Monthly Archives: April 2009

Thoughts on exploring a “Pregnant Pause”

An article in May’s issue of Vogue entitled “Pregnant Pause” by Alexis Jetter attempts to provide insight into the very confusing world of the pharmacological treatment of depression or mental illness during pregnancy. Ms. Jetter seems to have done her homework. She brings up some very valid points, includes supportive research, referring to specific studies all framed within a heart-tugging story of a boy born with a heart defect as a result of his Mom taking Paxil during her pregnancy. Yet Ms. Jetter forgets to tell both sides of the story. Here’s my take on the article.

In no way am I belittling this Mom’s experience by rebutting some of Ms. Jetter’s claims. As a Mom of a special needs child, I know first-hand how difficult life becomes as you work with and around your child’s needs. I also understand the enveloping guilt which rages inside you every time you see your child suffer or struggle and wonder “Did I do that? Was it my fault?”

You see, I didn’t take my pre-natal vitamins during my second pregnancy. At first it was because of the wretched morning sickness. Then I just didn’t want to take them. I even pondered what would happen if I didn’t take them, thinking it would be a neat little “experiment” to find out.

When my daughter was born with Pierre Robin Sequence which included a complete and bilateral cleft of her hard and soft palate, I felt a guilt that cannot begin to be described by any words known to mankind. It took me nearly two years to admit this to anyone. I lied at the hospital when I was asked if I had taken my prenatal vitamins. Why? Because I knew from my mom’s quick research about PRS that lack of folic acid in the maternal diet increases the risk for this particular condition. The last thing I needed was for the doctors to also blame me for my monumentally bad judgment. Looking back, I’m pretty sure this erratic behavior was directly related to my untreated issues with Postpartum OCD/Depression after the birth of our first daughter.

To this day as my daughter struggles with speech, socialization, and a myriad of other challenges, I still blame myself somewhat. Intellectually I know her problems are not my fault. I have accepted this on that level. But a small part of me will always wonder if she would have these problems if I had just taken my vitamins. So I get it. I get the guilt, I get the hind-sight. I get the anger and outrage. And I definitely get the need for education and informed consent.

What I don’t get is the desire to limit treatment options for other people. Instead of limiting, let’s encourage the development and shared knowledge of non-pharmacological therapies for mild cases of depression during pregnancy such as altering your diet, increasing exercise, natural supplements, psychotherapy, to name a few. Instead of judging, let’s allow women to make their own decisions regarding their mental health treatment. (you can read more on my thoughts regarding the ante-partum medication conundrum here)

Just as with those who are passionate for home-birth and those who are passionate for breastfeeding, there is a caution to be heeded here. We cannot convince a woman who is determined to have a caesarean section to have home-birth just as we cannot convince a woman who is convinced that a pill will solve her problems to try other therapies. All we can do is provide the education, statistics, and support. Then we need to step out of the way and let the woman make the decision with her medical professional team.

We can only fix ourselves, not those around us.

Now, onto the meat of the article, if you will.

After we meet Gina Fromm and hear of her difficult experience as a result of taking Paxil during her pregnancy, we are introduced to Dr. Anick Berard, PhD and Professor of Pharmacy at the University of Montreal. He discusses his study on Paxil, concluding that “..now other people have done the studies, too. And I’m much more comfortable saying that Paxil is a bad drug to take during pregnancy.”

Really, Dr. Berard?

I found a more recent study undertaken by none other than Dr. Anick Berard which concludes that unless the dose of Paxil is above 25mg during the first trimester, Paxil usage is not associated with an increase in congenital cardiac malformations when compared with non-SSRI usage. (Typical therapeutic dosage for Paxil can range anywhere from 10mg to 40mg.) When researching it’s not difficult to find studies to contradict one another but when you find them from the same researcher it’s a bit odd.

Next we meet Carol Louik, Sc.D, author of one of the two studies released in June of 2007 extolling the small risk SSRI’s posed to the human fetus. Turns out Carol’s study was partially funded by GlaxoSmithKline, Sanofi Aventis, and another Pharmaceutical Company. However, at the same time Carol’s study was published in the New England Journal of Medicine, another study was also published. This study was coordinated by the CDC out of Atlanta and did not have any financial disclosures to the Pharmaceutical Companies. Sura Alwan, MSc, and Jennita Reefhuis, RN, were first and senior authors respectively. Their study concluded the absolute risk of exposure vs. non-exposure not to be much different than the standard baseline risk for defects in any healthy pregnancy.

But the Alwan/Reffhuis study results are not present in the Vogue article.

Then we’re tossed this golden nugget – “….SSRI usage dramatically increases the chances that a baby may be miscarried, born prematurely or too small, suffer erratic heartbeats, and have trouble breathing.” The author further states that “Taken together the NEW research caught many experts by surprise.” Yet most of the research articles I located by the researchers quoted were from 2006 or earlier. This is hardly NEW research. In fact, the NEW research contradicts many of the studies referenced in the Vogue Article.

For instance, we’re informed through a quote from Dr. Adam Urato, M.D. That “these antidepressants are portrayed almost like prenatal vitamins that will level out their mood and lead to a healthier baby. But antidepressants have not been shown to decrease rates of miscarriage or birth defects or low birth weight. On the contrary, they’ve been shown to increase those problems.” Then directly after this quote, Ms. Jetters states pregnant women are routinely excluded from clinical tests of new drugs. But she fails to ask a very important question.

Why?

A solid answer can be found in the February 2009 Carlat Psychiatry Report, an unbiased report regarding all things psychiatry related, including medication. According to an article entitled “Psychotropics and Pregnancy: An Update,” the Carlat Psychiatry Report states “the gold standard study will never occur. It will never be ethically permissible to enroll pregnant women into a randomized, placebo controlled trial designed to determine if a drug causes birth defects. For this reason, we are left with less than ideal methods of determining risk.”

To seemingly substantiate Dr. Urato’s quote regarding miscarriage, birth defects, or low birth weight, a study performed by Developmental Pediatrician Tim Oberlander, M.D. At the University of British Columbia is briefly examined. This study concluded after tracking the birth outcomes of 120,000 women that infants exposed to SSRI’s prenatally were born too small and have trouble breathing. Oberlander’s quoted conclusion for the article? “It’s not the mother’s mood,” Oberlander says. “It’s the medication.”

Yet Oberlander’s study is negated by Einarson’s study, “Evaluation of the Risk of Congenital Cardiovascular Defects Associated With Use of Paroxetine During Pregnancy” Einarson also writes a letter to the American Journal of Psychiatry, (located in Vol. 64, No. 7, July 2007) which states the conclusions made by Oberlander and others is not supported by the data presented. Einarson points out that low birth weight was not stated as an investigated outcome and that only average weight of newborns and proportion falling lower than the 10th percentile (ie, small for gestational age but NOT low birth weight. Low birth weight is technically defined as >2500g2.

Einarson’s study combined both prospective and retrospective methodology to examine a large number of women specifically on Paxil. Their conclusion? “Paroxetine does not appear to be associated with an increased risk of cardiovascular defects following use in early pregnancy, as the incidence in more than 3,000 infants was well within the population incidence of approximately 1%.”

Just in case you’re wondering, no, their study was not funded by GlaxoSmithKline. The Carlat Psychiatry Report is quick to point out that seven of the nine authors received no funding from GSK or any other drug company but two have received funding for drug research from other drug companies but not GSK.

The Carlat Report also address what one should do with conflicting information regarding medicating during pregnancy. The best one can do from a “medico-legal perspective is to avoid paroxetine. But the data does suggest that paroxetine – and perhaps by extension, all SSRI’s – may be safer than what has been suggested by other smaller studies.”

Going back to the issue of pre-term delivery as well as low birth weight and their relation to mood or medication, a recent study released by Dr. Katherine Wisner examines this very topic. The study looked at 238 women with no, partial, or continuous exposure to either SSRI treatment or depression and compared infant outcomes. Dr. Wisner’s study found that exposure to SSRI’s did not increase birth defects or affect infant birth weight but the importance of this study lies within the finding that the pre-term delivery rates were the same with depression exclusive of SSRI treatment, leading the researchers to state that it is “possible that underlying depressive disorder is a factor in pre-term birth among women taking SSRI’s.” Dr. Wisner also encourages further research into this topic even though her study was just released this year. You can read more about this study by clicking here.

Rita Suri, M.D. from UCLA also studied this very situation, publishing her research in August 2007 in the American Journal of Psychiatry. Not surprisingly, Suri’s study is quoted in the Vogue article. Her results found that infants born to women taking SSRI’s were three times more likely to be born prematurely (although most were only 1 week early) She also found that the higher the antidepressant dose, the higher the risk of early delivery. However, her results did not show that untreated mild depression had an effect on prematurity. I’d like to add a personal digression here. My second daughter was born at 36 weeks. While not officially diagnosed, I would say that I suffered from untreated depression during that pregnancy. Sure it’s not an official research study but it’s very hard to discount personal experience especially when it agrees with current research.

At this point in the article, we’re introduced to one of the more well-known disorders associated with paroxetine usage, Persistent Pulmonary Hypertension of the newborn. Tina Chambers, Ph.d, a birth-defects researcher from University of California at San Diego is the chosen expert for this topic. She states that this condition normally strikes only one or two infants in 1,000. But Chambers found that rates jumped between six and twelve per 1,000 for mothers who take SSRI’s. In contrast, a recent prospective study by Susan Andrade, ScD, concluded no relationship between SSRI usage and PPHN but did admit that given limitations of the study and small number of confirmed cases, further study in this area may be warranted. In Andrade’s study, 1104 mothers were followed with only 5 confirmed cases of PPHN reported.

Alexis McLaughlin’s story about her daughter’s struggle with PPHN is striking, especially for me, because I’ve seen my daughter struggle for breath immediately after birth. Her quote, “It’s difficult because you need good mental health and a healthy baby,” is very reminiscent. You do indeed need good mental health and a healthy baby. When I was pregnant with Charlotte, we told people we didn’t care about gender, all we cared about was health. But if that doesn’t happen? You do your best to get through it because there is nothing you can do to go back and change what was done in the past. We can only move forward, changing what we can, and if we can’t change it, we change the way we think about it. Even with a normal pregnancy given no SSRI exposure or depressive exposure, a mother faces a 3% risk of giving birth to a child with a birth defect of some kind.

We are then moved into the science behind the affect of an anti-depressant on the human fetus. It’s hypothesized that serotonin is responsible for sending “crucial developmental signals to the fetal heart, lung, and brain….[and that]…SSRI’s, which prevent the body’s natural absorption of serotonin, could be tampering with essential cell growth.” A study by Francine Cote concludes that maternal serotonin is indeed involved in fetal development, precedes the appearance of sertogenic neurons, and is critical for development. The latter hypothesis regarding the interference of SSRI with essential cell growth has been and I’m sure will be studied for quite some time.

Shortly after this, the article winds down by warning of the “small coterie of influential doctors who…underplay the dangers of antidepressants,” again, a quote from Dr. Adam Urato. I do agree whole-heartedly with the latter part of his quote: “We want and need expert opinion that’s free from industry influence and from the appearance of bias,” Urato says. “It’s just outrageous that doctors have to work with that.”

Any of the several women I’ve come across who work with the Perinatal Population will be some of the first to admit that yes, there are risks to taking medications while pregnant or nursing. We even inform women we support to not only weigh the benefits against the risks by researching their options but let the professionals determine if the situation is severe enough to warrant medication.

Dr. Katherine Wisner examined this Risk-Benefit relationship in a study back in 2000. In this study, Dr. Wisner encourages physician and patient communication through the use of informed consent, provided the patient meets the legal definition of competent. She also recommends a family member or friend of the patient be present to help alleviate any anxiety and to ask questions the patient may not think of asking regarding any medication decision.

Many of the recommendations Dr. Wisner sets forth should be commonly used by a competent physician. Unfortunately there are physicians who do not follow informed consent and instead pay attention to the perks offered by Pharmaceutical Companies. However; these perks are slowly disappearing as the medical community awakens to the ethical dangers they pose as a result of increased consumer advocacy for fair and informed treatment when it comes to mental illness. If you should find yourself with a physician who prescribes SSRI’s like m&m’s or refuses to listen to your situation, it is time to find a new doctor for your care. A good doctor will listen, research, and collaborate with you.

I want to close with a quote directly from the Vogue article by Gina Fromm, Mother to Mark Fromm, the little boy with the heart defect as a result of his mother’s usage of Paxil. I couldn’t say it any better than this.

“It is easier to take a pill,” Gina says. “But over the long run, that’s not the best solution. It certainly hasn’t been for my life.”

I agree Gina, I agree whole-heartedly.

In my opinion, society today has gotten in the habit of quick fixes instead of sustaining solutions. I personally think it’s time we change that. But let’s do so in a logical, evidence based, and bias-free manner. Otherwise we’ll all just end up stuck right where we are screaming at each other so loud we can no longer hear ourselves think.

Senator Coburn: A walking oxymoron

Tom Coburn makes my head hurt!!!!!!!

Seriously. I was doing my homework on Senator Coburn last night and landed a headache miles longer than Route 66.

Senator Tom Coburn, R, OK, has been by far one of the staunchest opposers of the MOTHER’S Act.

BUT –

He’s an OB

He’s delivered 4,000 babies.

Statistics would lead you to believe he’s seen at LEAST a few cases of PPD, right?

According to Dr. Coburn, breastfeeding is automatic protection against postpartum mood disorders. (Ok Sen Coburn – so where was my protection when I was exclusively nursing my first daughter or exclusively pumping for my second? seriously – where was it? Was it hiding under some mysterious rock? Behind my back? Did I leave it at the hospital? Perhaps my first OB stole it from me – but wherever it was, I sure as heck didn’t have it!)

His primary argument for being against The Melanie Blocker Stokes Act? He doesn’t support disease specific legislation. Yeah, um, ok.

Let’s delve into some legislation Senator Coburn has authored, shall we? (By the way, everything below was pulled directly off his Senate website)

Guaranteeing Patient’s Rights (author)

A law to guarantee patients’ rights for those enrolled in Medicare and Medicaid, including timely access to primary and specialty health care providers, a timely grievance process with appeals, an explanation of the enrollee’s rights and plan information, and prohibitions on restrictions on communications between patients and doctors and financial incentives to encourage health care providers to deny medically necessary care. Provision contained within Public Law 105-33, signed 8/5/1997.

YET Dr. Coburn does NOT accept Medicaid/Medicare patients at HIS OWN PRACTICE! (OK Medical Board website)

Streamlining the Approval of Disease Diagnostics (author)

A law to improve the review and approval process of radiopharmaceuticals (articles used in the diagnosis or monitoring of a disease). Provision contained within Public Law 105-115, signed 11/21/1997.

(Is it just me or is the word DISEASE not only in the title but the description too?)

Protecting Babies from AIDS (author)

A law to require all pregnant women to be counseled about and offered testing for HIV to prevent the transmission of the virus to unborn and newborn babies.  Provision contained with Public Law 104-146, signed 5/20/1996.

(Hmmm. AIDS is a disease. Pretty specific one too. AND this one requires counseling and an offer of a test)

Treating and Preventing HIV/AIDS (author)

A law to provide access to AIDS treatment for underinsured Americans living with HIV, including counseling for those with HIV emphasizing it is the continuing duty of those infected not to infect others with the disease.  Public Law 106-345, signed on 10/20/2000.

(Wow. Treating AND Preventing HIV, huh? Feeling a little warm over here…)

Providing Access to Affordable Prescription Drugs (author)

A law to allow Americans to import prescription drugs approved by the Food and Drug Administration. Provision contained with Public Law 106-387, signed 10/28/2000.

(So he’s ok with importing drugs that yes, may be approved by the FDA but only God knows from where some of them are sourced. Yet he wants to deny new moms access to care and aid for Postpartum Depression?????)

Preventing Cervical Cancer(author)

A law to educate the public about human papillomavirus (HPV), a leading cause of cervical cancer, including how to prevent HPV infection. The law also requires condoms to be relabeled with a warning that condom use does not protect against HPV infection. Provision contained within Public Law 106-554, signed 12/21/2000.

(Wow. A law to educate the public about a DISEASE. Again – common ground?)

Source: http://coburn.senate.gov/public/index.cfm?FuseAction=AboutSenatorCoburn.Accomplishments on April 21, 2009 @ 1132pm.

Seriously though.

Postpartum Mood Disorders should not be a ping pong ball across the aisles of the Senate. Just as it is not black and white out here in the real world as to who will get it, it’s not JUST a Democratic Issue. It’s not JUST a Republican Issue. It’s an every party issue. It’s a 20% of ALL new moms issue. It’s a 50% higher risk of repeat for survivors the second time around. It’s a 95% risk of repeat for survivors the third time around! It’s a 2.3x higher risk for Moms who have husbands/partners deployed issue. It’s a 3x higher risk for first time Moms over the age of 35 developing Postpartum Psychosis issue. It’s a HUGE issue, ok?

I want to know at what point in the feminist movement Moms got screwed over. When did we become ok with chilling on the back burner? Where is Susan B Anthony when we need her? Anyone out there in need of a kick in your activism spirit? Watch Iron Jawed Angels. It’s about suffrage. And man did those chicks go through it. I HOPE it doesn’t come to that but I am passionately determined to get this bill passed. Thing is, I can’t do it by myself.

Senator Menendez can’t do it by himself. Neither can Congressman Bobby Rush. Or Carole Blocker. Or Susan Stone. We need YOUR help, YOUR voices. Your stories of survival, strength, and experiences with a system that is failing new families each and every day. We HAVE to raise awareness.

Don’t wait any longer to pick up that phone and call the H.E.L.P. Committee. Go to your email and send a message RIGHT now to Susan Dowd Stone (susanstonelcsw@aol.com). Include your name, state, and any professional credentials or organizational affilitations. Let others know you support the MOTHER’S Act.

SPEAK UP!

National Association of Certified Professional Midwives Endorses MOTHER’S Act

With astonishing grit and determination, midwifery is making a comeback here in the United States. Back in the day (and boy do I mean BACK in the day), midwifery was common practice. Many women relied on other women to help them through pregnancy and childbirth. You see, childbirth has not always been as medically complicated as it is now. In fact, involving a doctor in childbirth started out as a status symbol towards the end of the eighteenth century. Even though women in the home had been acting physicians for years, a belief sprung up that these same women were “emotionally and intellectually unable to learn the new obstetric methods.” Medical schools were also not available for women to attend. Thus began the introduction of the Obstetrician and the downfall of the biblical midwife. (see Genesis 35:17. Yes, GENESIS!)

One of the primary risk factors for a Postpartum Mood Disorder is lack of social support. When midwifery was widely practiced here in the United States, childbirth was a very social event. Women would fill the homes of the expectant mother with food, offers of respite, shared knowledge, and community.

Nowadays many of us are lucky if we even get one meal prepared for us let alone any offers of respite immediately after birth. Yet what are we told to do? REST! But how are we to do this when society fails to allow us to do so? And what happened to our 40 days? Why is it that every other culture seems to treat their mothers better than ours? When did we allow ourselves to take a backseat? Where’s the self-care in the birthing period? And more importantly – why have we as women allowed this to be stolen from us? Why are we silently suffering?

The Melanie Blocker Stokes MOTHER’S Act stipulates the funding of a rather large awareness campaign for both medical professionals and consumers. Through this campaign, mothers would be able to shed the stigma which keeps them from seeking help. It would enable new mothers to be more comfortable with coming forward into the light rather than staying in the dark as a risk not only to themselves but to their families as well. Mothers and families would be educated about the signs, symptoms that may indicate postpartum depression. They would also be educated about prevention tips and self-care methods that would either completely prevent or significantly shorten any negative Postpartum Experience.

It is important to note that The National Association of Certified Professional Midwives (NACPM) has endorsed the MOTHER’S Act. With this endorsement comes recognition that yes, something is wrong with the birthing system in America. We need to start somewhere. Why not with Midwives? Why not with Mothers who want to give birth the way it was meant to be experienced? While still possible, risks of developing a Postpartum Mood Disorder are significantly lower when a doula or a midwife is present at birth. (If you really want an eye opener into the mess of the Birthing Industry, I highly recommend The Business of Being Born)

So on this day, April 22, 2009, Earth Day, I urge you to call the H.E.L.P. Committee and let them know the MOST important thing to preserve today is the Mother/Child dyad. We can do this by passing the MOTHER’S Act. First we need to get it OUT of the HELP Committee and onto the Senate Floor.

Email Susan Dowd Stone (susanstonelcsw@aol.com) over at Perinatal Pro to have your name placed on the list in support of the MOTHER’S Act. (Be sure to include your name, state, any credentials and/or organizational affiliations!)

A Postpartum Mood Disorder doesn’t care if you’re a Democrat or a Republican. Heck, the mom seeking help from her doctor doesn’t even care what his or her political views are. All she cares about is that he/she is aware of what’s going on and is willing to work with her to find a solution that fits her lifestyle.

Today let your Earth Day Action be a political one.

Call the H.E.L.P. Committee.

Support The MOTHER’S Act!

Save a Mom.

Postpartum Mood Disorder Awareness Month Proclaimed in IL!

GOVERNOR QUINN PROCLAIMS MAY 2009 POSTPARTUM MOOD DISORDERS AWARENESS MONTH IN ILLINOIS

FOR IMMEDIATE RELEASE April 21, 2009
Contact:
Dr. Sarah Allen, Chair: 847 791 -7722, sarahfcallen@comcast.net

Chicago, Illinois — Illinois Governor Pat Quinn is proclaiming May 2009 Postpartum Mood Disorders Awareness Month in order to raise awareness of the common illness experienced by moms and moms-to-be.

“I am proud to declare May 2009 as Postpartum Mood Disorders Awareness Month in Illinois. By increasing public awareness of these disorders, we can identify women who will benefit from treatment, saving them from unnecessary distress and suffering,” said Governor Quinn.

Here in Illinois, the Postpartum Depression Illinois Alliance (PPD IL) works to promote awareness, prevention and treatment of maternal mental health issues throughout the state. PPD IL offers a helpline (847-205-4455) and website (www.PPDil.org) for women and their families so they can learn more about pregnancy & postpartum mood disorders and access local resources such as support groups and trained healthcare providers.

“We want women to realize that they are not alone, they are not to blame and with help, you can be well again”. Dr. Sarah Allen, Chair PPD IL Alliance.

The PPD IL Alliance is choosing May, as it is home to Mother’s Day, to educate women and their families and friends about the nature of this illness. Approximately 15 – 20% of pregnant women and 15% of new mothers experience major or minor depression in the first year after giving birth. Symptoms differ for everyone but may include:

• Feelings of sadness, fear, anger and guilt
• Appetite & Sleep Disturbance
• Difficulty concentrating and making decisions
• Lack of interest in the baby
• Many worries and panic attacks
• Possible thoughts of harming the baby or oneself

“In this day and age, I think it’s deplorable that so many women still have to suffer in shame and silence with a disorder that, when identified and treated early, does not have to be an impediment to a woman and her family’s ability to enjoy the birth of a child,” said U. S. Rep. Bobby L. Rush (D-IL) who recently re-introduced H.R. 20, the Melanie Blocker Stokes MOTHERS Act of 2009. “I lend my voice and full support of the work of the PPD IL Alliance and other groups throughout our state and nation who are as committed as I am to working to ensure that all new mothers get the support they need to ensure that this special time of their lives is a safe, healthy and happy one.”

Symptoms of depression and anxiety occur in up to 20% of expectant and new moms, making these the most common complication of pregnancy, affecting nearly 1 million women every year in the United States alone. These emotional disorders cover a wide spectrum, including pregnancy depression and anxiety, postpartum depression, postpartum anxiety, postpartum obsessive-compulsive disorder, postpartum post-traumatic stress disorder and postpartum psychosis. Yet despite their prevalence, perinatal mood and anxiety disorders are under-detected by health care professionals and many women go without treatment.

Vanessa, a survivor of PPD describes her experience:
I was diagnosed with post partum depression 6 weeks after the birth of my son. I was sleep deprived, anxious, short tempered with my family, and plagued by horrible intrusive thoughts of my infant son falling over the balcony, or falling down the stairs. I also couldn’t look at knives and had to hide them away. I was so horrified by the vivid pictures of this in my head. As a result of these thoughts I could barely eat and was always nervous and anxious.
I knew this was not how it was supposed to be since I already had a 5 year old daughter and never suffered from these symptoms after her birth. I was afraid to be with my children alone so decided to stay with my mom for a few weeks. With medication and talk therapy I began my way to recovery. My saving grace was an online support group. I was able to read the feelings of others suffering and post my own. I felt an instant bond and was so thankful. I made a promise to myself and God that if I got through this horrible illness, I would help others. I was able to come off my antidepressant medication after 9 months and I became a moderator for PPDsupportpage.com and a telephone helpline volunteer for the PPD IL Alliance. My son is now 4 years old and I feel that time in my life was a blur. I make sure I spread the word about PPD and how common it really is. I feel that this illness was dealt to me for a positive reason. I am able to touch others that suffer and tell them that it isn’t a life sentence. PPD can be treated and cured.

PPD IL Alliance is the Illinois subsidiary of Postpartum Support International, the world’s largest non-profit organization supporting women with perinatal mood and anxiety disorders.

For more information about pregnancy & postpartum mood disorders & PPMD Awareness month Contact: Dr. Sarah Allen, Chair IL PPD Alliance
847 791 -7722
sarahfcallen@comcast.net

From the trenches…

Today I’d like to focus on the real faces and true stories of Perinatal Mood Disorders.

These are the stories of everyday people who have ferociously fought to survive this insidious illness.

These are the people who realize the true value of The Melanie Blocker Stokes MOTHER’S Act. They passionately support the legislation.

Many of them are also now ardently dedicated to supporting others as they tread on this dark and lonely path.tea-cup-and-strainer1

Got a few minutes?

C’mon in – grab a cup of tea and sit down.

Let me introduce you to a few of them.

Meet Heather. Her brush with Postpartum Depression began during the pregnancy of her first child. Anxiety and intrusive thoughts settled in, causing her to obsess about birth defects of her unborn infant. Things went from difficult to worse when Heather experienced a reaction to a pain medicine administered during labor. She awoke at 7 hours postpartum only to witness her son receiving oxygen. Once home, she stopped sleeping, going days without rest. Her milk supply dried up as a result of the intense stress she was experiencing. Heather and her family moved in with a family member as it was no longer safe for her to be on her own. With an intolerance to all medications (including antibiotics), she sought help via talk therapy and a kinesiologist. After a few months of therapy, she was given a clean bill of health. Heather now serves as a moderator at the Online PPD Support Page and finds helping others very rewarding and meaningful. You can read more of Heather’s story by clicking here.

Ruth Rhoden Craven & son

Ruth Rhoden Craven & son

Then there’s Helena Bradford, one of the most amazing women I have ever had the privilege of knowing. Her daughter Ruth Rhoden Craven tragically ended her life after struggling with Postpartum Depression. Doctors were unable to help and some bad internet advice led the family to believe all Ruth needed was a vacation. How wrong they were! Helena works each and every day with a determination to prevent what happened to Ruth from happening to others. She is deeply rooted in her faith and believes without a doubt that the Lord has used Ruth to further the cause of PPD awareness. Helena has an amazing will. She is standing strong despite her tragic loss. Read an interview with Helena by clicking here.

headshot_bob-gibbsAnother parent who has joined the battle is Bob Gibbs. Bob lost his daughter and grandson, Jennifer Gibbs Bankston and Graham Bankston on December 19, 2007. This particular story is very hard for me to write about. I gave birth to my son on December 18, 2007, just a day before Jenny and Graham lost their lives. Even in the face of this tragedy that would cause most to buckle and falter, Bob and family have instead garnered strength and power. They have turned their loss into a powerful outreach program which has garnered national recognition. Jennyslight.org is a powerful and energetic new force within the Postpartum Advocacy landscape, one we hope will continue for a very long time. While we are saddened for their loss, we are thankful for their dedication and passion to families struggling with Postpartum Mood Disorders. Get to know Bob Gibbs in his own words by clicking here.

cheryljazzar1Meet Cheryl Jazzar. She experienced a psychotic break after the birth of her first child and was subsequently hospitalized. The break destroyed her marriage and she lost her child as a result. Five years later found her remarried with another child on the way. She experienced a depression a few months after birth. Using self-care, she rebounded quickly and knew she had something to share. Cheryl began to educate herself regarding alternative and complementary methods of treatments available to mothers during the perinatal period. She quickly became quite knowledgeable regarding non-traditional methods of treatment with a strong desire to share this with other mothers. Cheryl is a passionately dedicated volunteer for PSI and also blogs at Wellpostpartum regarding alternative and compassionate care. You can read Chery’s interview here.

danscottNow I’d like to provide a different point of view. A mom is not the only one affected by a Postpartum Mood Disorder. Her husband is also affected. Meet Dan Scott, a father who has stood by his wife as she struggled three times with a Postpartum Mood Disorder. Each time was a unique experience, one that tested their marriage and their faith. Dan states that the second time around was the worst – there are moments they don’t even remember because the circumstances were so dark. As a result of his journey, he finds himself more sensitive towards new mothers. He recognizes the hard times the birth of a child can bring. He advocates for new fathers to step up and take their vow of “for better or for worse” seriously. Dan believes he is a better man for having been through this with his wife. Want to read more about Dan’s story in his words? Click here.

Last but not least, I’d really like to introduce you to a mom named Jamie. She’s a mother to one daughter and is due to give birth in June. Is she scared of experiencing Postpartum Depression again? Absolutely. Has she had issues with mood already during pregnancy? Yeap. But she is bravely speaking up about her experience and is being very pro-active this time around. Her first episode found her not wanting to bond with her child. Instead of being the blissful new mom society tells we should be, Jamie cried, lashed out, and wanted to pack her bags to run away. She finally sought help after her father questioned her constant negativity. Jamie has one piece of advice for new moms. Get help – the sooner the better. Want to read more about Jamie’s story in her own words? Click here.

Now that you’ve had a chance to read some of the true stories of survival, I hope you’re picking up your phone and calling the H.E.L.P. Committee.(If the line is busy, call the next member but keep trying until you’ve spoken with every office!)

Have you emailed Susan Stone yet with permission to be added to a list of supporters? If not, email her with your name, state, and any credentials or organizational affiliations at susanstonelcsw@aol.com right now! (Seriously – you’re already on your computer, right? It takes five seconds!)

I hope you’re blogging to raise awareness and support for The Melanie Blocker Stokes MOTHER’S Act. Got a twitter account? Raise your voice there too. Share this on Facebook! DIGG it! Don’t let these voices go to waste. Raise yours with them.

Remember in the children’s book, Horton Hears a Who, it wasn’t until the tiniest Who raised his voice that the jungle animals finally believed in the existence of the Whos. We need ALL of your voices. Now.

Sharing the Journey with Mary Jo Codey

As those of you who are familiar with Postpartum Advocacy know, Mary Jo has worked tirelessly to increase awareness and education of those around her. In fact, along with her husband, former NJ Governor Ritchie Codey, Mary Jo aided in passing New Jersey’s state-wide legislation for Postpartum Mood Disorder Screening education and screening. She also strongly advocates for the passage of The MOTHER’S Act, a bill that will increase funding for research, education, and awareness of Postpartum Mood Disorders here in the United States. Mary Jo has graciously agreed to Share her Journey today with the hopes of increasing signatures to the Perinatal Pro list as well as calls to the Senate H.E.L.P. Committee.

I sincerely hope her words will help spur you into action. Let me put it this way. If you know ten mothers, at least eight of them have experienced the Baby Blues. Two of them have experienced full-blown Postpartum Depression. And these are only the ones we know about. How many other mothers have suffered in silence? Help them break the silence. Let them know you are on their side. As New Jersey’s campaign says – “Speak Up when you’re Down!”


88_mary_joTell us a little bit about yourself. Who is Mary Jo Codey when she’s not passionately speaking out about Postpartum Mood Disorders?

I’m a teacher at the Gregory Elementary School in West Orange NJ. I love spending time with the children, watching them grow and flourish, and to instill a good self concept about themselves so they can take with them and utilize throughout their lives. When I’m not teaching I love to spend time with my husband Ritchie and my two boy’s, Kevin and Christopher. I also enjoy gardening, playing golf and eating chocolate with my dear friend Sylvia!

In 1984, after the birth of your first son, you began to experience some very frightening thoughts and moods. Would you share with us what you went through?

After the birth of my first child, Kevin, I had terrifying thoughts about hurting him. I had intrusive thoughts about smothering and drowning him. Those scary thoughts raced in my mind over and over throughout the day and night. It caused me such a great deal of pain and shame.

After the birth of your second son, with the aid of medication, you were able to have a “normal” experience. Describe the differences. At any point during this second postpartum period, did you find yourself upset about having missed out on your first son’s infancy?

With the birth of my first son Kevin, I had no idea what postpartum depression was. I never even heard those words before. I couldn’t even get out of my bed to visit the nursery to see or feed him.

With the birth of my second son Christopher, I was immediately put on medication which were extremely effective. I was elated that I could care for him and take care of him. I did however feel cheated by postpartum depression with my first child. At times I mourned and felt guilt for missing the first years with Kevin. I remember reporters coming to my home to do a story on me and I was asked if I had any pictures of Kevin. I was ashamed that I could not provide them with one picture of him.

When you first talked with your sons about Postpartum Mood Disorders, what did you tell them? How have they handled knowing about your experience?

I started to talk to my boys about my experience with postpartum depression at a very young age. I made sure that they understood that, it wasn’t their fault and that I loved them more than they could ever imagine. I explained to them that I was sick at the time. I also told them that they were the two greatest gifts that God had given me. They’ve handled it remarkably well.
New Jersey is the first state to enact legislation for Postpartum Mood Disorder screening and education. How did this law come about and what was your involvement in it’s development?

The minute Ritchie became Acting Governor for New Jersey the first item on our agenda was postpartum depression. Which led to “Speak Up When You’re Down.” It encourages women and their families to talk openly with each other and with their health-care provider if they are feeling depressed after the birth of their child. It also provides a 24/7 PPD Help line and postpartum depression information and resources; 1-888-404-7763.

Name three things that made you laugh today.

Watching my friend Phyllis come out of her home with 5 dog’s on leashes and luggage as we were leaving for the airport!

Trying to get on a large tube for “The Rapid River Ride.” After numerous failed attempts trying to get myself positioned on the tube, a stranger approached me and shoved me on the tube finally! He said that he couldn’t stand watching me struggle anymore…well it finally worked!

Calling my friend Sylvia and listening her imitate her Sicilian mother on the phone. Every time she imitates her mom it literally slays me!! It leaves me in stitches!

Senator Robert Menendez, NJ, introduced The MOTHER’S Act earlier this year to Congress. Share with us what this bill would do for women and families.

This bill is so very crucial for all women and families suffering with postpartum depression. It will help provide support services to women suffering from postpartum depression and psychosis and will also help educate mothers and their families about these conditions. In addition, it will support research into the causes, diagnoses and treatments for postpartum depression and psychosis.

Stigma plays a large role in women not reporting symptoms of Postpartum Mood Disorders. What can we do to overcome this stigma and replace it with acceptance and compassion?

Having women share their experience with postpartum depression, rather than keeping it to themselves is very important. To not be ashamed or afraid to speak up to their family members, health providers and women’s groups when they are grappling with postpartum depression. This will help replace the stigma of postpartum depression with acceptance and compassion.

How did your husband handle the changes your struggle with Postpartum Mood Disorder brought into the home? What can new dads do to support their wives as they fight to move back to “normal”?

At first my husband Ritchie blamed himself for what I was going through. He thought it was because he didn’t pay much attention to me because he was too involved with sports. He couldn’t understand what and why I was going through this. He was angry that I asked him to find another wife when I went to the hospital because I believed that I wasn’t going to get better. He never gave up on me! He stayed with me and understood that postpartum was an illness that we were going to overcome as a family. He never stopped praying. New dads need to be supportive and understanding towards their wife who is suffering with postpartum depression. Most importantly, they need to be patient and compassionate.

Last but not least, if you had the opportunity to give an expectant mother (new or experienced) just one piece of advice about Postpartum Mood Disorders, what would you tell her?

Women suffering with postpartum depression need to know that they are GREAT MOTHER’S! Do not worry about not being able to bond with your baby, it will happen. First you need to get well. Most importantly please, please, please don’t be afraid to reach out for help.

MOTHER’S Act Blog Week Participation List

Welcome to Blog Week for the MOTHER’S Act

Above you’ll see a tab for the MOTHER’S Act Blog Week. Clicking on it will take you to more information (including a snazzy graphic) for this week’s action.

We want you to email Susan Stone @ Perinatal Pro to be added to the growing list of supporters for The Melanie Blocker Stokes MOTHER’S Act. This important legislation will aid with funding for increased legislation, education, awareness, and treatment services for mothers who struggle with insidious Perinatal Mood Disorders silently every day.

We also want you to call the Senate HELP Committee. Raise your voice and let them know you care and new Mothers DESERVE this legislation. They NEED it. The MOTHER’S Act will save lives!

Our movement here is applauded today by Sen. Robert Menendez, the primary sponsor of the Melanie Blocker Stokes MOTHER’S Act.

“Postpartum depression is a condition that is not only more widespread than most realize but also more debilitating than most realize,” said Menendez. “We need to make sure these mothers are fully supported and informed, rather than scared and alone. Working together with a nationwide community of mothers, we are so close to enacting this important legislation into law. What we need is an intense dose of public pressure. This Blog Day helps reinforce the type of grassroots movement that will create the pressure that is needed, and I commend the participants. I invite mothers, fathers and anyone else who believes we need to better support those with postpartum depression to contact their Senators and urge them to vocally support S.324”

Please leave a comment on this post with your blog post URL in which you encourage others to:

Email Susan Stone (susanstonelcsw@aol.com)

Provide a Link to Read the Bill

Include a link to Mary Jo Codey’s Interview

State whether or not you’ve called the H.E.L.P. Committee.

You can find links and more participation guidelines by clicking here.

Thank you for your participation. Don’t forget to pass it on!

Blog Week for Melanie Blocker Stokes MOTHER’S Act starts at midnight!

candle-wicks1Are you excited?

I am!

Starting tonight at midnight, you’ll be able to get the low-down on all the details of this week’s blog campaign to show support for the Melanie Blocker Stokes MOTHER’S Act.

(By the way, there’s an interview with Mary Jo Codey on the way too!)

There will be blogging, twittering, facebooking, myspacing, DIGGing, and whatever other form of social media you’re into.

There will be calling.

There will be sharing, paying it forward, and strength in numbers as those of us dedicated to supporting new moms in the perinatal period raise our voices in support of this important legislation.

Even if you don’t do blogging or social media, call the H.E.L.P. Committee members to let them know you support this legislation. There will be a call script provided at midnight as well. And if you’re in the mood, there will also be a suggested letter to the editor for you to send into your local papers.

Let’s make this one for the record books, folks!

What a week!

Monday was Charlotte’s cleft repair, pharyngoplasty surgery, and ear tubes.

Tuesday morning she got the nasal tube they put in to aid in breathing removed. Then she ate. And ate some more. And drank.

So we were discharged Tuesday afternoon.

She stopped eating Wednesday morning. Stopped talking by the middle of the day. She was also refusing all medication and foods.

We were instructed to return to the hospital.

So we did.

And there we stayed until yesterday morning when her appetite and fluid intake finally picked up enough to make me feel comfortable with bringing her back home.

Our stay was riddled with issues.

The first issue was failure to get written consent for her ear tube surgery. The surgeon took the time to track down where the breakdown in communication happened and did apologize to us but then just a few sentences later admitted that post-consent happens quite a bit in her practice with her adults. Yeah. We’re SO not going back to see her.

Second issue arose during our return to the hospital. The ER had a hard time getting ahold of Charlotte’s doctor to approve admission even though we had been instructed to return by them. We arrived at the ER at 830p but did not get a room until nearly 2a Thursday morning.

Third issue was our day nurse on Thursday. She was a bit flighty and had a propensity for over-explaining things and failed to be prompt in her attention to us. My daughter’s med pump went off repeatedly as did her fluid pump with no response from her whatsoever. She was apologetic and spent some time trying to kiss Charlotte’s behind but I had the nurse replaced. It’s not my kid you have to impress, lady.

Fourth and fifth issue happened on Friday.

Fourth: A tech walked into our room and asked if I wanted to give Charlotte a bath. I said that I did. So she got everything ready and decided we needed to give Charlotte a sponge bath in bed. We had Charlotte lean back over a bowl of water and wiped her hair down. The tech realized she didn’t have water to rinse with so she went and got some while I tried to keep Charlotte calm and still. The tech returned with the water and began to pour it on Charlotte’s head. Charlotte screamed. I reached up and felt the water. It was absolutely scalding. I immediately told the tech to stop and get out of our room. The water she had gotten was entirely too hot! She acted surprised and I had to ask her several times to leave the room. I asked our nurse to make sure she was not allowed back in our room. I didn’t see her again during our stay.

Fifth: At about 1p the phone in our room rang. I answered. It was a prank call. I hung up. They of course, redialed. I was very unsettled (they said horribly mean and rude things to me) and called our nurse. He came right away and handled the situation beautifully. Unplugged our phone and had our phone number changed. A report was filed.

I don’t tell you all of this to complain. I’m telling you all of this to stand strong. I got flustered only twice during our stays. The first was immediately after surgery when we had to hold Charlotte down as the anestethia worked its way out of her system. She was angry, confused, and frustrated. Kept pulling at her IV, her nose, and wanted to be done with all of the pain. I admit that I cried. It took four hours for her to finally calm down.

The second time was when we got prank called. I was very very scared. I didn’t know if it was someone from inside the hospital or outside. I felt very vulnerable and afraid. I even had a plan in place if someone we did not know were to burst into our room. But nothing came of it and I was able to get back to sleep within the hour.

I am glad this past week is behind us.

On a positive note, Charlotte’s speech is ALREADY improved. She’s saying words that we can now understand a lot more often. There are sounds she struggled with before that she is now making with seemingly no effort. We still have quite a bit of work ahead of us but for now, we’re miles away from where we were this time last week.

Last night was rough but I have hopes tonight won’t be as bad. I think she’s got some night terrors and trauma residuals going on as a result of spending the week at the hospital. Teething tablets and a night light finally helped her go to sleep on her own last night but she spent the bulk of the evening in the living room with me. We’re going to have her return to school so her mind will have other things to focus on as well to help leave the memories of this past week behind.