Health and Wellness Mental Health Social Isolation Is Already a Big Part of New Motherhood It's traditional in many cultures to hunker down at home with baby, and it can be really healing. By Kaelyn Forde Kaelyn Forde Kaelyn Forde is a freelance reporter and producer covering news, politics, motherhood, fertility, and health. Her reporting has been published by InStyle, Glamour, Allure, Cosmopolitan and BBC Magazine, among others. InStyle's editorial guidelines Updated on May 7, 2020 @ 04:30PM Pin Share Tweet Email Photo: Julian Birchman/inStyle Just before the coronavirus pandemic hit the U.S., I scrawled notes of encouragement to several of my dearest moms-to-be: You got this! Good luck! You’ll be amazing! I felt a tiny bit guilty about the unbridled enthusiasm. I had struggled with postpartum anxiety and the sheer isolation of new motherhood myself. Over the first year of my son’s life, I’d shed plenty of tears, hated my Medela with a passion, quit my full-time job to go freelance, and spent many a night wondering if I was doing this right. But all that doesn’t fit in a card, so I stuck with: Text me day or night. Seriously. Then, as stay-at-home orders went into effect, and friends prepared to give birth during a pandemic, I wondered how quarantining would change their experience of new motherhood. Would it be tougher and more isolating? Or are there silver linings to a quarantined maternity leave — fewer visitors, fewer expectations to have your shit together, more help from your partner, less time putting on a bravely made-up face for the world? As I dove deeper, I found many cultures have post-birth rituals that involve isolating new moms, a sacred way of drawing inward that can feel natural after the transformative experience of birth. It’s something many moms are experiencing by necessity now, and finding rather nice. Julian Birchman/inStyle ‘Doing the month.’ Around the world, new moms go through a period of isolation after giving birth — it’s often called “doing the month,” and variations of it exist in many East Asian, South Asian, Latin American, and Middle Eastern cultures, says Cindy-Lee Dennis, PhD, a professor in the faculty of nursing at the University of Toronto. While Dennis’ 2007 study of postpartum rituals found that the tradition goes by different names — saam-chil-il in Korea, zuo yue zi in China, yu duan in Thailand and la cuarentena (literally, the quarantine) in Mexico — it universally involves mothering the mother. “There’s social isolation and staying home during those 30 to 40 days,” Dennis tells InStyle, and some cultures believe it’s also a time to “get a mother from a state of cold, of losing blood during birth, to a state of warmth.” That can entail staying indoors, “not bathing or eating certain foods, or sitting by a fire or putting hot stones on your belly,” she explains, but the goal is to provide “additional nurturing and support to recover from delivery.” In Japan, that period begins even before birth, as women travel back to their mothers’ homes during late pregnancy to be cared for until eight weeks after delivery in a tradition known as Satogaeri bunben, Dennis found. Moms in the U.S., however, have very little postpartum support. We are the only developed country in the world that doesn’t guarantee any maternity leave, and many partners are expected back in the office within a few days or weeks. Usually a new mom doesn’t see her doctor until the infamous six-week checkup. Meanwhile, research shows 15 to 20% of women experience a perinatal mood disorder during pregnancy or within a year of giving birth, but the silence around maternal mental health can be deafening. Suicide is a leading cause of death for new mothers, and overall, maternal mortality in the U.S. has increased, especially for women of color. There is clearly a need for more attention, more nurturing and care in the crucial weeks and months after giving birth. The COVID-19 crisis has intensified this need, forcing new moms into isolation often without family members to step in and help. It has also made in-person resources, like lactation consultants, support groups, and postpartum doulas, move online. (Looking for help? Postpartum Support International is a good place to start.) What’s lost in that virtual switch is some of the comfort and closeness — a shoulder to cry on, a hand to check your baby’s latch, or someone to simply hold your infant while you pee. (Such resources, it should be noted, have already been difficult for women living in poverty or in abusive home situations to access.) Even still, there are bright spots expecting mothers can look forward to in a locked-down postpartum phase, and adjustments we may try to carry through to life post-coronavirus. VIDEO: How COVID-19 Has Impacted Pregnancy And Childbirth in America ‘More slowed-down time.’ Even amid the uncertainty of this moment, some new mothers told me the pandemic has had an unexpected silver lining. For those with the privilege of being able to take it, “there is appreciation of more slowed-down time,” says Alexandra Sacks, MD, a reproductive psychiatrist and the host of the Motherhood Sessions podcast. “The postpartum period is a time of tremendous change — both physical and emotional, not to mention interpersonal,” Sacks tells InStyle. “So having a slower pace, with the potential to look inward or look more deeply at the relationships you share with your family, may give you more time to catch up with this tremendous life change.” New Jersey’s coronavirus crisis meant Erin H., 40, could bring only one person into the delivery room when she gave birth on April 22, 2020. She chose her doula, while her husband stayed home with their 2-year-old son. Erin, who is finishing her Master’s degree in social work and asked not to use her last name, was discharged just 26 hours later. While it’s been challenging, she says this postpartum experience has given her more of what she needs. “Having been through a non-pandemic new-mom period and now a pandemic new-mom period, I can definitively say that what I am getting to do now is better for my mental health, my breastfeeding relationship, my marriage, and for the overall good of my family,” Erin tells InStyle. “The expectations to be a glowing new mom that has it all together have been removed, and I have been able to sink into the reality of it in a really beautiful way.” "It Can Still Be Beautiful" — What Labor & Delivery Nurses Want You to Know About Childbirth During Coronavirus That’s also been the case for Crystal Rosario, 36, who gave birth to her third child on April 3. “Entering the hospital for delivery during a pandemic was nerve-wracking, but we found that one silver lining was less unnecessary intrusions after delivery,” she says. While new moms in the U.S. are isolating out of necessity, limiting who can help a new mom is part of many cultures’ postpartum traditions. In Nepal, moms remain a “peripheral figure” in the first days after birth as the baby’s paternal grandmother or aunt takes over, Dennis found, and in India, a dai, or midwife, visits daily to care for the baby and massage the mom. Rosario has her husband and older children to care for her, but once home, the Washington, D.C.-based stay-at-home mom and consultant found peace in that isolation. “We have been able to cocoon and adjust to our new addition,” she says. “We miss family and friends and are gutted that we can’t share this amazing newborn stage with them, but there’s also something nice about not worrying about cleaning up or getting dressed for someone stopping by or having to worry about covering up while nursing or the kids having a meltdown while friends are here.” Stay-at-home orders have also made breastfeeding easier for some new moms. Sara Rossi, 32, says after having her son on Jan. 8, “I tended to fill my days with errands and tasks to accomplish,” including coffee dates, workout classes, and weekends away. But, “in a flash, so many of my plans and expectations for the second half of maternity leave — the months so many women had told me were the fun part — were upended,” Rossi tells InStyle. Instead, the San Francisco-based public health professional learned to embrace the simplicity and extra family time, and found it easier to exclusively breastfeed. “Since I won’t be going to the office any time soon when I go back to work, I can ostensibly keep nursing, postponing the need to build a stockpile of pumped milk,” she adds. Helping new moms feel confident in their ability to feed their babies is a key part of supporting them, Dennis says, and around the world, postpartum rituals focus on it. In some Hindu communities, female family members symbolically wash a mother’s breasts before she begins breastfeeding; in Thailand, women massage their own breasts to increase milk production. Allowing moms and babies to learn to breastfeed with few interruptions is a key part of “doing the month” in many cultures — yet another task that feels tailor-made for quarantine. ‘Everyone is just muddling through.’ Heather Petersen, 36, experienced postpartum anxiety after having both of her sons, the youngest of whom was born Jan. 28. She feels like this time around, she can be more real about how hard it is. “I’m definitely more open to talking about it,” she says. “It does help to know everybody is just muddling through, I’m not the only one.” Plus, in quarantine, "there is no hustle and bustle — no alarms, packing lunches, setting out everyone’s clothes the night before, leaving early to get gas, no ‘hurry ups’ every morning,” she says. As a teacher with summers off, Petersen is used to taking on the lion’s share of childcare. But, she says, “my already amazing and appreciative husband now has a real and true understanding of what I do at home and how hard it is to be home with the kids.” Having more help from her partner has been a silver lining for Julia Jacobo, 31, too. The news reporter’s son was born eight weeks early on March 22, and he spent 26 days in a Long Island, New York, neonatal intensive care unit, a harrowing experience amid the pandemic. Jacobo’s mom isn’t able to come up from Florida to help her, but with her partner’s travel business on hold, “the plus side has been that he’s essentially on paternity leave,” Jacobo tells InStyle. “We’ve pretty much been dividing duties equally and have been doing shifts with the feedings so that we can each have some down time and sleep.” This sounds a lot like how Nordic countries handle early parenthood — with gender-equal leave options that allow all new parents ample time to bond with and care for their kiddo. I Gave Birth to a Preemie During a Pandemic The pandemic has also made it easier to explain to friends that sometimes what a new mom needs is time and privacy. After the birth of her first son, Erin H. says, “some very well-meaning friends brought over a ton of flowers and my internal thought was, ‘This is another thing to take care of and clean up after.’ I didn't need that gesture, I needed my time and space and respect for the hard work that new parenthood is,” she says. Drawing inward to heal is an important part of many cultures’ postpartum traditions. In la cuarentena, the postpartum body is seen as open and vulnerable, and 40 days of rest are necessary to help it “close,” a 2011 study of the practice found. But crucially, Dennis says, these rituals are only helpful when moms want to do them, and can cause an increase in anxiety or depression if they don’t. Ironically, for women in traditional cultures who don’t want to “do the month,” the pandemic may have also provided a way out, she explains. “In some cultures, mothers may be strongly encouraged by their elders to do the traditional 30 to 40 days. And now, because those family members are not coming into the home, maybe they're not being forced to do that,” she says. Isolation after giving birth wasn’t totally Erin’s choice, but it’s been positive. Friends have left food and hand-me-down clothes on her doorstep, and she says, “with each drop-off, I've felt extremely loved and have deeply, deeply appreciated the few minutes where we wave through the window, hold the baby up to show off, and exchanged our wishes for a different type of visit. But I've also been clear with everyone: It’s pretty nice getting to do this the way we are right now.” This is Real Women, Real Bodies, your destination for trusted health and wellness advice, reflecting the untold experiences of people like you. This month, we’re exploring maternal mental health, including the myths and misconceptions surrounding motherhood.