Postpartum Depression

When I was in graduate school in the early 1980’s, postpartum depression was never discussed. In the past month, postpartum psychosis has been all over the news. In fact, I just saw a play featuring a woman experiencing postpartum depression during the pandemic. Obviously, postpartum issues have been around as long as women have been having babies. In other words, always.

I tried to think about my personal memories of women going through postpartum depression. I remembered a woman on my block who gave birth to a child who developed cerebral palsy, a condition which occurs before or during childbirth. I heard this woman made a suicide attempt. Her devastation was evident.

While in graduate school, my apartment-mate had given birth and reluctantly placed her baby for adoption shortly before coming to the university. She knew she was ill-equipped to be a parent and believed she would be providing her baby with a better life. Several months later, our landlady became pregnant, triggering my friend’s depression. I attributed her debilitating depression to the loss and grief she had experienced. I never once considered her postpartum issues.

A friend of mine chose to terminate a non-viable pregnancy while I was pregnant. She went on to experience severe depression and anxiety. After I gave birth, her breasts would express milk when my baby cried. She was overwhelmed.

In all cases, the three women experienced a trauma. I did not consider the possibility that being postpartum itself could cause depression. People mentioned the ‘baby blues.’ I never thought about the dramatic shifts in hormones as precipitating a depressed state. Most wanted pregnancies are assumed to be followed by joy, if the baby is healthy.

Working in the field of infertility, a hard-won pregnancy is almost always a cause for celebration. How much more difficult it is to admit to experiencing depression after birth when having a baby was all you dreamed about. Who will be inclined to sympathize? Not your friends who are still infertile.

So many women are more comfortable confessing their postpartum depression in the current era. What is more important is the recognition by the medical and psychological communities that this condition must be treated seriously and with compassion, and often with therapy and medication. When I was born in the late 50’s, women spent a significant number of days recovering from childbirth in the hospital. My grandmother worked as a ‘baby nurse,’ helping postpartum mothers with childcare, infant care, cooking and cleaning for several weeks. Support was expected.

Now, mothers are often released from the hospital within 24 to 48 hours. Many mothers cannot afford full-time care. Other mothers need to return to work. Fortunately, postpartum issues are asked about by obstetricians when women return for follow-up visits. What is unclear is how many women admit to their symptoms and feelings. Women who have experienced postpartum depression in past pregnancies are given special consideration by physicians who may medically treat mothers soon after giving birth and, when indicated, before childbirth.

Postpartum psychosis resulting in the murder of children as seen in the Clancy case is, thankfully, very rare. However, even mothers who do not experience significant postpartum issues live with fear and anxiety, and sometimes nightmares, about unintentionally harming their babies. Giving birth to another human and being responsible for keeping that baby alive, while trying to figure out what your infant needs and learning how to comfort your baby, are monumental tasks. Add sleep deprivation and constant nursing, and parenting can feel like the most difficult job you may have desperately wanted. Family and social support are critical. Admitting to depression, anxiety and unwanted thoughts does not make anyone a bad parent, just an honest one. Scary thoughts rarely lead to scary behavior but may lead to crying and difficulty functioning. As a psychologist who has worked with many new parents, I can help you through this postpartum period. Working virtually, I can see you without your having to arrange childcare. However, having another adult around to allow you to have some time for yourself is ideal. Feel free to contact me for a complementary 15-minute consultation to see if I can be of help.

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