Suicide is the 2nd leading cause of death in postpartum women. That statistic makes me shudder. People always talk about how having a baby is the most special time in a woman’s life. For some woman, that is not the case, it is a time of immense sadness, anxiety, guilt, and pain. Postpartum depression affects 7-13% of all new mothers. It happened to me, it has happened to friends, it could happen to anyone. My sister was diagnosed with postpartum depression before her suicide. This is not the “baby blues” that I’m talking about, which usually happens a couple days after giving birth and subsides in a couple of weeks. This depression stays, sometimes becomes debilitating, and could have life threatening effects, if not treated. BUT before giving birth, even before you get pregnant, there are postpartum depressions risk factors that you should discuss with your OB/GYN.
3 Postpartum Depression Risk Factors
If you have any or all of these risk factors, you should speak openly and honestly with you OB/GYN about them. This is the point where your ego, and possibly shame, should be put aside for your sake and the sake of your unborn child.
- History of Mood Disorder-this includes depression, anxiety, bipolar disorder, borderline personality disorder, schizophrenia, etc. This should be one of the first things you discuss with your doctor if you are planning on getting pregnant or find out you are pregnant. This is especially important, if you are on medication for any of the above. Certain medications are not deemed safe to be taken during pregnancy. This will also assist your doctor in giving you a more thorough screening in the months following the birth of your child. New recommendations are even calling for OB/GYNs to screen for depression in pregnant woman who have no prior history of a mental illness, stating that postpartum depression could actually begin while pregnant.
- Severe PMS symptoms also called Premenstrual Dysphoric Disorder (PMDD)- which causes emotional and physical symptoms like PMS, only these symptoms are debilitating. The symptoms including severe mood swings, feelings of hopelessness, intense anger, tension, severe cramps, sleep problems, feeling out of control, headaches, and severe breast tenderness. Not much is known about the correlation between PMDD and postpartum depression but some studies have found a direct correlation, making it a major talking point with your OB/GYN. If for some reason you are sent to a specialist of some kind, definitely speak to them if you have been diagnosed or think you may have PMDD.
- Social Stressors (such as poor family support or financial difficulties)-I know….. this is not something you want to discuss with your doctor but it is a good idea to mention how much stress you are under during your pregnancy. Being honest with your doctor will allow them to monitor you more closely the months following the birth of your child. If you’re stressed about not having help with the baby and not being able to afford the basic necessities for your child during your pregnancy, these stressors can increase tremendously after having the baby.
Universal Screening For Postpartum Depression
There is no US federal policy making it mandatory to screen new mothers for postpartum depression. 12 states (including my great state of NJ) have adopted either state legislation, awareness campaigns, or convened task forces to address the issue of postpartum depression. Recently, the United States Preventive Services Task Force, made a new recommendation. They recommended that all women be screened during their pregnancy, stating new evidence shows postpartum depression starts during pregnancy.
An Experts Opinion
Cheryl Beck, an international expert on postpartum depression, thinks universal screening will help to remove some of the stigma of mental illness, since all woman will be screened. She also feels the timing of the screening is important. Miss Beck feels screening in the first 2 weeks could cause a false positive because of “baby blues.” She feels postpartum depression could become an issue at any time during the first 12 months. So, even if a woman screens negative at her 6 weeks check up, she could still develop the illness after that check up, and should continue to be screened.
A Non-Expert Opinion
Postpartum depression lead to my sister’s suicide. I feel like she was given inadequate services. Jessie could have been monitored more closely. She had no insurance, not that insurance makes it any better, but sometimes you are given more choices on how to handle the situation. She was given one choice, go to this clinic, and get a prescription. NO follow up, no nothing, they never even noticed she never showed up again to get a refill on her prescription. I’m not blaming the doctor, or the clinic, she went. I’m not blaming anyone. I just want woman to be aware of the risk factors. So they can be more informed of the possibility of it happening to them. Jessie made her decision. She chose to go off her meds, chose not to go back and get the help she needed. She chose to leave, but I wholeheartedly believe that her illness changed her brain enough to make her think this was the only way to feel better.
If anyone you know shows signs of depression during or after their pregnancy, please encourage them to speak to a professional about it. Being anxious and sleep deprived after having a baby is normal but when it starts to adversely affect your life, that is not normal. I, myself, was petrified to leave the house with my oldest daughter, because I thought random strangers would hurt her. That is not normal. Normal response would be to not want strangers or family members touch your new baby so he/or she doesn’t get sick. Thinking people are going to kill your child is not normal. I’m glad I got up the nerve to speak to my OB/GYN about it because I didn’t want to, but I knew something wasn’t right. Again, if you know someone who is pregnant or recently had a baby that is acting strangely or not like themselves, please ask them to seek help. They can get in touch with multiple organizations like http://www.postpartumprogress.com/postpartum-depression-support-organizations-in-the-us-canada-uk-south-africa-australia-new-zealand (an international site, which also gives all sites for different countries, including the US and England)
http://www.postpartum.net/ (United States)