Tag Archives: birth

Sticks and Stones Will Break My Bones But Words….

I started this post the other day after a comment was left on a post I promoted on Facebook. Then I had to walk away because I started down a path I did not want to go down. This was a difficult post for me to write as it forces me to revisit a meeting which left me both enraged and shaken. I’ve calmed down quite a bit and the following is a much more polite response than the one I started the other day.

The post is a wonderful interview of Dr. Katherine Wisner by Walker Karraa. The interview, found here, focuses on Postpartum Mood Disorders, of course, but also addresses the challenge and controversy of screening mothers for the presence of Postpartum Mood Disorders.

Screening is a hot topic and has been for quite awhile. There are a lot of unknowns regarding when to screen, how to screen, what happens after a positive screen, liability for care of the patient, when to refer, etc. Bottom line, I feel, is that we need to screen in order to start the dialogue about Postpartum Mood Disorders with care providers in every field that comes in contact with both expecting and new mamas. We also need to work more diligently to create supportive nets of care for women in our communities – coalitions of OB’s, Midwives, Pediatricians, IBCLC’s, Psychiatrists, Psychologists, therapists, doulas, and other various caregivers for pregnant women and young children. It needs to be comprehensive.

Those of us who advocate for the care and support of families battling Postpartum Mood Disorders must be well-versed in all things relating to pregnancy and postpartum. Our scope of knowledge must include a basic grasp on the rights of the expectant woman and as a new mothers. This is in addition to the psychiatric knowledge we also hold and are constantly researching in order to better arm new and expectant mothers.

It is exhausting sometimes, to read all of this information. I myself have suffered from information overload. But, empowering new and expectant mothers to make healthy and better decisions for their care and therefore for their families, is what I have been called to do so read I must.

In the past couple of years I haven’t been reading as much, I’ll admit, but prior to that, I read voraciously. I dove into all things birth related. So when there was a chance to go see Henci Goer at a local get together on August 26, 2010, I went.

Henci, a well-known author and advocate for Lamaze birth and healthier women-empowered births, was someone I admired.

Until the night I met her and discussed my experiences which led to my own advocacy with her.

Henci, after discussing at length, her new project, completely shot down my experience with a very dismissive sentence, the gist of which was left in a comment at Karraa’s interview with Dr. Katherine Wisner I referenced above.

Here was a woman, who seemingly was all about empowering women and improving their birth experiences, failing to even acknowledge the difficulties I experienced after my own. I didn’t experience Postpartum Depression, according to Goer, my experiences were directly related to my birthing experience and therefore weren’t my fault but that of the system’s.

While I agree there are far too many interventions in the modern birthing realm for many mothers and it’s sad that organizations like Solace for Mothers even have to exist, to shoot down the experience of another and how she has worked through it in one dismissive sentence is almost as bad as what my first OB did to me.

PTSD QuoteTrauma is about perception. It’s not about what happened to you, it’s about how you perceive what happened to you. This perception is shaded by our own personal experiences and baggage. These experiences and this baggage also directly affects how we process our experience after our brush with trauma.

No one has the right to question a woman’s perception of her birth experience.

No one has the right to re-frame her experience FOR her. It is hers and hers alone to process. It is hers to share as she feels necessary, with whatever details she deems necessary.

The comment Henci left on Karraa’s interview with Dr. Wisner reads as follows:

I am extremely concerned that the focus on screening for postpartum depression using an instrument solely designed for this purpose will miss diagnosis of childbirth-related post-traumatic stress symptoms and full-blown PTSD altogether or will mislabel women experiencing post-traumatic distress as depressed. PTSD symptoms are fairly common–as New Mothers Speak Out found, 18% of women were experiencing symptoms and 9% met the diagnostic criteria for PTSD–and while some symptoms overlap with depression, the treatment differs.

Furthermore, on-site mental health services would be of little use to women suffering from childbirth-related emotional trauma because one of the prime protective responses is avoidance of environments and personnel that re-trigger traumatic memories.

I have as well a philosophical issue with making depression the preeminent postpartum mood disorder. Depression centers the problem in the woman, and therefore the cure is centered in her as well. PTSD, however, is centered in the system, and therefore its cure depends on systemic reforms. The incidence of emotional trauma can be minimized by reducing the overuse of cesarean surgery and other painful and invasive treatments, by implementing shared decision-making, and by providing physically and emotionally supportive care. So long as postpartum mood disorders are primarily seen as an issue of depression, little or no attention will be paid to the all too common glaring deficiencies of medical model management in this respect.

I have several issues with Henci’s comment.

She seemingly assumes that the Postpartum Mood Disorder community is unaware of the difference between Postpartum Depression and Postpartum Post-traumatic Traumatic Stress Disorder. I can assure her that we are indeed not unaware. Most providers and advocates I know work diligently to go beyond the EPDS to dig deeper for possible birth trauma. The EPDS, while yes, not designed to pick up specifically on PTSD, is a starting point for a conversation about emotional issues during the perinatal period. Henci’s issue with this illustrates exactly why we work to educate providers about the many aspects of Postpartum Mood and Anxiety Disorders.

The discussion with a mother who had a traumatic birth experience is wildly different than with one who did not. Not all mothers who experience a Postpartum Mood Disorder necessarily experience PPTSD. Nor are their issues rooted in an issue with the so-called system. May I remind you, Henci, that PMD’s have existed since the time of Hippocrates. It is not some new fangled “too-many interventions” kind of disorder.

Not all of us are not “victims” at the hand of the system as you would have us believe, Ms. Goer. I’ve held discussions with mothers who had home births or natural births in a birthing center and still gone on to experience a Postpartum Mood Disorder. While it’s certainly not as common and there is a seeming correlation to interventions during the birth experience, there simply isn’t enough evidence to claim interventions (particularly cesarean sections) are the definitive root of all Postpartum Mood & Anxiety Disorders as Henci claims in her comment. (See article “Is there a link between C-sections and Postpartum Mood Disorders?)

We, the advocates for care and empowerment of women who do experience emotional trauma during and after birth, are working diligently to bring to light the additional issues on the Postpartum Spectrum such as Postpartum Post-Traumatic Stress Disorder, Postpartum Obsessive Compulsive Disorder, Postpartum Anxiety, and others. We no longer focus solely on depression. If we do, it is only because Postpartum Depression has been used as a catch-all phrase for so very long.

In the past six years I have been blogging, the term has graduated from Postpartum Depression to Postpartum Mood Disorders to Perinatal Mood Disorders to Postpartum Mood and Anxiety Disorders. In fact, I’m often at a loss as to which one to use. Postpartum Mood and Anxiety Disorders covers it most thoroughly, I believe.

There are researchers who focus on nothing but birth trauma and Post-Traumatic Stress Disorders – such as Cheryl Tatano Beck. I had the pleasure of meeting Cheryl at the 2010 PSI Conference in Pittsburgh. That meeting was so much different than my meeting with Henci. Cheryl was warm, accepting, and thanked me for my work in bringing my experience to light and fighting for others who had been through the same thing.

I do not hide that my first birth was a rough one. I know there are other mothers out there who had even more horrific experiences. But I talk about it because negative birth experiences do happen. I talk about it so that other women will read it, and know that it’s okay to talk about their experiences. If I simply dismissed the experiences of all the women who reached out to me, well, I’d be doing a huge disservice to the community around me. To women in general. In essence, I’d be traumatizing them even further.

With wisdom and knowledge comes power. With that power, comes great responsibility. I hold that responsibility as if it were a fragile ball of glass. My goal is to keep it from shattering. My goal is to create a safe and soft space for it as it grows stronger.

If only Henci Goer saw the birthing world the same way.

Guest post by @ksluiter: and now my depression is affecting those not yet born…

Hi.

It’s me, Katie, from Sluiter Nation.

I have a problem.

I’m not pregnant.

Sigh.  Yes, this is a problem.

Let me back up the truck for those of you who don’t know my back story.

I have an almost-two-year-old son, Eddie. Three months before Eddie turned a year, I was diagnosed with postpartum depression and anxiety.

I have been fighting this damn disease ever since March of 2010.

The therapist I see and my general practitioner both agree that at this point?  Because I had a pre-existing anxiety disorder?  I can likely drop the “postpartum” part of the label.

I suffer from depression and anxiety.

And I am trying to get pregnant.

Also?  My husband suffers from extremely mild depression.

up until very recently we were both medicated.

Do you know how hard it is to conceive when both players are on drugs?  The med that my hubs was on?  Decreased sperm count and made it difficult to…um…finish.

You can’t get a baby without the finish, people.

My meds kill libido.

So let’s recap.  One of us doesn’t want it and the other can’t complete the task anyway.

And here we are…three months later…no baby.

Not surprising, but still frustrating.

So now the hubs is off his meds.  And he is all raring to go…all the time.

Yay for lots of baby making, right?

Wrong.

It’s still hard for me to want to.  I mean, I so want to.  I want another baby so bad it’s hard to be excited when others are blessed with little lives.  And I want to be close with my husband.

But…stupid medication.  stupid depression sucking the joy out of my sex life.  stupid anxiety about what my body looks like.

People keep telling me to relax.

How do I do that?    How do I enjoy sexy time more than only a couple times…a  month?  Because it’s going to take more than that for us to make a human.

I am so tired of this stupid depression and anxiety taking over every aspect of my life.

It stole so much precious time away from my son and my husband.  And now I feel like it’s taking time away from my not-yet-created baby.

Then & Now: Why I blog turns three

Three years ago and thirty nine or so weeks ago, I was driving home from my therapy appointment for the Postpartum Mood Disorder I struggled with after the birth of our second daughter. It was THE DAY. The trees were greener. The rain drops sparkled. The sun breaking through the grey clouds summed up my mood perfectly. My heart soared. My oldest daughter would soon be three years old. Our youngest had just turned one. I was heading out to a relative’s house for the weekend with my mom, my first weekend away from the kids in a very long… well, ever. The Sunday after that weekend, I would discover I was pregnant with our son. And would totally freak out.

I did not want to go back to that dark place. So I read. Intensely advocated and prepared. Began to blog as an outlet for myself and to help other women.

Little did I have any clue that my first post would lead me here.

To three years and thirty nine or so weeks later. Never did I have a clue that I would interview Karen Kleiman, the author of What Am I Thinking: Having a baby after Postpartum Depression, here on my blog. Her book was what inspired me to begin to blog in the first place as it urged moms facing subsequent pregnancies to reframe them. So I did.

I haven’t stopped yet a nor do I plan on stopping any time soon.

I am ever so grateful for my positive Postpartum experience after the birth of my son. After struggling so hard with the first two, I finally got to immerse myself in the bliss of motherhood. I smeared Vaseline on the lens of my life and it totally rocked. Having been through hell it was certainly even more cherished and certainly not taken for granted.

I remember losing myself in the sweet scent of new baby. I remember holding him close and feeling our hearts beat in sync with each other. I remember him nuzzling my neck as he cuddled closely after nursing. I also remember curling my toes in pain because nursing was rough with him. I remember Thrush. I remember cracked nipples. But mostly I remember all the good stuff.

And these days, he is the light of our lives. Our little boy is a joker, a prankster, a caring and concerned three year old who loves to kiss, hug, and watch Cars. He doesn’t snuggle nearly as much but that’s okay. He will sit down on the couch with his toy laptop and blog right along with Mommy & (now) Daddy.

I am ever so thankful for his presence in our lives. Ever so thankful for his laughter, his camaraderie, his energy, and his caring spirit. Even when things get challenging with him, it is hard for me to keep a straight face. Damn his adorable infectious cuteness.

Who knew that when God decided to bless us with our son, it would also birth in me such a strong advocate for women with Postpartum Mood Disorders?

Thank you, little buddy, for motivating Mommy to put herself out there for so many women. You have no idea how many lives you have helped touch. None.

C-Sections and Postpartum Depression: Is there a link?

When Theresa over at The Healthy Baby Network asked me to write an article about the potential link between Postpartum Mood Disorders and Cesarean Sections, I was excited as it was a new area of research for me. I started out with the expectation of finding a definitive link. However, I failed to locate just such a link. Many of the research studies swing toward or away from a link. And one review study lacks a conclusive result in either direction.

Why is this? Why is there no proven link when repeatedly I have heard from mother after mother who had a cesarean section of the emotional struggles she has faced after the birth of her child? Of the trauma, the disappointment, the disbelief that birth did not go quite the way it should have?

Go read the article I wrote for Theresa over at The Healthy Baby Network and chime in with your thoughts. We would love to hear them!

Six years ago

Six years ago today I began a journey at 1:15p.m.

I had no idea where I was going. No clue regarding the difficulty of the tasks ahead.

I could say it was the beginning of the fall. But I won’t. I don’t see it that way.

Six years ago, not only did I give birth to my first child, I unknowingly gave birth to a new me. I gave birth to a strong new woman who was about to be tested in ways she never thought possible. Ways that allowed me to grow in directions I never thought possible.

I am constantly amazed at my daughter’s intelligence, her impeccable sense of humor, and her compassion toward everyone around her. The girl would give you the shirt off her back if she thought it would help you. (I have NO idea where she gets all this compassion from. None! *wink*)

I’m thrilled to celebrate her birthday today. And truly the ultimate Survivor Mama Day for me. Because six years ago today is when the me today was born. And I am madly in love with both of us!

Birth: A Play by Karen Brody

EVERY WOMAN IN AMERICA NEEDS TO SEE THIS PLAY.

EVERY WOMAN IN AMERICA NEEDS TO SEE THIS PLAY.

And yes, every woman SHOULD see this play. With their husbands and family members. This play is amazingly honest, straightforward, and touching. I had the honor of seeing this play in Atlanta Saturday night with a friend of mine, Cheryl Jazzar. (You’ll get to know her on Thursday!) We thoroughly enjoyed the performance and the panel discussion afterward. Want to giggle? We saw it at the Push Push Theatre in Decatur. I know, right?

I related to so many of the characters. My birth experiences have all been so different – with Alli it was very un-informed, very non-consensual, very traumatic. Charlotte’s birth was long, no pain meds for 24 hours, and I was truly exhausted when finally I got to hold her. Cameron – well, I was induced with him, five hours from beginning to finish and yes, I had an epidural for all three of them. But I do not feel the need to justify my decisions to anyone. These are MY BIRTHS, no apology or explanation needed. And this is precisely what BIRTH is about. Reclaiming Birth for ourselves. OUR BODY. OUR DECISION. No rushing by doctors, no being TOLD what we will do during delivery – what happened to the home birth? What happened to being surrounded by a caring community of knowledgeable women as you bring your baby into the world? When did we lose sight of this and graduate to giving birth in the hospital? Whatever happened to the beauty and power that lies within the act of BIRTH? If these questions are ones you have often wondered about, see BIRTH. If you can’t see BIRTH, read it.

You can also read Karen Brody’s blog here.

Sharing the Journey with ME!

Here’s a twist on the typical Thursday Interview fare around here.

I asked my husband to email me 10 questions. He sent 11. I figured it was only fair to allow him to interview me being that he was kind enough to do the same.

Enjoy getting to know me even better!

Tell me about the first time that you thought you might be suffering from PPD. How did you cope with it?

We were living in South Carolina and miles away from any family or support when our first daughter was born. Just a few months prior to her birth I discovered the online community at iVillage.com and became quite active there as I did not have any friends or family nearby and was practically bedridden due to severe pelvic misalignment issues. Allison’s birth was quite the traumatic experience (the doctor is very lucky I had a moment of sanity and decided NOT to kick him) and no one really seemed to offer any help after she was born. It was kind of an in and out experience, which, unfortunately, is the norm nowadays.

Once we got her home, the first thing that happened was an employee of yours stopping by the house with her son who was sick and sneezing. He proceeded to touch all of the baby stuff and I totally freaked out. At the time I did not see this as the beginning but the level of anxiety I felt that day took a very long time to dissipate. I really started to sink lower when you went back to work and remember standing over Alli’s crib and apologizing to her because I had no idea what to say to her. I thought she was judging me for not knowing how to be a good mommy. I was also very upset with myself because motherhood was what I wanted – even more than being a wife – I grew up wanting to be a mommy more than anything and here I was, finally a mom, and felt I was failing.

I realized it might be PPD through the online community at iVillage and reading things other women had posted. At three months postpartum and after some serious soul searching, I finally made an appointment with my OB. I was tired of the intrusive thoughts, the anxiety, the anger, I was tired of not being myself. So I went online, took a screening test and scored severely depressed having answered the questions about self-harm and harming my infant with a yes. I took this to my OB and he refused to acknowledge the possibility of PPD but did admit something was going on – PPD, no – because I was more than 6 weeks PP and my “hormones should be back to normal by now” Calm down now – it gets worse. Alli was screaming to be nursed as we discussed things (crying is my WORST trigger) and my OB brazenly asked how important it was to continue breastfeeding. What he said next shocked me. He refused to medicate me because I refused to quit nursing. His precise words were that I refused to stop nursing for trial therapy. I have my medical records to prove it. Because I was clean, had applied make-up, and was well-spoken, I couldn’t be depressed. Because I didn’t “look” the part, that couldn’t be what was wrong with me. He admitted something was going on but refused to admit that it was PPD. I was referred to the in-house counselor but they kept changing my appointment which made things worse so I refused to go and canceled my appointment.

Just two months later we moved back to Georgia and things started to improve because we were able to leave Alli with your parents and I started to get some time to myself. I thought I was recovered but sadly we discovered after I gave birth to Charlotte that I had not and things were worse than ever.

After giving birth to three children, how did your pregnancies differ in relation to your PPD experiences?

My first pregnancy was the easiest but I think all Moms say that – after all, you don’t have other little ones to chase around or keep up with. My first round of PPD was also mild compared to the second time around.

The second pregnancy was a bit easier physically because I knew what to expect but harder in the aspect that I had a toddler to run around after which is the last thing you feel like doing when your stomach is revolting against well, the world. The postpartum period after Charlotte’s birth was the most intense – her cleft palate, my depression and subsequent hospitalization, her multiple surgeries, Alli’s terrible two’s, your stressful and exhaustive job, pumping full time for Charlotte… you name it, there wasn’t a roadblock we didn’t face. But we made it through, clutching the bar holding us down into the roller coaster until our knuckles were transparent.

Honestly, how supportive was I when you were going through such a terrible time? What do you wish I had done differently?

Wow. Hard question. I think you were as supportive as you could be given the existential circumstances of each situation (no support system, birth defect & NICU, unexpected pregnancy), the information available to you at the time, and the irritability that you were constantly ducking from me. I am sure you probably felt as if you were walking on eggshells most of the time, not knowing if the next word out of your mouth would set off an “episode.”

Knowing what we now know as a couple about PPD, obviously there are some things we would have done differently like gone for a second opinion, pushed for better treatment, worked together instead of drifting apart into our own worlds which I think led to the path on which we found ourselves after Charlotte’s birth. I wasn’t able to be there for you and you felt as you couldn’t show any emotion when all I wanted was for you to show something – to let know that I wasn’t alone in feeling so lost about her cleft palate and the NICU stay. Of course I didn’t say this to you – I expected you to read my mind and got pissed when you didn’t. That’s just not fair at all (and is hallmark behavior of a postpartum woman)

Overall, you did a great job keeping us together as a family even if it meant putting on a show for me and for everyone else. As for having done something differently, hindsight is 20/20 and there’s nothing we can do to change our past behavior. I believe strongly that our marriage can now withstand anything anyone wishes to toss our way. We’ve certainly been through quite a bit in six short years.

You have certainly turned some very tragic events into ammunition to help other women fight PPD? How have your PPD experiences helped you help others?

I have found my inner strength, beauty, and grace as a result of the darkness of PPD. The same strength with which I battled my own PPD energizes me each and everyday to help other women who are in the same place I used to be. I will NOT let another woman suffer alone if there is anything I can do to change that for her. Each day I wake up with the goal of helping at least one woman. Small contribution but it goes back to a quote I fell in love with while in college by Ghandi: “Be the change you wish to see in the world.”

What role has your faith and belief in God played in your battles with PPD?

Raised Christian and having given my heart to the Lord at the tender age of 6, I had fallen away from the Lord and had really not been close with him for quite some time when Alli was born. I started to pray more and continued with this throughout my pregnancy with Charlotte. After Charlotte’s birth, I could feel His presence and let myself lean on Him although not as much as I should have, looking back. God knew he wasn’t done with me yet so He sent us Cameron to show me how much of a miracle He was capable of making. And He made a cute one!

When I first started helping others with PPD, I was uncomfortable talking about faith and God. Now it’s one of the easiest things to talk about. God has truly taken me into his Arms and blessed me. And I figure – if Jesus died for our sins, what a small price PPD is compared to His sacrifice. It’s taken me nearly four years of intense growth and molding to come to that conclusion and is not something I have come to believe lightly. My faith is stronger than ever and is still growing.

On the other side of the coin, have your PPD experiences affected your faith? How?

My PPD experiences have certainly brought me closer to God. I have come to realize that He has big plans for me and I have learned to quietly listen to his voice and truly lean on Him during times of need. In fact, if I start to worry now, I instantly pray rather than let it spiral out of control. I can’t even begin to express how grateful I am for all the growth He has allowed in my life over the past few years!

Life can be busy. Ours certainly is. You are a mother of three, homemaker, PPD advocate and wife. It almost seems impossible what you do. So I have to know, how do you do it?

I have no idea. If you figure it out, let me know.

Seriously though – I grew up watching (and helping) my mother around the house. She was a Stay at home mom too and I picked up a lot of tips from her too. I still call every day (HI MOM) well, almost every day as I’m much busier now and she gives me lots and lots of tips.

A lot of the PPD work I do is online so I can do bits and pieces here and there. I’ve also got the housework down to a science and can have that going while I’m working on PPD stuff in the living room.

One rule I’m working on is that when the girls are awake, I am all theirs unless I have to cook or clean. Even then I try to get them involved so they don’t feel left out or get them playing with play-doh at the dining room table so they’ll at least be having fun. I love my times with the girls as it’s what keeps me sane – well, along with time with you too!

What do you find most challenging about motherhood?

It never ends. My mom has a cartoon on her fridge at her house that I would LOVE to have – a census worker is at the door and a woman is standing there. She is saying, “Work? I just wake up and there it is.” I am never off – I am on call 24/7. Just today I was mother, nurse, friend, poopy cleaner, fan fixer, chef, linguist, wife, writer, brain-stormer, dishwasher, laundry lady, pie maker, dog walker, hand-holder, singer, and most importantly, ME.

What is your favorite thing about motherhood?

Bedtime.

Seriously though – I would have to go with getting the kids to laugh and have a good time. There is NOTHING more heartwarming and uplifting than allowing myself to be a total kid right along with them. I know this is not something you’ve seen terribly often but I’m working on it. At least I’m singing more in front of you more, right?

And last, but not least. What is it like being married to such a hunk and amazing man?

I’ll let you know when that happens. 😉

It’s like the way the Earth smells right after an afternoon rain shower. No matter how many times you experience it, it’s always new, refreshing, and uplifting even though the storm that brought you there may have been the most difficult storm you’ve ever experienced.