Mark Schafer/HBO

Experts weigh in on the postpartum issues portrayed in the episode.

April 17, 2017

Much has be been written about the many ways in which the HBO show Girls is unrealistic: Critics have pointed out that oft-unemployed characters couldn't afford such spacious Brooklyn apartments, for example. And that Hannah would never have gotten that job teaching "the Internet" at an upstate college. Even the timeline of Hannah's pregnancy seems suspect. (She slept with Paul-Louis at the beginning of summer, and then we see her heavily pregnant and it is somehow still summer?) But experts say last night's series finale accurately portrayed several lesser-known truths about new motherhood. Below, a lactation consultant, an ob-gyn, and a psychologist highlight some of the postpartum challenges depicted in the episode.

Grover's on-and-off breastfeeding

Throughout the episode Hannah struggles to breastfeed baby Grover. Adding to her frustration is the fact that he was breastfeeding just fine at first, until suddenly he would only take a bottle. Danielle Tropea, a lactation consultant based in the New York City metro area, says this isn't unusual. "Sometimes a baby breastfeeds really well right after the birth, and afterwards it can go downhill," she says. Mom and baby may be successful at the hospital. "Then when they're on their own at home, they have problems."

One reason is simply that breastfeeding is a new skill for new moms, and it can take time to get the hang of it, Tropea says. (She recommends moms-to-be take a breastfeeding class while they're still pregnant to help them feel more confident once baby arrives.)

Women who are struggling may hire a lactation consultant, or attend a new mom support group. Many hospitals offer them, as well as out-patient consultations. Moms can also seek advice through La Leche League's breastfeeding helpline: 877-452-5324.

Sometimes simple tweaks can make all the difference, such as positioning the baby differently, or holding her with a different arm. "These are things that most women don't realize, especially when you haven't seen breastfeeding happen up close before," Tropea explains.

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Marnie's "envelope" technique

As Hanna attempts to get Grover to latch, Marnie suggests she try making "an envelope" with her nipple. Tropea says she hadn't heard of the "envelope" before, but teaches her clients a technique that sounds similar to the one Marnie was describing. Called sandwiching, it involves pinching the areola into a sandwich shape, tilting baby's head back, and then placing the nipple on baby's top lip. "When they open up, you bring baby in fast and you're holding the areola, and for lack of a better word, you smush most of it in their mouth and hold until they start sucking," she says.

Why the term "sandwich"? "When you eat a sandwich, you eat it parallel to your lips: it aligns with the line of your mouth," explains Tropea. "Imagine the way you would eat it, then imagine if you flipped it over so it was parallel to your nose. If you explain that to a parent, they can visualize it better."

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Hannah's down-there recovery

Hannah alludes to her slow physical recovery from childbirth, commenting to her mother that she's "still bleeding" and waiting for her vagina and butt to "feel like separate entities" again. This is a normal, albeit uncomfortable postpartum sensation, says ob-gyn Sherry Ross, MD, author of She-ology: The Definitive Guide to Women's Intimate Health.

"After having a vaginal birth, it's hard to differentiate your vagina and rectum," says Dr. Ross. "The trauma from pushing the baby out and having unexpected tearing in this area causes pain, tenderness, and numbing weeks after delivery."

The good news: "The vagina is very resilient," says Dr. Ross, adding that the area should be "close to 'as good as new'" within six weeks.

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The difficulties of new motherhood

Adjusting to life as a mom is challenging for many women, and Hannah's emotional roller coaster, while dramatic, is pretty relatable. "At a fundamental level, new moms have to deal with physical changes, emotional changes, planning and scheduling challenges, career changes, and immeasurable sleep loss," says psychologist Kevin Gilliland, PsyD, executive director of Innovation360. "It's a mix of feelings, from overwhelming joy to just plain overwhelming."

During this time, self-care is key, experts say. Get as much rest as you can. Drink lots of water. Eat healthy, balanced meals. Ask for help when you need it. And above all else, be patient with yourself.

"I always tell my patients they get a 'pass' for one year following the birth of their baby," says Dr. Ross. That means going easy on yourself, setting realistic expectations about what you can handle, and not pressuring yourself to "get back" to your pre-baby body.

It may help to remember you are not alone. As Dr. Ross points out, "Everyone who has ever had a baby has gone through the same experiences."