At 6:12 on the fourth morning after my C-section, I found my mother packing the suitcase she had promised would stay in my house for six weeks.

At six weeks, Dr. Mehta walked into exam room three with my chart tucked under her arm. She was a no-nonsense obstetrician in her fifties who had delivered half the babies in Mecklenburg County.

"Alright, Rachel," she said, pulling up her stool. "Let's see how that belly is knitting."

I climbed onto the examination table, wincing slightly as I lay flat. Dr. Mehta pulled up my shirt and pressed her fingers methodically along the lower ridge of my pelvis. The incision was a thin, angry pink line, slightly puckered on the left corner.

"There's some mild hypertrophic scarring here," she observed, her gloved fingers gentle but firm. "You've been lifting things you shouldn't have been lifting."

"I have twins," I said simply.

Dr. Mehta glanced up over her glasses. "Your chart says you had full-time family support lined up for the first six weeks. Your mother was staying through mid-October, correct?"

A dry, bitter knot rose in my throat. "Plans changed. She had an emergency in Florida."

Dr. Mehta held my gaze for three beats too long. She didn't ask what the emergency was. Doctors who deal with postpartum women see the wreckage of broken families every single day. She wheeled her stool back over to the desk, pulled out the postpartum depression screening sheet, and set it down before me.

"Your Edinburgh score is elevated, Rachel. You scored high on anxiety and feelings of isolation."

"I'm not depressed," I said quickly. "I'm just tired. I'm taking care of two infants alone from seven to six every single day."

"That isn't exhaustion; that’s structural failure," Dr. Mehta countered, signing her name with an aggressive stroke of her pen. "The human female is not biologically designed to survive the fourth trimester in solitary confinement with multiples. You are physically healing, yes. The uterus is involuted. But your nervous system is in redline."

She tore the referral slip from her pad and handed it to me. It had the name of an individual trauma therapist specializing in familial enmeshment and postpartum transitions.

"What is this for?" I asked.

"For the incision nobody can see," Dr. Mehta said softly. "The one your mother left when she took the stitches out before the wound was closed."

I folded the paper into quarters and pressed it into the bottom of my diaper bag, right next to the spare pacifiers and the burp cloths. When I walked out to the parking lot, Evan was waiting in the idling car, both car seats buckled into the back.

He looked at me through the driver's side window, his face full of quiet, desperate love. I opened the door, climbed into the passenger seat, and for the first time in six weeks, I didn't cry.

"She cleared me," I told him. "Physically, at least."

"And the rest?" he asked.