Megan Thomas follows up her heart wrenching birth story with what I am calling a love story. The dedication of her husband during her postpartum period is unwavering. She is right though, dads need support. If you know a dad that needs support, encourage him to visit Postpartum International for more resources for dads.  

Thank you again for sharing your story Megan.

Holding the umbrella,

Elizabeth 

The following blog post is the story of a guest blogger. It is a heart-wrenching story of birth trauma and taking it one moment at a time.  
Thank you Megan for your strength and willingness to open up about your experiences. 

Holding the Umbrella,
Elizabeth 

Nothing went as expected! I couldn't breastfeed, I couldn't get up and care for my baby; I couldn't even care for myself! I expected to fall instantly in love with this little human I helped create and be in this perfect bubble of joy and bliss and smiles. Well someone burst my bubble! Instead I was filled with pain, sadness, and guilt. I had a friend that delivered about a month after me and when I asked how her delivery went she said it was splendid and she loved it. 

What?? What was wrong with me then? I never expected to feel this way but I did. I had to leave the hospital with an external drain coming out of my kidney because they could not operate to repair the ureter until I had healed from the c-section. I had what is called a nephrostomy tube and I had it for 8 long weeks. One of the hardest parts for me was the constant physical reminder of what I was going through. It was bad enough that I was in pain from the C-section and also from trying to delivery vaginally but the tube coming out of my kidney was a whole new pain.

​I couldn't get up without help, I could barely walk. When Ella cried, I couldn't get up and take care of her. It was always kind of an unspoken rule between my husband and I that I would be the primary caregiver for the baby. ​

This can be pretty scary really!  

*** Resume Reading Here***
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Then I remember how brave I was to get help.  How important it was for me and my children that I sought medical treatment.  That I let go of my ego and stopped trying to "power" through.  By getting treatment, I took a huge step to reduce these risks and improve the health of my children.  This is the thread I hold onto when the guilt starts trying to eat me alive.  My saving grace.  

So to focus on the positives, I am sharing a few images of my beautiful, healthy children. Please feel free to share yours too!

Splashing in puddles with the kids,


Elizabeth 

August is National Breastfeeding Month, the first week (8/1-8/7) is World Breastfeeding Week and the last week (8/25-8/31) is Black Breastfeeding Week.  Thus, it is a time of increased breastfeeding advocacy and celebration. It is not a time to shame non-breastfeeding families. In fact, as a breastfeeding advocate, certified lactation counselor, and breastfeeding mother, nothing irritates me more than an attack on a formula feeding family.  

​My advocacy and promotion for increased breastfeeding support is not an attack on the use of formula.  It is an attack on the lack of appropriate social support that fails the moms who wanted to breastfeed. My celebration is about how far we have come, while simultaneously recognizing how much more work there is to be done.

We will be celebrating at the Tampa Bay Breastfeeding Task Force's Big Latch On on August 6th and at the Black Breastfeeding Week Celebration on Aug 27th. 

Caught in a landslide..no escape from reality... (I am sorry, kind of) 

Yesterday morning, I was semi-daydreaming through a workshop titled “Expectations in Relationships”.  While the workshop was focused on romantic relationships, I couldn’t help but think about a different relationship and the expectations I had once held for motherhood.  The definition of expectation is “the act or state of looking forward; a strong belief that something will happen or be the case in the future.”

The goals of the workshop were to decide if we should have expectations? Identify Healthy Vs. Unhealthy Expectations, and to offer tools to build healthy expectations.

Immediately I thought about how Motherhood is rampant with misconceptions, expectations, and idealizations that unlike the gradual reality of a romantic relationship, are typically thrust upon you in one final push. 
Some healthy examples of expectations for relationships included: my partner will communicate with me and my partner will put in their share of the work.  Unhealthy examples included, my partner will know what I am thinking, and my partner will complete me or make me fully happy.
Comparing the examples to the list of “Motherhood Expectations” I solicited from an online group of moms, I found that many moms are entering this relationship full of unrealistic and unhealthy expectations for themselves, their partners, and their babies.  The crash of reality with these unrealistic expectations has to do damage mentally, emotionally, and socially. 

Where do our Motherhood Expectations come from?

Expectations typically come from our experiences (ie, we decide to do things or not to do things the way our mother did them), our past experiences with infants, and societal norms. One way our unrealistic expectations are allowed to develop is the fact that nobody talks about the ugly, the unpleasant, or the unmentionable. We often only see the pretty side of motherhood, amazing birth photos or new nursing mom's with a happy baby perfectly latched, or my personal favorite, calmly sleeping babies in a beautifully decorated nursery. Social Media highlights the joys and precious moments. What about the sore bottoms and chapped nipples? Friend and mentor Sarah Workman Checcone of Postpartum Society of Florida decided to change this by discussing the unspoken details in her book From Bump to Grind.  

Let's look at some of the Motherhood Expectations voiced by the mom's group members.

1. There would be an INSTANT, OBVIOUS BOND with my baby.
2.  Breastfeeding would feel natural or be easy.
3. I would understand what my baby needs by the sound of her cries.
4. I would lose my baby weight by taking daily jogs through the park.
5. My house would be clean, and I would have plenty of time to prepare healthy dinners for my partner.
6. I would be able to set an evening routine: dinner, bath, bedtime for baby, cuddle time for partner and I.
7. Baby will accommodate my set routine and we would live happily ever after.
8. I would spend my days drinking Starbucks, lazily window shopping Target, rocking an adorable messy mom bun and yoga pants. 
9. Being a mom would make me feel complete and happy.

 
Full disclosure, for my first son, some of these expectations were met.  So I had no reason to believe otherwise that there weren’t universal truths.  And in the same manner, some realities were blown with him, so my second time around I had no expectation of a clean house, healthy prepped dinners, or routine.  But each expectation or “ideal” we strive for, is an opportunity for disappointment. 

Part of me laughs as I say the easiest way to deal with this disappointment is to drop the expectations.  But realistically, we will have expectations.  So, based on the suggestions from the presentation, I would like to offer some tools, or tips really, for creating healthy expectations.

1. Be Realistic. Anything that says ALWAYS or NEVER is a dead giveaway of being unattainable. 
2. Ask “Why?”  "Where did this expectation come from?"  "Is it a valued standard for me to follow?"
3. Accept differences.  There is no one way to parent, and you won’t do it the same way every time.  Your partner will have differences and the relationships between you and your baby will be different than that of your baby and anyone else.
4. Respect changes.  See above.  It is okay to amend your expectations to fit your reality.
5. Respect the rights of your partner, your baby and other family members.
6. Maintain open communication with your partner and other loved ones. 

Occasionally, even when we manage to lower our expectations, we discover that something about motherhood just doesn’t meet the bar.  When these expectations are unmet, it is common to feel upset.  So I leave you with a few reminders of what to do when you find yourself disappointed by unmet expectations. 

1. First, Remember that NO ONE can (or should) do it ALL, and definitely not ALL THE TIME.
2. Avoid comparisons to others.  Remember that their reality and your perception of their reality likely differ greatly.
3. Finally, be gentle to yourself.  If you are having a rough day, talk to yourself like you would your best friend. 
4. If nothing else works, have a dance party (Now open your eyes, look up to the skies and see...)

​I remember asking Daniel to go get a pregnancy test. He scoffed at me and blew my instinct off because so many times I had felt pregnant and was wrong. Still he came home with a pregnancy test that night after work.

Unlike the 20 or so pregnancy tests I took hopefully expecting a positive result during my first marriage, this pregnancy test I was praying would be negative. I had just been laid off a few months earlier. Neither Daniel nor I had a driver’s license. I was 20 pounds heavier than my heaviest weight. I was not prepared to be pregnant. I knew this was the worst possible time in my life to be pregnant. There was no way after trying for 5 years and not getting pregnant. There was no way to conceive with out fertility treatment like I’d been told in my last marriage. How could this be happening now with no medical intervention?

Obviously the pregnancy test was positive, or I wouldn’t be writing about perinatal mood distress.
Daniel’s knee jerk reaction was, “What if we abort it? You really shouldn’t be pregnant or deliver a baby with all your health issues.”
I sat outside on our balcony. I thought about aborting the pregnancy. I thought about how I had always wanted to be a mom. I knew I had to have the baby. I had to give it a try because what if I never get pregnant again.

So we decided to have a baby. I wasn’t prepared for what happened next.

We moved the weekend following the positive test. This was December 2009, by Christmas we told our family.
Before New Year’s I realized something wasn’t right. I just felt so hopeless. I couldn’t eat. My mind was consumed about how everything in my life was going wrong. I had no money. I had no way to get around without depending on my mom. I had no health insurance.
The uncontrollable crying began. The intrusive thoughts, of hurting myself or falling on my uterus causing the baby to be aborted, began.

I told my mom and Dan about my fears. We took steps to find help. I got my proof of pregnancy from the health department. I called an Ob/Gyn to help me find a provider to take me to provide treatment for my depression during my prenatal care. I was told sure they would give me prenatal care as self pay but I had to see a psychiatrist for depression. I called psychiatrists and they told me that I needed to see an OB for it because I was pregnant.
I remember going to PEHMS Emergency Adult office downtown St. Pete. I stood at the receptionist window sobbing. The lady was nice, but she told me because I had no insurance and no Medicaid, I was ineligible for services. She also said, “It’s normal to be so tearful in pregnancy, it’s just the hormones.”

Even with my attempts to find treatment, I received nothing. No meds, no counseling, nothing. My depression and isolation worsened. I began looking into midwives and birth centers. Insurance policies and finances excluded many of these options. I had some prenatal care at one office, but I wasn’t happy with my care there. I went to Breath of Life and spoke to Chris Hildebrandt. She listened, she didn’t dismiss my depression. She recommended Family Systems of Care.
After an intake session and setting up some case manager visits at home I got to be seen at Directions for mental health with a counselor. My first counselor there again dismissed my issues as pregnancy related and told me that everything would be better once I had baby. I was so distraught, I felt belittled and ignored by yet another person dismissing my condition.

I spoke up to my case manager and was assigned a new therapist. Finally I had a therapist that I could work with. I also began seeing a psychiatrist about the possibility of taking medicine. Things got better. The light at the end of the tunnel could be seen.

That light ended with a beautiful baby. I am so happy to be raising a delightful little boy. I still struggle with mental illness, but I now know it is common and can be treated when caught by knowledgeable and caring providers.

I want all moms and anyone that works with moms to know that pregnancy or prenatal depression is real. It isn’t just hormones, though it can be exacerbated by the hormones of pregnancy. I want providers to know that treating mood disorders like they are simply side effects of pregnancy or the postpartum period and not addressing the root illness is the ultimate reinforcement that mothers don’t matter. There were more instances of my experience being dismissed I only mention the most memorable. These examples of dismissal say to me that women’s mental health issues aren’t important enough to be dealt with and treated. I ask myself, “How do psychiatrists not have knowledge of prescribing medications during pregnancy? How do obstetricians not know more about how to address refer and treat women who sit on their exam tables suffering?”

Due to my experiences, I desperately feel that appropriate care for moms experiencing perinatal mood and anxiety disorders is a human rights issue. Thankfully, Chris caught me and directed me to Family systems of care, who helped me obtain treatment at directions was my salvation. Sadly, Directions is currently unfunded.

So who is helping moms like me today? That's right, I am.

Holding Umbrellas,

Cat, a fellow Seventh Mom

Tired of so many moms saying to her, "I wish someone had told me...", our mentor and friend, Sarah Workman Checcone has even written a semi autobiographical book about all the things they don't tell you about labor, birth, breastfeeding and the postpartum experience. Her book, Bump to Grind is a very point blank reality check for many moms.
(NOTE: Bump to Grind is the story of many mothers, but Elizabeth suggests to balance your childbirth education with something like Ina May's Guide to Childbirth and to talk with as many moms as possible to get a better picture of the various ways birth happens.)

​​I don't know if I should even get into all the things I was wrong about becoming a mother. The process of becoming a mother, followed by parenting a tiny little human is full of possibilities for making what I used to consider mistakes. Pregnancy, labor, hospitals, feeding, sleeping, toys, clothes, cartoons, mothers and mother-in-laws. For instance, after the birth of my first child, I vowed never to wear those ridiculous mesh panties again, and held to the promise through two more babies.  Enter baby number four and hello cheesecloth underwear.  Again. I was wrong.

In our year of conversations, Elizabeth and I have discovered many similarities in unmet expectations.  I, too, was once a woman who thought if I have the most beautiful, amazing, natural birth, I'll will avoid postpartum depression. Guess what home birth moms can and do struggle with perinatal distress as well. Elizabeth shared her story recently about how her reality challenged her expectations after her perfect birth. 

I also believed that the feeling of detachment I experienced in pregnancy would go away as soon as I held my baby. I just knew all those happy mushy in-love feelings would simply appear the moment he was born. Nope. Not after I first held him. Not after we left the hospital. Not after I went back to work. Not after I quit my job and stayed home.  In fact, it took months before I actually felt like "I love this tiny human; I really love my baby". ​

Another mythic image of motherhood is the blissed-out new mom, breastfeeding with no trouble and no signs of lack of sleep. I can tell you now if a mom is breastfeeding or pumping she's giving up sleep somewhere and it's going to be visible. If she's formula feeding, she's also losing rest to feedings; possibly even more time than the mom who's nursing. Breastfeeding in itself can be mythical.
For some moms, breastfeeding comes almost second nature. For others, breastfeeding hurts or causes a multitude of other issues. There's poor latches, engorgement, thrush, and mastitis. I'm pretty convinced that difficulty with nursing or not meeting our own expectations can exasperate postpartum distress. Let's be real with new moms and moms to be. It's not going to be all sunshine and rainbows. For some women the hormones that our body produces associated with breastfeeding can really upset their mental state. And weaning depression, yeah it's a thing. it's a real thing for anyone who thinks that it's easy to just stop breastfeeding and move forward happily even when they had difficulty and did not enjoy breastfeeding, guess what they're wrong too. In fact ask my friend Cat, an IBCLC about breastfeeding and maternal mental health. Oh boy what she could tell you about false expectations! She voiced a multitude of concerns that we will have to share with you later.
For expectant moms, we suggest lining up the people you will need for breastfeeding support now. Find a local La Leche League group or Lactation Support Group. Moms that have a goal and a plan including the support of their partner are most likely to continue breastfeeding than those that don't prepare. Breastfeeding classes in Hillsborough County can been found here.

While reviewing Tuesday’s blog post about International Women’s Day, it occurred to me how happy I am to have my amazing, feisty daughter. I am excited to be pushing these initiatives today, to provide for her generation a better tomorrow for women. I am not only excited to guide Allison and aid her individual growth; but also am excited to see who she will become. I look forward to a future of strong female leaders in a society that takes care of mothers the way they deserve to be cared for.
​
But it wasn’t always this way. From the moment I was pregnant, I tried to deny I was pregnant with a girl. I was so brutally sick, depressed and anxious. I wasn’t ready to accept I could parent a girl. People would ask and excitedly say, “One of each!” I would fill with dread. I was perfectly happy to raise two little boys and their older bonus sister on the weekends. I already had a girl and I had the luxury of sharing the role model responsibility with her biological mother.

My family was undergoing a lot of external stress when we found out we were pregnant with a girl.  I luckily had read that girls withstand stress in the womb better, so I clung to that as a good thing.  At least my baby would be more resilient.  This was quickly counteracted with “WHO THINKS LIKE THIS?” screaming through my thoughts.  Calmly followed by, “You, you do, because it’s all you have to hold on to right now.”  My prenatal depression fed me lies.  Told me I wouldn’t be a good mom to a girl.  That I wouldn’t know what I was doing.  My disappointment fed into my guilt and the whole thing escalated beyond my control.  So I kept life moving, but underneath, I was an anxious, depressed kettle, ready to explode.

​After International Women’s Day, and my epiphany that maybe this wasn’t an individual thing, maybe, like perinatal distress, there are more moms experiencing this disappointment, fear and guilt.  So, I did what most moms would do, I turned to Google to find out.  I was blown away by how prevalent this issue appeared on mom blogs and discussion boards.  Notice the 282,000 google results!

I am glad other parents are speaking out about this issue!  It’s always nice to see that you’re not alone.  I attempted to access some scholarly articles, and the one I found that linked gender disappointment as a risk factor was based on a cohort of women in rural Tamil Nadu, India.  Interestingly enough, that study found that disappointment in having a girl was the concern for these mothers; while according to my completely unscientific review of the Internet, the western world seems to covet little girls.  I found this personally interesting.  The other studies I found on Google Scholar required paid memberships to access or a student ID.  In my motherly opinion, I feel strongly that gender disappointment in the USA has to be tied to unrealistic expectations in American parenting (a subject I feel very soap boxy about, so let’s catch up another time). I would love to see more research and a transparent examination of gender disappointment; why it happens, how to help reduce the occurrence, and how to cope with it. 

Realizing how much I love being a strong woman, made me realize how excited I am to raise a strong woman.  Yes, it made me twinge with guilt for not embracing my daughter earlier, but also made me realize that I have embraced her fully. For this I am beyond  grateful.  She is my driving force and when (if) she has babies, postpartum life in America will be vastly different.  This mama is making sure of it. ​

So tell me, did you experience mixed feelings when you found out the gender of your baby?

Reflecting on the rain,
 

Elizabeth