R.I. - Depression. Incontinence. Guilt. Stretch marks on
Mama never said there would days like these - nor
worries like these - after giving birth.
''No one told me to feel depressed is normal; to have
aches and pains is normal,'' says Lisa McLeod, 39, a new
mother from Providence, R.I. ''It's not all sunshine and
roses, being pregnant.''
That's why Sylvia Brown, a descendant of the Browns
of Brown University fame who's now living in England,
worked with Mary Dowd Struck, vice president for patient
care at Women & Infants Hospital, to produce ''The
Post-Pregnancy Handbook.'' The authors claim it is ''the
only book that tells you what the first year after
childbirth is really all about - physically, emotionally
''It's the best-kept secret,'' Brown said in a recent
telephone interview from her London home. ''We're just
not prepared in any way - in terms of organizing our
lives, or in terms of the physical consequences or the
Even here in the States, Struck said, ''There's a lot
of information out there, but there isn't a book that
sort of pulls it all together ... that really connects
the emotional and physical together in one place.''
The book is designed as a reference guide, outlining
a host of problems and concerns women may face after
giving birth and offering potential solutions, including
traditional and alternative or complementary treatments.
Brown admits it's not light or cheerful reading, and it
could add an entire new list of worries for nervous
''I tell first-time pregnant women not to read it
until one or two weeks before the birth because they'll
get a little bit rattled,'' she said.
But on the other hand, Brown said, it's better to be
prepared rather than to feel like you're all alone in
dealing with the issues that many women face after
''The point of my book,'' she said, ''is to give a
new mother the tools she needs so she can get over these
problems and get on with her new baby.''
McLeod is among the new mothers interviewed for this
story who said they wish people had given them more
information about what to expect.
McLeod thought she was going to love being pregnant.
She envisioned it as a happy time, when she'd be
pampered by everyone. No one told her she might be
horribly depressed instead. But for much of her
pregnancy, she said, ''I was very moody. I would cry at
the drop of a hat.''
It was so bad, she worried about taking her son,
Quenten, now four months old, home from the hospital
because she figured she was at risk for severe
postpartum depression. Thankfully, she said, that didn't
But looking back, she was surprised no one warned her
how much it would hurt when the baby kicked while in her
belly, or that she'd need so many tests because hers was
considered a ''high-risk pregnancy,'' or that breast
feeding isn't nearly as easy as it looks.
''I wish more people would actually tell you the
truth (up front),'' McLeod said. ''They don't want to
upset you, because you're pregnant, but you're going to
go through it anyway.''
Candy Hall, 31, of Providence, wishes someone had
warned her that she'd have embarrassing episodes of
incontinence, during and after pregnancy. ''That was a
huge surprise. I kept thinking there was something
And no one told her the back pain could get so bad
she had to leave work two weeks before her son, Maison,
was born on Sept. 6.
She also didn't expect that afterward she'd become so
forgetful, or that she'd get varicose veins so young, or
that she'd have stretch marks on her breasts - and not
her stomach. ''That was a big surprise,'' she said.
Lisa Guarino, 36, another new mother from Pawtucket,
R.I., said she was surprised it took so long to become
pregnant in the first place. She also didn't expect
morning sickness to last the whole nine months. ''It
went from one thing to the next.''
Guarino said she was as prepared as she could be for
the emergency C-section she had to undergo when her
daughter, Emily, was born April 20. But she didn't
realize the surgery could result in intestinal problems
that caused her to be readmitted to the hospital the day
after she came home.
Fortunately, she said, everything turned out fine.
But, she recalled, ''When I went to one of my
(postnatal) appointments, I was still feeling sick. ...
I was still having gas and getting nauseous. And (the
doctor) said, 'Well, I'm glad you're feeling better.'
And I'm like, 'But I'm not feeling better.'''
''I knew in my mind everything was fine,'' she said.
''... But I guess I didn't expect to feel the way I
felt. I felt sort of sick and just weird.''
Brown said she decided to write the book ''within
hours'' of giving birth to her son Adrian, now 9.
She was living overseas at the time, with her former
husband, a United Nations official stationed in the war
zones of Croatia and Pakistan. She went to Paris to
deliver the baby, and realized she had no network of
family or friends there to turn to for help and advice.
It was tough, she recalled. ''I had a difficult birth
... and I was in such pain the day after his birth I
took 17 showers to relieve the pain.''
She said she was angry at not getting help and
information from the medical community and friends, and
she was frustrated at not finding any books dedicated to
what to expect after giving birth.
''I had read all the pregnancy and childbirth books
and had a pretty good idea of what to expect with the
baby. ... But no one told me you get hemorrhoids after
you have a baby, and I didn't know what to do to make
the stitches (from the episitomy) more comfortable.''
She didn't know which of her aches and pains were
normal, or what to do about them.
But it wasn't until the birth of her second child,
Laure, now 7, that she actually began work on her book -
hoping it could provide other women with the type of
information she wishes had been available to her.
She started by surveying more than 300 new mothers,
and found that 64 percent had bad experiences after
giving birth, including medical concerns ranging from
back pain to migraines to incontinence.
She was surprised to find that 8 out of 10 women
suffered some symptoms of ''the baby blues'' after
giving birth. And, she also estimates that many women
suffered from undiagnosed cases of postpartum depression
that they or their doctors had dismissed as fatigue or
She also was amazed to see how little attention the
medical establishment placed on the ''pelvic floor,'' a
network of muscles that supports a woman's genital and
digestive organs, which affects everything from
incontinence to sexual satisfaction. Her book devotes an
entire chapter to ''strengthening the pelvic floor''
through a variety of simple exercises.
The information and tips in the book ''come from all
over the place,'' she said, noting that she interviewed
nearly 60 medical specialists ''in all areas of maternal
health,'' in addition to sorting through the information
submitted by the new moms who'd responded to her
The advice ranges from common sense (make sure you
rest as much as possible and make time for adult
activities to stimulate your brain) to medical
treatments, including traditional and alternative
medicines, exercises and therapies for everything from
stress to recovering from a C-section.
''In my book,'' she said, ''I try to define every
possible problem and define what is serious and what you
can take care of yourself.''
''It's not a book that's supposed to be read cover to
cover,'' she noted. ''It's really a reference book. The
idea is to look up whatever problem you might have in
the index, and then find out why this is happening and
what you can do about it.''
Some of these issues may be mentioned in other
pregnancy books, Brown acknowledged. However, she said,
while ''most pregnancy books warn you that this might
happen, but they don't give you a lot of constructive
advice and concrete suggestions. I do give a lot of tips
and advice and suggestions.''
Brown initially published the book in France two
years ago, and she later teamed with Struck, whom she
met through a family friend, to review it for medical
accuracy here in the United States before the book was
published this past July (St. Martin's Press, $24.95).
''Naturally, women tend to be so focused on the birth
itself that they really need extra prodding to think
about the rest of their lives,'' Brown said. She said
she hopes childbirth educators and medical professionals
around the world will do more in the future to educate
women about life after the baby is born. ''Women think
they're just going to ride off into the sunset, and
that's obviously not the case.''
As Struck noted, ''I think people are very surprised
by the physical trauma that happens to them during
delivery, and they are totally unprepared for it. ...
It's all right to feel like you've been in a car
accident after you've had a baby.
''You need to recuperate. You need to allow your body
to return to normal. ... You need to concentrate on
yourself and your baby for the first few months.''
In another new book, ''Becoming a Mother,'' author
Gro Nylander noted that midwives and others who work
with pregnant women say, ''It is almost impossible to
get pregnant women to look beyond the birth. It's like a
mountain on the horizon that blocks the view.''
''This is a shame,'' Nylander writes. ''... The
postpartum period is a very special time, and it can be
helpful to know a little bit about it.''
That's why she includes in her book a chapter called
''Postpartum: Blood, Sweat, Smiles and Tears,'' where
she examines everything from incontinence to hemorrhoids
to massive hair loss soon after giving birth because of
But all the books and advice in the world can't
prepare new moms for the feelings they'll experience
when they hold their babies near.
As McLeod says of baby Quenten, as he nuzzles against
her chest, ''He's, like, the most amazing thing.''
Guarino agrees. She says of Emily: ''Every morning, I
just feel blessed.''