This month we’re talking post-birth recovery, postpartum depression, and breastfeeding struggles.

We’re led to believe that after a baby arrives, we’ll all know exactly what to do, and we’ll “bounce back” in a few short weeks. I’m here to tell you, that is bull.

Babies are overwhelming, recovering from birth is hard, and today, information overload is very very real. That’s why I became a doula after having my daughter.

Doulas are today’s modern answer to the old-fashioned village. We are the gatekeepers of evidence-based information and heartfelt support.

Consider this column your place to ask all the important, frustrating, mind-boggling, and embarrassing questions you’re not getting answered elsewhere. I’m here for you.

What is [postpartum] physical recovery really like, and when should you consult a doctor?

I’m so glad you asked! It’s something we don’t talk about nearly enough. And I’m all about getting real with expectations because celebrities and social media are not doing us any favors with sanitized versions of the fourth trimester.

Getting a clear sense of expectations now can empower you to make important decisions about your postpartum health in the future.

Postpartum recovery happens in phases, but it depends on a few things: Your mental and physical health prepregnancy and during pregnancy, and the details of your birth.

Someone who has an unmedicated vaginal birth with no stitches will have a different journey than someone who endured prolonged pushing and an emergency C-section.

Check out our postpartum recovery timeline and then read more about what to expect from your after-baby body. Go slowly in those first 42 days. You need to heal, deal, and adjust to a whole new life.

When to seek help:

  • Severe headaches and/or blurred vision after birth — get to the ER.
  • Passing a blood clot bigger than a plum or soaking through more than one hospital-grade pad within an hour — get to the ER.
  • Rapid onset fever and acute breast pain if breastfeeding — call your primary caregiver or go to urgent care.
  • Still “don’t quite feel like yourself” after the first 2 to 3 weeks — call your primary caregiver and/or connect with resources at Postpartum Support International (PSI). If you’re ever concerned about harming yourself or your infant call your local emergency services or the National Suicide Prevention Hotline (800) 273-8255 for confidential support.
  • Incontinence after 3 months (give or take depending on your birth experience) — call your OB-GYN and seek a consultation with a pelvic floor therapist.
  • Pain after resuming sex — call your OB-GYN and seek a consultation with a pelvic floor therapist.

The most important thing? If you are concerned or bothered by something, then it warrants a conversation with your doctor. If they don’t have the answer, find someone else who does. If they tell you it’s “just how it is” after having a baby, find another provider who will take your concerns seriously.

This applies to everything. Listen to your gut. Don’t worry about annoying your provider(s). That’s what they are there for! Ask away and get the information you need.

Is there a link between sleep deprivation and postpartum depression?

That is a great question. Everyone jokes about sleep deprivation and how awful it is after having a baby, but a lack of sleep is serious. And so is postpartum depression.

Researchers have found a significant link between the two. A 2015 study found that insomnia and poor sleep quality are associated with greater depressive symptoms during pregnancy and postpartum.

Another study followed 80 mothers to investigate the connection among sleep, postpartum depression, and the “self-perceived mother-infant emotional relationship.” The study found “significant correlations” between poor sleep and negative maternal perceptions.

Whatever brought you to ask this question, I want you to know that resources are available to support you. Here are several options:

  • Call your OB-GYN or primary care doctor for reproductive psychologist/psychiatrist recommendations.
  • PSI is a wonderful organization with local and online tools. It can connect you with providers and it also hosts weekly virtual support groups.
  • Postpartum doulas have also been shown to be very effective in providing supportive care. They can troubleshoot your sleep situation, offer support that is free from judgment, walk you through some reflective mental health questionnaires, and connect you with specialists if needed.

Whatever you decide to do, please know there is strength in asking for help. This isn’t the time to “grin and bear it” or minimize your experience.

Breastfeeding has been horrible and painful for 11 weeks. Lactation experts have not been helpful. When is it time to give up?

You have my heart! Breast/chestfeeding is anything but easy, and we’re made to think it’ll be a breeze. I’m sorry to hear your journey has been so challenging.

Since I don’t have all the facts — there are myriad factors to consider, from supply to latch to nipple concerns — all I will say is this: 11 weeks of breast milk is a gift to your baby. By doing this, you’ve reduced Baby’s chance of SIDS and helped lay a foundation for their immune system and microbiome.

Breastfeeding is emotional and challenging; to show up for every feeding when it’s been a terrible experience is next-level commitment. You’re incredible! I want to commend you on that, and give you permission to re-evaluate your breastfeeding journey.

You have a lot of options: You could troubleshoot things with a different lactation consultant in your area (search for an IBCLC here) or connect with a virtual service like Pacify or Lactation Link if you’re intent on hitting the 6-month mark (to optimize immune-boosting benefits of breastfeeding).

Alternately, you could switch to exclusively pumping or consider the use of formula or donor breast milk. All of these are equally suitable options.

All in all, I believe fed is best. You and baby are a dyad, meaning you are two parts of a whole. Your health and well-being is equally important to that of your baby’s.

Evaluate the options above, talk with those you love and trust, and lean into whatever makes the most sense for you as a unit. I wish you luck!

Mandy Major is a mother, certified postpartum doula PCD(DONA), and the co-founder of Major Care, a telehealth startup offering remote doula care for new parents. Follow along @majorcaredoulas.