Post-partum depression is something people don't like to think or talk about, but its prevalence is alarming: about one in every nine women will go through it, according to the CDC. That PPD is often considered taboo is not surprising; pregnancy and birth are supposed to be among the happiest, most exciting and fulfilling events in a woman's life. No one wants to contemplate a different type of experience.
Let's Abandon "Normal"
But it's time we should. We need to recognize that each woman's experience bringing life into the world is unique and inextricably tied to her life context. It can go as planned or not. It can be straightforward or complex, joyful or scary, mundane or extraordinary, and anywhere in between, or all of the above. We can agree it's "the most natural thing in the world” but also acknowledge that “natural” doesn't bring with it any notion of “normal."
My Story of High-Risk Pregnancy - Everything Was Fine, at First
November 1, 1999 was one of the most gleeful days of my life - I laughed upon the discovery of not just one fetal heartbeat but two. Twins. As a twin myself, I was overcome with emotion. Wonder, joy, trepidation were some of what I documented feeling (I'm consulting my journal as I write this). My husband just shook his head in disbelief.
In the early days, I was a boring patient. Doctor visits were filled with idle chit chat as routine exams confirmed everything was fine.
Until suddenly it wasn't. Occasional contractions began at week 19, and by week 25, the babies showed alarming signs of wanting out of their confined space. Joy turned to abject fear as the nurses told me I was “in a really bad spot.” Babies born at week 25 have a 50% chance of survival.
Bed rest it was. And medication every three hours, around the clock, to tame the contractions. No trips downstairs. Short showers. The HR manager at my employer called me at home to cut me off from work completely - no, she said, I wasn't allowed to conduct any work at all, as much as I pleaded my case. The days became very long and lonely. I felt isolated and exhausted. At week 28, my doctor came clean: “I have to be brutally honest with you,” he said. “This is a very scary situation.” I cried all the way home.
By week 32, preeclampsia became the new challenge. Blood pressure medicine was added to the regimen in careful balance with the anti-contraction medicine. At week 33, I was hospitalized. Baby A was not only breech, but his cord was hanging below his body (umbilical cord prolapse), which meant I was headed for an emergency C-section should I go into labor.
Eleven days in the hospital were tough, especially as I witnessed a roommate suffer the loss of her premature twins. She hadn't received the same level of support I had throughout my pregnancy.
Delivery At Last
Finally, with lungs deemed sufficiently mature, the babies were delivered at week 35 - two tiny boys weighing a combined 9.9 lbs. And after just a week in the NICU, they came home. An indisputable success story. We were very fortunate: I had been blessed with access to a high-risk pregnancy program at one of the top health systems in the country. It's hard to imagine how badly things could have gone if I hadn't.
But the challenges continued:
- A severe allergic reaction to my pain medication added major insult to injury, and made it even more difficult to care for the boys.
- Baby A and I wound up back in the hospital as his temperature plummeted to 92 degrees. A spinal tap, IV, more pricks, and more sleepless nights in a room shared with other families and beeping machines.
- And then months of nearly sleepless nights and a level of exhaustion I hope never to experience again.
- Above all, a shocking anxiety emerged: intrusive, uncontrollable thoughts about extreme harm coming to my babies that I couldn't prevent. Daily nightmares about failing to make a specific phone call that meant the difference between life and death. I kept it to myself. I didn't want anyone to question my ability to care for my boys, especially after I had worked so hard to protect them throughout the pregnancy.
Needing More Support Beyond the Walls of Healthcare
Somehow, we all made it through over time. After several months, I returned to work and showed my colleagues happy pictures. I'm sure it all seemed completely normal.
In hindsight, even though I had access to some of the best medical care in the country, I needed more support. As one would expect, the OB/GYN doctor had focused on bringing the babies as close as possible to term, and after they were born, on making sure they were gaining weight. My primary care physician focused on my own weight gain and recovery from the C-section. No one was focused on uncovering my mental challenges - issues I kept hidden but would have gladly shared with someone I could trust to help me. My employer may have offered an employee assistance program (EAP), but if so, I wasn't aware of it at the time and it never occurred to me to find out.
Today, nearly 20 years since my boys were born, there are innovative approaches for helping women through all phases of pregnancy and beyond, including post-partum depression. Employers have access to new high-touch/high-tech solutions that offer support beyond the walls of healthcare, where pregnant women and new mothers need it most. What's more, employers have good reason to provide these solutions -- a healthier, happier employee is good for families, productivity and the bottom line.
A Webinar for HR Managers to Learn More about Supporting Women with PPD
HR Managers can learn how their organizations can provide more support for women in the workplace by tuning in to a webinar recently hosted by Ovia Health and Accolade: Not Just the Baby Blues: How Postpartum Depression Impacts Women, Babies and Employers. Clinical experts specializing in women's health and PPD address:
- What Post-Partum Depression is
- How PPD affects mom, baby and employer
- Why we don't talk about PPD
- The role employers can play in helping women with PPD
- Steps employers can take to offer better support