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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.



( 16 comments — Leave a comment )
Aug. 20th, 2013 05:34 pm (UTC)
AMEN, lady!
Aug. 20th, 2013 06:16 pm (UTC)
Great post.
Aug. 20th, 2013 07:00 pm (UTC)
My midwives prescribed me a minimum of three days full, and ten days partial, bed rest after my first was born. My husband returned to work after two days. On his first day back I had a ten-year-old for help (good for fetching gatorade, but not much else); after that, it was just me and the newborn during the days.

All in all, I was much too active the first couple weeks and tore my stitches. I wound up with a painful surface-level adhesion that had to be clipped. And, I found out three years later during pregnancy #2, I must also have torn some of the lower layered stitches: I have a line of weakness inside my vagina that no amount of kegeling helps because, apparently, the muscles are separated. I fear - and rather expect - I will re-tear on that line when I give birth in the next few weeks. </p>

And I don't expect much more postpartum support this time (husband has accrued less than a week of leave at new job) - but I will have a newborn and a three-year-old to tend.

Aug. 20th, 2013 07:25 pm (UTC)
I think the lack of information regarding this is just shocking. I think in part it may be because it involves talking about things that are normally private. I wish someone had told me the truth, I regret having a vaginal birth so much.
Aug. 20th, 2013 11:13 pm (UTC)
Wow. Thank you for writing this.
Aug. 20th, 2013 11:27 pm (UTC)
Agreed!! I just recently posted something about how maternity leave is waaay too short in the U.S...

I had an emergency C-section following a 50 hour labor, and let me tell you, the difference between pre and post partum care started right IN the hospital! My L&D nurses were awesome, the PP ones sucked- or at the very least were under-staffed.

I had to spend 3 hours hitting my buzzer to get someone to take my catheter out.

I got YELLED at for not dressing my baby warmly enough... when I couldn't physically do it because I could barely get him back in the bassinet after breastfeeding him, let alone swaddling him, since I could not sit up and had to do it all lying down. She told me I should have called someone for help... well yeah, I would have, if anyone would ever show up. With a 15 minute-2 hours response time, I had to do things myself.

I sent my husband home to sleep... and the nurses told me that he needed to be there overnight to help me to the bathroom, etc, since it was the first night with my catheter out. Because obviously they couldn't do it. I couldn't get ahold of him (because he was dead asleep). I had to get someone to bang on his door so I would have someone who could actually help.

Luckily my parents came for a week and did everything (cooking, cleaning- yay!) but if I had been a single parent with no support, the 2 day hospital stay post C-section- even with the terrible aftercare- was NOT enough.

And for anyone googling, the was University of Michigan, Ann Arbor C.S. Mott Women and Children's- a GREAT hospital, and GREAT L&D- but shitty PP. (Also all my friends gave birth in the same hospital and reports the same stark contrast.)
Aug. 21st, 2013 02:53 pm (UTC)
I had a friend who was forbidden to leave her hospital bed after a c-section, hooked up to all kinds of IVs, when she noticed her newborn across the room choking on spitup. The nurses didn't answer the button, she started screaming, got up when the boy started turning the wrong color, also got yelled at. The hospital staff said they were "doing paperwork". just not even safe!
Aug. 20th, 2013 11:49 pm (UTC)
Two more important links: the postpartum period and the uses of food stamps
User browngirl referenced to your post from Two more important links: the postpartum period and the uses of food stamps saying: [...] writes about the lack of discussion of and knowledge about postpartum recovery [...]
Aug. 21st, 2013 04:10 am (UTC)
I had post-partum hemorrhaging, lost a lot of blood, and ended up with post-partum anemia. The first week home we had family in town so I mostly slept and nursed. The second week I was all by myself and the only thing that I think really got me through it was having a mini-fridge upstairs that my step-mother had stocked with some easy to eat high in iron foods. If we'd had known how bad I really was, I think my mother would have stuck around an extra week.

Where I live there is a mamas group that will organize red tents (food trees, play dates for older kids, etc) for new moms or moms who are having some trouble and need some help. I was okay with food right after Little Prince was born, it was during the adjustment time when I went back to work full time at 12 weeks that I would have liked to have had a food tree set up for me.

PS. Hema-plex is the only thing that kicked my iron levels back up to a decent count.
Aug. 21st, 2013 07:26 am (UTC)
There's a reason that in the Netherlands, it is mandatory that a post-natal nurse visit a new mom for minimum of 4 (most people sign up for 8) hours a a day for the first 8 days (with an option of 2 more if the conditions indicate it).

I was lucky in that I really had an easy birth to recover from, even including the episiotomy and accompanying stitches. We left the hospital about four hours after Gwen was born, five after we'd arrived, and I remember getting into bed upon return and thinking "You know, I thought I'd be more wrecked by the experience. Whereas I'm just as tired as I'd feel as if I'd woken up at 3:30am, which I did." Nevertheless, I spent pretty much the next week in bed, letting Joel, my mom, and the post-natal nurse fetch and carry and do for me, and I needed every minute of it. It wasn't until Gwen was a week old that the concept of getting out of bed for more than going to the bathroom or moving to the couch so I could get some sunshine seemed remotely possible.
Aug. 21st, 2013 02:00 pm (UTC)
Yeah, this is something that needs much further exploration. One interesting way to look at it is how do the cultures of other countries look at post-partum recovery? Is it just the US that handles it so badly?

America might begin by conceding that the postnatal period ought to be a formal, protected, well-monitored term [...]. Increased paid parental leave and insurance policies that include longer hospital stays and regular postnatal visits would be helpful.

True, but that opens the can of worms of "Who's going to pay for that?" It won't be cheap.
Aug. 21st, 2013 02:48 pm (UTC)
Well right now we're paying for postpartum depression treatments, increased healthcare costs due to babies missing out on breastfeeding benefits.

Most other industrialized nations manage to pay for it somehow. Everywhere in Europe has more paid leave, as does Canada. We just don't think it's important.

This page is just depressing, listing all the paid leave days countries provide new parents, until you get to the "zero days" that the US gives: http://en.wikipedia.org/wiki/Parental_leave
Aug. 21st, 2013 06:21 pm (UTC)
I posted a link to that article on FB and I got a huge overwhelming response much like here... really we do need to have these conversations about it!

@achinhibitor: If you read the linked article (and the link to the wiki page), pretty much *every* other country handles it better than we do.
Aug. 21st, 2013 08:11 pm (UTC)
I was thinking about this post for the last couple of days and honestly, i think one of the points that's missing here is that people feel (at least subconsiously) that mothers deserve less help than say, someone who is sick or had a death in the family or even someone with a broken limb because there is an element of choice and an element of non-surprise.

like, you knew a baby was coming, you had nine months to cook and freeze meals. also, like you chose this. you did it to yourself. (this is more common with subsequent babies. i see people getting decent support with #1, sketchy support with #2 and basically none for any babies after that.)

not saying i agree with any of this mentality, just that this is what american society thinks as a whole, possibly even without realizing it.
Aug. 22nd, 2013 04:00 am (UTC)
I almost feel like it's smoothed over just so women keep having babies.

speaking as someone who has never had a baby and has gone into panic before thinking about the prospect.
Aug. 22nd, 2013 06:13 am (UTC)
Couldn't agree more, I am so grateful for my wifes sister and friends who took our other kids for days and brought a meal round most nights for 2 weeks. I was shocked when I came to the USA and saw how little maternity leave women take.
( 16 comments — Leave a comment )

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