Doctor Preeya Alexander shares with us what happens behind the closed doors of a general practice, and why you're never (ever) alone...
“As a GP, I often reassure my patients that what they’re feeling is normal – how do I know? Because many women have disclosed this to me over time and I had similar emotions as a new mother. I can assure you the loss of sense of self is something I commonly encounter in my consulting room,” Preeya said. “So to the women who read this – if you can relate to all or some of these then know you are certainly not alone, you are right in the great big spectrum of normal and these thoughts about mental exhaustion, loss of identity and female mental load are something many of us are dealing with – on both sides of the consulting room door.”
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“I’m pregnant, but I’m here because I don’t want to go ahead with this”
This is not an uncommon statement I hear when the door shuts. I think many envision a certain stereotype when it comes to this kind of consult – it’s assumed that its mainly teenagers with unintended pregnancies who come in with this request- but I can assure you that is far from the truth. I’ve supported all sorts of women through the termination of pregnancy process- married, in long term relationships, women desperate for children but without the financial capacity to sustain a child at the time, victims of sexual assault. There is often some reluctance from the patient – I often see a searching look pass across my face trying to see if there is judgement – but my response is always the same, “it’s great you’re here, let’s talk options.” I’m a GP who is prochoice – I believe a woman should know her all options and feel empowered to make whatever decision suits her mental and physical wellbeing at the time. As a GP I spend often multiple consults helping women through the decision, discussing options (from proceeding with pregnancy, to adoption to potential options for termination) – it is our job as the doctor to ensure a woman is supported so that she can make the decision that suits her. There are some doctors who do not discuss termination options or offer counselling based on their own religious or ethical reasons – but they do have a duty of care to inform you and refer you on to other doctors who can help you.
“I feel like I’m constantly thinking about what needs to be done, and I’m exhausted by it”
The female mental load can be heavy –I know this from personal experience. Many women will admit to me the heaviness of the constant juggling, the constant need to think about what needs to be done. I often feel the same way and as the GP it can often be quite comforting knowing I am not alone in my thoughts. “I can relate to how you are feeling in more ways than you could know” is a common response from me. The therapeutic relationship and its boundaries can be tricky to navigate as a GP – we get to know our patients, their families so incredibly well and sometimes we start to share bits and pieces of ourselves. Some in my profession might say we shouldn’t reveal a thing about ourselves to our patients to maintain a clear boundary. Personally, I disagree; if I know the patient may gain comfort, insight, courage from one of my own stories then I will consider sharing it. So yes, I have previously shared that I struggle with the constant juggle as well – and I’ve shared that as a family we too have survived miscarriages and that I myself have battled anxiety years ago and taken medication; if the story adds value to the consult then I may share it and my experience has been that it strengthens the relationships with my patients as opposed to weakening it. And so, I often agree with my female patients who struggle with the mental load- the list in heads, on paper, on phones is never ending for many of us – there’s a lot to think about constantly and for many reasons, women tend to carry the main mental load of the household. Does the household have milk for coffee in the morning? Is there a meal for tomorrow night when everyone comes home exhausted tomorrow from school and work? Are there enough clean undies for everyone? Are the dogs fed/walked/groomed? Are the forms for school filled? Are swimming lessons on next week or do they go miss a week because of the public holiday? It’s life – but for many, me included, it is exhausting so you are not alone!
“I feel like I’ve lost myself”
New mothers will often very quietly admit this in the consulting room. The social media letter boards one often sees with the statement “I found myself in motherhood” can just be a “kick in the balls, or ovaries” as a patient once told me. She was one of many who felt her identity has struggled somewhat as a new mother.
“I feel like I’ve lost my identity”
“I feel like people just see me as a mother now” “I feel like I’ve forgotten who I used to be” “I just don’t feel sexy anymore since becoming a Mum” I’ve heard all of these in my consulting room before, and personally, I don’t think we openly discuss this enough as women who become mothers. I think many of us struggle to find ourselves again in motherhood and many might gain comfort in knowing they’re not alone in this journey. Motherhood is a wonderful, tumultuous, fascinating, sometimes ugly dark journey. It has its real ups, but it also has its testing (and very exhausting) moments. In those initial month’s patients will often reveal that they are struggling with the loss of identity or feeling lonely. Yes, you have an infant with you constantly- feeding off you, sleeping on you – but somehow you can still feel an overwhelming loneliness, an isolation from the “real world” as you mourn your pre-child life a little and the ease of it (if only you had really relished sleep-ins and pop-ins to the shops).