Strategies for Surviving Postpartum

Youíve spent nine months reading obsessively about all the minute (even slightly disgusting) details of pregnancy. Youíve spent weeks in a childbirth class preparing for your heroic labor. Unfortunately, thereís 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.)

Navigating the Emotional Roller Coaster

The cold reality is that the postpartum months are among the most stressful of a womanís 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 arenít babies wonderful, and donít you feel fulfilled. I think if women feel anything other than that, they feel a lot of shame. They feel guilt. They feel somethingís 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 donít get postpartum depression can have difficulty adjusting to a new baby. "A lot of people donít take to babies immediately, and thereís 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. Youíve 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.

Bottom line: Accept your ambivalence. Itís completely normal. You can still love your new child and at the same time feel let down. And though it seems awkward to speak of loss when youíve just gained a new baby, itís important to grieve the losses before they lead to full-blown depression. Ideally, begin discussing these issues with your partner before the baby arrives, recommends Dr. Issokson. List the many things that will change in your life -- no more snuggling on the sofa in the evening (at least not for a while), no more spontaneous vacations. Movies and nice restaurants may become rare treats. (Movies? What are those?) Give yourself permission to be sad about this.

You also need to adapt to your new identity. "This change into motherhood doesnít just happen overnight," explains Issokson. "Within the first few weeks, you might not love mothering. And you might really like your baby, but you might not feel the kind of love you were hoping to feel because itís a relationship and you have to grow into it."

Women who find themselves dwelling on negative thoughts can reverse this habit through counseling, journal writing, talking to friends and other new moms, even pasting positive affirmations all over the house, like

Iím doing my best.


Itís okay to make mistakes.

"I have a client whoís convinced sheís doing a terrible job with her baby when in fact sheís not," says Dr. Issokson. "So every night before she goes to bed, she needs to say to herself and write down three things that went well with the baby that day."

Dr. Issokson urges women to seek professional help if they experience any of the following: inconsolable crying, excessive worry about the baby, disinterest in the baby, sleeping all the time or not at all, decreased appetite, a desire to hurt yourself or the baby, an urge to run away. "If youíre the least bit concerned about how youíre feeling, then err on the side of caution and go talk to somebody who can help you." Keep in mind that this is not your fault and asking for help does not make you a failure. "To me, failure is not recognizing your vulnerability and not getting support," says Dr. Issokson. "Every woman needs some kind of support postpartum. I donít know anyone who totally breezes through this first year unscathed by something."

Asking for and Accepting the Help You Need

Women, who are conditioned to give to others, often have difficulty asking others to help them. But since a new baby is so overwhelming, itís important to have a support network to assist with hands-on as well as emotional issues. "This is a time in your life when you owe it to yourself to call in every favor youíve banked over the years," says Ann Douglas, author of The Unofficial Guide to Having a Baby (MacMillan 1999) and The Unofficial Guide to Childcare (MacMillan 1998). "If people ask what they can do to help, donít just brush them off and say youíre getting along okay." Simple chores can seem impossible when youíre fatigued and caring for a newborn 24 hours a day. "Itís just so demoralizing if you look around and your whole kitchen is trashed, and you know that you wonít even have a spare minute to wash a teacup," recalls Douglas.

Make a list of concrete things people can do:

  • fold a load of baby laundry

  • drop off a homemade casserole

  • give your house a quick vacuum

  • pick up items from the drugstore

  • invite older siblings for play dates

You can even contact friends and family before the baby arrives to let them know their help will be welcomed. "In my fantasy world, we would be setting up this support system long before the baby comes for every woman," says Dr. Issokson emphatically.

Getting your partnerís support is also key. Contrary to popular belief, having a new baby does not initially enhance wedded bliss. "In the most wonderfully solid relationships, a baby is like a little earthquake. And in a really troubled relationship, a baby is earth shattering," warns Dr. Issokson. Discuss your images of each other as parents before the baby comes. And donít cut your partner out of childcare responsibilities. "Some women have a real territorial thing where the baby is concerned," explains Douglas. "Dad will put the diaper on, and mom will rediaper the baby because he hasnít put it on properly. This can really undercut the fatherís confidence and willingness to help." Let dad work out his own relationship with the baby and do things his way.

Isolating yourself from others is a natural urge during times of stress. But this will only make you feel worse. Instead, make getting out of the house a priority each day. Find a new mom support group, call someone from your prenatal classes, go to a park and strike up a conversation with another mom. "You really need to push yourself to connect with others," urges Douglas. "On a day where you have a baby with an ear infection whoís screaming constantly, it really helps to talk to somebody else whoís gone through it and lived."

Nurturing the Nurturer

Taking care of your physical and emotional needs during this stressful time is a necessity, not a luxury.

Make sleep a priority. Youíve heard it a million times. Sleep when the baby sleeps -- even if it means leaving dishes piled high in the sink and wearing wrinkled clothes.

Eat nutritious foods. Even women who carefully monitored every forkful of food during pregnancy can fall into poor eating habits once the baby arrives. Stock up on healthy foods that can be eaten on the run, recommends Douglas. Boil a dozen eggs, cut up cubes of cheese, buy fruit you can eat with one hand. "If youíre planning on cooking your usual gourmet stir-fry, you will be very hungry by the time you get to make it."

Exercise. No, not because you need to look like Cindy Crawford by your six-week check up. Donít even worry about fitting into your pre-pregnancy jeans. Just do it for the energy and endorphins (those natural antidepressants our body makes).

Set Limits. The last thing you need is a barrage of phone calls and visitors right now. In fact, Ann Douglas recommends a "babymoon" when the baby comes home from the hospital, a few days to be alone as a family. After that, perhaps invite people over in groups -- have a "baby open house" -- rather than accepting a never-ending parade of guests. "Even though people usually donít make any demands on you, it forces you to stay awake if the babyís asleep. It just puts more stress on you at a time when youíre already dealing with quite enough." As for the phone calls, turn off the ringer when youíre sleeping, and donít feel obliged to pick up the phone if youíre up to your elbows in dirty diapers. Douglas recommends putting baby updates on your answering machine. Or better yet, send e-mail updates to let people know how youíre doing.

Remember, you canít care for others if you donít take care of yourself. So take that bubble bath, read that frivolous novel, go to sleep when youíre tired, and ask other kind souls to help with some of the daily chores. "If youíre giving everything to the baby and your partner and you donít take any time to nurture yourself, then you really will feel that all you can do is give, give, give, and nobodyís giving back to you," says Douglas. "That can make for a very exhausting, frustrating, and depressing experience. Motherhood is tough enough as it is."


Depression After Delivery:

Postpartum Support International:

More> Postpartum Stress Reducers