We Must Do Better When it Comes to Postpartum Care

I didn’t know what hard work was until I had my first child. I was 30 years old and had never stayed at a job longer than two years, so it shocked me to my core how hard caring for a newborn was. I always hated working and the responsibility that came with it, but this was a million times harder than any job I temporarily held.

I didn’t have much help with my daughter because my husband was dealing with his father’s death just months before Isla was born. I don’t blame him now, because the loss of his father, his best friend, was gut wrenching and tragic. But back then I resented it. My husband also was dealing with serious family turmoil after his dad’s death and that was almost as tragic. My family all lives in Dallas, but my mom would try to come down and help some.

I didn’t get much sleep; I was exhausted all the time. I was breastfeeding, and I think that made everything harder. I breastfed for eight months, which I considered a feat, but I also became severely depressed and believed I couldn’t take any antidepressants while breastfeeding. My psychiatrist told me that. He was dead wrong.

There was nobody to pick up the slack while my husband was at work or at night, which made the depression and anxiety worse. At the time I didn’t have a housekeeper, so household chores fell by the wayside. I wanted to be like my mom friends who seemed to do it all — take care of a newborn, work, clean the house, etc. They all looked like they were handling being a new mom so well; it made me feel like a failure. I felt guilty all the time, too. I didn’t lose the baby weight I had gained, and my self-image went down the toilet.

I was in bad shape, to say the least, but my psychiatrist didn’t seem to care about the issues I told him about. He told me I had treatment-resistant depression and didn’t change a thing in my treatment plan, despite my suicidal ideation at times. I felt hopeless and wanted a new doctor but there aren’t a lot in Corpus Christi. The ones I called had months-long wait lists.

When my daughter was still little, we decided to get pregnant again. Immediately the depression lifted, thanks to a ton of feel-good hormones. I was tired a lot but it was a nice respite from the darkness I faced after having my daughter. But all good things come to an end. After my son was born I had severe postpartum depression. This time I talked with my OBGYN about taking antidepressants, which she assured me was fine to do while breastfeeding.

Things were different after I had my son, Eli. First of all, I had help; my mother in law moved to Corpus Christi and helped out with the kids a lot. And we were able to get a housekeeper, which lightened my load a lot. Despite things being somewhat easier, my depression continued. I started abusing my anxiety medication and was suicidal again.

One night I made a plan to die by suicide. I didn’t make an attempt, but I was close. I was sobbing and hysterical. My best friend told me to go to the emergency room, so I drove myself and was hospitalized for two days. When I left, I didn’t feel any better, but I did find a new psychiatrist from Southlake who could do phone visits.

I was still suffering though, which led me to enter an inpatient program at the Menninger Clinic in Houston, TX. I stayed there for six weeks. My medications were changed, I was introduced to new therapies, and most importantly, I was given hope that I would feel better. And eventually I did.

I know I talk a lot about my hospitalization, but I have a point — postpartum care, well, mental health care in general, is bullshit. I reached out to my doctor and the doctors at the hospital where I first stayed. But it didn’t matter. I was flailing, about to kill myself, before getting actual help. WE SHOULDN’T HAVE TO BREAKDOWN IN ORDER TO GET CARE WE NEED. I know that not everybody can go to a high dollar hospital and stay for six weeks. A lot of people can’t afford to pay out of pocket for mental health care, which I do a lot. My therapist and psychiatrist don’t even take insurance.

We must change the way we care for new mothers. We must change mental health care and make it affordable to all. One in five adults in the U.S. experience mental illness. One in 20 experience serious mental illness. Only 45 percent of people with mental illness get treatment in a given year. About 1 in 8 women experience symptoms of postpartum depression. These other types of postpartum depression include postpartum anxiety, postpartum obsessive-compulsive disorder (OCD), postpartum panic disorder, postpartum post-traumatic stress disorder (PTSD) and postpartum psychosis. It’s not a minor illness; it affects a lot of women on a daily basis.

I feel like if it happened to me, it’s happened to many others (especially women of color) who didn’t fare quite as well as I did. The National Institutes of Health reports this: Nine percent of white women initiated postpartum mental health care, compared with 4 percent of black women and 5 percent of Latinas. Black women are more likely to have PPD and are less likely to receive help.

There’s so much more to say, but I’m going to wrap it up. I just want to leave you with this: We need to do better. Mental health care is health care, and it’s absolutely a necessity.

If you are struggling with suicidal thoughts, go to the emergency room or call the National Suicide Prevention Lifeline at 800-273-8255.

See below for symptoms of postpartum depression.

According to the CDC, symptoms of PPD include:

  • Guilt
  • Fears of harming the baby
  • Feeling angry
  • Isolating from family
  • Feeling disconnected from their baby
  • Crying more than normal

Post partum depression, trucks and ponies

I’m cleaning out my car the other day and finding the odd little things moms find in their cars – a pair of shoes, one sock, three My Little Ponies and a monster truck. These make me smile because at one point in my car all that was there was Chick-fil-a trash, which also makes me smile, but for different reasons. I love finding toys here and there, reminding me how lucky I am that I have two beautiful, clever children who love me.

But to be honest, after giving birth to them my depression worsened. My hormones and brain chemistry were altered and I went down dark roads I never imagined existed. Do I regret having babies? No way. Will I have more? No way. But I do want to discuss Postpartum Depression and Post Weaning Depression.

During my first pregnancy, I was happy a lot, albeit anxious, even though my family was facing terrible times – my husband’s dad died and there was chaos within the family. But my hormones wouldn’t let me be sad a whole lot during these times. After giving birth to a girl, I breastfed her for 8 months. I felt the depression creeping back in and I no longer had the protection of pregnancy hormones to keep me happy. I stopped breastfeeding cold turkey, without so much as talking to a lactation consultant or my doctor. I just wanted to get back on meds (at this time I was told by my now former psychiatrist that I would not be able to be on meds and breastfeed, which is not true).

The pain in my breasts was nothing compared to the waves of depression that crashed down on me over and over. I was suicidal. My husband and mom didn’t understand what was happening. My doctors didn’t know what to do so they recommended I go to the local psychiatric hospital, which I didn’t want to do and I found inadequate. I felt my whole postpartum care was inadequate, except for my OB’s care. Once I was on meds, and then more meds, the darkness began to let up. The suicidal thoughts receded.

I was on meds on top of meds and it was then I was labeled “treatment resistant.” I felt brushed off my psychiatrist. This was what it was going to be like forever? When my daughter was about 16 or 17 months old, my husband and I decided I would get off my meds and try for another baby. Secretly I was hoping to feel the happiness I had felt with my first pregnancy but no such luck. I felt anxious and moody, but I could go several weeks without a migraine, so there’s that. It was a difficult pregnancy – I was diagnosed with gestational diabetes at 20 weeks followed by polyhydraminos which led me to give birth to my son at 37 weeks. So I was relieved when it was over and I was prepared for the PPD, asking for Zoloft as soon as I could get it. My OB understood. Nobody wanted a repeat of last time.

And even though I was prepared and on medication, it still hit. It was more than the “baby blues.” I was sad all the time, I didn’t think anyone else could take care of the baby the way I could which led to exhaustion, which led to more anxiety and irritability. I constantly checked on the baby and worried. I was weepy. And worst case scenarios always popped through my head. Plus, I had a toddler to take care of. Whether you have help is irrelevant. You feel so alone and scared.  It’s like someone has taken over your body and brain. When it gets really bad, you have suicidal thoughts. If that happens, you need to tell someone and seek help immediately by going to the ER or calling 911.

The “baby blues” affects up to 80% of births, according to the National Institute of Mental Health (NIMH), but those symptoms are mild and usually go away after about two weeks. The NIMH also says that PPD affects almost 15% of births – that sounds awfully low to me – symptoms are severe and can began between a week to a month after delivery. Because of the severity of PPD’s symptoms, women may have trouble taking care of themselves and the baby, so it’s really important to take note of your symptoms – how long they stick around and just how bad they get.

Postpartum depression is no joke and I had never heard of Post Weaning Depression after breastfeeding before I experienced it. People are starting to learn more about PPD and Post Weaning Depression but it’s still something that needs to discussed. It’s not just a “women’s problem” that should be discussed behind closed doors. Forget that. It really does take a village.