Let’s lose the myth of the ‘bad ‘mother’
Many are reluctant to seek professional advice for fear of being labelled ‘bad mothers’
Mother’s Day comes and has just gone, but the unbreakable cord of maternal love – “among the most powerful engines of life on earth”, as Allison Pearson memorably expressed it in her column in this newspaper last week – endures for a lifetime.
That tenacious bond originates in that sensuous, instinctive reciprocity between mother and infant verging on the miraculous. The baby loves her mother’s smell and the mother her baby’s; the mother gains physical satisfaction from breastfeeding and the baby flourishes on its mother’s milk; the baby expresses its needs by crying and the mother is gratified by relieving its distress.
It does not work for everyone, with one in 10 mothers being troubled to a degree with the postpartum blues.
Yet again we learnt last week from a survey of a thousand mothers that many are reluctant to seek professional advice for fear of being labelled “bad mothers” and leading to the intrusive involvement of social services with the prospect of their child being taken into care.
These fears may be exaggerated but understandable given the prevailing view that the postpartum blues are primarily “psychosocial” due, for example, to the stresses of marital conflict in those with a depressive personality. These factors may be relevant for some but certainly not all.
Twenty years ago obstetrician Professor John Studd demonstrated that the hormonal changes following childbirth are likely to be significant, as oestrogen treatment resulted in a “rapid improvement”.
Heat and sleep
The plight of the woman whose sensation of feeling uncomfortably hot at night is exacerbated by close proximity to her husband – such that he must vacate the marital bed for a single room
– has prompted a voluminous correspondence.
This problem, clearly not unusual, falls into two distinct categories. The first, the minority, is where there may be some underlying medical condition – such as a persistent “hangover” effect from the menopause, or an overactive thyroid – that warrant appropriate treatment.
These possibilities should be considered, but do not apply to the majority whose associated symptoms of unrefreshing sleep, panic attacks on waking and dry, rough skin point, rather, to some generalised, sleep-induced disturbance of brain function affecting the perception of body heat and thermoregulation, the control of blood flow through the skin that regulates heat exchange.
This is not a recognised syndrome and so can only be speculation, though a couple of readers astutely suggest it may be a variant of obstructive sleep apnoea. So perhaps referral to a sleep clinic may be in order.
Beyond that, the empirical solution, commended by several, is that switching from a double to two single duvets (or sheets and cellular blankets) allows each partner to separately regulate the temperature under the bed clothes to their satisfaction.
Added complication
Finally, the comments last week on the advantages for the many with atrial fibrillation of the new oral anticoagulants (NOACS) – as effective, safer and less hassle than the long-established warfarin – requires a qualification.
To be sure, they are safer – that is, less likely to cause the complications of internal bleeding or brain haemorrhage. But when such serious misfortunes do occur, they are more difficult to control as, unlike warfarin, their blood-thinning effects cannot be readily reversed by the injection of vitamin K.
The prevailing view, according to a review that was published in the British Medical Journal last year, holds that “in many instances, the bleeding can be managed by the infusion of blood products” – or, for those taking Dabigatran, a specific (if very costly) antidote.
Still, there is understandably reassurance in the ready reversibility of warfarin’s effects and circumstances where it remains the better option.