One of my biggest concerns is how little people pay attention to the mental health of mothers, including postpartum depression.
We talk about breastfeeding. We talk about postpartum hemorrhage. We talk about vaginal births versus c-sections. We talk about OBs and midwives and doulas. Natural birth and epidurals. You can search the net and find gazillions of stories about these issues every week.
But mental health is never at the top of the list. Don’t even try to argue with me that it is, because it ain’t. Period. This irks me to no end, given how many mothers suffer postpartum depression (at least 600,000 every year and more likely closer to 1 million). Given how many mothers actually get treated for postpartum depression (only 15%). And given that at no other time does a mother’s depression have more of an impact on her child’s current and future health than during the first year postpartum.
This morning, my friend Emily McKhann sent me a link from the New York Times Well blog this week and now I feel ever-so-slightly better …
Nowadays it’s increasingly clear that pediatricians, obstetrician-gynecologists and internists must be more alert. Research into postnatal depression in particular has underscored the importance of checking up on parents’ mental health in the first months of a baby’s life.
Dr. Perri Klass goes on to explain the impact untreated postpartum depression can have on kids. Thank you Dr. Klass. Thank you thank you thank you. Now we just need a million more of you, and some funding, and mandated screening, and we’ll be in good shape.
One of my biggest, takes-my-breath away fears about having PPD is not only its effect on my baby, but also on my toddler, whose observant little eyes saw my tears and despair and had to put up with an impatient and sometimes non-communicative, frustrated, mother. Though I am being treated, as we know, there is no quick fix, and there are months of symptoms she saw. I am terrified of the damage done to my children and pray that I can hug and kiss them enough to let them know they were and are always loved. I hope the treatment I sought was in-time to ward off any repercussions to my children. The crushing guilt of PPD is bad enough; I don’t want to also be responsible for lifelong issues my children develop because of this disease.
Lisa, The lifelong issues are much more likely to come for those who are never treated and haven’t sought help. Don’t be terrified. The fact that you care so much says a lot about the bonds you’ve formed with your children.
I was screened at my 6 week post partum checkup by my OB and I feel that this is not enough. I recently read that the most critical time for PPD to arise is 6 months post partum. If there is going to be mandated screening it should include something further out than the first month. My experience with PPD was feeling great for the first three months after my second child was born, then at month four I thought I was going to fall apart! I was uneducated at that point and thought that since I had been screened at 6 weeks and passed that I wasn’t suffering from PPD. I did not know that it can begin at any point in the first year. So I thought I was just not cut out to handle being a mom of 2 kids and other awful, untrue things.
I couldn’t agree more. That little questionnaire isn’t exactly easy to figure out either, if you’ve never dealt with PPD and have no idea what they’re talking about. My practitioner didn’t even look at mine or ask me about it during my 6wk postpartum checkup. Nobody ever followed up with me. And at 6 weeks pp, I still blew off what I was feeling as normal and sleep deprivation. At 6 months it would have been a lot harder to do that. PostPartum care and follow up absolutely needs to extend farther than 6 weeks. If PPD can occur any time within 12 months after birth, why are we NOT screening for it for that long? Are we just hoping that the moms will realize it and come in for help on their own without even knowing what they’re looking for?
But then, I also think they should scrap the literature they currently hand out and use the “Plain Mama English” symptom lists.
Thank you for sharing that atrticle. There realy does need to be a more comprehensive aproach to treating moms and the entire family when ppd/a strikes. No mother should fall through the cracks and be left untreated. But sometimes even if mom is recieving treatment that treatment may be completely inadequite and inflict more trauma on a family system that is more than likely already completely overtaxed. There are so many factors that play into the dynamics of depression and how it plays itself out. I developed severe ptsd & ppd. At my 6 wk postpartum visit i cryed the entire time and “spilled my guts“ about trauma due to domestic violence spured by untreated mental health issues in my husband that included depression & alcaholism. It was a nitemare. I was completly overwhelmed & could barely function. I could not get an appt at the psych clinic for a month even though the midwife helped set up the appt & it was made clear we were in severe crisis. I ended up hospitalized one week before the appt. The only reason I even stayed alive that long was because the midwives called every day to check up on me & help me get assistance from family, friends. I could not think for myself so they would call back to make sure I followed thru with their suggestions. They also made themselves available 24/7 as they encouraged me to contact the midwife on call if i needed someone to talk to. That group of women saved my life and the life of my children. For me one month wait was much too long. This major univetsity hospital had nothing else to offer except being sent to the emergency room or being evaled by a PET team wich would have been more traumatizing. Two hospitalizations later I was deamned a danger to my children for reporting intrusive thoughts. I was still sent home under the care of my sister after no visits allowed from my childen for the 10 day hold and no meds to stabilize my ptsd or ppd/a which they felt developed into bipolar disorder. From there things got tremedously worse before they got any better and even after 2 yrs of treatment we were never refered to services to help our family, my children and I, cope and function as a family unit. Now that I am more stable I can see the impact my and my husband’s mental health has had on my children. But there has also been a positive impact on my children along with the negative. All along they have been watching, learning and growing as they see mom work, struggle and fight toward health and recovery. It still continues to be a grueling process but worth all of the sweat and tears that have been invested in my mental health and that of my children.
Katherine, I SO agree with your frustration regarding the pitiful facetime PPD gets. It is more than just that people and websites and professionals are not talking about it; the audience isn’t reading it, either! I am the editor of Mothers of Change, an organization that advocates for improved maternity care in Canada. So we write about everything you listed; natural birth, epidurals, cesareans, breastfeeding; all things pregnancy, birth, and postpartum. When I write about PPD, I get about HALF the hits/views as when I write about anything else. I want to pull my hair out in frustration! This information will save lives! It will reduce illness! It will stop suffering! But women don’t want to read it! I want to put up a snarky post that says, ‘Refusing to READ about PPD is not a safeguard AGAINST IT.’
I keep having to remind myself that if I publish posts about PPD, at least they are out there in cyberspace, and hopefully people will come across them when they need them. But sheesh. Maybe it’s one of those things where you have to live in the trenches yourself for a bit before you care. Before you really realize the implications, and that you can be both mentally ill and normal.
Great link too! TY.