I Will No Longer Tell New Moms "You're Doing Great!" (And Why)

Dear New Moms Out There (whether you're new last week or new a year ago, a first time mom or a mom of a dozen),

I'm veering off the topic of play today to talk a bit about parenting and self care. Specifically about postpartum parenting and self care, but this applies just as much to dads and caregivers of all kinds. I want to show you a few photos of what postpartum anxiety can look like:

1. Postpartum Anxiety

2. Postpartum Anxiety

3. Postpartum Anxiety

To be clear, I do not think tea parties, science experiments and joyful frolics in the woods are a clinical concern (at least not yet...) but in each of these photos I had (and have) postpartum anxiety. It is the oft looked-over kissing cousin of postpartum depression. Postpartum health issues do not always look like panicking or excessive worrying (although they can). It does not always look like withdrawing from activities you normally enjoy, though it can. It does not always mean you are excessively crying and unhappy and overwhelmed, although it can. It does not always strike the second you give birth or by the time you fill out the PPD screening as you leave the hospital (it can). It does not always rear it's head by the time you have your 6 week check up with your obstetrician, although it may. And sometimes, maybe it did show up in those first weeks, but you and those around you normalize it as the typical baby blues.

With me, what postpartum anxiety does look like is a feeling of being rushed all of the time even though I have no where in particular to be. It looks like a tether between calm and yelling that breaks one too many days of the week and a shortened threshold between Mommy and Monster. Yes, sometimes PPA looks like seething rage at your husband, your kids and random strangers in a parking lot who honk at me to get a spot while I'm trying to load my kids into the van. Sometimes it does look like "typical anxiety" like when I am a passenger in the car and am white knuckling the door handle trying to veer our vehicle from the passenger seat back into what I have convinced myself is the middle of the lane using The Force and an invisible steering wheel. Or being so afraid riding back from a day trip during a storm that I am crying in the passenger seat and rethinking family vacation plans so I won't have to ride in the car anymore maybe ever again. And as I wonder to myself how you can go from fearlessly pushing a baby out-- VBAC with no epidural-- to coming home and being afraid of everything, I realize this isn't me. As I pray that my kids are more resilient than I am, I realize this isn't me. And as I wonder how I went from being able to count the days on one hand in a year that I totally lost my temper to counting the days on one hand in the last few months that I didn't lose my temper, I realize this isn't me. 

With each of my pregnancies, I had a few weeks postpartum where things were just bat sh*t cray cray. Each time I had what I call The Postpartum Meltdown. After S, it was on Day 2, and I cried and cried and cried for 45 minutes because he would someday get married and move away from home. After Y, it was an incident forever titled The Torn Book Tantrum. With each of them as infants, I would have some anxiety with milk letdown and as soon as I started nursing, it subsided. This disappeared altogether with both of them by the time we got to 6-8 weeks postpartum and my supply stabilized. In fact, as we neared the time that Y was due to arrive, I actually asked our pediatrician what I should do to prepare and gave me words of advice I have carried with me and repeated to others ever since. They are also the words that encouraged me to make an appointment and get some help this time.

Count 100 days from the day you give birth. Mark it on your calendar. You're not going to parent the way you want to in those first 100 days. But if at the 100th day you're not feeling like yourself and you're not parenting the way you want to most of the time, get some help on board.

C was a different pregnancy. She was a different birth. A different recovery. We struggled to establish breastfeeding in a way I had not with my first two. Transition-wise, I feel this was the easiest of all three even though most of my friends told me the transition between 2-3 kids was the hardest. With each of my three births, there would come a time I would ask myself or even ask my husband if I was "still in the range of 'normal'" and with the first two, those roller coaster weeks passed and the dust settled. This time, that question came up repeatedly and I repeatedly came up with excuses when I answered it. In a sense, they were not even "excuses," they were true. I have a lot of support. I have a lot of tools. It's hard to be home with all three kids all summer long. I'm doing a lot of things with my kids, I'm not withdrawing from activities or social events. I'm eating well, sleeping as much as possible, exercising. It looked good. Yes, it felt like my threshold for certain things in life had shrunk to the size of a pea, but there had been some things in life that were a lot larger than a pea this past summer and those things would put anyone on edge. And there's such a thing as a functioning addict so why can there not also be such a thing as a functioning anxious person?

In fact, I asked that question quite casually to a friend in conversation one afternoon and she answered me quite casually that she takes a very small amount of medication for anxiety after having PPA that has significantly helped her. She still has no idea how enormous of a gift that was to me. I went home that afternoon and looked at my calendar. We were rounding the bend of Day 100. The next afternoon I called my doctor and made an appointment.

In the week prior to my appointment, I happened without even searching for them to see three stories on Facebook in three different venues that hit me hard and assured me I was making the right decision even though the decision felt hard to make. One was an anonymous post in a group of women by a mother of 3 who lost her temper at her strong willed middle child and felt so guilty for it that she tried to choke herself. One was about a mother who shared that she one day was driving her kids around and decided she needed to make an extra unplanned stop and got herself to the ER for help right away to begin the process of treating postpartum depression. And the last was an article written about a mother who took her own life and no one suspected she was suffering from postpartum depression at all. Thank G-d, my symptoms were not in any way as severe as the three accounts above. And yet, they do not need to be that severe to warrant getting some help on board whether is therapy, medication, help at home, time away from home, self care, support groups or a combination of these.

I do have my personal reasons that making that call was very hard. The biggest and foremost reason it was hard is that there is a part of my medical history I do not have in any current medical charts. When I was 13, I became excessively sleepy during the daytime and went to my pediatrician. At first, she normalized it as typical teen "behavior" and when I brought it up again, she suggested I begin treatment for depression and referred me to a specialist. This began my journey down a path that, thank G-d eventually landed a correct diagnosis but also included the use of over 20 different psychotropic medications, several of which were not FDA approved by doctors for use with patients who have depression. When I first saw a doctor in 2008 after moving to a new state who questioned the medications prescribed by previous providers, I was skeptical. Why would anyone prescribe a medication that wasn't appropriate or needed? Furthermore why would anyone prescribe medications that were as dangerous as this doctor felt they were? So I went for a second opinion and a third and then back to the first to begin the arduous process of carefully coming off of the medications. 

And during the decade of being on them, the quality of my healthcare changed as well. I once went to my primary care physician having an asthma attack and was told it was impossible I was having an asthma attack because he would have heard me wheezing from the waiting room. I walked out without any treatment and without any prescription for a rescue inhaler. He never did a peak flow test; he didn't even use his stethoscope. When I was still struggling a few days later, I went to an urgent care where a peak flow meter revealed I was indeed having an asthma flare up and I was given a nebulizer treatment onsite as well as prescriptions for appropriate maintenance and rescue medications.  On another occasion, I had a positive MRSA 

culture and I cried in the doctor's office, partly because I was sick and had a high fever and horrible headache and also because I had never heard of MRSA but had just read WebMD Magazine in the waiting room and happened to read an article about it that said it was fatal. Yeah, don't read WebMD in the waiting room. Ever. But his response was that I "needed to get my anxiety in check" because he'd just done a colonoscopy on a man in the room next door without any anesthesia and I was crying over having an infection drained. These feelings of being pigeon holed kept me from seeking medical help when I needed it and also convinced me that any physical concern I had was, in fact, in my head. After all, doctors know. 

The process of coming off of the medications I was on in 2008 took about two years total. And a few months later, I began having neurological symptoms. I tried and tried to ignore it, normalize it, wait it out and when I couldn't, I took the plunge and saw a doctor. She said three words that would change my life: "I don't know." And referred me. I began working with a neurologist and the lengthy process of testing and ruling things out until we got to a non-diagnosis and what it "most looked like" along with a plan to medicate away the symptoms after one more test: a sleep study. A sleep study for a patient who originally saw a doctor because she was sleepy; how original. And 45 minutes later, I had a diagnosis: severe central sleep apnea. Yes, folks, it took three words and 45 minutes to correctly diagnose and treat the actual health issue at hand. "I don't know" meets "I don't breathe" in a beautiful romance that would lead to a life lived happily ever after.

Mostly... 

So last week, I walked into my appointment with a doctor I fully trust. And I began with "there's a part of my medical history that is not in my charts and I am asking you that if you are OK with it when I'm done, I'd like to leave it off." She's not the first doctor I've given the shpiel to and she's also not the first doctor to leave it off the charts. 

"Logically I know that this is the right thing to do," I said to my doctor as we talked about options and medication came up. "Why can't I see it as something I am doing for my children and even for myself and not something I failed at doing by myself?" We acknowledged the power of history and the flaws in the medical world that hopefully are shifting as time goes on. We came up with a plan together that for me does include a medication but the question still lingered in my mind. I thought about those three random, anonymous women on Facebook from the previous week and when I got into my car, before I left the parking lot, I wrote my own post on a group of moms (apologies in advance for the redundancy):

When I was expecting my second, I asked our pediatrician for advice on adjusting afterward. He told us to count 100 days from the day I gave birth and to mark it on the calendar. He said if on that day I didn't feel like myself and like I was parenting the way I wanted to most of the time, to get some help on board.
This group has been a source of comic relief, virtual sisterhood and at times, chizzuk. I'm 4 months postpartum with our third, BH. This time we got to day 100 and this time I needed to get some help on board. I have all the logic to know I am doing the right thing and three beautiful little reasons to do it. It should have been one of the easiest choices of my life but it feels like one of the hardest. I BH have a lot of support and still there are many like me who do not.
I believe there are a lot of reasons it's hard to make that call. Time, taking care of others, the belief that somehow we should just try harder and be better. That for anyone else we see in a hole, we'd toss a ladder, but for ourselves, we think we should just be able to claw ourselves up the muddy sides with our bare hands. And I also believe one of the biggest reasons is stigma. But time and time again, I see women here courageous enough to post about this and for me, that was a ladder. So if you are in hole today or ever, here's a ladder for you.

And the responses flooded in. Women in the same boat at all stages: sinking, floating, treading water, smooth sailing now, weathering the storm... Not all of these women have my history and I do not have theirs. We all have our reasons for grabbing a hold of that ladder, for why we do and when we do and if we do at all. But I also realized a flaw in my own methods of supporting new moms. I always go out of my way to say "you're doing great!" Yeah, moms need that cheer. Even (and especially) when we have dark circles under our eyes, sweat stains under our arms, spit up down our shirt and a screaming toddler being carried like a football across the parking lot. Heck, we need that cheer when the house is clean and the laundry is folded and dinner is on the table. Momming is hard work. Often underappreciated. And postpartum Momming is even harder. You go from being the center of gravity and center of attention to completely invisible behind that new and adorable bundle of joy and I remember that feeling was so alarming after my first. So I go out of my way to see those moms. To see the mom of three successfully walking through a door (even if, like me, it took 4 tries to clear it with the back left wheel of the double stroller). To see the mom who got to the park and left the park with two kids: the same two kids. To see the mom who made it to the grocery line with her cart full of groceries when she only came in for carrots and guess what, she forgot the carrots. I tell them "you're doing great!" But it doesn't leave a whole lot of room for the conversation to continue and maybe it should.

So new moms, here you go: You're doing great and if you're not, that's also OK. It's OK if you're tired. It's OK if you're done, just done, and it's only 4:00. It's OK if this is way harder than you thought it would be and you're questioning whether you're cut out for this; we're right her with you. But it's also OK if you're really NOT OK and you need some help. You didn't fail. You didn't mess up. You didn't ask for stretch marks up to your newly hairy chin. It's OK to be NOT OK and to decide that you do want that ladder after all. You might have amazing nails that are painted to perfection and those muddy sides would get them dirty. You might have muddy nails already and clawing just ain't working or just ain't worth the effort when there's so many other more important things to do. Or you may have one hand where you clipped the nails but then the baby woke up and you had to go feed her and you never got around to clipping the nails on the other one. But either way, I'm tossing you a ladder. There's no rule about when you use it or when you need it. It could be right away. It could be after 6 weeks. It could be on the 100th day or even further down the line, but do me a favor. Keep it with you. Keep it in an attic or a closet or, better yet, keep it in the hole in case you do fall in and need it; then it will already be there and you won't have to wrack your Mombrain and the back of the freezer to try and find it. New Mom, You're doing great, and if you're not, that's OK, too.

I am so immensely grateful for the honesty of a friend of mine who maybe doesn't even know she was my ladder. I am so immensely grateful for the bravery of anonymous women to share their own stories or stories about someone else. I am immensely grateful for my husband and my three kids for each being a ladder in their own right (because there are a lot of places in life I need to climb and it's not always a hole either; I'm short). Yes, that tiny little white dot might be a loaded bomb for me but the cost of not taking it is a harder pill to swallow. I'm doing great and I'm not OK just yet and that's alright for now.

Lots of love,

Your Next Ladder