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New (and not so new) Motherhood In The Time of COVID

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In the last three or so months, our lives have all been upended, to varying degrees, by the emergence of COVID-19 across the globe. Virtually everything about the way we live our daily lives has been drastically altered, including how we work, care for our children, shop for basic necessities, and interact with loved ones outside of our immediate household. The level of fear, anxiety, and depression is at an all-time high as is the level of uncertainty that we, as a society, are being asked to tolerate.

The experience of new motherhood has not been spared this new reality. Pregnant women, who were previously anticipating the delivery of their child in the late winter/spring/summer of 2020 with joy and excitement, now must contend with worries and anxieties that most of us simply never thought about prior to the current moment. Some may have already been experiencing anxiety and/or depression and either way must now grapple with the ways in which the pandemic will impact their birth plans, their current health behaviors (including the way they are cared for by their OB’s), and what their postpartum days will be like in lock-down.

Speaking of postpartum days, this is a time when typically a woman needs support of many different kinds. She needs help learning how to care for her infant, which may include breastfeeding. She needs practical support in the form of respite so that she can sleep, shower, and rest. Meals and childcare for older children are extremely helpful. Social support is critical, as this time is so prone to being isolating. Now, little of this is possible with the exception of support from those who live in the household (often just the partner) or friends/family who may be able to drop off meals or groceries. All of the emotional complications that can arise under usual circumstances are amplified by the enforced isolation of social-distancing and the fear of infection. Financial concerns are intensified.

During this time, I encourage my clients, especially new (and not so new) moms, to remember a couple of things. First, limiting your exposure to the news and social media can be very helpful in containing anxiety. Lots of information is reported/posted, but not all of it is true or accurate. If Facebook helps you to feel connected to the outside world, by all means continue to use it. Just recognize that you may encounter triggering articles or posts that may exacerbate anxiety and you may need to just keep scrolling. Or consider filtering out upsetting material. Also, be aware of what I call “toxic positivity,” or posts which seem to criticize us for having negative feelings right now and encourage us to only focus on “silver linings” and gratitude. Silver linings and gratitude are important and have a role to play here, but they can and do exist at the same time as the negative feelings, and that’s okay, because that’s how human beings are.

Next, understand that we are all collectively grieving and undergoing a trauma right now. We have experienced loss, all of us in different ways. Some are experiencing more traditionally recognized grief/trauma in the form of having lost or almost lost loved ones, or have been ill themselves. However, all are grieving a way of life, a sense of normalcy, safety and predictability, and many individualized losses too numerous to name. This is also grief, and it is also trauma. Allow yourself to grieve your losses, whatever they may be, and try not to push the feelings away. Feelings are not permanent states of being, even though it may feel like it sometimes. Self-compassion is key here. We need to treat ourselves the way we would treat a friend or loved one who is suffering; without judgment and with care and love.

Finally, and this is connected to the first point regarding limiting exposure to the news, etc. Try to keep your focus on what is under your control, and away from what is not. Seeing less news and reports on the behaviors of others helps, as we can’t control other people and what they do, nor can we control the course of this virus. We can, however, control how we direct our attention. We can manage anxiety by directing our focus away from things we know will provoke our anxiety. We can decrease our sense of isolation by reaching out via Zoom or other video platforms to our loved ones. We can choose to engage in activities that bring us joy/pleasure. We can talk with our partners about how we are feeling and be honest about what we need right now. We can be compassionate with ourselves and remember that this situation is not like any other most of us have ever experience, and how we feel and behave now might not be how we would under usual circumstances. We can remember that we are doing the best that we can do in a very difficult time. And of course, if you feel that you need more emotional support, please reach out to a qualified mental health professional. I am available to you via telehealth, and am just a phone call away.

I leave you with the words of the Loving-Kindness Meditation:

May you be peaceful.

May you be well.

May you be safe.

May you live with ease.

Happy Holidays! (?)

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The holiday season is imminently upon us. Some of us are finalizing our travel plans to visit family members, others are preparing for relatives to come and visit them, and still others are planning small celebrations with their new little families. There are gifts to buy, greeting cards to be sent, decorations to put up, parties to attend, and lots of demands on our time. Needless to say, while this is often an exciting and special time of year, it can be simultaneously stressful and filled with conflicting emotions.

Many new parents have imagined what it would be like during their child’s first holiday season. The cute outfits, family photos, memories made with loved ones. And, as with so many things about parenting, our expectations of how things will be usually are different than how things actually turn out. The amount of pressure we put on ourselves to achieve the ideal we had in mind can leave us feeling stressed, drained, and disappointed when we end up not enjoying the experience as much as we had envisioned. Feelings of guilt sometimes follow.

The pressure does not just come from within. Family members, however well-meaning, can unwittingly add to the stress via their own expectations and visions of spending holiday time with your new child. The relationship you have with various family members impacts the degree to which you feel burdened by their expectations. Do your in-laws insist that you spend the holidays with them, while your parents do the same? Do you feel caught in the middle? Are you planning to attend celebrations with people who you enjoy and are supportive of you, of are you feeling obligated to do so with relatives who demand more of your energy than you are willing or able to give at this time? How much family drama is going on and how much will you be affected by it? I’m thinking of Prince Harry and Meghan, Duchess of Sussex, who have chosen to spend baby Archie’s first Christmas away from the British royal family, and rather will be with the Duchess’ mother in the United States. Given all the focus on the mess in the Royal Family in the media, it is easy to assume that the Sussex family has made a choice that will allow them to enjoy the holiday without having to deal with whatever is going on behind the Palace doors!

Of course, not all of us can make those kinds of choices and don’t have (or feel that we have) options to make other plans. If you are faced with the prospect of being with people, family or otherwise, with whom you anticipate a difficult time, and there’s no way out (and I encourage you to examine that), it is important to plan ahead for how you will take care of yourself during that time. Some suggestions:

  1. Remember that it is okay to take breaks. If you are in your own home, and need some time away, go off to your bedroom or some other quiet, private place to do what you need to do to calm yourself or reduce any sense of overwhelm. If you will not be at home, think ahead to how and where you might find quiet space to be alone if necessary.
  2. Breathe. It sounds trite, but it is amazing how often we can forget to breathe properly! The breath can serve as an anchor in a chaotic situation. Try breathing in and out to the count of four, while focusing on the sensation of the breath going in and out.
  3. When others have opinions about your parenting choices, whether about a schedule you have chosen for your baby, or about how you are feeding them, or some other thing (it’s amazing the things people can have opinions about!), a good mantra is “good for you, not for me.” You are still the parent, and as long as no one is being hurt, it really isn’t anyone else’s business how you do things.
  4. Make sure you are drinking enough water, and guard your sleep like the precious resource it is!
  5. Think about someone who might be a source of emotional support, someone you can call or text if not talk to in person who understands and can commiserate with you.

My wish for you is that you have a healthy and happy holiday season, full of love, special moments, and boundaries that allow you to enjoy this “most wonderful time of the year.” Or, at least to get through until New Year’s!

Thoughts During National Breastfeeding Month

August is National Breastfeeding Month, a time when advocates of breastfeeding focus their efforts on awareness, education, and support for breastfeeding mothers. Education, awareness, and support regarding this issue is extremely important, given how many people struggle with nursing and how few structural supports there are in place for it. Women are told constantly during pregnancy that “breast is best,” are bombarded with information about its benefits, and are advised that the American Academy of Pediatrics recommends that breastmilk be the sole source of nutrition for the infant until at least six months of age. But when the baby comes, there is often little practical support available to most moms to actually achieve their breastfeeding goals. Certainly, there are qualified professionals such as lactation consultants holding the IBCLC designation, however while insurance coverage is improving, these services are largely paid out of pocket. The same can be said for postpartum doula services. The cost is a barrier for many, many families (this can be said for psychotherapy as well, but that’s for another post!). Breastfeeding support groups can sometimes be helpful, but that is dependent on who is running them and their philosophy. Next, while new mothers are learning how to feed their babies, many times they need to go back to work very soon after giving birth, sometimes as early as six weeks and very often after 3 months. There are laws protecting nursing mothers in the workplace that require that there be a private space other than a bathroom for them to pump, a break to do so, and storage space for the breastmilk, but often on the ground, these rules are being followed on paper but do not actually make pumping possible. Maybe the pumping room takes a lot of time to walk to and from.Maybe there is nowhere to sit near an outlet. Maybe the additional breaks needed cause the pumping person’s workload to pile up. Not to mention that some people find pumping extremely difficult. All this to say, advocacy, awareness, education, and support are needed on many levels.

If breastfeeding is a struggle, there can be intense feelings of inadequacy. Mothers fear that they will not be able to bond with their baby, that there is something wrong with them as mothers, or even as women, if they cannot do it. They may feel quite isolated, especially if they are not pumping or supplementing with formula, and sleep can be severely impacted. On the other hand, if breastfeeding is going well or eventually “clicks,” it can be a source of deep joy. The release of oxytocin (the “feel good” or “cuddle” hormone) triggered by the infant’s suckle can be very calming. There can be mixed emotions; “I love nursing, but I wish I could get away for more than two hours to do something I need to do,” “This is really hard, painful, and draining, but I really want to be able to do this.”

And what about those who are suffering from a postpartum mood or anxiety disorder? Well, its complicated! Some research shows that breastfeeding, when it goes well, can be protective against pmad’s, as it provides that boost of oxytocin, and can also give the mother a feeling of accomplishment and competence at a time when she may not be feeling either of those things very much. And, we also know that when breastfeeding isn’t going well, it can exacerbate or be a source of negative emotions. Sleep is also critically important in the managements of a pmad, and breastfeeding most definitely impacts sleep! Finally, many folks are concerned about the utilization of medication while nursing. There is plenty of evidence that many anti-depressant and anti-anxiety medications are compatible with breastfeeding, but it is very important to find a provider who is skilled in prescribing during the reproductive period of life.

Here is my personal take. Fed is best. I support breastfeeding, pumping, formula feeding, and any combination of the above. The most important thing is that Mom can take care of herself, and that the baby is fed. Sometimes, that means making changes to plans that may have been precious and a part of how a woman envisioned herself mothering. This involves loss, and that loss must be acknowledged. Sometimes, making sure Mom is doing well and baby is fed means working with the right professionals (IBCLC, psychiatrist, etc) to make sure that conditions for nursing are optimal. Every family’s situation is different and the solution is not one size fits all. The current cultural climate around mothering in general and nursing in particular is pretty prescriptive, and it can be hard to live in this climate while doing things your own way. Mothers today face so much judgment for all of their choices, whatever those choices are. I see my role in the bigger picture of all of this as being to help dismantle the culture of mom-shaming, one therapy session at a time. So, come on in, talk to me about whats going on, and if you want, feed your baby however is best for you while we sort it all out!

What’s with all the butterflies everywhere?

I’m so glad you asked!

selective focus photography of tiger swallowtail butterfly perched on lavender flower
Photo by Marian Florinel Condruz on Pexels.com

The image of the butterfly appears frequently on my website, my marketing materials, in my office, and even in elements of my clothing! This is because I believe that the butterfly has important symbolism both for the transition to motherhood and for healing from perinatal mood and anxiety disorders.

A caterpillar emerges from an egg, and after a while enters a cocoon in which it transforms into a beautiful butterfly. Similarly, during and after pregnancy, a woman enters a period of transition and transformation, from a person who may have many facets to her own identity but is only responsible in many cases for her own well-being, to a new role in which she is now mother to a tiny being completely reliant on her for everything. This role change and identity shift is as monumental as any could be. It has been said that when a baby is born, so is a mother. She emerges from the cocoon of the perinatal period as a beautiful new self in many ways. This is something to be nurtured and celebrated, and it must be recognized for the power and strength it takes to get there. And of course, it can take lot of difficulty to “get there.”

As for healing, during the course of our work together, you may find that you are beginning to notice moments, however fleeting, of beauty and joy where you did not see them before. Maybe you take surprising delight in the smell of a fresh spring flower, or in your baby’s smile, or in the way that the sun is shining through the leaves of a tree right at that moment. My teacher Karen Kleiman refers to these instances of joy as “butterflies,” and encourages her clients to seek them out. I love this notion of finding joy in the smallest things, even if it only lasts as long as a butterfly landing on your fingertip. My hope for you is that as we help you find your way back to yourself (however transformed), that you will experience many butterflies along the way.