The Birth of Postpartum

Hey y’all, I recently spoke on a podcast with my fantastic colleague Dr. Adam Rinde about postpartum care, stories, and how people’s lives have changed mine. And maybe how we can get better as a healthcare system, providers, and community in the way that we care for postpartum people.

He has written this really incredible piece on postpartum depression and hormonal influences, linked here:
https://www.soundintegrative.com/post/is-postpartum-depression-an-estrogen-receptor-issue

The way to get to our episode on his podcast, One Thing, is linked in the article (you can access via Apple or Android). Take a listen and tell me what you think!

Apple listeners:
https://overcast.fm/itunes1457478235/one-thing-with-dr-adam-rinde

Android listeners:
https://www.stitcher.com/podcast/one-thing/e/60556368

#postpartum #midwifeforlife #podcasting #carework #mentalhealthawareness

The Birth of Grief

A new mom and her baby had come in for their first well-child visit and her son was just 3 days old.  Mom was tired and overwhelmed as many new parents are.  She was sitting by the window, changing her son’s diaper and just watching him, and she sighed a long, heavy sigh.  And just gazed at her son quietly as he wiggled around.  There was no slow smile or beaming pride.  Just deep sadness.  

What clinical guidelines, healthcare, and social convention tell us is that she was exhibiting signs of postpartum depression.  While that may also have been true, she was also exhibiting signs of deep grief and loss. 

I looked at her across the room and just said to her, “You don’t have to love this.  Or even like it.”  I said that for her, but also for the hundreds of people I had sat with before her for whom the sadness was enveloping.  She looked at me in surprise, “Really?” She sighed again, but this time with a slow smile, and said, “Thank you.” 

What is often disclosed to me by new parents is that postpartum engenders isolation, being untethered, disembodiment, and a contemplation of mortality. Could this many people really have postpartum depression? Is it possible that this many people opt to transition to parenthood, and meet some or all the criteria for a mental health concern? Or is there another way to understand what this mom and thousands like her are experiencing?

What other process in our life looks like heavy sadness and defeat, and flattens us to the wall? 

Grief and loss.  Losing someone we love. Losing ourselves.  My curiosity is whether we can reframe the postpartum transition as a grief process. As a natural life event, but of loss.  What if our culture, our healthcare delivery, and policies all viewed and cared for postpartum people as grieving people? 

I consider the grace that we offer people who have lost a loved one: the length of time and freedom that they are given to grieve, the expectation of being changed and never quite being the same, and the ability to go deep and dark but not have it be inherently pathologic.  There is a freedom in that.  A deep breath and a slow smile. 

Month of Remembrance

For as long as I can remember, March has always been a really uncomfortable month. Whether here in the PNW or back in the Northeast, March is incredibly strange. It’s wet, cold, windy, sunny, glorious, and in swift rotation.

But March and early April has been strange for over 20 years for other reasons too. My grandfather died in March. My nephew died in March. And so did a baby I cared for. And my aunt. Then in April, my grandmother. And Michelle. Strangely, in these same 4 or 5 weeks, over the course two decades, many people I cared about left.

While things are literally springing from the ground, we are getting glimmers of warmer days to come, people are juicing or cleansing, and there is movement all around us. It feels like a time to get excited, to feel like the dark cloud of Winter (especially our PNW winters) is sliding away.

For me, it’s a time to slow it down and remember. To remember the letters I painstakingly wrote to my grandmother in Tamil. To remember the randomness of being there the day my nephew was born. To remember my dear friend’s undying love for Easter and mostly her love of candy.

This intense period of remembrance is actually kind of joyous. It’s sort of a ‘time shrine’ to those who I have been lucky enough to cross paths with, learn from, and be loved by.

Memento mori

Rosemary for Remembrance. Students in ancient Greece are reported to have worn sprigs of rosemary in their hair while studying for exams to improve their memory, and mourners would throw it into graves as a symbol of remembrance for the dead.

What kind of loss is harder?

If you have been following along for a little while, you know that one of the things I have been ruminating and writing about is loss. We all know it in some way. And we will certainly know more. To live is to love, and also to lose.

It’s not uncommon for us to ‘rank’ loss. Which kind of loss is worse, changes us more deeply, is more worthy of grieving, or warrants talking about at all. Is the loss of an aging parent worthy of years of sadness? Can you be devastated by the way divorce changes your life? Are you allowed to grieve a welcome change like the birth of your healthy and living child?

A friend shared this article written by Camille Hawkins LCSW: Miscarriage or Stillbirth: Which Is Harder? It is a powerfully written perspective on just this thing: attempting to rank our grief. She shares some interesting insights into why some griefs may be shrouded in darkness, and why some may feel more survivable.

Reading this article allowed me to realize that one element of my storytelling has not surfaced, yet. I have waded through the grieving process, felt its depth, and received its tangible gifts. But what still lurks is: are the losses I (and our family) have experienced these past few years worthy of this much grief? And when should this story end?

Another thread that I have been grasping at for some time in my clinical work is shaping postpartum depression as a grief process. Not just that grief can be normal after birth, but that the true baseline IS grief. Postpartum wouldn’t just be worthy of grief, it would BE grief. Perhaps we could surround, hold, and integrate our grieving loved ones as if they had suffered loss.

Witness that they had suffered loss.

What would we do differently? When would we feel as if that story should end?

#neverendingstory #griefworkislifework #griefworkismywork

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Oldie but Goodie

Yesterday was my son’s 8th birthday. All of his birthdays kick up some emotional dust for me. I rejoice in what an amazing human he continues to be. I grieve that he is one year closer toward individuation and needing to know himself away from us.

I remember his eventful arrival and how it birthed a mother, father, grandparents, aunt, and a brand-new nurse (she was in the room and possibly crying more than anyone).

And I remember what I wrote half his lifetime ago, after his 4th birthday, that still rings true for me today.

So I will share it with you again: Birth and Rebirth. Enjoy!

So Maybe I Did Write One or Two…

If you recently read my Muse-letter that I sent out this week, you know that these last few days have been a celebration of life and loss. Maybe it seems weird to celebrate loss, but if you have been reading along with me these last few months, it’s really not so strange.

Loss, death, disappointment, or not getting what we want (even when we work really, really hard for it) shreds a layer or two. We feel raw and grated. Exposed and vulnerable. But what settles in its place are new cells, new skin, new life. The last three years have felt like an onslaught of loss, death, and disappointment. I won’t lie; even with my super intact ego, it’s been really hard.

One of the things that has been especially tricky for me is to not let the hard make me hard. I am actually a pretty trusting and loyal person. A ride-or-die sort. But when things keep coming at you, sometimes it feels like the best way to survive is to make a shield. A thick, crusty layer that I can see out of, but keeps the world’s badness out. Like my friend here, the Indian Star Tortoise. She’s got it down.

But those layers can get old, grizzled, weak, and are shed too. And underneath, strength still has to be built and sustained. Like muscle; well-formed but pliable.

So #whattodo? How do I stay protected and strong without getting hardened? These are my goals this year: to be strong and pliable. And here are the few simple things that I am going to work into my daily life more often than I do:

  • Water: to have force alongside fluidity, take it from the master. Literally, drink it in. That’s my plan.
  • Stretch: muscles are only as useful as they are mobile. And it also happens that I am aging, and so is my fascia. What isn’t softened can become brittle.

To make resolutions, we have to be resolved. RE-solved. Look closely at our problems, errors, misfortunes, or disappointments and be dedicated to the solution. Again. What are you resolved to work on this time around?

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One Long Night

As the days get shorter and the darkness much thicker, it sometimes feels like we are wading through one long night.

The other day my son asked me what my favorite shade of blue was. Sidebar- I love his questions. He didn’t ask me what my favorite color was, but rather my favorite shade of blue. I just love those little moments where you can see and feel their swift minds whirring.

So back to my favorite shade of blue. It’s twilight. You know that deep, resonant, silky, purply, dark blue when the sky moves from sunset to night. The world becomes more quiet; the crows have settled. But you are still very much alert and watchful. The mind is full. You are full.

This time of year feels like twilight to me. Rich and resonant. One full, long night.

Here’s to your long, luxurious night. Rest up for the new year, my friends; it’s going to be wild.

Is gratitude enough?

As we approach Thanksgiving and the holiday season in the US, one of the things that gets tossed around is Gratitude.  The Big G.  gratitude

If you weren’t feeling that grateful, or even worse, were feeling whiny and self-deprecating, this is the week and the season to just snap out of it!

This is the season for good tidings, well wishes, thoughts, prayers, and plain ol’ cheer, right?

Don’t get me wrong; I love the concept of cultivating gratitude.  There is an intense and dark beauty in being a witness to and feeling appreciation for the ride-or-die friendships or miraculous children that we are even alive to experience.  In fact, this practice and experience of positivity has true impact on our health.  

And sometimes…we say a lot of things and don’t feel them.  We don’t witness and experience them.  Is that gratitude? Or platitude?

Does it matter?

I have a not-so-small request this week and this season: say what you feel.  It’s easy for us to get caught up in “I love my kids-house-car-job-husband”  like we are in competition for how #blessed we are.

Before you get caught up in gratitude guerilla warfare, stop and feel.  Rather than being grateful, consider what allows you to feel gratitude.  It’s a subtle but different experience.  More physical or kinesthetic than intellectual.  Something that feels like peace or joy.   (And maybe there is a better word than ‘gratitude’)

When I sit and really allow myself to feel gratitude, here is my list of what washes up (in no particular order):

  • My son: he is the greatest thing I have ever done and will ever do with my life.  He is everything I could have ever imagined in a human being.  His presence and his countenance has allowed my heart to be wide and strong enough for all of the turmoil, loss, and grief that has absorbed these last few years of our lives.
  • My family: my family is the fortress-like foundation that I was able to jump up and stomp on to make my way in this life.  What is most astounding to me about my family is their ability to pivot, start over, and crush it on the next thing.  Grit and resilience are our keystones.
  • My framily: this unlikely group of people sat down together at cafeteria tables 15 years ago and have never really been apart since.  Not even with death or geography.  Some beautiful thread wove us together and I will never stop being mesmerized by how random and powerful this life is because of it.
  • My other half: After 19 years, I can honestly say, I have no idea what relationships ‘should’ be.  It has been all the things; and really the only way I could have made it out alive and well.  I am thriving, not just surviving, because of this human.  That’s his magic.
  • Michelle: watching her wrestle with her life, her dying, the guilt, the grief, and the deep, eviscerating sadness flipped a switch in me.  She gave us the gift of allowing us to be part of it all, to allow it to change us as it changed her, and to keep her alive with us as we speak her name.

What washes over you when you feel gratitude?  #gratitudenotplatitude #tellthem

Would You Do It All Over Again?

This past weekend I got to spend some quality time with my Framily.  These people are my friend-family. My chosen family.  People who have literally been with me through some of the darkest days of my life thus far, and will also walk alongside me through the ones that await (cuz there’s always more).

So naturally we get into some murky stuff as we wade through the years and losses we have lived together.  We wondered aloud: do you have any regrets?  Would you do everything, as it has played out, over again?

We all felt like we were perfectly where we needed to be.  Even if where we are is uncomfortable or broke.  There are real teachings, gratitude, and self-love that we have cultivated from the time, money, opportunities, and people we have lost.  We wouldn’t be perfectly ourselves if we had chosen a different adventure.

For me-I may never have chosen myself otherwise.

And I will tell you what…now that I have, I am never going back.  I feel as well, as strong, and as on fire as I was at 21.  Half a lifetime ago.

Our greatest failures, heartbreaks, and losses can be our best medicine.

They may possibly be the only medicine that matters.

**As always, I turn it back to you.  Would you do it all again?**

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There’s a little more to this story that I shared with my Muse-letter followers.  You can join the conversation by subscribing here