By Barbara Smith Decker
“During those first six to eight weeks, a mom’s basic need for food and sleep is pitted against her baby’s needs. It’s a really hard time.”
– Dr. Diana Dell, Ob/Gyn and psychiatriist
At first blush, the birth or adoption of a child is often met with overwhelming joy, excitement and fulfillment. But, early in the transition to parenthood – whether with one’s first child or not – emotions can become mixed. Feelings of chronic exhaustion, physical discomfort after delivery, constant caretaking demands, loss of independence and lack of control over one’s schedule can take their toll.
One mom reported that as she sat in the kitchen during a heat wave with her 1-week-old baby girl, a thought flashed through her mind of her putting the baby in the refrigerator for a minute to get a break from the incessant crying. “I was terrified that such a thought would even enter my mind,” she confessed. “I loved my baby and I knew I wouldn’t do anything to hurt her, but I thought I was going nuts. I scared myself.”“Lots of new moms I see think they’re going crazy,” says Dr. Diana Dell, an obstetrician/gynecologist and psychiatrist at Duke University Medical Center.
"But during those first six to eight weeks, a mom’s basic need for food and sleep is pitted against her baby’s needs,” she says.
"It’s a really hard time: the mom suffers sleep deprivation, outside help starts to dwindle, dad goes back to work and, many times, mom watches longingly as he leaves, wishing she could go back to her old life, too. But when the baby starts to smile at about six weeks, the recognition and response to her makes it easier for a new mom to feel needed and connected to her baby."
Some of a new mother’s mood swings can be triggered by physiological changes. It is normal, for example, for a woman to experience crying spells and irritability during the first week or so after giving birth while her hormones begin their return to their pre-pregnancy levels. Other emotions are triggered by the conflict between expectations and reality, the stressful transition to parenting 24/7 after having been primarily responsible only for oneself, and the cultural pressures of what a mom should be and do. Feeling overwhelmed by responsibility, isolation and inadequacy may trigger loneliness, fatigue, restlessness, anxiety and even loss of appetite. Generally, these feelings are not severe, they don’t affect a mom’s ability to function and care for her baby, and they don’t require treatment. They usually disappear within a few days to a week. And, it helps to know that these feelings may resurface at stressful points throughout the first year, such as when a baby is teething or ill.
Facing the Realities
"Often, a period of grief for one’s ‘old life’ follows the birth of a child,” notes Dell, who is co-author of The Women’s Complete Wellness Book and Do I Want to Be a Mom? “It takes time for a person to grow into this new life as a parent. There is no way a new mom can anticipate all the changes that will take place when a child enters her life. Even her relationship with her husband changes; she realizes that her life is forever changed.
"At a cultural level, we have to adjust our expectations," Dell says. "In Asian cultures, there are traditions and rituals where other adults, usually one's own mother, come in to help. Secrets are shared and family objects are passed on to a daughter in honor of her new role. But women in our culture think that they have to do everything. Women are under enormous pressure to make perfect babies and care for them. But parenting is a shared responsibility."
Dr. Frank Ling, a clinical professor of obstetrics/gynecology at Vanderbilt University and a nationally recognized expert in depressive disorders in women, points out that “expectations can’t be met because women nowadays have many roles they have to fill, which wasn’t true 20 years ago. The period of transition is being shortened. After a few weeks, women start preparing to go back to work. The baby, then, can become the focus of why the mom is falling behind in her career, her relationship with single friends or her relationship with her husband.”
Learning to Cope
Accepting the reality of the changes and challenges faced as a new mom is the first step in coping with mixed feelings about parenting.
• Rest whenever you can. Research shows that a four-hour stretch of sleep is critical.• Drink plenty of water.• Ask for help from your partner, family members and friends. Insist that your partner help with nightly feedings and diapering. Taking care of your child is a family responsibility; setting expectations for mutual caregiving from the beginning is not only important for the new mother but it also promotes healthy parent-child bonding for both parents.• Eat healthy to keep your strength up. Dads can help by preparing snacks, which can be consumed one-handed in case the baby is having a hard day and needs constant holding.• Take care of yourself. Ask for regular breaks from mothering. You have to ask for what you need and take responsibility for setting a boundary between where your baby ends and you start.• Join a mother’s group and, as your baby gets older, a play group. “Women feel guilty if they sound like they don’t love their child unconditionally,” says Dr. Ling. “They need permission to talk about it.”• Get structure in your life, adapt to your baby’s routines and get out of the house!• Work with your partner toward meeting the baby’s needs.• Learn what to expect developmentally from your baby to reduce stress about teething, separation anxiety and other natural stages.
If Negative Feelings Don’t Go Away …
Studies have shown that between 6 and 12 weeks, moms adapt to the lack of sleep and learn to rest when their child does. “But moms with depression don’t learn to adapt and they may not sleep at all,” notes Bobbie Posmontier, a veteran nurse/midwife and mother, whose research at the University of Pennsylvania’s School of Nursing focuses on how the activities of normal and depressed mothers differ.
Depressed moods after the birth of a child are common, but it is the extent to which a woman is unable to function that signals “postpartum depression,” Dell says. “People know about postpartum depression, but they don’t think it will happen to them. In the first year after childbirth, 20 percent of all adult mothers and 25 percent of all teenage mothers suffer from the disease.”
Postpartum depression is treatable – with counseling, support and medications. “It is not a character flaw,” says Dell.
Depressed people often do not realize that they are depressed, so it’s important for partners, relatives and friends to help the mom get intervention if needed (see Resources and On the Web link below).
“The emotional health of a mom has tremendous impact on her baby,” Dell says. “A baby has to be able to engage a caregiver, and if a mom can’t respond to her baby, the baby will be affected.”
Bringing Out the Best
Parenting helps women to develop patience, responsibility, caring, organization and teamwork. It can bring out the best in you and your partner. It’s important to recognize – and celebrate – what each of you brings to your relationship and to your child. It is especially important for new moms to feel appreciated, especially in a culture where the baby becomes the focus of attention. A partner who remembers the mom in romantic ways and helps her feel more of a woman and less of a caretaker, does her a great service and strengthens their relationship.
Seeking (and Finding) Support
The Need to Screen for PPD
Identifying and Coping with Postpartum Depression
Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression, by Shoshana Bennett and Pec Indman, Moodswings Press, 2003. Covers risk factors, diagnosis, treatment and prevention, and includes chapters for husbands, family members and friends.The Postpartum Husband: Practical Solutions for Living with Postpartum Depression, by Karen Kleiman, Xlibris Corp., 2000. Helps partners recognize, understand and deal with the impact of depression after a baby is born.
Mothers & More – This national organization helps mothers network through local chapters that offer moms’ groups, play groups, mom’s night out, book clubs, newsletter and online discussions.National Women’s Health Information Center – 800-994-9662; Offers resources and information about depression during and after pregnancy.
Postpartum Support International – 800-773-6667; Provides information on the treatment of postpartum illness, listings of nationwide support groups and links to support resources.
Postpartum Dads – This outreach program of Postpartum Support International provides information and resources to dads and families, and guides them through postpartum depression.When 'Newborn Fatigue' Leads to Resentment
Barbara Smith Decker is a writer, editor and mother of three.