What Is Going on in the Postpartum: Why Are Mothers Struggling?
Rewind the times... An edited blog post first written in 2018
**We acknowledge that some people do not identify with gender normative terminology and instead identify with terms such as a person with a uterus, a person who has given birth and/or a parent, etc. The written content below includes thoughts, opinions, and experiences that use gender normative language such as woman, mother and she/her in relationship to a person’s experience of birth and the postpartum period. **
**This post speaks to a mothers experience of the postpartum after having given birth to a healthy newborn. It does not speak to a mothers experience of the postpartum after loss, newborn illness, or premature birth'. We will speak to the experience of loss and/or newborn health risks as a separate post.**
Integration.
In psychology, integration is a key component of mental health, and overall health. When we can make sense out of our life circumstances, feel our emotions that have been trapped in our body, and flow a coherent story about our life without a huge amount of activation, it is said that we have integrated an experience.
Thus, we can weave this story into the tapestry of our life, giving rise to our individual humanity. Some stories carry more heft resulting in requiring more time to integrate. Yet, usually those experiences are turning points throughout our life that mold and shape our character.
Childbirth is one of these kinds of experiences – rich in meaning and gravitas.
Hence, when a woman gives birth, regardless of her birth experience and outcome, she holds a very precious story that will forever be etched into her psyche and cells.
This process of unfolding, uncovering, undoing, re-claiming, re-membering, and re-orienting is and never was intended to be rushed.
We rush the postpartum.
I invite you to pause for a moment and consider the above notion.
How did you rush your postpartum period?
How did the people around you rush your postpartum?
What were you in a rush to do? What were you rushing? Why were you rushing?
What were the consequences of rushing the postpartum? Rushing to get back to normal? What normal? What was your concept of normal? Who defined ‘normal’ anyways?
In all seriousness, take out a pen and paper, and write down all the ways that you were rushed in the postpartum.
……..
When a mother is rushed in her postpartum or holds an impression that she should somehow get it ‘together’ and ‘get back to a normal way of being and doing’, she is often faced with struggles in the postpartum. Those struggles can show up as depression and anxiety, or they can also show up as an increase in irritability, disconnection, distraction or relational conflict.
Is it possible that the symptoms are a reflection of a mother’s intelligent system that is screaming at her to pay attention, to slow down and listen; something might be off balance?
What if you, as a mother, were encouraged to drop in and listen to what the symptoms are saying - what is the message?
Allow me to elaborate. Having personal experience with three postpartums, held space for many new moms as a doula, and beared witness to many in the counselling office, there are a few things that I have observed over the years.
First point of consideration…
After a woman has given birth she is in an altered state of consciousness which is experienced as a felt sense of being held within a liminal space - an in-between state of reality. This is akin to having one foot in two different worlds. We can also experience this non-ordinary state as a result of grief, orgasm, athletic flow, creative expression, music, ceremony or ritual, dreaming, prayer, meditation to name a few. Non-ordinary states are inherent to the human experience and as one of my mentors would say, ‘we court these expanded states’.
However, it is not always obvious for new mothers or onlookers, that this is occurring in the postpartum, and because our everyday experience is often void of expanded states of consciousness, it can feel very foreign and unfamiliar to new moms and their circle of support.
Even if the mother does not ‘feel’ this liminal state, something in her knows that something is or should be different.
It is important to reflect that a miracle took place, an everyday miracle albeit, but a miracle of creation. Hence, the need for integration. And, why is it that we are so quick to close this state of awe? Society grants very little attention and reverence to what the mother just experienced – need alone the fact that she sacrificed her body, in an act of love, for the past nine months.
Second point of consideration…
She just delivered a baby earth bound and she is expected to have it all figured out within a few weeks?
There are so many physical changes that are taking place in the immediate postpartum that use up a lot of vital energy.
For example: The uterus changes shape and size and shifts from being the size of a watermelon to that of a pear again; her hormones change; her blood volume goes back to normal after doubling in quantity; her organs go back into ‘place’ within the body; If she had a cesarean birth she is healing an incision; If there is an injury to her pelvic floor, she is healing her tissue; If she lost blood, she is rebuilding blood volume; She is regaining vitality after giving all her nutrients to the growing baby for the past nine moons; She is replenishing her energy after exerting it during labor and delivery; She is resting after staying up for hours upon hours during a long labour.
As you can imagine there are many physiological adjustments and changes taking place that would exhaust anyone. And standard care suggests that this process takes 6 weeks to return to ‘pre-pregnancy’ mode. First, there is no such thing as pre-pregnancy or going back. Secondly – none of these physiological changes address the psychological, emotional, relationally, and spiritual/energetic changes that occurred and, need time for integration.
Third point of consideration…
Childbirth is a woman’s vision quest story.
Much about modern obstetrics and midwifery lack regard for this above notion. It is important to recognize that the modern practice of birthing professionals is driven by protocols and procedures that seek to prevent death and litigation charges. As such, although many would agree that they are grateful for these advancements in obstetrical and midwifery knowledge and practices, we fail to recognize and address the implications of such practices - ‘At what cost?’
The largest implication is the lack of regard to the sacred act of giving birth – the dismembering of birth. If you are passionate about decolonizing practices, it is imperative that you look at all the ways that the birthing space has been colonized and how the woman’s body and experience has been compartmentalized (so to be managed).
As a keeper of birth stories I have heard and read hundreds. These stories have included everything from orgasmic birthing experiences to violent traumatic events. In all of these stories there is a common thread – These women, regardless if medication was present or not, knew that they were experiencing something profound, life altering, and other worldly.
Foundationally, every women who has shared her story has been deeply imprinted by that event. It is etched into her cells and her psyche. Our cultural lack of reverence for the experience of birth is, in my opinion, showing up in the postpartum.
Somehow, many mothers internalize that they are supposed to just sort it all out, on their own, in a short period of time. There is this energy of needing to just get over the event, to get on with life. This is compounded by another layer of internalizing that puts pressure on the mother to have it all figured out – nursing/feeding, night sleeping, crying, diapering, leaving the house, showering, newborn development. Each baby requires time and attention to nurture the unique relational bond between each family member. There is no right way or one way, but there is a unique way.
On top of the pressure to have it all figured out within a certain time frame, there is the added pressure, for those who take on the new ‘job’ as a stay-at-home mother that includes – cleaning, cooking, organizing, socializing and tending to the baby. I have heard over and over again mothers express guilt connected to the concept that they ‘should’ be doing more around the house now that they are home all day, and that they are failures because they can’t ‘keep it in order’.
Can you sense the tension that can build in a mother’s experience of the postpartum?
If for some reason a mother is challenged to have all of this figured out within the first few weeks or months after giving birth, and if her body is not healing as ‘normal’, and if she is struggling with sleep, colic, illness, or nursing, one can understand how her nervous system would be absolutely taxed. Thus, contributing to the onset of a postpartum mood challenge that can include anxiety and/or depressive states.
Fourth point of consideration…
Not only has her nervous system gone array, she feels as if she is withering on a soul level.
Let us add one more challenge that many mothers face in the postpartum – isolation and loneliness.
Motherhood can be a very isolating experience. Part of this is because many mothers are exhausted, and adding a social engagement to the mix is just too much. Sometimes, mothers have expressed feeling too ashamed to connect with other mothers because they are struggling so much. This isolation is a direct result of our culture of separation and the praise of the nuclear family structure, which has separated us from extended community and connection. Motherhood was never intended to be a role that is ‘performed’ in an isolated environment.
All of these factors impact the postpartum mother’s process of integration.
Further, when a mother’s primary partner and closest family members feed a mythical tale that she is supposed to: ‘be better by now’, ‘have it all figured out’, ‘hide her emotions or tone down her emotions’, ‘just be happy, love her children’, ‘have a nice clean home, nourish her family, and work towards getting her pre-pregnancy body back’, she is likely to go ‘mad’.
Both ‘mad’ in the sense of a psychic wild pain and ‘mad’ in the sense of rage.
I would argue that this rage is necessary and insightful. It is a collective rage that is screaming ‘something is terribly wrong about what is happening’. This rage is shared, and I can attest to this because I have both experienced it, and witnessed it in hundreds of women. Most often however, this rage is never given space to be witnessed. There is fear that this rage will either a. harm another or self or b. cause one to be sent to a mental institution. Sadly, when we explore the depths of this fear, usually these are the two fears that prevent a mother from moving into this sacred rage. And behind the rage, is deep grief; a soul grief.
Women are not allowed to rage. Period.
We are fed to believe that it is dangerous. Too much. Violent. Aggressive. Wrong. Bad. Mean. Denotes a lack of control. What happens when mothers are not encouraged to voice and do something with their rage?
It can turn into anxiety or depression, or in some horrific cases, psychosis.
What would being held in a manner that fosters integration offer mothers?
Space to speak about the fullness of their perinatal experience
Space to emote and feel into the fullness of this experience
Time to collect her pieces that have just been totally discombobulated throughout pregnancy and birth
Time to re-connect and re-calabrate to herself, her baby, her loved ones
Nourishment both physically and soulfully
Space to create meaning from this life changing experience
A knowing that she does not have to have it all together or figured out, and that there is no pressure for her to be a certain way or do certain things
A trust in the process and in herself as a mother
Healing
Some questions to ponder:
How have you been held in your postpartum?
What expectations have been placed upon you – internally and externally?
What do you need to begin to integrate the fullness of your childbirth experience?
What is being asked of you?
What would you like to say to those you love, to other mothers, to the world that you know would shift something for you and other mothers?
What was lacking in your postpartum? What was off?
What is your rage about?
I invite you to contemplate these questions. Share them with others or keep them close to your heart. Begin conversations with other mothers in your community about any or all of these concepts presented. I believe that change will happen when mothers claim something different for themselves; when collectively we begin to speak about the ‘unspeakable’ aspects of the childbirth continuum. When the sacred is included in the conversations about birth and postpartum. And when the rage is acknowledged and understood, the grief pours out, and the heart expands.
Authored by: Jennifer Summerfeldt
**The views expressed are unique to Jennifer and do not necessarily represent the views of the other staff counsellors who work for ASK Therapy.**