I think it’s both a subject that saturates the type of media and websites that pregnant women and new moms consume and is also completely absent from other discussions of mental health that aren’t primarily aimed at women who plan to become pregnant or are pregnant.
I have known quite a few women that have gone though postpartum depression but none of them directed their anger or depression at the white male patriarchy. Maybe there are two topics here to discuss?
Yes, and that kind of demented politically-performative wailing is why I still sometimes worry that "feminists" might be an alien species, despite knowing several sensible, sassy, and down-to-earth ones. "I'm glad you didn't have a sex-selective abortion, but why didn't you?" is what I'd be thinking but not saying if I had to deal with someone like that in real life.
At the same time, politically-performative wailing happens on both political sides of the "mommy wars". Among the army of full-time Trumpist pundettes, for example, are some that, before Trump's rise, bewailed having delayed childbearing for the sake of their careers. Then MAGA happened and their careers *really* took off. They're not bewailing the career track anymore. Funny, that.
I doubt it's possible to have "mommy wars" without performative cringe.
It is offensive. More offensive would be if she had an abortion because the baby was male (or female). If having a non-white baby is so important to her, then she needs to get knocked up (can that still be said -? IDK) by a non-white sperm donor. How virtuous she would be.
I could relate to the envy in "She told me she particularly hated... how peacefully he slept. ‘There is nothing worse than the undisturbed sleep of a white man in a patriarchal world.’”
I felt petty resentment toward my husband's "sleep superpowers" while I was miserably peripartum, too, though I didn't think of my envy as political.
I did harbor political resentment toward a certain type of pro-life mommyblogger that insisted -- with the best of intentions, I'm sure -- that "pregnancy is not a disease": that it's a perfectly natural and healthy state that women who've taken care of themselves have no reason to fear. The whole idealization of motherhood as the ultimate sacrifice, on the one hand, but also no sacrifice at all on the other (because it's what you and your body were "meant to do", because (it was often insinuated) all it takes to achieve healthy pre- and post-partum states is sufficient discipline, because any worthwhile woman will find it more fulfilling than anything...) grated on me.
I did experience pregnancy as a "disease", that is, as something my particular body was *not* set up to do "naturally", and while that can be attributed to underlying conditions, I didn't earn those conditions through lack of discipline. Instead, I entered my childbearing years quite fit and physically disciplined considering their presence -- then childbearing "broke" me for a while.
The term "kyriarchy" is intended to extend "the patriarchy" beyond gender. I'm not a serious feminist, but at least where these particular mommybloggers were concerned, I began to see why the label "kyriarchy" might stick. I had some loose professional relationships with them, and, while I think their intention was to buck other women up, to make being a "good mom" seem within every ordinary woman's reach and carrying a pregnancy to term seem unfrightening (and abortion therefore less attractive), the effect of such seemingly oblivious cheerleading on someone already suffering was the opposite, isolating and shaming.
Did I resent my husband politically? Or men as such? Nope. The "kyriarchy"? Justaweelittlebit. Sometimes.
Sherri - our next door neighbor, Mormon, mother of five, nine-months pregnant... I left for work and she was out tending her front-yard garden. I came back from work at the end of the day and she was out tending her front-yard garden. I parked and came inside and my wife said "did you hear that Sherri had her baby?"
I think I said "now, there is a woman!"
She did not ever seem the slightest bit oppressed.
The vast majority of my waking moments are spent feeling not in the least oppressed by "the man" or "the system".
But I do face concrete limitations I did not "earn" and therefore will find it slightly "oppressive" when the conservative mommysphere (whom I used to work with, as I said) cannot bring itself to be honest about what motherhood may be like, even for the "good girls".
I have no wish to take joy, health, and social support away from Mormon mothers who can garden without trouble (and I can't be sure Sherri had no trouble, just that you did not see it) immediately before and after giving birth.
I could not honestly convert to Mormonism myself, since it would require confession to things I cannot honestly believe, but I think there's much to be said for the Mormon support of family life. (It's not all rosy. There can be abuses. But, until our plans changed, my husband and I had planned to move to where the Mormons were to raise our family, and I was mostly looking forward to it.)
There's nothing wrong with admiring strong, healthy women who seem untroubled by childbearing. There is something wrong, logically and morally, with supposing all "sufficiently virtuous" women get to be those women.
True, but I find it completely impossible to believe that "I wouldn't have said that if I wasn't depressed" would be an effective magic spell to invoke for a white guy caught saying something offensive about a protected minority group.
If anybody is both crass and stupid enough to criticize her, I will formally apologize for judging you for periodically pitching a shit fit about the junior high school antics of this comments section, where I can be found smoking in the back.
Scrolling through old photos today for a project, I saw myself with my young babies and was shocked by how decent I looked. Not that I'm Gisele Bundchen, but I thought *at the time* that I was a hideous husk of the woman I was before. Now I've reached a point of motherhood that includes such self-care practices as painting my nails and thinking about one day possibly joining the Y.
I've heard a lot of mothers complain about lack of sleep or lack of time. Is this not a problem that could be solved with money, i.e., hire a nanny/night nanny, or spend a few nights in a hotel to catch up on sleep?
I understand that not everyone has that much money, and some people might feel obligated to stay with the baby at night to breastfeed. But am I being naive to think that if you have money and are not wedded to only breastfeeding, this would be less of a problem?
It is in theory, but it's not a minor amount of money (a regular teenager-type babysitter around here in small town PA is $17-20/hr) and small babies are just so, so needy. Not just for milk but for parental affection. Every parent I've known has felt horrible leaving them with someone else early on...and also craved it incredibly...leading to the confused brain-breaking guilty doublethink of PPD.
Anyway, I needed this post today. I'm sure as Phoebe said the physical effects of pregnancy can play a big part in it, but you can also get PPD as a father, or an adoptive parent (or both). It's just such a major life change and the crash from "wanting this so very badly" to "what have I done with my life" is pretty severe.
Newborns wake up to feed every couple of hours, and crucially, many will not sleep alone. They cry unless someone holds them. This would be fine if we could curl up with our babies and co-sleep, but NOPE that’s unsafe because of SIDS.
If you’re breastfeeding, you have to nurse or pump every few hours. And even if you’re not, you can easily spend 24 hours trying and failing to get the baby to sleep on his own. If your baby isn’t a good sleeper, and you don’t have someone who can take shifts, you’re fucked. My spouse only got one week of leave, so we had to split the night in half.
In theory, I could have hired someone. I was committed to breastfeeding, so I didn’t. Also it would have been emotionally difficult when I knew my baby was crying for me. It sounds easy to hire someone, but it means not breastfeeding and spending a lot of money (my son didn't start sleeping on his own until 5 months--not through the night, just on his own at all.)
>It sounds easy to hire someone, but it means not breastfeeding and spending a lot of money...
That actually...sounds pretty easy. I mean, it's costly, but I think a reasonable person would do a lot to avoid chronic sleep deprivation. Because sleep deprivation is just horrible—it lowers your IQ, feels terrible, it can trigger or worsen mental illness and it's dangerous if you ever need to drive or make important decisions. I've heard the cost of a night nurse estimated at 800/week, and I'd pay that.
But I also would never tolerate a partner who took only one week of leave! So sorry you had to deal with that level of disengagement.
I had enough money for this, and we had a wet nurse for a couple weeks for our 2nd kid. It’s tough to explain why it didn’t work well. It was upsetting for my wife, and even me a little. It just didn’t feel right. Not looking after your baby can feel worse than the lack of sleep. Plus as others have pointed out, it doesn’t work out as smoothly as you’d imagine.
Really the best thing is to have parents and friends near by to help out and give you a break every once and a while.
Having someone who can come over and wash the dishes, do your laundry or just hold the baby for 2-3 hours while you get uninterrupted sleep is a life saver. Those first 6-10 weeks can be very difficult, especially with the first child.
If you haven’t experienced PPD, this might seem like a good solution. In my case, my PPD robbed me of the ability to sleep. It wouldn’t have mattered if there had been a nurse there to help. I had so much anxiety that as I was dropping off to sleep, if I heard even the tiniest rustle somewhere in the apartment, I would get a huge adrenalin rush, my heart would race (and not stop for hours), and all hope of sleeping was over for the night.
I looked into a night nanny, thinking we could spend the money to have someone come over once a week to watch the newborn all night. Then, we could at least have one night of sleep a week. No one would not come unless they were hired for at least 5 days a week, and it was too expensive.
First off, a lot of people who can hire a night nanny... do hire one. This is a thing, someone in my prenatal class did this, a wealthy acquaintance in my neighborhood also did, doubtless more people I'm not thinking of/who don't advertise it. It's a problem some absolutely do address with money.
I say "address" but not solve because... yes there are reasons even some who can afford this route don't take it. The part at the beginning where you stay up all night is... a bonding experience with the baby and in a way with your partner? A rite of passage?
And then there's the kicking-can-down-the-road aspect, where (I'd imagine) if you get used to someone else dealing with baby-stuff at night, and then are suddenly dealing with it on your own. Unless it's a Downton Abbey situation where the help never ends!
Thanks for writing this. My girlfriend worries deeply about the experience of birthing a child, I worry deeply for what her mental health and her outlook would be after the fact (and y’know, while being pregnant too). I think she may appreciate your perspective.
I do think there is a stigma to PPD. Which seems weird because yes it is a very commonly discussed issue, but also it feels sometimes like unless it is incredibly severe, it’s not quite regarded as a real mental health issue in the way other depressions are. There’s sort of the idea that it’s something that privileged women spend their time navel gazing about and underprivileged women just deal with. Sort of like a midlife crisis. Or maybe I only felt that way because of some of the feelings of undeservingness you discuss in your piece. At any rate, PPD with my oldest daughter was one of the pivotal crises of my life. The depths of mental deterioration I sunk to are something I dislike thinking about now, but for how bad it was I recovered very quickly when I got help. For me it was therapy, medication, and a change in circumstances that were making life unbearable for me. In that sense I do think modern life and lack of close social relationships can exacerbate or make more common a disorder that most definitely also has physiological origins.
I totally agree there is a stigma to PPD. I had postpartum anxiety that I didn’t recognized until I found myself unable to sleep because I KNEW if I fell asleep my 9 month old would stop breathing and I would have caused it. And I’m very sure I didn’t recognize what was going on sooner because I did believe that it was just comfortable women feeling sorry for themselves because their lives had changed. And sometimes it is that. But its also a real crisis, that is probably linked to sleep deprivation, underlying brain physiology, hormonal changes, and our modern disconnectedness.
In hindsight (more than a decade and a half later), I was probably dealing with postpartum depression and anxiety, but it just didn't feel like a relapse soul-crushing depression I was used to, there were all kinds of situational things I could use to excuse it (no financial cushion because I'd ended up with an expensive high-risk pregnancy, weeks bed rest, and a lot of income loss, as I wasn't able to work a full 40 a week, etc.), and I could explain away the anxiety, after all.
This: "What I want from life but don’t have is salient, not what’s objectively going well. The parent-acquaintances who prefer one another to me I think about, not the ones who’ve asked for my contact info so we can meet up for coffee. I become immature, caring a way I had not thought I was capable of, past age 12, what people I don’t particularly like think about me. I am an unpopular middle schooler but one who is well into her 30s"
That is painfully, painfully familiar. I was emotionally fragile and petty, and, I will shamefully admit, I'm still bitter about the tiny slights and my ignored awkward efforts at asking for company or help, where my desire to not be a burden or a bother probably made them invisible efforts to the people outside my head. I loved my baby (and still love my now-teen), she was the absolute best, but man, I spent too much of her babyhood feeling like an isolated, pathetic failure with no social skills.
Guest post about how deeply sad 'Keeping Up Appearances' is please! (On watching it for the last time properly a few months back, I found the stuff with the Major genuinely disturbing - I have near endless pity for Hyacinth, she's kind of the British Peggy Hill!)
Hatred of the patriarchy ... I'm constantly beside-myself that people can engage in racial hatred, yet somehow delude themselves that they're not in-fact racists, despite practicing racism. Would it be unracist to hate Chinese people if we coined the term Sinoarchy?
Goes to show you, the easiest people to delude is ourselves.
Thank you for sharing this. I’m glad you found an antidepressant that helps and that you’re seeking a more effective dose.
I hope anyone with similar experiences or concerns will consider seeing a reproductive psychiatrist. Regular doctors and psychiatrists often don’t know what they’re doing when it comes to pregnancy.
For years, doctors told women to go off their psych meds for pregnancy and breastfeeding. The guidance was to suck it up for 9 months because medication might harm the baby.
Now we know this is wrong. There are many psych meds that carry minimal risk to the baby, and going off meds is often a terrible idea for the mother AND the baby. Unhealthy choices aren’t good for the baby. High stress hormones aren’t good for the baby. It’s a myth that suffering for 9 months is the best thing you can do for your child.
I tell everyone, if your doctor says to stop taking your psych meds for pregnancy, see a reproductive psychiatrist. They will tell you the latest research on every medication and explore alternatives if necessary, but they won’t just say “stop everything.”
My original psychiatrist told me to go off *Zoloft.* One of the safest psych meds for pregnancy. Fortunately, my spouse is a psychiatrist so she told me “Yeah that’s wrong. See a reproductive psychiatrist.” And it made a huge difference for me. I kept my anxiety under control throughout pregnancy and the stressful newborn months (when I was terrified of SIDS).
As always, I just wonder how difficult finding and gaining access to such a psychiatrist would be for the average person. I was literally suicidal and barely functioning after having my first kid, and unfortunately I did not have the resources I have now and was being seen in a community clinic for primary care. I called them and they told me they couldn’t get me into any therapist for 9 weeks. I ended up going to urgent care and they still didn’t give my a psych referral but told me to try matching with a therapist through my work’s EAP.
It’s an unfortunate irony that finding a mental health provider is incredibly difficult and takes the kind of executive functioning skills and resources that people in a crisis most lack.
Yes, this is a huge problem. It's hard to find someone if you don't live near a city, and many reproductive psychiatrists do not take insurance. They have a rare speciality, so they can afford it. I am lucky that I lived in a major city, and I was able to find someone through a university.
I had suicidal prenatal depression that seemed to be triggered by, of all things, asthma. That is, we eventually realized during my first pregnancy that the times when hurling self and the poor unborn one with the misfortune to have me as a mom off a cliff seemed like a good idea corresponded with my lung function deteriorating into the "yellow zone" or worse. I also had weird rheumatic problems pre- and post-partum thanks to a congenital thing diagnosed only after my first kid.
Both hospital systems I received maternal care through are reputed to be excellent, and both *can* give excellent pre- and post-natal care (psychiatric care tends to be self-pay but affordab-ish). I got some excellent care, but also some crappy care -- including enough episodes of simply not being believed or my basic comfort and function not being valued "because the baby should still be OK" that I stopped wanting to go back.
Any interruption to continuity of psychiatric care can blow it all to hell, in my experience, risking whoever you redo intake with trying to rediagnose you with red herrings that have already been ruled out.
One of the benefits of consolidated hospital systems with electronic medical records should be that Provider A within the system shares your whole chart with Provider B, so that if you have conditions C, D, E... every provider is alerted to all of them, so that the Specialist in C doesn't have to assume a complaint is caused by C when it's fairly obviously attributable D.
Yeah, no. Especially, it seems, not where psychiatry is concerned. I had some good care, then lost it during COVID because the provider left the system. I would describe re-intake as positively demeaning to me as a patient and mom as well as unmedical (seeming lack of awareness of the basics right at the top of my chart!).
Despite aspirations to world-class pre- and post-natal care for moms, including psychiatry, in these hospital systems, resources have simply been too strained since COVID to deliver.
My wife struggled a lot after the birth of our first son (had a pretty traumatic birth experience that led to significant physical recovery time). Our pediatrician was great, saw the signs, and got her to someone who could help.
Excellent advice. One destructive myth in our Puritanical culture is that suffering is good, and that if something makes your experience somewhat easier, it must be harmful or wrong. Now that you mention it, why DO doctors worry about medications and not about cortisol?!
This was fucking spectacular. It speaks to the postpartum depression I experienced (and, likewise, had been sort of unsure about whether it "counted" as such) much more than anything else I've ever read. Perhaps it's cliche to say, but good lord, I feel relieved that I'm not the only one.
There's a twist after that, you should keep reading.
Perhaps literally, yea. I just figured she was being snarky there.
I think it’s both a subject that saturates the type of media and websites that pregnant women and new moms consume and is also completely absent from other discussions of mental health that aren’t primarily aimed at women who plan to become pregnant or are pregnant.
I have known quite a few women that have gone though postpartum depression but none of them directed their anger or depression at the white male patriarchy. Maybe there are two topics here to discuss?
Yes, and that kind of demented politically-performative wailing is why I still sometimes worry that "feminists" might be an alien species, despite knowing several sensible, sassy, and down-to-earth ones. "I'm glad you didn't have a sex-selective abortion, but why didn't you?" is what I'd be thinking but not saying if I had to deal with someone like that in real life.
At the same time, politically-performative wailing happens on both political sides of the "mommy wars". Among the army of full-time Trumpist pundettes, for example, are some that, before Trump's rise, bewailed having delayed childbearing for the sake of their careers. Then MAGA happened and their careers *really* took off. They're not bewailing the career track anymore. Funny, that.
I doubt it's possible to have "mommy wars" without performative cringe.
It is offensive. More offensive would be if she had an abortion because the baby was male (or female). If having a non-white baby is so important to her, then she needs to get knocked up (can that still be said -? IDK) by a non-white sperm donor. How virtuous she would be.
I could relate to the envy in "She told me she particularly hated... how peacefully he slept. ‘There is nothing worse than the undisturbed sleep of a white man in a patriarchal world.’”
I felt petty resentment toward my husband's "sleep superpowers" while I was miserably peripartum, too, though I didn't think of my envy as political.
I did harbor political resentment toward a certain type of pro-life mommyblogger that insisted -- with the best of intentions, I'm sure -- that "pregnancy is not a disease": that it's a perfectly natural and healthy state that women who've taken care of themselves have no reason to fear. The whole idealization of motherhood as the ultimate sacrifice, on the one hand, but also no sacrifice at all on the other (because it's what you and your body were "meant to do", because (it was often insinuated) all it takes to achieve healthy pre- and post-partum states is sufficient discipline, because any worthwhile woman will find it more fulfilling than anything...) grated on me.
I did experience pregnancy as a "disease", that is, as something my particular body was *not* set up to do "naturally", and while that can be attributed to underlying conditions, I didn't earn those conditions through lack of discipline. Instead, I entered my childbearing years quite fit and physically disciplined considering their presence -- then childbearing "broke" me for a while.
The term "kyriarchy" is intended to extend "the patriarchy" beyond gender. I'm not a serious feminist, but at least where these particular mommybloggers were concerned, I began to see why the label "kyriarchy" might stick. I had some loose professional relationships with them, and, while I think their intention was to buck other women up, to make being a "good mom" seem within every ordinary woman's reach and carrying a pregnancy to term seem unfrightening (and abortion therefore less attractive), the effect of such seemingly oblivious cheerleading on someone already suffering was the opposite, isolating and shaming.
Did I resent my husband politically? Or men as such? Nope. The "kyriarchy"? Justaweelittlebit. Sometimes.
Sherri - our next door neighbor, Mormon, mother of five, nine-months pregnant... I left for work and she was out tending her front-yard garden. I came back from work at the end of the day and she was out tending her front-yard garden. I parked and came inside and my wife said "did you hear that Sherri had her baby?"
I think I said "now, there is a woman!"
She did not ever seem the slightest bit oppressed.
The vast majority of my waking moments are spent feeling not in the least oppressed by "the man" or "the system".
But I do face concrete limitations I did not "earn" and therefore will find it slightly "oppressive" when the conservative mommysphere (whom I used to work with, as I said) cannot bring itself to be honest about what motherhood may be like, even for the "good girls".
I have no wish to take joy, health, and social support away from Mormon mothers who can garden without trouble (and I can't be sure Sherri had no trouble, just that you did not see it) immediately before and after giving birth.
I could not honestly convert to Mormonism myself, since it would require confession to things I cannot honestly believe, but I think there's much to be said for the Mormon support of family life. (It's not all rosy. There can be abuses. But, until our plans changed, my husband and I had planned to move to where the Mormons were to raise our family, and I was mostly looking forward to it.)
There's nothing wrong with admiring strong, healthy women who seem untroubled by childbearing. There is something wrong, logically and morally, with supposing all "sufficiently virtuous" women get to be those women.
When you are depressed you aren't going to rational about a lot of things.
True, but I find it completely impossible to believe that "I wouldn't have said that if I wasn't depressed" would be an effective magic spell to invoke for a white guy caught saying something offensive about a protected minority group.
Phoebe is a guest columnist here; that means she is a guest, here in my place. So treat her like one. Criticize if you'd like, but do it respectfully.
Thanks for introducing her! I also subscribe to Phoebe's substack.
If anybody is both crass and stupid enough to criticize her, I will formally apologize for judging you for periodically pitching a shit fit about the junior high school antics of this comments section, where I can be found smoking in the back.
i'm going to do the thing that mr deBoer asked us not to and type something peripheral but certainly off-topic.
i adore Maltz Bovy's writing and Rosenfield's as well.
that is all.
Scrolling through old photos today for a project, I saw myself with my young babies and was shocked by how decent I looked. Not that I'm Gisele Bundchen, but I thought *at the time* that I was a hideous husk of the woman I was before. Now I've reached a point of motherhood that includes such self-care practices as painting my nails and thinking about one day possibly joining the Y.
I've heard a lot of mothers complain about lack of sleep or lack of time. Is this not a problem that could be solved with money, i.e., hire a nanny/night nanny, or spend a few nights in a hotel to catch up on sleep?
I understand that not everyone has that much money, and some people might feel obligated to stay with the baby at night to breastfeed. But am I being naive to think that if you have money and are not wedded to only breastfeeding, this would be less of a problem?
It is in theory, but it's not a minor amount of money (a regular teenager-type babysitter around here in small town PA is $17-20/hr) and small babies are just so, so needy. Not just for milk but for parental affection. Every parent I've known has felt horrible leaving them with someone else early on...and also craved it incredibly...leading to the confused brain-breaking guilty doublethink of PPD.
Anyway, I needed this post today. I'm sure as Phoebe said the physical effects of pregnancy can play a big part in it, but you can also get PPD as a father, or an adoptive parent (or both). It's just such a major life change and the crash from "wanting this so very badly" to "what have I done with my life" is pretty severe.
Newborns wake up to feed every couple of hours, and crucially, many will not sleep alone. They cry unless someone holds them. This would be fine if we could curl up with our babies and co-sleep, but NOPE that’s unsafe because of SIDS.
If you’re breastfeeding, you have to nurse or pump every few hours. And even if you’re not, you can easily spend 24 hours trying and failing to get the baby to sleep on his own. If your baby isn’t a good sleeper, and you don’t have someone who can take shifts, you’re fucked. My spouse only got one week of leave, so we had to split the night in half.
In theory, I could have hired someone. I was committed to breastfeeding, so I didn’t. Also it would have been emotionally difficult when I knew my baby was crying for me. It sounds easy to hire someone, but it means not breastfeeding and spending a lot of money (my son didn't start sleeping on his own until 5 months--not through the night, just on his own at all.)
>It sounds easy to hire someone, but it means not breastfeeding and spending a lot of money...
That actually...sounds pretty easy. I mean, it's costly, but I think a reasonable person would do a lot to avoid chronic sleep deprivation. Because sleep deprivation is just horrible—it lowers your IQ, feels terrible, it can trigger or worsen mental illness and it's dangerous if you ever need to drive or make important decisions. I've heard the cost of a night nurse estimated at 800/week, and I'd pay that.
But I also would never tolerate a partner who took only one week of leave! So sorry you had to deal with that level of disengagement.
I had enough money for this, and we had a wet nurse for a couple weeks for our 2nd kid. It’s tough to explain why it didn’t work well. It was upsetting for my wife, and even me a little. It just didn’t feel right. Not looking after your baby can feel worse than the lack of sleep. Plus as others have pointed out, it doesn’t work out as smoothly as you’d imagine.
Really the best thing is to have parents and friends near by to help out and give you a break every once and a while.
Having someone who can come over and wash the dishes, do your laundry or just hold the baby for 2-3 hours while you get uninterrupted sleep is a life saver. Those first 6-10 weeks can be very difficult, especially with the first child.
If you haven’t experienced PPD, this might seem like a good solution. In my case, my PPD robbed me of the ability to sleep. It wouldn’t have mattered if there had been a nurse there to help. I had so much anxiety that as I was dropping off to sleep, if I heard even the tiniest rustle somewhere in the apartment, I would get a huge adrenalin rush, my heart would race (and not stop for hours), and all hope of sleeping was over for the night.
I looked into a night nanny, thinking we could spend the money to have someone come over once a week to watch the newborn all night. Then, we could at least have one night of sleep a week. No one would not come unless they were hired for at least 5 days a week, and it was too expensive.
First off, a lot of people who can hire a night nanny... do hire one. This is a thing, someone in my prenatal class did this, a wealthy acquaintance in my neighborhood also did, doubtless more people I'm not thinking of/who don't advertise it. It's a problem some absolutely do address with money.
I say "address" but not solve because... yes there are reasons even some who can afford this route don't take it. The part at the beginning where you stay up all night is... a bonding experience with the baby and in a way with your partner? A rite of passage?
And then there's the kicking-can-down-the-road aspect, where (I'd imagine) if you get used to someone else dealing with baby-stuff at night, and then are suddenly dealing with it on your own. Unless it's a Downton Abbey situation where the help never ends!
Thanks for writing this. My girlfriend worries deeply about the experience of birthing a child, I worry deeply for what her mental health and her outlook would be after the fact (and y’know, while being pregnant too). I think she may appreciate your perspective.
I do think there is a stigma to PPD. Which seems weird because yes it is a very commonly discussed issue, but also it feels sometimes like unless it is incredibly severe, it’s not quite regarded as a real mental health issue in the way other depressions are. There’s sort of the idea that it’s something that privileged women spend their time navel gazing about and underprivileged women just deal with. Sort of like a midlife crisis. Or maybe I only felt that way because of some of the feelings of undeservingness you discuss in your piece. At any rate, PPD with my oldest daughter was one of the pivotal crises of my life. The depths of mental deterioration I sunk to are something I dislike thinking about now, but for how bad it was I recovered very quickly when I got help. For me it was therapy, medication, and a change in circumstances that were making life unbearable for me. In that sense I do think modern life and lack of close social relationships can exacerbate or make more common a disorder that most definitely also has physiological origins.
I totally agree there is a stigma to PPD. I had postpartum anxiety that I didn’t recognized until I found myself unable to sleep because I KNEW if I fell asleep my 9 month old would stop breathing and I would have caused it. And I’m very sure I didn’t recognize what was going on sooner because I did believe that it was just comfortable women feeling sorry for themselves because their lives had changed. And sometimes it is that. But its also a real crisis, that is probably linked to sleep deprivation, underlying brain physiology, hormonal changes, and our modern disconnectedness.
'Twitter was for the people who were in the game, who counted."
This is the for sale baby shoes never worn of the 21st century.
In hindsight (more than a decade and a half later), I was probably dealing with postpartum depression and anxiety, but it just didn't feel like a relapse soul-crushing depression I was used to, there were all kinds of situational things I could use to excuse it (no financial cushion because I'd ended up with an expensive high-risk pregnancy, weeks bed rest, and a lot of income loss, as I wasn't able to work a full 40 a week, etc.), and I could explain away the anxiety, after all.
This: "What I want from life but don’t have is salient, not what’s objectively going well. The parent-acquaintances who prefer one another to me I think about, not the ones who’ve asked for my contact info so we can meet up for coffee. I become immature, caring a way I had not thought I was capable of, past age 12, what people I don’t particularly like think about me. I am an unpopular middle schooler but one who is well into her 30s"
That is painfully, painfully familiar. I was emotionally fragile and petty, and, I will shamefully admit, I'm still bitter about the tiny slights and my ignored awkward efforts at asking for company or help, where my desire to not be a burden or a bother probably made them invisible efforts to the people outside my head. I loved my baby (and still love my now-teen), she was the absolute best, but man, I spent too much of her babyhood feeling like an isolated, pathetic failure with no social skills.
Guest post about how deeply sad 'Keeping Up Appearances' is please! (On watching it for the last time properly a few months back, I found the stuff with the Major genuinely disturbing - I have near endless pity for Hyacinth, she's kind of the British Peggy Hill!)
I have written about this! On Hyacinth's tragedy: https://phoebemaltzbovy.substack.com/p/hyacinth-of-keeping-up-appearances and on the Major: https://phoebemaltzbovy.substack.com/p/hyacinthtoo
Oh! Amazing! Thank you! I need to go to sleep but this will be tomorrow's reading for sure!
Hatred of the patriarchy ... I'm constantly beside-myself that people can engage in racial hatred, yet somehow delude themselves that they're not in-fact racists, despite practicing racism. Would it be unracist to hate Chinese people if we coined the term Sinoarchy?
Goes to show you, the easiest people to delude is ourselves.
Thank you for sharing this. I’m glad you found an antidepressant that helps and that you’re seeking a more effective dose.
I hope anyone with similar experiences or concerns will consider seeing a reproductive psychiatrist. Regular doctors and psychiatrists often don’t know what they’re doing when it comes to pregnancy.
For years, doctors told women to go off their psych meds for pregnancy and breastfeeding. The guidance was to suck it up for 9 months because medication might harm the baby.
Now we know this is wrong. There are many psych meds that carry minimal risk to the baby, and going off meds is often a terrible idea for the mother AND the baby. Unhealthy choices aren’t good for the baby. High stress hormones aren’t good for the baby. It’s a myth that suffering for 9 months is the best thing you can do for your child.
I tell everyone, if your doctor says to stop taking your psych meds for pregnancy, see a reproductive psychiatrist. They will tell you the latest research on every medication and explore alternatives if necessary, but they won’t just say “stop everything.”
My original psychiatrist told me to go off *Zoloft.* One of the safest psych meds for pregnancy. Fortunately, my spouse is a psychiatrist so she told me “Yeah that’s wrong. See a reproductive psychiatrist.” And it made a huge difference for me. I kept my anxiety under control throughout pregnancy and the stressful newborn months (when I was terrified of SIDS).
As always, I just wonder how difficult finding and gaining access to such a psychiatrist would be for the average person. I was literally suicidal and barely functioning after having my first kid, and unfortunately I did not have the resources I have now and was being seen in a community clinic for primary care. I called them and they told me they couldn’t get me into any therapist for 9 weeks. I ended up going to urgent care and they still didn’t give my a psych referral but told me to try matching with a therapist through my work’s EAP.
It’s an unfortunate irony that finding a mental health provider is incredibly difficult and takes the kind of executive functioning skills and resources that people in a crisis most lack.
Yes, this is a huge problem. It's hard to find someone if you don't live near a city, and many reproductive psychiatrists do not take insurance. They have a rare speciality, so they can afford it. I am lucky that I lived in a major city, and I was able to find someone through a university.
I had suicidal prenatal depression that seemed to be triggered by, of all things, asthma. That is, we eventually realized during my first pregnancy that the times when hurling self and the poor unborn one with the misfortune to have me as a mom off a cliff seemed like a good idea corresponded with my lung function deteriorating into the "yellow zone" or worse. I also had weird rheumatic problems pre- and post-partum thanks to a congenital thing diagnosed only after my first kid.
Both hospital systems I received maternal care through are reputed to be excellent, and both *can* give excellent pre- and post-natal care (psychiatric care tends to be self-pay but affordab-ish). I got some excellent care, but also some crappy care -- including enough episodes of simply not being believed or my basic comfort and function not being valued "because the baby should still be OK" that I stopped wanting to go back.
Any interruption to continuity of psychiatric care can blow it all to hell, in my experience, risking whoever you redo intake with trying to rediagnose you with red herrings that have already been ruled out.
One of the benefits of consolidated hospital systems with electronic medical records should be that Provider A within the system shares your whole chart with Provider B, so that if you have conditions C, D, E... every provider is alerted to all of them, so that the Specialist in C doesn't have to assume a complaint is caused by C when it's fairly obviously attributable D.
Yeah, no. Especially, it seems, not where psychiatry is concerned. I had some good care, then lost it during COVID because the provider left the system. I would describe re-intake as positively demeaning to me as a patient and mom as well as unmedical (seeming lack of awareness of the basics right at the top of my chart!).
Despite aspirations to world-class pre- and post-natal care for moms, including psychiatry, in these hospital systems, resources have simply been too strained since COVID to deliver.
This is a great comment.
My wife struggled a lot after the birth of our first son (had a pretty traumatic birth experience that led to significant physical recovery time). Our pediatrician was great, saw the signs, and got her to someone who could help.
And it helped tremendously.
Excellent advice. One destructive myth in our Puritanical culture is that suffering is good, and that if something makes your experience somewhat easier, it must be harmful or wrong. Now that you mention it, why DO doctors worry about medications and not about cortisol?!
because one is regulated by the FDA and the other is not.
You could sue a doctor for adverse effects to your baby for taking a medication. You can't do that for cortisol exposure.
Hang in there Phoebe.
This was fucking spectacular. It speaks to the postpartum depression I experienced (and, likewise, had been sort of unsure about whether it "counted" as such) much more than anything else I've ever read. Perhaps it's cliche to say, but good lord, I feel relieved that I'm not the only one.