Stitches, Shame and Sleepless Nights

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There is a stunned look on the face of the first-time mother. We noticed it as we wandered the corridors of the maternity ward in the days after we first gave birth. Quite quickly we could tell the difference between the new mums and the old hands. Those fresh to the experience wore dazed, pained expressions, not entirely due to the physical transformation they had endured. They were in deep shock from becoming mothers. Little did they (and we) know what was in store.

The first time you give birth, you don’t just give birth to a baby. You give birth to yourself as a mother. Without wanting to belittle for a moment what it is to become a father, there is perhaps no greater life transition than from childless woman to mother. Perhaps that is why we so rarely hear of postnatal depression in men.

The shock of the transition is blindsiding. Your body has changed beyond all recognition; it has just taken you through labour – an awe-inspiring, primeval and dangerous experience over which you have little or no rational control – and it has left you high but certainly not dry, weeping with the pain of engorged breasts in a hospital bed. Beside you is the world’s most unfathomable creature, a mysterious newborn, that people tell you is your child.

Some women bond immediately with their child, but as any obstetrician can tell you, many don’t. The more traumatic the birth, the more shocking the experience has been for them, the less energy they have to invest in the baby who after all is the direct cause of their current misery.

And for many women it is miserable. Apart from the engorged breasts (an experience impossible to describe and do justice to its full horror), there are likely to be stitches to contend with, either perineal or caesarean, and if labour has been hard and long, it is possible to feel as if you have been run over by a truck.

But instead of someone coming to mother you, you are expected to mother someone else. And all the eager visitors who arrive are quite clearly much more interested in the alternately squalling/comatose infant in the perspex box beside your bed than they are in you. Through it all, you are meant to be ecstatically happy and besotted with the tiny stranger that has so comprehensively invaded your body, your life and your future. Most women smile bravely and pretend, but if you look at a new mother’s face carefully, you can see how shattered she feels. The person she used to be has gone forever, and she isn’t yet sure who she is supposed to replace her with.

After the birth of her second child, Jane remembers meeting one of those shell-shocked first-time mothers at some ungodly hour in the maternity ward common room of Sydney’s King George V hospital. As they made themselves a cup of tea, the wan-faced and exhausted new mum said, "Oh well, I suppose it gets better once you go home."

Jane looked at her and debated silently whether it would be better to tell her a comforting lie or the truth and decided on the latter. "No," she said. "In my experience, it gets worse. Here you’ve got nurses to help you, your meals delivered and your laundry done; at home, it’s all up to you. All I can say is don’t think when you’ve patted your baby’s bottom for the 682nd time at 3am and they are still wide awake that you are the only person in the world doing it. We all struggle to get our children to do anything. And you can take comfort in the fact that in the long run, it must be worth it, because, despite everything, I am back here doing it for a second time."

And it does get worse – at least for a short time – once you get your baby home. Many women (including us) can feel like a complete fraud as they leave the relative safety of the maternity ward pretending to be any kind of real mother. What on earth can the world be thinking of to entrust me, all on my own, to look after this very vulnerable creature?

It can feel surreal the first time you are alone with your newborn at home. No state feels right. If the baby is asleep, you fear it is dead or is about to die, but you dare not disturb it to find out. If your baby is awake, you try feeding it, rocking it, taking it for a drive in the car; you try settling it, patting it, burping it, all of the 101 things everyone and anyone has told you about. At your wits’ end, you put the red-faced, squalling infant in their cot and hover anxiously by the door, wondering if you are scarring your child for life by not being able to comfort it. Then the horrible thought strikes you, what if your baby simply doesn’t like you? Mercifully it isn’t until they are teenagers that you discover the profound truth in that observation.

And if it is terrifying coming home with one newborn, imagine how much worse it must be with two. As a mother of a toddler and newborn twins, Catherine felt as though she would never get back to a normal life again.

Most mothers of twins ruefully confess that their children’s first year passes in a blur of exhaustion, nappies and feeds. Catherine’s premature twin daughters, Evie and Antonia, didn’t understand they should synchronise their feeding times and took it in turns to wake up every hour or so all night. Her husband dutifully got up with her to feed one of the babies and then would try to catch some sleep before going off to work. How do many families survive without a division of labour between the parents?

Evie and Antonia were only 12 weeks old when they developed a respiratory infection and as her husband had taken their toddler to childcare in their only car she was unable to get to the family GP. Instead, she decided to walk to a local medical centre and have them examined.

The woman doctor she saw was about her age and confirmed the girls would need antibiotics. As they chatted the doctor asked if Catherine was breastfeeding and she explained that despite making every effort to feed the twins, who had been failing to gain weight, she was unable to produce enough milk while also caring for a toddler.

The doctor gave Catherine a severe talking to, lecturing her to pull her socks up and breastfeed them for longer or put their health at risk. There was no mention of Catherine’s health, mental and physical, from attempting to care for three small children with little assistance. She walked home and collapsed in tears, feeling like a failure and incompetent at even feeding her own babies. When she told her husband he was furious and couldn’t understand why the doctor hadn’t bothered to listen when she tried to explain what she was going through. But Catherine realised the doctor couldn’t see beyond those two little babies and that she was purely subsidiary to them. Catherine was no longer a person, she was a mother.

Both of Jane’s children were also born prematurely, Polly at 34 weeks and Charlotte at 36. Both were also large and healthy. Jane was given steroids before Polly was induced to make sure the baby’s lungs were properly developed. And thank goodness she was, because Polly caught a virus in the special care nursery of King George V, and at 10 days old was admitted into Camperdown Children’s Hospital with respiratory syncytial virus (RSV) positive bronchiolitis, the biggest single cause of death of babies under one.

At 13 days old, Polly had to be resuscitated three times and was given the last neonatal intensive care bed in NSW so she could be intubated and survive. Jane will never forget the intensity of fear and grief she felt at the time and also vividly recalls saying to a visitor, "I’ve only known her for 13 days, but if she dies I think I will too."

Every mother has a story about the dawning realisation that they are no longer an autonomous individual; some of those stories more extreme than others. Motherhood is not like any ordinary job, it is not something you can pick up and put down. Women who secretly find themselves occasionally resenting this demanding new presence in their lives are neither unnatural nor unusual. They are simply normal. This needs to be acknowledged, not ignored. However much we love our children, none of us can give up our autonomy without some grief over the loss.

Acknowledging the real – rather than the romanticised – experience of mothering is essential if we want to help and support new mothers adjust. Feminism has enabled us to bring the experience of pregnancy and childbirth out of the closet, because it has legitimised such experiences and challenged the belief that women are naturally equipped to deal with them.

When our own mothers gave birth to us, they had little access to information about what to expect in the labour ward or the nursery. If they asked, they were often dismissed or told to shut up. Now the opposite is the case – whole sections of bookshops are dedicated to pregnancy, birth and parenting. It ain’t secret women’s business anymore.

This is an edited extract from The F Word, by Jane Caro and Catherine Fox (UNSW Press).

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