Written by Jenny Block
In my work as a postpartum doula and mentor to Amma’s postnatal volunteers, I always try to gaze at each family I support through a holistic lens, where all the various interconnected elements of their particular circumstance are considered. There is no one-size-fits-all solution, and it’s not my goal to lecture parents on how to do things in a certain way. Rather, I aim to provide support so that they can rest, catch their breath and, in turn, gain the confidence to parent the way that they want to.
In my pursuit of this goal, I usually encounter multiple obstacles. It can prove a hard task trying to convince birthing people that physical rest after the marathon that is conception-pregnancy-birth is not simply optimal but, in fact, essential. The consequences of a physically depleted new parent are far-reaching and long-lasting.
With semi-regularity I have to remind postpartum folk that they have a placenta sized wound (8 1/2 inches in diameter) on their uterine lining, and that if this were a visible, external injury, they would crawl back into bed without putting up such a fight.
Getting parents to accept rest, food and a delegation of their usual chores without guilt or shame is no small feat. Society tells them to pull themselves up by their bootstraps and muscle through without complaint, and it can feel hard to stand strong against that pressure. For the community that Amma supports, who have often accomplished enormous feats alone, it can be even harder to relax and embrace help.
As difficult as it can be to convince people to take their need for physical healing seriously, it is an even trickier task to persuade someone to prioritize their mental health. Education around postpartum mood disorders ahead of birth is sub-par, at best. You might get a pamphlet at some point in your birthing journey telling you to look out for some arbitrary line where you may cross from ‘baby blues’ in to something more serious. But how is a person supposed to know when that line has been crossed?
After the birth, with hormones swinging, sleep desperately elusive and relationships shifting, it’s a pretty normal response to not be happy all the time. It’s really ok and really normal to love your baby but secretly wish for aspects of your old life back. Crossing the threshold into parenthood is one of the most monumental transformations a human can experience, so it stands to reason that the emotions swirling around it are bound to be big and mixed. But if these darker moods persist or swell, a birthing person should consider additional support.
Postpartum mood disorders can be sneaky. While it is true that people who have existing mental health conditions run a higher risk of experiencing them, these disorders can creep up on anyone. A person expecting a baby may feel nothing but excitement and peace around an upcoming birth and then encounter a surprising deterioration in mental health soon after. If they don’t have the tools to navigate it, or the support and reassurance that they are not “the only one,” it can be a very serious and sad situation.
The community of parents we support through Amma often have additional traumas and exceptionally stressful living situations, providing a fertile ground for mental distress.
When it comes to mood disorders following birth, postnatal depression typically gets the spotlight, but there are other common subcategories that a birthing person might experience to varying degrees. Anxiety, OCD and intrusive thoughts are far more typical than we are led to believe and are exacerbated by sleep deprivation and traumatic birth experiences. A parent might have persistent thoughts about harm coming to their baby that they can’t shake no matter how much they love and want to protect them. The shame and fear around exposing these feelings often means that parents experiencing postpartum mood disorders suffer in silence, confused and panicked by the dissonance between their heart and mind.
A far less common and more serious disorder is postpartum psychosis, which can lead to confusion, delusion and loss of consciousness. Immediate and appropriate help should be sought in these instances as it is a true emergency.
So what to do? Preparation for the postpartum period can absolutely decrease the chances of a serious decline in mental health following the birth of a baby. Hiring additional people in the form of birth and postpartum doulas is an excellent way to plug the gaps. For Amma families, voluntary birth and postnatal companions provide essential care both emotionally and practically before, during and after the birth. Oftentimes, the people who Amma support are solo parenting, so having a kind ear and extra pair of hands is truly invaluable.
In an ideal situation, regardless of their means or background, birthing parents should be rested and their healing taken seriously. They should feel loved and feel listened to. Their chores should be delegated and their bellies full. They should feel safe to express themselves without judgement. Partners (who can absolutely experience postpartum mood disorders as well) should be supported by the larger community as well. If all those things are in place and still a more serious problem is suspected, parents should feel safe to seek treatment without shame or stigma.
For families undergoing the asylum process at such a vulnerable time, it is essential that they enjoy this same standard of care. Amma can help to plug the holes where the village should be, advocating for birthing people and providing resources for matters beyond our scope. When a parent is concerned about their mental health, their Amma companion may well be the one trusted person who they talk to about it.
When exploring treatment for postpartum mental health, I’ll reiterate my ethos that one size does not fit all. For some, western medication is an incredible route. For others, alternative options such as herbs and other natural practices make a better fit. Counsel can be sought in therapists or spiritual guides. Support groups can be a potent solace when experiences are shared and normalized safely. In every instance, cultural competency and trauma sensitivity needs to be centered. The informed choice of the birthing parent needs to be respected at every stage.
Unfortunately, postpartum mood disorders are not rare, but nor are they a marker for how good or bad a parent is. Stigma and shame surrounding them exacerbate an already desperate situation, with far too many families unable to access good support. With all the hurdles society puts in place, cultivating happiness as a birthing person is a radical act. Nobody should ever feel indulgent or apologetic in pursuing their peace as a new parent.
If you or any parent you know is struggling with mental health, here are a few useful resources:
Perinatal and Infant Mental Health Third Sector Service Directory (Scotland)
Perinatal Mental Health in the Time of Covid (Scotland)
Perinatal Mental Health Support During Covid-19 and Beyond (UK-wide)
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