Last week I began to address the topic of traumatic births and postpartum PTSD. This week I want to delve more into the emotional experiences of new moms following a traumatic birth. In my work with postpartum clients, I’ve observed that these reactions often come in waves, with some shifts and changes with time and distance from the trauma. Below are some examples culled from my clinical practice. 

Perhaps you have been imagining your “perfect” birth experience for months. You have a playlist ready to go, a doula, and birth plan on hand. You are prepared, you’ve done your due diligence, you’ve read every book, and then things fall apart.

In the last few years there has been a significant push to screen pregnant and postpartum women for symptoms of depression. In fact, in 2015 the American College of Obstetrics and Gynecologists (ACOG) recommended screening at least once during the perinatal period for symptoms of anxiety and depression using a clinically validated assessment tool such as the EDPS (Edinburgh Postnatal Depression Scale) or the PHQ-9 (Patient Health Questionnaire-9). Several states have followed suit in mandating depression screenings for perinatal populations.

I encourage all my pregnant and postpartum clients to draft a list of ways they would like their medical care providers to interact with them which are supportive of  their emotional needs and bolster their mental health. I refer to this as their Pregnancy/Postpartum Bill of Rights.  Yes, it’s strong rhetoric but the language is intentional as I often see women who are reluctant to advocate for themselves. They don’t want to be difficult, they don’t want to offend, they want to be “good patients.” Consequently, they feel disempowered and their emotional wellbeing suffers.

A few weeks ago, ProPublica published a sobering article entitled The Last Person You’d Expect to Die in Childbirth. The article addressed the extremely high maternal mortality rates in the United States, which are contrasted significantly with low infant mortality rates.

In trying to understand this enormous discrepancy, the authors note numerous examples in which our medical system: from medical education, to Medicaid spending, to hospital credentialing, to routine obstetric and postpartum care protocols; privileges the health of babies while ignoring the health of moms.

Parenting, and particularly parenting a baby, requires an enormous amount of mental and physical effort.  There are the logistical challenges of making sure everyone is fed, clothed, and bathed.  And that everyone gets to where they need to be on time.  There are intense physical demands such as healing a postpartum body, nursing, and getting very little sleep.  And of course, there are significant emotional challenges.  Adjusting to the significant shift in identity (great piece on this here,) struggling with the very real problem of mommy guilt, and managing the emotional labor of a family can take a real toll on one’s emotional wellbeing.

June marks Pride month, with cities around the world marking the occasion with marches, parades, family carnivals, and all kinds of great events. This past weekend we celebrated pride right here in the nation’s capital. Pride is of course about celebrating and supporting our GLBTQI family members, friends, and community. But it’s also a reminder to take stock of and consider the numerous ways our country’s policies, laws, and protections continue to marginalize and discriminate against GLBTQI people. This is especially true for those of us whose identities and various points of privilege affords us the space to not think about this daily.

Over the past few weeks, you’ve learned about perinatal mood and anxiety factors, how to find support, and how to support a friend or partner. This week I wanted to speak to the importance of social support, and specifically, how essential it is to connect with other moms and parents with kids of the same age. There is incredible value in this. Indeed, countless studies have shown that lack of social support during pregnancy and the postpartum period puts women at higher risk for developing a perinatal mood or anxiety disorder (PMAD).

In last week’s post, I ended with a promise to feature more information and more first first person accounts of women and men who have experienced perinatal mood and anxiety disorders whose voices are underrepresented. With that goal in mind, I am thrilled to have had the opportunity to interview Divya B. Kumar, ScM, CPD, CLC; a co-founder of the Perinatal Mental Health Alliance for Women of Color (PMHA-WOC).

In last week’s post, I spoke about what to do and where to turn if you are concerned you are experiencing a perinatal mood or anxiety disorder.  A question I get asked frequently is how to be helpful if you have a friend or partner who is suffering, or if you are concerned about someone. I wanted to spend this week’s post addressing this.