Imagine your favorite rom-com, in which the happy ending involves a perfectly smooth childbirth with a blissful, happily-ever-after with the newborn. Sure, many parts of this narrative have merit: in some cases, births are easier than expected or a birthing parent feels an instant connection with their baby. But other times, the moments, days and months after having a baby can be filled with low moods, detached feelings or physical conditions that can leave a birthing person feeling isolated, shameful and guilty.
The difficulties and stigma around postpartum life
Nailah Dodd, a certified nurse midwife at the Maternal & Infant Care Clinic at UW Medical Center – Montlake, explains why the expectations attached to birth and the postpartum period can be harmful.
“There are many stereotypes and stigmas attached to birth and the postpartum period,” Dodd says. “The ‘as seen on tv’ version of birth is fraught with theatrical level trauma and immense fear. Somehow, then immediately after the baby is born, all becomes blissful within seconds. This is a dangerous and unrealistic representation of birth and the fourth trimester that leaves a massive void where many postpartum mood disorders can fester and take root.”
Conversations around some of these mood disorders, such as postpartum depression or anxiety, are becoming less taboo, but these low or anxious moods can be just the tip of the iceberg on how birthing parents can feel.
Both physical and psychological symptoms can set in. Everything from psychosis and post-traumatic stress disorder (PTSD) to infections and clots can plague a birthing parent’s mind both before, and especially after, the baby. It’s not dramatic to say that in some cases, postpartum symptoms can be a life-or-death situation, with a study from the Centers for Disease Control and Prevention (CDC) reporting that over half of all maternal deaths related to live births occurred sometime after delivery.
Please keep in mind, if you are expecting a baby, that doesn’t mean you’ll have a difficult experience. But if you’re currently in your postpartum period and are struggling, take an extra breath. Not only do thousands of other birthing parents have this experience, but more importantly, it’s nothing you’re doing wrong. Sometimes, it might even be due to genetics or a preexisting condition.
“The development of a postpartum mood disorder is not the birthing person’s fault,” Dodd says. “‘Baby blues’, postpartum depression, postpartum anxiety, psychosis and postpartum post-traumatic stress disorder have not made it into Hollywood’s depiction of birth, but have managed to stigmatize them, nonetheless. Preexisting mental health conditions, societal or personal trauma, poor support and trauma surrounding the prenatal or birthing periods can all contribute to a person’s risk of developing a postpartum mood disorder. These risk factors may be present in any birthing person regardless of age, race or sociodemographic status.”
How to set postpartum expectations
“Screening for risk factors should begin at the very first prenatal visit,” Dodd says. “It is the job of the care team to provide resources, support and education to mitigate these risks as much as possible.”
Some things you can talk to your doctor about to prepare for childbirth include expectations and risks for the birth itself, what feelings or symptoms you should immediately report back to the doctor in the days and weeks after birth, and who to reach out to for any other types of support. It can be hard to know what’s going on with your body after so much change, which is why conversation and awareness is important.
“The journey of finding a new normal after birth is expected to be a somewhat challenging one with normal ebbs and flows of emotions,” Dodd says.
Dodd also explains that these fluctuations generally fall under the umbrella of the ‘baby blues’ which affects up to 80% of the birthing population. Depending on the person, the onset can happen within the first few days post-delivery and could even develop up to a year after childbirth.
“Symptoms such as sadness, anxiety, panic, irritability, crying episodes, anger, changes in appetite, loss of motivation, or triggering flashbacks begin to present clues that there is a larger issue at play,” says Dodd. “These symptoms should not be ignored; especially after the two-week postpartum period.”
Caring for your mental and physical health takes priority
If you’re struggling with postpartum symptoms, physical or mental, it’s hard to be transparent about them when you’re also worrying about taking care of a brand-new human. Take a tip from the classic airplane analogy, here — make sure your mask is on before helping others.
If, in this case, the proverbial “mask” is reaching out for extra support from family, doctors or anything else, don’t let the stigma tell you that it’s not OK to do so.
“Having a trusted and compassionate healthcare team is so important,” Dodd says. “Beyond family or friends, obstetric providers (midwives and OB-GYNs), nurses, doulas (birth and postpartum) and all clerical staff should be well versed on the signs and symptoms of postpartum mood disorders. Early detection and treatment are crucial. Untreated, postpartum depression can persist for over a year. Anxiety, PTSD, and psychosis can also have lifelong ramifications when left unaddressed. Additional in-home support, therapy, support groups and medication can all be a part of someone’s healing journey.”
If your symptoms are more physical, have this discussion with your doctor. Some recommendations include making note of any physical conditions or symptoms that other people in your family have had after giving birth or other conditions you might have concerns about. During your regular check-ins, you and your doctor can keep an eye on this part of your health. And with these ongoing conversations, we can continue to ensure that the person who gives birth to the baby is just as supported as the baby themselves.
“Once we as a society start to dismantle our collective stigmas around birth and parenting, we will open the door to a new normal that no longer sees these postpartum conditions as taboo,” says Dodd.