A Portrait of Postpartum
There still seems to be a nagging sense of shame that keeps many women from talking openly about postpartum disorders. But 85% of all women experience some sort of postpartum hormonal change after birth. (Source) These changes and their effects vary in type, intensity, and duration from woman to woman. In that regard, postpartum “disorders” exist on a continuum.
On one end of the spectrum - postpartum blues (symptoms include: moodiness, tearfulness, and irritability), which is So Common among mothers in the weeks after birth that it is considered NORMAL.
And on the opposite end of the spectrum - postpartum psychosis (symptoms include: hallucinations, confusion, and erratic behavior), this is the most extreme and severe postpartum disorder and is considered a psychiatric illness.
In between, there is postpartum depression and postpartum anxiety. Postpartum depression often manifests itself as feelings of guilt, worthlessness, and loneliness, which are accompanied by tearfulness, loss of appetite and insomnia. Whereas postpartum anxiety reveals itself through obsessive worry that your new baby will get sick, insomnia, difficulty concentrating, and a nagging fear that even with the best intentions and calculations, you’ll still end up hurting your child.
Postpartum disorders, particularly the “baby blues,” generally occur in the first weeks after birth and resolve within the first six months after childbirth. But postpartum disorders can occur anytime within the first year and can last for up to three years after the child has been born. (Source)
I consider my own experience with postpartum hormonal changes to be mild. But it is still something that flares up every now and again and is hard to identify in the moment.
Extreme fatigue—the result of cumulative exhaustion from the night before as well as the labor and delivery itself—coupled with complete disbelief kept my mind in a sort of fog that first week.
The first night Malachi slept for three hours or so at a time, before waking up to nurse. I
remember looking at the time early Monday morning (April 9), looking at Malachi in the hospital bassinet next to me, and then looking over at Danny and thinking, “We made it through the first night, thank God.”
Nothing could have prepared me for the mind bender that would be night two.
On night two, baby was nursing every hour, sometimes for 30, 45-minutes at a time. He would doze off for a nap every now and then, but every time I put him down, his eyes opened and he cried, wanting to eat and be held again.
My nerves weren’t frazzled, they were completely fried.
I was petrified that I would be holding my brand new baby, breastfeeding him, and then doze off only to drop him. My mom stayed with me in the hospital on night two. At one point I woke her up, voice trembling with fatigue and asked her to take the baby so I could sleep for 15 minutes. She did. And it turned out to be exactly 15 minutes before Malachi was crying ready to eat again.
The next day, the adrenaline that came from knowing we would finally be going home kept me on autopilot, even though I was a complete zombie.
The pediatrician at the hospital told me Malachi would be more sleepy in the day time but that I needed to wake him up every two hours to make sure he was eating so that he maintained his weight and would put on weight steadily, which was important since he was a month early.
We went home Tuesday, and had our first appointment with Malachi’s pediatrician on Thursday. I more or less floated into that appointment. My post-baby body felt foreign to me. My legs felt heavy and my ankles were swollen. My brain was only half awake.
At the appointment, Malachi hadn’t lost any weight since being discharged from the hospital, but he had not put any weight on either. His doctor told me that I would need to breastfeed as well as pump to supplement Malachi with a bottle.
That grabbed my attention. I hadn’t planned on introducing the bottle so early (it’s not usually recommended if you want breastfeeding to go smoothly).
The doctor asked if I had any questions. Still in a stupor, I shook my head “No,” because there was a disconnect between my mouth and the part of my brain that was awake and shouting,
“No wait. I have all the questions, all of this is new, what should I be doing, looking for, where do I even start?”
Danny looked at me in surprise and then asked the questions. I was happy to defer to him.
We had to go back in on Saturday for a weight check, thankfully between Thursday and Saturday with the breastfeeding and bottle, Malachi put on almost a pound!
But at the weight check we were sent to the hospital next door for jaundice testing.
Before we got home, the doctor called with the results and said she was concerned about the number and that we would need to retest the next day.
I half listened, my mind already spiraling, as the doctor’s voice over speaker phone filled the car - possible jaundice complications...kidney failure...courses of treatment...light therapy...
There in a Chick-fil-a parking lot, sitting in the back next to Malachi, the fog suddenly lifted, but only to give way to my first postpartum melt down:
I was a horrible mother. My baby was only a week old and already I was failing him.
My body had failed to carry my baby to term.
And because he came so early, he had jaundice.
I was working so hard to get him to put on weight for the last couple days by pumping and breastfeeding only to hear that his jaundice could possibly cause him to go into kidney failure!?
I couldn’t articulate the hundreds of thoughts running through my mind or the volcano of emotions erupting inside of me.
I did the only thing my sapped body could do -
Danny and my mom did their best to try to understand me. And when they saw that wasn’t helping they said what they could to comfort me. “It’s going to be okay. Let’s take it one step at a time.”
I wept silently on the car ride back home, the numbness of fatigue slowly washing back over my body as I looked at Malachi and stuffed waffle fries in my mouth to stifle the lump that had formed in my throat.
We retested the next day and the results showed that his jaundice number was decreasing. I dared to breathe a sigh of relief as I whispered my two-word prayer to God, “Thank you.”
And haven’t other mothers gone through similar, (and even that exact) situation(s)?
In fact, many mothers have had to go through worse. But none of that registers in the disordered postpartum mind. It's all one big emotional hallucination.
Breastfeeding and pumping to use a bottle to supplement also caused me to spiral that first month.
My nipples were sore from baby latching on in hangry frustration before calming down and correcting himself. In those moments when he would chomp down, I wanted nothing more than to jump out of my skin and get as far away as possible.
And I found it difficult to rest, pump, and eat while the baby slept. Usually, sleep won, and I would feel guilty about not pumping, and eating was no longer a priority, which meant no fuel for my body. When I did pump I was discouraged because I was only pumping about .5 to 1 ounce from each breast. What was the point?
When my mom was with us she made it her duty to make sure I ate and pumped, which meant not resting as much as my exhausted body felt it needed to. That only increased my irritability and I would verbally lash out at my mom in frustration, arguing to the point of tears. One night I even slammed my pumping parts down on the table because I kept dropping them and all I wanted to do was sleep before Malachi woke back up.
Recognizing the Symptoms
There are moments and sometimes days when I feel stretched beyond my capacity. But thankfully I am doing a better job of recognizing the symptoms and catching myself before my emotions spiral out of control.
For me, postpartum issues look like outrageous mood swings, insomnia, distressing guilt, feeling lethargic and not wanting to move, feelings of anger and resentment, picking apart my appearance, wanting to shout when the baby is crying and nothing seems to be soothing him, feeling incompetent, generally feeling lousy, feelings of intense loneliness, and yes a complete meltdown into tears.
But I've been getting better at identifying what I need (Jesus + fresh air go a long way) and asking for help, and perhaps most importantly talking to other mothers who are willing to share their experience and getting out of my own head.
As challenging as motherhood can be, I LIVE for my son. Looking into his alert eyes, kissing his sweet face, seeing his gummy smile, and watching him as he sleeps peaceful are the highlights of even the most difficult days. It's a blessing to watch him grow and have a hand in that.
You Are Not Alone
Literally, in the last week as I was planning this post in my head, several really good related items found me. (Coincidence? I think not. Plus everybody knows the "Internet" is listening in our homes as well as watching our online activity).
When it comes to matters of postpartum, the most important thing to remember is that
You Are Not Alone
talking it out really does help, and if more serious intervention is needed that's okay too. Babies need healthy mamas.
If you're a mom in need of a friend to talk to talk to, I'm here. Let's talk.
But if you think you may need more serious help call the National Postpartum Depression Hotline at 1-800-PPD-MOMS (1-800-773-6667) and talk to your medical provider.