I’m not going to go into all the factors that can lead to the onset of depression around impending or new motherhood, although I did read an interesting study recently that correlated the level of pain and trauma a woman experienced during delivery with her level of depression afterwards.
A good friend of mine experienced significant trauma in her delivery, and her experience coincides with what the study describes.
For me, the hospital portions of my deliveries were–aside from a few moments of terror–mostly surreal, almost spa-like oases of kindness and competence. (Thank you, Virginia Hospital Center. ) With my first baby, what I would say caused my depression and anxiety was the way the bottom dropped out of my predictable, generally gender-equitable daily life.
Anecdotally, I would say that the majority of my friends have all described–with tensed jaws and unblinking eye contact– the Apocalypse-Now-level darkness they went to inside their minds during a good bit of that charmingly unpaid FMLA leave.
Isolation, confusion, sleeplessness. A world of laundry, standing at the sink cleaning those pump parts and bottles with hot water, sitting cross-legged on a suspicious carpet at the library while you try to cheerfully sing the ABC’s in Spanish to your two-month old.
Oh yeah, I said I wasn’t going to talk about what leads to the shockin’ high levels of perinatal (that includes pre- and postpartum) depression and anxiety. So how high are these rates?
- For postpartum depression in the US: one in seven women
- For perinatal depression in low-income countries: one in five women
- For perinatal depression in high-income countries: one in ten women.
What I want to share is this new research proving that a really simple, non-medical intervention can treat and heal postpartum depression. This work was carried out in India and Pakistan, but is universally applicable, in my opinion. Regular community members, all women, were trained to deliver a tested program called “Thinking Healthy,” which WHO developed. The trainees then supported diagnosed women, and were able to provide relief. This article describes the situation and how the support worked, and you can download the actual program here.
The program consists of a set of protocols that change as the baby gets older, and each protocol is broken down into three sections:
- the mother’s personal health
- the mother’s relationship with the baby
- the mother’s relationship with other people.
Here are some excerpts, so you can feel the open and warm tone of this program. You can also probably see how efforts are made to reach people who would be less likely to access mental health care, which is not always correlated with wealth, but has more to do with cultural models (in my opinion).
- “Move away from the purely medical care model. In Thinking Healthy, perinatal depression is treated by psychosocial interventions. This requires a different approach to one that most primary care centers are used to — one that relies on having conversations with the mother rather than giving her pills or injections.
- “Focus on mother and infant well-being rather than maternal depression: Many women and their families do not see depression as a problem requiring intervention. Some would perceive it as a stigmatizing. It is therefore useful to avoid medical terms such as ‘depression’ or ‘illness/disorder’ when talking to mothers and families. Women and their families relate better to everyday terms such as stress and burden.
- “Optimal development of the infant can provide the pivot around which families can be engaged: Family members may disagree on many things, but infant health is usually a common agenda. Within this agenda, efforts to improve the physical and psychological health of the mother can be addressed.”
In my dream future, not only will we have universal high-quality child care and guaranteed paid parental leave in the US, we will also have generous support for the mental, emotional, and physical health of new parents.