Normalizing the Moods of Motherhood with Dr. Alexandra Sacks

Newly crowned TED speaker Alexandra Sacks, M.D. wants moms to know that all those overwhelming thoughts swirling around in your head are to be expected when you’re expecting–and acclimating to motherhood.

“Am I cut out for this?” is one of the most common questions Dr. Sacks hears from moms who assume that such closed-door confessions will lead to a diagnosis of postpartum depression.

“I realized that part of what was contributing to people feeling like a lower mood, and feeling better after they spoke to me, is that they weren’t talking to each other,” she says.

That’s why Dr. Sacks recently took to the stage at TED Residency with an important message around the concept of “matrescence,” a transformative developmental stage that occurs as women become mothers.

“Shifting the focus from the baby to the mother is a pretty radical idea, globally,” she says.

“I’ve been getting letters, emails from people all over the world,” she says, including a mental health worker in Zimbabwe raising funds for a women’s health conference, and women in Pakistan, Malaysia, Australia and beyond.

“Matrescence” started to take off when Dr. Sacks penned “The Birth of Mother” in The New York Times in 2017. She was blown away by the response when the story went viral, which solidified the need for a broader public health push.

“I thought it was pretty straight forward stuff that everybody knew, so I was really surprised that it got passed around so much. Then I thought we have to keep going,” she says about the steps that led to the TED talk.

Dr. Sacks has also co-authored a book coming out in 2019, What No One Tells You: A Guide to Your Emotions from Pregnancy to Motherhood, which features “the most common psychological challenges that we’ve seen in our patient population” along with Dr. Catherine Birndorf.

“The book is really supposed to be a how-to guide to get through pregnancy and your first year of motherhood in a way that helps you really understand the terrain of the psychological transition,” she says.

It Takes a Village

There are signs the medical industry is beginning to embrace “matrescence.” In fact, Dr. Sacks says the American College of Obstetrics and Gynecology is changing their guidelines to encourage postpartum moms to see their doctors before 6 weeks.

As for those whispers of postpartum depression?

“The medical community is shifting to a broader umbrella term called PMAD (postpartum mood and anxiety disorder),” she says. “Some people feel more anxiety than depression…I don’t even think of them as two separate conditions; I think of it more as a spectrum.”

Dr. Sacks believes that treating this spectrum is a “community exercise” that requires partners, friends, family and/or hired help to allow mom to get out of the house and take a break.

“Cutting off self-care will also lead to anxiety,” she says. “We need to rest. We need to be able to relax, to calm our nervous system, to have social interaction, to not work 24/7 which is essentially what the job of caring for an infant is.”

“Sometimes people just need a good night’s sleep and then they feel better,” says Dr. Sacks. “It’s really just about sleep deprivation sometimes.”

(There aren’t enough emojis for me to convey how relevant this is for me and so many moms I know.)

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Photo credit: TED/Ryan Lash

“If you stop doing the things that make you feel like you, you’re going to stop feeling like you,” she says.

Plus, the whole family benefits when mom carves out time for herself.

“When you preserve a part of your identity, you’re also leaving room for your child to develop their own,” says Dr. Sacks, in my favorite line from her TED talk.

Women Helping Women Succeed

“I want the definition of matrescence–and what will best support a woman when she’s going through matrescence–I want that conversation to be guided by mothers,” she says.

“In order for that to happen we need to reduce shame and stigma. Talking and putting your feelings into words is one of the most helpful things you can do to protect yourself against social isolation and depression.”

Dr. Sacks wants moms out there to take up this challenge. Confess something you’re struggling with to another mom. Take time out to do something that you used to do.

For more information about matrescence and Dr. Sacks, visit AlexandraSacksMD.com.

Photos courtesy of TED/Ryan Lash.

When Life Catches You By Surprise

Today is the original due date of our now 3.5-week old baby. His early arrival and the transition for our whole family have kept us on our toes ever since.

When I became a mother for the first time with my oldest, and then a working mother, life changed dramatically. Little did I know that baby number two would completely rock our world again, in his own unique ways.

Here’s what I did (and didn’t) expect while expecting, and what’s surprised us most now that he’s here:

The third trimester was faster and more intense the second time

Around the mid-point of my pregnancy, I started to sense that this baby might run ahead of schedule. He was measuring a week ahead at his 20-week anatomy scan and the technician and doctors all made comments about active he was, making it hard to measure him as he did flips and somersaults for the camera.

Right at the start of the third trimester, the doctor confirmed he was already head down, which was no surprise to me. I was having strong Braxton Hicks, which I didn’t have until the very end of my first pregnancy.

(I also learned that if you’re dehydrated, contractions can quickly turn into something more serious. It still seems to be a little known secret of just how important drinking water is during pregnancy.)

I carried on, preparing at work for the countdown to my planned start of maternity leave, and enjoying our final moments in the family routines that we had become accustomed to. We took lots of evening walks and I savored bedtime snuggles with my toddler, anticipating those moments would be harder to come by after the baby’s arrival.

However, I was growing increasingly slow on those walks and often felt too tired to read more than a couple of books before bedtime. (I would liberally edit our big brother-in-training’s favorite “hospital book” aka Babies Don’t Eat Pizza: A Big Kids’ Book About Baby Brothers and Baby Sisters.)

At my 35-week appointment, I was already 3.5cm dilated and 80% effaced, so the doctor predicted a couple of more weeks at most.

Little did I know, I’d be back in L&D 9 days later with contractions, another 1.5 cm dilated, and no signs of stopping.

Just because we’ve done it before, doesn’t mean it’s easier this time

When we found out we were having another boy, my first thought after laughing at our luck, was that we had everything we needed so it would be easy. From clothes to baby gear, and eventually less hormonal teenage years, I felt like we were all set.

Then I delivered a “late pre-term” baby at 36 weeks + 4 days, and everything changed.

That morning I had taken our first born to school, feeling like it might be my last time for a while. I took one more conference call and then walked into the family birth center to get checked out. While sitting there chugging water, I went from 4.5 cm to 6 cm, at which point they decided to admit me.

The labor itself was about as comfortable and peaceful as you can get. I repeated the low-dose epidural that had worked well with my first delivery, and sat around waiting to progress.

Meanwhile, we started to wise up to what it might mean to have a baby almost a month early. Despite reassurance from nurses and doctors that had preemies of their own who are now thriving 20-somethings, we didn’t know what to expect other than the immediate goal of delivering a 5-pounder.

Well, our little guy arrived at 9:26 p.m. on May 31 at a whopping 7 pounds, with a head full of thick black hair. All over again, we were instantly in love and mesmerized to finally meet him after all this time.

He passed all the tests they run for things like breathing, blood sugar and temperature regulation. He was sleepy during feedings, so the nurses encouraged me to try hand-expressing — but I quickly turned to my old friend Medela and a syringe to make it easier.

We were released from the hospital on schedule, and made an appointment to return to the doctor 48 hours later to check for jaundice. The doctor’s main concern at that visit was his weight, which had dropped down to 6 lbs 6 oz, so my new goal was to make sure he was eating enough.

Out came my brand new pocket-sized breast pump, bottles that claimed to be the next best thing to mom and a whole lot of math to figure out how often to pump, how long the milk could stay at room temperature, and how long before I had to toss a bottle he had started. (All while sleep deprived, since he was eating every 1-2 hours around the clock.)

It wasn’t until 5 days later that our instincts told us that his coloring didn’t look right, so we requested a blood test. Our suspicions were confirmed with a phone call that I don’t wish upon anyone, telling us our 6-day-old newborn had to be re-admitted to the hospital. His bilirubin levels had spiked and he needed blue-light phototherapy to flush out the jaundice.

One of the hardest parts of that dizzying moment was fighting back tears while telling our toddler that we needed him to be a big boy, and get back in the car to head to the hospital, right after he had walked in the door from school. This is one of the many reasons we’re so grateful to live near his grandparents.

I grabbed all the bottles I had pumped and some basic necessities, and we rushed out the door. What followed were two days and two nights of sitting in a hospital room while our tiny, lethargic 6-pounder lay under a blue light with a mask on for hours at a time.

My mission during that hazy hospital stay was simple: get him to eat and fill as many diapers as possible. I bottle-fed him under the light, and passed the hours by scheduling out feedings, pumping, and hand-washing bottles and pump parts, over and over again. The nurses came in every hour or so to check how much he was eating and what his diapers weighed.

He passed his final blood test with flying colors, and we celebrated with our much more alert baby. We came home and started to settle back into what felt like the beginning of a new routine for our expanded family.

Our whole family is changing, together

The four of us are operating on little sleep, so we can instantly go from happy to sad or angry in a flash. We’re all being challenged and pushing up against each others’ boundaries.

The stressful moments have been peppered in with plenty of happy times too, like visits from the grandparents, starting out weekends crowded together in bed, and sitting at the kitchen table enjoying daddy’s new dinner creations.

Some of what we’ve experienced has been pretty textbook, including the potty training regression and acting out by our toddler to get attention.

What I didn’t expect was being hit by a ton of bricks when I couldn’t be available to my first born for routine things like helping him get dressed or putting him to bed. I was a puddle of tears the first night home, but now my heart swells watching father-son bonding take its place.

While we’ve dedicated so much time and attention to helping our newborn gain weight and keep the jaundice at bay, our now 2 3/4 year old is blossoming before our eyes.

His vocabulary has doubled again, as he uses full sentences, asks questions and energetically narrates what we’re all doing. He’s obsessed with how things work, and can use his age-appropriate screwdriver surprisingly well.

Friends told me he would seem like a giant next to his tiny little brother — which is exactly what he looked like when he came to the hospital to meet him — but what I didn’t expect is how quickly he would take to his newfound independence. He loves to be a helper, too.

We’re learning, all over again, to prioritize what’s best for the moment

The first time around, it took me a lot longer to surrender to the changes brought on by parenthood. We basically added a child to the lifestyle we had created in an urban setting, and I attempted to keep my foot on the gas pedal at work.

It wasn’t until I realized I was putting too much pressure on myself to be super mom, right around the same time that we began house hunting in the burbs, that we realized how much change was inevitable.

This time, just under a month of two kids under our belt, we are turning everything upside to create the life that’s best for right now. We’re even flirting with the idea of getting a minivan.

Through more doctors appointments and lab visits than seem possible in 27 days’ time, we’ve learned to advocate for our family when something doesn’t feel right, even when we’re told otherwise. We’re mama bear and papa bear on steroids.

And while I’m looking forward to reconnecting with working mamas and mompreneurs to tell their stories, I’m currently in awe of moms who stay home full-time.

(The prospect of being outnumbered for more than a few minutes at a time was terrifying at first, until I reminded myself of what I’m capable of managing in the workplace.)

I’m so grateful for the village of parents who’ve been through this before us, and amazed by those who’ve dealt with much more.

In hindsight, finding diapers and clothes that fit (a la Chrissy Teigen) and pumping around the clock are the least of our worries.

Thankfully, the couple of hours that we get to enjoy “wake time” with our sleepy little guy are growing in number each day.

Even though this month is a blur, we’re living this new life one moment at a time.