Out from the Shadows – Article in Women Magazine

Taking a moment to post a quick blurb about the article “Out from the Shadows” in the June 2014 edition of Women Magazine.  Thank you, Diana Price, for including my story in this wonderfully informative article on perinatal mood and anxiety disorders (PMAD).

The articles touches on key points to try to increase awareness of PMADs, including:

  1. What does a PMAD encompass and what are some of the causes/risk factors.
  2. The importance of screening new moms.
  3. What should be done to prevent and treat PMADs.
  4. Tips for family members and friends of new moms experiencing a PMAD.
  5. Resources, including the blog Postpartum Progress and the international organization Postpartum Support International (of which I’ve been a member since 2006).  PSI is currently hosting its annual conference at the University of North Carolina Center for Women’s Mood Disorders, Chapel Hill, NC.  Certificate training took place on June 18-19 and the main conference begins tomorrow, June 20 and ends the evening of June 21st.  Click here for more details.  On Twitter, look for the #PSIconf2014 hashtag.

Please take a few minutes to read this article and share it with others via Facebook and Twitter.  The more we educate, the less ignorance and stigma on maternal mental health issues!

Thank you!

Learning from Tragedies: Listen to the New Mom and Respect Her Needs

*** This post may be triggering if you are suffering from postpartum depression (PPD) and are sensitive to negative news events ***

*  *  *  *  *  *  *  *  *  *

There was another tragic and preventable loss of a new mother’s life.
AND
Another family is now without their mother.

This mother’s name is Joe Bingley.  Joe’s husband is determined to try to prevent what happened to his wife from happening to other mothers.  He has formed the Joanne Bingley Memorial Foundation to raise awareness of this debilitating, highly stigmatized, misunderstood, and potentially life-threatening condition experienced by approximately 1 out of 8 new mothers.  Realizing the family history for postpartum depression (PPD) that ran in Joe’s family, he is determined to prevent what happened to Joe from happening to his daughter.  Joe’s death occurred back in April 2010, and this Daily Mail (UK) article was posted a few days ago to raise awareness of PPD and of the foundation that has been set up in her name.  I am writing about what happened to Joe to raise awareness and point out the importance of LISTENING TO NEW MOMS.  I mean, REALLY listen to them.

The title of the Daily Mail news article isThe ‘breast is best’ obsession and a mother driven to take her own life: This new mum was taken into hospital TWICE because she couldn’t feed her baby, but her pleas for help went unheeded.”  Between its posting date on January 2, 2014 and now, it has been shared 37,144 times and garnered 667 comments (none of which I had any desire to read).  Thanks to the attention-getting headline, it caused a large number of people to “converse” about the issues at hand as soon as that article was posted and started circulating via social media.  Having a dialogue about topics like PPD and breastfeeding (BFing) difficulties is good—especially since we don’t have enough dialogues on these “shush” topics, in general, hence the stigma—as long as it is done WITHOUT attacking one other.

The article quickly made its way around cyberspace, including many in the PPD world, as well as on such Facebook pages as The Fearless Formula Feeder (because many in that community have also survived PPD).  Unfortunately, it also attracted the attention of lactivists (hereafter referred to as breastfeeding zealots or BFZs, for short).  The FFF page’s post also attracted the attention of the BFZs who left trollish, angry comments until the entire post (it was merely a link to the Daily Mail article) was taken down…..but not before I read most of them.

When I saw the article title, my gut instinct was to REALLY wish I could pay a visit to all the healthcare professionals that failed to heed all the signs that something was wrong and failed to prevent such tragic loss of life, and tell them how I really feel and how they failed this poor woman and her family.  In this day and age, it is simply inexcusable for any healthcare professional that comes in contact with new moms—from the obstetrician to the nurses, lactation consultants—to fail to recognize that a new mom is in a distressed state and needs immediate treatment.

The gut instinct of the BFZs, on the other hand, was to be incensed about the title, insisting that it was deliberately worded to make it sound like BFing was a direct cause of Joe’s PPD and subsequent death.  They got their panties all up in a wad over AN ARTICLE TITLE.  I would like to ask the BFZs to take a step back and realize that there will only be progress in maternal mental healthcare as long as mothers feel safe in sharing their PPD experiences and BFing experiences.  What do they hope to accomplish by bashing, hating, forcing people to think their way is the only right way, and looking for conflict where there is none?  Progress can only successfully be made if we work together in finding ways to provide the support new mothers need and helping them to feel less alone and guilty in their struggles as new moms, rather than adding to the anxiety and guilt new mothers feel when they fail to perform up to so-called societal standards.

There were at least half a dozen BFZs who kept on insisting that Joe’s death had NOTHING AT ALL to do with BFing and everything to do with the lack of mental support—all the while insisting that everyone was erroneously confusing the two issues.  They claimed that Joe would’ve gotten PPD regardless of how she fed her baby.  Um, did you become an expert at PPD and a fortune teller all at the same time?  How can you possibly know this?  For Joe, these two issues were ABSOLUTELY interrelated!

The following is what I took away from the article, and  I sincerely hope the healthcare system in the UK would seriously learn from such tragedies…tragedies that could have been prevented by simply listening to the mother and nurturing her rather than letting a failing NHS system in the UK allow guidelines for postpartum assessment fail to be followed repeatedly (as in Joe’s case) and in so doing, destroying lives and families:

  1. Joe’s BFing difficulties were one of the many risk factors she had for PPD.  a) A history of miscarriages, family history of PPD (her mother, grandmother and aunt had all suffered PPD), b) personal history of PPD after 2 miscarriages and not receiving treatment (her home visitor told her to stay occupied to keep her mind busy….wtf?!), c) high anxiety levels from being a first-time mother who had previously had miscarriages so she was worried about her baby thriving, and d) feelings of BFing failure (her daughter was losing weight and she wasn’t producing enough milk)…. these were some of the risk factors that caused her PPD to rear its ugly head. Her prior PPD experiences after her miscarriages increased her risk for PPD after the birth of her daughter in 2010, and yet her home visitor, GP and everyone else who came in contact with her during her bout with PPD failed to make that connection. A mom’s feeling of not being able to provide the most basic and most critical function of being a mother to a baby–especially when the distress is so evident that she was hospitalized twice for BFing difficulties alone– can most certainly be the last straw that breaks the camel’s back. Plus, Joe was not told that it was okay to supplement breast milk with formula until her PPD was at a severe stage. If BFing challenges and pressure to BF did not exacerbate Joe’s PPD, it’s safe to say that these issues never would’ve been brought up in the article.  Even Joe’s husband clearly stated that the tremendous pressure to BF and her struggles with it were a contributing factor.  Joe’s husband is quoted as saying:

Joe was beside herself and returned to hospital on March 10. Her medical records say she was stressed and tearful. They suspected she was suffering from post-natal depression, but she was never referred for any kind of mental health help, only help with breastfeeding. The hospital seemed only to focus on the breastfeeding issue, not the mental health one. That’s the breastfeeding lobby for you…Joe ended up being connected to a breast pump for most of the day. By the time I got there in the evening, her chest was battered and bruised. She looked as if she’d been in a fight and was in a desperate state…I questioned why no one had suggested that she bottle-feed the baby. The midwife said that unless Joe or I specifically asked for advice on bottle-feeding, then they weren’t allowed to raise the subject.

  1. Joe had tried to seek help for her mental state.  However, despite her signs of distress and red flags for PPD, instead of being treated for PPD, she was re-hospitalized twice to provide her with BFing support!  The fact that they admitted her into the hospital for BFing reasons…and yet they did not give her any mental help?   Does that not tell you that HER wellbeing was not important?  Why on earth was there SO MUCH emphasis on BFing that her mental state was ignored and she was not treated despite her PPD symptoms?  How in the world could the health professionals who saw Joe ignore her cries for help?  Better yet, how in the world could they make a claim that her anxiety levels were considered normal for a first-time mother?  THAT is seriously messed up.    Public health services continue to fail our mothers by failing to prioritize maternal mental health services and policies.  Maternal mental health absolutely should demand the same kind of attention as BFing. Mothers need support REGARDLESS of how they feed their babies.  What I don’t get is this obsession with the baby with the mom falling by the wayside.

A woman who is depressed NEEDS HELP.  If she is suicidal, she needs to be taken SERIOUSLY.  Do not doubt for one second that she would carry it out.  According to the article, this poor woman had mentioned numerous ways she’d thought of killing herself.  At that point, she should have been immediately admitted to the local mother and baby psychiatric unit (that had 3 beds open at the time), but no one suggested such a thing!  Despite personally witnessing her deteriorating condition and hearing her say that she’d be better off dead, the home visitor continued to stand by the recommendation that she be cared for at home.  Frankly, I am shocked.  Here I thought the UK was leaps and bounds ahead of us with respect to postpartum support services, treatment protocols for perinatal mood disorders, the presence of psychiatric mother-baby room-in units, in-home health visitors to check up on the new mother, and even infanticide laws.  But it looks like somewhere along the way, time has stopped dead in its tracks across the pond.

Every single obstetrician, nurse and lactation consultant—whether it be in the US, UK or elsewhere—MUST BE required to receive training on perinatal mood disorder (PMD)—including but not limited to PPD, postpartum OCD and postpartum psychosis—symptoms and what to do if a PMD is suspected.  This includes training on when to recognize when an emergency situation (requiring hospitalization) and to react accordingly, taking into account: 1) every mother is unique, 2) every mother’s needs are unique, 3) every mother’s birth experience is unique, and 4) the risk factors for PPD are different for everyone who experiences PPD.  For some, it’s the birth experience itself.  For others, it’s the way they are treated by healthcare professionals (i.e., being disrespected, dismissed).  For others, it’s inadequate social and/or practical support.  For others, it’s sleep deprivation and the hormonal changes from childbirth.  The list of risk factors goes on and on.

How I’d like to address some of the comments I read:

  1. If moms claim that BFing cured them of their PPD, then we need to question whether it was PPD or the blues that they experienced.  Differences between them are still misunderstood by the public.  I know this because of recent conversations I’ve had with various people, including friends and co-workers.
  2. PPD can happen in both BFing and formula feeding moms.  Neither BFing nor bottle feeding should be seen as a sole remedy to PPD.  BFing can reduce the risk or severity of PPD for some mothers, but for a larger number of mothers, BFing can exacerbate the situation for moms already experiencing  sky-high anxiety levels, uncertainty due to lack of self confidence, inadequate support—not to mention difficulties with BFing.  If a mom has PPD, then she needs to seek treatment from a licensed mental health practitioner.  She also needs social support AND practical support.  That social support would include BFing support IF SHE CHOOSES TO BF.  If a lactation consultant provides BFing support to a mom with PPD, then she should be able to at least recognize that there is PPD to be reckoned with and provide her with referrals.  They should NEVER let the mom’s health fall by the wayside.  That’s just common sense to me.
  3. Every mom is not an abundant milk producer.  The mom is not a machine to pump milk from.  She needs to be well to produce milk well.  See my previous post on mothering the mother….a very important concept at which industrialized/capitalistic societies fail miserably.  Being well doesn’t just mean being physically well.  It also means being mentally/emotionally well.  Every woman is not confident—or even prepared—to BF.  There could be a physical issue preventing milk production and mom’s milk alone is insufficient, then formula or donor milk should be made available (they would come into play should she choose to stop BFing altogether).  If a new mom has a preference not to BF (that reason is important to her and we must acknowledge that), then so be it.  As long as the baby is eating and thriving, that’s all that really matters.  The priority should be to ensure the baby is fed.  Period.  If she wishes to BF, then adequate support should be provided (by a lactation consultant).   The mother should be supported regardless of how she feeds her baby.
  4. I wasn’t breastfed, just like many others from my generation.  Does that make me physically/mentally deficient because I didn’t have breastmilk?  I would like to think not, thank you very much.
  5. Just because one mom has a positive BFing experience doesn’t mean that all other moms must have positive BFing experiences.  For all those who think this way:  it truly helps to keep an open mind and trying to put yourself in another person’s shoes.  There’s a word for that:  EMPATHY.  Everyone is NOT the same.
  6. BFZs insist that the tragedy had nothing to do with BFing or the pressure put on women to BF.  But for many women (just read the comments in the FFF and Bottle Babies communities to see that this is the case), the pressure to BF and the ensuing difficulties to succeed with BFing has led many a mom down a PPD spiral.  There should NEVER be any pressure to BF.  But that pressure is there.  It’s all around the pregnant mom. It’s in daily conversations.  It’s in doctor visits.  It’s in advertisements.  It’s there once the baby arrives and never ceases to let up.  All this pressure sets up the first-time mom to experience high anxiety during pregnancy and if things don’t go well during the first postpartum days, the high anxiety in a mom with high risk of mental health issues can most definitely tip the scale toward PPD.  BFZs are concerned about one thing only:  that mothers use their boobs for the reason that they were designed: to feed their babies.  They don’t care one smidgeon about any extenuating circumstances that could preclude BFing.  They are so blinded by their passion that they are willing to make bold claims about BFing struggles/pressure to succeed and guilt for BFing failure as having nothing whatsoever to do with PPD.  They are so obsessed (mostly due to inexperience and some kind of narrow-minded superiority complex) with BFing at all costs that they can’t see the forest through the trees.  They can’t see the big picture.  Posts and comments written by women who don’t exactly think the way they do—like moms who have actually experienced BFing difficulties and/or PPD—cause  their panties to get all up in a bunch.  And that’s when they come a trollin’ in their narrow-minded, petty, and condescending mindset.

I want to see the end to this crazy system that we have going on here that sets women up for PPD. The impossibly high stakes raised by the BFZs whose mantra is:  the one and only and most important thing a mother can do for her baby is to BF her baby—everything else, including the mother’s health, be damned.  The BFZs will make claims that the sleep deprived, anxious mom who lacks support and confidence in BFing and is clearly having difficulties feeding her baby is just lazy and is merely making up every excuse in the book to feed her baby formula–that sub par, evil stuff.

Nah, the new mom doesn’t need sleep.  She can stay on—er, up—all night long because her boobs will automatically pump out endless amounts of milk on demand. She doesn’t need any nurturing or rest to regain strength.  After all, she’s a machine, right?  Not a living, breathing individual who just lost large amounts of blood during many hours of delivery—perhaps even had a complication or two (like I did with the placenta accreta and emergency partial hysterectomy)—and is in the process of hormonal upheavals.

Sound absurd?  You bet!

Bottom Line:
We all know the benefits of breastmilk and most, if not all, mothers would like to provide what’s best for their babies.  BFing is beneficial to the mental health of some moms, but NOT all moms.  EVERY MOM’S EXPERIENCE IS UNIQUE TO HER.  To ensure the health of the baby, you need to ensure the health of the mother.  Societal attitudes of the baby’s life meaning more than the mother’s (you’ll find evidence of this in daily posts on the ways certain states want to control women’s reproductive lives) NEED TO STOP.  EACH AND EVERY MOTHER’S voice must be heard, not ignored or shrugged off.

REALLY LISTEN TO THE NEW MOM
AND
RESPECT HER NEEDS

FOR MIRIAM

Has it really been over 2 months since my last blog post?  I did say previously that I’ve been slowly losing momentum over the past year or so.  As most bloggers can appreciate, my tendency is to blog in reaction to something that either upsets me or excites me.  While there’s been a general lack of negative news (including ignorant things uttered by the public and journalists about incidents that only serve to further stigmatize postpartum mood and disorders, or PMADs), there’s also been a dearth of exciting new research, legislative and/or postpartum support services developments over the past couple of months to motivate me to put pen to paper—or fingers to keyboard.  The former is good; the latter not so good.

Well, I’ve taken up the virtual pen to write today’s blog post.  It’s a blog post that will share the same title with numerous others (based on the support the For Miriam FB page has received in the past few days) who are banding together to spread awareness about PMADs.  These blog posts are dedicated to Miriam Carey.

Miriam.  We know she was a mother.  We know she had her one year old child in her car.  We know that that child is now without a mother.  We know from what has been shared by Miriam’s loved ones that she was being treated for postpartum psychosis.  We know that medication was found in her Stamford, CT, home.  We know she was using her vehicle in a way that caused law enforcement to, unfortunately, shoot to kill.  We know (but far from like the fact) that they are trained to do that.  Though, I’m not sure the one who shot her feels too good about what they had to do.  This loss of life is, simply put, tragic….and the reason why my dear friend, Dr. Walker Karraa, decided to corral this blog carnival in Miriam’s name.

Anyhow, without Miriam’s doctor coming forward and confirming the actual diagnosis, let’s just say that we are going to take this opportunity—since misinformation was once again so quick to be released to the public—to educate the public about PMADs.  Postpartum depression (PPD), postpartum psychosis (PPP), and postpartum obsessive compulsive disorder are some of the PMADs that exist.  They are real and they are treatable.  Problem is, all too many mothers suffering such disorders are 1) failing to seek treatment for whatever reason, 2) seeking help but are either not getting the right treatment or are getting the right treatment but not staying on it long enough for it to become effective, and/or 3) not getting enough support during recovery.

A lot of people have this tendency—a tendency that is in serious need of a reality check—to use PPD to generalize the spectrum of PMADs that exist.  It does not help anyone to report in such a fashion as to fan the embers of stigma and myths that PMAD advocates are trying so desperately to put out.  It definitely does NOT help when you have psychologists who are claiming that “postpartum depression has led mothers to kill their children.”  We know we have a lot of work to do if a psychologist is saying things like this on a show watched by over 4 million people.  Talk about taking 1 step forward and 2 gigantic leaps–not steps–backward.  Geez Louise.  Can’t the networks do a better job of finding true subject matter experts from organizations like Postpartum Support International (PSI)?  They should have PSI on their list of subject matter experts under the category of Mental Health (or more aptly Maternal Mental Health).  PSI should be the very FIRST place to consult with in times like this!

I can’t say that absolutely nothing grates me more than major news agencies spreading misinformation, because I do have a couple things that grate me more….but I won’t get into that here.  But I have to say that it angers me enough to want to do something.  Since video/television opportunities are not something I actively seek—and I’m probably the last person anyone would ever call on anyway—the only thing I can do is lend my voice today, on World Mental Health Day 2013.  Today, I join with other bloggers in a For Miriam blog carnival to try to increase the reach of getting our voices out there for the world to see.

PPD is quite a common illness.  It is experienced by one out of eight new mothers.  I am, in fact, a PPD survivor.  Many of the For Miriam bloggers are PMAD survivors.  Many of us took up blogging to try to reach other moms suffering from a PMAD and making sure they don’t suffer as much and feel as alone as we did in our experiences.  We don’t like it that there’s stigma.  We don’t like it that there are unknown numbers of women who fail to seek treatment due to this stigma.  And we definitely don’t like it when we hear about yet another PMAD-related tragedy.

Granted, information is nowadays very accessible when you search on the Internet for information and blogs about PMADs.  However, I still have yet to see posters and pamphlets in all the offices of medical health practitioners (i.e., general practitioners, OB/GYNs) in this country!  Between misleading statements made by mental health care practitioners, like the psychologist interviewed for The Today Show, plus the lack of information proactively being given to the public, we still find ourselves stuck in a similar ignorance- and stigma-filled rut that we were stuck in 12 years ago after the Andrea Yates’ tragedy.   I can’t say how disappointed and frustrated I really am.

The good that’s stemming from this tragedy is the number of advocates speaking up and sharing their subject matter expertise on PMADs, specifically PPP.

With that <clearing throat>….

AHEM, ALL MEDIA OUTLETS!  Please DO NOT continue to focus on publishing news in a rush because you want to be the first to get your article out to the public.  Ask yourselves:  Is your priority to get your headline to trend?  Or is it to serve the public well by disseminating accurate information?  Please, please, please read the For Miriam posts and please, please, please go to the below sites for ACCURATE information about PPP:

Postpartum Support International
Dr. Walker Karraa
Postpartum Stress Center (Karen Kleinman)
Perinatal Pro (Susan  Dowd Stone)

Now, as I end this post, I would like to humbly ask you to consider doing the following, as part of World Mental Health Day 2013….and for Miriam:

First, to join me in prayer for Miriam’s loved ones.

Second, to go and read as many of the other For Miriam blog posts that you can find the time to do, and share them on Facebook and Twitter to help spread the word that we will NOT cease in our quest to banish the ignorance and stigma when it comes to maternal mental health matters.

Third, if we see a mom who is in need of support, reach out to her.  Ask her how she’s doing.  If she had a baby within the past year, tell her about PSI.  She just might benefit from speaking to someone on the PSI warm line or seek local PMAD resources.  Remember that  approximately one in eight new mothers will experience a PMAD.

Our mothers matter.  Our families matter. 

Do it for Miriam.

Do it for yourself.

Do it for all the other moms out there who have suffered, are currently suffering, and may someday find themselves suffering from a PMAD.