The reluctant breastfeeder

I roll over, bleary-eyed and sore from a restless night of sleep, and feel the familiar tug of tiny hands on my cotton T-shirt. My two-year-old, Elsie, pulls down my shirt and latches on to my nipple—nursing hungrily with her eyes still shut, her tiny nails pulling at the soft flesh on my breast.

“Ouch!” I shout, instantly awake, Elsie’s nail digs deep into my skin, leaving a tiny violet-hued mark. I stick my finger in her mouth to cut the suction to my nipple, but she angrily bites down on my finger. I let out another painful yelp, and her eyes fly open. Elsie shrieks at the abrupt ending to her nursing session, and the rude awakening from her slumber. All I feel is anger, pain, and fatigue, frustrated that I’m still nursing and wishing I knew how to stop.

I’ve been a mother for a total of seven years, raising my three daughters alongside my husband in our little city known for attachment parenting and “hippie” lifestyles. I’ve been breastfeeding my children for a combined total of 67 months, my middle daughter having nursed until she was almost three, and my youngest still going strong after 26 months. I’ve spent many late nights on Google, searching “how to stop nursing your toddler” and “support groups for women who want to stop nursing.” There’s not much out there for women like me, extended breastfeeders who wish they weren’t.

I fell into this role accidentally. My oldest daughter nursed for “only” seven months; when she started losing weight and arching her back at the breast, I knew it was time to switch to full-time formula. I felt like a failure; I had read all the books on nursing and still was unable to reach my goal of breastfeeding for a full year. Now I just look back on the freedom I had as a young mom to one, bottle full of formula in my purse, willingly passing on the feeding duties to my husband or anyone else.

By the time I had my second daughter, Gigi, I was committed to making it to that one-year mark, pitting myself against my former perceived failure. We celebrated her first birthday (and my crowning achievement), where she washed down her birthday cake with breast milk. My breasts were still full of milk as she grew older, and she had no interest in stopping, so we naturally fell into the rhythm of nursing beyond a year. By the time Gigi was two she was practically addicted, nursing throughout the day, waking up throughout the night for precious milk. I nursed her through most of my pregnancy with Elsie, even dabbling in the painful art of “dry nursing” for a few months, which means my daughter latched on to my breast, but I was no longer producing any milk. When I was six weeks away from my due date, I started getting painful contractions when Gigi was latched—afraid of going into labor early, I firmly said no, but the aftermath remains a blur.

With Elsie things became a bit more complicated. Shortly after she was born she stopped gaining weight, and at a few weeks old she was diagnosed with a heart condition. Life felt a lot more precarious for all of us. For a brief time we had to supplement with formula, while I pumped almost exclusively, doing everything to make sure she was fed and gaining. Eventually Elsie went back to drinking “from the tap,” but her weight gain issues continued. As she got older she started refusing the bottle and also refused whole or pureed foods. If I didn’t nurse her, she didn’t eat or receive any nourishment. I was trapped, forced to provide calories and sustenance through my breasts. By the time Elsie was two her weight gain and feeding issues resolved, but she was connected to my breasts as if they were her second mother, offering her love, support, and unconditional love. If I refused the breast she dissolved into unconsolable sobs, which eventually turned to two-year-old anger, complete with tiny nails clawing at my chest.

Recently, I reached out to my local La Leche League, hoping that they could do exactly the opposite of what they were trained to do: teach me to get my baby off my chest. I was advised to take it slow, cut out one feed each day, allowing for a gentle and slow weaning. I knew that I needed to somehow come up with a practical plan that would help me to put this advice into practice and decided that I’d start saying no to nursing in public. Luckily I live in an accepting community (remember: hippie town) and have never felt uncomfortable about pulling my shirt down to console or feed my child. But I still wanted some freedom, and this felt like the right way to do it. What I didn’t expect was how my times my two-year-old would scream “MAMA BOOBIES”—at the library, in the middle of a church pew, while grocery shopping, or at a friend’s house. I’ve tried to retrain her: “No, Elsie, mama milk.” But so far my efforts have been fruitless.

Breastfeeding a toddler (and even a preschooler) hasn’t been all terrible. I’ve loved those quiet moments, when my growing child looks like the tiny baby that exists only in memories. I appreciate the fact that a big bump to the head or a scrape to their knees can be instantly consoled by a breast full of milk, the ultimate comforter. I know I’ve saved a lot of money over the years. And I wonder, how dire would Elsie’s health condition become if I didn’t have the milk to sustain her? When I ask myself that question, I nearly dissolve into tears. I don’t regret the pain or trials extended breastfeeding have caused if it’s meant filling Elsie’s belly and keeping her safe.

I became a mother not knowing what it meant to nurture and raise children, with idyllic visions that came crashing down the moment breast milk soaked through my shirt. I’m forever grateful that I have the opportunity to nurse, knowing that not everyone has that chance. But I also feel an overwhelming desire to tell the truth: that extended breastfeeding isn’t for everyone, even those of us who end up on this particular road. And once you’re on the path, it’s hard to get off. If I figure out how to magically wean a determined two-year-old, I’ll let you know.

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It’s OK not to be OK

I knew I wanted to be a mom when I was five—I wanted to be pregnant, I wanted to rock babies, and I practiced it all. From immaculate conception to mystical pregnancy, I carried and birthed a Cabbage Patch Doll within the four walls of my pink bedroom. By age seven, I thought I had mastered the art of child-rearing.

What the future held for me as an actual mother defied all of my expectations. There have been incredible moments and tiresome moments and every moment in between. There were also the moments no one talks about: The moments I spent locked in the back of my closet, uncertain if I could survive another day. The moment my doctor told me that our son had multiple abnormalities on his anatomy scan. The moment I stood in my kitchen with a positive pregnancy test and an eight-month-old baby at my feet. And the moment a biopsy confirmed I had a precancerous tumor around my facial nerves, while my husband and our two boys, two and a half years and nine months old, waited for me at home. Nothing prepared me for the way life still goes on while you mother your children.

The initial 12 weeks of my first pregnancy were average: There was exhaustion, sickness, and aversions. I hid my belly under flowy shirts. It was exciting. And then I hit a wall when the 12-week anatomy scan flagged a soft marker for Down’s syndrome. There was also a rare build-up of fluid on my son’s brain, raising concerns that he may have a chromosomal microdeletion.

My world immediately fell apart, and I realized that the baby growing inside of me may not survive. So, strangely enough, I tried not to grow too attached. I didn’t know what to expect, how to hurt, how to heal, or how to even communicate my feelings. I was the first of my girlfriends to be pregnant, and none of them could wrap their minds around this kind of emotional trauma. Then there was my husband, a man of science. He analyzed every statistic and outcome. To my husband, the risk was small, and the numbers were in our favor. The chances of losing our son were slim. But to me, the mother, every second of every day was filled with worry. After all, I was the one being poked and prodded. I was the one feeling every kick and squirm. I felt alone in this.

After eight long weeks of noninvasive and invasive testing, my husband and I learned that our son was healthy after all, and the markers detected in those initial scans luckily had been false alarms. A couple months later, we welcomed his 10 little fingers and 10 little toes into the world.

But shortly after that, I noticed I wasn’t quite myself. My son couldn’t latch, so breastfeeding wasn’t going how I expected it to. Our new sleep pattern was certainly hard to adjust to. And I was very protective of my son and panicked any time someone asked to hold him. But I didn’t tell anyone any of this. I held all of my feelings in, assuming they were normal. I was the girl who had wanted to become a mother my entire life, so how could I have postpartum depression? I had a loving, supportive husband. I had parents, in-laws, and friends itching to help. I had a village. But no one, no matter the circumstances, is off-limits when it comes to depression.

I slowly adjusted to my new life, my new role, my new friends, and the new relationship dynamic I had with my husband, my in-laws, and my own parents. But just as I was finally getting a grip on things, I found myself pregnant again.

This time, my pregnancy wasn’t planned and was a complete surprise—and at the time, another baby was the last thing I wanted. I went through the pregnancy paralyzed with fear. For one, I feared losing my unborn baby. I feared every blood test, ultrasound, and doctor’s visit, worried it would bring bad news. Then there was the fear of failing my children. I was struggling with one, and now I was about to have two babies 17 months apart. I had yet to figure out the sleep thing, breastfeeding was hard as hell for me, and I was constantly crying. With double the demands, it seemed like it would be impossible to meet all of the expectations I set for myself. How was I supposed to put both down for a nap? How was I supposed to give them both enough attention? How was I supposed to navigate my sad days with two kids pitter-pattering behind my every step. I wasn’t ready.

Yet, I carried on. On the outside, I was a beaming mother anxiously awaiting the arrival of her second child. But on the inside, my intrusive thoughts came more frequently, more clearly, and in more detail. The depression was all consuming, and I wasn’t sure I would come out alive. I’m certain my doctor could see this, but every time she asked me if I needed to talk about anything, I said no. I couldn’t bear to accept that this was happening to me, And I didn’t want to be the woman who was associated with such sadness.

Nonetheless, after my second son was born, my depression grew even darker and more unmanageable. Intrusive thoughts consumed me, I resented my husband and my marriage was falling apart, and I was truly struggling to connect with both of my boys. I often found myself wishing for phases, moments, and stages of their lives to pass by quickly, without realizing I’d be kicking myself later for missing out on them. I thought I was a mother with endless character flaws. And as if that weren’t enough, I was soon diagnosed with a tumor in my parotid gland, and I officially broke. My husband took me in his arms, told me what I already knew to be true—and I finally sought help for postpartum depression.

I learned the hard way that when we become mothers, it doesn’t mean that the rest of our lives stop. There are great and wonderful things that happen in our lives, just like there are devastating and scary things, too, and we still have to show up. Showing up wasn’t easy for me when I was hurting so very much, but with the help of therapy and antidepressants, I’m finally able to.

Today, I’m that girl I was when I was five and loving being a mother (most days). But I also love embracing the other parts of my identity, and I’m finally able to balance both only because I sought help. My transition into motherhood was a far cry from what I fantasized about as a child, but in the end my complicated journey into motherhood has made me a better person. And I can’t wait, when my boys are old enough, to tell them how I got here.

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Striking a balance

After my baby was born, I knew I needed to be on guard for signs of postpartum depression. I paid attention to my thoughts and feelings, and I felt OK most of the time—never sad, just desperately tired and more anxious than ever. I brushed it off as normal.

A couple of weeks later, the virtual company where I worked as a customer service team manager, which at the time had no formal maternity leave policy, reached out to remind me that I needed to be back at the 12-week mark. Panicked at the thought, I proposed coming back part-time, feeling completely unprepared to do my job well. They said that wasn’t an option.

Nursing the baby one afternoon, I cried thinking about returning to work. I felt silly being upset, though. After all, going back had always been the plan! It hadn’t crossed my mind to be a stay-at-home mom or not go back to the job I loved. But if I wanted my position back, which I was good at and which helped us pay our bills, I’d have to start work before my son was even three months old. My job was virtual and I worked from home, so my husband’s and my plan initially was to use a combination of family help in-house and outside daycare or babysitters to watch our son. But in the thick of newborn life, handing him off to anyone else felt scary.

I imagined him crying, his hunger or wet diaper being ignored by the caregiver. I pictured myself trying to focus on work but my brain never being as sharp as before. And worst of all, I worried that he might fall asleep when he was away from me and not wake up. That thought looped in my mind.

I’d been told months before I left for maternity leave that there would be flexibility should 12 weeks not feel long enough. In reality, though, that wasn’t the case, and I started to seriously consider the possibility of not going back to work once it became clear that there were truly only two choices: go back or don’t. I was averaging a couple of hours of sleep each day, starting to see symptoms of my autoimmune disease flaring up again, and felt riddled with anxiety at the thought of leaving my baby in someone else’s care.

Without the option of working part-time, my husband and I crunched numbers, looked at our savings, figured the large portion of my income that childcare would consume, and assessed how I was feeling. Honestly, I felt lousy, both physically and mentally. So I didn’t go back. I stayed home, making a major life change I had never anticipated.

At first, I felt relief: that I didn’t have to leave my son with a stranger or work half-heartedly while constantly worrying. But without the consistency of a work schedule and routine, my days with an infant began to overwhelm me. The irony is that being with a baby all day is an incredible amount of work yet also very boring. I would nurse him and hold him while he napped, wondering if I’d made the right choice but also being truly thrilled to be with him all day. And then I’d swing in the opposite direction just as quickly, crushed by self-doubt and the prospect of never working again.

The number of contradictions that can coexist in a person is staggering. I did my best to seem fine, but I was bowled over by motherhood in those early months. I loved it, even though I kept thinking I had made a mistake giving up my job. I was grateful that I was privileged enough to stay home when so many women have no choice, yet I also felt suffocated by the decision.

Even when we started to settle into the new normal, I couldn’t get a handle on the hamster wheel of thoughts in my head. During the long, idle days, I thought about the last conversations I’d had with my boss. I replayed the conversations but embellished them in my mind: saying better things and crying far less than I had in reality—I was more assertive, bolder, less apologetic, less worried about how my choice would impact other people, and more confident in my decision. But every time my brain spun these invented exchanges, I just felt awful all over again.

I acknowledged that I didn’t have the right tools to properly process how much my life had changed in such a short period of time, so I made an appointment at a local therapy office that focused on holistic mental health care. I’d gone to a therapist years before to help me learn how to deal with anxiety when my autoimmune disease flared up. This time, though, I just wanted someone to listen to the things I was thinking about in an endless loop and tell me how to make it stop.

At the end of the first session, I asked my therapist what I should do until the next time we met. Were there exercises I could try? What does one do, exactly, to stop feeling how I was feeling?

She gave me an understanding smile and said, “You could cut yourself some slack.”

It wasn’t the answer I wanted to hear, but now I understand how right she was. It took a little over a year of seeing her regularly before I felt emotionally settled. The anxiety that had once been so loud and oppressive felt more manageable. I could see myself clearly again and didn’t feel like I was lost inside a dense postpartum fog anymore. She helped me process the range of emotions I experienced as a new mother transitioning into a whole new identity and taught me to question the validity of each anxious thought.

While there are still days I feel uneasy about not working full-time, as if I’ve derailed the professional side of my life forever, I know I really haven’t. I’ve been fortunate to stay home with my son during his early years, and I know there are so many ways a person can make a living.

As someone who likes control and predictability, leaving the routine of a job and throwing myself into motherhood allowed for incredible growth in my life. Although it was scary and difficult at first, fear, anxiety, and therapy became some of my best teachers—alongside my son.

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Breathing through the pain

My contractions feel like a clamp inside my abdomen, its torsion gripping tighter and tighter. The twist clenches, more (breathe), then more (breathe). Then it crests with an unbearable torso-wide pinch (exhale, long and slow). More than anything on earth in this moment what I want is an epidural. But in the midwife center where I’ve chosen to deliver my second child, epidurals aren’t an option.

I didn’t know that it was nearly over. All I knew was that the pain was too hard, and I didn’t want to go on. I didn’t think I could. The midwife whispered words of support: “You’re doing so well.” My birth plan asked for silence. My husband pressed a heating pad on my back. My nurse crouched nearby.

This was my second labor, so I’d been through this pain before. Both of my labors progressed identically. They were both natural, though the first, a hospital birth, by accident. Both labors also ended up taking about the same length of time—13 hours, except for the pushing. My first son took 44 minutes to emerge, and my second, only eight. Eight agonizing, burning minutes of profound discomfort, to put it mildly. I hadn’t planned on so much pain the second time around.

I hadn’t planned on it the first time either, but since it was my first time, I hadn’t known what to expect.

“Why didn’t you tell me?” I whined to my mother when she entered my room post-delivery. “Why didn’t you tell me how bad it hurts?”

“Because I didn’t want to scare you,” she said calmly.

I get that. I’ve always been hesitant to tell expectant first-time moms how much childbirth really hurts. That’s because I hope that maybe it won’t hurt. After all, 6 percent of women experience something called “orgasmic birth.” This kind of bliss was hard to imagine after my first labor, but I admit I hoped it was possible.

The first time, everything went wrong. I didn’t know the random staff. One nurse stood with folded arms watching me wail. First, she’d told me I’d have to wait for the epidural, then shortly afterward, she announced its time had passed. I gave birth midday under a skylight, with sunlight searing my eyes after my room-change request went unnoticed. The doctor was elsewhere. A nurse delivered my son, and she seemed miffed, too stern. After it was over, I didn’t see her again. I was transferred to a different staff. I felt insignificant, as if no one cared about my needs.

I wanted everything about my second birth to be different. And it was. First of all, I was with a different partner. Our relationship was strong and loving, while my first son’s father had been abusive. I imagined the stress of that relationship must have contributed to the difficult birth.

To prepare for my second birth, I read Ina Mae Gaskin’s books on natural childbirth. I found her work empowering. I decided I didn’t want another hospital. I went for visits and check-ups at the midwife center. I attended discussions with other expectant moms. The staff made sure we met all the midwives and nurses so no one would be a stranger once labor started. I was also asked to write a detailed birth plan. Each midwife and nurse would read it. They referred to it often during my labor. My needs mattered.

My birth plan was precise and exhaustive. I went over everything that still haunted me from my first labor. Not just the sunlight, but the coldness. The lack of empathy. My confusion and isolation. My feeling that no one was listening.

This time, I wanted soft light and soft voices. In the hospital, my then partner kept taking business calls in my delivery room. This round, I spelled out the peaceful, supportive environment I needed. And I wanted my son to be placed on my stomach the moment he was born. There were complications during my first labor, so I didn’t hold my son or see him for an hour after he was born.

I felt so prepared that I honestly didn’t believe I would experience much pain, and certainly not as much as I did the first time.

When my second labor started, I checked into the midwife center’s “desert room.” One of the nurses burned sage. I spent hours in a hot bath—it was like a hotel room. My older son and mother-in-law were permitted to come in and out.

As my labor progressed, I was surprised as my pain intensified. I whispered for my husband to tend to my older son. I couldn’t be conscious of anyone else’s needs. The pain grew gigantic. I couldn’t think. I settled into the rhythm of the contractions. I breathed through each one with closed eyes. My husband at my back, supporting my whole torso now. A nurse and a midwife knelt on either side. All of them quiet. That’s what I’d asked for.

I remember their hushed chatter. Their attendance to my needs. When I had to vomit, they whisked a receptacle to me and then away without my asking.

As the labor wore on, I looked out the small window of my room and watched the first snowfall of the year. I wanted something for the pain. I cried. I remember this: the quiet tumult of support around me. My husband’s love, and the women, listening, attending. Soon, it was time to push.

The moment he was out, the midwife whooshed him onto my tummy. He looked at me, eyes open, arms outstretched. I thought I would want to hold him. That was the plan—but I was wrong again.

“Take him,” I said to my husband, who swooped our baby up. I needed a few minutes to collect myself, to recover. And this time, everyone present was listening.

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When asking isn’t enough

Near the end of the third trimester, many women start to envision what it might be like to snuggle their newborn and step into motherhood for the first time. They know they’ll be exhausted and overwhelmed, but they also know that it’ll be worth it for all of the rewarding new-mom bliss around the corner. But that anticipated bliss isn’t always immediately apparent. Sometimes it takes a while to show up. Sometimes it never does.

There are many reasons why the postpartum reality isn’t quite as shiny as the ideal image of it we are sold. For one thing, postpartum mental health can be precarious: postpartum depression (PPD), postpartum PTSD, and other conditions are more common than people realize. On top of all of that, new mothers need so much more help than we are getting. We need to normalize asking for help. And when polite requests don’t shift the workload much, we need to start demanding help.

Partners, particularly fathers, are still performing abysmally when going head-to-head with mothers on parenting-related labor. In the recent New York Times piece “What Good Dads Get Away With,” the author cites studies demonstrating that while fathers did pick up some slack in the ’80s and ’90s, this leveled off in the aughts. Fathers, collectively, have yet to gain any new ground in equitable parenting since. Mothers still take on 65 percent of the childcare labor on average, and there are still plenty of households wherein that percentage is much higher.

In “You Should’ve Asked,” French cartoonist Emma makes the case that men shouldn’t be waiting around to be asked to help by their partners. They should know how to take initiative. But let’s face it: when we don’t ask, we do more. And when we do ask, there’s still no guarantee the thing will get done. So what can we do?

I suggest that instead of asking, we start demanding. We need to make our boundaries unmovable. We need partners in particular to step up and do as much work as we are doing. We need partners to understand that this work is not just the physical stuff that they see—the physical stuff is just the tip of the iceberg to the mental and emotional stuff. We need them to get on the same page and to have them truly copiloting parenting with us. We need partners who are also thinking ahead to the next well baby appointment and scheduling it on their own. We need partners who notice when diapers are running low and who think to grab some at the store.

Our demands need to be direct and omnipresent shapeshifters, and we’re going to have to work just as doggedly on getting men to hear as on getting women to speak up. But we also need to talk about toxic masculinity—and often—with our partners, friends, and children. We need to implore men who get it to speak up to other men. And, as women, we might have to step back and see what happens when the men who truly want to be more accountable make attempts to change.

The days that turned into the months that followed my daughter’s birth via emergency C-section were tinted an unfamiliar and unlikable color. I experienced plenty of blissful moments with my daughter back then. I’ll say I even experienced pretty regular bursts of love and gratitude and awe, but everything about my reality there for a while was slightly distorted, and not in a euphoric way. I adjusted to the presence of something dark.

I had postpartum PTSD. And I was sleep-deprived to the point of hallucinating sometimes. I didn’t have the ability to take any maternity leave whatsoever, and the stressors of needing to earn money while my C-section stitches were still fresh were real. But perhaps more than anything else: I just wasn’t getting the help I’d expected. The help I needed.

I still managed to be a pretty good mom, I think. But I felt like I’d been transplanted into a new universe, and what was worse, I felt like I was the only one who could see that everything had changed.

But I always felt like I was asking for too much. My partner wanted to help but had just started a new job that had early morning meetings, and therefore, he wouldn’t do the middle-of-the-night wake-ups. When he was done working and I badly wanted to do some work myself, he often stressed out about how he needed to walk the dogs or do some kind of house work or go biking instead.

Loved ones came to visit during the months that followed my daughter’s birth and I, maybe kind of foolishly, hoped those visits would be a boon for me. I daydreamed about relatives and/or close friends truly helping me pick up the slack for a minute. Maybe they would cook the meals or insist I take a bath or something. But when the visits came and went, it became clearer to me with each one that the trip to see me and the new baby was largely framed as a vacation in their minds. I definitely got some help here and there, but it was nothing like what I’d envisioned. I dreamed every member of my village would swoop in to lessen my load and show me the motherhood ropes, but it just didn’t happen that way.

But some of my village did come through and new members to it surprised me along the way. A mom friend I made just before I gave birth helped to keep me sane, focused, and validated. Her baby was just a few months older than mine, and she was also struggling with getting the kind of help she needed. While we didn’t go clean the other’s house or even exchange babysitting favors, her reassurance that my overwhelming experience was normal kept me afloat. Her advice at each milestone was welcome and readily available. She always brought a little extra food or wine over and it helped me to feel seen.

If I could do it all again, I’d demand. I’d demand help, plain and simple. I wouldn’t back down so easily. I wouldn’t take on so much. My partner and I would outline which aspects of parenting we each were best suited to captain. I would dive into learning about domestic inequalities and how they relate to feminism, and I would speak up more loudly and frequently to anyone who would listen. I would insist on getting the help I needed, not just for my own sake, but for the sake of every mother. And if I ever wanted to give in and give up, I’d think of my daughter and what I would like for her mothering experience to be like one day, should she choose that path. And I’d get back to demanding.

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Everything about my birth plan went wrong

After feeling debilitating, nearly indescribable pain one Saturday, I found out, at 10 weeks pregnant, that I had a massive ovarian tumor and was experiencing an ovarian torsion, which was brutal. Thankfully, my ovary stopped twisting on its own that night (after nine hours of agonizing pain), which meant I could avoid immediate surgery. But surgery would have to happen at some point. The entire color of my pregnancy changed hue after that night.

I was no longer able to freely move around the way I’d been able to before. I was also no longer able to imagine much of a specific birth plan. I also didn’t know if the tumor was malignant or not, which threw a significant amount of fear into the mix of my pregnancy. Before all this, I had hoped I would sail through an unmedicated, vaginal delivery the same way my own mom had for me, but no one could give me a definitive answer on whether I should even attempt a vaginal delivery at all. Tumors as large as mine was just aren’t seen in pregnancy regularly enough for anyone to feel certain, but an OB/GYN and a gynecologic oncologist both said it would probably be safe to try.

My birth plan, as much as I could make one, was mostly filled with ideas, suggestions, and things I could control. Dimmed lighting—check. My own music—check. Essential oils—check. When it came down to the things some people tend to get more dogmatic about, I refused to allow myself to step into rigidity. Even before my pregnancy became high-risk, my birth plan was always an idea, not a plan. I understood that the birth itself would be a wild card. Now, 10 weeks in, I knew I was dealing with something exceptional and I also knew that we don’t ever truly grasp what we need or want until we are actually in a situation. I wrote down my opinions on medication types and the kinds I would be most comfortable with if medication were needed. I also wrote down what I wanted to happen for me and the baby after the birth. But there was one thing and one thing only that I was strict about: If I had to have an emergency C-section, I wanted the tumor taken out at the same time.

This was something I’d discussed with every OB/GYN who worked at the hospital where I gave birth. We all agreed that this would make the most sense. After all, the tumor needed to come out ASAP, and leaving it in after my baby’s birth would create a huge risk of torsion again due to the sudden space in my abdomen. If I delivered vaginally, I would have to be on bed rest for a month to reduce the risk of torsion and then proceed to surgery. If I delivered via C-section, however, we could remove the mass then and there and have the results of the biopsy within a week.

When I finally went into labor (10 days after my daughter’s due date), I braced myself. I hadn’t scheduled a C-section, and it was clear to me that no one really knew what to expect out of a vaginal birth attempt. My doula met me at the hospital around 2:30 in the morning and, together, we focused on mastering the elements we could control. We did dim the lights, play the music I’d selected, and utilize essential oils. She massaged me and used her soothing voice to encourage me throughout. She dutifully took notes of the process as it unfolded, and I can’t understate the relaxing energy she brought to the experience. However, the physical reality of my birth was something we could not control.

Despite knowing all that I did about my situation, I didn’t expect for the tumor to interfere with delivery as much as it did. My baby’s posterior position was perhaps related to the soccer-ball-sized mass getting in her way. She struggled to move through my birth canal. When she finally was getting close to crowning, she got stuck. We could have tried forceps or a vacuum, but without knowing for sure whether the tumor was playing a role in the stuck-ness, and to what degree if so, those interventions would be more dangerous than usual. As she began showing signs of serious distress, it was time to make the call for an emergency C-section.

We had to wait 45 minutes for everyone on call to arrive to the tiny rural hospital where I delivered. During that time, the epidural I’d received at the end of my laboring was removed and I was left to feel every bit of a sustained ring of fire while writhing around on the operating table. My daughter wound up being so physically lodged that the surgeon had to manually push her back into my abdomen so that she could be delivered through my incision. The mass was in the way of everything so much that it had to be pulled out and repositioned to the side before she could come out.

Many of the things I’d requested in my birth plan for the immediate after-birth chapter weren’t possible. We couldn’t give her ample skin-to-skin time with me because she was born in distress and had to be hooked up to oxygen and heart-rate monitors urgently. I wanted her to have a delayed bath, but that doesn’t top the list of priorities when dealing with a newborn who may or may not make it. She was rushed to a NICU two hours away, and I didn’t get to hold her until two days after she was born.

Everything about my birth unfolded in less-than-ideal ways. In the end, I clung hard to my gratitude that we both made it out alive, but I eventually had to deal with the trauma of the birth itself. Reflecting back on it now, nearly five years later, I think my birth plan was perfectly appropriate for my situation. It pragmatically addressed the wild card situation I’d been handed while offering me some autonomy over the little things. Because I was accepting from the start of the fact that I couldn’t be fully in control, I didn’t have to contend with shocking disappointment over expectations that weren’t met.

Birth plans aren’t meant to be unwavering instructions. They are meant to be a set of hopes and goals; they are meant to be a loose guide. And they should be reflective of each individual mama and her situation. We can and should aspire for the most peaceful and comfortable birth experiences possible. When we don’t get what we’d hoped for, when we feel traumatized by what we did get, we can and should process that and push for self-advocacy. But the cliché that the only thing that matters is an alive baby doesn’t offend me. In the end, that slice of gratitude for an alive baby—something so many mamas do not get to have—is what gave me strength.

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Stop asking new moms when you can visit the baby

In the days after I gave birth, I sat on the couch, wincing in pain as my baby’s latch lacerated my nipples. The phone didn’t stop ringing, and I hoped someone would call to ask me how I was holding up, since my daughter’s birth hadn’t exactly gone to plan. But no, instead everyone was desperate to know one thing: “When can we come see the baby?” “When can we come over and give the little cherub a cuddle?”

After a grueling 44-hour labor, I had hemorrhaged half of my overall blood volume. It would be several years before my official diagnosis of PTSD would make itself known, yet even in the immediate aftermath of my daughter’s birth, it was already clear that the postpartum period was not a kindly beast.

The extent and speed of my hemorrhage had left the obstetrician with no other option than to carry out bimanual uterine compressions. The procedure saved my life but left me with physical issues I’m still dealing with today, nearly eight years later.

So when I came home with my daughter, I was far from recovered. Aside from the physical pain pulsing through me, there was also the overall body weakness to contend with. I couldn’t walk up the stairs without stopping halfway to avoid passing out, as my resting heart rate was twice what it should have been, and I was constantly breathless and exhausted.

As I adjusted my daughter’s latch for the hundredth time, I remember glancing past the array of pastel pink teddy bear cards displayed on the windowsill and settling my gaze on several bunches of flowers that had been left by the door, still wrapped and starting to wilt from neglect.

Physically, I felt solidarity with the dehydrated and lifeless flowers; emotionally, I found myself in a state of sheer terror and shock. My disbelief and grief at what had happened and what could have happened were followed by immense guilt, because I had a healthy baby, after all; I was one of the lucky ones.

And so I buried my sadness deep down, since I had a nagging suspicion that lucky mothers with healthy babies were not supposed to wallow. Instead of focusing on healing and recovery, I followed the new-mom script to the letter. In my first three days postpartum, I’d already hosted 11 visitors and was meticulously scheduling in five more as soon as was logistically possible.

I smiled as faces smiled at my daughter. I clasped my hands as their hands held her perfect body against their own. I chatted, over and over, about her beautiful eyes and her rolls of baby fat. I said thank you for the teddy bears, for the balloons, for the flowers, and for the cards.

And yet I needed none of these things, and neither did my daughter.

What I needed was safety, security, and sleep. I needed the safety of a space in which to voice the grief I felt about the way my birthing experience had panned out. I needed the security of only my most intimate humans tending to my wounds and nourishing my body with their tender care and understanding. I needed to rest and, wherever possible, to sleep. Plus, I needed to learn how to breastfeed without trying to hide my nipples for fear of offending one of the relatives.

And really, my baby just needed my body. The only home she’d ever known, she needed my skin, my breasts, my scent, and my voice. We needed to get to know each other on the outside, where the sounds were louder and the sensations sharper. We needed to find our groove together, slowly and quietly.

The invisibility of new motherhood is something that many of us can relate to, and nowhere does it make itself more apparent than those first few days and weeks postpartum. Childbirth is intense and exhausting, and in the days of fresh motherhood, we find ourselves at our most vulnerable. It is only now, with the security blanket of hindsight wrapped tightly around my shoulders, that I can peek out and say: I needed more. As a whole, moms need more during the postpartum period: we need, at the very least, to feel seen.

Of course, my daughter and I are privileged that she received such a warm welcome to the world. We are lucky that so many people wanted to celebrate her very existence. Yet these celebrations felt misplaced and insensitive somehow … they seemed to be too much, too soon.

In hindsight, I wonder how different my postpartum experience could have been if our well-wishers might have asked us if we needed a little time for bonding, a meal, or maybe even a listening ear, as opposed to the question that rang out from the telephone every time it called us to attention: “When can we come see the baby?”

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Mothering my adopted son

I thought that as soon as we signed the paperwork, I would feel like my adopted son was mine.

My husband and I had been fostering him for almost a year. But that whole time we had been in limbo, told repeatedly that the goal was reunification with his parents. So I operated like adoption wasn’t an option. I spent most of that year of his life reminding myself not to get too attached because he wasn’t my son.

But we couldn’t resist wondering if he would eventually become a permanent fixture in our home as well as our hearts. And by the time the state began terminating the parents’ rights, I couldn’t imagine life without him.

It was harder than I expected to unwind that year of uncertainty and turbulence. I kept waiting to feel the change, that shift from “not our baby” to “could be our baby,” then to “yes, our baby.”

I thought that if the courts and government legally recognized him as mine, surely my heart would too.

It didn’t happen. On the day we officially adopted him, I of course felt joy and love. We celebrated with family. But when I tucked him into bed that night, I still felt the itch of “not mine.”

At the time, I was in an adoption social media group and couldn’t find a post that discussed what I was feeling. Most families talked about being grateful and lucky. I was those things too, but I still couldn’t reconcile that feeling that my connection to him was different from my connection to my daughter. I hadn’t spend hours rocking him to sleep or breastfeeding. And that whole first year, I felt I was fighting that mom feeling.

I was relieved the first time my husband uttered my feelings out loud and I had someone I could talk to openly. We agreed that we loved him and we had no regrets about adopting him; but, we also couldn’t dismiss the differences we felt between our two children.

Our adoption story is a strange, but not uncommon, one. My son is my biological nephew and we agreed to foster him because his biological parents were not allowed to take him home from the hospital–we were the only family in the county, so it was either us or strangers. When reunification was taken off the table, we were given the option of adopting him and welcoming him into our family permanently.

Knowing I loved him and knowing he was my son did not magically forge a bond though. With my daughter, it had felt instant. We were bonded by pregnancy and birth, of course: I spent nine months preparing for her, setting up her nursery, picking out adorable outfits, and talking to my belly. With my son, we had less than a week’s notice between being asked if we could foster him and picking him up from the hospital. From the moment my daughter was born, it was just the two of us for over a year, and there was no question about whether or not she would be a permanent member of our family. We went to mommy-and-me yoga. We went on hikes, walks, and meet-ups with a local group of moms and their children.

Although I didn’t recognize it at the time, we were constantly deepening our bond, whether intentionally or not.

On the other hand, I mothered my son for two years without feeling quite like his mother: I cared for him, kissed his owies, celebrated his milestones, and scooped him up when he was crying. I did all the outwardly mom things; if someone saw my two children and me at the park, they wouldn’t be able to tell that I inwardly struggled with my feelings. I was constantly keeping a mental score of whether I treated my two children fairly. If I pushed one on the swings, I would push the other. If I chased one, I would chase the other. If I gave one kisses, I would make a mental note of it until I had the opportunity to give the other kisses, too.

But I knew he deserved better than a mom who had to keep a mental tally of fairness to alleviate guilt, and I got tired of waiting for the bond to strengthen on its own somehow. Instead, I began to create intentional, purposeful moments to forge that bond. Eventually, it shifted from moments I had to orchestrate to moments that–slowly, finally–came naturally.

I started small. I created a bedtime routine that was just the two of us. It was challenging because my daughter and son are close in age, but by pushing her bedtime back just a little bit, I was able to devote 15 minutes of myself completely to my son. We brushed our teeth together, picked out books to read together, and sang “Twinkle, Twinkle Little Star” each night. I made sure all 12 of his favorite stuffed animals were placed in bed with him, and tucked him in. We ended each day with a positive, peaceful interaction.

Then, I signed us up for mom-and-me-style classes in yoga and gymnastics. By setting aside the time and space to build memories with my son, too, I was able to close that emotional gap between us. I was able to watch him grow and take risks in a place where my only job was to be his mom.

Soon, I started to invite him into the places that already had positive associations in my brain. I took him with me to do the things I loved: hiking, running, strolling Target, and coffee and cookie dates. It wasn’t simply about creating new adventures but embedding him into my daily activities, especially the ones I enjoyed the most. I had, of course, included him in these activities earlier, but my daughter had always been there too. I realized I still did these things one-on-one with my daughter but couldn’t name many instances where it was just my son and me.

These small conscious changes became the catalyst for building the connection I wanted to have with my son. As time went on, it wasn’t something I had to intentionally incorporate–it was just what our relationship looked like. My son has always been sensitive and loving, but the opportunities for bonding seemed to have reciprocal effects. He began interacting with me more, asking me to play more games with him, and sitting in my lap when we read. He became easier to calm down when things did not go his way, and overall tantrums seemed to lessen. It took nearly six months for me to feel the difference, but it was a big difference.

There are many adoption stories out there, but I struggled to find voices echoing what I was feeling. I felt guilty for feeling a difference in the bonds I felt with each of my children. Acknowledging this truth gave me the capacity to change it. Now, a year after I began consciously creating a deep bond with my son, I do not question the differences between my relationship with him and with my daughter. Our relationships will always be different because they are different, but not because I love them differently. A year later, I don’t keep score of kisses and gifts. A year later, my son is unequivocally mine.

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Rh sensitization and what it taught me

I learned about Rh incompatibility when I was pregnant with my first son: I have A negative blood, which means I lack the Rh protein in my blood cells, while my husband is B positive, which means he has the protein.

The incompatibility exists because, in essence, the immune systems of Rh-negative individuals, like me, view the Rh protein as a threat. When Rh-positive blood gets mixed with Rh-negative—like during childbirth ifan Rh-positive baby is born to an Rh-negative mom—the mother’s immune system goes on alert to eliminate the threat. In the process, it forms antibodies against Rh-positive blood to protect against future “assaults.”

Our first son was born in a smooth, beautiful home birth. And while the Rh incompatibility wasn’t an issue then, I knew it had the potential to turn into Rh sensitization, which could be disastrous if we were going to have any more kids. During my pregnancy, my midwife had advised receiving a shot of RhoGAM, the medicine that prevents sensitization, after giving birth to prevent that particular complication in the future, as blood mixing can happen even in the gentlest of births. A few days after my son was born, I went to receive my dose, and I thought that was that.

RhoGAM is supposed to provide purified antibodies that eliminate the Rh-positive blood cells before your own body can mount an immune response. Prior to its invention, women in an Rh-incompatible situation would have one baby, maybe two, before the next was born anemic and sick. Once a woman’s body has anti-Rh antibodies, they never go away. Antibodies will cross the placenta and go after the blood of unborn babies. And the immune response gets stronger with each subsequent pregnancy.

I hadn’t realized that my body had already built up defenses against my babies, despite the RhoGAM. My husband and I decided to try for another child when our first was about two years old. I miscarried a few months in, and it was then that I learned that the medicine hadn’t been effective for me. My Rh sensitization was a casual diagnosis, thrown out between pacifying comments about how I could get pregnant again right away and (incorrect) advice to get RhoGAM again to keep my sensitization from worsening. Sensitization hadn’t caused my miscarriage, but it would play a huge role in my reproductive future.

My last pregnancy was a struggle, as I sought to understand Rh-sensitization, dealt with the medical procedures it entails, and worried about the effect this seemingly harmless protein would have on my baby.

Rh disease can cause anemia and jaundice. It can cause birth defects. It can cause stillbirth.

Nowadays, thanks to awareness and the aggressive use of RhoGAM, Rh sensitization is rare. It’s given during pregnancy and after birth; after abortions and miscarriages; and after amniocentesis and any prenatal procedure that has even the slightest chance of causing blood mixing.

In recent years, there’s been some pushback against RhoGAM within the natural birth community. There are many myths about sensitization. Some people swear that delayed cord clamping will prevent it. Others worry that there are dangerous ingredients in the shot. Still others maintain that sensitization is exceedingly unusual, and the medication simply isn’t necessary in most cases. All of this is false. The use of RhoGAM has enabled countless women with Rh-negative blood to go on to have healthy second and subsequent babies.

In my case, the RhoGAM hadn’t worked, though I’m not sure why. Rh sensitization was my new normal. So when I got pregnant again, I had to deal with the aftereffects.

The beginning of my pregnancy was straightforward. My perinatologist was impressed with my knowledge of my condition yet always made time after appointments to answer my questions. Early monitoring of Rh sensitization is primarily via bloodwork: titer tests to determine how many anti-Rh antibodies I had. If antibody levels were low, the baby was safe. Once antibody levels started to rise, it indicated a problem.

Next came regular ultrasounds, checking for four “soft” markers for fetal anemia—one of the major risks of Rh sensitization. First was the rate of blood flow in the medial cerebral artery (MCA) in my baby’s brain; faster blood could be anemic blood. Second was the presence of extra fluid around certain organs (lungs, stomach, or heart) or just under the skin. Third was swelling of either the liver or spleen. Fourth was excess amniotic fluid.

The presence of any two of these would mean closer monitoring and more testing. But most important was the MCA. When, at around 28 weeks, my baby’s blood flow in the MCA shot up, I was immediately scheduled for cordocentesis, in which a sample of the baby’s blood is taken from the umbilical cord to check complete blood count (CBC). My baby wasn’t actually anemic at the time of this first procedure, but knowing the CBC helped us develop a timeline for the coming weeks.

Two weeks later, I arrived at the hospital for a second cordocentesis, knowing it would likely be followed by an intrauterine blood transfusion. I checked in early, fully aware of all risks; the procedures could possibly trigger premature labor or otherwise necessitate immediate surgical delivery. I was given an IV and a hospital gown and left to wait.

Early afternoon. The operating room was cold; socks weren’t allowed. My stomach was numbed with a local anesthetic before ultrasound was used to guide a large needle through my abdomen and into my child’s umbilical cord. First, a blood sample was taken and CBC determined; then, blood was transfused.

After each procedure, I remained in recovery for hours, fetal monitors keeping an eye on the baby’s health and ensuring I wasn’t beginning labor. On one occasion, the wiggly baby required anesthesia before a transfusion; that time, I was monitored until I felt fetal movement again.

All in all, my baby received three transfusions and two separate bouts of cordocentesis during my third trimester.

I knew all along that I was looking at medical induction, possibly as early as 34 weeks, although our plan was 37 weeks. At my 36-week appointment, however, things changed. MCA blood flow was high again, and my baby was too big for another transfusion to be safe.

I opted for a membrane sweep and scheduled an induction for the following weekend. Thankfully, the sweep nudged things along, and my little one was born the following evening. The birth was so different from my peaceful home birth but perfect in its own way.

I wish I could say that birth was the end of my second son’s troubles, but my antibodies remained in his blood. He endured 11 days in the NICU under constant phototherapy for Rh-related jaundice, nearly requiring more transfusions. Even after he came home, he still had to be monitored for a month for his fading Rh disease.

Overall, we were lucky. My son is healthy and sustained no lasting damage.

I, on the other hand, am still mildly traumatized and have since sought sterilization because I simply cannot do it again. I had my blood drawn 25 times over the course of pregnancy and received 18 ultrasounds. I spent 25 hours under fetal monitoring when I wasn’t actually in labor. If I didn’t have solid health insurance, I’d be mired deep in debt.

I have long felt that being informed is the biggest key to a satisfying birth experience. I am very thankful that I took the time to learn about my condition before becoming pregnant again. Books, websites, and an interview with a specialist all helped me understand the risks I was facing; I can’t imagine how scary such a pregnancy would have been if I hadn’t been expecting any of the monitoring or procedures!

Because I was informed, my doctors were better able to involve me in making decisions for my care. I walked into every procedure with a plan, and I was able to write a flexible birth plan that covered all possible outcomes. This gave me peace of mind, which meant my hospital birth was every bit as beautiful and empowering as my home birth.

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Discovering my pelvic organ prolapse

I worked up the courage to take a peek a few weeks after giving birth to my second child, a 10-pound, 7-ounce, boy with a large Irish head who so kindly caused my second perineal tear in less than two years. I was sore and stitched up, so taking out the handheld mirror in the midst of postpartum healing was a bit foolish. Still, I felt like something was wrong down there and wanted to know what was going on. I took a look, saw a protruding bulge, and immediately freaked out.

I started to sob and imagine a lifetime of pain and embarrassment. I told my husband I was “ruined”! Then, I Googled. Google told me I had pelvic organ prolapse, which confirmed my suspicions that I was a broken, deformed woman. My life as I knew it was over, or so I thought.

That was almost eight years ago, and luckily none of my dire predictions have come true. I’m no longer an emotional wreck when talking about my prolapse, likely because I’m no longer in the fog of new motherhood, which included taking care of a newborn and toddler while also healing from a traumatic birth experience.

However, that discovery was scary not just because of fatigue and new-mom hormones. My terror was also a result of simple ignorance. I had taken months of birthing classes, read all the “what to expect” books, and had given birth twice, yet I was shockingly clueless about childbirth injuries.

I’m the type of person who likes information, but my panicked post-birth Googling was the first time I heard the term “pelvic organ prolapse.” It hadn’t come up in my months of research during my first pregnancy, wasn’t mentioned after my first difficult birth, and never appeared on my radar even as I peed myself while vomiting throughout my second pregnancy. I didn’t know permanent pelvic floor injury was a possibility; most of my pre-birth anxiety was about having a c-section. I was supposed to be relieved I had given birth vaginally, even if my two large children born 19 months apart had ripped me up while getting stuck on the way out.

So when I took out that mirror, still swollen and too sore to walk properly, I had no idea what to expect, but I knew seeing a bulge was not normal. What I didn’t know was what to do about it.

At my six-week checkup, I swallowed my embarrassment and asked my midwife what was wrong with my vagina, but she seemed unconcerned, probably because she had examined me while I lay supine, a position in which gravity was my friend. I should have been relieved by her nonchalance, but I suspected she was wrong, so I kept taking out that mirror, noticing the bulge that wouldn’t budge, feeling a heaviness that wasn’t there before.

I eventually made an appointment with a gynecologist who finally confirmed I did indeed have prolapse of the uterus and bladder, a result of permanent damage to support structures during my difficult pregnancies and deliveries, as well as unlucky genetics. At 31 I was told by multiple doctors I’d need surgery someday—a when, not an if, statement.

Over the years I’ve made a tenuous peace with my prolapse, mostly because I’ve advocated for myself. I asked for pelvic floor physical therapy, which didn’t fix me, but did inform and empower me. I asked for pessaries to use during exercise, even after one old-school doctor told me they were only for older women. I found a different doctor who agreed to fit me, telling me she wished more younger women were proactive and comfortable with their bodies. I read credible resources about prolapse. I even went on to have another child, but worked with an OB-GYN who recommended a c-section so my baby wouldn’t get stuck and cause further injury to both of us.

I’ve yet to have surgery. Most days I feel surprisingly good. Sometimes I even forget about my prolapse—that is until my children ask me to jump on a trampoline. I am not “ruined,” but neither am I fixed. Although I can lift weights, do circuits, go for long walks, and even do some jumping jacks, I’ve also accepted that some sports are no longer feasible. Accepting limitations isn’t failure; it’s prudent.

Over the years, as age has caused the shape and strength of my body to fluctuate, my mind-set has steadily improved. I’m not glad I have pelvic organ prolapse, but I am glad I’ve learned to accept my body, limitations and all. I’m like so many other moms with invisible injuries who get up every day and make it work. I’ve decided being a little broken doesn’t make me ruined; it makes me tough.

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