One in five women will experience Postpartum Depression. In my doula training, we all discussed that we think that number might be higher, closer to one in four. Postpartum Depression is a condition that people are generally aware of but few understand. I experienced Postpartum Depression after I gave birth to my daughter. No one warned me that I would feel suicidal and have violent disturbing intrusive thoughts. If I had had some warning I think I could have managed better, I might have asked for help. Instead, I suffered in silence.
Now that I’m a doula, looking back at my daughter’s birth I can see the “pink” flags. We call them pink flags because women experiencing these things don’t always get PPD, but the more stress a woman experiences during her pregnancy the more likely she is to experience PPD. I suffered from Hyperemesis Gravidarum my entire pregnancy, vomiting all day every day and spending the night in the hospital after a particularly violent session. I was also going through an identity crisis because my pregnancy was preventing me from working and I didn’t know who I was anymore after spending 10 months with my head in a toilet. On the day I delivered my daughter, my OB was unavailable and I met the woman who would deliver my daughter five minutes before pushing. After my daughter was born we had difficulty latching. I remember when the nurse came in and asked me if my daughter wanted some shot, and I remember thinking why the hell would she ask me that? I don’t know, she’s the professional, I’ve been a mom for ten seconds! And I felt so scared. I was terrified. I had these big brown eyes looking at me for help and not an ounce of instinct for what to do. And, she did not stop crying. I was unprepared for how much crying and how little sleeping happens after birth.
I expected everyone to respect the fact that I had pushed a baby out of my body, but there’s no recovery time. We were discharged the next morning and I remember the fear overtaking me when we couldn’t figure out her car seat. No one would help us, and yet here we were trying to get the most important thing in our lives home safely. And when people honked at us in the parking lot of the hospital to hurry up, I remember feeling completely hopeless. How were we ever going to manage?
You’d think having a night nurse would have made things better, but mental health challenges never make sense! Because we have no family nearby, we hired a baby nurse to help us for the first two weeks. I want to pause here and distinguish a night nurse or baby nurse from a doula. A doula helps the mom. A baby nurse helps the baby. I am a doula, I help the mommy and the family which can mean baby care, but it’s not specifically baby care. The nurse changes, feeds and watches the baby and washes some bottles.
Anyway, we had a night nurse who I became both afraid of and then resentful of – all due to my Postpartum Depression. At first, we were so relieved to see her because we were both feeling insecure and scared. She swaddled our daughter and all was good. I took a shower and climbed into bed, beyond exhausted from the whirlwind 24 hours. Literally an hour later my chest started leaking. Painful and engorged boobs that seemingly came out of nowhere. No one explained to me that your milk comes in like that, I thought the failed breastfeeding we had tried at the hospital was milk. Turns out that was colostrum. Add a little pink flag to your column if you’re keeping score. I might have known some more if I had hired a doula, but hindsight can drive you crazy too.
So our nurse was very strict. This made me feel even worse, I felt like I didn’t know the first thing about how to care for my baby. When I would feel sad, I would walk back to my room and lay down. I didn’t want anyone to see me crying as much as I was. I knew something was wrong when I kept hiding from everyone. After a good cry I would fall asleep and that’s when the intrusive thoughts would invade. Visions of jumping out a window and leaving her to be raised without me because surely I would mess things up for her; visions of car accidents with the whole family … horrible, horrible thoughts would pop into my head every time I’d drift into sleep. When I would wake up, the emotion would be gone and then shame would take over. I would feel embarrassed and disgusted with myself. What kind of a person, what kind of a mother has these thoughts? Sometimes this shame spiral would send me into another torture sleep. Sometimes I’d drag myself out of the house and force myself to get air.
Little by little as we got our systems in place and figured out how to do all the basic things like diaper changes and how to interpret her cries my cloud started to lift. Seeing other moms struggle with their basics at my first Mommy & Me group helped me feel more confident. Sleep though was by far the best remedy. The more quality sleep I could get, the less likely it was that the intrusive thoughts would attack.
And then one day, it was completely gone. I remember it because I was playing basketball and a girl knocked me to the ground. I was so happy to be knocked on the ground. It felt like home. Something I had done in my pre-pregnancy life I played a lot of basketball, which is a contact sport. When I got pregnant and then was recovering I felt fragile and vulnerable. This hit brought me back to my old self, this girl wasn’t treating me like a mom or a pregnant girl, she needed the ball and I had it. I came back from the game non stop chattering to my partner. I talked the entire drive back and all the next morning. I remember feeling happy to be happy again. That was also when I had this thought like: holy shit I’ve been depressed this whole time.
Even now, three years later, once in a while I feel a pang of shame over those intrusive thoughts. I’ve learned to accept my experience as normal and strive to help women experiencing PPD themselves as a doula.
As a doula, I help women in their postpartum period, their 4th trimester as we say. Because I experienced Postpartum Depression, I know from experience as well as my doula training what to look for and how to help. If I know a mama has a few pink flags, I know to expect some mental health challenges. Not all women who experience PPD will have pink flags, they might have no flags and the PPD attacks out of nowhere. But going in with a battle plan for PPD is standard for me these days. And, men can experience a version of depression following the birth of a new family member. Dads experience the anxiety, depression and sleepless nights too.
So what can you do when you notice a new family struggling? I have a three-step action plan for anyone helping a new family or a family that just expanded:
- Do don’t ask. See dirty dishes or a big laundry pile? Roll up your sleeves and get to work. Everyone is exhausted and overwhelmed: they don’t have the bandwidth to notice the work piling up, be an asset, not a guest. If you can allow the new parents some quality sleep by picking up a few chores that’s a huge help.
- Get the mama outside in fresh air. Encourage her to take walks with the baby, encourage her to attend Mommy & Me groups so she can build her community. If you notice her withdrawing and retreating, open the windows and get fresh air into the house. This is the biggest and most significant weapon when fighting PPD. Fresh air and community.
- Encourage her. Or him. This demon is rooted in insecurity and doubt, collaborate with the parents on how to tackle their hurdles. Don’t offer unsolicited advice, build them up and highlight their mini successes during the day. Give an end of day recap to the mama about all the great things she did for her baby.
Professional help is available to women experiencing PPD, and often times I have clients seek therapy before birth either because they had PPD before or they have a few pink flags and they want some systems in place. Therapy is the best. If you can get your struggling mama to therapy go for it, but don’t feel like you have to suggest it if you feel like she might be offended by the idea.
If you’re a partner to a woman who you think is experiencing postpartum depression, you can get help for yourself. If your partner won’t get help, you can be the leader and get into therapy to get some coping skills for your new family. I suggest this too.
If you think you’re experiencing Postpartum Depression yourself, I see you. You’re not alone and you’re not a bad mom. You’re tired, you’re scared and you need support. You are going to come through this darkness eventually. The intrusive thoughts are not you and they do not define you. You will connect with that baby and you will be the mom you want to be. And, I’m sending you a big hug right now.
