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Baby, don’t sing me the blues

Nupur Dhingra Paiva | Updated on January 23, 2018 Published on May 15, 2015
No let up: Our anxiety of looking after a fragile life and creating it into a halfway-decent human being — if we are lucky — begins with the child’s birth. Photo: G Ramakrishna

No let up: Our anxiety of looking after a fragile life and creating it into a halfway-decent human being — if we are lucky — begins with the child’s birth. Photo: G Ramakrishna   -  The Hindu

Shadow lives: Postnatal depression does not exist in India because families and even doctors don’t recognise it. Photo: K R Deepak

Shadow lives: Postnatal depression does not exist in India because families and even doctors don’t recognise it. Photo: K R Deepak   -  The Hindu

Postnatal depression is also about losses — of other parts of our lives as women, of other parts of our identities, as they become subsumed under the one title ‘mother’

Can I say this out loud? As a woman, can I give myself permission to acknowledge that I am not entirely, deliriously happy with my newly-acquired motherhood? Does our society, especially the media, give a woman, from any socio-economic class, the permission to have mixed feelings, including unhappiness, about becoming a mother? Yes. There is one clause under which you may get such permission — if you have given birth to more than one daughter. A friend was told by a psychiatrist, “You have had a son! How can you be upset?” And since this is not an acknowledged psychiatric category, one cannot be diagnosed with ‘postnatal depression’. It does not exist in India because no one will believe you. Not your mother, your gynaecologist, your child’s paediatrician, not even your husband.

Worried sick

So what do you tell the 15 per cent of women who are likely to experience postnatal depression? This would be 15 per cent of non-Indian women. After all we deny the very experience, so there is no question of quantifying it. A bit like marital rape, postnatal depression is ‘not in our culture’.

Postpartum depression is mostly because of the anxiety of death. From the moment the baby is conceived, this anxiety grows from being barely perceptible to more palpable. ‘Will my child be fine?’, ‘How will I handle this pregnancy?’, are just a few of our concerns. We fret over the right diet, the right exercise, but our real worry is whether this baby will be okay inside. The truth is that the baby will never be safer anywhere else. The outside world will always feel more threatening, with germs and viruses, unsterilised bottles and strangers and whatever else have you.

Then there is the birth; also replete with the anxiety of death but once you have survived the terror of childbirth, whether by pushing and shoving or by being slit open, the haze of pain recedes as the baby — hopefully, with 10 fingers and 10 toes intact — is brought to your chest. One way or another, the baby you have longed to hold is finally in your arms. You are overwhelmed, perhaps crying and laughing at the same time. Our anxiety of looking after a fragile life and creating it into a halfway-decent human being — if we are lucky — begins here.

Postnatal depression is also about losses — of other parts of our lives as women, of other parts of our identities, as they become swamped and subsumed under the one title of ‘mother’. It is a continuous, often lonely (because women don’t converse with each other about the internal struggles that matter the most) personal battle to reclaim the lost parts — the friendships, the career, the sexual life and, most immediately, the body.

Every woman who has given birth and not had a ‘tummy tuck’ simultaneously, knows that she still looks about six-months pregnant even though the baby is out. Only now, it is a hanging bag of loose muscle — terribly unattractive yet unavoidable. My male friends expressed horror at my leftover pregnant body, saying, ‘Why is your stomach still like this?!’

Your body has not been your own since you went into labour and will not be for many following months. A friend told me she felt like she was a cow since her primary function was to eat right and produce milk. Luckily, she got on with the task at hand and her body took care of its shape after a few months. To be honest, even your mind is not your own. It has probably become a conduit for intense feelings from your own past, the present and anxieties about the future. Any lurking feelings leftover from adolescence and early adulthood are probably going to resurface now and create inexplicable low moods, hopelessness and weepiness. Add to that incessant infant-care advice from in-laws, parents and every passing neighbour, and you have a recipe for internal chaos.

Big picture

For a decade, I worked in the UK in a multidisciplinary mental health team that included midwives and children’s nurses. My job description specifically included working with families with postnatal depression. Mind you, families. Not just mothers. It is possible for the father to experience difficult feelings after the birth of his child — girl or boy — but we cannot address this here. Let’s just deal with one bit of denial at a time.

I recall young women abandoned by their boyfriends after an unplanned pregnancy; couples lonely and drifting away from each other by the entry of a baby they thought they were looking forward to. I remember homesick, immigrant first-time mothers who yearned to be looked after by their own families but instead were in an alien country with grey, dripping skies, surrounded by unfamiliar food, a foreign language and strange-sounding child-rearing advice. It’s enough to send anyone spiralling into depression.

When I returned to Delhi, I was not surprised to find that no one spoke of depression and motherhood in the same sentence. However, I was surprised that even medical doctors dismissed it. When I met an old college friend after 10 years, we spoke about ourselves as ‘working mothers’. She is a successful businesswoman and shared with me how she was terribly unprepared for the total takeover of her life by her newborn son. She was exhausted all the time and could not keep up with work, yet her business was her ‘baby’ too. She had set it up from scratch and could not let it die. It was an important part of her identity. She felt lonely, trapped and resentful at her husband, who was working in another city. Upset at herself for feeling upset, she looked for someone who would hear her out. Her gynaecologist told her to go away; the psychiatrist told her that she could not possibly be upset after giving birth to a son and prescribed antidepressants anyway; her mother denied that such a feeling could even exist.

Eventually, my friend found a psychotherapist, people of my ilk, who at least believe that her experience is legitimate. She could be overwhelmed with panic, loneliness and love for her child, all at the same time. A few months later she forgave herself, acknowledged that conflicting emotions were normal and moved on. She continues to be a wonderful mother, friend, and a successful businesswoman.

My own story is not too different. The postnatal midwife watched me struggle to breastfeed my first-born. Instead of helping to adjust the latch, she told me that my nipples were the “wrong shape” and that I should probably give up and give her formula. My daughter was three days old and here I was, a first-time mother, being told that I was fundamentally ‘wrong’ and needed formula to keep my child alive. I was so vulnerable, and in pain, that I was devastated, even as my rational mind refused to believe it. It did not occur to me to throw her out of my house. Luckily, it did occur to my husband, who did exactly that.

A friend who was also a trained midwife came over, helped me hold my baby the right way and we figured it out together. I breastfed my daughter successfully for a year and turned into one of those annoying mothers who never used a bottle and whose child went from ‘breast to cup’. There was nothing ‘wrong’ with me. But I saw how callous handling of the postnatal mother, an over-mechanised, medicalised birthing experience, complications in the mother and baby’s health also lead to postnatal depression.

However, the fatigue, loneliness and sheer repetitiveness of caring for an infant did tip me into feeling depressed. Six months later, when my baby woke incessantly at nights and I had not had four hours of unbroken sleep for a month, I found myself crying in the day and easily overwhelmed by every small demand. I was lonely at home with a baby, while everyone else had resumed their pre-baby life. I had not had an uninterrupted meal, nap, bath or conversation ever since she had been born. I could not read or concentrate on any adult conversation, let alone on intelligent adult conversations about society, politics or my work. I could not focus on anything, not even the baby. I was slipping away from everyone, including my husband. I was a zombie.

Eventually, it was my mother who rescued me by taking the baby away so I could sleep for a while. I had clearly needed mothering, alongside conversations about how I was feeling and sufficient rest. A routine that included meeting likeminded mothers with children, physical exercise and a few breaks from the baby also helped.

Did I just say that out loud, again? Breaks from the baby made me feel better. That is what I needed and I refuse to feel guilty about it. If I needed to look after my baby to the best of my ability, I needed to look after myself.

Nupur Dhingra Paiva is a clinical child psychologist who teaches at Ambedkar UniversityDelhi; is the mother of two daughters

Published on May 15, 2015
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