When my three children were very small, a friend told me one day: "You need mothering." She went on to explain herself, but I took offense; I was managing quite well, thank you very much! That night, when I finally rolled into bed, exhausted, I bawled. I knew she was right, I longed to be mothered, for someone to pour some love into me, cook me a meal, say a few kind words, give me a dose of wisdom, spend a little bit of time, or just make me a hot drink, just for me.
With my family far away and no support system to speak of, I couldn't give in to those feelings, so I carried on. With the help of anti-depressants, prescribed to me for postnatal depression, some tight meal planning, and a few well-thumbed parenting books, I soldiered on. I managed and came out the other end. And to be fair, many of my peers were in similar situations, so why should I complain?
This is precisely the attitude I encountered when I first stepped out into postpartum care. New mothers had difficulty accepting the help I was offering, believing they had to be able to manage on their own, and they possibly had a need to keep up a wall of self-sufficiency, because once you give in, you might implode, and then what? The ones that did accept the support though, still talk about how helpful it was, even now, 15+ years on. This begs the question: Were we really meant to do it alone?
The postpartum well-being of new parents has been a hot topic lately, thankfully, and for good reason. According to PADA (Perinatal Anxiety and Depression Aotearoa), a whopping 25% of women suffer from depression during or after pregnancy, 10% of men develop depression after childbirth, and suicide is the leading cause of death for postpartum mothers in New Zealand. Support during the postpartum period - the first 7 weeks after a baby is born - is not only important, it is critical. When we look at numbers, we need to include the time before birth too, the entire perinatal period is from approx. 22 weeks gestation till 7 weeks post birth, according to the World Health Organisation. Maternal mortality rates are the highest during this time, the global estimate is that 1 in 74 women die during labour, childbirth, or immediately postpartum. Not only for women this is a dangerous time, worldwide, newborns account for nearly half of all mortality in those under 5 years old (UN Interagency Group for Child Mortality Estimates, 2017). These are staggering numbers.
Support during the perinatal period is not going to prevent all fatalities, clearly, quite likely not even half, but I think we can safely establish that support has value for anyone closely involved in the birth.
Just think of the incredible change of hormones in a woman's body immediately after the astonishing feat of giving birth, after which there is no time for a couple of solid nights' sleep to recover, not to speak of trying to successfully establish breastfeeding during that time. Especially for first-time parents, there is the steep learning curve of caring for a fragile newborn, on limited hours of sleep while still maintaining jobs, household tasks, and relationships. If you haven't been near a family with a newborn for a while, you may need a little more context.
Brooke Scelza and Katie Hinde published a sizeable piece of research on this topic in 2019, they drew on many research papers published over a span of 5 decades, as well as studying an indigenous people group, the Himba, who live in northern Namibia. Their research recognises that the perinatal period is a time of heightened vulnerability and that support specifically in the form of grandmaternal care has a noticeable impact (note that we are talking about baby's grandmother here). People are social beings, and from research, it is clear that social support impacts us significantly; in the case of perinatal mothers it appears that social support has many benefits, it improves birth outcomes, contributes to easier labours, is associated with lower infant mortality rates, and it reduces the incidence of postpartum depression. These alone are noteworthy side effects of social support, but Scelza and Hinde specifically looked at grandmaternal care, perinatal support offered by, especially, the birthgiver's mother. Amongst the Himba people group, and other more traditional cultures, the perinatal period is a time when the pregnant and newborn mother spends time somewhat secluded from society, often under the care of her own mother. In these cultures, the postpartum time is sometimes called 'the golden month', or 'the 4th trimester', or simply 'the first 40 days'.
So, what does grand-motherly support look like?
There are 3 impactful forms of support that appear to be universal. Firstly, instrumental, or practical support, such as care for the infant, bathing, soothing, and changing nappies. There is the taking over of household tasks, yes, washing, cooking, and cleaning, sometimes even temporarily taking over of the mother's job, and perhaps most importantly, simply taking care that the mother gets the proper sustenance.
Secondly, informational support, especially when there are challenges. Due to her own experience, grand-mother is often called upon for breastfeeding advice, information about infant care and safety, and even advice around treating health problems. There is very little detailed information available about the specific kinds of advice mothers share with their daughters, but outside the formalised healthcare system, women's mothers are routinely mentioned as a key source of information on all of the above topics.
And lastly, emotional support. In one particular study, grand-parental emotional support was listed as the most critical type of support by doctors, nurses, and the new parents. This is evident in other studies that have highlighted that support from especially a woman's own mother can relieve stress and anxiety, and leads to greater satisfaction as well as a sense of competency with parenting. When the relationship with their own mother is good, it helps the baby's mother to be more sensitive to their infants' needs and positively impacts mother-infant attachment. Another study demonstrated that the presence of support during labour shortened the time in labour and reduced caesarian sections. Social support is also associated with reduced maternal fatigue, and improved breastfeeding practices.
It is interesting to note that in some studies support from grandmother-in-law can result in negative perinatal outcomes, due to power dynamics between women and their mother-in-law. I was lucky enough to have had my mother-in-law present with us after our second baby was born, she couldn't cook to save her life, but I am forever grateful for the level-headed emotional support she provided, as well as the mountains of washing she processed. There were no power dynamics in play and I believe that at that time, I escaped postnatal depression, because of her.
At Eaglevision Coaching and Training we are very aware that not everyone is so fortunate to have their natural support system around them or to have a working relationship with them. That's why we exist! Browse our website to see how we can help.
The research mentioned in the above article: Scelza, B. A., & Hinde, K. (2019, December 4). Crucial contributions : A biocultural study of grandmothering during the perinatal period. Human nature (Hawthorne, N.Y.). https://pubmed.ncbi.nlm.nih.gov/31802396/
At Eaglevision Coaching and Training, we zoom in on parents who are having a baby in need of medical attention immediately, or soon after birth. Along with all of the above postpartum happenings, these parents are facing a whole extra journey with its own set of challenges. We will talk more about this in time to come, keep checking back in, or for more information visit our website.
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