Emotional Stages of Postpartum

Most of us know about the emotional and physical signs of labor progression (and if you don't, consider signing up for the next EB local or online class)... however, we're still a little foggy on the postpartum period and the expectations of a new family.  Interestingly, there seems to be an emotional progression typical of a mother after the birth of her baby - it looks a little something like this:

  • Birth High - The mother is high on oxytocin, bonding with her baby, empowered by this feat she just accomplished, and retelling the events.  Important to note, this doesn't only happen in a vaginal unmedicated birth - but also in any type of birth that the mother felt well supported and made positive active decisions for her birth.  If you want to put a number on it, this is the first few days/week after the birth, until around the time the milk matures.
  • Let Down - We'll describe this metaphorically and physically.  When the milk matures, the hormones shift and the milk starts to "let down."  This little physical let down is followed by a surge of oxytocin that is incredibly beneficial to pick us up when the going gets tough and sends a release of prolactin that helps us feel motherly and a small sense of release.  This is also the time when mothers come down off their birth high and reality starts to set in.  They might begin to question their birth experience (even a "perfect" birth), retelling the details (which may be foggy in this postpartum haze of emotional and physical sensations) or just generally need some extra sleep.  The rush of visitors and even help may decrease and mom starts to do more on her own.  The babymoon is often over and the family might start to get a little cabin fever - especially mom if dad has went back to work already, and the kids if they aren't playing like they're used to.  This is when support really needs to continue and mothers may need to be reminded to rest.  If breastfeeding has been a bit difficult, it really starts to wear on mom and she needs advice, encouragement, and general social time without overstimulating the new baby, family, or mother.  Someone needs to come play with the older kids and help tidy up around the house or let mom shower alone for a few minutes.  Maybe a blanket outside, or a brief, low key, picnic in the park (with someone to watch and occupy the older kids) would be helpful if the weather permits to keep the oxytocin high and mother feeling motherly.
  • Metamorphosis- This is the turning point, and similar to what you might refer to as transition in labor, it might be the hardest part of postpartum.  Mom is either feeling great and moving on, or she is really worn down and needs uplifted - but there is a beautiful butterfly that will emerge on the other side.  At this point, many of mom's support might not be around or the "newness" has worn off except for those immediately connected with the baby.  This is somewhere around 4-6 weeks postpartum - give or take - and also when postpartum depression tends to peak.  Mom needs supported.  It is still wonderful for her to get meals made, the house cleaned, and general social time.  This is often a time period when moms say "I'm done" with breastfeeding -  but take note, this is that same "I can't do this" attitude of labor transition and moms really need that extra bit of encouragement that "this too shall pass" and it is easier on the other side.  There are a significant amount of developmental changes happening in the baby at this stage, also, which triggers more nursing sessions and waking periods (and mom and baby may not have breastfeeding figured out at this point).  Breastfeeding doesn't typically become bliss until closer to 3-6 months when you're confident, milk supply is well established, and the growth spurts have slowed just a bit.  If mom is really happy with her birth experience, this is a boost that will be wonderful for this time.  If mom is not happy with her birth experience, it can really take a toll on her motivation, care, and emotional health.  Talk to mom about her birth experience, and remember to always put in a positive thought in the process.  This doesn't mean to discount any negative feelings of the birth - as "all that matters is...." is a ridiculous assumption - but to remember that we can reshape our memories of our births and it is important to talk about the positive with the negative as a way to work through any let down feelings of the experience.  An many cases, this transition period only lasts a few weeks - give or take - but for some moms, it can last a very long time, a sort of plateau, so to speak, if the disappointment isn't worked through.  Listen to mom, as with all perinatal stages - she will be your guide and her emotional progression is usually more significant than - and directly influences - her physical progression.
  • Empowerment - You've made it through.  You're either at peace with *your* perfect birth and things are going beautifully, or you're at peace with a positive look on the experience as a whole.  Your hormones are leveling out, and milk supply is on its way to being established for the rest of your breastfeeding relationship.  Lochia has likely stopped and you're probably into a routine (yes, a routine can be one that is all over the place, but simply follows baby's lead in a way of understanding their needs, cues, and cries).  You get a boost of confidence to feel empowered about your choices, your support, and your parenting relationship.  This doesn't make things perfect in everyone's eyes, or necessarily easy, but you have blossomed into the new mother that you were meant to be from this spiritual journey.  You may feel a sense of pride, and also a sense of hope for your next birth experience.  No two experiences are the same, but there are certainly similarities - and mostly maturity and inner growth.

Ultimately, this time is largely influenced by our birth experience and our support.  A positive, biological, birth experience is intended to give us the most endurance and motivation for this time.  Having anything other doesn't mean that we are ruined and can't handle postpartum - it simiply means that we're in a variation of normal, and might have a little something extra to work through.  Was your postpartum progression similar to this?  How can you relate, and how do you see this in others?