Katherine Stone

is the creator of this blog, and the founder and executive director of Postpartum Progress. She has been named a WebMD Health Hero, one of the fiercest women in America by More magazine, and one of the 15 most influential patient advocates to follow. She is a survivor of postpartum OCD.

Antidepressants During Pregnancy & Autism: A New Study

Antidepressants During Pregnancy & Autism: A New Study -postpartumprogress.com
Making the decision to get treatment for postpartum depression is hard. Making the decision whether to take antidepressants during pregnancy is even harder. I know. I’ve done both.

Any time either of my kids has a problem or shows a vulnerability, the first thought that will come to my head is, “It’s my fault.” For the first kid, now 14, it’s that he had to go through postpartum OCD with me. For the second, now 9, it’s that I chose to stay on my meds while I was pregnant with her so that I would be healthy and hopefully not get it again. (I didn’t, by the way.)

As someone who still struggles with anxiety to this day, I will tell you that it takes very little for my worries to blow up into big hairy nightmares that focus my every waking thought on all the most horrible things that could go wrong for my kids. And my worst fears of all are those where I’m the reason things go wrong.

The only thing that brings me back down out of the Cloud of Terror is data. Numbers. Real information. Could something bad happen? Yes. But what is the likelihood? What is the reality? And could there be other reasons why bad things happen that have nothing to do with me?

This week a study was published in JAMA Pediatrics that found that taking antidepressants during pregnancy may increase the risk of having a child with autism spectrum disorder. Is your heart racing? I know mine is. Uh oh. Here comes the Cloud of Terror again.

Except, wait. Stop. Think. Ask questions about this from people who are experts. Find out the real data.

I reached out to Samantha Meltzer-Brody, MD and Marlene Freeman, MD and asked what they thought about the study. And they said it doesn’t prove much. The rate of autism without exposure to antidepressants is 1%. The rate of autism among children whose moms took antidepressants in trimesters 2 and 3, according to this particular study, is 1.87%. The rate of autism among children whose mothers have anxiety or depression that goes untreated during pregnancy? I don’t know, but it’s a good question.

As Dr. Byan H. King, program director at the Seattle Children’s Autism Center at Seattle Children’s Hospital, pointed out in his editorial about the study, it tells us is that for every 200 moms who continue their antidepressants during pregnancy there may be one more child with autism than would be expected. And yet we still don’t know if the cause for that one more child is the antidepressant or something else. That’s the real data.

I know when you see these headlines it scares the daylights out of you. We’ve already been down this road before, and I’m sure we will again. I would encourage you to stop, breathe, and then read this story from the American Association of the Advancement of Science: “Reality check: Taking antidepressants while pregnant unlikely to double autism risk in kids.” It’s worth the read.

Each mother can only make the best decision she can for herself with the information available to her at that time. I wish it were easier. There’s no right answer. You have to talk to your doctor. You have to recognize there are risks, no matter which decisions we make. There are even risks in making no decisions at all.  You have to know that there are so many other moms out there with the same concerns and worries.  We know what it’s like. You’re not alone.

You might also like: How to Think About the Risk of Autism, The New York Times

We’re Researching ACEs and PPD, and We Need Your Help

Dear Warrior Moms,

If you have been around these parts for awhile, you know that Postpartum Progress is an amazingly strong, supportive, ass-kicking group of women. We have all walked through incredibly dark times, are currently walking through them, or battle the guilt and flashbacks following an arduous recovery. We battled through together. After experiencing a perinatal mood disorder, I know that I personally often look back and say, “Why did this happen to me?!” Although we are stronger because of our struggles, there is power in asking pertinent questions and reflecting on where we have been and how far we have come.

We want you to take an even farther look back, to the time of your life prior to becoming a mom. We want you to imagine your childhood and what shaped you to be the woman that you are today.

So often we analyze our pregnancies, past mental health history, and current life situations when battling a postpartum illness, which are all important frames of reference. But we got to thinking, what if there are factors from childhood that increase a woman’s potential to experience a perinatal mood disorder? What if we could harness information from all of you to understand how to better help protect and support women that might get PPD?

Well Warrior Moms, we are doing just that. We have an exciting research study that we are eager for you to be apart of, something that has never been done before.

In a simple, straight-forward survey that you can take in less than 2 minutes, we will ask you about any Adverse Childhood Experiences (ACEs) you may have had. In Plain Mama English, Adverse Childhood Experiences are traumatic personal or relational situations that took place when you were younger. The Centers for Disease Control have uncovered a link between childhood trauma (ACEs) and chronic diseases developed during adulthood, as well as social and emotional problems including depression and anxiety. We’ll also be asking you questions from about Resiliency, which looks at any protective factors you may have had that would have helped combat the negative effects of ACEs. Measures of resiliency include relationships and supportive infrastructures that encouraged you, offered love, and fostered your self image as a child.

This survey is absolutely anonymous. We want you to answer the questions completely honestly because it helps us see how many moms who’ve have perinatal mood or anxiety disorders may have had traumatic experiences as a child. Also, you can take it at any time, so please make sure you set aside a minute or two to help contribute your information.

We hope that, with your help, we can analyze this childhood data and see how it relates to the frequency of perinatal mood disorders. Again, all responses will be completely anonymous. Please help us gather this important retrospective information that could potentially assist moms in the future! Visit this link to complete the survey: http://fluidsurveys.com/surveys/postpartumprog/warrior-moms-aces/

Please note the survey is open to any mom who has had postpartum depression, postpartum anxiety, postpartum OCD, postpartum psychosis, postpartum bipolar onset, postpartum PTSD or anxiety or depression during pregnancy. It doesn’t matter if you are struggling with this illness now or did so in the past.

Please take our survey on Adverse Childhood Experiences and Postpartum Depression. -postpartumprogress.com
Thank you endlessly for your participation and support.
Your inner child also thanks you :o)

-Maria Weiters for Postpartum Progress

Postpartum Depression Stigma Persists Even In Federal Government

Postpartum Depression Stigma Still Exists, Even in the Federal Government -postpartumprogress.com
Update: We did hear back from the Office of Women’s Health quite quickly and they apologized for the tweet even though it didn’t come from their office. They assured us that they are fully supportive of moms with perinatal mental illness and that they don’t support stigmatizing language. They’re looking into where the tweet came from and why. We really appreciated the positive and sincere conversation about this. 

Someone told a mom in the Postpartum Progress community the other day that there is no longer any stigma when it comes to postpartum depression. We’re talking about it. We’re doing things about it. Moms need to realize that the stigma has abated! This mom reached out to me because she couldn’t believe what she was hearing. The person who had said that in her presence was a person in a position of leadership, a person with a lot of knowledge about perinatal mood and anxiety disorders. A person who should have known better.

Here at Postpartum Progress we talk to moms from around the US and around the world every day. We know how much the stigma of postpartum depression and related illnesses persists. And worse, we know how much that stigma scares moms and makes them afraid to reach out for the treatment that can help them.

Today I was fortunate to be part of a Twitter chat with the March of Dimes focusing on postpartum depression in NICU moms. Imagine my surprise when a chat that was supposed to help raise awareness and provide support to mothers ended up creating stigma.

Someone officially representing the US Department of Health and Human Services, Office of the Assistant Secretary for Health, tweeted the following: “In the United States, postpartum depression is one of the leading causes of murder of children less than one year of age.”

I was stunned. I took a screen capture of the tweet, because I was convinced no one would believe me that a statement like that would be made. It’s not correct. It’s unbelievably stigmatizing. And it came from people responsible for health in our own government. People who should definitely know better.

Tweet from @HHS_OASHRegion2 at 1:32 PM EST on 11/18/15 -postpartumprogress.com
So let’s talk for a minute about perinatal mental health and real information about infanticide. If you are a mom who is sensitive right now, I would suggest not reading any further because data about babies and tragedy can be really hard to deal with when you’re struggling.

Okay? Trigger warning commenced. Okay. 

According to the National Center for Vital Statistics, here are the top 10 leading causes of death of children from 0 to age 1 in the year 2013 (none of these, you’ll notice, is homicide):

  1. Birth defects (congenital anomalies)
  2. Short gestation
  3. Maternal pregnancy complications
  4. SIDS
  5. Unintentional injury
  6. Placenta & cord issues
  7. Bacterial sepsis
  8. Respiratory distress
  9. Circulatory system disease
  10. Neonatal hemorrhage

According to the CDC, there were 23,440 deaths of children between the ages of 0 and 1 in 2013. Their data shows that a total of 282 of those 2013 deaths were homicides, but the data doesn’t drill down any further to offer information about who the perpetrator of the crimes may have been. If you read the infanticide report from Child Trends, a nonprofit nonpartisan research center, however, studies suggest that male caretakers are the perpetrators of the majority of infant homicides.

We can’t ignore, of course, that there is a 4% infanticide rate for women who experience postpartum psychosis. Postpartum psychosis occurs in approximately 1 in 1,000 mothers. Postpartum depression, on the other hand, occurs in 1 in 7 mothers. Thankfully infanticide due to psychosis is rare. It is a very serious illness that can lead a mom to suffer from delusions and/or hallucinations that may lead her to do things she would never otherwise do. This is why it’s so important that we take good care of these moms and that they get the professional medical care they need and deserve… something that is not happening in a lot of places.

Moms with postpartum depression are not likely to harm their kids. That’s the truth. But the fear that they will, or could, is one of the things that makes them afraid to reach out for help. This is what makes them keep their thoughts and feelings to themselves, rather than tell another person. This is why that tweet matters. Because we want women who are struggling to reach out as soon as possible. The sooner they get help the sooner they get better, and that has a big positive impact on both mom’s and baby’s health.

The tweet has since been taken down. That’s important, and we’re glad. It’s a start. But just taking it down doesn’t address what led someone in Health & Human Services to think it was correct and should be shared in the first place. How do we as a community make sure that there is a better understanding of the facts of maternal mental health, and a better understanding of and how to communicate with moms that postpartum depression is common and that it’s important to get help? As the executive director of Postpartum Progress, I have reached out to the Office of Women’s Health and asked them to call us back. We know we can have a really great conversation together. We’ll let you all know what happens next.

PPD in the News: What to Do When Tragedy Strikes

PPD in the News: What to Do When Tragedy Strikes -postpartumprogress.com

If you ever have the radio on, a television on in your vicinity, or follow social media at any point during any given day, you will hear stories of tragedy. Sadly, sometimes those stories involve moms with perinatal mood and anxiety disorders.

We know stories such as those are painful to hear and can make you fearful and anxious and also have the potential to trigger your symptoms. So here’s a guide for what to do and how to care for yourself when you hear upsetting news.

Self-Care Steps to Take When Tragedy Strikes

First and foremost, please to try remember that another person’s story is NOT your story. We don’t know what goes on behind the scenes in another person’s life, and neither does the media.

You don’t know what a person’s risk factors are, what type of symptoms she has or had and how severe they were; whether she sought professional help and received a proper diagnosis; whether she was being treated at all or effectively; what her life circumstances are and what stressors she may have been dealing with; and what kind of support she may have had around her. Each of us is a very unique individual and this is why it’s just never helpful or healthy to compare. The fact that a mom in the news has an illness that is the same as yours or similar to yours has little bearing on you and what is happening with you. Her story is NOT your story.

Second, try to consider the data. Numbers don’t lie. The vast, VAST, SUPERVAST majority of moms with perinatal mood or anxiety disorders never end up in the news. There’s a reason for that: It’s rare for a tragedy to happen. We still talk about them because, when they do happen, it’s an important reminder that maternal mental health awareness is important and providing the best help to moms who need it is important.

Third, try to remove yourself from news that might be upsetting to you or affect your health. You can turn off the TV or radio, walk away from the computer or smartphone, and instead do something nice for yourself. Focus on people or things you enjoy or that help you feel centered. Sometimes I light a candle. Sometimes I take a hot shower. Sometimes I play a favorite CD. These are little things that tend to help me calm down when I feel myself drifting toward anxiety or becoming obsessed over bad things that could happen but very likely never will.

And finally, if national tragedies or upsetting stories related to moms are really triggering you to the point that you have a worsening of your own symptoms and all the self-care in the world isn’t helping, call your therapist, social worker, psychiatrist, or whoever the person is who is already helping you with your perinatal mood or anxiety disorder. It’s more than okay to reach back out for help and say that you are concerned and need some support during this time. If you don’t have someone you can reach out to, try the SAMHSA Disaster Distress Helpline.