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Lamott is a self-confessed non-superwoman--preoccupied with Sam in the early months of his life, it is as much as she can do to brush her teeth, let alone get out of bed. Writing, her life's work? She obviously misses it, but for a few difficult months, even as she is sole-breadwinner for her little family--she just can't get up the energy to do it. The reader knows that she finished this book, that she kept on writing--but the reader also understands that for a certain time period Lamott was paralyzed by her new experience.
The book is very obviously adapted from a real journal--prior to Sam's birth, she worries about the fact that he is male. She worries about his alien genitals, and goes for circumcision because it's obviously what she likes in a man, as much as it is for any health reasons. These worries fade once Sam is born, replaced by the reality of colic, poop, and struggle for a balance between "Sam-time" and "Mom-time." It shows Lamott's talent as a writer that this sequential experience of changes in her baby's life comes as a strength, not a weakness.