What a Postpartum Enema Taught Me About Self-Care

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During labor I’d been surprised to learn the obvious: contraction is a literal name. Once mine kicked in with gusto, my insides felt like they were squeezed in a vise powered by thunder, compressing my body into a black hole. The power of the constriction actually lifted me into the air. 

I’d asked the delivery nurses how anyone ever pooped again after labor. They let my question hang in the air, unanswered. So I was grateful the next day for my first postpartum crap. But a few weeks later, my luck had run out. 

When I could no longer sit because of the constipation contortion, and my home remedies did nothing, I drove myself to a local emergency clinic. After a brief intake questioning by the admitting nurse, I was led to an exam compartment in a windowless corridor at the back of the building, where they’d administer a saline enema. 

After the nurse completed her professional handiwork, I leapt from the exam table and fled towards the bathroom adjoining the compartment. My hospital gown flapped open in the back. I was glad it hadn’t fallen off, though I’d been more worried about evacuating my bowels onto the floor. I’d presumed one bag of saline solution injected into my butthole would do the trick. But once inside the bathroom, I sat, and waited, with no relief forthcoming. 

I calculated when I’d have to get home to my newborn daughter, who’d be due for a rendezvous with my boobs. I’d left her with my husband so abruptly I hadn’t factored in pumping a reserve supply. I’d had one thing on my mind and one thing only — rectal relief. For the first time since childbirth, I’d put myself first. 

If something didn’t start moving as I perched on the toilet, I’d be facing another sleepless night of nursing accompanied by the sensation of impending explosion in my colon. An added pressure quickly presented itself: the bathroom I’d run into was shared with the exam compartment on the other side. As I waited for the enema to kick in, I could hear my neighbors assessing their takeout: “My burger was cold – how ‘bout you?” So if relief came, I’d have to decide how much dignity I could squander as I grunted my way to bowel liberation. 

“How are you doing? Anything happen yet?” the clinic nurse asked me through the door.

“Not yet — shouldn’t it have worked by now?” I responded, imploringly, as if the way I asked would jumpstart my bowels.

“OK, just give it some more time,” she said. “If it doesn’t work we’ll send you home with some other options.” I didn’t want other options. I wanted relief, and I wanted it yesterday. 

A new mama’s body is an animal body, capable of many strengths and fragilities. (And this can be true, with countless variations, whether a mother has birthed her child or not.) In my first month of motherhood I’d learned quickly my animal body was usually left to fend for itself, the terrain of newborn care a galaxy where I orbited mostly alone. It was a final frontier, with infrequent visitors.

I’d scroll through posts and articles about self-care for new mothers, but how it actually happened in any meaningful form had been lost on me. My trip to the clinic to cure my constipation had been born of brute necessity, a far cry from the fantasies I’d had of eating oysters and sipping champagne in a luxurious bubble bath. 

The clinic bathroom was a slate grey, tiled box that conjured a hotel aesthetic, but was clearly designed to accommodate being hosed down with industrial grade cleaners. My eyes focused on the drain in the floor. I wondered how much could be washed down its patterned holes. I checked my phone to keep track of the elapsing minutes. The countdown to nursing and the countdown to giving up on the enema ran in parallel time.

Sitting there, trying to relax in the chill of the antiseptic decor, I had no way of knowing that four months later I still wouldn’t have had a bath with oysters and champagne. But I’d have an ultrasound taken of my right boob, followed by a biopsy, to make sure a small lump was related to breastfeeding and not cancer. 

Nor could I foresee that six months later, I still wouldn’t have had that bath with oysters and champagne. But I’d have a color printout of pictures of my colon with an “A+” the doctor had scrolled across the paper before handing it to me, for a colonoscopy performed to make sure my recurring bleeding was just due to small tears in rectal tissue still sensitive from birth. 

Or, that as my daughter turned one, and then two, I’d still be barely able to scrounge up a shower more than once a week, and would have finally given up on the self-care fantasy of the indulgent bath. 

By then, I’d acknowledge the vast space between wish and the reality in which I lived. By then, I would part ways with surface, inadequate models of self-care — many of which I’d blithely followed before motherhood — and enter something else. I’d release myself from pre-birth expectations, expectations I couldn’t live up to, and, worse, that my spouse couldn’t figure out how to live up to. We just kept crossing our wires in my postpartum flight to a new normal. 

Eventually I’d throw my expectations into the void between fantasy and reality, just hurl them off the precipice from which I ended up dangling. And I’d give up. And I’d let it be okay. And I’d love my daughter. And I’d remember loving my spouse with abandon. And I’d just accept it all. And I’d listen to The Mother by Brandi Carlile blaring on repeat when I got to leave the house alone.

And by the time my daughter was three, I’d pick up on the male-parent strategy (ruse? oblivious individualism?) of just ducking out to do things, without asking permission or over-coordinating my absence. I’d sneak up the stairs and fill the bath as hot as I could stand it, and submerge my head into steaming silence. Or, I’d leave the house and finally get my long-awaited oysters with a good, older friend who assured me everything I was navigating was normal, and not a shameful aberration.

And by the time my daughter was four, I’d let go of the over-worn paradigms of self-care, and decide that, for me, self-preservation and mother-celebration would be my thing, would be essential aspects of how I’d lead our family beyond survival into wholeness. Oysters and champagne in bubble baths are delightful treats, but I’d see how I deserved — and my family required — more. 

I’d come to understand — as so many different voices in the contemporary cultural landscape have begun articulating — that in order to parent my child with radiant strength, I had to regard myself as worthy of a nourished, boundary-protected haven. I’d have to recognize how I’m not just a woman craving luxurious reprieve. I’m an essential leader and caregiver for our species, trying one-domestic-day-at-a-time to rebuild the macro through the micro.     

But that night at the clinic, I couldn’t know any of those recognitions were coming. I could only sit and wait, my eyes flitting between the grey tile and my phone, my mind moving between my daughter, my bowels, and a glorious future of bubbles and oysters. I could only sit and wait, and nearly howl with relief when everything I no longer needed got evacuated into the waters below, and the tile chamber let the splash echo, the impassive walls witness to my joyous release.