Nearly 1 in 7 women experience symptoms of postpartum depression during their reproductive years – and that number represents only the reported cases. The actual incidence is believed by some to be significantly higher. Recognizing the need to discuss this vital maternal health issue, the School of Social Work at The University of Texas at Austin and The Pregnancy and Postpartum Health Alliance of Texas (PPHA) teamed up this spring to host their inaugural Maternal Mental Health Conference (MMHC). As an incoming student at Dell Medical School, I was privileged to assist with and attend a large portion of this historic event.
Maternal Mental Health Conference ~ April 27-29, 2017 ~ #TXMMHCON
Did you know that depression is the #1 complication of childbirth? I didn’t, and I’ve given birth to three babies. Before the MMHC, I had little prior knowledge of either the clinical definition of postpartum depression or the broad spectrum of disorders that fall under its umbrella. For example, could you recognize the differences between postpartum psychosis and postpartum obsessive compulsive disorder (OCD)? I captured this photo during the excellent opening keynote presentation by Lucy J. Puryear, MD.
A tragic and well-known example of postpartum psychosis is the story of Andrea Yates, who was assisted in her re-trial by Dr. Puryear. Postpartum OCD, on the other hand, is likely suffered in silence by many women who are afraid of or who don’t understand what they’re thinking and feeling. As a future medical provider to women and families, I appreciated the high level of detail that Dr. Puryear was able to share about the symptoms, diagnosis, and treatment of postpartum depression spectrum disorders.
My Personal Experience with Postpartum Mood Changes
When I was pregnant with my first baby, my doctor warned me that I might experience “baby blues” after my little one was born. Beyond that, I honestly didn’t know what to expect with regard to my mental health. The rollercoaster of emotions I felt after my son was born was unlike anything I’d ever experienced. First came the overwhelming joy of meeting the child I had grown and becoming a mother. The physiological response to new motherhood is truly transformative: I never knew I could be so happy.
But after a few days, painful challenges arose. My baby boy was born with two bottom teeth (like his Momma) and he spent the vast majority of his first 48 hours cluster feeding. By the time we got home from the hospital, my nipples were already purple and cracking. Then, at around 3 days old, he bit me – hard. I wailed in pain and sobbed as I handed my fussy bundle over to my husband and my mom. I was afraid to nurse, especially on the raw side, which took more than a week to heal. I even developed an abscess that required antibiotics.
Already exhausted from all the shushing and feeding, I sat at my kitchen table with my electric Medela pump to try and keep up my supply. In all honesty, it was humiliating. Those first three weeks were the hardest of my life. Despite my fear of the pain, I clung desperately to the nursing relationship we had started. I was not breastfed by my mom, and when I first got pregnant, I wasn’t even sure I wanted to breastfeed. And yet, here I was, terrified that I was not capable of providing for my child. Disappointed beyond measure that my poor baby was hungry and that I’d had to supplement with formula (which, in my mind, was a huge failure). I spent a lot of time in those early weeks worried and crying.
Luckily for me, things improved. A skilled and attentive lactation consultant, who I paid out-of-pocket to visit us at home, helped us get back on track and we nursed part-time until he was eight months old. This experience taught me a hard lesson about parenting: when it comes to raising your children, nothing will be perfect. A lifelong Type A perfectionist, I had to overcome my disappointment and focus on what was best for my baby. This seems like common sense, but it was actually very difficult at the time. I can imagine how easy it would have been to fall into a deeper depression, especially if I lacked family support. I didn’t realize it at the time, but my difficult initiation into motherhood played a large role in my decision to become a physician.
Knowing what I know now about the postpartum depression spectrum, I feel more qualified and motivated to help mothers and families overcome postpartum mood changes. I hope that primary care providers will take up this cause, so that all new moms have the support and resources they need to survive those critical early months of motherhood.