Two to Two

I went to sleep in the springtime
I awoke in summer

A riot of green,
a vibrant rush,
an air of energy

My body reclaimed and yet not my own
Inside out
the protective covering of conception gone

Gaunt fingers and ankles
ghosts of padded appendages
no longer needed to sustain life
for two

Whole again
and yet suddenly separate
A new path split
in two

When does a perinatal mood disorder start?

Please read on to pinpoint when you or a woman close to you will begin to see signs of a perinatal mood and/or anxiety disorder.

  • When two lines appear on the pregnancy test
  • When pregnancy is unexpected
  • When pregnancy is finally achieved
  • When pregnancy is not achieved
  • When the mother loses the baby
  • When the mother chooses not to have the baby
  • When the adoption falls through
  • When the drastic changes in lifestyle that having a baby will induce begin to occur:
    • nausea
    • extreme exhaustion
    • no more wine with dinner or beer after a rough day
    • limited mobility
  • When the hormones at flux in the pregnant body affect thought processes
    • heightened anxiety at the amazing responsibility of growing and then caring for a baby
    • fear of the unknown or varied outcomes of gestation, labor, delivery, and aftercare
    • ambivalence over the new self the mother must create or become
    • mourning the loss of the former self
  • When medication regimens must be altered due to unknown effects of routine prescriptions on the fetus
  • When mother worries and feels guilty about continuing medication and its effects on fetus
  • When mother suffers a loss during pregnancy
    postpartum_pathways_logo

    postpartumpathways.com

    • death of a loved one
    • separation from partner
  • When the mother has no partner or support person
  • When a drastic transition occurs during pregnancy
    • moving homes and/or locations
    • away from support network
    • loss of own or partner’s employment
  • When labor and/or delivery does not go as planned or expected
  • Traumatic labor and/or delivery
    • physical trauma
    • emotional or psychological trauma
  • Complicated recovery from labor and/or delivery
    • infection
    • injury
  • When adoption is complete
  • Unexpected medical condition in infant
  • Loss of infant
  • Difficulty feeding infant
    • breastfeeding
    • colic
    • reflux
    • allergies
    • tongue tied
  • Extreme fatigue recovering from labor and caring for newborn around the clock
  • No routine
  • No schedule
  • No down time – constantly being needed, touched, suckled
  • Disappointment at real life not matching imagined version of motherhood
  • Hormones further thrown into flux after baby-growing part of process complete
  • Stress
  • Too much interference and advice from others
  • Not enough support and help from others
  • Isolation
  • Weaning child from breast (days, weeks, years after birth)
  • Being sole caregiver for a fragile, totally dependent being

After reading this list, it should be an incredibly simple and precise process to pinpoint exactly when you or a woman close to you will exhibit signs of a perinatal mood disorder. Diagnosing and treating it should be even simpler. And recovery? Piece of cake.


Hopefully it is quite obvious that the way I’ve chosen to frame this list is tongue in cheek. The individual items on the list are anything but. They are varied; some mutually exclusive and many overlapping – to show that there is no one road map for predicting, preventing, diagnosing, or treating perinatal mood disorders. Perinatal mood disorders come in many different forms with many different time lines. The one surefire tool to helping yourself or a woman close to you who is suffering is awareness. Awareness of the myriad possible causes and many symptoms that can present. And then reaching out.

To her. To your physician. Midwife. OB. GYN. Pediatrician. Counselor. Therapist. Psychologist. Psychiatrist. Friend. Mother. Partner. Neighbor.

With an illness this insidious, multi-faceted, and far-reaching, silence is not an option. The lives of our mothers, babies, and families depend upon it.

Locked On

They put the baby lo-jack on the umbilical stump.

If I had to choose one phrase illustrating how relaxed my most recent and hopefully last tour of a maternity ward was, that would be it.

It may not seem like much, but to me, it’s a huge deal.

Over six years ago, it was an errant lo-jack slipping off my baby’s slender little ankle that precipitated my fall into postpartum mood and anxiety disorders (PPMAD). Her squirming and that slipping gave my irrational mind the fuel it needed to doubt whether I was taking home the right baby.

I haven’t had that fear this time or denial or doubt, and the nurse only mentioned that additional bit of information as we headed for the elevator, but it capped our visit in the best way possible. As the elevator doors slid shut, I looked at my husband with relief and said if she’d told us nothing else, our tour was worth that one statement.

It’s an odd sensation that washes over one as she walks the floors she knows she’ll next be pacing in pain. To see the calm, the fresh beds, the quiet daylight streaming in the windows. I know the harsh fluorescent lights will glare, the linens no longer be fresh, the quiet replaced with beeps and moans and directions. It’s enough to put anyone on edge – either a woman trying to anticipate something she’s never experienced before or one who knows all too well what to expect.

This fourth tour I’ve taken was the least anxious I’ve ever been, however. It was due in large part to the relaxed community atmosphere of this particular ward. I think I also have finally realized that how ever much I dread labor, there is no way around it, only through it.

The nurse was very low-key, gentle and calming, as she shared information and answered our questions. When I asked about labor positions and modifications due to a weak pubic bone, she explained how the end of the bed came off, a yoga ball could be used, a kneel or squat bar . . . she even said she’d make a note in my chart to request an automatic PT consult after the birth. I wanted to hug and kiss her.

And then she made my day even better when she shared the positioning of the lo-jack. I hadn’t mentioned anything about my postpartum experience last time. I hadn’t mentioned that a tiny locator device could be such a trigger. I hadn’t expressed any concerns about security. Maybe it was just that we were approaching the locked door of the ward as the tour ended, but she told us hospitals have changed procedure to attach the device on the umbilical stump because it can’t fall off.

With that one bit of information, that I hadn’t known I needed to hear or was even a possibility, my mind opened up. The iron grip of anxiety I’d unwittingly been living with lifted – if only enough to let me breathe. To see that this labor and delivery and recovery will be different. There will be no fear concerning the baby.

I am hers, she is mine. Everything will happen as it should.

baby feet

flickrhivemind

If You Give a Mom a Chore . . .

If you give a mom a chore, she’ll likely find three other things to be done before it.

If the corner of her room has to be cleared to make room for baby’s changing table, she’ll first vacuum the floor. She’ll move the bed to get under there. If she moves the bed, she’ll see the mangled metal blind she’s been meaning to put back in its bent brackets. Before she can replace the blind, she’ll need to wash the windows behind it. If she’s washing the windows, she’ll need to pull out the screens that need to be replaced. Saving the screens for another day, she uses the ball of clean sheets waiting on the side chair to change the bed – after she hangs the kids’ clothing that’s been waiting on top of the sheets. Chair clear, she turns to the writing desk she’ll eventually need to move as well. The desk itself will need to be dismantled and saved for another day, but first she’ll need to sort through and separate the absolutely essential papers and supplies, putting them in the smaller cart nearby. She needs to do that before the cart can be moved to a new corner in the dining room. To move the cart, she’ll have to move the tray table holding the sewing machine. Before she puts away the sewing machine, she’ll need to mend the fastener on the tankini top that won’t fit her right now anyway – and make that roman shade for which she’s been saving that fabric. When she moves the typewriter table and its antique occupant, she’ll have to clean the window behind that, too, adding its screen to her pile of replacements.

Are you as exhausted as I am just thinking about all this?

This is the way my anal-retentive, procedural, obsessive, perfectionist, over-achieving mind works. As I described an abbreviated version of this undertaking to a friend, she said I sounded liked the main character in If You Give a Mouse a Cookie. We both burst out laughing, as it was the perfect description. I am the mouse. Coo coo ca choo. Or something like that.

Though the mouse has a much more fun trajectory.

Do all these chores need to be completed before the simple placement of a changing table? No. But, in my mind, do I feel that they all need to be? Yes. Is it a chance to complete tasks long overdue? Yes. Is there a modicum of guilt and desire for redemption in finally completing them? Yes. Do I see the arrival of baby as a waypoint closing a window of opportunity at this point in my life? Yes. Is this a completely arbitrary creation of my mind? Yes.

A rational working through of it may help me realize the origin of such mouse mayhem, but the animal instinct driving it remains. I. still. need. to. follow. protocol. Whatever need for self-preservation I have – and physical exhaustion that comes with pregnancy – does keep me from manically pushing through the entire process at once. Well, that and three children, a husband, and a house to run.

But I’ve started the process. It’s well on its way – thank goodness – which means it’s almost done. Well, hopefully.

Hopefully, there’s also a cookie for me at the end of this trail.mouse cookie

 

Bitter Sweet

I never wanted another baby. I didn’t desire to hold one. I didn’t get the ‘aww’s and the itch when I’d see someone else’s. I wouldn’t wistfully remember packing them into footies when I saw someone with toddlers preparing to leave a late-night party.

I would bless my lucky stars it wasn’t me.

The very thought of returning to that period rife with anxiety and stress, dark anger and overwhelming feelings made me a bitter, sarcastic person. I was most certainly the old crone in the corner who said, better you than me.

raindrops

Jennifer Butler Basile

In fact, just this last summer, a friend and I attended an outdoor concert on the grounds of a winery. As we toasted each other in the camp chairs we’d squeezed into the back end of the event tent to avoid the rain, I thought how lovely it was to get away. We ate our cheese and crackers, we laughed, we reveled in our unfettered evening. As the clouds broke just before sunset, some people ventured onto the surrounding lawn and set up blankets. A stylish young mother in a flowing skirt with dark hair to match, swaddled her baby and rocked to the music. Though we hadn’t said a word to each other, both my friend and I watched the scene; for as soon as I opened my mouth, she knew exactly of whom I spoke.

“Good for her,” I said, in a tone that unmistakably meant – better her than me; taking an infant to an outdoor evening concert, contending with rain; controlling wine intake if he needs to breastfeed; leaving early if he gets cranky.

My friend laughed and, in effect, toasted that sentiment.

The very sight of a mother and child, lovely as it was, brought my back up in disdain, for fear of the anxiety that wasn’t far behind. I was here to escape; I wanted no such reminder of that part of my life I was trying to escape.

And yet, though feelings like this were very authentic, they didn’t sit well with me.

I loved my girls. I welcomed them willingly into my life. I may not have liked or gracefully handled every aspect of my days with them, but I was dedicated to the role and importance of family in the world.

And so, to scorn other people doing the same thing – it did not compute. I knew exactly how hard it was and should have been supportive rather than snarky. And I suppose I wasn’t overtly snarky, but my attitude toward life had changed. I think the snark helped me build a shell around my wounded psyche. I’d returned to real life, but I hadn’t healed. I needed some fail safe so my wounds didn’t weep everywhere while I went about my business.

In September, I got pregnant.

I had referred to number three as a surprise; what a poor example that was compared to this! Six years out from our youngest. All three kids: potty-trained and self-feeding; able to run around without a bodyguard; play dates with friends and some quiet time for us adults.

What!?

I felt really silly when I thought back to that scene at the concert. I’d served myself up a huge slice of humble pie. How could I have made such a remark and then go and do it to myself? But there was no way I could’ve held my tongue in preparation for what was to come. I never imagined it would be so.

In the days following the birth of our third, I slept fitfully while the baby dozed nearby. I awoke at one point in a cold sweat, having dreamt I was in labor, contracting forcefully. When I realized it was a dream, I thanked God it was over and prayed I’d never have to do it again. It was almost a PTSD reaction. (side note: my postpartum depression was swiftly developing and I’d had a traumatic recovery from labor)

Yet, here we were. Preparing to do it all over again. With a strange sense of calm. I’d had a spiritual epiphany of sorts at the start of my pregnancy that set me off on a good foot. But I also had already faced nearly everything of which I was afraid. I’d seen how shitty it could be – and how I’d survived.

Obviously not unscathed, given my snarky attitude, but I think that’s precisely why I find myself in this lovely predicament. This baby is a chance to wipe away all my negative associations with expecting and bringing a child into this world. Does that mean I’ll push out roses and sunshine? Hell, no. It’s going to be a hard road, but I feel this experience will also rebirth my wonder in life. My ability to see love and light in little faces and the tired faces of mothers. To once again give a shit, to stand and support myself and other mothers around me. To say, not only will you survive, but you will enter a place of peace – at some point.

light

Jennifer Butler Basile

All Sorts of Bombs

The hours that stretched between late afternoon and evening yesterday were tough.

I hustled my three girls off the bus and into the car, rushing off into the next installment of the ‘passport debacle’ (I may pen a frustrating short story of the same title). They were tired, hot, sticky, hungry, and probably would’ve had to pee if they weren’t so dehydrated from the high temperatures. After toting them through two venues and experiencing botched passport attempts (adding to the overall debacle), they hooted and hollered, spat and pinched the whole ride home. Home. The place where I got to give my husband a quick smooch, eat a hamburger right off the grill as I set the table for the sit-down dinner the rest of my family would be enjoying while I rushed off to a curriculum night at the school. School. The place that was boarded up tight because the curriculum night is, in fact, tonight. I got back in the car and thanked my lucky stars that I’d loaded Led Zeppelin II in the CD player so I wouldn’t go out of my ever-living mind. I promptly popped a bottle of beer when I got home and joined my husband on the porch. Trying to recount my frustration and agitation to him, I was repeatedly interrupted by our cherubs, one of whom snagged a butterfly net over my cranium, God bless her.

In a rare moment of calm, I said to him, life would be so much easier if we hadn’t had them.

That’s one of those statements you know you probably shouldn’t say out loud; that you know was a mistake as soon as you see your spouse’s face.

In his ever-present magnamity in the face of my melancholy, he replied, but we wouldn’t have the joy, either.

I know, you’re right, I sheepishly yet grudgingly replied. Still, my days the last week or so have been fine – until I have to get them off the bus.

And then – not with a lightning bolt, but with a gradual blossoming like a-bomb footage on slow mo – I realized that I’d have had depression anyway – with or without them. If left to my own devices, depression would’ve snuck in in the quiet moments, seeped through the cracks of career dissatisfaction, cycles of stress and PMS, self-loathing and pity.

abomb

Life with three little people is insane. It would be so easy to pin my struggles on them. It’s hard to see anything else, to even draw a spare breath. And the tenor of my life with them did seem to kickstart whatever this alternate mental atmosphere I’m living in is – but in that one absurdly clear and dissonant moment, I saw my struggle, my illness, my self for what it is.

That doesn’t make it any easier to raise three littles in the midst of all that. But it makes it easier not to resent them and their needs. And to love myself – faults and all.

Manual Motherhood

image

“Why do you have all these books on motherhood?  I think you’re a good mother.”

Leaves room; returns a moment later, popping head around door frame

“A weird one, but in a good way.”

Go With the Flow

I visited a delightful yoga studio today.

So delightful that it made me wish I still had a baby so I could attend mom and baby yoga there. The wish of a woman so far removed from pregnancy and new motherhood that it only sounded slightly ridiculous as I voiced it.

I had grand dreams of doing yoga with baby. With my first pregnancy, I practiced prenatal yoga up to two weeks before delivery. How fun and rejuvenating it would be to practice postpartum.

It never happened.

Unpaid maternity leave was a practical reason, but the all-encompassing new job of mama was the overarching one. Get dressed? Leave the house? With an infant who could demand milk at any given moment? In public?!

During pregnancy number two, I didn’t even make the prenatal yoga studio. I bought a DVD set. I followed the safety guidelines at the start of the program to a T, watching the routine all the way through before practicing. That was as far as I ever made it. Usually by the end of Phase I, I would be half-asleep on the mat.

Pregnancy number three? Ha ha ha ha ha. I was lucky I could walk by the end of it – literally.

I did eventually try a postnatal DVD purchased at the same time as the prenatal one. The cover showed a picture of a radiant Shiva Rea holding her plump, beautiful baby. All the intro material showed the glowing yoginis cradling their babies while holding various poses. I looked forward to bonding with baby and regaining my strength. The flow itself was great; in fact, I still use it five years after my last to rebuild those still bent and broken places of my body. But the closest my baby got to the action was swinging beside me. There were no poses incorporating her, no touch, no bonding. It was yoga ‘while your baby sleeps or plays quietly beside you.’

There is a certain pang of regret in my solar plexus that I never got my mom and baby yoga fix. Again, not so much that I want to start that whole chain of events all over again, but enough to make my harpy hindsight crystal clear.

My advice to new mothers – don’t wait till you get your shit together to do something you really want to with baby. You never will.

Now before you bludgeon me with yoga bricks, let me explain exactly what I mean.

It took me five years after the birth of my third child to realize that all those imperfect moments for going to yoga, starting a new activity, walking to the park, visiting a relative – were all missed opportunities for fun with baby. Opportunities for me to save just a bit of my sanity. To bond with other moms in the same disheveled boat as me. To seize a fleeting moment in time.

Just when we mothers think we have our shit together, our kids shift into the next phase of development. We are in a constant cycle of up, down, back, forth – that if entered into with unrealistic expectations can leave us feeling as disconcerted as a set of sun salutations at the end of our yoga practice.

Just as there’s no right time to buy a house, switch jobs, or go back to school, there is no pinnacle of motherhood we must reach before we start living the lives we want with our babies. Such a pinnacle does not exist. Just as in yoga, we must accept our inner mother in its current state – and honor it.

jadeintegratedhealth.com

jadeintegratedhealth.com

Craft Time: It Giveth and It Taketh Away

I always feel a little guilty when I think how long it’s been since I’ve done a craft project with my kids. When they were small – at least numbers one and two – we’d whip recycled materials into an artistic representation of almost every season. We’d cover the dining room table with the vinyl tablecloth saved especially for catching craft gak. We’d paint and glitter to their hearts’ content and I’d pat myself on the back that I’d saved their malleable minds from another hour of dreaded TV.

Add more kids and less patience and craft times were fewer and farther between.

But Good Friday – the kids were out of school and I’d found a beautiful Easter/spring craft project online. It’d been awhile. Maybe I was feeling nostalgic. Maybe the years had dulled my memory of how harrowing the combination of wet, gelatinous substances and children can be.

So we set out to make string Easter eggs.

First I dumped a mess of embroidery floss in the middle of that glitter-spattered vinyl tablecloth, the kids thrusting their hands in and claiming their colors. Oh, but wait, we have to ‘cook’ the paste, a combination of flour and water on the stove top. Stirring that – and fighting their sisters for their turn – kept their attention for a little bit. While it cooled, we blew up the balloons. When I wasn’t about to pass out from lack of oxygen, I was dodging spit missiles as the underinflated balloons shot from their mouths. About this time, their father called, stating “Better you than me.” Thank you, dear. But even as I said this, the peals of their laughter drowned out my words. My girls and I were united in this experience, this common goal. We were gathered around that palm-tree tablecloth laughing and smiling and having fun. The separation of all time and space disappeared. It was the same feeling I’d had whenever we’d gathered at our craft table – no matter the year or house.

And then we actually started the project.

Ever tried to separate six strands of embroidery floss into two sets of three without tangling them? Ever asked an impatient seven year-old to do it? She was out by the time the first strings knotted. My other two started dipping the first string they’d unraveled in the goo right away, only to realize they had to unravel about eighty more to finish one egg since they’d blown the balloons up to dinosaur egg proportions. And the goo, oh the goo. Because I’d told her not to use too much, my oldest ran her fingers along the string to siphon some off, but started at the bowl and moved upward, splattering the slime in a wide arc over her shoulder. Even a tablecloth especially set aside for this purpose couldn’t help that. I was a thread-separating machine, draping strands over the backs of their chairs so they could wrap them around the balloons. My five year-old ran past the chairs and swept them all to the floor in a heap. It quickly became a learning experience for them in colorful language.

My oldest hung in the longest with me, the other two abandoning the project for bopping extra balloons around. But even she bailed out eventually. My husband arrived home to me, alone at the dining room table, wrist-deep in wheat paste.

I was miffed that they’d left me to do our project alone. But I was also relieved.  Definitely more relaxed. I had fun choosing the colors and winding the string around the balloons in criss-cross patterns. I made a lot less mess than the little ones.

That night, my youngest helped me hang them up to dry on a makeshift line in the bathroom, ferrying them two at a time in her little palms from the dining room. And they all came in to admire them hanging there. Easter morning they had tons of fun pricking the balloons with pins and watching them fizzle and shrink down before shimmying them out through one of the gaps.

Jennifer Butler Basile

Jennifer Butler Basile

They are gorgeous.

But there are still flakes of dried gak on every surface they touched. And I’m not quite sure if I’d do it again – at least as a kid project. When I posted a picture of the eggs on Facebook, another mother said she doesn’t have the time or patience for a such a project. I quickly replied that I didn’t either! But I forgot the winky face and I fear she thought I meant but I did it anyway. Though I shared the best shot of the stinking eggs, there was a whole lot of backstory that photo left out. The don’t-touch-that-not-yet-not-like-that-wait-no-slow-down-aaaaahhh-#$%@*$! Believe me, I am no Martha Stewart martyr.

Those were the moments craft time taketh from my patience and sanity and peace of mind. But there were moments that gave laughter, joy, and bonding. I think that’s why I periodically try such projects. I think that’s why this little batch of eggs makes a good metaphor for the greater yield of motherhood.

More to the Story

I spent an hour and a half sitting on the basement floor of my local library the other morning.  I’d found the general Dewey decimal neighborhood I’d wanted and set about meeting the locals.

One good thing about living in a small town on a frigid morning and rushing the library doors as soon as they open is that you have nearly the whole place to yourself.  I was the one who flipped on the banks of fluorescent lights as I descended the stairs.  I sipped from my travel mug of tea as I decided which books would aid me in my research journey.  I read nearly an entire chapter of one that I eventually set back on the shelf – one I’ll certainly return to, but didn’t match the goals of today’s project.

Today’s project is preventing postpartum depression.

Though I checked out nine books, welcoming jokes from the clerks at the front desk as to what kind of wagon I’d need to transport them to the car, none is about postpartum depression.  One is about ‘regular old’ depression.  Others have a few pages, maybe a section specifically about postpartum.  But not one of the towering stack I selected gave an in-depth discussion of postpartum depression.

In the online catalog of our state’s inter-library system, there were some, but still not that many.  And none that looked, on first glance, like they offered the kind of practical information and solace that a woman in the throes of postpartum would want or need.  I know.  It doesn’t take much to put myself back to that hopeless place I experienced myself.

I ended up checking out mostly childbirth preparation books or ‘how-to’ guides to pregnancy, which made my children, upon seeing Mommy read a book with a woman’s round belly on the front, very suspicious.  Two of my girls put in orders for a baby brother.  I asked my eldest if she’d want me to be pregnant, to which she said, no, but if you were I’d want a brother.  Only now do I see the irony in their thinking I needed to read another book about pregnancy after three times around the mountain.

Been there, done that.

But this time, I was trying to read these pregnancy preparation books with new eyes.  Having been through it and having had the experiences I did, what would help me do it differently?  Or more importantly, what support systems would have kept me from plunging into the depths of despair?  And how can I apply those to helping other women?

I was surprised to enjoy Ina May’s Guide to Childbirth (Ina May Gaskin) as much as I did.  I figured that title would be one I skimmed to find anecdotes or info pertaining to postpartum, but I am thoroughly enjoying delving into the personal accounts of unhurried, gradual childbirths.  I am rediscovering the empowering parts of my own labors and deliveries – the first two for their strengths and victories, the last for my eventual triumph over seemingly insurmountable odds.  With that last one as my capstone, I’d forgotten the positive parts of pregnancy and childbirth.  Remembering that gives me something to help women to which to aspire.

The disparity between parts of my own experience and beautiful birth stories brings into sharp focus those areas that can serve as triggers, flashpoints for distress and disorder.  And by beautiful, I do not mean perfect or idyllic.  As Anne Cushman says in The Mindful Way Through Pregnancy, “labor and delivery are wild and messy and animal and angry and bloody and painful.  The transcendent act of giving birth is made up of the earthiest of elements: bodily fluids, a hospital gown stained with blood and excrement, the bruises left on your partner’s arm by the agonized grip of your fingers.” (Piver 16)  All this is normal, to be expected.  That’s not what we need to worry about.  We (women, mothers, humans, physicians, therapists, ob/gyns, midwives) need to help women recognize when there is cause to worry.

So maybe sitting on the floor of my local library and freaking my kids out with pictures of the ocarina found in one of my books will help me figure out how exactly to do that.  As with anything, it’s all about dialogue.  Whether that dialogue comes through books at the library, blog posts, or conversations with doctors, expectant and newborn mothers need to know there’s more to the story.

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