Postpartum Depression Stigma Persists Even In Federal Government

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Postpartum Depression Stigma Still Exists, Even in the Federal Government
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
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.

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The Dignity of Each Recovery Path

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This guest post had me giddy from the very first sentence. I too, have always related to Perkins-Gilman’s story, “The Yellow Wallpaper”, even before I became a mother. After experiencing my own maternal mental health challenges, I discovered that Gilman’s authorship of this story and her determination to speak up about the deficiencies in her own treatment, actually caused her physician to change his mind about how women who fought “hysteria”, as it was called back in her day, should be treated. You see? Gilman is a Warrior Mama, just like all of us.

I love the message of this guest post and I know you will too. Go forth and read!

flourish-31609_1280wall-745023_640There’s a story called “The Yellow Wallpaper” by Charlotte Perkins Gilman. It was written over a hundred years ago about a woman suffering from exhaustion. She was locked in a room, all by herself, and she quite obviously started to go mad.

I guess I’ve always related to the narrator of that story because I’ve suffered from mood disorders for most of my life, most notably after the birth of my daughter.

When I got pregnant with my first daughter, I decided to go off of the medications that I had been on for years. I was lucky because while I was pregnant I was also working full time and was quite busy. I had a lot of distractions, and I had a lot to keep my mind occupied. I was able to function with therapy but no medications.

And then one day I gave birth.  It was beautiful and life changing and miraculous and breath taking.  It was the full of human experience distilled and brought to light in a single moment.

I was a mom.

I was different.

The world was different. 

We brought home that little bundle and we loved her with every ounce of our beings. After enduring years of infertility, I finally had my little girl. My family could ride off into the sunset of our happily ever after.

Except that’s not how it went. At all.

I spent half the time with her in her bouncy seat facing away from me because I didn’t want her to see her mother sobbing. I stopped talking to most people because conversations just left me feeling empty — like I was skeleton talking to a real person. I couldn’t leave our house. The sunlight was too much. Too much of a contrast between what was in my head and what was out there in the world.

We sat inside of our house with all of the curtains closed for months. I gave her every ounce of my being. It took everything I had to sing to her and rock her and read to her and cuddle her. But that was all of me. That was all I had. When she would sleep, I would retreat into nothingness. I had no hope. I had no belief that a future existed. All I had was panic and despair.

Finally one day through sobs and dizzying thoughts, I realized this wasn’t working. I contacted my therapist and asked for an opinion about medication. Within seconds he responded that he thought it was a good idea, and a day later I had a prescription to fill.

Life didn’t instantly get better. I went on a new medication and it made me near manic. It was scary. But then I found one that worked, and with the support of my husband and a daily habit of journaling and very close contact with a therapist, I climbed my way out.

I share this story out of a desire to spread hope, but I also share it to inspire acceptance — acceptance of every woman’s right to choose her own path to recovery.

As I started the piece with, centuries went by where treatments for mood disorders were forced on women by men who couldn’t have understood women’s issues less. We were locked away and our brains were drilled into and we were burned at the stakes.

Now, however, we live in an era where there are actual, legitimate treatments.  They won’t cure depression, and there’s no one right drug or combination for every woman, but they are out there, and they can make a difference.

My concern is that while we live in a time with more effective options, I’m not sure we live in a time that is more kind or is more accepting of the different circumstances of women. Nearly daily, I read an article or hear a speaker who will say the medications are okay in some circumstances.  Or medications are okay short term.  Or medications are not necessary because I did xyz and it worked incredibly well.

Whenever I find myself listening to those stories, I find myself cheering for the authors, genuinely grateful that they have been able to find their cure, but I also find my heart breaking for those women out there who are still suffering. Women who have been offered medications, who might desperately want to try them, but who might feel the sting of the stigma.

There are millions of women in this world and many of us will suffer from a mood disorder at some point. We are all complex, full, vibrant, unique human beings. Our suffering might appear the same, but it can be caused by so many factors. My hope is that we are able to come together and erase the stigma that surrounds antidepressants. That we no longer label them as the purview of the weak.  That we no longer see them only as a last ditch effort to be tried when our lives are on the brink of destruction.

So take your meds. Or exercise. Or do yoga. Or stand on your head in the middle of a field of daisies if it will help you. Learn your body. Learn your mind. Make up your mind. And let’s lead ourselves into a future where every choice will be respected, even those that come from a prescription pad.

{pic source (flourish): Pixabay}


Amanda Knapp is a stay at home mom and a writer who has been published on Psych Central, Mothering, and her own blog, Indisposable Mama.


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Birth Trauma: Coping with Triggers

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The following is a guest post written by Karin Beschen, a Warrior Mom living in Iowa with her husband and two sons.  

She works as a psychotherapist, specializing in perinatal mood and anxiety disorders.


This morning I walked outside to grab the newspaper and felt the distinct autumn chill. It’s the same chill that has always made me smile because it’s paired with cozy sweaters, hot apple cider and football. Then I took a breath. It wasn’t a breath of warm memories; it was suddenly a breath of fear and panic – an inhale that has become a familiar blend of sinking and stinging through my whole body.
“I’m okay.  I’m safe.”
It’s been years since my son’s traumatic birth, but every first scent of the season nearly sends me to my knees. I have done a tremendous amount of work with the trauma, yet my journey continues to be scattered with these triggers – these “rocks” on my path of healing. Rocks that I kick, boulders that I avoid and pebbles that I hold lovingly in my hand.

Early on, the triggers were overwhelming. My mind easily fell back to my son’s birth and related events and it was difficult – sometimes impossible – to be in the present moment. I was fearful of what I may see, smell, feel or hear that would begin the flood of thoughts and images. Some triggers were more evident and I could prepare for them and work through them fairly quickly.  Other triggers were spontaneous and seemed to have the most power behind them. These were the times when it felt like someone put a fresh set of batteries in my mind – everything felt brighter, sharper, louder … scarier.

People tend to think triggers are negative things – obvious things from the trauma. Many of my triggers were items or experiences I had previously associated with happiness or pleasure – seeing pregnancy, a baby aisle at the store or maternity clothing. Post-birth these things would jolt me and they became a source of avoidance and aversion.  They symbolized a tremendous amount of loss and disappointment. They reminded me how everything changed from calm to chaos in a handful of minutes.

Coping with Triggers

It’s impossible to completely avoid triggers, so it’s important to learn how to cope with them. There are numerous effective, healthy strategies for managing triggers of post-traumatic stress (and can be valuable with any perinatal emotional distress).

The list below outlines a few ideas for lessening the impact of triggers. I’ve found them especially helpful because they can be used in a variety of environments, even when my son was napping in my arms.

Finding Presence: Grounding exercises are a way to connect with the present moment. They help by easing out of the distressing thoughts and becoming more aware of the immediate environment. “Out of the mind and into the body.” Simple body movements like stretching or walking around the house (feeling feet on the floor, altering light and heavy steps) can improve presence.

Taking away the story:  The triggers are triggering because they carry a story. I found it helpful to take in the triggering object or situation for what it was – without the narrative. It can be challenging to do in the moment, but becomes easier with time and practice. For example, the hospital baby blanket was a trigger for me. Even though I had put ours away, the familiar blanket seemed to follow me around town, pop up in other babies’ photos and plague me with fear. I re-introduced myself to the blanket without the story.  It was soft, light-weight, rectangular and had pastel footprints printed on one side. Little by little, the traumatic story that had been associated with the blanket lessened.

Care and affirmation:  Holding my hand to my heart was a way of feeling and showing self-compassion.  It was an important gesture that I did throughout the day, especially at times when I felt the least-deserving of care. It offered a pause. I was going through the most difficult time of my life and I needed to be kind to myself.

I had a few affirmations to write or say to myself to acknowledge that I was safe in that moment (no matter how real my flashback felt) and the original experience/trauma was over.

“I’m okay.  I’m safe.”
“All of my feelings are okay.”
“I will feel better.”
“I can heal.”

Affirmations can become reality. I am safe. Every feeling I’ve had and every one I continue to have is okay. I am better – a lot better.  I’m healing.  Every day brings more healing, and I will continue to walk on the path. Rocks and all.

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Intrusive Thoughts: A Conversation

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emergency-stop-buttonYesterday, I wrote “Let’s Talk About Intrusive Thoughts.” Today? I’ve intertwined stories from moms (including myself) who have all experienced intrusive thoughts in one form or another during their postpartum experience. For one mom, she didn’t experience them until her son was two and she was off medication, something that made the experience even more difficult.

Again, as with yesterday’s post, if you are in a fragile state, please skip reading, particularly if you find that you are easily influenced by reading the experiences of others. We don’t hold anything back.

I also want to remind our readers that every mother’s experience and subsequent reaction/seeking of help is different; molded to her own life and journey. These mothers did the best they could with what they had available to them at the time – the important thing, though, is that each one of them fought like hell the best way they could to get free of these horrible thoughts holding them captive.

Today’s video is a fun one. Tiny Hamsters Tiny Date. Hamsters. On a DATE. AWWWWW.





coffee-791201_640Picture it, 2015, a small coffee shop on Main Street. A group of women sitting, sipping various hot beverages, chatting among themselves. No one thinks anything of it, until they get close enough to hear their conversation.

“I wanted to smother my daughters on the day my brain nearly broke. The thought played over and over in my head. Before THE day, I had obsessive thoughts about knives. I couldn’t use them. I cleaned obsessively. Scrubbed my hands. I exclusively pumped for my second daughter, which only fed my cleaning obsession. The stress. The meds. They broke me. I just couldn’t do it anymore. Before the thought grew feet, I curled up in the fetal position in bed, afraid that if I got up, I wouldn’t be able to control my actions. I still remember the way the wind rustled through the giant oak outside the window and the squirrels scurrying along the massive limbs. I had never been so scared in my entire life.” Even though she shared her experience this often, her voice still broke as the memories washed over her.

“I wanted to drive my car into oncoming traffic while my kids were in the car. And don’t get me started about the panic attacks I would have while driving,” one of them said.

The rest nodded slowly, their faces somber yet understanding.

“I wanted to drive off overpasses or bridges. I would think, what if I just let go of the steering wheel? I also thought about not waking up in the morning. Something I later found out was what they call passive suicidal idealizations. I didn’t really want to hurt or kill myself, I just didn’t want to wake up. Oh, and while pregnant with my second? I wanted to throw myself down the stairs.”

As the women nodded, one of them clenched her cup a little tighter, then started to speak, softly.

“I…I…..I bounced back and forth between harm and sexual. Mostly knives and pillows were the focus of the harm ones. But really anything I saw turned into a weapon in my mind that could hurt my son. Then, an incident happened at our church where a mother and her husband were assaulting her daughter. My mind latched right on to it as if it were the edge of a cliff and if I let go, I’d fall. I thought she was “normal”…and I thought I was “normal.” If she could do it, then what was to stop me from doing it? This thought swallowed me whole, it was always there, clinging to me: did I wipe too much…was I looking at “it” …. did I want to do something? Mostly with my child but during the worst of it, even when we were in public…which I started to avoid because I was convinced something in my mind flipped and I WAS my thoughts. It was around his first birthday when the other ones popped up. The news or shows I watched determined my obsessive thoughts for the day. During the worst of it, I would say if I had one every 30 was a GREAT day as they were always one after another. …no breaks.”

The others in the group again nodded in solidarity. There wasn’t much they hadn’t heard by this point.

“I didn’t realize I had a problem when my son was an infant. I just couldn’t stop picturing the real dangerous chemicals that do actually “off gas.” At some point, I crossed from knowing that this was an environmental hazard to picturing or imagining the chemicals on our skin, in our hair, in the air we were breathing. They eventually had colors. Each type had a different color. The worst was plastic being heated…” her voice trailed off. This realization has been tough for her.

“I had visions of stabbing my precious new baby over and over.  I couldn’t stop them.  I couldn’t conjure up a happy thought.  I couldn’t distract myself.  I couldn’t relax.  I sure as hell couldn’t zone out watching the Food Channel with knives being brandished left and right.  It was like being stuck in rough surf close to the beach where you just can’t seem to make headway on land before the next wave crashes over you.  I was in a black hole of terror that started a few days after my beloved son was born.  My soul draining each moment as the horror show played over and over in my head.  What kind of a mother would ever think such a thing?”

Finally, the last woman in the group spoke, “My story doesn’t start when my son was an infant. Two years later, and off medication, my anxiety came back, fiercely. I was a very angry person. Was off for three months. Never felt quite like myself. Then we went on vacation. I don’t know if it was the stress of the trip or my brain just not being well, but my anxiety came back just as it was when the baby was born. But worse…I thought I had moved past it all. I was very angry. Couldn’t look at my child. I even had a fleeting intrusive thought of pushing him in front of a moving car while we went for an evening walk. And whenever my son wanted to wrestle around, as boys do, I had urges to actually cause him harm. Thoughts would pop up of pushing him down or being really rough with him.”

Customers in the coffee shop came and went, catching fragments of the conversation as they did so, each of them slightly perplexed at the depth and magnitude of the topic contrasted with the seemingly nonchalant way these women were discussing these dark thoughts in public. But not one of them stopped to comment or join in. There were a few raised eyebrows and strange looks as the snippets delved into their space, but nothing beyond that.

The women continued, sipping coffee and tea as the sun peered through the window of the quiet coffee shop, discussing how they each managed to move past these thoughts intruding on their lives.

“I ended up in the ER, then in a psychiatric ward. My med was changed. I began practicing self-care. I threw myself into advocacy and growing my own support group. I needed to know that my crazy wasn’t going to be permanent, that others had survived. Eventually, I ended up on meds and in therapy. I’m still on meds, for OCD & anxiety, and I am okay with that. I remember hating the pills. But now? They’re part of me and just the way things are. I’m a much stronger woman and mother because of what I have been through. And my self-care skills rock.”

“I would shake my head to banish these thoughts of driving into oncoming traffic from my mind. Eventually, I realized I am not my thoughts. They didn’t hold any power over me. I listened to music, books on tape, called friends and family, used deep breathing techniques from yoga. I pictured these horrible thoughts as bubbles just floating away. The thoughts still crop up from time to time when I am sleep deprived or very stressed. Medication and therapy were key to helping me develop the tools I needed. I needed to change that negative loop in my head and realize that my thoughts were just thoughts.“ She sipped her coffee, legs crossed as she glanced around the cozy shop.

“Medication helped immensely. Therapy helped me find strategies to cope with and shut down the thoughts. When my anxiety is high these days, I still struggle with Intrusive rage-filled thoughts. But I am better armed to recognize them and cope,” she said, firmly.

“I constantly asked my husband if he thought I would xyz. I was told that I had to stop confessing so the thoughts would become less important to me. That was SO hard, because I thought if I just “sat” with them in my mind, it meant I was ok with the thoughts. But eventually, I saw that it did work. It was a hard battle to be ok with them NOT bothering me because I was always told crazy people don’t know they’re crazy…the thoughts don’t bother them. When they started to bother me less, I worried!!! I still have them, but now I can brush them off. If I let myself slip and start confessing, it’s like a drug. It stops the anxiety for just a little bit. It feels so good you want to continue! I have to also watch what I read or see on tv because I find myself comparing: if they did that, maybe I would too. I even remember comparing myself to all those mass shooters. I searched for news stories of Andrea Yates, seeking any tiny trait similar between those folks and me. Now, I always try to bring up intrusive thoughts with my moms. Intrusive thoughts are SO not talked about and really should be.”

“My thoughts would get softer, like music, if I could avoid them. I tried to shop my way out of it, too. Organic cloth diapers with wool covers hand made by other moms. Glass and stainless steel. Only one brand of organic formula. Organic foods for me and the baby. New shower curtain, fabric and then a phthalate-free liner. I cleaned with vinegar or baking soda. Washing clothes. I did so much laundry. I knew all the ingredients in my laundry detergent. I could handle even pajamas with flame retardant chemicals if I just washed them enough….which doesn’t actually do much, but it was not as logical a compulsion as it seemed to be. I also sought out other moms who worried about the same things, or did the same things, so that I could talk about cleaning with essential oils or lanolizing wool without sounding “crazy.” I’m just now starting to talk about what all of this really was. It explains so much about my many behaviours.”

“I slowly got better with therapy and medication. The intrusive thoughts ebbed and finally faded.  Only there was still this huge gaping hole in my heart. I swear you could see all the way to infinity and back that hole was so big. I was sure I would never really be happy again or be joyful as mother because this terrible experience haunted me. I put on brave face. I cared for and played with my baby. I worked hard at my job. I prayed, tried to meditate, did yoga, spent time with dear family and friends, and watched chick flicks. I did all my happy things. Only it was still there—that void of fear and sadness over this experience. One day I found a blog full of other mothers’ stories of surviving postpartum mood disorders.  The founder put it out there in a matter-of-fact way about how postpartum depression, anxiety, OCD and psychosis are simply treatable diseases. And she got other women to share their stories on her blog.  Reading these stories let me know I wasn’t alone. It was huge. Apparently, a lot of us moms obsess over just one terrible image. Our brains all go haywire in a similar way!”

Every mother there nodded in agreement, knowing exactly how it felt to be the owner of a brain gone horribly haywire.

“I would have to stop playtime, breathe and regroup my thoughts. Knowing I didn’t WANT to cause him harm, and wouldn’t, but was scared of what might happen if I continued. I’ve come to terms with so much the past six months. The Climb and all my warrior moms have really helped a lot this year. I am a proudly medicated mommy! Things are much better these days. Much better.”

The moms chatted for awhile longer, about more acceptable things, such as childhood milestones, what kind of wines they preferred, and what their weekend plans were for the upcoming holiday. As the conversation navigated in this direction, the reaction of the customers in the coffee shop as they passed by them changed. They smiled, offered suggestions about local events for the upcoming holiday, and one older woman even complimented one of the mothers on her jewelry.

As the mothers stood to leave, each of them grabbing their purses, making sure they had their phones and their keys, they hugged, a little tighter than they would normally, because they had bonded in a way mothers who haven’t been in this type of hell can’t.

They went their separate ways, then, their hearts and minds forever entwined as fierce survivors and warriors.


PS. If today’s post has you feeling fragile, please find me on Twitter @unxpctdblessing or email me at mypostpartumvoice(@) I will be happy to talk with you about whatever it is you’re feeling.


{photo source, pixabay}

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