In all the fun and joy of preparing for birth, very few give postpartum depression anything more than an obligatory nod. Most people are inclined to skip over it when preparing for a baby, because of they, naturally, think it will never happen to them. Some may just resolve to deal with it if they face it and otherwise leave it alone.
Nobody can possibly prepare every little detail about the coming life with their baby. But a little basic understanding of postpartum depression can go a long way toward prevention and management, should the need arise. I certainly cannot provide you with all there is to know about PPD in a single blog post, but I hope you will gain some basic knowledge to help you be aware and prepare.
First, what causes postpartum depression? We still have so much to learn despite the amount of research that has been done already. Each case is unique, and the way it is experienced and manifested differs from woman to woman. Causes can be rooted in something mental, emotional, physical, or spiritual, or any combination of these.
Physically, as a woman recovers from birth, her hormones take a while to readjust to a new normal. During this time, it is likely that she is not getting adequate nutrition to support this process if she doesn’t have enough help at home. If she is breastfeeding, prolactin is at work as well, trying to perform its essential function. In addition, she is also likely sleep deprived of caring for a new baby.
Emotionally, a woman can understandably feel overwhelmed by the demanding job of caring for her new baby. If and when her partner returns to work this stress can be amplified especially if there is no additional help at home.
The symptoms of postpartum depression are easy to observe. It is classified as a condition that can be self-diagnosed. Postpartum depression is not to be confused with baby blues, which generally only last a few days after birth. Conversely, postpartum depression tends to be more extreme and rather relentless.
Many women feel ashamed about the possibility of having postpartum depression because motherhood is “supposed” to be the happiest time of your life. In theory. The reality is often much grimmer than we presupposed, as this season of life involves so much life adjustment, difficult navigation, and physical strain involved in baby care. Women are afraid to admit that they are depressed during this time for fear of being shunned.
Some general signs to watch for:
Women are more likely to experience PPD if they have:
The standard postpartum follow up visit with a care provider after birth is a full 6 weeks. That means a woman is sent home from the hospital on her own, and they do not see a professional who can help them for 6 whole weeks. This is a huge gap in maternity care in the US. After birth, a lot can happen in a couple of days, let alone 6 weeks.
The exception to this rule is the home birth midwife. Home birth midwives usually see their clients several times between birth and 6 weeks, but only 3% of births in the US are attended by home birth midwives. The majority of other providers do not do visits before 6 weeks.
This is significant because one of the most well-known causes of postpartum depression is the lack of support.
Both birth and postpartum doulas are in a unique position with a mother. Doulas can come and visit a mother to provide support, but they can also be a perceptive eye in this sensitive time. A doula sees the mother in her own home, in her element. Even though birth doulas generally do not to postpartum doula work, most birth doulas tend to stay in touch with their clients long after the birth. They can be a source of emotional support, and they can provide resources for professionalhelp and support should it become needed.
In theory, a postpartum doula can help prevent postpartum depression. We know that postpartum depression can be caused by stress, breastfeeding problems, emotional demands, or lack of support. We also know that the postpartum doula helps support all of these issues. When she hires a postpartum doula, a new mother does not need to juggle the demands of the household, worry about meals, or handle the housework. She can get adequate rest too since the doula helps the mother make sure she is getting some sleep. A postpartum doula can help reduce stress in an indescribable way.
If you think you may be experiencing Postpartum Depression, it’s so important to talk to someone. It can be managed in a number of ways that range from additional support to herbal supplements to medication. You must know that you are no less of a mother because you are struggling with postpartum depression – there are 3 million known sufferers in the US alone. You do not need to suffer in isolation.
For more information, check out these resources:
Preferred Counseling / Support Groups
Alexia Johnstone, LMHC
Mental Health Counselor
Expressive Arts Therapist
Mara Acel Green LICSW
Massachusetts Postpartum Depression Treatment
Boston – Massachusetts General Hospital’s Center for Women’s Mental Health
Boston – Brigham and Women’s Hospital Women’s Mental Health Program
Boston – Judith Robinson MD, Tufts Medical Center
Boston- Vivian Halfin MD, Tufts Medical Center
Cambridge – Laurie Ganberg LICSW
Cambridge – Suzan Wolpow LMHC
Lexington – Ellen Hilsinger MD, 781-863-5225
Roslindale – The Leggett Group
Somerville – Vicky Reichert LMHC
Wakefield – Janice Goodman
Waltham – Jewish Family & Children’s Services PPD Support
Waltham – Jessica Foley MA
Watertown – Mara Acel Green LICSW
Wellesley Hills – Deborah Issokson PsyD
Westborough – Carolyn Chapman MSW
Worcester – Univ. of Mass. Medical School Women’s Mental Health Program
Worcester – Birchtree Psychology, Rachel Smook PsyD
For more PPD specialists in Massachusetts, visit the North Shore PPD Task Force’s provider list
If you are seeking therapy offering a sliding scale fee based on income, or free counseling services, you might try: La Alianza (Boston, Roxbury)
It’s a topic that we tend to overlook when preparing for a baby, because we think it will never happen to us. Or we decide we will cross that bridge when we get there if we get there. It’s a rather depressing and confusing thing to think about when you haven’t experienced it. Amidst all the splendor of dreamy baby preparations, we try not to think about it.
While you can’t completely prepare for every detail about postpartum life and caring for a newborn, some basic understanding of postpartum depression can go a long way toward preventing and handling it.
In this post, I hope to provide you with some basic information, and I hope to provide encouragement if you are struggling. Sometimes, a little affirmation to remind you that you are normal and not isolated in your struggle goes a long way.
What causes postpartum depression? There has been a fair amount of research done on it, and yet we still have so much to learn. Furthermore, the way each woman experiences postpartum depression will be unique. We know that the cause can be physical, mental/emotional, or both. Physically, a woman is recovering from birth, her hormones are readjusting to a new normal, she is likely not getting enough nutrition if she doesn’t have enough help at home, and if she’s breastfeeding, her lactation hormones are regulating. She is also likely to sleep deprived. Emotionally, a woman can simply feel overwhelmed by the demanding and arduous task of caring for a new tiny person, particularly if her partner has returned to work, if she has returned to work, if there isn’t enough support in the home for her, if she is isolated for much of the day, and if circumstances in her life are causing stress.
Symptoms of postpartum depression are pretty simple to observe and it is classified something that can be self-diagnosed. It goes past the baby blues, which generally only last a short time after birth. Postpartum depression is more extreme and it lasts longer. Symptoms can present in a number of different ways, different times and for different reasons in women.
Some general signs to watch for:
Women are more likely to experience PPD if they have:
Why do doulas care so much about postpartum depression?
After birth, it’s a standard 6 weeks until a woman sees her provider again for follow up postpartum care. A lot can happen in a couple of days, let alone 6 weeks. Do women routinely see ANY professional during that time? Home birth midwives see their clients several times between birth and 6 weeks, but other providers do not and only 3% of births in the US are attended by home birth midwives and only about 1% in Massachusetts. The other 97% nationwide and 99% statewide are sent home from the hospital a day or two after birth with their new baby and no support or regular contact with a professional for the first 6 weeks of the infant’s life.
What is one of the well-known causes of postpartum depression? Lack of support.
The doula is in the unique position of being a perceptive eye in a sensitive time where there is very little support for women. She can see the mother in her own home, in her element. During that time, the birth doula who attended the mother’s birth will visit with the mother for a postpartum visit, ask her how she is doing, and see if she notices any concerning signs. Most birth doulas tend to stay in touch with their clients long after the birth and they can be a resource, emotional support, and source of encouragement for the new mother.
A postpartum doula can, theoretically, help women prevent or curb postpartum depression. We know that postpartum depression can be caused by breastfeeding problems, stress, lack of support and other emotional stressors, and we know that the postpartum doula helps with all of these. Her job is to take care of the mom and baby so they can figure out life together after the birth. The mother does not need to stress about meals, housework or lack of sleep since the doula helps the mother make sure she has all of those needs are being addressed to the best of her ability. A woman’s stress level goes way down when a postpartum doula is present.
If you are experiencing Postpartum Depression, it’s so important to talk to your care provider. There are a number of ways that it can be handled, and your provider is going to know you and your needs best. There are pharmaceutical medications available as well as nutritional supplements that can help.
Finally, if you are one that is struggling with postpartum depression, hang in there. There is a help and there are available resources to get you through this understandably rocky time. You are no less of a mother because you are struggling with postpartum depression. And with 3 million known sufferers, you are absolutely not alone.
For more information, check out http://www.postpartum.net