Embracing the Mama Pouch

Four days after giving birth to my first child, I caught a glimpse of myself in the mirror upon arriving home. As I marveled at the massive changes that had taken place in my body and mind, I wondered why I didn't recognize myself anymore. Staring at the new body in front of me it felt alien, foreign, almost subhuman. I began to scrutinize each individual area of this new vessel - first my swollen face, then my  plump arms, swollen breasts and finally, my bloated, sagging tummy. The skin on my stomach was so stretched out that it didn't even seem real, striped in hues of bright white and deep purple. The pouch dangled from my torso, pulling my belly button toward the floor. The new heaviness of my pouch paled in comparison to the heft of the overwhelming feelings in my chest. Underneath the pouch I sported a large incision where my baby had been delivered. Four days after my son was born I stood weeping in front of the bathroom mirror at the drastic changes, staring in horror through tears at the fallout from his birth. The birthing experience itself was traumatic, but it wasn't until the fourth day looking at my new body that I realized that the pregnancy, delivery, and the aftermath - the massive, unrecognized toll taken on my mind and body, was also traumatic. I had a newborn to care for and motherhood to navigate, but I also had this terrifying trauma to contend with and the negative feelings that lingered about my new body. Was this normal? Beyond acknowledging and dealing with my own feelings I realized that I would also have to contend with the bombardment of opinions and judgements from everyone around me, and the stances taken by media on pregnant and postpartum bodies. The overwhelm was crushing, suffocating.

New mothers rarely talk about the full motherhood experience, in part, because many of them don't know what to say, or they do know what to say but they're afraid that the world around them might find their expressions inappropriate. Motherhood in modern western culture is supposed to be full of nothing but joy and happiness for the new life born into the world. No room exists for any feelings otherwise, although we never question why. The most likely answer to the question is simply fear; fear of judgement, fear of not meeting expectations, fear of not being seen as a good and grateful mother. Making space for all of the feelings that motherhood brings is vital to the revolution of the mental health of moms. We must embrace a wholistic human approach, one that allows for an array of feelings whether we feel they are inappropriate or not. Sharing these stories enables women to take control of the narrative and to hold space for fellow mothers struggling on a similar path. Basically, it’s okay to not feel okay, even when you’re holding the brand new love of your life.

Months passed and my body continued to change. The sore swollen breasts full of new milk for my newborn had finally shrunken as the milk dissipated, leaving my breasts sagging and ill-shapen. Fluid retention subsided all over as the days and weeks passed. Still the pouch lingered, protruding from my stomach, elongated and dangling above my pubic bone. Soon I noticed another small pouch dangling from my pubic area - a small, fatty pad of flesh above my genitals, similar to the pouch above my incision. After doing some research about postpartum bodies I realized this was my new normal. No one warned me of the vast array of feelings or differences in my mind and body I might encounter postpartum. C-sections often leave women with something called a ‘shelf’, which before I had my surgery was something that I was completely unaware. The shelf can be reduced through healthy diet and exercise, but for many women can never be removed without surgery and it’s unlikely the body will return to its pre-pregnancy state. The tight suturing of the skin and muscle during the procedure, combined with the development of scar tissue create a tension in the abdominal wall. Tension puckers the skin and causes the excess from pregnancy to form a small pouch. The pouch is the price we pay for our baby’s safe delivery into the world. Even mothers who have successful vaginal deliveries still deal with some form of stretched, sagging skin. In all my research it was rare to see a pouch on a woman online unless it was on a before and after surgery website. Clearly the pouch is something our societal norms deem ugly and undesirable, something to be hidden or removed, never to be seen or discussed. When something of this magnitude is consistently hidden or dismissed, disgust and shame inevitably follow. In this case most mothers, especially mothers who deliver via cesarean, aren't permitted to feel anything unless it is a form of shame.

I questioned other mothers about this shelf on my stomach. Why was it such a big deal? Why was I having all these wretched feelings? The general consensus was that it sometimes happens and you're supposed to hide it with compression clothing, try to lose weight, and potentially consider a tummy tuck. Surgery? Again? Risk my life for a pouch of fat and skin? A few of them insisted that's just the way it is after childbirth, but not one of them embraced their new pouch or dealt with their negative feelings. Suppress and repress and repeat. Each of our pouches varied in size due to a variety of reasons such as body shape, weight, and healthy diet but no matter how noticeable the area seemed, not one woman embraced the new body that childbearing bequeathed. Again, why? Inherently one should be in awe of what she has created, housed, and birthed. Proud of the battle scars of procreation where she earned her badge of honor and courage. Instead it seems we worry that the new body will not be acceptable, lovable to outside eyes. 

Even knowing this, I still cried. I cried at the loss of the familiar, the perceived loss of my youth, the loss of the sense of my body only ever belonging to me. Not only had this body become an incubator but it was left somewhat ravaged in the process. Even though the baby had vacated, my womb would never forget. No longer did I feel that I had true autonomy, that my body was only ever mine again. In some ways it was miraculous and incredible, unlike anything I have ever or will ever experience. In other ways, it was brutal. I felt hijacked emotionally and physically, consumed by a foreigner in a land with which I was rapidly becoming unfamiliar. The scope of ever-evolving changes were overwhelming and I was expected in just a few days to recover from pregnancy and then surgery while learning to mother a new being and to rapidly balance my emotions against raging hormones. Days, weeks, and even months aren’t enough for any person to adequately understand, process, and recover from such a miraculous and intense experience.

Recovering from the surgery itself was a feat with an expected 6-week healing period.  Total healing time from childbirth, in truth, is nine months to a year to ensure a full recovery. Yet, many women by the 6-week mark are caring for their families while returning to their full-time jobs, operating in survival mode in order to get everything done that is required. No rest is found in motherhood. No rest is found during the meager six-week recovery time. Still, we expect somehow for all women to carry on, to acclimate as though nothing has occurred. Nonsensical and irrational it is to have such expectations of women, and yet the timeline is still standard practice. In the first six weeks postpartum, not only had I not acclimated to my new life but I still hadn't had enough time to process everything that occurred through my pregnancy and childbirth including the relationship with my new body. Feeling down because I couldn’t meet expectations, shame invaded. Instead of processing through all of that information because I did not have the time or the emotional bandwidth, I dissociated from my body pretending that my body and myself were two separate entities. I decided I would not let my body or the outside views of others dictate my value. For many years this worked in some ways. Dissociating from your body means that it hurts less when someone remarks on it because to you your body isn't Who You Are. However, there are consequences of separating body and mind, including trauma and post-traumatic stress sometimes manifested as physical symptoms. Thus, it is no shock to me looking back on the circumstances that within three months after my first son was born I was  diagnosed with postpartum depression. Meeting the expectations of motherhood in the modern world was too much for me to handle.

In hindsight, I recognize that it wasn't me or any of the other mothers that had a problem - rather, it is the society and the systems in which we live that created much of our suffering.  Never allowing the time to deconstruct and sit with what happened and all of the changes that followed set me and all of the other mothers up for failure, overwhelming feelings of shame, and even depression. With little support it's amazing that each of us made it through to the other side of ourselves, raising a child in the process. 

Sometimes I still cringe when I see my pouch. Reintegration requires radical acceptance and large doses of self-love. Now that I've been working on reuniting body, mind, and spirit, I treat my pouch with kindness and gentleness. I allow myself time to grieve and to process the traumas still aching in the past. I remind myself of everything I went through to bring my baby into this world. I remind my body of how good of a job it did at sustaining me and my sons through conception, incubation, and delivery. I remind my pouch I don't hate it. In fact, I'm starting to see it for what it really is: excess skin from extraordinary lives being brought into the world through everything that is me, culminating in a fuller, more beautiful experience: the experience of motherhood.