There are hundreds of thousands of women suffering at this very moment from mental illnesses related to pregnancy and childbirth like postpartum depression. This very minute. Only 15% of them are getting the professional mental health care they need and deserve.
I’m not kidding. Only a small minority are getting help. The rest are left to fend for themselves.
Maybe they don’t know they need help. The amount of education and awareness offered is usually brief, if offered at all. Almost dismal, really. So many childbirth educators and OBs don’t want to upset or offend pregnant moms by getting into the dirty details of postpartum depression.
And the mamas fend for themselves.
We don’t have time to screen for postpartum depression, the providers say. We don’t have time to take social histories. We aren’t reimbursed. There’s no mandate to do it in most states. Besides, who should do it? The pediatrician? The OB? Someone else? Who’s paying for this? When should we do it? Where do I send her if she’s sick? Which tool do I use?
And the mamas continue to fend for themselves.
Their family members either don’t know what is wrong or don’t know how to help. (And why would they?) Or, even worse, they don’t support a woman getting the psychiatric help she needs.
And the mamas suffer and fend for themselves.
Some don’t have insurance. Or they don’t have any money, or childcare or bus fare or any of the many things that can prevent them from getting to help.
And so the mamas must fend for themselves.
They see what people say about women who have postpartum depression. They hear the jokes. They know people think of mothers with PPD as murderers. Or as selfish women who don’t want to be moms. Or as having a major character flaw. Or as everything other than what they really are: people with a treatable illness. There is shame and stigma. There is fear.
So the mamas fend for themselves.
Oh my heart hurts. On the heels of the Hermosillo infanticide in California, today I read of Naiyana Patel in Asheville, NC. She just killed her two daughters, aged 4 and 7, after having lost a pregnancy. She was, according to reports, being treated for depression due to the loss.
My heart doesn’t just hurt. It SCREAMS.
Every day I hear from those of you who weren’t warned. Weren’t educated. Whose phone calls for help have gone unreturned. Who never knew they needed to be treated and whose illness is now chronic. Who had to wait years before getting a correct diagnosis. Who were diagnosed but then told they’d have to wait months to see a psychiatrist. Or who know they need help but can’t get to it or pay for it.
I can’t take it anymore. Can anyone hear me? White House? President Obama? Michelle Obama? Department of Health & Human Services? Kathleen Sebelius? The National Prevention Council? Surgeon General Regina Benjamin? NIMH? SAMHSA? Anybody?!
For God’s sake, there is no excuse that we don’t have a scalable, standardized, integrated and operational system for supporting and ensuring women’s mental health during 9 months of pregnancy and 12 months postpartum. No freaking excuse.
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I applaud your efforts. YOU are doing something! When others have failed you have helped.
It's not much better in Canada. I am one of the unfortunate who has never been "cured" of the PPD and it has been deemed chronic depresion/anxiety. I waited months to see someone, and it was regular for a while then one day I got a call that she was out of the office sick and they would be calling me back to reschedule. They never did, and I have called to tell them & rebook 3 times. Never a call back. They don;t seem to notice or care that I've slipped through the cracks.
The system is broken, and more needs to be done to care for people who are suffering from PPD. I wish it were as easy as yelling from the rooftops. Not sure what it's going to take to get people to take notic and act on it.
Sighhhh.
The health system in general is messy. In the US, the only law protecting your job says you get 12 weeks – max! – unpaid as a new mom. We're the only civilization that does NOT offer better, paid benefits. How does that make sense?
America fails moms. Over and over again. Sure, you can pump at work now… but ONLY if your employee has FIFTY employees. (Another stipulation for FMLA laws as well.) And does that cover you for harassment from fellow coworkers?
It's a ridiculous, pathetic mess.
Completely, 100% righteous anger.
I even find it difficult as a doula to navigate the woefully inadequate postpartum care that many women receive. We discuss the Edinburgh Postnatal Depression scale, local mental health care providers, online resources (like yours), etc.. prenatally and in the postpartum visit, but as a non-medical care person, I can only recommend and refer so much before what a women needs goes way beyond my scope of practice. And it infuriates me that women AREN'T getting the information they need before they even leave the hospital! Or even before they even have their babies!
But I will say this: keep fighting the (inspiring) fight you're fighting. You'll make this whole mess less messy for lots of women. You already have.
Powerful.
I needed help and I've yet to find the professional support I need. It's so hard to start with a therapist and then switch and switch. Both my OB and my primary care doctor had zero recommendations for therapists that were on my insurance. Their suggest of writing in a journal didn't help, I need/Ed something more.
I've been on and off meds because they aren't working well and none are safe during TTC. When we started trying I had come over the hump, but then had a miscarriage in may and now were faced with secondary infertility. A year of TTC was august 1st.
There isn't help and there isn't support. Most suggestions are meds and while they help sort the imbalance it doesn't help you sort through the feelings, especially after a pregnancy loss and my first onset of PDD was because, I think, my failure of breastfeeding, I had one therapist that told me I was orobably better off for not breastfeeding,
Ugh. There needs to be change.
This resonates with me so much. There is such a gap between professional help and new mamas. How can we be a better support for each other, be more open, say to the ranks, "I've been there and I won't judge you; I will love you and help you and support you?" Thank you for writing this.
Our society is all about demonizing and criminalizing the woman rather than trying to understand her condition. These pregnancy and childbirth related mental illnesses are as real as any of the other conditions they DO screen for (pre-eclampsia, gestational diabetes, etc.). Postpartum depression is NOT uncommon and can cause a lot of suffering and harm to mother and family, and postpartum psychosis, while rare, can lead to unspeakable tragedies. It's time we got the word out and demanded that medical professionals pay attention through proper screening and postpartum care. The media is complicit, too. I'm so sick of news about "evil" postpartum mothers killing their babies. I'm sorry, but no mother, under normal, healthy circumstances, wishes to harm her children. It is by definition abnormal behavior. These are all tragedies caused by postpartum and pregnancy related mental illnesses and psychosis, and the sad thing is that many such tragedies could have been prevented with a better system of postpartum care.
America fails us. Again. Thank you for your brave perseverance. Don't give up Katherine! You are making a huge difference.
When I first got pregnant with kiddo, I was being seen at the Naval Hospital here. I was given a piece of paper every appointment, asking me my emotions, and how I was feeling. They never looked at it in front of me, so I have no idea what it was for.
We then moved to Pendleton, and I was seen by a civilian doctor. Not once did she ever ask me about how I was feeling and doing mentally and emotionally. Never before I gave birth, and never after. I had mentioned being moody, but that was all I ever said, and she just gave me Yaz. She never asked me anything relating to sadness, anger, nothing.
When I FINALLY sought treatment for PPD, the doctor I went to was an older gentleman. I told him what was going on, and he described it back to me as "just being bitchy." He gave me a prescription for Prozac, and told me he thought that would help my husband. You know, because it would make me less bitchy. I didn't go back to a doctor about my depression for another couple years.
I suffered, partly because of me, and partly because the medical system failed me. It doesn't have to be that way. It shouldn't be that way!
I agree that doctors really need to do screenings. I will never understand why the objections you listed in your post are acceptable. I have an masters in clinical social work, I was trained to identify and help people with depression and I was still in denial when I developed PPD. It took someone else making me an appointment with a psychologist before I even remotely accepted the idea that there might be a problem and even then I refused medication. If my OB had done a screening I'm sure I would have been treated much earlier.
There also needs to be more education provided. My husband and I attended a birthing/parenting class before the birth of our first child and no mention of PPD was brought up. I finally asked about it and the nurse actually said "yes, you should be aware this is a possibility but the majority of you in this room will not experience this at all." I was flabbergasted, she basically told people that it wouldn't happen to them.
Yes! The state of mental health services for women with pregnancy related mental illness is SAD. Most women end up getting ping-ponged from one shrugging professional to another.
There needs to be an increase in comprehensive programming that is run by people committed specifically to PPD. Unfortunately a lot of therapists (bless their hearts for trying, though) often say "I can treat PPD, I know a lot about depression" without realizing the true need to specialize. PPD is not like other depression. Its risks are different. Its presentation is SO different. It requires specialized care, and there are many of us out here scrambling to make that specialized care more available.
Thanks for all you do!
Melina
How hard is it for a pediatrician to administer a simple oral check-list screening? I had to return to my family home in Australia to recover from severe PPD and the difference in treatment was night and day. My friends talked about how they were screened at each Well Baby visit through the first 12 months. In comparison no one talked about this with me in the US. No doctor here talked about how PPD can really kick in when you stop breast feeding, perhaps it was because I breast fed for longer than 3 months. And when I was offered medication for depression here it was 10mg of Prozac, which my doctor in Australia was appalled at.
It has been devastating and I would not be recovering if it was not for the love of my parents and the doctors in Australia.
I am so glad I have found this site. Thank you.