from Spiritual Midwifery by Ina May Gaskin

copyright © 1975, 1977, 1980, 1990, 2002 Book Publishing Company

Book Publishing Company, PO Box 99, Summertown TN 38483



The postpartum period has been better understood in  indigenous societies than in mot modern ones. In indigenous societies, women with newborn babies always have family members around to help them. Women are not expected to resume their ordinary activities right away, so someone else is doing the cooking and care of any older children. New mothers are pampered for three to six weeks, giving them the chance to rest after the rigors of pregnancy and birth and to establish a smooth breastfeeding routine. They are fed special foods and few visitors are allowed.


Modern societies, on the other hand, tend to place much higher expectations on the new mother now that the nuclear, rather than extended family is seen as the norm. In the United States, most women go home from the hospital expecting to be able to cope with new motherhood virtually alone during the postpartum weeks. About one quarter will be recovering from major surgery, while other are dealing with the discomforts of healing episiotomies, sore breasts and the fatigue of missed sleep. Is it any wonder then, that postpartum depression (PPD) is the most common post-birth complication in our society? Some say that 85% of US women are affected, while others put the incidence at 25%. (The incidence at the Farm was far lower than 25%, probably because of the strong social support system that we developed for the benefit of new mothers.)


Let's be clear: feeling like weeping for a day or two following the birth does not necessarily mean that a woman has PPD. Many women tend to get teary on the day their milk comes in. Some women have "baby blues," a mild change in mood occurring a day or two after the birth, that is usually resolved within two weeks. Characterized by tearfulness, difficulty sleeping, irritability, anger, tension, and mild anxiety, it can be surprising to those who experience these symptoms, since society's portrayal of motherhood does not recognize such feelings. Women find it especially disturbing and isolating if they find they get angry with their baby for crying, "ordering them around," or refusing the breast, but these feelings are much more common than most realize. Women need permission to talk about sadness, anger and shattered expectations. They also need frequent breaks from the feeling of a 24-hour-per-day responsibility for the new baby.

The woman with baby-blues is at risk for full-blown PPD if her needs are not recognized and met. Unfortunately, the tendency in our society is to medicate women rather than provide social support. Nowadays, postpartum doulas (professional caregivers to new mothers) are available for hire in some areas and may be the factor which prevents the development o full-blown depression or even psychosis.