Bloghop! Good Catholic Moms and Maternal Depression

“This is what I’ve always wanted!  So why am I unhappy?”

This was my dominant thought when I was postpartum with my first child.  My husband and I both came from large families, and we had joyfully planned for a life like our parents’: lots of kids, starting right away, and a stay-at-home mom.  I felt shocked, angry, guilty, and disillusioned when my first year at home with my baby was horrible.

To begin with, I was bored.  I didn’t really know what to do with a newborn besides nurse him, and I didn’t know how to keep busy while I was holding him, and I felt guilty whenever I put him down.  And I do mean every time.  He would be sitting there happily, staring at the pictures on the wall, and I would look at him and think, “I’m a bad mother.”  Looking back, these were two tell-tale signs of depression: irrational guilt, and uncontrollable negative thoughts flooding my mind.  And always in the background there was the meta-guilt of my inability to enjoy motherhood the way I had pictured.

Two years later, my dread of another postpartum like that one outweighed my fear of pills, and I agreed to try antidepressants a few days after I gave birth to my second baby.  I clearly remember my ten-day checkup at the midwives’, when they asked me about my depression and I realized that I hadn’t cried AT ALL since giving birth.  Even for someone not prone to depression, that’s practically a miracle!  (I’m not trying to recommend antidepressants as a cure-all for everyone, but I do hope that anyone in this situation will consider them as a real option.)  The second step, in my case, was therapy.  The greatest gift my therapist gave me was to help sort out an identity for myself, separate from that of a wife or mother.  This allowed me to invest some energy into finding fulfillment outside of the sphere of motherhood, which is crucial.  If you’re at all prone to depression, anxiety, guilt, self-comparison, or low self-esteem (that covers just about everyone, right?), investing your self-worth entirely into some ideal of motherhood is guaranteed to invite depression.

Not everyone’s experience will be like mine, and therapy and antidepressants may not be the right course for everyone; but the important thing is to realize that something external must be done about your depression.  You can not pray or will your depression away, because its origin is not in your failings.  Maternal depression can feel like it’s your fault, because motherhood seems like something that should come naturally and easily; but this is a fallen world, and what’s natural is not always easy.  Even if motherhood is what you’ve always wanted, there is nothing wrong with needing help.

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Thank you so much to Katherine at Half Kindled for hosting this much-needed conversation!  I’m really thrilled to be a part of this.  Please read what my fellow bloggers have contributed at A Knotted Life, Call Her Happy, Half Kindled, This Felicitous Life, and Mama Needs Coffee.

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A few resources I have found helpful:

• therapy: ask your midwife or OB/GYN for a recommendation.  They may be able to give you the name of a therapist who’s been recommended by other patients in their practice.
• self-help books: I really appreciated Gregory Popcak’s book, God Help Me! This Stress Is Driving Me Crazy!, which is an extremely helpful and practical mix of tried-and-true psychotherapy techniques and spiritual advice and encouragement.  (I have a few reviews of Popcak’s books in the works.)  I haven’t read Aaron Kheriaty’s Catholic Guide to Depression yet, but it’s been recommended to me by so many trusted friends that I feel comfortable passing it on to you.  I hope to tackle it soon and review it for you.  I find this blurb extremely encouraging: “…the confessional can’t cure neuroses, nor can the couch forgive sins.  Healing comes only when we integrate the legitimate discoveries of modern psychology and pharmacology with spiritual direction and the sacraments….”
• NaPro technology.  I know many people who have been helped by NaPro, which specializes in helping women overcome infertility, postpartum depression, and other reproductive problems through natural and morally permissible means, specifically through the Creighton method of natural family planning.  I know a few people whose postpartum depression was linked to low progesterone, and NaPro doctors were able to prescribe progesterone supplements that changed their lives. Here is a website for locating NaPro doctors in your area.
• For those of you who are nervous about antidepressants during pregnancy or breastfeeding, I found these studies from Mass. General Hospital, which were given to me by my midwife, extremely comforting.

“When Did I Get Like This?”

When I was pregnant, too exhausted to read anything of substance, and desperately in need of comic relief, I searched around on my husband’s kindle and grabbed the first mommy humor book I found: When Did I Get Like This?, by Amy Wilson.  It wasn’t the self-deprecating, witty stand-up routine I was expecting: instead it was the vulnerable, candid memoir of a modern professional New Yorker, learning everything about motherhood the hard way.  This poor lady got sucked into all the popular pregnancy and motherhood myths, and had to figure everything out by herself.  Take her experience with her first pregnancy:

Today, everything from pacifiers to preschools seems to be marketed to mothers in one overarching way: this product, the ads say in one way or another, is chosen by mothers who want what is best for their children.  Well, who doesn’t want that?….But…should you ignore this new and helpful parenting suggestion, you are in effect saying that no, you do not want what is best for your children….With every step we mothers take these days, we are aware that there is only one right and true path that we should follow, a ‘better’ way to feed our baby, a ‘best birth’….

Her guilt-wracked pregnancy, complete with detailed birth plan and the infamous “Best-Odds” diet from What to Expect When You’re Expecting, ended with a revelation: doctors are not the enemy.  Her doctor, on hearing her desire to avoid fetal monitoring and stay mobile, had a gentle suggestion: “‘You may find, though, as many of my patients do, that once you are admitted to the hospital, you will be happy to lie down.'”  She comments, wonderingly: “Dr. Merman did not seem dismissive when he said this, neither rigid nor patriarchal.  He seemed, merely, kind.”  Sure enough, lying down with an epidural 11 hours into labor feels awfully good.  But when the baby is finally born, she confesses:

[Before the birth] I thought…I would become another victim of a needlessly meddling medical establishment.  But in the end,…I had an episiotomy, which the books warned me would happen to any mother who didn’t stand up for herself,….I had also had an epidural, which the books warned were foisted on all laboring mothers…[T]here was a tiny part of me thinking not of how I had made it through a twenty-hour labor to deliver a perfect baby boy, but of how I had fallen short.  I was a quitter….But lying there holding my son, I could also see that it was screwed up to regard my caregivers’ attempts to alleviate the pain and inertia of…a first labor, as the machinations of the enemy.  They had only been trying to make me feel more comfortable, trying to deliver my baby to me as soon as possible, as safely as possible.  And they had.  That could not have been wrong.

In the hands of a perfectionist like me, the birth plan was the snake in the garden, dangling the apple of an idea that there could be a ‘better’ or a ‘best’ birth, one that could in any way exceed the happy ending of a healthy baby, safe in its mother’s arms, both of them whole.

There’s a lot of other great bits in this book–I plan to write a bit more of a review later–but for now I’m going to leave it here.  I think this is such an important insight.  Sure, you have to look out for yourself, and there are ignorant or mean doctors out there; but what a horrible burden to put on a new mother, to convince her that she is the only one capable of making sure everything goes perfectly, and she had better live in suspicion and guilt for 9 months to make sure she doesn’t mess it up.

Is “Natural” Always Better?

There’s a great scene in the British show Doc Martin where the doctor finds out that some of his patients have been visiting an amateur natural medicine practitioner on the sly.  One of them is nearly killed by an herbal remedy which the natural doctor recommended to him without doing any research into his medical history, which would have shown that this particular herb is contraindicated for people with his condition.  When one of the villagers protests that he doesn’t see what could be wrong with taking something natural, Doc Martin snaps, “poison ivy’s natural, too!  You wouldn’t take that, would you?”

I’m not here to dismiss natural remedies, but I want to talk a little bit about the danger of assuming that natural necessarily means better.  When it comes to women’s health, especially, I am so tired of hearing that your body knows what it is supposed to do.  Yes, most of the time, it does.  But sometimes it screws up.  This isn’t necessarily because nature is bad, or God created us with flaws; it’s because our nature isn’t what it used to be.

Most of the time, pregnancy and childbirth go smoothly, because a woman’s body was made for that. But sometimes, your body doesn’t know how to take care of the baby, or when it’s time for him to come out.  If you sit around for 43 weeks waiting for that baby to come out naturally, he may not make it out alive.  Time for an intervention.

Most of the time, breastfeeding goes smoothly.  They tell you, “if it hurts, something is wrong.  It shouldn’t hurt.”  But sometimes, you’re doing everything right, and it just hurts anyway.  Time for…well, there’s not much you can do, but time to stop thinking it’s your fault for not doing it the way nature intended!

Sometimes, depression can be cured with changes in diet, exercise, and mental routine.  Sometimes, all you need to do is take care of your body, and it will function normally.  But sometimes, if you don’t interfere with your body, it will kill you.

Now, our bodies are still wonderful things.  It makes sense to look for natural remedies first, and to try to be in tune with the way our bodies were intended to work.  But to act as if the “natural” course is always the right course is to ignore the fact that our nature is no longer what God intended it to be.  It’s fallen.  The woman in the NFP forum, who thought that antidepressants were just as bad as artificial birth control, was mixing up “natural” with “moral.”  For her, birth control was not evil because it does violence to God’s original design for our sexuality; it was evil because it was artificial.  In reality, though, the Church doesn’t reject any artificial or technological remedies unless they interfere with the integrity of the person.  As one of my sisters pointed out, if the Church were against artificial medical remedies, she would not approve of any fertility treatments, either.

To be continued when I manage to sort out my thoughts a little more, hopefully without getting a little heretical!  I’m still trying to figure this out.  Thanks for listening!

In Case You Care…

Here are my own birth stories!  I don’t know, I like birth stories.  Feel free to skip, or to leave your own stories in the comments!

1.  Water broke early, induction wouldn’t take, labor kicked in at the last minute.  In transition, I told my husband that the priest would just have to give me a dispensation for birth control, because I was not doing this again for a LONG time.  Then I told him that I wanted some pain medication after all, and he said “well, maybe you should just wait a while and see.”  Then the midwife told me it was too late anyway, because it was time to push.  Boy, was I mad.  We hadn’t found out the sex of the baby, and I kept asking, until my poor dazed husband (it was 4 in the morning) said, “I think it’s a boy.”  After it all, my midwife said, “well, Rosie, you did it your way” (meaning without pain meds).  I snapped, “I don’t care!”  Suddenly I realized that it really didn’t matter–I had a baby!

2. Had her about 45 minutes after we got to the hospital.  I had just gotten into the nice warm jacuzzi when my water broke and I had to get out and push, darn it.  Came out in three pushes.  Good girl.  Even though she came out so easily, I felt guilty because I hadn’t pushed as hard as I possibly could.  Gotta feel guilty about something, right?

3.  Went in on Halloween night because I thought I was in labor, spent a couple of hours galloping around the hallways, looking ridiculous, got sent home.  A week later, my water broke, at full term this time.  By the time I checked in, I was shaking uncontrollably with panic, and labor had barely begun.  Epidural!  Why didn’t I do this before!  Slept through my Pitocin-induced contractions, woke up, and it was time to have the baby.  10 minutes and she was out, even though her shoulder got stuck on the way because she was 2 pounds bigger than my other babies.  Made up for the horrible pregnancy by coming out fast and almost immediately sleeping through the night.

What is a “Good Birth”?

My husband and I often talk about how much we plan to shelter our children.  We both know families whose kids have been completely sucked into the worst of pop culture; but we seem to know even more families whose attempts at sheltering their kids backfired badly.  When the kids finally encountered the real world, they often rebelled or succumbed to the worst, because they had not had the benefit of knowledge or exposure to build up their defenses.  (I’m being vague here, because I don’t mean to criticize any of the parents I knew, who were certainly doing their best!  But I have experience with all the examples in this post.)  I have seen parents be so scared of inappropriate sex education that they barely gave their children any at all.  The kids had to learn it on their own, either through experience, or through less reputable sources than their parents or teachers.  There is also the danger of sex being seen as something “dirty” that you don’t talk about, which leads to a really unhealthy attitude toward sex.

What I’ve realized lately is that this is not just a problem for children, but for adults as well.  In my last post, I talked about the dangers of sheltering women from the realistic expectations of pregnancy.  I see something very similar happening with childbirth.  Women are assured that, with the proper “birth plan,” they can achieve the perfect “birth experience.”  Now, I know that I have been very lucky: my midwives and nurses were respectful and considerate, and I was never pushed into something I was not comfortable with.  However, I have also heard of so many women who were led to believe that they could have a low-intervention, peaceful, joyful natural birth, only to be crushed when necessity dictated otherwise.  Once again, we’re setting women up for shame and guilt. No matter how much we understand rationally that a C-section, or an induction, or an epidural may be necessary, that nagging little voice inside our head will say “you’re taking the easy way out” or “you’re not letting your body do what it’s made to do” or “you’re giving in;” but if we’ve let our expectations become completely unrealistic, we are feeding that irrational guilt.

The friend I quoted in my last post made the same connection between pregnancy and childbirth expectations; after commenting on the importance of your “attitude” and “focusing on the positive,” she noted that “the people who helped me have a good birth were the ones who kept telling me a good birth was actually possible.”  Now: how do you define a “good birth?”  A birth that goes as planned?  A birth that is peaceful and expected?  Or a birth that results in a healthy baby?  If you only tell a pregnant woman stories of ideal births, how will she feel when her labor fails to progress, and her baby is in distress?  Google “birth disappointment.”  I have seen so many sad stories of women who felt horribly disappointed in themselves because they “gave in” and got the epidural, or because they had to have a C-section.  Instead of fully enjoying the baby, they feel a sense of loss and grieving. They may feel, like this poor lady, that “this was my fault” because their bodies are “broken.” 

[A side note: yes, your body is broken!  But it’s because of Original Sin.  This is why it doesn’t make sense to me to expect childbirth, or sex, or breastfeeding, to go perfectly just because it’s natural and it’s “what our bodies were made to do.”  Our bodies, like everything else in the world, sometimes don’t do what they were made to do.  If we put all our faith in “nature,” we are going to be let down because our nature is broken.]

Again, I am not recommending that we flood pregnant women with horror stories!  But imagine that we tell them something like this instead: “My first was born naturally, and it was wonderful!  My second had to be induced, and I was hooked up to 3 IVs, and that was pretty awful.  But you know what?  I didn’t even care, because then I got to hold my beautiful baby.”  Or this: “I was really loopy after the pain meds, so I don’t really remember the birth well, but we had nice quiet cuddling time afterwards.”  Or this: “The epidural worked great for my first, and failed for my second.  But either way, I got through it.”  Let’s give them realistic expectations, so they’ll be prepared; but let’s always remember to finish up with the most important part: the baby.  A good pregnancy is a pregnancy that ends in a good childbirth, and a good childbirth is one where the baby gets born.  Period.  Natural birth, water birth, home birth, epidural, induction, C-section, forceps, IV, hypnosis, episiotomy, whatever–I wish you a peaceful and pleasant birth, but please remember that no matter what your “birth experience,” the main thing is getting that baby safely into your arms!

 

Should We Shelter? (updated)

After I first read Rebecca Frech’s crisis pregnancy post, I shared it on Facebook with some reflections that eventually became my own contribution to the conversation.  One of my friends agreed with the main point of the post, but said she didn’t think it was a good idea to speak to unmarried or newly pregnant women about the potential trials of pregnancy.  She said she liked to “just focus on the positive” and “shield young ([especially] non mothers or unmarried) girls from too much talk of how hard it could be.”

I understand where she’s coming from.  After all, plenty of women are already afraid of pregnancy and parenthood, without us adding to it.  But if women are surrounded by messages that pregnancy is supposed to make you feel natural and empowered and joyful and radiant, what’s going to happen when they get pregnant unexpectedly?  In addition to the surprise, (and the heartburn, and the nausea, and the sciatica, and the weight gain, and the carpal tunnel, and the varicose veins, and the insomnia…) they are going to feel horribly guilty about their mixed emotions.  They will feel alone, because everyone else seems to be handling pregnancy just fine.  And this fear and guilt and loneliness will push them a little closer towards abortion.

I am not recommending that we just focus on the negative; I’m talking about giving women the whole picture.  We need to be giving women a three-part message: (1) pregnancy can be horrible, and that’s normal; (2) you are not alone, and we will support you; and (3) pregnancy is worth it.  Shielding them is not going to help them deal with the inevitable trials of pregnancy; but because we’re also letting them know that the baby is worth the suffering, we’re giving them the tools they need to get through it.

My friend explained that the other reason she believed in “focusing on the positive” was that “attitude is huge in determining whether [pregnant women] will have a good time or a hard time of it.”  Now, as far as I understand, this has some psychological truth behind it; being positive really does help us with deal with rough times.  But when it comes to the experience of pregnancy, which is so emotional and life-changing, and varies so much from woman to woman, I think this is an extremely dangerous idea.  If someone had told me that I should try to have a more positive attitude during my last pregnancy, I would have been very angry, because it sounds unsympathetic: “if you weren’t so negative, you would feel better!”  And I would have felt guilty.  Inside me, a little voice would repeat that advice over and over again, whispering, “this is all your fault.  If you weren’t such a wimp, and if you were more open to life, you wouldn’t be complaining.”  Now let me tell you: this pregnancy was so bad that at one point this thought entered my mind: “if this was torture, I would have given in long ago and done everything they wanted me to.”  No amount of good attitude is going to help with that.  Now imagine a woman who has it much worse than me: maybe she has hyperemesis gravidarum, maybe she’s homeless, maybe she’s being abused by her boyfriend; do you think we did her a favor by telling her that pregnancy would be fine if she had a good attitude?

There’s more to say, but I think I’m in enough trouble for today.  Tomorrow or the day after I’d like to talk a little bit about the effects of sheltering people when it comes to sex education and preparing for childbirth.

EDITED TO ADD:

I don’t mean to criticize my friend who suggested focusing on the positive. I know she has our best interests in mind, and would never come out and say “if you’re having a hard time, it’s your fault.”  However, the insidious voice inside my head hears it that way.  Even when we mean well, we need to be very careful what we say to pregnant women–guilt and shame are always waiting in the wings.