I 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 eight 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 antenatal 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 or the potential for antenatal anxiety, 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 anxiety, and all perinatal 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.
- 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.
- Keep telling it until you are listened to.
- 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.