The Changing Face of New Motherhood

Why are new mothers today so overextended? Why are they completely overwhelmed by new motherhood?

New mothers today are facing much higher demands and responsibilities than they did in the 1950s, 60s, and 70s. Most new mothers contribute to a dual income household, attempt to balance workplace responsibilities and childcare, and maintain the home, pets, and a social life. Let’s not forget, they have to eat, too! 

Our female predecessors worked very hard to establish equality and partnership.  They entered the workforce and divided up responsibilities in the home.  Women have made great strides in professional and economic advancement, only to have the stress of trying to do it all and be the perfect mother, wife, and employee.  New mothers are struggling to manage everything at once; in addition to keeping up with friends and family, and trying to make it all look good on Instagram.

Mothers deal with all sorts of political issues, as well. There are always new policies in place regarding workload responsibilities and time off. They have to ask for time off or set hours at work, and find a private place to pump, or breastfeed if day care is on-site.  New mothers deal with many more issues than they did back in the day; daycare, nannies, workplace prejudice, and trying to carve out vacation time to unplug. Many government and social programs have changed, and together with higher workplace demands and household and childcare responsibilities, new mothers are left completely stressed out.

How many women were passed over for promotions due to pregnancy or a new baby?  How many women are disappointed that they couldn’t handle their prior job responsibilities as well as they used to because they’re now sleep deprived and overwhelmed as a new mom?  How many new mothers either had to walk away from a promotion, or step down from a job role because they could not stay late at work anymore, because they wanted to go home and see their baby before he/she went to sleep for the night?

I see many of these women in my practice as a psychiatric nurse practitioner, struggling with trying to keep up with doing it “all”. More often than not, the pressure to keep up is something we put on ourselves. Here are some of the solutions many new mommies and I have worked out together:

  • Try and lighten the load at work if you can, and if your job allows it, get more flexible work hours, or see if you can work from home at least one day a week
  • Try and lighten the workload at home if you can afford some household help, or enlist in some family help
  • Spend time on the weekends preparing for the week, limit plans and running around so you can have time to relax and enjoy your new family
  • Take some time for yourself whenever and however you can
  • Don’t blame yourself when things are not perfect, no one is perfect and no matter how well you try, you'll make mistakes—but you will learn from them
  • Don’t be your worst critic, you are doing the very best that you can.

You may decide to put your career on hold if things get to be too much, if you can afford to. Don’t feel guilty about it. You can always go back to your career, but you won't get this time back with your baby.

And don’t let social media make you think you’re not doing as much as you should be, or that anyone else is doing it better than you are.  Shift priorities, and just give some tasks the boot. Get this weight off your shoulders! Celebrate life, and enjoy being a mom!

Cheryl Zauderer, PhD, CNM, NPP, IBCLChas been a registered nurse since 1985. She is a nurse-midwife, a lactation consultant and a psychiatric nurse practitioner specializing in perinatal mood disorders and other women’s health issues. Dr. Zauderer has authored her first book entitled Maternity Leave: A New Mothers Guide to the First Six Weeks Postpartum, Praeclarus Press. It is a self-help book for new mothers focusing on the first six weeks postpartum. You can follow her with her blog and on her website at: postpartumcare1.com, on twitter, and on facebook.  Dr. Zauderer has also served as a board member for PSI (Postpartum Support International) and has been the Nassau/Suffolk coordinator for PSI since 2009.

Postpartum Depression - it's not just your mother's blues anymore

It's common today to hear about women experiencing some form of Postpartum Depression (PPD) -  why?

What it is

PPD, also commonly known as Postpartum Perinatal Mood Disorders (PPMD), is the most common complication of childbirth today. Approximately 9-16 % of postpartum women will experience some form of PPD/PPMD—and this number doesn’t include those who suffer in silence. PPD/PPMD is not a failure to be a good mother, or a way to seek attention, or get out of caring for your baby. It is an illness, affecting many aspects of your psychological and physical wellbeing. Sometimes PPD/PPMD can be very frightening for the new mother, causing her to fear coming forward with her symptoms.

PPD/PPMD Today

New mothers today are more isolated than they were years ago.  In the past, many young women had babies at relatively the same time as their friends, which provided greater peer support. Grandparents and other family members were more readily available to step in and offer help.

Grandparents may not be available to help out as easily today with more and more households requiring two incomes.  Women are also now able to focus on their career, and have their babies at different stages in their lives, without that same built-in support network. Many new mothers are also focused on returning to work, and worry about childcare and getting things in order.

We know a lot more about PPD/PPMD than we did years ago.  Women did suffer back then, but for most, it was swept under the carpet and ignored.  We simply didn’t understand what it was, or how to treat it.

PPD/PPMD is an umbrella term that describes a cluster of symptoms and can be broken down further into five categories:

  • Postpartum depression and/or anxiety.
  • Postpartum obsessive-compulsive disorder.
  • Postpartum panic disorder.
  • Postpartum post-traumatic stress disorder.
  • Postpartum psychosis.

The “blues” are considered part of normal postpartum adjustment and are not part of these disorders.

Baby Blues, or postpartum blues, are usually seen within the first week or two postpartum and symptoms can last up to six weeks, including:

  • Mood instability
  • Weepiness
  • Sadness
  • Anxiety
  • Inability to concentrate
  • Overly sensitive
  • Emotionally labile
  • Mild depression
  • Restlessness
  • Fatigue
  • Insomnia
  • Overwhelmed
  • Anxious

We've put together some facts about postpartum depression to help you understand the signs and symptoms and get help as soon as possible.

PPD/PPMD and/or anxiety

  • Can occur at any time within the first year and beyond
  • Can be triggered by a hormonal change, such as beginning of the menstrual cycle, or cessation of breastfeeding
  • Can begin during pregnancy

 

Signs and Symptoms

  • Excessive worry or anxiety
  • Irritability or short temper
  • Feelings of being overwhelmed
  • Feeling sad, guilty or phobic
  • Feelings of hopelessness
  • Major sleep disturbances; insomnia, or fatigue
  • Loss of appetite, or craving carbohydrates and sugar

Physical symptoms

  • Uncontrollable crying, irritability
  • Nervousness, anxiety, panic
  • Poor concentration, confusion, memory loss
  • Feelings of guilt, inadequacy, worthlessness
  • Overly concerned or lack of concern for the baby
  • Fear of harming the baby or self

Postpartum Obsessive Compulsive Disorder (POCD)

  • Intrusive, repetitive, and persistent thoughts or mental pictures
  • Thoughts often are about harming the baby or self
  • Can include excessive counting or checking, or other repetitive behaviors
  • Fear or shock in herself for having these thoughts
  • Sometimes exhibiting strange behaviors to reduce the anxiety of these thoughts

Postpartum Panic Disorder

  • Episodes of extreme anxiety
  • Shortness of breath, chest pain, sensations of choking or smothering, dizziness
  • Hot or cold flashes, trembling, palpitations, numbness or tingling sensation
  • Possible restlessness, agitation or irritability
  • During the attack: fear of going crazy, dying, or losing control
  • Panic attack may wake you from sleep
  • Sometimes there is no identifiable trigger
  • Excessive worry or fears, usually worry about more panic attacks

Postpartum Post-Traumatic Stress Disorder (PPTSD)

  • Repetitive flashbacks and images of an event (often of the birth experience or of prior sexual abuse)
  • Nightmares and “Daymares”
  • Hypervigilance (always on alert)
  • Increased arousal (startles easily)
  • Depressive symptoms and anxiety tend to co-occur
  • Conditioned insomnia

Postpartum Psychosis (PPP)

  • Extremely rare and occurs in one to three per thousand new mothers
  • Onset typically is three days postpartum
  • Visual or auditory hallucinations
  • Delusional thinking
  • Delirium or mania

Getting Help

If you are experiencing any of the above symptoms, please seek treatment and remember that PPD/PPMD is curable, and you will get well.

The following organizations have many valuable resources:

Please don't hesitate to contact my office in Garden City, New York if I can be of assistance.

Cheryl Zauderer, PhD, CNM, NPP, IBCLChas been a registered nurse since 1985. She is a nurse-midwife, a lactation consultant and a psychiatric nurse practitioner specializing in perinatal mood disorders and other women’s health issues. Dr. Zauderer has authored her first book entitled Maternity Leave: A New Mothers Guide to the First Six Weeks Postpartum, Praeclarus Press. It is a self-help book for new mothers focusing on the first six weeks postpartum. You can follow her with her blog and on her website at: postpartumcare1.com, on twitter, and on facebook.  Dr. Zauderer has also served as a board member for PSI (Postpartum Support International) and has been the Nassau/Suffolk coordinator for PSI since 2009.

Nurturing the New Mom - Gift Ideas!

If you have an expectant new mom in your life, you may want to pamper her, or help make this time go a little more smoothly for her.

It's so important in the first six weeks postpartum that she feels supported, and that she is able to get rest and good meals so that she is able to bond with her baby.

Mommies, when you're out shopping for all of your baby supplies, remember to shop now for things to take care of yourself with as well! 

Here's a list of ideas for things you can give or bring to the expectant mom to make things a little easier and more restful for her: 

- A muffin and a latte*

- A gift card for a haircut and blowout

- An offer to pay for a doula for a couple of days

- A gift card for a pedicure

- A gift card for diaper service

- An offer to watch the baby so she can take a long hot shower or a nap

- Healthy meals she can freeze

- Healthy snacks

- Herbal teas

- Travel coffee/tea mug 

- A great water bottle

- Magazines or a bestseller

- A DVD or gift card for Netflix or an iTunes movie

- Comfy pajamas or a robe (make sure it is breastfeeding friendly)

- Long, comfortable sweatshirts and leggings

- Lavender spray for her pillow

- Bath salts and candles

- Small diaper bag size hand creams

- Cocoa butter

- A fashionable diaper bag 

- A belly wrap

- Baby wrap or sling

- Basket of lotions

- A Boppy or other type of comfortable pillow

- A portable compact breast pump that plugs into your car lighter

- Baby and breastfeeding books (a copy of my book, Maternity Leave, which focuses on the first six weeks postpartum, will be available this fall!)

If you bring a baby gift, consider bringing a small gift for an older child as well.

 

*Caffeine? It's ok in moderation - if the baby is getting over-active or not sleeping, cut down. One cup a day during pregnancy and breast-feeding is best.

Cheryl Zauderer, PhD, CNM, NPP, IBCLChas been a registered nurse since 1985. She is a nurse-midwife, a lactation consultant and a psychiatric nurse practitioner specializing in perinatal mood disorders and other women’s health issues. Dr. Zauderer has authored her first book entitled Maternity Leave: A New Mothers Guide to the First Six Weeks Postpartum, Praeclarus Press. It is a self-help book for new mothers focusing on the first six weeks postpartum. You can follow her with her blog and on her website at: postpartumcare1.com, on twitter, and on facebook.  Dr. Zauderer has also served as a board member for PSI (Postpartum Support International) and has been the Nassau/Suffolk coordinator for PSI since 2009.

Maternity Leave: Not Just for Working Moms

Fotolia_79703038_S.jpg

Maternity leave, frequently known as parental leave, or family leave, is defined as the time a new mother or father takes off from their job after the birth of a baby. This interval varies and could range from 6-12 weeks, to up to a year. 

What about the stay at home mom?  All new mothers need time to recuperate; a metaphorical maternity leave.  Six weeks to recuperate from the birth of her newborn is the minimum amount of time that a new mother should take to rest, eat and feed her baby. Bonding during this time is crucial for the new family, and important for a newborn’s development.  It is equally important for mom to get her rest so she will be relaxed, adjust to her new role as a mother, and heal from the physical strain of labor and birth.  A new mother needs to use this time to “learn” her baby, and her baby needs to feel loved and cared for, and have an easy transition into the outside world. 

Some new mothers are anxious to push themselves to return to their old selves as soon as possible.  They want to get their lives and their bodies back quickly and use this time to get as much done as they can. She may be experiencing spurts of energy and the desire to “do it all!” It can be very tempting to want to get the house back in order, grocery shop, cook, or run around returning or exchanging baby gifts. All this can lead to overload, a body that won’t heal, exhaustion, and/or difficulty breastfeeding.  She can develop common postpartum complications such as increased bleeding, anemia, stomach problems, infection, and possibly postpartum depression.

Labor has four stages.

·      Stage one is the labor stage, which is broken down to into three phases - early, active, and transition.

·      The second stage is the pushing stage.

·      The third stage of labor is the placental stage.

·      The fourth stage of labor, also known as the recovery stage, begins with the birth of the placenta, and typically ends once the body has stabilized. Many consider this period to extend for about six to eight weeks.

This is the period of time from the baby’s birth until the body makes an almost complete recovery. This is known as the postpartum period, or the puerperium, which means the period of time following childbirth.

Recovering from birth and coming home with a new baby is not easy. The first six weeks are a very sensitive time for a new mom and her newborn. She will have a heightened awareness during this early postpartum period. Emotions, as well as instincts, are very strong during this period and it is a good time to grow into motherhood.

How can I get the postpartum rest that I need?

·      Rest and Sleep - sleep when the baby sleeps. Rest quietly with your newborn. Use this time to catch up on phone calls, texting, reading, bonding with your new family, journaling, blogging or other writing methods, or even starting your baby book.

·      Help - try to arrange for as much help as you can, have your partner take time off, your mother or mother in law, friend, relative or even hired help. If you can’t find anyone to help you try to rest on the couch, let older children play, or watch educational shows on TV. You can let the house go for a little while, order takeout, or ask visitors to bring over a healthy meal.

·      Limit activities - for yourself and your children. Arrange for car pools, and don't take on anything new. You don't have to be productive during this time, learn to lay low, and prepare easy simple meals and snacks. Remember that this is your time to bond as a family.

·      Hydrate - Drink a lot of fluids and consume healthy snacks. Keep small snack baskets near your feeding chair along with some bottles of water.

·      Take care of your body - Let your body heal, take care of your incisions if you have had an episiotomy or cesarean birth, if you had neither, you still need to heal from the inside.

Education, good nutrition and rest will all contribute to you having the best maternity leave for yourself and your newborn, whether it is an actual maternity leave or a symbolic one. This time period is short and babies grow up fast, so celebrate your newborn’s birth and enjoy this time as much as you possibly can.

Cheryl Zauderer, PhD, CNM, NPP, IBCLChas been a registered nurse since 1985. She is a nurse-midwife, a lactation consultant and a psychiatric nurse practitioner specializing in perinatal mood disorders and other women’s health issues. Dr. Zauderer has authored her first book entitled Maternity Leave: A New Mothers Guide to the First Six Weeks Postpartum, Praeclarus Press. It is a self-help book for new mothers focusing on the first six weeks postpartum. You can follow her with her blog and on her website at: postpartumcare1.com, on twitter, and on facebook.  Dr. Zauderer has also served as a board member for PSI (Postpartum Support International) and has been the Nassau/Suffolk coordinator for PSI since 2009.

 

Big City Syndrome: Postpartum relocation to the suburbs

The lives of professional women can change drastically with pregnancy – including a sudden shift from career-focused city life to wanting to create a new domestic bliss in the ‘burbs. Die-hard New Yorkers believe that when you leave Manhattan you fall off the ends of the earth – and your new postpartum life can feel like a major adjustment on many different levels when it includes a move.

Living in a big city, working to build your career, going out with friends and enjoying life as a young professional are normal activities during early adulthood. Pregnancy can change this significantly. Your charming city apartment can start to look cramped when you’re expecting, and good schools, fresh air, and being closer to parents and family members may suddenly become new priorities.

While the suburbs can have clear benefits for families, a new baby, a new home and facing a longer commute to work can all seem very overwhelming. If you decide to leave a big city for something a little quieter, there are a few points to think about as you plan your move.

This is a big shift from your familiar professional life - give yourself time to adjust. It takes a lot of patience to set up a new home while adapting to being a new mother with a newborn to take care of. For the first six weeks, try giving the physical work a rest and remember to take care of yourself, while spending time getting to know your baby. You will have plenty of time to work on the home later; it doesn’t have to be done all at once, despite the pressures we put on ourselves. You can still keep in touch with your old friends from the city, but it may be a bit more challenging now. Schedules may not permit getting together, or they may not understand that you have new responsibilities and may not be able to partake in the same activities you used to. Engage them in your new lifestyle, have them out for dinner and let them be somewhat involved in your baby’s life.

 A baby is a wonderful gateway to making new friends. Once your newborn is a few months old you can join new mom groups, classes, reading time at the library or local bookstore, even going for a stroll in the park can be an opportunity to meet new people with common interests. Fitness programs like Fit4Mom is a great way to get in some exercise while meeting other new moms or dads. Take advantage of having relatives close by, and enlist some babysitters so that you and your partner can enjoy an evening out, or maybe even get together with some friend in the city. Remember that this is a huge adjustment for all of you, give yourself time and remember why you chose to make these changes in your lives. You will adapt, and it will be wonderful.

  1. Don’t rush the unpacking, decorating and/or construction - you have years ahead of you to fix up your home
  2. Sign up for classes geared towards moms and babies, such as fit4mom, Mommy and Me, Gymboree, and story hour.
  3. Take advantage of what the suburbs have to offer, like a car, more space, a yard with a garden, plenty of parks, fresh air, hearing the birds chirping in the morning and the crickets chirping at night.
  4. Remember the reasons you moved and enjoy them. Ask family members for help, with babysitting, meals, etc.
  5. Give yourself plenty of time to adjust to your new life

It's easy to get overwhelmed at times like these, so be easy on yourself, and remember to ask for help along the way. 

Cheryl Zauderer, PhD, CNM, NPP, IBCLChas been a registered nurse since 1985. She is a nurse-midwife, a lactation consultant and a psychiatric nurse practitioner specializing in perinatal mood disorders and other women’s health issues. Dr. Zauderer has authored her first book entitled Maternity Leave: A New Mothers Guide to the First Six Weeks Postpartum, Praeclarus Press. It is a self-help book for new mothers focusing on the first six weeks postpartum. You can follow her with her blog and on her website at: postpartumcare1.com, on twitter, and on facebook.  Dr. Zauderer has also served as a board member for PSI (Postpartum Support International) and has been the Nassau/Suffolk coordinator for PSI since 2009.

The Importance of Postpartum Care for the Working Mom

Shifting gears between career and motherhood can be a momentous step for many professional women. We tend to discernibly separate these two areas of our lives as new mothers, to prevent one from having a negative effect on the other.

New motherhood is challenging for all new moms, even without the addition of career concerns. However, it’s vital to acknowledge that we can be both nurturing mothers and ambitious professionals, and give ourselves the space for postpartum help and healing.

It’s my hope that by joining the blogging community, I can proactively bring the healthy discussion of postpartum care to professional women, and help to ease that gear shifting.

Taking good care of yourself and your newborn during the postpartum period, typically for the first 6-8 weeks, will help set the stage for a complete and healthy recovery, both mentally and physically.  Your body needs to heal itself, and you need to get to know your newborn, and learn how to be a mom.

For the new mom who is planning on returning to work, you will come across a different set of challenges.  For American mothers, maternity leave can vary from 6-12 weeks, and sometimes longer.  Following maternity leave, you’ll need to be emotionally and physically ready to leave your home and newborn and focus on your job during the day, and on being a new mother in the evenings and on days off.  By planning now for postpartum care, you’ll make it easier for yourself to return to work refreshed and ready.  

Some things to think about to ready yourself and reduce stress and emotional conflicts:

  1. Make sure you are comfortable with the childcare you have chosen so that you can focus on your job with peace of mind.
  2. Prepare as much as possible in advance; purchase some comfortable clothing that will be conducive for you if you need to pump at work, and plan with your partner to stock up on groceries and freeze meals.
  3. Incorporate staying in touch throughout the day with your work schedule - your caregiver can send you texts, photos and videos.
  4. Try to return to work in the middle of the week so you can adjust, and then have the weekend to iron out any kinks.
  5. Don't overextend yourselves on the weekends or your days off - spend as much time as you can with your new family, and get ready for the work week ahead so things run as smoothly as possible.

Be kind to yourself while you embrace your role as a new mom. The first six weeks are an incredibly significant time for you and your baby, and with some preparation, you can smooth the way for this next chapter.

Cheryl Zauderer, PhD, CNM, NPP, IBCLChas been a registered nurse since 1985. She is a nurse-midwife, a lactation consultant and a psychiatric nurse practitioner specializing in perinatal mood disorders and other women’s health issues. Dr. Zauderer has authored her first book entitled Maternity Leave: A New Mothers Guide to the First Six Weeks Postpartum, Praeclarus Press. It is a self-help book for new mothers focusing on the first six weeks postpartum. You can follow her with her blog and on her website at: postpartumcare1.com, on twitter, and on facebook.  Dr. Zauderer has also served as a board member for PSI (Postpartum Support International) and has been the Nassau/Suffolk coordinator for PSI since 2009.