Emotional Adjustment After Birth of a Child in Shanghai



The birth of a child is a very exciting time in the life of a family. However, the joy a child brings is accompanied by additional responsibilities, new roles and identities, and stress. For expats living in a foreign country away from their usual support system, having a baby can be even more stressful. By being aware of these stressors and taking advantage of resources available in Shanghai, you can take steps to minimize your stress and improve your chances of a smooth transition to parenthood.

 When people think in terms of having babies, they usually fantasize about what will be gained: that bundle of joy. We are probably used to being successful at our jobs and our relationships, and now we long to be the perfect mother and to meet our child’s every need with selflessness and ease.

The reality is quite different. We are suddenly given total responsibility for a child we know little about. Our new job is to comfort a crying baby, or wait endlessly in the middle of the night for that burp so we can all go to sleep. Babies can be unpredictable, and the harder we aim for perfection, the less likely we are to find it. And the gains of motherhood are often accompanied by losses for which we’re unprepared: spontaneity, self-confidence, independence, control, predictability, sleep, our physical shape, a career, time for oneself, intimacy, sexuality, the special attention of being pregnant and adult company.

Many new mothers are surprised at how weak, alone, and upset they feel after giving birth. Their feelings don’t seem to match the feelings they thought they would have. They wonder why they’re feeling depressed and fear that these feelings mean that they are bad mothers.

An estimated 70 to 80 percent of women who give birth experience “the baby blues,” which is characterized by mood swings sometimes accompanied by crying, sadness, irritability, or frustration. This syndrome is considered a normal part of motherhood and usually begins on the second to third postpartum day and typically goes away within 10 days after delivery. It is believed that rapidly changing hormones play a large role in the development of such psychological symptoms after birth. Less commonly, new mothers can have a more severe or longer lasting depression or emotional disorder. 
Whether you are having the baby blues or more significant distress, there are some steps you can take to reduce emotional distress postpartum.

Take Care of Yourself

If you paid attention to the flight attendant on your trip to Shanghai, you heard her tell you to “secure your own oxygen mask before placing one on your child.” New mothers need to follow this as well: if you don’t make your own needs a priority you won’t be able to adequately care for your baby. Much fuss is made about the baby’s initial adjustment and the baby’s physical needs while less attention is paid to the mother’s needs. Most women are discharged from the hospital within 24 to 72 hours after giving birth – inadequate time to recuperate before being thrust into the role of being a new mother, often without the support of nearby family. There seems to be an expectation that the postpartum depletion is unavoidable.

But as a new mother, you can’t just “run on empty.” You must take special care to monitor your own health and well-being. Taking care of yourself through exercise, good nutrition, sleep, and other esteem-building and stress-reducing activities will make you a better mother.

Exercise

Many studies have found a link between mood and exercise. Exercise is believed to have an antidepressant effect by helping to release brain chemicals called endorphins that evoke a feeling of well-being. Exercise is beneficial for reducing anxiety and stress as well. Finally, it helps toward the regaining of your prior shape which will in turn improve your self-esteem.
Always check with your obstetrician for medical clearance especially if you had a caesarian delivery, are fewer than six weeks postpartum, have not recently been exercising, or have any preexisting medical conditions. If nursing, be sure to wear a supportive bra. A vigorous walk is an excellent and free type of postpartum exercise. You can bring the baby in the stroller or go for a twenty-minute walk before your spouse leaves for work or after he comes home. Or all three of you can go for a walk.

Eat Right

Inadequate nutrition can cause vitamin deficiencies and contribute to fatigue. It can also lower self-esteem when you criticize yourself for eating poorly. Especially when you’re feeling cranky and tired, it’s tempting to grab the first thing available that doesn’t require any preparation. Fast food and snack foods are usually readily available while making salads, peeling carrots, and cutting vegetables seem to require a lot of effort. With a little advance preparation or support from your family or ayi you can try to keep cut vegetables and fresh fruits in the house. Yogurt is also easy to eat. Similarly, avoid crash diets. Try to maintain a healthy diet and consult with a nutritionist if necessary.

Get Some Sleep

Some sleep deprivation is inevitable. Newborns generally lack the ability to sleep for long stretches until their nervous systems mature around four or five months of age. However, it is critical that the new mother gets some sleep as well. Some strategies include napping when the baby is napping during the day, and pumping and letting the father (or other family member or helper) bottle feed either the late night or early morning feeding so that you can get a stretch of at least 4-5 hours of uninterrupted sleep.

Take Care of Your Physical Appearance

While it may be much harder to find time between feedings and caring for the baby to take a shower, taking care of your physical appearance is important because attending to your physical health is a package that includes eating right, exercising, resting enough, and caring about the basics of your appearance. Letting one area go has a domino effect on the other areas. If you feel like an ugly blob, you won’t find the strength to make eating right or exercising a priority.

Get dressed, even if you can’t get to it until 10:00 a.m. Wearing your nightgown all day will only contribute to depression. Put on a little makeup, even if you won’t see anyone else all day. You deserve to look pretty, just for yourself. Even if you can’t fit into your pre-pregnancy clothes, don’t only wear old maternity clothes. Buy yourself at least two outfits that fit now, even though you know you’ll be too thin for them soon.

Reduce Stress

Almost all mothers caring for infants have many more things to do than hours in the day or energy to get them done. Eliminating, reducing, or delegating some chores can significantly reduce the overload you will feel on any given day. Take some time to pamper yourself as well. Some stress reducing strategies include: leaving the beds unmade, taking a bath using scented bath oil or wearing perfume, getting a massage (or a foot massage while the baby’s in the stroller if need be), watching movies or reading a trashy novel, hiring an ayi (even part-time can be a big help and help in Shanghai is relatively inexpensive), bringing in dinner, having your driver pick up the groceries or doing other errands.

Get Help

Getting help in concrete practical ways can provide some physical relief as well as give you more time to rest and take care of yourself. Many spouses are eager to provide practical assistance and are eager to be involved. Think of some ways your spouse can help out, whether it’s running errands, fielding phone calls, doing the laundry, writing some thank you notes, taking the baby for a walk so you can rest, or taking over the baby’s bath or nighttime bottles. Similarly, allow your friends to do some things for you. When they call and ask if there’s anything they can do, don’t turn away the help. Let them bring you dinner.

Seek Support Wherever You Can Find It
Social support is a powerful factor affecting the severity of stress during the postpartum period. A support system can help nurture and maintain self-esteem at stressful times. While getting out of the house with a newborn is difficult, isolating at home with your baby can be very lonely. Here are some things you can do: invite friends over to watch TV or take a walk, join a mother’s group, attend an exercise class, take your baby for a walk, bring the baby to your spouse’s office for lunch. 
Being a new mom is very difficult. New moms really benefit from having other moms to turn to for advice and questions. Additionally having someone with whom you can share your feelings, your worries, doubts, and concerns about parenthood can be very validating and rewarding.

Learn to Accept Imperfection

Accept that this is one area in which you cannot be perfect (or at least you won’t necessarily be getting a lot of immediate praise for a job well-done). As one of my friends jokes, once when she was obsessing over a parenting fine point her pediatrician advised that it didn’t really matter; her child would probably be in therapy at some point anyway. By contrast, as we learn to accept ourselves as we are and model self-acceptance, we guide our children in their journey toward loving themselves as we love them, flaws and all.

Nurture Your Relationship with Your Spouse

When baby makes three it is almost inevitable that couples time is sacrificed to make room for the enormous demands the baby makes on your time. Many women describe an almost reflexive effort to “put the relationship on hold” for a little while and report that they hardly miss it until the pain of isolation or tension in the marriage becomes unbearable. It’s also important to remember that your spouse is going through changes too as he adjusts to his new role as a father, and that it is not a good time to ignore the relationship. Instead you should support each other through the changes and communicate. Be sure to spend time together that is not entirely focused on the baby in order to build intimacy and grow in your role as parents together.

When Problems are Worse: Postpartum Depression

While the baby blues is extremely common and symptoms tend to come and go, less commonly new mothers have a more severe reaction. Approximately ten percent of women have more severe symptoms or symptoms that persist and last longer than a few days. This is called postpartum depression. Postpartum depression is an illness characterized by:

  • Feeling sad or down often
  • Frequent crying or tearfulness
  • Feeling restless, irritable or anxious
  • Loss of interest or pleasure in life
  • Loss of appetite
  • Less energy and motivation to do things
  • Difficulty sleeping, including trouble falling asleep, trouble staying asleep or sleeping more than usual
  • Feeling worthless, hopeless or guilty
  • Unexplained weight loss or gain
  • Feeling like life isn’t worth living
  • Showing little interest in your baby

In addition to postpartum depression, there are a variety of postpartum anxiety disorders that some women may experience, such as obsessive-compulsive disorder or panic disorder. The most severe postpartum illness is postpartum psychosis, which is rare. Women suffering from this condition may experience paranoia, delusions, or hallucinations.
Postpartum depression can be devastating physically and emotionally to the new parents. It can strain the marriage. Additionally, there is some research that a severely depressed mother may not interact with her baby the same way she does when she is feeling better. Finally, postpartum depression can be hard on friends and family who may be trying to be helpful, but cannot understand why their efforts to be helpful are not helping.

Onset of postpartum depression is usually within a one to three months after giving birth, but it has been known to emerge any time from immediately following the birth of the baby until a year after. Numerous factors are believed to contribute to postpartum depression. Hormonal changes following the birth are believed to be a big factor. Other factors include sleep deprivation, a difficult pregnancy, complications at birth for the mother or child, inadequate social support, marital problems, a history of depression, and the recent occurrence of a major life change, such as divorce, death, or recent move. If you have any of these risk factors, it is helpful to discuss them with your doctor prior to delivery. 

While the milder baby blues typically resolve on their own or with the additional strategies outlined above, if your symptoms are more severe or last for more than two weeks it is a good idea to talk to your doctor and consider getting counseling. Psychotherapy can be very helpful in treating postpartum disorders. In addition, sometimes medication for depression is used. There are even medication options suitable for breastfeeding mothers. If you have signs of psychosis or more severe problems you should seek help right away.

It is important to remember that most women will not have any problems more significant than the baby blues. Follow these suggestions and I wish you a smooth transition into motherhood.



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