Ashwinni Manasseh | Ep #9 | Demistifying Postpartum Part 1

psychologist who specializes in perinatal mental health which means she works with new and expecting parents she also does a lot of work with people going through significant life or relationship changes and has specialized training in acceptance and commitment therapy and cognitive behavioral therapy her career in counseling started in melbourne australia and now has continued across borders with alliance counseling in singapore she is also a badass super cool mom to an adorable baby boy and is now working towards furthering her training in eye movement desensitization and reprocessing and so without further ado welcome ashwini to dartif the podcast thank you for having me on the show it’s very exciting um to be talking about a topic that i’m very passionate about both professionally and personally experiencing it right now um like you know you’re a new mom right and and most of your clients are new moms or new parents to be basically so in in your experience what are the common things you you see or themes that you see with your clients um that’s a yeah a big question i’ve got lots to share when it comes to i guess challenges that moms face um so i see moms anything from like newborn like who have just had babies all the way until like they have toddlers like you know multiple sometimes toddlers and are just kind of struggling with the challenges of managing the unexpected things that come up with kids so all sorts of stuff there’s grief and lofts around birth that i see a lot as well um in fact i myself struggled with that um having a child you know having an emergency section and a child brought to icu i found that right a real challenge for me like what was i guessing some in summary um your experience with with you know uh having that happen to you um i think what was really difficult was i went into labor much earlier than i thought so just not feeling prepared um practically even um but also just prepared for what was to come um and being separated at birth from my baby and that was yeah just it was quite difficult and i don’t think i realized how much it impacted me until later on and i would you know go to see my obstetrician or i would hear my baby crying those were really triggers for me because they would bring back lots of memories and i found myself kind of kept going back to the birth and and kind of going it over and over in my head and so then i realized that i really do need to see somebody and i sought treatment i had emdr and um yeah it was fantastic i feel that women don’t really want to talk about the negative side of it for someone who hasn’t had any children i just feel that it’s an experience that is somewhat glorified and the whole thing of you you’re going to be glowing etc but secretly you feel that there is something that they’re not telling you and so you being specialized in that in in more the postpartum side i think it is very unique and it kind of brings a light on something that women feel like they need to hide or not talk about do you do you know why it’s a thing and if it is why do you think women kind of hide that side and don’t really want to talk about it yeah and that’s a really good point and and i do agree i do feel like there isn’t there’s just so much that’s unsaid and i think women really go into this unprepared and like i hear women telling me like you know why didn’t anyone tell me that like naps are gonna be really hard like getting my baby to sleep during the day like everyone says you won’t get much sleep but they never really tell you that actually even just getting your baby to sleep is really hard and not only at night it’s during the day i guess a lot of women um i don’t know i think we’d like to show that we’re coping really well we like to put on this like super mom kind of look and we are quite guarded like we don’t want to share our vulnerabilities we don’t want to tell what people when we’re struggling because maybe it means acknowledging that you know we are struggling and then it might feel like a failure um i know i i mean the circle of friends i have are very open but i know there’s still a lot of shame and stigma talking about not coping and sometimes moms feel guilty when they say anything negative about their birth experience or parenting because a lot of shame comes up like you know they’ll think i’m a bad mom if i talk negatively about my baby or my birth like i i should only share that i’m happy and actually that’s why they call it smiling depression um so postnatal depression is actually called smiling depression because on the outside like moms look like they’re coping you know they they kind of have to right they have to get on with things um they’re out with other moms they may have to look like they’re coping but often under the others that they’re crying and so it’s one of those types of depression that is actually quite hard to detect because on the outside they look often like they’ve got it all together but on a bit of a show but actually no behind closed doors most women are struggling and that’s actually one thing i share a lot with other moms in counseling i i spend a lot of time normalizing that like tell them like actually i hear this all the time like you’re not the only mom i’m feeling that way sometimes that’s enough to make them feel like significantly better okay right right it’s it’s so interesting that you pointed that out because moms have to cope they have to just manage and because they’re always uh playing this role of like i need to just deal with it um your mind also is like trying to believe the message you’re sending and so if you lack that awareness then it’s easy to just like buy the message that you’re selling yourself i can imagine that being like a real difficult cycle to break especially because being a mom is like it’s always on right and then that’s why it makes it hard to detect definitely um and yeah there’s just no kind of pausing and checking in with yourself and there’s so much it’s like all the focus is always on a baby that moms really tend to neglect themselves um that’s a real problem i guess that’s when they get burnt out and can slip into depression or anxiety i remember having my cousin so her mom went to see her and was there to say i’m going to take care of my daughter and not the child because as you were saying is that from the moment the child is delivered the focus is directly on the child and in the same time i had another friend who was from portugal but her mom said i’m going for the baby and i thought okay different perception or goals and the mother is supposed to deal with the trauma of like this human being that is leaving your body after nine months um and i guess that also physically speaking like literal physical separation and so she’s into ayurveda so she brought in some herbs for the healing part of her daughter and she was focused on her daughter and not on the baby and whereas the western side was more how can i help you with with the child more taking care of their child and i thought it was such a powerful moment as like a mother-daughter type of experience because um at least she’s been seen you know i do you feel that you kind of as a mother you you disappear for like as a person forbid um yeah i can see how that could happen if you don’t have the right support i think it it really depends i think each woman is so different and i know in asian culture a lot of the women i see they have a confinement nanny who lives with them for at least the first month yeah and cooks for them you know gives them massages does everything for the baby so the mother could rest and a large part of that is because there’s acknowledgement that the mom needs to heal the mom you know has had a major major like you know changes in their body and is healing and whether it’s labor or a c-section um is sleep deprived and they really do see in this culture at least i’m in singapore the need for support for moms and and actually you know as a psychologist i really do see the benefit in that because if your cup is not full then you can’t really you don’t have anything to pour for this child so moms do really need to put themselves first and i think you know just to to everyone out there like when you are visiting a mom or whether it’s a friend or a relative and they’ve just had a baby like try to look at the mom and ask the mom you know how are you feeling how are you um sometimes again even as visitors we just straight away attend to the baby and you know yeah like our fixation is on the baby and how beautiful they are which is of course part of it and you will do that but take time to acknowledge the mom and ask her specifically like how is she feeling emotionally that question can really go a long way yeah i think that’s a that’s a good tip uh to practice um so you said like uh the one of the first trauma point might be like you know from delivery right and other than that what are the other things that they come to you for yeah so i guess as yeah as a new mum um one of the biggest issues would be like breastfeeding that women struggle with that is one thing that i think is they assume is just kind of going to happen naturally you know how hard can it be um there’s so much focus and preparation on the birth and that comes immediately after the birth yet there’s little um preparation for that part and that is what women really struggle with a lot because they may not have the right support in the hospital you know it’s very normal their milk won’t come in for a couple of days um and it can be very stressful because hospitals may start to suggest formula and that may not be what they want um and they are kind of they may feel pressured to go down that track they feel the stress that their milk is not coming in maybe may not be latching you know there may be weight concerns so it can be a very stressful time and puts a lot of pressure on the mum to feel like they need to provide for their baby and they are failing if they can’t feed their baby that way of course there’s moms who choose not to but there is a lot of pressure to breastfeed right and of course because there are benefits of it it also comes from you know who has advised that like it’s important to breastfeed um exclusively you know for the first year and then maybe from your own community even online like they’re part of social media also and amongst their mom group friends watching other women being able to do it yeah so one thing i would really suggest is finding the right support for breastfeeding i think a lot of women like forget there are people out there who can help you and like like as much as doing birth preparation classes are important you can actually do a pre-lactation consult so even before you have the baby at 37 weeks you can have a lactation consultant help you do colostrum harvesting which helps the milk come in helps you freeze colostrum so then if your baby has to go to icu or your milk doesn’t come in straight away it just takes that pressure off um sorry what is what is colostrum colostrum is like the liquid gold that comes out like those first few days after the baby is born but you actually start to produce it already while you’re pregnant um in those last few weeks so you can panda express put it into syringes and freeze it i’m not an expert in this but my mom’s a lactation consultant so i have some experience she helped me a lot and it’s actually more about being comfortable with your body like learning how you work like it’s just one less thing to have to figure out after a baby comes out it’s like how your body functions um and if you can kind of get comfortable with that before and your husband can even you know learn how to support you with breastfeeding before the baby comes it’s just one less thing to deal with once the baby’s there interesting if i look at my mom her experience with breastfeeding she would tell tell us about this and she said it was a horrible experience because for her it actually hurt so much that every time you know she she was breastfeeding my brother she said she would dread that moment and so she started giving formula quite early and that stigma that goes to i think it goes back to like expectations uh or what society thinks you should be doing and what your body can do or what you’re expecting for yourself for her until this day she’s like women who do not want to breastfeed she’s totally like for them like i think it goes to another extreme um but would you be able to explain like why why it would hurt that much um i’m not an expert in this but i think the most important thing is choice firstly like health professionals you know should really just ask like what would they like to do not assuming that every woman like to breastfeed some women don’t want to for personal reasons um any reason really it doesn’t matter but it’s really about choice interesting that you you said that um one of my good friends was telling me that when she gave birth to her second son in belgium i think she had a lot of stress and she was actually struggling she really wanted to breastfeed and she know she understands the value in it and her doctors and her nurses were actually shaming her for not breastfeeding and she kept telling them like she’s trying and she already saw a lactation consultant and she was still struggling with that and this is what i couldn’t understand like why is a medical professional making you feel worse about something that you are trying to to fix right so i can imagine the trauma on top of like the pressure that you put on on yourself like the society kind of telling you this is how you should do it absolutely yeah they get i mean there’s a lot of pressure i think that many people are breastfeeding and that can make a woman who doesn’t want to or who’s struggling feel a lot of shame a lot of guilt and it can be a very tough part of this postpartum period for a lot of moms um if for women who want to breastfeed getting support is really important for women who choose not to breastfeed you know sticking by that if that’s important to you that that’s okay and there will be a lot of stuff out there but you need to surround yourself by professionals that support your values and your choices and if there are family and friends and social media that is making that choice hard for you then really kind of setting some boundaries on on that for your mental health makes sense so um there’s one thing that i’m dreading from being pregnant if that happens to me is the change in my body from stretch mark to actually having like just that that experience is kind of scary uh what have you picked up on with your your clients or with regards to body body change um that’s a big thing that comes up for several reasons for some women just the physical changes actually can impact their functioning so even incontinence or if it can affect their ability to exercise and that some of them are quite active before they have babies and then they really need to slow down that’s you that’s you goonie yeah i was like how am i gonna be like back back on my treadmill or even just running or just like get that recovery period and even when you’re you’re pregnant right you can’t really necessarily work out as much as you used to so yeah definitely activities on a side note i just remembered this thing when i was in sri lanka on a holiday i climbed like a sigiriya rock and there was a woman and she had a newborn with her in like the sling and she was climbing the rock and it was raining and i i was shocked and also amazed at the same time and could see myself judging this woman because i’m like how is she doing this and is this something she should be doing but it’s interesting as you were saying that i was thinking so many moms like look at other moms in that way and think oh my god how come she’s doing it and i can’t how come this woman’s awesome with me and i haven’t you know there’s so much comparison that goes on at this stage and you’re not really being kind to yourself when you do compare yourself and everyone’s recovery you know is going to look different depending on what kind of birth you had your own body um you know your baby your support system everyone’s recovery is different so really focusing on your own situation um again giving yourself time to recover like taking it slow i think a lot of women forget how much they’ve been through their body and their their whole being has been through through birth and they have a lot of pressure to like you know maybe at three months i need to get back into activity again and sometimes they set really unrealistic goals um so be kind to yourself give yourself time you know ease into it um i would say as well a lot of women forget that even after you’ve had the baby you also need to regularly seek consultation from like women’s physio um there’s a lot of changes that happen down there with pelvic floor issues continence can happen at prolapse um yeah lots of changes um to our bodies in terms of women’s health issues so again i’m not a specialist in this but i would definitely recommend seeing the women’s physio after giving birth usually i think it’s after six weeks you should see someone for how you can recover and but yeah osteopath or chiropractor just to kind of get your alignment back again and there’s lots of aches and pains that come with breastfeeding and delivery and just getting all of that checked out i wonder ashwini like if for me i’m i’m not a mom right but then as an outsider who’s not gone through the process i often think that like oh if our ancestors did this um without any like guidance and assistance from you know medical professionals how come we can’t do the same thing right why can’t we just take this natural healing process and natural process of delivering um is that something that like you see that comes up as an issue yeah i definitely notice that there is this difference not necessarily what my clients are saying but just from my own observation from my own parents and their you know their generation i think part of it is them lacking resources and knowledge um i think a lot of these women like have issues like the goodies mum who is having pain with breastfeeding and like maybe at that point like i don’t know if lactation consultants were like really well trained in this area even like women may have incontinence now um you know our moms our grandmas we don’t know about that um but maybe if they saw women’s physios like we do now they may have had years of like you know pelvic floor training and exercises that may have helped prevent some of that um so i think one part maybe lack of of our awareness of and their awareness of the support and it’s also our lifestyle is also very different right i don’t know about your parents and grandparents but my parents told me they used to walk a lot more than we used to and ride bicycles and you know they weren’t living as sedentary lifestyles as we are so i’m sure that has a big part to play in how our bodies cope with these changes yeah um like i guess with with what rooney just said like how women generally set high expectations of themselves um how much of that stress and you know if you’re not able to meet that right how much of that stress actually can translate and pass on to a child and have an impact on the child yeah that’s something i think about even in parenting right now right so if we’re constantly aiming to be perfect like our child doesn’t see us as human and then when they make mistakes or if they’re not good enough they’re going to feel like they’re failing so even today you know even though i’m a psychologist you know i make mistakes all the time and like my son was he’s almost two and he was driving me you know nuts today just spilling water throwing food not eating anything just one of those days um and i raised my voice at him and i don’t often do that but i had really likes reached my threshold and i raised my voice and i realized in that moment that like i have this power to like use that moment as a teaching moment like i could kind of you know beat myself up about it okay i could actually use that as a moment to like help him see that this is really normal um yeah sometimes you you know we’re all human and so i just sat down and i apologized to him raising my voice and he just said it’s like okay mommy like you know he really he actually took note of it as well he actually realized what i was saying and yeah um yeah i mean like just teaching them to like forgive themselves that you if you can forgive modeling that’s the word modeling you can model to your children that like you’re human you make mistakes but what’s more important is the repair attempts yeah relationship right um yeah so i guess like we talked about the trauma from labor the breastfeeding challenges and and even body changes and i think one of the points i wanted to touch on is also like baby sleep cycles i i noticed this was something a few my new mum friends had a lot of obstacles with because you know there’s so many schools of thought about how to to train your baby to sleep and how to care for your baby you know in in that space what’s your kind of take on on this um yeah this is definitely like a very sensitive topic i didn’t realize that until i came into this mom world and realized like how there are very different schools when it comes to sleep right so with the women i see a lot of them struggle with like this loss of control that they have before they have babies so when we’re so used to routine and then we have a baby and like we don’t know when they’re gonna sleep when they’re gonna wake um it can be really stressful and hard to plan things it can make you sleep deprived and i see a lot of women who struggle just with anxiety um around like infant sleep there’s so many websites out there um written by a lot of them are laymen um just stating like what um like sleep schedules and like how long they should be sleeping for in different age groups um their weight windows and like very precise and women who generally like have this need for like control and perfection and um routine they tend to hold on to these things too tightly and then they start getting really anxious because they’re like oh it’s like three o’clock and my babies should have gone down for a nap but they haven’t yet and they get really stressed i see a lot of women who come in because they’re just like i can’t quote like what’s wrong with my baby what am i doing wrong and i just see that sometimes like these schedules that they read online or hear about from other moms you know it can be very unhelpful because firstly they’re not research based secondly they’re just like it’s like a one model fits all which every baby is different so i know my baby baby was extremely low sleep needs compared to his other babies his age and so it can make you feel like something is wrong if you follow these routines too closely so what i would suggest to moms is i guess as you’re reading these things just first of all check your sources make sure that they’re research based um take them lightly like okay maybe that’s what some babies do but always look at what works for your baby and try to follow their lead a little bit because sleep is one thing we cannot control and it can get so obsessive to the point where women like won’t even leave the house because they want to make sure that their baby like goes down at this time for their nap time and that can lead to depression so this is where my concern comes in really it’s not so much about the infancy it’s about how it affects the mom who gets so fixated on these schedules and so the two schools of thought are either you sleep train your baby and um there the other school of thought is no sleep training which is tough because it means you just need to kind of go with where your baby is at um and it might mean co-sleeping it might mean like breastfeeding on demand not really following any schedule and i think in our society it is really hard because a lot of women have to go back to work i think it’s a societal issue as well because we’re gonna have to go back to work sometimes at three to four months and they cannot cope with a baby who doesn’t have a sleep routine they cannot be sleep deprived from their jobs so they feel really stuck and desperate and that’s when they go in to look into these kind of sleep training schools and for some women you know it works and it’s very helpful but the other school of thought is that it could be harmful for the baby because some of these this training requires babies to cry it out um so that’s kind of just overview of these two schools yeah i mean i think on this point is like a huge part is actually the society because everybody has to work now because it’s it’s a necessity but as like an outsider who’s seeing it the other part is also like the expectations which is reality conversation we’ve been having is that they think having a baby is at their convenience right and so once the baby comes it’s like okay now let me go back to my normal life but there’s no such thing your life is completely changed right so you have to adjust and create a new type of life and routine and this kind of expectation that they said is is probably detrimental to their mental health in the long run yeah definitely so yeah they may sometimes not really expect their lives to train so drastically and so they may be looking at on the moms and um get their expectations from there so i think asking themselves where is this coming from and yeah being really realistic with that like not adding pressure on yourself self-compassion is key to that just being kind to yourself not comparing um and really yeah taking your time to get to where you are not putting extra time pressure on yourself yeah interesting thank you for listening to part one of our discussion with counseling psychologist ashwini malase part 2 drops next week where we demystify postpartum in the context of relationship changes new mother’s experience with themselves and their partners with that said if you enjoyed this episode go ahead and select that follow or subscribe button for now stay safe