Category Archives: pregnancy

#PPDChat Topic 08.04.14: Getting Pro-active: Facing Pregnancy after a Perinatal Mood & Anxiety Disorder

ppdchat-08-04-14

Along with countless women, I have been in this boat. It’s an intimidating boat, let me tell you what. But, with some preparation, things don’t have to be quite that scary.

My first experience with a PMAD was frightening. I had no idea what was happening in my head in addition to trying to get myself adjusted to motherhood for the first time around. Talk about one helluva screwball. Thanks, life.

I survived. My daughter survived. Did we come out unscathed? No. But I definitely came out wiser. I view my first brush with PP OCD as one heck of a learning curve which prepared me for the second time I found myself in an even deeper valley than the first.

Halle Berry said it best on Oprah: “Once you’ve been through depression, it gets easier to get out because you have a road map.” Each episode, while it may have different nuances and causes, is essentially the same basic experience deep down. You get used to battling your way out of it and yes, you absolutely have a road map. You learn to recognize the curves and know how to adjust for them well before they even appear on your horizon.

Just as with a road trip, preparation is key. While even the best preparation in the world does not guarantee that a PMAD will stay at bay, it does empower you and enables you to seek help sooner rather than later.

I sincerely hope you’ll join us tonight to discuss the importance of preparing yourself and your loved ones for the possibility of another bout of a PMAD after the birth of a sibling. I have experienced both a planned and an unplanned pregnancy after my episodes so there will be lots of insight into both situations, including a very honest discussion about depression and other mental health issues during pregnancy.

Tonight’s chat is an important one. Don’t miss it. See you on Twitter at 830pm ET!

Thoughts about Ebony

I was going to wait to publish this post until after I’d had time to read it through. But given that I just accidentally posted it, freaked out, made it private, I’m realizing that folks who got it through email will be able to read the entire thing anyway. SO. Here ya go. With a temporary title that obviously will be the permanent title – my ramblings and thoughts regarding Ebony Wilkerson, tragically better known as the mom in Daytona who drove  her minivan into the sea.

The public defender’s office said there was a reason she beat her stomach. “She {is} being held in seclusion naked in her cell,” said Craig Byer.

Public defender James Purdey at first asked for Monday’s hearing to get Wilkerson’s 1.2 million bond reduced.

Purdey instead asked his client be transferred from the Volusia County Branch Jail to a psychiatric ward for longer than a typical Baker Act hold, so she can get mental pre-natal care.

The judge did not rule on the request to move Wilkerson because the judge said it’s something that hasn’t been done before. (Source)

According to the Ebony Wilkerson narrative we have thus far, she drove to Central Florida from South Carolina to escape an abusive partner. Her family struggled to get her help but she signed herself out of the hospital and somehow managed to get the keys to the minivan and drive it and all of her children into the ocean despite the family’s efforts to hide the keys from her.

This week, we are told she has been held naked, in seclusion at the local jail and started punching her stomach, causing her defenders to push for her to be moved to a psychiatric ward for “mental pre-natal care.”

What the hell is wrong with this picture?

From an emotional and advocate standpoint, a lot.

From a logical standpoint, I can understand why these measures may need to be taken, particularly if Ebony has been suicidal. Of course you don’t want to give her anything that she could possibly harm herself with but there has to be a way to do that without completely stripping her down and removing all sense of dignity, something she was more than likely running low on if indeed she was escaping an abusive relationship.

The judge’s reluctance to move her may also be grounded in logic as well. Perhaps she did not feel she had enough facts to justify setting a precedence with Ebony’s case. Or perhaps the Volusia County Jail has the capability to be considered as “clinically appropriate” (as is required of examination/treatment in the Baker Act) and therefore the judge did not see moving her as a necessity. Or perhaps there simply wasn’t anywhere to move her to which offered the same level of security the judge felt Ebony requires at the moment.

But when examined from an emotional and advocate point of view, this is absolutely heartbreaking.

A pregnant mother, escaping an alleged abusive relationship, drives her kids into the ocean despite attempts to help her. To me, this screams of absolute desperation. This is beyond sanity. It’s more than a call for help. This type of behaviour requires action.

But is what Volusia County doing enough?

How do we best handle this type of situation in this day and age?

It’s like I tell my kids and my partner – we can’t fix a problem unless we know about it. Unfortunately, women (and men especially) who are in abusive relationships are often quiet about their situations until it’s almost too late, and some until it is too late. Why? Because they are often threatened by the perpetrator that if they don’t remain silent, there will be repercussions.

Silence is also a hallmark of Perinatal Mood & Anxiety Disorders for multiple reasons. Society believes we should be happy when pregnant or in the throes of new parenthood. Thing is, mood disorders have been happening since the dawn of time. Our responses to them over the centuries have varied but even early on, a few folks got it right. Take Asclepiades, for example. According to Thomas Millons Masters Of The Mind, he “argued against dark cells and dungeons for the mentally ill…thought patients should be in settings that were well lit and comfortable.” Asclepiades also proposed that “biological and chemically based treatment would be beneficial” in addition to dividing conditions into acute versus chronic and also distinguished between hallucinations, delusions, and illusions.

The main point of Asclepiades is that even in the early ages (171-110BC, by the way), someone recognized that locking away the mentally ill in dark, dank places was NOT the way to go.

Arataeus believed the “soul was the basis of psychic disturbances” and “mental disorders were exaggerated normal processes”. (Millon)

Then there’s Soranus who posited “consider(ing) culture as a factor in both investigating and treating mental patient.” (Millon, Masters Of The Mind). He also advocated for decent and kind treatment of the mentally ill, asking “his peers to remember who was ill; physicians should not view their patients as disagreeable persons who offended their self-image.” (Millon) It seems to this outside observer that Volusia County is not doing that in Ebony’s case.

Does being an abused woman or a woman at the hands of a Perinatal Mood Disorder excuse the type of behaviour Ebony Wilkerson has exhibited? No. But both are mitigating factors which led to her behaviour and should absolutely be taken into consideration as her case proceeds.

I’ve written extensively about Postpartum Depression as a defense. Cases like these are both fascinating and heartbreaking because all at once, those of us who have experienced a Perinatal Mood & Anxiety Disorder, see fractions of ourselves in the women who make headlines. We collectively gasp and think, my God, what if I had given into all those thoughts racing through my head? I could be her. I could be Ebony. I could be Miriam, I could be Andrea, I could be Otty.

We shudder because we were there, with them, in the dark, in the hell, holding their hands and they fell as we watch in horror. The way their fall is paraded in front of society scares the crap out of us and drives many to silence. Is this healthy for society? Yes and no. We should be outraged when children are subjected to death (or the threat thereof) at the hands of their parents. But at the same time, we need to take steps to prevent this type of situation from occurring in the first place.

How do we do that when every single case, every single situation from mother to mother and from birth to birth is different? How do we catch a falling mother if we don’t know she is falling?

Even if we start by putting measures in place to check for signs of falling, we will still fail if the mother doesn’t admit to having a problem or, as in Ebony’s case, refuses help (for whatever reasons – cultural stigma, fear, etc) which is offered to her because she is far past the breaking point and sees death as the only way out. Do we just throw our hands up in the air and let her do what she may? No. So what do we do then?

I don’t know.

What I do know is this:

  • Mothers (and fathers) do not deserve to be alone in this battle
  • Mothers (and fathers) deserve emotional support
  • Mothers and fathers need a village
  • Perinatal Mood & Anxiety Disorders are not deserving of whispers, they require shouts
  • We need to speak up, every single time, not just when there is a crisis
  • Accept those who are hurting with open arms and provide a safe space for them to fall apart
  • Not judge those who have/are struggling so harshly

So what can we do to improve the situation for struggling parents across the globe with the very real (and often co-occurring) issue of domestic abuse/violence and Perinatal Mood & Anxiety Disorders?

  • Make it okay to reach out for help and ditch the supermom/superwoman/superman/superdad façade
  • Initiate requirements for ALL health professionals who may come in contact with an expecting or new mother to be well-versed in the ins and outs of a Perinatal Mood & Anxiety Disorders (this includes pediatricians, OBGYN’s, GP’s, Family Doctors, IBCLC’s, doulas, midwives, naturopaths, you get my point…)
  • Create local, state, and national referral networks which incorporate above said training on a regular basis
  • Create networks of parents willing to mentor other parents through these tough situations and make it easy to access across the board

Are these solutions going to fix our current problem? No. But they’re a start and sadly, most of it revolves around a tradition which our current technologically advanced society has strayed greatly from – the tight knit expanded family. It takes a village to raise a child but it also takes a village to raise a mother to raise a child right. In my post “On Not Wanting To,” I state the following:

Our village is in peril. Our village? FELL THE FUCK APART AND NO ONE GIVES A DAMN.

In America, we have a pitiful excuse for maternity leave. We are bombarded by stories of celebs who gave birth and look AHMAZING in less than three weeks after giving birth. We are insanely comparing ourselves to women who are a) genetically blessed and b) have crazy access to things like trainers, nutritionists, nannies… and then there are the way we compare ourselves to each other. Stupid idiotic milestones of when we went back to work, how much we manage to get done every day, pushing ourselves to be better than the next mom and still have it all pulled together.

It’s no wonder we are screaming out for help and some of us are doing so through extreme measures.

Let’s keep the “if I were her, I would” out of the conversation. We do not know what she’s going through. Even if we’ve been through hell ourselves, we do not know *her* hell nor should we take her story as one which portends the downfall of ALL women who struggle with domestic violence/abuse and a Perinatal Mood & Anxiety Disorder. Instead, reach out to mothers, to fathers, let them know it is okay to reach out for help. For that matter, teach it to your kids so that when they get older they don’t feel as if reaching for help is in essence, failure to handle something on their own. Yes, independence is a grand thing but there is a time and a place to lean on someone else. Not to lean in, but to lean on, sometimes for dear life.

Our village has forgotten how to do this very simple yet necessary human act. We are now expected to be everything to everyone and dear GOD help us if we are not. Should we assume something is wrong with every mother? No. But instead of oohing and ahhing at her baby, ask how she’s doing. Ask how Dad is doing. Do not dismiss their very real role in their new situation. By acknowledging them, you acknowledge their existence and empower them to express their feelings. And that, my friends, is possibly one of the most powerful things we can ever do for a new parent.

Will it keep more pregnant women from being held in seclusion, naked in a prison cell, after they’ve attempted to kill their older children and themselves? Not all of them, no. But it’s a start.

An even better start would be to continue educating people about Perinatal Mood & Anxiety Disorders, including those in the law enforcement and legal arena. I realize they are bound by the courts and must adhere to the law but if they had a better understanding of the facts behind Perinatal Mood & Anxiety Disorders, perhaps, at least, the treatment of mothers imprisoned for crimes committed whilst experience these disorders would stand a chance of improving.

In the meantime, I genuinely hope that Ebony Wilkerson receives the help she so desperately needs as she awaits trial for her actions on the fateful day she drove her minivan into the sea. We’re watching, Volusia County. Don’t fail us more than you already have failed Ebony.

On Not Wanting To

I’m tired, y’all.

I’m so damn tired of reading about women splashed across the front page because they’ve done something horrible to themselves or their children.

I’m tired of immediately wondering who let her down. I’m tired of wondering at what point did she fall through the cracks. I’m fed up, to be honest.

It happens way too often, these worst case scenarios splayed across the front page for all to read and shake their heads in disgust or sigh in exasperation because yet another mom has lost her mind.

I’m tired of this bullshit.

I get that drama sells and when it comes to sales or clicks, it’s all about the what will draw people in so OF COURSE LET’S SHARE A STORY ABOUT A MOM WHO FAILED.

Where the hell are the stories about the doctors who failed to screen? Where the hell are the stories about the partners who told these new moms to just suck it up? Where are the stories about their loved ones who didn’t show up to help them when they cried out for help? WHERE THE HELL ARE THESE STORIES?

It takes a damn village, people.

Our village is in peril. Our village? FELL THE FUCK APART AND NO ONE GIVES A DAMN.

In America, we have a pitiful excuse for maternity leave. We are bombarded by stories of celebs who gave birth and look AHMAZING in less than three weeks after giving birth. We are insanely comparing ourselves to women who are a) genetically blessed and b) have crazy access to things like trainers, nutritionists, nannies… and then there are the way we compare ourselves to each other. Stupid idiotic milestones of when we went back to work, how much we manage to get done every day, pushing ourselves to be better than the next mom and still have it all pulled together.

It’s no wonder we are screaming out for help and some of us are doing so through extreme measures.

There was a push for screening but it’s buried in the ACA and we know how well that’s been going with implementation, right?

Then there’s the complication of who will screen. Maternal mental health care crosses so many specialties it’s not even funny. OBGYN, midwives, doulas, Pediatrician, General Practitioner, Lactation Consultants….so who screens? Does the OB? The midwife? The doula? The Pediatrician? The GP? The IBCLC? WHO? Once they screen, what happens? Is the woman informed of her results? Is she successfully referred to the proper care? Is that care knowledgeable about Perinatal Mood Disorders? Will they dismiss her as an exhausted mom instead?

What about the potential physical issues which can masquerade as PPD? Like anemia, thyroid issues, vitamin D deficiencies, etc? Will those be ruled out before she’s put on medication? Or is the doctor just going to toss a script at her and leave her all alone on her skiff in the middle of a hurricane at sea?

Where is this information in childbirth classes? Why are we not informing new moms about this? Why are we not telling them that it can happen, dear caregivers? WHERE ARE YOU? WHY ARE YOU FAILING US? WHY ARE YOU GLOSSING OVER THE DANGER???

Wake up.

Women are dying.

Children are dying.

Families are being destroyed.

And you, you are sitting there claiming “It’s not my place.”

But it is.

Your move.

Get it right.

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.

The Scorpion Tale of Perinatal Mood Disorders

Last night, I had a rather in-depth discussion with Addye over at Butterfly Confessions. We’ve discussed the same topic before and we’re finally doing something about it because we both think there’s not enough out there about this subject. Her blog post went up last night, discussing the role her antenatal depression, postpartum mood disorders, and other mental health struggles have played in her son’s recent diagnosis of being on the autism spectrum. While our children’s diagnoses are different, our story is the same, and it begins with a long hard look at the stinging guilt with which we now carry along our paths of Motherhood.

******************************

It’s taboo, really, more so than admitting you struggled with a Postpartum Mood Disorder. It’s a secret locked in a trunk hidden in a house deep in the woods where no one will find it. It’s the poison-tipped tail of a scorpion, the thing that gets you after the initial reaction of having a scorpion land in front of you. It’s the nagging feeling you get in your throat every damn time you look at your kid and think, even for a brief second, that you did that to them. It’s YOUR fault.

I’ve been there. I still am, sometimes. Not as much as before, but it’s something that I will always carry with me. A small part of my heart will always be tinged with guilt and a depth of sadness I’ll never shake. I’ve learned to accept it instead of fight it, to give it space to just breathe, knowing I’ll never get rid of it as long as I live. Right next to it though, now, is a space that is filled with a peace I’ve worked very hard to achieve – a peace that cancels out that guilt and sadness…as long as the see-saw is working that day, that is.

I struggled with Postpartum OCD after the birth of my first daughter. I’ve made no secret of that. I sought help but was shot down by my OB, an integral part of this story. I had to fight on my own to heal. Looking back, I didn’t do a great job at healing. What I excelled at was shoving all of the darkness down and faking it until I felt like I made it. Only by the time I got there, I was pregnant again and my hormones became the scorpion.

They flowed into my pregnancy, along with severe morning sickness. There were days I had to choose between eating or my prenatal vitamin. I often chose eating because I knew the vitamin would make me vomit whereas I might be able to keep the food down. One day, I lived on just one powdered donut. Other days, less. I couldn’t tolerate food for almost four months, if memory serves correctly.

I remember thinking I didn’t need the prenatal vitamin. I’d be okay, baby would be fine. Or so my hormone rattled brain said so. I didn’t want to get up, I would lay on the couch as our oldest, just a little under a year and a half, begged me to play with her. I couldn’t move or I’d vomit. So she learned to play by herself.

The pregnancy progressed, everything seemed fine, I didn’t have Gestational Diabetes again, the baby measured fine, all was good.

Until my baby shower. I went into labor that evening. I was 35wks and 6 days pregnant. (Women with untreated antenatal depression are more likely to go into labor early….or so says the research). At the time, I didn’t relate the two. I just knew I wasn’t full term and contracting. I labored at home until the next morning when we finally saw the doctor. I was dilated enough for them to send me to the hospital. Baby was on her way. Instead of happy, I was nervous. What was wrong? Why was she coming early? We were close enough to full term, really, less than a week away. But still, she was early.

After 42 hours of grueling labor, my daughter was born. She looked perfect. 10 fingers. 10 toes, screaming, a perfect squishable pink human all mine. I made her. As I tried to latch her to nurse, she wouldn’t latch. Just kept screaming. I didn’t know why. I tried for 30 minutes. Then we called the Lactation Consultant. I knew what I was doing, damn it, I had nursed our first for 16 months. Why wouldn’t she latch?

The Lactation Consultant swept her mouth as soon as she got to our room.

That’s when shit got real.

My darling perfect little squishable baby was rushed away from me, the word “cleft palate” left hanging in the air.

There I lay, in a hospital room, epidural still wearing off, all alone, no staff, no husband, nothing to show for almost 2 full days of labor except for the echoing of my heart shattering, insidious voices flooding my head with the phrase, “It’s your fault.”

I did that to her. She grew inside of me, imperfectly.

I lost it that night, brushed my hair for 10 minutes in front of the mirror. Ugly cried on the phone a lot that week, so much so that my ex-husband couldn’t even understand me at several points. In front of nurses. I cried a LOT. This? Wasn’t the way things were supposed to go. Why had I failed?

She was in the NICU for 21 days, undergoing one major surgery for her jaw at just 9 days old. Seeing your 9 day old infant on apparatus breathing FOR her… yeah.. um… yeah. “I did that to her.”

The kicker? The geneticist at the hospital asked me if I took my prenatal vitamins. I lied. I didn’t need any more guilt. I really didn’t. In my fog, I failed a lot.

People told us if we made it through the first year….we’d be scot-free.

They lied.

She’s seven now. Is one of the bubbliest personalities you could ever hope to meet. She’s perfect in every possible way. But she’s struggled so much and her struggles are far from over. Because of me.

She fights for every word she says. It could be worse, I tell myself. She could have so many other issues kids with her same condition have – texture issues, an additional syndrome, etc. Aside from her Pierre Robin Sequence at birth, she’s fine. She has speech therapy, and has had additional surgeries to help with her speech. Before she was 2, she’d been through three times as many surgeries as I have in my entire life.

I did that to her.

What if I’d taken my prenatals? Would she have been born this way? What if I’d fought harder for myself in seeking help for my depression after the birth of her sister?

Intellectually, I KNOW it’s not my fault. But still, the sting is there, long after the scorpion has faded out of sight.

It’s there, just a tinge of it, every time we talk. Every time I have to decipher what she’s said to me based on the context of the words I am able to understand because I still can’t understand every single thing she says. I recently won $200 headphones. They help me immensely in understanding her when we Skype. The ear-buds I had before just weren’t high enough quality to do so. Even now, I have to make her slow down and repeat what she’s said because she’s seven and well, seven year olds get excited.

She will need a lot of orthodontic work. She has the risk of giving birth to a child with similar issues. Kids will tease her because of the way she talks. She was born a fighter without having a say in the matter. While I know this will serve her well later in life, it is something with which I struggle.

Some mothers have Postpartum Depression, Anxiety, PTSD, etc, and they heal, with no adverse affect on their children. But there are those out there who experience issues with their children. And because of what we’ve been through, we draw that line from point PPD to point whatever Alphabet Soup DX with our kids. There’s research to back most of it up. There isn’t research (that I’ve found) to back up PPD related to cleft palate but a “Friend” of mine once tried to draw a line to the type of med I may have taken to my daughter’s cleft palate. Punch.IN.THE.GUT.

Moms like me need a gentle hand. We need to be heard, not dismissed. We don’t need to hear that “It’s not your fault” because in our heads? It is. It always will be no matter how much you tell us that it’s not. It just will be. We need you to stand with us, to be there when we need to scream, cry, vent, and shake our fists at the sky. To understand that our truth is a hard truth and sometimes it will break us but we will rebuild, a constant practice in our lives shattered by this spike of unexpected blow-back from our already complex, shame, and stigma-riddled experiences.

We are women made of glass. Under that glass, yes, we are steel, because we have to be, but on the outside, we are glass and we shatter. We need you to be someone who lets us shatter, someone who helps put us back together and take another step forward as we walk toward processing our new truth.

It’s time for us to come out of the darkness and speak up, to be honest about the role we feel we played in the issues affecting our kids, and to find support, REAL support, not dismissive attitudes, in our search for the light both we and our children need to thrive. We seek out the research drawing the lines from Mom to our kid’s issues, whatever they may be. Sometimes, the line tracing back to Mom is real, worth exploring, and worth understanding. Without it, we’re just left wondering why. I, for one, don’t like hanging out in the middle of nowhere with no answers.

Any answer, even a horrible one, is better than no answer at all.

It’s something. A direction in which we can begin to move forward from, a new beginning from which we can start to walk toward solace. Even if we never reach it, walking toward it is often enough. It has to be, right?