Marriage and the Postpartum Period

When a new entity like a job, a hobby, or a church community is introduced in to a couple’s life, the relationship reorganizes.  A baby is no exception.  In fact, the impact of a baby is far greater, and there was no book, or proverb, or movie that could really prepare the new couple for these changes.  Often, this new being and the new roles its presence requires acts as a catalyst for deepened awareness and an altered vision for the future (as in, “I don’t want my baby growing up in a marriage like the one I grew up watching”).  This is particularly true for people who may have minimized or denied the hurts of their past and have now had their first child.
While I had long been interested in Women’s Issues, my training at the Postpartum Stress Center (PSC) in 2000 was an initiation in to the world of women’s mental health issues during pregnancy and following.  At the time my supervisor and director of the PSC, Karen Kleiman, author of This Isn’t What I Expected:  Overcoming Postpartum Depression, was a pioneer in her field.  The learning curve was large for me, as I had not even had any personal experience with pregnancy or birth.  I learned some powerful lessons there, about the pivotal nature of this new phase of life.
Some of the women suffering from Pregnancy and Postpartum depression or anxiety have no pressing external stressors and are not dissatisfied with their lives, but are purely experiencing a physiological reaction to their status.  For others, there are more layers to their problems.  Here are some of the most common issues that bring women and/or couples to therapy during this time:
1) Feeling the absence of a supportive or nearby family, or grieving that your family members are dysfunctional and cause you additional stress.

2) A sense of being overwhelmed at home because husband works too much, or she has trouble asking for what she needs.  And for the 1st time, this old “system” or contract in the marriage doesn’t work.

3) Identity crises are also often underlying a grief reaction for many new mothers:  Women who give up a job and vocational identity are more likely to experience adjustment problems.  This spurs many arguments between couples as she says, “but you don’t understand, I gave up my whole life and you didn’t have to give up anything.”  Of course, this is not true:  He is also adjusting to new schedules and disrupted sleep, and the postpartum father has lost something, too:  the wife he knew before is not available to him, and he worries she won’t return.  He feels criticized and alone. He might even be thinking she’s lucky for being home, having a fantasy himself of what it would be like to be home with “no demands” (i.e., pressure to perform at work).  To complicate matters, she might be feeling on empty, so-to-speak, and pressured (to “snap out of it”).  This leads her to feel anger that he doesn’t have the ability to self soothe and her give to her while she’s down.  In other words, everyone needs something, and perhaps there are even competing needs.

4) Couples trying to manage too much. 2 Careers, Church/Community commitments, kids, big (sometimes 2) houses & “toys” (boats, jet skis etc.).  We as a culture have been duped in to thinking that we can “have it all,” and that if we can’t or don’t, we are a failure.  Instead, we have material full and spiritually and relationally bankrupt lives.

5) Breastfeeding/Sleeplessness issues interrupting sexual desire/drive.  Couples want to do the right thing and nourish and protect their baby by breastfeeding, but it is a huge commitment and can interrupt many aspects of a couple’s life.  For more on that, read the article on Breastfeeding.

6) Feeling “let down” that they are not handling parenthood as they fantasized, that the baby is not as fun, loveable, etc. as they imagined, that they cannot accomplish or experience what they used to be able to.  Coping with the lack of freedom, and with the general constraints a baby imposes on the coupledom.
With 21st Century science behind us, we know now that Postpartum Depression is not simply the result of a couples’ failure to adjust to the normal interruption to the family system following childbirth.  But there is a documented relationship between postpartum depression and marital dysfunction, and I certainly see this in my practice.  I tend to work a great deal with the partners of women suffering from Postpartum Depression, because of the central role they can play in nurturing mother and baby, and because I believe the whole family suffers when Mom is down and the child’s other resource doesn’t know how to help.  The good news is that when couples confront problems and actively work to grow themselves, there is a solid strength that is built around the couple’s new nuclear family.

SOME ADVICE BASED ON MY CLINICAL EXPERIENCE, AND RESEARCH:

What husbands can do:
1)  Increase your relational tool bag:  learn new communication skills, see a counselor yourself for support and education.  She needs emotional support in the postpartum period like people need water. It is essential and if she is feeling unheard or invalidated, she may become angrier and agitated, or more withdrawn, lonely and depressed.

2) Increase verbal and behavioral expressions of care and appreciation:  make them like a vitamin you give daily to your spouse.

3) Participate in childcare.  This is how attachments are formed.  For example, if she is breastfeeding, she is showing care and responsiveness for the baby by feeding him/her, and husband can show care for baby by changing the diaper.  Make absolute certain she is getting rest.  This is a non-negotiable.  Take some playtime with baby and let her rest each day.

4) Redistribute the household duties.  Make a revised plan and check back in about how it’s working in 2 weeks.  Nothing ever has to be set in stone.  Experiment with things until you get it right.  Encourage her to not try and be perfect, to let some things go.

5) Be more friend-ly:  Act like you would to a dear friend who had a major loss.  Listen, and ask if it’s o.k. to problem solve.  If you move too quickly in to problem solving, people feel as if you aren’t “there” with them.

6) Take any expressions of self-harm (suicide) seriously.  This is a better to be safe than sorry kind of event.  Even if she says she’d never do it, you need to get to a counselor immediately to evaluate the extent of her depression.

WHAT THE NEW MOTHER CAN DO:

1) Ask for what you need.  If you don’t know how to do that or he can’t hear you, go to a counselor and get help.

2) Increase your supports.  You do not have to go it alone, and isolation will not help.  There is a wealth of great support groups and networks for mothers in Grand Rapids and you will benefit from having some time away from baby as some of them have day care.  See Resources for links to area organizations.

3) Increase your awareness and understanding of postpartum issues.  Education is available and unfortunately our doctors and family members do not always have an accurate understanding of what is needed or what is normal.  Often what people have been taught to expect, what the fantasies have been about parenthood, and what other people have experienced is far different than what the postpartum woman is living with.  Sometimes a qualified therapist is needed to help explain and sort of “translate” things to women’s significant others. See Resources for links to area organizations.

4) Learn to “let go.”  The new mother must sleep when baby sleeps, get exercise and get out of the house.  This is not the time to re-organize your closets.  It is o.k. if your house is less than perfect.  Nothing is more important right now than baby’s and Mommy’s health.

5) Sleep.  I am saying it again, because it is SO important.  In fact, it is crucial.  Sleep deprivation is dangerous and you need to find a way to get at least 5 hours of uninterrupted sleep a day if you are suffering from depression.

WHAT YOU CAN DO TOGETHER AS A COUPLE:

1) Make a couples mission statement together (you can find directives on this in Steve Covey’s  The 7 Habits of Highly Effective Families ).

2) Find new ways to have fun.

3) Compliment each other.

4) Anticipate differences.

5) Build faith (and act “as if” you have it).  You will all adjust, and reorganize in to a new system, but it might take some time.  Reach out to others for support.

6) Stretch toward one another (give an emotional or behavioral “gift”).  Now is a great time to come through on things that are real work for you, because the stakes are high in a crisis and this kind of “work” for the relationship is a big symbol for the other person.

7) Consider practical solutions (divvy up chores, change work schedules, sign up for auto pay, hire a local middle schooler to come over and play with baby so you can talk, increase your exercise, get a membership to a gym with childcare, etc.)

8)  Commit to a “date night” at least once a month & a weekend away at least once a year (use resources: take advantage of the church’s daycare, sign up for YMCA’s Date Night program; go on a cruise with childcare, find other couples to swap kids with, take a marriage enrichment or couples communication class).
Websites
Mother support groups: http://www.grmomsclub.org/ or http://www.grmothersandmore.org/
The Postpartum Stress Center: http://www.postpartumstress.com/

Recommended Reading for Postpartum Depression
The Secrets of Happily Married Men: Eight Ways to Win Your Wife’s Heart Forever , by Scott Haltzman, MD, a clinical assistant professor of psychiatry and human behavior at Brown University in Providence, R.I.
Partnering, by psychologists Hal and Sidra Stone
How Can We Light a Fire When the Kids are Driving us Crazy by Ellen Kreidman

Remi Spicer Rakipi, LMSW