Maybe you’ve been thinking about it for as far back as you can remember…Maybe it never even crossed your mind until it became your reality…Or maybe it was something you thought you did not want or could not have and yet here you are….
For a woman, becoming a mother is quite possibly the most transformative experience of her life. Or at least it was for me. My career, my marriage (and other relationships), my body, my brain, my whole life…and soul changed forever. Was that change for the better? In some ways, yes. In some ways, no. And that is where I’d like to begin.
There is this crazy notion out there that a woman’s transition into motherhood goes something like this:
First, you pee on a stick.
The plus sign shows up and you and your partner cry tears of joy. Then the next 9 months are spent joyfully preparing for baby’s arrival. This likely includes buying adorable little outfits and toys, choosing a theme for the nursery, making a baby registry for that amazing shower your friends and family will surely throw you and of course getting to show off your adorable baby bump.
Then, when the 9 months are up, poof…
Your water breaks in some comedic fashion and before you know it, you are delivering your baby. This all seems to happen while you are looking your most beautiful and “glowing.” And when it’s all said and done, you are handed this perfect little creature (this part is true) and so begins the next phase of your life where it’s all sunshine and rainbows… except it isn’t.
You have probably heard the term ‘postpartum depression’. What you probably have not heard is the updated and more accurate term that better captures the myriad of mental health conditions facing women during pregnancy and postpartum, Perinatal Mood and Anxiety Disorders (PMAD).
The perinatal period
This starts at the beginning of pregnancy and lasts through the first year after childbirth. You know, that really “magical” time when you spend your days being cared for by family and friends while you lovingly gaze at your baby who has also seamlessly taken to your breast. HA, I know, right?
A lot happens with hormones, brain chemistry and life in general when you are pregnant. And when you give birth. And when you stop nursing (if you did – no judgement here). In fact, so much happens that what is supposedly a “magical” time can actually be incredibly stressful, sometimes terrifying and in rare cases, even dangerous for mom and baby.
When receiving prenatal care, a woman is always screened for gestational diabetes and gestational hypertension. 8% of pregnant women will be diagnosed with one of these conditions and monitored closely by her doctor or midwife for the duration of her pregnancy and up to 6-8 weeks after birth. There is not yet a standard screening procedure for assessing a woman’s mental health during and after pregnancy, but approximately 21% will have symptoms of a PMAD. This makes it the #1 complication of pregnancy and childbirth. Let that swirl around in your brain for a bit.
So, what conditions make up PMAD? I’m glad you asked…
Depression
This can involve: feelings of anger, sadness, irritability, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, thoughts of helplessness and hopelessness and possibly thoughts of harming yourself and/or your baby.
Anxiety
This can include: extreme worry and fear, often about the health and safety of your baby. This can sometimes include panic attacks which are absolutely awful and can really leave you feeling paralysed with fear.
Obsessive-Compulsive Disorder (OCD) aka the story of my life
This includes repetitive, upsetting and unwarranted thoughts or images (obsessions) which can sometimes lead to repetitive behaviors (compulsions) in order to reduce the anxiety produced by the obsessions. For some new moms, these obsessions can include thoughts of harming your baby which can be absolutely devastating because of how unlikely it is that you would ever act out on them. What breaks my heart the most is when I hear stories of new moms who ended their lives because they did not know that perinatal OCD is temporary and treatable and not at all indicative of the kind of mother you are. I can speak most to OCD due to my own struggles with this illness that started in my teens and, despite being well managed for years with medication and therapy, came back with a vengeance during my pregnancy with my first child. But that’s another story for another day.
Post-Traumatic Stress Disorder (PTSD)
This is usually caused by a traumatic or frightening childbirth (because childbirth ain’t always magical) and can include flashbacks which create a tremendous amount of anxiety and can lead to the avoidance of things that may trigger the flashbacks.
Psychosis
This can include seeing or hearing things that are not there (hallucinations) or believing things that are not true (delusions) and distrusting those around you (paranoia). There can also be periods of confusion and memory loss. Psychosis is very rare but very real and is considered a serious medical condition that requires immediate attention.
So, the gist of what I’m trying to say is that motherhood is awesome and amazing and beautiful…but it’s also scary and isolating and stressful and there is absolutely no shame if you find yourself struggling. There are a lot of great resources available online. Postpartum Support International is the largest and most comprehensive organization dedicated to helping women and their families during the perinatal period. Check them out at https://www.postpartum.net Please know that PMADs are temporary and can be treated effectively with a combination of self-care, social support, therapy and sometimes medication. There is no reason to suffer in silence. There are many of us out there who know your struggles all too well. We are with you and we share our stories in hopes that you will feel less alone. There is a light at the end of tunnel, I can promise you that.
