You want to see someone shaken to their core? Take a corporate executive or schoolteacher or engineer or government clerk or whomever and leave them at home, alone with the mystery of a screaming, starving new person who is also trying to navigate an uncharted experience – life outside the womb. Oh and to add to the fun of figuring out this life-and-death situation: If you have delivered this baby, your body has recently performed astonishing feats. Take some time in bed to recover? Ha! No, no. Your sleep pattern is going to look something like two hours at a time for the next few weeks or even months. It's like some kind of cosmic joke.
The popular narrative around pregnancy and new parenthood suggests a blissful experience: beatific mother and child, glowing, glorious – ah, so this is what I was put on the planet to do.
But this magnificent experience can also be overwhelming, even terrifying. When you're in the infant trenches – unshowered, sleep-deprived, with sore nipples and a depleted spirit – you need support. You certainly don't need additional pressure.
This week, the American College of Obstetricians and Gynecologists published revised guidelines on infant feeding. While exclusive breastfeeding is still recommended for the first six months, health-care providers should "respect and support" an informed decision not to breastfeed. Also this week, the U.S. Preventive Services Task Force recommended screening adults for depression, specifically mentioning pregnant and postpartum women, for whom depression is "common" and "affects not only the woman but her child as well."
To quote the song I sang to my screaming, acid reflux-suffering, premature baby every night as I desperately tried to get him to sleep: Hallelujah.
When it comes to feeding your baby, breast is best – and can be an extremely fulfilling (if at times painful and frustrating) experience for the mother. (That, I would like to add, can and should be done anywhere.) But for those having trouble, being pressured – even shamed – to persist can be pretty devastating. Especially for a woman who may already be experiencing feelings of guilt and inadequacy over having a child she is unable to feed the way nature intended – as she keeps being reminded.
(People feel a certain permission to weigh in on baby-care issues – including the f-word. A stranger in the supermarket aisle may offer an impromptu lecture if she spots formula in your cart.)
When I was in that world, I saw women who couldn't breastfeed go to great lengths for their babies. One woman pumped and bottle-fed her son for six months – hugely laborious and stressful. Another hooked up a device that allowed her baby to feed at the breast – even formula. I was fortunate; when I had challenges, I was able to access the milk bank at B.C. Women's Hospital.
But I wonder: If the heroic efforts are draining the already exhausted new mother, but she feels compelled to persevere – maybe against her will – what impact is her stress having on her baby?
I'm glad the pendulum has swung to the right place (when I was born, formula was recommended), but breastfeeding has become a political minefield. And we should not be comfortable with that.
This week's other recommendation, about screening for depression, is so utterly important for new mothers. It's one way to help a woman at what might be one of the most difficult times of her life – even if it's the best thing that's ever happened to her.
When I had my baby, British Columbia had a program where a public health nurse would visit you the day after your discharge from hospital, no matter your circumstances, income or risk factors (or lack thereof). This has been scaled back. Now you get a phone call – and a visit only if it's determined that you need one. I know that I never would have asked. And I needed it.
When you're pregnant, so much emphasis is placed on the birth itself. You go to prenatal classes and learn what to expect at delivery, discuss pain management, try out some positions and learn how to construct a birth plan. That's all good, but I think we need more emphasis on what happens later. After all, when you're giving birth, you're usually with professionals. Once you're home, alone, with no pediatric nurse in sight and just a shelf full of possibly contradictory baby books to help you determine if that wail means hungry, wet, tired or go directly to the emergency room – that's when you need help.
I have seen people step up and do amazing things for new parents – way beyond a casserole at the doorstep. A stranger, probably recognizing that I was alone and frazzled, invited me out with a group of moms after our first salsa babies class (moms salsa while wearing their infants in a Baby Bjorn or equivalent – hey it gets you out of the house). When friends became adoptive dads of a newborn with a few hours' notice, breastfeeding women in the neighbourhood began dropping off bottles of milk. Beautiful acts of kindness. But not everyone can count on that kind of support.
Having a baby may be the most important and most difficult thing you ever do. The baby's health is paramount, of course – but the mother's well-being is inextricably linked to that. The system needs to be responsive to the unique challenges of this crucial period – for mother and baby. Anything less is a crying shame.
Marsha Lederman