Tag Archives: cesarean section

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!

This week’s Postpartum Voice: Miranda of Not Super Just Mom

Miranda of Not Super Just Mom, is sharing as this week’s Postpartum Voice. She’s been hosting guest bloggers on the topic of  PPD/PPA over at her place this week as part of Mental Health Month and the D-Listed Blog Hop. Miranda and I met via #PPDChat at Twitter (I’ve been meeting SO many new moms there lately!) and I’ve really enjoyed getting to know her.

Miranda’s story starts out with disappointment after delivery didn’t quite go the way she had planned. I’ll let her tell her story in her voice now….

Ask anyone who knows me and they will tell you one thing. I am an over-achiever. I expect my best from myself in all things. I do not settle. I never have. Slowly, however, I’m learning to accept that sometimes my “best” has to be “good enough.”

I began battling depression in late high school. I fought with anxiety and depression off and on for years.  Once I got to college, I had pressure to keep my scholarships, to not disappoint my parents, to make sure I paid my mortgage and car payments and insurance and utility bills on time. To maintain a social life and find the person with whom I was going to spend the rest of my life.

I finally got help during my junior year of college when I broke down and realized I couldn’t continue to live the way I’d been living. What I was facing was something bigger than me. The clinicians and psychiatrist who helped me were amazing and I owe them a debt of gratitude for teaching me how to “deal.” While I was in treatment, I met a wonderful guy, got married, and set out to suburbia. Eventually, we decided to expand our family.

I knew I was meant to be a mother.  I knew that I would be good at this.  It was my destiny.  How could I not be a natural?

So imagine my shock when, two days after having my beautiful plans of a natural, vaginal, med-free delivery shot down due to “failure to progress,” I found myself crying into my meatloaf.  Apparently, someone having an “inappropriate response to meatloaf” has become code-language in my doctor’s office for “watch out for this one.  She’s on the fast-track to medication.” Or something like that.  But see, that wasn’t normal.  And I didn’t know it.

And when I wrote that post, the anger over my C-section was definitely present.  I was angry.  I am angry.  Even now, 14 months later.

And that’s how my PPD/PPA started.  With anger.  And bitterness.  And resentment.

And then the anger and bitterness and resentment turned into sadness over how things didn’t go the way I planned.

And then I heard the words “you’ll have to supplement” at my son’s first newborn visit after being discharged and that’s where the no-no “F” word started creeping in.

FAILURE.

I had only been a mom for five days and already I was a failure.  I’d failed to get him here the way I’d envisioned.  I’d failed to keep him from losing 10% of his birth weight because my stress and anxiety over the surgery (and the pain! Sweet baby Jesus in a manger the pain) kept my milk from coming in.

And I just KNEW that supplementing would be doom for breastfeeding for us.

And then I’d be failing at yet ANOTHER thing and I was BARELY EVEN A MOTHER YET AND HOW CAN I ALREADY BE SO BAD AT THIS?!?!?

When my one-week postpartum check-up came around, Peggy-the-PA and Dan and I discussed my “inappropriate response to meatloaf” in the hospital while Joshua, ever the little stinker he is, slept peacefully in his carseat.  A carseat that he HATED for the first four months of his life (which effectively trapped me in the house because the sound of him screaming would send me into what I now think were mild panic attacks…WHILE DRIVING).

While we were at that visit, Peggy wrote me a prescription for an anti-depressant.  She thought it’d be a good idea for me to go ahead and start taking them.

But I didn’t.  Because I wanted to believe that I was stronger than that.  I wanted to believe that this was just the “Baby Blues” and that they’d go away and I’d realize that I was a natural at this.  That I was a PERFECT mother.

But I wasn’t.  I’m still not.  And the “Baby Blues” didn’t just evaporate.

It didn’t help that a mere seven days after giving birth, I was flying solo with this tiny bundle of lungs and poop.  I couldn’t drive because it still hurt to sneeze, so I still needed to take pain medication. But I couldn’t take pain medication and be home all day with the baby because what if he needed me and the medication made me drowsy and I was sent a baby who wouldn’t sleep so there was no “sleep when baby is sleeping” in this house for at least three weeks.

I resented my husband.  I resented the fact that he got to leave every day and go to work.  He got to get out.  He got to see people.  If I tried to leave, even to go to Target, I’d have the baby screaming his tiny baby lungs out the whole way there.  The whole time we walked around the store.  The whole time we drove home.  It just wasn’t worth it.  So I didn’t leave.  And when Dan left for work, I’d cry.

And because I was so mired up in my own grief, I didn’t feel connected to my son.  I’d read blogs written by women who would gush and gush about how when they saw their baby it was love at first sight and they knew instinctively what to do and what their baby needed and part of me screamed “THAT IS BULLSHIT” and then part of me cried.

Because that’s what I wanted.  I wanted that instant bond.  That connection.  That look from my baby that said “You are my mommy and I know this because I have heard your heart for 40 weeks and 5 days and it is the greatest sound in the world and I love you, Mommy.  And I promise to sleep all night long and save all the poop-splosions for Daddy.”

And I didn’t get that.  Even close to a year out, I still didn’t feel that.  Even now, there are times where I look at my son and go “WHAT PLANET ARE YOU FROM!?!?” because he and I just don’t seem to understand each other very well.

The times that I felt most at peace were the times when my mother came down to spend the day with me.  She’d get here early in the morning and do a load of laundry or dishes or sweep my floor.  And then?  Then she’d hold Joshua while I napped in the bed.  It was glorious.  But it was brief.  My reprieves from the resentment were short-lived.  I knew she’d leave soon, so when it would be time for her to leave, I’d get all anxious in the pit of my stomach and I’d feel the lump forming in my throat.  And then she’d walk out the door and I’d be choking back tears and trying to hold it together.

And in the midst of all of this, Joshua was diagnosed with reflux and a milk protein allergy.  Which meant mixing up little packets of Zegerid twice a day and me cutting out all yummy dairy goodness for as long as I planned to breastfeed.  Me and Oreos became BFFs because they are totally, completely dairy free.  And some days, I’d eat Oreos.  All day long.  That’s almost all I’d have to eat.  Maybe I’d sneak in a graham cracker and some peanut butter.  But I didn’t have much of an appetite, despite the fact that I was a dairy-free dairy cow.

(I think the fact that we finally got breastfeeding worked out is the only thing that helped me keep it together.  It’s the only thing I knew I didn’t totally suck at, even though it had its own set of drawbacks…like growth spurts, and nursing every hour, on the hour, all.night.long. AND GIVING UP CHEESE AND COFFEE CREAMER.)

At my six week postpartum visit, I finally admitted to Peggy, and my husband, and my mom, and myself, that I needed to fill the prescription she’d written me six weeks earlier.  I knew that this was not something I could do alone.  So, I drove to the pharmacy, filled the prescription, and started taking them that night.

And I didn’t feel instantly better.  I still have days where I don’t feel better.  I have days where I just want to cry.  Or where it physically hurts to move my body because I’m just so weighed down with my thoughts.  And there are times when Joshua screams (um..hello…he’s a Tiny Terrorist.  That’s pretty much all he does is scream) and I feel my heart start to beat faster and I kind of lose my train of thought and I become robotic.  GET.DIAPER.ON.NOW.PICK.UP.BABY.NOW. And I just sort of “do” it.

One of the things I’ve come to realize through my battle with PPD/PPA is that I have to take every day as it comes.  I’ve also had to abandon the quest for “perfection.”  Nothing is perfect.  Especially not me.  Which is the purpose behind this blog.  I’m not perfect.  I’m never going to BE perfect.

I’ll have perfect moments, and moments where I go “Hey, I don’t suck at this!” but I’m not going to have those moments all the time.  The “perfect” world of mommyhood that I envisioned for myself prior to actually being a mom doesn’t exist.

And slowly…slowly, I’m becoming more and more okay with the lack of perfection in my life.  And I’m finding something kind of perfect in the imperfection.  I’m finding me.

Miranda can be found at Not Super…Just Mom. She’d like everyone to know that she is not, in fact, a Supermom. But with a cape and a tiara she could probably save the world.

Just Talkin’ Tuesday 05.11.10: Postpartum invoke guilt? You are not alone

I know some of you are sucking air past your teeth through pursed lips right now, nodding your heads in agreement, rolling your eyes and possibly even muttering.

Really? She’s dragging THAT ghost up?

Yup. I sure am.

But why?

Because it’s important to face every facet of Postpartum head on – even the ugly parts.

Why is it so important? So those who are currently struggling KNOW that they’re not alone. So they KNOW that the emotions they’re feeling – while alien to them – are actually quite common among those of us who have struggled before them. The more we talk about our experience, the less victorious the stigma, fear, and guilt will be!

And let’s face it, GUILT is one of the uglier parts of Postpartum. It makes decisions we’re faced with during our Postpartum Mood Disorder even harder. No decision we make is a guilt-free decision.

Breastfeeding and having to medicate? Guilty. What is this doing to my baby? Should I be medicating and breastfeeding?

I had a c-section. Maybe I shouldn’t have had that done. Maybe that’s why I have postpartum. There’s that guilt again, sliding in through the door.

I had a vaginal birth but my c/s friends think I’m holier than thou now (even if I’m not) and won’t talk to me. HELLLLOOOOOO guilt.

I’m bottlefeeding because I can’t breastfeed or breastfeeding grosses me out or I was told to stop by my doc. Oh guilt? Won’t you PLEASE come in? Please?

My daughter/husband/others are judging me for my lack of parenting skills. I don’t know what the hell I’m doing. Fishbowl Guilt: The feeling of judgment from everyone!

I’m thinking about having another baby/I don’t want another baby. Guilty over lack/desire to become/not become a mom again. Especially when pressured by others to become a mom!

I struggled with Fishbowl guilt with my first daughter. I sucked as a mom. My husband told me all the time what a great mom I was and how amazing I was at taking care of our precious daughter. But I never believed him. Even my 7 day old daughter judged me. I had no idea how to relate to a newborn. I’d never done this and just like her, I was brand new at this relationship. I kept the blinds in our house closed all the time. I used the excuse of nursing but it was really to keep all the people outside from peering inside to witness my daily failures as a woman, a mother, and a wife. I had fallen and there was no way I was sharing THAT with the world.

With our second daughter, I pumped exclusively for 7 months so she could get breastmilk as she was born with a cleft palate. It finally came down to my mental health and my relationship with my first daughter and husband or breastmilk for my second daughter. I bought formula. Cried all the way there and all the way home. Managed to keep the tears down in the store but heaven help anyone who had decided to give me a speech about the superiority of breastmilk. I had a whole tirade planned. I even had to fight with WIC to provide Enfamil instead of Similac because they were under contract with Similac but my daughter couldn’t tolerate the stuff. I had to get a doctor’s prescription for plain old Enfamil in order to win that battle. And that meant I had to fight with my then idiot pediatrician because he couldn’t understand what the difference was between the two and almost refused to write the script. Thank goodness for a local IBCLC who gave me the free Enfamil sample she had in her office. She saved them just for me and that meant the world to me.

Our son was a champ nurser from the start. And then we had issues with a bad latch habit. Then there were the back to back to back cases of thrush. I even had to go on an anti-candida diet to finally kick it because our ped and the OB couldn’t get their treatment schedules lined up. I nursed my son for 6 months. During that time, I had some severe emotional trauma unrelated to PPD. It killed my supply. My son was diagnosed as Failure to Thrive at 6 months old. The NEW pediatrician wanted me to pump. HAH! I was so not going back down that road. After a very emotional day of contemplation, we opted for formula. Everyone in the family dove in and donated bottles, a warmer, and we were on our way. Cameron switched completely within the next day and we never looked back.

I did not have Postpartum with my son. Sure, I had issues crop up, but they were not related to the birth of my son. And I weathered them just fine.

I had finally learned to put my guilt up on a shelf and leave it there. I still get it down to dust it off occasionally but it’s never stayed down for very long.

The biggest lesson I learned from my Postpartum was to let go of my guilt. How did I do this? My angel of a therapist once said something to me in relation to a situation with which I was struggling. She told me that how others react to you is THEIR gig, not yours. Wow. HUGE. It really hit home with me and I practice it each and every day. I’m also a huge proponent of believing that as moms, we have to make the decision that’s the best for ourselves and our families. I respect that in others and in myself.

So let’s get to just talking.

Do you deal with guilt? What’s your biggest source of guilt as a mom who’s struggled with Postpartum? Have you put the guilt behind you? How’d you do that? Share your tips for guilt-free living as a mom. Are you still dealing with the guilt and think you shouldn’t be? Try giving yourself permission to be ok with your decision. It’s amazing how far permission will go if you give it a chance.

Just Talkin’ Tuesday: Did your birth story affect the development of your Postpartum Mood Disorder?

When I saw my very first positive pregnancy test, I wasn’t thinking about labor. I wasn’t thinking about birth. I certainly wasn’t thinking about the major depressive episode awaiting me at the end of the journey. I was just thinking about the awesome little life growing inside of me. The second time around though, after a tough delivery and a life lesson in what the birds and bees really do talk about, I cringed. My first thought? Oh crap. There’s a baby in there. And it’s got to come out somehow. I ended up with another spontaneous vaginal delivery with our second daughter. This delivery, although labor was nearly tripled, went much smoother. The trauma came 30 minutes after birth when she was diagnosed with a cleft palate. I ended up with a nasty nasty episode of postpartum depression. The third time around I also had a vaginal delivery but it was induced because I was measuring 2wks ahead of schedule. Amnio showed lung maturity and my pelvis (god bless it) had become so loose I could barely walk without wincing in pain every time I took a step. We were ready. This delivery was short, sweet, and outcome was much better. I also didn’t experience postpartum after my third birth.

With my first birth, I did not take a childbirth class. I didn’t with my second or third either but by then, I had been through it, done research, explored a few options, knew my body was capable of birth, and learned to trust myself and not rely on medical intervention. I was also much more capable of advocating for myself in the delivery room. I went in with what I call a flexible birth plan because I knew how fluid birth could be and did not want to be unprepared for any possibility after my first delivery at which I was pumped full of Pitocin and stuck in a hospital bed for the entire labor. I opted for an epidural with all three births. My first birth was the toughest – Pitocin contractions on top of one another for nearly 8 hours straight with a one-sided epidural the anesthesiologist tried to place 7X during transitional labor. Ever tried to sit still during transitional labor? Yeh. I’m SO not one of those women who can do that. So the second time around, I had my birth plan. The biggest thing was not to be offered any kind of pain medication. I’d ask if I needed it. And I asked at just over 24 hours of labor. Tired, exhausted, no end in sight (my water hadn’t even broken yet), I needed rest. But I did it on my terms. The third time around I got a little irked at the midwife nurse at my birth. I went in with the same birth plan. I asked for pain meds and she attempted to talk me out of it. I understand the desire to have an unmedicated birth. A woman has a right to the kind of birth she wants even if we don’t agree with it. As long as she’s making those decisions in an educated manner, let the woman have what she wants.  A woman absolutely should not be judged for her choices at birth. Instead, we should try to understand the choices and enable her to make educated decisions in the future. I advocated for myself and ended up having a great birth experience even if she was disappointed in my ability not to go au natural. Looking back, I probably should have asked for another nurse. But hey, it is what it is and my third birth ended up being my best experience overall.

For today’s Just Talkin’ Tuesday, I would really like to explore your birth story. Was your birth what you expected? Did you have a birth plan? What kind of birth did you have? Research has shown repeatedly that c-section mamas are more likely to develop a postpartum mood disorder. And with the soaring c/s rates here in the US, I have to wonder if perhaps that is why there are more mamas struggling with emotional adjustment after birth. Although there are plenty of mamas out there who gave birth at home with no medical intervention who also struggle with postpartum mood disorders so maybe that’s a non-issue altogether. Overall though, do you feel your birth experience impacted your development of a postpartum mood disorder? Or did the Postpartum Mood Disorder just happen? And if your birth experience negatively impacted your development of a postpartum mood disorder and you went on to have more children, did you opt for a different type of birth? Do you feel changing your birth choice have an impact on whether or not you developed a Postpartum Mood Disorder? If you haven’t had any subsequent pregnancies, will you change your approach toward birthing as a result of your experience with Postpartum Depression if any more children are planned?

I know those are tough questions but it’s what I’m wondering today. So let’s get to Just Talkin’, shall we?