The Secret Conspiracy of Motherhood

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What Mothers Don't Tell You: The Secret Conspiracy of Motherhood
by Alison Palmer, RN, MS, WHNP-BC

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It all starts in childhood when we played “dress up” and pretended to be “mommy.” As young girls we learn that
“mom” plays a significant role in the family. But the transition from playing with dolls to nursing our own bundle of
joy is not something that we are fully prepared for.

Who knew that getting out of the house to do one simple errand would take more planning than a weekend away at
camp! And those baby yoga moms, look like they have it all together, right? No one told us how exhausting
motherhood would be.   Have you asked yourself: what’s wrong with me?

The answer is: Nothing. It’s all part of the conspiracy. The secret conspiracy of motherhood is that women do not
want to admit they are having a hard time after having a baby. Playing mom when we were kids should have
prepped us for being a mom, right? Wrong. It takes awhile for us to adjust to the most difficult and important job
there is, motherhood. Think back to when you started a new job, you probably had an orientation period. There’s
no orientation for motherhood. It’s all hands on experience because babies don’t come with instructions.
No instructions, sleepless nights and a dramatic drop in pregnancy hormones can cause a shift in the brain
chemistry, which may contribute, to mood swings, anxiety, or depression. Normal life stressors, adapting to a new
role and learning to care for a newborn or balance a baby amidst meeting the needs of older children, can be
overwhelming.

Many women (over 80%) experience the “baby blues;” which is a normal period of high and low emotions during the
first several weeks following birth. The extreme is postpartum psychosis, which is rare (0.1%), and may result in
paranoia or hallucinations commanding mom to hurt herself or others.   But, the most common complication of
childbirth is postpartum anxiety and depression (PPD).

Twenty percent of mothers may experience PPD anytime in the first year after birth. Risk factors may include a
family history of depression, difficult pregnancy, and personal history of a mood disorder, relationship stress, or
unplanned pregnancy. A constant, intense feeling of sadness worry, nervousness, and emptiness that last 2 weeks
or more, and affect sleep and eating habits, is an illness requiring medical attention. New mothers often feel tired
and overwhelmed. However, the feelings associated with PPD are stronger and longer lasting. Effective treatment
is available. Treatment may include; medication to treat brain chemistry imbalance, talk therapy to discuss
psychological struggles, and support groups where moms can share feelings with others in similar situations.

If you or someone you love is feeling overwhelmed with their new role, be a savvy consumer. Find healthcare
providers who will take the time to discuss your emotional well-being. Obstetric, family practice, and pediatric
providers should screen for PPD, and can assess whether what you are experiencing is a normal transition to
motherhood, or something more serious. It’s also important to seek referrals to mental health specialists who have
clinical knowledge of perinatal mood disorders and a comfort level in prescribing medications, as necessary during
pregnancy and lactation. Lastly, social support is essential to help prevent isolation. Inquire if your local hospital
offers a support group for PPD. Do not suffer in silence. Postpartum mood disorders are treatable, and are more
common that you think. There are resources available to help you feel more like yourself again and give you the
ability to truly enjoy this exciting journey of motherhood.

Alison Palmer, RN, MS, WHNP-BC is certified as a women’s health nurse practitioner. She is a maternal-newborn
clinical nurse specialist and perinatal mental health nurse coordinator at Elliot Hospital, Manchester, NH where she
developed the Elliot Postpartum Emotional Support Program. Alison received her undergraduate and master’s
degrees from Boston College. She is also a mother to two young and active boys. For more information contact her
at (603) 663-8927 or palmer1@elliot-hs.org.