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Be Prepared for the Reality of Postpartum


It happens this way: The 7-pound bundle with the soft, spiky hair and fingernails like tiny pearls lands in your arms--the greatest gift of your life.

Emotion No. 1: You will throw yourself in front of a train to spare this child a single moment of pain or despair.

Sleepers have to be changed after one spit-up; crib sheets laundered if a single drop of pee comes into contact with the 100% cotton. Babe has to be held if he so much as whimpers. Absolutely no one but Mom, Dad and maybe Grandma will be allowed to place their germy mitts on this perfect specimen.

Soon, according to a number of studies on the postpartum period, the health of many new mothers begins to erode. Dad's health and mood can slip as well. And the marriage, studies find, isn't as satisfactory as it once was.

At some point along this typical spectrum, new parents, particularly mothers, usually discover the downside of caring for an infant--the fatigue, the dilemmas, the quarrels, the shock that it can be so very hard, say experts on parenting and the postpartum period.

"The focus has been on the arrival of the baby. But we have not paid significant attention to the fact that the transition to motherhood is the single most important life transition that a woman can make," says Sherman Oaks psychologist Evelyn G. Kohan. "You become responsible for another human life, and it's an ongoing responsibility."

According to Kohan, an expert in postpartum mood disorders, the major obstacle in adjusting to parenthood occurs when one's expectations don't match reality.

Experienced parents can attest to the challenges during baby's first year. Jackie Miller can look back and laugh ruefully over how her preconceived notions of motherhood clashed with the real thing.

The Long Beach woman gave birth to son James five months ago.

"I was naive. I'm 34; I thought it would be a piece of cake. This is hilarious--I actually thought I might be able to study for a graduate exam!" Miller says.

Even being warned that parenthood was hard had not prepared her.

"I had feelings of being incompetent as a mother. And you feel like you're the only one who is. It makes you feel that you're no good at the one role that you're really supposed to be playing," says Miller, who adds that a very supportive relationship with her husband helped her adjust.

Studies confirm that many mothers find the postpartum months unexpectedly difficult.

The physical recovery from pregnancy and childbirth is also a more drawn-out process than women typically expect, researchers have found.

A 1993 study by a University of Minnesota rsearcher found that, three months after delivery, many women experience physical problems such as poor appetite, fatigue, hemorrhoids, constipation, hot flashes, pain during sexual intercourse, respiratory infections. Even at nine months postpartum, many women said they had vaginal discomfort and constipation.

"Mothers typically do not pay enough attention to themselves," Kohan says. "They focus on the baby and don't realize that the mother's adjustment is the key element in caring for the baby. There is a new body of research showing that babies develop differently based on the mother's adjustment."


It is an all-too-typical morning at the Moms & Babies Support Group meeting at Long Beach Memorial Medical Center.

Chris Knight and her son, Dylan, 5 months, kick off the meeting.

"He's waking up every morning around 4. I put in his pacifier, and he'll go back to sleep. But I'm wondering why he does that," she muses.

Liz MacDonald cradles 4-month-old Annabella.

"We're starting a bedtime routine," McDonald offers. "Hopefully, in a couple of weeks, we'll have some results."

About 10 minutes into the meeting, Lori Doty enters the room with a diaper bag and 6-day-old Tara. The pinkish, wrinkled newborn attracts the attention of all the new moms. One of them praises Lori for "getting out so soon."

The meeting resumes, but within minutes, Lori is starting to sniffle. The group politely ignores her and continues to discuss baby-sitting issues, teething pain and the travails of traveling with baby.

Lori, however, advances to sobs. Pam Hastings, a nurse educator and facilitator of the group, walks over to her, hugs her and tells her that it's normal to be teary in the first few weeks.

"I guess I wasn't ready for this," Lori says, smiling through her tears.

The other moms murmur words of encouragement. Lori nods but continues to cry. A couple of the other mothers start to sniffle. Three are crying, then four, five.

Hastings passes out tissues.

Eventually, Lori confides that everything is fine. But: "I wish I was back in the hospital," she whispers. "You feel so safe there."

For the most part, new mothers simply need support, says Hastings. The Moms & Babies Support Group is a free, weekly group.

"The purpose of the group is to make friends and build support systems within this group," Hastings explains. "They become aware that they are not alone and other mothers are experiencing the same things."

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