Wednesday, October 24, 2007

Postpartum Depression - MOTHERS Act

As my contribution to this day I decided to write a post that's hopefully somewhat enlightening & that might help lift the taboo from postpartum depression (also known as postnatal depression), particularly in women who suffered from infertility prior to the birth of their child/ren. (Interested in articles about PPD after Assisted Reproduction? See the bottom of this blog post.)

Infertility usually means at least a year of unsuccessful attemts to conceive before turning to a medical professional for help. After this, it's a process of many months or even years before a baby becomes a reality. During this time, having a baby often becomes a woman's goal in life (I'm deliberately leaving out the father here, because I want to refer to my thoughts on what might contribute to the incidence of PPD specifically in women), often taking a toll on her education, career, marriage, friendships, etc. Having a baby is the goal & the baby can become idealized, frequently as a warm, cuddly creature dressed in pastel colors, who coos on cue and smiles lovingly at her mommy...

I think it's rare for a woman to be prepared for the reality of motherhood (not exactly the description above, at least not all the time). Although I have a sister who is 9 years younger than I (and therefore I should have known something about having a baby), when I first brought Hadas home from the hospital, all I could think was, "OK, so what do I do with her now?" When she cried and I didn't know how to calm her, I was practically in tears. She was a fairly good sleeper - at night - but during the day, she demanded pretty much constant attention - 16 hours a day. She was alert, interested in everything, a good eater and mostly happy, but it was tiring - day after day, every day. I didn't have many people to interact with or places to take her, so aside from walks, we were mostly at home. My whole life changed when she was born but, of course, having her had been my choice, something I'd waited for for over 3 years (3 years of TTC + 9 months until she was born). How could I possibly complain about having a beautiful, healthy baby?

Fortunately, I have no personal experience with PPD, but I'm guessing that's how it is - there are the perfectly normal hardships and then the depression that sets in. On top of that, is the guilt for feeling the way you do - or for completely losing control of your emotions.

Having the "baby blues" is normal, but baby blues are very different from Postpartum Depression. Here are some brief descriptions adapted from
emedicinehealth (in purple):

The "baby blues" are a passing state of heightened emotions that occurs in about half of women who have recently given birth. It peaks 3-5 days after delivery and lasts up to 2 weeks, during which time the woman may cry more easily than usual and may have trouble sleeping or feel irritable, sad, and "on edge" emotionally. Baby blues don't interfere with a woman's ability to care for her baby.

Postpartum depression is depression that occurs soon after having a baby. Some health professionals call it postpartum nonpsychotic depression. It occurs in about 10-20% of women, usually within a few months of delivery. Symptoms include depressed mood, tearfulness, inability to enjoy pleasurable activities, trouble sleeping, fatigue, appetite problems, suicidal thoughts, feelings of inadequacy as a parent, and impaired concentration.

A woman who experiences postpartum depression may worry about the baby's health and well-being. She may have negative thoughts about the baby and fears about harming the infant.
Postpartum depression interferes with a woman's ability to care for her baby. It can also lead to suicidal and homicidal thoughts.

Having PPD, from what I learned is a serious problem, but what is really important is to know that it's treatable. Treating PPD is the best thing a woman can do both for herself and for her baby. Women with PPD may have difficulty taking the first step, or even acknowledging that there is a problem. If you're a woman with PPD - tell someone. Let them help you get help. If you have a friend with PPD, find out more about getting help for your friend. If the first professional doesn't help, persist until you find someone who does.

Getting help means giving yourself an excellent chance of going on to having a healthy, rewarding experience as a mommy.

Special thanks to Katherine Stone who took the time to speak to me at BlogHer 2007 and who, as a survivor, devotes incredible amounts of time and energy to increasing awareness about postpartum mood disorders.

Recent research performed by Karin Hammarberg (link to doctoral thesis), who also published an article entitled "Assisted conception is a risk factor for postnatal mood disturbance and early parenting difficulties" in Fertility & Sterility (link to abstract) has indeed shown a higher incidence of postpartum mood disorders among women who conceived with the help of ART.

An additional article I read, entitled "Impact of a multiple, IVF birth on post-partum mental health: a composite analysis", published in Human Reproduction (link to abstract, full pdf available from that page), suggests that the higher incidence of multiples in IVF births is a factor that raises the risk of PPD after ART.

Feel free to ask for explanations :-) This post is just getting too long...


Unknown said...

Hi Rachel! Nice to "meet" you. I have a best friend struggling with infertility now and will send her your site as another means of support.

Great blog! Six children is the most wonderful thing EVER!!


Anonymous said...

Women who have struggled with infertility are particularly vulnerable to pospartum depression. They, more than others, have seen their desired baby as being the goal that they've been striving for-- through years of treatment, ups and downs, unpleasant or unthinking comments of others, and significant physical stress and pain. The child who is born cannot possibly meet the idyllic expectations of the mother. The baby will cry and the mother will be unable to comfort him or her. The mother may feel a sense of betrayal. After all, "this is the baby for whom I yearned" and yet the baby refuses to be calm. The mother can feel disappointment and then guilt for feeling disappointed. Add to that the hormonal changes that birth brings, and the mother can sink into a depression that becomes debilitating. Well-meaning family and friends often offer sage advice: "You shouldn't feel sad; you finally have your baby and he is beautiful." Such "help" only causes the mother to feel worse. A mother suffering postpartum depression needs to be listened to patiently, and professional help should be sought. Husbands and parents need to be supportive and helpful. Women do recover from this to become loving and caring mothers.

Anonymous said...

Rachel this is a terrific post. Thanks for participating in the Blog Day for the Mothers Act.

JewishMama said...

Thank you so much for this post. You're right, those of us TTC for years get fixated on having a baby- it's the ultimate goal, and we mistakenly think having a child will solve all our problems.

Anonymous said...

Thanks for your support of the MOTHERS Act. Too often postpartum depression is a problem that goes unnoticed, and most women with PPD never receive any type of treatment. PPD is a treatable illness, and it is essential that we continue to educate ourselves and others about this important issue.

For more information on PPD, visit us at The MGH Center for Women's Mental Health

Sarah said...

thanks for posting this, such an important topic.

ps- your new profile pic is great, looks very happy!

Sambalina said...

Thanks for posting this. As someone who went through infertility, and now PPD.. its nice to know I'm not alone. Thank you.

kelly said...

hi rachel, nice to heard that your blog is helping wemens who are suffering from infertility . I have a friend who is suffering with infertility ill advice her to visit your site.Its nice to know that my friend is not alone now
Dual Diagnosis

Anonymous said...

Wow! That was a really helpful explaination with some nice suggestions. There really is so much taboo surrounding postpartum. I think it all comes down to understanding, it's a purely chemical process happening in your body and it WILL eventually pass.

Thanks again.