"Dark Side of the Full Moon" - film + discussion

On Friday night, I headed to Cary to see Dark Side of the Full Moon, a new documentary produced by two moms about postpartum mood disorders. Local new mom resources, Postpartum Education and Support offered the film as a fundraiser and a post-film discussion panel which was moderated by yours truly. 

First, a few thoughts on the film itself. I was sent the a link to see the whole film before Friday night. I'm glad I did. Dark Side can be shocking in points, even to someone who didn't suffer from a postpartum mood disorder. Interspersed in the film are past news stories about moms like Andrea Yates and Cynthia Wachenheim who had either killed their children and/or killed themselves. As one member of the audience pointed out during the panel, these news stories are problematic because they exclusively portray postpartum psychosis which is at the other end of the postpartum mood disorder spectrum. Postpartum psychosis only affects about 1 in 1000 women, about 1%. Postpartum depression or anxiety however is much more common, affecting 15-20% of women. In spite of this (and the sometimes overly dramatic "is this really how it is?" refrain that Maureen and Jennifer often utter incredulously) Dark Side of the Full Moon offers an authentic exploration of the number one complication of childbirth that no one really wants to own. It's well worth seeing.

As good, if not better than the movie, was the discussion panel after the movie. Yes, I moderated it but I was truly blown away by both the honesty of the panelists as well as the insightful audience questions. We had an OB/GYN, the former medical director of the UNC Perinatal Mood Disorders Clinic now in private practice, a physicatric physician assistant and new mom, a mom ppd survivor and a clinical social worker who facilitated a postpartum support group for twenty years. They were an impressive group. Not just because of titles and experience but mainly because of their honesty. The audience heard about ER docs who didn't know about UNC Perinatal Mood Disorders Clinic 6-8 months after it had opened. We learned about pediatricians who follow more of a "don't ask, don't tell" policy with new moms even though we all know a new mom's mental health has an impact on a baby's success. One panelist admires the centering pregnancy model and wishes that was more prevalent in our area as a way to build community, support and trust into prenatal care. Audience members worried about socio-economic gaps for new moms, as many of the moms featured in the movie were employed and in better financial shape than poor moms, "what's being done for them?" she asked. (Socio economic status is a risk factor for postpartum depression.) Collectively, we talked about the bar being raised so high for new moms and how that can exacerbate the isolation and loneliness that new moms can feel.

Perhaps the best question of the night, however, came when an audience member asked panelists if they were to wave a magic wand to help fix some of these issues, what would they choose to do? One panelist thought separating OBs from GYNs would be a good idea. Paid maternity leave was suggested, by the sole male panelist. "Being the main breadwinner exacerbated my symptoms," one woman said. Another panelist wished for communities to rally around each other and neighbors to get involved and check in on new moms, families. More training and interaction between OBs and psychiatrists was also suggested. 

It was a remarkable evening. But if you did miss out on this showing and you'd like still like to see the film, there is a screening coming up May 1 in Chapel Hill. Head here for details on that and other showings nationwide.

#newmoms group: What's Your #Postpartum Plan?

The second Saturday of each month is the free Outside The Mom Box support group for pregnant women and new moms with babies under 1 year. Each session starts with introductions and then goes in our main topic. We leave about 30 minutes at the end for Q&A. Last Saturday we had post partum doula and mom, Suzanne Lee of Eno River Doula talk with us about postpartum planning. Here are a few noteworthy bits of advice from that conversation:

Suzanne started out by asking our group of five new moms and one pregnant woman about postpartum plans were or had been. We heard first from a mom of a five month old who was easily able to share some advice about her experience. "I needed to accept a lot more help than I ever had before," she shared with us. This struck me as not only self-aware but also brave. It's hard to admit that we need help, especially when new moms are often told, (subconsciously or overtly) that they should be able to do it all. I remember feeling like I should be able to do it all, in spite of having a local sister who had already been there before.

Moms talked a lot about the challenges that surfaced that we hadn't anticipated. With unexpected challenges (not being able to produce enough milk for example) then it's often easy to label ourselves as a "bad" mom, a mom who "cannot even feed her own child," as one mom told me once. We are our own worst critic. That must change when we have children. If it doesn't, our negative self-talk will spill over onto our child. Kids miss nothing. They might not have the language yet to talk about what they see but they will. They might not understand the reasoning behind our anxiety yet but they feel it now. Better to start to work on those issues now than later on when your child is way faster at noticing and adapting than the baby he is now.

One new mom reminded us that it is also helpful to be willing to let go of our preconceived ideas about baby raising. That for her was about bedsharing. But this can be true of diapering choices, formula vs. breastmilk, baby wearing or vaccination schedules. When we let go of a set idea because we realize that it is no longer serving us, we not only grow more confident as a mom but we also gain skills in the practice of responding to our baby's needs. 

We all know that family can be a blessing or, sometimes, a real curse. So as one new mom pointed out, "try to plan your visitors based on how helpful they are to you." Someone who is not as helpful or who may be higher maintenance, less independent and more needy could be told to come at twelve weeks instead of three weeks. Remember, this is the one time in your life when the world will essentially revolve around you...as long as you make your needs and wants clear!

Lastly, don't put off the inevitable: childcare for example. If you know you're going back to work, make as many arrangements in advance as you can to alleviate worries down the road. Plans can always change (see above!) but it's better to have a plan than to wing it later on when emotions are running high.

Questions? Comments? Share them by visiting my contact page or leaving your thoughts below. Thank you for reading! We will meet again Feb 14 from 2-4.  Join us!

{new post} #newmoms group: understanding #postpartum #moods

The second Saturday of each month is the free Outside The Mom Box support group for new moms with babies under 1 year. Each session starts with introductions and then goes in our main topic. We leave about 30 minutes for Q&A, then close. For November, we had local therapist and mom, Aimee Vandemark talk with us about understanding our postpartum moods. Here are a few noteworthy snippets from that conversation:

Aimee started our conversation off by sharing a story of an experience she had with her own young children. She asked herself in that moment and to us on Saturday to consider, "what does it mean to have another being call us "mom"?". That question segued into a conversation on how personal identity shifts for us during the postpartum period. Our identity as a woman shifts so much as soon as we become a mother. New moods, feelings or other different emotions can become a new norm. But when should we pay attention to those new feelings and when can we accept and move on?

What does postpartum depression look like? There are lots of different emotions or feelings that go into the mix (overwhelm, guilty, confusion, irritation, anger, sadness, numbness, etc.), Aimee told us. One mom commented, "that felt like Tuesday!". I know the feeling! So how do we know if we should be concerned? Aimee said that the intensity and duration of those feelings is really crucial to pay attention to. Thinking about duration: were they happening on Tuesday or for the past two weeks? And when examining intensity, it's important to consider how those feelings are affecting your life: are you able to get through the day? And perhaps find that things are better the next day? Or do you find yourself so overwhelmed that even basic daily tasks feel impossible? 

One of our new moms who has struggled with depression in the past shared that our partners can serve as a good reality check for our emotional health. What a good point! Our partners are the people who know us best in the world. If they are noticing that we are different or that our behavior seems problematic or concerning, then that is absolutely something worth pay attention to. 

In addition to awareness from our partners, Aimee said that our own self-awareness is a really important skill to develop. And that may be fine-tuning, instead, if it's been a while since we've been in touch with how we're feeling about things. Issues like anxiety, depression, sadness don't go away in pregnancy or even after we have our child/children. It's important for our emotional health as well as the health of our entire family that we are self-aware.

With self-awareness, ideally, goes action. So if we are feeling overwhelmed by some of the mood swings that we have going on during the postpartum period, or otherwise, we need to reach out for help and support. Help and support can include: self-care, groups like this new moms group, time talking to a professional like Aimee, connecting with other new moms or even adjustments to schedule, parenting responsibilities. And self-compassion.

I often focus on self-care as an important piece for new moms to practice getting into the habit of but Aimee reminded us that self-compassion is just as important. Self-compassion is just what it sounds like: letting ourselves off the hook sometimes. Talk ourselves the way that we would talk to our child, to at minimum a stranger. Compassion for ourselves can look as "simple" as putting away the parenting books that are causing anxiety, talking yourself out of a negative "tape" that's playing in your mind, or reaching out to someone who has been a supporter of you, to give you a reality check.

Questions? Comments? Share them by visiting my contact page or leaving your thoughts below.

For more information on postpartum mood disorders, please visit my page on mothering and mental health. Thank you for reading! On the calendar for next month: travel with baby! Join us on Saturday December 13 from 2-4 pm.

{new post} August #pregnant ladies support group

The 2nd Thursday evening of each month is Outside The Mom Box pregnant women support group. We meet from 6:30-8:30 pm at my office as a way to share resources, have important conversations and build community. Last Thursday we talked about postpartum support. Here's a bit from that conversation-

New moms are very aware that there isn't a great deal of postpartum support for them and their babies after they arrive home from hospital or birth center. Cobbling together support (a parent here, sibling there, perhaps a good friend or a postpartum doula provides a few visits) is about as good as it gets. To make matters even more challenging, moms are expected to head back to work after a relatively short amount of time after baby. That varies from mom to mom, of course, but what isn't variable is the fact that time off isn't paid. [Except in California where you can receive six weeks paid leave.] So not only is there very little emotional and physical support after you have a new baby, financial support is also pretty much nonexistent. 

After having delivered a baby, our bodies need time and rest to heal properly. Depending on the circumstances of delivery (a scheduled csection will have different healing needs than an unplanned csection), the nature of what needs healing and rest will vary but here are some areas of your body that likely will need attention:

Baby's room or your room may be your new resting place once baby arrives. Make it an oasis of comfort and calm.

• Uterus needs to get back to its usual fist-size (this process is called involution) that means that you need to rest in order to help that happen. Breastfeeding also helps.
• Muscle aches: physically your body has been sleep deprived, stretched, pulled etc. Muscles you didn't know you had will be sore;
• Hemorrhoids can pop out from stress of labor…not dangerous but one more piece of your body that requires times for healing, sitz baths and attention.
• Crotch pain in general: I had some tearing with my daughter and should have been icing more than I was (who knew?!) so my stitches became itchy and uncomfortable. There may also be general soreness, burning/stinging, etc. Sitting can be very uncomfortable for weeks.
• Constipation, nausea, aches, tingly feelings from drug hangovers from epidural, narcotics etc 
• Sweating-the water weight you packed on will be coming out!
• Csection incision will need time to heal, that means rest, minimal or no lifting, altered positions for breastfeeding, etc.

And our mind needs extra attention, too. Emotionally, new moms have a lot to deal with! New mothering can be isolating. As we saw, new moms are dealing with a lot physically which can translate into less facility get out and go anywhere. But it can be just plain scary leaving the cocoon of your home for those early days with baby. Many unknowns fly through the mind, everything to how temperature might affect baby to "what if she starts to cry?". It's important to remember that "just" becoming this new person called "mom" can be scary and overwhelming. Who are we? We don't feel like our old self and the mom hat is still really stiff. New moms might find themselves not feeling connected to baby, not "liking" baby immediately. That kind of thinking can be devastating for new moms and can cause feelings of guilt. New moms need emotional support to be assured that all of these feelings are usually normal and completely okay. It helps to hear this reassurance from a real person ideally from another mom or trusted friend or confidante, someone who has been there before.There are so many areas that new moms need emotional support that having someone come into the home and help not only with daily tasks and hands-on support but also normalizing feelings of anxiety is crucial.

But how? How do new moms get the support that they need? Where do we go from here? Up! Things can only get better and here are a few ideas on how we, as a community, make that happen:

• New moms support group: open to any new mom, with or without baby, they happen on the 2nd Saturday of the month in my Durham office. 2-4 pm. A great way to connect with other new moms, get some love, reassurance and a bit of information along the way.
• (Drop off) Supper Clubs: I'm going to start this in my neighborhood (Old North Durham) first but I think it's an easy enough idea for anyone to tackle who feels strongly about supporting new moms. Send an email to your local list serve and ask for volunteers to make and drop off a supper at the home of a new mom. I'll post more about this next month with clearer directions, etc. This could be a great way to build community within your neighborhood and among different generations!
• Post-partum doula services: I believe in DONA's motto, "a doula for every woman who wants one," and so this fall, I will be doing some outreach to other local postpartum doulas to see if they might donate a block of their time to pop in to see new moms who would like their services. I will of course, offer the same: donating time each time to check in on new moms.

So, action steps-

...for pregnant ladies:

1. Make your list and check it twice of who will be on hand and help after baby arrives. Make sure that they are helpers, not family or friends looking for entertainment!
2. Visit my contact page if you'd like a visit from me or another postpartum doula after your baby arrives.
3. Plan to come to a Saturday afternoon with other new moms at my support group.

...for new moms: what would you add to this list? How could you better support a new mom and her baby? Leave a comment below.