about overexertion seem ridiculous or at best totally unrealistic. The new reality is that there’s a new boss in town, i.e. the newborn baby and Mom is no longer the focus of attention. Any wish for an extra dose of TLC is often self-perceived as selfishness or weakness. A father who has no or limited paternity leave (The U.S. is the only industrialized nation in the world not to mandate paid maternal leave never mind paternity leave) may wish to care or help his wife but if he’s at work it’s just not feasible and even the most loving husbands may become disgruntled when they come home day after day to a house that looks like a dump and an empty fridge to boot! The realities of life in addition to the cultural lack of understanding regarding the kind of support a mother needs after birth leaves most mothers feeling completely alone, overwhelmed and incapable of making themselves a priority alongside the baby.
So we push ourselves to the limit and it’s no surprise that we have an alarming portion of new mothers suffering from postpartum depression (PPD) and anxiety (PPA)*. In the US the reported rate of clinical postpartum depression among new mothers is between 10 to 20 percent. A recent study found that 1 in 7 women may experience PPD in the first year after giving birth. With approximately 4 million live births each year in the US, this equates to almost 600,000 postpartum depression diagnoses! But did you know that in addition to mothers, 10% of new fathers experience depression in the post-partum period and even more fascinating some studies have shown that rates of PPD in adoptive parents are comparable to PPD rates in biological mothers! Clearly, there are many factors that can contribute to these disorders outside of the neurochemical imbalance that post-partum mothers can experience.
I suspect that some mothers may not even realize they are suffering from PPD or PPA because they can identify exactly why they are feeling so low and/or anxious. After all their emotions are based in reality! They are overwhelmed and exhausted from inadequate rest, care and attention creating the perfect storm for the development of depression and anxiety. In other words as Hillary Brenhouse states in her article entitled “Why Are America’s Postpartum Practices So Rough on New Mothers?”, “PPD becomes the consequence not the cause” in a culture that doesn’t recognize the post-partum period as time of increased emotional and physical vulnerability and risk.
So what needs to be done?
We need to start by having an honest conversation about the true needs of new mothers; beginning with practical solutions in the immediate post-partum period, extending all the way to specialized support systems in place for mothers returning to the workforce. So please stay tuned as we discuss these ideas in our upcoming blog series.