Postpartum Depression – How We Are Failing Mothers

*Disclaimer. I am NOT a medical professional. I will link outside sources for you to begin further personal research. Please do not substitute what is written here for proper medical and scientific research.*

This isn’t a topic many enjoy talking about, it’s not even a topic many want to talk about. But that is part of the problem. More and more I realize that our medical system is failing mothers and their newborns. It is failing them in that postpartum depression screening is not standard protocol in ALL practices.

Lately I have noticed that I am extremely lucky to have OBs AND a pediatrician that screen mothers for postpartum depression. They use a questionnaire called the Edinburgh Postnatal Depression Scale (EPDS), at each postpartum followup, as well as well-baby checkups. It is the standard for determining if a mother might be suffering from postpartum depression. It’s a simple 2 minute questionnaire that can drastically change the course of a mother’s treatment.

After Sebastian was born I had horrible thoughts. Thoughts that made me feel as though I were crazy. Yet instead of opening up to someone and seeking help – I kept how I felt to myself. Partly due to the fact that, even though I was taking the EPDS, I hadn’t fully admitted to myself how I was feeling. So while answering truthfully, my truth at the time didn’t reflect the actual facts. That I had PPD.

I didn’t know much about PPD at the time and I didn’t realize how common it was. How a hormone imbalance after having a baby can be the cause. Getting PPD was not something I could control, but it was something I could do something about – I simply chose not to, which was the wrong choice!

Thankfully my PPD wasnt all too severe, however it did put a strain on our marriage for a while. I was angry for no reason (a sign of depression) and I had ZERO motivation to do ANYTHING (another sign of depression) but sit and hold my baby. Now I have a patient, and I mean PATIENT man for a husband but even he can only take so much. He would ask if anything was wrong and I would lash out. Accusing him of thinking I wasnt a good mother – knowing full well he didn’t think that. Yet in my irrational mind, I thought I wasnt. So clearly everyone else must have thought so too.

Time went on and things got better (thankfully); I got pregnant with Theo and eventually opened up to EM about how I had been feeling after Bastian was born. He reassured me that though the thoughts I had were not normal, it wasnt me, it was the PPD and that it was something we could take on … together. 9 months later Theo was born and this time we had a plan. We were going to be open with each other. I with him about how I was feeling, and he with me in case he noticed signs I didn’t. And it worked! This time I didn’t suffer from PPD right away – but PPD’s less known sister PPA. Postpartum Anxiety.
I couldn’t sleep due to thoughts of Theo somehow coming loose from his swaddle and suffocating himself. From thinking the room was either too hot and he’d over heat, or he was too cold and would freeze. It didn’t matter if I KNEW the thermostat was set to a comfortable temperature, or that I KNEW he was dressed properly – it was never right and it would surely lead to a poor end. I would stare at him all night long. I worried about things that I personally didn’t normally worry about – not even with a previous newborn. Then at 4 months postpartum PPD showed up. Late onset is common, and yet (from speaking to other moms) easily ignored by their medical professionals. They are told that it’s too far after giving birth to be PPD related, so it must be something else.

It took admitting to myself that I needed help, for me to start doing more research. 50-80% of mothers will have “baby blues” and approximately 15% will suffer from PPD. Now I personally take issue with that number – and here is why. I have spoken to too many mothers that have admitted to either, 1) suffering in silence – as I did after Bastian, 2) to not seeking help, or 3) never having had their medical provider mention PPD, screen for PPD, OR (this is the worst one) dismiss it as “baby blues” even when it is well after the 2-3 week period and it NOT going away on its own, as baby blues does.

That right there is where we are failing mothers!

First off, we all need to be more vocal about our experience. It is scary but it is NOT something to be ashamed of! And listen – it does not, and I repeat DOES NOT mean that you’re a crazy person.

Second, we need to push for an industry wide screening protocol standard for new mothers, and for a  longer period of time than just the first month postpartum. I was shocked and saddened by how many mothers I have met that have felt hopeless and lost, and whose provider never even mentioned PPD nor gave them the EPDS questionnaire. It is a simple piece of paper folks! With the amount of paperwork you fill out while pregnant, this one extra sheet won’t break the bank. PRINT IT OUT AND GIVE IT TO THESE MOTHERS! It’s not complicated! What it is, is potentially life saving in some cases!

Too often you hear of mothers who have taken their own lives after the overwhelming feelings of PPD and not having had anyone reach out to offer help. No mother should EVER get to that point – especially not for something that is treatable.

Which brings me to my next issue. There is a stigma around mental health. There is a stigma around mothers needing medicine to help them “mother”, as some would view it. Here’s the thing – if you aren’t healthy, you aren’t helping anyone. Mama needs to take care of herself first! While I have no issues with pharmaceuticals, I prefer to find possible alternatives. However, if the alternatives don’t help or don’t help enough, then I switch to the medicine that does. There are options before medicating, if the thought of medicating is what is keeping you from seeking help.

1) Get your progesterone levels checked by your provider. Some will tell you there is no point…they are wrong – insist upon it. YOU are your greatest advocate, it is YOUR medical care – the provider merely PROVIDES it. Inform yourself. Here’s a great link to medical research done by the PPVI Institute for the Study of Human Reproduction and data as to the benefits of progesterone therapy for postpartum depression. It has been a night and day difference for a lot of mothers!

2) Get your vitamin D levels checked. Another test many providers will question – rather annoyingly – but even if you’re not lucky enough to have a supportive one such as my own – insist upon it. A diet lacking in certain vitamins may cause PPD in certain women. This is especially true for PPA. Three common symptoms of a vitamin D deficiency are depression, mood changes and irritability, and fatigue. (This is the method that has worked best for me. To the point where EM mentioned how much better I was doing.)

3) Counseling. A lot of women find this extremely beneficial, and for some it is enough to treat the PPD.

If none of those three methods seem to be working for you – speak to your medical provider about other options. For a lot of mothers the help of SSRI’s has allowed them to escape the suppression of PPD and live a normal life.

The method that works best is different for each case of PPD. No method is inherently better than the other, and no method makes you a better or worse mother. The best method is the method that works.

What is important is that we can help mothers heal and not feel as though there is no way out of this darkness. There is a light, we merely need to shine it! We need to make PPD/PPA/PPP (postpartum psychosis: suicidal thoughts, hallucinations etc. If you are experiencing either of those symptoms please go to your nearest emergency room) awareness a core issue in maternal fetal care. If we are failing mothers we are failing their children.