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Better after baby: Coping with ‘postpartum depletion’ + how you can bounce back

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A quick story—a little over a year ago, I was walking out of a play gym class with my toddler and newborn, when my toddler ran out towards the parking lot. Don’t worry, I caught him. But not without skinning both my knees (ps that hurts way more than I remember from my childhood) and almost dropping my newborn. It turned out fine, but all I could do in that moment was sit on the sidewalk and cry.


I was just so, so tired. I felt depleted, overwhelmed and quite frankly, a little lost.

And that’s when a mom—an angel—came over to me, bent down to help me up and said the words I will never, ever forget (and always appreciate)—

You’re not doing it wrong. It’s just that hard.

Still makes me cry to this day.

Because the thing is, we moms are simply too hard on ourselves. We do this massively incredible task of growing and birthing a baby, and then expect to snap back to being even “more” than we were before. We need to really start thinking and talking about the impact pregnancy has on us. It’s wonderful, absolutely. But it’s hard.

Understanding why exactly we feel so depleted may be the first step in figuring out how to feel better.

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Postpartum depletion isn't a medical term per se, but a way to describe the way new mothers—their bodies + their brains—feel for months and even years after baby is born.

So let’s get science-y—

During pregnancy, there is a tremendous exchange of nutrients, fat, hormones and iron between mom and baby. Not to mention ALL the physical and emotional changes you experience as you grow and give birth to your baby. And while this is on purpose and fabulous for growing those sweet little faces of theirs, it takes a significant toll on us moms. . .for years to come.

Let’s talk about the ways this depletion happens + then what you can do about it to feel better now—

1. Sleep (#duh)

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This one should come as no surprise, but almost all moms experience at least some degree of sleep deprivation. Many, many studies have found that women who experience poor sleep after they have a baby (um, anyone NOT raising their hands on this one?) have an increased chance of developing postpartum depression and more health problems in general.

What you can do—

Delegate. Consider hiring a postpartum doula or baby nurse, or simply asking a family member to spend the night, so you can get a solid chunk of sleep.

Don’t over-exert yourself. You are already super-mom, so no need to add anything else to your plate right now. Don’t feel obligated to take on any extra responsibilities—just focus on you and your baby.

Practice good sleep hygiene. This means no TV or smartphones in bed (and the hour leading up to it), consistent bed and wake times when possible and using your bed only for sleep and sex. In other words, no reading stressful work emails in bed right before you try to fall asleep.

Ask for help. Don’t assume that your sleeping difficulties are because you are taking care of a newborn... they very well may be, but it helps to rule out something else more serious by talking to your health care provider.

2. Your pelvic floor changes

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The muscles of your pelvis can change pretty dramatically after birth. In fact, most women experience at least some degree of incontience (peeing when you don’t mean to, like when you cough or laugh), general muscle weakness and even sexual discomfort. The unfortunately truth is that in the U.S., we don’t do a great job of helping women get the support they need in this department. In Europe, for example, women are routinely referred to specialists to address any pelvic floor concerns.

What you can do—

Kegels! Kegels are exercises that strengthen your pelvic floor muscles. Check out this guide to doing them correctly.

See a pelvic floor physical therapist. “That’s normal after you have a baby” is not always true, and sometimes an expert can help make a dramatic difference in your life.

3. Your belly shifts

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In order to grow a baby, our abdominal muscles have to stretch, and even separate a bit. This separation, known as diastase recti, occurs in almost half of all women and can last well after the baby has been born. This can lead to decreased ab strength, as well as discomfort and pain.

What you can do—

Gentle, firming exercises. Here’s a guide on how to do them.

Seek help. It’s never a bad idea to have your abdomen examined by your provider. Sometimes the separation is severe enough that it will require medical intervention (and you’ll feel so much better when it’s done).

4. Your digestion changes

We’re all familiar with the um, digestion challenges, of pregnancy. But these troubles can last into the postpartum period as well—constipation, nausea and heartburn continue for many women, especially when you add the effects of stress, poor diets (anyone else existing on leftover mac n’ cheese these days?) and exhaustion.

What you can do—

Eat well. Fruits and veggies can alleviate constipation while super foods will give you more energy to care for your little one. Inspiration here, here, and here.

5. Your brain

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The actual structure of your brain changes when you have a baby. The good news is that our brains become more efficient and responsive to emotions (um, check). The bad news is that “mommy-brain” is an actual phenomenon—women scored slightly lower on some tests taken during the first few years after birth (so I am not the only one putting her keys in the freezer?!).

What you can do—

Focus on safety. Seriously. It’s estimated that exhaustion accounts for as many as 100,000 car accidents per year, just as an example. Before you get in the car, do a little self-check and make sure you’re really okay to drive.

Be gentle on yourself. It can be really frustrating to feel like you’re not as sharp as you used to be. Remember- you are actually SHARPER than before... your brain power is just focused in a new area now.

6. And what about the baby weight?

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Pretty quickly after giving birth, our culture has us wanting to get our “pre-baby body” back. But this is no easy task. The hormone changes alone can make weight loss pretty tricky, not to mention the added stress and schedule changes that come with a new little life to take care of. Have you heard the expression, “it took you 9 months to gain the weight, don’t expect to lose it over night”? It’s pretty true—research has found that it takes most women a year (or more) to lose the baby weight.

What you can do—

Breastfeed. Breastfeeding burns an average of 500 calories/day, and many women find that breastfeeding helps them take the weight off more quickly.

Don’t wait to get healthy... but also ENJOY this time and don’t stress. There is a really fine line to toe here. Research does indicate that baby weight that hangs on for longer than a year can become permanent weight gain. That being said, you are under a tremendous amount of stress as a new mom and adding this to the lot doesn’t help. And, your body has just done an AH-MA-ZING thing—the last thing you need to do is feel bad about your body in any way. Here’s some inspiration for embracing your beautiful body.

7. Postpartum mood shifts, depression + anxiety

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Did you know that as many 10-25% of women will experience postpartum depression and/or postpartum anxiety? And that 80% of women will experience notable mood shifts after giving birth, commonly known as the “Baby Blues”? PLEASE check out this list of symptoms, even if for a friend and not you. Postpartum emotional difficulties are caused by hormonal changes, as well as many of the things discussed earlier.

In other words, IT’S NOT YOUR FAULT.

And, help is out there. Speaking with a therapist or doctor will absolutely change your life. Also remember that if you ever feel like hurting yourself or your baby, you can call 911 or go to an ER.

New motherhood—it demands more than you than you ever thought you could give.

That parking lot jetting toddler is now about to start pre-school, and that newborn is now a toddler. My knees scrapes have heeled and I haven’t cried on a sidewalk in recent history. In other words, I promise you it gets better, mama. But it’s still hard. It’s taken me 3 kids to realize just how hard it all is, and how crucial taking care of myself is.

I’ve learned that self-care is not a luxury, it’s a necessity.

My wish for you, new mama and seasoned mama, is that you truly understand how amazing you and your body are, and treat yourself like the mama-goddess that you are.

You’ve got this.

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It's 5 pm. You just got home from a busy day at work, dinner is nowhere close to being started, and the afternoon shenanigans have taken ahold of your little ones. They need some time to decompress from their busy day and, let's be honest, you need a few moments to transition into the last part of yours, too.

Your child asks, "Mooooom? Can I watch a show?"

Cue parenting inner-dilemma.

You want to say yes, but you also have fears about technology. How much is too much? Is it bad for my children? Will it isolate my children from me?

Sara DeWitt, the vice president of PBS KIDS Digital, said in her TED Talk that this last question is a big concern for parents. We desperately want to be connected to our children, and for our children to be connected to the world.

Unfortunately, she says, the "fear and skepticism about these devices hold us back from their potential." The truth is, high-quality educational screen time can actually build connections (more on that in a minute). Even more exciting, did you know that the right screen time can help your child develop empathy?

Empathy is a skill, but as a society, we are losing it. A shocking study found that empathy drops by about 40% by the time kids get to college. In a world fraught with inequities, divisiveness and conflict, rebuilding empathy is paramount. Motherly mamas agree. In the 2019 State of Motherhood survey, you told us that your top priority was to nurture kindness with your children.

But how do we do this? Telling our child to "be a kind person" is great, but in order to truly understand, they need to see empathy in context. By using digital content as a prompt for communication and conversation, it becomes one of the many tools we have at our disposal to help guide our children on the path to becoming empathic, kind people.

Enter PBS KIDS.

Raun D. Melmed, MD, FAAP, a developmental and behavioral pediatrician, and author of the Monster Diary series told us that, "our children have unprecedented access to wonderful educational opportunities through digital media. Interactive, nonjudgmental apps can enhance cognitive development (processing and organization, visual-spatial awareness, pattern recognition and even reading), social and emotional awareness, and even moral development."

When we control technology—and not the other way around—the potential is enormous.

The American Academy of Pediatrics says that "media can have educational value for children starting at around 18 months of age, but it's critically important that this be high-quality programming, such as the content offered by Sesame Workshop and PBS."

Researchers looked at the impact of watching PBS KIDS' series, Daniel Tiger's Neighborhood, and the results were pretty inspiring. Children who watched the show for 30 minutes each day for two weeks demonstrated improved empathy, the ability to recognize emotions and increased social confidence.

But, here's the catch: In order to experience this growth, children needed to have recurrent conversations about what they saw with their parents.

Nicole Dreiske, Executive Director of the International Children's Media Center and author of The Upside of Digital Devices: How to Make Your Child More Screen Smart encourages parents to utilize screen time "in the same way that they would use story time: to build trust, emotional intelligence, and empathy." By spending just 10 minutes discussing what happened in a show, children can experience significant benefits.

Knowing the science behind the benefits of screen time is great. But when that afternoon struggle hits, it can be hard to remember exactly what to do, so DeWitt encourages parents to make a plan—here's how.

How to make a screen time plan for your family

Ask yourself the following two questions:

1. What do I want my kids to get out of their digital media time?

Do you want them to have an opportunity to be creative and think outside the box? Pull up PBS KIDS ScratchJr. Is there something going on at home or in school that requires learning about sharing? Share the "Daniel Shares his Tigertastic Car" episode of Daniel Tiger's Neighborhood with them.

Consider your goals, and then choose media accordingly.

2. What do I want my kids to get out of their digital media time? How can it support our family schedule and priorities?

It is okay to factor your needs into the equation, mama. Deriving benefit from your child's screen time is no need to feel guilty. Go ahead and start dinner, or send that email, or yes (gasp), put your feet up and relax for a bit.

Once you've figured out your 'why,' it's time to consider the 'how.'

1. Communicate the plan to your kids (and be clear about limits).

Kids do best with clear boundaries and expectations. This will be especially important if you are implementing changes to how screen time is done in your home.

You could say, "You can play the Wild Kratts game for 30 minutes while I work on dinner, and then we are going to go outside and flap our wings as bats do! Do you think we should eat mosquitos for dinner like they do?!"

Before you start the show, Dreiske recommends planting the communication seed: "Today we're going to notice what we're feeling and what the characters are feeling."

2. Discuss what your kid played or watched.

When screen time is over, strike up a conversation. Dreiske suggests open-ended questions that help to "[create] a special space in which your child feels safe enough emotionally to confide in you about their experiences. Let the child's emotion or feelings 'lead' the talk rather than being obscured by your feelings." You can try the following starters:

  • How did you feel when… ? Why?
  • How do you think that character felt?
  • What if that happened to one of your friends?

3. Find a balance of activities.

Like everything in life, screen time is best in moderation. It is important that children know that screen time is one of the many options they have for activities. Exercise, outdoor play, reading, coloring and more are also incredibly important.

If there is a show or game your child particularly loves, DeWitt suggests finding the non-screen time version of it. "For example, if the kids in Dinosaur Train start a nature collection, suggest a nature walk through your neighborhood after they've watched. If your child likes Ready Jet Go!, use the Ready Jet Go Space Explorer app to look at the stars together and then continue exploring the night sky away from the screen. In other words, we can make digital media as a jumping off point for family fun!"

Sara DeWitt writes, "It helps to remember digital media is simply a tool, just like books, toys and art supplies. As parents, we have the power to decide how and when to use these tools with our kids."

When used thoughtfully, and with love, high-quality screen time is an incredibly powerful way to foster empathy and kindness in the next generation.

This article is sponsored by PBS KIDS. Thank you for supporting the brands that support Motherly and mamas.

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On Tuesday Connecticut became the eighth state (including D.C.) to pass and enact a paid family and medical leave program when Governor Ned Lamont signed the Paid Family and Medical Leave bill into law.

Today was a win for family leave advocates in Connecticut, as it's been a long road to getting this bill passed. At one point it was even suggested that Lamont would veto the bill, but in the end, lawmakers came to a consensus that it is in the best interest of parents, babies and basically everyone in Connecticut.

"We all agreed on the need to pass this landmark support for working families so they don't have to choose between the job they need and the family they love, or their own health," Lamont said earlier this month.

On Tuesday, he spoke again about how this was a victory for lawmakers and workers.

"Adopting this program means that workers who need to take time off for a new baby or recover from illness are not punished financially, and businesses do not risk losing good workers during those emergencies," he said.

Connecticut's plan is widely regarded as the most generous in the United States because workers will get 12 paid weeks of work to take care of a new baby, sick family member or take care of themselves. The benefits cover 95% of lower wage earner's pay, up to $900 a week.

Oh, and anyone experiencing complications from pregnancy can take an extra two weeks of paid leave to recover from that.

👏👏👏

Workers in the state will be able to start collecting these benefits in 2021 and the plan is funded through a 0.5% payroll tax, much like what other states and countries do.

In a statement to Motherly, Catherine Bailey the Deputy Director or Campaign for Paid Family Leave at Connecticut Women's Education and Legal Fund explained the campaign (a coalition of more than 75 organizations that has fought for paid family and medical leave) applauds the paid family and medical leave plan.

"Paid leave is a critical step forward for women's economic security, especially for low-wage workers and women of color who are an increasing number of primary breadwinners to their families."

She believes the plan will "provide economic stability when women and families need it most - when they need to care for themselves or a loved one, or welcome a new child."

Good job, Connecticut.

[Correction: A previous version of this post said 12 weeks is 4 months, it's not quite 3 months. We regret the error.]

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There are many heartwarming stories out there about people with different disabilities defying the odds. So many that Leigh Merryday Porch, mom to a 10-year-old autistic boy from Florida, felt the need to share her story—which paints a different perspective—on Facebook.

Merryday Porch told People in an interview "the accomplishments are beautiful, what's disturbing are the lessons people try to take away—that if you just follow the formula someone else did, that any child with a disability can do the same. It's oversimplified and ultimately hints that any other outcome is less worthy."

The facebook post, which has been shared over 250 times, reads:

"If you have an autistic child, you've seen the stories. Friends tend to tag you in them or PM you to share. They're stories of autistic kids who didn't talk but do now, children who sing the national anthem, young women who compete in beauty pageants, and those on the spectrum who graduate from college. And you don't mind the stories, because human beings persevering in the face of adversity is a beautiful thing.

But invariably, somewhere in the story is a quote that goes something like this:

"When experts told her her son would never talk, never have friends, never graduate, she declared 'Over my dead body.'"

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Those quotes are all sorts of inspirational—for some. But if you have a child whose disability is severe, such quotes are felt like a slap. Because some disabilities cannot be overcome. They can be accepted, worked with, planned for, and accommodated, but no amount of parental love and determination can erase them. Callum is not going to go to law school. He's simply not wired for that, and I can't rewire him. The fact that I can accept that and love him unconditionally does not reflect him having not been raised by someone willing to try harder.

Because—over my dead body—will he be relegated as somehow less worthy for not doing the unexpected and unrealistic. The presence of an autistic adult in the world who doesn't make the newspaper is not a statement of failure. Not of society, not of his family, and certainly not of himself. And other than steadfastly insisting he be given every reasonable opportunity any other person has to live, learn, and grow, no other declarations need be made—and no dead bodies required."

Thank you for your honesty mama.

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Life

You can write up a birth plan and pack your hospital bags well in advance, but here's the truth: Having a baby doesn't always go according to plan. You can anticipate a vaginal delivery and wind up having a C-section, go into labor before you've completed your nursery, find yourself very pregnant days after your due date has passed...or, in rarer cases, you could end up having your baby before you've made it to the hospital or birthing center where you'd planned to deliver.

Take Jessa Duggar Seewald, for example. The Counting On star recently gave birth to her third child, a little girl named Ivy Jane Seewald. But while the TV personality didn't plan on having a home birth, that became her reality when she went into labor ahead of her due date.

"My water broke right here in the kitchen," Jessa explains in a video from TLC. "Our birth plan through this whole pregnancy was that we would deliver at a birthing suite at the hospital with a midwife there. However, the morning that my water broke was the morning that my midwife had left town for a week."

Jessa and her husband, Ben, go on to explain that she was about 10 days ahead of her due date and wasn't expecting to have the baby early at this point. When Jessa and Ben realized they'd inevitably deliver before they could proceed with their plan, they decided to call another midwife in and go for a home birth. At that point, Jessa opted to speed up her labor with the help of a castor oil smoothie (note: You should chat with a medical professional before trying this at home) and some light exercise.

The video follows the mother of three through much of her labor and, eventually, the birth of her baby girl... which happened right there on the Seewald's couch. Don't worry: The sofa was covered with pads before the big moment!

Home births are totally an option for some moms 

Unfortunately, Jessa encountered something pretty scary after she delivered: Her bleeding wouldn't stop, which prompted the family to call 911. Luckily, all appears to be well with both the mama and her sweet daughter now.

Jessa's home birth wasn't like most home births, which can be a totally viable option in specific situations.

"Home births are a wonderful option for women with low-risk pregnancies, who want to have low intervention births in the comfort of their own home," says Diana Spalding, Digital Education Editor for Motherly, who is also a pediatric nurse and midwife. "ACOG [the American College of Obstetricians and Gynecologists] states that while they believe hospitals and in-hospital birthing centers to be the safest place to have a baby, women should be supported when they choose home birth in the presence of [a qualified midwife]. If you are considering a home birth, a bit of research is involved. Reach out to local home birth midwives to have in-depth conversations about your specific scenario. And don't forget to contact your insurance company—it's not always covered."

As wild as her birth experience was, Jessa isn't the only celeb mom to have had a home birth—she follows in the footsteps of fellow mamas like Hilary Duff. It just goes to show that delivering a baby looks different for each mama, but whether it goes according to plan or not, it's all pretty beautiful.

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News

Some women are more at risk than others when it comes to being pregnant. Black moms are up to four times more likely to die from complications of pregnancy and childbirth and another group, Native American and Alaska Native women, are also dying from complications in childbirth at a disproportionate rate.

Native American and Native Alaskans make up just 2% of the total U.S. population but account for the second highest number of maternal deaths in the only industrialized country where maternal deaths, overall, are rising. They are approximately 3.3 and 2.5 times more likely, respectively, to die while pregnant or as new moms than white women are.

Alarming statistics released by the Centers for Disease Control and Prevention (CDC) in May 2019 show that between 2011–2015, black women had the highest maternal death rate at 43 deaths per 100,000 live births, followed by American Indian and Alaska Native women at nearly 33 deaths. Thirteen white mothers died in the same time period.

"Racial disparities in maternal mortality are staggering" 

"More women die in the US from pregnancy-related complications than in any other developed country," the American College of Obstetricians and Gynecologists (ACOG) states on its website. According to the ACOG, the "racial disparities in maternal mortality are staggering…"

According to the CDC, 60% of maternal deaths are preventable. The leading causes of deaths during pregnancy, birth and the first year after childbirth include cardiovascular conditions, infection, and hemorrhage, but preventative strategies—including improving access to care and how it is coordinated and delivered—could save lives.

And in order to save lives, we have to acknowledge that Native American and Native Alaskan moms are dying because the health care system is failing them.

Meet Nicolle Gonzales 

Nicolle Gonzales is a Dine' Nurse-Midwife and the founder of the non-profit Changing Woman Initiative (CWI), in Santa Fe, New Mexico. A Native American-centered women's health collective, CWI aims to improve the health of expectant mothers, but Gonzales tells Motherly that she's been frustrated by a lack of information around native women's health available to medical professionals.

"When I attended conferences where they claimed to focus on Native American women's health, I found them sharing data that did not tell the full story about why our health outcomes were so bad," said Gonzales. "Further, blames seemed to be placed on native women and that it was their behavior that was the cause. I also saw the same old health frameworks being used to address known health disparities and then they would sit back and wonder why the outcomes were still terrible."

Gonzales witnessed many Native American women struggling with navigating the western medical healthcare system throughout her career. She saw assimilation practices from birth and on, that stopped Native American families from "bringing their loved ones into this world in a culturally supported and ceremonial way."

The disconnect helped inspire Gonzales to launch CWI in the fall of 2018.

Prenatal care can be culturally centered and accessible

It's on a mission to renew cultural birth knowledge, promote reproductive wellness, to support healing through holistic approaches and to strengthen women's bonds to family and community. The non-profit organization also provides training to increase the number of Indigenous midwives and encourage policy advocacy related to native women's health.

Gonzales believes some of the reasons behind the higher rates of birth mortality in Native American women are socio/economically and culturally linked. There are longer wait times to see obstetricians and/or midwives in native communities because of the remoteness of some reservations, she explains. Sometimes it's a lack of having a Medicaid card at the time of appointment, having no transportation or not making prenatal care a priority, Gonzales continues.

She believes taking the initial steps to seek medical care are crucial and wants to see moms better supported to do so. "First-trimester prenatal visits are very important. They identify health risks early, genetic screenings can be done sooner, and social circumstances and resources can be brought in," Gonzales says.

According to Gonzales' expertise, native women are at higher risk for adverse birth outcomes due to higher rates of gestational diabetes, hypertension, obesity, blood clotting disorders, drug addictions and limited access to healthcare education.

A less talked about cause of birth mortality rates for Native American women is intimate partner violence, she added. "There are limited places Native American women can go for safety and they are more likely to experience this or die from violence during their pregnancy."

The Changing Woman Initiative

The CWI also provides expectant mothers with access to healthy foods, plants and traditional medicines and time with a traditional doctor commonly called 'a medicine person.' It's a one-of-a-kind approach to a serious problem and the CWI is working to change the statistics from within its own community.

In the next three years, it aims to provide an Indigenous doula and peer counselor training to over 100 women in New Mexico.

The CDC study states that reducing pregnancy-related deaths requires reviewing and learning from each death, improving women's health, and reducing social inequities across the life span, as well as ensuring quality care for pregnant and postpartum periods, and for providers and patients to work together to optimally manage chronic health conditions.

America cannot save the lives of Native mothers if it doesn't understand why they are at risk, and supporting women who can provide culturally appropriate care—and listening to them—is vital.

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