Book Review: The Postnatal Depletion Cure

After I had my second baby, I entered into a different, and I want to say darker phase of life than I had ever experienced. I wouldn’t say I was depressed, yet I distinctly remember, when my baby was around a year old, my older daughter looking up at me and saying out of the blue, “Mommy, you haven’t cried in a while!”

Baby #2 was constantly fussy, so I was caring for two needy little ones on very little sleep. I was experiencing constant back pain, making daily tasks and childcare painful. I didn’t have the level of practical support from extended family that I needed. And though I had an amazing 2-hour labor and delivery at home, I just wasn’t bouncing back from pregnancy and birth like I did the first go-round.

That little baby is now 6 years old (!), and I feel like I’m just now coming out of the fog, getting back to my old self. Talking with friends about those first couple of years in particular, I would say, “I feel like maybe I had postpartum depression??” Because I knew I wasn’t well. I wasn’t feeling normal, or healthy. But at the same time, the word depression didn’t seem to fit. Though not quite right, it was the only word I could come up with to describe my experience.

Until recently, when I received a copy of International Doula (a publication put out by my certifying organization, DONA). On the cover, I read the words “postnatal depletion,” and I was intrigued. Immediately I flipped to the article, reading an interview with Dr. Oscar Serrallach, about this new term and finally identifying with a set of symptoms that made up the syndrome that I’m sure I had. Wanting to know more, I checked out his book, The Postnatal Depletion Cure, from the library.

Before even starting chapter one, I was floored by Dr. Serrallach’s compassion and understanding of what mothers in modern cultures are experiencing. He says:

This book is dedicated to all mothers who have suffered and struggled in their selfless roles as caregivers, often without the unconditional support and wisdom from their culture, societies, and families that should have been their birthright. It is your strength that has inspired and guided me in writing this book. The well-being of mothers is the fabric from which the cloth of the future of our society is made.

Those words made me want to cry. And hug him.

The book begins by defining postnatal depletion, and differentiating between depletion and depression. In the DONA article, the phrase that stood out to me referring to a depleted mom was that she feels “tired and wired.” This was exactly my experience - I was utterly exhausted, yet robbed of sleep. I would wake up on high alert to any little sounds, whether it be the baby or my husband shifting in bed next to me, and be unable to fall back to sleep easily. I was hormonal and emotional, and yet I never experienced hopelessness or lack of joy and happiness around things that have always made me happy. I was in love with my baby and so happy to have him in our family, I was just having trouble coping with life.

Dr Serrallach then goes on to describe how different cultures around the world care for their newly postpartum mothers. I have heard bits and pieces of these customs, but seeing them all in one place, and contrasting them with how we treat new moms in America was truly eye-opening. I thought, no wonder so many new moms are struggling.

The rest of the book is filled with incredibly helpful information for mothers struggling with this condition. I absolutely love how Dr. Serrallach speaks to women with deep compassion and understanding, validates our struggles, and views us as whole people - not isolating different symptoms, but really understanding and conveying that postnatal depletion is a result of many different factors. Throughout the book, he thoroughly covers important information on nutrition, hormones, sleep, exercise, and emotional well-being.

If you are interested in learning more about postnatal depletion, this article is a great place to start. And of course, pick up a copy of his book. If you feel like you have postnatal depletion and are looking for more resources or local practitioners to walk through the journey to healing with you, please be in touch with me! I would love to hear your story and help get you pointed in the right direction.

Blessings, hope, and healing, my friends!

Let's change the way we talk about this.

I often hear people ask a woman, “Who delivered your baby?” to which the woman replies with the name of whatever doctor was present at her birth.  This is a typical conversation among childbearing women, one at which no one bats an eye. 

But I would argue that this language is not the best choice of wording when we talking about how we give birth.

A few weeks ago, I was talking with a pregnant woman who said of her first birth, “Dr. So-and-So delivered me.”

Delivered me.

I know she didn’t mean it like this, but it sounded as if she was in a situation from which she needed to be delivered.  This language infers that the woman is the passive party in the scenario, a helpless one at that, who needs a stronger, more capable person to free her from the burden of pregnancy and labor.

On the other hand, I love how midwives talk about the act of a woman giving birth into the hands of a competent provider. 

They say “catch.” 

“I caught the baby.”

I LOVE THIS. 

It puts the emphasis right where it belongs.  The mother as the active, strong, capable person delivering her baby into the hands of a gentle, caring midwife. The mother is the one who does the delivering here.

This wording implies humility and honor on the part of the provider.  It gives praise and acknowledgement to the one who did all the work and deserves all the credit – Mom.

So next time you cross paths with a freshly postpartum mother, ask her how her birth went, and ask her, “Who caught your baby?”

(photo by Kim. See more of Jenn's birth here)

Finnian's Birth: A Photo Essay

In 2015, I was invited to attend 14 births, all of which were filled with beautiful and awe-inspiring moments.  For most births, I am asked to capture some of those beautiful, intimate moments with my camera.  I love photographing births in any setting, but home births are especially fun for me.  The natural setting and lighting provides the perfect backdrop for capturing such a sweet, special day for the family, and little nuances and things a couple have done to make their house a home make the photographs even more special.

I was able to serve Jenn and Stephen at the birth of their first son, Seeley, back in 2013, and loved capturing the moments that made up her beautiful labor.  A couple of years later, I was asked again to help with the birth of their second son, Finnian.

Jenn is a labor goddess.  She is relaxed, calm, and in control.  It's amazing to watch.

Thanks, Jenn and Stephen, for inviting me into your space to help you bring Finnian in to the world.  It was a joy and a blessing to be there with you!

Seeley's Birth ~ A Photo Essay

I got a call from Stephen at 5am on February 12th, saying that today was the day!  Jenn's contractions were definitely the real deal.  Thankful for an (almost) full-night's sleep, I got up and got ready to go.  I arrived at their house at 6:30, and Jenn was doing so well, chatting and watching Ice Age 3.  As soon as a contraction hit, though, I could tell this was active labor.  She leaned up against a wall, relaxed, and moaned through it.  It was dark and candles were lit; the perfect environment for labor.

Karen got there shortly after I did, and got her computer and paperwork all set up on the kitchen table.

Don't you think she looks like an angel?

Well, she is. A birth angel. ;)

Jenn had group prenatal meetings/childbirth education with her midwives and a group of women due around the same time she was.  They all wore these bracelets to remind eachother of their bond through each of their births.

So peaceful.  Resting between contractions.  All that relaxation practice was paying off.

Muffins Jenn had prepared in advance for the birth team.  Labor was in full swing at 9:05am.

Swaying with Stephen ~ he was her rock.

Doula at work!  Thanks, Karen, for this shot! 

As labor progressed, Jenn moved to the tub to help her relax more fully.

Jenn's mom arrived toward the end of her labor.  Her presence and hand-holding was such a comfort to Jenn.

Midwife Christina, checking baby's heart tones.

The final push...

Seeley Michael Carter was born at 2:01pm on February 12.  6 lbs 11 oz. 19 inches.

Jenn's labor was about 12 hours long, with only 30 minutes of pushing.

I am continually amazed at the intensity and amazing challenge of labor and birth.  During Jenn's most difficult contractions, Karen would pray, "Thank you, Jesus, for these powerful contractions.  Thank you that her body is doing what you made it to do.  Thank you!"  It was with much gratitude and leaning on God that Jenn birthed her baby into the world.  What a holy and joyful experience!

A Summer in the Life of a Doula

Wow!  It's been a long time since I've posted here... probably because I've been at BIRTHS all summer!!  I had a wonderful three months of doula-ing, and last week was my final follow-visit for my last birth of the summer.  Here's a recap of what I've been up to (with names changed) ...

May's birth
In April (I know that's not technically summer, but it was such an awesome birth that I wanted to throw it in :), I had the privilege of attending an incredible and insanely FAST vbac (vaginal birth after cesarean)!!  May had gone into her first birth as most moms do, not really educating herself about labor and birth, and she ended up having "the works" in the hospital.  Pitocin, epidural, c-section.  I loved May so much because she took the traumatic experience of her first birth and used it to change and grow and become a stronger woman.  And let me tell you--she is strong.  Her entire labor was LESS THAN THREE HOURS and completely intense the ENTIRE time.  It was actually kind of funny, because we had spent so much time prenatally preparing for a totally "zen" type of labor, with calming visualization and relaxation techniques, and we used absolutely none of it.  But it was awesome.  She called me at about 1pm, saying that her water broke, I met them at the hospital at about 3pm, and baby was born at 3:22.  It. Was. Insane.  And completely beautiful. 

Christine's birth
Christine's water broke at 10pm about a week before her due date--the first week of May.  She and her husband, Jeremy, worked through early labor at home for most of the night, and met me at the hospital at 8am.  She was definitely in early active labor, having to concentrate through each contraction.  I loved supporting this couple because they worked so well together, Jeremy supporting Christine with the relaxation exercises they had been practicing at home during her pregnancy.  As labor got more intense, it took everything she had to make it through each contraction.  It was an incredible effort for her to even speak, she kept alternating between too hot and too cold, and was nauseous the entire time.  She experienced several moments of self-doubt ("I can't do this for hours and hours!), but pushed through it all with incredible endurance.  Early in pushing, the doctor took a look at her perineum and told us, "Look how tight this is, we are going to need to cut this."  Nevertheless, I coached Christine to keep all those muscles down there relaxed, and to keep her jaws and hands open (per Ina May's "Sphincter Law").  And wouldn't you know it, she opened up just fine, and birthed her baby without even a tear!!  The whole birth was just so rewarding.

Julie's birth
In early July, I had the amazing privilege of attending the second birth of my very first clients!  Julie's first birth was incredibly long (water broke, no contractions, pitocin, hard labor for 8 hours, only 1cm dilated, epidural, rest, FULL DILATION, and two hours of pushing!), and quite the initation to being a doula!  But while spending all that time with her we bonded quite a bit, and became good friends after that.  She was SO hoping to go into labor naturally this time around, but due to some complications in her pregnancy, her doctor wanted to induce her early.  This was my first planned induction, and it was quite different.  The pitocin didn't really do anything the first day, so they turned it off at night and gave it a go again in the morning, this time breaking her water.  That got things moving along, and soon contractions became really painful.  It was such a cool experience coaching her through these contractions, knowing what worked well for her with her first labor.  She eventually opted for the epidural again, knowing firsthand how difficult labor was for her with a broken water bag and pitocin.  Pushing went much smoother this time, and she pushed her second baby boy out in to the hands of his daddy!!  (The doctor had him put on gloves to catch the baby!  So crazy!)  In spite of all the unwanted interventions, it was so good to support Julie and Kevin through their second birth.  What an honor!

Nola's birth
This was probably my favorite birth yet.  It was also my longest (second only to Julie's first!), and most challenging.  Actually, there is so much that I want to say about it that I'll save it for another entry.  Stay posted!  It's a good one!

Jamie's birth
Finally, in August, I had my last birth of the summer.  Jamie had been hoping and preparing for a natural birth, staying at home for as long as possible, and laboring in their secluded outdoor hot tub.  Unfortunately, she had tested positive for Group B Strep, which meant that if her water broke, they would want her to get to this hospital right away.  Which is what happened.  When they got to the hospital, the nurse started pitocin, and I arrived shortly thereafter.  Labor wasn't too painful at first, but quickly intensified and she needed lots of support.  We tried different positions and relaxation techniques, and definitely utilized the shower a few times.  She was laboring beautifully, and was doing a great job with her relaxation, and getting into a rhythm as labor got more difficult.  She made it to 6cm, labored for a couple of more hours, and was still at 6cm.  She had had enough, and chose to get an epidural.  This allowed her to get some rest (it was about 11pm and she had been in pitocin-induced labor ALL day), and was completely dilated at around 3 in the morning.  She pushed like a CHAMP for 2 hours in all different positions, but the baby was not budging.  The doctor recommended a c-setion, which she agreed to, and after quite a rough procedure her baby boy was born (they discovered that he was OP, or "sunny-side up," which is why he wasn't moving through the birth canal.  Babies can definitely be born in this position, but this little guy didn't want to budge).  The doctor had arranged for me to go into the operating room to sit with Jamie while they stiched her up (since dad would go with baby to the nursery).  This was a very cool experience, as I got to be with her as she saw her baby and kissed him for the first time, and as dad got to hold him.  It was such a surreal and sweet moment.  And it was such a joy that I was able to be with her for the next few hours, rubbing her shoulders and neck, and just making sure that she knew she was cared for even though things obviously didn't turn out as planned. 

All in all, I'd say it was a pretty awesome summer in the birth department.  I don't have any clients lined up for the immediate future, and I have to say that it feels AMAZING to not be on call.  And while I'm taking a litttle break from births, I'm working together with some very talented friends on a super-amazing, top secret project, that will hopefully be ready for the public sometime late this fall...  I can't wait to show you!

My First Birth: A 36-Hour-Long Lesson

Posted with permission.

"I will never give birth without a doula."
~Jennifer, after the birth.

Jennifer's water broke at 3am this past Thursday. 35 intense hours later, her son, Andrew, was born. Here is what I learned.

1. Doulas are crucial for not only unmedicated births, but also--maybe even more so--for births where interventions are used.

Jen and Keenon had been preparing for a natural labor and delivery, and Jen had been reading and practicing Hypnobirthing, which uses relaxation, visualization, and meditation to cope with the pain of labor. Many hours after the broken bag of waters, though, her contractions were just too weak and far apart to be helpful. But the doctor was very patient, and waited until 6:45 pm to start augmentation with pitocin. It took an hour or so for contractions to really get started up, but when they did they were pretty painful, continuing to get stronger and closer as time passed. Jen did an amazing job of staying focused and breathing through each contraction, and Keenon was such a strong support to her. I suggested different positions and tried to create a relaxing environment for them to labor in. When things really started getting intense, she settled in the bed for some concentrated focus and relaxing. I was reading a meditation script to her, which helped get her focused, and after that she came up with her own ritual (a sign that she was really coping well). She started repeating in her head, "in love, out pain" with each breath, as I stood by her side and repeated that mantra out loud. After about eight hours of laboring with pitocin, the nurse checked her and she was still only 1cm dilated. This was awful, disheartening news. The good news was that her cervix was 100% effaced, or thinned out, which is what we had been accomplishing for the past eight hours. This was probably a low-point in the labor--Jen was so discouraged, and in her discouragement expressed that she just wanted to get a c-section and be done. Keenon was also in a state of disbelief, and very concerned for his wife. I knew, though, that they were speaking out of pure emotion, and in the end would most likely regret it if that was what happened. The nurse (who had been rather prickly up until this point) really came through, and with me, encouraged an epidural, some rest, and to go from there. Which brings me to point number two...

2. Epidurals can be very, very helpful.

Under normal conditions, I believe that women have an innate strength to get them through labor, if they are well-educated, prepared, and have a strong support system around them. This was not a normal circumstance, though, and the options were either an epidural and some rest, or a c-section. Thankfully, they decided an epidural would be the best way to go, and this was given at 3:30 a.m.

3. It is impossible to sleep in the waiting room, no matter how tired you are.

Heather (Jen's best friend, who was also a part of the support team) and I left the room so Jen and Keenon could get some much-needed sleep. We begged the nurse for some hospital blankets and headed out to the waiting room. After 2 hours of twisting and turning from floor to chair to small-hard-couch-thingy, we headed back to the room to see how things were progressing.

4. When working as a doula, I hold up just fine on zero sleep.

I walked back in the room, bright-eyed and feeling like a million bucks (well, almost). The nurse came to check Jen at 6am, and she had progressed to four centimeters! The baby was also moving down. This was awesome news! We still had quite a ways to go, but we were making progress. Friday morning was less intense than the night before, but still required constant vigilance and attending to Jen. I felt totally awake and sustained by the prayers of friends who were praying for me and for Jen and Keenon. What a blessing.

5. The "24-hour rule" can be bent if both mom and baby are doing well.

Typically, after the bag of waters breaks, the clock starts ticking--doctors say they will have the baby out 24 hours later one way or another because of the risk of infection. But as we were well past the 24-hour mark and there was no talk of c-section, I was hopeful that her baby could still be born vaginally. (After the birth, I asked a nurse why they let her go so long without operating, and she said it was because the baby's heart rate was strong and Jen was doing really well. It would have been nice to know this was a possibility!)

6. Emotions are ten times stronger when running on no sleep and adrenaline.

We didn't know this at the time, but around 11:00 the doctor had told the nurse to get the papers ready for a c-section and to bring them in for Jen to sign, but to check her one last time just in case. So she came in, checked her, and said, "I don't feel any cervix!" I couldn't contain myself--I was so happy I started crying. They asked, "Is that good?" I said, "Yes, this is so good! We made it! You can start pushing!!" It was a beautiful moment. Our awesome new nurse started rushing around to get the room ready for a baby!

7. Women can be strong. So, so strong.

Before she was checked, Jen started feeling the contractions getting stronger. She started having a urge to poop, and I was suspicious that we were nearing the end (having felt that same sensation not too long ago myself). She started having to really focus on her breathing during each contraction, and soon, it seemed like she didn't have the epidural at all. She also started getting pretty emotional, and losing her focus (which we later discerned was a sign that she was in the transition stage of labor--between 7 and 10 cm). Thankfully, her friend Heather knew just how to calm her down and talk her through it. Then I informed her that the pushing stage was going to get very intense again, and that she was going to have to draw from all her inner strength. The room was ready, the spotlights turned on. Heather and I each grabbed a leg while Keenon stood by her head, and the nurse coached her on how to push. She was in so much pain, and could feel everything, but she was so strong for her baby. For two hours, I counted to 10 for each push, which was 3 or 4 times per contraction. She was exhausted, but so focused, and took advantage of every second between contractions to rest. After almost a day-and-a-half of no sleep and barely any food, I was blown away by her strength. She pushed Andrew out into the world at two o'clock pm.

8. The minutes after birth are the most beautiful, spiritual, and love-filled moments ever.

Their new baby was placed on Jennifer's chest. There were tears, kisses, and so much love between their new family. I was crying and taking pictures, doctors and nurses were bustling around attending to Jen and the baby as she held him. But they were in the zone. Nothing could distract them from the miracle of what was happening. I am so blessed and thankful to have been a part of this incredible journey.