Let your patients know that motherhood is more than giving birth

For days on end, she looked out of the bedroom window, rocking her baby back and forth on her glider. The maple tree waved at her daily as the breeze came through its branches. Gradually, the leaves made their annual change from green to red and orange and yellow. She watched as the leaves transformed, jealous of their seamless change as she struggled to make her own transition to motherhood.

Eventually, the leaves turned brown and one by one, fell to the ground, allowing the tree to gather energy from within to make it through the cold winter. She wondered whether she would ever have energy again as night after night, her sleep was interrupted by the needs of her baby. On those long nights, the tree would tap the window as if saying, “Hello, you are not alone.” Sometimes, though, as the wind blew, the branches let out a deep, slow moan — the same moan the new mother let escape from her lips only in the company of this tree. Her tears fell, tears of fatigue, tears of loneliness, tears of doubt. Shaken to the core, this was not what she expected as a new mother.

Mostly, she dreaded the endless nights trying to nurse, trying to get her baby to sleep, trying to find rest herself. Although she loved her baby fiercely, where was the joy in motherhood? The exhaustion was relentless — soon she didn’t even recognize her disheveled self. Baggy, ill-fitted clothes, unbrushed hair, puffy eyes. Normally ready for any adventure, now she didn’t want to leave the house. She had previously prided herself in being a self-sufficient career woman, yet she struggled to take a shower.

In those long, dark nights, she began to wonder if something was wrong with her.

Her sister came to visit — she cooked, she cleaned, she laughed with the new mom at 3 a.m., lighting up the night, banishing any dark thoughts. A week of reprieve, of building back her strength and finding her will to go out into the world. One day, they ventured out to a new market with a beautiful bakery. They stood at the counter tasting every dessert possible and giggling with delight as crumbs on their faces fell to the ground. The new mom’s eyes were bright with life again. But the week went by quickly, and she found herself sobbing, “How am I going to do this without you?” as she said goodbye to her sister.

Then her brother came to visit. During his visit, she woke to chills and a horrendous headache. She couldn’t get out of bed and shouted out to her brother for help. She took her temperature, and it was 103. In a haze, she found some Tylenol and fell back in bed, not even thinking about her baby. Her brother brought her food and attended to her baby while she recovered. Upon his departure, she once again wondered how she would manage.

Gradually, her postpartum fog lifted. She had days she exercised, showered, went to the grocery store and cooked dinner. Or some days, she could only do one of those. On sunny days, she strolled outside to see all the trees nearby changing colors, strapping her baby to her chest in a carrier. And then some days, the lack of sleep wore on her, and she allowed herself to rest rather than do laundry. Over time, she also accepted help from others more easily, finding strength through her village of friends and family. Although it was an inner battle to put her needs first sometimes, she found ways to take time for herself too, even if it was just having a good meal. With the return to work came new challenges of finding someone to watch her baby, pumping and storing breast milk at work accepting that she would miss some milestone moments with her baby. And all this was really just the beginning of her parenthood journey.

This is a true story. This every woman’s story in some part. This is my story.

Frequently, I hear similar stories from my postpartum moms. When I see them in the office, I can usually tell if they are struggling by just looking at their faces, whether they have sunken eyes or a hollowed look, or unkempt hair and clothes. And usually, the first thing they say to me is, “Nobody told me how hard it would be.”

So much focus is spent on preparing for birth and the birthing experience, but very little on afterward. Not to downplay the birth, it is a meaningful experience, but it is just a speck in the journey of parenthood. The days and nights, and weeks and years of nurturing this new life can be the most challenging, and the most rewarding moments of your life. But who teaches you about this?

Many years ago, multi-generational families lived together or, at least, near each other. Each generation could then learn from the one before and experience what it is like to parent by observing others in their family or even taking care of younger siblings. But now, it is more often the case that families live in different cities or states and new parents are alone to “figure out” their new baby. I see new parents struggling to find their way as they battle fatigue and perhaps even isolation.

For me the question has always been how do you prepare someone for such a huge change in their life, perhaps so foreign to them until they live it? I pepper prenatal appointments with questions like, “Will you have help at home after the delivery? How much time off work are you planning? Breastfeeding or bottle feeding?” At least this gets my patients to start considering more than just the birth. And afterward, I try to reinforce that asking and receiving help is not only OK but may make family and friends feel more useful and engaged.

My children are teens now, and I still have that glider. Sometimes, I’m nostalgic for that innocent baby age. But I definitely don’t miss those long, sleepless nights watching my maple tree change with the seasons in my postpartum fog, wondering if I’m a good mother.