by Ann Douglas
Feeling good about yourself is the key to making the most of the childbearing year. A woman who feels good about herself will celebrate the changes that her body experiences during pregnancy, look forward to the challenge of giving birth, and willingly accept the physical and emotional changes of the postpartum period.
Unfortunately, not all women embark on pregnancy with a healthy self-image. Feeling good about themselves as their bodies experience extraordinary changes can be extremely difficult for these women, and they may require a great deal of support from friends and family during this challenging year in their lives.
Women tend to fall into one of two camps during their pregnancies, says midwife Mary Hunking, those who feel very negatively, and those who feel very positively.
"For some women, it's just the changing weight," says Hunking. "Many young women in our culture have real love-hate relationships with their bodies. There's such a strong pressure in our culture to be young and slim and active and vital, and for some women, when they're pregnant, that doesn't happen. They're always tired, weight gets put on, and they struggle with body changes they don't really have any control over. In a sense, there is a loss of control.
"For other women, it's a really positive thing. They're the healthiest they've ever been, they feel good about their bodies, and the fact that their bodies have life growing within them. Some women talk about when they were pregnant being the best time in their lives."
It is normal, says Hunking, for a woman's self-image to fluctuate over the course of her pregnancy. It is hard to feel particularly healthy or vital while you are bending over a toilet throwing up, but you may feel entirely different about your changing body by the time you've moved into the second trimester, when you may be awed by your baby's movements. Then, once the breathlessness and difficulty sleeping so characteristic of the third trimester kick in, you may find yourself feeling considerably less than enthusiastic about the entire business of being pregnant. It is during this final trimester when many women start to feel negatively towards their pregnant bodies, says author Carl Jones in his book After the Baby is Born. "Many expectant mothers see themselves as misshapen, awkward, and even ugly during the later prenatal months."
For Margaret Allan of Calgary, Alberta, it was during her second pregnancy that she experienced the most difficulty with her body image. Her two sons, Gordon and Andrew, were born 17 months apart, and she recalls that the spacing of her two pregnancies left her feeling "like I was pregnant for two years." Gordon was born six weeks prematurely, while Andrew was a full-term baby, and, because of the differences in her two pregnancies, Allan remembers feeling much larger and bulkier during the final weeks of her second pregnancy: "The second time I felt absolutely enormous!" she exclaims. She feels that the support and interest that her husband Drew took in her pregnancies was instrumental in allowing her to continue to feel good about herself.
The partner is not the only person who can have a significant impact on a pregnant woman's body image, however. Family and friends also have a significant role to play. "I think it's important for women to have a lot of positive support around pregnancy," says Hunking, but, unfortunately, many pregnant women are subjected to "very subtle remarks that can be very insensitive." In an attempt to counteract these potentially hurtful remarks, many of which focus on the pregnant woman's size, Hunking and her midwifery partner, Kelly Sexsmith, make a concerted effort to reassure their clients that all babies are carried differently. For example, a woman pregnant with her first baby will carry differently than a woman carrying her fourth child, and a woman with a large frame may carry differently than a woman with a petite one.
Not only do pregnant women find themselves being subjected to insensitive remarks about their size; they may feel that their entire private lives have become public property and that what matters to everyone is not they themselves, but rather their childbearing function. Author Sheila Kitzinger writes in The Experience of Childbirth, "Suddenly [she] is somebody different - an expectant mother - a subject of interest and concern to society - her life seems to be no longer intimate and apart, but something anybody can talk about. They even know when her last period was, whether she is being sick in the morning, and whether her nipples are the "right" shape." Trying to measure up to everyone's expectations of the perfect mother-to-be can have a devastating effect on a woman's self-esteem.
Preparing for Birth
Having a positive self-image and confidence in her own body is crucial for the woman who is approaching delivery. Unfortunately, in our society, many women approach the birth of their child with tremendous anxiety and a sense that they are not quite up to the task at hand.
"There is so much fear about childbirth in our culture," says Hunking, "because the birth stories aren't getting passed on anymore. Grandmothers and mothers traditionally passed on birth stories in a way that we don't anymore because there's a whole generation there - our mothers - who totally lost control of what happened to them, and don't have memories. All those memories are erased, and when you don't have the memories, what replaces them is fear.
Women are then left with a sense that "somebody else has to control it; somebody else has to do the delivery because that person knows what's going on."
Author Carl Jones agrees. In his book After the Baby is Born, he describes views about childbirth in Western society, and their impact on women's self-image. "The way birth has been viewed in this society affects a new mother's self image, as well as the way she thinks about childbirth during pregnancy. In this country [the U.S.A.], birth has been approached almost as if it were an illness. The overall effect of such an approach to childbearing may leave the new mother feeling more awkward, more isolated, and less sure of herself than she might otherwise."
Encouraging a positive self-image in preparation for birth is one of the caregiver's most important responsibilities. "We talk about fears that come up, especially fears around pain," says Hunking. "That's really important to talk about prenatally." She believes that women should work towards gaining an understanding of what the pain means in labour, and that they should plan their births in a way that ensures that they will have abundant support and be surrounded by people they want around them, and who feel positively about the choices they have made about the birth.
While many women manage to make it through pregnancy and delivery with their self-image relatively intact, it is common for many of these women to feel their self confidence slipping away during the postpartum period.
It is hard to imagine any period in a woman's life which is more demanding of her both physically and emotionally. Not only is her body experiencing tremendous changes as it returns to its non-pregnant self, but she is simultaneously struggling to adjust to the many changes in her life.
The first thing she must come to terms with is, of course, her birth experience. Many women have a specific birth plan in mind when they go into labour, and may experience extreme disappointment if the reality of their delivery in no way measures up to the birth plans that they nurtured in their hearts as their babies grew in their bellies. Many women feel a sense of inadequacy, for example, if their plans for an unmedicated birth were suddenly shattered by the need for an emergency caesarean. It is not enough for these women to be told that they should just be happy because they ended up with a beautiful, healthy baby; they should be allowed to grieve for the loss of what they had hoped for.
Women also have to come to terms with their physical appearance. The first time a woman sees herself naked after delivery can be quite a shock. Many women are not realistic about what a postpartum body should look like, and are often devastated when they see the sagging belly or the stretch marks.
"I hated my postpartum body," confesses Marie-Lane Smith, a Waterloo, Ontario, mother of two. Always conscious about the size of her hips, Marie was horrified to discover that pregnancy and childbirth had only compounded the problem. While it took her a while to find the time to join a fitness club, for Marie, that was the best thing she ever did in terms of starting to feel good about herself once again. She joined a women's health club with on-site babysitting, and was soon feeling stronger and more in touch with her body, and thrilled by the rapid loss of inches from her hips. Getting exercise during the postpartum period is "almost imperative," says Marie. "You've got to get exercise and eat well because you're not going to get a lot of sleep. I wish I had taken the step of joining a health club earlier."
Still, even a rigorous exercise program is not going to undo overnight what nine months of pregnancy has done to your body, so it is important for women to be realistic about what postpartum bodies are supposed to look like. Many new mothers comment that they feel "out of shape" when exactly the opposite is true; they are in perfect shape for having just had a baby. Still, in a society which equates slimness with beauty, is it any wonder that many postpartum women have a difficult time coming to terms with their bodies?
The end of pregnancy also can be a source of sadness for many women, particularly for those who felt extremely positively about their pregnancy experience. At the same time, after the birth, the focus almost invariably shifts from mother to baby. She is no longer as important or as interesting as the baby she carried, or so it might seem to the new mother. The best remedy for this is for friends and family "to mother the mother," says Hunking, and to recognize the important role she played in the birth process. "We forget the hard work that she did. We forget that women work hard to give birth."
Women who choose to breastfeed their infants are often subject to a great deal of hostility which may also impact upon their self-image, says Hunking. For many women, their ability to breastfeed is really tied up with their feelings of adequacy as a mother. For this reason, breastfeeding women are extremely vulnerable to remarks by others. Women with small breasts, for example, may find themselves being subject to remarks which basically amount to criticisms of their ability to feed their infants.
Diane Wolf, a Peterborough, Ontario, mother of three, recalls how devastated she was when the doctor who delivered her first child in Germany discouraged her attempts at breastfeeding by informing her that "redheads can't breastfeed." Her confidence shattered, she reluctantly switched her daughter to a bottle. Her inability to breastfeed her first child was a source of great disappointment to her until the birth of her second child. Happily, however, a move to Canada led her to switch doctors prior to the birth of her second child, and, with a lot of encouragement from her new practitioner, she went on to not only successfully breastfeed her second child but her third as well.
Diane's experience shows how crucial it is for breastfeeding women to receive ongoing support and reassurance. Unfortunately, such assistance is not always readily forthcoming.
"Breastfeeding women do not get nearly the positive support that they need," says Hunking. "There is so much hostility to the breastfeeding woman in our culture. It's changing, but it's very, very slow change."
Finding yourself at home alone with a new baby for the first time can also be quite a challenge. If she has always been an active participant in the workforce, a new mother may feel lost during her first weeks at home with a new baby. She may feel frightened by her increased dependency on her partner, and may feel frustrated by her inability to accomplish what once seemed to be simple tasks (i.e. housework, meal preparation) while caring for a baby.
In their book, The Second Nine Months, Judith M. Gansberg and Arthur P. Mostel discuss the significant adjustment that postpartum women must make if they are to regain their feelings of self-worth: "One of the first things a new mother must learn to do before she can really build up her self-esteem and feel fully human again is to treat herself like a worthwhile person. That includes a whole range of things... - whatever makes her feel good about her physical appearance and wellbeing. But getting yourself together also requires a kind of mental exercise - the development of perspective on what is really important and necessary, what can be put off, what can realistically be accomplished, and what the woman needs to stay in balance emotionally."
Friends and family have a critical role to play during the postpartum period, and women need to learn how to accept their offers of help. "It's a time when a lot of people do offer a lot of help, and I think it's a time when women should accept it, and be directive about what is helpful to them," says Hunking.
Hunking feels that the first six weeks postpartum are crucial in that they often set the tone of things for the entire first year. "Let yourself sleep when you need to sleep," she advises. "There are so many other things to do, but taking care of yourself in the postpartum is also a really, really important thing to do. Many women are made to feel that they aren't allowed to have that rest.
"If you aren't allowed to recuperate and recover and take the time to process this magnificent event, it's really hard to catch up. Women deserve the time to process everything on a physical level and an emotional level. They deserve that time. Friends and families need to start giving postpartum women that time."
For Marie Lane-Smith, the hardest part of the postpartum period for her was learning to give herself permission to nurture herself, even if that sometimes meant thinking of her own needs before those of her child. "I learned that the baby's survival depends on the mother's survival," she explains. "It was hard to see that after the first baby. I had to take care of myself, or the whole family would suffer. It was truly a matter of survival."
Peterborough, Ontario, mother of two Jennifer Massie agrees. "On the outside, it may seem like the baby is the priority, but, really, you're the priority because you're the baby's food supply. Besides, your mental health affects the baby's mental health. You have to make yourself the priority."
Ann Douglas is the author of numerous books about pregnancy and parenting including the bestselling "The Mother of All Pregnancy Books." She regularly contributes to a number of print and online publications, is frequently quoted in the media on a range of parenting-related topics, and has appeared as a guest on a number of television and radio shows. Ann and her husband Neil live in Peterborough, Ontario. with the youngest of their four children. Learn more at her site, having-a-baby.com.
Copyright © Ann Douglas. Permission to republish granted to Pregnancy.org.