Tuesday, June 5, 2012

Make a postpartum plan a priority

Postpartum plan
Having a baby is a beautiful, life altering, and sometimes petrifying experience. Women need to have a realistic expectation of the postpartum period, as well as a solid post-birth mental health plan. I want to scream this from the highest of heights so every woman who is currently pregnant or thinking about getting pregnant hears it and prepares herself. I'm not trying to frighten anyone, but we need to get real about the fact that postpartum depression (PPD) exists and can be addressed before it appears. It rears its ugly head unexpectedly and indiscriminately to a wide variety of women and surfaces in the form of baby blues, depression, anxiety, psychosis, a little sadness, a lot of hell, or, for some lucky women, not at all. So far my postpartum depression/anxiety has been condensed into just a few short weeks and I am gratefully on the upswing, but I have learned so much about how to deal with it and heal that I feel inclined to share. Here is what I wish I would have been told before postpartum depression/anxiety punched me in the face:
  • Rally a rock solid support system. Know who you're going to call on if things get rough. Surround yourself with people who care about you, believe in you, and want the best for you. Avoid people who might be toxic and stick with people who want to help you and who will influence you with optimism. And let them help you. As women we have a tendency to think we need to do it all on our own. We don't, and when it comes to this big of a life change, we shouldn't even try.
  • Learn what might put you at higher risk for PPD. There are a lot of triggers that might make you more susceptible to suffering PPD, such as a history of anxiety or depression, age, and even the complication level of your delivery. There are several consistent lists of risk factors for PPD, such as these published by the Mayo Clinic, WebMD, and the Center for Postpartum Adjustment.
  • Trust your intuition. The reason so many women put off getting the help they need is because they second guess that what they're going through merits medical intervention. We've all heard of "baby blues," so when you're experiencing it for the first time you might assume that your thoughts and feelings are normal and will pass with time. That might be the case, but maybe not. Only you know what you're feeling and how deeply it is impacting your ability to function. If it doesn't feel right, trust your instincts and don't hesitate to get help.
  • Have a psychiatrist / counseling team prepared in advance. Knowing that I had a history of anxiety, one of the biggest lessons I learned was that I could have avoided a lot of my postpartum problems if I would have developed a PPD plan with a psychiatrist during my pregnancy. Medicinal therapy can also be made more effective when done in conjunction with talk therapy. It makes it easier if you know who you're going to work with before you decide you need them.
  • If necessary, take the medicine. Antidepressants take weeks to get into your system and make a difference, so the sooner you take the medicine you're prescribed the sooner you'll feel better. There are several antidepressants that are considered safe to use while nursing, so if that is part of your plan you may want to know up front which medicine you will consider taking.
  • Try to be positive, but definitely be honest. PPD sucks beyond belief, and it has nothing to do with loving your baby or your life in general. A lot of people will tell you to think positive thoughts, and that's good advice. But, sometimes it's not possible, and it just feels damn good to acknowledge that you feel bad. It's also OK to vent to people in like situations, but make sure you don't spend too much time dwelling on what's going wrong. If too much heavy conversation starts to weigh you down, it might be time to change the subject.
  • Put yourself first. You can't take care of a baby if you don't take care of yourself. Once you are in good working order, you will enjoy motherhood far more than if you were only functioning at half capacity or less. Try to avoid the guilt we all inevitably feel when we decide that we deserve to be a priority.
  • Have faith in yourself and the healing process. Give it time, and trust that it will pass. And give yourself a break. You're not a failure because things didn't work out as planned. It isn't an overnight thing, but if you believe in yourself and your ability to feel better, it will make it easier and probably speed things along quite a bit.
  • Have faith in God. During my worst PPD moments, I begged God for healing and at times wondered if He had abandoned me. God knew how I felt, including my anger at Him for allowing me to suffer. My faith kept me alive. I hated the experience, but I have always known a God that is not the author of trauma but occasionally allows it as part of a grander plan. I have to keep my trust there.
  • Rest. Lack of sleep is par for the newborn course, but it also has a tremendous impact on your mood. Rest is so vital to your ability to feel good, so do everything you can to take it easy when you can.
  • Once you reach a conclusion, stop. When you're an anxious new mother, you may have a tendency to try to diagnose everything about yourself and your new baby on your own. But it might be dangerous to read too much about a topic, and there are certainly a lot of opinions out there. Too much research can scare you more than it can help you. So once you take a stance on something, stop reading. I try to use my expert resources (OB, psychiatrist, pediatrician, etc.) as often as possible when I have a concern so I can avoid looking things up online or in books because there are so many conflicting opinions available for the reading. Find a trusted source, formulate a position, and then let it go.
  • Listen to music to suit or change your mood. Music has healing powers. I personally recommend a mellow, optimistic soundtrack for therapeutic purposes. As I went through my troubling time, I listened to Josh Ritter's Lark and sang the words "I am assured peace will come to me" out loud. I was comforted by the words "You are not alone in this; as brothers we will stand and we'll hold your hand" in Mumford and Sons' Timshel as I thought about all of the people who came to my aid during my darkest moments. There are so many empowering songs available to help you heal.
  • Keep moving. Exercise or simply just stay moving. A walk outside in the sunshine can do wonders for your soul. A good hard run on the treadmill releases endorphins. A simple trip out to the store can help you feel human. Even when you feel completely unmotivated, move. Starting is the hardest part, but once you get going you will be glad you got moving.
  • Know that you will probably feel disappointed in the dissolution of your plans. You've been anticipating the arrival of this beautiful baby for months. So why aren't you feeling anything but ecstatic when he/she arrives? Because having a baby is a shock to your system, and things like hormone fluctuations, serotonin level changes, and interruptions of the best-intended plans happen. I was going to spend my maternity leave showing off my daughter, enjoying the spring weather, nursing, and dressing her in all of the cute baby clothes we were given. Instead, I suffered a severe postpartum mental crash that kept me indoors and agoraphobic, prevented me from being able to breastfeed, and by the time I came around she had already outgrown some of the outfits. "Disappointed" doesn't do the feeling justice. But, I am grateful for the help that got me back on track, I am thankful formula exists so she can eat and thrive, and she still has plenty of cute clothes to wear. Sometimes you plan life, and sometimes life plans you.
  • Know that some people might disappoint you. A lot of people won't understand what you're going through, but they should still trust that you're suffering if you say you are and want to be there for you. If they hold your problem against you, forgive them and move on. Sometimes it takes the trials of life for you to separate people who care for you from people who don't, and that's actually one of the benefits of enduring a hardship. If you don't know who you can count on, adversity will help you find out pretty quickly.
  • Don't worry what other people think about what you're experiencing. One of the reasons mental illness is so controversial is because the afflicted person can easily appear fine but still be fighting their demons on the inside, so to the outside world they appear to be thriving and anyone in contact with them might find it hard to believe they are struggling. A person suffering a mental setback often rides a roller coaster of good moments and bad moments, and sometimes they are just pushing through and trying to act normal in an effort to feel normal. People are a lot more sympathetic to physical injuries than mental issues because they are visible and tangible. For instance, if I were to get in a bad car accident and go out in public in a wheelchair, people would know I'm still struggling and be sympathetic regarding my recovery. However, if I have a bad mental breakdown but get medical treatment and feel up to going out during a good spell, people might assume I'm completely healed because I'm there. Try not to get too disappointed by someones lack of understanding.
Granted, not everything that works for one person will work for someone else. I would love to hear what has benefited others and continue adding to this list, and then get it in the hands of women so that we can all stop being caught off guard and sweeping this under the rug.


  1. Boy do I wish I could have ready this April of 2011 after I had my first. Thank you so much. Reading this makes me feel I'm not the only one that had a bad case of the Baby Blues. This gives me courage that I can do it again:) Thank you!

  2. Keep up the good work! Rock solid post


Feel free to share your thoughts! You don't need any sort of Google account or otherwise to post a comment.