Toxic Expectations for Birth

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What if every expectant mother could rely on her community to celebrate and protect her?  [Photo Credit: Rachel Wilder]

What if every expectant mother could rely on her community to celebrate and protect her?
[Photo Credit: Rachel Wilder]

We build our expectations for birth and pregnancy from childhood; birth stories pervade our culture, from TV and movies to baby dolls. My own life always included lovely retellings of my birth, at home, peaceful and perfect. The trouble is that fear pervades our birth culture, and more often than not, the only stories we hear and the only images we see depict dramatic “success” and dramatic “failure.” The media’s close attention to how celebrity mothers look while pregnant and just after giving birth places enormous pressure on all moms to seem as though pregnancy is effortless and birth leaves us unchanged, physically, emotionally, and mentally. Glossy magazines give the impression that bringing new life into the world is as simple as adopting a kitten. At the same time, this culture that fails to celebrate the enormous strength a mother displays, no matter what her story holds, exaggerates the risks and pain of pregnancy and birth. Even the most conservative of studies shows that there are too many interventions during birth, with no apparent medical reason. A woman’s care provider is likely to question her ability to carry and birth her baby safely, even when she shows no signs of any risk for any complication. What a powerful message!

We are afraid–the stakes are too high. Failure is everywhere in medical language around birth and infancy. How can we begin our journey as mothers with any confidence, when culture and medical authority combine to express their anxieties that we will fail? It’s everywhere: “failure to progress” is an official medical diagnosis during labor, and a baby who does not fit on a growth chart may be diagnosed with “failure to thrive.” We might find comfort and faith in the everyday, commonplace, health most moms and babies clearly display, but even the doctors who know better warn us about every risk and danger. Friends, family, the media, our own care providers, all nervously question a mother’s ability to safely carry, birth, and nurture her baby. We have to fight much too hard to avoid internalizing their doubts as proof our of our inadequacy.

We must work hard, if we want to find positive birth stories and images, while terrifying scenes assault us without our permission. The images of birth that are most common actually depict extremes or pure fiction. Strangers seem somehow compelled to share the most horrifying birth story they have ever heard. Meanwhile, photographs that manage to capture a birthing mother’s inner strength are removed from social media for depicting nudity, even when “the rules” claim that nude photographs are taken down only to protect us from pornography. This applies to images of the postpartum body, as well, unless it reveals no trace of a pregnancy. The perfect mother does not exist, but to know that and to feel it, deeply, are very different things. Effortless perfection is a toxic standard, even when our armor is up and strong. The vulnerability of pregnancy and new motherhood deserve our protection. We could make a shield out of our collective experience, offer reminders to each other, “I know that you are strong, even when you don’t feel strong.” Why doesn’t every mother heard that message loudly and clearly?

“Fear can only be overcome only by Faith” — this is my favorite quote. It comes from an extraordinary doctor and veteran of World War I, who dared to write about “the dignity of motherhood” in his book, Childbirth Without Fear, published in the first part of the twentieth century, as fears about birth rose exponentially every year, and faith in mothers plummeted.others who cherish their memories of birth, like me, work against the same culture of silence around the realities of birth and new motherhood that threatens to overwhelm mothers who feel that they failed, somehow. That culture does not hear any mention of the real and difficult work that a mother does during pregnancy and birth, and that silence breeds fear. My own life seems defined by silence and fear, since my first anxiety attack, around age eight. During my pregnancy and birth preparation, I desperately sought an escape for me, my baby, and my husband. We found it, in the tools provided by HypnoBirthing, a movement partly inspired by Childbirth Without Fear. After a lifetime of feeling that my anxiety could to invade every moment, I moved into pure faith, during my birth, and experienced precious hours with no fear. What a gift I gave myself! A childbirth class did not instill a lifetime of faith in myself as a mother or just in me, but those hours of freedom from fear remain a potent reminder of my own strength, even in my darkest moments. I teach HypnoBirthing now, because the tools I learned from my teacher, while I was pregnant, helped me and my partner overcome our fears, until we were both filled with faith in me. I hope to help other moms have that same confident beginning.

I often wonder what would happen to perinatal mental health, if our culture asked for and listened to our birth stories. What if birth stories were as commonly shared as our newborns babies’ statistics? What if we combed birth stories for a mother’s strength, instead of asking about pain and complications? What if we told a new mother, “Look how you acted as advocate for your health, and your baby’s best interests, even when you thought you were too exhausted!” What if we congratulated new parents on the way they partnered during birth to welcome their newest family member, together? We can always find moments that highlight beauty, strength, advocacy, power, because giving birth requires all of these things! What a gift we could offer new mothers, if we refused fear and chose faith, instead! What a start we could provide, if we truly listened to every mom?

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I Am A Warrior Mom

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Warrior Mom ConferenceHere at Postpartum Progress, we choose our words with intention.  “Warrior Mom” is no exception.

Every mom’s journey through PPD is different and we all see our experiences in a way that helps and heals us.  In my six years advocating for mothers with perinatal mood and anxiety disorders, I’ve met moms who call themselves “survivors,” and others who identify themselves simply as “having experienced PPD.”  And while there is no right or wrong way to think about your time struggling with depression or anxiety, for the mamas who join us here at Postpartum Progress, “Warrior Mom” resonates and empowers in a way other language falls short.

In 9 short weeks, over 100 of these amazing women will come together in Boston for the inaugural  Warrior Mom™ Conference, the first patient-centered conference on perinatal mood and anxiety disorders.  A few of the attendees recently shared why the phrase “Warrior Mom” resonates with them:

The phrase “Warrior Mom” makes me feels strong, like I have some control.  I’m not a victim.  I’m not “suffering” from PMADs.  I’m fighting and surviving.  When things get crazy and out of control, I can at least give myself a positive label that gives me the confidence to push on, even if only a minute at a time.  I’m not a solo warrior.  I’m part of a band of warriors in a tribe of motherhood, and that… feels a lot less lonely and hopeless than being a victim.

– Amber Swinford Dunn


I felt so weak after having my baby and falling apart.  I felt like there was a war for my life and my soul that I couldn’t win.  The war went on for so long and I stumbled and fell so many times.  Finally, the smoke started to clear and I could see the battlefield.  I could see fears and pain that I had slain.  I could see friends and family standing beside me, some wounded in their own ways.  I could see legions of other mamas, each fighting their own wars.  The field stretched out seemingly forever.  And that is when I finally realized who I am.  I am a warrior.  I fight for myself, for my babies, for my family.  I also fight beside every other mama out there.  I fight against stigma and for funding.  I fight for treatment and for education.  I am a warrior, forged in battle and ready to lead.

– Gra Sea


The phrase to me means I’ve made it through my own personal war and survived.  Although I have scars, they have healed and keep fading as time goes on.  I’m stronger for the battle I fought and I am a Warrior Mom.  I now am there for other moms going through this war, to stop the stigma and help them get past the battle.

– Tara Stafford DeTore


The term Warrior Mom resonates with me because in my darkest moments I would visualize myself in an empty stadium facing my nemesis.  Then slowly the stands surrounding me filled with everybody I knew was supporting me.  Each seat was occupied with someone who wanted what was best for me, was encouraging me, was helping in my recovery, or reminding me that they had been there and had come out the other side.  As a Warrior Mom™ in recovery, I had to do the work on my own, but that didn’t mean I was alone.  During a time when I felt mostly powerless to the thoughts in my head, this moment of meditation would bring me peace and awareness that I (with my army of supporters) was powerful beyond measure.

– Kersten Larson

We had so many responses to our post that we’ll be sharing the rest next week, in Part Two!  Be sure to come back for more from our amazing advocates and Warrior Moms.

For the latest in Warrior Mom™ Conference news and information (and to take part in the conference from home), be sure you’re following us over on Facebook!

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The Truth About Postpartum Psychosis

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emergency-stop-buttonThese are the kind of posts we don’t like to write. But they are also the posts we must write because these situations carry the most potential for stigma and misunderstanding as they relate to the Perinatal Mood & Anxiety realm.

A recent situation in Cincinnati is the reason for this post. I won’t link for safety reasons, and if you are fragile, I would recommend you NOT Google for the story. (If, however, you do, and you need someone to talk to about it during the day, find me on Twitter here: @unxpctdblessing. I will be happy to chat with you.)

Media sensationalism along with misunderstanding by society at large can turn a singular incident into a large scale stigma fest. THIS is why we write posts like this. To educate and prevent misunderstandings in the future. It is a delicate balance to write these posts without triggering our audience, hence the emergency stop picture. While I have tried to keep this post as non-triggering as possible, again, if you are fragile, you may want to skip this post.

When a mother with Postpartum Psychosis follows through with behavior which is limited to a very small percentage of mothers who do experience psychosis, it is splashed across the front pages and often combined with the term “postpartum depression” or “baby blues,” leading readers to believe a depressed mother is capable of this act.

Let’s get a few things straight here.

Postpartum Psychosis only occurs in 1-2 of every 1000 births, or .1% of births.

Of those .1%, only 4% may commit infanticide, and 5% may commit suicide.

Postpartum Psychosis is NOT Postpartum Depression.

Postpartum Psychosis is defined by hallucinations, delusions, rapid mood swings, decreased sleep, and increased paranoia.

Postpartum Depression is defined by increased sadness, irritability, increased sleep, feelings of guilt, and loss of interest in usual things. It also carries the risk of thoughts of harming your child or yourself, but mothers with Postpartum Depression are highly unlikely to follow through.

Baby Blues is experienced by up to 80% of all new mothers and is NOT a disorder found on the Perinatal Mood & Anxiety spectrum.

It’s important to note here that I know more than a few mothers who have successfully fought back against psychosis and won. They (and their children) are still with us. Psychosis also does not always equal the death of a mother or a child. It is, however, the one disorder on the spectrum which carries the highest risk for loss of life.

I want to add that Postpartum OCD is the other disorder on the spectrum closest to the signs and symptoms of Postpartum Psychosis. How do you tell the two apart? OCD moms are typically disgusted by the thoughts which flit through their heads while moms with Psychosis believe the thoughts they are experiencing, no matter how delusional, are real and rational. They are driven to follow through with them, while moms with OCD fight against them and do everything to make them go away. Am I saying moms with Psychosis WANT to follow through with their delusions? No. I’m saying that because of the nature of the disorder, they are unable to fight back without help.

From the Postpartum Support International Website:

It is also important to know that many survivors of postpartum psychosis never had delusions containing violent commands. Delusions take many forms, and not all of them are destructive. Most women who experience postpartum psychosis do not harm themselves or anyone else. However, there is always the risk of danger because psychosis includes delusional thinking and irrational judgment, and this is why women with this illness must be treated and carefully monitored by a trained healthcare professional.

So what should you do if you or a mother you know and love shows signs and symptoms of Postpartum Psychosis?

She should immediately be seen by a physician. She should not be left by herself, or alone with her infant at any time. It is possible she may need to be hospitalized for a short (or longer) time until she begins to respond to any prescription medications to balance her psychosis. Unfortunately, we do not live in a perfect world and mothers often fall through the cracks. Compliance with medications outside of the hospital setting (which is the alleged case in Cincinnati), is something no one can monitor. What we can do, however, is continue to educate the population at large about the signs and symptoms, encourage them to not leave the mother alone, and encourage compliance with any treatments set forth by a medical professional.

Healing from a Perinatal Mood & Anxiety Disorder is not a solo journey, nor is it an easy journey. We need a village to wrap their arms around us as we learn how to walk again. Be a part of that village. Please.

Here are some resources to get you started:

Signs & Symptoms of Postpartum Psychosis

Suicide Hotlines

Know that above all, you are not alone and you will get through this.


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Breaking Down The Privilege of Me Too

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women talking and woman standingThis past week, I had the privilege of speaking about Perinatal Mood and Anxiety Disorders with the Moms’ weekly group I attend. It was a bit beyond my comfort zone as I am accustomed to supporting and disseminating information in cyberspace more than in person, something I hope to change this year.

One of the things I love about sharing information is the inevitable “Me too,” which reverberates among the group, much like a pinball caught in a continuous loop in a pinball machine, refusing to exit until it has hit every available surface.

Me too.

Think about how huge that is for so many of us.

Despite the fact that up to 10% of new moms struggle with a Perinatal Mood & Anxiety Disorder, many of us don’t have the PRIVILEGE of having someone we can say “Me too” with at the end of a hard day with the baby in our arms and the struggling brain in our head.

“Me too” shouldn’t be a privilege.

It’s something we should be able to say without guilt, without fear, without shame, without stigma.

I have intrusive thoughts.

Me too.

I didn’t love my baby at first sight.

Me too.

I cried all the time.

Me too.

I was inexplicably and illogically filled with rage.

Me too.

I still wonder if my baby loves me.

Me too.

I am scared to talk to my doctor about what’s wrong with me.

Me too.

I wonder if I will ever be well.

Me too.

I worry about everything and think everyone who sees me knows I am a horrible mother.

Me too.

We all have these thoughts. They’re on parade in our head on a daily basis. For me, I even went as far to keep all the blinds down in my house because I was convinced that if anyone saw in, they would know I was a horrible mother. I felt as if I were living in a fish bowl. Saying “Me too,” finally, helped that feeling to fade and I finally allowed the sunshine into my life.

This privilege, this “me too” phenomenon, is why I started #PPDChat and why I will always listen when a mother begins to talk about the emotional roller-coaster that is motherhood. Because we ALL deserve to have someone with whom we can say, “Me too.”

What’s the one thing you wish you had been able to tell someone and have them respond with “Me too?”

Tell us in the comments. Or take to Twitter and use the hashtag #ppdme2.


photo source: “women talking and woman standing” by kalexanderson on flickr
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