Postpartum depression and anxiety diagnosis and my personal recovery

On Becoming What I Needed: How my experience with a perinatal mood and anxiety diagnosis helped me to be a better mother and practitioner.

I feel guilt around the ease of my first two births. During each postpartum period, nursing was challenging but not impossible and parenting my two babies was instinctive. I’m sympathetic to the number of people who experience perinatal trauma, and therefore, never felt it was appropriate to speak about how much I enjoyed giving birth…until my third baby came.

With my first child, I labored for five hours in a bath, catching sleep between contractions, with my husband and my doula by my side. Midwives and nurses looked on and offered encouraging words. After 20 minutes of pushing, I held my newborn son in my arms. I was fortunate in so many ways and it was very much my ideal birth.

In 2014, my daughter was born in under three hours. I was eight cm when we arrived at the hospital. My doula, midwife and husband gently encouraged me through my fast labor. When she was born, my attending supporters looked on in awe, seeing what was to many of them their first birth en-caul. I repeat, I was fortunate in so many ways and it was very much my ideal birth.

Then, my third child was born:

In my apartment bathtub, in less than an hour, medically unassisted but attended by my husband. I had three minor contractions and a sudden strong desire to be in cold water. I bore down once and my water broke. Moments later, a second push brought my son earthside. It was several seconds before he started breathing.

In this same moment, my husband simultaneously managed to text our doula, call our midwife and contact 911. Eight firemen from Engine 240 burst through our apartment door where I stood paralyzed; wet, shivering, and bleeding while cradling my newborn son (imagine my combined horror: the station is next door to my home and I know these men well). They cut our umbilical cord and I lost sight of my husband and baby. I didn’t move from that bathtub for a long time.  

I remember feeling cold and confused. Instead of reveling in the beautiful new human I’d just birthed, all I could think about was how humiliated I was, how I’d robbed my baby of a decent entrance, and how my body didn’t wait to deliver him in a sanitary, supervised place. I also became super focused on the dinner we’d started cooking less than an hour before. There was no skin-to-skin, no delayed cord clamping, no magic hour. Mentally, I ran every scenario on how I could have lost him.

Realizing I needed help

Later, when my older two children came to meet their new brother, I felt no tenderness— only absolute fear and panic as they held him and cooed at his tiny hands and feet. I have little memory after week four other than the problematic, disruptive, and intrusive thoughts that I couldn’t curb; I was unable to focus and felt disconnected from life. I was hyper vigilant, I wouldn’t let my new baby out of my sight but was afraid to be alone with all three of my children. What if I couldn’t protect us? The ceiling could collapse and we could be swarmed by mosquitoes. A meteor could hit. I was restless, pacing, not sleeping and terrified of everything. I yelled, and raged; I was paranoid and fixated, I cried endlessly. Then one day my 5-year-old son wrote me a letter. It read, “Mommy, I’m so sorry you are so sad these days,” alongside a note that read, “Daddy, I know you have a lot of work to do, I want you to know I’m here to help.” It was time to seek help.

My path to recovery

My midwives introduced me to The Motherhood Center of New York. During that first phone call, I was met with compassion, insight, and wisdom. I was admitted to their day program, which both shocked and comforted me. I met thoughtful, strong, smart women who were having similar experiences as me and we shared our stories, shared meals together, held each other’s babies, and had the space to be truthful and authentic about motherhood. Community is missing in modern parenting. I was given the space to be “mothered”.

Recognizing the patterns – a call for help

Rapid birth leaves room for lots of wounds – literal and figurative – and birth PTSD is a risk factor for PMADs. However, many symptoms showed up while I was pregnant. I had jumped head first into managing a stressful large-scale project at work (which sent me to the hospital twice). I was not taking the proper care of myself, or preparing for the baby to arrive, or even paying much attention to my family. I kept insisting that I had to complete the project before I could go back to thinking about the baby, my family or myself and the anxiety was mounting. Shifts in priorities and distraction tactics: red flags for perinatal anxiety.

My inspiration and advocacy

I recognize very few people have access to this kind of specific treatment and care but I’m so glad I had this experience because it helped me identify the gaps in care needed by new families. I’ve since begun an MSW program to focus on perinatal mental health. I became certified as a birth and postpartum doula, lactation counselor and childbirth educator.

I’m an advocate for elevating this issue; we must stop requiring our new parents to be the same person, do the same things or return to a “before” following the birth of a baby. I felt a calling to do the work about a week into my experience at The Motherhood Center when I realized how supportive women can be of those around them while simultaneously being so hard on themselves. I didn’t understand the spectrum of disorders and the range of symptoms and intensity within them. I certainly didn’t think it could affect a third-time “seasoned” mother.

Birth work puts me in front of families, supporting them as they make decisions about their health, pregnancy, birth and beyond. Many birthing people believe the extreme feelings they are experiencing are normal and don’t seek treatment. While we focus on baby care, we neglect to care for new mothers. I want to be there for the people who are brave enough to take the next steps for self-care, which is essential for being a “good” parent. I can now recognize the signs and understand that even the most experienced parents are not necessarily experienced at helping themselves. I want to help change the narrative for new parents struggling with identity shifts and help them navigate through the tricky politics of self-care.     

I feel obligated to disclose my story – because while not normal, this is a very common biological shift which happens to many people (15 -20% of new mothers according to PSI). Additionally, 10% of people with partners who experience a PMAD will themselves suffer from the same diagnosis.

I want to speak this secret out loud so others don’t feel so alone. I want to have a real conversation about the trickle down effect of poor perinatal mental health and why new parents need care as much as new babies. For me, treatment, community and self-care/loving kindness were instrumental when facing my postpartum anxiety. While I was treated by incredible clinicians who helped me through a genuinely tender time, it was authentically connecting with other people which was equally healing.

How can we change the narrative and create healing spaces for new families while championing the need for support?

New parents shouldn’t require critical care to be well cared for. Parenthood is a great equalizer and ALL parents deserve permission to take care of themselves during the transition to parenthood. One of my professional goals is to help parents understand their experiences are common and unique all at once. My doula reclaimed my experiences, held the feelings I couldn’t yet process myself and brought me back to the present. It felt like a magic trick. It’s now so important to me to show parents they are seen, they are known, and they are not alone.

Think you might know someone who is struggling with a PMAD? Here are a few tips to help them.

1. Take note of their behavior during pregnancy. Look for red flags and risk factors. Learn the symptoms to help your friends or family members find help early. Have they adjusted their behavior? Are they often canceling plans? Or are they avoiding activities that used to bring them joy? Are they responding to phone calls or texts?
2. Visit new parents, but for a reasonable amount of time (think 30 minutes)…and bring food or newborn diapers. Checking in after some routines have been established can be helpful if you suspect your friend/family member might have had a few risk factors for a PMAD. It doesn’t hurt to be prepared with resources in your area.
3. Help your friends establish a community through new parenting groups or breastfeeding support groups. Community building helps because it reminds new families they are not alone, and if they are struggling, with help, they can get better.
4. Take your cues from the new mama but be mindful – new parents often appear “fine”. Don’t be afraid to ask the deep questions and remember, early detection can help ward off longer periods of struggle.
5. Looking for a gift for a friend? Hire them a postpartum doula. 🙂