After an Abortion

For about six years I worked in an abortion clinic.  This generally sparks a lot of feelings in people, most of which is general curiosity.  Which I welcome!  I tend to get a lot of questions about what I did (short answer: I started out as a counselor that supported women through their procedures and eventually went on to run their counseling program), if I liked it (short answer: I loved my job) and if I felt any differently about my time there now that I have children (short answer: No. Definitely not).

At the clinic we knew that if women felt confident in their decision, felt supported by someone around them and that they weren't being coerced by anyone that they would likely cope well after their abortion.  And the largest group of psychologists in the United States agrees (read more). In fact, women are at a higher risk of mental health issues if they are denied an abortion (more on that).

The reality is, after having an abortion, most women feel a combination of sadness and relief.  But abortion is a socially charged issue and so we tend to pick apart these emotions and try to label them as right and wrong.  I remember a patient who came to see me a few weeks after her abortion who was struggling with the fact that she didn't feel more sad.  Or, those patients who were sad about their decision and a little surprised by the relief they were experiencing.

Have you ever been through a divorce or its equivalent?  Have you ever had to move to another city because of a job?  Life is full of experiences that leave us with complex and at times conflicting emotions.  We make decisions based on the information that is in front of us.  We can know with all of our hearts that it is the right decision for us and still feel sad that it is the best decision. 

I trust women.  I trust them to make decisions about their lives and their existing and future families.  I also trust that grief and healing are an individual process that look different for everyone. 

If you are finding yourself tangled in "shoulds" or lost in grief, reach out.   Find someone you can talk to who will listen, without judgment of your experience.  Because what is mentionable becomes manageable and I trust you have the ability to come out on the other side.


Maternal Mental Health Awareness Week!

It's Maternal Mental Health Awareness Week where we highlight the importance of talking about postpartum depression and anxiety, the importance of screening and intervention and the critical need for supportive legislation and funding around perinatal mental health.

Pop Quiz:  What is the most common complication of childbirth?

Answer: Pregnancy and postpartum mood and anxiety disorders.

1 in 7 women will experience pregnancy and postpartum mood disorders with one or more of their pregnancies.  That's 15-20% of all pregnancies!  But, not all women are screened for postpartum depression and anxiety.  And when they are, it's usually at their OBGYN appointment 6 weeks after they give birth...that's roughly 4 weeks after symptoms of postpartum depression and anxiety kick in!

We can do better.  YOU deserve better.  Having a baby is HARD.  And no matter what your Facebook or Instagram friends tell you, it's hard for them too.  There is no shame in the simple fact that your body just went through a complete hormonal and physical upheaval and now you're trying to figure out a whole new life with your baby. 

Wondering if what your feeling is the "baby blues" or something more?  Complete this screening tool for a little more insight.  Get a score that concerns or surprised you?  Contact a therapist who specializes in maternal mental health so that you can get back to feeling like you again.

Want to learn more about maternal mental health?  Check out this fact sheet

Want to improve MMH screening for pregnant women and families in your area?  Talk to your providers about how and when they screen for pregnancy and postpartum mood disorders.  Do you need help preparing for that conversation?  Do they need help improving their screening process?   I'm here to help.


Guest Post: Patti's Story

Today we are lucky to have a guest post by Patricia Cruz.  Patti was kind enough to share her story of pregnancy loss and postpartum depression.  She's also sharing her 10 Tips to Coping During the Postpartum Period.  I hope you find some comfort and maybe a few smiles from it.

I hate that I am writing about postpartum depression. I hate writing about it because before I had it, I honestly thought that some people were just not strong enough, or that they just couldn’t handle it and they should go for a walk and they would feel better. I grew up in the North East! We are a strong bunch! We don’t have time for “mental” problems. I remember talking to my parents when I thought it might be going on and them brushing it off and saying that I was “just tired”. I was also really, really, tired. To the point where I would cry for no reason, feel nauseous during the day and managed most days with a mild headache and a promise that “tonight just has to be better”.

I believe part of what contributed to my postpartum depression is my road to being a parent. It wasn’t easy for us to have a baby. This was my third pregnancy. The first pregnancy was lost to an early miscarriage that shook my confidence and introduced me to a world where it’s possible to have the excitement of a positive pregnancy test and that not result in a child some months later. The second pregnancy loss was shocking and heartbreaking to our family. After the miscarriage, my only concern was making it past 12 weeks, past the “danger zone”. Once I was 12 weeks pregnant I told friends and family, we celebrated out at dinner. I was assured that in the Spring our guest room would be a baby room. But it was not to be and after a devastating prenatal diagnosis, I gave birth to and lost a baby boy at 22 weeks pregnant. It was a loss that broke my heart and made me feel like I was in this category of women that just doesn’t have a good outcome. I was a reproduction loser. Friends and family around me were having children. I could mark my losses by their children’s birthdays. Attending those parties without my boy, and with no pregnancy to speak of exhausted me. I just wanted to have a baby, quietly, with no one noticing. I wanted to not have people tilt their head sideways and look at me with pity when they talked of my family.

So when I got pregnant for the third time I kept it a secret. I didn’t tell anyone until three months. And then I only told my immediate family. Some of my closest friends didn’t know until I was 20 weeks pregnant. I told people at work only after an anatomy scan at 5 months revealed that the child was healthy as far as they could see. So when I made it to 38 weeks and my son arrived, I expected to feel so much relief from the sadness I had carried. I did feel some relief that he was here safely and that I could stare at him and know he was real, and coming home with us. I remember being in the delivery room feeling like I should some sort of euphoric moment that I was not having. Instead when they put me in a wheelchair and handed me my son to go to the recovery room, I fell asleep with him in my arms. I also felt overwhelmed, tired and struggled with feeling like things should be coming “naturally” that really weren’t.

I was home with this little guy for the first three months on (unpaid) maternity leave. It was a drastic shift from working full time and feeling like an accomplished professional. We didn’t have the kind of day to day help that I had imagined and there were too many days where I didn’t talk to another adult for 8-10 hours. My husband went back to work a week after our son was born. While we both had parents we loved, they lived out of state, the closest being over two hours away. People came to visit but I felt so isolated and when they left I often felt more exhausted and really believed that no one understood what I was going through.

I reached out for help at my six week postpartum appointment. They did a screening test in the office and I “passed”.  When the doctor came in to see me and I gathered everything in me to tell him I thought I might have postpartum depression, he said “Yeah, that happens. It will go away soon”. But he was wrong. I didn’t really start to feel like myself until about nine months after having my son. And only then through a combination of exercise, sleep and therapy.  The physician’s lack of support and unwillingness to help me address this depression made me feel like I should just handle it on my own, and that it wasn’t worth it to see if perhaps I could feel better than I did. I thought maybe that’s just how everyone felt postpartum. I dreaded my son waking up, I was constantly mad at my husband and I felt like I had fallen into a hole and no one would understand or be helpful to me. I was almost unable to have any empathy for my son or anyone else. I loved him, but it was through gritted teeth, struggling just to get dressed and feel okay about the new world I was in.

I have a new little one at home now. It’s been four months and I’ve been vigilant about waiting, watching to see if any signs of postpartum depression will come back. I feel that down, terrible feeling very infrequently and usually when I am my most exhausted. Those around me reassure me that I am tired, and it’s not the same, and it will be okay. I asked them to do this for me, and also to get me help should it not be okay.  There were other things I felt like I would have done differently or did do differently this time. I made a list, because if you are tired and postpartum, I’m impressed you even read this far and you deserve a list.

Here is what I would have done differently if I could do it again.

  1. I would pump milk early on. I would start pumping around day four or five of life. I know this sounds crazy, but for me, it would have been worth it to have one stretch each day where I could have my partner feed the baby and I could sleep for 3 or 4 hours instead of 1 or 2.

  2. Speaking of milk, and this one is hard. I should have stopped nursing. It was making me miserable, I didn’t enjoy it and it was causing me to dread my son being awake because I was so nervous/scared about feeding him. I look back on this and really regret that I could have been just happily feeding him and enjoying his company instead of constantly calculating how much milk he had, if I had enough and how much time I had to eat/poop/take a walk before he needed to eat again.

  3. I would put all of my friends and family on warning. I would tell them to come over, bring me food, send meals and ask them what days they would be free for me to stop by and have them hold the baby.

  4. I would use my wonderful neighbors. I would drop the baby off to them and just go back in my house for ten minutes alone. I did this recently with my little guy, and the neighbor talked about it for weeks, and how much it meant to her to have special time with him.
  5. I would go outside. Even in the cold/rain/dreary days. Everything is worse when you are stuck inside your house. I would bundle the baby up and take the bus downtown to get something good to eat. Then I would bus it back.

  6. I would get a counselor before having the baby and make three appointments for after I had the baby. That way I would make sure that I already had someone established who I could go talk to. I would tell the counselor that I was worried about postpartum depression so she would seek me out when I tried to cancel those appointments. And if that counselor recommended medication, I would take it!

  7. I would deeply believe (still working on this one) that my body is capable of healing itself, getting back in shape and recovering but that I would need to give it time. Like 9 months of time, not three months.

  8. I would stop cleaning/cooking and caring about those things. For real. I am not uniquely qualified to do those things.

  9. I would write about it. Or find a blog where someone is writing about it and read it. I felt alone, like no one really got it.  A friend tried to tell me that she thought I had postpartum depression and it really took a toll on our friendship. I thought she was judging me and looking down on me. She was trying to help and I wasn’t ready.

  10. I would forgive myself for having postpartum depression. It has taken four years, a second child (where I didn’t have postpartum depression) and a lot of counseling to realize that I felt really guilty and struggled with feeling like I wasn’t good enough, or strong enough. I am enough. You are enough.

Patti is thankful to be a Mom to two great boys and a wife to a great husband who loves Midori sours. She writes about finding joy in unexpected places, losing her Dad to cancer, having a Mom with Alzheimer's disease and her love of baking on her blog:

When Birth Ain't All That Beautiful

Giving birth is an amazing, beautiful thing.  Except when it's not.  Or, maybe you're overwhelmingly happy that your baby is healthy and safe, but in the end the whole thing left you feeling detached... or sad that it wasn't what you imagined or worse, scared because the experience was so traumatic.

Many new moms feeling the "baby blues" may not realize that the way they feel is connected to their birthing experience. Traumatic birth experiences include feelings of helplessness, loss of control or imminent danger to you or the baby during childbirth.  

Did you feel left out of the decision making during your labor and delivery?  Was there an emergency with you or the baby? 

Consider reading more on traumatic birth and know that getting support can help you to heal and be the mom you want to be.