The 4th Trimester: Postpartum Support Across Different Cultures

Apr 11, 2023 | Contributor Articles, Featured Posts, Modern Counseling News, Motherhood, Postpartum Care

Have you heard of nesting parties? The concept is really an old tradition with a modern-day twist. Nesting parties today are gatherings that help the new parents prepare prior to the birth of their baby. A small group of friends and/or family come over during the last month of pregnancy to deep clean the home, stock the freezer with meals, help put furniture together, and more. Unlike baby showers that focus on celebrating the anticipated birth of the baby, nesting parties focus on supporting the parents, particularly the new mother, directly. But could we offer even more support?

Last year I was fortunate to have two High Tech High Mesa student interns helping me research and develop social media content. Below is the second of two articles written by Alissa Flores, now a high school senior. She examines how different cultures support the new mother during the fourth trimester.

The 4th Trimester

By Contributing Writer Alissa Flores, Intern
Class of 2023 high school student at High Tech High Mesa.
Interested in making mental health information more accessible and comprehensive.

Imagine having the house cleaned and food cooked for 40 days straight and just being able to focus on your newborn infant. Believe it or not, this is reality in various countries and cultures around the world for the postpartum mother. Postpartum periods are a vital transition for women as they journey into motherhood. This momentous shift is recognized in numerous nations ranging from Belgium to the Dominican Republic. Conversely in the U.S. the motherhood journey is often a solitary one where the mother is expected to “do it all” without much or (or any) community and family support beyond the first two weeks postpartum.

Studies determined the average postpartum period in other cultures is around 40 days. Focusing on women after delivery is essential for many cultures. Cultural practices from Latin America include a 40-day postpartum isolation period where the new mother only worries about healing from labor and bonding with her baby. This practice, known as La Cuarentena, means “the quarantine” in Spanish. Rest is required and female family members support the new mother by doing the chores and cooking. On the menu for mom might be nourishing foods like broth and roasted chicken. Across the Pacific in China, a 2,000 year old tradition, known as zuo yue zi or “sitting the month,” prioritizes the new mom’s recovery by resting and having a special diet. Other countries have routine in-home postpartum care. For instance, Belgium and the Netherlands provide new moms with a maternity nurse that gives at-home care for a minimum of 24 hours within 8 days of discharge. Nordic customs often have visitors bring the new mother meals to eat during her 40-day rest period to support her. The female friends and family took turns helping around the house and with the baby.

Some studies show that the U.S. strongly differs from other cultures in that Americans do not participate in postpartum customs which “mother” women for longer periods (Parents,2021). American standards lead many women to feel like they have to do it all immediately after birth.

The custom of La Cuarentena is believed by Latinas to keep good health and prevent illness throughout their life. The Chinese tradition of “doing the month”, descended from the Sung Dynasty and Chinese medicine that supports the balance of yin and yang (Slate,2011). Postpartum Mexican women in the U.S. were studied in 1982; those who followed La Cuarentena reported less symptoms of depression compared to women who did not (Archives of Women’s Mental Health,2010). In 2006, a study on the Chinese tradition was also linked to lower signs of postpartum depression. Evidently these customs are working for mothers. New mother, Evelyn Escobar who lives in Los Angeles, took part in La Cuarentena. She says that she had her husband, delivery help, and her community to care for her as she healed. She was able to rest and recover which allowed her to transition seamlessly into motherhood. She claims,” ‘It gave me the preparation that I needed to sort of come out and feel confident about my new role as a mother’ “(Parents,2021). Author Heng Ou, of the book, The First Forty Days: The Essential Art of Nourishing the New Mother, emphasizes “If we take care of our mothers, we really take care of our society as a whole”. Ou only practiced “sitting the month” for her first born and as a result, with her other children, she felt disconnected from her body because she immediately returned to work after birth (Parents,2021).

While these traditions aren’t perfect or ensure success, they all have one thing in common for mothers to learn from: slowing down is key. Studies show that “postnatal social support indicates positive effects on the mothers’ mood” (Archives of Women’s Mental Health,2010). Postpartum care in the U.S. is often inadequate, particularly for families who lack the resources to hire help if family is not nearby. We must ask for more support of our postpartum mothers. Many cultures truly believe women are vulnerable postpartum and must be well taken care of like the newborn for a reason. Modern mothers don’t have to follow traditions step by step but having more help (e.g. someone to cook and clean, take care of the older children) can be beneficial for the entire family and society as a whole. According to Ou: “Healthy babies start with healthy parents” (Parents,2021).

The Science Behind ‘Mommy Brain’

Jan 5, 2023 | Contributor Articles, Featured Posts, Modern Counseling News, Motherhood

Last Spring I was fortunate to have two High Tech High Mesa student interns helping me research and develop social media content. Below is one of two articles written by Alissa Flores, now a high school senior. For this article, Alissa examined recent scientific research on motherhood and cognitive changes happening in the brain.

The Science Behind ‘Mommy Brain’

By Contributing Writer Alissa Flores, Intern

Is mommy brain real? Up to 80% of new mothers experience this distracted feeling and brain fog post-partum (Washington Post, 2021). But why? New research suggests that women’s brains are wired to adapt to the role of motherhood. First-time mothers experience changes in their brain during pregnancy and post-partum. Also during pregnancy, hormones such as progesterone and estrogen, rise. But, the high rise of hormones, especially estrogen, along with stress and anxiety brought by motherhood can also cause what has been referred to as “mommy brain” in popular culture.

What changes are happening?

A 2016 study found that first-time mothers experienced reductions in gray brain matter in regions responsible for social cognition that lasted up to 2 years. Mothers were scanned pre-pregnancy and again after birth. When the scans were compared to non-mothers, the matter loss was seen only in the mothers. Men’s brains have also been observed and it was seen they only adapt when deeply involved in caring for a child. (Washington Post,2021). The gray matter in the brain takes part in the process of important functions such as processing emotions, hearing, seeing, and making decisions. This reduction is known as synaptic pruning which is a natural process. As you evolve in life, this process happens in your brain to eliminate extra neural connections thus improving brain efficacy. As an illustration, think of it as a bush being “pruned” so it can regrow better. Your body releases more hormones like progesterone to prepare your uterus and body to carry a baby. Estrogen helps your body develop your baby. However, the fluctuation of hormones make you more prone to mood swings and anxiety.

Chart of Amygdala and Synaptic Pruning | Article by Guest Contributor/Intern Alissa Flores | Modern Counseling San Diego

How does this benefit me?

Your brain changing during pregnancy can sound like a scary thing at first, but your body does this to allow you to better respond to the cues and needs of an infant post-partum. As pruning takes place, other areas of the brain experience new growth. Your amygdala grows during pregnancy and postpartum; this area has many receptors for hormones like oxytocin. Oxytocin levels flourish in women during pregnancy and postpartum; higher levels of the hormone oxytocin have been connected to highly involved mothers. The amount of oxytocin flowing to the amygdala correlates with high amygdala activation.

The loss in gray brain matter previously mentioned also occurred in the hippocampus (brain’s memory control). As a mother, your focus goes towards the part of the brain that’s responsible for figuring out your infant’s wants and needs. Synaptic pruning causes the decreases to happen, which according to researcher Elseline Hoekzema, is a process that “eliminates certain connections between brain cells to encourage the facilitation of new connections” (NY Times,2020). These changes could be beneficial to you in motherhood as the process can aid in the brain’s focus on certain actions and activities.

Researchers claim that the changes can be an advantage throughout not only motherhood, but when taking on caregiving responsibilities later in life, as they don’t immediately disappear. Abigail Tucker, the author of Mom Genes: Inside the New Science of Our Ancient Maternal Instinct, says “The cognitive advantages [new moms] have are something like a super power” and “Brain shrinkage sounds sad and depressing… [but it] might not actually mean these brain parts are getting worse”. Expecting and new mothers are able to differentiate more details ranging from minute color differences to their babies’ distinctive cries. These changes allow your brain to distinguish minute details. Another study, done by Valeria Tucker Miller at Purdue University, discovered that mothers’ reaction times were often better than those of other women. As these studies show, these brain changes have an adaptive quality.

How are they linked to postpartum issues?

Approximately one in six women will suffer from postpartum depression and other issues that develop after giving birth (The Atlantic,2015). Some experts believe the brain changes might contribute to postpartum depression and anxiety. New mothers experience growth in brain areas that are responsible for regulation of emotions and empathy. Researcher Pilyoung Kim believes that this is what causes new mothers to develop obsessive-compulsive behaviors: “Mothers actually report very high levels of patterns of thinking about things that they cannot control”; this stems from the urgency and desire to take great care of your child. Have you found yourself obsessing over whether your baby is safe and sound? Your amygdala after giving birth continues to grow and is “correlated with how a new mother behaves—an enhanced amygdala makes her hypersensitive to her baby’s needs” (The Atlantic,2015). Other researchers like Dr.Simone Vigod, believe synaptic pruning and brain alteration are connected to postpartum depression and anxiety (NY Times,2020). Unfortunately, your brain attempting to prepare you to be a better mom can be the cause of your constant feeling of sadness and disconnection to your baby. Postpartum depression and negative moods after birth are not your fault, it’s just human nature.

Conclusion

The pregnant and postpartum brain go through neural changes which can cause mommy brain but this also sets up our brains to allow us to be caring and careful mothers. The drastic changes that happen are so much more than just dealing with forgetfulness, our brains are designed to be mothers but things like postpartum depression can cause difficulty. Yale researchers say that studying and learning more about the postpartum brain will reveal why the maternal brain is developed this way and help with getting rid of the overwhelming stigma centered around postpartum illness (Greater Good,2008). As a result, more mothers will break their silence about their experiences and seek help. To reiterate, research shows that 85% of new moms endure a “passing period of sadness or irritability” (Greater Good,2008). Too many women are experiencing this for there not to be more research available. It is necessary for more studies to be done so more women will understand their behaviors more and we can work on treating them. Our brains function the way they do for a reason. It is not 100% clear why new mothers experience melancholy but always remember that you are not alone. It can feel like these struggles are unnatural, that nobody else will understand or that something is wrong with you, but this shouldn’t be and isn’t your reality. There are several ways to alleviate this shame and stress: psychotherapy and various support groups are available to help. Reaching out to friends and family for assistance allows you to prevent sleep deprivation, which is essential for relieving symptoms of postpartum illness. Therapeutic strategies and medication have been found to help and transform mothers cope with their postpartum depression. This isn’t a helpless battle, many other women are going through the same thing.

San Diego Professionals & Crisis Number :
https://postpartumhealthalliance.org
Local Postpartum Groups:
https://www.sharp.com/health-classes/postpartum-support-group—sharp-mary-birch-hospital-for-women–newborns-17
Hotline Number & Specialized Help:
https://www.postpartum.net/get-help/locations/
Further reading on Postpartum Depression: https://familydoctor.org/condition/postpartum-depression/
https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

Momdemic Stress

Aug 12, 2021 | Contributor Articles, Featured Posts, Motherhood, Stress Reduction

By Contributing Writer Darién Castillo

Worn out by endless Zoom calls, household chores that seem to double every week, the stress of juggling work and family tasks? Pandemic life has certainly taken its toll on almost everyone and seems to be hitting moms the hardest, especially those with younger children. The constant stress of managing multiple lives at once is contributing to a staggering 93% of mothers in the US saying they feel burned out, while 16% feel burned out all of the time (according to a recent survey by Motherly). It is also no surprise that 74% of moms say they feel mentally worse since the start of the pandemic, while 63% say they have been managing household responsibilities and chores mostly by themselves.

The constant multitasking and invisible labor involved in managing household and family life, also known as the mental load, typically falls on women’s shoulders and pandemic life has amplified it. Many mothers wonder how much more they can take. In serious cases, the stress of quarantine can manifest itself in the forms of depression, anxiety, and/or severe insomnia that contributes to feelings of mental and physical exhaustion.

So how to fight burnout? There are of course general strategies that you probably hear over and over such as spend time outdoors, find time to exercise, sign up for online yoga or meditation classes, read, and try to stay socially active. But what about those who find themselves managing work zooming, their young children’s zoom schooling, making grocery lists, throwing in a load of laundry and breakfast all before 9am? Finding even 10-15 minute ‘rest breaks’ throughout the day is a strategy recommended by psychological experts. Another is trying to limit the number of zoom work meetings and replacing some with phone meetings and email. It can also be beneficial to stay away from social media or other news outlets during your downtime, as these will inevitably introduce more things to worry about when you should be unwinding. Similarly, you can completely cut yourself off from technology during the small breaks you find for yourself throughout the day. For more tips, visit the resources below:

UCI Health: Coping with Mommy Burnout

HBR: Combating Burnout as a Single Working Parent

Coping with Stress

Jun 15, 2021 | Contributor Articles, Modern Counseling News

By: Gabriel Vitug
High School Student & Guest Author

When we encounter a threatening situation, our bodies go into fight, flight or freeze mode. This reaction was extremely beneficial in pre-modern society. However, instead of being at risk of being eaten by a saber-toothed tiger, modern humans face stress in their jobs, relationships, or finances. Since stressors are all around us, some might find themselves in this hyper-alert mode constantly which can cause chronic tension. Some people may also be more prone to stress due to their genetics, upbringing, or environment.

The biology behind stress.

When we face a threat, the hypothalamus (a tiny region in your brain’s base) sets off an alarm that causes a domino effect. In response, adrenal glands located atop of the kidneys release adrenaline and cortisol into the body. Adrenaline increases your heart rate, causes a rise in blood pressure, and boosts energy supplies. Cortisol on the other hand suppresses bodily functions that would be non-essential in a fight or flight situation. Non-essential functions include the digestive system, reproductive system, and the growth process. This intricate alarm system also communicates with the brain’s regions that control mood, motivation, and fear.

The negative effects of chronic stress.

Chronic stress is the constant, prolonged exposure to stress. This can be very damaging to your health. According to the Mayo Clinic, the long term health problems include:

Anxiety
Depression
Digestive problems
Headaches
Heart disease
Sleep problems
Weight gain
Memory and concentration impairment

What are the different ways to relieve stress?

Stress is a normal part of life and there’s no way around it. You may have no control over your situation. Still, there are plenty of ways to ease stress in a healthy way. The Mayo Clinic recommends the following stress management strategies:

Eating a healthy diet and getting regular exercise and plenty of sleep
Practicing relaxation techniques such as trying yoga, practicing deep breathing, getting a massage or learning to meditate
Exercise, such as walking, strength training, or swimming
Taking time for hobbies, such as reading a book or listening to music
Fostering healthy friendships
Having a sense of humor
Volunteering in your community
Seeking professional counseling when needed

Practicing these stress management techniques works because they are able to keep you preoccupied. Personally, an effective stress reliever for me is connecting with friends. Meeting up with friends either physically or over the internet is a great way for me to de-stress and take my mind off things.

Being able to manage stress in a healthy way could offer you “peace of mind and perhaps a longer, healthier life.”

Works Cited

Mayo Clinic. “Chronic stress puts your health at risk.” Mayo Clinic, 19 March 2019,
https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037. Accessed 3 June 2021
Harvard Health. “Exercising to Relax.” Harvard Health Publishing, 7 July 2020,
https://www.health.harvard.edu/staying-healthy/exercising-to-relax. Accessed 3 June 2021
Harvard Health. “5 of the best exercises you can ever do” Harvard Health Publishing, 7 July
2020, https://www.health.harvard.edu/staying-healthy/5-of-the-best-exercises-you-can-ever-do. Accessed 4 June 2021

How to Recognize Our Emotions

Jun 8, 2021 | Anxiety Management, Contributor Articles

By: Gabriel Vitug
Guest Writer

When it comes to coping with anxiety, an effective first step is to recognize our emotions. However, identifying emotions and what causes them can be daunting at first. Below is a step by step guide that will help you through the process.

Step 1: Take your emotional temperature.

To take your emotional temperature, try to evaluate what you feel, mentally, emotionally, and physically whenever you experience anxiety or are overwhelmed by stress. Ask yourself, how do I feel? Whatever that may be, it is important to be specific. Try to avoid vague statements such as “fine” or “okay.” To help you identify and name different emotions, here’s a feelings wheel. Next, identify which emotions are the strongest and try to pinpoint when you started feeling this way. Take your time, the key is to be thorough.

Don’t forget to acknowledge the positive emotions. Identifying the feelings that enrich our lives is also very important. Documenting your responses can be beneficial to the process as well. This way, you can easily come back and pick up where you left off.

Step 2: Identify what causes your emotions.

Once you have taken your emotional temperature, identify what triggers certain emotions. Just like the previous step, being specific and thorough is crucial. To do this, think about a moment where you felt anxious. Try to pick apart that moment. Are you talking to someone new? Or are you overwhelmed by multiple looming deadlines at school or work? Also, try to consider emotional reactions to situations you have no control over such as world events or dreams.

Step 3: Self-compassion.

Feeling guilty for feeling anxious is a common mistake we make. Try being kinder to yourself; talk to yourself like you would a friend. Another mistake people make is ignoring their emotions. In an article for Psychology Today, Dr. Joan Cusack Handler says that “feelings function like a pressure cooker: Pressure increases without release. Then, once released, the intensity is reduced. The corollary is the fact that feelings that are denied or dismissed do NOT diminish in size or disappear, but are intensified.”

I can definitely attest to Dr. Handler’s previous statement. Before learning about coping strategies and anxiety in general, whenever I felt strong emotions, I’d always try to bottle them up and wait for them to go away. Spoiler alert: these emotions never went away. It wasn’t until I started being more proactive that I started to feel better. To learn some effective strategies, check out our article on coping with stress.

Unless our emotions are negatively impacting others around us, we should remind ourselves that what we feel is valid. But If dealing with emotions ever becomes too much to handle on your own, reach out to a mental health professional.

Works Cited

Turrell et al. The Mindfulness & Acceptance Workbook for Teen Anxiety. New Harbinger
Publications.
Handler, Joan Cusack. “Identifying Your Feelings.” Psychology Today, 19 January 2018,
https://www.psychologytoday.com/us/blog/art-and-science/201801/identifying-your-feelings. Accessed 1 June 2021.

Coping with COVID-19 Stress

Jun 1, 2021 | Anxiety Management, Contributor Articles, Featured Posts, Stress Reduction

By Contributing Writer Darién Castillo

With more and more people getting vaccinated in the US, it appears like the end to the quarantine experience is just around the corner. Some dealt with the emotional toll of the pandemic by finding new creative outlets, such as baking bread, socially-distanced nature walks, picking up new hobbies, maybe even writing a book. But not all people experienced the pandemic in the same way. With a death toll of over 1 million worldwide, the Pandemic certainly inflicted much loss and grief onto communities. And, many who survived Covid continue to experience lingering health and mental health issues. Aside from the physical consequences inflicted directly by the virus, many have also been affected by fear of the virus itself or by extended periods of loneliness during quarantine isolation. Even as Covid restrictions appear to be coming to an end, the physical and psychological consequences persist.

If you or a loved one still suffer from psychological impacts caused by the pandemic, you are not alone. After more than a year of isolation depression, anxiety and social anxiety have been on the rise. Symptoms may include mental or physical fatigue/exhaustion, lack of motivation, or anxiety about social interactions.

Fortunately, these symptoms are manageable and treatable. If you are anxious about socializing or interacting with large groups of people, start slow. Meet up with one or two people, then slowly expand your social circle to a point that feels comfortable. Follow pandemic safety protocols such as social distancing and wearing masks, and larger social interactions will inevitably begin to feel more natural. Small communal activities such as book/movie clubs or outdoor visits are a great way to reintegrate social interaction into one’s life.

For essential workers as well as those just returning to in-person work environments, it is important to take frequent breaks and get plenty of rest. Consistent sleep schedules can improve one’s mental health greatly as well. Mental and physical wellness programs are a great tool to take advantage of, as some companies offer them to employees and their families. You may also want to seek professional help through therapy and teletherapy, a safe and convenient alternative to in-person counseling sessions. However you may be feeling now, it is important to remember that these symptoms do not last forever, and that however long it may take, life will eventually begin to feel normal again.

Visit these resources for coping strategies (updated):

Coping With Stress – CDC

Mental Health and COVID-19 Information and Resources

NIH Shareable Resources on Coping With COVID-19 Related Mental Health Issues

Resources for Employees and Workers: Pandemic Stress and Anxiety

For additional resources in San Diego County, call the Access and Crisis Line 24/7 at 1-888 724-7240. If you or a loved one is experiencing a mental health emergency, call 911 or visit the nearest Emergency Room (ER).