Strategies for Surviving Postpartum

You’ve spent nine months reading obsessively about all the minute (even slightly disgusting) details of pregnancy. You’ve spent weeks in a childbirth class preparing for your heroic labor. Unfortunately, there’s one small detail your obstetrician, childbirth educator, and pregnancy books neglected to mention -- this is the easy part..

Blame the media for their images of euphoric, well-rested moms and blissful babies frolicking in leak-proof diapers. The countless movies that hold up childbirth as a happily-ever-after ending. The profiles in People magazine that show celebrity new moms like Celine Dion lounging in a designer negligee with an angelic baby at her side, gushing, "His arrival is like a ray of sunshine." (Of course, no mention is made of the army of live-in nannies, housekeepers and decorators hired to assist the new mother.)

The cold reality is that the postpartum months are among the most stressful of a woman’s life. In fact, psychiatrists list the birth of a first child as a severe stressor, comparable to the stress of getting a divorce. "The myth is that this is the most wonderful time of your life, and aren’t babies wonderful, and don’t you feel fulfilled. I think if women feel anything other than that, they feel a lot of shame. They feel guilt. They feel something’s wrong with them," says psychologist Debbie Issokson, who specializes in pregnancy and postpartum issues in her Watertown, Massachusetts practice.

Most women experience what is known as the "Baby Blues" 3-5 days postpartum. This can last a few hours or a few days and usually resolves on its own. Postpartum depression strikes 400,000 women each year, usually 6-8 weeks after delivery. Its causes include hormonal changes, fatigue, genetic predisposition, colicky babies, medical complications, and a lack of social support for the new mom.

But even women who don’t get postpartum depression can have difficulty adjusting to a new baby. "A lot of people don’t take to babies immediately, and there’s nothing like a cute little baby to make an adult feel completely incapable and inefficient," says Dr. Issokson. Women must also confront the many losses that accompany motherhood. You’ve lost your spontaneity, your freedom, as well as your fantasy of what motherhood is supposed to be like. "Some of what we see that people call depression is actually grief, normal grief in response to the normal losses that are inherent in this process," says Issokson.