This compelling article is about postpartum psychosis.   A must read! 

Lisa Abramson says that even after all she has been through — the helicopters circling her house, the snipers on the roof, and the car ride to jail — she still wants to have a second child.

That's because right after her daughter was born in 2014 — before all that trouble began — everything felt amazing. Lisa was smitten, just like she had imagined she would be. She would look into her baby's round, alert eyes and feel the adrenaline rush through her. She had so much energy. She was so excited.

"I actually was thinking like, 'I don't get why other moms say they're so tired, or this is so hard. I got this,' " she says.

Lisa wanted to be the perfect mom. She was ready to be the perfect mom. She and her husband lived in San Francisco, and Lisa had worked as a successful entrepreneur and as a marketing executive for a Silicon Valley tech company. When it came to starting her family, she was organized and ready to go. And that first week after her baby was born, everything was going according to plan. The world was nothing but love.

David Abramson found "postpartum psychosis" on the Internet after his wife, Lisa, developed signs of anxiety and delusions in 2014 after their daughter Lucy was born. Studies suggest the condition affects about one or two women out of every thousand who give birth.

Then the baby started losing weight, and the pediatrician told Lisa to feed her every two hours.
Lisa started to feel like she couldn't keep up.

"It weighed on me as, 'I've failed as a mom. I can't feed my child,' " she says. "I needed to feed her — that was the most important thing. And my well-being didn't matter."

She was barely sleeping. Even when she could get a release from what felt like breastfeeding purgatory, she couldn't relax. As she got more and more exhausted, she started to get confused.

Lisa thought going to a spin class would help. This was something she usually loved. But after 10 minutes, she fled the room.

"The noises and intense volume of the spin class was really alarming to me," Lisa says, "It felt like the walls were talking to me."

Then, back at home, she noticed police helicopters circling over their apartment. "There were snipers on the roof," she remembers thinking, "and there were spy cams in our bedroom and everyone was watching me. And my cellphone was giving me weird messages."

Lisa waited for the police to burst in and take her away. But the next morning, she woke up in her own bed.

The cops must have arrested the nanny instead, she decided. That was wrong, Lisa thought to herself. The nanny shouldn't be punished for my crime.

Lisa told her husband it wasn't fair. She was going to jump off the Golden Gate Bridge.

And that was when her husband told her he was going to drive her to the police station himself.

"It was like, 'Oh, OK, he's taking me in, and I guess I'm getting arrested,' " Lisa says.

Her husband, David Abramson, remembers it as one of the worst days of his life.

"I'm bringing my wife to the hospital and then checking her into an inpatient unit," says David, explaining what really happened that day. "It was really, really challenging."

Not jail, but a psych ward

There had been no crime after all -- and no snipers and no spy cams. The nanny hadn't been arrested, and Lisa's destination that day wasn't a jail cell, but rather the general psychiatric ward at Sutter Health's    California Pacific Medical Center in San Francisco.

The other patients were there for drug overdoses or alcohol withdrawal. People were screaming. One patient thought he was a dog and was crawling around on all fours, barking. To David, it didn't seem like the right place for a new mom.

"That was probably the most heart-wrenching thing, was having to leave her that night with the hospital staff," he says. "You could see in her eyes and her body language that she was panicked."

For the first five days, Lisa says, she didn't speak to anyone.

"I don't know if I couldn't speak, or I wasn't speaking," she says, "but I was terrified enough of the environment that I decided I wasn't going to answer anyone's questions."

Lisa doesn't remember any doctors or nurses telling her why she was there or what was going on. But she does remember, about a week into her hospitalization, her husband bringing a printout from online about postpartum psychosis.

The article said elevated hormones from childbirth — plus sleep deprivation — can trigger confusion and paranoia. Lisa didn't believe it — she thought her husband was tricking her and had spent hours using Photoshop to piece together a fake article.

"I really was just like, 'No. I've heard of postpartum depression,' " she says. "No! I have never heard that there's postpartum crazy."

New data on moms who die by suicide

But postpartum psychosis is real. Studies suggest it affects about one or two women out of every thousand who give birth; some doctors now think even more women than that are affected, but go undiagnosed. Without proper treatment, some of those women end up dying — by suicide.

California researchers just finished their first big study on maternal suicides. The state's public health department hasn't published the findings yet, KQED was able to review some of the data: 99 new moms in the state died by suicide over a 10-year period.

The investigators determined that of those 99 suicides, 98 were preventable. The women might be alive today if the health care system in California had done a better job   screening  women, diagnosing their illness and   treating   them.

"The work that we do here is less than 10 percent of what needs to be done," says   Dr. Nirmaljit Dhami, a psychiatrist at El Camino Hospital in Mountain View, Calif. She helped review the suicides but did not share data from the report with journalists.

Dhami is an expert on postpartum mental illness and often treats cases of postpartum psychosis that OB-GYNs mishandled. Based on her clinical experience and observations, she says, a lot of doctors don't know the early signs of postpartum psychosis and don't know that the symptoms wax and wane.

"A lot of times the patient will present very clearly, then at other times, will present with acute confusion and disorganization," Dhami says.

It's what happened to Lisa Abramson — feeling like she was of sound mind one moment and then believing the walls were talking to her in the next.

"This is a symptom that clinicians who are not trained in this field can easily miss," Dhami says, "because when they see the patient in their office with the family, they can think that the patient is normal and is probably suffering from sleep deprivation — and discharge them home."

That's how women can end up dead. In the U.S., mental health problems are one of main contributors to maternal mortality, according to   a 2018 report  from a Centers for Disease Control and Prevention initiative called Building U.S. Capacity to Review and Prevent Maternal Deaths. On the report's list of causes of death among new moms, mental health problems (which include drug overdoses) rank seventh — nearly tied with the complications of high blood pressure. For white women, mental health problems are the fourth leading cause of death.

Even when new moms do get referred for psychiatric care in the days and weeks after their child's birth, Dhami says, the care is often inadequate or inappropriate. Doctors prescribe the wrong medications. Insurance companies push patients out of psychiatric units before they are ready. And the staff of psych units, generally, are not trained in these illnesses, Dhami says, and may not be equipped to care for even the most basic physical needs of new moms.

For example, when Lisa Abramson first arrived at the psych ward, her husband told the medical resident who admitted her that he thought Lisa had postpartum psychosis. The resident said to him,
"Postpartum what?"

Then, several days into Lisa's stay, she complained of pain in her breasts. She had stopped breastfeeding when she left home, and it didn't seem to occur to anyone that her breasts would become engorged.

Her husband had to negotiate with the staff to bring in Lisa's breast pump from home.
She remembers that when she wanted to pump, she had to use a room with padded walls that looked like a solitary confinement chamber — "what you'd imagine from a terror movie," Lisa says.

But the worst thing of all was not being allowed to see her baby daughter. The inpatient unit has a strict policy: No infants or children on the ward. The hospital says this is intended as a safety measure for everybody.

Her family lobbied on her behalf.

"They said, 'She's a new mom and she needs to see her baby. That's keeping this bond going, it's important,' " Lisa recalls, tearing up. "That was the hard part, was not getting to see her."

About five days into her time there, Lisa's family was able to negotiate permission for one-hour visits with her daughter, but they were supervised by a person who kept looking at his watch.

Lisa's family was so unhappy with her care at the hospital, that her husband decided he needed to get her out of there. They found Dhami and asked her to take over Lisa's treatment.

Dhami enrolled Lisa in a comprehensive outpatient program she runs at El Camino Hospital, called the Maternal Outreach Mood Services (MOMS) program, where the new mother can bring her baby along during appointments.

California Pacific Medical Center declined to comment on Lisa's case specifically, even though Lisa authorized the hospital to discuss her medical records. The hospital's inpatient psychiatric medical director,   Dr. Stephanie Wilson, says that breast pumps are now available to women who need them and that health care providers review new moms' wishes to see their babies on a case-by-case basis.

"We take into full consideration all of the circumstances and the details of that patient, of the infant — and really seeing what, if any, benefit or even potential harm, it could have to the mother," Wilson says. "Once the symptoms of depression and psychosis start to get better, that's when I would start to allow more visitations."

A different kind of care for moms

There's   plenty of research, dating back to the 1940s, on the ideal protocols for inpatient treatment of postpartum mental illnesses. The gold standard is to admit the mother and the baby into the hospital together, on a specialized mother-baby unit, where they're treated as a pair.
Part of the mom's therapy in these units is getting guidance on how to read the baby's cues and how to meet the baby's needs — as well as her own. At night, the baby sleeps in a supervised nursery, so the mom can get uninterrupted sleep.

In the United Kingdom, there are 21 of these mother-baby psychiatric units. In France, there are 15. They exist in Belgium and New Zealand and one in India.

But in the U.S., there are zero.

The closest approximation can be found in North Carolina, 3,000 miles from where Lisa lives, in the hospital at the University of North Carolina in Chapel Hill.

The perinatal psychiatric unit here is reserved exclusively for pregnant women and new moms.
"There is a need for them to see other moms going through what they're going through," says   Dr. Mary Kimmel, the psychiatrist who runs the unit. She wears a denim jacket and black suede ankle boots, and whenever a patient wants to know whether she's a mom too, she says yes, she has two kids.

Every room has a hospital-grade breast pump, Kimmel says, and there's a lactation consultant who helps women with breastfeeding. The unit has a designated refrigerator for moms to store pumped milk.

Psychiatrist Mary Kimmel runs the mom's psychiatry unit at the University of North Carolina at Chapel Hill.

The most distinctive feature about the program is the visitor policy.

"Babies can come to the unit, and we really encourage that," Kimmel says. "We encourage older kids to also come to the unit."

Most afternoons, toddlers scurry around the day room or color, play with toys and play with each other. Women cradle their visiting newborns, rocking them, feeding them.

The babies are not allowed to stay overnight though. Unlike the units in Europe, there's no nursery here. The main reasons for that policy are the restrictions of U.S. insurance plans.

Kimmel says no insurer in the U.S. would ever pay for a healthy baby to be admitted to a hospital.
"That baby doesn't have a distinct need to be admitted and so it's not possible to bill for that baby being at the hospital," she says. And without that, the hospital can't afford to run a nursery.

The days on the UNC unit are very structured, with a range of treatments. There's one-on-one therapy and lots of group classes: parenting and time management lessons, for example, where women practice asking their partner for help; relaxation classes; and spiritual counseling.

Alice Sarti says the moms unit at UNC was the first place that gave her hope as a new mother. After she gave birth to her son, she became engulfed by mania. She had dealt with depression many times before, she says, but never this.

"Every minute I had to fill with a task: researching day cares, doing and re-doing my budget," she remembers. "I'm not going to line up three bottles — I'm going to line up 17 bottles."

She loved how productive she was. She's a business analyst and loves getting things done. But then, everything started to spiral.

"There was a definite snap," she says. "I started yelling about things that didn't make sense. They made sense to me."

To her family, it was just an incoherent rage. They called the police and they took Alice to the nearest hospital that had an available bed — not the mom's unit at UNC, but rather a general psych ward, several towns away.

"You saw people that couldn't speak, that could barely walk," she says. "People were discharged in that condition."

Alice refused to take any meds, making her unpopular with the staff.

"I did have a social worker tell me I was going to lose my child if I didn't 'pull it together,' " she says.
During her three-week stay, she saw her son once, for 20 minutes.

"I was not able to touch him on any level. He was in his car seat and I reached for him and I was yelled at," she says.

It's hard for her to admit what it was like coming back to him, after she was discharged.

"It felt like a burden, "Alice says. "It felt like, 'How am I ever going to do this?' I held him, I bathed him, and I did all the things — but the connection was not there. I lost time with my son and I'm never going to get it back."

Alice was treated at two hospitals, never feeling any better, before she ended up at the moms psych unit at UNC Chapel Hill.

Finally, everyone seemed to understand what she was going through, she says — the pressure she was feeling and the guilt. She saw her son regularly, and staff helped her start to re-establish her bond with him.

"It was this incredibly nurturing environment," she says. "It changed the trajectory of my life, and my son's life."

Yet, even in this seemingly perfect place, things can go wrong. By the time Alice was discharged, her mania had cleared. But then she slipped into the deepest, darkest depression she had ever known. She checked herself back into UNC, afraid she was going to kill herself.

With Alice, and with other patients, doctors are under so much pressure to get moms home quickly that sometimes they overshoot on the medications, Kimmel explains. Some of that pressure comes from the moms themselves, who want to be with their kids, but it also comes from the insurance companies.

UNC's moms unit pays the bills like other hospitals — they take commercial insurance and Medicaid to cover the costs of care.

But the longer a patient stays, the more an insurer has to pay, and that's not good for its bottom line. Kimmel and other doctors say as soon as a patient comes off suicide watch, insurers start calling, asking when she can go home.

"Our average length of stay runs from about one week to two weeks," Kimmel says.

And in Europe? "About 40 to 50 days is the average length of stay there," she says.

That means that some U.S. doctors may start their patients on new drugs but not have time to see if they work well. Or they have to start women on the most intense medications right away — medications that force her to stop breastfeeding — instead of slower-acting therapies that could allow a mother more time to feed her infant breast milk.

It also means that patients like Alice can end up hospitalized four times before they get the right treatment they need to truly recover.

Insurers insist the decision to discharge is not just about cost, but about what's best for patients.

Hospitals are not necessarily the ideal environment for making sure medications are stabilized, says  Kate Berry, senior vice president of Clinical Innovation for America's Health Insurance Plans, a trade group for insurers.

"There are other settings where the care can continue," she says, "such as a partial hospital or an intensive outpatient care setting that may be more supportive of having the mom and the baby together."

Alice Sarti says mental hospitals in the U.S. are just warehousing people. Only the mom's unit felt like a place of healing.

"It's a different kind of place," she says. "It's the type of mental health care that everyone should have access to — not just mothers. That's what mental health care in this country should look like. And it doesn't come close."

Right now, UNC is the only hospital in the country that has a designated psych unit just for pregnant women and new moms. A hospital in New York has a women-only unit. And El Camino Hospital, where Dhami practices in California, will soon start construction on a women-only psych unit, with a special focus on the needs of new moms. It is slated to open in 2019.

Ready to try again

Lisa Abramson is playing catch with her daughter Lucy.

"Ready? Set? Go!" Lucy shouts, and Lisa rolls her a small rubber soccer ball.

Lisa feels like she's back to her normal self. But she has been thinking a lot about her experience with postpartum psychosis.

Despite everything, she decided to have another baby.

"That was the most courageous moment of my life," she says. "Without knowing anything [about] how this is really going to work out, let's try it again."

She was terrified, though, that the psychosis would come back.

"They say there's about a 50 percent chance," she says. "I can try to set up a more optimal situation, but you also just don't know — and it's out of your control, which is hard."

The No. 1 thing she wanted to avoid was going back to the hospital.

"The hospitalization was probably the most traumatic [aspect] of the whole experience," Lisa says.
These days, she loves being a mom, she says. Lucy is 5 now. Her second daughter, Vivian, is 18 months old.

The psychosis did not come back after Vivian's birth, in part because of all the precautions Lisa took. She made sure she got enough sleep. She gave herself permission to give up breastfeeding if it became too much.

"We've got so many messages of just self-sacrifice," Lisa says. " 'Do anything for your kids.' 'Drop everything. That's what it means to be a good mom.' And for me, that's not what made me a good mom. That's what made me fall apart.

"I'm trying to put myself first — guilt-free — and know that that makes me a better mom."

This story is part of NPR's reporting partnership with KQED, the California Report and  Kaiser Health News.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting 741741.

Book review by  Sian  Godin     -   The first  40 days 

Blame women's rights, blame abysmal maternity leave policies in the US, blame the crazy consumer industries urging mothers to ‘bounce right back into those pre pregnancy jeans!’, blame who you like, the truth is that the modern mother is no longer revered as she once was. The intensely beautiful, uncomfortable, hormonally charged rollercoaster ride that marks the transition from expectant woman to mother is no longer viewed by society as such a critically important period for rest, recovery and re-discovery of self. In her book ‘The First 40 Days’ Heng Ou takes us back to a bygone era when the role of the mother in society was revered and cherished, new mothers were confined to bed with their babies and ‘mothered’ by friends and relatives with nourishing foods, comforting rituals and most importantly the time and the space they needed to recover from birth and bond with their newborn. Sadly the modern mother reading this book is probably thinking ‘Yeah right, in my dreams! 40 days of hanging out in my PJ’S! My household / career / business would fall apart! Who has the time to spend a month or more taking things easy?!’ Ou takes the stance that in truth none of us can afford not press pause for a few weeks, weather we believe we deserve it or not, for the sake of our future health and happiness 40 days is something we all owe ourselves.
​
​Heng Ou, together with her co her collaborators Amely Green and Marisa Belger, draw from their own postpartum experiences to produce a book that inspires and empowers women to seek the care and nurturing they deserve after bringing a baby into the world. Between them they collectively mothered six children, during the writing and editing process. As Ou puts it motherhood can sometimes feel very ‘divisive’ with all the options, opinions, different experts and different philosophies whirling around, birth planning can often get parents so befuddled they end up wildly stressing themselves out over what should be a joyous process. ‘The First 40 Days’ is a wonderful remedy to all that, from the moment you open the pages you are basked in warmth, love, inclusivity and themes that will speak to everyone's’ heart. It’s one of those books that just screams “Go grab a blanket, make some hot chocolate, curl up and enjoy!” Come to think of it the ‘Ceremonial Hot Chocolate’  recipe on page 216 is actually a wonderful place to start.

 
​At the heart of this book is the food, the nourishment that a new mother needs to keep her going through sleepless night and challenging days of feeding a newborn. As the author points out, so many postpartum pitfalls can be avoided through good nourishment - being undernourished, dehydrated and exhausted is a volatile combination which can lead down the garden path to a myriad of health problems. With her Asian heritage and modern American upbringing, Ou finds the perfect fusion of traditional and modern flavours in mouthwatering recipes like ‘Postpartum Egg-Drop Soup with Liver and Greens’ and ‘Pink Cranberry Porridge’. Both are just as delectable as they sound - I can testify!

Almost all the recipes in this book come served in a bowl and can be eaten one handed with a spoon. All are incredibly simple to make, easy on the digestive system and contain nutrient dense ingredients. Such is their simplicity and pure lip smacking satisfaction upon consuming that my husband and I are yet to graduate onto any more complicated fare …. our baby is 9 months old! With a few tweaks here and there for variety these recipes really will see you through some of the toughest parenting grinds…the growth spurts, the teathing, the horrors of the 4 month sleep regression…all these things are somehow overcome with a few mouthfuls of something warm, comforting and nourishing.
​
​Scattered throughout the text are some very useful nuggets of good common sense postpartum care ‘The Art of Sitting Still’ for example - may come naturally to some but there are others amongst us who will benefit from these gentle reminders. For those of us who struggle with it there is encouragement and advice on how to ask for help and how to deal with the influx of family and visitors that will soon be arriving at your door. The ‘Postpartum Pantry’ list and ‘Essential Kitchenware’ are wonderful practical resources for postpartum planning and can easily be passed on to loved ones who want to help with shopping or give an alternative but truly useful baby shower gift.
If you think the idea of a postpartum plan sounds like the biggest oxymoron you ever heard, this book is for you. If you have a friend, loved one or family member expecting and you wish to support them in the most loving and truly helpful ways possible, then this book is for you. If you are the kind of mother - like I was - who knows she is going to have a really hard time sitting still and asking for help, this book is definitely for you. To summarise, this book is an absolute gem, generations of wisdom and practical knowledge with a modern twist that all expectant women would be wise to read and to heed.

by Jocelyn Wells

It’s the end of an era…

My faithful pump that has served me for nearly 3 years of breastfeeding has been cleaned and sterilized for the last time and is on its way to another mama.

No, I really didn’t ‘enjoy’ pumping, but it did offer me a reprieve from being my baby’s only source of nourishment 24/7 and the freedom to be able to stay away for more than a few hours at a time. It allowed others to feed and bond with both of my babies and enjoy those close quiet snuggles.

But pumping is no picnic – it takes time and energy at at a period in your life when you sometimes feel short on both. Here’s how I made pumping work for me:

• I bought a double electric pump. It is faster and you typically get more volume when you use a double pump
• I brought it with me every time I was away and kept pumping at my regular nursing times (if I was in a hotel I brought a cooler bag with me or asked for a room with a fridge)
• Once my babies dropped a night feeding I pumped at that time for a while to build a freezer stash
• I kept my pump plugged in and ready to go right beside where I usually nursed and kept the pump parts in the fridge (if pumping multiple times a day instead of needing to wash and sterilize every time)*
• I used microwave steam cleaning bags for easy weekly sterilization
• I regularly replaced the membranes so the pump was as efficient as possible
• I laid freezer storage bags flat in the freezer so they thawed quickly and were easy to store
• I froze milk in 4 oz portions as it was enough to fill up my babies and not have any left over

Now, double electric pumps can be pricey. Here are a few ways to help with the cost:

• Some extended health benefits will cover up to $200 for a breast pump – you will likely just need a prescription from your health care practitioner
• Shop around – I purchased mine off Amazon.com. It was much cheaper than the Canadian site – even with the exchange
• You don’t need the fancy brand name milk storage bags – generic store brand work just as well for a fraction of the price
• Check out mom’s buy and sell groups on Facebook. There are often brand new in the box pumps available (make sure you check them out in person)
• You can buy used pumps and replace the breast shields, valves, membranes, and bottles (the only parts that touch your skin or milk) for around $30
• Think carefully about your needs – hand pumps are extremely efficient and perfectly fine for occasional pumping and many hospitals and pharmacies will rent pumps too. You might want to try these options first if you are unsure about pumping

For reference – I used the Medela Pump In Style and I loved it. It met all my needs. The tote bag style was convenient to carry all the required paraphernalia and I loved the included battery pack and cooler.

Pumping isn’t for everyone, neither is breastfeeding. That’s ok. It has to work for you and your family. It worked for me which is why I share my story.

If you’d like some more info on pumping – or maybe even just some words of encouragement to keep pumping longer – send me a message! I’d love to chat.

*if your baby is premature or has other complications you should speak to your healthcare practitioner before doing this.

 Jocelyn is a Guelph Ontario based Postpartum Doula.  

Momaste. 'The mom in me honors the mom in you.'
* The “I see you, I get you, I’m with you” look. You know it. I know it. It’s a day-changer. It lowers the shoulders and the blood pressure and might even bring a smile.
It can be as little as a look in the grocery store when you’re about to lose it.
Give that. Be that. Spread that.
* The mess in me honors the mess in you.
* The dirty clothes on my floor honor the dirty clothes on your floor.
* The yell hiding in me honors the yell hiding in you.
* The nap I won’t be taking honors the nap you won’t be taking.
* The wine in me honors the wine in you
~ Julie Ford

 By Jocelyn Wells  - Postpartum Doula     

A few weeks ago I came across this amazing    TED Talk    by Dr. Alexandra Sacks on a new way of thinking about the transition to motherhood. She calls it Matrescence. 

This six minute talk put words to something I (and likely millions of other women) have been thinking and feeling for years!

Dr. Sacks explains that as a society we understand and allow for the awkwardness and developmental arc of adolescence. We recognize that it is a period fraught with transition and growth. We understand that it makes you think and do and feel weird things. Adolescence is a time where changing bodies and changing hormones change the way we fit into the world. Hello – does this not also sound like the experience of becoming mothers?

Dr. Sacks agrees. But, she says, we do not allow for that same transition time for pregnant and postpartum women. We’re expected to know it all (and love it all) right out of the gate.

I remember so intimately that feeling of going from an independent and autonomous person to an exhausted, aching, and frustrated thing called ‘mom’.

Overnight.

All of a sudden I had this tiny human who’s life was literally in my hands. They were 100% reliant on me. That was daunting to me.

But don’t you love it? They would say.

Yes, of course! I would say out loud. But not all the time. I would say in my head. I didn’t think I was allowed to not love it all the time – I had tons of friends with babies and no one else seemed to ‘not love it all the time’.

Motherhood changed the way I relate to people and it also changed the way people relate to me – during maternity leave when I wasn’t working outside my home I often had this worry that I had nothing to contribute to conversations. I didn’t have the typical work gripes that you share with your friends and people looked at me strangely when I complained about my baby the way you would complain about your boss. But hey, sometimes my baby was overworking and over stressing me!

It’s the push and the pull of motherhood, as Sacks describes. The pull is that oxytocin induced feeling that the baby and their needs is the center of your universe. The push is your brain reminding you of all the other things in your life and the other needs that   you  have.

I remember distinctly grieving the parts of myself I thought I had lost. Oh how I miss a lazy long mimosa filled brunch (for the record I still miss this). Remember when I used my brain for solving complex workplace issues, instead of just for figuring out how many sleepers I need to buy?

I also remember thinking that I must the only one who felt this way and I’m probably a bad mother for even thinking this way.

**Newsflash**

I wasn’t. And I’m not.

This is common. It’s normal. Most parents struggle with the push and pull of parenthood.

So why aren’t we talking about it?

Sacks argues we need to normalize these experiences of motherhood – negotiating different identities of who we were vs. who we are becoming. We need to talk about this with other moms. I want to hear about the days when you don’t love it. I want to hear about your ambivalence to this motherhood identity.

Tell me about your matrescence.

Author: Brielle  Ross ~  Postpartum Doula

You did it! You grew a human (or two) in your body for 9 months. You adjusted and readjusted on the couch to find a comfortable position. You ate right and indulged in cravings within moderation. You bounced and swivelled on your yoga ball. You counted kicks and contractions. You were a warrior and brought your baby into the world with love and power and maternal instinct. YOU DID IT!

You fumbled and tried and retried breastfeeding; and you were able to feed your baby (breast or bottle, you made the best choices for your family).

You coped with sleepless nights and exhausting days; but you did it!

You mastered the art of feeding a half asleep baby while eating yourself.

You survived the first six weeks, so the postpartum recovery stage is over right? …not so fast…

The fourth trimester is a theory that Dr. Karp explains how human babies are born ‘developmentally early’, fully dependent on their mothers for food, warmth, security, survival, and physically moving; whereas other mammals are born with the ability to walk and run the same day they are born. (Dr. Karp’s philosophy on the fourth trimester is a great read. Check out more here https://www.coliccalm.com/baby_infant_newborn_articles/4th-trimester-theory.htm).

The fourth trimester lasts three months (assuming the baby is born at full term gestation) and can be a wonderful time for mom and baby to bond through breastfeeding for the purpose of nutrition as well as comfort, skin-to-skin cuddles for warmth and the reminder of ‘home’ for baby, and a magical time to learn with your baby how to soothe and read ques.

But this can also be a time of confusion for a mom who is wanting to re-emerge into previous physical fitness while balancing the needs of a new baby. While it is wonderful for moms to exercise for many reasons, it can be difficult for moms to know what their bodies ‘should’ be doing in the early postpartum months.

While there are many companies profiting off of postpartum women, reinforcing the fantasy that a woman’s body can and should return to a perfect-pre-baby-state…this can be damaging for multiple reasons. Our culture has glamorized Hollywood-moms who are photographed with their newborns and flat tummies, which creates an unrealistic expectation of the postpartum body.

I am not suggesting that postpartum women should not exercise; rather, I am heeding advice before you begin. Enjoy your baby. Get to know your new body. Do not expect your body to return to its pre-baby body.

Michigan University found “some women sustain injuries during child-birth comparable to those sustained during an intense athletic event. Fractures, muscle tears and strains that are undetectable without an MRI scan, which is why your pelvic floor and body could take a lot longer to heal than six weeks. And why you might need to modify your fitness drive” (http://www.huffingtonpost.co.uk/karen-laing/post-baby-body_b_8739254.html). Take the time to heal and consult your doctor to ensure any stitches or tearing have healed. Just as athletes are encouraged to rest and go slow, a mom should too! Your body has gone through a lot; do not rush.

While you may be eager to lose your ‘mom belly’ understand that diastasis-recti (split abs) is very real and your doctor and physiotherapist can give you wonderful care to heal this. Even if you did not experience diastasis-recti know that it can take two years for your uterus to completely shrink back into place and be supported by abdominal muscles (https://mamaandbabylove.com/post-partum-is-3-years-not-6-weeks/).

So what can you do!?
**before engaging in any exercise routine, speak with your care provider**
There are many things you can do to regain strength and workout-endorphins in your postpartum transitions.

Go for a walk—try out a stretchy wrap so you can be close to baby, which will help his/her fourth trimester transition, and will allow you to respond to baby’s cues.

Squats—try without any weights, your body has been through a lot. Once you have gained strength try out some fun baby bonding time holding baby while squatting. https://www.parenting.com/gallery/exercises-to-do-with-your-baby?page=6

Hand weights—eager to lift weights again? Start from basics and lift some hand weights.
Your changed body is beautiful! Get to know your new body and fall in love with it.

Check out the Fourth Trimester Bodies Project for some inspiration! http://www.4thtrimesterbodiesproject.com/