August 20th, 2013

planet

postpartum recovery: what's with the discussion void?

My friend @DrJaneChi brought up an interesting link last week: Why Are America’s Postpartum Practices So Rough on New Mothers?

It's basically about how we think childbirth should be no biggie, we admit that labor is a bit taxing but then you get to lay around for a night in a hospital and then you can go home and play with your new baby and lose weight before jumping back into your office routine in six weeks. Hell, that's what I thought happened. Then I had a baby and was shocked to learn that I'd need every inch of that six weeks to heal from what had just happened to me in childbirth.

It was so shocking to me that I wrote this entry late in my second pregnancy about how I was scared shitless at the idea of going through postpartum recovery again... because seriously, I was. When I thought back on Josie's first few weeks all I could remember was my own pain. Then guilt, because no one else seemed to relate, everyone who talked to me made jokes about sleep deprivation or missing nights out at clubs, I was afraid to bring up the fact that I could barely walk. Was I the only one who'd ever needed to heal?

It turns out, no:

[dailybeast] The problem is that no one recognizes the new mother as a recuperating person, and she does not see herself as one. For the mourning or the injured, we will activate a meal tree. For the woman who is torturously fatigued, who has lost one 10th of her body’s blood supply, who can scarcely pee for the stiches running up her perineum, we will not.


You guys, it is weird how little discussion there is about this topic. You all know me, I spend too much time on the internet, I read up on women's issues. But when it came to postpartum healing there was just this silence.

One potential reason is that every birth is different. My second birth, I'm happy to say, resulted in none of the injuries. I actually enjoyed my maternity leave. I was walking the dog four days after her birth, and felt really ready to be back at work in six weeks - sitting in the chair didn't make me sore. I didn't do anything different in preparing for the birth, it was just luck of the draw. And it made me realize that if this was the birth I'd had the first time, I might not be able to relate to women who needed to take time to heal either. Maybe that's why when I posted this article to my birth club, I basically got responses along the lines of "oh I didn't need healing, I was in shape before I gave birth. I did my kegels."

Okay that's great that so many women apparently come through unscathed, maybe I was just unlucky? We don't want to make birth sound worse than it is. Maybe we should just shine a light on the good stories and sweep the bad ones aside so we all feel more empowered.

But then I remembered an interview I did online for my weekly pregnancy blog. I wanted to find someone who'd write me an entry about postpartum depression. I did not need to look far. It's incredibly common. I met a writer named Jannine who wrote about her experience in a powerful, yet incredibly haunting way... of a PPD after a caesarean recovery that left her all on her own:

[spacefem.com] I really think it had a lot to do with how I was treated after surgery. Many people seem to think that just because a c-section results in a baby that it isn't a big deal. C-sections are major surgery, and most people are laid up in bed for weeks after something like that, a hernia, or broken leg, seem to get more sympathy then a c-section. I had no idea how to take care of myself and no one seemed to have any answers.


What is the result of us pretending that "normal" birth is an event that a woman can do & recover from all on her own? This marginalization. Every time we act like weight loss is the most important thing to do after you have a baby, we put someone else at risk for a serious condition, during an already risky time. And that's what gets me, it doesn't have to be like this. Why wasn't I okay with just laying in bed, nursing my baby, healing and accepting that my body would hurt for a few weeks? Why was Jannine left on her own with a newborn 14 days into her recovery? My friend tabloidscully even commented on my original post about she doesn't even want to give birth again, ever, between the awfulness of it all and the persistent "oh just focus on the good things!" attitude that everyone around her kept driving at. It's like we're all, individually, just feeling totally alone.

[dailybeast] America might begin by conceding that the postnatal period ought to be a formal, protected, well-monitored term and that any woman who does not adequately and restfully observe it is putting herself and her infant at risk. Increased paid parental leave and insurance policies that include longer hospital stays and regular postnatal visits would be helpful. So would a national discourse that does not stop at postpartum depression, which is the consequence and not the cause.


If you didn't need to heal after giving birth that's great, but I think it should be looked at with a bit more sensitivity. When someone cuts their hand you don't shrug and say "oh, that's never happened to me" and walk off. Or "it's a normal cut, see you in six weeks" which is basically what my OB said when I called them crying on the phone. I think what scares me about Jannine's story is that I can see myself in it, if I hadn't had a very supportive mother and a few other friends, the perky voices around me saying "hey, visit us at the office next week! we'll do lunch!" might have won out. When a woman has a baby, we need to start asking if she's okay and let her talk. America sucks at that right now.