Love & Marriage

in which I reveal too much about postpartum health

Please note that the following contains what is probably way too much information about postpartum vaginas.

After you have a baby, you get one follow-up appointment with your doctor, usually around six weeks postpartum. This appointment masquerades as a general checkup of your postpartum health—is everything healing, how is your mood, do you have any questions or concerns about breastfeeding—but really the purpose is for the doctor to let you know if you’re ready to have sex again. 

When my first son was born, I had my postpartum appointment at four weeks because I was considered high risk for postpartum depression and they wanted me to come in earlier than usual for screening (the appointment was supposed to be only two weeks postpartum, but the practice didn’t have any appointments available until four weeks after I gave birth. This is the nature of American healthcare). I was still having a lot of physical discomfort at the time of the appointment. I had torn during delivery and kept getting a searing pain in my vagina whenever I walked. It turned out that whoever had stitched me up did a bum job of it and a bit of the internal tissue from the wall of my vagina was poking out through the stitches. The midwife at my follow-up explained that the internal layers of tissue have more nerve endings than the more external ones, so every time I moved this bit of nerve-heavy tissue was getting rubbed and that’s what was causing the pain. “No biggie,” she said (I remember her exact intonation even six years later—no biggie!), it could easily be fixed by putting a bit of silver nitrate on the spot to cauterize the tissue and deaden the nerves. She warned me that it would feel uncomfortable when she applied the silver nitrate—hurt like hell would have been a more accurate description—but that after that, I’d be good as new. When she was all done burning off a portion of my vaginal wall, she let me know that as long as there wasn’t anything else that was bothering me, I was all set to start having sex again.

This time around, I had my postpartum visit at six weeks. I was supposed to go in during my first week postpartum to get my blood pressure checked because I’d had high blood pressure readings toward the end of my pregnancy. And I was supposed to go in again at two weeks postpartum because I was still high risk for postpartum depression. The hospital staff told me that someone from scheduling would contact me to set up these appointments, but that never happened, so I didn’t go. Again, this is the nature of American healthcare. Since it was my responsibility to schedule the six-week follow-up, that was the only appointment I attended. After a cursory round of how are you, how’s the baby, any concerns, and a few uncomfortable minutes of rooting around inside my vagina to make sure everything looked okay, the doctor asked me if I had started having sex again yet. I laughed and said no, and she cheerily informed me that I was good to start doing so at any time. “What is your plan for birth control?” she asked and I replied, “breastfeeding.” She reminded me that you can get pregnant while breastfeeding, and I clarified, “Oh sorry, no, I mean abstinence because I’m breastfeeding.” Abstinence because I have a baby pressed against my body nearly every hour of the day. Abstinence because when I’m not holding the baby, I’m doing my best to spend that time with my six-year-old, hearing about his school day, playing games, reading books, letting his warm, sweaty, dirty-from-recess body press against mine. Abstinence because I’m often covered in someone else’s snot or spit-up. Abstinence because I have one breast that keeps getting engorged in a way that feels like a cartoon balloon slowly filling beyond capacity and I’m sure that at any moment it will burst and spray milk everywhere. Abstinence because I still pee myself a little bit if I move too quickly or sneeze too hard. Abstinence because at this moment, only two months after birthing a human that grew inside of me for nine months, I have zero sexual needs of my own and I couldn’t possibly give less of a fuck about the sexual needs of my husband. 

She wrote “condoms” in my chart and suggested we could follow up in a few weeks to discuss other methods. 

I do not expect to hear from her. You know, because of the nature of American healthcare. 

* * *

My husband and I are celebrating our 15th wedding anniversary this week. That’s one year less than my age when we started dating. I’ll admit it’s a bit crazy to fall in love with someone at 16 and then remain in love with them for over two decades. We should be one of those couples that are disproportionately represented in divorce statistics, a precautionary tale about getting married too young. There’s a writer whose work I enjoy and respect very much who is adamant that no one should get married before the age of 30. She argues that your twenties are for finding yourself, and no one should get married before they have discovered who they are. It’s a sentiment I’ve seen repeated elsewhere, and I guess it makes sense, but only if you marry someone who isn’t interested in seeing the ways you change and grow as you age, or if you believe the Self is a fixed point that can be reached rather than a complex organism that is constantly changing and adapting throughout your life. 

I have a very good marriage. I don’t say that to brag (okay, maybe I’m bragging a little), but rather to note that much of my ability to manage my depression over the years, to engage in creative pursuits, and deal with the ups and downs of attempting to build a writing career, to live a life that leaves me feeling happy and fulfilled can be attributed to this successful and supportive partnership. My husband is the first reader of all my work. He is gentle but honest in his critiques. He helpfully pushes back against my negativity and woe-is-me vibes when things aren’t going well. He genuinely wants to see me succeed and fully believes that I can. He wants me to be happy. It’s nice. 

I recently read You Could Make This Place Beautiful, (poet, not actress) Maggie Smith’s memoir about the dissolution of her marriage and the aftermath of her divorce. It was really good. I highly recommend it. Though her marriage ended ostensibly because of her husband’s affair, she reflects on other moments that in hindsight feel like warning signs. She acknowledges that though the affair was the final nail, she could point to a variety of reasons for why her marriage failed, most notably, her husband’s response to her work. You can read excerpts from the book about this topic in an essay she wrote for The Cut. I found these sections of the book to be truly infuriating. 

“Did my children see their father’s job as more “real” than mine because it happened outside the home, and because despite my work, I was the primary caregiver? I felt that he treated my (writing) work like an interruption of my (domestic) work, and did they see that, too?

When my husband traveled for work, I looked forward to his return — especially if the kids were sick or I had multiple deadlines of my own — but the daily fires were ones I was used to putting out myself. On the other hand, when I would call home from a trip, I remember feeling like I was in trouble. I’d made his life more difficult, and I might pay for that with the silent treatment or a cold reception when I returned home. I didn’t feel missed as a person, I felt missed as staff. My invisible labor was made painfully visible when I left the house. I was needed back in my post.”

Fuck that guy. 

People say marriage is hard, but I have not personally found this to be true. Life can be hard. Finding time to get everything that needs doing done can be hard. Meeting people and losing people, knowing which choices are the right ones to make, making the right choices even if it will upset other people, those things can be hard. And yes, it takes effort to find balance in a relationship. It takes an honest evaluation of each person’s roles and contributions, and open communication about what feels unfair in those imbalances, and what is a source of animosity toward your partner. One advantage of having been in a relationship with the same person from an early age is that there was no fixed Self for life’s changing demands to butt up against. Because we have grown directly alongside each other through very formative periods of our lives rather than coming together after we each had already separately determined who we were and what we wanted from life, we have been able to make those evaluations and adjustments without either of us feeling like we’re being asked to change too much or to fundamentally disrupt the identities we had formed on our own. My marriage feels easy and it is often what helps make the other harder stuff feel a little easier too. I recognize how fortunate I am to be able to say this. 

The other night, after a very long day where the baby was needier and fussier than he has been thus far, I sat on the couch in the dark and sobbed. I couldn’t do days like this, I told my husband, where from the moment the baby woke in the morning to when he finally went down for the night around 10, I was carrying him, or walking him, feeding him, again and again, all day long. Never mind that my husband had been the one to carry him during his evening witching hour several nights in a row, walking through the neighborhood without embarrassment while the baby screamed against his chest (something I can’t bring myself to do; I always have to get him settled at home before we set out, lest my neighbors think I’m a terrible nuisance or a mediocre mother. My husband doesn’t feel this pressure. The world sees him as a Good Dad just by virtue of the fact that he’s out there walking around with the baby at all. Talk about an imbalance!). We came up with a plan for my husband to take over a feeding in the evening, and for me to get an hour to myself to relax at the end of the day. I worried that I didn’t have enough milk stored up to cover a bottle a day, or that I won’t be able to pump enough to rebuild our supply and my husband gently pushed back, reminded me we could supplement with formula, that I didn’t have to feel guilty about doing that, didn’t have to push myself to be everything for the baby, for everyone, all the time. We had agreed from the start that with this baby, we would more equitably share the load because we knew what to expect, we are both more confident parents than we were the first time around, and because fuck the patriarchy, that’s why. But I was starting to let the weight of expectation and societal pressure creep in and take over my thinking. I could feel myself sinking beneath it. My husband pulled me back up. 

Like Maggie Smith, I am self-employed while my husband’s job has a steady, reliable income and provides our health insurance. It would be easy to see his work as work, and my work as a hobby, but he has never treated it that way. We have childcare even though I’m still on leave from my job specifically so that I can keep up with my writing. Over a decade ago, when I told him I wanted to become a Licensed Massage Therapist and start my own practice so that I could work part-time and devote the rest of my hours to writing, he told me I should do it, even though it probably wasn’t the best financial decision for us at the time. When I said I wanted to take over the basement room of our small row house to turn it into my massage studio for a few years, he told me to go for it and helped me pick out a soothing green color for the walls. Years later, after I wrote a picture book in my head while I was giving a massage one evening and missing out on whatever he and our toddler were up to that night, he told me yes, I should definitely look into getting a literary agent. “I don’t know what that entails,” he said, but he assured me that the book was good and it was the right move. Whenever I’ve wanted to devote more time to writing, we’ve worked together to find a way for me to do that. Whenever I’ve doubted that I could do something, or questioned my abilities and the usefulness of pushing forward with an idea, especially after seeing it fail again and again, he’s been the voice that is missing from my own mind that tells me to keep going. Never once has even suggested that maybe this whole writing thing isn’t worth the effort. Perhaps I would have developed this voice on my own and wouldn’t need him to play that role if I had waited to find myself before we got married. But just like if you have a partner who belittles you and downplays your accomplishments until that dialogue eventually becomes your inner monologue, if you have one who repeatedly raises you up, points out your strengths, and encourages you to keep going, eventually you start to do that for yourself as well. My husband sees my wholeness because he’s witnessed every new piece that has been added to the circle. Sometimes he sees me more clearly than I see myself, as if I were an impressionist painting, a bit of distance bringing the image into focus. 

We went out the other night to celebrate our anniversary. My parents stayed with the kids while we enjoyed an early dinner at a restaurant that we figured would be pretty empty at 5 pm on a Saturday. It was, but only briefly, as we learned when we asked for a table for two and were told that they were all booked up for the evening. We were welcome to find a seat at the bar. That worked fine for us and is actually what we usually prefer, a habit we’ve borrowed from my parents who pretty much always choose seats at a bar over a table and like to chat up bartenders. We ate lots of delicious food, had some wine and cocktails, reminisced about earlier moments in our marriage, and discussed which of our friends could be entrusted to perform a Weekend At Bernie’s-style farewell for my husband if he died unexpectedly. It goes without saying who we picked; they know who they are. 

My parents have been married for almost fifty years and they too got married young—my mother was still an undergrad. The way I remember them telling it, they were only planning to live together, but they couldn’t find anyone who would rent an apartment to an unmarried couple so they said, fuck it, let’s just do this. I wonder if at the time they could have predicted that “fuck it, let’s just do this” would become a sort of ethos for their lives. I admire the way you can see their friendship at the foundation of their relationship even all these years later. They still make each other laugh. They genuinely enjoy each other’s company. This is how I feel about my husband. At every point where our relationship reasonably would have ended, we chose to stay together for no reason other than we just like being together. We’ve never been ready for that enjoyment to end. Who knows what the future will bring, but I expect that fifteen years from now, I’ll still find him delightful at least most of the time. And I hope the same is true fifteen years after that, and so on and so on until we are two old, wrinkled people still making each other laugh. 

Thank you for reading Other Thoughts. This post is public so feel free to share it.

I have many, many pieces of writing about my husband that I could share and though I am tempted to say, here are fifteen of my favorites in honor of our anniversary, I will keep it to just a few, including this one, which is unpublished but part of a larger collection of poems that all share the title One Good Thing:

One Good Thing 

is my frozen toes sandwiched between your bare thighs. Though I suppose this is a matter of perspective. You snore from your right nostril only. A whistle like a train in the night. Or maybe that is actually a train I’m hearing? Either way, I wake you. Irritated. The first time you broke up with me your hair was dyed green. The first time I broke up with you I took it back ten seconds later. I needed to see what you looked like, crushed beneath the weight of my many failures. In the back of my mind there plays a song you used to sing that wasn’t written for me. I forget its name. I forget the many times I went out of my way to make you cry. If I die before you, tell our son every day how much I loved him. If you die before me, I’ll be up all night listening for a train that never comes.

* * *

And a few links to other pieces:

including my husband’s favorite, “Cardinals Mate for Life”

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