The intense range of emotions you'll experience after the birth can be bewildering. Here's how to cope with the ups and downs of life with a new baby.
Alison Sampson couldn't wait to hold her new baby for the first time. She was sure that she'd fall instantly in love with him or her and cope with giving birth and motherhood as efficiently as she did with the demands of her high-achieving career as a clinical psychologist. But her expectations fell far short of reality.
"I'm used to working hard and getting results for my efforts, and thought everything would be easy", says Alison, who was 31 at the time. But it wasn't. Instead of the natural birth I'd planned, I ended up having a traumatic vaginal breech birth. And when I saw my baby son, I didn't feel the instant rush of euphoria or maternal love I'd anticipated. I just felt oddly numb.
I hoped that I'd grow to love my baby, but all I felt was a sense of relief when he went to sleep. He was a hungry baby too, and I was totally exhausted. I felt an overwhelming sense of guilt and shame - like I'd failed to be this perfect mother I was supposed to be.
I was reluctant to ask for help, because that would mean seeing another professional in the field. My clinic sister suggested medication, but I didn't want to take anything. Eventually, after about three months, I joined a mom and baby support group, which helped. So did going back to work on a part-time basis.
Most new moms are familiar with moods swings triggered by out of control hormones. According to Alison, the KwaZulu Natal representative of the Postnatal Depression Support Association of South Africa (PNDSA), about 85 percent of all new moms are affected by baby blues. Of these, 30 percent will develop postnatal depression.
"The baby blues are a biological response to pregnancy and childbirth," says Alison.
"This condition is very real and quite unique to new moms but, unfortunately, is generally not given enough recognition by medical professionals."
"Most new moms aren't prepared for the intense range of emotions they experience," says one understanding gynaecologist. "They think they'll be totally thrilled with their new baby all the time, and may feel guilty if they have any doubts or negative feelings at all."
The birth of a first child is a life-altering event. As an article in the PND newsletter puts it, "A new baby involves more changes than emigrating to another country. Everything changes, your body, mind, responsibilities, relationships, career and financial status."
Initially, it can be quite overwhelming to know that you're responsible for a helpless newborn 24 hours a day. Nothing is easy at first, and you're constantly wondering if you're doing the right thing, or whether baby is OK. It's no wonder you're feeling exhausted and confused. All these changes would be stressful even if you were getting eight hours sleep a night.
Says Liz Mills, Founder-President of the PNDSA, "It's important to remember that expectations very often don't live up to reality, and that the birth of a mother may not happen at the same time as the birth of the baby."
"This may sound strange, but many first-time moms don't feel like moms immediately. All they know is that they feel very different, almost like a new person, and they're right. This is a new you, and it may take time to adjust to a new life."
Most women, and medical professionals too aren't fully aware of the crucial role hormones play at peak transitional phases in the average woman's reproductive cycle.
Says Liz Mills, "Research shows that the areas of the brain in which female reproductive hormones act are also the areas involved in mood stability regulation."
Specific brain chemicals are involved in the emotional symptoms that women may experience in their reproductive years, particularly serotonin.
Oestrogen, the main hormone released by the ovaries has a pronounced effect on serotonin, and on the communication of nerve cells in the brain.
"Many women's emotional problems are related to PMS, pregnancy, infertility treatment and menopause. It follows that there are certain high-risk periods in a woman's life. For example, 10 percent of women will be depressed during pregnancy. Many of these will experience a worsening of the symptoms after birth."
Huge hormonal changes take place during and after childbirth, which can alter biochemical pathways. Oestrogen and progesterone levels are highest at the end of pregnancy, but plummet after the birth. The oestrogen receptors work on the area of the brain, which governs emotion, so it's not surprising that this rapid drop affects so many vulnerable women.
Progesterone also takes several days to normalise after delivery, which may contribute to feelings of anxiety. There's also a shift in thyroid-hormone activity, and some women who experience depression do, in fact, have abnormal thyroid functioning. Even when this is corrected they're still likely to need treatment for depression.
In a recent UK study, researchers found that postnatal care tailored to individual women's needs could help identify and reduce depression among new moms. Research published in the medical journal, The Lancet, found extending midwife visits and using checklists to identify common symptoms could help ward off postnatal depression.
Says Professor Christine MacArthur, and epidemiologist at the University of Birmingham, who led the research team, "We know that women have health problems after childbirth and are often misidentified. The form of care delivered is able to identify missed problems and actually make a difference."
She added that the children of mothers suffering from postnatal depression often develop behavioural, developmental and emotional problems too- these often last for a long time.
If you're feeling alone or anxious, the best remedy is reaching out. Find, or form, a group by calling women from your antenatal class, or chatting to other moms while you're at the clinic or waiting in your doctor's rooms. You'll also find support group contact details in your community newspaper.
However, if you're experiencing feelings of profound sadness, hopelessness, and a sense of detachment from baby and the rest of the world, it's important to seek professional help. Postnatal depression can be effectively treated.
Above all, try to remember that this time will pass. Soon, you'll experience the pride and joy that comes with loving your baby - and knowing that you're being the best mom you possibly can.
Research carried out in the UK on women's expectations of birth and the period following revealed five commonly held myths. Once you are able to identify these, you can sidestep the trap of thinking that.
In addition to hormones, many other factors play their part in mood disorders. One of these is a traumatic birth, or one that didn't go as planned. Others include, a genetic predisposition: depression is often hereditary.
Traumatic experiences at critical ages: These include difficult events early on, bereavement and unresolved grief.
Bonding is automatic: most pregnant women expect to experience a rush of maternal feelings the moment they see their babies. This is the exception rather than the rule. Love often grows with getting to know your baby. Many moms feel awkward and unsure in the first weeks of caring for their babies. Every mom is different too - some enjoy the new baby stage, others enjoy the later stages more.
You'll feel happy all the time: There'll be times when you feel exhausted, confused, overwhelmed, angry or frustrated, when baby won't feed or sleep - especially in the middle of the night.
Breastfeeding is natural and easy: Some babies are easy to feed, but there are often initial problems, such as sore breasts or a lazy feeder, until you establish a routine. These problems are only temporary, and you'll soon sort them out with the help of a breastfeeding counsellor.
You can do it all: This isn't really possible or wise. For the first two months you need to concentrate on getting to know your baby and her needs, and making sure that you get enough rest. You'll need practical help for domestic chores and emotional support for yourself.
Accept offers of help that come your way, or actively seek out assistance (see When you need help).
After six weeks your sex life will return to normal: It usually takes much longer than six weeks before you feel in the mood. Apart from feeling exhausted, baby's demands may take all your energy, and your partner needs to understand that "not tonight, darling" doesn't mean you no longer love and desire him.
The unique mother-daughter relationship: The quality of a woman's own experience of being mothered can affect her ability to adjust to her new role.
Issues like self esteem: The desire to achieve and the need for recognition, add to the pressure of doing it right.