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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How a Traumatic Birth Gave Me Postpartum PTSD & Depression

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How My Traumatic Birth Experience Gave Me Postpartum PTSD & Depression

My child will be an only child.

I want to talk about one of the reasons she will be an only child. I want to talk about why I roll my eyes or wince when someone tells me that I’m too young to say something like this or to “give it time.”

I have diagnosed PTSD from giving birth.

I can still see every detail of my labor in my mind; I replay it more often than I admit. I obsess over it. I romanticize about other people’s labor stories. My best friend just did a home birth. She walked around in the calm darkness and labored and loved and labored some more. She gave birth to a beautiful, healthy girl.

I feel robbed.

Nothing went right.

But, Carrie, things don’t always go to plan! Calm down.

No. Nothing went right.

In fact, things went so not-right that it is affecting me mentally. Still. It has been five years.

My water broke naturally at home, three days before my due date. I arrived at the hospital, after having some small contractions, and was three centimeters dilated. I was wheeled into a room, given a gown, and hooked up.

Hooked up.

First, they put my IV in. Then they put the fetal  heart monitor on my belly. I was told to lay on my back so it wouldn’t slide. I was told not to move.

I wasn’t hooked up. I was strapped down. I was rendered immobile.

I was young and didn’t know any different. These people knew what they were doing. I’m just here to have a baby, folks.

When I didn’t progress fast enough, I was given a bag of Pitocin. This worked. I progressed. I was asked if I wanted an epidural. I said sure. The pain wasn’t insane, but it wasn’t great and “the guy is on the floor now so it’s now or never.” Okay. It’s now.

I was given an epidural. It did not work.

I was given a second epidural. It did not work.

They kept that one hooked up just in case it decided to work. Just for fun. That’s three things tethering me to the bed at this point. Three things keeping me on my back, the most difficult position to be in to push something the size of a pug out of your vagina.

I stalled at six centimeters. I was made to feel like I was wasting everyone’s time, like I was failing at my job. You had one job, cervix. C’mon.

I was given a second bag of Pitocin. I began to run a fever. I had to have that little finger monitor on to keep track of my fever. Four things, now.

The Pitocin pushed me, quickly and painfully, to 9 1/2 centimeters. Everyone stood around and watched me. They waited as I labored with a faulty epidural and a net cast over my body like a beached whale.

“We are going to push now.”

I wasn’t at 10 yet. My body wasn’t ready yet. I told everyone this. They assured me all would be well, they were just going to push aside the last 1/2 centimeter every time I pushed.

Push it aside. No epidural. It felt like a giant hug, let me tell you.

At this point I had been in labor for 20 hours. My family was told to leave the room and things seemed to get serious.

I pushed. I pushed in a way that I didn’t know I could push. None of us ever know, do we? We always pause for a split-second in awe of ourselves. I am doing it. I can feel it.

I tore myself on the inside. But I kept pushing. I lost bladder control. But I kept pushing. I began to black out between pushes. I swallowed ice chips brought from my bewildered husband and kept pushing.


I was told stop.

They could see the top of her head, but it wasn’t going to happen. She wasn’t coming out this way. The head was not going to fit through my body this way.

Two hours of straight pushing. A fever. No epidural.

And suddenly, I was drinking a terrible medication to keep me from throwing up during surgery. I was taking off my jewelry. I was saying goodbye to my mother.

I was wheeled away.

People became more kind now. They played music for me in the surgery room. Someone was singing along. The anesthesiologist came in and said he heard my epidurals didn’t work. I nodded. He assured me this spinal was going to work.

It worked. I lost feeling from my neck, down. My arms were shaking so badly that they had to strap them down.

Strapped down.

I didn’t feel much. It felt like a cat kneading my stomach. Pulling at me, pushing at me. It felt like how you would imagine life beating you up from the inside.

Then she was free and everyone gasped. She was huge and had been facing forward. She was never going to come out of me naturally, they said. They held her up to my face for three seconds. She smelled like me. She looked like me. They took her away, pushed a bit more medication into me, and I woke up in the hallway, stitched up.

I had split myself in half to have a baby. I had labored for 22 hours to have a baby.

I was alone in the hallway.

Where was my baby? Was it all just a dream?

Of course, I saw her in my room shortly after. I remember thinking to myself, “I already feel it. I already have postpartum depression.

I did. I had it badly. But, it went beyond postpartum depression. I was obsessed with watching her, but wouldn’t touch her. I would have sleep paralysis. I would get sick to my stomach when she cried.

I still won’t consider doing it again.

My psychiatrist, years after, finally mentioned it sounded like PTSD. How could that be? I wasn’t in a war! I wasn’t wounded! Nothing traumatic happened to me!

Something traumatic did happen to me. I was robbed of something very important to all mothers: I was robbed of my power. I created a human being out of cells for nine months. For nine months all I thought about, all I was trained for, was to push this human being out of my body and be the woman I was supposed to be. For nine months I played my labor plan over and over in my head. It took them less than 10 minutes to hack her out of me.

I was robbed of my power.

They robbed me of that. Never again. I will keep this child precious and make sure those around me retain their power. I will use my story to make sure it doesn’t happen to other women.

This is my story. It doesn’t have to happen to you.


Read more about PTSD and Postpartum Depression:

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We Need to Talk About Postpartum Disorders

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[Editor’s Note: Today we are thrilled to have a guest post by Betsy Schwartz, Vice President of Public Education & Strategic Initiatives at the National Council for Behavioral Health.]

Mental Health First Aid USA + National Council for Behavioral Health + Postpartum Progress

In 2001, a tragic event in a suburb of Houston Texas shook the soul of the nation. A successful nurse, daughter, wife and mother did the unthinkable. In a state of postpartum psychosis, Andrea Yates systematically drowned each of her five innocent children. She emphatically believed that her action was the only way to prevent them from spending eternity in damnation. The State of Texas found her guilty and sentenced her to life in prison.

In 2006, the case was re-tried, at which time Yates was found not guilty by reason of insanity. And rightfully so. International media attention focused on Yates’ trials offered a tragic opportunity to teach the world about postpartum illnesses.

During my tenure as CEO of Mental Health America of Greater Houston, we created a fund in memory of the Yates children dedicated to educating new moms and dads about the risks, signs and symptoms of postpartum disorders.

Now, fourteen years later, Mental Health First Aid USA has an opportunity to expand that national dialogue and education. Through a partnership between the National Council for Behavioral Health and Postpartum Progress, new moms can receive training to become Mental Health First Aid instructors, giving them the knowledge and skills they need to spread the word that postpartum illnesses are real, and when recognized, can be treated effectively.

Postpartum education will play an integral role in Mental Health First Aid’s mission of creating healthier communities, as research shows that the health of the mother determines the health of the infant. We look forward to this important collaboration and the work of Postpartum Progress. Together, we can work toward creating stronger, safer communities for all.

Together, We Can Work Toward Creating Stronger, Safer Communities for All. -Betsy Schwartz

-Betsy Schwartz, National Council for Behavioral Health

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Surviving the Dark Season

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I reached out to some of my fellow warrior moms to see if anyone wanted to share their story, and the following is by one of the brave women who responded to say, “Yes, it’s finally time for me to share.” Thank you to Diane Stenglein of Motherhood is Painless for writing this.

Surviving the Dark Season

Sometimes my daughter wants to know what she was like when she was a baby. She folds her lanky eight year-old self into my lap. “Tell me about my chubba cheeks,” she says. And so I do. I tell her about the nurse who carried her around the delivery ward, showing off her chubby cheeks, or what she sounded like when she first giggled. She was perfect. Brown hair, brown eyes. Chubby cheeks and plump thighs.

Sometimes, I tell her about taking her to see the fireworks on the Fourth of July when she was two months old and cupping my hands over her ears, or about Daddy carrying her in the Baby Bjorn around our neighborhood. I tell her about how she slept soundly in her stroller at her Aunt Kathy’s wedding, even as all the guests oohed and ahhed over her.

She was so much to us. After battling cancer and the resulting fertility hurdles, we had our family. So I tell her.

And I love to tell her, because then I don’t have to think about the rest of it.

I can’t forget the dark corners of that first summer. How scared I was from the moment she was born. I remember holding her in the hospital and thinking, “Who are you?”

I remember sitting in the park near our apartment, on the phone with my best friend and her husband. I was shaking with the fear, crying while they talked me back to reality. “I can’t do this. I’m not supposed to do it this way,” I told them.

I can still picture myself lying on the bed in our third story walk-up, hysterically sobbing with sleep deprivation. I can still hear the sound of my cries, matching hers in the other room, I remember being afraid to put her down, so I spent hours with her, sitting in the glider. Day after day, waking, nursing and sleeping. Many more hours than I should have stayed.

She was born in May, and I didn’t leave the apartment again until the end of July. I came up with reason after reason. First, it was because she was so very new. Then I told myself it was because it was too hot. But I was scared. I was afraid of the cars, or of falling with her in my arms as we navigated the stairways in our crooked building. I lived for the weekly visits from my mother-in-law, bringing me food and a respite for a few hours.

One moment still echoes in my memory. It was late. She had been fussing, and my husband was changing the bedding since she had had a leaky diaper. I was lying in bed, nursing her, and crying.

“I am your mommy,” I said. “I will be your mom forever. I’ll be there when you are a big girl baby, and a little girl. I’ll take care of you until you are a grown up Clairebaby, and when you have a baby of your own, I’ll take care of you and your little one.”

Thinking of those years, rolling ahead of me shook me to the core. My husband took her back to her bed, and I lay there, the rest of the night, wondering why the thought of my child growing up made me so sad.

I didn’t realize how depressed I was until the pain had faded. One day in July, the weather abruptly changed, and we had a glorious day. It was clear and sunny, but not humid. I managed to get us out of the apartment, in clean clothes, and got the stroller down the stairs without stumbling.

I started walking, feeling a brightness start to form in the darkness. We met my brother, had some coffee. I walked down to the river and found the park. We watched the kids playing for a while, and I could finally see things a little more clearly.

Looking back, I know that I needed help getting through those days. But I didn’t know any better. Parenthood shouldn’t make you sad all the time, or afraid. And if it does, you shouldn’t feel ashamed to say “I don’t think I feel like I’m supposed to feel.”


Editor’s Note: Please check out our PPD Support Groups in the US and Canada Resource if you don’t know where to start looking for help. You are not alone.

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