How My Doctors Missed My Antenatal Anxiety

Share Button

antidepressants pregnancyI was in my first trimester of my first pregnancy when antenatal anxiety washed over me like the tide, insidious and unstoppable.  We were living on our own in the midwest at the time, and the loneliness was crushing.  I compensated for my irrational worries by donning a brave face and making light of my anxiety, to both friends and my doctors, and I assumed all newly pregnant women felt the same trepidation and slight panic I was suppressing.

I was 8 weeks pregnant when my OB called me into her office.  My fears and worries were suddenly compounded by a previously-undiagnosed kidney disease.  A giant mass in my abdomen.  And they had no idea what it was.  I taciturnly absorbed all the doctor said and then politely asked for a few moments alone.  When the door shut behind her, something in me broke.  I walked out of there a shadow of myself.  The next 6 months brought a multitude of diagnoses.  I was ultrasounded and MRIed (twice).  I met with several surgeons and had a cathertized void test done.  There were very few cases of pregnant women with my eventual diagnosis of severe unilateral hydronephrosis with 1% kidney function, and so few doctors could tell me exactly what to expect or how it would impact my pregnancy.  And that scared me to death.

Six months into my pregnancy, we moved to the North East.  My need for my family (who had moved up to the Boston area a few years before) outweighed my terror at the prospect of moving, but leading up to moving day, I had increased symptoms of panic attack.  I refused to drive while house hunting, irrationally fearful of the alien traffic patterns of our new-home-to-be.  I fought back waves of nausea at each apartment-hunting appointment, instead playing the part of the happy, expectant couple.  The night before our final flight out of the midwest, I became convinced I had a blood clot in my right leg – and the resulting (unnecessary) hospital trip ended in a 2am leg ultrasound for me and a busted blood vessel in my husband’s eye from the stress.  My husband tells me that when I fainted from panic on the 4 hour flight to Boston the next day, he took special notice of the halfway mark in the flight.  “At least there was no turning back,” he says, only half-jokingly.

Unfortunately, arriving in Boston alleviated the anxiety only temporarily.  As I neared the end of my pregnancy, I began having irrational, intrusive thoughts about my husband leaving me.  “He’s only staying until the baby is born,” the lies whispered, “he never wanted a baby anyway.”  I became increasingly irritable and emotional, and finally suffered enough to mention it to my OB, a high-risk, high-profile doctor at Massachusetts General Hospital.  With my mother in the room, I explained my heart palpitations and my trouble breathing.  I outlined my mood swings and my panic attacks.  It took every ounce of courage in my body to admit that I was struggling.

In return, she told me to “stop worrying.  Pregnancy is an emotional time.”

That was it.  We moved on to belly measurements and discussions of pain management during labor.

With only two sentences, she had me doubting my need for help. I suddenly “just wasn’t trying hard enough.”  And I believed her.

Throughout the course of my first pregnancy, I saw 5 different OBs, 3 surgeons, 2 primary care physicians, and a myriad of nurses and techs.  None of them EVER asked about my emotional well-being, and when I did speak up for myself?  I was ignored.  Dismissed.  And the thing that angers me the most is that MGH has a world-renouned Center for Women’s Health, run in part by the incomparable Dr. Marlene Freeman, an expert in the field of pre and post-natal mood and anxiety disorders.  Sitting in my OB’s office, I was one elevator ride away from help.

Instead, it took me 5 months after my daughter was born – five months of intrusive thoughts about shaking my baby or letting her slip in the bath tub (I would like to emphasize here that intrusive thoughts are distinguished from psychosis by a mother’s ability to recognize the thoughts as scary) – five months of obsessively folding and lining up burp rags and matching bottle tops to bottle bottoms by shape and color – five months of rage and of falling apart behind the scenes before I recognized I needed help.

It’s hard for me to think back through that time because I find myself so ANGRY.  My struggle was preventable.  Avoidable.  Not once during or after my pregnancy was I asked about my emotional well-being, and when I mentioned physical and emotional symptoms of my condition, they were ignored.  A few simple questions and an honest conversation with a trusted doctor was all it would have taken.

I want you to know that there are many wonderful doctors, psychologists, and social workers out there.  Many obstetricians and primary care physicians are well-educated and have amazing bedside manner.  But a large percentage of them are still grossly undereducated about antenatal and postpartum mood and anxiety disorders.  Advocates in the PPD community are working towards universal postpartum mental health screening, but in the meanwhile, each mama has to be her own best advocate.

  1. If you are struggling, tell the truth, the whole truth, to someone you trust.  I know how scary this is (really and truly), but it’s vital you are honest about your symptoms in order for you to get the best treatment possible.
  2. Keep telling it until you are listened to.
  3. Ask for help finding a therapist or doctor who has experience treating postpartum mood and anxiety disorders and seek support groups in your area.

You deserve to be well.  We’re here fighting with you and ready to help you find the care you need to feel like yourself again.

Share Button
About Susan Petcher

Susan is thrilled to be on staff at Postpartum Progress, directing the 2015 Warrior Mom Conference. At home, she has her hands in a bit of everything, from parenting to teaching private music lessons. In her spare time, she pimps her crocheted wares for yarn money at http://etsy.com/shop/learnedhappiness, and tweets @learndhappiness.

Tell Us What You Think

Comments

  1. One elevator ride away from help, wow. You’d think Mass General of all places does cross-training between OBs and mental health, but apparently not. I went through antepartum anxiety/depression too, and found it a special version of hell, since I was still carrying the baby while I suffered.

    • It is shocking, isn’t it? And it *is* a special version of hell, because you can’t get away from it. Nobody can hold that baby for you while you escape, even for a moment. I’m sorry to hear you’ve been where I have.

      • And when I said I would take my anti-anxiety meds so that I wouldn’t have to go through that, knowing what life was already like without them, people actually told me, “it’s just for a few months!”

        • Ugh. It’s like they were really saying, “if you were stronger, you wouldn’t need the medications,” and “don’t you care about your baby?!” I hate that moms are meant to feel like they have to choose between their health and their baby’s health. Healthy moms = healthy babies.

  2. Lots of doctors don’t understand. My husband’s a doctor and he is divorcing me because of my ppd with OCD. I told him what was happening and now he’s trying to use it against me in . Saying i’m crazy and he’s afraid I’ll put the baby in the microwave. I’ve been in therapy and am doing so much better but he won’t. Sooooo now i’m really depressed.

    • Ginger, I’m so sorry to hear about your divorce and that you didn’t get the help you needed from your husband. Please know that you have a supportive group of mamas here who know what you’re going through. <3

  3. So interesting that you say that about not knowing about MGH, Susan. Because when I was sick with postpartum OCD I had NO IDEA that here in Atlanta we had the Emory Women’s Mental Health Program, with expert specialists in perinatal mood and anxiety disorders. They became my support team when I was pregnant with my second child, but how I wish I’d known about them when going through postpartum OCD.

  4. Thank you so much for writing this, Susan. I am always shocked at how much anxiety pregnant women are expected to feel. People were surprised when I said my anxiety was part of an anxiety disorder–doesn’t every expectant mother feel that way? But the same anxiety, now that my kid passed his first birthday, is so obviously not ok that people are NOT surprised that I’m in therapy twice a week and heavily medicated.

    In my work teaching HypnoBirthing, I got a call from a mother past 30 weeks who had only just realized that she shouldn’t have to feel afraid (HypnoBirthing teaches tools for dealing with fear, releasing it, rejecting scary stories, etc). “Everything is totally ok; why do they tell me about all these risks and things I should fear?” It’s so wrong that we have normalized panic and anxiety for mothers, when anyone else would see so much more concern from a health care provider.

    • We really have, haven’t we, AM? We’ve normalized anxiety in pregnancy to the point where expectant mothers feel they SHOULD suffer, that they have to suffer. It makes me furious.

      • I saw a Facebook post just yesterday from a mom asking which baby breathing monitor she should buy, because her anxiety about her baby and SIDS was overwhelming her. Mine was the only response that said “hey, in case this feels like too much–there’s help.” Everyone else said “THIS brand lets me watch, listen and tracks his heart rate!” or some other review. (Those monitors make me furious, because they profit off our worst nightmares.)

  5. In my childbirth classes, we do an exercise where parents put various signs and symptoms into categories of “normal” or “see a healthcare provider”. One of the signs is “overwhelming anxiety” and at least 50% of the time, parents put that card into the normal category. It makes me sooo sad that parents think it is normal to be overwhelmed by anxiety…

    • Wow, Nicole! That’s really telling, isn’t it?! I think that’s a stellar thing to have in a childbirth class. My class glanced over PPD and we all assumed we would know if we had it.

    • Very cool exercise that should be included as a discussion in every prenatal class, and between every provider and mama. The really unfortunate thing is that simply “seeing a healthcare provider” isn’t always enough – it is seeing the right provider who will listen!

  6. Samantha Dowd says:

    Susan – THANK YOU so much for sharing. I am able to relate, oh so well! Would you mind if I shared on my FB page?

  7. Oh Sarah, I’m so sorry. I’m sad I can relate. I had/have postpartum anxiety and when I first reached out to my OB for help with insomnia, I was met with a return call from a random phone nurse who said I had a prescription for zoloft waiting for me at the pharmacy. I didn’t know what to think. I know I felt betrayed, that this woman who walked me through my nine months of pregnancy didn’t even have the decency to call me back. This needs to change and sharing your story is part of that change.

  8. Nickole says:

    Hi. Thanks so much for getting your story out there. And for being so honest. I have had the whole range of issues with Borge pregnancies and even still going to counseling for GAD. Anyhow, I just want to clear up a couple things you stated. You said your “issue was preventable. Avoidable!” and I think I know what you mean, but moms struggling probably don’t. Can you give some more details to how and what steps/meds ect. can help!? Tha ks. As, I don’t think it is really avoidable or preventable in most people. ;) also, I have been working to get a support group in the Kansas city north (Missouri) area and one was just started in Jan at a local hospital- put in by the wonderful non -profit, Pregnancy and Post -pardum group of Kansas!! I am passionate about these mom issues. I feel so badly for moms who suffer. It is often just too hard to articulate how you feel or even your racing thoughts are hard to blurt out. I wish there were screenings for ppd/ppa at all follow up check ups at the OB and pedi offices!! Especially from birth to even one year! Thanks, again! N

    • Nickole says:

      *both pregnancies

    • Hi Nickole,

      I’m so glad you commented and asked me to clear up a few things. Truly. When I said my issue was preventable, it was because PPD is completely treatable. You’re right in that it’s not completely preventable for all people, but it really was in my case. I had a history of anxiety that had been untreated for years, and had my doctors caught my anxiety symptoms early in my pregnancy, my problems with the intrusive thoughts probably could have been been stopped before they started. I’m being optimistic here, of course. I just know what a difference my treatment, including both therapy and medication, has made, and I wish I had been treated sooner.

      I guess I think the preventable part was the severity of my symptoms. I hit almost complete rock bottom before seeking help and I still find myself so angry because I shouldn’t have had to. Does that make sense?

      I hear you looking out for other mamas who might find themselves blaming themselves for not preventing their PPD. I really want all moms to know that in my experience, mamas really aren’t capable, in their fragile state, to self-diagnose. It’s NOT YOUR FAULT. Please believe your doctors need to be looking out for you.

  9. Elizabeth SIlverman says:

    So sorry to hear about your horrible experiences. I am glad that you are aware that there are many physicians and women’s health specialists who would have been more proactive in your case. I view myself as one of those physicians; however, in my experience I identify anxiety disorders and depression in many expectant as well as postpartum mothers and they MORE OFTEN THAN NOT decline to follow up with the mental health professionals to whom I refer them. As OB/GYNs I agree that we can do a better job of identifying those who need help but we are not the professionals who are trained to provide the therapy that helps. If someone were not pregnant and suffering from anxiety or depression, the obstetrician ‘s office would not be the place to find treatment.

    • Elizabeth, you make a very valid point. I think a woman’s GP or OB/GYN can be and should be a first line of defense, but it’s equally as important that mamas get in with mental health professionals that specialize in treating maternal mood and anxiety disorders.

      • Hello all.
        I would like to share my story. I want to start off by saying I have never had any anxiety , depression , or ocd. My son was born April 2012 everything went great. I even left the hospital 2 days early from a c/s. When my son was about 9 months old I woke up one morning with a headace , dizziness , and I could not concertante . I went to my doctor were she said I had a mild case of vertigo . After about week and a half of visiting my doctors office all hell broke lose in my head. The nightmare began. I had thoughts that I have never in my life ever thought off. They were a horror show in my head. Everything in my house was negative . I would look at my fireplace and i thought I would throw my kids in. I can go on and on . I had every thought the stabbing, drowning, putting them in the dryer. I hope I’m not scarring anyone. I knew these thoughts were wrong and not me. I really thought I was going crazy. I headed back to my doctors office the next day. We’re she told me it was sleep deprivation . I asked her are you sure she said yes. I went home I finally told my husband and my cousin. They all said the samething you have postpartum . I started todo some research on the web and came cross postpartum ocd. I wasn’t depressed I was function perfectly . I was just so sad and unhappy of all these crazy thoughts i was having. After going 3 more times to my doctors office she was still telling me I had sleep deprivation . After 6 months of hell I finally went to see an other doctor. I Told him the whole story. He looked at me and said postpartum ocd. Finally!!!!
        I went I meds a very low does. I tired a therapist it’s not for me. I’m a year and 3 months I’m a lot better then what I was. I don’t have the fear like I did or the crazy thoughts or the triggers of watching the tv. I do get them right around I’m pmsing . I think this just takes lots of time and support. I know the worst is behind and now there habit thoughts. I know it’s a long story.
        What I want to say is you know yourself better then anyone . Trust your gut and get the help you need. It is temporary. It just takes a long time to recovery from all the crazy thoughts that go on. I hope this helps someone out there.
        Love Maria