Postpartum taboo is slowly crumbling, but there is still work to be done

• Feminist activist Illana Weizman recently launched the hashtag #MonPostPartum to free the voices of young mothers on the subject.
• “The postpartum is not all rosy. However, we do not talk about it, ”observes Dr. Marie Mercier, doctor responsible for the consequences of childbirth at the Angers University Hospital.
• While France remains very focused on childbirth, support for "after" must be improved.

Hide this layer that you cannot see! During the very glamorous Oscar party in early February, an advertisement for special postpartum hygienic protections was banned from broadcasting by the ABC chain, as it was deemed "too raw". What was "too raw"? The fact, obviously, to show that a woman does not have a flat stomach the day after giving birth and that she can have pain and bleeding that force her to wear appropriate protections. What ulcer many women, including the model Ashley Graham, who has just had a baby, and who did not hesitate to post a photo of her in diapers on Instagram. An initiative taken up by the feminist activist Illana Weizman: “We just saw a woman who is suffering, gets up to change her protection, against the sound of baby crying, it was very soft . It made me angry to see that it was already too much, and that the suffering of women must be killed.

She decided to launch the hashtag #MonPostPartum on social networks, "to free speech and put an end to the invisibility and distress of young mothers". Thousands of women answered the call, sharing one observation: during the postpartum, women suffer all the more because they do not know what to expect. The blame for a lead silence and a lack of information and support.

Ignorance, source of suffering

“Episiotomy, tears, cracks in the breasts due to breastfeeding, hemorrhoids, slices [strong contractions allowing the uterus to regain its size and shape], without forgetting the lochia - these uterine bleeding which can last several weeks: Postpartum physical manifestations are numerous and, if they vary from one woman to another, can be very painful, "warns Dr Odile Bagot, obstetrician gynecologist, author of the blog Mam Gynéco and of the book Vagin et Cie , We tell you everything! (ed. Mango). Added to this is “a context of psychological fragility,” says the gynecologist. It's the baby blues, which affects 70% of young mothers. They have everything on paper to be happy. However, they cry all the tears of their body ”.

Traditionally, “we associate birth with joy, but the postpartum is not all rosy. However, we do not talk about it, observes Dr Marie Mercier, doctor responsible for the consequences of childbirth at the CHU of Angers. Postpartum ailments are rarely - if at all - discussed during childbirth classes. Mothers are vulnerable during their postpartum period, and because they are ill-informed, they do not dare to complain, feel ashamed and have a very strong sense of abandonment. Remember that postpartum depression affects 10 to 12% of mothers, and that the first cause of death during this period is suicide! "

Because we do not measure the devastating effects of this silence. "I wondered why my mother and my friends hadn't told me anything," recalls Illana Weizman. We often hear: "we must leave a part of mystery". But why ? This mystery increases distress! Failing to know, I woke up a few days after giving birth with excruciating pain, draining my blood and thinking that I was going to die. To the point of going to the emergency room, where I was told that everything was normal. But if that's the case, why hasn't anyone ever told me? Because of all this, I had postpartum depression and this period traumatized me much more than pregnancy and childbirth. ”

"Women's voices have been disqualified"

So why this silence? Because "we must not say everything, otherwise we will scare women", we often hear. “This speech is infantilization, deciphers Marie-Hélène Lahaye, author of the blog Marie accouchement there and of the book Accouchement, les femmes des méreux mieux (éd. Michalon). However, it is not a question of balancing horrible speeches, but of providing necessary information. Yes, you can bleed, have breast pain while breastfeeding, be tired, have back and arm pain because you spend hours carrying your baby. But how can we explain that, while women have always given birth, they know so little about this period? “From the 1960s, there was medicalization of the body of women during pregnancy and childbirth, explains Marie-Hélène Lahaye. The goal was to prevent them from aborting. This movement was accompanied by a powerful discourse aimed at urging them to no longer listen to the women around them, but to trust only the doctors. The voices of women have been disqualified and there has no longer been this transmission between generations. "

When she posted photos of her, Illana Weizman received thousands of likes and comments, "a sign that many women were just waiting for a space where they were given the opportunity to speak." With several militant friends and young mothers, we launched #MonPostPartum. These testimonies are like collective therapy, this hashtag like an exorcism, because not even I or my friends had spoken about it. The silence and the taboo are such that one feels illegitimate. Even today, everything related to the uterus, the vagina, the female body, is taboo. Look at how menstruation and endometriosis have been very difficult to tackle. We invisibilize the suffering and pain of women. A number of studies conducted on this point show that they are perceived as hysterical, and on average, a man with pain managed in the hospital will receive painkillers more quickly than a woman. Sexism in medicine is still a reality. ”

View this post on Instagram

#monpostpartum - In response to an advertisement rejected by @abcnews and the Academy of Oscars which honestly portrays the painful episode of the postpartum as well as the publication of @ ashleygraham which points the silence around this convalescence, here I am , wearing a diaper for an adult, mopping up the blood that flows for days and weeks, the belly still swollen, the uterus still extended, the contractions that gently put it back in place, the blued legs, the points that pull, the unable to sit without pain, burning urine, the impression of having passed under a steamroller. If we talked more about these subjects, if we did not invisibilize them systematically, the mothers would feel less isolated, less deprived. Take care of mothers. Highlight their experiences.

A post shared by Illana Weizman (@illanaweizman) on Feb 12, 2020 at 3:48 am PST

Improving support for mothers after childbirth

In Germany, the term “postpartum” is not used, but “wochenbett”, or “weeks in bed”. Sign that this moment is considered as a period of convalescence. And in the Netherlands, "when they return home, mothers benefit from the services of a kraamzorg , a specialized caregiver who looks after the mother and baby, learns first aid, how to bathe, help with cleaning, prepares meals, does the shopping and takes care of the other children if there are any, describes Marie-Hélène Lahaye. And it's fully supported, it's institutionalized. In France, this system only exists on the fringes for young isolated mothers in vulnerable situations. ”

In France, therefore, "we are very focused on childbirth, but" the after "is not prepared, regrets Dr. Mercier". In her unit, she has 60 beds to hospitalize physical, psychological and psychosocial complications after childbirth. For the doctor, "we must rethink postpartum support, from pregnancy". Illana Weizman then evokes “the petition launched on Change.org to improve the preparation of young mothers and their support on their return home. First, at least two of the childbirth preparation modules should be devoted to the aftermath. " When following the pregnancy of a woman, Isabelle Fournier, midwife and president of the National Association of Liberal Midwives (ANSFL), “devotes at least three sessions to what happens during the post- partum: breastfeeding, the baby's rhythm, and the return home, with all its upheavals, fatigue and the place of the couple ”.

According to Dr Mercier and Bagot, "to improve support, liberal midwives play an essential role". But "it is still necessary to pass the information on to mothers, who do not always know that they can be so supported", insists Isabelle Fournier, who also advocates prenatal follow-up which continues after childbirth. "It is essential that any pregnant woman has the number of a contact person whom she can reach after birth".

Better distribute tasks and recreate benevolent solidarity

Everyone has a role to play. "One of the keys is the extension of paternity leave, on the Finnish model: four months together for both parents," also explains Illana Weizman. It is essential for the mother to be supported by her spouse, and it is also important for the father, who builds a bond with his child ”. And "this allows for a more equal distribution of tasks from the start, with a dad who knows how to change, bathe and feed his baby very early on," says Marie-Hélène Lahaye. And that's not all: "When we go to visit relatives after a birth, we bring a gift - often useless - for the baby, we eat a cake and we leave leaving the dirty dishes to an exhausted mother at who have been given muddy advice, she notes. Instead, if you really want to help, why not offer hours of cleaning, a massage, or bring ready meals? ".

Following the #monpostpartum I decided that I will come to see my friends who have just given birth and help them do the housework at home, it will be serious better than offering stuff for a baby who grows every 2 hours 🧐🧐🧐

And in order not to feel alone, "why not plan group courses in perineal reeducation?" Suggests Marie-Hélène Lahaye. This would allow young mothers to exchange ideas and find allies. ” Or “postnatal groups,” suggests Isabelle Fournier. Young parents are in demand, it makes it possible to break the loneliness, to know that what one experiences is normal and that others live it ”.

Television

Oscars: Postpartum ad deemed "too raw" by ABC

Society

"The extension of paternity leave and childcare would be beneficial to all of society"

• Pain
• Depression
• Pregnancy
• Delivery
• Women's health
• Women
• Health