Contrary to popular belief, the perinatal period is not always filled with joy and happiness. For many, it is a cause for celebration and a very exciting time. However, what is less talked about is how, at times, it can also feel very isolating. It is important to understand that one can experience conflicting feelings at the very same time. When you think about it, it might be hard to fully comprehend that one can feel joy and gratitude to be pregnant and postpartum, but also be feeling deep sadness and alone. Let’s discuss.

PREGNANCY

Pregnancy can bring on a mix of emotions. Even if we are planning to start a family, wishing and hoping to become pregnant, once we find out that we are, it might come as a surprise and create anxiety. Becoming pregnant does not always equate to happiness and every day is not always easy. When I am working with clients, one of the hardest things for them to comprehend is how they can possibly have wanted nothing more than to be pregnant, but find themselves unhappy at times or anxious. This then turns into feelings of guilt and blame that they are potentially ungrateful for their miracle. I always remind my clients, in a pregnancy that is progressing normally, you can have difficult days. It makes sense then that, when we add potential health-related complications or fear of complications, physical ailments, pre-existing or new mental health issues, lack of support, and/or unresolved grief, the prenatal experience can be very difficult. When one is faced with these challenges, they may feel as though no one else can truly relate to these experiences or would understand. This then creates feelings of isolation. It can be difficult to articulate these feelings, and therefore, many of us do not. Sometimes we can be surrounded by others and still feel lonely. This experience may be hard to share due to fear of perception or judgment. One might be concerned that others will think they are unhappy or ungrateful about their pregnancy. This is heightened if that person has also gone through fertility struggles and/or loss. These feelings can become extremely complex. Many feel they should not be anything but grateful for the miracle they created. Which can bring on a new wave of guilt and further isolation. Some might think, “how could anyone understand my thoughts and feelings when this is all I have ever wanted?” It is so important to remember, although we are all in our own context and life circumstances, one thing is for sure, you are not alone in these thoughts and feelings.

POSTPARTUM

The postpartum period is a time where we see a heightened risk for feelings of isolation. There is so much occurring in the postpartum period, especially during the first few weeks and months, that impact our emotional and physical health. We are adjusting to becoming parents or transitioning into adding more children into the family. We are navigating our use of diapers, sitz baths, leaky, engorged breasts, c-section healing, and many other physical constraints. All the while, we are also navigating fluctuating hormones and the inability to fully process due to a lack of sleep. The emotional and physical toll is vast. This is a period of vulnerability, and we must be treating this time as such.

Physical Constraints

Physical constraints may create feelings of isolation. From a practical standpoint, perhaps we feel isolated if our physical health is limiting our access to our support system or we have experienced a birthing scenario that has complicated the physical healing process. We really were able to see the impact of physical distancing on mental health throughout the pandemic. In the perinatal context, many were only allowed certain people in their labour/delivery room (if any) and there were often limited amounts of people who met baby afterwards (if any). Both of these scenarios of physical distancing/physical isolation also impacted emotional well-being, which perpetuated feelings of isolation.

Emotional Toll

Let’s just put this out there now:
Anxiety can lead to feelings of isolation—
Depression can lead to feelings of isolation—
PTSD can lead to feelings of isolation—
OCD can lead to feelings of isolation—
Birth Trauma can lead to feelings of isolation—
Grief can lead to feelings of isolation—

Perinatal mood disorders will impact ones ability to process their thoughts and feelings. Therefore, it is much easier for our experiences to feel isolating. Many women experience perinatal mood disorders, and are unable to recognize it or worry about reaching out for help due to fear of judgment. Simply having a perinatal mood disorder can be met with shame and guilt, which further facilitates feelings of isolation.

It is important to note, emotional fluctuations and experiences do not necessarily equate to having a perinatal mood disorder. We can experience symptoms without meeting a diagnosis. Therefore, simply having fluctuations in our moods and emotions, can lead to feelings of isolation.

PANDEMIC IMPACT

We cannot discuss the perinatal period in 2022, without addressing the pandemic. Many of the women who gave birth in March 2020 were met with very different births than anyone prior to that time. It will forever be a part of their perinatal experience. As we shift away from the mandates/restrictions, we will see different experiences of the perinatal journey. But it has to be mentioned until that occurs (at the time I am writing this we are still very much “in it” in Ontario).

Many women who became pregnant and had babies during March 2020 and beyond, did so in a very different world than they had once expected it to be. Some women have not been able to see their friends or families throughout their entire pregnancy, their babies have not been held by anyone but their immediate family, and the only exposure to the outside world has been doctors appointments for check-ups. Even thinking about these circumstances can feel overwhelming, underwhelming and lonely. In addition to that, many are identifying feelings of grief at the loss of what they expected their experience might look like. They’re mourning the loss of a baby shower, professional maternity or newborn photos, sharing their experience with best friends going through a similar journey, having partners at doctors appointments/ultrasounds, and a maternity leave that essentially kept them isolated at home. Many are grieving the loss of expectations around what motherhood would look like, and, following that, the guilt of not enjoying the present moment or simply being “grateful for a healthy baby”.

The pandemic imposed physical isolation on us, and this was very difficult to manage because it was beyond our control. Lack of control the pandemic created perpetuates anxiety, depression, grief, feelings of helplessness and isolation. What made matters worse, was that the physical isolation and mandates prevented many from accessing their coping strategies. It prevented women from seeing friends, going to yoga, having a mommy/baby class, or meeting other mothers who were going through similar timelines with their pregnancy/postpartum journey. All of these situations were once possible during the perinatal period, and were taken away. Yes, we can all acknowledge privilege in this moment, but it does not take away from each individual context and their own experience of these circumstances. This will forever be a cohort of women that have experienced perinatal life in a pandemic. There will be various repercussions from this, both positive and negative, and we won’t know the effects until much later when we are able to see the research and various outcomes from this time in the world. One thing is for sure, feelings of isolation will be and have been different during this time. They were heightened and, possibly, debilitating.

FINAL THOUGHTS

What is the point of this post? Sometimes it simply takes someone saying, “I understand isolation”, “I understand loneliness”, “I may not have the same situation as you, but I understand the feeling.” The emptiness. The sadness. The fear. The guilt. The grief. All of which can be associated with isolation that can come in the perinatal period. Sometimes we just need to feel validated in these feelings, to feel better. I encourage you to reach out to someone, whether it be your support people, village, community, or professional, if you are feeling isolated. It would be beneficial to talk about it. Talking about these feelings, is helpful and with help, you will feel better. With support, you will feel better. You are not alone.

Take Care,

Lisha Cash
MSW, RSW, Psychotherapist
Nest & Nurture Psychotherapy