After nine months of growing a baby and many long hours of birthing it, your body has just endured one of the greatest challenges known to humankind. It’s been drained of nutritional reserves, zapped of strength, deprived of rest, pushed to limits you didn’t know existed. And as if that’s not enough, now that you’re finished with the hard work of expecting, you’re expected to begin an even tougher job: motherhood.
Because pregnancy, labor, and delivery are so physically grueling, the first six weeks after the birth of a baby are considered a “recovery period.” But once the fog of the first six postpartum weeks has lifted and the aches and pains of delivery have (mostly) faded, you’ll probably begin to feel vaguely human again. You may even begin to feel as though you’re falling into a rhythm with your baby (albeit an exhausting rhythm) and that the routines you struggled with before now come to both of you almost easily. Still, even once you’ve started getting the hang of this parenting thing, many challenges still await you in the first year of your baby’s life: from finding time for your spouse to finding time for yourself, from reentering the workplace to reestablishing friendships, from working on that balancing act they call parenthood to recognizing that even professional jugglers drop a few balls from time to time. And just when you’re starting to wonder whether your life will ever be the same as it was prebaby, you may be surprised to suddenly realize that you’re really glad it isn’t.
If you worked hard to revamp your eating habits during pregnancy, now isn’t the time to abandon your newly improved ones, temporarily or permanently. If you didn’t eat as well as you might have liked during pregnancy, you couldn’t pick a better time to start good habits than now. Though a postpartum diet plan will include a few more perks and a lot more leeway than did the pregnancy one, careful eating will be essential if you’re going to keep up your energy level (so you can keep up with your baby), gradually take off those extra pounds put on during the nine months of pregnancy, and, if you’re breastfeeding, produce enough quality milk.
Good nutrition helps fuel a speedy recovery from childbirth, while maintaining the abundant energy and optimum health necessary for top-notch mothering. It is also crucial to successful breastfeeding. While neglecting nutrition essentials when you’re breastfeeding won’t necessarily reduce your milk supply, at least not for a couple of months (even women who are severely undernourished can often produce milk for a while), it may affect the nutritive value of your milk and shortchange your own body nutritionally. Whether you decide to nurse or not, these nine basic principles can serve as a general guide to eating well during the postpartum period:
Make most bites count. Though the bites you take aren’t shared with your baby as directly in the postpartum period as they were during pregnancy (and aren’t really shared at all if you’re not nursing), it’s still important to make as many of them as possible count toward good nutrition. Careful food selection will help ensure a plentiful supply of quality breast milk, enough energy to survive sleepless nights and endless days, and a speedier return to prepregnancy shape. Of course, as long as you’re taking in your share of nutrients—and not taking in a surplus of calories that might make weight loss elusive—treat yourself now and then to bites that feed only your cravings. You’ve earned a little indulgence.
All calories are not created equal. No matter who in the family you’re feeding, the 2,000 calories in one typical fast-food meal aren’t nutritionally equal to the 2,000 calories in threewell-balanced meals. Consider, too: The 235 calories in a sliver of frosted devil’s food cake are undeniably delicious, but so are the 235 calories in half a ripe cantaloupe mounded high with chocolate frozen yogurt—and one (guess which) offers a bounty of nutrition, while the other offers nothing but calories. The same holds true for the 160 calories in ten French fries—nutritionally lightweight when weighed against the 160 calories in a baked potato topped with shredded Cheddar cheese and steamed broccoli.
Starve yourself, cheat your baby. Missing meals isn’t potentially harmful (as it was when you were pregnant), but a consistently irregular eating schedule can cut into your own reserves, leaving you lagging. If you’re breastfeeding, severely inadequate nutrition—such as might develop on certain fad diets (juice fasts, for instance)—could in time seriously reduce your milk supply.
Stay an efficiency expert. To keep your postpartum weight going down and your nutrition up, it’s still important to select foods dense in nutrition in relation to their calorie content—turkey over bologna for lunch, pasta with vegetables over pasta with cream sauce for dinner. If your problem is losing too much weight, look for foods high in both nutrition and calories but low in bulk, such as avocado and nuts, but stay away from foods like air-popped popcorn that fill you up without filling you, or your nutritional requirements, out.
Carbohydrates are a complex issue. And complex carbohydrates, unrefined, are just the kind you want to concentrate on postpartum (and beyond, for a lifetime of good nutrition for yourself and your family). Whole-grain breads, cereals, and cakes, brown rice, dried beans, peas, and other legumes provide fiber (as important now as during pregnancy to ensure regularity) and plenty of vitamins and minerals. They also give you a longer-lasting energy boost than refined carbs do.
Sweet nothings are exactly that. The average American consumes a whopping 150 pounds of sugar a year. Some of this comes right from the sugar bowl, sprinkled on cereals and fruits or stirred into coffee or tea. A fair amount is taken, not unexpectedly, in cakes, cookies, candies, pastries, and pies. But a surprising proportion comes from such unlikely sources as soups, salad dressings, breakfast cereals, breads, hot dogs, luncheon meats, and processed, canned, or frozen main courses and side dishes.
If your sugar intake is just average, you’re consuming over 800 nutritionless or empty calories a day. For a new mother who wants to make sure she gets her Daily Dozen without gaining a dozen (or more) pounds in the process, having sugary treats occasionally won’t create nutritional havoc, but consuming a great many empty calories a day can.
Eat foods that remember where they came from. Foods that are highly processed lose a lot of their nutrition along the way. These foods also often contain unhealthy excesses of saturated fat, sodium, and sugar, as well as artificial colors and other chemical additives, none of which enhance the diet, and the last of which can occasionally contaminate breast milk (see page 97). The closer the food you eat is to its natural state, the better for your baby—and for you.
Make good eating a family affair. Include the whole household in your good eating, and your baby will grow up in a home where good nutrition is natural. This may translate to better long-term health (and longer life) not only for you, but for your spouse and your children as well.
Don’t sabotage your diet. Though you may enjoy an occasional alcoholic beverage even if you’re breastfeeding, too much alcohol can definitely affect you and your baby adversely, as can any amount of tobacco or illicit drug use (see page 96).
If you’re familiar with the Pregnancy Diet, you already know that you don’t have to sit down with a ledger, a calculator, and volumes of nutritive value tables before each meal in order to be sure you’re getting the nutrients you need (to produce milk and stay healthy yourself if you’re breastfeeding, or just to stay healthy if you’re not). All you have to do is get your Daily Dozen.
Calories. You’ll need to take in enough calories to fuel the energy you’ll require as a new mother, but not so many that you can’t begin shedding those pregnancy pounds. If you’re breastfeeding, that breaks down to about 400 to 500 extra calories a day above what you would need to maintain your prepregnancy weight (double that if you’re breastfeeding twins, and triple that for triplets). You can reduce that number a little after the first six postpartum weeks if you don’t seem to be losing weight, but you shouldn’t cut calories drastically, as that could cut down on your milk supply.
Even if you’re not breastfeeding, you should put serious dieting on hold until after the first six weeks. During that recovery period, you should be able to begin losing those unwanted pregnancy pounds while sustaining your energy levels by eating about as many calories as you would need to maintain your prepregnancy weight.1 When recovery is complete and dieting is safer, you can reduce that number by 200 to 500 calories a day, but don’t go on a very stringent diet without medical supervision.
Breastfeeding or not, weighing yourself regularly is the best way of determining whether your calorie intake is high, low, or just right. As long as you are losing pregnancy pounds gradually and stop losing once your desired weight is reached, you’re on target. Adjust your calories up or down if you’re not. Keep in mind, too, that it’s always wiser to increase exercise than to dramatically decrease calories. If you can’t put the brakes on a too rapid weight loss, see your doctor.
Want to pack in the nutrition without packing on the pounds? Choose foods that efficiently fill more than one requirement in a serving. Many dairy products provide protein and calcium servings, some over-achieving fruits and vegetables offer up both yellow or green leafy and vitamin C. A real nutritional super-star? Broccoli, which packs a onetwo-three punch (green leafy, vitamin C, and, if eaten in somewhat greater quantity, a calcium serving).
Protein—three servings daily if you’re breastfeeding, two if you’re not. Many of these also serve up a calcium requirement. One serving equals any of the following: 2½ to 3 glasses skim or lowfat milk; 1¾ cups lowfat yogurt; ¾ cup lowfat cottage cheese; 2 large eggs plus 2 whites; 5 egg whites; 3 to 3½ ounces fish, meat, or poultry; 5 to 6 ounces tofu. Other soy products (including many vegetarian frozen dinners) may also contain plenty of protein; check labels. Breastfeeding mothers of twins or triplets need an extra serving for each additional baby. Vegans, those vegetarians who eat no animal protein, should add an extra protein serving daily since the quality of vegetable protein is not as high as that of animal protein.
Vitamin C foods—two servings daily if you’re breastfeeding, at least one if you’re not. Keep in mind that many vitamin C foods also fill the requirement for green leafy and yellow vegetables and yellow fruits. One serving equals any of the following: ½ cup strawberries; ¼ small cantaloupe; ½ grapefruit; 1 small orange; 
to ½ cup citrus juice; ½ large mango, papaya, or guava; 
cup cooked broccoli or ¾ cup cooked cauliflower; 1½ cups shredded raw cabbage; ¾ cup cooked kale, collard greens, or kohlrabi; 1 medium green bell pepper or ½ medium red bell pepper; 2 small tomatoes or 1 cup tomato juice.
Green leafy and yellow vegetables and yellow fruits—at least three servings daily if you’re breastfeeding, two or more if you’re not. Keep in mind that many of these also fill the requirement for vitamin C. One serving equals any of the following: 2 fresh or dried apricots; 
cantaloupe; ½ mango; 1 large yellow (not white) peach or nectarine; ¾ cup cooked broccoli; ½ medium carrot; 8 to 10 large leaves of romaine lettuce; ¼ to ½ cup cooked greens; ¼ cup cooked winter squash; ¼ small sweet potato; 1 tablespoon unsweetened canned pumpkin.
Calcium—five servings daily if you’re breastfeeding, three plus if you’re not. Many of these also serve up a considerable amount of protein. One serving equals any of the following: 1¼ ounces Swiss cheese; 1½ ounces Cheddar cheese; 1 cup skim or low-fat milk; 5 ounces calcium-added milk; ½ cup evaporated skim milk; cup nonfat dry milk; 1½ cups low-fat cottage cheese; 6 to 8 ounces yogurt; frozen yogurt (calcium content varies, so check label or ask for nutritional information); 6 ounces calcium-fortified orange juice; 1¾ cups broccoli; 1 cup collard greens; 2½ tablespoons blackstrap molasses; 4 ounces canned salmon or 3 ounces sardines, with bones; tofu (calcium content varies, so check label; a serving should contain about 30 percent of the daily value—DV); 2 corn tortillas (again, check label). Mothers breastfeeding twins, triplets, or more will need an extra calcium serving for each additional baby, and may want to use calcium-enriched dairy products or calcium supplements to get their quota. Vegetarians who don’t use dairy products may find it difficult to meet the requirement from purely vegetable sources unless they are fortified with calcium (orange juice, for example) and may need calcium supplements. Though lack of calcium when breastfeeding isn’t likely to affect breast milk composition, the calcium drawn from a mother’s bones to produce breast milk may make her more susceptible to osteoporosis later in life.
Other fruits and vegetables—two or more servings daily. One serving equals any of the following: 1 apple, pear, banana, or white peach; cup fresh cherries or grapes; cup blueberries; 1 slice pineapple; 2 cups watermelon; 5 dates; 3 figs; ¼ cup raisins; ¾ cup cooked green beans; 6 or 7 asparagus spears; cup cooked Brussels sprouts; cup cooked parsnips, snow peas, or green peas; 1 medium potato; 1 cup fresh mushrooms.
Whole grains and other concentrated complex carbohydrates—six servings daily whether you’re breastfeeding or not. One serving equals any of the following: ½ cup cooked brown rice, wild rice, millet, kasha (buckwheat groats), unpearled barley, bulgar, quinoa, or triticale; ½ cup cooked beans or peas; 1 serving (1 ounce) cooked or ready-to-eat whole-grain cereal; 2 tablespoons wheat germ; 1 slice whole-grain bread; ½ whole-wheat bagel or English muffin; 1 small or ½ large whole-wheat pita; 1 corn or whole-wheat tortilla; 1 serving whole-grain or soy crackers; 2 rice cakes; 1 ounce whole-grain, soy, or high-protein-type pasta; 2 cups air-popped popcorn.
Iron-rich foods—one or more daily. Iron is found in varying amounts in dried fruit, beef, chickpeas and other dried legumes, potatoes in their skins, pumpkin, cooked greens, Jerusalem artichokes, oysters, sardines, soybeans and soy products, spinach, blackstrap molasses, carob, and liver.2 It is also found in wheat germ, whole grains, and cereals that are iron fortified.
High-fat foods—small amounts daily. While an adequate fat intake was essential during pregnancy, and your body was able to handle even those foods high in cholesterol with impunity, it is now once again necessary for you to consider limiting fat in your diet and carefully selecting the type of fat you do consume. It is generally agreed that the average adult should get no more than 30 percent of his or her total calories from fat. Those at high risk for heart disease should limit their intake even more rigidly. This means that if your ideal weight is 125 pounds, you need 1,875 calories daily, no more than 30 percent of those, or 62 grams, from fat. That’s the equivalent of 4½ fat servings (at 14 grams each) a day. If you’re lighter, you will need fewer servings; if you’re heavier, more. You can expect that you will get roughly one serving from drips and drabs in low-fat foods; the rest can come from fatty foods. High-fat foods that will provide you with one half a fat serving include: 1 ounce of hard cheese (Swiss, Cheddar, provolone); 2 tablespoons grated Parmesan; 1½ tablespoons light cream, pecans, peanuts, or walnuts; 2 tablespoons whipped cream; 1 tablespoon cream cheese; 2 rounded tablespoons sour cream; 1 cup whole milk or whole-milk yogurt; ½ cup regular ice cream; 6 ounces tofu; ¼ small avocado; 1 tablespoon peanut butter; 3½ ounces dark meat or 7 ounces light meat turkey or chicken (no skin); 4 ounces fatty fish (such as salmon); 2 large eggs or 2 large egg yolks; 2 small biscuits or 1 average muffin; 1 slice of cake or 3 cookies (sizes vary with recipes). Pure fats which provide one full serving include: 1 tablespoon olive, safflower, corn, canola, or other vegetable oils, butter, margarine, or regular mayonnaise; 2 tablespoons “light” margarine; 2 tablespoons regular salad dressing.
Salty foods—limited quantities. While it may not have been necessary to limit your sodium intake during pregnancy, it might be smart to start cutting back on the salty stuff now. Read labels to screen for foods high in sodium, and avoid making them staples in your diet. Unless someone in your family is on a sodium-restricted diet, lightly salting to taste when cooking is fine. But remember that any family food you’re planning to also feed to your baby should go unsalted to the table—both because infants can’t handle a great deal of sodium and because exposing them to salt early will help give them a taste for it.
Fluid—8 cups daily whether you’re breastfeeding or not. (You may need to drink more if you’re breastfeeding twins.) Water, sparkling water, fruit and vegetable juices, and clear soups are all good fluid choices. You can also count milk (which is about water); fruits and vegetables with a high water content will add more. But beware of too much of a good thing: excessive fluids (more than 12 cups a day if you’re breastfeeding one child) can inhibit breast milk production.
Vitamin supplements. Take a pregnancy/lactation formula daily if you’re breastfeeding, not as a replacement for a good diet but as nutritional insurance. The supplement should contain zinc and vitamin K. If you eat no animal products (not even milk and eggs), you should also be certain your supplement contains at least 4 micrograms of vitamin B12 (which is found naturally only in animal foods), 0.5 milligrams of folic acid, and if you don’t get at least half an hour’s dose of sunshine daily, 400 milligrams of vitamin D (the amount fortifying a quart of milk).
Even if you’re not breastfeeding, you should continue taking your pregnancy vitamins for at least the first six weeks postpartum. After that, a standard multiple vitamin/mineral supplement will fill in the nutritional gaps if you find you don’t always have the time or opportunity to eat as well as you’d like. A supplement designed for women in the childbearing years will provide the extra iron needed to replace iron that might have been depleted with pregnancy and/or post-partum bleeding and will again be lost when menstruation resumes.
Good nutrition is important for all mothers postpartum. Eating well will not only help ensure a speedy recovery, but it will fuel you with the energy you’ll need to keep up with a growing baby (and to keep going in that sleep-deprived state they call new parenthood). It will also help ward off a variety of illnesses (from certain cancers to diabetes to osteoporosis) that are known to be diet-related. So even if you’re not breastfeeding, continue to eat to your good health, using the Nine Basic Principles and the Daily Dozen as a general guide to generally good nutrition—for your sake as well as your baby’s.
“I expected to be tired during the first few weeks after my baby’s birth, but it’s been a few months now since I had my baby and I’m still exhausted.”
Between recovering from the demanding physical biathlon of labor and childbirth, caring for a newborn who hasn’t yet figured out the difference between day and night, and adjusting to the round-the-clock responsibilities of parenthood, virtually all new mothers feel like walking (and diaper-changing and breastfeeding) zombies at first. But while the postpartum recovery period is officially over after six weeks, feelings of exhaustion don’t usually end with it. Rare is the woman (or man, especially if he’s a stay-at-home parent) who escapes continued parental fatigue syndrome during the first year. And it’s not surprising. There’s no other job as emotionally and physically taxing as parenting in the first year. The strain and pressure are not limited to eight hours a day or five days a week, and there are no lunch hours or coffee breaks to spell relief. For the first-time parent, there’s also the stress inherent in any new job: mistakes to be made, problems to solve, a lot to learn. If all this isn’t enough to produce exhaustion, the new mother may also have her strength sapped by breastfeeding, by toting around a rapidly growing infant (and accompanying paraphernalia) and by night after night of broken sleep.
The new mother who goes back to work outside the home may also suffer from the kind of fatigue that comes from trying to do two jobs well. She gets up early to attend to several mommying jobs, often including breastfeeding, before she even leaves for her job away from home. When she returns home, she still has baby care and, often, cooking, cleaning, and laundry to contend with. To top it all off, she can be up with the baby half the night and still be expected to be alert, cheerful, and efficient in the morning. Exhaustion would be inevitable for Supermom herself.
Of course, it’s a good idea to see your doctor to be sure there is no medical cause for your exhaustion (such as postpartum thyroiditis). If you get a clean bill of health, be assured that in time, as you gain experience, as your routine becomes routine, and as your baby begins sleeping through the night, the unrelenting fatigue will gradually fade (though you may not feel totally caught up on your rest until your children are all in school). And your energy level should pick up a bit, too, once your body adjusts to the new demands. In the meantime, there are ways to minimize that night-of-the-living-dead feeling:
Get all the help you can, and then some. Sign up help, paid or otherwise, to pick up the slack (and the groceries, and the house) so you don’t have to.
Share, share alike. Make a list of all of the baby-care tasks and household chores that need to be done, then split them evenly between you and your spouse. Assign according to schedule (if he works during the day, he’ll obviously have to do his share in the early morning and at night), preference, and ability (keeping in mind that the only way to get really good at a task—whether it’s diaper or bathing—is to practice, practice, practice). If you are formula feeding, you can switch off on night feedings (one night on, one night off) so you can switch off on getting some sleep. But even if you’re breastfeeding, dad can rise to the occasion to do any necessary diaper changing before handing baby to you for a feeding. Or, keep the baby in a bassinet beside your bed (or, if you’re co-sleeping, next to you in bed) so you can just reach over and latch baby on. Once breastfeeding is established, you can also pump a bottle of milk each day for dad to give in the middle of the night while you catch some zzz’s.
Be an equal-opportunity parent. There is nothing, besides breastfeeding, that a father can’t do as well or better than a mother. Yet many a new mom doesn’t give dad a chance when it comes to baby care—or she stands over his shoulder criticizing so much that he ends up throwing in the diaper. So if it’s an “I’d rather do it myself because I do it better” mentality that’s standing between you and some rest, lose it now.
Turn in earlier. It may be stating the obvious, but earlier to bed will make it easier to rise. Don’t stay up late to watch the news or surf the Internet. Go to bed as early as possible to get as much sleep (even if it’ll be interrupted) as you can.
Nap when the baby naps. As crazy as that sounds (after all, there’s laundry, cooking, and a thousand other things to do) and as unrealistic as it seems (especially if there’s a toddler at home or if older children need homework help), try to rest when baby does, even if it’s just for half of baby’s nap time. “Power naps” of even fifteen minutes can be surprisingly refreshing.
Don’t forget to feed yourself. Sure, you’re busy feeding your baby (if you’re nursing, it may seem like you’re always busy feeding your baby). But don’t neglect your own nutritional needs (which will be even greater if you’re breastfeeding). Grazing is fine (what new parent has time for a full-fledged meal during the day?), as long as the snacks you reach for are healthful ones. Keep a supply of easy-to-grab but nutritious foods in stock: cheese sticks, hard-boiled eggs, individual servings of yogurt and cottage cheese, small pieces of fruit, ready-cut raw vegetables and dip, cereal mix (combine a few of your favorites with some nuts and raisins in single-serving plastic bags), ready-to-eat edamame (soybeans), whole-grain crackers and pretzels, frozen fruit juice pops, frozen yogurt bars.
Then you’re bound to have almost as many questions about how to care for yourself as you do about how to care for your newborn. For answers on everything you might encounter (and worry about) during your six-week recovery period—from lochia to hemorrhoids, hair loss to night sweats, that first bowel movement to that first postpartum checkup—read chapters 15 and 16 in What to Expect When You’re Expecting. Then, when those six weeks are behind you, come back here for answers to all your other questions about the first year postpartum.
Get moving. Though postpartum fatigue is caused by a lack of rest, it can be heightened by a lack of activity—and a lack of fresh air. So try to take a walk with your baby every day (particularly during those afternoon slumps). If the weather’s not baby-friendly, try a mall or museum walk instead. Joining a postpartum exercise class or doing some postpartum exercises at home (see page 684) will also give you the lift you’re looking for.
“My baby is over a month old and I can’t stop feeling depressed. Shouldn’t I be feeling better by now?”
If the baby blues (which strike 60 to 80 percent of women, most commonly in the first postpartum week) don’t fade by the third or fourth week, chances are post-partum depression is to blame. True post-partum depression (PPD) is less common (affecting about 10 to 20 percent of women) than the baby blues, much more enduring (lasting anywhere from a few weeks to a year or more), and much more serious. PPD may begin at delivery, but more often not until a month or two later; in some women, it doesn’t begin until the first postpartum menstrual period occurs or until weaning (due in part to fluctuating hormones). Women who have had PPD before, have a personal or family history of depression or severe PMS, felt depressed during pregnancy and/or had a complicated pregnancy and delivery, or have a sick or difficult baby are more susceptible to the illness.
The symptoms of PPD are similar to those of the baby blues,3 though much more pronounced. They include crying and irritability; sleep problems (not being able to sleep or sleeping the day away); eating problems (having no appetite or eating all day); persistent feelings of sadness; an inability or a lack of desire to take care of yourself or your newborn; exaggerated concerns about your baby; and memory loss. If symptoms persist for more than two or three weeks, chances are you have PPD and it won’t go away without professional help. Don’t wait to see if it does.
Until recently, postpartum depression was a condition that was largely swept under the rug of medical practice. It was ignored by the public, minimally discussed by doctors, and suffered with unnecessarily in shame and silence by the women who experienced it. This attitude has prevented women from learning about postpartum depression and its highly effective treatments. Worst of all, it has kept women from getting the help they need.
Fortunately, there’s been a shift in the way the medical community views and treats PPD. Public education campaigns are or soon will be under way in some states, requiring hospitals to send women home with educational material about the condition so that new parents will be able to recognize the symptoms early and seek treatment.
Practitioners are also becoming better educated about PPD—learning how to look for risk factors during pregnancy, to screen routinely for PPD during postpartum visits, and to treat it quickly, safely, and successfully. There are also several standardized tests (Edinburgh Postnatal Screening Scale and Cheryl Beck’s Post-partum Depression Screening Scale) that have been shown to be effective in screening for PPD.
Postpartum depression is one of the most treatable forms of depression. So if it strikes you, don’t suffer with it any longer than you have to. Speak up and get the help you need now.
For more help contact Postpartum Support International: 927 N. Kellogg Avenue, Santa Barbara, CA 93111 805-967-7636, www.postpartum.net; Postpartum Assistance for Mother: 390 Diablo Road, Suite 115, Danville, CA 94526, (925) 552-5127, www.postpartumassistance.com; Depression After Delivery: www.depression afterdelivery.com.
First, call your practitioner and ask for a thyroid test. Irregularities in thyroid hormone levels (very common in the postpartum period) can lead to emotional instability. If those levels check out normally, ask for a referral to a therapist who has a clinical background in the treatment of postpartum depression and make an appointment promptly. Antidepressants such as Zoloft or Prozac (which appear to be safe during lactation), combined with counseling, can help you feel better fast. Bright light therapy may bring relief from PPD and can be used instead of or in addition to medication. (Recent studies have shown that high-risk women can take antidepressants such as Zoloft or Prozac right after delivery to prevent postpartum depression. Some physicians will even prescribe low doses of antidepressants during the third trimester of pregnancy to women with a history of postpartum depression.)
Whichever treatment route you and your therapist decide is right for your postpartum depression, keep in mind that swift intervention is critical. Without it, PPD can prevent you from bonding with, caring for, and enjoying your baby. It can also have a devastating effect on your relationship with your spouse and other children, as well as on your own health and well-being.
Some women, instead of (or in addition to) feeling depressed postpartum feel extremely anxious or fearful, sometimes experiencing panic attacks, including rapid heartbeat and breathing, hot or cold flashes, chest pain, dizziness, and shaking. These symptoms also require prompt treatment by a qualified therapist.
Much more rare and more serious than PPD is postpartum psychosis. Its symptoms include loss of reality, hallucinations, and/or delusions. If you are experiencing suicidal, violent, or aggressive feelings, or hearing voices or have other signs of psychosis, don’t wait—call your doctor and go to the emergency room immediately. Don’t let anyone reassure you that these kinds of feelings are normal during the postpartum period—they’re not. To be sure you don’t act out any dangerous feelings, try to get a neighbor to stay with you while you contact the doctor.
“Now that I have a baby, I’m falling behind on everything: cleaning, laundry, dishes, literally everything. My once immaculate house is now a mess. I’ve always considered myself a together person—until now.”
Take the responsibility of caring for a newborn baby for the first time. Days and nights that seem to blur together as one endless feeding. Add a few too many visitors, a generous helping of postpartum hormonal upheaval, and, possibly, a fair amount of clutter accumulated during your stay in the hospital, or in the last days of pregnancy—when you could barely move, never mind clean. Throw in the inevitable mountain of gifts, boxes, wrapping paper, and cards to keep track of. It’s only natural to feel that as your new life with your baby is beginning, your old life—with its order and cleanliness—is crumbling around you.
Don’t despair. Your inability to keep up with both baby and house during the first weeks at home in no way predicts your future success at the juggling act they call motherhood. Things are bound to get better as you regain your strength, become familiar with the basic baby-care tasks, and learn to be a little more flexible. It will also help to:
Get hold of yourself. Dwelling anxiously on what you have to do makes facing it twice as difficult. So relax. Take a few deep breaths. Then, instead of trying to do it all at once (which you can’t), focus on what’s really important: getting to know and enjoy your newborn. Banish thoughts of household chores while you’re with her (relaxation techniques learned in childbirth class may help you to do this). When you look around later on, the clutter and chaos will still be there, but you’ll be better able to deal with it.
Get rest. Paradoxically, the best way to start getting things done is to start getting more rest. Give yourself a chance to recuperate fully from childbirth and you will be better able to tackle your new responsibilities.
Get help. If you haven’t already arranged for household help—paid or unpaid—and taken steps to streamline housekeeping and cooking chores, now’s the time to do so. Also be sure that there is a fair division of labor (both baby care and household care) between you and your spouse.
Get your priorities straight. Is it more important to get the vacuuming done while baby’s napping or to put your feet up and relax so you can be refreshed when she awakens? Is it really essential to dust the bookshelves, or would taking the baby out for a walk in the stroller be a better use of your time? Keep in mind that doing too much too soon can rob you of the energy to accomplish anything well, and that while your house will someday be clean again, your baby will never be two days, or two weeks, or two months old again.
Get organized. Lists are a new mother’s best friend. First thing every morning, jot down a list of what needs to be done. Divide your priorities into three categories: chores that must be taken care of as soon as possible, those that can wait until later in the day, and those that can be put off until tomorrow, or next week, or indefinitely. Assign approximate times to each activity, taking into account your personal biological clock (are you useless first thing in the morning, or do you do your best work at the crack of dawn?) as well as your baby’s (as best you can determine it at this point).
Though organizing your day on paper doesn’t always mean that everything will get done on schedule (in fact, for new parents it rarely does), it will give you a sense of control over what may now seem like a completely uncontrollable situation. Plans on paper are always more manageable than plans flying frenetically around your head. You may even find, once you’ve made your list, that you actually have less to do than you thought. Don’t forget to cross off completed tasks for a satisfying feeling of accomplishment. And don’t worry about what’s not crossed off—just move those items to the next day’s list.
Another good organizational trick of the new mother trade: Keep a running list of baby gifts and their givers as they’re received. You think you’ll remember that your cousin Jessica sent that darling blue-and-yellow sweater set, but after the seventeenth sweater set has arrived, that memory may be dimmed. And check off each gift on the list as the thank-you note is sent, so you don’t end up sending two notes to Aunt Karen and Uncle Bob and none to your boss.
Get simplified. Take every shortcut you can find. Make friends with frozen vegetables, your local salad bar, the pizza delivery guy.
Get a jump on tomorrow tonight. Once you’ve bedded baby down each night and before you collapse onto the sofa for that well-deserved rest, summon up the strength to take care of a few chores so that you’ll have a head start on the next morning. Restock the diaper bag. Measure out the coffee for the coffee pot. Sort the laundry. Lay out clothes for yourself and the baby. In ten minutes or so, you’ll accomplish what would take you at least three times as long with the baby awake. And you’ll be able to sleep better (when she lets you) knowing that you’ll have less to do in the morning.
Get good at doubling up. Become a master of multitasking. Learn to do two things or more at once. Wash the dishes or chop vegetables for the salad while you’re on the phone. Balance your checkbook or fold the laundry while you catch the news on TV. Check your e-mail or help an older child with homework while breastfeeding. There still won’t be enough hours in the day, but this way you may only crave 36 instead of 48.
Get out. Plan an outing every day—even if it’s just a walk around the mall. The change of pace and space will allow you to return somewhat refreshed.
Get to expect the unexpected. The best-laid plans of mothers often (actually veryoften) go astray. Baby’s all bundled up for an outing, the diaper bag is ready, your coat is on, and suddenly the distinct gurglings of a bowel movement can be heard from under all baby’s gear. Off comes coat, bunting, diaper—ten minutes lost from an already tight schedule. To allow for the unexpected, build extra time into everything you do.
Get the joke. If you can laugh, you’re less likely to cry. So keep your sense of humor, even in the face of total disorder and utter clutter; it’ll help you keep your sanity, too.
Get used to it. Living with a baby means living with a certain amount of mayhem most of the time. And as baby grows, so will the challenge of keeping the mayhem in check. No sooner will you scoop the blocks back into their canister than she will dump them back out again. As fast as you can wipe mashed peas off the wall behind her high chair, she can redecorate with strained peaches. You’ll put safety latches on the kitchen cabinets, and she’ll figure out how to open them, covering the floor with your pots and pans.
And remember, when you finally pack your last child off to college, your house will be immaculate once again—and so empty and quiet that you’ll be ready to welcome the pandemonium (and dirty laundry) they bring home on school vacations.
“For the last ten years I’ve run my business, my household, and every other aspect of my life quite effectively. But ever since I came home with my little boy, I can’t seem to get control of anything.”
There’s been a coup in your home—as there is in the homes of all new parents. And the man who would be king in your castle isn’t a man at all, he’s a newborn baby boy. As powerless as he may seem, he is quite capable of disrupting your life and usurping the control you once had over it. He won’t care if you customarily take your shower at 7:15 and your coffee at 8:05, if you favor a leisurely cocktail at 6:30 and dinner promptly at 7:00, if you enjoy dancing into the wee hours on Saturday night and sleeping luxuriously late the morning after. He’ll demand feedings and attention when he wants them, without first checking your schedule to see if it’s convenient. Which means your routine and many of your old, comfortable ways may have to be abandoned for several months, if not several years. The only schedule that will matter, particularly in these early weeks, is his. And that schedule, at first, may have no discernible pattern you can latch onto. Days, and especially nights, may pass as a blur. You may often feel more like an automaton (and if you’re Breastfeeding, a milk cow) than a person, more servant than master, wielding not the slightest measure of power over your life.
What to do? Hand the scepter over graciously—at least for now. With the passage of time, as you grow more competent, confident, and comfortable in your new role, and as your baby becomes more capable and less dependent, you will regain some (though not all) of the control you’ve lost.
In other words, you might as well accept the fact that your life will never be quite the same. But then, would you really want it to be?
“I really thought I could handle it. But the moment our little girl was handed to me, all my confidence dissolved. I feel as though I’m a total flop as a parent.”
Though the ultimate rewards of parenthood are greater than those of any other occupation, the stresses and challenges are greater, too—particularly at the beginning. After all, there’s no other job in the world that thrusts you, without previous training or experience and without supervisory guidance, into fully responsible eighteen-to-twenty-hour shifts. What’s more, there’s no other job that offers as little feedback during the first weeks to let you know how you’re doing. The only person who could possibly give you a job evaluation is a largely unresponsive, unpredictable, and uncooperative newborn who doesn’t smile when she’s satisfied, doesn’t hug you when she’s grateful, sleeps when she should be eating, cries when she should be sleeping, hardly even looks at you for more than a couple of minutes, and doesn’t seem to know you from the next-door neighbor. A sense of satisfaction in a job completed may seem totally absent. Virtually everything you do—changing diapers, making formula, washing baby clothes, feeding baby—is quickly undone and/or needs redoing almost immediately. It’s not surprising that you feel like a flop at your new profession.
Even for a seasoned pro the post-partum period is no picnic. For a novice, it can seem like a never-ending series of blunders, bumbles, mishaps, and misadventures. Yet there are better times in sight (though you may have trouble envisioning them); competence at parenting is closer than you’d now imagine. In the meantime, keep these points in mind:
You’re unique. And so is your baby. What works for another parent and baby may not work for you, and vice versa. Avoid making comparisons.
You’re not the only one. More first-time parents than ever before have had no previous experience with newborns. Even among those who’ve had some, very few manage to glide through those first weeks as though they’d been doing it all their lives. Remember, parents are not born, they are made on the job. Hormones do not magically transform newly delivered women into able parents; time, trial and error, and experience do. If you have the opportunity of sharing your worries with other new parents, you will be reminded that though you are unique, your concerns as a new parent are not.
You need to be babied. In order to be an effective parent, you’ve got to baby yourself a little. Tell yourself, as your own parent would, that you need to eat right and get enough rest, particularly in the post-partum period, and that moderate exercise to keep your energy level up and a bit of relaxation now and then to elevate your spirits are important, too.
You’re both only human. There’s no such thing as a perfect parent, or a perfect baby—so try to keep your expectations realistic, taking into account that you’re both only human.
Your instincts can be trusted. In many cases, even the greenest parent often knows more about what’s right for her baby than friends and relatives or baby books.
You needn’t go it alone. Realize that you won’t always know what to do—no parent does—and that asking for guidance doesn’t mean that you’re short on instincts, just that you’re short on experience. There’s a lot of good advice and comforting support out there you can benefit from. Judiciously sift through information acquired from others, test out what seems right for you and your baby, toss what doesn’t.
Your mistakes can help you grow, and they won’t count against you. Nobody’s going to fire you if you make mistakes (though on a particularly bad day you may wish that you could quit). Mistakes are an important part of learning to be a parent. You can expect to continue making them at least until your children are off to college. And if at first you don’t succeed, just try, try something else (the baby only screams louder when you rock her in your arms side to side, so try holding her over your shoulder and swaying back and forth).
Your love won’t always come easy. It’s sometimes difficult to relate lovingly to a newborn—a basically unresponsive creature who takes but doesn’t offer much in return (except an endless supply of spit-up and dirty diapers). It may be some time before you stop feeling like a fool babbling in baby talk and crooning off-key lullabies and before you can hug and kiss this tiny bundle naturally and unself-consciously. But it will happen.
Whether you are a single mother (or father) by choice or by circumstance, whether you’re on your own for the foreseeable future or just until your spouse returns from a long business trip or ships back from overseas duty, being the sole parent—and possibly the sole provider—for your baby is at least twice the work, twice the responsibility, and twice the challenge of shared parenting. It can also be isolating, especially when you see couples caring for their babies together (he’s closing up the stroller while she carries the baby onto the bus), while you care for yours on your own (you’re struggling to close up the stroller while you carry the baby onto the bus). It can be lonely, particularly when it’s two in the morning and you’ve been walking the floor with a crying baby for an hour and a half, with no one to hand him or her off to. And it can be frustrating when you read magazines and books (including this one) that offer tip after tip about lightening a new mother’s load by “depending on dad.”
The fact is that there are no easy tips for how to lighten a new mother’s load when she’s carrying the load by herself. The tips in this chapter apply doubly to you. Also, check out the numerous online resources available for single parents, including: www.singleparentcentral.com; www.parentswithoutpartners.org; www.singlerose.com; www.singleparents.org; www.makinglemonade.com; www.single mothersbychoice.com.
Remember, too, that though being your child’s only parent can be twice as challenging, it can also be twice as rewarding, with a bond between the two of you that is at least twice as strong and twice as special. In other words, more than worth that extra effort.
Your baby is forgiving. Forget to change her diaper before a feeding. Let soap drip into her eye during her shampoo. Get a T-shirt stuck halfway over her head. Your baby will forgive and forget these and a multitude of other minor mishaps—as long as she gets the message that you love her loud and clear.
The ultimate rewards are unparalleled. Think of parenthood as a long-term project, with results that will be unfolding in the months and years ahead. When you see your baby’s first smile, watch her reach for a toy, laugh out loud, pull herself up, say “Mommy, I love you,” you will know that your efforts have paid off, and that you have indeed accomplished something very special.
“I’m so worried that I’m going to make a wrong move that I spend hours researching every little decision I make about my baby. I want to make sure I do everything right for her, but I’m driving myself and my spouse crazy.”
No parent can do everything right. In fact, all parents make their share of mistakes—mostly little ones, occasionally bigger ones—in raising their children. And it’s through making a few mistakes and learning from them (at least some of the time) that you become a more effective parent. Keep in mind, too, that since all parents and babies are different, what’s right on target for one set may in some cases be way off base for another.
Even reading all the literature and consulting all the experts won’t always give you all the answers. Getting to know your baby and yourself and learning to trust your instincts and good sense is often a better route to making decisions you both can live with. It’s true, for example, that some babies love to be snugly swaddled, but if yours cries whenever she’s wrapped up tightly in a receiving blanket, consider that she would rather be free to kick up her heels. The experts may tell you young babies like to listen to high-pitched coos, but if yours clearly responds more positively to a deep voice, come down an octave. Trust yourself and your baby—you may not always be right, but you won’t go too far wrong.
“I’ve been having backaches and a nagging pain in my neck, arm, and shoulder ever since our son was born.”
New parents don’t have to hang out at the local gym to do their share of weight lifting—all they have to do is carry a growing baby and an overstuffed diaper bag around all day. But in addition to building muscles, carting this heavy load can also trigger a variety of aches and pains in the neck, arms, wrists, fingers, shoulders, and backs of moms and dads—especially if it’s done the wrong way.
As long as you remain your son’s major source of transportation and comfort, you’ll be pumping plenty of baby. To minimize the aches and pains:
Take it off. If you haven’t yet taken off all of your pregnancy weight, try, gradually, to do so now. Excess weight puts unnecessary strain on your back.
Work out. Exercise regularly, concentrating on those exercises that strengthen the abdominal muscles (which support the back) and those that strengthen the arms.
Assume a comfortable position for feeding baby. Don’t slouch, and be sure your back is supported—if you can’t slide all the way to the back of the chair, tuck a pillow behind you. Use pillows or armrests, as needed, to support your arms as you hold baby and direct breast or bottle. And don’t cross your legs.
Lift and bend smart. You’ll be doing more lifting (of baby and baby paraphernalia) and bending (to pick up all those toys strewn on the floor) than ever before. It pays to do it the right way. When lifting baby, put the weight of the load on your arms and legs rather than on your back. Bend at the knees, with your feet shoulder-width apart, not at the waist. And keep your wrists straight when picking up your baby.
Sleep smart. Sleep on a firm mattress, or put a board under an overly soft one. A mattress that sags in the middle will have you sagging, too. Lie on your back or side with your knees bent.
Get a step up. Don’t stretch to reach high places; stand on a ladder or foot-stool instead.
Listen to your mother. Remember all the times she told you, “Don’t slouch. Stand up straight!” You’d be smart to follow that advice now, being extra conscious of your posture. Walk, sit, and lie with your buttocks tucked under, abdomen tilted inward (this is called a “pelvic tilt”), and keep your shoulders back instead of slouched.
Make adjustments. If you push a carriage or stroller, be sure the handles are at a comfortable height for you. If they aren’t, see if you can have them adjusted, or if they’re too short, buy extenders.
Do a lot of switching. If one shoulder starts to ache from the weight of the diaper bag, periodically switch shoulders, carry the bag in the crook of your arm for a while, or opt for a backpack. Switch baby from arm to arm, too, rather than always relying on the same one. Instead of walking the floor all night with your colicky baby, alternate time spent rocking in your arms to time spent rocking in an infant swing.
Use a baby carrier or sling—whichever seems easier on your back—to give your aching arms a break.
Turn on the heat. A heating pad or a warm bath can spell relief from muscle discomfort and spasms.
Take a seat. Try not to stand for long periods of time. If you must stand, keep one foot on a low stool with your knee bent. Use a small rug as a cushion underfoot if you’re often standing on a hard-surfaced floor.
“I weaned my daughter two months ago and I still haven’t gotten a period. Shouldn’t I have by now?”
There aren’t any sure formulas for calculating when a nursing mother will resume her periods—and there’s a wide range of normal. Some women produce enough estrogen to begin menstruating again even before they’ve weaned their babies, occasionally as early as six weeks to three months postpartum. But others, particularly those who have breastfed for a long time, nursed exclusively, or had irregular menstrual periods before pregnancy, will have a vacation from menstruation until several months after they’ve weaned. Chances are you’re just lucky enough to fall into this group. Be sure, however, that you’re eating enough and haven’t been losing weight too quickly; strenuous dieting, especially when combined with strenuous exercise, can temporarily stall the return of the menstrual cycle. And mention the situation to your practitioner at your next checkup, which will probably be scheduled some time after the sixth month postpartum. (See box, next page, for more on postpartum periods.)
Keep in mind that just because you’re not getting your period doesn’t mean you can’t get pregnant (it’s possible to ovulate before your first postpartum period). See page 692 for information on more reliable means of contraception.
“My first period after the pregnancy was really heavy and painful. Can something be wrong?”
Your cycle’s been on hiatus for probably a year or longer, so it’s not surprising it has a few kinks to work out on its return. In fact, most women find that their first postpartum period is different from prepregnancy periods. Often it’s heavier, crampier, and longer, though occasionally it’s lighter and shorter. Cycles may be irregular, too, for at least a few months. Once your body gets used to ovulating and menstruating again—and once hormone levels finally get back to prepregnancy levels—your periods will almost certainly return to business as usual. One plus you can probably look forward to: Many women find their periods eventually become less painful and less heavy after they’ve delivered a baby.
While there’s no telling for sure when your menstruation vacation will end, there are some averages to consider. The earliest a breastfeeding mom might expect her period is six weeks postpartum, though such an early resumption is rare. Up to 30 percent will get their first period within three months after delivery, just over 50 percent by the six-month mark. Still others won’t be pulling the tampons out of storage until closer to the end of the first year, and a few who continue breastfeeding will be period free well into the second year. Though some women have a sterile first cycle (without an egg being released), the longer that first period is delayed, the more likely it will be a fertile one.
On average, woman who don’t breastfeed will find themselves back on schedule sooner. The first period may occur as early as four weeks after delivery (though, again, this is less common); 40 percent will resume their cycle by six weeks post-partum, 65 percent by twelve weeks, and 90 percent by twenty-four weeks.
“Ever since my second child was born, I find that I leak a bit of urine when I cough or laugh or strain to lift something.”
Sounds like stress incontinence, a common symptom in women after child-birth—particularly those who’ve had more than one child. Annoying, messy, and often embarrassing, postpartum stress incontinence is generally a direct result of labor and delivery, when the connective tissues and muscles that support the bladder and urethra are stretched and weakened, allowing urine to leak out whenever the bladder is stressed (as when you cough or sneeze). Pelvic nerves may also be damaged from labor and delivery, compounding the problem.
The good news is that urinary incontinence is usually temporary (though it may last a few months or even longer) and treatable (so you won’t have to buy diapers for both you and your baby). Here are some tips to help you regain bladder control:
Do your Kegels. Spreading out Kegel exercises over the course of a day every day for a couple of months (see box, facing page) may help to strengthen the muscles in the vaginal wall and eliminate the problem. Start off by doing sets of ten, three to four times a day, and work your way up to more. Biofeedback or electrical stimulation may help make Kegel exercises more effective; ask your practitioner.
Eat right. Avoid bladder irritants, such as caffeinated beverages, alcohol, carbonated drinks, citrus drinks, and spicy foods.
Don’t smoke. Nicotine acts directly on the muscles of the bladder, causing them to contract. Smokers also tend to cough often, leading to more urine leakage.
Take off the pounds. Too much weight on the bladder can stress the pelvic floor and cause incontinence. If you’re overweight, try to shed some pounds.
Don’t hold it in. Urinate frequently so your bladder doesn’t get too full.
While you’re waiting for some improvement, use maxipads or panty liners to absorb the flow of urine. If incontinence continues, consult your practitioner. In severe cases, surgery may be needed to remedy the condition.
Sure, doing Kegels during pregnancy was a great way to get your perineum in shape for delivery. But there even more reasons to keep your Kegel routine up now that you’ve delivered—starting, in fact, as soon as you’ve delivered. These perineum-tightening exercises firm up muscles left slack by delivery, increase circulation to the area (promoting healing), prevent and/or treat urinary and fecal incontinence, and ease hemorrhoids.
In case you’ve never done a Kegel before or you need a refresher, it’s simple:
Firmly tense the muscles that you use to stop the flow of urine. Hold for as long as you can, up to eight or ten seconds, then slowly release the muscles and relax for several seconds. Repeat. Do at least 25 repetitions at various times during the day, while sitting, standing, lying on your back, making love (a great way to mix business with pleasure), standing on line at the grocery store, talking on the phone, checking e-mail, changing baby’s diaper, taking a bath … basically any time is Kegel time!
“I knew I wouldn’t be ready for a bikini right after delivery, but I still look six months pregnant a few weeks later.”
Back when you were pregnant, looking the part was half the fun. Remember the thrill of buying your first pair of maternity jeans? The excitement of watching your belly swell from a scarcely noticeable (if you stuck your stomach out) bulge to a larger-than-life watermelon? And the momentous day when you could finally walk down the street confident that everyone you passed could plainly see that you were pregnant and not just plump?
Once delivery day has come and gone, however, looking pregnant quickly loses its appeal. No woman wants to look as though she’s still toting a baby in her belly once she’s toting a newborn in her arms.
Though childbirth produces more rapid initial weight loss than any diet you’ll find on the bestseller list (an average of 12 pounds at delivery), few women are satisfied with the results. Particularly after they catch a glimpse of their post-partum silhouettes in a mirror and see that they still look distressingly pregnant. The good news is that most are able to pack away their pregnancy jeans within the first month or two. The bad news: The old jeans may not fit the way they used to for a while longer.
How quickly you return to your prepregnant shape and weight will depend on how many pounds and inches you put on during pregnancy—and where they settled. Women who gained the recommended number of pounds on a good diet and at a gradual and steady pace may be able to shed it all, without dieting, by the end of the second month or so postpartum. On the other hand, those whose gain far exceeded that magic number—particularly if they gained the weight in uneven spurts or on a steady diet of junk food—may find the return to prepregnancy shape more challenging.
No matter how much you gained and how you gained it, sticking to the Postpartum Diet now should lead to slow, steady weight loss—with no loss of energy. Moms who do not breastfeed can, once the six-week postpartum recovery period has passed, move on to a sensible, well-balanced reducing diet to drop whatever pounds remain. Breastfeeding mothers who aren’t losing weight can reduce calorie intake by a couple hundred a day and increase activity to encourage weight loss without cutting into milk production. Though some won’t manage to lose all of the weight while they’re nursing, most will be able to take off any remaining excess poundage once they wean their babies.
Of course, one of the major reasons why most women continue to look a little pregnant well after delivery—and sometimes even after they’ve lost all the pregnancy pounds—doesn’t have anything to do with weight gain. It has to do with stretched-out abdominal muscles and skin (see the next question).
“I’ve lost all my pregnancy weight, but I still don’t look like I did before I got pregnant. How can I get my body back to the way it was before?
For many women it’s not pregnancy pounds that keep them looking pregnant; most are shed without much effort in the first six weeks postpartum. Rather, it’s stretched-out abdominal muscles that stand between those new mothers and their old prepregnancy profiles.
Unfortunately, simply waiting it out won’t work. Pregnancy-stretched muscles regain some of their tone as time goes by, but won’t ever return to their prepregnancy condition without exercise. Leave your tummy muscles to their own devices, and you’ll find that their sagging increases as the years pass, and with each baby you deliver.
Postpartum exercise will do more than help you pull your tummy in. Abdominal routines will improve general circulation and reduce the risk of back problems (which new mothers are more susceptible to, simply because of all the baby toting they do), varicose veins, leg cramps, swelling of ankles and feet, and the formation of clots in blood vessels. Perineal exercises (Kegels) will help you avoid stress incontinence (leaking of urine), which sometimes occurs after childbirth as well as dropping, or prolapse, of the pelvic organs. Plus, they’ll tighten your perineum so that making love eventually will be as good or better than ever. Regular exercise will also promote healing of your uterine, abdominal, and pelvic muscles, hastening their return to normal and preventing further weakening from inactivity, as well as help your pregnancy-and-delivery-loosened joints tighten back up (or nearly so). If excess pounds are a problem, exercise will help you shed them (you can burn the 100 calories of a baked potato in just 20 minutes of brisk walking, even faster if you’re power walking). Finally, exercise can provide psychological benefits, improving your ability to handle stress and to relax, while minimizing the baby blues.
If you have the time, opportunity, and inclination, sign up for a postpartum exercise class (you can usually bring baby along), or buy a postpartum exercise book or video and fit an at-home program into your schedule (baby will probably love watching you jump around). If you’re currently too exhausted to contemplate an intense exercise program, regularly doing just a few simple exercises aimed at your particular problem areas (such as tummy, thighs, buttocks) can also get you back into shape. Add a daily brisk walk or other aerobic activity (or combine both, as with stroller exercise) to your agenda and you will have put together an adequate exercise program. Before you begin any exercise program, of course, be sure you have your practitioner’s okay.
Keep these tips in mind when exercising postpartum:
Stick to a schedule. Exercise done only sporadically is useless and thus a waste of the time you’re so short on to begin with. Muscle-toning exercises (leg lifts, sit-ups, and pelvic tilts, for example) are best done daily in short takes; two or three 5-minute sessions a day will tone you up better than one 20-minute workout. Once you begin doing aerobic exercises (brisk walking, jogging, bicycling, and swimming, for example), aim for at least three 20-minute sessions of sustained activity a week—though 40 minutes four or five times weekly may be a better goal for strengthening bones and preventing osteoporosis later in life.
Don’t rush. Muscle-toning exercises are most effective when done slowly and deliberately, with adequate recovery time between repetitions. It’s during the recovery periods that muscle buildup occurs.
Start slowly if you haven’t exercised recently or are doing unfamiliar exercises. Do only a few repetitions the first day, and increase the number gradually over the next week or two. Don’t do more than the recommended amount, even if you feel great. Stop your workout as soon as you begin to tire.
Avoid competitive sports until you get your doctor’s okay to participate.
Because your joints are still unstable and your connective tissue lax, avoid jumping; rapid changes of direction; jerky, bouncy, or jarring motions; and deep flexion or extension of joints. Also avoid knee-chest exercises, full sit-ups, and double leg lifts during the first six weeks postpartum.
Do muscle-toning exercises on a wood floor or tightly carpeted surface to reduce shock.
Do five minutes of warm-ups (very light stretching exercises, slow walking, or stationary biking against low resistance) before you begin exercising. Cool down at the end of each session with some gentle stretching exercises, but to avoid damaging still-loose joints, don’t stretch to the maximum for the first six weeks.
Get up slowly to avoid dizziness from a sudden drop in blood pressure, and to equalize circulation, keep your legs moving for a few moments (by walking, for example) when you stand up.
Once you begin doing aerobic exercises, be careful not to exceed your target heart rate. Ask your practitioner what that is.
Drink plenty of fluids before and after exercising, and if the weather is very hot or you are perspiring a great deal, have something to drink as you go, as well. Water’s the best sports drink; avoid sugar-sweetened beverages, including those marketed especially for athletes.
Don’t use your baby as an excuse for not exercising. Most babies love lying on mommy’s chest during a calisthenics session; snuggling in a baby carrier while she pedals a stationary bike, works a rowing machine or skiing machine, or walks on a treadmill; and being pushed in the stroller or carriage while mommy walks or jogs. But don’t bounce an infant around in a baby carrier while you jog.
You’ve got sneakers? You’ve got a baby? You’ve got a stroller? You’ve got all it takes to try stroller exercise—a program designed for new moms. Stroller exercising is as easy as taking your baby out for a walk in the stroller; no other equipment is necessary. Begin by strolling for about five minutes at a slow pace, to warm up your muscles. Then work your way to a brisk pace. Because you’re pushing, you’ll be working harder (especially as your baby gets heavier) than if you were walking without baby or with baby in a carrier. You can also use the stroller (and the baby) as a resistance apparatus, allowing for numerous stretching and muscle-building exercises. Another plus: The motion will soothe a colicky baby. For more information, check out these Web sites: www.strollercize.com; www3.telus.net/lets_strollercise.
There are, alas, some postpartum body changes that will stay with you no matter how many sit-ups and leg lifts you do—and how carefully you monitor your diet. These changes—which may be imperceptible or significant enough to increase a shoe or dress size—are largely due to the loosening of the joints during pregnancy (to make room for delivery) and their tightening up again (though not necessarily in exactly the same configuration) postpartum. Women who have had cesareans may also note a slight alteration in the shape of the abdomen that won’t yield to exercise.
“We’ve gotten the go-ahead on sex—but sex is the last thing I feel like doing now.”
Is the honeymoon over? Has the romance faded now that there’s a little fledgling sharing your love nest? Will you ever feel that heady rush of abandon in bed again? For that matter, will you ever stop feeling tired long enough to feel anything else at all?
For most women, even those who lived highly memorable love lives before delivery, doubts that any kind of sexual relationship with their spouse will ever resume, at least on a regular basis, are nagging and numerous. The fact is, many couples find the postpartum period (and sometimes a several-month stretch following it) a sexual wasteland.
Sure, maybe all you really need is each other—and five uninterrupted minutes—to make love in the postpartum period. But to make love and actually enjoy it, taking the following steps may help:
Lubricate. Altered hormone levels during the postpartum period (which may not normalize in the breastfeeding mother until her baby is partially or totally weaned) can make the vagina uncomfortably dry. Use a lubricating product (like K-Y jelly) or lubricating vaginal suppositories until your own natural secretions return.
Medicate. If necessary, ask your practitioner to prescribe a topical estrogen cream to lessen pain and tenderness.
Warm up. Assuming you have the time, indulge in plenty of foreplay. Think of it as an appetizer that will whet your appetite for the main course.
Loosen up. Try a massage, a shower for two, or anything else that can help you unwind and relax. Or try a glass of wine to take the edge off (but be aware that too much alcohol can interfere with sexual desire and performance).
Exercise. Kegel exercises (see box, page 682) will help to tone the pelvic muscles, which are associated with vaginal sensation and response during intercourse.
Vary positions. Side-to-side or woman-ontop positions allow more control of depth of penetration and put less pressure on a sore perineum. Experiment to find what works best for you.
There’s no shortage of reasons why you may not feel like making love now, among them:
Readjusting hormones can zap sexual desire and response during the post-partum period, especially if you’re breastfeeding.
Your libidos (yours and your spouse’s) usually lose when they compete with sleepless nights, exhausting days, dirty diapers, and the endless needs of a demanding baby.
Fear of pain, of your vagina being stretched out, or of becoming pregnant again too soon may nip any romantic buds before they blossom.
A painful first intercourse postpartum can make the thought of further attempts unappealing. Pain on subsequent tries can make lovemaking extremely awkward and uncomfortable. Such pain may continue for a while even after the perineum is healed.
Discomfort because of decreased vaginal lubrication, a result of hormonal changes during the postpartum period, can also dull desire. The problem usually lasts longer in Breastfeeding mothers, but can continue for as long as six months, even in those who are not breastfeeding.
Uneasiness over the sudden lack of privacy, particularly if baby’s in the room with you, can help you lose that loving feeling. Even if your head believes what you’ve heard—that your baby will be oblivious to and unaffected by your lovemaking—your body may balk at the idea.
Mothering may be taking all the loving and nurturing you have to give right now, and you may sometimes be unable to summon any up for anyone else, even your spouse.
Breastfeeding may be satisfying your needs for intimacy (without your realizing it), making you less interested in encounters of the sexual kind.
Leaking of breast milk, stimulated by sexual foreplay, may make either you or your spouse uncomfortable, physically as well as psychologically. Or, with your breasts suddenly serving such a nurturing purpose, you may have trouble with the idea of using them for pleasure.
There are so many other things that you feel you need or want to do that sex may just seem less important now—if you have a spare half hour, lovemaking may not be at the top of the list (or on the list at all).
Still, there’s promise for the future. You will surely live to love again, with as much pleasure and passion as ever—and maybe, because you have been brought closer by sharing parenthood, even more. In the meantime, there are many steps you can take to improve both interest and performance right now:
Don’t rush it. It takes at least six weeks for your body to recover completely, and sometimes much longer—especially if you had a difficult vaginal delivery or a cesarean section. Your hormonal balance may not return to normal until you resume menstruating, which, if you are breastfeeding, may not be for several months or more. Don’t feel obligated to jump into bed until you feel up to it—mentally, emotionally, and physically.
Express love in other ways. Intercourse isn’t the only way for a couple to love. If you’re not ready to go all the way, try cuddling and caressing in front of the TV, back rubs in bed, and hand holding while strolling in the park with baby. As for any couple getting acquainted (and you, after all, are becoming reacquainted physically), romance en route to the bed is an important first step. If you’re not too pooped to pop, you can even try mutual masturbation. But some evenings, there may be nothing more satisfying than the intimacy that is shared lying in each other’s arms.
Expect some discomfort. Many women are surprised and disheartened to find that postpartum intercourse can really hurt. If you’ve had stitches, you may indeed experience some degree of pain or discomfort (ranging from mild to severe) for weeks, even months, after the tissues have outwardly healed. You may have pain with intercourse, though probably less of it, if you delivered vaginally, perineum intact—and even if you had a cesarean. To minimize pain, try the tips in the Easing Back into Sex box, page 686.
Occasionally, a couple of months postpartum, a new mother notes very slight spotting after intercourse. This may be due to the growth of skin flaps at the site of an incision or tear. These skin flaps are easily repaired. Report such spotting to your practitioner.
Don’t expect perfection. Don’t count on perfectly orchestrated orgasms at your very first return engagement. Many usually orgasmic women don’t have orgasms for several weeks or even longer when they start making love again. But with time, caring, and patience, the thrill does return and sex becomes as satisfying as ever (maybe more, if you’ve been faithful with your Kegels!).
If you can’t beat baby’s schedule, work around it. Falling into each other’s arms when and where the spirit moves may no longer be possible. Instead, you may have to set your sexual watches according to that spirited little alarm clock in the crib. Baby is napping at 3 o’clock on Saturday afternoon; drop everything and head for the bedroom. Or if the little angel has been predictably sleeping from 7 to 10 every evening, plan ahead for a romantic interlude. If he or she wakes up crying just as your evening is reaching a climax, try to see the humor in the situation. (If you really, really concentrate, you may be able to finish up while you keep your little coitus interrupter waiting for a couple of minutes.) Should sexual encounters with your spouse continue to be less frequent for a while (perhaps even for a long while), strive for quality rather than quantity.
Keep your priorities straight. If making love is important to you, reserve energy for it by cutting corners elsewhere (in areas that won’t affect your family’s physical or emotional well-being, like housekeeping). If you spend your entire day at full throttle, you won’t have the strength left to do anything in bed but close your eyes.
Talk about it. A good sexual relationship is built on trust, understanding, and communication. If, for instance, you’re too exhausted one night from your 24-hour baby-care shift to feel sexy, don’t beg off with a headache. Instead, tell it like it is. If your spouse has been sharing baby-care responsibilities from the beginning, he’s very likely to understand (he may, in fact, be too fathered out some nights himself). If he hasn’t, this may be the time to explain the many reasons, including this one, why he should be.
Communicate, too, about problems like a dry vagina or pain during intercourse. Let your spouse know what hurts, what feels good, what you’d rather put off until next time.
Don’t worry about it. The more you worry about a lack of libido, the less libido you’re likely to have. So face the facts of postpartum life, relax, and take your sexual relationship one night at a time, confident that the romance will return to your life.
“It seems like my vagina is roomier than before I delivered, and making love is less satisfying for both of us.”
Most women come out of vaginal deliveries roomier than when they went in. Often, the change isn’t significant enough to be noticed by either partner. Sometimes, as when conditions were previously too cramped for comfort, it’s welcomed. Occasionally, however, a vaginal delivery can leave a woman who was “just right” before stretched out enough to markedly decrease the pleasure she and her spouse experience during intercourse.
The passing of time may help tighten things up a bit, and so can keeping up with your Kegels. Repeat these multipurpose muscle toners as many times as you can during the day; get into the habit of doing them while you’re cooking, watching TV, breastfeeding, or reading—even during intercourse.
Very rarely, the muscles don’t tighten up satisfactorily. If six months have passed since delivery and you still feel that you’re too slack, discuss with your practitioner the possibility of surgical repair to snug things up. The procedure is a minor one, but it can make a major difference in your love life.
“My spouse and I are both so busy—with our jobs, our new son, the house—that we rarely find any time for each other. When we do, we’re too tired to make the most of it.”
The three that baby makes isn’t necessarily a crowd, but caring for that baby can crowd your days and nights so much that you feel as though you have no time left for the company of two. And though it’s true that your relationship with your spouse is the most important in your life (babies grow up into children, who grow up and move away from home, but your mate will hopefully be yours into old age), it’s also true that it’s the easiest in your life to take for granted. Neglect your baby, neglect your jobs, neglect your home, and the consequences would be clear and swift. But the results of neglecting a marriage are often not apparent at first. Still, they can erode a relationship before the partners even realize it.
So start giving your relationship its due. Make a conscious effort to keep the love lights glowing or, if they seem to have flickered out, to rekindle them. Rethink your priorities and reorganize your time in any way you have to, but free some up to spend alone together. For instance, consider putting your baby on a reasonably early-to-bed schedule so that you can settle back for some quality time with each other. Share a leisurely late dinner (no TV, no phone calls, no reading the paper or checking e-mail, and with any luck, no crying baby allowed). A glass of wine may help you unwind (unless it leads to three or four, which may unravel you completely). Candlelight and soft background music will help set the romantic mood.
Every such evening doesn’t need to culminate in sex. Indeed, sex may turn out to be a relatively rare treat in the exhausting early months—it may even be a treat you won’t be very interested in for a while. Right now, verbal intercourse can be even more beneficial to your relationship than the sexual variety. But resist the temptation to talk exclusively about the baby; that would defeat the purpose of your interlude.
Schedule a romantic night out on the town once a week (if it’s the same night each week, with a standing sitter, you’re both less likely to find a reason why you can’t make it). Have dinner, see a movie, visit with friends, or do whatever it is you enjoy doing together most. Also try to arrange for a baby-free hour or two on weekends to pursue a shared interest. Hire a sitter, swap sitting time with a neighbor, or enlist a grandparent.
If you can’t seem to squeeze a regular rendezvous into your current schedule, it’s time to start making your relationship a top priority.
“Ever since our son was born, I’ve felt that my husband sees me only as the mother of his child, not as a lover.”
Tiny babies can bring some huge changes when they appear on the family scene. From how much (or how little) you sleep to how you spend your money and your free time, to how much money and free time you have, having a baby impacts nearly every aspect of your life, including your romantic life. Almost every couple finds that the dynamics of their relationship undergo significant shifts as they adjust to being both a two-some and a threesome.
Just as you’re adjusting to becoming a mother, your mate is adjusting to becoming a father. With so much energy focused on that challenging transition into parenthood, it’s not surprising that the romantic side of your relationship has been put on hold. But while many of the changes you’ve noticed around the house are permanent—at least until baby grows up and leaves the nest—the change in your relationship is not. Once you’re comfortable in your new roles as parents, you’ll both be able to focus energy on reestablishing your old ones as lovers. Not only are the roles not mutually exclusive—you can be parents and lovers at the same time—but they’re mutually beneficial. There’s no better way to ensure that a child will grow up in a happy, intact home than by taking the time to nurture the romance that created that child in the first place.
That said, it’s not easy to nurture romance when you’re so busy nurturing a newborn—or to see each other as lovers when you’re so busy learning how to be mothers and fathers. These tips, as well as those above, can help:
Make yourself feel like a woman. Yes, you’re preoccupied with baby care—and that leaves you with very little time to care for yourself. But, let’s face it, going three days without a shampoo or two days in the same spit-up-stained sweatshirt isn’t going to put either one of you in the mood for romance. Spending a half hour perfecting your blow dry and another on your makeup obviously isn’t a realistic goal when you’re the mother of a newborn, but finding the time for a shampoo, a little mascara and lipstick (and maybe a lot of concealer), a dab of your favorite scent, and some fresh clothes might be. Such efforts won’t only make you look more attractive, they’ll make you feel more attractive.
Make him feel like a man. Most new mothers transfer their focus from their partner to their baby, at least initially. That’s good for the perpetuation of the species, but not so good for the perpetuation of the relationship. Make it a point to romance your spouse as you would like to be romanced. Hug him unexpectedly from behind while he’s washing the dishes, squeeze his hand when he passes the baby shampoo, notice when he comes home with a new haircut, kiss him anytime (and anywhere) at all.
Make time for romance. Choose to share dinner after baby’s down for the night, rather than eating on the run while you take turns walking the floor. Keep a bottle of massage oil and a few candles by the bed, and give each other a romantic rubdown after baby has conked out (and before you do). Establish a “date night” once a week and use it to catch up on each other. Be impulsive, too, indulging in a bubble bath or grabbing a quickie when baby’s napping.
“My daughter is nearly a year old. We’re definitely planning to have another child, but we’re not sure how far apart to space them.”
Mother Nature notwithstanding, the decision of how many months or years to wait before getting pregnant again is a couple’s alone to make, and different couples feel very differently on the subject. Some feel very strongly that they’d like to cluster their children together, one directly after the other. Others feel just as strongly that they’d like several years—or more—of breathing (and sleeping) room between deliveries. And the way couples feel about child spacing before they actually become parents (“Wouldn’t it be great to have them just a year apart?”) isn’t necessarily the way they feel once the reality of endless diaper changes and sleepless nights sinks in (“Maybe we need a break before we try this again.”).
There aren’t very many firm facts to help parents out in making their decision. Most experts agree that postponing conception for at least a year after baby number one allows a woman’s body to recover fully from pregnancy and childbirth before beginning the reproductive cycle all over again. But that health issue aside, there’s little evidence to show that there is an ideal spacing period between children. Researchers haven’t found that spacing affects a child’s intelligence or emotional development, the children’s eventual relationship (which has more to do with their personalities than their age difference), or the parents’ relationship.
The bottom line: It’s up to you. The best time for you to add to your family is when you and your spouse feel your family is ready.
Still don’t have a clue? There are many questions to ask yourself when deciding how close or how far apart to space your children:
Will I be able to handle the demands of two babies? Children under age three are high maintenance, requiring constant attention and care. If your second baby arrives before your oldest is two years old, you’ll be doing double diaper duty, enduring endless sleepless nights, and if they’re really close in age, dealing with the more difficult aspects of toddler behavior (such as tantrums and negativity) in two toddlers at once. On the flip side, although caring for closely spaced children will probably leave you exhausted at first, once the first few years have passed, you’ll have put those challenges behind you (unless you decide to start all over again with number three). Though your children won’t necessarily be close just because they’re close in age, they’re more likely—because of their developmental similarities—to be natural playmates for each other. Another convenience: They’ll likely find the same toys, movies, activities, and vacations interesting.
Do I want to start all over again? Once you’re in “baby mode,” it’s sometimes easier to just stay that way, consolidating the years spent on baby care. The crib is set up, the diaper wipes are in place, the stroller isn’t yet collecting dust in the attic, and the safety gates are still up. Spacing children far apart requires you to reorient yourself to the demands of having a baby again, just when your oldest is independently off at school and you’re getting your “life” back in order. Of course, having a new baby a few years after the first allows you ample time to enjoy and shower attention on one child before the arrival of the next. And since the oldest most likely won’t be at home all the time, you’ll get that same opportunity to provide individual attention to your younger child.
Am I physically ready to go through a new pregnancy? Some women just don’t feel ready to go through pregnancy again so soon, especially if their first pregnancy was difficult. Toting a young toddler while also carting around a watermelon-size belly isn’t easy; neither is running after your newly mobile fifteen-month-old while you’re doubled over in the bathroom with morning sickness. Also take into consideration your feelings about going from a pregnancy to breastfeeding to another pregnancy and breastfeeding again. You may decide that you’d like to give yourself a physical break—to experience a completely baby-free body again before resuming reproduction. On the other hand, women who thoroughly enjoy both pregnancy and breastfeeding may see no reason to postpone further bundles of joy. And parents who would prefer to have their children by a certain age or women who feel that the ticking of their biological clock doesn’t give them time to wait, may opt for close spacing simply because it’s their best option.
Thinking about expanding the family again? There are plenty of preconception steps you and your spouse can take to improve your chances of fertility success, as well as the odds of having a safe pregnancy and a healthy baby. For a complete list of tips, see chapter 21 of What to Expect When You’re Expecting.
What is best for my children? There’s certainly no consensus on this issue—and results can vary widely, depending on the children’s temperament, the way sibling conflicts are resolved, the atmosphere around the home, and many more factors. For instance, if there is a very large gap in ages between siblings, they might grow up not feeling like siblings at all—or they might have a very special affection for each other. Siblings spaced far apart may experience less sibling rivalry than those closer in age, since the oldest sibling already has a life outside the home (school, sports, friends), may actually appreciate the new addition more, and may enjoy helping care for the baby. Or she may resent the responsibilities that often come with being the much older child.
If the gap is very small—less than two years—closeness in age won’t necessarily guarantee closeness between your children. Because of their developmental similarities, they may be built-in playmates for each other, although they may also, because of their developmental similarities, be more likely to fight. The fact that they’ll probably enjoy the same toys might be both a convenience (fewer toys to buy) and a potential nightmare (more tug-of-war over the toys). Having children close in age may minimize the adjustment of the oldest child to a new sibling; feelings of displacement are less common and less pronounced, since the oldest doesn’t remember what it was like to be the “only.” On the other hand, a very young older sibling may resent the sudden shortage of lap space—lap space she still very much needs.
What is best for my personality? If your temperament is easygoing, it may not matter if you’ve chosen a large gap or small one between children. Having two closely spaced children may not bother you in the least; neither might having to get back into baby mode again after a long hiatus. On the other hand, if you have a hard time dealing with chaos and clutter, a longer interval between children might be best.
How close in age are my siblings to me? The way you grew up may influence how you’d like your family to be structured. If you had a great experience growing up with a brother eighteen months older than you, you might wish the same for your children. If you hated that you went off to college when your younger sister was still in elementary school, you may choose to have children closer in age. If you found yourself always fighting with your close-in-age sister, you may choose to space your own kids farther apart.
“I’m definitely not ready to have another baby yet. What are my options for birth control?”
Okay, maybe sex isn’t the first thing on your minds these days—particularly as you spend yet another evening playing “pass the crying baby” (rock and sing lullabies until your arms are aching and your voice is hoarse, pass the baby to your spouse, rest and repeat). Maybe it’s the last thing on your mind most of the time. Yet there will come a night (or a Sunday afternoon when baby’s napping) when you’ll get the urge to sweep the pacifiers and burping cloths off the bed and sweep each other off your feet—when lust will return to your life, and passion will pick up where it left off pre-baby.
So be prepared. To avoid back-to-back pregnancies, you’ll need to use some form of birth control as soon as you begin having sex again. And because you never know when the urge might first strike, it’s good to have that birth control in hand (or by your bed) well in advance of that first amorous advance.
Unless you’re a gambling woman (and one who doesn’t mind becoming pregnant again right away), counting on breastfeeding to provide birth control is risky, to say the least. Although some women do not begin menstruating while they’re nursing exclusively, many do. And since it’s possible to ovulate and conceive before ever having that first postpartum period, some women who go that risky route end up going from pregnancy to pregnancy without menstruating in between. In other words, the fact that your periods have been suppressed by breastfeeding doesn’t mean you’re not capable of conception, or that you should consider yourself “safe” without birth control.
So you’ll need a more reliable form of contraception. Nearly every method of contraception is available to new mothers, though there are many factors (such as whether you’re breastfeeding, how much childbirth has changed the size of your cervix) that must be considered before choosing which method is right for you. Don’t automatically assume that the type of birth control you used before getting pregnant is the best one to return to postpartum. Your contraceptive needs and concerns may be different now than before. And with today’s rapid advances in contraceptives, there may be new options open to you that weren’t even on the market before you became pregnant. Be sure to read up on and discuss with your practitioner all the birth-control methods available before selecting the one that’s right for you now.
Each of the following methods of birth control has its benefits and drawbacks. Deciding which will work best for you will depend on your gynecological history, your lifestyle, your practitioner’s recommendation, whether you want to become pregnant again in the future (and how certain you want to be about preventing pregnancy in the meantime), and your own feelings and circumstances. All are effective when used correctly and consistently, though some offer better results than others.
Oral contraception. Available by prescription only, oral contraceptives (or “the Pill”) are among the most effective nonpermanent methods of birth control, with a success rate of 99.5 percent (most failures are due to a user’s missing a day or taking pills in the wrong order). Another plus: They allow for spontaneity in lovemaking.
There are two basic types of oral contraception: combination pills (which contain both estrogen and progestin) and progestin-only pills (minipills). Both work by preventing ovulation and by thickening cervical mucus to keep sperm from reaching an egg, should one be released. They also prevent a fertilized egg from implanting in the uterus. The combination pills are slightly more effective in preventing pregnancy than the mini ones. For maximum efficacy, the mini-pills must be taken at the same time every day (the combination pills have a slightly longer window).
Some women experience side effects from oral contraception (which vary, depending on which pill they use), most commonly fluid retention; weight changes; nausea; breast tenderness; an increase or decrease in sex drive; hair loss; and menstrual irregularities (spotting, breakthrough bleeding, or rarely, amenorrhea, or total cessation of menstruation). Less common are reports of depression, listlessness, or tenseness. After the first few cycles of pill use, side effects often diminish or disappear completely. In general, today’s oral contraceptives trigger fewer side effects than pills did years ago. Newer versions of the Pill (Yasmin, Cyclessa) deliver constant levels of estrogen and a new type of progestin or use three different levels of estrogen and progestin, to reduce bloating and PMS. A new entry into the category, which might be especially appealing to women who aren’t fond of that monthly flow, is Seasonale. It comes in a package with 84 hormone pills and 7 inactive pills; women take the hormones for 12 weeks straight before taking a break for their period (which then only comes four times a year). Some women, however, experience more break-through bleeding with Seasonale than with monthly pills. (Most doctors agree that it’s safe to take any monophasic pill continuously—by skipping the inactive pills—to avoid that monthly period.).
The vast majority of women who use hormonal contraceptives do so with very few side effects, most of them mild. But because an occasional serious side effect occurs, you should be alert to the following warning signs, just in case.
If you are taking an oral contraceptive (or using any other hormonal contraceptive) and experience any of the following symptoms, call your physician immediately. If your doctor can’t be reached, go to the nearest emergency room.
sharp pains in the chest
coughing up of blood
sudden shortness of breath
pain or tenderness in the calf or thigh
severe headache
dizziness or faintness
muscle weakness or numbness
disturbed speech
sudden partial or complete loss of vision, blurred vision, flashing lights
severe depression
yellowing of the skin
severe abdominal pain
Women who are over age thirty-five and heavy smokers may be at increased risk of adverse side effects (such as blood clots, heart attack, or stroke) from the Pill. The Pill may also be unsuitable for women with certain medical conditions, including a history of blood clots (thromboses), fibroids, diabetes, hypertension, and certain types of cancers. Check with your doctor.
On the plus side, the Pill appears to protect against a whole host of conditions, including pelvic inflammatory disease, nonmalignant breast disease, ectopic pregnancy, ovarian and uterine cancer, ovarian cysts, and iron-deficiency anemia (because menstrual flow is lighter); taking it may also reduce the risk of arthritis, possibly osteoporosis, and the incidence of menstrual cramping. Other benefits experienced by some women who take the Pill are diminished premenstrual tension, very regular periods, and (more with some pills than with others) clearer skin. Research has found that taking the Pill does not increase the risk of developing breast cancer.
If you’re planning to have another baby, fertility may take longer to return if you’re using the Pill than if you’re using a barrier contraceptive. Ideally, you should switch to a barrier method (see page 697) about three months prior to the time you plan to try to conceive. About 80 percent of women ovulate within the first three months after stopping the Pill, 95 percent within a year.
If you decide to try the Pill, your doctor will help you determine which type and which dose is best for you, based on whether you’re breastfeeding (any oral contraception containing estrogen is not recommended during lactation, but a progestin-only pill is safe to use), as well as on your menstrual cycle, weight, age, and medical history. Making sure the Pill that’s prescribed works the way it’s supposed to is up to you. Take it regularly; if you miss even one pill, or if you have diarrhea or vomiting (which can interfere with absorption of the Pill by your body), use back-up protection (such as a condom and foam) until your next period. See your doctor every six months to one year for monitoring of your health; report any problems or signs of complications that show up between visits, and be sure to inform anyone prescribing medication of any kind that you are on oral contraceptives (some herbs and medications, such as antibiotics, interact adversely with the Pill, making it less effective).
The Pill does not protect against sexually transmitted diseases, so be sure to supplement with a condom if there is a chance of contracting an STD from your partner. Because oral contraceptives increase the need for certain nutrients (though they decrease the need for others), take a daily vitamin supplement that contains B6, B12, C, riboflavin, zinc, and folic acid while on the Pill.
Injections. Hormonal injection, such as Depo-Provera, is a highly effective method of birth control (with a success rate of 99.7 percent) that stops ovulation and thickens cervical mucus to keep sperm and egg from meeting. The shot, given in the arm or buttock, is effective for three months. Depo-Provera is a progestin-only injection, so it is safe for breastfeeding mothers.
As with oral contraception, side effects of hormonal injections can include irregular periods, weight gain, and bloating. For some women, periods become fewer and lighter, and many women will have no periods after five years of using Depo-Provera. Other women might experience longer and heavier periods. And, like the Pill, the shot is not for every woman, depending on her specific health and medical condition.
The greatest advantage to the shot is that it prevents pregnancy for twelve weeks, and this can be compelling for someone who doesn’t like to have to think about birth control or who often forgets to take a pill or insert a diaphragm. It also protects against endometrial and ovarian cancers. But there are disadvantages, too: having to return to your health-care provider every twelve weeks for another shot, the fact that the effects of the shot cannot be reversed immediately (if you suddenly want to become pregnant) and that it may take up to a year for fertility to return after discontinuing Depo-Provera.
Patch. The Ortho Evra patch, a matchbox-size adhesive patch, delivers the same hormones as the combination pill but in a patch form. Unlike oral contraceptives, the patch maintains a steady state of hormonal levels because it constantly and continuously delivers hormones through the skin. The patch is worn for one week at a time and is replaced on the same day of the week for three consecutive weeks. The fourth week is “patch free,” during which you’ll get your period. The patch can be changed any time of the day. If you forget to change the patch and leave it on beyond seven days, there is a twoday-grace period during which the hormones are still effective.
Most women who use an IUD find that it provides long-lasting, hassle-free birth control with few if any side effects. However, because the potential for complications exists, a woman wearing an IUD should call her doctor immediately if she experiences any of the following:
cramping, tenderness, sharp pain in the pelvis or lower abdomen (after the discomfort of initial insertion has passed)
an urge to have a bowel movement associated with lower pelvis pain or cramping
fainting
painful intercourse
pain that radiates down the legs, or pain in the shoulder
a missed or delayed period, followed by spotty, scanty, or irregular bleeding
unusual or abnormal vaginal bleeding, with or without pain (other than the not unusual spotting or staining following the initial insertion)
unexplained chills and fever
genital sores or vaginal discharge
The patch can be worn during all kinds of activities—when showering, while exercising, while in a sauna or whirlpool, and so on. Patch adhesion is not affected by humidity or temperature. Most women choose to wear the patch on the buttock or abdomen. It can also be worn on the upper torso (excluding the breasts) or the upper outer arm.
Like other hormonal contraceptives, the patch is highly effective in preventing pregnancy (99.5 percent effective). However, the patch may be less effective in women weighing over 198 pounds. Side effects of the patch are the same as the Pill.
Rings. The NuvaRing is a small (about the size of a silver dollar), transparent, flexible plastic ring that can flatten like a rubber band, be inserted into the vagina, and left in place for twenty-one days. Once inserted, the ring releases a steady flow of low doses of estrogen and progestin. The exact positioning of the ring within the vagina is not critical for it to work because it is not a barrier method of birth control. You can easily insert the ring yourself once a month and don’t have to remember to take a daily pill or insert a diaphragm before intercourse. Once it’s removed, you’ll get your period. You’ll need to insert a new ring one week after the last one was removed (even if your period has not stopped). Studies show that the level of cycle control with the NuvaRing is better than that with the Pill and there is little breakthrough bleeding. Because the hormones are the same as those used in the combination pills, side effects are generally the same, and those women who are advised not to use oral contraceptives are also advised not to use contraceptive rings. The ring is also not for breastfeeding mothers. It has a success rate of 98 to 99 percent.
Implants. Under-the-skin progestin implants have been shown to be a safe and effective method of birth control (with a success rate of 99.9 percent), but the manufacturer of Norplant has discontinued making it. The next generation of implants includes a one-rod system such as Implanon that is effective for three years and a two-rod system that is effective for five years. Such implants are currently undergoing trials and should reach the U.S. market soon.
The IUD is the world’s most commonly used method of reversible birth control for women, yet only 1 percent of women in the United States use one. Today’s IUDs are considered to be one of the safest methods of birth control—with a pregnancy rate equivalent to that of sterilization (over 99 percent effective). They’re also the most convenient, and, for most women, trouble free—definitely worth considering.
IUDs are small plastic devices that are inserted by a doctor into a woman’s uterus and are left there for a number of years, depending on the type of IUD. There are two types of IUDs available. The ParaGard copper IUD releases copper in the uterus to immobilize sperm. It also prevents implantation in the uterus. The ParaGard IUD can be left in for ten years. The Mirena IUD releases progestin into the uterine walls, thickening cervical mucus and blocking sperm, while also preventing implantation. It lasts for five years.
The major advantage of an IUD is that it offers the ultimate in convenience. Once it is inserted, it can be forgotten about except to check regularly (monthly is a good idea) for the string attached to it. This allows for a completely spontaneous sex life—with no pausing to find and insert a diaphragm or put on a condom, or remembering to take a daily pill. In addition, the IUD does not interfere with breastfeeding nor does it affect the breastfeeding infant.
You can increase the already excellent protection from pregnancy provided by the IUD if you check regularly for the IUD string and if you use condoms and/or spermicides for the first two or three months following insertion (when most failures occur).
The IUD should not be used by a woman who has gonorrhea or chlamydia, or who is exposed to multiple partners, or has a partner who is. Nor should it be used by a woman with a history of pelvic inflammatory disease (PID) or ectopic pregnancy; known or suspected uterine or cervical malignancy or premalignancy (or even an unexplained abnormal Pap smear); abnormalities of the uterus or an unusually small uterus; menstrual or other bleeding irregularities (the IUD can increase menstrual flow and cramping, though it doesn’t always); post-partum or postabortion infection within the past three months; or by a woman who delivered a baby, experienced a miscarriage, or had an abortion within the past six weeks. Allergy or suspected allergy to copper rules out the use of a copper IUD.
Possible complications include cramping (which can be severe) during insertion and, rarely, for a few hours or even days following; uterine perforation (extremely rare); accidental expulsion (it might go unnoticed and leave you unprotected); and tubal or pelvic infections (also rare). Some women may experience spotting between periods during the first few months after insertion. The first few periods may also last longer and be heavier. It’s also not unusual for a woman to continue having heavier and longer periods while using an IUD, though the progestin-releasing IUD may lessen the amount of bleeding.
Diaphragm. The diaphragm is a dome-shaped rubber cap that is placed over the cervix to block the entry of sperm. It is an effective birth-control method when used properly with a spermicidal gel to inactivate any sperm that might get past the barrier (94 percent effective). Aside from possible increases in urinary tract infections and an occasional allergic reaction triggered by either the spermicide or the rubber, the diaphragm is safe. In fact, used with a spermicide, it appears to reduce the risk of pelvic infections that can lead to infertility. It in no way interferes with lactation or affects a breastfeeding baby.
Check with your doctor if any of the following symptoms occur when using a diaphragm or cervical cap:
discomfort when the diaphragm or cap is in place
burning sensations while urinating
irritation or itching in the genital area
unusual discharge from the vagina
irregular spotting and bleeding
redness or swelling of the vulva or vagina
sudden high fever
diarrhea and/or vomiting
dizziness, faintness, and weakness
a sunburn-type rash not related to sun exposure
The diaphragm must be prescribed and fitted by a medical professional. Refitting is essential after childbirth because the size and shape of the cervix may have changed. The diaphragm has the disadvantage of having to be inserted before each intercourse (unless you’ll be having an encore sexual performance within a few hours, in which case you just need to add more spermicide), left in for six to eight hours, and removed within twenty-four hours. (Some experts suggest it’s prudent to remove it within twelve to eighteen hours, and some recommend women insert their diaphragms nightly when they brush their teeth so they don’t forget to use it in a moment of passion). The fact that the diaphragm must be inserted through the vagina makes this method unappealing to some women. The diaphragm needs to be checked periodically for holes.
Cervical cap. The cervical cap is similar to the diaphragm in many ways. It must be fitted by a physician, must be used with a spermicide, and does its job by preventing the entry of sperm into the uterus. Its success at preventing pregnancy is lower than the diaphragm (approximately 60 to 75 percent). However, the cap offers a couple of advantages over the diaphragm. Shaped like a large thimble, the pliable rubber cap has a firm rim that fits snugly around the cervix, making it only about half the size of the diaphragm. A convenience plus: It can be left in place for forty-eight hours rather than the twenty-four-hour outside limit recommended for the diaphragm. Some women find that an unpleasant odor can develop when the cervical cap is left in for a couple of days; for others, the insertion process presents problems.
The FemCap, a newer type of barrier contraceptive (with a success rate of 85 percent), is a silicone dome shaped like a sailor’s hat. It fits over the cervix with a brim that seals against the vaginal walls and has a groove that stores the spermicides and traps the sperm. It also has a removal strap.
Vaginal sponge. The Today sponge, which currently has limited availability, blocks the entrance to the uterus; it works by keeping sperm from swimming up to meet an ovum and also by absorbing sperm. The sponge requires neither a visit to the doctor nor a prescription, it is relatively easy to use (you insert it yourself, like a diaphragm), it allows for greater spontaneity than other barrier methods (providing continuous protection for a full twenty-four hours after insertion), and has no effect on the breastfeeding infant. The major contraceptive effect of the sponge is probably through the spermicide it releases. It is somewhat less effective than the diaphragm (about 80 percent effective), but because it contains nonoxynol-9 (a spermicide that acts as a disinfectant), it appears to reduce the risk of contracting such sexually transmitted diseases as gonorrhea and chlamydia. It can, however, increase the risk of the yeast infection candida. Some people are allergic to the spermicide used, and some women are uncomfortable inserting the sponge into the vagina. It should not be left in longer than recommended, and great care should be taken to remove the entire sponge (a piece left in could cause odor and infection). The sponge can’t be reused.
Condoms. A sheath for the penis made of latex or natural skin (from the intestines of a sheep) and often called a rubber, the condom is a very effective birth-control method if used conscientiously, though it is somewhat less foolproof than others (success rate of 86 percent). Its effectiveness, as well as its ability to combat pelvic infection, is enhanced if it is used with a spermicidal agent or jelly, and if care is taken to see that it is undamaged before use. The condom is totally harmless, though the latex or any spermicide used with it may spark an allergic reaction in some people. It has the advantage of not requiring a doctor’s visit or prescription, of being easily available and easy to carry, and of reducing the risk of transmitting infections, such as gonorrhea, chlamydia, and AIDS (the latex variety is better at preventing passage of the AIDS virus). Because it in no way interferes with breastfeeding or affects the breastfeeding infant, and because it doesn’t require postpartum refitting (as does the diaphragm), it is an ideal “transitional” method for many couples. Some find, however, that because it must be put on before intercourse (and not until erection), it interferes with spontaneity. Others find that putting on the condom can become an enjoyable part of the lovemaking.
To increase effectiveness, the penis should be withdrawn before the erection is totally lost and while the condom is held on, to avoid leakage. The use of a lubricating cream (or a lubricated condom) will help make insertion more comfortable when the vagina is dry after pregnancy and during lactation. (But don’t use oil-based lubricants, such as baby, massage, or bath oils or Vaseline, because they can damage the condom.)
The female condom is a thin lubricated polyurethane pouch that lines the vagina and is held in place by a closed inner ring near the cervix and an outer open ring at the opening of the vagina. The female condom is inserted into the vagina up to eight hours before intercourse and is removed right after sex. The downsides to the female condom are that it is more expensive than the male condom, may prevent full sensation, and is clearly noticeable once in place. The good news is that it’s more effective than the male condom (success rate of 95 percent) and, like the male condom, also prevents STDs and HIV.
Spermicide foams, creams, jellies, suppositories, and contraceptive films. Used alone, these antisperm agents are fairly effective (approximately 72 to 94 percent) at preventing pregnancies. They are easy to obtain without a prescription and don’t interfere appreciably with lovemaking, but they can be messy and inconvenient. They can be inserted up to one hour before intercourse.
The basal body temperature (BBT): The BBT can help to pinpoint more accurately the period of ovulation during which unprotected intercourse is riskiest. To get the BBT, the woman takes her temperature with a special basal body thermometer every morning immediately on awakening, before speaking or sitting up, etc. (the thermometer should be shaken down and left next to the bed the night before). In most women the temperature will drop and then rise abruptly at the time of ovulation as seen above. Three full days after ovulation, intercourse can be resumed. See next page for more on natural family planning.
The emergency contraception pill (ECP) is the only method of birth control that can be used after unprotected intercourse (or as backup when your contraceptive method has failed, as with a broken condom, slipped diaphragm, or missed oral contraceptive pills) but before a pregnancy is established.4 Both Preven and Plan B reduce a woman’s risk of pregnancy by 75 percent when taken within seventy-two hours of unprotected sex. The sooner ECPs are taken after unprotected sex, the more effective they are. (Your doctor might also recommend using ordinary birth control pills as emergency contraception, but check with him or her first to confirm the dose you should use.)
ECPs work by temporarily stopping ovulation, or by preventing fertilization. They may also work by preventing a fertilized egg from attaching to the uterus.
Like combination pills, Preven contains estrogen and progestin. Side effects are similar to those associated with combination oral contraceptive pills and are usually mild. Plan B contains only progestin and may cause fewer side effects.
Presently, emergency contraceptive pills are available by prescription in some states, over-the-counter in others.
Sterilization is frequently the choice of couples who feel that their families are complete, don’t have a problem with closing (and locking) the door to conception, and are anxious to dispense with contraception altogether. It’s increasingly safe (with no known long-term health effects) and virtually foolproof. The occasional failure can be attributed to a slip-up in surgery or, in the case of vasectomy, not using alternative birth control until all viable sperm have been ejaculated. Though sterilization is sometimes reversible, it should be considered permanent.
Tubal ligation is a procedure done under general or epidural anesthesia in which a small incision is made in the abdomen and the fallopian tubes are either cut, tied, or blocked. It does require some down time, usually two days (sometimes more) of only light activity. A vasectomy (the tying or cutting of the vasa deferentia, the tubes that transport sperm from testicles to penis) is a much easier, in-office procedure done with local anesthesia, and it carries far fewer risks than tubal ligation. It doesn’t (as some men fear) affect the ability to achieve erection or ejaculate. Research has also shown that there is no increased risk of prostate cancer for men with vasectomies.
A newer permanent birth-control option for women is called Essure. An alternative to tubal ligation, this type of sterilization requires neither an abdominal incision (as does tubal ligation) nor general anesthesia. A soft, flexible microinsert is placed into each fallopian tube via a catheter (tube) inserted through the cervix. Over the course of three months, new tissue grows in the fallopian tube (inside the insert), blocking the tubes completely. Another method of birth control must be used until the doctor can confirm through testing that your tubes are effectively blocked (usually after three months).
Women who prefer not to use hormonal or mechanical contraception can opt for a “natural” form of birth control (also called “natural family planning”). This approach relies on the woman becoming aware of a number of body signs or symptoms to determine the time of ovulation. If done perfectly correctly, couples using the NFP approach can be just as successful avoiding pregnancy as those couples using birth control methods.
The more factors a couple takes into consideration, the better the success rate. These factors include keeping track of mucus changes in that vagina (the mucus is clear, copious, thin, has an egg white consistency, and can be pulled into a long string at ovulation); basal body temperature changes (the baseline temperature, measured first thing in the morning, drops slightly just before ovulation, reaches its lowest point at ovulation, and then immediately rises to a high point before returning to the baseline for the rest of the cycle; see diagram, page 700); and cervical changes (the normally firm cervix becomes a little softer; it is also slightly higher and more open than normal during ovulation). Ovulation predictor kits can also help to pinpoint ovulation (though using them every month to prevent pregnancy can get very costly). Saliva tests for ovulation can also help some women predict when ovulation is imminent and are more cost effective. Intercourse is avoided from the first sign that ovulation is about to occur until three days after.
“I had a baby about twelve weeks ago, and I started feeling a little queasy yesterday. How soon can you get pregnant again, and if you’re breastfeeding, how can you tell?”
A new pregnancy at twelve weeks post-partum is very unusual, particularly in a breastfeeding mother, though it has been known to happen. The fact is that unless you or your partner have been sterilized, you run the risk of conceiving any time you have intercourse, even if you use birth control and especially if you don’t. A postpartum pregnancy, however, may be difficult to recognize. This is particularly true if you haven’t resumed menstruating, since the first tip-off most women get that they might be pregnant is a missed period. If you’re breastfeeding, another pregnancy clue many women rely on—tender and enlarged breasts with more noticeable veins—may be obscured. However, you may begin to notice other clues that you may have conceived once a new pregnancy is established: a diminished milk supply because different sets of hormones operate in pregnancy and lactation (but such a drop in production may also be due to exhaustion, not Breastfeeding enough, or other factors); morning sickness or queasiness (which could also result from something you ate or a gastrointestinal virus); or frequent urination (this could instead be due to a urinary tract infection).
If you have any reason to suspect you are pregnant, or even if you’re just unreasonably nervous about the possibility, take a home-pregnancy test. In the unlikely event that you turn out to be pregnant, be sure to begin regular prenatal care as soon as possible. A new pregnancy so close to childbirth puts a tremendous strain on the body, and you’ll need close medical supervision, extra rest, and plenty of good nutrition.
As long as you feel up to it, you can continue breastfeeding your baby while expecting another. If you feel utterly exhausted, you may want to supplement with formula or even wean completely. Discuss the options with your practitioner. If you do breastfeed while pregnant, it will be extremely important to consume enough extra calories (about 300 for the fetus and another 200 to 500 for milk production), protein (four servings a day), and calcium (the equivalent of six servings a day), as well as to get plenty of rest.
“I have a really bad cold. Can my son catch it?”
Germs have a way of making rounds through the family, and later on, when your son is in school, he’ll be bringing plenty your way. For now (unless he’s already in day care), chances are much better that you or other family members will pass germs on to him.
To minimize the possibility that your baby will catch your cold—or any other infection you or another family member comes down with—wash your hands very thoroughly before handling him or anything that goes into his mouth (including his hands, bottle, or pacifier, and your nipples), and avoid drinking from the same cup. Keep baby from touching any cold sore or other contagious rash, and steer clear of kissing (as hard as it will be to keep your lips off that yummy face) while you have symptoms of infection. Make sure other family members follow the same rules. By the way, it’s fine to continue nursing your baby while you’re sick; in fact, breastfeeding strengthens your baby’s immune system.
All that said, you’ll also have to resign yourself to the fact that few babies escape their first year cold free. Even with all the above precautions, he’s likely to succumb to the sniffles at some point—and, because you spend so much close time together and share susceptibility (he receives only immunities from you that you already have), he’s actually more liable to catch a cold from you than from a passing sneezer on the street.
“I’m so busy taking care of my new daughter’s needs that I never have time to take care of my own. Sometimes I don’t even have a chance to take a shower.”
Little things can mean a lot to the parent of a young baby. And often these little things that others take for granted—going to the bathroom when you feel the urge, having a cup of coffee while it’s still hot, sitting down for lunch—become luxuries you can no longer afford.
Still, it’s important to make time you can call your own. Not only so that you (and your spouse) will remember that your needs count, but so that your baby, as she grows in awareness, will recognize this, too. “Mother” needn’t be (and really shouldn’t be) synonymous with “martyr.” You don’t have to suffer frequent urinary tract infections or constipation from infrequent trips to the bathroom, or indigestion from eating on the go, or depressingly dirty hair from postponing showers. Though it will, indeed, take a lot of judicious juggling to meet your own needs without neglecting your baby’s, it will be well worth it for both of you. After all, a happier parent is a better parent.
How to best make time for yourself will depend on such factors as your schedule, your priorities, and just what it is you want to find time for. But the following tips can help put a little more personal time in your life:
Let baby cry. Not for half an hour, but certainly it won’t hurt if you put her safely in her crib and let her fuss while you brush your teeth or go to the bathroom.
Include baby. Sit down to lunch with your baby. If she’s not yet on solids, put her in a baby seat on the table (only while you’re sitting right next to her) and chat with her as you eat. Or take your lunch to the park if she’s more content in her stroller and if weather permits. Place her in her baby seat on the bathroom floor while you attend to personal needs—she’ll be getting early potty training while you get relief. Or play peekaboo with her from behind the curtain while you shower.
Depend on daddy. Shower while he breakfasts with her in the morning, or give yourself a facial while he takes her for a walk on Saturday afternoon. Don’t feel guilty about turning baby over to him in his spare time; a mother’s work (whether full- or part-time) is more consuming and demanding than any paid job. Parenthood is a partnership, and when two parents are on the scene, all the responsibilities of baby care should be shared equally.
Exchange favors. Trade baby-sitting services with other parents who also need to free up some time. Sit for a friend’s baby and your own one afternoon or morning a week while she does whatever it is she needs to get done; she reciprocates another day.
Hire help. You may not be able to afford even a part-time baby-sitter, but you probably can afford a responsible teenager to entertain your baby (when you are in the house), while you buy a little time for yourself.
“As much as I’m committed to being a full-time mother, I’m starting to feel suffocated by staying home with my new daughter. There’s got to be more to life than changing diapers.”
In the first few months of a baby’s life, when the demands of feeding and caring for her are round-the-clock and seemingly endless, about all a new mother has the time or inclination to crave is sleep. But once baby has settled into a routine and mom into a manageable rhythm, the dreary doldrums may settle over the frenetic fog of earlier weeks. Instead of finding yourself with too much to do and not enough time in which to do it, you may find yourself with too much time and not enough to do with it. The challenge gone from getting through a day’s baby-care chores, you may well begin to feel like a wind-up mother going mechanically through the motions, and to crave the stimulations and satisfactions of life beyond the four walls of home. Particularly if you were involved in many activities before—a career, hobbies, school, athletics, community work—you may start to feel those four walls closing in, and start doubting your self-worth as well as your decision to stay home with your baby.
Yet a rich, full, satisfying lifestyle and life with baby are not, as they may seem now, mutually exclusive. The important first step toward achieving such a lifestyle is to recognize that woman (or man) cannot live by baby alone. Even if you adore every moment with your baby, you still need intellectual stimulation and the chance to communicate with someone who can say more than ah-goo, ahgoo (cute as that may be). There are a variety of ways of achieving these goals, and of reclaiming the sense of self you feel you’ve lost.
You can look upon your baby as an obstacle to reentry into the grownup world—or as a ticket to it. The following will give you a shot at finding adult interaction through your baby:
Play groups. Locate an existing group or seek out mothers interested in joining you to set up a new one up by putting up a notice at the baby’s doctor’s office; at your house of worship; on your building complex, supermarket, or community bulletin board. Try for a group with mothers whose interests match yours. See page 444 for more on setting up a play group.
Baby classes. Classes designed for babies are often more valuable for their parents. By signing up for such a class (first making sure it’s appropriate and safe for your baby; see page 447), you’ll have the weekly opportunity to meet and talk with other women, many of whom have chosen to stay home with their babies.
Parents’ discussion groups. Join an established one, or become involved in setting up a new one. Invite guest speakers (a local pediatrician, a nurse, an author, and others who can address your needs as parents and/or as women); jointly hire a baby-sitter or sitters for the children. Meet in homes, school, a community center—or wherever there’s space available—weekly, every other week, or monthly. Joining online chats and discussion boards will also help you feel connected, provide you with valuable resources, give you a chance to vent, and most of all, remind you that you’re not alone in your situation.
The local playground or play area. Where babies play, parents can’t be far behind. The playground is not only a great place for infants (even when too young to be mobile, they find watching the children and the activity fascinating) and older babies (when they can sit well, they usually love the swings, and many can tackle the slide and climbing areas before they are a year old), it is also an ideal place for mothers to meet other mothers and set up “play dates.” These dates, too, are more for the benefit of the parents at this point than they are for their babies, who aren’t yet capable of “playing together.”
Being a full-time mother doesn’t mean you can’t be anything else. Continue to pursue old interests, or find new ones, through any of the following:
A course at a local college. Take it for credit or just for fun or intellectual enrichment.
An adult education class. These are proliferating all over the country and offer everything from aerobics to Zen.
An exercise class. Challenging the body activates the mind. In addition, an exercise program, particularly one that offers child care or combines mother exercise with baby exercise, is a good place to meet other women with similar interests.
Active sports. Playing tennis or golf or another favorite sport regularly will help keep both body and mind well toned, as well as provide companionship.
A museum or art gallery. Become a member of a local museum and visit regularly, studying one exhibit each time. (It will be even more fun if you go with another parent.) Added benefits for baby: Early exposure to art and artifacts is visually and intellectually stimulating (infants are often fascinated by paintings and sculpture) and will help keep young minds open to them later.
Educational DVDs or CDs. Watch a DVD while doing household chores or breastfeeding; listen to CDs while driving; keep up with an old interest or explore a new one (learn a foreign language using computer software, for instance). Educational tapes are often available at no charge at the public library.
Books. They can take you anywhere, anytime. Read while you nurse, on a stationary bike, while baby naps, before bed. You’ll not only be entertaining and stimulating yourself by reading but, through your example, you nurture a life-long love of reading in your child. A great way to combine a love of literature and a need for adult companionship is to start or join a book club. If the club is made up of other new mothers and fathers, it can double as a parents’ group (where you talk books and babies). Babies can be invited, or the club can hire a sitter or two to care for them while parents chat.
More and more colleges, community centers, workplaces, and gyms or exercise studios are offering on-site child care, allowing parents to drop baby off while they study, work, or work out. Another option if you’re taking a class or course: See if there are other parents of infants or young children enrolled, and ask them if they’d like to chip in for a communal sitter.
If you’re not in the paid workforce, then your local charities and community service organizations could use your help. Choose an organization you already belong to or join a new one, and offer your services. If you don’t know where to start, you can contact a central clearinghouse for volunteers if there is one in your city, or you can ask at your local school, hospital, house of worship, or community centers where volunteers are needed. The possibilities are endless: tutoring a child or adult in English or other subjects; visiting the elderly (they’ll doubly appreciate your visit if you bring your baby along) or shut-ins; cheering patients at hospitals; acting as a “big sister” and source of support for a teenage mother or mother-to-be; serving meals at a soup kitchen; and so on.
Or use volunteer work to keep your professional skills from becoming rusty. Teach a course in your area of expertise at your local adult learning center; write a newsletter; design a Web site or a direct mail campaign; or provide medical care or legal counsel pro bono.
Being a full-time mother doesn’t mean you can’t be a part-time worker. A few hours a week at work related to your present field or a field you’d like to break into can keep you in touch, provide adult contacts, and offer escape from your daily routine. See box on pages 712–713 for suggestions on how to find or create such work options, particularly those you can pursue from your home.
“I feel uncomfortable with my friends who don’t have children, but I don’t know any women with young babies, and I feel very lonely.”
Major changes in one’s life—a new school, a new job, a new marriage, a move to a new community, a divorce, children leaving the nest, retirement, widowhood—almost always have some effect on relationships. The arrival of a baby is no different. So it’s no wonder many women seem uncertain about how to deal with the changing balance of friendships when they become mothers.
Many factors can contribute to changes in your social life postbaby. For one, you undoubtedly have a lot less time and energy for socializing. For another, until you go back to paid employment—whether that’s six weeks or six years after your baby is born—you’ll feel somewhat removed emotionally as well as physically from the circle of friends that revolved around your job or career. For still another, your interests, if they haven’t already, will begin to change. As much as you still might enjoy a conversation centered around foreign policy, films, literature, or entertainment gossip, you’ve probably recently developed an interest in discussing the merits of baby exercise classes or the efficacy of various diaper-rash preparations, sharing thoughts on how to quiet a crying baby or how to get more sleep, bragging about baby’s first successful attempt at turning over or cutting a first tooth. Yet another factor upsetting your social life: Some single friends seem less comfortable with you. This may be partly because you share less in common and partly because some of them, consciously or unconsciously, are envious of your new family. Finally, friendships that are only job-deep (or partying-deep) often don’t have what it takes to survive change.
What most women are searching for is a way to integrate the women they were with the mothers they’ve become—without diminishing either. That isn’t easy. Trying to stay completely within the old circle denies that you’re a mother now. Abandoning old friends and spending time only with other new mothers denies the old you. Making new friends while keeping as many of the old as possible will probably be the happiest and most fulfilling of compromises, one which satisfies all the women you are.
See your old friends socially on occasion—for lunch, a drink, a movie. They’ll want to hear about your baby and your new lifestyle (but not exclusively), and you’ll want to hear what’s new and what’s the same, at work and with their relationships. Try to stick to subjects you have in common, whatever brought you together in the first place. You may find yourself feeling a little uncomfortable at first, but pretty soon you’ll know which friendships are going to continue and which it makes sense to put on hold, except perhaps for birthdays and holidays. You may be surprised to find that one or more old friends become very involved in your new life and offer a great source of support. And those old friends you lose touch with may suddenly seek you out again when they begin to have families of their own.
Making new friends among the new mothers in your community is relatively easy. It only requires your turning up at places where mothers of babies congregate (at playgrounds, exercise classes, mothers’ groups, play groups, your house of worship). Seek out those who share not only your interest in babies but also some of your other interests, so that these friendships can be multidimensional and so that you’ll have more to talk about than diapers and day care—though you’ll find babies will often be the subject of choice.
“My closest friend is relaxed and disorganized, doesn’t worry if her seven-month-old doesn’t get his lunch until dinnertime, drags him to parties until all hours, and is in no hurry to return to work. I’m compulsive about everything—bedtimes, meals, clean laundry—and I went back to work part-time when my son was three months old. Is either of us doing something wrong?”
Nope—you’re each doing what feels right for you, and there’s no “righter” way to to parent than that. Let’s face it: You would probably have a nervous breakdown trying your friend’s laissez-faire parenting style, and she would do likewise trying yours. The only time you need fear you’re doing something wrong is when your baby tells you—by crying a lot, by being unresponsive, or by not thriving physically—that he’s not satisfied with your approach to mothering. If that happens, you’ve got to make some adjustments, because babies, like mothers, are individuals, with different styles.
A baby who is happy and healthy is saying to his mother, no matter what her style, “You’re doing a great job!”
“I thought that mothers were supposed to be naturally better at parenting than fathers. But my spouse has a way with our son—making him laugh, calming him down, rocking him to sleep—that I don’t. And that makes me feel inadequate and insecure.”
Every parent enters parenthood with something to offer his or her baby, with no one contribution more valuable or desirable than another, at least not as far as the little beneficiary is concerned. Some parents are better at the fun-and-games aspects of baby raising (getting a good giggle going, playing peekaboo), some at the nuts-and-bolts tasks (feeding, bathing, getting baby dressed without a struggle). Some, like your spouse, display a knack for building rapport with baby.
It isn’t uncommon for one parent to be a little envious of the other’s parenting finesse. But it’s possible to shake such feelings:
Consider yourself lucky. While many women still complain of spouses who don’t do enough, you’re fortunate enough to have a partner who’s not only happy to do more than his share, but who’s gifted at doing it. An involved father can take a lot of the pressure off mom—and can have a dramatically positive effect on his child’s development. So let him practice his baby magic whenever possible.
Don’t be a female chauvinist. Sexual stereotypes that depict women as naturally better at parenting than men are inaccurate and, ultimately, destructive all around. There is no childcare responsibility—other than breastfeeding—that all mothers are more naturally suited to than all fathers, or vice versa. Some parents (no matter what gender) have a natural knack for parenting skills; some have to work hard at mastering infant care. Given the opportunity and some time, any parent of either sex can overcome a lack of natural aptitude or experience.
Give yourself more credit. You may not realize how much you do for your baby and how well you do it—though your baby almost certainly does, and he couldn’t do without you.
Give yourself a chance. Just because certain parenting skills don’t come as easily to you as they do to your spouse doesn’t mean they’ll always be elusive. If you’re breastfeeding, you may find that once you’ve weaned your baby and the distraction of breast milk is past, you’ll be able to calm him on your chest as well as daddy does. With practice and a lessening of self-consciousness, you will also learn to sing the lullabies and silly songs your baby loves, to play finger games and make funny faces, and to rock him with a comforting rhythm. But for best results, don’t mimic what seems to work for your spouse or compare your technique to his. Instead try doing what comes naturally to you. Your own parenting style will emerge and evolve if you let it.
And remember, no matter how wonderful a relationship dad and baby have developed, there will always be times when no one else will do for your child but you, and you’ll hear those soon-to-be familiar words: “I want my mommy.”
“As terrible as this sounds, I’m finding that I’m jealous of the time my spouse spends with our daughter. I sometimes wish he’d devote half as much attention to me.”
As heartwarming as a budding romance between father and infant may seem to an outsider, it can be genuinely threatening to a woman who’s not used to sharing her spouse’s affection, particularly if she’s enjoyed his especially solicitous attention during nine months of pregnancy.
Although your feelings of jealousy will probably subside on their own once the family dynamics have had some time to work themselves out, there are several steps you can take to deal with them in the meantime:
Be assured. The first thing you need to do to overcome the feelings you’re experiencing is to recognize that they’re normal and common—not petty, selfish, or otherwise shameful. Dump that guilt.
Be grateful. Consider how lucky you are to be with to the kind of man who’s eager to spend time with his baby. Take advantage of the time they spend together to catch up on chores or personal needs. Watch with appreciation the love that’s blossoming between the two of them, and try to support it. The bonds they’re building now will last a lifetime, through the terrible twos and even the turbulent teens, and will make your daughter a better woman (or make your son a better man).
Be a part of it. Father and baby should certainly share some time alone together, but sometimes a third player will be welcome. Join that cuddle fest (he gets the tummy, you get the toes), flop down on the bed beside them as they read a book, sit down and make their two-way game of “catch” on the rug three-way.
Be honest and open. Don’t just sulk from the sidelines when daddy and baby leave you out of the loving action. In the excitement of discovering a new best buddy, your spouse may not realize that he’s been shutting out his (relatively) old one; he may even believe he’s helping you out. Tell him, without being offensive or putting him on the defensive, how you feel and exactly what he can do about it (for example, tell both of you how pretty you look, give both of you a kiss and hug when he comes and goes, snuggle spontaneously with both of you). He can’t fulfill your needs unless he knows what they are.
Be there for him. Remember, a relationship that works, works two ways. You can’t ask your spouse to devote more attention to you without your reciprocating. Make sure you, too, haven’t been spending all your time, energy, and affection on the baby, unwittingly leaving none for him. Dote on him, and you’re bound to find him doting back.
“I hear a lot about the importance of spending quality time with your children. Well, even though I spend virtually all my time with my son, I’m so busy that I’m not sure there’s any quality to it.”
Along with the proliferation of the term “working mother” (a misnomer, since all mothers work) came the popularization of the concept of “quality time”: If a mother couldn’t spend a lot of time with her child, the least she could do was make the best of the time she did spend with him. The theory seemed to imply that quantity was no longer important. But there’s quality in quantity, too. You don’t have to drop everything, sit down on the floor, and play with your baby all day long to provide him with quality care. You give quality time every time you change his diaper and smile at him, every time you feed him and talk to him, every time you bathe him and splash around with bath toys. You do it even when you chat with him from the kitchen as he races around on hands and knees, sing to him while you’re driving in the car, lean over to tickle him in his play yard as you vacuum by, or sit him down with the shape sorter while you pay some bills.
Quality parenting time is time spent relating to your child in passive as well as active ways, and something that a loving and responsive parent who spends a lot of time with her child can hardly avoid providing. You’ll know if you’re succeeding just by watching your baby: Does he smile, laugh, respond, seem basically content? If the answers are yes, he’s getting plenty of quality time.
“As a parent who works outside the house full-time, I worry that I don’t spend enough quality time with my daughter.”
When you have limited time to spend with your baby, the impulse is great to make every minute count. Accepting the impossibility of this (there will be moments when you’ll need to do things other than child care, moments when she’ll want to turn her interests elsewhere; days when you’ll be in a lousy mood, days when she’ll be) will, ironically, be the first step in ensuring your time with her is well spent. The following are other steps you can take:
Act natural. No need to don your Super-parent cape before you walk through the door. All your daughter wants is you. There is no need to fill every minute you have with her with stimulating activities. Instead, be spontaneous, and take your cues from your baby (she may be too pooped at day’s end for active play). Quality time is time spent together, whether it’s eating together, cuddling together, or just being together in the same room (even if you’re not doing the same thing).
Involve your baby. Take her with you into the bedroom while you change from your work clothes, and otherwise include her in your routine when you get home from work. She can play with the empty envelopes while you open the mail, empty the market bags while you put away groceries, or bang on pots and pans while you prepare dinner.
Tell her about your day. This will serve two purposes. One, it will ensure that you’re communicating with her (she loves to listen to you talk, even if she doesn’t understand what you’re saying). Two, unloading your day’s experiences (in an upbeat voice, even if your day was a downer) will help you unwind and make a faster transition from your job to your home life.
Give your house short shrift. With time at a premium, devote less of it to matters that matter less (cleaning, cooking, and clothes care for instance). Take shortcuts in dinner preparation wherever possible (cook double quantities, freeze half to reheat another night; use frozen vegetables; get your green leafies from the ready-to-serve bags). Let the dust accumulate all week, and wait until the weekend to tackle it all at once with your spouse. Or if you can afford it, hire someone to clean once a week. Put the iron in storage and send out your shirts if they have to be perfect.
Keep your dinner on the back burner. Or don’t put it on at all until your baby’s gone to bed. Late meals may not be best for digestion, but they’ll give you more time to spend with your baby while she’s awake (give her your undivided attention while she dines) and more time to spend with your spouse when she’s asleep. Though family dinnertimes are important later on, they’re not really necessary now. At this age, in fact, meals with baby can be so stressful that instead of enhancing togetherness, they can give it a bad name.
Tune out distractions. You can’t give your baby quality time while you’re catching the six o’clock news. Save television watching, Net surfing, and phone-call making for after your baby’s gone to bed. Let voice mail pick up the phone to postpone talking to incoming callers until after her bedtime, too.
Don’t shut out your spouse. In your quest for quality time with your baby, don’t forget time spent as a family. Include your spouse in whatever you’re doing with the baby, from bathing to cuddling. Also keep in mind that the time each parent spends with her alone is important, too, giving your baby the benefits of closeness with two unique individuals—and it doubles her quality time.
“I don’t work outside the home, but I do occasionally leave my nine-month-old son with a sitter, and always feel guilty when I do.”
As every employer knows, no worker can stay on the job round the clock and round the calendar, and still be effective. As a self-employed mother, you’ll have to recognize this fact, too. No matter how much you enjoy your child and how much he enjoys you, you’ll both benefit from some time apart. Take it—and don’t feel guilty.
For many women, there’s no decision to make. Because of a variety of pressures—financial, career, societal—returning to work after their babies are born is the only option. However, for those who have a choice, the process of decision making can be agonizing. Child development experts—because they are in disagreement—offer these mothers little to go on. Some believe there is no harm and possibly some benefit when a mother takes a job and leaves her baby in a childcare situation. Others believe just as strongly that there is the potential for more than a little damage to the infant in a two-paycheck family, and urge that one parent stay at home, at least part-time, until the baby is three years old.
Objective research is no more helpful. Study results are contradictory, primarily because such studies are both difficult to do and difficult to evaluate. (How do you judge the effects on her offspring when a mother holds a paying job? Or doesn’t hold one? Which effects are important to evaluate? Which are difficult to quantify? Are there some we can’t even predict? Will problems show up early or not until adulthood?) In addition, the research isn’t as objective as it should be. It’s often colored by the bias of the researcher. It also rarely shows the whole picture.
With no clear-cut evidence on the long-term risks or benefits of a mother’s working outside the home to go on, the full weight of making this decision falls entirely on the parents. If you’re pondering the question, asking yourself the following questions may help you sort out the best way to go.
What are your priorities? Consider carefully what is most important in your life. List your priorities in order on paper. They may include your baby, your family, your career, financial security, the luxuries of life, vacations, study—and may be vastly different from those of the woman next door or the woman at the next desk. After charting your priorities, consider whether returning to employment or staying at home will best meet the most important of them.
Which full-time role suits your personality best? Are you at your best at home with the baby? Or does staying home make you impatient and tense? Will you be able to leave worries about your baby at home when you go to your job and worries about your job at the office when you’re home with the baby? Or will an inability to compartmentalize your life keep you from doing your best at either job?
Would you feel comfortable having someone else take care of your baby? Do you feel no one else can do the job as well as you can? Or do you feel secure that you can find (or have found) a person (or group situation) that can substitute well for you during your hours away from home?
How do you feel about missing some major milestones? The first time your baby laughs, sits alone, gets up on all fours and crawls, or takes a step—do you think you’ll mind hearing about it secondhand, if you happen to be at work when it happens? Will you feel slighted if the baby develops a close bond with the sitter? Do you feel you can learn to tune in to your baby’s unspoken needs and feelings by just spending evenings and weekends together? Remember that most mothers who work outside the home manage to build just as strong a relationship with their children as stay-at-home moms. And no matter how close your baby becomes to the sitter, no one can take your place in your child’s heart.
How much energy do you have? You’ll need plenty of emotional and physical stamina to rise with a baby, get yourself ready for work, put in a full day on the job, then return to the demands of your baby, home, and spouse once again (though you’d also need plenty of energy to be a stay-at-home mom). On the other hand, many women—particularly those who really love their work—find their time at the office rejuvenating, a respite from home life that allows them to reenter each night refreshed and ready to tackle the very different challenges of baby care. Keep in mind, however, that what often suffers most when energy is lacking in the two-paycheck family with young children is the relationship between spouses. If you decide to return to work, you’ll need to make an effort to nurture that relationship, too.
Working doesn’t always have to mean 9-to-5 (or 8-to-7). Innovations in the working world can sometimes allow parents more flexibility, making that family-work balancing act somewhat more manageable. Here are some of the many options available:
Part-time. This is an old favorite of working mothers, the twist being that more and more fathers are taking advantage of this kind of work, too. The bottom line: If your skills are valuable to someone full-time, then you hopefully can sell them part-time, either to a current employer, a previous one, or someone new. See which option works best for you and your employer—five mornings or afternoons, two full days and one half (they can be consecutive, or spread out during the workweek), some mornings, some afternoons.
Freelance. Freelancing isn’t an easy way to earn a living—you’ll have to spend time hustling up work before you can get started—but for some moms it’s the best way. It allows you to be your own boss and work your own hours.
Telecommuting. So much of today’s corporate world runs electronically that many jobs can be done from just about anywhere, including from home. Given the right equipment, you may able to conduct most of your business via e-mail, fax, and phone—even videoconference (but remember to change out of your bathrobe and wash the spit-up off your shoulder).
Compressed workweek. For those with stamina, working ten hours a day can give you a full forty-hour week in only four days, leaving you with one day off. You can take the day off in the middle of the week, or opt for a three-day weekend.
Flextime. This is all about flexibility, and if your employer is willing to accommodate, you may be able to devise a schedule that works better for you and your baby than a typical 9 A.M. to 5 P.M. For instance, you can work some evening or weekend hours (when your spouse can be on duty at home), so that you can spend some weekdays at home. Or you can work the early shift (6:30 A.M. to 2:30 P.M., perhaps).
Job sharing. Chances are you’re not the only working parent at your company who yearns for more time with his or her family. If your employer is amenable (and you can afford to share your salary), consider splitting your job with another employee (you work the mornings while she works the afternoons; you and he alternate Monday-Wednesday-Friday schedules with Tuesday-Thursdays). This way, two part-time employees do the work of one full-timer.
Baby on board. Some parents have managed to mix baby with business—literally—by bringing their offspring to the office. Another option (if you’re in the right line of work and you have a baby with the right kind of temperament): Take your baby along with you to see clients and on assignments. Business travel is even possible if you bring along or hire baby-sitters wherever you go.
Home-based business. Running a part-time or full-time business out of your home can give you the best of both worlds. If you’re an accountant, an advertising copywriter, or fund-raiser, find a few clients whose accounts you can handle from your den. If you’re a writer, editor, or graphic designer, look for freelance assignments. If you have a knack for knitting, design sweaters to sell to baby boutiques. If you make an incomparable carrot cake, package your creations for a local gourmet shop.
Keep in mind that if you do decide to work out of your home—either for yourself or someone else—you may still need a sitter for at least part of your working hours. But you can also plan to work while baby naps and after he or she’s bedded down for the night, and (though the logistics won’t be easy) to do pickups and deliveries with baby in tow. Getting help with the household chores and shopping will be important, though, so that you won’t have to give up too much of your time with baby.
How stressful are your job and your baby? If your job is low stress and your baby’s a piece of cake to care for, the duo may be relatively easy to handle. If your job is high pressure and your baby is, too, will you find yourself unable to cope with both, day in and day out? Of course, how well you handle stress is also an important factor to consider; some women thrive under it.
If you do return to employment, will you get adequate support from your spouse or from some other source? No mother can do it all alone—and no mother, whether she works outside the home or not, should be expected to. Will your spouse be doing his share (read: half) of baby care, shopping, cooking, cleaning, and laundry? Are you able to afford outside help to take up the slack or to reduce the load for both of you?
What is your financial situation? If you don’t work, will it threaten your family’s economic survival, or just mean you’ll have to cut down on some extras? Are there ways of cutting back so that the loss of your income won’t hurt so much? If you go back to work, how much of a dent will job-related costs (clothes, commuting, child care) make in your income? In some cases, once you’ve added in those costs, working hardly pays.
How flexible is your job? Will you be able to take time off if your baby or your baby-sitter is sick? Or come in late or leave early if there’s an emergency at home? Does your job require long hours, weekends, and/or travel? Are you willing to spend extended time away from the baby?
How will not returning to your job affect your career? Putting a career on hold can sometimes set you back when you return to the working world. If you suspect this will happen to you (though many women discover when they return, that their fears haven’t materialized), are you willing to make this sacrifice? Are there ways to keep yourself in touch professionally during your at-home years without making a full-time commitment?
Is there a compromise position? Maybe you can’t have it all and remain sane, but you may be able to have the best of both worlds by looking for a creative compromise. The possibilities are endless and depend on your skills and work experience (see box above).
Whatever choice you make, it’s likely to require some measure of sacrifice. As committed as you might be to staying home, you may, nevertheless, feel a pang or two (or more) of regret when you talk to friends who are still pursuing their careers. Or as committed as you might be to returning to your job, you may experience regret when you pass mothers and their babies on their way to the park while you’re on your way to the office.
Such misgivings are normal, and since few perfect situations exist in our imperfect world, they’re something you’ll have to learn to live with. If, however, they begin to multiply and you find dissatisfaction outweighing satisfaction, it’s time to reassess the choice you’ve made. A decision that seemed right in theory when you made it may seem all wrong in practice now—in which case you shouldn’t hesitate to reverse or alter it, if at all possible. No decision is final.
And when everything isn’t as idyllic as you’d like, remember that children who get plenty of love and attention are very resilient, and likely to grow up happy and secure, whether their mothers work outside the home or not.
There’s no predictably perfect point at which someone can say, “Okay, now you can go back to your job. Your baby will be fine and so will you.” If you decide to go back to work during the first year, when you pick up that briefcase or lunchbox will depend in part on your job and the amount of maternity leave you were able to wangle and in part on when you and your baby are ready. All of which is highly personal and highly individual.
If you have the choice, experts suggest that you wait at least until you’ve “attached” or “bonded” with your baby and feel competent as a mother. Bonding can take three months (though if your baby has had colic, you will probably just be starting to become friends at this point), or it can take five or six. Some research suggests that there are benefits to waiting a year, if possible (though, for many parents, this isn’t possible), to return full-time.
But, as always, no research—and no expert—can tell you what’s right for you and your baby. Ultimately, that’s a decision only you can and should make.
1. To find out how many calories it takes to sustain your prepregnancy weight, multiply your pre-pregnancy weight by 12 if you’re sedentary, 15 if you’re moderately active, and up to 22 if you’re very active.
2. Eat liver only rarely in spite of its great nutritive value, because it is a storehouse for the chemicals, including questionable ones, to which an animal is exposed.
3. For more on baby blues, see What to Expect When You’re Expecting.
4. Emergency contraception pills will not work if you are already pregnant. It is not an abortion pill like RU486.