Leave mum holding the baby at your peril: Postnatal depression and what we expect of women

trauma mum n babyI just left a woman in her house with her baby.  I was her doula, and I was visiting her after the birth, to congratulate her, and make sure she is okay.  My role wasn’t actually to check that she is okay.  Most people want a doula for the birth process itself, not for after the birth.  But as a doula who is also a psychologist, I know that the time of settling in after you’ve had a baby can be much more of a roller coaster ride than the birth itself.  And it lasts much longer.

Knowing how hard it is to adjust to a new baby, I found it difficult to walk away.  She is doing really well.  I have no concerns about her or the baby at all.  She expressed the usual bewilderment, lack of confidence, tiredness, tearful days, that all new mothers experience.  Her tiredness and anxiety are “normal”.

But I came away questioning this once again.  How can it be that we accept it as “normal” to feel overwhelmed, anxious, tearful  and tired, after having a baby? Neuropsychology actually suggests that parents and babies are primed for joy, love and connection, not misery.  In fact, every time there is a joyful and loving interaction, the baby’s neural connections become stronger.  The baby’s brain literally grows in response to joy and oxytocin.  Evolution has encouraged this, and we can see it every time some-one comes in to look more closely at the baby (which, as it happens, is the prefect distance for the baby to be able to focus on you) and then smiles and coos at the baby.  And we simply can’t help ourselves when babies smile back at us.  We immediately laugh, smile, and coo even more (or is that just me?).  We all do it, adults and children alike.  In other words, the need for joy and connection is not just met by the mother, it is met by all of the baby’s social circle.

However, in our society, we seem to think it is normal to feel exhausted, overwhelmed and wretched in the first 6 weeks of babyhood. And if we “expect” mum to be struggling, then how do we spot when “normal” becomes “depression”?   Women I speak to whose diagnosis was missed,  say that they did tell their midwives and health visitors that something wasn’t right, and that they didn’t feel normal.  But they were told that that was normal.   We are also missing the signs in fathers too.  Postnatal depression amongst fathers is on the increase. This, I am sure, is related to the enormous pressure they are under to be a hands-on dad, to be at the birth, to look after mum, and to continue to work full time, with barely any paternal leave or additional support.

How did we get to a place where it is considered normal to feel rubbish after you’ve had a baby? Is it really normal to feel miserable and trapped and overwhelmed and exhausted?  While I was vaguely musing about this in the back of my head, I left my doula client on her own in her house.   As I left, I said “it doesn’t feel right leaving you alone”.  And it really didn’t feel alright.  Not because there’s anything wrong with her, or her ability to cope, or her mental health, or her bonding with her baby.  But because I was leaving a woman on her own in a house with a four week old baby.   If that seems okay to you, then that is because that is what our society does.  It’s normal in our eyes.  We have stopped being able to see just how wrong that is.  But it is wrong.

Looking after a baby is a full time job. Well, no, it isn’t actually.  With a full time job, we get to go home, sleep, eat, shower, tidy up, switch off mentally, and choose what to do in between the job.  A baby does not give you predictable time to do any of the above.  You might get to take the lunch out of the fridge and microwave it, but you might not get time to eat it.  You can never switch off, and you have to be always instantly interruptible.  Just having one other person in the house makes such an enormous difference to all of these things.  You can shower.  You can prepare lunch.  You can leave the house for hours!  You can sleep for hours.  You can turn to some-one and say “oh my goodness, this is ridiculous” and have a bit of a laugh together.  Just having one other person in the house makes such a difference.  And yet, we leave women on their own in the house all day every day, and think nothing of it.  Single women also have that burden all night too (I can’t even imagine how our society can fail to grant them utmost respect .  They certainly have mine.).  Not only are new mothers left with the constant rolling demands of looking after a baby, but they are left in a house which needs attention.  If it isn’t given attention, she will be living in her own mess and dirt.  No-one wants to do that, and yet, we happily say to new mothers “leave the housework, it will wait”. I disagree.  It won’t wait, unless you actually want to live in your own dirt.

Contrast this with other cultures.  Imagine , for a moment, that you have just had a baby.  You are tucked up in your bed, with your baby beside you (yes, you are allowed to sleep alongside your baby, just like every other mammal on the planet does).  Your room is clean and tidy, because some-one else is looking after that for you.  Every four hours, some-one comes in with delicious home cooked food for you to eat.  Every morning, some-one is there so that you can get out of bed and shower and freshen up.  Once a day, you are given a hot stone all-over body massage.  Yes, this really does happen in a number of cultures!  The daily food and massage are considered to be an essential part of your recovery, both physical and mental.  You and your baby are together. Your job is to get to know your baby, and enjoy being with your baby.  You feed and change your baby.  You get to know your baby. You sleep and recover.  After a number of weeks of this, you are considered transformed enough to emerge into the real world as a fully-fledged mother.  Like a butterfly emerging from its chrysalis, the transition to motherhood is viewed as a psychological and physical process, not as a on- off biological “event”.

Our culture doesn’t do that.  And we pay the toll.  Perinatal mental illness is a rising problem generally, and the government are trying to put in place strategies for identifying and treating people who are suffering. While identification and treatment is important, it does place the emphasis on the individual woman, with the risk of blaming her as some-one who “couldn’t cope”.  Also, thinking that all we need to do is “treat” her with tablets and therapy also risks us reducing postnatal problems to discreet illnesses that just need “medication”.  Postnatal depression is not the women’s fault, and it is not a discrete illness like diabetes.  It needs attention from our culture too.  We need to treat women better when they come home with their new babies.  We need to realise that what we are asking of them is too much.  Being on your own regularly in your house with a baby or toddler is asking too much.  We need to start honouring, and caring for, mothers and fathers, because that is how we built parents strong enough to really care for our future generation.    power of compassion

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16 Responses to “Leave mum holding the baby at your peril: Postnatal depression and what we expect of women”

  1. Helen Says:

    Thank you for this really thought-provoking piece. We do expect mothers to feel shaken up, and I can see that this is troubling, though I suppose there’s also a positive gloss on it – having a baby (particularly your first) is and should be life-changing, and *sometimes* being thrown into it gives mothers a chance to access resources and strength they didn’t know they had. But in my own voluntary work I see so many new mothers who are intensely vulnerable, to the point where they can only just reach out for help (and retreat back into themselves if help isn’t then immediately forthcoming, eg when a helpline call isn’t picked up), and I think part of this is to do with the prevailing narrative that says we should be independent and successful and bring the same strength and confidence to mothering that we used to bring to our jobs.

    • miadoula Says:

      I absolutely agree. In some parts of Japan, the mother is spoken to in a baby voice for the first few weeks, while she recuperates. I think that gives her permission to be vulnerable and needy, which, as you say, we don’t do. Instead, we favour independence and getting “back to normality”.

  2. mary Says:

    This was wrote so beautifuly, after suffering with PND myself after my son, I only know to well the mental torture that can follow after haven a baby. I feel just as you put it yourself more help should be given to the mother at home. I felt completely isolated.
    Thanks again for shining light on this topic.

    • miadoula Says:

      You are more than welcome. I’m glad it speaks to people who have suffered, as well as those trying to help. I hope that you’re feeling a lot better.

  3. Renske Says:

    Great article. In the Netherlands every mum gets a carer for 2 weeks, paid for by health insurance cover which everyone has, who teaches the mum how to look after her baby and entertains the other children if necessary, welcomes and manages guests and even cleans and cooks. I am Dutch but unfortunately had my baby in the UK so i missed out on this!

  4. Mel Says:

    Thank you so much for putting into words some of the thoughts I have had! I can identify on a couple of levels, both personally and as a doula.
    I remember when I had my babies away from extended family not being able to put my finger on what exactly I was feeling. If someone asked me how I was doing, I was fine. And I wouldn’t have been able to articulate then the aloneness I felt. I certainly wouldn’t have asked someone to come over just to be with me, and I would’ve felt bad to ask for someone to do my washing or vacuum… yet that’s what I probably needed. Some of those issues were my own.. but some of it is how our society conditions us to be. Self reliant – alone.

  5. Name Says:

    Great article. I suffered PND with my first and on 2 instances of asking for help I was refused. I had an emergency csection & couldn’t drive, I was living in a cottage in the woods with nothing within walking distance. My mum came for a week & my husband had 2 weeks off. However once alone I started to feel terrible, isolated. I was really distraught when explaining to my health visitor however she angrily questioned how I could feel that way when I had such a beautiful baby. She then produced a questionnaire for me to complete. She left the house soon after & I felt worse. I never heard anything again about that questionaire. When I went back to work I really struggled & I saw a Dr about taking something to help who advised there was nothing she could do while I was still breastfeeding. I had my daughter with me & she told me I looked like I was doing great and was great with my daughter. I felt like a failure, maybe I didn’t articulate how I felt properly as she didn’t believe me. My second is just 7 months old and again I’ve had a terrible time. I have a lovely Dr who consulted with me on what I could take & still breastfeed. So am now on antidepressants which are really helping me day to day. It’s horrible to feel this way and I do think we need to understand it better to offer more support. I live away from family support so do wonder if I lived closer would I have felt this bad.

    • Fi Says:

      I feel for you. I understand you! I felt the same- but I was too ashamed to tell anyone so kept it all inside as I felt I was failing. I hope that time heals and as your kids get older and you have more time for yourself, you will feel like you have re-emerged and embrace all the colours of life again. Keep doing the wonderful job you do. woman are amazing that they can suffer like this and still meet the needs of their babies. I think you are awesome!

  6. Annie Says:

    absolutely…highlighting the importance of mother to mother support..how do we create a spa village to hold the new mother and baby with honour and care….? lets look out for each other and enjoy the mutual benefits of creating a mindful community….

  7. Louise Sutton Says:

    Here here Mia! My biggest gripe with the system today is encouraging women to leave hospital and support so soon after they give birth. You have your baby with you, meals cooked, showers and uninterrupted bonding time with your baby and even though this may not prevent clinical post natal depression it prepares the mum to go back home with a chance. I am 48 and have 6 kids ranging from 27 to 6, so with my first 2 i was encoraged to stay in hospital for a week by the time i had my sixth i had to stand my ground in being allowed to stay in for 3 days as they would have preferred i go home after one. This is so wrong on many levels and is not going to address the varying levels of experience and ability to cope for a new mum with a healing body and raging hormones, ripped off!

  8. Felicity Says:

    Well said.

  9. ripeka123 Says:

    They say it takes a village to raise a child. Being isolated in your own home for hours on end while feeling intensely vulnerable, anxious, and uncertain with a new baby is the exact opposite of that. How can we get this so badly wrong as a modern society? On a political, cultural and social level, we pride ourselves as being advanced with all our education and “successes”. Rubbish. We don’t even met the most basic needs of society when if we aren’t offering women and their babies the love, respect and support they need.

  10. Olivia Says:

    This is one of the best articles I have read in a very long time. i suffered with Postnatal Depression following the birth of both my little girls and have always thought that a period of confinement, like you detailed, to enable us women to make the transition into motherhood and be able to just concentrate on us and our babies would have been key not only to my recovery but potentially me not suffering with it in the first place. Thank you so much for sharing this xxx

  11. Fi Says:

    I couldn’t believe how I felt following the birth of my first son. I was expecting this feeling of love and immediate connection and pictured this blissfull scene. Well, I can tell you now that the reality was exactly as you have described above. The need to support woman is so massive- and yet so not even thought of as an option. We all just believe this is what you do. You suffer through it. I cannot wait to have visitors when I am home with the kids. Even annoying door salesmen seem like a treat to an isolated at-home mum. That seems so ad doesn’t it?!
    I thank you for highlighting an option here. And an idea like this would certainly support the well being not only of our NZ mums, but entire families.
    You are awesome. Please keep this dream alive and push forward. You can count on BIG support!

  12. Rey Parmantier Says:

    I appeciate your point.Please give me more info on this!

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