Navigating Postpartum: The Emotional and Physical Impact on New Mothers

"As a health writer, I had often heard and written about postpartum depression, but it wasn’t until I experienced it myself after delivery that I truly understood its intensity. I had never felt so low and hopeless before. I found myself crying at the smallest things, and no amount of support from family and friends could lift my spirits. I spent my days in a deep, unshakable sadness, unable to feel the 'motherly' emotions I had expected towards my baby," shares journalist Kalpana Sharma.

A woman’s body changes every week. With the four phases of the menstrual cycle, a woman’s feelings, her body and her emotions are always changing. However, when a woman becomes a mother, her body experiences tremendous changes. Furthermore, the responsibility of being a new mom too could be overwhelming, leading to postpartum depression.

“I am a very positive person. I know I can handle anything. So, when my friends would tell me their stories of postpartum, I would tell myself that I could handle it. I could talk myself out of it. But to my surprise, it was very difficult. My body and my mind went through so much,” says Akanksha Thapliyal, 34 from Siliguri, a creative consultant, who became a mother at 33.

Thapliyal shares that there were days when she would just cry, without even knowing the reason. At times, everyone felt like her enemy, including her husband.

A mother from East Tennessee, Tiffany Toombs Clevinger, now 39, shares she was 37 when she had her baby and her first feeling was, “Oh no, what did we just do?” She was in disbelief and did not know what to do to take care of her child.

Why were these mothers confronted by such feelings? The answer is postpartum depression. Postpartum is a phase after childbirth, where mothers go through physical changes. These physical changes in their bodies affect them mentally, the added responsibility of being a mother further makes this phase stressful and anxiety-stricken.

Dr Sushma Pampanavar, gyneacologist and obstetrician at the Iswarya Fertility and ICF Centre and a member of DocTube says that there are many physical effects of postpartum on a woman’s body. “There are uterine changes, which means the uterus expands during the pregnancy and begins to shrink back to its pre-pregnancy size after childbirth. This may cause cramping.” Other effects include postpartum bleeding and discharge, also known as lochia, which goes on for a few weeks.

“Hormonal shifts, especially estrogen and progesterone drop rapidly after delivery, this can affect the mood,” she points out.

The body too begins to change its shape, breasts get engorged, nipples get sensitive, changes in pelvic floor also occur which may lead to urinary incontinence and discomfort.

All of these, combined with the added responsibility of being a mother is what causes postpartum depression or what is commonly known as ‘baby blues.’

“Your body goes through so many changes all at once. You are a different person when you are pregnant, a different person when you deliver and a different person a year later. You are three different persons when you are a mother,” says Thapliyal.

Sarah Fletcher, 49 from Blackpool UK, a hypnobirthing practitioner had her child when she was 25. She had severe anxiety and struggled to enjoy being a new mom. It affected her relationship with her partner and her child's behaviour.

“One day I had tormented him [partner] so badly that he was crying in a corner, begging me to stop. I was fearful, depressed, lonely and felt useless. This is reflected in my baby’s behaviour through him being unsettled, agitated and not sleeping,” she shares.

Dr Himanshu Nirvan, a psychiatrist at the Noida International Institute of Medical Sciences and (NIIMS) Hospital says that persistent feelings of sadness, hopelessness and irritability in mothers can lead to difficult bonding with the baby and “thoughts of harming oneself or the baby.”

If unaddressed, suggests Dr Nirvan, postpartum can potentially strain the mother-child relationship, leading to feelings of detachment, neglect or irritability.

The added responsibility of being a mother, and not being able to perform well as a mother too causes stress. Both Thapliyal and Clevinger share that they were not able to breastfeed their child. This made them feel useless and caused them to feel the mother’s guilt. This term refers to the feeling of shame and guilt that a mother feels when she thinks she is unable to live up to the standards of being a ‘good mother.’

“I struggled with breastfeeding, my body wasn’t doing what I wanted it to do. I was frustrated and I felt like a failure. I felt like I was not good enough,” shares Clevinger. She spiralled into anxiety and depression and lost the motivation to drive to work. This lasted for 20 months.

For Thapliyal, the feeling was the same. She went to her mother to seek her advice; however, she did not get any help. “My breasts would hurt, and my nipples were sore from breastfeeding. When I asked my mother, she told me that it was normal. But it is not. It was so painful that I could not breastfeed my child for two days,” she says.

This is when she finally reached out to a lactation expert and a counsellor. “Her name is Divya Kapoor. She helped me a lot through this phase. A lot of lactation experts or birth counsellors come from an empathetic background. Mostly because they did not have a great birthing or post-birthing experience. Divya struggled so she wanted it to be better for other mothers. She is now a doula,” shares Thapliyal.

Thapliyal has also shared her journey of motherhood in an attempt to help other new mothers in her podcast 'Manomanjan.'

The same is the story of Fletcher, who discovered neurolinguistic programming that helped her in her healing journey. She now teaches this to others and helps them with their mental well-being. As a hypnobirthing practitioner, she also supports women during the birthing process and helps them to keep a positive outlook.

Sejal Malhotra (name changed), 24, an advocate from Delhi shares that she underwent the postpartum phase when she experienced a surgical abortion, last year September. “I went through an unplanned pregnancy and for the first 10 weeks, I did not realise I was pregnant. Complications arose and it was determined that the pregnancy needed to be terminated,” she shares.

The surgical abortion caused her body to react in ways akin to labour. “I endured pain, particularly in my vaginal area. Even doing simple activities like stretching, and sitting down, became a task, causing excruciating pain. The physical discomfort lingered for months. There was a complete loss of sexual desire, and this deeply affected my relationship with my husband,” she shares.

“Postpartum recovery can significantly impact a woman’s relationship with her partner, as both partners adjust to new roles and responsibilities. The physical, emotional, and psychological changes that occur during this period can strain intimacy and communication, but with understanding and effort, couples can navigate these changes effectively,” points out Dr Pampanavar

Malhotra also underwent hormonal shifts and experienced postpartum depression, leaving her feeling emotionally numb, feeling isolated and guilty for not being enough as a partner and a woman. There were days when she could not get out of her bed.

Gynaecologist and obstetrician Dr Avir Sarkar, Assistant Professor at NIIMS says, “Experiencing a pregnancy loss, whether through surgical abortion or delivering a stillborn baby due to miscarriage, can indeed lead to a complex and emotional postpartum experience for women.”

Dr Sarkar says that women still experience bleeding, hormonal shifts and other postpartum symptoms, along with the profound emotional impact of pregnancy loss.

“Allow yourself to grieve, express your emotions and seek support from loved ones and healthcare providers,” suggests Dr Sarkar.

For Malhotra, her partner gave her the support she needed. At times, she noticed her partner mirroring the same emotional signs as hers. She is now in therapy and is doing much better.

“Physical intimacy may change during postpartum,” suggests Dr Sarkar. Partners too show the same emotional signs as they also experience the secondhand pain of their partners.

“Joining new parent groups, seeking online forums, attending support groups, and connecting with other mothers can combat feelings of isolation,” says Dr Nirvan. Partners too can assist with childcare and share household tasks.

Dr Pampanavar says that self-care, rest, counselling and therapy are some of the ways one can heal through postpartum. Experts also suggest that allowing mothers the time to bond with their child also helps reduce the feeling of sadness.