I am a birth doula with first-hand experience in Postpartum Depression (PPD), Post Traumatic Stress Disorder (PTSD), and ongoing bouts of anxiety. With every family I serve, I seek to stress the importance of learning how to recognize the signs of depression and other Perinatal Mood and Anxiety Disorders (PMADs). Once thought of as an extreme case of the “baby blues,” we now know that Perinatal Mood and Anxiety Disorders affect at least 1 in 7 pregnant women. Women with clinical depression and/or anxiety during pregnancy or the year following childbirth account for a much larger portion of society than just a seldom “extreme case.”
My depression began immediately after the birth of my second child in February of 2009. The birth was traumatic: an attempted homebirth that ended in cesarean section. I was angry at the outcome of the birth and how the hospital staff treated me and my daughter. I felt betrayed by my own body and by my care providers. I went through the classic stages of depression: sorrow, anger, grief, hopelessness and loss; and yet no-one offered true, tangible, medical help for my sickness. I needed help and no-one was there to give it. My family and a couple of therapists I saw shrugged me off and told me that I should just “be happy” since the baby was healthy. My husband supported me but was clueless as to how to help. Any “help” I got came in the form of books and the internet. The medical establishment totally failed me. Thankfully, I did not act on either of the suicidal ideations that I had.
There was one friend who was able to give me true help. She had spent the last few years caring for her mother who suffered from bipolar disorder and had been on antidepressants herself. My friend listened to my story without judgement and offered sound advice, but reminded me that there was no single “right” way for treatment. She told me the best treatment is targeted for each person’s specific needs and to not give up trying until I had found what treatment worked for me. I am incredibly thankful for that sound wisdom as I was able to come out of the depression after 2 years of struggling.
Depression runs in my family; my grandmother has diagnosed bipolar disorder and many of my female relatives have suffered from depression. And yet in all my pregnancies, no-one ever wanted to discuss my family history of mental illness. As a birth doula, I am adamant in discussing histories of mental illness, as it increases a woman’s likelihood to develop a PMAD of some sort. Other risk factors include a sensitivity to hormonal changes, a history of trauma or abuse, stress, a lack of support, and your personality type. I had four risk factors total.
I dream of a day when every pregnant woman would have discussions with their care providers about their mental health as often as they get their urine tested (every appointment). Mainstream media has begun to highlight the complexities of PMADs. Documentaries, such as When The Bough Breaks and Dark Side of The Full Moon, have brought much needed attention to these topics and are helping to break down the stigma surrounding women and childbirth (namely, that having a baby should be the happiest moment in a woman’s life and that motherhood will come naturally). In an episode titled Mother Nature, ABC’s show Black-ish showcased a mother of 5 realizing that, although she’s considered herself a novice mother, her fifth birth brought on Postpartum Depression. It showed her family’s fear, support, and judgement in an honest way. If more media will show women struggling through Perinatal Mood and Anxiety Disorders, popular opinion will see it as a variation of normal. Then we can begin to rally around women to see changes in healthcare.
Currently, six Perinatal Mood and Anxiety Disorders are recognized: Depression, Anxiety, OCD, PTSD, Bipolar Disorder, and Psychosis. If you are suffering with Perinatal Mood and Anxiety Disorder, please know that you are not alone. There is help. Contact me or the resources listed below.
Be well, dear ones.