Postpartum Sleep Deprivation

I have something to say. It’s off topic, uncharted waters for this blog, but it is important in my opinion.

So if you wanna know details and you aren’t afraid to get into some feelings, settle in. If not, come back later and we’ll talk about food.

TLDR: Sleep deprivation is dangerous, postpartum anxiety sucks, keep an eye on your loved ones having babies.

 

Kind of a big deal

So Margot’s birth ended up being one of those sort of eventful ones. I mean, I’ve heard of much worse, but it wasn’t nothing. I ended up having to be induced after about 2 weeks of “prodromal labor” which is where you start getting labor contractions but they go away on their own (usually every night when you lie down). When you’re induced they give you this drug called pitocin which can cause you to have irregular (i.e. hellish) contractions. I was able to make it through about 5 hours of those before I abandoned my hopes for a natural birth and got that sweet sweet epidural.

All this is to say I was pretty damn tired going into the delivery. Which was epic. Most women have to actively push their babies out for about 30-60 minutes (on the long side of things) but Margot had what’s called a “nuchal hand” which just means that her hand was up by her face and she refused to move it even while she was being born, which is ergonomically NOT IDEAL for birthing and which (I assume) is what caused my pushing phase to last THREE AND A HALF HOURS.

After she was out I hemorrhaged, tore, and the placenta didn’t come out in one piece. All of those things are bad, so I was pumped full of various drugs to make sure I stopped bleeding and didn’t get an infection. A couple of hours later I looked and felt like I had been hit by a truck.

The hospital where we delivered (which was wonderful, don’t get me wrong) has a “rooming in” policy which means that babies don’t get carted away to a nursery to sleep, they stay in the hospital room with their parents, which makes a lot of sense for bonding in those first hours. However, it also means that between making attempts to nurse, being checked for bleeding, and trying to keep the baby happy, Cody and I didn’t sleep more than 15 minutes at a time for the three days we were there.

The morning we were to be discharged, the overnight nurses insisted that we make a special exception to the “rooming in” rule because Cody and I were, in their words, “stupid tired” and they fed Margot some formula and took her away so we could sleep for 3 blessed hours. I wanted to stay another week because I was still so exhausted, but that’s not how it’s done here in the US. In fact, for less-eventful births, moms are usually discharged 24 hours after giving birth, which is mind-blowing to me.

So basically, childbirth is like surgery, but one from which the patient (mom) doesn’t get to recover properly. BECAUSE…

Nursing. Everyone agrees nursing is great. It’s free, it’s the best kind of nutrition for babies and helps to build their immune system, which is kind of important! But in order for a new mom to get her milk supply established, she has to nurse her baby and/or pump about every two hours. Which makes sleeping (and hence, recovering) difficult, even if the baby is a great sleeper, and even if latching and milk production are not a problem.

 

An ouroboros of hunger and unsleep

Margot was not a great sleeper. I assumed she was colicky and did my best to burp her often. For the first two months of her life, I would nurse her for 20 minutes on each side, change her, pat her, and try to get her to sleep over and over and over. At the most, she slept for about 40 minutes at a time. Which meant I didn’t sleep unless Cody was home and could take care of her while I slept. I was not letting Cody help at night during the work week because he was now our sole earner and I had a ton of anxiety about him being able to keep up at work. My choice there.

So I was constantly making difficult choices with my 40 minutes of Margot-sleep time: should I pump to help my pathetic milk supply? Eat something? Try to sleep for 30 minutes? Usually, I would pump for 20 minutes, wash the pump (so it would be dry and ready to use at the next cycle), and use the last 10 minutes to find something to eat. All day. Every day.

As you can probably imagine, I was not sleeping very much. At all. I was averaging about 2 hours total per day, broken into pieces. There were a few days where I got no sleep, and more than a few where I got 30 minutes or less. I thought it was just typical “newborn mom who is having a hard time nursing” stuff, and figured it would get better when I got better at producing enough milk.

You guys, it’s not normal to sleep that little. In fact, it’s dangerous.

I’ve done some reading on the topic, and one kid actually forced himself into a mental hospital after nearly 4 days of intentional sleeplessness. Doctors who specialize in sleep find it unethical to conduct sleep deprivation studies on humans, but rat studies have demonstrated actual death from sleep deprivation. Sleep deprivation is an effective interrogation tactic that was used by the CIA but it was later prohibited for being too severe. According to the handful of articles out there on new parent sleep, the average sleep LOSS is 2-3 hours per night for wakings and feedings. So if the average adult’s night of sleep is 8 hours, getting 5-6 hours (broken up, most likely) in the first months of a baby’s life would be about typical. Still not good, but maybe manageable for the short term.

The awful thing is that in the worst, most sleep-deprived days, I didn’t realize what damage I was doing. I felt overwhelmed and frustrated, couldn’t believe I was still functioning, but surprisingly kind of fine. I could keep my eyes open during the day, I startled wide awake any time Margot made a peep (even sometimes when she didn’t make any sound at all) and I was generally in spaced-out but even-tempered spirits. My body was running on adrenaline and like, microwaved burritos.

At the 2 month doctor appointment, the pediatrician told me Margot needed to eat more, but I was already feeding her around the clock, so I gave up on exclusively nursing and started supplementing with formula. Logically, this was my best option, and making sure a baby is properly fed is what matters, but I still had that irrational mom guilt over it.

Cody sent me to bed that night and Margot, finally stuffed for once (apparently it wasn’t colic, she was just starving), slept for 5 hours straight.

 

One step forward, two steps back

It wasn’t until I started sleeping more and trying to live like a normal human, shifting out of “survival mode” that depression started creeping in.

I developed postpartum depression and anxiety to the point that I started having repetitive, unwelcome thoughts about accidentally dropping Margot down the stairs. I would hug the opposite wall and carefully tiptoe any time I had to walk past them. I had thoughts about how nice it would be to just die in my sleep just so I could rest, escape, be done. Thankfully, I never got to the point of planning or actively thinking of taking my own life, but the thoughts I had were unsettling. I couldn’t believe that this relentless, menial, exhausting slog was my life now.

I was tired in my bones even after Margot started sleeping well and I could count on a solid 8 hours most nights. For almost the whole first year of Margot’s life, I was desperate for escape. The moment Cody got home from work every day I was in my bed or out the door, and when I returned I felt just as drained. I couldn’t physically or mentally relax when Margot and I were in the same room. I was jittery and SO irritable and waking up from a dead sleep in the middle of the night with my heart racing for no reason.

At the 6 month mark, my wimpy milk supply became unsatisfactory and Margot weaned herself completely. I was again irrationally guilt-ridden, but also glad to have my body back to myself. When my hormones tanked from the lack of nursing and I got even sadder, I realized that I needed to see a doctor for help. I was put on an anti-anxiety/antidepressant medication and referred to a therapist for counseling. Both helped a lot.

In therapy, I came to learn that those first sleepless months with Margot were much more impactful than I realized at the time. I was showing signs of trauma. It’s possible that the difficult birth played a part, but talking about those first sleepless months in therapy would make me feel panicky and this breathless sobbing would sneak up on me every time. My therapist explained that the dread that comes up when I think about what happened is my body’s way of telling me not to let that happen again – a defense mechanism that I did not consciously create.

Just last month I took down an instagram photo of Margot at 2 months old because she was so skinny and looking at it took me back in a way that was too tangible.  I’ve made a lot of progress and I don’t panic when I think about it now, but it’s still uncomfortable.

Margot is two now and I feel so much better. Getting to this place, where I want to DO things again was a lot of work, and I’m lucky I had the support and time to get here. It really wasn’t until the last 6 months that I started to feel like a person again. Wanting to accomplish things beyond showering and doing my hair.

I have more to say about how this whole saga has impacted my sense of self, but I’ll save that for later. My point with this post is to share my experience with sleep deprivation and encourage everyone to take it seriously.

 

So what can you actually do?

 

First of all, I just want to acknowledge that everyone is different and while our healthcare situation in the US does have some awareness of postpartum depression, I slipped through the cracks because my depression started later. Also, at no point did any healthcare professionals ask me if I was sleeping enough, or how much.

1. If you know someone who has a newborn, ask them if they are getting enough sleep. They will laugh at you, because they aren’t. “Enough sleep” is probably relative, but I’m going to go out on a limb and say a total 6 hours a day minimum, especially if it has been going on for more than a couple of weeks. If you have the ability to offer to help them for a few hours and insist that they sleep while you are there, do.

2. If you are a new mom flirting with serious sleep deprivation for the sake of your milk supply, consider backing off, at least temporarily. Let someone else feed your kid a bottle while you sleep for a few hours every day (if you can swing a whole night, do it). I understand that nursing is important to a lot of people. I will probably try to nurse again If I have any more kids, but having a baby that is flexible and willing to take a bottle will give you so much freedom. Your milk supply might even improve with a bit of rest.

3. If you are a new parent and people offer to help, try to accept. My mom flew to Maryland and stayed with Cody and me for two weeks after Margot was born, and I was actually able to get more like 4-5 hours of sleep on the days she was here. I was stupid not to keep her longer.

4. If you are a parent, remember that just because you might be “functioning” or not feeling sad or overwhelmed doesn’t mean you aren’t doing damage. When I was sleeping the least, my body compensated with cortisol and adrenaline and I wasn’t very emotional at all. I was tired and I couldn’t believe my body was still working, but I felt kind of fine/numb. I call that “survival mode” and it’s something to be very wary of.

5. If you are pregnant, read up on sleep training options and methods before baby arrives. I wasn’t planning on starting as early or going as hardcore as I ended up going, but Margot and I were both in a bad state of exhaustion. Googling sleep training articles during my precious 40 minute breaks was not my favorite activity, which is why I recommend doing it now. With sleep training, Margot started sleeping 8-10 hours straight per night by about the 4 month mark and 12 hours straight per night pretty predictably by 6 months. With naps during the day. It saved us both.

 

Obviously, everyone has to do what they are comfortable with and what works for their unique child, but like they say on airplanes, make sure you put your own mask on first.

I want to know what you guys have to say about postpartum sleep deprivation. Bring your stories, experiences, and opinions! I ain’t scared. I know my postpartum experience isn’t totally common but I can’t be the only one who got a taste of CIA-banned torture tactics.

  1. ralph didn't sleep well at all (day or night) until he was 8-9 months old. it was miserable. i was totally thrown for a loop because rhoda was a relatively good sleeper. with her i didn't mind the middle of the night feeding till she was 9 months because it was predictable and she'd just fall back asleep in bed with me. ralph wouldn't even go down to sleep to begin with and every night it was a 2-3 hour process trying to get him to bed (and then another 2-3 hours in the middle of the night trying to get him to go BACK to sleep) and i literally tried every single sleep training tactic. he didn't even sleep when he was in bed with me! at any rate we are out of the woods now with sleep which has helped a lot since i wouldn't be able to deal with his toddler antics if i weren't sleeping. SUPER glad that you sought help and that you're on the other side of things.

    hannah — August 31, 2018
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  2. also, my pediatrician questionnaire always included a thinly veiled question about my mental health and i was like... YEAH sure i'm going to have a heart to heart with him about it, haha. though to his credit he is wonderful and sussed out how i was feeling between my wide-eyed, maniacal laughter accompanying my sleeping report at each appointment (though he never said hey, maybe you should go talk to someone about this) and was very compassionate and listened to my rants every time. when ralph finally started sleeping through the night he high fived me and said "you did a lot of hard work to get here and it has paid off." and for whatever reason that remains my favorite compliment i've received to date, haha.

    hannah — August 31, 2018
    1. Hannah I can't even imagine having to deal with sleep issues like that through the 9 month mark - I'd be beyond zombie status. You are a trooper. I'm glad Ralph's pediatrician was at least interested in your mental health enough to ask. Mine asked too, but the questions stopped right before I started feeling really depressed. I think we (womankind, Americans, idk) need more postpartum professionals and advocates to make sure we are thriving like our babies. And sleep training is so hard - I'm glad you are able to get some rest now! Solidarity, mamma.

      courtneybuell — August 31, 2018
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