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. 

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!

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

Doing Hard Things Could Be Easy

Recently, I did something that was really hard for me.  In fact, I was completely unprepared for it.  And- some might say- unqualified.  They wouldn’t be wrong.  But other people’s opinions have rarely stopped me from doing what I believe in, love, or am just plain ol’ fired up to do.  #firestarter #changeagent

you can do hard things_Page_2

I realized a few things in the process:

  • I believe that I can do hard things
  • In fact, I believe that I should do hard things
  • And more importantly, I believe that I should do things that make me absolutely afraid and uncomfortable

I am already 15,443 days old.  The average lifespan is 27,375.  What the hell else am I going to do?  Sit around and wait?

What are you going to do?  #whatchagonnado

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If you want to hear more storytelling, and occasionally something witty or compelling, I write a Muse-letter.  You can subscribe here: Subscribe to My Muse-letter

It Should Have Been Me…

Have you ever flashed back to crazy, possibly dangerous, times in your life and thought: “holy crap, I should have died!”

You shudder.  Maybe you look over at your kid, your partner, your cat, or even at your own hands.  You feel your heart beating in your chest.  You feel your breath slide in and roll out of your body.  And in that swift and fantastic moment, you are so fully alive.

Recently I wrote to my Muse-letter followers about being not-dead-today, and being fully alive.  Digging deep and getting a little murky, as I love to do, while contemplating this: what moves you to step boldly from your comfort zone? 42974306_351407882270930_3416594696280501552_n(1)

I share some of my story and thoughts in my piece, and you can subscribe to my list here: Subscribe to My Muse-letter

Why Does My Brain Feel Like it is Leaking?

An interesting article was published this past Summer on the very real, little-discussed changes that occur in the brain of a pregnant, postpartum, and/or caregiving person. Mommy-brain-2

There are a number of rapid and monumental changes that happen to the portion of our brains that control social-emotional processes or the “ability to atttribute emotions and mental states to other people- key to raising a human.”

“The more brain change the mothers experienced, the higher they scored on measures of emotional attachment to their babies, a finding that echoed past studies. And the changes in most brain regions remained two years later.”

Whoa.  Two years?!

What is even more fascinating is that this change was most profound in the parents who were also pregnant, but was not limited to them.  Caregivers other than the birthing parent,  including fathers, experienced some of these same changes that correlated with how much ‘exposure’ they had to the babies and children.

For many of us who have been pregnant, postpartum, and/or a parent, we already know that this is true.  It’s not just our bodies that change.  Something else changes that never goes back to its original configuration: our brains.  Maybe all the time we spend consumed with getting bodies back is more about getting our brain back; a more tangible and socially-acceptable pursuit.  All the while knowing, in the murky recesses of our changed brains, that the worry, the conjured scenes of certain death, and deep guilt over every imperfect moment will never leave us.

What if we better understood what was happening to our brains and not just our bodies?  Would it change our relationship to postpartum and parenting?  Would it reframe what we experience as depression, anxiety, or plain-old feeling like we are losing our minds?  Would we reach for help, talk more openly, or simply settle into it more easily?

Would you?

This spins other spirals of thought for me also.  Is it possible for this effect to be compounded?  If we have more than one pregnancy, more than one postpartum, and, truly, more ‘exposure,’ do our brains continue to change? Do the changes add up? Do these spaces in our brains grow deeper and wider?

I wrote a new installement of my Muse-letter, due to break later this week, before I even read this article.  Ironically, it touches upon parallel notes of exposure, changes, and leakiness of our hearts and emotional selves.  And, of course, I have to ask: what is the gift?

What new wild and remote expanses of our minds can we now saunter through that were not accessible before?  In what ways can we empathize, understand, or simply be with our fellow humans that were not as effortless?

Children and change have a lot in common. Endless. Relentless.  Generous with their gifts.

What are your favorite gifts?

#pregnancybrainisreal #postpartumbrainisreal #parentingbrainisreal #changeisreal #giftsarereal

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Flossing…not just a dance move

You have probably been reprimanded, just as I have, by your hygienist and dentist to floss more.  The reasoning that we are often given is that it helps agitate and dislodge the tartar and plaque buildup, reduces the resulting and/or ongoing inflammation in your gums, and reduces the chances of gum disease.  All seems pretty true to me.  If you leave crusty crap bumping up against soft tissue, the tissue is going to get angry.

What might not be part of the discussion is that flossing is also preventive for some downstream effects that we might not associate with it.  For example, blood sugar irregularities, diabetes, and cardiovascular disease.  Again, it all seems pretty true to me.  If you leave angry tissue captured in your body, and especially in the entry point to your entire digestive tube (think: end to end), it’s going rogue, right?

Check out this article for more details: https://www.mindbodygreen.com/articles/flossing-inflammation-blood-sugar-balance

And really, just floss

PS- Yes, I am a total cornball.  Consequences of being a mom to a 7 yo 🙂

This whole food allergy thing is nuts

If you were listening to NPR this week (listen here), you may have heard that feeding babies peanut products prior to 12 months of age is actually preventive in terms of developing true allergies to peanuts.  Not too long ago, we were recommending to parents that they wait until 3 years old to start nuts.  Then the advice and the guideline shifted to waiting until one year old.  Sound confusing?

What can be frustrating and is fascinating to me is that what we ‘know’ about nutrition is always changing.  The world of food allergies, intolerances, and sensitivities (they are not the same thing in my books) is no longer a small and isolated world.  Phrases like ‘gluten free’ and ‘vegan’ show up on even the most mainstream of menus.  It is no surprise that we are learning more about the things we put in our kiddos bodies, not just from a biochemical nutrition perspective, but also as allergy prevention.

Based on articles in the last few years (some links below) and my own observations, it seems like the ‘sweet spot’ for introducing foods is 4-7 months of age.  By introducing, I mean offering tastes and sampling of different foods and creating a palate that is curious about and enjoys different flavors and consistencies.  The other aspect of food introduction is to induce or educate the immune system gently to prevent allergies, intolerances, or sensitivities.  What we introduce during this time is the part that changes the most.  Last year I would have said peanuts were not on this list, now they are a maybe.  I would also like to offer that the quality and wholeness of the food is important in this process of introduction.

Here are some other ideas I have people keep in mind:

  • Start by looking at your own plates; if there isn’t anything on there that you would like to introduce to your five month-old maybe it doesn’t need to be in your body 🙂
  • Work from your family’s diet and your goals for family eating.  You are introducing a way of eating and a way of life.  If you are not happy with the way your family eats, the time to change is when you have little people really paying attention.
  • Introduce slowly at first, taking 2-3 days to see how your baby reacts to food at first.  Then you can speed it up a little as you watch them take to eating, digesting well, and being interested in more.
  • If there are foods that parents and/or other siblings react to, try to introduce those foods all on their own so you can see if that is true for this new eater.
  • Worldwide, eating together is the way that we share our love, appreciation, and connection with one another.  Let that be the center of food introduction and family eating for years to come.

Enjoy!  Dr. S

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More reading:

http://articles.chicagotribune.com/2012-09-12/health/ct-x-0912-food-allergies-20120912_1_food-allergies-environmental-allergies-first-child