Katherine Stone

is the founder 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 top 20 Social Media Moms by Working Mother magazine. She is a survivor of postpartum OCD.

Parenting After Childhood Trauma

parenting after childhood traumaDid you experience childhood trauma? It’s worth thinking about if you are pregnant or postpartum and struggling with symptoms of depression, anxiety or PTSD. Or even, actually, if you’re just a mom out there reading this and wondering how early traumatic events could possibly affect your parenting.

Childhood trauma can include any event during which you felt (even if you don’t remember) helpless, scared, horrified, out of control and/or overwhelmed. These events or situations can include:

  • extreme poverty
  • homelessness
  • a natural disaster or war happening where you lived
  • physical, emotional or sexual abuse
  • neglect
  • domestic violence in the home, such as seeing your mother choked or hit
  • a parent with alcoholism or addiction
  • a parent with a mental illness
  • a parent in prison
  • the death of a parent
  • a parent who left your family (abandonment)

These are events that obviously can deeply affect anyone. And yet as adults we often think what “happened in the past shouldn’t affect me” because it’s “old news.” We think as adults we should no longer be impacted by experiences that happened decades ago.

The truth is childhood trauma can actually change how your body works, including your brain. This is why it has the power to affect you later in life, even when you are all grown up.

When I think about the traumas I went through as a child, it makes things that have happened to me and continue to happen to me as a mother make a lot more sense.

When I was born I was placed for adoption. I lived with my adoptive parents for a few months — I don’t even know how many, to be honest — and then was returned back to my biological parents, two young college students who hadn’t planned on getting married or having a baby. I lived with parental alcoholism at a young age and also parental mental illness. It’s no surprise to me, when I think about it, that I later suffered postpartum anxiety and OCD after the birth of my first child.

I was essentially hysterically vigilant over Jackson from the moment he was born. I worried I wouldn’t be able to take care of him enough. I couldn’t sleep. Couldn’t relax. It felt very important to protect him, so much so that all of my intrusive thoughts were about me being the one to cause him hurt. I think now about the fact that my own experience in the first few unstable months of my life MUST have impacted how I was thinking and behaving when Jack was a newborn.

In my tween years, I was fondled by a strange man in a Sears department store. My dad was in a different part of the store with my brother, and I was alone in the girls’ section when he approached me. He tried to get me to leave the store with him but I managed to run away. I can’t remember a lot of the details but I do remember standing in the store while people looked for him, and having all of these salespeople worrying over me and talking about what happened while I was standing right there.

It’s no surprise then, that I have a thing about my 10-year-old daughter walking through the neighborhood by herself. I feel I have to watch her as she goes. HAVE TO.  The other girls her age are walking around alone, yet I feel a compulsion in my very cells to stand on the porch and watch her to make sure she arrives safely.

Parenting can be a trigger for those of us who have experienced childhood trauma. You might find yourself in a situation with your child that reminds you, even if you don’t recognize it, of something that happened to you. You might find yourself acting in ways as a parent that you don’t quite understand. Can you think of ways you might be reacting right now that could be tied back to your experiences as a kid?

What You Should Know About Childhood Trauma

If you went through childhood trauma, you might find yourself feeling some of the following ways:

  • always on guard
  • always vigilant
  • like you can only let a few people, if any, get really close to you
  • unsafe, or very focused on maintaining your safety and protecting yourself
  • anxious
  • unable to relax

You also might experience:

  • higher stress levels
  • shame or guilt
  • low self-esteem
  • feelings of emptiness
  • depression, anxiety, PTSD
  • physical ailments like headaches, panic attacks, stomach upset

Here’s what you should know: You can heal. If you managed to get through childhood trauma then you have a source of strength. You already have tools you might not even know you have.  You’ve already figured out how to keep going in life, and you are already doing things, great things, to take care of your child DESPITE what you experienced. If you feel that you are being impacted by traumatic events in your life in ways you don’t like, you can reach out for help.

You have many choices and options when it comes to getting support in healing from trauma. They include attending a support group, trying art therapy, learning how to use mindfulness tools and other coping techniques, trying EMDR therapy or ACT therapy, seeing a counselor, or even working through a workbook that offers exercises in healing from trauma like this one and this one.

You might also like:

When Postpartum Depression Rises Up Out of the Buried Traumas of Childhood

How Your Own Mother & Childhood Trauma Can Impact Postpartum Depression

 

 

Postpartum Psychosis Help: Where Can Moms Go For Help? [Infographic]

Postpartum Progress is often asked where moms can go for postpartum psychosis help. What if you have psychosis or severe postpartum depression and need hospitalization or intensive treatment?

There simply aren’t enough beds and spaces at perinatal inpatient and partial hospitalization/intensive outpatient programs in the United States compared to the number of women who will need them each year.

Why a perinatal unit? Just ask the moms who have been hospitalized for postpartum psychosis or severe PPD.  We’ve talked to moms placed in general units with whom not a soul ever mentioned the words perinatal or postpartum. No one talked about role transitions or becoming a mother. No one offered lactation support. Some had no access to supplies like pads for post-birth bleeding. Some were told they had to quit breastfeeding. Many were not allowed to see their babies at all, or only for brief moments, during their hospital stay. Most were the only person there with a maternal mental illness.

We know that specialized programs for women with perinatal mood and anxiety disorders work. We know taking care of both mother and baby during pregnancy and first year is critical to health. These programs are led by people who are experts in maternal mental health. Who understand how medication affects pregnancy and breastfeeding. They make sure that mother-infant attachment is supported and encouraged. And they readily provide supplies like breast pumps and safe places to store breast milk.

We wanted you to see how few of these place there are in the United States, because this matters. Mothers deserve the best possible postpartum psychosis help, and not enough of them are getting it.

postpartum psychosis help

 

Postpartum Psychosis Help (as of September 2016)

California – Huntington Hospital Maternal Wellness Program (Pasadena), El Camino Hospital MOMS Program (Mountain View), MemorialCare Perinatal Mood & Anxiety Disorders Program (Long Beach)

Illinois – Perinatal Intensive Outpatient Program of AMITA Health (Chicago area)

Michigan – Pine Rest Mother & Baby Program (Grand Rapids)

Minnesota – Hennepin Mother-Baby Program (Minneapolis)

New York – Zucker Hillside Perinatal Psychiatry Unit (Glen Oaks)

North Carolina – University of North Carolina Perinatal Psychiatry Inpatient Unit (Chapel Hill)

Pennsylvania – Drexel Mother Baby Connections (Philadelphia)

Rhode Island – Women & Infants Day Hospital (Providence)

 

Special thanks to Heather, Candice, Laurie, Laura, Catherine, Samantha, Stephanie, Lisa, Jess and many more members of the Warrior Mom® Community for helping us put this project together. 

PPD & Suicidal Thoughts: So Glad To Be Alive 15 Years Later

postpartum depression recoveryMy son was born 15 years ago today. My first child, the one with whom I had postpartum anxiety/OCD, the experience that eventually led me to start Postpartum Progress. I find it kind of magical that his birthday is occurring during National Suicide Prevention Week. I remember having suicidal thoughts when I was struggling with maternal mental illness after his birth.

To be clear, I didn’t want to die. It’s not that I didn’t want to be alive. Or to be my kid’s mom. I was just so scared. So terrified I might hurt him. I was worried I might ruin his life. That I was a terrible, horrible, no good very bad mom. And I was in so much pain. This super dark place that I was convinced I’d never be able to leave again – I’d be locked in there forever.

It’s very easy to become convinced — or at least toy with the idea — that the only way out is to stop existing.  I’m sure this is beyond hard to understand for people who have never been in the dark place. It’s not logical. Yes, we are fortunate. We may have very wonderful and loving people around us. Yes, there is help. No, we’re not alone. It’s just that when you are in a pain that you can’t see living with for another second you can come to believe that leaving this earth is the answer.

It isn’t.

I know this. I’m so grateful I got to hug and kiss my boy this morning on his birthday and tell him how proud I am to have become his mama 15 years ago. It turns out I’m actually a pretty good mom. I did leave that dark place thanks to the help of others. Even though my career as a mother had a really crappy start, it has rocketed upward ever since. I have experienced so much joy. Parenting is still hard, of course. I’m not perfect and neither is life. There have been moments of pain. Frustration. Self-doubt. But the moments of joy have outweighed all of it.

It’s very special to me that Jack knows he’s the baby in the Warrior Mom logo and he’s proud of it. PROUD, y’all. He’s not ashamed that I had postpartum anxiety/OCD. He doesn’t question whether I loved him as a baby. He KNOWS I did and he knows what I had was a very common illness and that it wasn’t his fault or mine.

He loves me and I love him, and that’s the biggest “F— YOU” to postpartum depression that I know of. We win, PPD. We. Win.

I want you to know that if you are a pregnant or new mom struggling mightily right now and you have had suicidal thoughts, you aren’t alone. The Warrior Moms of Postpartum Progress are here with you, and many of us have had the same exact thoughts. We’ve been in that place where it felt like there was no way out. We understand, and we love you. There is help. If you don’t believe me, you need to know that no one could convince me there was help either, and yet THERE WAS. I didn’t believe I’d get better either, and yet I DID. Postpartum depression and related illnesses are still an awful experience. I know that. I just ask you to please be willing to accept the help that is out there. It’s worth it.

What To Do If You Or Someone You Love Is Having Suicidal Thoughts

As the American Federation for Suicide Prevention explains, suicide often occurs when stressors exceed the current coping abilities of someone suffering from a mental health condition, like depression. There are people who understand and know how to help you, no matter what you are going through or why. If you are in crisis or having suicidal thoughts, PLEASE call 1-800-273-TALK (1-888-628-9454 en espanol).

A Look at Pregnancy And Suicide During National Suicide Prevention Week

pregnancy associated suicideSince it’s National Suicide Prevention Week, I’d like to focus on a very critical issue: childbirth, pregnancy and suicide. (Trigger warning: If you are feeling fragile right now and think a discussion about the loss of new mothers will upset you, you can skip this one.)

I want to highlight an important statement made by Nancy C. Chescheir, MD, editor-in-chief of the journal Obstetrics & Gynecology, in her editorial in the September 2016 issue:

“… deaths from violent causes (motor vehicle accidents, homicide, suicide, and substance abuse) occur at a rate of about 15 per 100,000 live births, whereas deaths from the four leading pregnancy-related causes of maternal mortality (hemorrhage, embolic disease, hypertensive disease, and sepsis) occur at a rate of about 4.5 per 100,000 live births. Thus, the rate of maternal deaths from violent, pregnancy-associated causes was more than three times higher than those from the major pregnancy-related causes.”

These words in Chescheir’s editorial were made about a study conducted in the state of Illinois on the causes of death of women during the pregnancy and postpartum periods, but they are relevant to us all. Suicide leads to the loss of new mothers at least as often as some of the most common causes of maternal mortality. So why don’t we pay more attention to postpartum depression? Why don’t we invest more?

Part of the problem is in our country’s history of even tracking data on the death of pregnant and postpartum women.

It wasn’t until 2003 (yes, you read that right, 2003!!!!) that the U.S. Standard Certificate of Death began to include a checkbox to indicate whether a woman who had died had been pregnant within the last year. The checkbox was important because it helped to improve data on women whose causes of death might have had something to do with pregnancy or childbirth. Still, some states use that checkbox consistently and some don’t, which means we don’t have a completely accurate set of data.

Also, you might be surprised that the US doesn’t consider suicide in the first year postpartum as a pregnancy-related death. This is important because most of the news, awareness-raising and funding you see related to maternal mortality in our country has to do with pregnancy-related deaths.

What are those? The definition of pregnancy-related death is the death of a woman during pregnancy or within one year of the end of pregnancy due to a pregnancy complication, a chain of events caused by pregnancy or birth, or the worsening of an unrelated condition in the mother due to pregnancy or birth. This includes most of the things people talk about when they talk about maternal mortality, such as eclampsia, infection, embolism, and hemorrhage (bleeding out). Again, suicide in the first year postpartum is NOT considered as or counted as a pregnancy-related death in most places. Only causes of death that are “biologically related” to the pregnancy count.

Pregnancy-associated deaths, on the other hand, are deaths of women that occur during pregnancy or in the first year postpartum that are not necessarily “biologically related” to pregnancy and childbirth. They include motor vehicle accidents, homicide, substance abuse and … suicide.

I don’t know about you, but I’m having a hard time understanding why at least some suicides in the first year postpartum are not counted as biologically related to pregnancy and childbirth. I personally consider postpartum depression VERY MUCH a complication of childbirth. I don’t understand why suicide would be lumped into the same category as accidental car crashes when it comes to the death of new moms.

In some states conducting maternal mortality reviews, this thinking is starting to change. A recent Arizona maternal mortality report notes, for instance, that “… practice is evolving to the extent that if [a suicide death] occurred within the first 42 days postpartum and the woman had made suicidal threats or ideations, the [suicide] should be considered pregnancy related.”

So how does suicide rank when it comes to causes of maternal deaths?

A study published in Obstetrics & Gynecology in 2011 by Palladino et al found that the rate of death from suicide among pregnant and new mothers is 2.0 (2 out of every 100,000 births). Now compare: The rate of deaths due to hemorrhage/placenta previa is 1.7. For eclampsia/pre-eclampsia it’s 1.7.  And the rate of deaths due to amniotic fluid embolism is 1.1. This demonstrates that while there are still some complications of pregnancy that outrank suicide as causes of death among pregnant and new mothers, suicide is among the leading causes. And more and more states are finding this is true.

Colorado found that suicide is the 3rd leading cause of death in the first year postpartum, ahead of pulmonary embolism and hemorrhage. A 2012 study in the state of Georgia of pregnancy-related and pregnancy-associated deaths found more women died from suicide (8) than from hemmorhage (7), hypertension (4), cardiac problems (4) and embolism (4) during or in the year after pregnancy. A Michigan study of data from 1995-2005 found that deaths due to intentional self-harm (11%) were at a similar rate to amniotic embolism (11%) and greater than hemorrhage (7.1%) and obstetric blood clot embolism (4%). A Wisconsin review found that suicide represented 13% of all pregnancy associated deaths.

We HAVE to pay attention to this. We have to track it better. Something must be done. Here’s how Postpartum Progress looks at it: Would the mother have died if she had not been pregnant or had a baby? Did the suicide happen as a result of the symptoms of a maternal mental illness? If it did, we consider it pregnancy related.

We wish more organizations deeply involved in maternal child health included maternal mental illness and suicide prevention in their programming. So do the authors of this fantastic paper from 2013 called Grand Challenges: Integrating Maternal Mental Health Into Maternal and Child Health Programmes when they stated, “Addressing mental health concerns such as maternal depression could play an important role in achieving the Millennium Development Goals set by the United Nations (three out of the eight goals refer specifically to women and children). However, mental health care remains conspicuous by its absence in large scale global maternal and child health (MCH) programmes.” So. Very. Conspicuous.

You won’t find maternal or pregnancy-related/associated suicide mentioned even once by Merck for Mothers, a 10-year $500 million initiative focused on improving the health and well-being of mothers during pregnancy and childbirth. It’s also not an area of focus in the Bill & Melinda Gates Foundation’s Maternal, Newborn & Child Health strategy. And yet we KNOW the health of children, including their mental health and development, is linked to that of their mothers.

Over my years of advocating for maternal mental health I’ve had more than one person say to me, “I’m sure postpartum depression is important. But there are other maternal health issues that are so much more so. I mean, no one dies from PPD.”

Oh yes they do. Indeed they do. And we can prevent it.

#stopsuicide