Physical recovery & mental health

During the pandemic, and whilst on maternity leave, I wrote a book. Before you eye-roll, I am not that type of person. I am not Type-A, I do not have my shit together, I am not even attempting to have it all. What I am trying to do, is highlight the chasm that represents our postnatal care – and, hopefully, provide a helping hand to other postnatal women. A hand that was not there when I had my first, nor my second, baby. My book is called ‘Your Postnatal Body’. It’s aim is to enable women to become familiar with their postpartum body, from top to toe, and to help them navigate their new normal. To heal and to thrive. The focus is heavily on the physical side-effects of pregnancy and childbirth. But, make no mistake, I am fully aware of how interconnected physical and mental health are. Without good health in one area, the other invariably suffers. It is why this initiative from Claire and Jenn is so very important. Their voices, amplifying the experience of countless neglected women in the UK and beyond, will be such a strong force for recognition and change.

We know that women’s health has been historically underfunded and misunderstood, with misdiagnosis and dismissive attitudes far too rife. We know that women go years seeking diagnosis and treatment, all the while buckling under the strain of the pain, discomfort, stress and upset that can accompany many common conditions. During the course of researching my book, as well as when I was preparing evidence for Parliament back in 2018, I read far too many accounts of women being ignored or neglected during the postpartum period and the profound impact this had on their mental health. If we want families to have the best start in life, we have to rewind right back to the beginning – to this very seismic change in a woman/birthing person’s life. If we don’t get the support right at this juncture, it can lead to a cascade of issues – both physical and mental – for the mother and the family that will potentially have a resounding impact.

One thing we MUST get right, is listening to women at this point. I have heard so many accounts of women being brushed off when things don’t feel right. It’s simply not good enough. We know the NHS is under strain. But missing physical cues at this point just adds extra burden on a stretched service, as the issues potentially intensify and more drastic or long -term interventions are then needed. By listening to women, and reflecting back their thoughts, we empower them to push for the right care. We give them the confidence to pursue a thorough recovery. A woman who is recovering well physically, will likely have a better chance of finding her mental health in a robust state.

Here is a brief excerpt from my book, to illustrate what I mean, “Dr Emma Svanberg (a Clinical Psychologist) and I spoke about how your mental health can affect your physical recovery post-birth, and vice versa. Emma was clear that, if a woman speaks about some mental health difficulties after the birth, and these are minimised, then she may not feel confident to bring up physical complaints, which can lead to undiagnosed postnatal issues (including undiagnosed severe tears). Equally, if a woman’s physical experience or issues are minimised, she may not feel able to broach any mental health issues she may be encountering. During research for my campaign, and this book, this is something I came across time and time again. It shook me how often the dismissal of women’s pain and physical challenges postpartum led to an alarming and severe downward spiral. It can be so hard to speak up in those early days, so having an advocate (a partner, doula, sibling, mother, friend) to help you express yourself and be understood, can be so very helpful.”

It seems that this is a common theme for women with pituitary issues after birth. It also seems incredibly common with pelvic pain. Although some pelvic and perineal pain, or c-section pain, can be expected – it seems women are far too often fobbed off with “What do you expect, you’ve had a baby” responses. This shuts down a conversation, making it even more difficult for a woman – who often feel weak or even a nuisance for raising any issues they may experience, as the focus is often firmly set on the baby – to speak up. In my book, women open up about the psychological toll that being ignored when suffering physically has taken – from a teen mum whose pain and sweating was repeatedly dismissed (it was retained placenta), to a mother with a postdural headache who was left alone to look after herself and her baby after a c-section, to a woman who became near suicidal due to experiencing prolapse, the issue stretches far and wide. The resounding theme from the book was to self advocate and keep pushing for diagnosis, care and treatment. It is not the message I want to give. I want to tell you to simply rest and recover. But it’s not that simple. Right now, with maternity services being the way that they are, we don’t have the ‘luxury’ (I baulk at this word, no one calls recovering after major surgery a luxury, do they?) of doing this. Right now, with proper support systems and structures so fragile and piecemeal, we must speak up for ourselves when something doesn’t feel right. Your mental health rests partly on the ability to properly physically recover after pregnancy and childbirth. The challenges of new parenthood are mammoth already, with the ‘normal’ hormonal shifts, the sleep deprivation, the new weight of responsibility and change in identity and relationship dynamics. When you throw pain, discomfort, extreme fatigue and other malaise into the pot, it becomes a recipe for faltering mental health. We are lucky that speaking up about mental health issues postpartum is much less taboo than it once was, and there is more awareness, and support, so you do not need to suffer in silence. Please speak with your midwife or health visitor in the first instance but – as researching the book has shown me – if you do not get anywhere with your first port of call – ask to speak to someone else.

I truly believe that neglecting proper physical recovery and care postpartum is partly to blame for high levels of postnatal depression and other mood disorders in this Country. At the moment, I am hoping to educate mothers on the need to prioritise their recovery after birth. The endgame - a culture shift which recognises the vital importance of proper postnatal care and support – will take the onus off the new mother and back to where it should be – on every-bloody-one else!

Lyanne Nicholl is a charity consultant and writer, living in East Kent with her husband and two young children. Mostly found in the sea or making noise about postnatal health.

‘Your Postnatal Body’ will be published in September 2022 by Pinter and Martin. Follow @postnatalhealthcommunity on Instagram or @pelvicuprising on Twitter for more information nearer the time.