If it were up to us, we’d wish every new parent pure bliss and happiness. But sometimes, new-parent happiness as we see it in magazines and in Instagram is just not to be found. Too many changes, sleep deprivation, missing support or unrealistic expectations from yourself and/or your environment can lead to postpartum depression. Julia Beck, the founder of the It’s Working Project and Forty Weeks, shares wise advice in an article at the Harvard Business Review.
Sarah was well-versed at the fine art of excelling. A Division 1 collegiate soccer player, she transitioned with ease into the highly-competitive corporate world after graduation, working for a well-respected global IT company. Moving from an entry-level events planner to senior manager within five years, Sarah was well-known in the organization for tending to urgently needed adjustments in real-time. Then, in August 2018, she was excited to learn she was pregnant. The next spring, Sarah and her husband welcomed a baby girl named Amelia Jeanne, or AJ for short.
While AJ was well and thriving, Sarah’s time on leave was full of complicated transitions. She and her husband decided to move from San Antonio to Austin for his new job, and in the new city she felt lost, with little comfort or connection. Even so, she was sure that her return to work after a three-month parental leave would bring her back to feeling like herself, flourishing and in control.
Sarah’s employers expected she would pick up exactly where she left off, and Sarah didn’t push back. She felt ready and willing to plunge back into a full schedule but soon learned that she wasn’t able. In managing a large, complicated trade show in Las Vegas, a three-hour flight away from her family, Sarah found herself in an unfamiliar place: she felt like she had no idea what she was doing. Her travel schedule left her seeing her daughter 45 minutes a day on average. Agents at TSA security checkpoints ruined her breastmilk and harassed her, asking why she wasn’t with her baby. She found herself sinking into distress and buried in thoughts of failure. She became sleep-deprived and came down with perioral dermatitis. Eventually, she experienced a range of suicidal thoughts, which she kept hidden from her support system, including her husband. Sarah was suffering from severe postpartum depression (PPD).
While PPD is physiological in origin, for Sarah it was exacerbated by her failure to find her professional footing. She clung to work desperately as means to feel stable again, yet she continued to plummet. In time, her ability to function in all aspects of her life decreased. Six months after returning from leave, Sarah left her job, an outcome that would have been unthinkable a year before. Throughout it all, she hid her PPD from her boss and colleagues. Many were surprised to hear she was struggling. Talking about it would have felt like displaying vulnerability in a way that was impossible in her unsupportive work environment. “I thought of myself as disciplined, strong and mentally capable, but after this I realized that PPD is completely non-discriminatory.” Sarah wishes she knew more before she fell so far.
More people are starting to know the basics of PPD and how common it is in the weeks after giving birth. Most people don’t know that PPD can strike up to a year later — long after most maternity leaves are finished — and that the stress of returning to work is a risk factor for exacerbating PPD. You (or your partner) are not likely to experience PPD as extreme as Sarah’s, but failing to understand its risks and realities before and during return to work can be dangerous to your well-being and your career. This piece will help you understand some small steps you can take to lower your risk and return to work with confidence.
PPD and Work: What You Need to Know
The facts are simply this: As a new mother, you are not the same woman you were prior to giving birth — not physically, not emotionally, and certainly not in terms of responsibilities.
The months leading up to childbirth are exhausting, yes, and filled with anxiety for many, but from belly kicks to showers to babymoons, it is often a time of anticipation, celebration, and togetherness. Contrast that to newly-minted mothers, who are often home alone with a new baby, recovering both physically and emotionally from birth while attempting to make sense of their new roles. Mixed with rapid hormone shifts, this isolation acts as a trigger for a spectrum of postpartum mood disorders, ranging from the milder Baby Blues to PPD to postpartum psychosis, a severe form of PPD like Sarah’s. (The Mayo Clinic does an excellent job of outlining specific symptoms.)
Meanwhile, another sudden dropoff occurs with maternal health care and support. D.C.-based OB-GYN Dr. Lauren Messinger shared with me, “We develop such strong relationships with women over the course of prenatal care, ultimately seeing them every week, then after delivery, we now go six weeks without so much as a scheduled call or visit.” (Dr. Messinger’s office has now added 2-week postpartum visits to address this.)
Combine all of this with your return to work, where you may be coming back to the same job, but as a new person who is managing a long and constantly evolving list of responsibilities at home. Yet somehow you are still fanning an old flame — your desire to do yet another thing well and right. Even with the most powerful and genuine peer support, return is a shock. The one area in which you reliably thrived and led the pack is now a steep upward climb, with a learning curve to match. Simply starting and ending your workday, once a simple task, may rise to horror level for new moms due to complicated new logistics, hormones, and exhaustion. This was the case with Sarah — already struggling during leave, she thought her return to work would be a cure-all. In fact, it was the final straw.
How to Prepare for Your Return
Fortunately, these feelings are all normal and can be addressed successfully. Ann Smith, Founder of Postpartum Support International pointed out to me, “PPD is the number one complication of childbearing. While 14% of women suffer, it is treatable. PPD is managed through a three-legged approach of therapy, medication and peer support.” While there is no surefire or one-size-fits-all approach to managing the very personal challenges of PPD, the following methods will help you create a sense of confidence as a first-time working parent and serve as a reminder that despite the challenge of the moment, this too shall pass.
Call on your village — and supplement it with additional support.
Surrounding yourself with loving, experienced friends, family, and caregivers is essential — not just in the first few weeks in the beginning, but throughout your parental leave. There is an ever-evolving range of services for mothers, including on-call professionals (such as therapists, lactation consultants, and parent coaching), peer-based groups, and other skilled digital supports. Many of these are born of women and their own experiences (good and bad).
Also take advantage of virtual and hands-on opportunities to build confidence and skills. There is no better way to understand your new roles, learn best practices, and most importantly, the clip of new parenting. The help is not only for you to learn skills such as how to swaddle or bathe, but also in offering perspective and kindness to yourself. Those who have already been there know this and will nurture you as you nurture your baby.
Embrace who you are.
“Some women simply are not great newborn mothers,” says Smith. Others find motherhood to be a new calling and start rethinking their careers during leave. Still others don’t really hit their stride as parents until their kids reach the school years. All of these experiences are normal. Mandy Major, a doula and the founder and CEO of postpartum care provider Major Care, shared her wise perspective:
“Culturally, I think we have an expectation that an innate motherhood gene will activate the minute we birth our babies. That we will magically know how to handle parenthood and also enjoy every stage of it. It’s wildly untrue, and can cause a lot of self-doubt and self-loathing. We all learn as we go, and your matrescence journey is uniquely personal based on your personality, preferences, life circumstances, and support systems.”
Instead of trying to meet others’ expectations, strive to pride yourself around your strengths and weaknesses. This will create a healthier path for any new parent, especially a first-time parent.
Say so-long to social media.
New motherhood is not as it appears on Instagram. Limit your exposure. Give yourself the chance to feel confident and secure on your own terms. Unrealistic social media images lead to negative self-views and insecurity, opening the door to PPD-related challenges. Smith shares, “We have a cultural issue. Social media has made a mess of expectations — that real moms do it all. This is not realistic and in fact dangerous.” he urges caution with other types of online support as well. “Non-professional online support groups can prove to be even more of a hazard — the words, ‘you’ve got this, mama’ — and can cause a woman suffering from the insecurities and anxieties of PPD to feel like even more of a failure.”
Sleep deprivation as the parent of a newborn is a given, but it’s still problematic. Sleep provides energy, increases milk supply, and keeps an individual feeling capable as opposed to vulnerable and insecure. Ask for and accept help from your village — they want to help you find sleep. There are professional options as well. Services like Let Mommy Sleep work with parents to provide the opportunity to sleep and recharge. Founder Denise Stern is careful with placing very specific caregivers in the home of first-time parents. “Finding the right fit for first-time parents is essential, [someone] who is interested in caring for mother and child as both adjust.”
Educate and elevate.
Self-knowledge and a connection to yourself can encourage your sense of security. Expectful is an app that offers accessible and guided hands-on tools to elevate your mood, and it offers support in finding quality sleep. It also hosts courses such as “Back to Business — Finding Your Work-Life Balance as a Working Mother.” The Breastfeeding Center for Greater Washington offers group classes including a range specific to navigating postpartum stresses — check in with your OB/GYN, the hospital where you gave birth, or other mothers to find classes in your area. Research and choose your options prenatally, too, to find the right fit in terms of chemistry and personality. The power of connecting with others deep in similar experiences along with a well-trained leader is an essential tool for empowerment and feeling less isolation or worse, failure.
Start preparing now.
All of the resources and care available for first-time mothers mentioned in this piece should be as well-researched as the right stroller or babysitter — and be accessible when you need them. Start today, whether you’re expecting, on leave, or already back to work. Some services may even be covered by your medical insurance or as an employee benefit, so ask your OB/GYN and your HR department. Know these providers’ contact info, rates, and rules of engagement. Another surprise or a panicked search for replacement pump part or a care provider will only worsen things. And be prepared for a prolonged search: there is a high level of need and regulated support is limited-to-anemic.
Return gradually — and know when it’s not working.
Sarah made the mistakes of ramping up too quickly, then suffering in silence. Options for creating a smoother return include remote work, peer mentoring to ease the transition, or if it is financially feasible for your family, a gradual return. Even for those who are well prepared, there are no promises or guarantees. You may find that you are simply not ready to take on the pressures of returning to work, or at least not yet. Work with your employer to understand your options. If your organization’s culture is more nurturing than Sarah’s, support from your manager can make a huge difference. Know that they want you to bring your best version of yourself back to work.
Sarah ultimately sought out professional help. It took time, but she was dedicated to improvement, and she recovered personally and professionally. In fact, AJ’s birth inspired Sarah to move into her next career phase as an entrepreneur. She started her own business, which was not only well suited for her lifestyle but thrived. She also found professional and personal relationships that are better suited for her needs.
There simply is no one-size-fits-all approach to addressing the spectrum of PPD. But making investments in your own postpartum physical and mental health are also investments in your career and your well-being as a new mother and as a woman.