Wellness hasn’t been a topic I’ve covered in the past, but recently I’ve been craving a way to amalgamate some of the health-focused materials I’ve been consuming. I’ve always had a habit of taking notes so I can revisit ideas that resonate with me at a later date. It occurred to me that I might launch a project within my website, whereby I’ll publish an abbreviated collection of themes, ideas and direct quotes from podcasts and books that I find impactful. I hope it will be especially useful for those who can’t find the time to read a book cover-to-cover or dig through a two hour podcast.
If something resonates with you, let me know by dropping a comment at the bottom of this page. Or, go ahead and make a recommendation if you think there’s a book, documentary or podcast you think I’d like and I’ll check it out.
Title: Postpartum Anxiety & the Motherhood Shift
Who: guest Psychiatrist Catherine Birndorf, M.D. + Goop CCO Elise Loehnen
Themes: mothering the mother; postnatal hormones
Listen to the full episode: https://goop.com/the-goop-podcast/postpartum-anxiety-the-motherhood-shift/
Please note, in transcribing this conversation, I have made minor edits for clarity.
[4:27] Birndorf: There’s this beautiful word called “matrescence”, which is like adolescence and I love these two words. Adolescence is very well known and people recognize it as this bumpy, changing, tumultuous time where your body changes, and your attitude and hormones are raging. And thank god we get through it.
Matrescence is the same thing about becoming a mother. Adolescence, which we respect as a crazy time in life, it ends. Matrescence happens and we think of this as this beautiful, blissful, natural “thing” that should happen to every woman; that it’s maternal destiny. What? It is like a nuclear bomb goes off; it’s a big deal. Everyone has to grapple with that shift in identity in becoming a mother.
Pregnant princess becomes postpartum peasant
[6:15] Loehnen: You become pregnant. You go to the doctor with increasing regularity. There’s so much attention on you; how you’re doing, what’s happening with the baby, etc. You go through this extreme physical experience, which I think is sort of like losing your virginity in some ways. There’s so much expectation and you’re like, “That hurt and I’m so tired,” and then you’re kind of abandoned. The shift is entirely on your child…and you are essentially a discarded vessel.
[7:02] Birndorf: Pregnant princess becomes postpartum peasant. We forget [her], it’s all about the baby. That is very much true of our North American culture. That is not true everywhere. Other cultures do it so much better. They coddle the mother; they celebrate the mother; they take care of the mother. And somebody else is helping with the kid; families. We’re a splintered [society], very independent. We don’t all live around our families. It’s just a different context. The landscape is so different but it’s also a mentality. You’re celebrated as a pregnant person. The minute that baby comes out, you’re sort of a discarded vessel. But you just went through the biggest, most profound bodily experience you can go through. And then you have essentially a major medical condition – I don’t mean to pathologize it – but if you have surgery, people respect surgery. No one respects a C-section as a surgical intervention from which one needs to recover. Even a vaginal delivery requires tremendous recovery. These are profound shifts in the physical being that we respect, but we forget about five minutes later.
Where’s the village?
[9:55] Loehnen: It’s that lack of alloparenting; there’s no more village. You’re alone and there’s this expectation that you should be able to handle it.
[11:20] Loehnen: Friends of mine who haven’t had amazing relationships with their own parents are like, “My mom wants to come and stay,” and I’m like, “Does she cook? Does she clean?” The baby is fine; the baby is sleeping. She can come and take care of you. So many women were missing that. Who is nurturing you?
[13:20] Birndorf: I do think it would be great if we had a better ritualistic process for immediately postpartum women, where we care while women repair and heal from the delivery. We all need to be mothered as we’re looking at our new roles and trying to make sense of it. Who was my mother? What did I get from her? I remember saying to my own mother, “I can’t believe what you did for me. God I didn’t appreciate you.” It didn’t occur to me to say that until I had my own kid. It’s just such an interesting, complex transition that for many people requires mothering.
Not PPD, but not okay
[15:16] Birndorf on postpartum depression: The reason we don’t know about anxiety is because the word depression doesn’t say the word anxiety in it. We’re trying to bring a new phrase into the lexicon: perinatal mood and anxiety disorder. (PMAD) Postpartum depression doesn’t capture it so women will come into the Motherhood Center and say, “I was miserable. I was anxious. I was up all night. But I wasn’t depressed so I didn’t have PPD.” Well, you had something that wasn’t making you feel good. We could have helped you had you come in. Or we could have identified that as something worth talking about. Not necessarily throwing medicine at you or hospitalization. Just talk about it; identify it; call it what it is and then talk about ways to feel less anxious. Because anxiety is very entwined with depression. They’re sort of alter egos of each other.
Anxiety & the blues
[20:48] Birndorf: Progesterone has a metabolite called allopregnanolone that skyrockets during pregnancy and has the effects of an anti-anxiety medication. It is not a guarantee so don’t think that if you’re an anxious person and you get pregnant it’s all going to be great. But for some people they get relief, they feel calmed at some points – but not always. After your hormones have gone to their highest levels towards the end of pregnancy, you deliver and the precipitous fall is that delta between the height and the bottom…and then things are trying to calibrate. It’s the fluctuation in hormonal balance that makes almost everybody feel nuts. Those are the blues. The blues, we know, are caused by those initial hormonal shifts. Hypersensitivity, mood goes up and down, you cry if someone looks at you the wrong way – that passes. That passes within two weeks. If it doesn’t pass or you came into it not feeling well, then we have a different situation on our hands. But up 80 percent of people will have that hormonal hypersensitivity we call the blues.
Food for thought
Women who are mothers intuitively know what first-time moms will need immediately following delivery, and in the weeks that follow. Let us rally around the parents of newborns – without getting in the way. No lectures, no self-righteousness, no judgement. Be useful. Don’t ask what she needs. (She’ll probably say, “Nothing!”) New parents don’t need visitors, they need staff. Ask what you can pick up on the way over. Insistently ask which explicit task you can help with before leaving. Ie: unloading the dishwasher, folding laundry, tidying up the kitchen, vacuuming, taking the dog for a walk, holding baby while she showers, etc.
Elise’s comment about moms/mother-in-laws wanting to come stay really resonated with me. While we live in a one-bedroom apartment and are unable to host a mom, you can be sure that for our second child (when we presumably live in a townhouse) I will throw open the doors and invite them for an extended stay. I wish I had had the opportunity to be mothered as a new mom. It’s an extra set of hands to hand off baby, tidy up the kitchen, or heat up a meal. It’s also a voice of encouragement, and a person who will draw you a bath, turn off the lamp when you spontaneously doze off, and restock your pads without asking. (Hopefully this describes how your mom would react.) However, as Dr. Birndorf alluded to, many people no longer live in close proximity to family; there are less people in our proverbial villages.
I also love the label ‘matrescence’. Giving this period of dynamic transformation a name has two upsides. First, it suggests that it will end. That no, this is not your new enduring physical and mental state. And second, it reminds new moms to be kinder to themselves. The physical recovery, a hormone bath, your new identity, baby-related tasks, sleep deprivation, your new marriage dynamic and household management; it’s a giant bubbling stew that might – okay, will very likely – boil over at some point.
Thoughts? Comment below!