Sylvia Brown - The Post-Pregnancy Handbook: The Only Book That Tells What the First Year After Childbirth Is Really All About—-Physically, Emotionally, Sexually

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Contents

For Adrian and Laure,

who have made it all worthwhile

By my fourteenth shower of the day, I became truly angry: Why was I so sore? No one had warned me that the days following childbirth could be so painful. I had attended prenatal classes, endlessly discussed the topic with my girlfriends, read a good dozen books on pregnancy and childcare. Not one had hinted that my insides might feel like they had been scraped with a cheese grater, nor that hemorrhoids could hurt so much, nor that it would be impossible to find a comfortable position, even lying down. I was in a prestigious maternity hospital but no one offered me the slightest tip or nonmedical remedy to alleviate all these aches and pains (I discovered the wonderfully soothing effect of running water all on my ownwhich explains my seventeen showers on the second day). To make matters worse, the midwife for whom I most cared was on a training course, and my doctor had left town immediately after my delivery to attend a family wedding. So there was not much sympathy coming from these quarters.

Once home, I found myself alone (my husband, a United Nations official, was posted at the time in the Balkans during the Yugoslav war and returned to work the day after our son was born), without a mother or mother-in-law, in an unfamiliar city (I had decided to have the baby in Paris, which was closer than the U.S. to our posting). As a result, I did not have the all-important support network which I discuss at length later in this book. Just like many other new mothers, I did not think that my discomfort warranted disturbing my obstetrician. The few pages on the postnatal period contained in various pregnancy handbooks seemed to gloss over these issues with a sweeping everything will be fine within a few days. This is when I decided to write my own guide to the days and weeks following childbirth, a book for mothers by a mother, filled with practical advice and realistic solutions.

I began by mentioning the idea to my doctor: Youre a wonderful obstetrician, but your postnatal care leaves something to be desired I therefore need your assistance in undertaking a project whose aim is to help women better understand their body, know when to seek medical advice, and thus take control of their health. He responded enthusiastically and gave me bountifully of a doctors most precious asset: his time.

Having spent ten years working in financial marketing, my second task was to take a survey of my future readers by distributing an anonymous questionnaire to 300 new mothers. Their answers confirmed the statistics I had seen in medical journals: 64 percent of women have bad memories of their postnatal experience. Furthermore, 47 percent of new mothers have at least one health concern in the six weeks after childbirth (back pain, migraines, and urinary incontinence, to mention but a few). In two-thirds of these cases, the problem persists well past the traditional postpartum phase. Indeed, pregnancy and childbirth have the unfortunate effect of revealing certain dormant health problems, or of exacerbating existing conditions.

Thanks to my dual Franco-American nationality, I was able to conduct research on both sides of the Atlantic. Over the course of three years, fifty-five specialists shared their knowledge and experience with me. The Post-Pregnancy Handbook was originally published in 2000 in France, where I had myself given birth to my two children. It has now been completely rewritten to meet American medical standards and has been adapted for the U.S. market. Before undertaking this rather awesome editing job, I was extremely fortunate to meet Mary Dowd Struck, head nurse at the Women and Infants Hospital in Providence, Rhode Island, which is not only one of Americas top maternity hospitals but also at the forefront of innovation in obstetric practice.

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In almost all non-Western cultures, the postnatal period is viewed as a time of healing, rest, and recuperation accompanied by specific rituals and traditions. Regardless of the actual effectiveness of these customs, they have the merit of making the new mother feel cherished and cared for at a time of great physical and emotional vulnerability. Such a sense of support will almost inevitably accelerate the recovery process. Most of these rituals also underscore the fact that recovering from childbirth takes timeforty days of complete rest in an almost exclusively female environment is common to many cultures. Our great-grandmothers and, for some, grandmothers, stayed in bed for twenty-one days. In 1970, the normal hospital stay in the United States was four days. By 1990, it was down to twenty-four hours. Since the passage of the Family and Medical Leave Act, it is now forty-eight hours for a normal delivery, and ninety-six hours after a cesarean section. But the length of hospital stay is only half the issue: the real problem in Western societies today is the lack of help and support for the new mother when she returns home. We so often hear that pregnancy and childbirth are not an illness that we no longer recognize the enormous physical and mental effort required to bring a child into the world.

At the beginning of the twentieth century, a woman had a 10 percent chance of dying each time she gave birth. Childbirth was the second most common cause of death after tuberculosis. Today, we take it for granted that we will leave the maternity hospital completely unscathed. Prenatal diagnostic tools, IVF, and epidural anesthesia all give us a completely different perception of childbirth than our predecessors had. We now have the luxury to experience childbirth as an enriching event and to focus above all on the welfare of the baby. As a result, we have tended to forget to take care of ourselves.

Since our expectations are now much higher than those of preceding generations were, we also run a greater risk of experiencing frustration and deception. We think that we can integrate a baby into a professional life that has been highly structured for many years. We expect our partners instantly to become perfect fathers and we begin immediately judging them on their ability to change a diaper or give a bath. Most of all, we refuse to accept that the postnatal period is a state of transition at all levels. The arrival of a child will change our lives forever, and adjusting to this reality takes time.

Far too many women have bad memories of their tenth month. What a pity! There seems to exist a kind of secrecy around the subject, as if no one dared admit that this transitional phase could be difficult. And yet medical advances in the post-pregnancy phase are impressive. A well-informed woman who understands what is happening to her body has every reason to live through a positive experience.

Most women feel highly motivated to take better care of themselves through their pregnancy. They generally actively seek information and undergo regular medical supervision. But if they really stop to think about their changes in lifestyle, most future mothers will admit that they are concerned primarily with the health of their baby. Recovering from childbirth is a unique opportunity for women to think about themselves and permanently adopt healthy habits in their nonpregnant state as well. This means understanding your body, knowing how to identify its alarm bells, eating a healthy diet, exercising appropriately, and watching your posture.