I am so lucky to have three beautiful healthy babies that came into this world in what I could only describe as a succession of increased triumph for me. Both of my girls were born unmedicated after relatively quick but intense labors -7 hours with Gabriella and 4 with Mila – delivering Gabi at Jefferson Hospital in West Mifflin, PA and Mila of course in my home in Gibsonia, PA.
However, my labor and delivery with Nico was nothing like that, and in many ways, was pretty darn traumatic for me and for my son.
I was in labor for nearly three days after three weeks of prodromal labor; I was exhausted. Nico was born posterior after a few hours of pushing and a labor that was nothing like I expected. He was whisked away from me, isolated and hungry in the NICU for four hours after birth while I was undergoing repair work and he was pumped full of unnecessary antibiotics to treat an infection that he didn’t have. Despite being healthy, he was held captive for 48 hours while I worked desperately to get him out while navigating those first few days postpartum without my child and with a lot of healing, physical and otherwise, to do.
I was extremely fortunate that I didn’t suffer from any sort of postpartum depression. In hindsight, I had all the makings of a classic case and many of the risk factors that I highlight below were relevant to me. I’m not sure if it helped or not, as different studies say different things, but I absolutely went all Chrissy Teigan and had my placenta encapsulated and ingested it as pills for 60 days postpartum which, at a minimum, had the effect of making me think it was helping. My ex told me that he could notice when I hadn’t taken them on any given morning, so perhaps they really did work to help me stave off baby blues or any more long term effects of a birth that didn’t go as I wanted it to or just generally the great hormonal shift that comes with motherhood.
Overview of Maternal Mental Health Disorders
Maternal Mental Health Disorders generally refers to mental health of the perinatal population (pregnant women and women in the postpartum period). Up to one in five women will suffer from a maternal mental health disorder at some point in their lives. These disorders can have new onset in the postpartum period, pregnancy or prior to pregnancy and persist through pregnancy. These disorders include the range of anxiety disorders, obsessive compulsive disorder, PTSD, depression and the rare but serious postpartum psychosis.
Mental Health of Mothers Through the COVID-19 Crisis
This time of social distancing and quarantine leaves mothers in an incredibly unique time to traverse pregnancy, labor and delivery, and the postpartum period.
“The COVID-19 crisis is unprecedented and highly stressful to the entire population. For pregnant women, the worries about the pandemic can increase anxiety and worsen mood during pregnancy—both of which are known risk factors for maternal mental health concerns during the pregnancy and postpartum period. This speaks to the great need for increased emotional support for perinatal women.”
-Samantha Meltzer-Brody, MD, MPH, Director, UNC Center for Women’s Mood Disorders
Motherload of Stressors and MMH Risk Factors
This year however, it’s critical to also acknowledge the motherload of stressors that all mothers with children in the home have faced during the COVID crisis. It is impossible to address maternal mental health without addressing the impact of the COVID crisis on maternal mental wellness. I’ve previously written about being pregnant during this global pandemic and the potential cascade of consequences this could have on birthing women.
The current restrictions implemented to minimize the spread of COVID has created and augmented many risk factors for maternal mental health. By any objective standard, moms giving birth now will most likely be at a higher risk for maternal mental health orders due to the unique nature of policies in place intended to stop the spread of COVID.
Risk factors heightened by the COVID situation include, but are not limited to:
● Inadequate support
● Financial stress
● Marital stress
● A major recent life event: loss, house move, job loss
● Feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery (risk factor for postpartum PTSD)
● Women in their childbearing years already account for the largest group with depression in the U.S
COVID, Moms and Trauma
Giving birth can be an incredibly empowering experience; it can also be traumatic- physically, emotionally, and mentally. With the restrictions, changes in policies, and actual health concerns that are present during this pandemic, moms are at risk for increased exposure to trauma and PTSD-like symptoms due to the COVID crisis.
○ Living through dangerous events and traumas
○ Exposure to actual or threatened death
○ Birth trauma during a global crisis
○ Getting hurt
○ Seeing another person hurt, or seeing a dead body
○ Childhood trauma
○ Feeling horror, helplessness, or extreme fear
○ Having little or no social support after the event
○ Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
○ Having a history of mental illness or substance abuse
○ Women are twice as likely to develop PTSD than men
Making Over Motherhood Challenge
As part of #MMHWeek2020, The Making Over Motherhood Challenge is a five day challenge to show that motherhood isn’t necessarily black and white. It’s a unique journey for every mom and the challenge is to flood social media with the reality of it all- moms need support in order to thrive. Below you’ll find a link describing the five days of the challenge, you can simply participate by following the daily prompts and using the #MMHWeek2020 and #MakingOverMotherhood hashtags!
The challenge for today is to share your story- I’ve shared quite a bit about my journey into motherhood and the births of my three children (Gabi’s Birth Story, Mila’s Birth Story, Podcast Birth Story Episodes), so I think I’ll just participate by leaving this black and white photo from my homebirth here and on my Instagram feed.