Unexpected Sadness

I saw a declaration posted on our unit (I'm a nurse in a hospital) the other day signed by the mayor of Calgary, designating January as Postpartum Depression Awareness Month. Now, it’s no longer January, and obviously I saw that poster a little late, but the issue of Postpartum Depression among women (and certainly men as well) is an important one that should be recognized through all months of the year. According to the Postpartum Support International website about 1 in 8 women suffer from postpartum depression. It’s an important issue to me because of the field of nursing I have chosen to work in, and because as women it’s important to support one another through issues like this when others may not understand. It also an issue that spans all cultures, countries, and even gender; though not as frequently reported, men do suffer from postpartum depression as well.

Photo courtesy of alexisnyal

According to the Alberta Health Services guide for expecting families (“From Here Through Maternity”) the symptoms of postpartum depression include: crying for no reason, feeling anxious or panicked, feeling angry, having no feelings or angry feelings towards baby, feeling helpless and/or overwhelmed, feelings of not doing anything right and ultimately just feeling depressed and sad. Postpartum depression (PPD) can begin anywhere from 1-12 months after baby is born. What differentiates PPD from the “baby blues” is essentially the severity and duration of the symptoms. Baby blues last for up to two weeks and manifest in behaviors such as crying, feeling sad, and feeling very tired, or having trouble concentrating. The causes of postpartum “blues” and potentially depression as well are hormonal changes, not getting enough sleep (who can’t relate to that???), putting too much on your plate at once, changes in relationships and disappointment. From what I see in the Neonatal Intensive Care, I would add “grief” to that list as well.

Some might wonder what grief has to do with the birth of a baby, which should be a celebration and a time of excitement and joy. However, I’m talking about the grief that can accompany the loss of a “normal” pregnancy, or birth, or even baby. With the first news of pregnancy come a range of emotions, depending on whether the pregnancy was planned or unexpected, and the medical repercussions of the same. But I’d say for the most part that pregnancy is exciting and full of hope. However, I’ve seen a lot of women who have been forced to deviate from their expected, or ideal, path of pregnancy and birth. We see a lot of that in the NICU - premature labor that comes as a complete surprise, or usually even requires the women to be in total bed rest for a few weeks up to a few months before they deliver. Then we see situations where medical emergencies for either the mom or the baby force the medical team and parents to drastically change their birthing plan. A lot of anxiety can accompany a forced decision to go to caesarean section rather than give birth ‘naturally’. Then, after all of the anxiety and fear over the uncertainties surrounding pregnancy and birth, the baby ends up a patient themselves in the neonatal intensive care unit. The parents, who should have taken their baby home after birth, become visitors with their time together restricted and subsequently the bonding process hindered.

Photo courtesy of Beth and Anth

I don’t know about you, but envisioning the hardships that some mothers go through for the sake of their newborns was hard and provokes a lot of empathy for them. There’s so much stress that can go along with a pregnancy and the pressures that family, friends, and the medical team put on a pregnant woman and subsequently new mother, coupled with hormonal fluctuations and a complete change in lifestyle; it’s no surprise that feelings of being overwhelmed, anxious, sad and disappointed arise. I guess what I’m trying to say is that though “baby blues” and postpartum depression don’t happen to everybody and are perhaps unexpected when they do, are completely understandable. As support people, it’s our job to look out for these symptoms in the new parents among us- and encourage them to talk about it. When Brooke Shields publicly spoke out about her bout with postpartum depression, she expressed feelings of guilt that accompanied her symptoms. As if going through this alone isn’t enough, guilt is unfortunately all too common as well- guilt over feeling one way when you’re “supposed” to feel another. This guilt can be a heavy weight, suppressing the urge to talk or even acknowledge symptoms of postpartum depression. If I can motivate just one mother (or father) to stop feeling guilty, and talk about what they’re feeling with a trusted one, or even just ask for some help with their little one, I’ll have accomplished the mission of this blog. For the rest of us, just being open, nonjudgmental, and looking past cultural stereotypes to the true stories of these mothers in order to express some empathy might be enough to make a real difference for them.

Photo courtesy of iandeth

If you or somebody you know might be experiencing postpartum blues, or depression, there are a few things you can do: Call the toll free Postpartum Support International line: 1-800-944-4PPD. Call your local Public Health Office/Nurse and ask for their resources- they have plenty and are always willing to share them. For my fellow Calgarians, there is a program called Families Matter 403-205-5177 where you can call and get support for any postpartum issues. A great website I found that listed important information and resources for my American friends was WomensHealth.gov.