The Mother Load: Why Maternal Health Does Not End at Six Weeks Postpartum

The Mother Load: Why Maternal Health Does Not End at Six Weeks Postpartum

Motherhood is often discussed in terms of everything a woman gives to her baby. Far less attention is paid to what she continues to carry physically, mentally and emotionally long after birth.

There is the visible work of feeding, soothing, dressing, organising and caring for children. Then there is everything that happens quietly in the background. Remembering appointments, anticipating everyone’s needs, managing work, carrying family worries and keeping daily life moving.

Alongside that mental load, many mothers are also living with physical symptoms from pregnancy and birth that have never been properly assessed or supported.

In a recent episode of the Midwife Pip Podcast, I spoke with NHS GP, BBC Morning Live health expert and author Dr Punam Krishan about her book The Mother Load and why maternal health should be treated as a lifelong area of health rather than something that ends at the postnatal check.

Our conversation explored identity, maternal wellbeing, the mental load of motherhood and why so many women become experts in their children’s health while quietly ignoring their own.

What is the mother load?

The mother load is everything mothers carry that often goes unseen.

It includes the mental work of remembering school dates, medical appointments, clothes sizes, food preferences and what each person in the family needs next. It includes paid work, household responsibilities, relationship pressures and caring for ageing relatives.

It also includes the physical load of pregnancy, birth and recovery.

Women do not simply return to their previous physical state after a six week check. Pregnancy can affect the pelvic floor, abdominal wall, joints, hormones, mental health and nervous system. Those changes can continue to influence a woman’s health throughout every stage of motherhood.

Yet women are often expected to function as though nothing significant has happened. When mothers speak about feeling exhausted or overwhelmed, they can be treated as though they are complaining about an ordinary responsibility rather than describing a genuine health and social issue.

The mother load gives language to the full weight of what mothers carry and validates the fact that it can be too much for one person to manage without support.

Maternal health should not end at the postnatal check

Pregnancy care involves appointments, monitoring and clear points of contact. After birth, that structure can disappear very quickly.

A mother may have a brief postnatal check and then find that most healthcare conversations focus almost entirely on her baby. Her body, recovery and long term wellbeing gradually move into the background.

This creates the impression that maternal health is a short term concern. Once the immediate recovery period has passed, women are expected to return to ordinary life without further assessment or rehabilitation.

But maternal health is lifelong.

A woman who has had one or more pregnancies has experienced substantial physiological change. Pelvic health symptoms, musculoskeletal pain, hormonal changes, mental health difficulties and exhaustion can continue for years.

These symptoms may also change or become more noticeable during later stages of life, particularly around perimenopause and menopause.

Postpartum should not be treated as a six week window. It is the beginning of a lifelong stage of women’s health.

Motherhood changes your identity

One of the biggest changes Dr Punam described was the shift in identity that happens when a woman becomes a mother.

Before motherhood, you may know yourself through your relationships, work, interests and ambitions. Then a completely new identity arrives and begins influencing every part of how you think and live.

This is not simply an emotional idea. Pregnancy and early motherhood are associated with changes that help women become more responsive and attentive to their babies. Mothers often describe becoming more alert to risk, more emotionally sensitive and constantly aware of what their child might need.

These adaptations can be protective and powerful, but they can also make it difficult to switch off or reconnect with the person you were before motherhood.

It is possible to love who you have become and still grieve parts of your previous identity. Those feelings do not contradict one another.

You do not need to return to the woman you were before having children. But you do deserve opportunities to understand who you are becoming and to retain parts of yourself that still matter to you.

Mothers grow through every stage of their children’s lives

Maternal health is often discussed only in relation to pregnancy, birth and the baby’s first year.

But motherhood continues to evolve. The newborn stage brings one set of demands, while toddlerhood, school years and adolescence bring entirely different emotional and practical challenges.

Many mothers assume things will become easier once their baby sleeps, walks, starts school or becomes more independent. Some aspects may become easier, but each stage brings a new version of the mother load.

The questions change. The worries change. The physical and hormonal landscape may change too.

A mother might be supporting a child through puberty while navigating perimenopause herself. She may be caring for teenagers, managing work and beginning to support ageing parents at the same time.

There is no single point at which maternal health stops mattering.

Mothers deserve information and support throughout these different chapters, not only when their children are babies.

Why mothers often ignore their own health

Mothers frequently know everything about their children’s health while having very little space to think about their own.

They may track feeding, nappies, sleep, symptoms and developmental changes in extraordinary detail. Yet persistent pain, exhaustion, leaking, low mood or anxiety in themselves can go unaddressed for months or years.

Part of the problem is practical. Making and attending an appointment can involve childcare, work arrangements and mental preparation.

There is also a deeply ingrained belief that a mother’s needs should come last. Women may fear taking up time, being seen as difficult or creating extra pressure for already stretched health services.

Dr Punam described seeing mothers attend an appointment for themselves and then ask whether the clinician could see their child instead because the child had developed a new symptom. The mother’s own concern is quietly postponed again.

But an untreated problem does not disappear. It often becomes more difficult to manage and may ultimately require more care.

Looking after mothers early is not an indulgence. It is preventative healthcare.

We have normalised symptoms that deserve attention

Many symptoms associated with motherhood have become so common that women assume they are normal and unavoidable.

Leaking urine when coughing, exercising or using a trampoline is often joked about. Persistent tiredness is dismissed as mum life. Painful sex, back pain, low mood and anxiety can all be accepted as part of the package.

Common does not always mean normal.

These symptoms may reflect pelvic floor dysfunction, anaemia, hormonal changes, thyroid problems, mental health difficulties or another treatable condition.

When women hear other mothers say “me too”, it can be enormously validating. But validation should be the beginning of the conversation, not the end.

The next response should be, “You are not alone, but you also deserve help.”

Mothers should not have to avoid activities, intimacy or parts of daily life because they believe their symptoms are simply something they must tolerate.

Information alone is not enough

Parents have access to more information than ever before. Advice about feeding, sleep, exercise, development and parenting is available around the clock.

But more information does not necessarily create more confidence.

Social media can leave women feeling as though they are failing at feeding, sleep, routines, relationships, exercise and parenting simultaneously. The volume of advice makes it difficult to distinguish what is useful, evidence based or relevant to one particular family.

What mothers often need is not another general instruction. They need help understanding what information means for them.

Support, context and individualised guidance allow women to move beyond knowing what they are supposedly meant to do and start making choices that are appropriate for their health, baby and family.

One question I often encourage mothers to ask is, “What would I choose if nobody else ever knew?”

Removing imagined judgement can make it easier to identify what genuinely feels right within your own family.

The modern mother’s brain is carrying too much

The adaptations that help mothers remain responsive to their children are happening within a world of constant stimulation.

Mothers are not only caring for their children. They are processing messages, emails, school notifications, work demands, social media content and endless decisions.

The human brain was not designed to nurture a family while also managing the sheer volume of information and responsibility that modern motherhood creates.

This can leave women feeling scattered, forgetful and constantly on alert. It may feel as though something is wrong with them when their brain is actually responding to an unreasonable level of demand.

Sometimes the most powerful support is simply hearing somebody say, “That is a lot for one person.”

Validation does not solve every practical problem, but it removes the idea that a mother should be able to carry everything without being affected by it.

Healthcare professionals need to ask mothers how they are

Maternal health can be supported when healthcare professionals look beyond the immediate reason for an appointment.

A mother may attend with a cough, a rash or another straightforward concern, but a simple question about how she is coping can reveal much more.

Does she have children? How old are they? Is she sleeping? Is she experiencing persistent pain, anxiety or pelvic health symptoms? Has she had space to think about her own wellbeing?

These questions matter because motherhood changes a woman’s social, physical and emotional context.

Dr Punam described the importance of opportunistically checking in with mothers rather than assuming they will always raise their own concerns. Many will not, particularly when appointments are short and they already feel guilty for taking up space.

Early intervention is more compassionate and often more effective than waiting until a mother reaches crisis point.

Supporting mothers benefits the entire family

When mothers are healthy and supported, the benefits extend far beyond the individual woman.

Children benefit from a parent who has more physical and emotional capacity. Relationships benefit when one person is not carrying every responsibility alone. Workplaces benefit when women receive appropriate support rather than being expected to hide the realities of motherhood.

Mothers are often central to holding family life together. That does not mean they should be expected to sacrifice themselves for everybody else.

The better we support mothers, the stronger the foundations become for the people and systems around them.

Maternal health should not be treated as a niche concern. It affects children, partners, workplaces, communities and health services.

Mothers need space, grace and validation

Modern mothers are often balancing the practical work of family life with careers, relationships and caring responsibilities.

Motherhood can develop extraordinary skills. Women become organised, adaptable and able to manage multiple demands. But these abilities should not be used as evidence that mothers can absorb unlimited pressure.

Dr Punam described mothers as needing space, grace and an acknowledgement that what they are carrying is not always easy.

That validation matters.

It gives women permission to recognise symptoms, ask for help and stop treating their needs as an inconvenience.

Maternal health should be treated as a lifelong specialty because a woman’s experience of motherhood can continue to influence her physical and mental health for decades.

Learning to advocate for yourself

Mothers are often powerful advocates for their children. They ask questions, seek second opinions and persist when they believe something is wrong.

Yet that same confidence can disappear when the concern is about their own body or wellbeing.

Self advocacy begins with recognising that your health matters.

It may mean writing symptoms down before an appointment, explaining how they affect your daily life or asking clearly what assessment, treatment or referral is available.

You can say that a symptom is persistent, worsening or interfering with exercise, intimacy, sleep, work or caring for your children.

You can ask what has been ruled out and what the next step will be if the first approach does not help.

Advocating for yourself does not mean being confrontational. It means giving your health the same seriousness and attention you would give your child’s.

You are allowed to make yourself a priority

Making yourself a priority does not require placing your children second.

Your needs and their needs can coexist.

You can be a loving, attentive mother and still require time, healthcare, rest and support. Looking after yourself does not reduce what you give your children. It helps make that care more sustainable.

For many women, the first step may be small. Booking an appointment, accepting help, eating a proper meal or telling somebody honestly that you are struggling all count.

You do not need to wait until you are burnt out or until your children reach a particular age.

Your health is worthy of attention now.

You are not alone in the mother load

Motherhood can be profoundly lonely, even when you are surrounded by people.

You may be awake at night believing you are the only person worrying, struggling or questioning whether you are doing things properly.

But many other mothers are having the same thoughts.

You do not need an enormous social group. One person who understands and allows you to speak honestly can make an enormous difference.

Connection does not remove every responsibility, but it helps remind you that you were never meant to carry motherhood entirely alone.

Reach out. Say what is happening. Allow somebody to support you without first needing to prove that you have reached breaking point.

Final thoughts

The mother load is not a personal failure to cope. It is the cumulative physical, emotional and mental weight of motherhood within a society that often expects women to carry too much without enough support.

Maternal health does not end at six weeks postpartum. It continues through toddlerhood, the school years, adolescence, perimenopause and every other stage of a woman’s life.

We need to stop normalising symptoms that deserve treatment, stop expecting mothers to disappear behind the needs of their families and start recognising maternal health as a lifelong priority.

You are allowed to take up space in a healthcare appointment. You are allowed to ask for support. You are allowed to care for your body and mind before reaching crisis point.

If you would like to hear the full conversation, listen to my episode with Dr Punam Krishan on the Midwife Pip Podcast, where we explore the mother load, identity after having children, the maternal health gap and why every mother deserves support throughout her whole life, not only during pregnancy and the first few weeks after birth.