In recent years, America’s neglectful approach to maternity care has been gaining the attention it rightfully deserves. Not only is America’s way of birth the costliest, but it also doesn’t grant paid maternity leave and has the highest rate of maternal deaths in the developed world. Not to mention that for one of the world’s richest countries, it’s particularly heedless of new mothers’ physical and emotional health. After birth, women are thrown into the world and expected to go back to work after three short months. However, in the Netherlands, for example, they have a mandatory postnatal system where maternity nurses are covered by insurance. They don’t just care for new babies, but for new mothers too.
One in nine new mothers experiences postpartum depression and one in 10 experiences anxiety during pregnancy. Medical experts believe that the rate of postpartum depression could be at least double what is actually reported and diagnosed. So, why are new mothers so hush-hush about the state of their mental well being?
Shame is the Driving Force of Silence
After speaking to many women about mental illnesses related to their pregnancies, it became clear to me that shame is the driving force of silence. Pregnancy is ‘supposed to be the happiest time of your life’ and women feel guilty for not feeling over the moon. “You don’t have to dance through the fields and bask in the glow of pregnancy. Sometimes, pregnancy sucks. Give yourself grace and don’t expect the world of yourself,” said 32-year-old Kristen Hatten.
Twenty-five year old Ruthy Zalta, MHC LP, explained how hormones increase a woman’s susceptibility to mental health issues. “When you’re pregnant, you build up hormones [like cortisol] that are produced for you to make a baby. And the second you give birth there’s a major drop in your hormones.” Additionally, an increase in estrogen during pregnancy results in a serotonin and dopamine level dip, which can lead to depression.
Most of these women said they experienced mental illnesses for the first time during or after pregnancy. And most turned to medication in addition to professional help. Besides mental illness itself, there’s a greater stigma for women who take medication while pregnant—even though it’s prescribed and monitored by a doctor.
Leaning on each other for support and speaking openly about our struggles can span boundaries. Read on for what five women had to say about their experiences.
“While I was going through [postpartum depression], I was in nursing school and had learned about it but never would have applied it to myself. . . I was so dreamy and excited while I was pregnant, there was nothing that could have predicted this.
My sister had warned me that not everyone connects with their baby immediately. It was only my husband who knew what was happening because I had a pretty good outer face. I was just miserable and having such a hard time with life and life with a newborn. It’s a 24-hour job and I thought I wasn’t ready for it. I was always crying. Every night at 7:30 pm I would lose it completely and that’s when I realized it was hormonal and it was more than just a hard time. I had a lot of trouble connecting to him and was constantly waiting for that moment where I’d feel he was my baby and not someone else’s that I was babysitting.
When people would text me congratulations, I felt like, “why are you so happy for me? Do you realize the state that I’m in?” Are you going to spend your whole life wishing you didn’t have the baby you had? No, you’re not. But sometimes it takes time for your baby to really feel like yours. I wish I could do it again with the love I have for him now.”
“For a person that already has mild anxiety, the fact that [pregnancy] can be so precarious creates a lot to be anxious about. You’re doing so many tests like genetic testing, sonograms, ultrasounds and wondering things like, Is the baby going to have a birth defect? Is it going to be ill?
I was seeing my therapist every single week throughout my pregnancy, and I just couldn’t get past certain fears like labor. I had a lot of chest pain and sometimes I’d map my entire body where all the shooting pains were. I thought I was having a heart attack; I would text people just in case. In my eighth month, my therapist and I discussed medication. I was worried about being a good enough mom and feared having post-partum depression. I had taken medication in the past, on occasion. But instead we decided on an SSRI that I took every day, and it slowly changed my brain waves. I really really saw a difference. All of a sudden I wasn’t crying at the drop of a hat.
“I never struggled with mental illness before my first pregnancy. After that, I had bad anxiety which turned into depression. I tried so hard to not categorize myself as having postpartum depression until it was too much to bare and I went to seek help. The doctor then diagnosed me with a hormonal imbalance. With my second pregnancy, I had extremely bad anxiety and depression for which I had to go on medication. With my second, third, and fourth pregnancies I was on Lexapro which helped me get through them along with professional help. My heart was hurting so badly that I remember saying to my husband, “I just need this to stop, this feeling has to stop.”
Lucky for me, one of my best friends had gone through this. And I felt awful because she was leaning on me for help and because I didn’t know what she had been through, I didn’t know how to help. She was there every step of the way for me. A cousin of mine had also gone through something similar and shared her experience as well. If it wasn’t for their support and the support of my amazing husband I don’t know where I would be today.”
“I eventually got the courage to tell my OB I was pretty certain I was depressed. She recommended a psychiatrist, who prescribed me Zoloft. I always had mixed feelings about taking psych meds, but two weeks later I was so grateful. I was back to taking pills every night. And I know some people might react with, you took an SSRI while pregnant?! But Zoloft is the most researched drug in any category for its effects on pregnancy.
More than Tylenol, more than Zofran. A pregnant woman might throw up, she might get a fever—and both of those things are potentially dangerous—they are just as dangerous as a pregnant woman being depressed. But the world doesn’t care to think about that. Because pregnancy isn’t allowed to be anything but happy. There’s a whole lot of shame attached to not constantly feeling like a majestic miracle maven while pregnant. Like all that you should feel is unwaveringly grateful.”
“I have non-stop thoughts. It interrupts every part of my functioning. I’m such a live-in-the-moment person and I’ve lost that. I question every aspect of my life.. I went to therapy last night and I was crying hysterically to [my therapist] that I don’t know how to live. I’ve grown so numb. I don’t want to project my feelings onto my baby—I’m terrified.
I was on Lexapro but I had to start at a very low dosage because I was pregnant. Then, when I finally hit the highest dose I could take, it didn’t work at all and I felt suicidal. I didn’t know what to do but it wasn’t working so I had to get on Klonopin which is not ideal during pregnancy, but it’s not totally harmful either. If you need it, you need it. It saved me, it gave me a second chance at stability. It stopped my panic attacks but I still have these intrusive thoughts that are debilitating.
The only solace I have is that my OCD really only manifested in the context of pregnancy. I’m hoping that when I give birth it’ll go away. And it’s a shame because before I got pregnant, I just lived and felt happy. Now every day feels like I’m carrying a thousand-pound weight on my back.”
Ed. note: Ruthy was interviewed at the height of her anxiety. After giving birth, she texted me: “I never thought that being a human was so difficult until this experience. We all live in isolation but we all need each other to get through this. My baby brings me a sense of happiness I never thought was possible. How can this little girl who caused me so much pain erase my memory [of that] instantly? I look at her and think about the inner strength she helped me find. She makes me want to be stronger.”