Only after the woman had her own child how difficult it was to be a mother. A. she realize

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A. she realized
B. had she realized
C. she had realized
(答案→)D. did she realize
解析：句意：只有那个女人有了自己的孩子之后，她才意识到做一个母亲有多难。Only+状语置于句首，主句要用部分倒装，故排除A&C；由因为状语从句中使用了一般过去时，主句的时态要发生在从句之后，因此排除B，故答案选D。