Things I Do for My Postpartum Friends As A Perinatal Psychiatrist
Tips by time period to help your friend who is about to have a mini friend
Let’s start with a few assumptions before we get into this article and what I’ve learned so far being an aunt, a friend, and physician to new parents.
In our society, there is a lot of focus on the primary core of community being the nuclear family. You know this already, and so do I. Especially for women, the story of a meaningful life has been almost exclusively around marriage and having children. There are many parts of the internet and my own writings that get at questioning the overvaluation of this component of life that also devalues other forms of love, community, and meaning.
Paradoxically, within this world view comes a set of ideas that women will automatically know how to mother, how to care for a family, and that other women will know almost magically how to care for the mother. This is all care work, and it is a set of skills that can be learned. However, many people are stuck in the socialized story that if you don’t have these skills immediately, then something is wrong. The implication being the damning story that there is something not maternal, not caring, not feminine enough about you. This story keeps women separated from one another, especially when some women are having children and mothering, others are not, and all of them feel bad for the current status of their life and a sense that somehow, always, they are doing something wrong.
This article is for people who are in kind and caring friendships or communities where you think it would be a delight to be able to be with your friend during this period, but you don’t know where to start. This article is not an exploration of if your friend is there for you in your life as much as they want from you in their parenthood, if there is prior resentment in the friendship, or a sense that one woman’s stage of life is no longer as interesting or mature as the other’s. That article should be written, but it isn’t this one.
During Pregnancy
When your friend tells you she is pregnant, there may be lots of emotions you feel around it. These are valid, and don’t need to be hid from the friend or within the relationship. However, we have the capacity in relationship to hold multiple things at once, and when you first learn, being able to celebrate them, and hold for another time if you have complex feelings about it may allow more space both for the celebration of her new phase of life AND the space for whatever feelings or fears it might bring you. The temptation is to err to extremes—ignore your own feelings and totally push them out of a close friendship, or demand they be the primary concern. In health relationships, there is time for prioritizing and journeying through both.
This includes if you don’t want kids or you’re surprised. Use curiosity and this change as a way to know your friend in a new way as they go through new life experiences.
First 4-5 months for pregnant folks is nausea time. The last few months they feel like they have a medicine ball strapped to their spine, on top of their bladder. Consider how you would plan to spend time with a friend who had broken a leg or had another mobility limiting ailment. Pregnancy is not an ailment, but it is a huge body change, and your friend might not be able to do the same pace or type of things they could when not pregnant. However, they also aren’t frail, and many women feel great during most of their pregnancy. Attunement and curiosity are the first step, and recognizing how big of a change in their body is happening.
Ginger supplements, mint, etc if approved by their doctors as safe as well as some perfume scents can help with nausea. There are medications they can discuss with their doctor, too.
Think about the things you both enjoy doing together, or think about the parts of them having a child you’re excited for. Offer one thing to do with them that they may be doing as part of baby prep that you could make an afternoon of, and then do your usual coffee or lunch spot with it. Your friend is still your friend, just with a new sort of existential job. It can be fun to live it with her.
Before Birth
Ask your friend when family or friends are coming to support them post birth. Many people will have parents or family who help them in the first four weeks postpartum, and they may be both learning the skill of keeping a newborn well while keeping their sanity. These four weeks may also be the time when parents want to expose their baby to less new people, as they are anxious around virus or flu exposure. Consider talking to your friend about their plans both to learn how they are getting support, and to know when their support levels might change and a visit might be nice.
Ask your friend what they are excited about for when they are not pregnant, and what foods or wine or experiences they most cannot wait for. Consider noting this and bringing whatever it is when you first visit.
Let them know that you know this period will be different, and while you’ll reach out to them, you also understand that the first few weeks post-birth are a brand new world and you’ll assume benefit of the doubt with them that if they don’t text back, it’s because they’re sleeping for the first time in 4 days. Talk about when it might feel good for you to visit, and then check in once their settled at home after the first week.
The Fourth Trimester
After birth, let your friend know you would love to meet their new baby, and that you’re happy to bring take out or a dessert or your nice vaccuum or anything they need from the store. You miss your friend, so getting to see them at all will be nice for you. They are trying to surf a brand new wave, and are probably tired: offering concrete things to bring that are reasonable for you to do helps them not have to try to come up with or ask things of you that might make them feel like they’re asking too much.
When you visit, ask about the birth experience and how things have gone so far. Normalize that this period feels somewhat nuts to most people, and that it is like being thrown into the ocean and being expected to surf when you’ve never seen the ocean before. If you’re new with babies, don’t let your fear of them prevent you from holding the baby if offered. Part of what makes postpartum so hard is that assumption that mom knows all, knows best, and is the director of care. The more comfortable you get with your friend’s baby, the more that when you’re together you can be helpful and your friend can be more mentally present with you and have the luxury of peeing without holding the baby. You laugh, but this is groundbreaking for new mothers.
The first few months postpartum strain a relationship. If both parents are involved (ideal), they’re tired, mother is bodily recovering, they have a little angry joyful being who they are just learning how to operate with. If this comes up, use your best judgment in normalizing this if your friend is anxious or taking too much on herself. Laughter and recognizing this is a phase is the best medicine.
Babies love to walk. There are videos from nurses on youtube on how to swadle or efficiently change a baby’s diaper. You don’t need to overdo this if kids really are not your thing, but the more comfortable you feel with being with the baby with your friend, the more comfortable your friend will be, and the more connected you will both be (and have capacity for).
If your friend has piles of laundry, help fold while you talk. If they have dishes, wash while you talk. Ask if they want to hold the baby or fold the laundry, ask if they want to ignore the chores and just talk while the baby sleeps because they never get to talk to other adults. Generally: offer concretely, but offer multiple choices so they can pick something that feels best for them. Do not offer things that you don’t have capacity or a little fun in yourself—we do not want resentment.
The First Year
You don’t know how to talk to them about babies. They don’t know how to talk to you about babies. Let’s embrace being awkward. Additionally, you may feel like you have to talk about the baby with them, and they may feel like they just want to talk about anything but the baby. Things get quite weird after birth and women compare themselves online to other mothers and their friends and everyone else while they scroll instagram during breast feeding. This can lead to insecurities about postpartum everything—from their bodies, to having the right feelings about work, to how they miss the part of them that used to go out with you and was more free. This readjustment will take time for both of you in your friendship.
Even if you don’t always love being around kids, especially in the first year, it’s really hard for parents to separate, especially breastfeeding moms. Get creative of what might be fun or easy to do together in this year. Once again: come up with something that you would actually like to do, because the more you keep some of your desire in there, the more you’ll feel like your old friendship.
Familiarity is the mother of liking in most things. You may just not have been around young people before in a comfortable environment or at all. You may be surprised what it’s like when your friend has a kid.
Something I’ve noticed that can be helpful for new parents but they feel guilty for needing: sensory adaptations. Below are some good ones to consider for your friend if you notice anything with them or from your knowledge of them before baby:
Babies scream. We need to know our baby is upset. We don’t have to feel on edge because the scream is so high pitched that our ear rings. Consider earbuds or adustable sound level earbuds like Loops (not sponsored).
Paper plates and bowls are allowed in the first year. Eating frozen food or the same thing more often than not is allowed in the first year. Running the dishwasher only half full because otherwise you forget and then the dishes are overwhelming is allowed. See where things can be made a bit easier while all energy is on figuring out how to have a kid.
Pelvic pain and difficulty with holding in pee is not normal as months and months go on. Pelvic PT and discussing with their doctor can help. Additionally, postpartum worsening mood, lack of enjoyment, irritability, insomnia, or other concerns can also be helped by mental health professionals and is more common than many think. Your job isn’t to be your friend’s therapist, but if you notice something even if you feel odd stating it, state it. There will be relief if it is there and someone wants to talk to her about it.
Babies need to eat, be changed, or be calmed to sleep. Sometimes they are a little too warm or cold, but mostly it is the first three. When you hold a baby and they’re older than like 8-10 weeks, hold them under a fan, a tree, or a mobile and they will fixate on those things for minutes sometimes. You’ve probably noticed people standing and swaying side to side when trying to calm a baby—this is the way. Additionally, containing them against your body, rubbing their head, and staying calm and gentle in hushing them or humming to them can help them regulate.
Night nurses exist. Lactation consultants exist. Not being too perfect about breast feeding exists as an attitude. Your friend will have 1000 voices telling her the ways she can fail as a mother. Be a voice where she can be open, explore, and come to her own sense of things with you.
As always, these are based in my understandings thus far as a perinatal and child psychiatry fellow, but this information is meant for general information and entertainment, not specific, targeted medical opinion or advice. This period can be such a special, beautiful, hard, and connective time, and seeking support should be more normalized than it is. We should take the idea that it requires a village more seriously, and some of the above are about how to sustainably be a member of that village.
Take care, and take your time,
Margaret of Bad Art Every Day