DIFFERENT PEOPLE will tell you different stories about parenthood, but only you can know how you really feel: ‘People kept saying to me when she was tiny, “Oh, make the most of it, this is the best time.” And I thought it was the most dreadful time of my life. I thought, “If this is the best time, how am I going to cope when things get worse?” Then I met someone else who felt the same way, and her baby was slightly older, and she said to me: “This isn’t the lovely time, this is the horrible time. Things do get better.” And that was such a relief. Not everyone thinks it’s good, that very early bit, though you get so wrapped up in it.’
Baby blues
BABY BLUES do seem fairly universal. That is to say, they have been suffered by women in all cultures and all times when their baby is very tiny – usually around three or four days after delivery, when hormone levels drop and milk production kicks in. They are often linked with a sense of physical and emotional anticlimax after the birth. Nurses will often dismiss your tears with the label ‘three-day blues’, which is of no help when you can’t stop crying.
This is something Helen tried to explain: ‘The day Jo and I came out of hospital was very exciting. I was so glad to be home, and so pleased to sleep in my own bed again. But the next morning my breasts were enormous and solid, Jo was fretful, and everything just seemed to fall apart. I started crying and crying and didn’t really know why. I felt odd but I didn’t feel sad. The tears just came out of nowhere.’
THE FACT that these blues are so common, and always happen at around the same time, leads many experts to think that one of their causes is hormonal, though this explanation may not be much comfort.
‘I was sobbing and sobbing, though if someone had asked me why I’d have been hard pushed to tell them, and the nurse said, “Oh, a lot of you go through this – you’ll feel better tomorrow, believe me,” and that just made it worse. I thought, “How do you know?” I felt so unhappy, I couldn’t see myself ever smiling again. It all just seemed so pointless.’
Baby blues, whatever their cause, are usually all over by Day 10 at the latest. Few women find that this unusual sadness persists for longer. If it happens to you, it will help if not only you but your partner and perhaps other members of your family are prepared for the possibility. That way people will be able to reassure you that everything will be all right again, and with their reassurance and support, and patience, it soon will.
Helen has an extra remedy of her own, however: ‘I was so sad, so sad and Kieron was flapping about not knowing what to do, so partly to get him away from me because I wanted to be able to cry in peace, I’d say, “Oh, I could just eat a Marks & Spencer prawn sandwich”, and off he’d pop to Hammersmith to bring one back. And then he ran me a bath, and then he took Jo for a long walk … And none of it made the slightest difference at the time. It only lasted a couple of days, this weepiness, but it seemed eternal, and then it was gone, without me even noticing. But a long time afterwards I thought: what loving things to do. Everything Kieron could do, he did. And whenever I was feeling down with the baby, that thought would help.’
Puerperal psychosis
WITHOUT WANTING to alarm people, it didn’t seem fair to write a book about becoming a family and not mention this acute illness. Puerperal psychosis is an illness completely different in kind to the usual ‘baby blues’. It is different to ordinary depression, too. Puerperal psychosis is an illness that makes its sufferers feel totally alienated from reality, as Denise explains: ‘I was overjoyed when my baby girl was born … and the joy and excitement of those first few days did not wear off Instead, I became more and more elated. For someone who is generally reserved, this was a change in personality. This powerful feeling of joy was one I had never felt before – nor have I since ever felt so happy. I literally could not stop talking – I felt that I had so much I wanted to say, so much to do, that I didn’t feel the need for sleep. I lost all inhibitions and said whatever came into my head without pausing to think. My mind had gone into overdrive. I no longer had any control. I knew that something was wrong, and told the midwife who visited me at home that I was worried I was too “high” and might come crashing down. She just gave me a strange look. My GP thought it was good that I was enjoying motherhood so much. And I was. Being a mother was the most wonderful thing that had ever happened to me. And then everything fell apart. I began having involuntary thoughts about harming my baby – not so much thoughts as real pictures of causing her harm. What bewildered me was that I adored her…so why was my mind repeatedly trying to bash her brains out?’
There is no mistaking puerperal psychosis – it is qualitatively different to other forms of ‘depression’ following childbirth. Its onset is rapid, there is no slow build up, and it seems to be a reaction to the sudden changes in hormone levels that occur after labour. It may help partners and supporting relatives to know that this is an illness completely outside the woman’s control. She cannot ‘snap herself out of it’ and she cannot ‘be reasonable’. She needs medical help.
Sadie saw visions and was more concerned to alert her friends and family to the meanings of these than to look after her baby: ‘I saw God and then Jesus, who was telling me I had done wrong. And I knew my child would be taken by the Devil if I didn’t protect her.’
Most women with this illness will need to be hospitalised as they are unable to function effectively, and many take several months to recover as Denise continues: ‘I spent four weeks on an Acute Admissions ward, then four weeks in a Mother-and-Baby Unit in the psychiatric hospital. By the time I went for my postnatal check with my GP at eight weeks, I was starting to get back to normal. I felt very vulnerable, sitting there in the waiting room. I watched another mother come in and very capably start to change her baby’s nappy. The tears came suddenly and violently as it came home to me just how different I was to “normal” mums. I came home at ten weeks, but it took the best part of a year before I felt ‘myself again and not just going through the motions.’
But women who have puerperal psychosis do recover, although it may take a long time and the demands upon partners and family will be very great. Often relatives will need to care for the child and, depending on the medication and state of mind of the mother, breastfeeding may not always be possible.
Research continues into the causes and the reasons why some women get this rare and distressing illness, and the most effective treatments, but there are no definite answers yet. The work done by Dr Katarina Dalton on the use of progesterone injections as a means of prevention is gaining coverage and acceptance. Although its preventive role cannot help a first-time sufferer, it can be of great reassurance to those who have suffered that they do not need to go through this again.
CHANCES ARE, at least one health professional or relative will have advised you how desirable a routine is for your baby, although very young babies may not respond well to being ‘put into’ a routine. However, it can be helpful to establish an evening routine of supper, bath, story, bed (or similar). This sort of routine, if established early, can reduce bedtime problems in toddlerhood. Indeed, it gives most children a feeling of safety and security if roughly the same things happen at roughly the same time every day. It helps to give a sense of pattern and reassurance. And it can help you, too, if you’re finding the demands of parenthood overwhelming: a routine can bring everything down to more manageable proportions.
Beverley felt she needed to get her new life into some sort of order: ‘I think my idea of a “routine” came from my mum. Also, it came from me in the first three months trying not to have a routine. I remember thinking, “I want Josh to be a really flexible baby. I’m going