I am so excited to share the following interview with you, between authors and fellow Warrior Moms Elizabeth Isadora Gold and Julia Ferro on the occasion of the release of Julia’s new novel, Cutting Teeth. Both had risk factors for postpartum anxiety, but were never warned or screened, and both found it difficult, as so many of you do, to find the help they needed.

I met Julia Fierro in 2009, when I was her student at one of her fiction workshops. We were both struggling writers, but Julia was also the mother of a toddler, Luca. I would sit in her kitchen, allegedly discussing a short story, but really staring at photos of her beautiful boy, wondering if I’d ever have a child. One day, towards the end of the workshop, she casually mentioned she’d had postpartum depression and postpartum anxiety after Luca’s birth. Though I’d heard of PPD, I’d had never known anyone with such a (to my mind, then) “rare” condition, and didn’t know what to say. We weren’t in touch much after the workshop – she had a second child, Cece (now four), I had my daughter, Clara (three). When I suffered my own postpartum mental illness, isolated and fearful, I didn’t feel comfortable reaching out to Julia. Then, last spring I saw via facebook that Julia had sold a novel, Cutting Teeth, and she would be reading a preview at a local Brooklyn bookstore. The excerpt was hilarious: a lone stay-at-home-dad in a mommy group, admires his nursing friends’ lactating breasts. After the reading, Julia and I hugged like long-lost friends. We’d spent several years on parallel tracks, both suffering from postpartum anxiety, writing about parenthood, community, and anxiety. In a happy coincidence, we were also each writing books about mother’s groups, though hers is a novel and mine is nonfiction. As Cutting Teeth (St. Martin’s Press) approached its release date, we chatted for Postpartum Progress about writing, motherhood, and life.  ~ EIG

EIG: So we should catch each other up on what we never talked about:  I was your student when Luca was a toddler, and knew you’d been sick, but I didn’t really understand.

JF: I’ve been obsessive compulsive since I was a child. I went on medication at the end of my college senior year, because I was having debilitating panic attacks. The first twenty-five years of my life were very exhausting. Obsession, obsession, and depression. When my husband, Justin, and I started getting ready to have a baby, the psychiatrist I was seeing made me go off medication a year before we even started trying. But she was the only person I could find on my insurance within miles.

EIG: No psychiatrist takes insurance. Which is an issue, because if you can’t afford a psychiatrist who doesn’t take insurance, you get less good psychiatric care.

JF: Right. She said, “You don’t want any medication. You don’t want to hurt the baby.” I didn’t have anyone to talk to. It was hard to go off medication, but I was working from home, I didn’t have a kid yet, and the business wasn’t as big. The pregnancy was difficult – I threw up every single day.  It was a difficult birth. I was in labor for three days. On the third night, they gave me the epidural and pitocin, but it still felt like he was going to come out of my hip. The delivery room was where the insecurity and the self-doubt that would hang over me for years began. The midwife was yelling at me to push, and I was like, “I don’t know what you’re telling me!”

EIG: For so many women, the birth is the beginning of feeling like you’re doing everything wrong. I don’t know if that’s a chicken and an egg thing. Would someone who had a difficult birth but not go on to get postpartum depression or anxiety feel okay about the birth? Or should part of the diagnostic for postpartum depression or anxiety be, immediately after birth, “How do you feel about this experience?”

JF: There should be some kind of therapy. Even a social worker in the hospital to ask, “How do you feel?” Just talking for five minutes would be more than nothing. I couldn’t even get a lactation consultant to visit me.

EIG: Me neither! You know who came to my room? People wanting to take photographs that I could pay for. They came twice.

JF: Yes!

EIG: Did you have a c-section?

JF: Yes. After that, for two days, it was great, Luca was beautiful. On the third night, they took him to get his vitals checked, and they didn’t bring him back! An intern came, stopped in our doorway, and said, “Your baby has a fever, so we took him up to the NICU.” And she just walked out! We were so exhausted, we cracked. Now, I met Justin when I was 21, so he practically raised me, getting me through my obsession, and the medications. So seeing him crumble? I actually said, “If the baby dies we can have another baby.” He just had a fever! Our family wasn’t there because they don’t live nearby. It was the worst moment. (Sighs.) I can’t believe I’m getting upset about it. It was seven years ago. His birthday is next week.

EIG: I’ve been doing interviews with moms for my book, and everyone starts crying when they talk about the birth.

JF: Luca was in the little bubble incubator, and I turned to the pediatrician – I was so out of my mind –and said, “Is he going to die?” And he was like, “No.” When they moved him to the bigger room in the NICU, and then I saw how big he was compared to the tiny preemies, that made me realize he was okay. That shaky feeling stayed with me for the next two years.

EIG: I had a very similar experience after my c-section, and I think it’s very common for women who have had surgery. I was very jealous of how Danny (my husband) was with her, how easy it seemed for him, how proud he was of her. For example, I didn’t seen Clara’s fully naked body until I was home for like a week, which was so upsetting. In my mind, I was supposed to have this experience where I would see her body come out of me, we would be naked together, and she would be on my chest. Because of the surgery, I never had that moment. As a result, for me, it took me a longer time to attach. I was like, I don’t know who this person is, this could be anybody’s baby. There was a sheet over me when I gave birth. It’s a very primal, primate-like thing when someone else touches your baby first.

JF: For me the breastfeeding was such a disaster that first time. I couldn’t breastfeed, because I was too anxious. I wish I could go back in time and fix that.

EIG: Do you wish you could go back in time and make the breastfeeding better? Or that you could get on medication, and make the feeling better? 

JF: Yes. (Laughs.) I didn’t know things like, your baby is going to want you to hold him. My babies were not the kind you could put down. They would cry endlessly. My philosophy of early parenting: do what’s easiest. That’s always going to be the right thing for you and your baby. I realized later we should have put Luca on formula, because it was so agonizing to breastfeed. Trying to nurse that first day when we were back home, I’d left the breast pump on, and I thought it was saying to me, “You can’t do this, you can’t do this.” I decided to stay off medication because I didn’t know you could go on medication and nurse. I didn’t have anyone to turn to. Our parents did this thirty years ago. They didn’t remember.

EIG: Having kids later, you don’t receive the same benefit of parental wisdom, because they don’t remember. My mom always told me, “We carried you around in a basket!” Once I had Clara, I was like, “With a pillow? Was I smothered?”

JF: Justin was back to work, and here I was with the baby who cried all day long. One weekend I panicked because I was worried about him getting dehydrated (which is why he got the fever and ended up in the NICU). He wasn’t nursing. We went to our pediatrician, who said to me, “Look at your baby, he is so healthy and fat. Do you think maybe it is your own anxiety that is causing him not to nurse?”

EIG: In that moment, he could have caught the fact that you were sick, and reframed it. He could have said, “Look at your baby. He’s healthy and fat. I’m concerned about you.”

JF: Or how about, “You’re doing a good job!” Instead, he said, “If you’re anxious, the child is going to feel that.” When a woman is feeling an uncontrollable postpartum depression or anxiety, to have someone say, “If you don’t stop feeling what you’re feeling you’re going to harm your child.” It’s so irresponsible.

EIG: My OB, who I’ve chosen to stay with, who I otherwise like very much, who got me through two miscarriages with grace and compassion, and performed surgery on me beautifully…  I went to her a few days before I was due with Clara, and I’d started having serious anxiety. I was saying, “I’m having trouble breathing, I’m feeling crawly feelings all over my body,” which are classic anxiety symptoms.  “I don’t know if I can give birth, have a baby, be a mother.” She said, “Do you want to have the baby right now then? I could just induce you.” I look back and realize what she should have said was, “It sounds like you’re having very serious anxiety. Maybe it would be a good idea to talk to somebody at this point.” In retrospect, what I was describing was not just advanced nesting, or slight nervousness, it was a marker of what was to come – and a more aware doctor might have seen that.

JF: Again, wouldn’t it be great in an ideal world if every OB had a therapist on staff?

EIG: There should be a psych consult, there should be something you fill out, a freaking pamphlet. When I had miscarriages, they didn’t even give me a pamphlet. You shouldn’t have to Google. Thank god for Postpartum Progress, because this was the web site I found.

JF: I can’t believe the years I spent where I didn’t even think to get treatment. I’d been obsessive my whole life, so I didn’t think my problem was postpartum. Even so, I made Justin take a month off after Luca was born because I was in such bad shape. He almost got fired.

EIG: My husband told me the hardest thing he ever had to do was leaving the house knowing I didn’t feel able to take care of the baby. We’d get sitters over to hang out with me and hold Clara because she wouldn’t take a bottle from me.

JF: Luca was a challenging child. When he was 18 months old, I still was not medicated, because I didn’t think I needed it! I was so mired in depression. Everyone was telling me I should be on medication, and I was miserable, and felt so guilty because I wasn’t enjoying my time with my son. I still worry that maybe my anxiety or depression affected him, and that he’ll have emotional problems. When he was two, he was running back and forth in the apartment all day long. There was a lot of stress on play dates, and on the playground.

EIG: I remember you told us about him in class. There was this photo of him in his Halloween costume, and he was so yummy and delicious…

JF: He was so beautiful. I had to write about it in Cutting Teeth with the characters Leah and Chase. I thought, there has to be a mother in this book who loves her child, and who’s worried about what other people are thinking about him, not just as a reflection on herself but because she wants her child to be loved.

Anyway, I finally got on Lexapro, and stayed on it… until I got pregnant again. That pregnancy with Cece was where everything fell apart. Again, I threw up every day. Justin lost his job, we had to move. Luca was home with me, I had a babysitter I didn’t like that much, and I would cancel babysitting. And then the swine flu stuff started happening…

EIG: Which, I should add, is a very big plot point in the book with the character Nicole, who obsesses over swine flu.

JF: People were getting sick with swine flu that summer, and Cece was due in the fall. I started obsessing over Mommy message boards, the news, googling H1N1. My mom pressured me to get everyone vaccinated, but I couldn’t find any. Pregnant women had died in the hospital. I didn’t feel irrational as it was happening. I was seeing another psychiatrist, and would call him in tears saying, “I can’t do this, I’m thinking about my family dying every second of every day. I’m in a serious episode.” He would pull out a book that looked like three bibles stacked together, and read the statistical possibility of birth defects if I went back on medication. We just never left the house.

JF: After Cece was born, everything went really well, because we could plan. I went on Zoloft three days later, and it absolutely transformed my life. I held her in my arms as I nursed for days and days. I’d had a c-section, and it hurt so much, but I wanted to do it. I avoided all postpartum depression the second time.

EIG: What you needed was a doctor who would interpret the information for you. When I first got sick, I had a phone call with one doctor, who was too expensive for me – her initial consult was five hundred dollars — but she gave me the best advice anyone gave me for free. At the time, I was taking Ativan throughout the day. I had been told by my psychiatrist and my pediatrician that I had to pump and dump, which was really hard to do four times a day. Clara was four months old, I was falling behind with my milk, and we were supplementing with formula. My major fear was that I would have to give up nursing, which felt like the one thing that had been going well. Anyway, this doctor said, “You don’t have to pump and dump. Just don’t nurse for four hours after taking a pill.” I had been waking up in the morning with the screaming child, pumping, feeling terrible. Her advice made it all feel more doable.

JF: None of the moms I was friends with at the time were on medication. It wasn’t until I wrote an essay for Huffington Post Parents, women write to me who I know, telling me they were on medication when they were pregnant. There’s still such a stigma. I think many women have postpartum anxiety and depression to some degree.

EG: And that the term, “baby blues” needs to be excised from the vocabulary.

JF: I put that line in the novel that if Nicole had to hear the term “baby blues” one more time, she would punch her pediatrician.

EG: And there is so little about anxiety as opposed to depression. What you – and we all — needed was your OB, your psychiatrist, and your pediatrician to be able and willing to freely consult with each other. When I went to my OB with postpartum anxiety, she didn’t even have any referrals to psychiatrists. 

JF: For the novel, I’ve started a “Parenting Confessional” on Tumblr. There are so many incredibly sad, terrified, alone women. These women are posting from all over the world. There’s not necessarily any place for them to go for help.

EG: It just argues for more awareness. We need a Business of Being Born for postpartum depression. Nobody told me I was at higher risk for postpartum if I’d had miscarriages, gestational diabetes, and a c-section. I needed someone to look at the big picture and say, “The level of hormonal fluctuation your body just went through is not typical; we should keep an eye on you.” For you, no one stepped back and said, “You have a history of depression and OCD. Let’s be proactive.” 

JF: I was so practiced at hiding my suffering. Women need better screening, because often they’re not able to help themselves. I’m really only talking about this in public now, when Luca is seven and Cece is four and a half. Cutting Teeth is really my confession. The public perception of what a good mother is does not include having a breakdown after your child is born, or of being on medication, or weeping, or having moments of regret.

EG: This is why my mom’s group was so great, and why I’m writing a book about it. We were not the perfect perception of new mothers, and all of us actually talked. Knowing that nothing and no one is having the perfect experience – that got me through the first year.

JF: I don’t think that anything is harder than being a mother. I just don’t.

Elizabeth Isadora Gold’s book, The Mommy Group: Freaking Out, F**king Up, and the First Two Years will be published by Atria Books in 2016. Her writing has appeared in The New York Times, The Believer, Tin House, the Rumpus, Time Out New York, as well as many other publications. She lives in Brooklyn with her husband and young daughter. She can be reached at her website,www.elizabethisadoragold.com, or via Twitter @elizisadora.

Julia Fierro’s novel, Cutting Teeth, about the complicated and often comical contemporary parenting experience, is one of the most anticipated debuts of 2014 and publishes on May 13th. She lives in Brooklyn with her husband and their two children. Visit Julia’s website at www.juliafierro.com and find her on Twitter @juliafierro.