So the day came and I sat there in the room with the Physicians Assistant and I thought maybe she'll tell me something has changed in the last three years (it hasn't) or that I can finally have deli meat (you can't) and as I told her how amazing my last pregnancy was, it seemed pointless to be there again. She explained exercise was fine (duh) and drink plenty of water (of course) and handed me my giant book all about how amazing being a mom was. The book was different than last time. Smaller. Interesting.
I briefly thumbed through it in front of her and took note of the stack of hand outs and pamphlets shoved inside the pocket about breastfeeding, carseat safety, vaccines, genetic testing and hospital registration information.
'Something is missing,' I told her.
'Oh? What's that?'
'There isn't anything in here about mental health.'
She stared at me for a brief moment before stumbling through her words, 'You mean, like, postpartum depression?'
'Well yeah. There's nothing in here about it.' Isn't that just as important as making sure my baby is vaccinated and protected against harmful diseases that can kill it?
'There's something in the book about it,' she explained.
Guys. It wasn't until I got home I decided to look it up in the book. Amongst the pages upon pages of how to care for all the lovely after birth physical symptoms and how a boob works, I found it: Perinatal Mood and Anxiety Disorders.
And it was a paragraph!
Dozens of pages on vaccinations and medications you can and cannot take and breastfeeding support and labor pains and everything else under the sun, but mood disorders got one paragraph. And here is what it said:
"Symptoms can appear any time during pregnancy and the first 12 months after giving birth. It does not matter how old you are, how much money you make, what your race is or culture you come from, any woman can develop these disorders."
The list of symptoms possible after that went on to list: trouble sleeping, changes in appetite, exhaustion, hopelessness, crying, trouble concentrating, feelings of being a bad mothers, lack of interest in sex and the baby, and thoughts of harming yourself or the baby.
This paragraph was then followed by two whole pages of helpful hints for dads and how to resume having sex again.
What this doesn't explain is that there is more than crying and feeling sad and lack of interest in your baby....it doesn't explain obsessive thoughts, extreme mood swings, psychosis and hallucinations, intrusive thoughts or pure fear of literally almost anything. We are missing women here. 15-20% of women will develop postpartum depression or anxiety, and that's not including postpartum OCD, psychosis, post-traumatic stress disorder or bipolar disorder, or the fact that some men develop these conditions postpartum too. It is even estimated that 25% of Americans (arguably 50% by some) will experience a mental illness of some type at some point in their life.
I am sad. I am sad that this is what the women in my community are given when they first become pregnant, when you already don't have a clue of what's going on and are afraid of every symptom you get regardless of what it is. This is how we are preparing women and their families. 20% may not seem significant to some of you, but can we talk about these stats for a minute?
12%: Adults diagnosed with heart disease
3%: People diagnosed with celiac disease
12%: Women diagnosed with breast cancer
9%: Amount of current population diagnosed with diabetes
1.5%: Number of women that will experience bulimia
1%: Number of children identified on the Autism spectrum
My point here isn't to negate any of these illnesses or diseases; they are all important. My point here is that awareness for these conditions is widely spread and accepted in society. There are countless resources, screenings and support groups available for those that need it. Then there are new moms and babies and families that feel ashamed, confused and lost about what is happening in their own bodies. Most don't know where to turn. Many don't even know how to begin to ask for help, even though they have identified that something is wrong. And too many doctors are missing the signs in their own patients and letting them leave their office feeling hopeless over and over. When does it stop? When do we learn that mental health needs to be a priority?
Now that I am expecting again, I have been asked about how I feel about postpartum depression again. I know I'm at risk. I know I'm also at a higher risk of developing a more severe perinatal mood disorder. I won't lie, it is a little scary. The thought of having to experience that yet again not only terrifies me, but angers me. Once was enough!
My doctor is also fully aware of my history and has already flagged my file at my own request to consistently screen me at every appointment while pregnant and and post-birth before I get the chance to leave the hospital. I hope I am strong enough to advocate for myself when I feel something is wrong, and I hope that I don't slip into denial if these symptoms do arise, but I can't say that for sure I will. With P, I walked away from my doctor five times without a diagnosis before that breakdown in her office begging for help. Five times. And she had no idea.
I hope I have been transparent enough in my journey that my family and friends aren't afraid to ask me or question me if they sense something isn't right. In fact, even when things seem perfect, I hope you ask. I hope you ask the new mom in your life, whoever she may be, whether she smiles or not, laughs or joins you for dinner., ask her how she's really doing. Moms are warriors, and they are damn good at hiding their feelings when they need to. Don't be afraid.
Help be the change. Don't wait for it to be too late.
