Thanks @Veronique for the request. This is something I've thought about a lot during this first 6 weeks of motherhood. (For those that don't know me, I am a family physician who practices full scope medicine including obstetrics).
  1. Wow. Being a mom is the hardest thing I have ever done.
    I thought the nine months of pregnancy with hyperemesis, gestational diabetes, and cholestasis were tough, but they were nothing compared to what I'm dealing with now that the baby is here.
  2. It's hard enough on it's own, but add to that the constant judgment from others, "free advice" and self-guilt-tripping about EVERYTHING (using baby wipes vs warm water, buying one car seat over another, giving the baby a pacifier for a few min before feeding her so you can pee
    ... the list goes on), and you have a recipe for an anxious mother with broken confidence.
  3. #1) Take every concern seriously. Yes, she's a "new mom," anxious as all get-out.
    So am I! When everyone has their own opinions, sometimes patients need the doctor to give theirs, even on the seemingly tiniest matters, to drown out everything else.
  4. #2) Ask more open ended questions.
    Related to #1. If a patient has a concern about which formula to give and seems nervous about it, find out why. Sometimes it's as simple as her wanting to do what's best for her baby, but often it is because someone else criticized her decision or made her doubt herself.
  5. #3) Educate, but withhold judgment.
    Okay, I think I'm PRETTY good at this usually - I encourage breastfeeding but if you want to do formula, I'm fine with that, too! Fed is best! If you want to eat your placenta, okay (I have had two patients do this recently). I have a really hard time with anti-vaxxers, but I can acknowledge that while I think that it's a dangerous choice, it is a parental choice, and parents who choose not to vaccinate legitimately believe they're protecting their kid.
  6. #4) Be diligent about screening for postpartum depression and not chalking it up to the "baby blues."
    I have postpartum depression and anxiety. Yup. It sucks. It's crippling - I can't talk to anyone about the baby without breaking out into tears and then feeling like a horrible mother for not being more effusive about the joys of having a baby. I realized over the last couple weeks that I probably had PPD and got diagnosed by my OB at my appointment this week. Sleep deprivation and adjusting to life with a newborn are hard enough as it is. Add on PPD and PPA, and it reaches the next level.
  7. #5) Prepare my patients better, especially the first time parents.
    Insist on attending newborn care and education classes, especially those that describe what life is going to be like. Once Layla was born, I felt like the world played s cruel trick on me. All my friends talked about was how awesome having a baby was. Here I was with sore, cracked nipples, stuck to the couch while my loving husband went to work with bloodshot eyes, changing 12-15 diapers a day at first and finding it hard to shower, let alone brush my hair or teeth.
  8. #6) encourage patients to have a plan for support after baby is born.
    Major fail on my part. I'm so used to doing things on my own or with help from my husband that I had no plan for support in the home when the baby was born. My sister came for the birth and then had to leave immediately. My mom came 2 weeks later when I called her crying. Make sure you have a steady stream of help for the first 4-6 weeks at a minimum, especially if you're nursing or have had a c-section. Focus on sleep and baby. Let others bring you food/drinks and take the baby once in a while.
  9. #7) Breastfeeding education and care. We as a country and culture do a terrible job of supporting breastfeeding mothers. There's a lot of anxiety with feeding a seemingly always hungry newborn when you can't see how much milk they are getting, thanks to the formula feeding culture we live in.
    This alone causes many new moms to give up in the first few days. I could write a whole list about breastfeeding stuff I had no clue about as a doctor that I learned only after becoming a mother (from my lactation consultant and from hours of reading and research while my baby clusterfed for hours). Examples: breastfed newborns might eat every hour, sometimes all day long, not every 2-3 hours like a formula fed baby. Also there is a lack of acceptance for breastfeeding in public and way too few
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    options for breastfeeding mothers to feed their babies while out and about. And don't even get me started on the lack of breastfeeding friendly clothing (shoutout to H&M though, they have a few items as part of their MAMA line that are fashionable and nursing friendly).
  11. #7) Emphasizing the period of PURPLE crying (
    I have a colicky baby. It sucks. She cries inconsolably for hours every night. No one knows what causes colic, and unlike previously thought, it isn't necessarily due to a digestive issue, gas, or any other old wives' tale. We simply do not know. What we do know is that babies born to women in Mali who work in fields (and babywear all day long) don't experience colic. But maybe it's a dietary issue. Who knows? What I do know is that for the 15-20% of babies that have colic, the chance of the mom
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    having postpartum depression skyrockets. I have postpartum depression, I believe as a result of the significant additional challenges of having a colicky child, and it sucks. It makes it so much harder to enjoy your baby and just get simple tasks done, let alone be motivated enough to do helpful things like get out of the house with a newborn (daunting as it is, worse with a baby that experiences fits of inconsolable crying).
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  14. #8) Making sure patients know I am available.
    It's so important to reassure new mothers and fathers that there is support and help available, especially since they may not have actual physical support nearby. Being an army family, we move ever 2-3 years. That means we lose our support network each time we uproot our lives and settle in a new, unfamiliar place. We arrived at or current duty station when I was almost in my third trimester. My husband and I both work 80+ hours a week at a small base. While we have made friends, we haven't had
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    enough time to form close bonds with people to the degree that's necessary to feel truly supported. I'm also in a unique position as an active duty mother, since most of the mom's are SAHMs and our life challenges are different.
  16. I could go on and on. But I know that as a doctor, I am now capable of doing a much better job of caring of patients in my situation because I can truly empathize with them. I also think it has made me a better friend and family member for the same reasons.
  17. I'll end this list with a challenge to anyone who has managed to make it this far: if you know someone with a new baby, please take the extra minute to provide help or support.
    Don't ask, just do it. Most people don't want to impose and will decline if you ask. Bring over a meal, come over and help do a load of laundry or vacuum, or just go and sit with a new mom and keep her company for a couple hours. The abrupt switching of gears and often lack of any adult company besides your also-stressed-out spouse is traumatizing, and having another adult to talk to is so important for the mental health of new parents.
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  22. P.S. Don't forget the dads.
    They can get postpartum depression too. They went from having a partner they could talk to, cuddle, or be intimate with - and now there is someone else taking all their attention. They need support and help too and often feel overwhelmed with supporting a stressed out mother and new child. When you take a burden off of one parent, you take it off of the whole family.
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